BOYS & GIRLS CLUB OF SPARTA INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
BOYS & GIRLS CLUB OF SPARTA INC (EIN 39-1798177)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-13
IRS object ID
201903179349307705
Schema version
2018v3.1
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

FieldValueIRS element (for citing)
Return2019-11-13T15:45:44-06:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN391628949PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1JOHNSON BLOCK & CO INCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1122 6TH STREET NORTHAddressLine1Txt
CityLA CROSSECityNm
State AbbreviationWIStateAbbreviationCd
ZIP54601ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391798177EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BOYS & GIRLS CLUB OF SPARTA INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBOYSBusinessNameControlTxt
Phone6082692582PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11000 E MONTGOMERY STREETAddressLine1Txt
CitySPARTACityNm
State AbbreviationWIStateAbbreviationCd
ZIP54656ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJENNIFER SIMUNICHPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone6082692582PhoneNum
Signature2019-11-06SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSCOTT TURNBULLPreparerPersonNm
PTINP00446288PTIN
Phone6087841890PhoneNum
Preparation2019-11-13PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.16.49IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-11-13IPDt
IP Tm15:45:44IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdF5BD353FDDA2D60CE2C02026FC54D0DD6F32EBC8AtSubmissionCreationDeviceId
At Submission Filing Device Id2AF561AED5CF417DF4A8F4480DC7452C8E7912DAAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-03-31 21:24:44ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJENNIFER SIMUNICHPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 EAST MONTGOMERY STAddressLine1Txt
CitySPARTACityNm
State AbbreviationWIStateAbbreviationCd
ZIP54656ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$543,535GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.BGCOFSPARTA.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1995FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionTO INSPIRE AND ENABLE ALL YOUNG PEOPLE, ESPECIALLY THOSE WHO NEED US MOST, TO REALIZE THEIR FULL POTENTIAL AS PRODUCTIVE, RESPONSIBLE AND CARING CITIZENS.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee119TotalEmployeeCnt
Total Volunteers70TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$263,978PYContributionsGrantsAmt
CY Contributions Grants$185,446CYContributionsGrantsAmt
PY Program Service Revenue$306,499PYProgramServiceRevenueAmt
CY Program Service Revenue$311,690CYProgramServiceRevenueAmt
PY Investment Income$16,508PYInvestmentIncomeAmt
CY Investment Income$23,273CYInvestmentIncomeAmt
PY Other Revenue$523PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$587,508PYTotalRevenueAmt
CY Total Revenue$520,409CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$422,069PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$419,197CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$24,989CYTotalFundraisingExpenseAmt
PY Other Expenses$119,616PYOtherExpensesAmt
CY Other Expenses$131,098CYOtherExpensesAmt
PY Total Expenses$541,685PYTotalExpensesAmt
CY Total Expenses$550,295CYTotalExpensesAmt
PY Revenues Less Expenses$45,823PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$29,886CYRevenuesLessExpensesAmt
Total Assets BOY$557,462TotalAssetsBOYAmt
Total Assets EOY$510,489TotalAssetsEOYAmt
Total Liabilities BOY$15,894TotalLiabilitiesBOYAmt
Total Liabilities EOY$39,933TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$541,568NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$470,556NetAssetsOrFundBalancesEOYAmt
MissionTO INSPIRE AND ENABLE ALL YOUNG PEOPLE, ESPECIALLY THOSE WHO NEED US MOST, TO REALIZE THEIR FULL POTENTIAL AS PRODUCTIVE, RESPONSIBLE AND CARING CITIZENS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$442,756ExpenseAmt
Revenue$311,690RevenueAmt
DescPROVIDES A SAFE PLACE TO LEARN AND GROW; ONGOING RELATIONSHIPS WITH CARING, ADULT PROFESSIONALS; LIFE-ENHANCING PROGRAMS AND CHARACTER DEVELOPMENT EXPERIENCES; HOPE AND OPPORTUNITY.Desc
Total Program Service Expenses$442,756TotalProgramServiceExpensesAmt
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
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
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 With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee119EmployeeCnt
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 Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
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
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonPATTY ELSENPersonNm
Phone6082692582PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11000 EAST MONTGOMERY STREETAddressLine1Txt
CitySPARTACityNm
State AbbreviationWIStateAbbreviationCd
ZIP54656ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
MEGAN ABBOTT
SECRETARY1.00Yes (X)Yes (X)$0$0$0
BEN CRENSHAW
PRESIDENT EL1.00Yes (X)Yes (X)$0$0$0
KYLE DAVIS
TREASURER1.00Yes (X)Yes (X)$0$0$0
SAMANTHA GOFF
DIRECTOR1.00Yes (X)$0$0$0
JENNY HEDRICK-ERICKSON
PAST PRESIDE1.00Yes (X)Yes (X)$0$0$0
TAWNI KIND
DIRECTOR1.00Yes (X)$0$0$0
ANDY KUEN
DIRECTOR1.00Yes (X)$0$0$0
JOSH LYDON
DIRECTOR1.00Yes (X)$0$0$0
EMILEE NOTTESTAD
DIRECTOR1.00Yes (X)$0$0$0
ALEATRA OLSON
DIRECTOR1.00Yes (X)$0$0$0
PAUL SOLBERG
DIRECTOR1.00Yes (X)$0$0$0
BEN WAEGE
PRESIDENT1.00Yes (X)$0$0$0
JENNIFER SIMUNICH
EXECUTIVE DI40.00Yes (X)$50,013$0$1,500
FieldValueIRS element (for citing)
Total Reportable Comp From Org$50,013TotalReportableCompFromOrgAmt
Total Other Compensation$1,500TotalOtherCompensationAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Federated Campaigns$27,136FederatedCampaignsAmt
Fundraising$90,045FundraisingAmt
All Other Contributions$68,265AllOtherContributionsAmt
Total Contributions$185,446TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PROGRAM GRANTS AND CONTRACTS$239,827$239,827
PROGRAM$71,863$71,863
FieldValueIRS element (for citing)
Total Program Service Revenue$311,690TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$23,273TotalRevenueColumnAmt
Exclusion$23,273ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$23,126FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$90,045ContriRptFundraisingEventAmt
Fundraising Direct Expenses$23,126FundraisingDirectExpensesAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$520,409TotalRevenueColumnAmt
Related Or Exempt Func Income$311,690RelatedOrExemptFuncIncomeAmt
Exclusion$23,273ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$50,013TotalAmt
Program Services$38,570ProgramServicesAmt
Management And General$10,003ManagementAndGeneralAmt
Fundraising$1,440FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$322,406TotalAmt
Program Services$280,895ProgramServicesAmt
Management And General$28,981ManagementAndGeneralAmt
Fundraising$12,530FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$4,008TotalAmt
Program Services$2,342ProgramServicesAmt
Management And General$979ManagementAndGeneralAmt
Fundraising$687FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$14,074TotalAmt
Program Services$8,785ProgramServicesAmt
Management And General$1,811ManagementAndGeneralAmt
Fundraising$3,478FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$28,696TotalAmt
Program Services$24,014ProgramServicesAmt
Management And General$3,008ManagementAndGeneralAmt
Fundraising$1,674FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$16,869TotalAmt
Management And General$16,869ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$13,592TotalAmt
Program Services$10,967ProgramServicesAmt
Management And General$2,147ManagementAndGeneralAmt
Fundraising$478FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$4,366TotalAmt
Program Services$1,746ProgramServicesAmt
Management And General$2,620ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$527TotalAmt
Management And General$527ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,892TotalAmt
Program Services$5,008ProgramServicesAmt
Management And General$589ManagementAndGeneralAmt
Fundraising$295FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$17,190TotalAmt
Program Services$15,471ProgramServicesAmt
Management And General$1,719ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
OTHER$39,846$25,557$10,450$3,839
SUPPLIES$15,040$14,321$719
DUES AND SUBSCRIPTIONS$10,983$10,983
TELEPHONE$3,091$2,473$309$309

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$3,702TotalAmt
Program Services$1,624ProgramServicesAmt
Management And General$1,819ManagementAndGeneralAmt
Fundraising$259FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$550,295TotalAmt
Program Services$442,756ProgramServicesAmt
Management And General$82,550ManagementAndGeneralAmt
Fundraising$24,989FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$125BOYAmt
EOY$488EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$5,827BOYAmt
EOY$2,791EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$64,788BOYAmt
EOY$42,617EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$45BOYAmt
EOY$1,198EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$267,628LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$145,331LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$127,304BOYAmt
EOY$122,297EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$359,373BOYAmt
EOY$341,098EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$557,462BOYAmt
EOY$510,489EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$15,894BOYAmt
EOY$28,476EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
EOY$11,457EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$15,894BOYAmt
EOY$39,933EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$491,568BOYAmt
EOY$445,556EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$50,000BOYAmt
EOY$25,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$541,568BOYAmt
EOY$470,556EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$557,462BOYAmt
EOY$510,489EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$29,886ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$41,126NetUnrlzdGainsLossesInvstAmt
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$288,546CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$352,540CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$267,710CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$263,978CurrentTaxYearMinus1YearAmt
Current Tax Year$185,446CurrentTaxYearAmt
Total$1,358,220TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$288,546CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$352,540CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$267,710CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$263,978CurrentTaxYearMinus1YearAmt
Current Tax Year$185,446CurrentTaxYearAmt
Total$1,358,220TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$432,363SubstantialContributorsTotAmt
Public Support Total170$925,857PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,693CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,995CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,271CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,508CurrentTaxYearMinus1YearAmt
Current Tax Year$23,273CurrentTaxYearAmt
Total$62,740TotalAmt
FieldValueIRS element (for citing)
Total Support$1,420,960TotalSupportAmt
Gross Receipts Rltd Activities$660,700GrossReceiptsRltdActivitiesAmt
Public Support CY1700.65160PublicSupportCY170Pct
Public Support PY1700.66790PublicSupportPY170Pct
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$359,373BeginningYearBalanceAmt
Investment Earnings Or Losses-$18,275InvestmentEarningsOrLossesAmt
End Year Balance$341,098EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$247,476BeginningYearBalanceAmt
Contributions$72,196ContributionsAmt
Investment Earnings Or Losses$39,701InvestmentEarningsOrLossesAmt
End Year Balance$359,373EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$219,942BeginningYearBalanceAmt
Contributions$10,000ContributionsAmt
Investment Earnings Or Losses$17,534InvestmentEarningsOrLossesAmt
End Year Balance$247,476EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$116,530BeginningYearBalanceAmt
Contributions$105,800ContributionsAmt
Investment Earnings Or Losses-$2,388InvestmentEarningsOrLossesAmt
End Year Balance$219,942EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$38,267BeginningYearBalanceAmt
Contributions$76,600ContributionsAmt
Investment Earnings Or Losses$1,663InvestmentEarningsOrLossesAmt
End Year Balance$116,530EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1.00000BoardDesignatedBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$33,144OtherCostOrOtherBasisAmt
Book Value$33,144BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$234,484OtherCostOrOtherBasisAmt
Depreciation$145,331DepreciationAmt
Book Value$89,153BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$122,297TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$520,408TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$41,126NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$17,999DonatedServicesAndUseFcltsAmt
Other Revenue$23,126OtherRevenueAmt
Revenue Not Reported-$1RevenueNotReportedAmt
Revenue Subtotal$520,409RevenueSubtotalAmt
Total Revenue Per Form990$520,409TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$591,420TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$17,999DonatedServicesUseFcltsAmt
Other Expenses Included$23,126OtherExpensesIncludedAmt
Expenses Not Reported$41,125ExpensesNotReportedAmt
Expenses Subtotal$550,295ExpensesSubtotalAmt
Total Expenses Per Form990$550,295TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 3, PART XIN ACCORDANCE WITH PROFESSIONAL STANDARDS, THE CLUB FOLLOWS THE STATUTORY REQUIREMENTS FOR THEIR INCOME TAX ACCOUNTING AND GENERALLY AVOIDS RISKS ASSOCIATED WITH POTENTIALLY PROBLEMATIC TAX POSITIONS THAT MAY BE CHALLENGED UPON EXAMINATION. MANAGEMENT BELIEVES ANY LIABILITY RESULTING FROM TAXING AUTHORITIES IMPOSING ADDITIONAL INCOME TAXES FROM ACTIVITIES DEEMED TO BE UNRELATED TO THE CLUBS TAX-EXEMPT STATUS WOULD NOT HAVE A MATERIAL EFFECT ON THE ACCOMPANYING FINANCIAL STATEMENTS.
SCHEDULE D, PAGE 4, PART XI, LINE 2DSPECIAL EVENTS COSTS 23,126
SCHEDULE D, PAGE 4, PART XII, LINE 2DSPECIAL EVENTS COSTS 23,126

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1HOUSE OF SHADOWEvent1Nm
Gross Receipts Event1$67,081GrossReceiptsEvent1Amt
Charitable Contri Event1$53,799CharitableContriEvent1Amt
Gross Revenue Event1$13,282GrossRevenueEvent1Amt
Other Direct Expenses Event1$13,282OtherDirectExpensesEvent1Amt
Event2GOLF OUTINGEvent2Nm
Gross Receipts Event2$24,692GrossReceiptsEvent2Amt
Charitable Contri Event2$18,938CharitableContriEvent2Amt
Gross Revenue Event2$5,754GrossRevenueEvent2Amt
Other Direct Expenses Event2$5,754OtherDirectExpensesEvent2Amt
Other Events Total2OtherEventsTotalCnt
Gross Receipts Other Events$18,198GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$14,108CharitableContriOtherEventsAmt
Gross Revenue Other Events$4,090GrossRevenueOtherEventsAmt
Oth Direct Expnss Other Events$4,090OthDirectExpnssOtherEventsAmt
Gross Receipts Total$109,971GrossReceiptsTotalAmt
Charitable Contributions Tot$86,845CharitableContributionsTotAmt
Gross Revenue Total Events$23,126GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$23,126OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$23,126DirectExpenseSummaryEventsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BTHE ORGANIZATION PROVIDES A COPY OF THE FORM 990 ELECTRONICALLY TO ALL BOARD MEMBERS PRIOR TO ITS FILING.
FORM 990, PAGE 6, PART VI, LINE 12CPOLICY IS DISCLOSED TO ALL NEW MEMBERS.
FORM 990, PAGE 6, PART VI, LINE 15AREVIEW AND APPROVAL BY BOARD OF DIRECTORS.
FORM 990, PAGE 6, PART VI, LINE 15BREVIEW AND APPROVAL BY BOARD OF DIRECTORS.
FORM 990, PAGE 6, PART VI, LINE 19THESE DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC
FORM 990, PART XI, LINE 9SPECIAL EVENTS COSTS 23,126 SPECIAL EVENTS COSTS -23,126

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