FREE MEDICAL CLINIC OF OAK RIDGE INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- FREE MEDICAL CLINIC OF OAK RIDGE INC (EIN 90-0715369)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-16
- IRS object ID
- 202023219349315812
- Schema version
- 2019v5.1
- 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 | 2020-11-16T15:03:05-05:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 273289866 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | David J Ewan CPA PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1803 Clinch Ave | AddressLine1Txt |
| City | Knoxville | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37916 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 900715369 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FREE MEDICAL CLINIC OF OAK RIDGE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FREE | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 116 E DIVISION ROAD | AddressLine1Txt |
| City | OAK RIDGE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37830 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BILLY EDMONDS | PersonNm |
| Person Title | DIRECTOR | PersonTitleTxt |
| Phone | 8654833904 | PhoneNum |
| Signature | 2020-05-15 | SignatureDt |
| Discuss With Paid Preparer | false | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | David J Ewan | PreparerPersonNm |
| PTIN | P00072301 | PTIN |
| Phone | 8655447003 | PhoneNum |
| Preparation | 2020-11-16 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 96.69.121.241 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-11-16 | IPDt |
| IP Tm | 16:02:38 | IPTm |
| Federal Original Submission Id | 6243382020321x5qpunp | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2020-11-16 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | B8B8A0AF22268011CF1026993DE5C8B3F2D702C8 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | B8B8A0AF22268011CF1026993DE5C8B3F2D702C8 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBIN TEXTOR | PrincipalOfficerNm |
| Gross Receipts | $388,514 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | FMCOR.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2010 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | FREE MEDICAL CLINIC OF OAK RIDGE WAS ESTABLISHED TO PROMOTE AND DELIVER FREE MEDICAL AND DENTAL CARE TO UNISURED INDIVIDUALS WITH LIMITED ACCESS TO BASIC HEALTH CARE SERVICES. IT WILL ALSO HELP PROMOTE COORDINATION OF HEALTH CARE SERVICES AND EDUCATION TO THE PEOPLE OF THE REGION | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 12 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $383,352 | PYContributionsGrantsAmt |
| CY Contributions Grants | $385,287 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $565 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,227 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $383,917 | PYTotalRevenueAmt |
| CY Total Revenue | $388,514 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $264,855 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $236,570 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $31,704 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $178,980 | PYOtherExpensesAmt |
| CY Other Expenses | $159,278 | CYOtherExpensesAmt |
| PY Total Expenses | $443,835 | PYTotalExpensesAmt |
| CY Total Expenses | $395,848 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$59,918 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$7,334 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $269,906 | TotalAssetsBOYAmt |
| Total Assets EOY | $264,599 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $11,573 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $13,600 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $258,333 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $250,999 | NetAssetsOrFundBalancesEOYAmt |
| Mission | FREE MEDICAL CLINIC OF OAK RIDGE WAS ESTABLISHED TO PROMOTE AND DELIVER FREE MEDICAL AND DENTAL CARE TO UNISURED INDIVIDUALS WITH LIMITED ACCESS TO BASIC HEALTH CARE SERVICES. IT WILL ALSO HELP PROMOTE COORDINATION OF HEALTH CARE SERVICES AND EDUCATION TO THE PEOPLE OF THE REGION | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $272,413 | ExpenseAmt |
| Revenue | $379,095 | RevenueAmt |
| Desc | PRIMARY MEDICAL CAREPRIMARY MEDICAL CARE PROGRAM PROMOTES AND DELIVERS FREE MEDICAL TO THE ININDIRED INDIVIDUALS WHO HAVE LIMITED ACCESS TO BASIC HEALTH CARE SERVICES. IN 2019 MEDICAL WERE OFFERED TO 1,076 PATIENTS WITH A TOTAL OF 4,724 OFFICE VISITS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $8,676 | ExpenseAmt |
| Revenue | $9,419 | RevenueAmt |
| Desc | HEALTHY HABITS, HEALTHY LIVES IS A COMPREHENSIVE WELLNESS PROGRAM THAT BEGAN IN ANDERSON COUNTY, TN AND HAS EXPANDED INTO ROANE COUNTY, TN. THE PROGRAM OFFERS CLASSES IN DIET, NUTRITION, EXCERCISES, AND LIFE SKILLS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $281,089 | 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 | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | 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 | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | 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 |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 4 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 12 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | 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 | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | 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 | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | TN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BILLY EDMONDS | PersonNm |
| Phone | 8654833904 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 116 E DIVISION ROAD | AddressLine1Txt |
| City | OAK RIDGE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37830 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| ROBIN TEXTOR | |||||||
| PRESIDENT BOARD OF TRUSTEES | 3.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KAREN WILKEN | |||||||
| VICE PRESIDENT | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CARL PETERSON | |||||||
| TREASURER | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CAROLYN HENDERSON | |||||||
| SECRETARY | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JANE GROSSBECK | |||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| CAROL SMALLRIDGE | |||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| D RAY SMITH | |||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| TRACEY FARR | |||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| STEPHEN WHITSON | |||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| CHARLOTTE ONEIL | |||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MARIA HOOKS | |||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MIYERA CARNES | |||||||
| BOARD MEMBER | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| ANGELA RICHARDSON | |||||||
| BOARD MEMBER | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JANIS WILLIAMS | |||||||
| BOARD MEMBER | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Federated Campaigns | $8,075 | FederatedCampaignsAmt |
| Fundraising | $83,445 | FundraisingAmt |
| Government Grants | $104,600 | GovernmentGrantsAmt |
| All Other Contributions | $189,167 | AllOtherContributionsAmt |
| Total Contributions | $385,287 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,227 | TotalRevenueColumnAmt |
| Exclusion | $3,227 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rpt Fundraising Event | $83,445 | ContriRptFundraisingEventAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $388,514 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,227 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,560 | TotalAmt |
| Program Services | $40,706 | ProgramServicesAmt |
| Management And General | $9,105 | ManagementAndGeneralAmt |
| Fundraising | $3,749 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,054 | TotalAmt |
| Program Services | $122,401 | ProgramServicesAmt |
| Management And General | $27,379 | ManagementAndGeneralAmt |
| Fundraising | $11,274 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,506 | TotalAmt |
| Program Services | $4,901 | ProgramServicesAmt |
| Management And General | $440 | ManagementAndGeneralAmt |
| Fundraising | $165 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,450 | TotalAmt |
| Program Services | $14,311 | ProgramServicesAmt |
| Management And General | $1,316 | ManagementAndGeneralAmt |
| Fundraising | $823 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,044 | TotalAmt |
| Management And General | $12,044 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,642 | TotalAmt |
| Management And General | $2,890 | ManagementAndGeneralAmt |
| Fundraising | $2,752 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,770 | TotalAmt |
| Program Services | $23,199 | ProgramServicesAmt |
| Management And General | $10,229 | ManagementAndGeneralAmt |
| Fundraising | $342 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,850 | TotalAmt |
| Program Services | $1,850 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,854 | TotalAmt |
| Program Services | $37,091 | ProgramServicesAmt |
| Management And General | $5,763 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,375 | TotalAmt |
| Program Services | $3,187 | ProgramServicesAmt |
| Management And General | $2,869 | ManagementAndGeneralAmt |
| Fundraising | $319 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,897 | TotalAmt |
| Program Services | $4,113 | ProgramServicesAmt |
| Management And General | $784 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,207 | TotalAmt |
| Program Services | $1,113 | ProgramServicesAmt |
| Management And General | $1,991 | ManagementAndGeneralAmt |
| Fundraising | $103 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL EXPENSES | $26,799 | $25,418 | $1,381 | |
| VOLUNTEER RECOGNITION AND EX | $3,155 | $3,155 | ||
| SPECIAL EVENTS & FUNDRAISING | $12,177 | $12,177 | ||
| MEMBERSHIP & DUES | $2,792 | $2,792 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,716 | TotalAmt |
| Program Services | $2,799 | ProgramServicesAmt |
| Management And General | $917 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $395,848 | TotalAmt |
| Program Services | $281,089 | ProgramServicesAmt |
| Management And General | $83,055 | ManagementAndGeneralAmt |
| Fundraising | $31,704 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $98,917 | BOYAmt |
| EOY | $83,124 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,500 | BOYAmt |
| EOY | $111,819 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,035 | BOYAmt |
| EOY | $31,411 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,708 | BOYAmt |
| EOY | $2,396 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $59,485 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $23,636 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,746 | BOYAmt |
| EOY | $35,849 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $269,906 | BOYAmt |
| EOY | $264,599 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,573 | BOYAmt |
| EOY | $13,600 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,573 | BOYAmt |
| EOY | $13,600 | 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 | $258,333 | BOYAmt |
| EOY | $250,999 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $258,333 | BOYAmt |
| EOY | $250,999 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $269,906 | BOYAmt |
| EOY | $264,599 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$7,334 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (true) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
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 | $325,411 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $228,133 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $356,484 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $285,625 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $297,632 | CurrentTaxYearAmt |
| Total | $1,493,285 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $325,411 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $228,133 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $356,484 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $285,625 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $297,632 | CurrentTaxYearAmt |
| Total | $1,493,285 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $321,515 | SubstantialContributorsTotAmt |
| Public Support Total170 | $1,171,770 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $265 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $530 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $546 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $565 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,227 | CurrentTaxYearAmt |
| Total | $5,133 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $59,198 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $82,384 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $90,430 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $97,727 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $83,445 | CurrentTaxYearAmt |
| Total | $413,184 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $1,911,602 | TotalSupportAmt |
| Public Support CY170 | 0.61300 | PublicSupportCY170Pct |
| Public Support PY170 | 0.68430 | 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
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,977 | OtherCostOrOtherBasisAmt |
| Book Value | $14,977 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $43,148 | OtherCostOrOtherBasisAmt |
| Depreciation | $23,636 | DepreciationAmt |
| Book Value | $19,512 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,360 | OtherCostOrOtherBasisAmt |
| Book Value | $1,360 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $35,849 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $614,066 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $225,552 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $225,552 | RevenueNotReportedAmt |
| Revenue Subtotal | $388,514 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $388,514 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $621,400 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $225,552 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $225,552 | ExpensesNotReportedAmt |
| Expenses Subtotal | $395,848 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $395,848 | TotalExpensesPerForm990Amt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | BASH 2017 | Event1Nm |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990 governing body review Part VI line 11 | A REVIEW OF THE FORM 990 WILL BE CONDUCTED VIA EMAIL IN AN ELECTRONIC FORMAT ON 11.15.20. THE BOARD MEMBERS WILL APPROVE AND/OR SUMBIT QUESTIONS VIA EMAIL. |
| Conflict of interest policy compliance Part VI line 12c | THE CONFLICT OF INTEREST POLICY IS MONITORED BY THE BOARD ON ALL DECISIONS. ALL BOARD MEMBERS ARE INDEPENDENT FROM MANAGMENT AND FROM ALL CONTRACTORS. |
| CEO executive director top management comp Part VI line 15a | THE BOARD OF DIRECTORS REVIEWS AND SETS ALL SALARIES FOR ALL EMPLOYEES BASED ON PERFOMANCE REVIEWS. |
| Other officer or key employee compensation Part VI line 15b | THE BOARD OF DIRECTORS REVIEWS AND SETS SALARIES FOR ALL EMPLOYEES BASED ON PERFORMANCE REVIEWS. NO OFFICERS OR BOARD MEMBERS ARE COMPENSATED. |
| Governing documents etc available to public Part VI line 19 | DOCUMENTS ARE AVAILABLE UPON REQUEST AT THE MAIN OFFICE. |
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