FORM 1023-EZ for BLACK HERITAGE GALLERY

Field Data
EIN 84-3114106
Case Number EO-2021214-000335
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK HERITAGE GALLERY
Organization’s Mailing Address 1621 OREGON STREET
City LAKE CHARLES
State LA
ZIP 70607
Accounting period End 12
Primary contact name STELLA MILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CLAUDIA WILLIAMS
PRESIDENT
2605 5TH AVENUE
LAKE CHARLES LA 70601

Officer/Director/Trustee Two

JEANINE BLANEY
TREASURER
904 SHADY LANE B
LAKE CHARLES LA 70601

Officer/Director/Trustee Three

STELLA MILLER
SECRETARY
1621 OREGON STREET
LAKE CHARLES LA 70607

Organization’s website
Organization’s email STELLAKATEMILLER@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/19/2019
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
Literary: Yes
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 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 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 STELLA MILLER
Signature Title SECRETARY
Signature Date 7/29/2021

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