FORM 1023-EZ for MAUI CANCER WELLNESS RETREATS

Field Data
EIN 32-0604289
Case Number EO-2019205-000256
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MAUI CANCER WELLNESS RETREATS
Organization’s Mailing Address 100 MANO DRIVE
City KULA
State HI
ZIP 96790
Accounting period End 12
Primary contact name BRIDGET S BONGAARD MD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRIDGET BONGAARD
PRESIDENT
100 MANO DRIVE
KULA HI 96790

Officer/Director/Trustee Two

ANNA MAYEDA
SECRETARY
223 LIHOLIHO STREET
WAILUKU HI 96793

Officer/Director/Trustee Three

MARSEU SIMPSON
TREASURER
480 KENOLIO DRIVE APT 29-101
KIHEI HI 96753

Organization’s website WWW.MAUICANCERWELLNESSRETREATS.ORG
Organization’s email MAUICANCERWELLNESSRETREATS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/3/19
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B60 - Adult, Continuing Education
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name BRIDGET BONGAARD
Signature Title PRESIDENT
Signature Date 7/21/19

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