A PATTERN: Form 990EZ, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
A PATTERN (EIN 45-5094420)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-09-29
IRS object ID
201922729349200302
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)
Return2019-09-29T13:08:15-04:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN271750037PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1R & J ACCOUNTING & TAX SERVICESBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12601 CR 3260AddressLine1Txt
CitySALEMCityNm
State AbbreviationMOStateAbbreviationCd
ZIP65560ZIPCd
FieldValueIRS element (for citing)
Return Type990EZReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN455094420EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1A PATTERN INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlAPATBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1250 RICHTER ROADAddressLine1Txt
CityBOURBONCityNm
State AbbreviationMOStateAbbreviationCd
ZIP65441ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonANDREW S GRIVASPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone8559761888PhoneNum
Signature2019-09-29SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDIANA J LETTMANPreparerPersonNm
PTINP01201478PTIN
Phone5737294532PhoneNum
Self EmployedYes (X)SelfEmployedInd

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address174.30.80.34IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-09-29IPDt
IP Tm13:10:14IPTm
Federal Original Submission Id4371082019272licioygFederalOriginalSubmissionId
Federal Original Submission Id2019-09-29FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdCD539FE87873F2F1B06415EB622AA407F8F537D7AtSubmissionCreationDeviceId
At Submission Filing Device IdCD539FE87873F2F1B06415EB622AA407F8F537D7AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-01-14 16:20:31ZBuildTS

Form 990-EZ IRS990EZ

FieldValueIRS element (for citing)
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Gross Receipts$161,009GrossReceiptsAmt
Info In Schedule O Part IYes (X)InfoInScheduleOPartIInd
Contributions Gifts Grants Etc$80,688ContributionsGiftsGrantsEtcAmt
Investment Income$108InvestmentIncomeAmt
Other Revenue Total$80,213OtherRevenueTotalAmt
Total Revenue$161,009TotalRevenueAmt
Salaries Other Comp Empl Bnft$36,039SalariesOtherCompEmplBnftAmt
Fees And Other Pymt To Ind Cntrct$1,375FeesAndOtherPymtToIndCntrctAmt
Occupancy Rent Utlts And Maint$21,553OccupancyRentUtltsAndMaintAmt
Printing Publications Postage$107PrintingPublicationsPostageAmt
Other Expenses Total$38,261OtherExpensesTotalAmt
Total Expenses$97,335TotalExpensesAmt
Excess Or Deficit For Year$63,674ExcessOrDeficitForYearAmt
Net Assets Or Fund Balances BOY$239,399NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$303,073NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIYes (X)InfoInScheduleOPartIIInd

Cash Savings And Investments CashSavingsAndInvestmentsGrp

FieldValueIRS element (for citing)
BOY$96,402BOYAmt
EOY$58,989EOYAmt

Land And Buildings LandAndBuildingsGrp

FieldValueIRS element (for citing)
BOY$335,000BOYAmt
EOY$375,686EOYAmt

Other Assets Total Detail OtherAssetsTotalDetail

FieldValueIRS element (for citing)
BOY$10,660BOYAmt
EOY$18,420EOYAmt

Form990 Total Assets Form990TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$442,062BOYAmt
EOY$453,095EOYAmt

Sum Of Total Liabilities SumOfTotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$202,663BOYAmt
EOY$150,022EOYAmt

Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp

FieldValueIRS element (for citing)
BOY$239,399BOYAmt
EOY$303,073EOYAmt
FieldValueIRS element (for citing)
Primary Exempt PurposeProvide health and medical educationPrimaryExemptPurposeTxt

Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp (3 entries)

Description Program Srvc AccomDescriptionProgramSrvcAccomTxt
Provided 520 health and wellness lectures 32 cooking classes 32 home remedies classes for 282 days of the year
Staff participated in a Disaster Responses operation following the floods in Missouri
Participation in spiritual and health classes was provided to a local correctional facility for 40 classes once weekly during the year
FieldValueIRS element (for citing)
Total Program Service Expenses$0TotalProgramServiceExpensesAmt

Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (6 entries)

TitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
ANDREW S GRIVAS
PRESIDENT40.00$0$0$0
JOYCE GRIVAS
SECRETARY-TREASURER40.00$0$0$0
PAUL ROSS
GENERAL BUSINESS MANAGER0.00$0$0$0
MARTHA ROSS
ADMINISTRATIVE DIRECTOR0.00$0$0$0
CHARLES CLEVELAND
HER RESOURCE MANAGER0.00$0$0$0
VAUGHAN H SPARROW
DIRECTOR0.00$0$0$0
FieldValueIRS element (for citing)
Activities Not Previously RptfalseActivitiesNotPreviouslyRptInd
Chg Made To Orgnzng Doc Not RptfalseChgMadeToOrgnzngDocNotRptInd
Organization Had UBIfalseOrganizationHadUBIInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Organization Dissolved EtcfalseOrganizationDissolvedEtcInd
Form1120 Pol FiledfalseForm1120PolFiledInd
Made Loans To From OfficersfalseMadeLoansToFromOfficersInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonANDREW S GRIVASPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1250 RICHTER ROADAddressLine1Txt
CityBOURBONCityNm
State AbbreviationMOStateAbbreviationCd
ZIP65441ZIPCd
FieldValueIRS element (for citing)
Phone8559761888PhoneNum
FieldValueIRS element (for citing)
Foreign Financial AccountfalseForeignFinancialAccountInd
Foreign OfficefalseForeignOfficeInd
Donor Advised FndsfalseDonorAdvisedFndsInd
Operate HospitalfalseOperateHospitalInd
Tanning Services ProvidedfalseTanningServicesProvidedInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
School OperatingfalseSchoolOperatingInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Part VI Of Comp Of Hghst Pd EmplNONEPartVIOfCompOfHghstPdEmplTxt
Part VI Hghst Pd Cntrct Prof SrvcNONEPartVIHghstPdCntrctProfSrvcTxt
Filed Schedule AYes (true)FiledScheduleAInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$81,220CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$149,070CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$32,895CurrentTaxYearMinus1YearAmt
Current Tax Year$80,688CurrentTaxYearAmt
Total$343,873TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$17,564CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$40,436CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$58,207CurrentTaxYearMinus1YearAmt
Current Tax Year$67,964CurrentTaxYearAmt
Total$184,171TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$98,784CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$189,506CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$91,102CurrentTaxYearMinus1YearAmt
Current Tax Year$148,652CurrentTaxYearAmt
Total$528,044TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$528,044PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$55CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$133CurrentTaxYearMinus1YearAmt
Current Tax Year$108CurrentTaxYearAmt
Total$296TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$55CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$133CurrentTaxYearMinus1YearAmt
Current Tax Year$108CurrentTaxYearAmt
Total$296TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$19,600CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$11,113CurrentTaxYearMinus1YearAmt
Current Tax Year$12,250CurrentTaxYearAmt
Total$42,963TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$98,784CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$209,161CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$102,348CurrentTaxYearMinus1YearAmt
Current Tax Year$161,010CurrentTaxYearAmt
Total$571,303TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.92430PublicSupportCY509Pct
Public Support PY5090.00000PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Description of other revenue Part I line 8Description AmountLIFESTYLE INCOME 61,517PHONE CONSULTATIONS 3,815REFUNDS 2,631RENTAL INCOME 12,250
Description of other expenses Part I line 16Description AmountADVERTISING 1,931BANK FEES 741PURCHASED SERVICES 1,809TRAVEL 3,017TAXES 16,210INTEREST 7,119FOOD/SUPPLIES 6,442INSURANCE 599MISCELLANEOUS EXPENSES 393
Description of other assets Part II line 24Category Beginning of Year End of YearSTEAM SHOWER 1,437 1,437EQUIPMENT 3,893 3,893MOWER 5,330 5,330TRACTOR 0 7,000MOWER 0 760
Description of total liabilities Part II line 26Category Beginning of Year End of YearBUILDING AND LAND 201,903 150,022EQUIPMENT 760 0
Other program services Part III line 31One overseas event was engaged in, with health classes, health consultations, and area-wide TV broadcasts. Monthly participation was provided by the staff physician to another health and wellness facility to provide health consultations to interested health guests and training to other health providers.

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