HOSPICE HOUSE AND SUPPORT CARE OF WILLIAMSBURG INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: HOSPICE HOUSE AND SUPPORT CARE OF WILLIAMSBURG INC (EIN 52-1289657)
Tax period: 2020-07-01 to 2021-06-30
Filed: 2022-02-16
IRS object ID: 202210479349300831
Schema version: 2020v4.2
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule G
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-02-16T11:18:21-06:00	ReturnTs
Tax Period End	2021-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	453936274	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BETH MOORE & ASSOCIATES CPAS	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 120547	AddressLine1Txt
City	NEWPORT NEWS	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	23612	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2020-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	521289657	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	HOSPICE SUPPORT CARE OF	BusinessNameLine1Txt
Business Name Line2	WILLIAMSBURG INC	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	HOSP	BusinessNameControlTxt
Phone	7572531220	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4445 POWHATAN PARKWAY	AddressLine1Txt
City	WILLIAMSBURG	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	23188	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	SCOTT STABLER	PersonNm
Person Title	PRESIDENT	PersonTitleTxt
Phone	7572531220	PhoneNum
Signature	2022-02-12	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	SCOTT	PersonFirstNm
Person Last	STABLER	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	LISA CANDELLA CPA	PreparerPersonNm
PTIN	P01695830	PTIN
Phone	7572241174	PhoneNum
Preparation	2022-02-07	PreparationDt

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	2020	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	HOSPICE HOUSE & SUPPORT CARE OF	BusinessNameLine1Txt
Business Name Line2	WILLIAMSBURG	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Principal Officer	BRANDON RANDALL	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4445 POWHATAN PARKWAY	AddressLine1Txt
City	WILLIAMSBURG	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	23188	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$1,935,726	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.WILLIAMSBURGHOSPICE.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1982	FormationYr
Legal Domicile State	VA	LegalDomicileStateCd
Activity Or Mission	TO ENHANCE THE QUALITY OF LIVING FOR INDIVIDUALS FACING THE LAST PHASES OF LIFE AND TO SUPPORT THE PEOPLE THEY LOVE.	ActivityOrMissionDesc
Voting Members Governing Body	21	VotingMembersGoverningBodyCnt
Voting Members Independent	21	VotingMembersIndependentCnt
Total Employee	24	TotalEmployeeCnt
Total Volunteers	200	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$896,613	PYContributionsGrantsAmt
CY Contributions Grants	$1,618,912	CYContributionsGrantsAmt
PY Program Service Revenue	$0	PYProgramServiceRevenueAmt
CY Program Service Revenue	$0	CYProgramServiceRevenueAmt
PY Investment Income	$22,427	PYInvestmentIncomeAmt
CY Investment Income	$142,659	CYInvestmentIncomeAmt
PY Other Revenue	$160,311	PYOtherRevenueAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$1,079,351	PYTotalRevenueAmt
CY Total Revenue	$1,761,571	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	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	$754,942	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$680,910	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$34,645	CYTotalFundraisingExpenseAmt
PY Other Expenses	$233,039	PYOtherExpensesAmt
CY Other Expenses	$212,646	CYOtherExpensesAmt
PY Total Expenses	$987,981	PYTotalExpensesAmt
CY Total Expenses	$893,556	CYTotalExpensesAmt
PY Revenues Less Expenses	$91,370	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$868,015	CYRevenuesLessExpensesAmt
Total Assets BOY	$3,475,877	TotalAssetsBOYAmt
Total Assets EOY	$4,617,591	TotalAssetsEOYAmt
Total Liabilities BOY	$171,237	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$23,029	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$3,304,640	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$4,594,562	NetAssetsOrFundBalancesEOYAmt
Mission	TO ENHANCE THE QUALITY OF LIVING FOR INDIVIDUALS FACING THE LAST PHASES OF LIFE AND TO SUPPORT THE PEOPLE THEY LOVE.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$754,822	ExpenseAmt
Desc	PROVIDED HOSPICE AND OTHER SUPPORT SERVICES TO TERMINALLY ILL PATIENTS AND THEIR FAMILY MEMBERS AND OTHER BEREAVED MEMBERS OF THE COMMUNITY.	Desc
Total Program Service Expenses	$754,822	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	0	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	Yes (1)	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	6	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	24	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
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	21	GoverningBodyVotingMembersCnt
Independent Voting Member	21	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	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	VA	StatesWhereCopyOfReturnIsFldCd
Other Website	Yes (X)	OtherWebsiteInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	AUDREY SMITH	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	7572531220	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4445 POWHATAN PARKWAY	AddressLine1Txt
City	WILLIAMSBURG	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	23188	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt
JAMES E LESNICK
IMMEDIATE PAST CHAIR	1.00	Yes (X)	Yes (X)	$0	$0	$0
SCOTT STABLER
PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
JOHN R MILLER
MEDICAL DIRECTOR	1.00	Yes (X)	Yes (X)	$0	$0	$0
ROBERT C CANFIELD
TREASURER	1.00	Yes (X)	Yes (X)	$0	$0	$0
REBECCA AUSTIN
DIRECTOR	1.00	Yes (X)		$0	$0	$0
JAYNE BARNARD
DIRECTOR	1.00	Yes (X)		$0	$0	$0
DANIEL L CARLILE
DIRECTOR	1.00	Yes (X)		$0	$0	$0
BUDDY LEAGUE
DIRECTOR	1.00	Yes (X)		$0	$0	$0
JILL NAGEL MD
DIRECTOR	1.00	Yes (X)		$0	$0	$0
SHERRI NELSON
DIRECTOR	1.00	Yes (X)		$0	$0	$0
ELIZABETH WHITE
VICE PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
LARRY PULLEY
DIRECTOR	1.00	Yes (X)		$0	$0	$0
BRANDON RANDALL
EXECUTIVE DIRECTOR	40.00	Yes (X)		$0	$0	$0
TRACEY SHACKELFORD
DIRECTOR	1.00	Yes (X)		$0	$0	$0
JENNIFER SHINN
DIRECTOR	1.00	Yes (X)		$0	$0	$0
BRETT K SMITH
DIRECTOR	1.00	Yes (X)		$0	$0	$0
GREGORY T STORER
DIRECTOR	1.00	Yes (X)		$0	$0	$0
TERESA SWEANEY
DIRECTOR	1.00	Yes (X)		$0	$0	$0
SCOTT WISE
DIRECTOR	1.00	Yes (X)		$0	$0	$0
AUDREY SMITH
FORMER EXECUTIVE DIRECTOR	40.00	Yes (X)		$92,685	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$92,685	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$0	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
Federated Campaigns	$27,672	FederatedCampaignsAmt
Fundraising	$70,746	FundraisingAmt
Government Grants	$297,907	GovernmentGrantsAmt
All Other Contributions	$1,222,587	AllOtherContributionsAmt
Total Contributions	$1,618,912	TotalContributionsAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$134,075	TotalRevenueColumnAmt
Exclusion	$134,075	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$175,880	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$167,296	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$8,584	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$8,584	TotalRevenueColumnAmt
Exclusion	$8,584	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$6,859	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$70,746	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$6,859	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	$1,761,571	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$142,659	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$92,685	TotalAmt
Program Services	$68,937	ProgramServicesAmt
Management And General	$20,300	ManagementAndGeneralAmt
Fundraising	$3,448	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$524,715	TotalAmt
Program Services	$507,690	ProgramServicesAmt
Management And General	$10,379	ManagementAndGeneralAmt
Fundraising	$6,646	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$5,429	TotalAmt
Program Services	$5,084	ProgramServicesAmt
Management And General	$258	ManagementAndGeneralAmt
Fundraising	$87	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$10,376	TotalAmt
Program Services	$9,716	ProgramServicesAmt
Management And General	$493	ManagementAndGeneralAmt
Fundraising	$167	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$47,705	TotalAmt
Program Services	$46,158	ProgramServicesAmt
Management And General	$943	ManagementAndGeneralAmt
Fundraising	$604	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$3,600	TotalAmt
Management And General	$3,600	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$15,145	TotalAmt
Program Services	$7,800	ProgramServicesAmt
Management And General	$7,345	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$7,869	TotalAmt
Management And General	$7,869	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$20,608	TotalAmt
Program Services	$4,425	ProgramServicesAmt
Fundraising	$16,183	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$16,222	TotalAmt
Program Services	$1,204	ProgramServicesAmt
Management And General	$8,013	ManagementAndGeneralAmt
Fundraising	$7,005	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$27,195	TotalAmt
Program Services	$20,333	ProgramServicesAmt
Management And General	$6,862	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$43,417	TotalAmt
Program Services	$37,293	ProgramServicesAmt
Management And General	$6,124	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$35,479	TotalAmt
Program Services	$26,969	ProgramServicesAmt
Management And General	$8,510	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
EQUIPMENT REPAIRS	$26,783	$4,154	$22,629
ADMINISTRATIVE	$13,377	$12,108	$764	$505
PATIENT SUPPORT	$2,951	$2,951

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$893,556	TotalAmt
Program Services	$754,822	ProgramServicesAmt
Management And General	$104,089	ManagementAndGeneralAmt
Fundraising	$34,645	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$419,448	BOYAmt
EOY	$466,063	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$52,120	BOYAmt
EOY	$52,120	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$45,530	BOYAmt
EOY	$54,430	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$63,623	BOYAmt
EOY	$5,837	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$1,450,502	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$709,726	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$784,192	BOYAmt
EOY	$740,776	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$2,110,964	BOYAmt
EOY	$3,292,279	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$6,086	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,475,877	BOYAmt
EOY	$4,617,591	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$30,937	BOYAmt
EOY	$23,029	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$140,300	BOYAmt
EOY	$0	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$171,237	BOYAmt
EOY	$23,029	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	$3,093,115	BOYAmt
EOY	$4,348,987	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$211,525	BOYAmt
EOY	$245,575	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$3,304,640	BOYAmt
EOY	$4,594,562	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$3,475,877	BOYAmt
EOY	$4,617,591	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$868,015	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$421,907	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
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	$706,872	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$823,355	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$623,128	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$896,613	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,625,771	CurrentTaxYearAmt
Total	$4,675,739	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$706,872	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$823,355	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$623,128	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$896,613	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,625,771	CurrentTaxYearAmt
Total	$4,675,739	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total170	$4,675,739	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$77,909	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$118,555	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$117,218	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$88,682	CurrentTaxYearMinus1YearAmt
Current Tax Year	$134,075	CurrentTaxYearAmt
Total	$536,439	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$5,212,178	TotalSupportAmt
Public Support CY170	0.89710	PublicSupportCY170Pct
Public Support PY170	0.87780	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

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,185,449	BeginningYearBalanceAmt
Contributions	$675,703	ContributionsAmt
Investment Earnings Or Losses	$564,533	InvestmentEarningsOrLossesAmt
Other Expenditures	$12,000	OtherExpendituresAmt
Administrative Expenses	$7,869	AdministrativeExpensesAmt
End Year Balance	$3,405,816	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,147,267	BeginningYearBalanceAmt
Contributions	$55,198	ContributionsAmt
Investment Earnings Or Losses	$97,106	InvestmentEarningsOrLossesAmt
Other Expenditures	$107,000	OtherExpendituresAmt
Administrative Expenses	$7,122	AdministrativeExpensesAmt
End Year Balance	$2,185,449	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,073,761	BeginningYearBalanceAmt
Contributions	$71,140	ContributionsAmt
Investment Earnings Or Losses	$106,834	InvestmentEarningsOrLossesAmt
Other Expenditures	$96,500	OtherExpendituresAmt
Administrative Expenses	$7,968	AdministrativeExpensesAmt
End Year Balance	$2,147,267	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,959,638	BeginningYearBalanceAmt
Contributions	$73,466	ContributionsAmt
Investment Earnings Or Losses	$127,617	InvestmentEarningsOrLossesAmt
Other Expenditures	$79,000	OtherExpendituresAmt
Administrative Expenses	$7,960	AdministrativeExpensesAmt
End Year Balance	$2,073,761	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,729,253	BeginningYearBalanceAmt
Contributions	$146,987	ContributionsAmt
Investment Earnings Or Losses	$175,312	InvestmentEarningsOrLossesAmt
Other Expenditures	$85,000	OtherExpendituresAmt
Administrative Expenses	$6,914	AdministrativeExpensesAmt
End Year Balance	$1,959,638	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.98130	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.01870	PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$100,500	OtherCostOrOtherBasisAmt
Book Value	$100,500	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,110,236	OtherCostOrOtherBasisAmt
Depreciation	$546,811	DepreciationAmt
Book Value	$563,425	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$74,126	OtherCostOrOtherBasisAmt
Depreciation	$43,821	DepreciationAmt
Book Value	$30,305	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$165,640	OtherCostOrOtherBasisAmt
Depreciation	$119,094	DepreciationAmt
Book Value	$46,546	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$740,776	TotalBookValueLandBuildingsAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$2,175,609	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$421,907	NetUnrealizedGainsInvstAmt
Revenue Not Reported	$421,907	RevenueNotReportedAmt
Revenue Subtotal	$1,753,702	RevenueSubtotalAmt
Investment Expenses Not Incld	$7,869	InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt	$7,869	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$1,761,571	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$885,687	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$885,687	ExpensesSubtotalAmt
Investment Expenses Not Incld2	$7,869	InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt	$7,869	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$893,556	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, LINE 2:	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF JUNE 30, 2021. FISCAL YEARS ENDING ON OR AFTER JUNE 30, 2018, REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES.	ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	MEN'S CHARITY TENNIS	Event1Nm
Gross Receipts Event1	$27,249	GrossReceiptsEvent1Amt
Charitable Contri Event1	$27,150	CharitableContriEvent1Amt
Gross Revenue Event1	$99	GrossRevenueEvent1Amt
Other Direct Expenses Event1	$99	OtherDirectExpensesEvent1Amt
Event2	LIGHT UP A LIFE	Event2Nm
Gross Receipts Event2	$16,245	GrossReceiptsEvent2Amt
Charitable Contri Event2	$14,145	CharitableContriEvent2Amt
Gross Revenue Event2	$2,100	GrossRevenueEvent2Amt
Other Direct Expenses Event2	$2,100	OtherDirectExpensesEvent2Amt
Other Events Total	5	OtherEventsTotalCnt
Gross Receipts Other Events	$34,111	GrossReceiptsOtherEventsAmt
Charitable Contri Other Events	$29,451	CharitableContriOtherEventsAmt
Gross Revenue Other Events	$4,660	GrossRevenueOtherEventsAmt
Oth Direct Expnss Other Events	$4,660	OthDirectExpnssOtherEventsAmt
Gross Receipts Total	$77,605	GrossReceiptsTotalAmt
Charitable Contributions Tot	$70,746	CharitableContributionsTotAmt
Gross Revenue Total Events	$6,859	GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events	$6,859	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$6,859	DirectExpenseSummaryEventsAmt
Net Income Summary	$0	NetIncomeSummaryAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11B	ORGANIZATION'S PROCESS TO REVIEW FORM 990- THE TAX RETURN IS REVIEWED BY THE STAFF ACCOUNTANT, EXECUTIVE DIRECTOR, TREASURER, AND THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12C	ENFORCEMENT OF CONFLICTS POLICY- CONFLICT OF INTEREST POLICY IS ENFORCED BY BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 15A	COMPENSATION PROCESS FOR TOP OFFICIAL- THE EXECUTIVE DIRECTOR'S COMPENSATION IS DISCUSSED AND REVIEWED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19	GUIDESTAR, AVAILABLE UPON REQUEST.
FORM 990, PART XII, LINE 2C:	THERE HAS BEEN NO CHANGE IN THE COMMITTEE'S RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT.