CLARKSVILLE MONTGOMERY COUNTYCOMMUNITY HEALTH FOUNDATION INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- CLARKSVILLE MONTGOMERY COUNTYCOMMUNITY HEALTH FOUNDATION INC (EIN 20-4862825)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-14
- IRS object ID
- 201943189349308649
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-11-14T14:05:01-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 263683574 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THURMAN CAMPBELL GROUP PLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 324 FRANKLIN ST | AddressLine1Txt |
| City | CLARKSVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37040 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 204862825 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARKSVILLE-MONTGOMERY COUNTY | BusinessNameLine1Txt |
| Business Name Line2 | COMMUNITY HEALTH FOUNDATION INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CLAR | BusinessNameControlTxt |
| Phone | 9318962744 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 SOUTH 2ND ST | AddressLine1Txt |
| City | CLARKSVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37040 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOEY SMITH | PersonNm |
| Person Title | CHAIRMAN | PersonTitleTxt |
| Phone | 9312212492 | PhoneNum |
| Signature | 2019-04-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFFERY PROCTOR | PreparerPersonNm |
| PTIN | P00854519 | PTIN |
| Phone | 9315527474 | PhoneNum |
| Preparation | 2019-11-08 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.68.16.49 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-11-14 | IPDt |
| IP Tm | 14:05:01 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 997E27EEDE96FF58B0CDB27605100D82AF4113A2 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 978C6868E1FFD65FA1F0E03D65B6902AE2D87CAB | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-03-31 21:24:44Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOEY SMITH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 31003 | AddressLine1Txt |
| City | CLARKSVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37040 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,408,609 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.COMMUNITYHEALTHFOUNDATION.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION IS OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE RESIDENTS OF CLARKSVILLE,TN; MONTGOMERY COUNTY, TN; AND THE COUNTIES OF NORTHERN MIDDLE TN AND FORT CAMPBELL, KY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 2 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $5 | PYContributionsGrantsAmt |
| CY Contributions Grants | $500,005 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,143,284 | PYInvestmentIncomeAmt |
| CY Investment Income | $971,187 | CYInvestmentIncomeAmt |
| PY Other Revenue | $501,353 | PYOtherRevenueAmt |
| CY Other Revenue | $672,073 | CYOtherRevenueAmt |
| PY Total Revenue | $1,644,642 | PYTotalRevenueAmt |
| CY Total Revenue | $2,143,265 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,443,883 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,187,721 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $86,450 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $89,382 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $155,320 | PYOtherExpensesAmt |
| CY Other Expenses | $152,567 | CYOtherExpensesAmt |
| PY Total Expenses | $1,685,653 | PYTotalExpensesAmt |
| CY Total Expenses | $1,429,670 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$41,011 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $713,595 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $24,510,520 | TotalAssetsBOYAmt |
| Total Assets EOY | $23,035,665 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,257 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,259 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $24,509,263 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $23,030,406 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE ORGANIZATION IS OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE RESIDENTS OF CLARKSVILLE,TN; MONTGOMERY COUNTY, TN; AND THE COUNTIES OF NORTHERN MIDDLE TN AND FORT CAMPBELL, KY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,221,147 | ExpenseAmt |
| Grant | $1,187,721 | GrantAmt |
| Desc | HEALTH INITIATIVES, EDUCATION, AND PROJECTS SUPPORTING THE COMMUNITY. | Desc |
| Total Program Service Expenses | $1,221,147 | 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 |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | 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 | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | 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 With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| 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 |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | false | ScheduleORequiredInd |
| IRP Document | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 2 | EmployeeCnt |
| Employment Tax Returns Filed | false | 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 | false | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | false | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PAULA JOHNSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9318962744 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 SOUTH SECOND ST | AddressLine1Txt |
| City | CLARKSVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37040 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|
| MARCOS A ARANCIBIA | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| MARK BANASIAK | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| TOMMY BATES | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| JEFF BIBB | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| MICKI DAUGHERTY | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| DAVID DENTON | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| JIM DURRETT | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| ROSALIND KURITA | |||||
| VICE CHAIRMA | Yes (X) | $0 | $0 | $0 | Yes (X) |
| KYLE LUTHER | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| VINCENT PINKNEY | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| JOE PITTS | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| KHANDRA SMALLEY | |||||
| SECRETARY/TR | Yes (X) | $0 | $0 | $0 | Yes (X) |
| JOEY SMITH | |||||
| CHAIRMAN | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Related Organizations | $500,000 | RelatedOrganizationsAmt |
| All Other Contributions | $5 | AllOtherContributionsAmt |
| Total Contributions | $500,005 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $971,187 | TotalRevenueColumnAmt |
| Exclusion | $971,187 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $817,987 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $265,344 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $552,643 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $552,643 | TotalRevenueColumnAmt |
| Exclusion | $552,643 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|
| GRANT MONIES RETURNED | $61,632 | $61,632 |
| OTHER INCOME | $57,798 | $57,798 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $119,430 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,143,265 | TotalRevenueColumnAmt |
| Exclusion | $1,643,260 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,187,721 | TotalAmt |
| Program Services | $1,187,721 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,030 | TotalAmt |
| Program Services | $30,215 | ProgramServicesAmt |
| Management And General | $52,815 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,352 | TotalAmt |
| Program Services | $2,311 | ProgramServicesAmt |
| Management And General | $4,041 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,630 | TotalAmt |
| Management And General | $14,630 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,948 | TotalAmt |
| Management And General | $114,948 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,359 | TotalAmt |
| Program Services | $900 | ProgramServicesAmt |
| Management And General | $5,459 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,000 | TotalAmt |
| Management And General | $12,000 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $190 | TotalAmt |
| Management And General | $190 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,440 | TotalAmt |
| Management And General | $4,440 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,429,670 | TotalAmt |
| Program Services | $1,221,147 | ProgramServicesAmt |
| Management And General | $208,523 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,070,467 | BOYAmt |
| EOY | $1,257,368 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $907,899 | BOYAmt |
| EOY | $867,592 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $538 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,319 | BOYAmt |
| EOY | $56,835 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,670,058 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,251,818 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,487,815 | BOYAmt |
| EOY | $3,418,240 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,817,291 | BOYAmt |
| EOY | $13,763,751 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,221,191 | BOYAmt |
| EOY | $3,671,879 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,510,520 | BOYAmt |
| EOY | $23,035,665 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,257 | BOYAmt |
| EOY | $5,259 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,257 | BOYAmt |
| EOY | $5,259 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,099,347 | BOYAmt |
| EOY | $19,169,802 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,726,697 | BOYAmt |
| EOY | $3,240,330 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $683,219 | BOYAmt |
| EOY | $620,274 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,509,263 | BOYAmt |
| EOY | $23,030,406 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,510,520 | BOYAmt |
| EOY | $23,035,665 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $713,595 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$2,245,737 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $54,608 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$1,323 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Community Trust | Yes (X) | CommunityTrustInd |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,203,349 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus2 Years | $2,500,538 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $500,005 | CurrentTaxYearAmt |
| Total | $4,203,897 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,203,349 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus2 Years | $2,500,538 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $500,005 | CurrentTaxYearAmt |
| Total | $4,203,897 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $4,203,897 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,606,184 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,221,557 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,752,835 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,877,175 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,789,174 | CurrentTaxYearAmt |
| Total | $8,246,925 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $37,518 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $54,583 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $66,300 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $27,448 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $118,430 | CurrentTaxYearAmt |
| Total | $304,279 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $12,755,101 | TotalSupportAmt |
| Public Support CY170 | 0.32960 | PublicSupportCY170Pct |
| Public Support PY170 | 0.37110 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests PY170 | Yes (X) | ThirtyThrPctSuprtTestsPY170Ind |
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
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,221,190 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$260,726 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $249,255 | OtherExpendituresAmt |
| Administrative Expenses | $39,332 | AdministrativeExpensesAmt |
| End Year Balance | $3,671,877 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,728,743 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $693,188 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $169,752 | OtherExpendituresAmt |
| Administrative Expenses | $30,989 | AdministrativeExpensesAmt |
| End Year Balance | $4,221,190 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,701,412 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $227,177 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $161,484 | OtherExpendituresAmt |
| Administrative Expenses | $38,362 | AdministrativeExpensesAmt |
| End Year Balance | $3,728,743 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,856,472 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $41,183 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $162,216 | OtherExpendituresAmt |
| Administrative Expenses | $34,027 | AdministrativeExpensesAmt |
| End Year Balance | $3,701,412 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,957,937 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $246,077 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $316,767 | OtherExpendituresAmt |
| Administrative Expenses | $30,775 | AdministrativeExpensesAmt |
| End Year Balance | $3,856,472 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $2,265,537 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $55,483 | OtherCostOrOtherBasisAmt |
| Book Value | $2,321,020 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,381,491 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $1,159,235 | DepreciationAmt |
| Book Value | $222,256 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $64,139 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $39,127 | DepreciationAmt |
| Book Value | $25,012 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $903,408 | OtherCostOrOtherBasisAmt |
| Depreciation | $53,456 | DepreciationAmt |
| Book Value | $849,952 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,418,240 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INTEREST IN TRUSTS HELD BY OTHERS | $3,051,605 |
| BENEFICIAL INTEREST IN PERPETUAL TRU | $620,274 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,671,879 | TotalBookValueOtherAssetsAmt |
| Total Rev Etc Audited Fincl Stmt | $25,448 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$2,245,737 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $127,920 | OtherRevenueAmt |
| Revenue Not Reported | -$2,117,817 | RevenueNotReportedAmt |
| Revenue Subtotal | $2,143,265 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $2,143,265 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,558,913 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $129,243 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $129,243 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,429,670 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $1,429,670 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 4, PART XI, LINE 2D | RENTAL EXPENSES NETTED ON TAX RETURN WITH INCOME 242,868 INVESTMENT MGMT FEES NETTED WITH INCOME ON F/S -114,948 |
| SCHEDULE D, PAGE 4, PART XII, LINE 2D | RENTAL EXPENSES NETTED ON TAX RETURN WITH INCOME 242,868 INVESTMENT MGMT FEES NETTED WITH INCOME ON F/S -114,948 BOOK / TAX DEPRECIATION DIFFERENCE 1,323 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (22 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Business Name Line2RecipientBusinessName/BusinessNameLine2Txt | Recipient EINRecipientEIN |
|---|---|---|---|---|---|---|---|
| AUSTIN PEAY FOUNDATION | |||||||
| PO BOX 4417 | CLARKSVILLE | TN | 37044 | $110,000 | NURSING EDUCATION | ||
| AUSTIN PEAY FOUNDATION | |||||||
| PO BOX 4417 | CLARKSVILLE | TN | 37044 | $14,550 | PRIMARY CARE PROGRAM | ||
| BETHANY HOUSE | |||||||
| 230 GREAT CIRCLE RD SUITE 229 | NASHVILLE | TN | 37228 | $14,800 | DRUG REHAB PROGRAM | ||
| CLARKSVILLE ACADEMY | |||||||
| 710 NORTH 2ND ST | CLARKSVILLE | TN | 37040 | $100,527 | DISC GOLF ROTARY | ||
| CLARKSVILLE AREA MINISTERS TECHNICA | |||||||
| 1325 DODD ST | CLARKSVILLE | TN | 37040 | $30,767 | TRANSPORTATION | ASSISTANCE NETWORK (CAMTAN) | |
| MANNA CAFE | |||||||
| 1960-J MADISON ST | CLARKSVILLE | TN | 37043 | $58,428 | NUTRITION EDUCATION | ||
| NURSES FOR NEWBORNS | |||||||
| 50 VANTAGE WAY SUITE 101 | NASHVILLE | TN | 37288 | $15,000 | INFANT CARE | ||
| REBOOT COMBAT RECOVERY | |||||||
| PO BOX 1223 | FT CAMPBELL | KY | 42223 | $80,000 | PTSD & COMBAT TRAUMA | ||
| SAFE SOLDIERS AND FAMILIES | |||||||
| PO BOX 4008 | CLARKSVILLE | TN | 37043 | $118,000 | COUNSELING | EMBRACED | |
| SERENITY HOUSE | |||||||
| PO BOX 31251 | CLARKSVILLE | TN | 37040 | $29,730 | HEALTHY LIVING | ||
| SEXUAL ASSAULT CENTER | |||||||
| 101 FRENCH LANDING DR | NASHVILLE | TN | 37228 | $116,000 | COUNSELING | ||
| TN CLEAN WATER | |||||||
| 625 MARKET ST | KNOXVILLE | TN | 37902 | $116,709 | SCHOOL WATER REFILL | BRING TAP BACK | |
| YMCA | |||||||
| 260 HILLCREST DR | CLARKSVILLE | TN | 37043 | $28,157 | ABC PROGRAM/RESTORE | ||
| ROSSVIEW PTOBOY SCOUTS | |||||||
| 1988 NORWOOD TR | CLARKSVILLE | TN | 37043 | $13,657 | OUTDOOR BASKETBALL | 043844122 | |
| CUMBERLAND HEIGHTS | |||||||
| 8283 RIVER ROAD PIKE | NASHVILLE | TN | 37209 | $124,500 | SCHOLARSHIP/OUTPATIE | 626050684 | |
| FIRST LINE RECOVERY | |||||||
| PO BOX 1223 | FT CAMPBELL | KY | 42223 | $30,000 | FIRST RESPONDER | ||
| PROJECT TRANSFORMATION | |||||||
| 1008 19TH ST | NASHVILLE | TN | 37212 | $15,000 | SUMMER PROGRAM | 453265261 | |
| FOOD INITIATIVE | |||||||
| 1230 ROSSVIEW RD | CLARKSVILLE | TN | 37043 | $69,850 | FOOD PRODUCTION | 450493395 | |
| MEALS ON WHEELS | |||||||
| 1101 KERMIT DR SUITE 300 | NASHVILLE | TN | 37179 | $45,000 | FOOD | ||
| INSIGHT COUNSELING | |||||||
| PO BOX 50242 | NASHVILLE | TN | 37205 | $15,000 | MENTAL HEALTH | ||
| MENTAL HEALTH ASSOC OF MID TN | |||||||
| 446 METROPLEX DR SUITE A-224 | NASHVILLE | TN | 37211 | $15,000 | SUICIDE PREVENTION | 620637710 | |
| TN KIDNEY FOUNDATION | |||||||
| 37 PEADBODY ST SUITE 206 | NASHVILLE | TN | 37210 | $27,046 | DIALYSIS TREATMENT | 270812507 | |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | THE ORGANIZATION IS OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE RESIDENTS OF CLARKSVILLE,TN; MONTGOMERY COUNTY, TN; AND THE COUNTIES OF NORTHERN MIDDLE TN AND FORT CAMPBELL, KY. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE 990 WAS REVIEWED BY THE CHAIRMAN OF THE BOARD |
| FORM 990, PAGE 6, PART VI, LINE 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC |
| FORM 990, PART XI, LINE 9 | RENTAL EXPENSES NETTED ON TAX RETURN WITH INCOME 242,868 INVESTMENT MGMT FEES NETTED WITH INCOME ON F/S -114,948 RENTAL EXPENSES NETTED ON TAX RETURN WITH INCOME -242,868 INVESTMENT MGMT FEES NETTED WITH INCOME ON F/S 114,948 BOOK / TAX DEPRECIATION DIFFERENCE -1,323 TOTAL -1,323 |
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