FORM 1023-EZ for DECAF VILLAGE

Field Data
EIN 87-0842974
Case Number EO-2021256-000683
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DECAF VILLAGE
Organization’s Mailing Address 621 ST CHARLES AVE
City NEW ORLEANS
State LA
ZIP 70130
Accounting period End 12
Primary contact name MARK T WILLIAMS II
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MEGAN ADAMS
OFFICER
15702 LAKEDALE DR
HOUSTON TX 77095

Officer/Director/Trustee Two

AMANDA MENDOZA
DIRECTOR
3433 PAUGER STREET
NEW ORLEANS LA 70119

Officer/Director/Trustee Three

LEAH SIMPSON
OFFICER
12940 MCRAVEN CT
NEW ORLEANS LA 70128

Officer/Director/Trustee Four

MARK WILLIAMS
TRUSTEE
2121 LAHARPE STREET
NEW ORLEANS LA 70119

Organization’s website
Organization’s email MARKTWILLIAMSII@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/4/2021
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 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 Yes
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration No
Signature Name MARK WILLIAMS
Signature Title TRUSTEE
Signature Date 9/11/2021

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