BETA

JOB-SITE SAFETY INSTITUTE: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
JOB-SITE SAFETY INSTITUTE (EIN 47-3860174)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-15
IRS object ID
202213199349306866
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

FieldValueIRS element (for citing)
Return2022-11-15T10:00:08-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN473860174EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOB-SITE SAFETY INSTITUTEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlJOB-BusinessNameControlTxt
Phone8667025998PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 97503AddressLine1Txt
CityRALEIGHCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27624ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTHOMAS LOCKARDPersonNm
Person TitleVP/CFOPersonTitleTxt
Phone8667025998PhoneNum
Signature2022-11-15SignatureDt

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstTHOMASPersonFirstNm
Person LastLOCKARDPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBILL SCHAFFNERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 97503AddressLine1Txt
CityRALEIGHCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27624ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$87,313GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.JSSAFETY.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2014FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionJOB-SITE SAFETY INSTITUTE (JSI) IS DEDICATED TO CONDUCT SAFETY RESEARCH FOR RESIDENTIAL AND COMMERCIAL CONSTRUCTION JOB SITES LEADING TO PRACTICES, STANDARDS AND BEHAVIORS THAT WILL REDUCE JOB-SITE INJURIES AND FATALITIES.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$272,871PYContributionsGrantsAmt
CY Contributions Grants$87,313CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$272,871PYTotalRevenueAmt
CY Total Revenue$87,313CYTotalRevenueAmt
PY Grants And Similar Paid$90,159PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$63,753CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$40,000PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$40,000CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$2,750CYTotalFundraisingExpenseAmt
PY Other Expenses$55,373PYOtherExpensesAmt
CY Other Expenses$93,646CYOtherExpensesAmt
PY Total Expenses$185,532PYTotalExpensesAmt
CY Total Expenses$197,399CYTotalExpensesAmt
PY Revenues Less Expenses$87,339PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$110,086CYRevenuesLessExpensesAmt
Total Assets BOY$228,939TotalAssetsBOYAmt
Total Assets EOY$82,068TotalAssetsEOYAmt
Total Liabilities BOY$38,606TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,821TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$190,333NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$80,247NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionJSI SERVES AS A RESEARCH CENTER WHERE EDUCATIONAL INSTITUTIONS AND INDUSTRY LEADERS COLLABORATE AND EXCHANGE IDEAS TO INCREASE AWARENESS OF THE INHERENT DANGERS OF A CONSTRUCTION SITE. METHODS INCLUDE REAL-WORLD TESTING AS WELL AS QUANTITATIVE AND QUALITATIVE STUDIES. RESULTS ARE SHARED THROUGH A VARIETY OF MEDIA INCLUDING PUBLISHED STUDIES, TRAINING VIDEOS AND ONLINE RESOURCES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$19,772ExpenseAmt
Grant$33,769GrantAmt
DescOCCUPATIONAL SAFETY & HEALTH ADMINISTRATION (OSHA)-SUSAN HARWOOD TRAINING - JSI FOCUSED TRAINING EFFORTS ON FALL PREVENTION IN CONSTRUCTION. THE SUSAN HARWOOD GRANT ENABLED JSI TO PROVIDE FALL PREVENTION FOR RESIDENTIAL CONSTRUCTION WORKERS. TRAINING TOPICS FOCUSED ON THE MOST COMMON TYPES OF FALLS IN CONSTRUCTION INCLUDING FALLS FROM LADDERS, SCAFFOLDS, ROOFS, TRUSSES, AND STEEL ERECTION. THE TARGET AUDIENCE INCLUDED NON-LITERATE, LOW-LITERATE, OR LIMITED ENGLISH PROFIENCY WORKERS, AND FOCUSED ON WORKERS IN SMALL BUSINESSES. TO BRIDGE THE LANGUAGE GAP THAT EXISTS WITH THE TARGET AUDIENCE OF WORKERS, TRAINING WAS OFFERD IN BOTH ENGLISH AND SPANISH.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$25,000ExpenseAmt
Grant$13,334GrantAmt
DescNATIONAL ASSOCIATION OF HOMEBUILDERS (NAHB) "PROMOTING WORKER WELLBEING AND BEHAVIORAL HEALTH IN THE HOME BUILDING INDUSTRY"- JSI-NAHB IS DEVELOPING A MORE COMPREHENSIVE APPROACH TO RAISING AWARENESS OF THE IMPORTANCE OF MENTAL HEALTH AND WELLNESS. CONSTRUCTION WORKERS ARE PARTICULARLY SUSCEPTIBLE TO MENTAL HEALTH ISSUES AND SUICIDE. THE INDUSTRY RANKS FIRST FOR ALL INDUSTRIES BY HIGHEST NUMBER OF SUICIDES. MANY CONSTRUCTION COMPANIES HAVE NOT YET INCORPORATED MENTAL HEALTH, SUBSTANCE ABUSE, ADDICTION RECOVERY, AND SUICIDE PREVENTION INTO SAFETY, HEALTH AND WELLNESS CULTURE AND PROGRAMS. THIS INITIATIVE SEEKS TO DEVELOP PROGRAMS TO IMPROVE AWARENESS, FACILITATE DISCUSSIONS, DESTIGMATIZE MENTAL HEALTH AND ADDICTIONS AND TAKE A LEADERSHIP POSITION MOVING FORWARD.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$14,000ExpenseAmt
DescNATIONAL HOUSING ENDOWMENT-NATIONAL ASSOCIATION OF HOMEBUILDERS TOOLBOX TALKS- JSI-NAHB DEVELOPED A SERIES OF VIDEO TOOLBOX TALKS ON VARIOUS CONSTRUCTION SAFETY TOPICS. THE VIDEOS WERE PRODUCED BOTH IN ENGLISH AND SPANISH. THIS SERIES OF VIDEOS ARE INCLUDED IN A LIBRARY OF 36 VIDEO TOOLBOX TALKS ALREADY PRODUCED. THESE VIDEO TOOLBOX TALKS HAVE BEEN VIEWED OVER ONE MILION TIMES THROUGH VARIOUS YOUTUBE PLATFORMS AND WEBSITES.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$24,249ExpenseAmt
DescOTHER PROGRAM SERVICES INCLUDE GRANT TO CLEMSON UNIVERSITY, EXECUTIVE DIRECTOR SALARY, MARKETING AND LEGAL EXPENSES.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$24,249TotalOtherProgSrvcExpenseAmt
Total Program Service Expenses$83,021TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document2IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNCStatesWhereCopyOfReturnIsFldCd
Own WebsiteYes (X)OwnWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1J GARY HILL EXECUTIVE DIRECTORBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8667025998PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 97502AddressLine1Txt
CityRALEIGHCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27624ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
J GARY HILL
EXECUTIVE DIRECTOR25.00Yes (X)Yes (X)$40,000$0$0
ERIK ANDERSON
CHAIR/DIRECTOR0.75Yes (X)Yes (X)$0$0$0
BILL SCHAFFNER
PRESIDENT/DIRECTOR0.75Yes (X)Yes (X)$0$0$0
MIKE THIBODEAUX
SECRETARY/TREASURER/DIRECTOR0.50Yes (X)Yes (X)$0$0$0
CHRISTINE BRANCHE
DIRECTOR0.50Yes (X)$0$0$0
ANDREW HILLIARD
DIRECTOR0.50Yes (X)$0$0$0
WILLARD HUGHES
DIRECTOR0.50Yes (X)$0$0$0
ROBERT MATUGA
DIRECTOR0.50Yes (X)$0$0$0
TIM MINTON
DIRECTOR0.50Yes (X)$0$0$0
BRIAN PACE
DIRECTOR0.50Yes (X)$0$0$0
THOMAS TRAUGER
DIRECTOR0.50Yes (X)$0$0$0
THOMAS B LOCKARD
ASST SECRETARY/TREASURER0.50Yes (X)$0$0$0
MICHAEL GERBER
PRESIDENT0.75Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$40,000TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Related Organizations$44,244RelatedOrganizationsAmt
Government Grants$33,769GovernmentGrantsAmt
All Other Contributions$9,300AllOtherContributionsAmt
Total Contributions$87,313TotalContributionsAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$87,313TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$63,753TotalAmt
Program Services$63,753ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$40,000TotalAmt
Program Services$9,372ProgramServicesAmt
Management And General$27,878ManagementAndGeneralAmt
Fundraising$2,750FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$35,354TotalAmt
Program Services$8,240ProgramServicesAmt
Management And General$27,114ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$42,424TotalAmt
Program Services$413ProgramServicesAmt
Management And General$42,011ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,469TotalAmt
Program Services$1,243ProgramServicesAmt
Management And General$226ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$475TotalAmt
Management And General$475ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$5,703TotalAmt
Management And General$5,703ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmt
ASSOCIATION FEES$693$693
SOLICITATION FEES$385$385
PRINTING AND STATIONARY$187$187

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$6,956TotalAmt
Management And General$6,956ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$197,399TotalAmt
Program Services$83,021ProgramServicesAmt
Management And General$111,628ManagementAndGeneralAmt
Fundraising$2,750FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$201,939BOYAmt
EOY$82,068EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$27,000BOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$228,939BOYAmt
EOY$82,068EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$38,606BOYAmt
EOY$1,821EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$38,606BOYAmt
EOY$1,821EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$190,333BOYAmt
EOY$80,247EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$190,333BOYAmt
EOY$80,247EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$228,939BOYAmt
EOY$82,068EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$110,086ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,140CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$195,463CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$341,481CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$272,871CurrentTaxYearMinus1YearAmt
Current Tax Year$87,313CurrentTaxYearAmt
Total$898,268TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,140CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$195,463CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$341,481CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$272,871CurrentTaxYearMinus1YearAmt
Current Tax Year$87,313CurrentTaxYearAmt
Total$898,268TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$898,268PublicSupportTotal170Amt
Total Support$898,268TotalSupportAmt
Public Support CY1701.00000PublicSupportCY170Pct
Public Support PY1700.38210PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

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 I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxt
OCCUPATIONAL SAFETY & HEALTH ADMINISTRATION
200 CONSTITUTION AVE NWWASHINGTONDC20210115$19,772$0SUSAN HARWOOD TRAINING GRANT
CENTER FOR DISEASE CONTROL
600 PEACHTREE STE 1000ATLANTAGA30308115$13,997$0NIOSH SAFETY APP
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org2TotalOtherOrgCnt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2THE FOLLOWING OFFICERS AND DIRECTORS HAVE A BUSINESS RELATIONSHIP: MICHAEL GERBER, ERIK ANDERSON, BRIAN PACE, WILLARD HUGHES, BILL SCHAFFNER, TOM LOCKARD, AND ROB MATUGA.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 AND ITS ATTACHED SCHEDULES HAVE BEEN COMPLETED BY THE EXECUTIVE OFFICER, REVIEWED BY THE ACCOUNTANTS, AND AT LEAST ONE OFFICER BEFORE SUBMITTING TO THE GOVERNANCE COMMITTEE FOR APPROVAL, ACCORDING TO THE BOARD APPROVED POLICY AND DISSEMINATED TO THE BOARD MEMBERS AND OFFICERS.
FORM 990, PART VI, SECTION B, LINE 12CALL BOARD MEMBERS EXECUTE AN ANNUAL ACKNOWLEDGEMENT FORM AFFIRMING THAT EACH BOARD MEMBER HAS RECEIVED, REVIEWED AND COMPLIED WITH THE CONFLICT OF INTEREST POLICY. PERIODIC REVIEWS ARE CONDUCTED BY THE BOARD TO ENSURE THAT ALL JSI OPERATIONS ARE CONSISTENT WITH ITS CHARITABLE MISSION AND PURPOSE. IF AN INTERESTED PERSON FAILS TO DISCLOSE A CONFLICT OF INTEREST, THE INDEPENDENT BOARD MEMBERS WILL IMMEDIATELY ADDRESS THE ISSUE AND TAKE ANY NECESSARY DISCIPLINARY OR CORRECTIVE ACTION NEEDED.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST AND AVAILABLE TO THE PUBLIC ON THE ENTITY'S WEBSITE.

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