FORM 1023-EZ for DELIVERANCE IN ME

Field Data
EIN 81-0843209
Case Number EO-2017005-000273
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DELIVERANCE IN ME
Organization’s Mailing Address 220 CHESTER STREET
City LAFAYETTE
State LA
ZIP 70501
Accounting period End 12
Primary contact name DEWANNA LOUVIERE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CASSANDRA WILTZ
OFFICER
2602 BRENDA DRIVE
NEW IBERIA LA 70562

Officer/Director/Trustee Two

TONY JONES
OFFICER
125 GALLIAN STREET
LAFAYETTE LA 70501

Officer/Director/Trustee Three

ANN AMBERS
OFFICER
4343 DENHAM STREET
BATON ROUGE LA 70805

Officer/Director/Trustee Four

DEWANNA LOUVIERE
CHIEF OPERATING OFFICER
220 CHESTER STREET
LAFAYETTE LA 70501

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/22/2016
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P73 - Group Home (Long Term)
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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