FORM 1023-EZ for SOUTH LOUISIANA VETERAN OUTREACH

Field Data
EIN 84-1950164
Case Number EO-2020009-000417
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOUTH LOUISIANA VETERAN OUTREACH
Organization’s Mailing Address 114 BAYOU BEND DR
City HOUMA
State LA
ZIP 70364
Accounting period End 12
Primary contact name BROK TORBERT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BROK TORBERT
PRESIDENT
114 BAYOU BEND DR
HOUMA LA 70364

Officer/Director/Trustee Two

JORY CAMILLE
VICE PRESIDENT
175 LEBOEUF ST
HOUMA LA 70364

Officer/Director/Trustee Three

DEX MARTIN
TREASURER
225 RUE REECE
HOUMA LA 70364

Officer/Director/Trustee Four

DAVID RODRIGUEZ
DIRECTOR OF OPERATION
142 HICKORY KNOLL
HOUMA LA 70359

Officer/Director/Trustee Five

CLAY DUPLANTIS
ADMINISTRATOR
PO BOX 9052
HOUMA LA 70361

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/12/2019
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 Yes
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 BROK TORBERT
Signature Title PRESIDENT
Signature Date 1/7/2020

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