FORM 1023-EZ for CALVIN SUSIE HAWAII ANIMAL FOUNDATION

Field Data
EIN 82-1221524
Case Number EO-2017132-000177
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CALVIN SUSIE HAWAII ANIMAL FOUNDATION
Organization’s Mailing Address P O BOX 25881
City HONOLULU
State HI
ZIP 96825-0881
Accounting period End 12
Primary contact name ERIC M K WONG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AHYOUNG ALLI KIM-YAMANE
PRES/DIRECTOR
3693 DIAMOND HEAD CIR
HONOLULU HI 96815

Officer/Director/Trustee Two

ERIC M K WONG
VICE PRES/DIRECTOR
3705 WAIALAE AVE STE 208
HONOLULU HI 96816

Officer/Director/Trustee Three

KAORU HARADA
SECRETARY/DIRECTOR
375 DUNE CIR
KAILUA HI 96734

Officer/Director/Trustee Four

GAYLE TASAKA
TREASURER/DIRECTOR
841 BISHOP ST STE 930
HONOLULU HI 96813

Officer/Director/Trustee Five

GARY KAM
DIRECTOR
45-234 POPOKI PLACE
KANEOHE HI 96744

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/24/2017
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D20 - Animal Protection and Welfare
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence Yes
Compensation of Officer director trustee No
Donation of funds No
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
Signature Title
Signature Date

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