FORM 1023-EZ for LIFE RECOVERY SREVICES INC

Field Data
EIN 47-3067167
Case Number EO-2016013-000518
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIFE RECOVERY SREVICES INC
Organization’s Mailing Address 5113 SE 15TH SUITE D
City DEL CITY
State OK
ZIP 73115-3952
Accounting period End 6
Primary contact name CODY SHOEMAKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

WILLIAM CODY SHOEMAKER
EXECUTIVE DIRECTOR
3416 RIDGLEA CT
DEL CITY OK 73115

Officer/Director/Trustee Two

CLAUDEA LYNN SAGESER
CLINICAL DIRECTOR
1809 GUILFORD LANE
OKLAHOMA CITY OK 73120

Officer/Director/Trustee Three

DANIEL MARQUEZ
MEMBER
3416 RIDGLEA CT
DEL CITY OK 73115

Officer/Director/Trustee Four

GREGORY LEPAK
MEMBER
1809 GUILFORD
OKLAHOMA CITY OK 73120

Organization’s website WWW.OKLIFERECOVERY.ORG
Organization’s email CODYSHOEMAKER@HOTMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/16/2015
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F20 - Alcohol, Drug and Substance Abuse, Dependency Prevention and Treatment
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 No
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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
Signature Title
Signature Date

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