SUPER SHOT INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- SUPER SHOT INC (EIN 35-2122575)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-10-18
- IRS object ID
- 202202919349300215
- 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 | 2022-10-18T05:08:37-07:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010727068 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Targeted Services PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 709 Clay Street Suite 102 | AddressLine1Txt |
| City | Fort Wayne | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46802 | 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 | 352122575 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Super Shot Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SUPE | BusinessNameControlTxt |
| Phone | 2604247468 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1515 Hobson Road | AddressLine1Txt |
| City | Fort Wayne | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46805 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Connie Heflin | PersonNm |
| Person Title | Executive Dir. | PersonTitleTxt |
| Signature | 2022-10-18 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Connie | PersonFirstNm |
| Person Last | Heflin | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Patricia Oppor | PreparerPersonNm |
| PTIN | P00234243 | PTIN |
| Phone | 2602033121 | PhoneNum |
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 |
| 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 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Gail Doran | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1515 Hobson Road | AddressLine1Txt |
| City | Fort Wayne | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46805 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,065,133 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.supershot.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | To educate, promote vaccination and increase avenues for immunizations for all children in Allen County and surrounding communities. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 41 | TotalEmployeeCnt |
| Total Volunteers | 98 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $2,222,522 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,499,941 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $342,116 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $792,217 | CYProgramServiceRevenueAmt |
| PY Investment Income | $9,859 | PYInvestmentIncomeAmt |
| CY Investment Income | $20,296 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $2,574,497 | PYTotalRevenueAmt |
| CY Total Revenue | $4,312,454 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $458,442 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $680,468 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $19,700 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $25,937 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,688,467 | PYOtherExpensesAmt |
| CY Other Expenses | $1,642,994 | CYOtherExpensesAmt |
| PY Total Expenses | $2,166,609 | PYTotalExpensesAmt |
| CY Total Expenses | $2,323,462 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $407,888 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,988,992 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,474,264 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,496,185 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $20,099 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $42,243 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,454,165 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,453,942 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To educate, promote vaccination and increase avenues for immunizations for all children in Allen County and surrounding communities. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $2,178,154 | ExpenseAmt |
| Revenue | $792,217 | RevenueAmt |
| Desc | In 2021, Super Shot stepped up to support our communitys Covid-19 response by taking over routine vaccinations for the Allen County Department of Health, assisting with staffing at the Parkview Mirro Center Vaccine Clinic, and serving as the community vaccinator for children when the vaccine was approved for children. As a result, in 2021, Super Shot provided 26,735 vaccines for 17,823 children, 4,310 non-Covid immunizations at Super Shot clinics for 2,741 adults, and 52,000 Covid doses for 52,000 adults at the Mirro Clinic. This was a total of 72,564 individuals served in 2021 - an all-time record for our agency. We would typically serve this many people over a 45-year period. Pleae see Schedule O for further information. | Desc |
| Total Program Service Expenses | $2,178,154 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | 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 | Yes (true) | 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 | false | 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 | Yes (true) | 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 | 7 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 41 | 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 |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | 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 | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Targeted Services PC | PersonNm |
| Phone | 2602033121 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 709 Clay Street Ste 102 | AddressLine1Txt |
| City | Fort Wayne | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46802 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| Connie Heflin | |||||||
| Executive Dir. | 40.00 | 0.00 | Yes (X) | $68,000 | $0 | $0 | |
| Gail Doran | |||||||
| Chairman | 0.92 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Gregory Perigo | |||||||
| Vice-Chairman | 0.66 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Donald R Shook Jr | |||||||
| Treasurer | 0.77 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Sarah GiaQuinta MD | |||||||
| Secretary | 0.19 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Patti Brahe | |||||||
| Director | 0.19 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Corey Snider | |||||||
| Director | 0.19 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Krista Peak | |||||||
| Director | 0.19 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Don Schenkel | |||||||
| Director | 0.19 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Susan Johnson | |||||||
| Director | 0.19 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Mary Hess RN BSN | |||||||
| Director | 0.19 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Deb Jones | |||||||
| Director | 0.19 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Mona Reimers | |||||||
| Director | 0.19 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Douglas Beebe | |||||||
| Director | 0.19 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $68,000 | TotalReportableCompFromOrgAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | None | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $80,000 | FederatedCampaignsAmt |
| Government Grants | $87,293 | GovernmentGrantsAmt |
| All Other Contributions | $3,332,648 | AllOtherContributionsAmt |
| Noncash Contributions | $1,357,945 | NoncashContributionsAmt |
| Total Contributions | $3,499,941 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Vaccine administration | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $792,217 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $792,217 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $792,217 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,033 | TotalRevenueColumnAmt |
| Exclusion | $12,033 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $760,942 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $752,679 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $8,263 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,263 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,263 | RelatedOrExemptFuncIncomeAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,312,454 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $800,480 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $12,033 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,000 | TotalAmt |
| Program Services | $45,334 | ProgramServicesAmt |
| Management And General | $11,333 | ManagementAndGeneralAmt |
| Fundraising | $11,333 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $543,889 | TotalAmt |
| Program Services | $503,346 | ProgramServicesAmt |
| Management And General | $40,543 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,541 | TotalAmt |
| Program Services | $18,491 | ProgramServicesAmt |
| Management And General | $50 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,038 | TotalAmt |
| Program Services | $45,544 | ProgramServicesAmt |
| Management And General | $3,660 | ManagementAndGeneralAmt |
| Fundraising | $834 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,995 | TotalAmt |
| Management And General | $20,995 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3 | TotalAmt |
| Management And General | $3 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,633 | TotalAmt |
| Program Services | $42,694 | ProgramServicesAmt |
| Management And General | $38,488 | ManagementAndGeneralAmt |
| Fundraising | $11,451 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $500 | TotalAmt |
| Program Services | $500 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,887 | TotalAmt |
| Program Services | $15,454 | ProgramServicesAmt |
| Management And General | $114 | ManagementAndGeneralAmt |
| Fundraising | $2,319 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,211 | TotalAmt |
| Program Services | $34,211 | ProgramServicesAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,462 | TotalAmt |
| Program Services | $5,462 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $820 | TotalAmt |
| Program Services | $820 | ProgramServicesAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,999 | TotalAmt |
| Program Services | $13,488 | ProgramServicesAmt |
| Management And General | $511 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,611 | TotalAmt |
| Program Services | $24,568 | ProgramServicesAmt |
| Management And General | $3,043 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Donated Vaccine | $1,357,945 | $1,357,945 |
| Uncollectible accounts | $36,593 | $36,593 |
| Clinic Supplies | $25,670 | $25,670 |
| COVID-19 Vaccine Incentive | $4,980 | $4,980 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,685 | TotalAmt |
| Program Services | $3,054 | ProgramServicesAmt |
| Management And General | $631 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,323,462 | TotalAmt |
| Program Services | $2,178,154 | ProgramServicesAmt |
| Management And General | $119,371 | ManagementAndGeneralAmt |
| Fundraising | $25,937 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,032 | BOYAmt |
| EOY | $126,510 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,164,466 | BOYAmt |
| EOY | $1,332,420 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $214,180 | BOYAmt |
| EOY | $384,928 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,047 | BOYAmt |
| EOY | $70,735 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,368 | BOYAmt |
| EOY | $9,195 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $130,338 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $81,494 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,171 | BOYAmt |
| EOY | $48,844 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,523,553 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,474,264 | BOYAmt |
| EOY | $3,496,185 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,099 | BOYAmt |
| EOY | $42,243 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,099 | BOYAmt |
| EOY | $42,243 | 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 | $1,163,099 | BOYAmt |
| EOY | $2,527,161 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $291,066 | BOYAmt |
| EOY | $926,781 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,454,165 | BOYAmt |
| EOY | $3,453,942 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,474,264 | BOYAmt |
| EOY | $3,496,185 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,988,992 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $10,785 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (true) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | false | FSAuditedInd |
| Audit Committee | false | AuditCommitteeInd |
| Federal Grant Audit Required | false | 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 | $2,141,589 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,296,143 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,150,460 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,288,079 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,499,941 | CurrentTaxYearAmt |
| Total | $12,376,212 | 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 Minus4 Years | $2,141,589 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,296,143 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,150,460 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,288,079 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,499,941 | CurrentTaxYearAmt |
| Total | $12,376,212 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $136,139 | SubstantialContributorsTotAmt |
| Public Support Total170 | $12,240,073 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,519 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,687 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $16,695 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,859 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $31,078 | CurrentTaxYearAmt |
| Total | $66,838 | 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 | $12,443,050 | TotalSupportAmt |
| Public Support CY170 | 0.98370 | PublicSupportCY170Pct |
| Public Support PY170 | 0.96930 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $130,338 | OtherCostOrOtherBasisAmt |
| Depreciation | $81,494 | DepreciationAmt |
| Book Value | $48,844 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $48,844 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X : FIN48 Footnote | FormAndLineReferenceDesc |
| Explanation | Super Shot is a nonprofit organization exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code and qualifies for the 50% charitable contribution limitation. The Organization has been classified as an organization that is not a private foundation under Section 509(a) of the Internal Revenue Code. However, the Organization is subject to federal income tax on any unrelated business taxable income. No unrelated business taxable income was reported in 2021 or 2020. The company is generally no longer subject to examination by the Internal Revenue Service for years before 2018. Super Shot, Inc. follows the guidance in FASB ASC 740-10-25 and determined no material unrecognized tax benefits or liabilities exist as of December 31, 2021. The adoption of 740-10-25 did not impact Super Shot, Inc.'s financial position or results of operations. If applicable, Super Shot, Inc. will recognize interest and penalties related to underpayment of income taxes as income tax expense. As of December 31, 2021 and 2020, Super Shot, Inc. had no amounts related to unrecognized income tax benefits and no amounts related to accrued interest and penalties. Super Shot, Inc. does not anticipate any significant changes to unrecognized income tax benefits over the next year. | ExplanationTxt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contribution | 26131 | ContributionCnt |
| Noncash Contributions Rpt F990 | $1,357,945 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | CDC Pricing | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et | Several members of the Board of Directors are CEO's of clinics, hospitals and other health-related entities. These Board members have contact with each other when conducting business for their respective organizations. None have a 35% or greater ownership interest in the organizations that they serve. |
| Form 990, Part VI, Line 11b: Form 990 Review Process | Form 990 is reviewed by the full governing Board at its meeting preceding the filing deadline for the return. A vote is taken to approve the filing of Form 990 if no items are flagged for further review / investigation. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Annually, members of the governing Board and Officers provide the names of entities, from which they, or their family members, receive compensation, have greater than a 10% ownership or investment interest, or otherwise might benefit personally from business transactions between the entity and Super Shot. Steps outlined in the Conflict of Interest policy are followed when potential transactions involving these businesses and organizations arise. |
| Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | Annually, the Executive Committee obtains updated compensation data for comparable positions within Allen County, Indiana. These data are taken into account in determining Executive Director compensation for the upcoming budget year. The full Board approves the Executive Director's compensation in conjunction with its approval of the budget for the fiscal year. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | Not applicable. No officers other than the Executive Director are compensated. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Articles of Incorporation, by-laws, conflict of interest policy and annual report are made available upon request. |
| Part III, line 4a (continued) | Since 1993, Super Shot has been ensuring the health of the most vulnerable children in our community by providing life-saving immunizations. We break down the barriers of vaccination - access and cost - and increase awareness of the importance of vaccination though our four walk-in Clinics and community education. Super Shot was founded by the compassion of two determined community leaders who cared deeply about the health of local children. Dr. Jane Irmscher, Health Commissioner of the Allen County Health Department, and Sister Mary Conrad Kirchhoff, a Poor Handmaid of Jesus Christ, brought key community leaders and hundreds of volunteers together to address our communitys low immunization rate. Twenty-eight years later, there is still a great need. Nationally, Indiana ranks 49th worst in public health spending. Super Shot helps address this gap and with your support, we are ensuring the health of our community. We ask uninsured/underinsured families for a $15 administration fee, per vaccination, to help support our program, but no one is turned away if they are unable to pay. We offer 16 vaccines to uninsured, underinsured and Medicaid eligible children and 14 vaccines to underinsured and uninsured adults. We also accept most commercial insurance plans. Vaccines are one of the greatest medical advancements and are the best way to prevent infectious disease. While getting vaccinated seems like the obvious choice, barriers and awareness, remain obstacles. Continuing to break down barriers as we strive to increase vaccination rates is critical to the health of our community. Our clinics ensure the most vulnerable children and adults have access to vaccines.Clinics Locations and Times:1.Grabill Missionary Church 13637 State Street, Grabill, IN 46741Monday 10 am 1 pm 2.Hobson 1515 Hobson Rd, Fort Wayne, IN 46805Tuesday & Thursday 10 am 1 pm & 4 pm 7 pm; Saturday 9 am - 12 pm3.Anthony Medical Center 5717 S. Anthony Blvd., Fort Wayne, IN 46816Wednesday 4 7 pm4.Fort Wayne Community Schools FACE Center 230 E. Douglas Ave, Fort Wayne, IN 46802Monday - Friday 9 am 4 pm Super Shot works to educate the community on the importance of immunizations through ongoing training and distribution of educational materials at local hospitals, schools, health events, to child-care providers, and at our clinic sites. Our staff empowers parents by providing them with the facts on immunizations. Our education coordinator speaks, consults, and engages in the community to provide scientific data on how immunizations work, the immunization schedule, and how immunizations save lives. Super Shot participates in many community health events to reinforce the value of community immunity. We serve children from birth through age 18 that are eligible for the Vaccine for Children Program (Medicaid eligible, uninsured, underinsured) and uninsured and underinsured adults. We also serve children and adults that are commercially insured. There are many economic reasons why vaccinations are important. From containing an infectious outbreak, to employees calling in sick and absenteeism, disease and illness cost money. But more importantly, vaccinations save lives. Vaccines protect you, me, our children, our parents, our grandchildren, our neighbors, our co-workers, and our entire community against deadly diseases. |