K9S 4 MOBILITY: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
K9S 4 MOBILITY (EIN 45-4748121)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-11-15
IRS object ID
202343199349325839
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

FieldValueIRS element (for citing)
Return2023-11-15T17:43:06-06:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN830331229PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MCGEE HEARNE & PAIZ LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1088AddressLine1Txt
CityCHEYENNECityNm
State AbbreviationWYStateAbbreviationCd
ZIP82003ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN454748121EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1K9'S 4 MOBILITY INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlK9S4BusinessNameControlTxt
Phone3072229597PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line111805 CAMPSTOOL ROADAddressLine1Txt
CityCHEYENNECityNm
State AbbreviationWYStateAbbreviationCd
ZIP82007ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHELLE WOERNERPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone3072229597PhoneNum
Signature2023-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMICHELLEPersonFirstNm
Person LastWOERNERPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRANDY MARROUPreparerPersonNm
PTINP01204639PTIN
Phone3076342151PhoneNum
Preparation2023-11-15PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMICHELLE WOERNERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line111805 CAMPSTOOL ROADAddressLine1Txt
CityCHEYENNECityNm
State AbbreviationWYStateAbbreviationCd
ZIP82007ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$300,578GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.K9S4MOBILITY.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2012FormationYr
Legal Domicile StateWYLegalDomicileStateCd
Activity Or MissionK9S 4 MOBILITY, INC. IS DEDICATED TO ENRICHING THE LIVES OF OTHERS THROUGH THE TRAINING, PLACEMENT AND SUPPORT OF ASSISTANCE DOG PARTNERSHIPS BY ENHANCING MOBILITY, INCREASING INDEPENDENCE AND CONFIDENCE, AND PROVIDING DEVOTED COMPANIONSHIP. K9S 4 MOBILITY, INC. PLACES FOUR TO SIX ASSISTANCE DOG TEAMS PER YEAR, AND AIMS TO INCREASE ASSISTANCE DOG TEAM PLACEMENTS.K9S 4 MOBILITY, INC. HAS ALSO ESTABLISHED AN OWNER-TRAINED ASSISTANCE DOG TRAINING PROGRAM THAT IS OFFERED TO THOSE WISHING TO TRAIN THEIR OWN ASSISTANCE DOG UNDER THE SUPERVISION OF A CERTIFIED ASSISTANCE DOG TRAINER. ONCE ACCEPTED INTO THE OWNER-TRAINED PROGRAM, THE PERSON MUST BE WILLING TO TRAVEL TO K9S 4 MOBILITY'S TRAINING FACILITY MULTIPLE TIMES BEFORE CERTIFICATION OF THE TEAM.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee8TotalEmployeeCnt
Total Volunteers20TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$325,414PYContributionsGrantsAmt
CY Contributions Grants$160,471CYContributionsGrantsAmt
PY Program Service Revenue$10,287PYProgramServiceRevenueAmt
CY Program Service Revenue$23,796CYProgramServiceRevenueAmt
PY Investment Income$35,609PYInvestmentIncomeAmt
CY Investment Income$10,436CYInvestmentIncomeAmt
PY Other Revenue$17,472PYOtherRevenueAmt
CY Other Revenue-$760CYOtherRevenueAmt
PY Total Revenue$388,782PYTotalRevenueAmt
CY Total Revenue$193,943CYTotalRevenueAmt
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$88,172PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$107,203CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$7,271CYTotalFundraisingExpenseAmt
PY Other Expenses$99,435PYOtherExpensesAmt
CY Other Expenses$105,589CYOtherExpensesAmt
PY Total Expenses$187,607PYTotalExpensesAmt
CY Total Expenses$212,792CYTotalExpensesAmt
PY Revenues Less Expenses$201,175PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$18,849CYRevenuesLessExpensesAmt
Total Assets BOY$938,595TotalAssetsBOYAmt
Total Assets EOY$827,651TotalAssetsEOYAmt
Total Liabilities BOY$2,755TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,318TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$935,840NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$823,333NetAssetsOrFundBalancesEOYAmt
MissionK9S 4 MOBILITY, INC. IS DEDICATED TO ENRICHING THE LIVES OF OTHERS THROUGH THE TRAINING, PLACEMENT AND SUPPORT OF ASSISTANCE DOG PARTNERSHIPS BY ENHANCING MOBILITY, INCREASING INDEPENDENCE AND CONFIDENCE, AND PROVIDING DEVOTED COMPANIONSHIP.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$172,155ExpenseAmt
Revenue$23,796RevenueAmt
DescTRAIN AND PARTNER ASSISTANCE DOGS WITH PEOPLE WHO HAVE A DISABILITY.Desc
Total Program Service Expenses$172,155TotalProgramServiceExpensesAmt
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 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
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 Contri0DeductibleNonCashContriInd
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
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee8EmployeeCnt
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 Members8GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
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
Own WebsiteYes (X)OwnWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1EXECUTIVE DIRECTORBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3072229597PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line111805 CAMPSTOOL ROADAddressLine1Txt
CityCHEYENNECityNm
State AbbreviationWYStateAbbreviationCd
ZIP82007ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
CHRIS BASS
CHAIR2.00Yes (X)Yes (X)$0$0$0
DR TRACIE CALLER
VICE CHAIR2.00Yes (X)Yes (X)$0$0$0
HEATHER ROE DAY
SECRETARY2.00Yes (X)Yes (X)$0$0$0
DAWN CULPEPPER
TREASURER2.00Yes (X)Yes (X)$0$0$0
LAURIE FARKAS
BOARD MEMBER1.00Yes (X)$0$0$0
JOANNA VILOS
BOARD MEMBER1.00Yes (X)$0$0$0
DONNA KINCHELOE
BOARD MEMBER1.00Yes (X)$0$0$0
RIO SMITH
BOARD MEMBER1.00Yes (X)$0$0$0
MICHELLE WOERNER
EXECUTIVE DIRECTOR40.00Yes (X)$52,500$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$52,500TotalReportableCompFromOrgAmt
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
Fundraising$17,914FundraisingAmt
Government Grants$59,150GovernmentGrantsAmt
All Other Contributions$83,407AllOtherContributionsAmt
Noncash Contributions$7,584NoncashContributionsAmt
Total Contributions$160,471TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPROGRAM INCOMEDesc
Business900099BusinessCd
Total Revenue Column$23,796TotalRevenueColumnAmt
Related Or Exempt Func Income$23,796RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$23,796TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,510TotalRevenueColumnAmt
Exclusion$18,510ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$800RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$250RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$550RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$550TotalRevenueColumnAmt
Exclusion$550ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$90,000SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$98,074SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$8,074SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$8,074TotalRevenueColumnAmt
Exclusion-$8,074ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$7,001FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$17,914ContriRptFundraisingEventAmt
Fundraising Direct Expenses$8,311FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,310TotalRevenueColumnAmt
Exclusion-$1,310ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$193,943TotalRevenueColumnAmt
Related Or Exempt Func Income$23,796RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$9,676ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$52,500TotalAmt
Program Services$42,000ProgramServicesAmt
Management And General$5,250ManagementAndGeneralAmt
Fundraising$5,250FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$44,170TotalAmt
Program Services$43,731ProgramServicesAmt
Fundraising$439FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$10,533TotalAmt
Program Services$9,294ProgramServicesAmt
Management And General$622ManagementAndGeneralAmt
Fundraising$617FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$3,475TotalAmt
Management And General$3,475ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$4,945TotalAmt
Management And General$4,945ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$599TotalAmt
Fundraising$599FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,894TotalAmt
Management And General$2,894ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$6,476TotalAmt
Program Services$5,181ProgramServicesAmt
Management And General$1,295ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$90TotalAmt
Management And General$90ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$10,633TotalAmt
Program Services$9,681ProgramServicesAmt
Management And General$952ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$10,594TotalAmt
Program Services$9,535ProgramServicesAmt
Management And General$1,059ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
DOG SUPPLIES AND EQUIPM$18,481$18,481
VET CARE$14,635$14,635
COMPUTER & SOFTWARE EXP$7,317$7,317
UTITLITIES$6,581$5,923$658

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$18,869TotalAmt
Program Services$13,694ProgramServicesAmt
Management And General$4,809ManagementAndGeneralAmt
Fundraising$366FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$212,792TotalAmt
Program Services$172,155ProgramServicesAmt
Management And General$33,366ManagementAndGeneralAmt
Fundraising$7,271FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$225,160BOYAmt
EOY$190,138EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$76,822BOYAmt
EOY$25,118EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
EOY$9,521EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$200,640LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$61,510LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$136,406BOYAmt
EOY$139,130EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$500,207BOYAmt
EOY$463,744EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$938,595BOYAmt
EOY$827,651EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,755BOYAmt
EOY$4,318EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,755BOYAmt
EOY$4,318EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$935,840BOYAmt
EOY$808,333EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
EOY$15,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$935,840BOYAmt
EOY$823,333EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$938,595BOYAmt
EOY$827,651EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$18,849ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$93,658NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
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$128,022CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$177,791CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$78,476CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$325,414CurrentTaxYearMinus1YearAmt
Current Tax Year$160,471CurrentTaxYearAmt
Total$870,174TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$128,022CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$177,791CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$78,476CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$325,414CurrentTaxYearMinus1YearAmt
Current Tax Year$160,471CurrentTaxYearAmt
Total$870,174TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$104,520SubstantialContributorsTotAmt
Public Support Total170$765,654PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,687CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,847CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$13,010CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,783CurrentTaxYearMinus1YearAmt
Current Tax Year$19,310CurrentTaxYearAmt
Total$68,637TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$19,249CurrentTaxYearMinus3YearsAmt
Total$19,249TotalAmt
FieldValueIRS element (for citing)
Total Support$958,060TotalSupportAmt
Gross Receipts Rltd Activities$108,366GrossReceiptsRltdActivitiesAmt
Public Support CY1700.79920PublicSupportCY170Pct
Public Support PY1700.65430PublicSupportPY170Pct
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$500,207BeginningYearBalanceAmt
Investment Earnings Or Losses-$74,891InvestmentEarningsOrLossesAmt
Administrative Expenses$4,945AdministrativeExpensesAmt
End Year Balance$420,371EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$445,695BeginningYearBalanceAmt
Investment Earnings Or Losses$59,195InvestmentEarningsOrLossesAmt
Administrative Expenses$4,683AdministrativeExpensesAmt
End Year Balance$500,207EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$387,583BeginningYearBalanceAmt
Investment Earnings Or Losses$61,887InvestmentEarningsOrLossesAmt
Administrative Expenses$3,775AdministrativeExpensesAmt
End Year Balance$445,695EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1.00000BoardDesignatedBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$133,684OtherCostOrOtherBasisAmt
Depreciation$22,592DepreciationAmt
Book Value$111,092BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$19,668OtherCostOrOtherBasisAmt
Depreciation$6,668DepreciationAmt
Book Value$13,000BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$34,860OtherCostOrOtherBasisAmt
Depreciation$23,483DepreciationAmt
Book Value$11,377BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,428OtherCostOrOtherBasisAmt
Depreciation$8,767DepreciationAmt
Book Value$3,661BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$139,130TotalBookValueLandBuildingsAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1DERBY PARTYEvent1Nm
Gross Receipts Event1$16,117GrossReceiptsEvent1Amt
Charitable Contri Event1$11,116CharitableContriEvent1Amt
Gross Revenue Event1$5,001GrossRevenueEvent1Amt
Other Direct Expenses Event1$6,494OtherDirectExpensesEvent1Amt
Event2ALL JAZZED UPEvent2Nm
Gross Receipts Event2$8,798GrossReceiptsEvent2Amt
Charitable Contri Event2$6,798CharitableContriEvent2Amt
Gross Revenue Event2$2,000GrossRevenueEvent2Amt
Other Direct Expenses Event2$1,817OtherDirectExpensesEvent2Amt
Gross Receipts Total$24,915GrossReceiptsTotalAmt
Charitable Contributions Tot$17,914CharitableContributionsTotAmt
Gross Revenue Total Events$7,001GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$8,311OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$8,311DirectExpenseSummaryEventsAmt
Net Income Summary-$1,310NetIncomeSummaryAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11B990 IS PROVIDED TO THE BOARD PRIOR TO ITS FILING.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS SIGN A CONFLICT OF INTEREST POLICY ANNUALLY. COMPLIANCE WITH THE POLICY IS MONITORED BY THE BOARD OF DIRECTORS PRESIDENT AND EXECUTIVE DIRECTOR.
FORM 990, PART VI, SECTION B, LINE 15ATHE CEO'S PERFORMANCE AND ATTAINMENT OF PREVIOUSLY ESTABLISHED GOALS IS REVIEWED ANNUALLY BY THE BOARD OF DIRECTORS. THE RESULTS ARE THEN UTILIZED TO ESTABLISH THE EXECUTIVE DIRECTOR'S COMPENSATION FOR THE FOLLOWING YEAR.
FORM 990, PART VI, SECTION C, LINE 19ALL PUBLIC DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.

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