CHARITYVISION INTERNATIONAL INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
CHARITYVISION INTERNATIONAL INC (EIN 77-0222786)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-14
IRS object ID
202233189349317448
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

FieldValueIRS element (for citing)
Return2022-11-14T18:17:45-05:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN870343246PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SQUIRE & COMPANY PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11329 SOUTH 800 EASTAddressLine1Txt
CityOREMCityNm
State AbbreviationUTStateAbbreviationCd
ZIP840977737ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN770222786EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHARITYVISION INTERNATIONAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlDESEBusinessNameControlTxt
Phone4352004910PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13210 N CANYON RD SUITE 107AddressLine1Txt
CityPROVOCityNm
State AbbreviationUTStateAbbreviationCd
ZIP84604ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDOUG JACKSONPersonNm
Person TitleCEOPersonTitleTxt
Phone8016879699PhoneNum
Signature2022-11-14SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstDOUGPersonFirstNm
Person LastJACKSONPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonM PAUL WINWARD CPAPreparerPersonNm
PTINP00290039PTIN
Phone8012256900PhoneNum
Preparation2022-11-14PreparationDt
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDOUG JACKSONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13210 N CANYON ROAD SUITE 107AddressLine1Txt
CityPROVOCityNm
State AbbreviationUTStateAbbreviationCd
ZIP84604ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$10,018,697GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CHARITYVISION.NETWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1989FormationYr
Legal Domicile StateUTLegalDomicileStateCd
Activity Or MissionFACILITATING THE MEDICAL AND DENTAL CARE FOR INDIGENT PATIENTS THROUGHOUT THE WORLD.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee23TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$10,947,270PYContributionsGrantsAmt
CY Contributions Grants$8,449,215CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$613PYInvestmentIncomeAmt
CY Investment Income$5CYInvestmentIncomeAmt
PY Other Revenue$1,679,524PYOtherRevenueAmt
CY Other Revenue$1,140,932CYOtherRevenueAmt
PY Total Revenue$12,627,407PYTotalRevenueAmt
CY Total Revenue$9,590,152CYTotalRevenueAmt
PY Grants And Similar Paid$9,346,492PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$12,498,818CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,171,663PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,266,342CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$112,012CYTotalFundraisingExpenseAmt
PY Other Expenses$350,689PYOtherExpensesAmt
CY Other Expenses$546,713CYOtherExpensesAmt
PY Total Expenses$10,868,844PYTotalExpensesAmt
CY Total Expenses$14,311,873CYTotalExpensesAmt
PY Revenues Less Expenses$1,758,563PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$4,721,721CYRevenuesLessExpensesAmt
Total Assets BOY$12,079,771TotalAssetsBOYAmt
Total Assets EOY$7,076,179TotalAssetsEOYAmt
Total Liabilities BOY$806,474TotalLiabilitiesBOYAmt
Total Liabilities EOY$524,603TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$11,273,297NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$6,551,576NetAssetsOrFundBalancesEOYAmt
MissionFACILITATING THE MEDICAL AND DENTAL CARE FOR INDIGENT PATIENTS THROUGHOUT THE WORLD.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$13,898,150ExpenseAmt
Grant$12,498,818GrantAmt
DescTHE DISTRIBUTION OF EQUIPMENT AND SUPPLIES TO DOCTORS THROUGHOUT THE WORLD TO PROVIDE TREATMENT TO INDIGENT PATIENTS. ALSO INCLUDES THE DISTRIBUTION OF CASH TO ORGANIZATIONS AROUND THE WORLD FOR THE PURCHASE OF NEEDED EQUIPMENT AND SUPPLIES.Desc
Total Program Service Expenses$13,898,150TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesYes (true)ForeignActivitiesInd
More Than5000 K To OrgYes (true)MoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document11IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee23EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDANIEL NELSONPersonNm
Phone4352004910PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13210 N CANYON ROAD SUITE 107AddressLine1Txt
CityPROVOCityNm
State AbbreviationUTStateAbbreviationCd
ZIP84604ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
WALTER PLUMB III
CHAIR1.00Yes (X)$0$0$0
MIKE BENNETT
BOARD MEMBER1.00Yes (X)$0$0$0
KELLY BURT
BOARD MEMBER1.00Yes (X)$0$0$0
JENNY CRAIG
BOARD MEMBER1.00Yes (X)$0$0$0
TIM FENTON
BOARD MEMBER1.00Yes (X)$0$0$0
E WILLIAM JACKSON
BOARD MEMBER1.00Yes (X)$0$0$0
DUANE MILLARD
BOARD MEMBER1.00Yes (X)$0$0$0
ORRIN HATCH
BOARD MEMBER1.00Yes (X)$0$0$0
ANN ROMNEY
BOARD MEMBER1.00Yes (X)$0$0$0
SCOTT KELLER
BOARD MEMBER1.00Yes (X)$0$0$0
ANTHON STAUFFER
BOARD MEMBER1.00Yes (X)$0$0$0
RICH PARKE
BOARD MEMBER1.00Yes (X)$0$0$0
KIMBERLY GARDNER
BOARD MEMBER1.00Yes (X)$0$0$0
RON LINDORF
BOARD MEMBER1.00Yes (X)$0$0$0
JEVIN FERDUSON
BOARD MEMBER1.00Yes (X)$0$0$0
JOSH ROMNEY
BOARD MEMBER10.00$0$0$0Yes (X)
DOUG JACKSON
CEO40.00$121,361$0$0Yes (X)
AARON LOCK
WAREHOUSE DI40.00$403,016$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$524,377TotalReportableCompFromOrgAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$158,935GovernmentGrantsAmt
All Other Contributions$8,290,280AllOtherContributionsAmt
Noncash Contributions$5,914,946NoncashContributionsAmt
Total Contributions$8,449,215TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$5TotalRevenueColumnAmt
Exclusion$5ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$59,522FundraisingGrossIncomeAmt
Fundraising Direct Expenses$119,813FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$60,291TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$1,509,955GrossSalesOfInventoryAmt
Cost Of Goods Sold$308,732CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,201,223TotalRevenueColumnAmt
Exclusion$1,201,223ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,590,152TotalRevenueColumnAmt
Exclusion$1,201,228ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$23,129TotalAmt
Program Services$23,129ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$12,475,689TotalAmt
Program Services$12,475,689ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$121,361TotalAmt
Program Services$49,361ProgramServicesAmt
Management And General$48,000ManagementAndGeneralAmt
Fundraising$24,000FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,059,452TotalAmt
Program Services$821,075ProgramServicesAmt
Management And General$158,918ManagementAndGeneralAmt
Fundraising$79,459FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$11,316TotalAmt
Program Services$7,921ProgramServicesAmt
Management And General$2,263ManagementAndGeneralAmt
Fundraising$1,132FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$74,213TotalAmt
Program Services$51,949ProgramServicesAmt
Management And General$14,843ManagementAndGeneralAmt
Fundraising$7,421FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$631TotalAmt
Program Services$320ProgramServicesAmt
Management And General$311ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$15,058TotalAmt
Program Services$20ProgramServicesAmt
Management And General$15,038ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$45,902TotalAmt
Program Services$43,844ProgramServicesAmt
Management And General$2,058ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$4,012TotalAmt
Management And General$4,012ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$44,152TotalAmt
Program Services$13,593ProgramServicesAmt
Management And General$30,559ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,372TotalAmt
Management And General$1,372ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$342,075TotalAmt
Program Services$342,075ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$4,591TotalAmt
Program Services$4,591ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$3,505TotalAmt
Program Services$3,505ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$22,048TotalAmt
Program Services$20,342ProgramServicesAmt
Management And General$1,706ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$61,141TotalAmt
Program Services$40,344ProgramServicesAmt
Management And General$20,797ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescOTHERDesc
Total$2,226TotalAmt
Program Services$392ProgramServicesAmt
Management And General$1,834ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$14,311,873TotalAmt
Program Services$13,898,150ProgramServicesAmt
Management And General$301,711ManagementAndGeneralAmt
Fundraising$112,012FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,272,040BOYAmt
EOY$1,258,755EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,838BOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$194,658BOYAmt
EOY$144,230EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$9,414,324BOYAmt
EOY$5,367,682EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$51,966BOYAmt
EOY$90,706EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$215,088LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$115,983LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$26,244BOYAmt
EOY$99,105EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$115,701BOYAmt
EOY$115,701EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$12,079,771BOYAmt
EOY$7,076,179EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$685,328BOYAmt
EOY$405,049EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$121,146BOYAmt
EOY$119,554EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$806,474BOYAmt
EOY$524,603EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$11,173,297BOYAmt
EOY$6,351,576EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$100,000BOYAmt
EOY$200,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,273,297BOYAmt
EOY$6,551,576EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$12,079,771BOYAmt
EOY$7,076,179EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$4,721,721ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

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$14,744,661CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,592,983CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,993,243CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,947,270CurrentTaxYearMinus1YearAmt
Current Tax Year$8,449,215CurrentTaxYearAmt
Total$56,727,372TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$14,744,661CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,592,983CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,993,243CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,947,270CurrentTaxYearMinus1YearAmt
Current Tax Year$8,449,215CurrentTaxYearAmt
Total$56,727,372TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$512,398SubstantialContributorsTotAmt
Public Support Total170$56,214,974PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$418CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$613CurrentTaxYearMinus1YearAmt
Current Tax Year$5CurrentTaxYearAmt
Total$1,036TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,132,164CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,654,320CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,496,276CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,096,911CurrentTaxYearMinus1YearAmt
Current Tax Year$1,509,955CurrentTaxYearAmt
Total$7,889,626TotalAmt
FieldValueIRS element (for citing)
Total Support$64,618,034TotalSupportAmt
Gross Receipts Rltd Activities$1,314,128GrossReceiptsRltdActivitiesAmt
Public Support CY1700.87000PublicSupportCY170Pct
Public Support PY1700.88180PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART II, LINE 10FormAndLineReferenceDesc
ExplanationOTHER INCOME 6,379,671ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$215,088OtherCostOrOtherBasisAmt
Depreciation$115,983DepreciationAmt
Book Value$99,105BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$99,105TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescLEASE LIABILITYDesc
Amt$119,554Amt
FieldValueIRS element (for citing)
Total Liability$119,554TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$9,590,152TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$9,590,152RevenueSubtotalAmt
Total Revenue Per Form990$9,590,152TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$14,311,873TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$14,311,873ExpensesSubtotalAmt
Total Expenses Per Form990$14,311,873TotalExpensesPerForm990Amt

Schedule F IRS990ScheduleF

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

Account Activities Outside US AccountActivitiesOutsideUSGrp (9 entries)

RegionRegionTxtType Of Activities ConductedTypeOfActivitiesConductedTxtSpecific Services ProvidedSpecificServicesProvidedTxtRegion Total ExpendituresRegionTotalExpendituresAmt
CENTRAL AMERICA AND THE CARIBBEANPROGRAM SERVICESMEDICAL CARE$4,232,982
EAST ASIA AND THE PACIFICPROGRAM SERVICESMEDICAL CARE$3,464,718
EUROPEPROGRAM SERVICESMEDICAL CARE
MIDDLE EAST AND NORTH AFRICAPROGRAM SERVICESMEDICAL CARE$35,346
SOUTH AMERICAPROGRAM SERVICESMEDICAL CARE$3,452,557
SOUTH ASIAPROGRAM SERVICESMEDICAL CARE$710,726
SOUTHEAST AFRICAPROGRAM SERVICESMEDICAL CARE$10,332
SUB-SAHARAN AFRICAPROGRAM SERVICESMEDICAL CARE$592,157
WEST ASIAPROGRAM SERVICESMEDICAL CARE
FieldValueIRS element (for citing)
Subtotal Spent$12,498,818SubtotalSpentAmt
Total Spent$12,498,818TotalSpentAmt

Grants To Org Outside US GrantsToOrgOutsideUSGrp (22 entries)

RegionRegionTxtPurpose Of GrantPurposeOfGrantTxtCash GrantCashGrantAmtManner Of Cash DisbursementMannerOfCashDisbursementTxtDescription Of Non Cash AsstDescriptionOfNonCashAsstTxtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceAmt
SOUTH AMERICAMEDICAL CARE$72,772WIREEQPT/MED. SUPPLOTHER
CENTRAL AMERICA AND THE CARIBBEANMEDICAL CARE$14,261WIREEQPT/MED. SUPPLOTHER
CENTRAL AMERICA AND THE CARIBBEANMEDICAL CARE$128,719WIREEQPT/MED. SUPPLOTHER$4,046,686
SOUTH ASIAMEDICAL CARE$446,892WIREEQP./MEDICALOTHER
EAST ASIA AND THE PACIFICMEDICAL CARE$40,652WIREEQPT/MED. SUPPLOTHER
SUB-SAHARAN AFRICAMEDICAL CARE$23,436WIREEQPT/MED. SUPPLOTHER
SOUTH ASIAMEDICAL CARE$27,419WIREEQPT/MED. SUPPLOTHER
SUB-SAHARAN AFRICAMEDICAL CAREWIREEQPT/MED. SUPPLOTHER$28,814
SOUTH ASIAMEDICAL CARE$159,378WIREEQPT./MED SUPPOTHER
SOUTH AMERICAMEDICAL CARE$116,687WIREEQPT/MED. SUPPLOTHER$513,779
SUB-SAHARAN AFRICAMEDICAL CARE$35,750WIREEQPT/MED. SUPPLOTHER
CENTRAL AMERICAN AND THE CARIBBEANMEDICAL SUPPLIES$33,711WIREEQPT/MED SUPPLIOTHER$9,605
CENTRAL ASIAMEDICAL CARE$33,994WIREEQPT/MED. SUPPLOTHER$14,407
SOUTHEAST AFRICAMEDICAL CARE$10,332WIREEQPT/MED. SUPPLOTHER
SOUTH AMERICAMEDICAL CARE$15,735WIREMEDICAL EQUIPOTHER$2,695,715
EAST ASIA AND THE PACIFICMEDICAL CARE$14,228WIREMEDICAL EQUIP$14,407
SOUTH AMERICAMEDICAL CARE$24,969WIREEQPT./MED SUPPOTHER$4,102
SUB-SAHARAN AFRICAMEDICAL CARE$253,928WIREEQPT/ SUPPLIESOTHER$240,821
SUB-SAHARAN AFRICAMEDICAL CARE$9,408WIREMEDICAL SUPPLIEOTHER
EAST ASIA AND THE PACIFICMEDICAL CARE$769,613WIREMED EQUIPMENT$2,631,313
MIDDLE EAST AND NORTH AFRICAMEDICAL CARE$35,346WIRE
SOUTH AMERICAMEDICAL$7,610WIRE
FieldValueIRS element (for citing)
Total Other Org34TotalOtherOrgCnt
Transfer To Foreign CorpfalseTransferToForeignCorpInd
Interest In Foreign TrustfalseInterestInForeignTrustInd
Foreign Corp OwnershipfalseForeignCorpOwnershipInd
Passive Foreign Investmest CofalsePassiveForeignInvestmestCoInd
Foreign PartnershipfalseForeignPartnershipInd
Boycott CountriesfalseBoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE F, PAGE 1, PART I, LINE 2CHARITYVISION INTERNATIONAL ESTABLISHES PARTNERSHIPS WITH MEDICAL PRACTITIONERS THROUGHOUT THE WORLD. CHARITYVISION INTERNATIONAL PROVIDES THESE MEDICAL PRACTITIONERS WITH MEDICAL SUPPLIES AND EQUIPMENT AND CASH GRANTS IN EXCHANGE FOR FREE/SUBSIDIZED MEDICAL CARE BEING PERFORMED BY THE MEDICAL PRACTITIONER. CHARITYVISION INTERNATIONAL REGULARLY REVIEWS THE AMOUNT OF FREE/SUBSIDIZED MEDICAL CARE BEING PROVIDED BY A MEDICAL PRACTITIONER TO ENSURE THEIR CONTINUED ACCESS TO MEDICAL SUPPLIES AND EQUIPMENT IS MERITED.
SCHEDULE F, PAGE 1, PART I, LINE 3CENTRAL AMERICA AND THE CARIBBEAN 4,232,982 0 EAST ASIA AND THE PACIFIC 3,464,718 0 EUROPE 0 0 MIDDLE EAST AND NORTH AFRICA 35,346 0 SOUTH AMERICA 3,452,557 0 SOUTH ASIA 710,726 0 SOUTHEAST AFRICA 10,332 0 SUB-SAHARAN AFRICA 592,157 0 WEST ASIA 0 0
SCHEDULE F, PAGE 5, PART V169

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1CV EVENTSEvent1Nm
Gross Receipts Event1$59,522GrossReceiptsEvent1Amt
Gross Revenue Event1$59,522GrossRevenueEvent1Amt
Other Direct Expenses Event1$119,813OtherDirectExpensesEvent1Amt
Gross Receipts Total$59,522GrossReceiptsTotalAmt
Gross Revenue Total Events$59,522GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$119,813OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$119,813DirectExpenseSummaryEventsAmt
Net Income Summary-$60,291NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1JOHN A MORAN EYE CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line165 MARIO CAPECCHI DRIVEAddressLine1Txt
CitySALT LAKE CITYCityNm
State AbbreviationUTStateAbbreviationCd
ZIP84132ZIPCd
FieldValueIRS element (for citing)
Recipient EIN876000525RecipientEIN
IRC SectionGOVIRCSectionDesc
Cash Grant$15,975CashGrantAmt
Non Cash Assistance$2,295NonCashAssistanceAmt
Purpose Of GrantVISION PROJECTS UTAHPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org10Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE I, PAGE 1, PART I, LINE 2CHARITYVISION ESTABLISHES PARTNERSHIPS WITH MEDICAL PRACTITIONERS THROUGHOUT THE WORLD. CHARITYVISION PROVIDES THESE MEDICAL PRACTITIONERS WITH MEDICAL SUPPLIES AND EQUIPMENT AND CASH GRANTS IN EXCHANGE FOR FREE MEDICAL CARE BEING PERFORMED BY THE MEDICAL PRACTITIONER. CHARITYVISION REGULARLY REVIEWS THE AMOUNT OF FREE MEDICAL CARE BEING PROVIDED BY A MEDICAL PRACTITIONER TO ENSURE THEIR CONTINUED ACCESS TO MEDICAL SUPPLIES AND EQUIPMENT IS MERITED.
SCHEDULE I, PAGE 4, PART IVTHE VALUE OF DONATED MEDICAL SUPPLIES AND EQUIPMENT IS DISCOUNTED FROM ITS FAIR MARKET VALUE SINCE CHARITYVISION INTERNATIONAL HAS NO INTENTION OF SELLING THE DONATED ITEMS AND THE MEDICAL PRACTITIONERS HAVE NO MEANS TO PURCHASE THE GOODS AT ITS FAIR MARKET VALUE. WHILE SOME GRANTS ARE MADE TO MEDICAL PRACTITIONERS WITHIN THE UNITED STATES, THESE PRACTITIONERS PERFORM FREE MEDICAL SERVICES OUTSIDE OF THE UNITED STATES WITH THE FUNDS, SUPPLIES, AND EQUIPMENT PROVIDED BY CHARITYVISION INTERNATIONAL. AS A RESULT, WE HAVE REPORTED THE TOTAL EXPENDITURES IN COLUMN F AS WELL AS ON LINE 3 OF PART IX OF FORM 990 AS REPRESENTING BOTH AMOUNTS SENT TO ORGANIZATIONS WITHIN AND OUTSIDE OF THE UNITED STATES.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonAARON LOCKPersonNm
TitleWAREHOUSE DIRECTORTitleTxt
Base Compensation Filing Org$165,052BaseCompensationFilingOrgAmt
Bonus Filing Organization$237,964BonusFilingOrganizationAmount
Total Compensation Filing Org$403,016TotalCompensationFilingOrgAmt

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$5,914,946NoncashContributionsRptF990Amt
Method Of Determining RevenuesESTIMATED FAIR VALUEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 2E. WILLIAM JACKSON DOUG JACKSON BOARD MEMBER CEO FAMILY RELATIONSHIP ANN ROMNEY JOSH ROMNEY BOARD MEMBER PRESIDENT FAMILY RELATIONSHIP
FORM 990, PAGE 6, PART VI, LINE 11BCEO REVIEWS AND APPROVES FORM 990 PRIOR TO ITS FILING. FORM 990 IS PROVIDED TO BOARD SUBSEQUENTLY.
FORM 990, PAGE 6, PART VI, LINE 12CTHE BOARD REVIEWS ANY CONFLICTS IDENTIFIED BY MEMBERS.
FORM 990, PAGE 6, PART VI, LINE 15ATHE BOARD REVIEWS COMPENSATION OF OFFICERS ON A YEARLY BASIS.
FORM 990, PAGE 6, PART VI, LINE 15BTHE BOARD REVIEWS COMPENSATION OF OFFICERS AND KEY EMPLOYEES ON A YEARLY BASIS.
FORM 990, PAGE 6, PART VI, LINE 19SUCH DOCUMENTS ARE AVAILABLE UPON REQUEST, JUST AS FORMS 990.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
CV MEDICAL LLC
1282 E CAMBRIDGE CTPROVOUT84604EQPT SALESUTCHARITYVIS
CHARITYVISON EVENTS LLC
1282 E CAMBRIDGE CTPROVOUT84604FUNDRAISINUTCHARITYVIS

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