FORM 1023-EZ for ACTIVE IMPLEMENTATION RESEARCH NETWORK INC

Field Data
EIN 83-2155694
Case Number EO-2019079-000565
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ACTIVE IMPLEMENTATION RESEARCH NETWORK INC
Organization’s Mailing Address 6707 GLEN FOREST DRIVE
City CHAPEL HILL
State NC
ZIP 27517
Accounting period End 12
Primary contact name DEAN L FIXSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEAN FIXSEN
DIRECTOR PRESIDENT SECRETARY TREAS
6707 GLEN FOREST DRIVE
CHAPEL HILL NC 27517

Officer/Director/Trustee Two

KAREN BLASE
DIRECTOR
6707 GLEN FOREST DRIVE
CHAPEL HILL NC 27517

Officer/Director/Trustee Three

MELISSA VAN DYKE
DIRECTOR
6707 GLEN FOREST DRIVE
CHAPEL HILL NC 27517

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/3/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A05 - Research Institutes and/or Public Policy Analysis
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 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 No
Correctness Declaration Yes
Signature Name DEAN FIXSEN
Signature Title DIRECTOR PRESIDENT SECRETARY TREAS
Signature Date 3/18/19

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