K9S 4 MOBILITY: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
K9S 4 MOBILITY (EIN 45-4748121)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-15
IRS object ID
202243199349328764
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)
Return2022-11-15T18:09:53-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN830331229PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MCGEE HEARNE & PAIZ LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1088AddressLine1Txt
CityCHEYENNECityNm
State AbbreviationWYStateAbbreviationCd
ZIP82003ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN454748121EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1K9'S 4 MOBILITY INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlK9S4BusinessNameControlTxt
Phone3072141248PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line111805 CAMPSTOOL ROADAddressLine1Txt
CityCHEYENNECityNm
State AbbreviationWYStateAbbreviationCd
ZIP82007ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHELLE WOERNERPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone3072141248PhoneNum
Signature2022-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMICHELLEPersonFirstNm
Person LastWOERNERPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRANDY MARROUPreparerPersonNm
PTINP01204639PTIN
Phone3076342151PhoneNum
Preparation2022-11-15PreparationDt

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 OfficerMICHELLE WOERNERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line111805 CAMPSTOOL ROADAddressLine1Txt
CityCHEYENNECityNm
State AbbreviationWYStateAbbreviationCd
ZIP82007ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$420,989GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.K9S4MOBILITY.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2012FormationYr
Legal Domicile StateWYLegalDomicileStateCd
Activity Or MissionK9S 4 MOBILITY, INC. IS DEDICATED TO ENRICHING THE LIVES OF OTHERS THROUGH THE TRAINING, PLACEMENT AND SUPPORT OF ASSISTANCE DOG PARTNERSHIPS BY ENHANCING MOBILITY, INCREASING INDEPENDENCE AND CONFIDENCE, AND PROVIDING DEVOTED COMPANIONSHIP. K9S 4 MOBILITY, INC. PLACES FOUR TO SIX ASSISTANCE DOG TEAMS PER YEAR, AND AIMS TO INCREASE ASSISTANCE DOG TEAM PLACEMENTS.K9S 4 MOBILITY, INC. HAS ALSO ESTABLISHED AN OWNER-TRAINED ASSISTANCE DOG TRAINING PROGRAM THAT IS OFFERED TO THOSE WISHING TO TRAIN THEIR OWN ASSISTANCE DOG UNDER THE SUPERVISION OF A CERTIFIED ASSISTANCE DOG TRAINER. ONCE ACCEPTED INTO THE OWNER-TRAINED PROGRAM, THE PERSON MUST BE WILLING TO TRAVEL TO K9S 4 MOBILITY'S TRAINING FACILITY MULTIPLE TIMES BEFORE CERTIFICATION OF THE TEAM.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee3TotalEmployeeCnt
Total Volunteers20TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$127,992PYContributionsGrantsAmt
CY Contributions Grants$325,414CYContributionsGrantsAmt
PY Program Service Revenue$27,307PYProgramServiceRevenueAmt
CY Program Service Revenue$10,287CYProgramServiceRevenueAmt
PY Investment Income$9,240PYInvestmentIncomeAmt
CY Investment Income$35,609CYInvestmentIncomeAmt
PY Other Revenue$12,406PYOtherRevenueAmt
CY Other Revenue$17,472CYOtherRevenueAmt
PY Total Revenue$176,945PYTotalRevenueAmt
CY Total Revenue$388,782CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$84,690PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$88,172CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$10,590CYTotalFundraisingExpenseAmt
PY Other Expenses$76,335PYOtherExpensesAmt
CY Other Expenses$99,435CYOtherExpensesAmt
PY Total Expenses$161,025PYTotalExpensesAmt
CY Total Expenses$187,607CYTotalExpensesAmt
PY Revenues Less Expenses$15,920PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$201,175CYRevenuesLessExpensesAmt
Total Assets BOY$711,398TotalAssetsBOYAmt
Total Assets EOY$938,595TotalAssetsEOYAmt
Total Liabilities BOY$2,557TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,755TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$708,841NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$935,840NetAssetsOrFundBalancesEOYAmt
MissionK9S 4 MOBILITY, INC. IS DEDICATED TO ENRICHING THE LIVES OF OTHERS THROUGH THE TRAINING, PLACEMENT AND SUPPORT OF ASSISTANCE DOG PARTNERSHIPS BY ENHANCING MOBILITY, INCREASING INDEPENDENCE AND CONFIDENCE, AND PROVIDING DEVOTED COMPANIONSHIP.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$144,764ExpenseAmt
Revenue$10,287RevenueAmt
DescTRAIN AND PARTNER ASSISTANCE DOGS WITH PEOPLE WHO HAVE A DISABILITYDesc
Total Program Service Expenses$144,764TotalProgramServiceExpensesAmt
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 EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
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 ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
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 Document5IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee3EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
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
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 Members8GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
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 BodyYes (1)Form990ProvidedToGvrnBodyInd
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 CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MICHELLE WOERNERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3072141248PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line111805 CAMPSTOOL ROADAddressLine1Txt
CityCHEYENNECityNm
State AbbreviationWYStateAbbreviationCd
ZIP82007ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
MICHELLE WOERNER
EXECUTIVE DIRECTOR40.00Yes (X)$48,245$0$0
HEATHER ROE DAY
CHAIR2.00Yes (X)$0$0$0Yes (X)
CAROL RIESER
VICE CHAIR2.00Yes (X)$0$0$0Yes (X)
JESS RYAN
SECRETARY2.00Yes (X)$0$0$0Yes (X)
DAWN CULPEPPER
TREASURER2.00Yes (X)$0$0$0Yes (X)
DR TRACIE CALLER
BOARD MEMBER1.00$0$0$0Yes (X)
CHRIS BASS
BOARD MEMBER1.00$0$0$0Yes (X)
LAURIE FARKAS
BOARD MEMBER1.00$0$0$0Yes (X)
JOANNA VILOS
BOARD MEMBER1.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$48,245TotalReportableCompFromOrgAmt
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
Government Grants$165,641GovernmentGrantsAmt
All Other Contributions$159,773AllOtherContributionsAmt
Noncash Contributions$9,844NoncashContributionsAmt
Total Contributions$325,414TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPROGRAM INCOMEDesc
Business900099BusinessCd
Total Revenue Column$10,287TotalRevenueColumnAmt
Related Or Exempt Func Income$10,287RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$10,287TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,383TotalRevenueColumnAmt
Exclusion$17,383ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$2,400RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$1,905RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$495RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$495TotalRevenueColumnAmt
Exclusion$495ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$46,882SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$28,656SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$18,226SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,226TotalRevenueColumnAmt
Exclusion$18,226ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$18,623FundraisingGrossIncomeAmt
Fundraising Direct Expenses$1,646FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,977TotalRevenueColumnAmt
Exclusion$16,977ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$388,782TotalRevenueColumnAmt
Related Or Exempt Func Income$10,287RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$53,081ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$48,244TotalAmt
Program Services$38,596ProgramServicesAmt
Management And General$4,824ManagementAndGeneralAmt
Fundraising$4,824FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$31,785TotalAmt
Program Services$29,968ProgramServicesAmt
Management And General$869ManagementAndGeneralAmt
Fundraising$948FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$8,143TotalAmt
Program Services$6,977ProgramServicesAmt
Management And General$579ManagementAndGeneralAmt
Fundraising$587FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$5,250TotalAmt
Management And General$5,250ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$4,935TotalAmt
Management And General$4,935ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,041TotalAmt
Fundraising$2,041FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,609TotalAmt
Management And General$2,609ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$3,669TotalAmt
Program Services$2,935ProgramServicesAmt
Management And General$734ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$11,007TotalAmt
Program Services$10,459ProgramServicesAmt
Management And General$548ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$8,981TotalAmt
Program Services$8,083ProgramServicesAmt
Management And General$898ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
DOG SUPPLIES AND EQUIPM$22,191$22,191
VET CARE$8,246$8,246
UTITLITIES$7,529$6,776$753
COMPUTER & SOFTWARE EXP$6,027$6,027

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$16,950TotalAmt
Program Services$10,533ProgramServicesAmt
Management And General$4,227ManagementAndGeneralAmt
Fundraising$2,190FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$187,607TotalAmt
Program Services$144,764ProgramServicesAmt
Management And General$32,253ManagementAndGeneralAmt
Fundraising$10,590FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$106,954BOYAmt
EOY$225,160EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$25,821BOYAmt
EOY$76,822EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$189,783LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$53,377LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$132,928BOYAmt
EOY$136,406EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$445,695BOYAmt
EOY$500,207EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$711,398BOYAmt
EOY$938,595EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,557BOYAmt
EOY$2,755EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,557BOYAmt
EOY$2,755EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$708,841BOYAmt
EOY$935,840EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$708,841BOYAmt
EOY$935,840EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$711,398BOYAmt
EOY$938,595EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$201,175ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$25,824NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
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$316,488CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$128,022CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$177,791CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$78,476CurrentTaxYearMinus1YearAmt
Current Tax Year$325,414CurrentTaxYearAmt
Total$1,026,191TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$316,488CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$128,022CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$177,791CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$78,476CurrentTaxYearMinus1YearAmt
Current Tax Year$325,414CurrentTaxYearAmt
Total$1,026,191TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$308,408SubstantialContributorsTotAmt
Public Support Total170$717,783PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,200CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,687CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,847CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,010CurrentTaxYearMinus1YearAmt
Current Tax Year$19,783CurrentTaxYearAmt
Total$51,527TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$19,249CurrentTaxYearMinus2YearsAmt
Total$19,249TotalAmt
FieldValueIRS element (for citing)
Total Support$1,096,967TotalSupportAmt
Gross Receipts Rltd Activities$91,741GrossReceiptsRltdActivitiesAmt
Public Support CY1700.65430PublicSupportCY170Pct
Public Support PY1700.93910PublicSupportPY170Pct
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 D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$445,695BeginningYearBalanceAmt
Investment Earnings Or Losses$59,195InvestmentEarningsOrLossesAmt
Administrative Expenses$4,683AdministrativeExpensesAmt
End Year Balance$500,207EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$387,583BeginningYearBalanceAmt
Investment Earnings Or Losses$61,887InvestmentEarningsOrLossesAmt
Administrative Expenses$3,775AdministrativeExpensesAmt
End Year Balance$445,695EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1.00000BoardDesignatedBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$133,684OtherCostOrOtherBasisAmt
Depreciation$19,164DepreciationAmt
Book Value$114,520BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,489OtherCostOrOtherBasisAmt
Depreciation$6,663DepreciationAmt
Book Value$4,826BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$42,110OtherCostOrOtherBasisAmt
Depreciation$25,050DepreciationAmt
Book Value$17,060BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,500OtherCostOrOtherBasisAmt
Depreciation$2,500DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$136,406TotalBookValueLandBuildingsAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1ALL JAZZED UPEvent1Nm
Gross Receipts Event1$15,538GrossReceiptsEvent1Amt
Gross Revenue Event1$15,538GrossRevenueEvent1Amt
Other Direct Expenses Event1$1,646OtherDirectExpensesEvent1Amt
Other Events Total1OtherEventsTotalCnt
Gross Receipts Other Events$3,085GrossReceiptsOtherEventsAmt
Gross Revenue Other Events$3,085GrossRevenueOtherEventsAmt
Gross Receipts Total$18,623GrossReceiptsTotalAmt
Gross Revenue Total Events$18,623GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$1,646OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$1,646DirectExpenseSummaryEventsAmt
Net Income Summary$16,977NetIncomeSummaryAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11B990 IS PROVIDED TO THE BOARD PRIOR TO ITS FILING.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS SIGN A CONFLICT OF INTEREST POLICY ANNUALLY. COMPLIANCE WITH THE POLICY IS MONITORED BY THE BOARD OF DIRECTORS PRESIDENT AND EXECUTIVE DIRECTOR.
FORM 990, PART VI, SECTION B, LINE 15ATHE CEO'S PERFORMANCE AND ATTAINMENT OF PREVIOUSLY ESTABLISHED GOALS IS REVIEWED ANNUALLY BY THE BOARD OF DIRECTORS. THE RESULTS ARE THEN UTILIZED TO ESTABLISH THE EXECUTIVE DIRECTOR'S COMPENSATION FOR THE FOLLOWING YEAR.
FORM 990, PART VI, SECTION C, LINE 19ALL PUBLIC DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.

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