2022-05-27T10:21:50-05:00 2021-12-31 541953476 DAVIDSON DOYLE & HILTON LLP PO BOX 800 LYNCHBURG VA 245050800 990 2021-01-01 261275136 FREE CLINIC OF POWHATAN INC FREE 8045985637 2320 SKAGGS ROAD POWHATAN VA 23139 CONNIE MOSLOW EXECUTIVE DIRECTOR 8045985637 2022-05-26 1 CONNIE MOSLOW 999009999 AMY A GALLAGHER CPA P00884747 4348467611 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z CONNIE MOSLOW 3908 OLD BUCKINGHAM RD POWHATAN VA 23139 928143 0 X www.freeclinicofpowhatan.org X 2007 VA BUILDING A HEALTHIER COMMUNITY ONE PERSON AT A TIME 14 13 11 0 0 0 1773934 798616 0 0 17944 38267 5248 -7466 1797126 829417 0 0 0 0 169876 197681 0 0 3993 111472 263253 281348 460934 1515778 368483 2915310 3196146 87070 10718 2828240 3185428 BUILDING A HEALTHIER COMMUNITY ONE PERSON AT A TIME 0 0 286290 ORGANIZATION FACILITATES THE AVAILABILITY OF MEDICAL AND DENTAL SERVICES TO THE RESIDENTS OF POWHATAN, VIRGINIA THAT DO NOT HAVE THE RESOURCES TO THE SERVICES ELSEWHERE. 286290 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 11 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 13 0 0 0 0 0 1 0 1 1 0 0 0 1 1 1 1 0 1 1 0 X CONNIE MOSLOW 8045985637 3908 OLD BUCKINGHAM RD POWHATAN VA 23139 X INDIA COX VICE PRESIDENT 1.00 X X 0 0 0 TIMOTHY G BENUSA CPA TREASURER 1.00 X X 0 0 0 KARLA CURTIS DIRECTOR 1.00 X 0 0 0 STEVE HARRIS DIRECTOR 1.00 X 0 0 0 SISTER ELENA HENDERSON SECRETARY 1.00 X X 0 0 0 NED SMITHER DIRECTOR 1.00 X 0 0 0 CONNIE MOSLOW EXECUTIVE DIRECTOR 40.00 X X 0 0 0 TONYA PARRIS-WILKINS DDS DIRECTOR 1.00 X 0 0 0 WILL PERKINSON DDS DIRECTOR 1.00 X 0 0 0 ROBB STALLWORTH DIRECTOR 1.00 X 0 0 0 REV BRYAN STEVENS DIRECTOR 1.00 X 0 0 0 DEMETRIUS VENABLE PHD DIRECTOR 1.00 X 0 0 0 SHELIA GUNST DIRECTOR 1.00 X 0 0 0 BARBARA BROWN DIRECTOR 1.00 X 0 0 0 0 0 0 0 0 0 0 0 35209 62074 701333 37798 798616 34999 34999 94250 90982 3268 3268 3268 0 35209 7744 -7744 -7744 MISCELLANEOUS 621110 278 278 278 829417 278 0 30523 183748 106574 73499 3675 13933 8220 5713 6503 6503 5964 5964 2057 1954 103 67151 13430 53721 1000 1000 2276 2276 71356 71356 3989 3989 DENTAL SERVICES 36735 36735 PRESCRIPTIONS 16055 16055 DENTAL SUPPLIES 15420 15420 MEDICAL SUPPLIES 12722 12722 22025 3502 18308 215 460934 286290 170651 3993 1210188 866863 310927 311915 290297 189723 1124 1279 859922 91139 764449 768783 338325 1057583 2915310 3196146 87070 10718 87070 10718 X 2616128 3081946 212112 103482 2828240 3185428 2915310 3196146 368483 -11295 0 X 0 1 X 0 0 X 425335 325309 409697 1343120 798616 3302077 425335 325309 409697 1343120 798616 3302077 1189736 2112341 325 74 399 3302476 0.63960 0.57000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 652146 44251 607895 154094 39377 114717 53682 7511 46171 768783 X 848801 -11295 36643 -5964 19384 829417 0 829417 491613 36643 -5964 30679 460934 0 460934 Part X, Line 2: Accounting principles generally accepted in the United States of America require corporation management to evaluate tax positions taken by the corporation and recognize a tax liability (or asset) if the corporation has taken an uncertain tax position that more likely than not would be sustained upon examination by the Internal Revenue Service. Free Clinic of Powhatan's management has analyzed the tax positions taken by the clinic, and has concluded that as of December 31, 2021, no uncertain positions are taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the financial statements. The clinic is subject to routine audits by taxing jurisdictions; however, there are currently no audits of any tax periods in progress. The clinic believes it is no longer subject to income tax examinations for years prior to 2017. Part XI, Line 2d - Other Adjustments: INVESTMENT EXPENSE -5,964. Part XII, Line 2d - Other Adjustments: INVESTMENT EXPENSE -5,964. DINNER 35209 35209 7744 35209 35209 7744 7744 -7744 LISA BENUSA WIFE OF BOARD TREASURER 14640 USED BUSINESS LOCATION FOR EVENT AND WAS COMPENSATED FOR ITS USE. 0 X 1 37798 FAIR MARKET VALUE 0 0 0 Form 990, Part VI, Section A, line 7a THE EXECUTIVE BOARD NOMINATES DIRECTORS EVERY THREE YEARS. Form 990, Part VI, Section B, line 11b OFFICERS REVIEW ON AN ANNUAL BASIS Form 990, Part VI, Section B, line 12c THE OFFICER'S REVIEW FOR POTENTIAL CONFLICTS CONTINUOUSLY Form 990, Part VI, Section B, line 15 OFFICERS REVIEW ON ANNUAL BASIS Form 990, Part VI, Section C, line 19 AVAILABLE UPON REQUEST