The recipient entity's physical address:
           58280 Meriam Street
Plaquemine, LA 70764

The recipient entity's mailing address (if different):
           P.O. Box 562
Plaquemine, LA 70765

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

If the entity is a corporation, list the names of the incorporators:
          

The last four digits of the entity's taxpayer ID number:  6859

What is the dollar amount of the request?  $125,000

What type of request is this?  Capital Outlay 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:
           Dwayne A. Thomas - 301 Woodland Dr. Donaldsonville, LA 70346

Provide a summary of the project or program:
           1.To build a new addition to current building to add room for community outreach programs.
2. To clear land and prep land for new addition.
3. Run new utilities and upgrade existing equipment, electrical, plumbing.
4. Add windows to existing building.
5. Replace Air condition units and HVAC units.
6. Replace and upgrade appliances to commercial use.
7. Fire proof facility where needed.
8. Add handicap accessible walk ways and bathroom equipment.
9. Repair and upgrade computer lab building and equipment for after school program.
10. Purchase laptops and printers for computer lab.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $0
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $125,000
          Operating Services. . . . $0
          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?
          

What is the entity's public purpose, sought to be achieved through the use of state monies?
          Widow Son Lodge No.10 has been in the community for over 140 years this year. The purpose to promote a health and safe community environment. Provide a place where the community can come together for various projects. Provide venue for community outreach, youth education, adult education, and social events. Continuing to be a beacon of light in the community. These monies would help foster an affordable, safe, and clean place for all in the community to use and meet at.

What are the goals and objectives for achieving such purpose?
          Goal #1 is to make the building safe and useable for the public. Goal #2 is to add and addition onto the existing building for a bigger space for community outreach projects and community needs. Goal #3 is to initiate a community outreach to the citizens and local leaders advising that this building is ready for use to promote a better community. Goal #4 is to continue to improve and expand the building for future use by renting it for those who needed.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           6 months to 1 year.

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:
                 N/A
    
     (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:
                 N/A

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

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

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: 
               N/A

(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:
               N/A

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

          What is the nature of the relationship?  N/A

(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:
                 N/A

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


Contact Information
name:  Dwayne A Thomas 
                                       address:  301 WOODLAND DR.
Donaldsonville, LA 70346
                                       phone:  225-303-6048
                                       fax: 
                                       e-mail:  widowsonlodge10@gmail.com
                                       relationship to entity:  Worshipful Master (Director)