NGO Funding Request


The recipient entity's full legal name:  Catahoula Council on the Aging, Inc.

The recipient entity's physical address:
           901 First Street
Jonesville, La 71343


The recipient entity's mailing address (if different):
           Same

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

If the entity is a corporation, list the names of the incorporators:
          Cameron B. Coney
Garland L. Furr
P. J. Rison
S.E. Lanier
Mrs. D.E. Brown, Sr.
Alden A. Webb
Y.E. Sheppard
Joe M. Martin
Mrs. Eva Keenan


The last four digits of the entity's taxpayer ID number:  4006

What is the dollar amount of the request?  $10,000

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:
           Shirley Wilson - President Catherine Squyres - Vice President
109 Goldie Drive 1887 Hwy 923
Jonesville, Louisiana 71343 Jonesville, La 71343

Cindy Sanders - Secretary Karla McGee - Treasurer
306 Galloway St. 5350 Hwy 8
Jonesville, La 71343 Sicily Island 71360

Bill Adkins - Director David Mitchell - Director
606 Mound St. 126 Ellis Landing Rd.
Jonesville, La 71343 Harrisonburg, La 71340

Raymond Rouse - Director Patricia LaPrairie - Director
2805 4th St. 141 Hudson Lane
Jonesville, La 71343 Jonesville, La 71343

Frances Trisler - Director Sandra Barber - Director
183 Trisler Lane 804 Johnson St.
Jonesville, La 71343 Jonesville, La 71343

Bill Floyd - Director Ronald Canady - Director
7608 Hwy 8 PO Box 131
Harrisonburg, La 71340 Harrisonburg, La 71340

Billy Fletcher - Director
1580 Ratcliff Rd.
Sicily Island, La 71360

Bill Buie - Executive Director
108 Goldie Dr.
Jonesville, La 71343


Provide a summary of the project or program:
           The Catahoula Council on the Aging, Inc. wished to extend its services to more clients. We have waiting lists for almost all of our services. Extra funds would enable us to serve more seniors and to provide a more comprehensive recreation and rehabilitation program for them.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $5,000
          Professional Services. . . $100
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $2,000
          Major Repairs . . . . . . . $1,000
          Operating Services. . . . $1,151
          Other Charges. . . . . . . $749

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?
          We endeavor to provide services for the elderly 60 years and above so that they may live in their own homes as long as possible. It is a fact that our seniors are happier and fare better in their own homes.

What are the goals and objectives for achieving such purpose?
          We provide housekeeping, respite, home delivered meals, recreation, personal care, and health lectures and information to achieve the mission of our Council on Aging.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           12 Months

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:
                 No
    
     (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: 
               No

(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:
                 The Governor's Office of Elderly Affairs
PO Box 61
Baton Rouge, La 70821-0061


(d) The nature of the contract, including a description of the goods or services provided or to be provided pursuant to the contract:
               The contract is to provide the Senior Centers in our parish and meals five days a week, with recreation and information and assistance.


Contact Information
name:  Bill Buie 
                                       address:  108 Goldie Drive
Jonesville, La 71343

                                       phone:  318.680.0070
                                       fax: 
                                       e-mail:  awbuiejr@aol.com
                                       relationship to entity:  Executive Director