FORM 1023-EZ for ALCORN STATE UNIVERSITY NATIONAL ALUMNI ASSOCIATION SHREVEPORT BOSSIER

Field Data
EIN 72-1198092
Case Number EO-2018026-000252
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ALCORN STATE UNIVERSITY NATIONAL ALUMNI ASSOCIATION SHREVEPORT BOSSIER
Organization’s Mailing Address 6154 PEBBLE BEACH DR
City SHREVEPORT
State LA
ZIP 71129
Accounting period End 12
Primary contact name REED S EBARB
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JERRY PAIGE
PRESIDENT
6154 PEBBLE BEACH DR
SHREVEPORT LA 71129

Officer/Director/Trustee Two

EVELYN DAWSON
DIRECTOR
6333 KENWOOD
SHREVEPORT LA 71129

Officer/Director/Trustee Three

SHIRLEY LEE
DIRECTOR
9506 ROSE HOLLOW
SHREVEPORT LA 71118

Officer/Director/Trustee Four

CHARLES MCMILLON
DIRECTOR
508 CRICKET CV
BOSSIER CITY LA 71111

Officer/Director/Trustee Five

TERESA BELL
SECRETARY
8200 PINES ROAD
SHREVEPORT LA 71129

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/27/17
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B84 - Alumni Associations
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 JERRY PAIGE
Signature Title PRESIDENT
Signature Date 1/24/18

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