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NORTHWEST GEORGIA MEDICAL FOUNDATION INC: Form 990EZ, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
NORTHWEST GEORGIA MEDICAL FOUNDATION INC (EIN 45-3907541)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-15
IRS object ID
201803199349201065
Schema version
2017v2.3
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)
Return2018-11-15T07:42:11-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN461381910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WHITTINGTON JONES & RUDERT CPAS LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1264AddressLine1Txt
CityROMECityNm
State AbbreviationGAStateAbbreviationCd
ZIP301621264ZIPCd
FieldValueIRS element (for citing)
Return Type990EZReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN453907541EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NORTHWEST GEORGIA MEDICAL FOUNDATIONBusinessNameLine1Txt
Business Name Line2INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlNORTBusinessNameControlTxt
Phone7062956325PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1415 EAST THIRD AVEAddressLine1Txt
CityROMECityNm
State AbbreviationGAStateAbbreviationCd
ZIP30161ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDR AL DIAZPersonNm
Person TitleCHAIRMANPersonTitleTxt
Phone7062956325PhoneNum
Signature2018-11-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJILL MASLANKAPreparerPersonNm
PTINP01035911PTIN
Phone7062347571PhoneNum
Preparation2018-11-13PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address173.165.188.56IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-11-13IPDt
IP Tm09:01:43IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id7E4B5E219FA093DD2D29C777A3A5EF43F2BAE6A6AtSubmissionCreationDeviceId
At Submission Filing Device Id7E4B5E219FA093DD2D29C777A3A5EF43F2BAE6A6AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990-EZ IRS990EZ

FieldValueIRS element (for citing)
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Schedule B Not RequiredYes (X)ScheduleBNotRequiredInd
Website AddressN/AWebsiteAddressTxt
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization OtherYes (X)TypeOfOrganizationOtherInd
Type Of Organization OtherTAX-EXEMPTTypeOfOrganizationOtherDesc
Gross Receipts$500GrossReceiptsAmt
Info In Schedule O Part IYes (X)InfoInScheduleOPartIInd
Contributions Gifts Grants Etc$500ContributionsGiftsGrantsEtcAmt
Total Revenue$500TotalRevenueAmt
Fees And Other Pymt To Ind Cntrct$1,413FeesAndOtherPymtToIndCntrctAmt
Occupancy Rent Utlts And Maint$2,413OccupancyRentUtltsAndMaintAmt
Other Expenses Total$3,120OtherExpensesTotalAmt
Total Expenses$6,946TotalExpensesAmt
Excess Or Deficit For Year-$6,446ExcessOrDeficitForYearAmt
Net Assets Or Fund Balances BOY$125,838NetAssetsOrFundBalancesBOYAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Net Assets Or Fund Balances EOY$119,392NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIYes (X)InfoInScheduleOPartIIInd

Cash Savings And Investments CashSavingsAndInvestmentsGrp

FieldValueIRS element (for citing)
BOY$119,843BOYAmt
EOY$111,768EOYAmt

Other Assets Total Detail OtherAssetsTotalDetail

FieldValueIRS element (for citing)
BOY$5,995BOYAmt
EOY$7,624EOYAmt

Form990 Total Assets Form990TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$125,838BOYAmt
EOY$119,392EOYAmt

Sum Of Total Liabilities SumOfTotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp

FieldValueIRS element (for citing)
BOY$125,838BOYAmt
EOY$119,392EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
Primary Exempt PurposeTHE PRIMARY PURPOSE OF THE CORPORATION IS THE SOLICITATION OF CONTRIBUTIONS, GIFTS, BEQUESTS AND CONVEYANCES OF REAL AND PERSONAL PROPERTY, INCLUDING MONEY, TO BE USED FOR THE BENEFIT OF AND TO CARRY OUT THE MISSION AND PURPOSE OF EDUCATING STUDENTS OF THE GEORGIA HEALTH SCIENCES UNIVERSITY AT ITS ROME, GEORGIA CAMPUS.PrimaryExemptPurposeTxt

Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp

FieldValueIRS element (for citing)
Description Program Srvc AccomTO PROVIDE SUPPORT TO THE NORTHWEST GEORGIA CLINICAL CAMPUS OF THE MEDICAL COLLEGE OF GEORGIA.DescriptionProgramSrvcAccomTxt
Grants And Allocations$0GrantsAndAllocationsAmt
Program Service Expenses$5,842ProgramServiceExpensesAmt
FieldValueIRS element (for citing)
Total Program Service Expenses$5,842TotalProgramServiceExpensesAmt

Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (9 entries)

TitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
DR JULIE BARNES
CHAIRMAN1.00$0$0$0
DR JOE BURCH
SECRETARY1.00$0$0$0
DR ED MCBRIDE
TREASURER1.00$0$0$0
KENNA STOCK
DIRECTOR1.00$0$0$0
JOHN QUINLIVAN
DIRECTOR1.00$0$0$0
DR SIDNEY BELL
DIRECTOR1.00$0$0$0
DR JOHN DESMOND
DIRECTOR1.00$0$0$0
DR JOE BIUSO
DIRECTOR1.00$0$0$0
BILL TEMPLE
DIRECTOR1.00$0$0$0
FieldValueIRS element (for citing)
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
Activities Not Previously Rpt0ActivitiesNotPreviouslyRptInd
Chg Made To Orgnzng Doc Not Rpt0ChgMadeToOrgnzngDocNotRptInd
Organization Had UBI0OrganizationHadUBIInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Organization Dissolved Etc0OrganizationDissolvedEtcInd
Direct Indirect Pltcl Expend$0DirectIndirectPltclExpendAmt
Made Loans To From Officers0MadeLoansToFromOfficersInd
Tax Imposed Under IRC4911$0TaxImposedUnderIRC4911Amt
Tax Imposed Under IRC4912$0TaxImposedUnderIRC4912Amt
Tax Imposed Under IRC4955$0TaxImposedUnderIRC4955Amt
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
Tax Imposed On Organization Mgr$0TaxImposedOnOrganizationMgrAmt
Tax Reimbursed By Organization$0TaxReimbursedByOrganizationAmt
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DR JULIE BARNESBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1415 E 3RD AVENUEAddressLine1Txt
CityROMECityNm
State AbbreviationGAStateAbbreviationCd
ZIP30161ZIPCd
FieldValueIRS element (for citing)
Phone7062918853PhoneNum
FieldValueIRS element (for citing)
Foreign Financial Account0ForeignFinancialAccountInd
Foreign Office0ForeignOfficeInd
Donor Advised Fnds0DonorAdvisedFndsInd
Operate Hospital0OperateHospitalInd
Tanning Services Provided0TanningServicesProvidedInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
School Operating0SchoolOperatingInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Part VI Of Comp Of Hghst Pd EmplNONEPartVIOfCompOfHghstPdEmplTxt
Part VI Hghst Pd Cntrct Prof SrvcNONEPartVIHghstPdCntrctProfSrvcTxt
Filed Schedule AYes (1)FiledScheduleAInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
College OrganizationYes (X)CollegeOrganizationInd

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$27,000CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$58,500CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$52,000CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,864CurrentTaxYearMinus1YearAmt
Current Tax Year$500CurrentTaxYearAmt
Total$144,864TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$27,000CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$58,500CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$52,000CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,864CurrentTaxYearMinus1YearAmt
Current Tax Year$500CurrentTaxYearAmt
Total$144,864TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$144,864PublicSupportTotal170Amt
Total Support$144,864TotalSupportAmt
Public Support CY1701.00000PublicSupportCY170Pct
Public Support PY1701.00000PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990-EZ, PART I, LINE 14DESCRIPTION: DEPRECIATION. AMOUNT: 2,413.
FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSESDESCRIPTION: BANK CHARGES. AMOUNT: 10. DESCRIPTION: MISCELLANEOUS. AMOUNT: 386. DESCRIPTION: MEALS & EVENTS. AMOUNT: 2,724. TOTAL TO FORM 990-EZ, LINE 16: 3,120.
FORM 990-EZ, PART II, LINE 24 - OTHER ASSETSDESCRIPTION: OTHER DEPRECIABLE ASSETS. BEG. OF YEAR AMOUNT: 5,995. END OF YEAR AMOUNT: 7,624.

Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl

FieldValueIRS element (for citing)
DeclarationTHE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.DeclarationDesc

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