NORTHERN NEVADA DENTAL HEALTH PROGRAM: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
NORTHERN NEVADA DENTAL HEALTH PROGRAM (EIN 88-0411192)
Tax period
2021-07-01 to 2022-06-30
Filed
2023-05-15
IRS object ID
202321359349319692
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)
Return2023-05-15T15:59:21-04:00ReturnTs
Tax Period End2022-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Connie Christiansen CPABusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO Box 33875AddressLine1Txt
CityRenoCityNm
State AbbreviationNVStateAbbreviationCd
ZIP89533ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN880411192EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NORTHERN NEVADA DENTAL HEALTH PROGRAMSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlNORTBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line15605 RIGGINS COURT STE 101AAddressLine1Txt
CityRenoCityNm
State AbbreviationNVStateAbbreviationCd
ZIP89502ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonGilbert TrujilloPersonNm
Person TitlePresidentPersonTitleTxt
Phone7753370296PhoneNum
Signature2023-05-15SignatureDt
Discuss With Paid PreparerfalseDiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstGilbertPersonFirstNm
Person LastTrujilloPersonLastNm

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonConnie ChristiansenPreparerPersonNm
PTINP00398106PTIN
Phone7754134084PhoneNum
Preparation2023-05-15PreparationDt
Self EmployedYes (X)SelfEmployedInd

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer0TrustedCustomerCd
OOB Security Verification11OOBSecurityVerificationCd
Authentication Assurance LevelAAL2AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerGILBERT A TRUJILLO DDSPrincipalOfficerNm
Gross Receipts$229,570GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.nndhp.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1998FormationYr
Legal Domicile StateNVLegalDomicileStateCd
Activity Or MissionTO PROVIDE NO-COST TO LOW-COST DENTAL CARE TO THE UNDERSERVED IN NORTHERN NEVADAActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee2TotalEmployeeCnt
Total Volunteers150TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$180,553PYContributionsGrantsAmt
CY Contributions Grants$187,450CYContributionsGrantsAmt
PY Program Service Revenue$13,340PYProgramServiceRevenueAmt
CY Program Service Revenue$4,775CYProgramServiceRevenueAmt
CY Investment Income$670CYInvestmentIncomeAmt
PY Other Revenue$7,284PYOtherRevenueAmt
CY Other Revenue$8,166CYOtherRevenueAmt
PY Total Revenue$201,177PYTotalRevenueAmt
CY Total Revenue$201,061CYTotalRevenueAmt
PY Grants And Similar Paid$7,500PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$6,438PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$33,108CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$3,639CYTotalFundraisingExpenseAmt
PY Other Expenses$63,246PYOtherExpensesAmt
CY Other Expenses$49,991CYOtherExpensesAmt
PY Total Expenses$77,184PYTotalExpensesAmt
CY Total Expenses$83,099CYTotalExpensesAmt
PY Revenues Less Expenses$123,993PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$117,962CYRevenuesLessExpensesAmt
Total Assets BOY$328,321TotalAssetsBOYAmt
Total Assets EOY$292,404TotalAssetsEOYAmt
Total Liabilities BOY$151,815TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$176,506NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$292,404NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE NO-COST TO LOW-COST DENTAL CARE TO THE UNDERSERVED IN NORTHERN NEVADAMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$56,790ExpenseAmt
DescTHE ORGANIZATION CONSISTS OF HUNDREDS OF VOLUNTEERS, INCLUDING DENTISTS, HYGIENISTS, AND ORAL HEALTH SPECIALISTS, WHO GENEROUSLY DONATE THEIR TIME AND SERVICES TO PROVIDE PRO-BONO DENTAL CARE TO CHILDREN IN NEED. THE ORGANIZATION IDENTIFIES AND ASSESSES EACH CASE, THEN COORDINATES SERVICES WITH ITS TEAM OF VOLUNTEERS. EACH YEAR, THE ORGANIZATION HOLDS GIVE KIDS A SMILE EVENTS THAT PROVIDES FREE EDUCATIONAL, PREVENTATIVE, AND RESTORATIVE SERVICES FOR AT-RISK AND UNDERSERVED CHILDREN. THROUGH HEALTHY SMILE HEALTHY CHILD (HSHC), A PROGRAM OF THE NORTHERN NEVADA DENTAL HEALTH PROGRAMS, TEAMS ALSO VISIT SCHOOLS TO PROVIDE FREE DENTAL SCREENING, FLOURIDE VARNISH APPLICATIONS, ORAL HYGIENE, NUTRITION EDUCATION, AND DENTAL SEALANTS. HSHC ALSO PROVIDES HOSPITAL SCREENINGS AND PROVIDER PLACEMENT INCLUDED IN OUR PARTNERSHIP WITH RENOWN CHILDRENS HOSPITAL AND HOSPITAL SETTING DENTAL CARE FOR THOSE IN EXTREME NEED.Desc
Total Program Service Expenses$56,790TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
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
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document5IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee2EmployeeCnt
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 ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
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 Members8GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
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
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonLORI BENVINPersonNm
Phone7753370296PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15605 RIGGINS CT 101AAddressLine1Txt
CityRenoCityNm
State AbbreviationNVStateAbbreviationCd
ZIP89502ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
CHRIS GALEA DDS
DIRECTOR2.000.00Yes (X)$0$0$0
VICKIE COOPER
DIRECTOR2.000.00Yes (X)$0$0$0
JOSE CALDERON DDS
DIRECTOR2.000.00Yes (X)$0$0$0
WHITNEY GAROL DDS
DIRECTOR2.000.00Yes (X)$0$0$0
ROBERT BARONE
TREASURER3.000.00Yes (X)$0$0$0Yes (X)
DAVID RUSSELL
VICE PRESIDENT3.000.00Yes (X)$0$0$0Yes (X)
KATHY PEAK
SECRETARY3.000.00Yes (X)$0$0$0Yes (X)
GILBERT A TRUJILLO DDS
PRESIDENT4.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
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
Fundraising$56,350FundraisingAmt
All Other Contributions$131,100AllOtherContributionsAmt
Total Contributions$187,450TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPROGRAM COMMITMENT FEESDesc
Business621300BusinessCd
Total Revenue Column$4,775TotalRevenueColumnAmt
Related Or Exempt Func Income$4,775RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$4,775TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$670TotalRevenueColumnAmt
Exclusion$670ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$36,675FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$56,350ContriRptFundraisingEventAmt
Fundraising Direct Expenses$28,509FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,166TotalRevenueColumnAmt
Exclusion$8,166ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$201,061TotalRevenueColumnAmt
Related Or Exempt Func Income$4,775RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$8,836ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$30,837TotalAmt
Program Services$30,837ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,271TotalAmt
Program Services$2,271ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$14,000TotalAmt
Management And General$14,000ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$2,195TotalAmt
Management And General$2,195ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$11,259TotalAmt
Program Services$3,941ProgramServicesAmt
Management And General$5,629ManagementAndGeneralAmt
Fundraising$1,689FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$7,327TotalAmt
Program Services$7,327ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,287TotalAmt
Program Services$2,287ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtFundraisingFundraisingAmtManagement And GeneralManagementAndGeneralAmt
KIDS DENTAL PROGRAM$9,432$9,432
FUNDRAISING$1,950$1,950
TELEPHONE$1,391$695$696
OUTREACH$150$150

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$83,099TotalAmt
Program Services$56,790ProgramServicesAmt
Management And General$22,670ManagementAndGeneralAmt
Fundraising$3,639FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$319,713BOYAmt
EOY$93,798EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$148,606EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,100BOYAmt
EOY$50,000EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$7,508BOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$328,321BOYAmt
EOY$292,404EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,815BOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$150,000BOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$151,815BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$176,506BOYAmt
EOY$292,404EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$176,506BOYAmt
EOY$292,404EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$328,321BOYAmt
EOY$292,404EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$117,962ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$2,064NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
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$538,925CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$668,070CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$147,190CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$180,553CurrentTaxYearMinus1YearAmt
Current Tax Year$187,450CurrentTaxYearAmt
Total$1,722,188TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$538,925CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$668,070CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$147,190CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$180,553CurrentTaxYearMinus1YearAmt
Current Tax Year$187,450CurrentTaxYearAmt
Total$1,722,188TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$628,251SubstantialContributorsTotAmt
Public Support Total170$1,093,937PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$16CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14CurrentTaxYearMinus3YearsAmt
Current Tax Year$670CurrentTaxYearAmt
Total$700TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$2,709CurrentTaxYearMinus1YearAmt
Total$2,709TotalAmt
FieldValueIRS element (for citing)
Total Support$1,725,597TotalSupportAmt
Public Support CY1700.63390PublicSupportCY170Pct
Public Support PY1700.66940PublicSupportPY170Pct
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 G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GOLF TOURNAMEvent1Nm
Gross Receipts Event1$93,025GrossReceiptsEvent1Amt
Charitable Contri Event1$56,350CharitableContriEvent1Amt
Gross Revenue Event1$36,675GrossRevenueEvent1Amt
Rent Facility Costs Event1$28,509RentFacilityCostsEvent1Amt
Gross Receipts Total$93,025GrossReceiptsTotalAmt
Charitable Contributions Tot$56,350CharitableContributionsTotAmt
Gross Revenue Total Events$36,675GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$28,509RentFcltyCostsTotalEventsAmt
Direct Expense Summary Events$28,509DirectExpenseSummaryEventsAmt
Net Income Summary$8,166NetIncomeSummaryAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 governing body review Part VI line 11THE 990 IS PROVIDED TO THE GOVERNANCE ANNUALLY FOR REVIEW.
Other officer or key employee compensation Part VI line 15bTHE ORGANIZATION DOES NOT HAVE AN EXECUTIVE DIRECTOR OR MANAGEMENT PERSONNEL THAT ARE COMPENSATED BY THE ORGANIZATION.
Governing documents etc available to public Part VI line 19THE FORM 990 IS AVAILABLE UPON REQUEST OR ONLINE AT WWW.GUIDSTAR.ORG

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