FORM 1023-EZ for LOUISIANA WHEELCHAIR ATHLETICS

Field Data
EIN 82-5261486
Case Number EO-2018183-000345
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LOUISIANA WHEELCHAIR ATHLETICS
Organization’s Mailing Address 472 SUMMIT RIDGE DRIVE
City BATON ROUGE
State LA
ZIP 70815
Accounting period End 12
Primary contact name SHANE THERIOT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHANE THERIOT
PRESIDENT
472 SUMMIT RIDGE DRIVE
BATON ROUGE LA 70815

Officer/Director/Trustee Two

MATT AUCOIN
VICE-PRESIDENT
186 HWY 401
NAPOLEONVILLE LA 70390

Officer/Director/Trustee Three

CARLOS ROLDAN
TREASURER
1027 TANGLEBRIAR DR
BATON ROUGE LA 70810

Organization’s website
Organization’s email STHERIOT2012@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/25/18
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds Yes
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 SHANE THERIOT
Signature Title PRESIDENT
Signature Date 6/29/18

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