2023-11-15T16:48:36-06:00 2022-12-31 640575804 T E LOTT & COMPANY PA PO BOX 471 COLUMBUS MS 39703 990 2022-01-01 640926626 COLUMBUS-LOWNDES FREE MEDICAL CLINIC INC COLU 6622440044 PO BOX 661 COLUMBUS MS 39703 JOHN DAVIS VICE CHAIRMAN OF THE BOARD 6623863088 2023-11-15 1 JOHN DAVIS 999009999 0 ROBERT WHITAKER CPA P01707206 6623285387 2023-11-15 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z GOOD SAMARATIN MEDICAL CLINIC ALAN T WILLIAMS 687 GREENBRIAR COLUMBUS MS 39705 100004 0 X N/A X 2000 MS PROVIDE FREE MEDICAL PRIMARY HEALTHCARE FOR APPROXIMATELY 200 INDIGENT PATIENTS, PRIMARILY THROUGH VOLUNTEER HEALTHCARE PROFESSIONALS SERVING AT THE CLINIC'S LEASED FACILITIES. 13 13 2 0 0 0 107739 99525 30 25 120 454 0 0 107889 100004 3195 2692 0 0 70299 71807 0 0 4451 15717 18037 89211 92536 18678 7468 179686 183756 5820 2422 173866 181334 PROVIDE PRIMARY HEALTH CARE FOR APPROXIMATELY 200 INDIGENT PATIENTS, AS WELL AS PROVIDE PRESCRIPTION DRUGS OBTAINED PRIMARILY FROM THE MANUFACTURERS WITH PATIENT CARE PLANS, AND SECURED MAMMOGRAMS FOR FEMALE PATIENTS. 0 0 74012 2692 479 PROVIDE PRIMARY HEALTH CARE FOR APPROXIMATELY 200 INDIGENT PATIENTS, AS WELL AS PROVIDE PRESCRIPTION DRUGS OBTAINED PRIMARILY FROM THE MANUFACTURERS WITH PATIENT CARE PLANS, AND SECURED MAMMOGRAMS FOR FEMALE PATIENTS. 74012 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 1 0 MS X BILL WEST 6622440044 PO BOX 661 COLUMBUS MS 39703 ALAN T WILLIAMS CHAIRMAN BOARD OF DIRECT 0.00 X 0 0 0 JOHN DAVIS VICE-CHAIR BOARD OF DIRECT 0.00 X 0 0 0 RONNY ROBERTS SECRETARY BOARD OF DIRECTO 0.00 X 0 0 0 WILLIAM ROSENBLATT MEMBER, BOARD OF DIRECTORS 0.00 X 0 0 0 BILL WEST TREASURER, BOARD OF DIRECT 0.00 X 0 0 0 MAXINE GILMER MEMBER, BOARD OF DIRECTORS 0.00 X 0 0 0 JOHNNY JUDSON MEMBER, BOARD OF DIRECTORS 0.00 X 0 0 0 RICK GARNER MEMBER, BOARD OF DIRECTORS 0.00 X 0 0 0 ROBERT WHITE MEMBER, BOARD OF DIRECTORS 0.00 X 0 0 0 SAMMY SMITH MEMBER, BOARD OF DIRECTORS 0.00 X 0 0 0 RANDY BURRIS MEMBER, BOARD OF DIRECTORS 0.00 X 0 0 0 STEVE PORTER MEMBER, BOARD OF DIRECTORS 0.00 X 0 0 0 MARY ELLEN SUMRALL MEMBER, BOARD OF DIRECTORS 0.00 X 0 0 0 KATHERINE M TENTONI EXECUTIVE DIRECTOR 40.00 X 58003 0 0 58003 0 0 0 0 0 0 0 99525 99525 25 25 25 454 454 100004 479 0 0 2692 2692 56336 45069 8450 2817 750 599 113 38 9440 7552 1416 472 5281 4225 792 264 725 725 1933 1546 290 97 2432 1945 365 122 24 20 3 1 396 316 60 20 3327 2660 500 167 UTILITIES 9034 7227 1355 452 SUPPLIES 154 154 0 0 BANK CHARGES 12 7 4 1 92536 74012 14073 4451 10304 4766 166970 176974 45418 43402 2412 2016 179686 183756 5820 2422 5820 2422 X 173866 181334 173866 181334 179686 183756 7468 0 X 0 0 0 X 67312 94784 99609 107739 99525 468969 67312 94784 99609 107739 99525 468969 190769 278200 693 707 283 120 454 2257 30 25 55 471281 0.59030 0.60960 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2021 AMOUNT: $ 30. 2022 AMOUNT: $ 25. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 27031 25508 1523 18387 17894 493 2016 1 PRESCRIPTION DRUGS 200 2458 COST PRESCRIPTION DRUGS ARE PROVIDED DIRECTLY TO THE PATIENTS AT NO COST MAMMOGRAMS AND OTHER SERVICES 2 234 COST MAMMOGRAMS AND OTHER SERVICES ARE PROVIDED AT NO COST TO PATIENTS PART I, LINE 2: GRANTS PAID INCLUDE DIAGNOSTIC SERVICES (PRIMARILY MAMMOGRAMS) AND PRESCRIPTION MEDICATIONS MADE AVAILABLE TO SPECIFIC INDIGENT PATIENTS BY ORDERS OF LICENSED MEDICAL PROFESSIONALS FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CHAIRMAN OF THE BOARD OF DIRECTORS, THE EXECUTIVE DIRECTOR AND THE TREASURER, BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 15 THE ENTIRE BOARD OF DIRECTORS MEETS AT LEAST QUARTERLY TO DETERMINE COMPENSATION FOR THE EXECUTIVE DIRECTOR INCLUDING SALARY AND FRINGE BENEFITS FORM 990, PART VI, SECTION C, LINE 18 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC DURING THE TAX YEAR BY WAY OF RECORDS FILED WITH THE MS SECRETARY OF STATE AND IRS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC DURING THE TAX YEAR BY WAY OF RECORDS FILED WITH THE MS SECRETARY OF STATE AND IRS. FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC ALAN T. WILLIAMS - 4007 SOUTHERLAND DRIVE, OXFORD, MS 38655. JOHN DAVIS - P.O. BOX 631, COLUMBUS, MS 39703. RONNY ROBERTS - P.O. BOX 1366, COLUMBUS, MS 39703. WILLIAM ROSENBLATT - 551 TIMBER CREEK DRIVE, COLUMBUS, MS 39702. BILL WEST - P. O. BOX 173, COLUMBUS, MS 39703. MAXINE GILMER - 438 CHEROKEE ROAD, COLUMBUS, MS 39705. JOHNNY JUDSON - 3410 CAMELIA CIRCLE, COLUMBUS, MS 39703. RICK GARNER - 311 GREENBRIAR DRIVE, COLUMBUS, MS 39705. ROBERT WHITE - 2219 5TH STREET NORTH, COLUMBUS, MS 39705. SAMMY SMITH - 2640 JESS LYONS , COLUMBUS, MS 39705. RANDY BURRIS - 128 WOODRIDGE PLACE, COLUMBUS, MS 39702. KATHERINE M. TENTONI - 82 NOTTINGHAM LANE, COLUMBUS, MS 39705. STEVE PORTER - 2900 BLUECUTT ROAD #2, COLUMBUS, MS 39705. MARY ELLEN SUMRALL - 1184 JOLLY ROAD, COLUMBUS, MS 39705.