The recipient entity's physical address:
           1011 Lagarde St.
Thibodaux, LA 70301

The recipient entity's mailing address (if different):
           P.O. Box 5212
Thibodaux, LA 70302

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:  8060

What is the dollar amount of the request?  $150,000

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:
           1. Dwayne A. Thomas, Sr. Illustrious Potentate (Director) - 301 Woodland Dr. Donaldsonville, LA 70346.
2. Torrey Eubaire - Chief Rabban (Asst. Director) - 266 MARMANDE AVE. THIBODAUX, LA 70301.
3. Kevin Broomfield - Recorder - 218 Maracaibo Ct.
Houma, LA 70363

Provide a summary of the project or program:
           1. To obtain a parcel of land and build new Shiners building in the Thibodaux community to help facilitate community outreach and emergency response location for the community.
2. Run new utilities and upgrade existing equipment, electrical, and plumbing.
3. To clear land and prep land for new construction and parking lot.
4. Construct handicap accessible walk ways and bathroom expansion area.
5. Build and provide equipment for a computer lab to assist with after school activities and provide resources of the internet to community members who do not have access.
6. Install fencing for protection of all commerce property.
7. Install security cameras and alarms systems for security purposes.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $0
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $175,000
          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?
          Ma'Mun Temple #249 has been in the community for over 14 years this year. It's purpose is to promote a health and safe community environment. Provide a place where the community can come together for various purposes. Provide a 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 provide a safe and useable place for the public. Goal #2: Continue to foster a outreach programs for the youth, seniors, and the most at risk members of the community. Goal #3; Provide focal point in the community where goods and services can be provided to the community members in times of natural disasters. Provide a place viable place of commerce where resources can assemble and be distributed as needed.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           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:
                N/A

          What is the nature of the relationship?  Illustrious Potentate (Director)

(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, Sr. 
                                       address:  301 Woodland Dr. Donaldsonville, LA 70346
                                       phone:  225-303-6048
                                       fax: 
                                       e-mail:  mamuntempleno.249@gmail.com
                                       relationship to entity:  Illustrious Potentate (Director)