FORM 1023-EZ for DIVINE IMPACT FOUNDATION

Field Data
EIN 84-2768830
Case Number EO-2019324-000184
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DIVINE IMPACT FOUNDATION
Organization’s Mailing Address 1799 STUMPF BLVD BLDG 5 NO 1
City GRETNA
State LA
ZIP 70056
Accounting period End 12
Primary contact name PATRICE PASLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICE PASLEY
DIRECTOR
2740 BAYOU DES CANNES DRIVE
MARRERO LA 70072

Officer/Director/Trustee Two

CALVIN BROWN SR
VICE PRESIDENT
1612 MANSFIELD AVE
MARRERO LA 70072

Officer/Director/Trustee Three

HEIDIE RANDLE
SECRETARY
6364 WOODLAND HWY
NEW ORLEANS LA 70131

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/12/19
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O52 - Youth Development - Agricultural
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 PATRICE PASLEY
Signature Title DIRECTOR
Signature Date 11/18/19

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