CHURCH HEALTH SERVICES INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: CHURCH HEALTH SERVICES INC (EIN 39-1759669)
Tax period: 2022-01-01 to 2022-12-31
Filed: 2023-11-15
IRS object ID: 202343199349322154
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-11-15T15:45:13-06:00	ReturnTs
Tax Period End	2022-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	391742997	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	O'CONNOR WELLS & VANDER WERFF LLC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	111 E MAIN STREET	AddressLine1Txt
City	WAUPUN	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	53963	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	391759669	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CHURCH HEALTH SERVICES INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	CHUR	BusinessNameControlTxt
Phone	9208871766	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	115 N CENTER STREET	AddressLine1Txt
City	BEAVER DAM	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	53916	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	THEO O'CONNOR	PersonNm
Person Title	EXECUTIVE DIRECTOR	PersonTitleTxt
Phone	9208871766	PhoneNum
Signature	2023-11-15	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	THEO	PersonFirstNm
Person Last	OCONNOR	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	0	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	DIANE BANCROFT-DEYOUNG	PreparerPersonNm
PTIN	P00195537	PTIN
Phone	9203249711	PhoneNum
Preparation	2023-11-15	PreparationDt
Self Employed	Yes (X)	SelfEmployedInd

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd
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)
Principal Officer	STEVE VESSEY	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	115 N CENTER STREET	AddressLine1Txt
City	BEAVER DAM	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	53916	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$1,336,163	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.CHURCHCLINIC.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1993	FormationYr
Legal Domicile State	WI	LegalDomicileStateCd
Activity Or Mission	CHURCH HEALTH SERVICES IS A FAITH BASED HEALTH CARE ORGANIZATION THAT CONDUCTS PRIMARY, DENTAL AND MENTAL HEALTH CLINICS FOR THE POOR, UNINSURED OR UNDERINSURED.	ActivityOrMissionDesc
Voting Members Governing Body	10	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	33	TotalEmployeeCnt
Total Volunteers	22	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,505,881	PYContributionsGrantsAmt
CY Contributions Grants	$943,537	CYContributionsGrantsAmt
PY Program Service Revenue	$253,403	PYProgramServiceRevenueAmt
CY Program Service Revenue	$352,451	CYProgramServiceRevenueAmt
PY Investment Income	$218	PYInvestmentIncomeAmt
CY Investment Income	$8,919	CYInvestmentIncomeAmt
PY Other Revenue	-$4,404	PYOtherRevenueAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$1,755,098	PYTotalRevenueAmt
CY Total Revenue	$1,304,907	CYTotalRevenueAmt
PY Grants And Similar Paid	$137,814	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$601,162	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$924,686	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$85,762	CYTotalFundraisingExpenseAmt
PY Other Expenses	$151,326	PYOtherExpensesAmt
CY Other Expenses	$160,656	CYOtherExpensesAmt
PY Total Expenses	$890,302	PYTotalExpensesAmt
CY Total Expenses	$1,085,342	CYTotalExpensesAmt
PY Revenues Less Expenses	$864,796	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$219,565	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,483,035	TotalAssetsBOYAmt
Total Assets EOY	$1,680,519	TotalAssetsEOYAmt
Total Liabilities BOY	$20,710	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$148,671	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$1,462,325	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$1,531,848	NetAssetsOrFundBalancesEOYAmt
Mission	CHURCH HEALTH SERVICES IS A FAITH BASED HEALTH CARE ORGANIZATION THAT CONDUCTS PRIMARY, DENTAL AND MENTAL HEALTH CLINICS FOR THE POOR, UNINSURED OR UNDERINSURED.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$800,747	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$361,370	RevenueAmt
Desc	CHURCH HEALTH SERVICES IS A FAITH BASED HEALTH CARE ORGANIZATION THAT CONDUCTS PRIMARY, DENTAL AND MENTAL HEALTH CLINICS FOR THE POOR, UNINSURED OR UNDERINSURED.	Desc
Total Program Service Expenses	$800,747	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	0	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (1)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	0	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	2	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	33	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Form8899 Filedind	0	Form8899Filedind
Form1098 C Filed	0	Form1098CFiledInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	10	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	0	RegularMonitoringEnfrcInd
Whistleblower Policy	0	WhistleblowerPolicyInd
Document Retention Policy	0	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	WI	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	THEA O'CONNOR	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	9208871766	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	115 N CENTER STREET	AddressLine1Txt
City	BEAVER DAM	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	53916	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd
THEA O'CONNOR
EXECUTIVE DIRECTOR	35.00	Yes (X)	$80,000	$0	$5,266
STEVE VESSEY
PRESIDENT/BOARD MEMBER	1.00	Yes (X)	$0	$0	$0	Yes (X)
MARY VOGL-RAUSCHER
VICE PRESIDENT/BOARD MEMBE	1.00	Yes (X)	$0	$0	$0	Yes (X)
RICH ZIEMAN
TREASURER/BOARD MEMBER	1.00	Yes (X)	$0	$0	$0	Yes (X)
RICK VANT HOFF
SECRETARY/BOARD MEMBER	1.00	Yes (X)	$0	$0	$0	Yes (X)
JENNIFER CAMPBELL
BOARD MEMBER	1.00	Yes (X)	$0	$0	$0
KAREN COLEY
BOARD MEMBER	1.00	Yes (X)	$0	$0	$0
HEIDI WEISS
BOARD MEMBER	1.00	Yes (X)	$0	$0	$0
TOM HEFFRON
BOARD MEMBER	1.00	Yes (X)	$0	$0	$0
CATHY NELSON
BOARD MEMBER	1.00	Yes (X)	$0	$0	$0
JIM HANKES
BOARD MEMBER	1.00	Yes (X)	$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$80,000	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$5,266	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	0	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
Fundraising	$6,789	FundraisingAmt
Government Grants	$57,000	GovernmentGrantsAmt
All Other Contributions	$879,748	AllOtherContributionsAmt
Noncash Contributions	$13,950	NoncashContributionsAmt
Total Contributions	$943,537	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	PROGRAM REVENUES	Desc
Business	624100	BusinessCd
Total Revenue Column	$352,451	TotalRevenueColumnAmt
Related Or Exempt Func Income	$352,451	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$352,451	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$165	TotalRevenueColumnAmt
Related Or Exempt Func Income	$165	RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$40,010	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$31,256	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$8,754	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$8,754	TotalRevenueColumnAmt
Related Or Exempt Func Income	$8,754	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$6,789	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,304,907	TotalRevenueColumnAmt
Related Or Exempt Func Income	$361,370	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$80,000	TotalAmt
Program Services	$12,000	ProgramServicesAmt
Management And General	$40,000	ManagementAndGeneralAmt
Fundraising	$28,000	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$745,418	TotalAmt
Program Services	$651,748	ProgramServicesAmt
Management And General	$52,063	ManagementAndGeneralAmt
Fundraising	$41,607	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$9,611	TotalAmt
Program Services	$4,925	ProgramServicesAmt
Management And General	$2,616	ManagementAndGeneralAmt
Fundraising	$2,070	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$24,876	TotalAmt
Program Services	$822	ProgramServicesAmt
Management And General	$15,324	ManagementAndGeneralAmt
Fundraising	$8,730	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$64,781	TotalAmt
Program Services	$52,367	ProgramServicesAmt
Management And General	$7,059	ManagementAndGeneralAmt
Fundraising	$5,355	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$75	TotalAmt
Management And General	$75	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$11,203	TotalAmt
Management And General	$11,203	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$3,724	TotalAmt
Program Services	$3,724	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$11,699	TotalAmt
Program Services	$4,486	ProgramServicesAmt
Management And General	$7,213	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$44,439	TotalAmt
Program Services	$22,219	ProgramServicesAmt
Management And General	$22,220	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$21,239	TotalAmt
Program Services	$5,441	ProgramServicesAmt
Management And General	$15,798	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$1,715	TotalAmt
Management And General	$1,715	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$5,190	TotalAmt
Program Services	$5,190	ProgramServicesAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$4,829	TotalAmt
Program Services	$2,415	ProgramServicesAmt
Management And General	$2,414	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$20,761	TotalAmt
Program Services	$13,621	ProgramServicesAmt
Management And General	$7,140	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$10,470	TotalAmt
Management And General	$10,470	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES/SERVIC	$19,662	$19,662
MISCELLANEOUS EXPENSE	$3,477	$2,127	$1,350
PRINTING, PUBLICATIONS,	$2,173		$2,173

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,085,342	TotalAmt
Program Services	$800,747	ProgramServicesAmt
Management And General	$198,833	ManagementAndGeneralAmt
Fundraising	$85,762	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$62,225	BOYAmt
EOY	$566,603	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$15,397	BOYAmt
EOY	$516	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,750	BOYAmt
EOY	$4,000	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$95,200	BOYAmt
EOY	$25,166	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$782,930	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$294,423	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$509,268	BOYAmt
EOY	$488,507	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$34,646	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$764,549	BOYAmt
EOY	$595,727	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,483,035	BOYAmt
EOY	$1,680,519	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$20,710	BOYAmt
EOY	$63,671	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
EOY	$85,000	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$20,710	BOYAmt
EOY	$148,671	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	$1,424,910	BOYAmt
EOY	$993,348	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$37,415	BOYAmt
EOY	$538,500	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,462,325	BOYAmt
EOY	$1,531,848	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,483,035	BOYAmt
EOY	$1,680,519	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$219,565	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$16,219	NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts	$600,857	DonatedServicesAndUseFcltsAmt
Other Changes In Net Assets	-$734,680	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	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 (1)	AuditCommitteeInd
Federal Grant Audit Required	0	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	$628,068	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$533,038	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$610,066	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$849,155	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,295,988	CurrentTaxYearAmt
Total	$3,916,315	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$628,068	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$533,038	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$610,066	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$849,155	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,295,988	CurrentTaxYearAmt
Total	$3,916,315	TotalAmt

Field	Value	IRS element (for citing)
Substantial Contributors Tot	$516,588	SubstantialContributorsTotAmt
Public Support Total170	$3,399,727	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$381	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$447	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$273	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$215	CurrentTaxYearMinus1YearAmt
Current Tax Year	$165	CurrentTaxYearAmt
Total	$1,481	TotalAmt

Other Income170 OtherIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	-$146	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	-$17	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	-$46	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$3	CurrentTaxYearMinus1YearAmt
Current Tax Year	$8,754	CurrentTaxYearAmt
Total	$8,548	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$3,926,344	TotalSupportAmt
Public Support CY170	0.86590	PublicSupportCY170Pct
Public Support PY170	0.94310	PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170	Yes (X)	ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME:	FormAndLineReferenceDesc
Explanation	LOSS ON SALE OF SECURITIES - 2018 AMOUNT: $ -146. 2019 AMOUNT: $ -17. 2020 AMOUNT: $ -46. GAIN ON SALE OF SECURITIES - 2021 AMOUNT: $ 3. 2022 AMOUNT: $ 8,754.	ExplanationTxt

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

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$764,549	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$125,997	InvestmentEarningsOrLossesAmt
Other Expenditures	$35,000	OtherExpendituresAmt
Administrative Expenses	$7,825	AdministrativeExpensesAmt
End Year Balance	$595,727	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$36,682	BeginningYearBalanceAmt
Contributions	$705,000	ContributionsAmt
Investment Earnings Or Losses	-$756	InvestmentEarningsOrLossesAmt
Administrative Expenses	$5,704	AdministrativeExpensesAmt
End Year Balance	$764,549	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$0	BeginningYearBalanceAmt
Contributions	$32,500	ContributionsAmt
Investment Earnings Or Losses	$4,587	InvestmentEarningsOrLossesAmt
Administrative Expenses	$405	AdministrativeExpensesAmt
End Year Balance	$36,682	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	1.00000	BoardDesignatedBalanceEOYPct
Endowments Held Unrelated Org	Yes (1)	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$15,000	InvestmentCostOrOtherBasisAmt
Book Value	$15,000	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$628,569	InvestmentCostOrOtherBasisAmt
Depreciation	$161,449	DepreciationAmt
Book Value	$467,120	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$139,361	InvestmentCostOrOtherBasisAmt
Depreciation	$132,974	DepreciationAmt
Book Value	$6,387	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$488,507	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

Field	Value	IRS element (for citing)
Desc	BENEFICIAL INTEREST IN FUNDS HELD BY COMMUNITY FOUNDATION	Desc
Book Value	$595,727	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$595,727	TotalBookValueOtherAssetsAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$1,755,722	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	-$16,219	NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts	$600,857	DonatedServicesAndUseFcltsAmt
Other Revenue	-$133,823	OtherRevenueAmt
Revenue Not Reported	$450,815	RevenueNotReportedAmt
Revenue Subtotal	$1,304,907	RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt	$0	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$1,304,907	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$1,686,199	TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts	$600,857	DonatedServicesUseFcltsAmt
Expenses Not Reported	$600,857	ExpensesNotReportedAmt
Expenses Subtotal	$1,085,342	ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt	$0	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$1,085,342	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, LINE 4:	THE FUNDS ARE ESTABLISHED FOR THE THE PURPOSE OF SUPPORTING THE ORGANIZATION AS DEEMED NECESSARY ACCORDING TO THE SPENDING POLICY.
PART X, LINE 2:	THE ORGANIZATION IS A NON-PROFIT CORPORATION THAT IS TAX-EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, EXCEPT TO THE EXTENT OF UNRELATED BUSINESS INCOME, IF ANY. THE ORGANIZATION HAD NO UNRELATED BUSINESS INCOME FOR THE YEARS ENDED DECEMBER 31, 2022 AND 2021. MANAGEMENT IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE THE ORGANIZATION'S TAX-EXEMPT STATUS. THE ORGANIZATION IS NOT AWARE OF ANY TAX POSITIONS IT HAS TAKEN THAT ARE SUBJECT TO A SIGNIFICANT DEGREE OF UNCERTAINTY.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	CHANGE IN BENEFICIAL INTEREST IN FUNDS HELD BY COMMUNITY FOUNDATION -133,823.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 IS REVIEWED AND SIGNED BY AN OFFICER AND EXECUTIVE DIRECTOR PRIOR TO ELECTONIC FILING. THE FORM 990 IS AVAILABLE FOR REVIEW BY ALL BOARD MEMBERS AT THE NEXT MEETING.
FORM 990, PART VI, SECTION C, LINE 19	THE FINANCIAL DATA AND GOVERNING DOCUMENTS OF THE ORGANIZATION ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:	DONATED SERVICES EXPENSE -600,857. CHANGE IN VALUE - BENEFICIAL INTEREST IN FUNDS HELD BY COMMUNITY FOUNDATION -133,823.