FORM 1023-EZ for EVERGREEN SAFE HOUSE
| Field | Data |
|---|---|
| EIN | 81-0737992 |
| Case Number | EO-2015350-000124 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | EVERGREEN SAFE HOUSE |
| Organization’s Mailing Address | 205 HILL ST |
| City | EVERGREEN |
| State | LA |
| ZIP | 71333 |
| Accounting period End | 7 |
| Primary contact name | ANNETTE GOUDEAU |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
Officer/Director/Trustee One
ANNETTE GOUDEAU
OWNER/AUTHORIZING AGENT
205 HILL ST
EVERGREEN LA 71333
Officer/Director/Trustee Two
CORTEZ HARRIS
EXECUTIVE VICE PRESIDENT
7233 WEST 63RD PLACE
SUMMIT IL 60501
| Organization’s website | |
|---|---|
| Organization’s email | MSNET57@BELLSOUTH.NET |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 7/30/2014 |
| Organization Incorporation State | LA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | L25 - Housing Rehabilitation |
| 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 | Yes |
| Donation of funds | Yes |
| Conducting Activities Outside of United States | No |
| Financial transactions with officers | No |
| Unrelated Gross Income $1,000 or More | Yes |
| Gaming Activity | No |
| Disaster relief assistance | Yes |
| 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 | |
| Signature Title | |
| Signature Date |
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