CLARKSVILLE MONTGOMERY COUNTYCOMMUNITY HEALTH FOUNDATION INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- CLARKSVILLE MONTGOMERY COUNTYCOMMUNITY HEALTH FOUNDATION INC (EIN 20-4862825)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-15
- IRS object ID
- 202213199349327511
- 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 | 2022-11-15T18:19:24-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 263683574 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THURMAN CAMPBELL GROUP PLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 324 FRANKLIN ST | AddressLine1Txt |
| City | CLARKSVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37040 | 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 | 204862825 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARKSVILLE-MONTGOMERY COUNTY | BusinessNameLine1Txt |
| Business Name Line2 | COMMUNITY HEALTH FOUNDATION INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CLAR | BusinessNameControlTxt |
| Phone | 9318962744 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 SOUTH 2ND ST | AddressLine1Txt |
| City | CLARKSVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37040 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROSALIND KURITA | PersonNm |
| Person Title | CHAIRMAN | PersonTitleTxt |
| Phone | 9312212492 | PhoneNum |
| Signature | 2022-05-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ROSALIND | PersonFirstNm |
| Person Last | KURITA | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFFERY PROCTOR | PreparerPersonNm |
| PTIN | P00854519 | PTIN |
| Phone | 9315527474 | PhoneNum |
| Preparation | 2022-11-09 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROSALIND KURITA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 31003 | AddressLine1Txt |
| City | CLARKSVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37040 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,795,774 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.COMMUNITYHEALTHFOUNDATION.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION IS OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE RESIDENTS OF CLARKSVILLE,TN; MONTGOMERY COUNTY, TN; AND THE COUNTIES OF NORTHERN MIDDLE TN AND FORT CAMPBELL, KY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 3 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $3,000,005 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,000,000 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,507,793 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,815,664 | CYInvestmentIncomeAmt |
| PY Other Revenue | $658,764 | PYOtherRevenueAmt |
| CY Other Revenue | $802,161 | CYOtherRevenueAmt |
| PY Total Revenue | $6,166,562 | PYTotalRevenueAmt |
| CY Total Revenue | $7,617,825 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $5,147,310 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,707,336 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $82,024 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $83,759 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $49,210 | PYOtherExpensesAmt |
| CY Other Expenses | $75,625 | CYOtherExpensesAmt |
| PY Total Expenses | $5,278,544 | PYTotalExpensesAmt |
| CY Total Expenses | $1,866,720 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $888,018 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $5,751,105 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $34,156,655 | TotalAssetsBOYAmt |
| Total Assets EOY | $38,407,760 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,500,000 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $32,656,655 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $38,407,760 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE ORGANIZATION IS OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE RESIDENTS OF CLARKSVILLE,TN; MONTGOMERY COUNTY, TN; AND THE COUNTIES OF NORTHERN MIDDLE TN AND FORT CAMPBELL, KY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,731,481 | ExpenseAmt |
| Grant | $1,707,336 | GrantAmt |
| Desc | HEALTH INITIATIVES, EDUCATION, AND PROJECTS SUPPORTING THE COMMUNITY. | Desc |
| Total Program Service Expenses | $1,731,481 | 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 | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | 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 | Yes (true) | 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 | false | ScheduleORequiredInd |
| IRP Document | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 3 | EmployeeCnt |
| Employment Tax Returns Filed | false | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | false | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | false | RegularMonitoringEnfrcInd |
| 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
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PAULA JOHNSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9318962744 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 SOUTH SECOND ST | AddressLine1Txt |
| City | CLARKSVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37040 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| MARK BANASIAK | ||||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | ||
| TOMMY BATES | ||||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | ||
| JEFF BIBB | ||||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | ||
| JIM DURRETT | ||||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | ||
| TOM GRABENSTIEN | ||||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | ||
| MARK HOLLEMAN | ||||||
| TRUSTEE/DIRE | Yes (X) | $0 | $0 | $0 | 0.00 | |
| KELLIE JACKSON | ||||||
| TRUSTEE/DIRE | Yes (X) | $0 | $0 | $0 | 0.00 | |
| ROSALIND KURITA | ||||||
| CHAIRMAN | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| KYLE LUTHER | ||||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | ||
| VINCENT PINKNEY | ||||||
| VICE CHAIR | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JOE PITTS | ||||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | ||
| KHANDRA SMALLEY | ||||||
| SECRETARY/TR | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JOEY SMITH | ||||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | ||
| MARK TRAWINSKI | ||||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Related Organizations | $4,000,000 | RelatedOrganizationsAmt |
| Total Contributions | $4,000,000 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,815,664 | TotalRevenueColumnAmt |
| Exclusion | $2,815,664 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $938,896 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $177,949 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $760,947 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $760,947 | TotalRevenueColumnAmt |
| Exclusion | $760,947 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|
| GRANT MONIES RETURNED | $37,813 | $37,813 |
| OTHER | $3,401 | $3,401 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $41,214 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,617,825 | TotalRevenueColumnAmt |
| Exclusion | $3,617,825 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,707,336 | TotalAmt |
| Program Services | $1,707,336 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,758 | TotalAmt |
| Program Services | $21,593 | ProgramServicesAmt |
| Management And General | $56,165 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,001 | TotalAmt |
| Program Services | $1,652 | ProgramServicesAmt |
| Management And General | $4,349 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,000 | TotalAmt |
| Management And General | $38,000 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,450 | TotalAmt |
| Management And General | $2,450 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,905 | TotalAmt |
| Program Services | $900 | ProgramServicesAmt |
| Management And General | $5,005 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,691 | TotalAmt |
| Management And General | $4,691 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,780 | TotalAmt |
| Management And General | $17,780 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,799 | TotalAmt |
| Management And General | $6,799 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,866,720 | TotalAmt |
| Program Services | $1,731,481 | ProgramServicesAmt |
| Management And General | $135,239 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $323,990 | BOYAmt |
| EOY | $348,321 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,268,168 | BOYAmt |
| EOY | $10,065,069 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,617 | BOYAmt |
| EOY | $7,771 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,006,875 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,476,037 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,561,715 | BOYAmt |
| EOY | $3,530,838 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,847,698 | BOYAmt |
| EOY | $20,106,761 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,146,467 | BOYAmt |
| EOY | $4,349,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,156,655 | BOYAmt |
| EOY | $38,407,760 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,500,000 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,500,000 | 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 | $28,509,404 | BOYAmt |
| EOY | $34,057,975 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,147,251 | BOYAmt |
| EOY | $4,349,785 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,656,655 | BOYAmt |
| EOY | $38,407,760 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,156,655 | BOYAmt |
| EOY | $38,407,760 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $5,751,105 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Community Trust | Yes (X) | CommunityTrustInd |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $500,005 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,150,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,000,005 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,000,000 | CurrentTaxYearAmt |
| Total | $13,650,015 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $500,005 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,150,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,000,005 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,000,000 | CurrentTaxYearAmt |
| Total | $13,650,015 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $13,650,015 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,877,175 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,789,174 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $941,723 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,344,078 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,473,785 | CurrentTaxYearAmt |
| Total | $9,425,935 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $27,448 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $118,430 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $113,606 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $54,239 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $41,214 | CurrentTaxYearAmt |
| Total | $354,937 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $23,430,887 | TotalSupportAmt |
| Public Support CY170 | 0.58260 | PublicSupportCY170Pct |
| Public Support PY170 | 0.54640 | 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
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,146,467 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $374,547 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $172,014 | OtherExpendituresAmt |
| Administrative Expenses | $31,625 | AdministrativeExpensesAmt |
| End Year Balance | $4,349,000 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,141,857 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $249,047 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $199,502 | OtherExpendituresAmt |
| Administrative Expenses | $44,935 | AdministrativeExpensesAmt |
| End Year Balance | $4,146,467 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,671,877 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $677,189 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $176,959 | OtherExpendituresAmt |
| Administrative Expenses | $30,250 | AdministrativeExpensesAmt |
| End Year Balance | $4,141,857 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,221,190 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$260,726 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $249,255 | OtherExpendituresAmt |
| Administrative Expenses | $39,332 | AdministrativeExpensesAmt |
| End Year Balance | $3,671,877 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,728,743 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $693,188 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $169,752 | OtherExpendituresAmt |
| Administrative Expenses | $30,989 | AdministrativeExpensesAmt |
| End Year Balance | $4,221,190 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $2,321,020 | InvestmentCostOrOtherBasisAmt |
| Book Value | $2,321,020 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,381,491 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $1,290,145 | DepreciationAmt |
| Book Value | $91,346 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $64,139 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $44,756 | DepreciationAmt |
| Book Value | $19,383 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,184,136 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $56,089 | OtherCostOrOtherBasisAmt |
| Depreciation | $141,136 | DepreciationAmt |
| Book Value | $1,099,089 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,530,838 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INTEREST IN TRUSTS HELD BY OTHERS | $3,391,892 |
| BENEFICIAL INTEREST IN PERPETUAL TRU | $957,108 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,349,000 | TotalBookValueOtherAssetsAmt |
| Total Rev Etc Audited Fincl Stmt | $7,617,825 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $7,617,825 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $7,617,825 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,866,720 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $1,866,720 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $1,866,720 | TotalExpensesPerForm990Amt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (20 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|
| CLARKSVILLE- MONTG CO EDUCATION FOU | ||||||
| 621 GRACEY AVE | CLARKSVILLE | TN | 37043 | 581662301 | $67,634 | PUBLIC EDUCATION |
| CUMBERLAND HEIGHTS FOUNDATION | ||||||
| 8283 RIVER ROAD PIKE | NASHVILLE | TN | 37209 | 581965168 | $50,000 | SCHOLARSHIP/OUTPATIE |
| CUSTOMS HOUSE MUSEUM | ||||||
| 200 SOUTH 2ND ST | CLARKSVILLE | TN | 37040 | 581504427 | $150,000 | EDUCATION |
| FOOD INITIATIVE | ||||||
| 1230 ROSSVIEW RD | CLARKSVILLE | TN | 37043 | 450493395 | $45,500 | FOOD PRODUCTION |
| FRIENDS OF THE LIABRARY | ||||||
| 350 PAGEANT LN 501 | CLARKSVILLE | TN | 37040 | 581557594 | $112,200 | PUBLIC EDUCATION |
| MANNA CAFE | ||||||
| 1960-J MADISON ST | CLARKSVILLE | TN | 37043 | 271699146 | $363,900 | MEALS |
| MENTAL HEALTH ASSOC OF MID TN | ||||||
| 446 METROPLEX DR SUITE A-224 | NASHVILLE | TN | 37211 | 620637710 | $20,000 | SUICIDE PREVENTION |
| MID CUMBERLAND HUMAN RESOURCES | ||||||
| 1101 KERMIT DR STE 300 | NASHVILLE | TN | 37179 | 620923487 | $100,000 | MEALS ON WHEELS |
| MINDS MATTER | ||||||
| 1989 MADISON ST | CLARKSVILLE | TN | 37043 | 842193210 | $20,000 | MENTAL HEALTH SERVIC |
| MONTGOMERY CO VETERANS COALITION | ||||||
| PO BOX 491 | CLARKSVILLE | TN | 37041 | 473566838 | $46,899 | VETERANS HEALTH |
| NURSES FOR NEWBORNS | ||||||
| 50 VANTAGE WAY SUITE 101 | NASHVILLE | TN | 37288 | 431601329 | $15,000 | INFANT CARE |
| PASTORAL COUNSELING | ||||||
| PO BOX 50242 | NASHVILLE | TN | 37205 | 581731899 | $12,000 | MENTAL HEALTH |
| PROJECT TRANSFORMATION | ||||||
| 1088 19TH ST | NASHVILLE | TN | 37212 | 453265261 | $39,459 | SUMMER PROGRAM |
| REBOOT COMBAT RECOVERY | ||||||
| PO BOX 1223 | FT CAMPBELL | KY | 42223 | 453305357 | $48,024 | PTSD & COMBAT TRAUMA |
| SAFE SOLDIERS AND FAMILIES | ||||||
| PO BOX 4008 | CLARKSVILLE | TN | 37043 | 260498912 | $59,482 | COUNSELING |
| THE YOUTH COALITION | ||||||
| 2395 GOLDENEYE COURT | CLARKSVILLE | TN | 37042 | 832974157 | $142,734 | SUBSTANCE ABUSE PREV |
| TN KIDNEY FOUNDATION | ||||||
| 37 PEADBODY ST SUITE 206 | NASHVILLE | TN | 37210 | 270812507 | $37,252 | TRANSPORTATION |
| WADE L BOURNE NATURE CENTER | ||||||
| 2308 ROTARY PARK DR | CLARKSVILLE | TN | 37043 | 833481673 | $263,795 | PUBLIC HEALTH |
| WOMEN ELEVATED | ||||||
| 3404 BRADFIELD DR | CLARKSVILLE | TN | 37042 | 823341697 | $69,642 | VETERANS HEALTH |
| YMCA | ||||||
| 260 HILLCREST DR | CLARKSVILLE | TN | 37043 | 620476243 | $43,815 | HEALTH PROGRAMS |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | THE ORGANIZATION IS OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE RESIDENTS OF CLARKSVILLE,TN; MONTGOMERY COUNTY, TN; AND THE COUNTIES OF NORTHERN MIDDLE TN AND FORT CAMPBELL, KY. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE 990 WAS REVIEWED BY THE CHAIRMAN OF THE BOARD |
| FORM 990, PAGE 6, PART VI, LINE 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC |
Comments