FORM 1023-EZ for REV DR J BERTELL DAVIS SR FOUNDATION

Field Data
EIN 85-3151040
Case Number EO-2020309-000255
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name REV DR J BERTELL DAVIS SR FOUNDATION
Organization’s Mailing Address 2466 HARDING BLVD
City BATON ROUGE
State LA
ZIP 70807
Accounting period End 12
Primary contact name GERALYN L DAVIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GERALYN L DAVIS
PRESIDENT
2466 HARDING BLVD
BATON ROUGE LA 70807

Officer/Director/Trustee Two

JOSEPH DAVIS
SECRETARY TREASURER
2424 DRUSILLA LANE
BATON ROUGE LA 70815

Officer/Director/Trustee Three

OSHEA JOHNSON
DIRECTOR
2466 HARDING BLVD
BATON ROUGE LA 70807

Officer/Director/Trustee Four

ANAIAH FRANCIS
DIRECTOR
8619 FORESTWOOD AVE
BATON ROUGE LA 70812

Officer/Director/Trustee Five

JACOB DAVIS
DIRECTOR
7011 JUNO DRIVE
BAKER LA 70714

Organization’s website
Organization’s email slm3108@yahoo.com
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/29/2020
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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 GERALYN L DAVIS
Signature Title PRESIDENT
Signature Date 11/2/2020

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