SCALPEL AT THE CROSS INC: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
SCALPEL AT THE CROSS INC (EIN 20-1175847)
Tax period
2023-01-01 to 2023-12-31
Filed
2024-09-18
IRS object ID
202412629349300131
Schema version
2023v5.1
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

FieldValueIRS element (for citing)
Return2024-09-18T13:47:38-04:00ReturnTs
Tax Period End2023-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN200240322PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ECI Tax LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line15090 N 40th Street Suite 205AddressLine1Txt
CityPhoenixCityNm
State AbbreviationAZStateAbbreviationCd
ZIP85018ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2023-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN201175847EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SCALPEL AT THE CROSS INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSCALBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1146 W PLEASANT LAKE RDAddressLine1Txt
CityNORTH OAKSCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55127ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPETER COLEPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone3054672715PhoneNum
Signature2024-04-04SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (true)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBob KorljanPreparerPersonNm
PTINP00013653PTIN
Phone4803857399PhoneNum
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2024-08-08 14:25:15ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts$1,374,524GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressSCALPELATTHECROSS.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2004FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionPURPOSE IS TO BUILD AND MAINTAIN A MEDICAL MISSION WHICH SERVES THE ORTHOPEDIC NEEDS OF PUCALLPAN PERUVIANS NOT GENERALLY AVAILABLEActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee5TotalEmployeeCnt
Total Gross UBI$14,883TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,266,395PYContributionsGrantsAmt
CY Contributions Grants$1,359,011CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income-$46PYInvestmentIncomeAmt
CY Investment Income$14,883CYInvestmentIncomeAmt
PY Other Revenue$1,449PYOtherRevenueAmt
CY Other Revenue$630CYOtherRevenueAmt
PY Total Revenue$1,267,798PYTotalRevenueAmt
CY Total Revenue$1,374,524CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$149,314PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$164,535CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$73,919CYTotalFundraisingExpenseAmt
PY Other Expenses$380,668PYOtherExpensesAmt
CY Other Expenses$563,044CYOtherExpensesAmt
PY Total Expenses$529,982PYTotalExpensesAmt
CY Total Expenses$727,579CYTotalExpensesAmt
PY Revenues Less Expenses$737,816PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$646,945CYRevenuesLessExpensesAmt
Total Assets BOY$1,640,537TotalAssetsBOYAmt
Total Assets EOY$2,246,196TotalAssetsEOYAmt
Total Liabilities BOY$87,551TotalLiabilitiesBOYAmt
Total Liabilities EOY$46,265TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,552,986NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,199,931NetAssetsOrFundBalancesEOYAmt
MissionPURPOSE IS TO BUILD AND MAINTAIN A MEDICAL MISSION WHICH SERVES THE ORTHOPEDIC NEEDS OF PUCALLPAN PERUVIANS NOT GENERALLY AVAILABLEMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$223,652ExpenseAmt
DescMEDICAL MISSION CAMPAIGNS IN 2023: 66 VOLUNTEERS TRAVELED WITH SCALPEL AT THE CROSS ON 4DIFFERENT, 10-DAY MEDICAL MISSION CAMPAIGNS TO PROVIDE FREE CLINICAL AND SURGICAL CARE. FREESURGICAL CARE WAS PROVIDED TO 92 PATIENTS AND FREE CLINICAL CARE WAS PROVIDED TO 88 PATIENTS. INADDITION, FREE MEDICAL EVALUATIONS WERE PROVIDED TO 365 PATIENTS. THE ESTIMATED TOTAL VALUE OFMEDICAL CARE PROVIDED EQUALED $1,059,500. THE ESTIMATED VALUE OF DONATED TIME BY TEAM MEMBERSEQUALED $200,475Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$10,620ExpenseAmt
DescPERU MEDICAL COORDINATOR: WORKING WITH PAST SURGICAL AND NEW SCALPEL AT THE CROSS PATIENTS, THE PERUVIAN MEDICAL COORDINATOR PROVIDED FOLLOW-UP CARE TO 92 SURGICAL PATIENTS, SAW OVER SIXTY PATIENTS FOR PHYSICAL THERAPY SERVICES AND FABRICATED PROSTHESES. HE ALSO COORDINATED LOGISTICS FOR THE FOUR VOLUNTEER TEAMS AND TWO ADMINISTRATIVE TEAMS/Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$234,272TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficeYes (true)ForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee5EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Written Policy Or ProcedurefalseWrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonKARA RODRIGUEZPersonNm
Phone3054672715PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14818 Blistering WayAddressLine1Txt
CityLake WorthCityNm
State AbbreviationFLStateAbbreviationCd
ZIP33467ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (5 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
KARA RODRIGUEZ
EXEC MISSION DIRECTOR45.000.00Yes (X)$73,333$0$0
CLAYTON NELSON
VICE PRESIDENT2.000.00$0$0$0Yes (X)
JASON CARON
VICE PRESIDENT2.000.00$0$0$0Yes (X)
PETER COLE
PRESIDENT7.000.00$0$0$0Yes (X)
ROBERT R KORLJAN
CFO2.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$73,333TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$1,359,011AllOtherContributionsAmt
Total Contributions$1,359,011TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,883TotalRevenueColumnAmt
Unrelated Business Revenue$14,883UnrelatedBusinessRevenueAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$630RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$630RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$630TotalRevenueColumnAmt
Related Or Exempt Func Income$630RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,374,524TotalRevenueColumnAmt
Related Or Exempt Func Income$630RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$14,883UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$153,583TotalAmt
Management And General$153,583ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$10,952TotalAmt
Management And General$10,952ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$2,670TotalAmt
Program Services$2,670ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$6,913TotalAmt
Management And General$6,913ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$35,680TotalAmt
Management And General$35,680ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$346TotalAmt
Program Services$346ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$22,916TotalAmt
Management And General$22,916ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$71,973TotalAmt
Program Services$71,973ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,817TotalAmt
Management And General$1,817ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
MISSION TRAVEL$94,408$94,408
MEDICAL SUPPLIES SHIPPING$8,074$8,074
PERU MEDICAL COORDINATOR$10,620$10,620
TEAM HOUSING MEALS SUPPLIES$27,708$27,708

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$279,919TotalAmt
Program Services$18,473ProgramServicesAmt
Management And General$187,527ManagementAndGeneralAmt
Fundraising$73,919FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$727,579TotalAmt
Program Services$234,272ProgramServicesAmt
Management And General$419,388ManagementAndGeneralAmt
Fundraising$73,919FundraisingAmt
FieldValueIRS element (for citing)
Joint CostsYes (X)JointCostsInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$395,523BOYAmt
EOY$265,905EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$602,321BOYAmt
EOY$674,426EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,703,265LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$407,431LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$493,693BOYAmt
EOY$1,295,834EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$149,000BOYAmt
EOY$10,031EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,640,537BOYAmt
EOY$2,246,196EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$56,932BOYAmt
EOY$20,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$30,619BOYAmt
EOY$26,265EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$87,551BOYAmt
EOY$46,265EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$499,989BOYAmt
EOY$1,400,417EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,052,997BOYAmt
EOY$799,514EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,552,986BOYAmt
EOY$2,199,931EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,640,537BOYAmt
EOY$2,246,196EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$646,945ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$575,881CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$395,853CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$540,119CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,259,807CurrentTaxYearMinus1YearAmt
Current Tax Year$1,356,849CurrentTaxYearAmt
Total$4,128,509TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$575,881CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$395,853CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$540,119CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,259,807CurrentTaxYearMinus1YearAmt
Current Tax Year$1,356,849CurrentTaxYearAmt
Total$4,128,509TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$891,546SubstantialContributorsTotAmt
Public Support Total170$3,236,963PublicSupportTotal170Amt
Total Support$4,128,509TotalSupportAmt
Public Support CY1700.78410PublicSupportCY170Pct
Public Support PY1700.84100PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$118,242OtherCostOrOtherBasisAmt
Book Value$118,242BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$525,707OtherCostOrOtherBasisAmt
Depreciation$156,434DepreciationAmt
Book Value$369,273BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$271,392OtherCostOrOtherBasisAmt
Depreciation$250,997DepreciationAmt
Book Value$20,395BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$787,924OtherCostOrOtherBasisAmt
Book Value$787,924BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,295,834TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
CREDIT CARD PAYABLE$24,595
ACCRUED PTO$1,670
FieldValueIRS element (for citing)
Total Liability$26,265TotalLiabilityAmt

Schedule F IRS990ScheduleF

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Officer directors etc family relationship Part VI line 2PETER COLE-BOARD MEMBER, NANCY COLE-BOARD MEMBER, HUSBAND AND WIFE
Form 990 governing body review Part VI line 11ACCOUNTING FIRM PREPARES DRAFT OF FORM 990 FOR TREASURER AND BOARD OF DIRECTORS TO REVIEW. ANY CHANGES RESULTING FOR BOARD DISCUSSIONS ARE COMMUNICATED TO ACCOUNTANT FOR ANALYSIS AND ADJUSTMENT. ACCOUNTANT PREPARED FINAL COPY OF FORM 990 TO BE FILED.
Governing documents etc available to public Part VI line 19DOCUMENTS AVAILABLE UPON REQUEST
List of other expenses Part IX line 24ePROGRAM SERVICESPATIENT CARE & GIFTS $5CASHIBO EVERSIGHT EXPENSE $35591JUNGLE BUNKS UTILITIES $2006PERUVIAN MEDICAL CORRD EXPENSE $2218OUTPATIENT OUTCOME EXPENSE $2869MANAGEMENT AND GENERAL EXPENSECAMPAIGN EXPENSES $5974CONTRACT SERVICES $65195SUPPORT STAFF AND SERVICES $7236PRINTING AND COPYING $1937POSTAGE $473MAINTENANCE $556 FUNDRAISINGCONTRACT SERVICES $6098POSTAGE $4181SUPPLIES $366PRINTING AND COPYING $11924WEBISTE FEES $1181

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