FORM 1023-EZ for SINGLE MOTHERS ROCK

Field Data
EIN 85-2960078
Case Number EO-2021076-000814
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SINGLE MOTHERS ROCK
Organization’s Mailing Address 2611 GENERAL PATTON STREET
City LAKE CHARLES
State LA
ZIP 70601
Accounting period End 12
Primary contact name JAILA FONTENOT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAILA FONTENOT
PRESIDENT
2611 GENERAL PATTON STREET
LAKE CHARLES LA 70601

Officer/Director/Trustee Two

JERMERRO RYAN
VICE PRESIDENT
2611 GENERAL PATTON STREET
LAKE CHARLES LA 70601

Officer/Director/Trustee Three

TREMAINE COLLINS
TREASURER
7712 FARMDALE AVENUE
NORTH HOLLYWOOD CA 91605

Organization’s website
Organization’s email JAILA.FONTENOT@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/29/2020
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 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 JAILA FONTENOT
Signature Title PRESIDENT
Signature Date 1/19/2021

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