FORM 1023-EZ for NORTH TANGI ADULT DAY CARE

Field Data
EIN 82-5222595
Case Number EO-2018333-000148
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NORTH TANGI ADULT DAY CARE
Organization’s Mailing Address P O BOX 878
City HAMMOND
State LA
ZIP 70401-878
Accounting period End 12
Primary contact name SHIRLEY HENDRICKS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHIRLEY HENDRICKS
DIRECTOR, PRESIDENT, TREASURER
PO BOX 878
HAMMOND LA 70401

Officer/Director/Trustee Two

TERRY JACKSON
DIRECTOR, VICE PRESIDENT
PO BOX 878
HAMMOND LA 70401

Officer/Director/Trustee Three

DONTE MOORE
DIRECTOR, SECRETARY
PO BOX 878
HAMMOND LA 70401

Organization’s website
Organization’s email SHIRLSKEET@BELLSOUTH.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/24/18
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P61 - Travelers' Aid
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 SHIRLEY HENDRICKS
Signature Title DIRECTOR, PRESIDENT, TREASURER
Signature Date 11/27/18

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