The recipient entity's physical address:
           1846 Milam Street
Shreveport, LA 71103

The recipient entity's mailing address (if different):
           1846 Milam Street
Shreveport, LA 71103

Type of Entity (for instance, a nonprofit corporation):  Non-Profit Religious Corp.

If the entity is a corporation, list the names of the incorporators:
          C.E. McLain
Anthony Pikes
Ruther Washington

The last four digits of the entity's taxpayer ID number:  7872

What is the dollar amount of the request?  $400,000

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:
           Clifford Eugene McLain - 6513 Long Timbers Drive - Shreveport, LA 71119
Perry Moss - 140 Seventh- Benton, LA 71066
Ruther Washington - 9130 Candlestick Lane- Shreveport, LA 71129
Twan Knight - 5952 Yarbrough - Shreveport, LA 71119

Provide a summary of the project or program:
           Restoration of the historic Little Union Baptist Church - the epicenter of the civil rights activities in Shreveport

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $75,000
          Contracts . . . . . . . . . . . $75,000
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $250,000
          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?
          Project purpose is to restore building to a safe, inviting and comfortable environment with stabilized building structure to ensure safety when used for worship, meetings, and events.

What are the goals and objectives for achieving such purpose?
          Goals and objectives include:
Replacement of aged-deteriorated roof
Replacement of aged non-functioning HVAC system
Repair of inoperable elevator
Update plumbing and electrical systems

What is the proposed length of time estimated by the entity to accomplish the purpose?
           3 years

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:
                 Not Applicable
    
     (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:
                 Not Applicable

     (c) The percentage of the official's or immediate family member's ownership interest in the recipient entity, if any:
                 Not Applicable

     (d) The position, if any, held by the official or immediate family member in the recipient entity:
                  Not Applicable

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: 
               Not Applicable

(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:
               Not Applicable

          Provide the name, address, and office of the official to whom the person is related:
                Not Applicable

          What is the nature of the relationship?  Not Applicable

(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:
                 Not Applicable

(d) The nature of the contract, including a description of the goods or services provided or to be provided pursuant to the contract:
               Not Applicable


Contact Information
name:  Dianna McLain 
                                       address:  6513 Long Timbers Drive
                                       phone:  3184704918
                                       fax: 
                                       e-mail:  dwmclain@bellsouth.net
                                       relationship to entity:  Administrative Assistant