FORM 1023-EZ for SUSQUEHANNA RECOVERY INITIATIVE INC

Field Data
EIN 47-4140507
Case Number EO-2015216-000276
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SUSQUEHANNA RECOVERY INITIATIVE INC
Organization’s Mailing Address 232 S 3RD AVENUE
City LEBANON
State PA
ZIP 17042
Accounting period End 12
Primary contact name MARK T SCHAPPELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MATTHEW GLADSTONE
PRESIDENT
19 BERWYN PARK
LEBANON PA 17042

Officer/Director/Trustee Two

MARK SCHAPPELL
VICE PRESIDENT
232 S 3RD AVENUE
LEBANON PA 17042

Officer/Director/Trustee Three

PEARRE DEAN
SECRETARY
2012 CHEVY CHASE ROAD
HARRISBURG PA 17110

Officer/Director/Trustee Four

JAMES NOON
TREASURER
41 E ROOSEVELT AVENUE
MIDDLETOWN PA 17057

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/15/2015
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P72 - Half-Way House (Short-Term Residential Care)
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 Yes
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
Signature Title
Signature Date

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