FORM 1023-EZ for ACTIVE RECOVERY FOUNDATION INC

Field Data
EIN 47-1544129
Case Number EO-2017255-000025
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ACTIVE RECOVERY FOUNDATION INC
Organization’s Mailing Address 3821 SOUTHERN AVE
City SHREVEPORT
State LA
ZIP 71106-1033
Accounting period End 12
Primary contact name THERESE SCHAFFNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

THERESE SCHAFFNER
PRESIDENT
1520 ROSS RD
HAUGHTON LA 71037

Officer/Director/Trustee Two

VALERIE SCHAFFNER
TREASURER
3900 ELLA ST
BOSSIER CITY LA 71112

Officer/Director/Trustee Three

AMANDA VEULEMAN
SECRETARY
1824 BENTON RD
BOSSIER CITY LA 71111

Organization’s website WWW.ACTIVERECOVERYFOUNDATIONINC.ORG
Organization’s email VAL@ACTIVERECOVERYLA.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/8/2014
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date
EIN 47-1544129
Case Number EO-2014267-000249
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ACTIVE RECOVERY FOUNDATION INC
Organization’s Mailing Address 820 JORDAN ST SUITE 215
City SHREVEPORT
State LA
ZIP 71101
Accounting period End 12
Primary contact name RACHEL BARNHOUSE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

THERESE SCHAFFNER
PRESIDENT
1520 ROSS ROAD
HAUGHTON LA 71037

Officer/Director/Trustee Two

RACHEL BARNHOUSE
EXECUTIVE VICE - PRESIDENT
1015 COLLEGE STREET
SHREVEPORT LA 71101

Officer/Director/Trustee Three

ANGELIA OWEN
TREASURER
4407 CLINGMAN DRIVE
SHREVEPORT LA 71105

Officer/Director/Trustee Four

MELINDA BROWN
SECRETARY
8741 PINEHAVEN DRIVE
KEITHVILLE LA 71047

Organization’s website WWW.ACTIVERECOVERYFOUNDATIONINC.ORG
Organization’s email RACHEL@ACTIVERECOVERYLA.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/8/2014
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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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