MENTAL HEALTH ASSOCIATION OF FORSYTH COUNTY: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
MENTAL HEALTH ASSOCIATION OF FORSYTH COUNTY (EIN 56-0776248)
Tax period
2018-07-01 to 2019-06-30
Filed
2019-11-14
IRS object ID
201943189349306234
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)
Return2019-11-14T12:19:31-06:00ReturnTs
Tax Period End2019-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN561138530PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BUTLER BURKE LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1100 CLUB OAKS COURTAddressLine1Txt
CityWINSTONSALEMCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27104ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN560776248EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE MENTAL HEALTH ASSOCIATIONBusinessNameLine1Txt
Business Name Line2IN FORSYTH COUNTY INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlMENTBusinessNameControlTxt
Phone3367683880PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11509 S HAWTHORNE ROADAddressLine1Txt
CityWINSTONSALEMCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27103ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonANDY HAGLERPersonNm
Person TitleTREASURERPersonTitleTxt
Phone3367683880PhoneNum
Signature2019-11-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJANE R POTTERPreparerPersonNm
PTINP01057495PTIN
Phone3367682310PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address98.101.54.50IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-11-13IPDt
IP Tm08:04:40IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device Id0C69949445AFF7967C37FF4FA3E179E6153D10E9AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-03-31 21:24:44ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerANDY HAGLERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11509 S HAWTHORNE ROADAddressLine1Txt
CityWINSTONSALEMCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27103ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$247,491GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.TRIADMENTALHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1946FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionTO IMPROVE THE LIVES OF PERSONS AFFECTED BY MENTAL ILLNESS THROUGH ADVOCACY, EDUCATION & SUPPORT.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee4TotalEmployeeCnt
Total Volunteers102TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$200,811PYContributionsGrantsAmt
CY Contributions Grants$213,559CYContributionsGrantsAmt
PY Program Service Revenue$31,052PYProgramServiceRevenueAmt
CY Program Service Revenue$32,388CYProgramServiceRevenueAmt
PY Investment Income$142PYInvestmentIncomeAmt
CY Investment Income$1,071CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$441CYOtherRevenueAmt
PY Total Revenue$232,005PYTotalRevenueAmt
CY Total Revenue$247,459CYTotalRevenueAmt
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$181,695PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$181,647CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$9,082CYTotalFundraisingExpenseAmt
PY Other Expenses$72,830PYOtherExpensesAmt
CY Other Expenses$60,190CYOtherExpensesAmt
PY Total Expenses$254,525PYTotalExpensesAmt
CY Total Expenses$241,837CYTotalExpensesAmt
PY Revenues Less Expenses-$22,520PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,622CYRevenuesLessExpensesAmt
Total Assets BOY$711,253TotalAssetsBOYAmt
Total Assets EOY$718,595TotalAssetsEOYAmt
Total Liabilities BOY$78,104TotalLiabilitiesBOYAmt
Total Liabilities EOY$64,601TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$633,149NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$653,994NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE MENTAL HEALTH ASSOCIATION IN FORSYTH COUNTY IS A NON-PROFIT, NON-GOVERNMENTAL AGENCY THAT IS DEDICATED TO IMPROVING THE QUALITY OF LIFE FOR PERSONS AFFECTED BY MENTAL ILLNESS THROUGH ADVOCACY, EDUCATION AND SUPPORT SERVICES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$84,517ExpenseAmt
Revenue$11,713RevenueAmt
DescCONSUMER SUPPORT IS COMPOSED OF 11 PROGRAMS. (1)HOSPITAL OUTREACH PROGRAM: VOLUNTEERS AND STAFF PROVIDE INFORMATION AND RESOURCE ASSISTANCE TO PATIENTS AND THEIR FAMILIES AT LOCAL HOSPITALS AND AT MENTAL HEALTH FACILITIES ABOUT COMMUNITY SUPPORT SERVICES INFORMATION PRIOR TO THEIR DISCHARGE. THE ASSOCIATION RESPONDS TO SPECIAL REQUESTS FROM HOSPITAL PSYCHIATRIC STAFF AS NEEDED. (2) MOOD DISORDERS SUPPORT: TIDES IS A SUPPORT GROUP FOR PEOPLE WITH MOOD DISORDERS INCLUDING CLINICAL DEPRESSION, BI-POLAR DISORDER OR OTHER MOOD DISORDERS. SUPPORT GROUPS MEET FOUR TIMES A MONTH TO SHARE INFORMATION, RESOURCE ASSISTANCE AND TO DEVELOP SELF-ADVOCACY SKILLS. (3) ANXIETY DISORDERS:THIS SUPPORT GROUP IS FOR PEOPLE WITH PANIC DISORDER, AGORAPHOBIA, OBSESSIVE COMPULSIVE DISORDER, POSTTRAUMATIC STRESS DISORDER, ACUTE STRESS DISORDER OR GENERALIZED ANXIETY DISORDER. SUPPORT GROUPS MEET TWICE A MONTH TO HELP PARTICIPANTS LEARN COPING SKILLS AND UP-TO-DATE INFORMATION ABOUT ANXIETY DISORDERS, TREATMENTS AND MEDICATION. (4) PSYCHOTIC DISORDERS: THIS SUPPORT GROUP IS FOR ADULTS WITH PSYCHOTIC DISORDERS, SCHIZOPHRENIA AND SCHIZOAFFECTIVE DISORDERS. SUPPORT GROUPS MEET TWICE A MONTH TO HELP PARTICIPANTS LEARN COPING SKILLS AND UP-TO-DATE INFORMATION ABOUT PSYCHOTIC DISORDERS, TREATMENTS AND MEDICATION. (5) DUAL DIAGNOSIS: THIS SUPPORT GROUP IS OPEN TO ANYONE WHO IS DUALLY DIAGNOSED WITH MENTAL ILLNESS AND SUBSTANCE ABUSE, OR ANY OTHER ADDICTIVE DISORDER, OR BELIEVES THAT THEY FIT THIS DIAGNOSIS. (6) SPEAK OUT! ADOLESCENT SUPPORT: THIS SUPPORT GROUP IS FOR TEENS AGES 13-17 WHO HAVE MENTAL HEALTH ISSUES SUCH AS, BUT NOT LIMITED TO THE FOLLOWING: CLINICAL DEPRESSION, ANXIETY, BIPOLAR DISORDER, ADD AND/OR ADHD. SUPPORT GROUPS MEET EVERY FIRST, THIRD AND FIFTH MONDAY EVENINGS EACH MONTH AT BEST HEALTH IN HANES MALL. (7) SPEAKER MEETINGS: MENTAL HEALTH SPEAKER, EDUCATIONAL MEETINGS ARE DEVOTED SOLELY TO THE FIFTH TUESDAYS AND/OR FIFTH FRIDAYS IN A GIVEN MONTH. SPEAKER TOPICS VARY AND HAVE INCLUDED: STRESS AND CHANGE, NUTRITION, SMOKING CESSATION AND UPDATES ON SPECIFIC MENTAL DISORDERS SUCH AS DEPRESSION, OBSESSIVE-COMPULSIVE DISORDER AND BORDERLINE PERSONALITY DISORDER. TOPICS ARE CHOSEN FROM FEEDBACK FROM SUPPORT GROUP PARTICIPANTS AND OTHERS. (8) EATING DISORDERS: THIS SUPPORT GROUP IS FOR ADULTS WITH EATING DISORDERS SUCH AS ANOREXIA NERVOSA, BULIMIA NERVOSA OR OTHER ASSOCIATED EATING DISORDERS. SUPPORT GROUPS MEET TWICE A MONTH TO HELP PARTICIPANTS LEARN COPING SKILLS AND UP-TO-DATE INFORMATION ABOUT EATING DISORDERS, TREATMENTS AND MEDICATION. (9) OPERATION SANTA CLAUS: GIFTS, SPECIAL HOLIDAY ACTIVITIES, AND, WHEN NEEDED, YEAR-ROUND ASSISTANCE ARE PROVIDED TO FORSYTH COUNTY MENTAL HEALTH PATIENTS (CHILDREN AND ADULTS) AT LOCAL FACILITIES AND AT CENTRAL REGIONAL HOSPITAL IN BUTNER, THE O'BERRY CENTER IN GOLDSBORO AND ANY OTHER STATE PSYCHIATRIC FACILITY DURING DECEMBER. COMMUNITY AGENCIES, LOCAL BUSINESSES AND CIVIC GROUPS DONATE THEIR TIME, MONEY AND GIFTS TO MAKE THE HOLIDAYS SPECIAL FOR OUR COUNTY'S MENTAL HEALTH PATIENTS. (10) REPRESENTATIVE PAYEE SERVICES: THROUGH REFERRALS, THIS PROGRAM BENEFITS PEOPLE WITH SEVERE MENTAL ILLNESS WHO RECEIVE SOCIAL SECURITY DISABILITY AND/OR SUPPLEMENTARY SECURITY INCOME OR OTHER ENTITLEMENTS, SUCH AS RAILROAD RETIREMENT, VA BENEFITS AND CANNOT MANAGE THEIR OWN FUNDS. THE ASSOCIATION BECOMES THE CLIENT'S PAYEE BY SETTING UP A BUDGET FOR EACH CLIENT AND MANAGING HIS OR HER FUNDS TO PAY HIS OR HER RENT, UTILITIES, MEDICATIONS, FOOD AND OTHER BASIC NECESSITIES. (11) CLUBHOUSE FUND: THIS PROGRAM RAISES FUNDS FOR TRIUMPH'S "CLUBHOUSE" PROJECT MEMBERS. THESE FUNDS ARE RESTRICTED FOR EXTRACURRICULAR ACTIVITIES THAT ARE NOT A NORMAL PART OF THE CLUBHOUSE CURRICULUM. THE ASSOCIATION RECEIVES CONTRIBUTIONS FROM OUTSIDE DONORS IN ADDITION TO THE FUNDS ACTUALLY RAISED BY THE PARTICIPANTS. THE MENTAL HEALTH ASSOCIATION MANAGES THESE FUNDS AND DISBURSES THEM UPON REQUEST.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$74,807ExpenseAmt
Revenue$20,225RevenueAmt
DescFAMILY SUPPORT IS COMPOSED OF 3 PROGRAMS. (1) COURT ASSISTANCE PROGRAM: EVERY WEEK TRAINED VOLUNTEERS AND STAFF PROVIDE EMOTIONAL SUPPORT, TECHNICAL ASSISTANCE AND INFORMATION AND REFERRALS TO FAMILY MEMBERS AND OUTPATIENTS DURING JUDICIAL HOSPITAL HEARINGS AT THE FORSYTH HALL OF JUSTICE. THE ASSOCIATION MONITORS THE OUTCOMES OF THE WEEKLY HEARINGS, TABULATES THE OUTCOMES IN A DATABASE AND REPORTS PAPERWORK OR OTHER CLERICAL ERRORS TO APPROPRIATE HOSPITAL OR PROVIDER STAFF. (2) FAMILY / CONSUMER ADVOCACY AND OUTREACH: THE ASSOCIATION PROVIDES FREE INDIVIDUAL AND FAMILY ADVOCACY SERVICES, RESOURCE ASSISTANCE AND SERVICE COORDINATION. THE ASSOCIATION WORKS DIRECTLY WITH CHILDREN AND ADULTS WITH MENTAL HEALTH NEEDS, THEIR FAMILIES, FRIENDS AND SERVICE PROVIDERS TO ENSURE THAT THEY LIVE FULL AND PRODUCTIVE LIVES. THE ASSOCIATION IS INVOLVED IN COLLABORATIVES SUCH AS "CRISIS INTERVENTION TEAM" TRAININGS TO LAW ENFORCEMENT PERSONNEL AND THE ASSOCIATION IS ACTIVE IN A TRIAD COALITION DESIGNED TO ADDRESS THE GROWING DILEMMA OF SUICIDES IN OUR REGION THROUGH EDUCATION AND PREVENTION. (3) TRIAD FRIENDS & FAMILY: THIS SUPPORT GROUP IS FOR FAMILIES AND FRIENDS THAT HAVE LOVED ONES WITH AN EATING DISORDER SUCH AS ANOREXIA NERVOSA AND BULIMIA NERVOSA. LED BY A LICENSED MENTAL HEALTH PROFESSIONAL, TRIAD FRIENDS & FAMILY MEET MONTHLY AT THE ASSOCIATION'S OFFICE TO HELP PARTICIPANTS GAIN A BETTER UNDERSTANDING OF HAVING A LOVED ONE WITH AN EATING DISORDER AND TO DEVELOP BETTER, MORE APPROPRIATE COPING SKILLS.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$43,520ExpenseAmt
Revenue$450RevenueAmt
DescCOMMUNITY EDUCATION IS COMPOSED OF 6 PROGRAMS. (1) INFORMATION AND REFERRAL: THIS AGENCY PROVIDES INFORMATION/REFERRAL SERVICES TO CALLERS, E-MAIL INQUIRIES, AND WALK-IN VISITORS AS WELL AS TO AREA PROFESSIONALS ON VARIOUS TOPICS SUCH AS, BUT NOT LIMITED TO: SPECIFIC MENTAL HEALTH DISORDERS, COMMUNITY MENTAL HEALTH SERVICES, MEDICATION INFORMATION, COMMUNITY SUPPORT PROGRAMS AND/OR SUBSTANCE ABUSE SERVICES. THE ASSOCIATION MAINTAINS A DATABASE OF OVER 200 LOCAL MENTAL HEALTH PROVIDERS FOR THOSE INTERESTED IN SEEING A PROVIDER IN THE PRIVATE OR PUBLIC SECTORS AND PROVIDES REFERRALS BASED ON A PERSON'S MENTAL HEALTH AND/OR FINANCIAL NEEDS. (2) RESOURCE CENTER:THE ASSOCIATION HAS A LIBRARY FOR THE PUBLIC CONTAINING "FACT SHEETS", BOOKS, EDUCATIONAL PAMPHLETS, MEDICATION ASSISTANCE, ARTICLES, VIDEOS AND TAPES ABOUT MENTAL ILLNESS AND OTHER RELATED TOPICS. (3) SPEAKERS BUREAU: STAFF PROVIDES EDUCATIONAL PROGRAMS ON MENTAL HEALTH TOPICS TO BUSINESSES, CLUBS, SCHOOLS AND CHURCHES IN FORSYTH AND SURROUNDING COUNTIES. TOPICS INCLUDE: "MENTAL HEALTH 101", COPING WITH HOLIDAY STRESS, SEASONAL AFFECTIVE DISORDER, DEPRESSION AND ANXIETY DISORDERS AND SUICIDE AWARENESS. (4) MENTAL HEALTH AND MENTAL ILLNESS AWARENESS CAMPAIGNS: PROMOTIONAL CAMPAIGNS ARE HELD TWICE A YEAR TO SPREAD AWARENESS, UNDERSTANDING HEIGHTEN SENSITIVITY AND WORK TO REDUCE THE STIGMA ASSOCIATED WITH MENTAL ILLNESS. SERVICES INCLUDE: DEPRESSION AND ANXIETY SCREENINGS, RADIO AND TELEVISION INTERVIEWS AND PANEL DISCUSSIONS. THE ASSOCIATION SPONSORS FREE SEMINARS AND PUBLIC MEETINGS ON VARIOUS MENTAL HEALTH AND RELATED TOPICS, SUCH AS FUTURE PLANNING: LIFE PLAN TRUST. (5) SYSTEMS ADVOCACY: THE ASSOCIATION CONTINUALLY ADVOCATES ON THE LOCAL, STATE AND NATIONAL LEVELS TO GOVERNMENTAL AND LEGISLATIVE BODIES IN ORDER IMPROVE, ADVOCATE AND EXPAND MENTAL HEALTH AND RELATED SERVICES. (6) PRIMARY CARE PHYSICIAN OUTREACH: A MENTAL HEALTH AWARENESS AND OUTREACH INITIATIVE TARGETING LOCAL PRIMARY CARE PHYSICIANS, PEDIATRICIANS AND OB/GYNS AND THEIR STAFFS ABOUT THE ASSOCIATION'S PROGRAMS AND SERVICES AND HOW THEY CAN LINK THEIR PATIENTS TO SPECIALTY MENTAL HEALTH CARE, WHEN NEEDED. THIS PROGRAM BEGAN WITH START-UP FUNDING FROM THE WINSTON-SALEM FOUNDATION.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$202,844TotalProgramServiceExpensesAmt
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
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
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 With Officer Ent0BusinessRlnWithOfficerEntInd
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 Document6IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee4EmployeeCnt
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
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
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 Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
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
States Where Copy Of Return Is FldNCStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMR ANDY HAGLERPersonNm
Phone3367683880PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11509 S HAWTHORNE ROADAddressLine1Txt
CityWINSTONSALEMCityNm
State AbbreviationNCStateAbbreviationCd
ZIP271034125ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
ANDREW PRICE
HUMAN RESOURCES CHAIR1.00Yes (X)Yes (X)$0$0$0
APRIL M BROADWAY
BOARD MEMBER1.00Yes (X)$0$0$0
CATRINA THOMPSON
PAST PRESIDENT1.00Yes (X)Yes (X)$0$0$0
CHRIS DUNN
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
CURTIS BLAND
TREASURER1.00Yes (X)Yes (X)$0$0$0
ELIZABETH BAICY
BOARD MEMBER1.00Yes (X)$0$0$0
HARRY HARRIS
BOARD MEMBER1.00Yes (X)$0$0$0
KIMYA DENNIS
BOARD MEMBER1.00Yes (X)$0$0$0
MONICA BROWN
SECRETARY1.00Yes (X)Yes (X)$0$0$0
ROB MCKINNIE
BOARD MEMBER1.00Yes (X)$0$0$0
TIFFANY HALL
BOARD MEMBER1.00Yes (X)$0$0$0
RICHARD WORKMAN
BOARD MEMBER (ENDING 11/1/18)1.00Yes (X)$0$0$0
KENNETH ARCHIE
BOARD MEMBER (ENDING 11/1/18)1.00Yes (X)$0$0$0
JEREMY MOSELEY
BOARD MEMBER (ENDING 11/1/18)1.00Yes (X)$0$0$0
ANDY HAGLER
EXECUTIVE DIRECTOR40.00Yes (X)$66,968$0$14,228
FieldValueIRS element (for citing)
Total Reportable Comp From Org$66,968TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$14,228TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Federated Campaigns$161,806FederatedCampaignsAmt
All Other Contributions$51,753AllOtherContributionsAmt
Total Contributions$213,559TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
TRAINING REVENUE900099$20,225$20,225
REPRESENTATIVE PAYEE F900099$11,713$11,713
ASSIST900099$450$450
FieldValueIRS element (for citing)
Total Program Service Revenue$32,388TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,103TotalRevenueColumnAmt
Exclusion$1,103ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$32OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$32OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$32TotalRevenueColumnAmt
Exclusion-$32ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS REVENUEDesc
Business900099BusinessCd
Total Revenue Column$441TotalRevenueColumnAmt
Exclusion$441ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$441OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$247,459TotalRevenueColumnAmt
Related Or Exempt Func Income$32,388RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,512ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$81,924TotalAmt
Program Services$69,635ProgramServicesAmt
Management And General$8,193ManagementAndGeneralAmt
Fundraising$4,096FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$86,589TotalAmt
Program Services$73,602ProgramServicesAmt
Management And General$8,659ManagementAndGeneralAmt
Fundraising$4,328FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,411TotalAmt
Program Services$2,049ProgramServicesAmt
Management And General$241ManagementAndGeneralAmt
Fundraising$121FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$51TotalAmt
Program Services$43ProgramServicesAmt
Management And General$5ManagementAndGeneralAmt
Fundraising$3FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$10,672TotalAmt
Program Services$9,072ProgramServicesAmt
Management And General$1,066ManagementAndGeneralAmt
Fundraising$534FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$7,382TotalAmt
Program Services$6,349ProgramServicesAmt
Management And General$1,033ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,435TotalAmt
Program Services$2,954ProgramServicesAmt
Management And General$481ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$789TotalAmt
Program Services$679ProgramServicesAmt
Management And General$110ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$9,339TotalAmt
Program Services$8,032ProgramServicesAmt
Management And General$1,307ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$15,249TotalAmt
Program Services$13,114ProgramServicesAmt
Management And General$2,135ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$933TotalAmt
Program Services$802ProgramServicesAmt
Management And General$131ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$176TotalAmt
Program Services$151ProgramServicesAmt
Management And General$25ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$1,063TotalAmt
Management And General$1,063ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,106TotalAmt
Program Services$951ProgramServicesAmt
Management And General$155ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$5,490TotalAmt
Program Services$4,721ProgramServicesAmt
Management And General$769ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PROGRAM EXPENSE$9,710$9,710
MISCELLANEOUS$4,378$4,378
REPAIRS AND MAINTENANCE$1,140$980$160

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$241,837TotalAmt
Program Services$202,844ProgramServicesAmt
Management And General$29,911ManagementAndGeneralAmt
Fundraising$9,082FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$260,270BOYAmt
EOY$214,884EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$96,505BOYAmt
EOY$157,500EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,410BOYAmt
EOY$7,304EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$998BOYAmt
EOY$998EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$36,766LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$36,153LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,751BOYAmt
EOY$613EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$349,319BOYAmt
EOY$337,296EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$711,253BOYAmt
EOY$718,595EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$10,999BOYAmt
EOY$11,299EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$67,105BOYAmt
EOY$53,302EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$78,104BOYAmt
EOY$64,601EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$535,164BOYAmt
EOY$494,741EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$97,985BOYAmt
EOY$159,253EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$633,149BOYAmt
EOY$653,994EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$711,253BOYAmt
EOY$718,595EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$5,622ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$15,223NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
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$182,592CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$456,613CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$155,636CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$200,811CurrentTaxYearMinus1YearAmt
Current Tax Year$213,559CurrentTaxYearAmt
Total$1,209,211TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$182,592CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$456,613CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$155,636CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$200,811CurrentTaxYearMinus1YearAmt
Current Tax Year$213,559CurrentTaxYearAmt
Total$1,209,211TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$1,209,211PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$124CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$159CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$212CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$512CurrentTaxYearMinus1YearAmt
Current Tax Year$1,103CurrentTaxYearAmt
Total$2,110TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$745CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,305CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$120CurrentTaxYearMinus2YearsAmt
Current Tax Year$441CurrentTaxYearAmt
Total$2,611TotalAmt
FieldValueIRS element (for citing)
Total Support$1,213,932TotalSupportAmt
Gross Receipts Rltd Activities$135,525GrossReceiptsRltdActivitiesAmt
Public Support CY1700.99610PublicSupportCY170Pct
Public Support PY1700.99650PublicSupportPY170Pct
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

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Beginning Balance$67,105BeginningBalanceAmt
Ending Balance$67,105EndingBalanceAmt
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$282,214BeginningYearBalanceAmt
Investment Earnings Or Losses$12,640InvestmentEarningsOrLossesAmt
Other Expenditures$10,860OtherExpendituresAmt
End Year Balance$283,994EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$274,761BeginningYearBalanceAmt
Investment Earnings Or Losses$18,255InvestmentEarningsOrLossesAmt
Other Expenditures$10,802OtherExpendituresAmt
End Year Balance$282,214EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$259,876BeginningYearBalanceAmt
Investment Earnings Or Losses$25,899InvestmentEarningsOrLossesAmt
Other Expenditures$11,014OtherExpendituresAmt
End Year Balance$274,761EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$278,929BeginningYearBalanceAmt
Investment Earnings Or Losses-$7,723InvestmentEarningsOrLossesAmt
Other Expenditures$11,330OtherExpendituresAmt
End Year Balance$259,876EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$272,666BeginningYearBalanceAmt
Contributions$300ContributionsAmt
Investment Earnings Or Losses$17,463InvestmentEarningsOrLossesAmt
Other Expenditures$11,500OtherExpendituresAmt
End Year Balance$278,929EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$36,766OtherCostOrOtherBasisAmt
Depreciation$36,153DepreciationAmt
Book Value$613BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$613TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
CASH- REPRESENTATIVE PAYEE ACCOUNT$53,302
ENDOWMENT FUND$283,994
FieldValueIRS element (for citing)
Total Book Value Other Assets$337,296TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$259,932TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$12,441NetUnrealizedGainsInvstAmt
Other Revenue$32OtherRevenueAmt
Revenue Not Reported$12,473RevenueNotReportedAmt
Revenue Subtotal$247,459RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$247,459TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$239,087TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$32OtherExpensesIncludedAmt
Expenses Not Reported$32ExpensesNotReportedAmt
Expenses Subtotal$239,055ExpensesSubtotalAmt
Other Expenses Not Included$2,782OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$2,782ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$241,837TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:THE ASSOCIATION MAINTAINS CUSTODIAL ACCOUNTS FOR PERSONS WHO PARTICIPATE IN THE REPRESENTATIVE PAYEE PROGRAM. CASH IN THE CUSTODIAL BANK ACCOUNT IS RESTRICTED FOR THIS PURPOSE.
PART X, LINE 2:THE ASSOCIATION'S PRIMARY TAX POSITIONS RELATE TO ITS STATUS AS A NOT-FOR-PROFIT ENTITY EXEMPT FROM INCOME TAXES AND CLASSIFICATION OF ACTIVITIES RELATED TO ITS EXEMPT PURPOSE. IT IS THE OPINION OF MANAGEMENT THAT THE ASSOCIATION HAS NO UNCERTAIN TAX POSITIONS THAT WOULD BE SUBJECT TO CHANGE UPON EXAMINATION.
PART XI, LINE 2D - OTHER ADJUSTMENTS:LOSS ON ASSET DISPOSAL 32.
PART XII, LINE 2D - OTHER ADJUSTMENTS:LOSS ON ASSET DISPOSAL 32.
PART XII, LINE 4B - OTHER ADJUSTMENTS:ENDOWMENT FEES NET WITH REVENUE 2,782.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, LINE 13ANC
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS DISTRIBUTED TO THE FULL BOARD OF DIRECTORS ELECTRONICALLY BEFORE IT IS FILED. THE TREASURER AND EXECUTIVE DIRECTOR REVIEW THE FORM 990 BEFORE IT IS FILED TO CHECK FOR ACCURACY. THE TREASURER AND EXECUTIVE DIRECTOR CO-SIGN AND DATE THE FORM 990 PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT OF INTEREST POLICY REQUIRES EACH BOARD MEMBER TO SIGN TO VERIFY THAT THEY HAVE READ AND UNDERSTOOD THE AGENCY'S CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15ATHE BOARD OF DIRECTORS FACILITATES AN ANNUAL PERFORMANCE REVIEW TO DETERMINE THE COMPENSATION AND BENEFITS OF THE EXECUTIVE DIRECTOR.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XII, LINE 2C:THE OVERSIGHT/SELECTION PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

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