FORM 1023-EZ for BSAFE ADULT DAY CARE

Field Data
EIN 81-2761633
Case Number EO-2017102-000193
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BSAFE ADULT DAY CARE
Organization’s Mailing Address 113 EVERGOLD LANE
City WAGGAMAN
State LA
ZIP 70094
Accounting period End 12
Primary contact name NYKETI WRIGHT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NYKETI WRIGHT
DIRECTOR CEO
113 EVERGOLD LANE
WAGGAMAN LA 70094

Officer/Director/Trustee Two

TYRANISHA WRIGHT
PRESIDENT
113 EVERGOLD LANE
WAGGAMAN LA 70094

Officer/Director/Trustee Three

EBONY LAWSON
VICE PRESIDENT
800 HIGH MEADOW COURT
LEWISVILLE TX 75077

Officer/Director/Trustee Four

SHEIRRE ALLEN
SECRETARY
9696 HAYNE BLVD J24
NEW ORLEANS LA 70127

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/18/2016
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P71 - Adult Daycare
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 Yes
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 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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