HOSPICE OF THE HIGHLAND RIM FOUNDATION INC: Form 990, tax year 2021
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- Organization
- HOSPICE OF THE HIGHLAND RIM FOUNDATION INC (EIN 62-1874162)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-05-16
- IRS object ID
- 202231369349307568
- 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 | 2022-05-16T12:20:44-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 208032022 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOUSHOLDER ARTMAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 115 N JACKSON ST | AddressLine1Txt |
| City | TULLAHOMA | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 373883523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 621874162 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE OF THE HIGHLAND RIM | BusinessNameLine1Txt |
| Business Name Line2 | FOUNDATION INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOSP | BusinessNameControlTxt |
| Phone | 9315637439 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 BRAGG CIRCLE | AddressLine1Txt |
| City | TULLAHOMA | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37388 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAT HOWARD | PersonNm |
| Person Title | SECRETARY/TREASURER | PersonTitleTxt |
| Phone | 9315637439 | PhoneNum |
| Signature | 2022-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | PAT | PersonFirstNm |
| Person Last | HOWARD | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANGELA D ELDRIDGE CPA | PreparerPersonNm |
| PTIN | P00001213 | PTIN |
| Phone | 9314554248 | PhoneNum |
| Preparation | 2022-05-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PAT HOWARD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 BRAGG CIRCLE | AddressLine1Txt |
| City | TULLAHOMA | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37388 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $92,220 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2006 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | THE HOSPICE FOUNDATION PROVIDES FOR MEDICAL EXPENSES FOR INDIVIDUALS WHO ARE IN THE LAST STAGES OF TERMINAL ILLNESSES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 1 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $28,938 | PYContributionsGrantsAmt |
| CY Contributions Grants | $23,970 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$101,736 | PYInvestmentIncomeAmt |
| CY Investment Income | $38,622 | CYInvestmentIncomeAmt |
| PY Other Revenue | $5,657 | PYOtherRevenueAmt |
| CY Other Revenue | $11,637 | CYOtherRevenueAmt |
| PY Total Revenue | -$67,141 | PYTotalRevenueAmt |
| CY Total Revenue | $74,229 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $104,906 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $74,621 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $15,130 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,829 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $2,814 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $21,895 | PYOtherExpensesAmt |
| CY Other Expenses | $16,443 | CYOtherExpensesAmt |
| PY Total Expenses | $141,931 | PYTotalExpensesAmt |
| CY Total Expenses | $106,893 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$209,072 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$32,664 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $711,306 | TotalAssetsBOYAmt |
| Total Assets EOY | $711,298 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $543 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $656 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $710,763 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $710,642 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE HOSPICE FOUNDATION PROVIDES FOR MEDICAL EXPENSES FOR INDIVIDUALS WHO ARE IN THE LAST STAGES OF TERMINAL ILLNESSES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $102,083 | ExpenseAmt |
| Grant | $74,621 | GrantAmt |
| Desc | THE HOSPICE FOUNDATION ASSISTED TERMINALLY ILL PATIENTS WITH FINANCIAL NEEDS AND MEDICAL ATTENTION. | Desc |
| Total Program Service Expenses | $102,083 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicyInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | TN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAT HOWARD | PersonNm |
| Phone | 9315637439 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 BRAGG CIRCLE | AddressLine1Txt |
| City | TULLAHOMA | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37388 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| PAT HOWARD | ||||||
| SECRETARY/TR | 25.00 | Yes (X) | $14,704 | $0 | $0 | |
| DARLENE BUCKNER | ||||||
| BOARD MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |
| DR PARKER DAVID ELROD | ||||||
| PRESIDENT | 0.50 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| TJAWANNA HAMMOND | ||||||
| BOARD MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |
| TERRI MILAM | ||||||
| BOARD MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |
| REV MARTY NUTTER | ||||||
| BOARD MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $14,704 | TotalReportableCompFromOrgAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Federated Campaigns | $5,334 | FederatedCampaignsAmt |
| Fundraising | $1,056 | FundraisingAmt |
| All Other Contributions | $17,580 | AllOtherContributionsAmt |
| Total Contributions | $23,970 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,972 | TotalRevenueColumnAmt |
| Exclusion | $13,972 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $40,796 | SecuritiesAmt |
| Other | $148 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $16,294 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $24,502 | SecuritiesAmt |
| Other | $148 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,650 | TotalRevenueColumnAmt |
| Exclusion | $24,650 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $9,725 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $1,056 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $1,697 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,028 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Total Revenue Column | $3,609 | TotalRevenueColumnAmt |
| Exclusion | $3,609 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,609 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $74,229 | TotalRevenueColumnAmt |
| Exclusion | $42,231 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,621 | TotalAmt |
| Program Services | $74,621 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,704 | TotalAmt |
| Program Services | $14,704 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,125 | TotalAmt |
| Program Services | $844 | ProgramServicesAmt |
| Management And General | $281 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,580 | TotalAmt |
| Management And General | $1,580 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,280 | TotalAmt |
| Program Services | $6,280 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,864 | TotalAmt |
| Program Services | $50 | ProgramServicesAmt |
| Fundraising | $2,814 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,307 | TotalAmt |
| Program Services | $2,307 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117 | TotalAmt |
| Program Services | $117 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| TELEPHONE | $1,678 | $1,678 | |
| SUPPLIES | $845 | $845 | |
| FOREIGN TAX PAID | $637 | $637 | |
| REGISTRATION FEES | $120 | $120 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15 | TotalAmt |
| Management And General | $15 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,893 | TotalAmt |
| Program Services | $102,083 | ProgramServicesAmt |
| Management And General | $1,996 | ManagementAndGeneralAmt |
| Fundraising | $2,814 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,108 | BOYAmt |
| EOY | $6,182 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $132,437 | BOYAmt |
| EOY | $10 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,712 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,712 | LandBldgEquipAccumDeprecAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $565,761 | BOYAmt |
| EOY | $705,106 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $711,306 | BOYAmt |
| EOY | $711,298 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $543 | BOYAmt |
| EOY | $656 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $543 | BOYAmt |
| EOY | $656 | 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 | $710,763 | BOYAmt |
| EOY | $710,642 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $710,763 | BOYAmt |
| EOY | $710,642 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $711,306 | BOYAmt |
| EOY | $711,298 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$32,664 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $32,543 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
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 | $32,525 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $23,537 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $29,720 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $28,430 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $22,914 | CurrentTaxYearAmt |
| Total | $137,126 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $32,525 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $23,537 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $29,720 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $28,430 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $22,914 | CurrentTaxYearAmt |
| Total | $137,126 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $137,126 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $29,549 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,981 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,142 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,529 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $38,624 | CurrentTaxYearAmt |
| Total | $107,825 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $300 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,181 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $800 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,609 | CurrentTaxYearAmt |
| Total | $5,900 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $250,851 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $33,781 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.54660 | PublicSupportCY170Pct |
| Public Support PY170 | 0.61340 | 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 | PART II, LINE 10 | FormAndLineReferenceDesc |
| Explanation | OTHER INCOME 5,900 | ExplanationTxt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,712 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,712 | DepreciationAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | false | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | MEDICAL ASSISTANCE | GrantTypeTxt |
| Cash Grant | $74,621 | CashGrantAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | REVIEWED BY PRESIDENT & SECRETARY/TREASURER |
| FORM 990, PAGE 6, PART VI, LINE 15A | ANNUAL SALARY APPROVED BY ENTIRE BOARD OF DIRECTORS |
| FORM 990, PAGE 6, PART VI, LINE 19 | COPIES PROVIDED UPON REQUEST |
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