FORM 1023-EZ for REVELATION OUTREACH INC

Field Data
EIN 46-3197837
Case Number EO-2017265-000317
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name REVELATION OUTREACH INC
Organization’s Mailing Address 726 NORTH LATOUR STREET
City VILLE PLATTE
State LA
ZIP 70586-3408
Accounting period End 9
Primary contact name BRIAN ARDOIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DARWIN LAZARD
PRESIDENT
726 NORTH LATOUR
VILLE PLATTE LA 70586-3408

Officer/Director/Trustee Two

BRIAN ARDOIN
SECRETARY-TREASURER
2675 PINE POINT ROAD
VILLE PLATTE LA 70586-3408

Officer/Director/Trustee Three

JENNIFER VIDRINE
DIRECTOR
126 EAST MAIN STREET
VILLE PLATTE LA 70586-3408

Officer/Director/Trustee Four

MARK SUELLENTROP
DIRECTOR
2066 CABOT ROAD
VILLE PLATTE LA 70586-3408

Officer/Director/Trustee Five

HEATHER SMITH
DIRECTOR
300 SAINT MATTHIAS DRIVE
CARENCRO LA 70520

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/27/2013
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X19 - Nonmonetary Support N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: Yes
Amateur Sports: No
Cruelty Prevention: Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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