PROVAIL: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- PROVAIL (EIN 91-0593488)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-16
- IRS object ID
- 202211379349301101
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-16T23:02:59-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135381590 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BDO USA LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 UNION ST STE 2300 | AddressLine1Txt |
| City | SEATTLE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 981012345 | 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 | 910593488 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROVAIL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PROV | BusinessNameControlTxt |
| Phone | 2063637303 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12550 AURORA AVE N | AddressLine1Txt |
| City | SEATTLE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98133 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL J HATZENBELER | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 2063637303 | PhoneNum |
| Signature | 2022-05-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MICHAEL | PersonFirstNm |
| Person Last | HATZENBELER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MATTHEW R MATSON | PreparerPersonNm |
| PTIN | P00775671 | PTIN |
| Phone | 2063827777 | PhoneNum |
| Preparation | 2022-05-17 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL J HATZENBELER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12550 AURORA AVE N | AddressLine1Txt |
| City | SEATTLE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98133 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $21,004,842 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PROVAIL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1942 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | PROVAIL'S MISSION IS TO SUPPORT PEOPLE WITH DISABILITIES TO FULFILL THEIR LIFE CHOICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 22 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 22 | VotingMembersIndependentCnt |
| Total Employee | 514 | TotalEmployeeCnt |
| Total Volunteers | 50 | TotalVolunteersCnt |
| Total Gross UBI | -$1,646 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $18,547,491 | PYContributionsGrantsAmt |
| CY Contributions Grants | $20,221,486 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $702,938 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $725,692 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,400,057 | PYInvestmentIncomeAmt |
| CY Investment Income | $243 | CYInvestmentIncomeAmt |
| PY Other Revenue | $118,821 | PYOtherRevenueAmt |
| CY Other Revenue | -$26,509 | CYOtherRevenueAmt |
| PY Total Revenue | $21,769,307 | PYTotalRevenueAmt |
| CY Total Revenue | $20,920,912 | 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 | $16,370,132 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,411,076 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $5,663 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $14,533 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $373,665 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,152,588 | PYOtherExpensesAmt |
| CY Other Expenses | $1,945,878 | CYOtherExpensesAmt |
| PY Total Expenses | $18,528,383 | PYTotalExpensesAmt |
| CY Total Expenses | $19,371,487 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,240,924 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,549,425 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,262,574 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,228,128 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,353,330 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,844,224 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,909,244 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,383,904 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVAIL'S MISSION IS TO SUPPORT PEOPLE WITH DISABILITIES TO FULFILL THEIR LIFE CHOICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $12,082,552 | ExpenseAmt |
| Revenue | $566,132 | RevenueAmt |
| Desc | COMMUNITY LIVING SERVICES - PROVIDES SUPPORTED LIVING SERVICES TO ADULTS WITH SEVERE DEVELOPMENTAL DISABILITIES. WE PROVIDE 24-HOUR SUPPORT, INSTRUCTION, PERSONAL CARE, AND NURSING SERVICES IN ACCESSIBLE, COMMUNITY-BASED HOMES THROUGHOUT THE GREATER SEATTLE AREA. APPROXIMATELY 73 CLIENTS ARE SERVED. ADDITIONALLY WE OPEND OUR BRAINSPACE BOARDING HOME FOR SURVIVERS OF TRAUMATIC BRAIN INJURY IN FEBRUARY 2017 WITH SPACE TO SERVE 12 BOARDERS WITH A CURRENT 11 BOARDER STATUS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,044,166 | ExpenseAmt |
| Revenue | $159,560 | RevenueAmt |
| Desc | SUPPORTED EMPLOYMENT AND VOCATIONAL SERVICES - WE WORK WITH INDIVIDUALS WITH DISABILITIES TO SECURE AND RETAIN COMPETITIVE EMPLOYMENT BY HELPING WITH THE PROCESS OF IDENTIFYING CAREER GOALS, MATCHING CANDIDATES TO POSITIONS, TRAINING AND ORIENTATION AND ONGOING SUPPORT WHERE NEEDED. APPROXIMATE CASELOAD IS 485 CLIENTS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $938,924 | ExpenseAmt |
| Desc | THERAPEUTIC AND ASSISTIVE TECHNOLOGY SERVICES - OUR SERVICES INCLUDE SPEECH THERAPY, OCCUPATIONAL THERAPY AND ASSISTIVE TECHNOLOGY. THESE SERVICES ENABLE CHILDREN AND ADULTS WITH DISABILITIES OR INJURIES TO MAXIMIZE THEIR PERFORMANCE AND PRODUCTIVITY AT HOME, WORK, SCHOOL, AND IN LEISURE ACTIVITIES. APPROXIMATELY 178 CLIENTS WERE SERVED THIS YEAR. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $17,065,642 | 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 | 0 | 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 | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | 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 | Yes (1) | 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 | Yes (1) | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 514 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 |
| 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 | 22 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 22 | 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 | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| 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 | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEN ROBINSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2063637303 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12550 AURORA AVE N | AddressLine1Txt |
| City | SEATTLE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98133 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| DENISE KAJANOFF | |||||||
| CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| STEVE SUTER | |||||||
| 1ST VICE CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| TERRIE DIEDESHEIMER | |||||||
| 2ND VICE CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MIKE HUGHES | |||||||
| TREASURER | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| TERRI SUTTON | |||||||
| SECRETARY | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| HARRIS CLARKE | |||||||
| IMMEDIATE PAST CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JIM CHESEMORE | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DON BLACK | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DALE DEWHITT | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| BRANDON CHISHOLM | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JASON PETERSON | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WHITNEY KEYES | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ALESHE MORGAN MARTINEZ | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DOUGLAS BOWES | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| HEALTH ALDER | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BRET KOBES | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DR BINH LIEU | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| REX LUND | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARILYN HALL | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DOROTHY HARDIN | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JIM MITCHELL | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| AMANDA VAN HOOK | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL HATZENBELER | |||||||
| CEO | 40.00 | 1.00 | Yes (X) | $182,676 | $0 | $13,826 | |
| BEN ROBINSON | |||||||
| DIRECTOR OF FINANCE | 40.00 | 1.00 | Yes (X) | $142,832 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $325,508 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $13,826 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $130,783 | FundraisingAmt |
| Government Grants | $19,862,341 | GovernmentGrantsAmt |
| All Other Contributions | $228,362 | AllOtherContributionsAmt |
| Noncash Contributions | $11,272 | NoncashContributionsAmt |
| Total Contributions | $20,221,486 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| REHABILITATION & DENTAL | 900099 | $539,295 | $539,295 |
| TRANSITIONAL SERVICES | 900099 | $89,683 | $89,683 |
| SCHOOL | 900099 | $59,631 | $59,631 |
| COMMUNITY HOUSING | 531110 | $26,838 | $26,838 |
| EMPLOYMENT TRAINING | 561300 | $10,245 | $10,245 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $725,692 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $243 | TotalRevenueColumnAmt |
| Exclusion | $243 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $57,088 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $59,940 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$2,852 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$2,852 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | -$1,646 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$1,206 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $130,783 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $23,990 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$23,990 | TotalRevenueColumnAmt |
| Exclusion | -$23,990 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEETINGS, REFUNDS, AND OTHER | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $333 | TotalRevenueColumnAmt |
| Exclusion | $333 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $333 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,920,912 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $725,692 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$1,646 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$24,620 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $362,813 | TotalAmt |
| Program Services | $336,542 | ProgramServicesAmt |
| Management And General | $19,236 | ManagementAndGeneralAmt |
| Fundraising | $7,035 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,744,316 | TotalAmt |
| Program Services | $13,669,533 | ProgramServicesAmt |
| Management And General | $787,125 | ManagementAndGeneralAmt |
| Fundraising | $287,658 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,328,929 | TotalAmt |
| Program Services | $1,248,669 | ProgramServicesAmt |
| Management And General | $58,432 | ManagementAndGeneralAmt |
| Fundraising | $21,828 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $975,018 | TotalAmt |
| Program Services | $738,993 | ProgramServicesAmt |
| Management And General | $222,841 | ManagementAndGeneralAmt |
| Fundraising | $13,184 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,521 | TotalAmt |
| Management And General | $1,521 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,946 | TotalAmt |
| Program Services | $10,032 | ProgramServicesAmt |
| Management And General | $127,914 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,533 | TotalAmt |
| Fundraising | $14,533 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $366,631 | TotalAmt |
| Program Services | $96,733 | ProgramServicesAmt |
| Management And General | $242,680 | ManagementAndGeneralAmt |
| Fundraising | $27,218 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $225,627 | TotalAmt |
| Program Services | $189,528 | ProgramServicesAmt |
| Management And General | $36,099 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,889 | TotalAmt |
| Program Services | $53,873 | ProgramServicesAmt |
| Management And General | $10 | ManagementAndGeneralAmt |
| Fundraising | $6 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $112,305 | TotalAmt |
| Management And General | $112,305 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $183,145 | TotalAmt |
| Program Services | $71,609 | ProgramServicesAmt |
| Management And General | $111,084 | ManagementAndGeneralAmt |
| Fundraising | $452 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| GENERAL AND ADMINISTRAT | $453,101 | $453,101 | ||
| TELEPHONE | $178,216 | $102,107 | $75,459 | $650 |
| REPAIRS AND MAINTENANCE | $140,511 | $58,752 | $81,759 | |
| EQUIPMENT | $92,986 | $36,170 | $55,715 | $1,101 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,371,487 | TotalAmt |
| Program Services | $17,065,642 | ProgramServicesAmt |
| Management And General | $1,932,180 | ManagementAndGeneralAmt |
| Fundraising | $373,665 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,354,870 | BOYAmt |
| EOY | $7,083,543 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $99,545 | BOYAmt |
| EOY | $62,292 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,583,192 | BOYAmt |
| EOY | $1,916,788 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $107,791 | BOYAmt |
| EOY | $186,160 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $9,576,296 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,698,596 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,015,395 | BOYAmt |
| EOY | $7,877,700 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $87,663 | BOYAmt |
| EOY | $87,663 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,118 | BOYAmt |
| EOY | $13,982 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,262,574 | BOYAmt |
| EOY | $17,228,128 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,601,760 | BOYAmt |
| EOY | $1,185,185 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,444 | BOYAmt |
| EOY | $131,860 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,787,011 | BOYAmt |
| EOY | $5,621,064 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,906,115 | BOYAmt |
| EOY | $1,906,115 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,353,330 | BOYAmt |
| EOY | $8,844,224 | 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 | $6,811,844 | BOYAmt |
| EOY | $8,268,816 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,400 | BOYAmt |
| EOY | $115,088 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,909,244 | BOYAmt |
| EOY | $8,383,904 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,262,574 | BOYAmt |
| EOY | $17,228,128 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,549,425 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$74,765 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| 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 | $11,780,181 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,830,097 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,347,756 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $18,547,491 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,221,486 | CurrentTaxYearAmt |
| Total | $78,727,011 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,780,181 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,830,097 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,347,756 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $18,547,491 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,221,486 | CurrentTaxYearAmt |
| Total | $78,727,011 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $78,727,011 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $18,733 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $19,015 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $20,095 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $21,802 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $24,368 | CurrentTaxYearAmt |
| Total | $104,013 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,067 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,538 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,118 | CurrentTaxYearMinus2YearsAmt |
| Total | $33,723 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,165 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $17,479 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $58,622 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $23,362 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $333 | CurrentTaxYearAmt |
| Total | $107,961 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $78,972,708 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $3,534,087 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99690 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99600 | 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 | MISCELLANEOUS LAUNDRY INCOME LEASE DEPOSIT REFUND SECURITY DEPOSIT FORFEITURES MEETINGS REFUNDS AND OTHER | 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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,350,549 | OtherCostOrOtherBasisAmt |
| Book Value | $3,350,549 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,692,658 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,295,305 | DepreciationAmt |
| Book Value | $4,397,353 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $93,455 | OtherCostOrOtherBasisAmt |
| Depreciation | $53,353 | DepreciationAmt |
| Book Value | $40,102 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $439,634 | OtherCostOrOtherBasisAmt |
| Depreciation | $349,938 | DepreciationAmt |
| Book Value | $89,696 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,877,700 | TotalBookValueLandBuildingsAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF TOURNAMENT | Event1Nm |
| Gross Receipts Event1 | $130,783 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $130,783 | CharitableContriEvent1Amt |
| Other Direct Expenses Event1 | $23,990 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $130,783 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $130,783 | CharitableContributionsTotAmt |
| Oth Direct Expnss Total Events | $23,990 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $23,990 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$23,990 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL HATZENBELER | PersonNm |
| Title | CEO | TitleTxt |
| Base Compensation Filing Org | $182,676 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $13,826 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $196,502 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | PROVAIL PAID THE ROTARY CLUB DUES FOR THE CEO, $600 |
| PART I, LINE 1B | THE ROTARY CLUB MEMBERSHIP WAS PART OF THE BOARD'S RECOMMENDED DEVELOPMENT PLAN FOR THE CEO. |
| PART I, LINE 6 | THE CEO BONUS WAS BASED ON SEVERAL FACTORS; ONE OF WHICH WAS FINANCIAL PERFORMANCE. |
| PART I, LINE 7 | THE CEO BONUS WAS PARTIALLY DEPENDENT ON THE NET INCOME OF THE ORGANIZATION. THE AMOUNT WAS DETERMINED BY A PREVIOUSLY AGREED UPON CALCULATION. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION WILL PROVIDE A DRAFT COPY OF THE FORM 990 TO THE GOVERNING BOARD APPROXIMATELY TWO WEEKS PRIOR TO IT BEING FILED AND REQUEST ANY QUESTIONS OR COMMENTS BE DIRECTED TO THE CFO. THE ORGANIZATION WILL PROVIDE A DRAFT COPY OF THE FORM 990 TO THE MANAGEMENT OF THE ORGANIZATION APPROXIMATELY TWO WEEKS PRIOR TO IT BEING FILED AND REQUEST ANY QUESTIONS OR COMMENTS BE DIRECTED TO THE CFO. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH BOARD MEMBER IS ASKED TO REVIEW AND SIGN THE CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS AND ALSO FILL OUT A QUESTIONNAIRE AS PART OF THE PREPARATION FOR THE 990 DEALING WITH INDEPENDENCE. WE HAVE HAD NO CONFLICTS TO DEAL WITH. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMMITTEE OF THE BOARD UNDERTAKES THE EVALUATION AND COMPENSATION SETTING FOR THE CEO. THEY COMPLETED THE EVALUATION PORTION GETTING INPUT FROM THE BOD AND EMPLOYEES SUPERVISED BY THE CEO. THEY ALSO REVIEWED SALARIES AT COMPARABLE AGENCIES VIA A COMPENSATION SURVEY PERFORMED BY ARCHBRIGHT, AN INDEPENDENT ORGANIZATION. MINUTES OF THESE MEETINGS WERE KEPT. USING BOTH THE EVALUATION AND THE COMPARABLE SALARY INFORMATION THEY SET THE SALARY FOR THE CEO. WE HAVE NO OTHER EMPLOYEES WHO MEET THE DEFINITION OF KEY EMPLOYEE. EACH YEAR WE PULL SALARY INFORMATION FROM ARCHBRIGHT WHICH COMPILES COMPREHENSIVE NON-PROFIT AND FOR PROFIT SALARY INFORMATION FROM HUNDREDS OF COMPANIES AND NON-PROFITS IN THE PACIFIC NORTHWEST AND WE USE THAT SALARY INFORMATION TO INFORM PAY INCREASES AND WAGE RANGES FOR ALL POSITIONS AT PROVAIL. |
| FORM 990, PART VI, SECTION C, LINE 19 | THESE ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IV, LINE 12B | AFFILIATED GROUP MEMBERS LIST OF ALL MEMBERS OF THE GROUP THIS RETURN WILL COVER: PROVAIL 12550 AURORA AVE. N SEATTLE, WA 98133 EIN 91-0593488 LIST OF ALL MEMBERS OF THE GROUP THIS RETURN WILL NOT COVER: AUBURN COMMUNITY LIVING 12550 AURORA AVE. N SEATTLE, WA 98133 EIN 91-1814582 EASTSIDE COMMUNITY LIVING 12550 AURORA AVE. N SEATTLE, WA 98133 EIN 94-3206977 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| PROVAIL - AFFILIATES | ||||||||||
| 12550 AURORA AVE N | SEATTLE | WA | 98133 | 912146011 | COMMUNITY HOUSING | WA | 501(C)(3) | 7 | PROVAIL | Yes (1) |
| AUBURN COMMUNITY LIVING | ||||||||||
| 12550 AURORA AVE N | SEATTLE | WA | 98133 | 911814582 | COMMUNITY HOUSING | WA | 501(C)(3) | 7 | PROVAIL | Yes (1) |
| EASTSIDE COMMUNITY LIVING | ||||||||||
| 12550 AURORA AVE N | SEATTLE | WA | 98133 | 943206977 | COMMUNITY HOUSING | WA | 501(C)(3) | 7 | PROVAIL | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROVAIL AFFILIATES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | D | TransactionTypeTxt |
| Involved | $105,251 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |
Comments