The recipient entity's physical address:
           9007 Highland Rd # 39
Baton Rouge, LA 70810

The recipient entity's mailing address (if different):
           9007 Highland Rd # 39
Baton Rouge, LA 70810

Type of Entity (for instance, a nonprofit corporation):  Non-Profit Corporation

If the entity is a corporation, list the names of the incorporators:
          Beverly Tullos
Walter Tullos
Rachel Howell

The last four digits of the entity's taxpayer ID number:  5868

What is the dollar amount of the request?  $100,000

What type of request is this?  General Appropriation

Is this entity in good standing with the Secretary of State?  Yes

Provide the name of each member of the recipient entity's governing board and officers:
           Executive Director -Beverly Edwards Tullos
233 Summer Ridge Drive
Baton Rouge, LA 70810
Director - Walter V. Tullos
233 Summer Ridge Drive
Baton Rouge, LA 70810
Vice President - Rachel R. Howell
12200 Star Hill Trace
St Francisville, LA 70775

Provide a summary of the project or program:
           We are asking for funds to get a start up program to provide housing for special needs adults. It is currently very limited in the greater Baton Rouge area and the demand is quite high. We would like to establish a network of houses for these individuals in the greater Baton Rouge area. The staffing will be provided through their existing Medicaid waivers. We would like to acquire or build houses that would eventually be self sustaining through the waivers. Each house would be limited to 3 - 4 individuals according to guidelines from the Office of Citizens with Developmental disabilities. Once the funds are available, we will plan fund-raising opportunities to supplement and maintain the program.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $50,000
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $0
          Operating Services. . . . $0
          Other Charges. . . . . . . $50,000

Does your organization have any outstanding audit issues or findings?  No

If 'Yes' is your organization working with the appropriate governmental agencies to resolve those issues or findings?
          

What is the entity's public purpose, sought to be achieved through the use of state monies?
          Our purpose is to provide housing for special needs adults.

What are the goals and objectives for achieving such purpose?
          We will need fund-raising to enable purchase of land and houses to accommodate the special needs adults and give them independence and autonomy, and community integration while making this affordable. We are also concerned about providing a safe environment for the special needs adults. We will be linked to support services through the Medicaid waivers.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           Our goal is to have the first house in place by January 31, 2027.

If any elected or appointed state official or an immediate family member of such an official is an officer, director, trustee, or employee of the recipient entity who receives compensation or holds any ownership interest therein:
     (a) If an elected or appointed state official, the name and address of the official and the office held by such person:
                 none
    
     (b) If an immediate family member of an elected or appointed state official, the name and address of such person; the name, address, and office of the official to whom the person is related; and the nature of the relationship:
                 none

     (c) The percentage of the official's or immediate family member's ownership interest in the recipient entity, if any:
                 none

     (d) The position, if any, held by the official or immediate family member in the recipient entity:
                  none

If the recipient entity has a contract with any elected or appointed state official or an immediate family member of such an official or with the state or any political subdivision of the state:
(a) If the contract is with an elected or appointed state official, provide the name and address of the official and the office held by such person: 
               none

(b) If the contract is with an immediate family member of an elected or appointed state official:
          Provide the name and address of such person:
               none

          Provide the name, address, and office of the official to whom the person is related:
                none

          What is the nature of the relationship?  none

(c) If the contract is with the state or a political subdivision of the state, provide the name and address of the state entity or political subdivision of the state:
                 none

(d) The nature of the contract, including a description of the goods or services provided or to be provided pursuant to the contract:
               none


Contact Information
name:  Charlotte Hollman 
                                       address:  9007 Highland Rd # 39
Baton Rouge, LA 70810
                                       phone:  225-266-5593
                                       fax:  none
                                       e-mail:  jandchollman@gmail.com
                                       relationship to entity:  treasurer