FORM 1023-EZ for LOUISIANA BAYOU STORM SURGE INC

Field Data
EIN 84-2314200
Case Number EO-2019211-000244
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LOUISIANA BAYOU STORM SURGE INC
Organization’s Mailing Address 1824 JASMINE DRIVE
City OPELOUSAS
State LA
ZIP 70570
Accounting period End 7
Primary contact name MIA BEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MIA BEN
PRESIDENT/CEO
1824 JASMINE DRIVE
OPELOUSAS LA 70570-7028

Officer/Director/Trustee Two

KATHERINE MORALES
BOARD CHAIR
105 WHITE TAIL DRIVE
CARENCRO LA 70520-6191

Officer/Director/Trustee Three

DESMOND WOODS
VICE CHAIR
111 EDIE ANN DRIVE
LAFAYETTE, LA 70508-5364

Officer/Director/Trustee Four

SHAYLA RIDEAUX
MEMBER
1803 MIRGOLD AVENUE
NEW IBERIA LA 70560-6414

Organization’s website
Organization’s email LOUISIANABAYOUSTORMSURGE@OUTLOOK.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/26/19
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N65 - Football Clubs, Leagues
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 MIA BEN
Signature Title PRESIDENT/CEO
Signature Date 7/28/19

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