INSTRUCTIONS FOR NGO FUNDING REQUEST

SUPPLEMENTAL INFORMATION FORM

 


WHO SHOULD COMPLETE THIS FORM?

Each non-governmental, quasi-public, or private entity seeking consideration for a line-item appropriation in an appropriation bill is required to fill out the form. This includes religious associations, non-profit organizations, and 501(c)3 non-profit corporations.


Note: Parishes, municipalities, and other political subdivisions of the state DO NOT need to fill out this form.

 

HOW SHOULD THIS FORM BE COMPLETED?

The form must be completed using the Internet.

 

FIELDS MARKED WITH AN ASTERISK (*) MUST BE COMPLETED.


PAGE 1:

 

ENTITY INFORMATION

The requesting entity’s full legal name, physical address, and mailing address.

 

PAGE 2:

 

TYPE OF ENTITY may be any of the following: association, corporation, limited liability company, non-profit corporation, non-profit religious corporation, partnership, sole proprietorship, or other designation.

 

LIST OF THE INCORPORATORS

These will be the full, legal names of the individuals who incorporated the corporation, for-profit, not-for-profit, or L.L.C.

 

If the entity has filed articles of incorporation with the Louisiana Secretary of State, the information provided on the form should be identical to the information provided to that office.  To verify the information filed with the secretary of state, check the corporate database at:

http://www400.sos.louisiana.gov/app1/paygate/crpinq.jsp

 

LAST 4 DIGITS of the Federal Taxpayer ID Number

This is also known as the Employer Identification Number (EIN). If the identification number cannot be found, call the IRS at 1-800-829-4933 to get the entity’s EIN.

 

THE DOLLAR AMOUNT

This will be the amount the entity is requesting for the upcoming fiscal year.

 

THE TYPE OF REQUEST

General Appropriation, Capital Outlay Appropriation, or Both.

(Note: Selecting “Both” does not increase the opportunity to be funded).

 

GOOD STANDING WITH SECRETARY OF STATE

Is the requesting entity in good standing with the secretary of state? If unsure, consult the secretary of state’s website at:

http://www400.sos.louisiana.gov/app1/paygate/crpinq.jsp

 

PAGE 3:

 

NAMES AND ADDRESSES OF THE ENTITY’S GOVERNING BOARD AND OFFICERS

These will be the full legal names and addresses of the individuals who govern the entity; i.e., its board of directors, executive director, chief executive officer, or other person responsible for the entity, etc.

 

SUMMARY OF THE PROJECT OR PROGRAM

Provide a summary of the proposed project or program.

 

PAGE 4:

 

THE BUDGET FOR THE PROPOSED PROGRAM

(NOT the entity’s budget; the budget for the program for which funding is requested). Details must be provided for the program’s budget, including amounts budgeted for salaries, professional services, contracts, acquisitions, major repairs, operating services, and other charges.

 

OUTSTANDING AUDIT ISSUES OR FINDINGS

Does the requesting entity have any outstanding audit issues or findings?

 

IF “YES,” IS THE ENTITY WORKING WITH THE APPROPRIATE GOVERNMENTAL AGENCIES TO RESOLVE THE AUDIT ISSUES OR FINDINGS?

 

PAGE 5:

 

ENTITY’S PUBLIC PURPOSE

Provide a statement of the entity’s public purpose to be achieved through the expenditure of state monies on its program or project.

 

GOALS AND OBJECTIVES

Provide the entity’s goals and objectives to achieve the stated public purpose and do so in sufficient detail so as to inform readers of the true nature of the program or project.

 

LENGTH OF PROGRAM

Describe the estimated length of time to achieve the public purpose.

 

PAGE 6:

 

Must be completed if an elected or appointed official or a member of the official’s immediate family is an officer, director, trustee, or employee of the recipient entity or holds any ownership interest therein. State law (R.S.42:1102(13)) defines "immediate family" as the term relates to a public servant to mean his children, the spouses of his children, his brothers and their spouses, his sisters and their spouses, his parents, his spouse, and the parents of his spouse.

 

PAGES 7 and 8:

 

Must be completed if the recipient entity has a contract with any elected or appointed state official or if an immediate family member of such official, or with the state or any political subdivision of the state. State law (R.S.42:1102(13)) defines "immediate family" as the term relates to a public servant to mean his children, the spouses of his children, his brothers and their spouses, his sisters and their spouses, his parents, his spouse, and the parents of his spouse.

 

PAGE 9:

 

CONTACT’S NAME

This is the person filling in the information on the supplemental information form.  

 

CONTACT’S RELATIONSHIP TO ENTITY

 

CONTACT’S ADDRESS

 

CONTACT’S PHONE NUMBER

 

CONTACT’S FAX NUMBER

 

CONTACT’S E-MAIL

 

PROVIDE A PASSWORD

Any combination of letters and numbers may be chosen. HOWEVER, the password must be retained, or the form can never be amended. The preparer must begin the process over from the start if the password is lost!

 

 FINISH PAGE:

 

The information required by the database is complete. The “Submit” button must be clicked to send the data to the Legislature for review and publication. Entries on previous pages may be double checked by clicking on the page numbers, but failure to submit the form will erase all input and forces the preparer to start over from the beginning.

 

CONFIRMATION and LEGISLATIVE CONTACT INFO PAGE:

          

This screen confirms that the database form has successfully been submitted. At this point, please DO NOT re-submit the information. Staff must review and publish the data, and it is normal for this process to take a few days. A successfully submitted form will show the date it was submitted. For any questions, e-mail the Legislature at NGOdatabase@legis.la.gov. This e-mail address is monitored by staff members who can provide assistance.