FORM 1023-EZ for ARTIFACT INC

Field Data
EIN 85-2542346
Case Number EO-2020233-000257
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ARTIFACT INC
Organization’s Mailing Address 1120 TEXAS AVE
City SHREVEPORT
State LA
ZIP 71101
Accounting period End 12
Primary contact name THOMAS CHAVANNE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

THOMAS CHAVANNE
TREASURER
1100 TEXAS AVE
SHREVEPORT LA 71101

Officer/Director/Trustee Two

DEREK SIMMONS
MANAGER / EDUCATIONAL DIRECTOR
1110 TEXAS AVE
SHREVEPORT LA 71101

Officer/Director/Trustee Three

MARTHA LEPOW
BOARD MEMBER
1132 ERIE STREET
SHREVEPORT LA 71104

Officer/Director/Trustee Four

LAUREN SIMMONS
PROGRM DIRCTOR EDUCATIONAL OUTREACH
1110 TEXAS AVE
SHREVEPORT LA 71101

Officer/Director/Trustee Five

LIZ SWAINE
BOARD MEMBER
PO BOX 7542
SHREVEPORT LA 71137

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/17/2020
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B28 - Specialized Education Institutions
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name THOMAS CHAVANNE
Signature Title TREASURER
Signature Date 8/17/2020

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