COMMUNITY MEDICAL CLINIC OF KERSHAW COUNTY: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY MEDICAL CLINIC OF KERSHAW COUNTY (EIN 57-1074191)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2024-03-01
- IRS object ID
- 202440619349300404
- Schema version
- 2021v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-03-01T09:17:35-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 570568919 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CANTEY TILLER PIERCE & GREEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 862 | AddressLine1Txt |
| City | CAMDEN | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29021 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 571074191 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY MEDICAL CLINIC OF KERSHAW | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 8037130806 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110C E DEKALB ST | AddressLine1Txt |
| City | CAMDEN | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29021 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SUSAN WITKOWSKI | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 8034321436 | PhoneNum |
| Signature | 2024-02-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SUSAN | PersonFirstNm |
| Person Last | WITKOWSKI | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | HENRY D GREEN III | PreparerPersonNm |
| PTIN | P00497792 | PTIN |
| Phone | 8034321436 | PhoneNum |
| Preparation | 2024-02-29 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amended Return | Yes (X) | AmendedReturnInd |
| Principal Officer | SUSAN WITKOWSKI | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1907 CARRIAGE HOUSE LANE | AddressLine1Txt |
| City | CAMDEN | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29020 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,914,252 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CMCOFKC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1998 | FormationYr |
| Legal Domicile State | SC | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION IS ENGAGED IN THE OPERATION OF A MEDICAL CLINIC FOR RESIDENTS OF CAMDEN AND KERSHAW COUNTY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 21 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,654,083 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,756,319 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,719 | PYInvestmentIncomeAmt |
| CY Investment Income | $65,630 | CYInvestmentIncomeAmt |
| PY Other Revenue | $78,698 | PYOtherRevenueAmt |
| CY Other Revenue | $104,237 | CYOtherRevenueAmt |
| PY Total Revenue | $1,737,500 | PYTotalRevenueAmt |
| CY Total Revenue | $4,926,186 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,055,475 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,117,903 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $25,256 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $584,130 | PYOtherExpensesAmt |
| CY Other Expenses | $3,531,712 | CYOtherExpensesAmt |
| PY Total Expenses | $1,639,605 | PYTotalExpensesAmt |
| CY Total Expenses | $4,649,615 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $97,895 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $276,571 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,504,361 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,643,382 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $752,830 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $615,280 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $751,531 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,028,102 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE ORGANIZATION IS ENGAGED IN THE OPERATION OF A MEDICAL CLINIC FOR RESIDENTS OF CAMDEN AND KERSHAW COUNTY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $4,603,487 | ExpenseAmt |
| Desc | TO PROVIDE OUT-PATIENT HEALTH CARE SERVICES TO PERSONS IN KERSHAW COUNTY WHO CANNOT PAY FOR SUCH SERVICES OUT OF POCKET AND WHO DO NOT HAVE HEALTH INSURANCE | Desc |
| Total Program Service Expenses | $4,603,487 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 21 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 21 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SUSAN WITKOWSKI | PersonNm |
| Phone | 8037130806 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 E DEKALB ST | AddressLine1Txt |
| City | CAMDEN | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29020 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| WILLIAM COX | ||||||
| BOARD MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |
| CLAUDE EICHELBERGER | ||||||
| BOARD MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |
| CATHY FORRESTER | ||||||
| BOARD MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |
| HARVEY GALLOWAY | ||||||
| BOARD MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |
| HANK GREEN | ||||||
| TREASURER | 0.25 | Yes (X) | $0 | $0 | $0 | |
| SHELLEY JANSSEN MD | ||||||
| BOARD MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |
| TORRILL MELSON | ||||||
| CHAIRMAN | 0.25 | Yes (X) | $0 | $0 | $0 | |
| DEBORAH RANDOLPH | ||||||
| BOARD MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |
| APRIL WACH | ||||||
| BOARD MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |
| SUSAN WITKOWSKI | ||||||
| CEO | 40.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $1,724,909 | GovernmentGrantsAmt |
| All Other Contributions | $3,031,410 | AllOtherContributionsAmt |
| Noncash Contributions | $3,031,410 | NoncashContributionsAmt |
| Total Contributions | $4,756,319 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $65,630 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $65,630 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $92,303 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | -$11,934 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $104,237 | TotalRevenueColumnAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,926,186 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $65,630 | RelatedOrExemptFuncIncomeAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,029,213 | TotalAmt |
| Program Services | $1,029,213 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,380 | TotalAmt |
| Program Services | $14,380 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,310 | TotalAmt |
| Program Services | $74,310 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,425 | TotalAmt |
| Program Services | $12,701 | ProgramServicesAmt |
| Management And General | $2,724 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,947 | TotalAmt |
| Program Services | $4,947 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,019 | TotalAmt |
| Program Services | $36,019 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,171 | TotalAmt |
| Program Services | $75,171 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,849 | TotalAmt |
| Program Services | $6,849 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,833 | TotalAmt |
| Program Services | $3,833 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $442 | TotalAmt |
| Program Services | -$766 | ProgramServicesAmt |
| Management And General | $1,208 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,934 | TotalAmt |
| Program Services | $71,934 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt |
|---|---|---|---|
| DONATIONS IN KIND | $3,031,410 | $3,031,410 | |
| CONSULTANTS | $188,428 | $188,428 | |
| SPECIAL EVENT EXPENSE | $25,256 | $25,256 | |
| MEDICATION | $14,403 | $14,403 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,595 | TotalAmt |
| Program Services | $40,655 | ProgramServicesAmt |
| Management And General | $16,940 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,649,615 | TotalAmt |
| Program Services | $4,603,487 | ProgramServicesAmt |
| Management And General | $20,872 | ManagementAndGeneralAmt |
| Fundraising | $25,256 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,232,675 | BOYAmt |
| EOY | $1,091,722 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $260,448 | BOYAmt |
| EOY | $261,752 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $22,500 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $400 | BOYAmt |
| EOY | $400 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $175,598 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $165,202 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,838 | BOYAmt |
| EOY | $10,396 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $256,612 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,504,361 | BOYAmt |
| EOY | $1,643,382 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,354 | BOYAmt |
| EOY | $68,148 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $714,476 | BOYAmt |
| EOY | $547,132 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $752,830 | BOYAmt |
| EOY | $615,280 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $751,531 | BOYAmt |
| EOY | $771,490 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $256,612 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $751,531 | BOYAmt |
| EOY | $1,028,102 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,504,361 | BOYAmt |
| EOY | $1,643,382 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $276,571 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,331,052 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,537,942 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,947,196 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,654,083 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,756,319 | CurrentTaxYearAmt |
| Total | $17,226,592 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,331,052 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,537,942 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,947,196 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,654,083 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,756,319 | CurrentTaxYearAmt |
| Total | $17,226,592 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $17,226,592 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,875 | CurrentTaxYearMinus4YearsAmt |
| Total | $4,875 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $17,231,467 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $552,479 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99970 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99940 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $175,598 | OtherCostOrOtherBasisAmt |
| Depreciation | $165,202 | DepreciationAmt |
| Book Value | $10,396 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,396 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BENEFICIAL INTEREST IN TRUST | Desc |
| Book Value | $256,612 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $256,612 | TotalBookValueOtherAssetsAmt |
| Total Rev Etc Audited Fincl Stmt | $4,926,186 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $4,926,186 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $4,926,186 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $4,649,615 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $4,649,615 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $4,649,615 | TotalExpensesPerForm990Amt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | SPECIAL EVENTS | Event1Nm |
| Gross Receipts Event1 | $92,303 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $92,303 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | -$11,934 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $92,303 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $92,303 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | -$11,934 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | -$11,934 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $104,237 | NetIncomeSummaryAmt |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 3 | ContributionCnt |
| Noncash Contributions Rpt F990 | $3,031,410 | NoncashContributionsRptF990Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 1, ITEM B | NEED TO CORRECT QUESTIONS ON THE CHECKLIST FOR PREVIOUSLY COMPLETED AUDITS. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR AND APPROVED BY THE BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THIS IS REVIEWED ANNUALLY WITH THE BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION IS REVIEWED ANNUALLY BY THE BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THIS IS REVIEWED ANNUALLY BY THE BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. |
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