A PATTERN: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- A PATTERN (EIN 45-5094420)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-15
- IRS object ID
- 202203199349306465
- Schema version
- 2021v4.2
- 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 | 2022-11-15T10:48:09-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 271750037 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | R & J ACCOUNTING & TAX SERVICES | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2601 CR 3260 | AddressLine1Txt |
| City | SALEM | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65560 | 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 | 455094420 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | A PATTERN INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | APAT | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 RICHTER ROAD | AddressLine1Txt |
| City | BOURBON | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65441 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOYCE GRIVAS | PersonNm |
| Person Title | SECRETARYTREAS | PersonTitleTxt |
| Phone | 5732102455 | PhoneNum |
| Signature | 2022-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JOYCE | PersonFirstNm |
| Person Last | GRIVAS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DIANA J LETTMAN | PreparerPersonNm |
| PTIN | P01201478 | PTIN |
| Phone | 5732472554 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| OOB Security Verification | 11 | OOBSecurityVerificationCd |
| Authentication Assurance Level | AAL2 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| 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 | ANDREW S GRIVAS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 RICHTER ROAD | AddressLine1Txt |
| City | BOURBON | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65441 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $270,978 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2012 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | Provide 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 and extending to the four corners of US and beyond. | ActivityOrMissionDesc |
| Voting Members Governing Body | 0 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| CY Contributions Grants | $255,206 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $15,709 | CYProgramServiceRevenueAmt |
| CY Investment Income | $63 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| CY Total Revenue | $270,978 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $65,558 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| CY Other Expenses | $108,190 | CYOtherExpensesAmt |
| CY Total Expenses | $173,748 | CYTotalExpensesAmt |
| CY Revenues Less Expenses | $97,230 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $505,919 | TotalAssetsBOYAmt |
| Total Assets EOY | $555,838 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $47,311 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $458,608 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $555,838 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Provide 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 and extending to the four corners of US and beyond. | MissionDesc |
| Significant New Program Srvc | Yes (true) | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $87,270 | ExpenseAmt |
| Revenue | $87,270 | RevenueAmt |
| Desc | We continue to offer a monthly 11 day health and wellness training program at the Health RetreatCenter. It continues to emphasize classes in plant-based cooking, disease causes, prevention, andtreatment, mental and spiritual health, exercise, and others as health issues of participants maynecessitate. During 2021, we gave 78 cooking demonstrations, 78 home remedies demonstrations, 84exercise sessions, and 288 health lectures. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $13,000 | ExpenseAmt |
| Revenue | $13,000 | RevenueAmt |
| Desc | We offered a separate educational and training section on planning and building a rank of solar panels to supplement electricity and reduce dependence on carbon based fuels. The builder gave theory classes first and then the participants spent the next 3 days building, digging ditches for the output cables, etc. This was a class in sustainability, which we hoped the participants would follow by building such a system of their own. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $890 | ExpenseAmt |
| Revenue | $890 | RevenueAmt |
| Desc | Summer of 2021, we offered a one week class in disaster preparedness for our local community,attended also by individuals from a hundred mile radius of our center. We hired a disaster preparednessteam to present the various components, such as how to identify and harvest wild edibles, digginglatrines, cooking over outdoor home-made stoves, and much more. The day began and ended withspiritual and mental health classes in psychological preparedness for many stages and types of disasters. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $101,160 | 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 | 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 | 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 | 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 | 0 | EmployeeCnt |
| 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 | 0 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | 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 | Yes (true) | 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 | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOYCE GRIVAS | PersonNm |
| Phone | 8559761888 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 RICHTER ROAD | AddressLine1Txt |
| City | BOURBON | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65441 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Institutional TrusteeInstitutionalTrusteeInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|---|
| MARTHA ROSS | ||||||||
| DIRECTOR | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| CHARLES CLEVELAND | ||||||||
| HER RESOURCE MANAGER | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| VAUGHAN H SPARROW | ||||||||
| DIRECTOR | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| PAUL ROSS | ||||||||
| DIRECTOR | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ANDREW S GRIVAS | ||||||||
| PRESIDENT | 40.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| JOYCE GRIVAS | ||||||||
| SECRETARY-TREASURER | 40.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| 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 |
| All Other Contributions | $255,206 | AllOtherContributionsAmt |
| Total Contributions | $255,206 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROVIDER SERVICES | Desc |
| Business | 524114 | BusinessCd |
| Total Revenue Column | $15,709 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,709 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $15,709 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $63 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $63 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $270,978 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,772 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,899 | TotalAmt |
| Program Services | $45,375 | ProgramServicesAmt |
| Management And General | $15,524 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,659 | TotalAmt |
| Program Services | $4,659 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $275 | TotalAmt |
| Management And General | $275 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,672 | TotalAmt |
| Management And General | $15,672 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,601 | TotalAmt |
| Program Services | $1,601 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,179 | TotalAmt |
| Management And General | $7,179 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,546 | TotalAmt |
| Program Services | $34,372 | ProgramServicesAmt |
| Management And General | $19,174 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,947 | TotalAmt |
| Management And General | $8,947 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $913 | TotalAmt |
| Management And General | $913 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SEMINAR EXPENSES | $630 | $630 | |
| PROVIDER EXPENSES | $569 | $569 | |
| REFUND EXPENSES | $4,016 | $4,016 | |
| TITLE FEES | $319 | $319 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,523 | TotalAmt |
| Program Services | $14,523 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $173,748 | TotalAmt |
| Program Services | $101,160 | ProgramServicesAmt |
| Management And General | $72,588 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,003 | BOYAmt |
| EOY | $42,437 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,259 | BOYAmt |
| EOY | $104,011 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,311 | BOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $409,390 | LandBldgEquipCostOrOtherBssAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $398,346 | BOYAmt |
| EOY | $409,390 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $505,919 | BOYAmt |
| EOY | $555,838 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,311 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,311 | BOYAmt |
| EOY | $0 | 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 | $458,608 | BOYAmt |
| EOY | $555,838 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $458,608 | BOYAmt |
| EOY | $555,838 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $505,919 | BOYAmt |
| EOY | $555,838 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $97,230 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $32,895 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $80,688 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $38,599 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $29,242 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $128,246 | CurrentTaxYearAmt |
| Total | $309,670 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $58,207 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $67,964 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $86,490 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $125,561 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $142,451 | CurrentTaxYearAmt |
| Total | $480,673 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $91,102 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $148,652 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $125,089 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $154,803 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $270,697 | CurrentTaxYearAmt |
| Total | $790,343 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $790,343 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $133 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $108 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $68 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $57 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $63 | CurrentTaxYearAmt |
| Total | $429 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $133 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $108 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $68 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $57 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $63 | CurrentTaxYearAmt |
| Total | $429 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,113 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,250 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,875 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,175 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $159 | CurrentTaxYearAmt |
| Total | $52,572 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $102,348 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $161,010 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $138,032 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $171,035 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $270,919 | CurrentTaxYearAmt |
| Total | $843,344 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.93720 | PublicSupportCY509Pct |
| Public Support PY509 | 0.90730 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $375,686 | OtherCostOrOtherBasisAmt |
| Book Value | $375,686 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $33,704 | OtherCostOrOtherBasisAmt |
| Book Value | $33,704 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $409,390 | TotalBookValueLandBuildingsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Unrelated business income explanation Part V line 3b | THIS 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 2 | The 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 7a | There 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 11 | THE GOVERNING BODY DOES REVIEW THE TAX RETURN PRIOR TO FILING. |
| Officer director etc mailing address Part VI line 9 | CHARLES 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 19 | THE GOVERNING DOCUMENTS CAN BE MADE PUBLIC IF REQUESTED |
| Significant program services not listed on prior year return Part III line 2 | This 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 11g | SERVICES RENDERED BY INDIVIDUALS |
| List of other expenses Part IX line 24e | FOOD SUPPLIES $14522.85 |
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