JERRY RUBIN FOUNDATION FOR CANCER CARE: Form 990EZ, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- JERRY RUBIN FOUNDATION FOR CANCER CARE (EIN 86-3477976)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-06-13
- IRS object ID
- 202221649349200727
- Schema version
- 2021v4.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-06-13T09:08:03-07:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 201939256 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAYASHI WAYLAND Accounting & Consulting | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1188 Padre Drive Suite 101 | AddressLine1Txt |
| City | Salinas | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 863477976 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JERRY RUBIN FOUNDATION FOR CANCER CARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JERR | BusinessNameControlTxt |
| Phone | 8316424041 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 HARRIS COURT BUILDING T 201 | AddressLine1Txt |
| City | MONTEREY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93940 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VALERIA WAREHAM | PersonNm |
| Person Title | Executive Dir. | PersonTitleTxt |
| Signature | 2022-06-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | VALERIA | PersonFirstNm |
| Person Last | WAREHAM | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Mike Nolan CPA | PreparerPersonNm |
| PTIN | P00930869 | PTIN |
| Phone | 8317596300 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Federated Assurance Level | FAL1 | FederatedAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Initial Return | Yes (X) | InitialReturnInd |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Website Address | www.jerryrubinfoundationforcancercare.org | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $750 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $750 | ContributionsGiftsGrantsEtcAmt |
| Cost Or Other Basis Expense Sale | $0 | CostOrOtherBasisExpenseSaleAmt |
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Special Events Direct Expenses | $0 | SpecialEventsDirectExpensesAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
| Total Revenue | $750 | TotalRevenueAmt |
| Other Expenses Total | $30 | OtherExpensesTotalAmt |
| Total Expenses | $30 | TotalExpensesAmt |
| Excess Or Deficit For Year | $720 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances EOY | $720 | NetAssetsOrFundBalancesEOYAmt |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $720 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $720 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $720 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | The Foundation is formed to provide financial and other assistance and support to cancer patients, including, without limitation, programs designed to meet the psychological and emotional needs of cancer patients, to provide educational programs for medical professionals with respect to the diagnosis, treatment and management of cancer, to establish community-based educational initiatives to promote the early detection of cancer and an integrated approach to cancer treatment, to provide support groups focused on cancer patients, caregivers and the bereaved, and to provide such other programs as will assist cancer patients during their battle with cancer and with end of life. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | The Foundation is formed to provide financial and other assistance and support to cancer patients, including, without limitation, programs designed to meet the psychological and emotional needs of cancer patients, to provide educational programs for medical professionals with respect to the diagnosis, treatment and management of cancer, to establish community-based educational initiatives to promote the early detection of cancer and an integrated approach to cancer treatment, to provide support groups focused on cancer patients, caregivers and the bereaved, and to provide such other programs as will assist cancer patients during their battle with cancer and with end of life. | DescriptionProgramSrvcAccomTxt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (4 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt |
|---|---|---|
| JOHN HAUSDORFF MD | ||
| President | 2.00 | $0 |
| ROGER SHIFFMAN MD | ||
| Vice President | 1.00 | $0 |
| M ZACH KOONTZ MD | ||
| TREAS/SECRETARY | 2.00 | $0 |
| VALERIA WAREHAM | ||
| Executive Dir. | 5.00 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | false | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | false | OrganizationHadUBIInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Form1120 Pol Filed | false | Form1120PolFiledInd |
| Made Loans To From Officers | false | MadeLoansToFromOfficersInd |
| Tax Imposed Under IRC4911 | $0 | TaxImposedUnderIRC4911Amt |
| Tax Imposed Under IRC4912 | $0 | TaxImposedUnderIRC4912Amt |
| Tax Imposed Under IRC4955 | $0 | TaxImposedUnderIRC4955Amt |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| Tax Imposed On Organization Mgr | $0 | TaxImposedOnOrganizationMgrAmt |
| Tax Reimbursed By Organization | $0 | TaxReimbursedByOrganizationAmt |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VALERIA WAREHAM | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 HARRIS COURT BUILDING T SUITE 201 | AddressLine1Txt |
| City | MONTEREY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 939405750 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8316424041 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Foreign Office | false | ForeignOfficeInd |
| Donor Advised Fnds | false | DonorAdvisedFndsInd |
| Operate Hospital | false | OperateHospitalInd |
| Tanning Services Provided | false | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| School Operating | false | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (true) | FiledScheduleAInd |
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 | $750 | CurrentTaxYearAmt |
| Total | $750 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $750 | CurrentTaxYearAmt |
| Total | $750 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $750 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $750 | TotalSupportAmt |
| First5 Years170 | Yes (X) | First5Years170Ind |
| Public Support CY170 | 0.00000 | PublicSupportCY170Pct |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Other Expenses.1 | FormAndLineReferenceDesc |
| Explanation | BANK FEES $30 | ExplanationTxt |
Comments