FORM 1023-EZ for LAWRENCE ALCOHOLIC RECOVERY HOUSE

Field Data
EIN 48-1245191
Case Number EO-2017003-000089
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LAWRENCE ALCOHOLIC RECOVERY HOUSE
Organization’s Mailing Address 745 OHIO STREET
City LAWRENCE
State KS
ZIP 66044
Accounting period End 12
Primary contact name JOHN CLEMENTS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN CLEMENTS
TREASURER
745 OHIO
LAWRENCE KS 66044

Officer/Director/Trustee Two

GARRY BRADDY
BOARD MEMBER
745 OHIO
LAWRENCE KS 66044

Officer/Director/Trustee Three

DON DORSEY
PRESIDENT
745 OHIO
LAWRENCE KS 66044

Officer/Director/Trustee Four

NATHAN FELDT
BOARD MEMBER
745 OHIO
LAWRENCE KS 66044

Organization’s website HTTP://WWW.HEARTHSTONERECOVERY.ORG/
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/10/1980
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F21 - Alcohol, Drug Abuse, Prevention Only
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 No
Donation of funds No
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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