FORM 1023-EZ for FUSION FIVE
| Field | Data |
|---|---|
| EIN | 81-4706281 |
| Case Number | EO-2017020-000359 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | FUSION FIVE |
| Organization’s Mailing Address | 4310 RYAN STREET |
| City | LAKE CHARLES |
| State | LA |
| ZIP | 70605 |
| Accounting period End | 12 |
| Primary contact name | KATIE HEBERT |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
KATIE HEBERT
PRESIDENT
5854 W KAYLEIGH LANE
LAKE CHARLES LA 70605
Officer/Director/Trustee Two
CALEB WALDMEIER
TREASURER
4845 LAKE STREET STE 342
LAKE CHARLES LA 70605
Officer/Director/Trustee Three
ALBERTO GALAN
SECRETARY
PO DRAWER 1583
LAKE CHARLES LA 70602
Officer/Director/Trustee Four
BLAKE BRIGNAC
VICE PRESIDENT
308 CONTOUR DRIVE
LAKE CHARLES LA 70605
Officer/Director/Trustee Five
NICOLE LOUVIERE
DIRECTOR
422 EMILE ROAD
LAKE CHARLES LA 70611
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 11/30/2016 |
| Organization Incorporation State | LA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | S99 - Community Improvement, Capacity Building N.E.C. |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes 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 | 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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