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Contact Morniation <br />501(c)(3) Nonprofit Organization Contact Information <br />If you a, a applwog -ii h a A siDorscc, the im"Drni a 'lion providtd it this ion �o.I I core ec" )')n'd [c�e 501(c,(3) -,onl:, ofrk o,-qcni-,arion, as <br />hay will lGbh tlh-e legal gr-ote:,, <br />501(c)(3) Nonprofit Organization Name (As it Appears on iRS Forms)* <br />Hoernana <br />501(c)(3) Nonprofit Organization Mailing Address* <br />S I re e t cd d i e <br />R 0. Box 6116 <br />,'-,d&ass Line 2 <br />Siate <br />Kan-ruela HI <br />96743 us <br />501(0)(3) Nonprofit Organization Physical Address (if different from above) <br />Addr,,-,'ss Une 2 <br />C''11 / Province / Ragon <br />Pol i'! ( Zj�) Coda <br />Title ' Suffix <br />President <br />First Name'sLast Name" <br />Edward Teixeira <br />Contact Person for Grant Correspondence <br />ThIS ,vjll be the primary punt ofconLic� for all cornrnuni:.Mion rep iced to this q,@'FlC and c)vanj if ilia, appricanon is ll-troligh a <br />50 1(-.)(3) fiscal sponsor, provide the Contaci person for the D'-Cjtcth;xclgr9111 <br />Title * <br />President <br />First Name* <br />Edward <br />,Phone Number for Contact Person for Grant <br />Correspondence <br />(808)295-9174 <br />Last Name* <br />Teixeira <br />Email Address for Contact Person for Grant <br />Correspondence * <br />xeira8O8@gmail.com <br />8, Are you serving as a 501 (c)(3) fiscal sponsor for this application? <br />Yes No <br />cmlas= <br />