FORM 1023-EZ for GULF COAST BENEVOLENCE LLC

Field Data
EIN 47-5264254
Case Number EO-2016152-000344
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GULF COAST BENEVOLENCE LLC
Organization’s Mailing Address 2109 BRIGADE DR
City CHALMETTE
State LA
ZIP 70043-2109
Accounting period End 12
Primary contact name MARTIN RON FERNANDEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARTIN FERNANDEZ
AGENT
8360 LAFITTE COURT
CHALMETTE LA 70043-8360

Officer/Director/Trustee Two

SUSAN FERNANDEZ
DIRECTOR
2109 BRIGADE DR
CHALMETTE LA 70043-2109

Officer/Director/Trustee Three

MICHELLE LANDRY
ASST DIRECTOR
41310 HWY 621
GONZALES LA 70737-4131

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/8/2015
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D20 - Animal Protection and Welfare
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 Yes
Unrelated Gross Income $1,000 or More Yes
Gaming Activity No
Disaster relief assistance Yes
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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