HOSPICE HOUSE AND SUPPORT CARE OF WILLIAMSBURG INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
HOSPICE HOUSE AND SUPPORT CARE OF WILLIAMSBURG INC (EIN 52-1289657)
Tax period
2021-07-01 to 2022-06-30
Filed
2023-05-22
IRS object ID
202311429349301051
Schema version
2021v4.2
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)
Return2023-05-22T14:43:23-05:00ReturnTs
Tax Period End2022-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN453936274PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BETH MOORE & ASSOCIATES CPASBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 120547AddressLine1Txt
CityNEWPORT NEWSCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23612ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN521289657EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HOSPICE SUPPORT CARE OFBusinessNameLine1Txt
Business Name Line2WILLIAMSBURG INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlHOSPBusinessNameControlTxt
Phone7572531220PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14445 POWHATAN PARKWAYAddressLine1Txt
CityWILLIAMSBURGCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23188ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSCOTT STABLERPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone7572531220PhoneNum
Signature2023-05-17SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstSCOTTPersonFirstNm
Person LastSTABLERPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLISA CANDELLA CPAPreparerPersonNm
PTINP01695830PTIN
Phone7572241174PhoneNum
Preparation2023-05-17PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1HOSPICE HOUSE & SUPPORT CARE OFBusinessNameLine1Txt
Business Name Line2WILLIAMSBURGBusinessNameLine2Txt
FieldValueIRS element (for citing)
Principal OfficerBRANDON RANDALLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line14445 POWHATAN PARKWAYAddressLine1Txt
CityWILLIAMSBURGCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23188ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$2,964,030GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.WILLIAMSBURGHOSPICE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1982FormationYr
Legal Domicile StateVALegalDomicileStateCd
Activity Or Mission"WE GIVE CARE, COMFORT, AND COMPASSION THROUGH AND BEYOND END OF LIFE."ActivityOrMissionDesc
Voting Members Governing Body21VotingMembersGoverningBodyCnt
Voting Members Independent21VotingMembersIndependentCnt
Total Employee25TotalEmployeeCnt
Total Volunteers75TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,618,912PYContributionsGrantsAmt
CY Contributions Grants$1,998,492CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$142,659PYInvestmentIncomeAmt
CY Investment Income$366,462CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$1,761,571PYTotalRevenueAmt
CY Total Revenue$2,364,954CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$680,910PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$877,916CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$35,367CYTotalFundraisingExpenseAmt
PY Other Expenses$212,646PYOtherExpensesAmt
CY Other Expenses$233,654CYOtherExpensesAmt
PY Total Expenses$893,556PYTotalExpensesAmt
CY Total Expenses$1,111,570CYTotalExpensesAmt
PY Revenues Less Expenses$868,015PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,253,384CYRevenuesLessExpensesAmt
Total Assets BOY$4,617,591TotalAssetsBOYAmt
Total Assets EOY$4,927,119TotalAssetsEOYAmt
Total Liabilities BOY$23,029TotalLiabilitiesBOYAmt
Total Liabilities EOY$20,115TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,594,562NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,907,004NetAssetsOrFundBalancesEOYAmt
Mission"WE GIVE CARE, COMFORT, AND COMPASSION THROUGH AND BEYOND END OF LIFE."MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$997,575ExpenseAmt
DescPROVIDED HOSPICE AND OTHER SUPPORT SERVICES TO TERMINALLY ILL PATIENTS AND THEIR FAMILY MEMBERS AND OTHER BEREAVED MEMBERS OF THE COMMUNITY.Desc
Total Program Service Expenses$997,575TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document5IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee25EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members21GoverningBodyVotingMembersCnt
Independent Voting Member21IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldVAStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BRANDON RANDALLBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7572531220PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14445 POWHATAN PARKWAYAddressLine1Txt
CityWILLIAMSBURGCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23188ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
JAMES E LESNICK MD
IMMEDIATE PAST PRESIDENT1.00Yes (X)Yes (X)$0$0$0
JOHN MILLER MD
MEDICAL DIRECTOR1.00Yes (X)Yes (X)$0$0$0
BOB CANFIELD
DIRECTOR1.00Yes (X)$0$0$0
TRACY SHACKELFORD
DIRECTOR1.00Yes (X)$0$0$0
BRETT SMITH
DIRECTOR1.00Yes (X)$0$0$0
LARRY PULLEY
DIRECTOR1.00Yes (X)$0$0$0
SCOTT STABLER
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
ELIZABETH WHITE
VICE PRESIDENT1.00Yes (X)Yes (X)$0$0$0
GREGORY T STORER
DIRECTOR1.00Yes (X)$0$0$0
DANIEL CARLILE
TREASURER1.00Yes (X)Yes (X)$0$0$0
TERESA SWEANEY
DIRECTOR1.00Yes (X)$0$0$0
JAYNE BARNARD
DIRECTOR1.00Yes (X)$0$0$0
BUDDY LEAGUE
DIRECTOR1.00Yes (X)$0$0$0
SHERRI NELSON
SECRETARY1.00Yes (X)Yes (X)$0$0$0
BRANDON RANDALL
EXECUTIVE DIRECTOR40.00Yes (X)Yes (X)$54,212$0$0
JENNIFER SHINN
DIRECTOR1.00Yes (X)$0$0$0
SCOTT WISE
DIRECTOR1.00Yes (X)$0$0$0
DR DAVISON DOUGLAS
DIRECTOR1.00Yes (X)$0$0$0
SCOTT JOHNSTON
DIRECTOR1.00Yes (X)$0$0$0
DR ALEX JOOSE
DIRECTOR1.00Yes (X)$0$0$0
RABBIT DAVID KATZ
DIRECTOR1.00Yes (X)$0$0$0
DR HENRY RANGER
DIRECTOR1.00Yes (X)$0$0$0
PATRICA ROBBINS
DIRECTOR1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$54,212TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Federated Campaigns$25,640FederatedCampaignsAmt
Fundraising$302,290FundraisingAmt
Government Grants$255,822GovernmentGrantsAmt
All Other Contributions$1,414,740AllOtherContributionsAmt
Noncash Contributions$201,668NoncashContributionsAmt
Total Contributions$1,998,492TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$265,225TotalRevenueColumnAmt
Exclusion$265,225ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$635,091SecuritiesAmt
Other$33,221OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$522,602SecuritiesAmt
Other$44,473OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$112,489SecuritiesAmt
Other-$11,252OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$101,237TotalRevenueColumnAmt
Exclusion$101,237ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$32,001FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$302,290ContriRptFundraisingEventAmt
Fundraising Direct Expenses$32,001FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,364,954TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$366,462ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$54,212TotalAmt
Program Services$42,706ProgramServicesAmt
Management And General$5,544ManagementAndGeneralAmt
Fundraising$5,962FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$742,530TotalAmt
Program Services$697,978ProgramServicesAmt
Management And General$22,276ManagementAndGeneralAmt
Fundraising$22,276FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$4,562TotalAmt
Program Services$4,100ProgramServicesAmt
Management And General$196ManagementAndGeneralAmt
Fundraising$266FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$9,409TotalAmt
Program Services$9,343ProgramServicesAmt
Fundraising$66FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$67,203TotalAmt
Program Services$62,072ProgramServicesAmt
Management And General$3,038ManagementAndGeneralAmt
Fundraising$2,093FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$3,480TotalAmt
Management And General$3,480ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$22,692TotalAmt
Program Services$22,692ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$10,096TotalAmt
Management And General$10,096ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,850TotalAmt
Fundraising$3,850FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$6,147TotalAmt
Program Services$5,202ProgramServicesAmt
Management And General$101ManagementAndGeneralAmt
Fundraising$844FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$39,293TotalAmt
Program Services$35,866ProgramServicesAmt
Management And General$3,427ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$47,857TotalAmt
Program Services$41,733ProgramServicesAmt
Management And General$6,124ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$27,941TotalAmt
Program Services$18,652ProgramServicesAmt
Management And General$9,289ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
EQUIPMENT REPAIRS$41,836$30,555$11,281
ADMINISTRATIVE$25,149$21,363$3,776$10
PATIENT SUPPORT$5,313$5,313

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,111,570TotalAmt
Program Services$997,575ProgramServicesAmt
Management And General$78,628ManagementAndGeneralAmt
Fundraising$35,367FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$466,063BOYAmt
EOY$645,329EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$52,120BOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$54,430BOYAmt
EOY$293,560EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,837BOYAmt
EOY$13,228EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,535,542LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$724,362LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$740,776BOYAmt
EOY$811,180EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$3,292,279BOYAmt
EOY$2,972,522EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$6,086BOYAmt
EOY$191,300EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,617,591BOYAmt
EOY$4,927,119EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$23,029BOYAmt
EOY$20,115EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$23,029BOYAmt
EOY$20,115EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,348,987BOYAmt
EOY$4,196,246EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$245,575BOYAmt
EOY$710,758EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,594,562BOYAmt
EOY$4,907,004EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,617,591BOYAmt
EOY$4,927,119EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,253,384ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$940,942NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

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$823,355CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$623,128CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$896,613CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,625,771CurrentTaxYearMinus1YearAmt
Current Tax Year$1,978,255CurrentTaxYearAmt
Total$5,947,122TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$823,355CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$623,128CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$896,613CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,625,771CurrentTaxYearMinus1YearAmt
Current Tax Year$1,978,255CurrentTaxYearAmt
Total$5,947,122TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$5,947,122PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$118,555CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$117,218CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$88,682CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$134,075CurrentTaxYearMinus1YearAmt
Current Tax Year$265,225CurrentTaxYearAmt
Total$723,755TotalAmt
FieldValueIRS element (for citing)
Total Support$6,670,877TotalSupportAmt
Public Support CY1700.89150PublicSupportCY170Pct
Public Support PY1700.89710PublicSupportPY170Pct
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

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,405,816BeginningYearBalanceAmt
Contributions$263,087ContributionsAmt
Investment Earnings Or Losses-$563,461InvestmentEarningsOrLossesAmt
Administrative Expenses$10,096AdministrativeExpensesAmt
End Year Balance$3,095,346EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,185,449BeginningYearBalanceAmt
Contributions$675,703ContributionsAmt
Investment Earnings Or Losses$564,533InvestmentEarningsOrLossesAmt
Other Expenditures$12,000OtherExpendituresAmt
Administrative Expenses$7,869AdministrativeExpensesAmt
End Year Balance$3,405,816EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,147,267BeginningYearBalanceAmt
Contributions$55,198ContributionsAmt
Investment Earnings Or Losses$97,106InvestmentEarningsOrLossesAmt
Other Expenditures$107,000OtherExpendituresAmt
Administrative Expenses$7,122AdministrativeExpensesAmt
End Year Balance$2,185,449EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,073,761BeginningYearBalanceAmt
Contributions$71,140ContributionsAmt
Investment Earnings Or Losses$106,834InvestmentEarningsOrLossesAmt
Other Expenditures$96,500OtherExpendituresAmt
Administrative Expenses$7,968AdministrativeExpensesAmt
End Year Balance$2,147,267EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,959,638BeginningYearBalanceAmt
Contributions$73,466ContributionsAmt
Investment Earnings Or Losses$127,617InvestmentEarningsOrLossesAmt
Other Expenditures$79,000OtherExpendituresAmt
Administrative Expenses$7,960AdministrativeExpensesAmt
End Year Balance$2,073,761EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.91840BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.08160PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$100,500OtherCostOrOtherBasisAmt
Book Value$100,500BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,110,237OtherCostOrOtherBasisAmt
Depreciation$575,278DepreciationAmt
Book Value$534,959BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$202,439OtherCostOrOtherBasisAmt
Depreciation$51,301DepreciationAmt
Book Value$151,138BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$122,366OtherCostOrOtherBasisAmt
Depreciation$97,783DepreciationAmt
Book Value$24,583BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$811,180TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$1,413,916TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$940,942NetUnrealizedGainsInvstAmt
Revenue Not Reported-$940,942RevenueNotReportedAmt
Revenue Subtotal$2,354,858RevenueSubtotalAmt
Investment Expenses Not Incld$10,096InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$10,096RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$2,364,954TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,101,474TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$1,101,474ExpensesSubtotalAmt
Investment Expenses Not Incld2$10,096InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$10,096ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$1,111,570TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF JUNE 30, 2022. FISCAL YEARS ENDING ON OR AFTER JUNE 30, 2019, REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES.ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1ELEGANT CULINARY AFFAIREvent1Nm
Gross Receipts Event1$137,742GrossReceiptsEvent1Amt
Charitable Contri Event1$122,486CharitableContriEvent1Amt
Gross Revenue Event1$15,256GrossRevenueEvent1Amt
Other Direct Expenses Event1$15,256OtherDirectExpensesEvent1Amt
Event2LAYCOCK GOLF TOURNAMENTEvent2Nm
Gross Receipts Event2$75,000GrossReceiptsEvent2Amt
Charitable Contri Event2$75,000CharitableContriEvent2Amt
Other Events Total3OtherEventsTotalCnt
Gross Receipts Other Events$121,549GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$104,804CharitableContriOtherEventsAmt
Gross Revenue Other Events$16,745GrossRevenueOtherEventsAmt
Oth Direct Expnss Other Events$16,745OthDirectExpnssOtherEventsAmt
Gross Receipts Total$334,291GrossReceiptsTotalAmt
Charitable Contributions Tot$302,290CharitableContributionsTotAmt
Gross Revenue Total Events$32,001GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$32,001OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$32,001DirectExpenseSummaryEventsAmt
Net Income Summary$0NetIncomeSummaryAmt

Schedule M IRS990ScheduleM

Real Estate Residential RealEstateResidentialGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$193,100NoncashContributionsRptF990Amt

Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)

Non Cash CheckboxNonCashCheckboxIndDescDescContributionContributionCntNoncash Contributions Rpt F990NoncashContributionsRptF990Amt
Yes (X)PENINSULA HEAT & AIR1$6,568
Yes (X)JACKS TILE AND CARPET1$2,000
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BORGANIZATION'S PROCESS TO REVIEW FORM 990- THE TAX RETURN IS REVIEWED BY THE STAFF ACCOUNTANT, EXECUTIVE DIRECTOR, TREASURER, AND THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12CENFORCEMENT OF CONFLICTS POLICY- CONFLICT OF INTEREST POLICY IS ENFORCED BY BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 15ACOMPENSATION PROCESS FOR TOP OFFICIAL- THE EXECUTIVE DIRECTOR'S COMPENSATION IS DISCUSSED AND REVIEWED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19GUIDESTAR, AVAILABLE UPON REQUEST.
FORM 990, PART XII, LINE 2C:THERE HAS BEEN NO CHANGE IN THE COMMITTEE'S RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT.

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