FAYETTE CARE CLINIC INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- FAYETTE CARE CLINIC INC (EIN 20-0314897)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-07
- IRS object ID
- 202343129349300904
- Schema version
- 2022v5.0
- 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 | 2023-11-07T13:13:38-05:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 811336355 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Michelle L McGlaun CPA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1320 Lakehaven Pkwy | AddressLine1Txt |
| City | McDonough | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30253 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200314897 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Fayette CARE Clinic Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FAYE | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1260 Highway 54 West Ste 101 | AddressLine1Txt |
| City | Fayetteville | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30214 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Geneva Weaver | PersonNm |
| Person Title | Executive Direc | PersonTitleTxt |
| Phone | 7707194620 | PhoneNum |
| Signature | 2023-11-07 | SignatureDt |
| Discuss With Paid Preparer | false | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Geneva | PersonFirstNm |
| Person Last | Weaver | PersonLastNm |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Michelle L McGlaun-Davidson | PreparerPersonNm |
| PTIN | P01273842 | PTIN |
| Phone | 7708550954 | PhoneNum |
| Preparation | 2023-11-07 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| OOB Security Verification | 00 | OOBSecurityVerificationCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $569,553 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.fayettecareclinic.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2003 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | To provide a medical home in Fayette County for lower-income, uninsured adults and caring for them always with Compassion and Respect for everyone. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 10 | TotalEmployeeCnt |
| Total Volunteers | 22 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $309,710 | PYContributionsGrantsAmt |
| CY Contributions Grants | $521,383 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $360 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $775 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $23,787 | PYOtherRevenueAmt |
| CY Other Revenue | $40,593 | CYOtherRevenueAmt |
| PY Total Revenue | $333,859 | PYTotalRevenueAmt |
| CY Total Revenue | $562,751 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $181,277 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $116,732 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $9,034 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $94,635 | PYOtherExpensesAmt |
| CY Other Expenses | $506,305 | CYOtherExpensesAmt |
| PY Total Expenses | $275,912 | PYTotalExpensesAmt |
| CY Total Expenses | $623,037 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $57,947 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$60,286 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $82,651 | TotalAssetsBOYAmt |
| Total Assets EOY | $15,250 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,000 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $998 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $77,651 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $14,252 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To provide a medical home in Fayette County for lower-income, uninsured adults and caring for them always with Compassion and Respect for everyone. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $584,318 | ExpenseAmt |
| Desc | Fayette C.A.R.E. Clinic provides free health care for uninsured residents of Fayette County ages 18+ that are 200% or below the Federal Poverty Level.Building on the values and vital health care services that Fayette C.A.R.E. Clinic has provided to our community since 2005, our current strategic plan is not only a continuation of our mission and work but includes a new vision.Vision: Exemplary state of health and well-being for all in the Fayette County community. Each of us must now work to make this vision of our Fayette County community being exemplary in its health and wellbeing for ALL to become a reality by making sure ALL have access to healthcare. Achieving our mission will fill the gap for health care for a population that would otherwise have none, and reaching our vision will depend on quality patient care, goals, outcomes, and tracking of outcomes. Our planning includes increasing not only patient access but the scope of services.Current Free Health Care Services: Primary care, dental, vision, cardiology, podiatry, gastroenterology, chiropractic, gynecology, physical therapy, mental health, non-narcotic prescription, dermatology, labs, and imaging. All patients that meet our eligibility criteria have access to all of these services free of charge. | Desc |
| Total Program Service Expenses | $584,318 | 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 | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | 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 | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | 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 | Yes (true) | 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 | Yes (true) | ScheduleORequiredInd |
| IRP Document | 1 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 10 | 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 |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | false | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | false | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Geneva Weaver | PersonNm |
| Phone | 7707194620 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1260 Highway 54 West Ste 101 | AddressLine1Txt |
| City | Fayetteville | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30214 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| Brian Woods | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Mark Skibiel | |||||||
| Director Board Dev | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Paige Muh | |||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Cynthia Gober | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Nimish Dhruva | |||||||
| Former Board Chair | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Mark Kearsley | |||||||
| Treasurer | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Daye Bexley | |||||||
| Board Vice Chair | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Gregory Alvarez | |||||||
| Board Chair | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Mary Pecoraro | |||||||
| Secretary | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| All Other Contributions | $521,383 | AllOtherContributionsAmt |
| Noncash Contributions | $413,593 | NoncashContributionsAmt |
| Total Contributions | $521,383 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Clinic Fees | Desc |
| Business | 621300 | BusinessCd |
| Total Revenue Column | $775 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $775 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $775 | TotalProgramServiceRevenueAmt |
| Fundraising Gross Income | $47,395 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $6,802 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $40,593 | TotalRevenueColumnAmt |
| Exclusion | $40,593 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $562,751 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $775 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $40,593 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,558 | TotalAmt |
| Program Services | $10,846 | ProgramServicesAmt |
| Management And General | $2,712 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,777 | TotalAmt |
| Program Services | $83,929 | ProgramServicesAmt |
| Management And General | $7,765 | ManagementAndGeneralAmt |
| Fundraising | $3,083 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,397 | TotalAmt |
| Program Services | $7,346 | ProgramServicesAmt |
| Management And General | $812 | ManagementAndGeneralAmt |
| Fundraising | $239 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,953 | TotalAmt |
| Program Services | $17,555 | ProgramServicesAmt |
| Management And General | $5,302 | ManagementAndGeneralAmt |
| Fundraising | $96 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,298 | TotalAmt |
| Program Services | $1,649 | ProgramServicesAmt |
| Management And General | $1,649 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,038 | TotalAmt |
| Program Services | $27,231 | ProgramServicesAmt |
| Management And General | $6,807 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,810 | TotalAmt |
| Program Services | $2,810 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,476 | TotalAmt |
| Program Services | $6,190 | ProgramServicesAmt |
| Management And General | $936 | ManagementAndGeneralAmt |
| Fundraising | $350 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Medical and dental supplies | $418,203 | $418,203 | ||
| Dues and memberships | $325 | $325 | ||
| Telephone & communication | $7,183 | $5,713 | $668 | $802 |
| Repairs & maintenance | $1,773 | $1,454 | $319 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,246 | TotalAmt |
| Program Services | $1,392 | ProgramServicesAmt |
| Management And General | $2,390 | ManagementAndGeneralAmt |
| Fundraising | $4,464 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $623,037 | TotalAmt |
| Program Services | $584,318 | ProgramServicesAmt |
| Management And General | $29,685 | ManagementAndGeneralAmt |
| Fundraising | $9,034 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,571 | BOYAmt |
| EOY | $11,209 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,127 | BOYAmt |
| EOY | $898 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $115,973 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $112,830 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,953 | BOYAmt |
| EOY | $3,143 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82,651 | BOYAmt |
| EOY | $15,250 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,000 | BOYAmt |
| EOY | $998 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,000 | BOYAmt |
| EOY | $998 | 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 | $77,651 | BOYAmt |
| EOY | $14,252 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,651 | BOYAmt |
| EOY | $14,252 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82,651 | BOYAmt |
| EOY | $15,250 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$60,286 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$3,113 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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 | false | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $175,285 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $284,128 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $221,714 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $217,913 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $107,790 | CurrentTaxYearAmt |
| Total | $1,006,830 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $59,302 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $42,829 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $454,596 | CurrentTaxYearAmt |
| Total | $556,727 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $175,285 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $343,430 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $264,543 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $217,913 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $562,386 | CurrentTaxYearAmt |
| Total | $1,563,557 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $27,750 | SubstantialContributorsTotAmt |
| Public Support Total170 | $1,535,807 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2 | CurrentTaxYearMinus1YearAmt |
| Total | $11 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $103,622 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $89,380 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $41,546 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $23,788 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $40,593 | CurrentTaxYearAmt |
| Total | $298,929 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $1,862,497 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $3,470 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.82460 | PublicSupportCY170Pct |
| Public Support PY170 | 0.68710 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $93,931 | OtherCostOrOtherBasisAmt |
| Depreciation | $90,788 | DepreciationAmt |
| Book Value | $3,143 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,042 | OtherCostOrOtherBasisAmt |
| Depreciation | $22,042 | DepreciationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,143 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $2,792,474 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $2,229,723 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $2,229,723 | RevenueNotReportedAmt |
| Revenue Subtotal | $562,751 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $562,751 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,852,760 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $2,229,723 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $2,229,723 | ExpensesNotReportedAmt |
| Expenses Subtotal | $623,037 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $623,037 | TotalExpensesPerForm990Amt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Golf & Gala | Event1Nm |
| Gross Receipts Event1 | $47,395 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $47,395 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $4,182 | RentFacilityCostsEvent1Amt |
| Other Direct Expenses Event1 | $2,620 | OtherDirectExpensesEvent1Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Total | $47,395 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $47,395 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $4,182 | RentFcltyCostsTotalEventsAmt |
| Oth Direct Expnss Total Events | $2,620 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $6,802 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $40,593 | NetIncomeSummaryAmt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 60 | ContributionCnt |
| Noncash Contributions Rpt F990 | $413,593 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990 governing body review Part VI line 11 | A copy of the Form 990 is available for review by each Board Member. |
| CEO executive director top management comp Part VI line 15a | Compensation of the Executive Director is determined by the Executive Committee of the Board of Directors, reference is made to compensation paid by comparable organizations, but limited by budget restraints. |
| Form 990 availability to public Part VI line 18 | The Form 990 is available upon request and is publised on guidestar.com. |
| Governing documents etc available to public Part VI line 19 | Documents are available upon request. |