CREATE YOUR STATEMENT: Form 990EZ, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- CREATE YOUR STATEMENT (EIN 45-4505016)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-15
- IRS object ID
- 202143199349204329
- Schema version
- 2020v4.0
- 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 | 2021-11-15T09:30:53-08:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 842964799 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kirchner & Jordan CPA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 427 W Sinto Ave Ste 200 | AddressLine1Txt |
| City | Spokane | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 454505016 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CREATE YOUR STATEMENT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CREA | BusinessNameControlTxt |
| Phone | 5099937000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 18934 | AddressLine1Txt |
| City | SPOKANE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99228 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JENNY MOELLER | PersonNm |
| Person Title | President | PersonTitleTxt |
| Signature | 2021-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JENNY | PersonFirstNm |
| Person Last | MOELLER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KYLE JORDAN CPA | PreparerPersonNm |
| PTIN | P01287966 | PTIN |
| Phone | 5093288844 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Federated Assurance Level | FAL1 | FederatedAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Website Address | WWW.CREATEYOURSTATEMENT.COM | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $110,956 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $92,838 | ContributionsGiftsGrantsEtcAmt |
| Cost Or Other Basis Expense Sale | $0 | CostOrOtherBasisExpenseSaleAmt |
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Special Events Direct Expenses | $0 | SpecialEventsDirectExpensesAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
| Other Revenue Total | $18,118 | OtherRevenueTotalAmt |
| Total Revenue | $110,956 | TotalRevenueAmt |
| Salaries Other Comp Empl Bnft | $66,778 | SalariesOtherCompEmplBnftAmt |
| Occupancy Rent Utlts And Maint | $5,025 | OccupancyRentUtltsAndMaintAmt |
| Printing Publications Postage | $352 | PrintingPublicationsPostageAmt |
| Other Expenses Total | $27,975 | OtherExpensesTotalAmt |
| Total Expenses | $100,130 | TotalExpensesAmt |
| Excess Or Deficit For Year | $10,826 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $50,721 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $61,547 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,930 | BOYAmt |
| EOY | $63,314 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,000 | BOYAmt |
| EOY | $3,000 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,930 | BOYAmt |
| EOY | $66,314 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $209 | BOYAmt |
| EOY | $4,767 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,721 | BOYAmt |
| EOY | $61,547 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | STATEMENT WILL BRING EDUCATION AND AWARENESS TO THE PREVENTION OF DATING ABUSEWHILE PROMOTING LEADERSHIP AND CHARACTER DEVELOPMENT AMONG TODAYS YOUTH. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | STATEMENT IS SPECIFICALLY MEETING A UNIQUE NEED IN WASHINGTON STATE BY FOCUSING ONTHE PREVENTION OF DATING ABUSE AS OPPOSED TO DOMESTIC VIOLENCE VICTIMRECOVERY.LEADERSHIP AND CHARACTER DEVELOPMENT IS ESSENTIAL IN THE STATEMENTPROGRAMS. | DescriptionProgramSrvcAccomTxt |
| Grants And Allocations | $70,129 | GrantsAndAllocationsAmt |
| Program Service Expenses | $28,000 | ProgramServiceExpensesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $70,129 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (11 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt |
|---|---|---|
| HEIDI LAURITZEN | ||
| President | 0 | $0 |
| Jordan Ferguson | ||
| Director | 0 | $0 |
| Wendy Watson | ||
| Director | 0 | $0 |
| ED HOFFMAN | ||
| Director | 0 | $0 |
| Adriana Berndt | ||
| Director | 0 | $0 |
| Whitney Rolstad | ||
| Director | 0 | $0 |
| BRAD MOELLER | ||
| Director | 0 | $0 |
| YVONNE SMITH | ||
| Director | 0 | $0 |
| ANNE COWLES | ||
| Director | 0 | $0 |
| CASSIE ANDERSON | ||
| Secretary | 0 | $0 |
| ANNE OAKLEY | ||
| Director | 0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | false | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | false | OrganizationHadUBIInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Form1120 Pol Filed | false | Form1120PolFiledInd |
| Made Loans To From Officers | false | MadeLoansToFromOfficersInd |
| Tax Imposed Under IRC4911 | $0 | TaxImposedUnderIRC4911Amt |
| Tax Imposed Under IRC4912 | $0 | TaxImposedUnderIRC4912Amt |
| Tax Imposed Under IRC4955 | $0 | TaxImposedUnderIRC4955Amt |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| Tax Imposed On Organization Mgr | $0 | TaxImposedOnOrganizationMgrAmt |
| Tax Reimbursed By Organization | $0 | TaxReimbursedByOrganizationAmt |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JENNY MOELLER | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 18934 | AddressLine1Txt |
| City | SPOKANE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99228 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5099937000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Foreign Office | false | ForeignOfficeInd |
| Donor Advised Fnds | false | DonorAdvisedFndsInd |
| Operate Hospital | false | OperateHospitalInd |
| Tanning Services Provided | false | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| School Operating | false | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (true) | FiledScheduleAInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $79,674 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $144,840 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $89,937 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $145,049 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $92,838 | CurrentTaxYearAmt |
| Total | $552,338 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $79,674 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $144,840 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $89,937 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $145,049 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $92,838 | CurrentTaxYearAmt |
| Total | $552,338 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $552,338 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $552,338 | TotalSupportAmt |
| Public Support CY170 | 1.00000 | PublicSupportCY170Pct |
| Public Support PY170 | 1.00000 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Other Revenue.1 | PPP Loan Forgiveness $14168 |
| Other Revenue.2 | Program Revenue $3950 |
| Other Expenses.1001 | Advertising and Promotion $2006 |
| Other Expenses.1002 | Office Expenses $1505 |
| Other Expenses.1005 | Travel $859 |
| Other Expenses.1012 | Insurance $2071 |
| Other Expenses.1 | EVENTS COGS $9530 |
| Other Expenses.2 | GRANT WRITING $3800 |
| Other Expenses.3 | BOARD MEETING $3169 |
| Other Expenses.4 | BANK SERVICE CHARGE $2177 |
| Other Expenses.5 | MATERIAL $1034 |
| Other Expenses.6 | CONTRACT SERVICES $833 |
| Other Expenses.7 | SOFTWARE $525 |
| Other Expenses.8 | APPRECIATION $466 |
| Other Assets.1011 | Prepaid Expenses and Deferred Charges - Beginning $3000 Prepaid Expenses and Deferred Charges - Ending $3000 |
| Total Liabilities.1 | Payroll Liabilities - Beginning $209 Payroll Liabilities - Ending $4767 |
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