PEORIA HOSPITALS MOBILE MEDICAL SERVICES: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- PEORIA HOSPITALS MOBILE MEDICAL SERVICES (EIN 37-0999878)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-08-09
- IRS object ID
- 201942219349300124
- 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 | 2019-08-09T11:35:22-05:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 SW ADAMS STE 1000 | AddressLine1Txt |
| City | PEORIA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61602 | 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 | 370999878 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEORIA HOSPITALS MOBILE MEDICAL SERVICES | BusinessNameLine1Txt |
| Business Name Line2 | D/B/A ADV MEDICAL TRANS OF CENTRAL IL | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PEOR | BusinessNameControlTxt |
| Phone | 3094946200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1718 NORTH STERLING AVE | AddressLine1Txt |
| City | PEORIA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61604 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT ANDERSON | PersonNm |
| Person Title | BOARD CHAIRPERSON | PersonTitleTxt |
| Phone | 3094946200 | PhoneNum |
| Signature | 2019-07-24 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SAMUEL A CIGELNIK CPA | PreparerPersonNm |
| PTIN | P00324762 | PTIN |
| Phone | 3096714500 | PhoneNum |
| Preparation | 2019-07-24 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-07-24 | IPDt |
| IP Tm | 14:09:34 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DBA0DE0710B3CC388F2BEE46780927D00A68B01B | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 6536C806F53B74C078C7EC9B2427BCB239CA21E7 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT ANDERSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1718 NORTH STERLING AVE | AddressLine1Txt |
| City | PEORIA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61604 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $23,943,010 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ADVANCEDMEDICALTRANSPORT.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1975 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION PROVIDES EMERGENCY AMBULANCE CARE, TREATMENT AND TRANSPORTATION TO MULTIPLE JURISDICTIONS IN ILLINOIS. IN ADDITION TO EMERGENCY AMBULANCE SERVICES, THE ENTITY PROVIDES SCHEDULED AMBULANCE, BEHAVIORAL HEALTH (IPT) AND WHEELCHAIR TRANSPORTATION BETWEEN HOSPITALS AND OTHER HEALTHCARE FACILITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 421 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $22,711,497 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $23,745,380 | CYProgramServiceRevenueAmt |
| PY Investment Income | $184,484 | PYInvestmentIncomeAmt |
| CY Investment Income | $107,139 | CYInvestmentIncomeAmt |
| PY Other Revenue | $110,246 | PYOtherRevenueAmt |
| CY Other Revenue | $75,125 | CYOtherRevenueAmt |
| PY Total Revenue | $23,006,227 | PYTotalRevenueAmt |
| CY Total Revenue | $23,927,644 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $285,809 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $228,038 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $13,859,210 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $14,449,435 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,292,676 | PYOtherExpensesAmt |
| CY Other Expenses | $7,160,354 | CYOtherExpensesAmt |
| PY Total Expenses | $21,437,695 | PYTotalExpensesAmt |
| CY Total Expenses | $21,837,827 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,568,532 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,089,817 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $24,023,436 | TotalAssetsBOYAmt |
| Total Assets EOY | $25,794,644 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,597,872 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,522,820 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $21,425,564 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $23,271,824 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE ORGANIZATION PROVIDES EMERGENCY AMBULANCE CARE, TREATMENT AND TRANSPORTATION TO MULTIPLE JURISDICTIONS IN ILLINOIS. IN ADDITION TO EMERGENCY AMBULANCE SERVICES, THE ENTITY PROVIDES SCHEDULED AMBULANCE, BEHAVIORAL HEALTH (IPT) AND WHEELCHAIR TRANSPORTATION BETWEEN HOSPITALS AND OTHER HEALTHCARE FACILITIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $17,515,923 | ExpenseAmt |
| Grant | $228,038 | GrantAmt |
| Revenue | $23,781,331 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES EMERGENCY AMBULANCE CARE, TREATMENT AND TRANSPORTATION TO MULTIPLE JURISDICTIONS IN ILLINOIS. IN ADDITION, THE ENTITY PROVIDES SCHEDULED AMBULANCE, BEHAVIORAL HEALTH (IPT) AND WHEELCHAIR TRANSPORTATION BETWEEN HOSPITALS AND OTHER HEALTHCARE FACILITIES. THE ORGANIZATION PROVIDED 43,920 AMBULANCE, 2,530 IPT AND 5,743 WHEELCHAIR TRANSPORTS IN 2018. THE ORGANIZATION PROVIDED $703,857 IN CHARITABLE SERVICES TO QUALIFIED INDIVIDUALS AT NO CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. THE ORGANIZATION ALSO PROVIDED CARE TO MEDICAID PATIENTS AT RATES BELOW THE COST OF PROVIDING SERVICES. FOR 2018 PAYMENTS WERE LESS THAN ESTIMATED COSTS BY $3,161,690. THE ORGANIZATION ALSO PROVIDED $331,770 IN SUPPORT OF OTHER COMMUNITY BENEFITS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $417,838 | ExpenseAmt |
| Revenue | $39,174 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES PARAMEDIC AND OTHER EMS TRAINING PROGRAMS EACH YEAR. THESE PROGRAMS ARE AVAILABLE TO EXTERNAL AGENCIES AND EMPLOYEES OF THE ORGANIZATION. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $17,933,761 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 20 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 421 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANDREW RAND | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3094946200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1718 N STERLING AVE | AddressLine1Txt |
| City | PEORIA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61604 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ANDREW RAND | ||||||||
| CEO/BOARD MEMBER | 12.50 | 37.50 | Yes (X) | Yes (X) | $369,888 | $0 | $17,505 | |
| SHERRY HOFFMAN | ||||||||
| BOARD VICE-CHAIRPERSON | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROBERT ANDERSON | ||||||||
| BOARD CHAIRPERSON | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JAMES BROWN | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| TODD BAKER | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JEANINE SPAIN | ||||||||
| BOARD TREASURER/SECRETARY | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| THOMAS GERACI | ||||||||
| VP OF OPERATIONS | 12.50 | 37.50 | Yes (X) | Yes (X) | $131,787 | $0 | $3,295 | |
| TIM BECCUE | ||||||||
| VP OF FINANCE | 12.50 | 37.50 | Yes (X) | Yes (X) | $187,245 | $0 | $22,375 | |
| JAMES ADAMS | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ASHLEY SPAIN | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| GREG CHANCE | ||||||||
| VP OF STRATEGY | 12.50 | 37.50 | Yes (X) | Yes (X) | $147,259 | $0 | $11,529 | |
| DERRICK HAHN | ||||||||
| VP OF FLEET | 12.50 | 37.50 | Yes (X) | Yes (X) | $116,466 | $0 | $9,449 | |
| TAMMY PAUWELS | ||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SALLY SNYDER | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| CHELSEY TALLEY | ||||||||
| DIRECTOR OF ACCOUNTING | 12.50 | 37.50 | Yes (X) | Yes (X) | $131,804 | $0 | $6,510 | |
| CHAD CRAIG | ||||||||
| CRITICAL CARE PARAMEDIC | 50.00 | 0.00 | $116,620 | $0 | $20,264 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,201,069 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $90,927 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| TRANSPORT REVENUE | 621990 | $23,396,919 | $23,396,919 |
| SUBSIDY REVENUE | 621990 | $309,287 | $309,287 |
| TUITION REVENUE | 611600 | $39,174 | $39,174 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $23,745,380 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $92,652 | TotalRevenueColumnAmt |
| Exclusion | $92,652 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $29,853 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $15,366 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $14,487 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,487 | TotalRevenueColumnAmt |
| Exclusion | $14,487 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $75,125 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $75,125 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $75,125 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $23,927,644 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $23,820,505 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $107,139 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $228,038 | TotalAmt |
| Program Services | $228,038 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,084,450 | TotalAmt |
| Program Services | $902,287 | ProgramServicesAmt |
| Management And General | $182,163 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,885,594 | TotalAmt |
| Program Services | $9,057,060 | ProgramServicesAmt |
| Management And General | $1,828,534 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $320,127 | TotalAmt |
| Program Services | $266,353 | ProgramServicesAmt |
| Management And General | $53,774 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,235,865 | TotalAmt |
| Program Services | $1,065,427 | ProgramServicesAmt |
| Management And General | $170,438 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $923,399 | TotalAmt |
| Program Services | $789,746 | ProgramServicesAmt |
| Management And General | $133,653 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,350 | TotalAmt |
| Management And General | $38,350 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,000 | TotalAmt |
| Management And General | $60,000 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,103 | TotalAmt |
| Program Services | $5,814 | ProgramServicesAmt |
| Management And General | $8,289 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $175,316 | TotalAmt |
| Program Services | $148,195 | ProgramServicesAmt |
| Management And General | $27,121 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $388,744 | TotalAmt |
| Program Services | $122,269 | ProgramServicesAmt |
| Management And General | $266,475 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $270,628 | TotalAmt |
| Program Services | $185,887 | ProgramServicesAmt |
| Management And General | $84,741 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,612 | TotalAmt |
| Management And General | $1,612 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$231,739 | TotalAmt |
| Program Services | -$231,739 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,989,561 | TotalAmt |
| Program Services | $1,671,079 | ProgramServicesAmt |
| Management And General | $318,482 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,095,086 | TotalAmt |
| Program Services | $962,224 | ProgramServicesAmt |
| Management And General | $132,862 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $916,804 | $789,924 | $126,880 |
| FUEL | $658,422 | $656,883 | $1,539 |
| REPAIRS & MAINTENANCE | $420,139 | $335,396 | $84,743 |
| EDUCATION & TRAINING | $245,767 | $227,287 | $18,480 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,117,561 | TotalAmt |
| Program Services | $751,631 | ProgramServicesAmt |
| Management And General | $365,930 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,837,827 | TotalAmt |
| Program Services | $17,933,761 | ProgramServicesAmt |
| Management And General | $3,904,066 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,067,163 | BOYAmt |
| EOY | $6,735,436 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,984,776 | BOYAmt |
| EOY | $4,799,065 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,785,741 | BOYAmt |
| EOY | $3,146,110 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,290,387 | BOYAmt |
| EOY | $1,176,567 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $322,822 | BOYAmt |
| EOY | $500,477 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $21,615,086 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $12,214,097 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,536,547 | BOYAmt |
| EOY | $9,400,989 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,000 | BOYAmt |
| EOY | $36,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,023,436 | BOYAmt |
| EOY | $25,794,644 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $554,676 | BOYAmt |
| EOY | $644,233 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $183,334 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,859,862 | BOYAmt |
| EOY | $1,878,587 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,597,872 | BOYAmt |
| EOY | $2,522,820 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,425,564 | BOYAmt |
| EOY | $23,271,824 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,425,564 | BOYAmt |
| EOY | $23,271,824 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,023,436 | BOYAmt |
| EOY | $25,794,644 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,089,817 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$243,557 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,752,615 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $21,341,729 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $22,169,307 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $22,711,497 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $23,745,380 | CurrentTaxYearAmt |
| Total | $109,720,528 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,752,615 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $21,341,729 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $22,169,307 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $22,711,497 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $23,745,380 | CurrentTaxYearAmt |
| Total | $109,720,528 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $109,720,528 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $90,260 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $68,591 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $65,310 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $70,643 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $92,652 | CurrentTaxYearAmt |
| Total | $387,456 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $90,260 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $68,591 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $65,310 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $70,643 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $92,652 | CurrentTaxYearAmt |
| Total | $387,456 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $289,286 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $309,584 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $37,727 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $224,087 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $89,612 | CurrentTaxYearAmt |
| Total | $950,296 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $20,132,161 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $21,719,904 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $22,272,344 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $23,006,227 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $23,927,644 | CurrentTaxYearAmt |
| Total | $111,058,280 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98800 | PublicSupportCY509Pct |
| Public Support PY509 | 0.98830 | PublicSupportPY509Pct |
| Investment Income CY | 0.00350 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00370 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,200,323 | OtherCostOrOtherBasisAmt |
| Book Value | $1,200,323 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,350,585 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,316,912 | DepreciationAmt |
| Book Value | $5,033,673 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,064,178 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,897,185 | DepreciationAmt |
| Book Value | $3,166,993 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,400,989 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED WAGES, TAXES, AND WITHHOLDINGS | $690,641 |
| OTHER LIABILITIES | $457,946 |
| NOTE PAYABLE TO MEMSI | $730,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,878,587 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $23,684,087 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$243,557 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$243,557 | RevenueNotReportedAmt |
| Revenue Subtotal | $23,927,644 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $23,927,644 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $21,837,827 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $21,837,827 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $21,837,827 | TotalExpensesPerForm990Amt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| HEART OF ILLINOIS UNITED WAY | |||||||
| 509 W HIGH ST | PEORIA | IL | 61606 | 370661504 | 501(C)(3) | $73,000 | SUPPORT LOCAL HEALTH AND HUMAN CARE PROGRAMS |
| CEO COUNCIL - ALIGNMENT PEORIA | |||||||
| 100 SW WATER STREET | PEORIA | IL | 61602 | 371271212 | 501(C)(3) | $5,000 | SUPPORT ECONOMIC GROWTH |
| AMERICAN HEART ASSOCIATION | |||||||
| PO BOX 50035 | PRESCOTT | AZ | 86304 | 135613797 | 501(C)(3) | $10,000 | SUPPORT HEART HEALTH AND RESEARCH |
| OSF HEALTHCARE FOUNDATION | |||||||
| 530 NE GLEN OAK AVE | PEORIA | IL | 61614 | 371259284 | 501(C)(3) | $10,000 | SUPPORT CANCER CARE AND RESEARCH |
| JUNIOR ACHIEVEMENT OF CENTRAL ILLINOIS | |||||||
| 508 HIGH POINT LANE | EAST PEORIA | IL | 61611 | 370657600 | 501(C)(3) | $11,000 | SUPPORT LOCAL EDUCATION PROGRAMS |
| EPC | |||||||
| 1913 W TOWNLINE ROAD | PEORIA | IL | 61615 | 370794792 | 501(C)(3) | $15,000 | SUPPORT LOCAL HEALTH AND HUMAN CARE PROGRAMS |
| INVICTUS WOODS ENDOWMENT CENTER | |||||||
| 29240 N COUNTY HIGHWAY 28 | GLASFORD | IL | 61533 | $5,000 | SUPPORT LOCAL HEALTH AND HUMAN CARE PROGRAMS. | ||
| SALVATION ARMY | |||||||
| 401 NE ADAMS | PEORIA | IL | 61603 | 362167910 | 501(C)(3) | $5,000 | SUPPORT LOCAL HEALTH AND HUMAN CARE PROGRAMS |
| PEORIA AREA CHAMBER OF COMMERCE | |||||||
| 403 NE JEFFERSON AVE | PEORIA | IL | 61603 | 370459010 | 501(C)(6) | $5,000 | SUPPORT LOCAL EDUCATION PROGRAMS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 8 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANDREW RAND | ||||||||||||||
| CEO/BOARD MEMBER | $279,888 | $0 | $90,000 | $0 | $0 | $0 | $12,250 | $0 | $5,255 | $0 | $387,393 | $0 | $0 | $0 |
| TIM BECCUE | ||||||||||||||
| VP OF FINANCE | $161,552 | $0 | $25,693 | $0 | $0 | $0 | $9,250 | $0 | $13,125 | $0 | $209,620 | $0 | $0 | $0 |
| GREG CHANCE | ||||||||||||||
| VP OF STRATEGY | $130,542 | $0 | $16,717 | $0 | $0 | $0 | $1,919 | $0 | $9,610 | $0 | $158,788 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | BASED ON EMPLOYEE PERFORMANCE | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION PROVIDES A COPY OF FORM 990 TO THE BOARD FOR REVIEW PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE OF THE CONFLICT OF INTEREST POLICY. EACH BOARD MEMBER ANNUALLY COMPLETES A CONFLICT OF INTEREST STATEMENT. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD REVIEWS COMPARABLE DATA AND THE SPECIFIC PERFORMANCE OF THE EXECUTIVE DIRECTOR IN DETERMINING COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 24E | RECRUITING: PROGRAM SERVICE EXPENSES 226,896. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 226,896. BANK SERVICE CHARGES: PROGRAM SERVICE EXPENSES 116,574. MANAGEMENT AND GENERAL EXPENSES 100,673. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 217,247. FRANCHISE FEES: PROGRAM SERVICE EXPENSES 160,680. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 160,680. UNIFORMS: PROGRAM SERVICE EXPENSES 104,210. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 104,210. COMMUNITY PARTNERING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 97,264. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 97,264. COMMUNICATIONS: PROGRAM SERVICE EXPENSES 95,650. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 95,650. SUBCONTRACTOR SERVICES: PROGRAM SERVICE EXPENSES 47,621. MANAGEMENT AND GENERAL EXPENSES 38,099. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 85,720. MISCELLANEOUS EXPENSE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 67,214. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 67,214. ADMINISTRATIVE EXPENSES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 62,680. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 62,680. |
| FORM 990, PART XII, LINE 2C | THE PROCESS FOR OVERSEEING THE AUDIT AND SELECTING AN INDEPENDENT AUDITOR HAS NOT CHANGED FROM THE PRIOR YEAR. |
| FORM 990, PART IV, LINE 12 AND PART XII, LINE 2C | THE ORGANIZATION HAS AUDITED FINANCIAL STATEMENTS THAT ARE PREPARED ON A CONSOLIDATED BASIS. |
| FORM 5471, SCHEDULE O, PART I | THE OFFICERS AND/OR DIRECTORS OF THE FOREIGN CORPORATION FILE FORM 5471 AS CATEGORY 2 FILERS IN ACCORDANCE WITH TREASURY REGULATION SECTION 1.6046-1(A)(2)(I)(C). THERE WERE NO 10% ACQUISITIONS BY UNITED STATES PERSONS DURING THE CURRENT YEAR. EACH SHAREHOLDER WITH RESPECT TO WHOM THE CATEGORY 2 FORMS ARE FILED IS A UNITED STATES SHAREHOLDER UNDER SECTION 953(C) AND HAS PROVIDED THE INFORMATION REQUIRED BY TREASURY REGULATION SECTION 1.6046-1(A)(2)(II)(A) TO THE IRS ON FORM 5471 ATTACHED TO THEIR RESPECTIVE INCOME TAX RETURN. DUE TO SECURITY CONCERNS, THE INFORMATION IS AVAILABLE UPON REQUEST AND MAY BE OBTAINED FROM THE OFFICE OF THE FOREIGN CORPORATION. |
| FORM 5471, SCHEDULE B | NO U.S. PERSON OWNED (AT ANY TIME DURING THE ACCOUNTING PERIOD), DIRECTLY OR INDIRECTLY, 10% OR MORE IN VALUE OR VOTE OF ANY CLASS OF THE CORPORATION'S OUTSTANDING STOCK. |
| FORM 5471, SCHEDULE O, PART II, SECTION C & D | THE FILER IS A CATEGORY 3 FILER FOR FORM 5471 PURPOSES BECAUSE IT IS A UNITED STATES SHAREHOLDER OF THE FOREIGN CORPORATION UNDER IRC SECTION 953(C). THEREFORE, THE FILER IS REQUIRED TO COMPLETE SCHEDULE O EVEN IF IT NEITHER ACQUIRED NOR DISPOSED OF STOCK IN THE FOREIGN CORPORATION. |
| FORM 5471, SCHEDULE O, PART II, SECTION F | CATALYST INSURANCE, LTD. FILED FORM 1120-F, U.S. INCOME TAX RETURN OF A FOREIGN CORPORATION, FOR ITS TAX YEARS ENDED MAY 31, 2015, 2016, AND 2017. CATALYST INSURANCE, LTD. HAD NO TAXABLE INCOME AND NO TAX DUE ON THE RETURN. ADDITIONAL FILING REQUIREMENTS FOR CATEGORY 3 FILERS: 1. THE AMOUNT AND TYPE OF ANY INDEBTEDNESS THE FOREIGN CORPORATION HAS WITH THE RELATED PERSONS DESCRIBED IN REGULATION SEC. 1.6046-1(B)(11). N/A - THERE IS NO INDEBTEDNESS BETWEEN CATALYST INSURANCE, LTD. AND RELATED PARTIES. 2. THE NAME, ADDRESS, INDENTIFYING NUMBER AND NUMBER OF SHARES SUBSCRIBED TO BY EACH SUBSCRIBER TO THE FOREIGN CORPORATION'S STOCK. N/A - THERE ARE CURRENTLY NO SUBSCRIPTIONS FOR ANY OF CATALYST INSURANCE, LTD.'S STOCK. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|
| ADVANCED MEDICAL TRANSPORT INC | ||||||||||
| 1718 N STERLING AVE | PEORIA | IL | 61604 | 260312211 | CHARITABLE, SCIENTIFIC, AND EDUCATIONAL TO FUTHER PHMMS AND AMT OF IOWA | IL | 501(C)(3) | 9 | 0 | |
| ADVANCED MEDICAL TRANSPORT OF IOWA | ||||||||||
| 1718 N STERLING AVE | PEORIA | IL | 61604 | 274133957 | PROVIDES AMBULANCE AND PARAMEDIC SERVICES | IA | 501(C)(3) | 9 | 0 | ADVANCED MEDICAL TRANSPORT INC |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDWEST EMERGENCY MEDICAL SERVICES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1718 N STERLING AVE | AddressLine1Txt |
| City | PEORIA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61604 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 263021862 | EIN |
| Primary Activities | BILLING AND MANAGEMENT | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADVANCED MEDICAL TRANSPORT INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | Yes (1) | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (1) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (8 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MIDWEST EMERGENCY MEDICAL SERVICES | ||
| D | $730,000 | NOTE PAYABLE TO MEMSI |
| ADVANCED MEDICAL TRANSPORT OF IOWA | ||
| P | $817,566 | AMT IOWA EXPENSES PAID BY PHMMS |
| ADVANCED MEDICAL TRANSPORT OF IOWA | ||
| O | $873,389 | AMT IOWA PAYROLL PAID BY PHMMS |
| ADVANCED MEDICAL TRANSPORT OF IOWA | ||
| H | $50,585 | PURCHASE OF ASSETS FROM AMT IOWA |
| ADVANCED MEDICAL TRANSPORT OF IOWA | ||
| E | $220,038 | NOTE PAYABLE FROM AMTI |
| MIDWEST EMERGENCY MEDICAL SERVICES | ||
| O | $28,445 | MEMSI PAYROLL PAID BY PHMMS |
| MIDWEST EMERGENCY MEDICAL SERVICES | ||
| P | $144,816 | MEMSI EXPENSES PAID BY PHMMS |
| ADVANCED MEDICAL TRANSPORT OF IOWA | ||
| G | $115,487 | SALE OF ASSETS TO AMT IOWA |
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