CREATIVE LIVING SOLUTIONS INC: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- CREATIVE LIVING SOLUTIONS INC (EIN 46-5627443)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-10-24
- IRS object ID
- 202442989349301534
- Schema version
- 2023v5.0
- 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 | 2024-10-24T13:23:11-04:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 204461647 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DALLE ACCOUNTING AND CASH MANAGEMENT INC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 SECOND AVE | AddressLine1Txt |
| City | WATERVLIET | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12189 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 465627443 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CREATIVE LIVING SOLUTIONS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CREA | BusinessNameControlTxt |
| Phone | 5182505761 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 69 HURLBUT STREET | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12209 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TELBERTH FORDE | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 5184141943 | PhoneNum |
| Signature | 2024-10-22 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (true) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DANIEL LORTIE CPA | PreparerPersonNm |
| PTIN | P01281478 | PTIN |
| Phone | 5182709243 | PhoneNum |
| Preparation | 2024-10-22 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2024-10-15 13:58:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TELBERTH FORDE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 69 HURLBUT STREET | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12209 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,845,631 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CLSINC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2020 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION'S MISSION IS TO EMPOWER INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES AND THEIR FAMILIES TO "REALIZE WHAT'S POSSIBLE" IN THEIR EVERY-DAY LIVES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 4 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 116 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $2,069,615 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,711,764 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $85,305 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $133,864 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3 | PYInvestmentIncomeAmt |
| CY Investment Income | $3 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $2,154,923 | PYTotalRevenueAmt |
| CY Total Revenue | $2,845,631 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $152,636 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $375,514 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,531,194 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,100,479 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $227,240 | PYOtherExpensesAmt |
| CY Other Expenses | $311,176 | CYOtherExpensesAmt |
| PY Total Expenses | $1,911,070 | PYTotalExpensesAmt |
| CY Total Expenses | $2,787,169 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $243,853 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $58,462 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $359,053 | TotalAssetsBOYAmt |
| Total Assets EOY | $514,689 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $75,441 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $172,615 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $283,612 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $342,074 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE ORGANIZATION'S MISSION IS TO EMPOWER INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES AND THEIR FAMILIES TO "REALIZE WHAT'S POSSIBLE" IN THEIR EVERY-DAY LIVES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $2,026,148 | ExpenseAmt |
| Revenue | $133,864 | RevenueAmt |
| Desc | FISCAL INTERMEDIARY SERVICES THE ORGANIZATION IS A FISCAL INTERMEDIARY FOR INDIVIDUALS WHO HAVE CHOSEN SELF DIRECTED SERVICES. IT PROVIDES THE ADMINISTRATIVE AND BILLING SUPPORT TO A PERSON WHO CHOOSES SELF-DIRECTION. THIS INCLUDES: COMPLETING BACKGROUND CHECKS FOR SELF-HIRED STAFF, BILLING MEDICAID OR NEW YORK STATE FOR SERVICES IN THE BUDGET, PAYING STAFF, TRACKING EXPENDITURES, AND PROVIDING MONTHLY STATEMENTS TO THE INDIVIDUAL. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $375,514 | ExpenseAmt |
| Grant | $375,514 | GrantAmt |
| Desc | COMMUNITY HABILITATION OUR PROFESSIONALLY TRAINED SPECIALISTS WORK ONE TO ONE OR IN GROUP SETTINGS TO ASSIST THE INDIVIDUAL(S) ON AN ARRAY OF OUTCOMES TO DEVELOP SKILLS SUCH AS: TRAVEL TRAINING, MONEY MANAGEMENT, ASSISTANCE WITH ACTIVITIES OF DAILY LIVING, COMMUNITY INCLUSION AND RELATIONSHIP BUILDING, DEVELOPMENT OF SOCIAL SKILLS, LEISURE SKILLS, SELF-ADVOCACY AND INFORMED CHOICE SKILLS ACQUIRING, RETAINING AND IMPROVING ADAPTIVE SKILLS AND SELF-HELP SKILLS NEEDED TO LIVE INDEPENDENTLY AT HOME AND IN COMMUNITY-BASED SETTINGS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $2,401,662 | 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 | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | 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 | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | 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 | false | 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 | false | ScheduleORequiredInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 116 | 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 | 4 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | 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 | false | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TELBERTH FORDE | PersonNm |
| Phone | 5182505761 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 69 HURLBUT STREET | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12209 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (5 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| TELBERTH FORDE | ||||||
| EXECUTIVE DI | 40.00 | Yes (X) | Yes (X) | $208,100 | $0 | $2,400 |
| AKUA GIBSON | ||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| VALARIE MCGLOINE | ||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| RAFAEL VERAS | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CYNTHIA WILLIAMS-STEPHENS | ||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $208,100 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $2,400 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $2,709,414 | GovernmentGrantsAmt |
| All Other Contributions | $2,350 | AllOtherContributionsAmt |
| Total Contributions | $2,711,764 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BROKER SERVICES | Desc |
| Total Revenue Column | $133,864 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $133,864 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $133,864 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,845,631 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $133,867 | RelatedOrExemptFuncIncomeAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $375,514 | TotalAmt |
| Program Services | $375,514 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $210,500 | TotalAmt |
| Program Services | $178,925 | ProgramServicesAmt |
| Management And General | $31,575 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,685,697 | TotalAmt |
| Program Services | $1,432,842 | ProgramServicesAmt |
| Management And General | $252,855 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,622 | TotalAmt |
| Program Services | $1,379 | ProgramServicesAmt |
| Management And General | $243 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,172 | TotalAmt |
| Program Services | $29,046 | ProgramServicesAmt |
| Management And General | $5,126 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,488 | TotalAmt |
| Program Services | $143,215 | ProgramServicesAmt |
| Management And General | $25,273 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,700 | TotalAmt |
| Management And General | $17,700 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,529 | TotalAmt |
| Program Services | $107,665 | ProgramServicesAmt |
| Management And General | $6,864 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,109 | TotalAmt |
| Program Services | $1,109 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,232 | TotalAmt |
| Program Services | $9,173 | ProgramServicesAmt |
| Management And General | $3,059 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,949 | TotalAmt |
| Program Services | $71,962 | ProgramServicesAmt |
| Management And General | $23,987 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,790 | TotalAmt |
| Program Services | $25,863 | ProgramServicesAmt |
| Management And General | $13,927 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,676 | TotalAmt |
| Program Services | $14,676 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,488 | TotalAmt |
| Program Services | $1,617 | ProgramServicesAmt |
| Management And General | $871 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,509 | TotalAmt |
| Program Services | $7,482 | ProgramServicesAmt |
| Management And General | $4,027 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | REPAIRS AND MAINTENANCE | Desc |
| Total | $1,194 | TotalAmt |
| Program Services | $1,194 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,787,169 | TotalAmt |
| Program Services | $2,401,662 | ProgramServicesAmt |
| Management And General | $385,507 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,946 | BOYAmt |
| EOY | $4,272 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $23,278 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $312,248 | BOYAmt |
| EOY | $395,392 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,859 | BOYAmt |
| EOY | $91,747 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $359,053 | BOYAmt |
| EOY | $514,689 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,582 | BOYAmt |
| EOY | $80,868 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,859 | BOYAmt |
| EOY | $91,747 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,441 | BOYAmt |
| EOY | $172,615 | 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 | $283,612 | BOYAmt |
| EOY | $342,074 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $283,612 | BOYAmt |
| EOY | $342,074 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $359,053 | BOYAmt |
| EOY | $514,689 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $58,462 | 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) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $452,595 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $819,743 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,069,615 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,711,764 | CurrentTaxYearAmt |
| Total | $6,053,717 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $94,202 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $86,844 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $85,308 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $133,867 | CurrentTaxYearAmt |
| Total | $400,221 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $546,797 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $906,587 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,154,923 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,845,631 | CurrentTaxYearAmt |
| Total | $6,453,938 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $6,453,938 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $2 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3 | CurrentTaxYearAmt |
| Total | $12 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $2 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3 | CurrentTaxYearAmt |
| Total | $12 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $546,799 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $906,591 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,154,926 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,845,634 | CurrentTaxYearAmt |
| Total | $6,453,950 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 1.00000 | PublicSupportCY509Pct |
| Public Support PY509 | 1.00000 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RIGHT OF USE ASSET | Desc |
| Book Value | $91,747 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $91,747 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LEASE LIABILITY | Desc |
| Amt | $91,747 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $91,747 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $2,845,631 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $2,845,631 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $2,845,631 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,787,169 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $2,787,169 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $2,787,169 | TotalExpensesPerForm990Amt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | false | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | GOVERNMENT GRANT | GrantTypeTxt |
| Recipient | 140 | RecipientCnt |
| Cash Grant | $375,514 | CashGrantAmt |
| Valuation Method Used | FMV | ValuationMethodUsedDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PAGE 4, PART IV | FormAndLineReferenceDesc |
| Explanation | THE NUMBER OF RECIPIENTS IS ESTIMATED BY NUMBER OF TOTAL ACTIVE MEDICAID PARTICIPANTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TELBERTH FORDE | PersonNm |
| Title | EXECUTIVE DIRECTOR | TitleTxt |
| Base Compensation Filing Org | $208,100 | BaseCompensationFilingOrgAmt |
| Deferred Compensation Flng Org | $2,400 | DeferredCompensationFlngOrgAmt |
| Total Compensation Filing Org | $210,500 | TotalCompensationFilingOrgAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 10B | CONTACT ORGANIZATION |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM. A COPY OF THE FORM 990 IS REVIEWED BY THE BOARD PRIOR TO FILING WITH THE IRS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC |
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