A PATTERN: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
A PATTERN (EIN 45-5094420)
Tax period
2024-01-01 to 2024-12-31
Filed
2025-06-04
IRS object ID
202521559349300337
Schema version
2024v5.1
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

FieldValueIRS element (for citing)
Return2025-06-04T13:30:24-04:00ReturnTs
Tax Period End2024-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN271750037PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1R & J ACCOUNTING & TAX SERVICESBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12601 CR 3260AddressLine1Txt
CitySALEMCityNm
State AbbreviationMOStateAbbreviationCd
ZIP65560ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2024-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN455094420EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1A PATTERN INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% JOYCE GRIVASInCareOfNm
Business Name ControlAPATBusinessNameControlTxt
Phone8559761888PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1250 RICHTER ROADAddressLine1Txt
CityBOURBONCityNm
State AbbreviationMOStateAbbreviationCd
ZIP65441ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOYCE GRIVASPersonNm
Person TitleSECRETARYTREASURERPersonTitleTxt
Phone5732102455PhoneNum
Signature2025-06-04SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (true)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDIANA J LETTMANPreparerPersonNm
PTINP01201478PTIN
Phone5732472554PhoneNum
Preparation2025-06-04PreparationDt
Self EmployedYes (X)SelfEmployedInd
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerANDREW S GRIVASPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1250 RICHTER ROADAddressLine1Txt
CityBOURBONCityNm
State AbbreviationMOStateAbbreviationCd
ZIP65441ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$139,830GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2012FormationYr
Legal Domicile StateMOLegalDomicileStateCd
Activity Or MissionProvide a center for health education, medical, mental, spiritual health, and other training services to those interested in health and wellness and physical preparedness in our local community in Missouri.ActivityOrMissionDesc
Voting Members Governing Body0VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee5TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
CY Contributions Grants$132,049CYContributionsGrantsAmt
CY Program Service Revenue$7,620CYProgramServiceRevenueAmt
CY Investment Income$161CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
CY Total Revenue$139,830CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$69,536CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
CY Other Expenses$68,837CYOtherExpensesAmt
CY Total Expenses$138,373CYTotalExpensesAmt
CY Revenues Less Expenses$1,457CYRevenuesLessExpensesAmt
Total Assets BOY$167,829TotalAssetsBOYAmt
Total Assets EOY$169,286TotalAssetsEOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$167,829NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$169,286NetAssetsOrFundBalancesEOYAmt
MissionProvide a center for health education, medical, mental, spiritual health, and other training services to those interested in health and wellness and physical preparedness in our local community in Missouri.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$81,772ExpenseAmt
Revenue$139,830RevenueAmt
DescWe continue to offer a monthly 11 day health and wellness training program at the Health Retreat Center. It continues to emphasize classes in plant-based cooking, disease causes, prevention, and treatment, mental and spiritual health, exercise, and others as health issues of participants may necessitate.Desc
Total Program Service Expenses$81,772TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee5EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members0GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJOYCE GRIVASPersonNm
Phone8559761888PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1250 RICHTER ROADAddressLine1Txt
CityBOURBONCityNm
State AbbreviationMOStateAbbreviationCd
ZIP65441ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtInstitutional TrusteeInstitutionalTrusteeIndOfficerOfficerInd
PAUL ROSS
DIRECTOR0.000.00Yes (X)$0$0$0
MARTHA ROSS
DIRECTOR0.000.00Yes (X)$0$0$0
CHARLES CLEVELAND
HER RESOURCE MANAGER0.000.00Yes (X)$0$0$0
VAUGHAN H SPARROW
DIRECTOR0.000.00Yes (X)$0$0$0
ANDREW S GRIVAS
PRESIDENT40.000.00$0$0$0Yes (X)Yes (X)
JOYCE GRIVAS
SECRETARY-TREASURER40.000.00$0$0$0Yes (X)Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$132,049AllOtherContributionsAmt
Total Contributions$132,049TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPROVIDER SERVICESDesc
Business524114BusinessCd
Total Revenue Column$7,620TotalRevenueColumnAmt
Related Or Exempt Func Income$7,620RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$7,620TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$161TotalRevenueColumnAmt
Related Or Exempt Func Income$161RelatedOrExemptFuncIncomeAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$139,830TotalRevenueColumnAmt
Related Or Exempt Func Income$7,781RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$64,595TotalAmt
Program Services$64,595ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$4,941TotalAmt
Program Services$4,941ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$760TotalAmt
Management And General$760ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$26,616TotalAmt
Management And General$26,616ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$3,018TotalAmt
Program Services$3,018ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$9,118TotalAmt
Management And General$9,118ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$5,837TotalAmt
Management And General$5,837ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,641TotalAmt
Program Services$109ProgramServicesAmt
Management And General$3,532ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$5,246TotalAmt
Management And General$5,246ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescTAXESDesc
Total$5,492TotalAmt
Management And General$5,492ManagementAndGeneralAmt

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$9,109TotalAmt
Program Services$9,109ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$138,373TotalAmt
Program Services$81,772ProgramServicesAmt
Management And General$56,601ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$33,199BOYAmt
EOY$9,130EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$134,630BOYAmt
EOY$163,797EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$409,390LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$413,031LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
EOY-$3,641EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$167,829BOYAmt
EOY$169,286EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$167,829BOYAmt
EOY$169,286EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$167,829BOYAmt
EOY$169,286EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$167,829BOYAmt
EOY$169,286EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,457ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$29,242CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$128,246CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$39,911CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$24,661CurrentTaxYearMinus1YearAmt
Current Tax Year$24,016CurrentTaxYearAmt
Total$246,076TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$125,561CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$142,451CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$72,909CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$100,566CurrentTaxYearMinus1YearAmt
Current Tax Year$84,210CurrentTaxYearAmt
Total$525,697TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$154,803CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$270,697CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$112,820CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$125,227CurrentTaxYearMinus1YearAmt
Current Tax Year$108,226CurrentTaxYearAmt
Total$771,773TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$771,773PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$57CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$63CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$134CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$299CurrentTaxYearMinus1YearAmt
Current Tax Year$161CurrentTaxYearAmt
Total$714TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$57CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$63CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$134CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$299CurrentTaxYearMinus1YearAmt
Current Tax Year$161CurrentTaxYearAmt
Total$714TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$16,175CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$159CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$21,384CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$25,622CurrentTaxYearMinus1YearAmt
Current Tax Year$23,823CurrentTaxYearAmt
Total$87,163TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$171,035CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$270,919CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$134,338CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$151,148CurrentTaxYearMinus1YearAmt
Current Tax Year$132,210CurrentTaxYearAmt
Total$859,650TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.89780PublicSupportCY509Pct
Public Support PY5090.91120PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$375,686OtherCostOrOtherBasisAmt
Depreciation$375,686DepreciationAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$33,704OtherCostOrOtherBasisAmt
Depreciation$37,345DepreciationAmt
Book Value-$3,641BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings-$3,641TotalBookValueLandBuildingsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Unrelated business income explanation Part V line 3bTHIS ORGANIZATION RECEIVES A SMALL PORTION OF INCOME FOR THE USE OF A ROOM TO LIVE AND UTILITIES USED BY WORKERS.
Officer directors etc family relationship Part VI line 2The two officers of the corporation, Andrew S. Grivas and Joyce A. Grivas, are husband and wife. He isthe president of the corporation; she is the secretary/treasurer.
Member election for additional members Part VI line 7aThere are six directors of the corporation, listed in the tax document on page 7, Part VI.These directors elect the officers of the corporation, and replace vacancies on the board of directors atannual meetings.
Form 990 governing body review Part VI line 11THE GOVERNING BODY DOES REVIEW THE TAX RETURN PRIOR TO FILING.
Officer director etc mailing address Part VI line 9CHARLES CLEVELAND, 1814 MCCARVER LOOP ROAD, DUNLAP, TN 37327PAUL ROSS 2491 HWY O, SEDALIA, MO 65301MARTHA ROSS 2491 HWY O, SEDALIA, MO 65301VAUGHN H. SPARROW, 435 LIFESTYLE LANE, WILDWOOD, GA 30757
Governing documents etc available to public Part VI line 19THE GOVERNING DOCUMENTS CAN BE MADE PUBLIC IF REQUESTED
Significant program services not listed on prior year return Part III line 2This entity provides Health and Wellness classes, with health lectures, home remedies domonstrations, cooking classes, and personal health consultations. The entity has participated in community health events in Missouri, teaching health and disease classes, and counseling attendees regarding prevention and treatment of disease. A class was taught on solar power as a replacementfor electricty and it was built by the class.
List of other fees for services expenses Part IX line 11gSERVICES RENDERED BY INDIVIDUALS
List of other expenses Part IX line 24eFOOD SUPPLIES $8622.10GARDEN SUPPLIES $487.04

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