FORM 1023-EZ for TEAM NOAH FOUNDATION

Field Data
EIN 82-5049330
Case Number EO-2019329-000259
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TEAM NOAH FOUNDATION
Organization’s Mailing Address 231 VIOLA STREET
City HOUMA
State LA
ZIP 70360
Accounting period End 12
Primary contact name PERNELL PELLEGRIN CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BAYLIS BERGERON
PRESIDENT
231 VIOLA STREET
HOUMA LA 70360

Officer/Director/Trustee Two

MONIQUE BERGERON
SECRETARY/TREASURER
231 VIOLA STREET
HOUMA LA 70360

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/4/18
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P12 - Fund Raising and/or Fund Distribution
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 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 BAYLIS BERGERON
Signature Title PRESIDENT
Signature Date 11/21/19

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