FORM 1023-EZ for COURAJ TIBURON SOUTHWEST HAITI RELIEF AND DEVELOPMENT

Field Data
EIN 81-4127407
Case Number EO-2016315-000393
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COURAJ TIBURON SOUTHWEST HAITI RELIEF AND DEVELOPMENT
Organization’s Mailing Address 2623 URSULINES AVENUE
City NEW ORLEANS
State LA
ZIP 70119
Accounting period End 12
Primary contact name ALBERT GRANDOIT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALBERT GRANDOIT
PRESIDENT
2623 URSULINE AVENUE
NEW ORLEANS LA 70119

Officer/Director/Trustee Two

MICHELLE CLAY
SECRETARY
2623 URSULINE AVENUE
NEW ORLEANAS LA 70116

Officer/Director/Trustee Three

MARSON RAYMOND
BOARD MEMBER
362 RIDGE AVENUE APT 17
CAMBRIDGE MA 02140

Officer/Director/Trustee Four

REBECCA CHAISSON
BOARD MEMBER
49 NERON PLACE
NEW ORLEANS LA 70118

Officer/Director/Trustee Five

GALE WISE
BOARD MEMBER
1050 SOUTH JEFFERSON
NEW ORLEANAS LA 70125

Organization’s website
Organization’s email COURAJTIBURON@MAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/18/2016
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M20 - Disaster Preparedness and Relief Services
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States Yes
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
Signature Title
Signature Date

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