FORM 1023-EZ for RESPITE RETREAT BEACH

Field Data
EIN 86-3565857
Case Number EO-2021152-000644
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RESPITE RETREAT BEACH
Organization’s Mailing Address 923 SHARON STREET
City DENHAM SPRINGS
State LA
ZIP 70726-2508
Accounting period End 12
Primary contact name MELISSA BELGARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MELISSA BELGARD
PRESIDENT
923 SHARON STREET
DENHAM SPRINGS LA 70726-2508

Officer/Director/Trustee Two

GARY SULLIVAN
SECRETARY TREASURER
7595 PECAN GROVE
DENHAM SPRINGS LA 70726-8939

Officer/Director/Trustee Three

JO ANN HEGWOOD
DIRECTOR
33215 WEISS ROAD
WALKER LA 70785-3902

Organization’s website WWW.RESPITERETREATBEACH.COM
Organization’s email RESPITERETREATBEACH@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/27/2021
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P46 - Family Counseling
Organization’s purpose Charitable: Yes
Religious: Yes
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 MELISSA BELGARD
Signature Title PRESIDENT
Signature Date 5/28/2021

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