FORM 1023-EZ for MOTHERS IN ACTION

Field Data
EIN 83-0710383
Case Number EO-2018264-000319
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MOTHERS IN ACTION
Organization’s Mailing Address 1305 CALIFORNIA STREET
City LAKE CHARLES
State LA
ZIP 70607-1915
Accounting period End 12
Primary contact name BRITTANY MANUEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JALEESA BRAY
PRESIDENT
2794 CROWN LANE
LAKE CHARLES LA 70605

Officer/Director/Trustee Two

VALERIE JENKINS
EXECUTIVE VICE PRESIDENT
1064 WHIPPOORWILL DRIVE
LAKE CHARLES LA 70611

Officer/Director/Trustee Three

BRITTANY MANUEL
DIRECTOR
1305 CALIFORNIA STREET
LAKE CHARLES LA 70607

Officer/Director/Trustee Four

ANITA DEJEAN
TREASURER
1435 MITCHELL STREET
LAKE CHARLES LA 70611

Officer/Director/Trustee Five

RUTH ADAMS
SECRETARY
705A BRADLEY STREET APT 1
LAKE CHARLES LA 70605

Organization’s website
Organization’s email MOTHERSINACTIONLC@OUTLOOK.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/30/18
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family Services
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
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 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 BRITTANY MANUEL
Signature Title DIRECTOR
Signature Date 9/19/18

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