NGO Funding Request


The recipient entity's full legal name:  Franklin Parish Council on Aging, Inc

The recipient entity's physical address:
           714 Adams Street
Winnsboro, La. 71295


The recipient entity's mailing address (if different):
           714 Adams Street
Winnsboro, La. 71295


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

If the entity is a corporation, list the names of the incorporators:
          Governor's Office of Elderly Affairs
North Delta Area Agency on Aging


The last four digits of the entity's taxpayer ID number:  9345

What is the dollar amount of the request?  $25,000

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:
           Rev. Paul Perry, 1142 Hwy 578 Winnsboro, La. 71295
Marvin Parker 1212, L.D. Knox Road Gilbert, La. 71336
Claretha Washington, 1052 Hwy 135 Winnsboro, La. 71295
Mary Wolleson, 354 Lishman Road Winnsboro, La. 71295
Mike Woods, 994 Willie Hill Rd, Gilbert, La. 71336
Beverly Rogers, 1853 Hwy 857 Baskin, La. 71219
Mabel Thomas, 2014 Cypress St. Winnsboro, La. 71295
Steve Johnson, P.O. Box 165 Wisner, La. 71378
Karen Raley, P.O. Box 54 Crowville, La. 71230
Lola Hitt, P.O. Box 685 Jigger, La. 71249
Bishop Andrew White, 1304 First Street Winnsboro, La. 71295
Bob Temple, 3501 Hwy 128 Gilbert, La. 71336


Provide a summary of the project or program:
           To provide out of town transportation to our non-medicaid eligible elderly. This service will benefit the elderly and their families by providing transportation to doctor's appointments and allowing caregivers respite from their obligations of caring for their loved ones.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $5,000
          Professional Services. . . $0
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $0
          Operating Services. . . . $20,000
          Other Charges. . . . . . . $0

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?
          Not Applicable

What is the entity's public purpose, sought to be achieved through the use of state monies?
          These funding will allow us to continue providing transportation to out of town doctor's appointments for our non-medicaid eligible elderly.

What are the goals and objectives for achieving such purpose?
          Our goal is to assist the elderly and their families with a service that will allow the elderly to get to their appointments without their caregivers having to take off work and thus creating a hardship for their families. We want our elderly to be as independent as long as they can and this service allows just that.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           We are currently operating this program but we are struggling because of the demand for this service.

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:
                
    
     (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:
                

     (c) The percentage of the official's or immediate family member's ownership interest in the recipient entity, if any:
                

     (d) The position, if any, held by the official or immediate family member in the recipient entity:
                 

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: 
               

(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:
              

          Provide the name, address, and office of the official to whom the person is related:
               

          What is the nature of the relationship? 

(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:
                

(d) The nature of the contract, including a description of the goods or services provided or to be provided pursuant to the contract:
               


Contact Information
name:  Kay Thompson 
                                       address:  714 Adams Street
Winnsboro, La.

                                       phone:  318-435-7879
                                       fax:  318-435-3518
                                       e-mail:  kthompsonfpcoa@yahoo.com
                                       relationship to entity:  Executive Director