The recipient entity's physical address:
           9318 JIMMY WEDELL DRIVE
BATON ROUGE, LA 70807

The recipient entity's mailing address (if different):
           2053 W MAGNA CARTA PLACE
BATON ROUGE, LA 70815

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:  3897

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:
           Agent Name:
Name:
TODD TERRELL
Country:
United States
Address 1:
2053 WEST MAGNA CARTA PLACE
City, State, Zip:
BATON ROUGE, Louisiana 70815
Email:
ON FILE
Officer/Director Name:
Name:
TODD TERRELL
Roles:
President, Director
Country:
United States
Address 1:
2053 WEST MAGNA CARTA PLACE
City, State, Zip:
BATON ROUGE, Louisiana 70815
Email:
ON FILE
Officer/Director Name:
Name:
BRIAN TRASCHER
Roles:
Vice-President
Country:
United States
Address 1:
141 ROBERT E LEE BLVD
City, State, Zip:
NEW ORLEANS, Louisiana 70124-2534
Email:
ON FILE

Provide a summary of the project or program:
           FUEL REIMBURSEMENT FOR DEPLOYMENT FOLLOWING HURRICANE FRANCINE

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $0
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $0
          Operating Services. . . . $10,000
          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?
          

What is the entity's public purpose, sought to be achieved through the use of state monies?
          United Cajun Navy is a 501(c) 3 nonprofit organization dedicated to providing disaster relief and emergency response services to communities in need.

Founded on the principles of volunteerism and community support, we mobilize quickly to assist those affected by hurricanes, floods, wildfires, and other natural disasters.

What are the goals and objectives for achieving such purpose?
          United Cajun Navy is a volunteer-driven nonprofit committed to disaster response, community support, and bringing hope to those in need nationwide

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

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:  TODD TERRELL 
                                       address:  2053 W MAGNA CARTA PL
BATON ROUGE LA 70815
                                       phone:  2258060746
                                       fax: 
                                       e-mail:  TODD@THECAJUNNAVY,ORG
                                       relationship to entity:  PRESIDENT