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CREATE YOUR STATEMENT: Form 990EZ, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
CREATE YOUR STATEMENT (EIN 45-4505016)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-15
IRS object ID
201843199349206989
Schema version
2017v2.2
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)
Return2018-11-15T14:10:08-08:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN911157591PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Gary P Kirchner CPA PSBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1427 W Sinto Suite 200AddressLine1Txt
CitySpokaneCityNm
State AbbreviationWAStateAbbreviationCd
ZIP992012465ZIPCd
FieldValueIRS element (for citing)
Return Type990EZReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN454505016EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CREATE YOUR STATEMENTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCREABusinessNameControlTxt
Phone5099937000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 18934AddressLine1Txt
CitySPOKANECityNm
State AbbreviationWAStateAbbreviationCd
ZIP99228ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJENNY MOELLERPersonNm
Person TitlePresidentPersonTitleTxt
Signature2018-11-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKYLE JORDAN CPAPreparerPersonNm
PTINP01287966PTIN
Phone5093288844PhoneNum
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 AddressWWW.CREATEYOURSTATEMENT.COMWebsiteAddressTxt
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Gross Receipts$144,840GrossReceiptsAmt
Info In Schedule O Part IYes (X)InfoInScheduleOPartIInd
Contributions Gifts Grants Etc$112,045ContributionsGiftsGrantsEtcAmt
Cost Or Other Basis Expense Sale$0CostOrOtherBasisExpenseSaleAmt
Fundraising Gross Income$25,661FundraisingGrossIncomeAmt
Special Events Direct Expenses$29,672SpecialEventsDirectExpensesAmt
Special Events Net Income Loss-$4,011SpecialEventsNetIncomeLossAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt
Other Revenue Total$7,134OtherRevenueTotalAmt
Total Revenue$115,168TotalRevenueAmt
Salaries Other Comp Empl Bnft$52,299SalariesOtherCompEmplBnftAmt
Occupancy Rent Utlts And Maint$2,750OccupancyRentUtltsAndMaintAmt
Other Expenses Total$39,682OtherExpensesTotalAmt
Total Expenses$94,731TotalExpensesAmt
Excess Or Deficit For Year$20,437ExcessOrDeficitForYearAmt
Net Assets Or Fund Balances BOY$26,680NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$47,117NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIYes (X)InfoInScheduleOPartIIInd

Cash Savings And Investments CashSavingsAndInvestmentsGrp

FieldValueIRS element (for citing)
BOY$26,680BOYAmt
EOY$49,631EOYAmt

Form990 Total Assets Form990TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$26,680BOYAmt
EOY$49,631EOYAmt

Sum Of Total Liabilities SumOfTotalLiabilitiesGrp

FieldValueIRS element (for citing)
EOY$2,514EOYAmt

Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp

FieldValueIRS element (for citing)
BOY$26,680BOYAmt
EOY$47,117EOYAmt
FieldValueIRS element (for citing)
Primary Exempt PurposeSTATEMENT WILL BRING EDUCATION AND AWARENESS TO THE PREVENTION OF DATING ABUSEWHILE PROMOTING LEADERSHIP AND CHARACTER DEVELOPMENT AMONG TODAYS YOUTH.PrimaryExemptPurposeTxt

Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp

FieldValueIRS element (for citing)
Description Program Srvc AccomSTATEMENT IS SPECIFICALLY MEETING A UNIQUE NEED IN WASHINGTON STATE BY FOCUSING ONTHE PREVENTION OF DATING ABUSE AS OPPOSED TO DOMESTIC VIOLENCE VICTIMRECOVERY.LEADERSHIP AND CHARACTER DEVELOPMENT IS ESSENTIAL IN THE STATEMENTPROGRAMS.DescriptionProgramSrvcAccomTxt
Grants And Allocations$40,217GrantsAndAllocationsAmt
FieldValueIRS element (for citing)
Total Program Service Expenses$40,217TotalProgramServiceExpensesAmt

Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (11 entries)

TitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmt
HEIDI LAURITZEN
President0$0
OPHELIA ARAUJO
Vice President0$0
JEFF NICCUM
Treasurer0$0
KARILYNN CUNNINGHAM
Secretary0$0
STEVE ANDERSON
Director0$0
CONNIE STARK
Director0$0
BRAD MOELLER
Director0$0
YVONNE SMITH
Director0$0
ANNE COWLES
Director0$0
CASSIE ANDERSON
Director0$0
ANNE OAKLEY
Director0$0
FieldValueIRS element (for citing)
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
Activities Not Previously RptfalseActivitiesNotPreviouslyRptInd
Chg Made To Orgnzng Doc Not RptfalseChgMadeToOrgnzngDocNotRptInd
Organization Had UBIfalseOrganizationHadUBIInd
Organization Filed990 TfalseOrganizationFiled990TInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Organization Dissolved EtcfalseOrganizationDissolvedEtcInd
Form1120 Pol FiledfalseForm1120PolFiledInd
Made Loans To From OfficersfalseMadeLoansToFromOfficersInd
Initiation Fees And Cap Contri$0InitiationFeesAndCapContriAmt
Gross Receipts For Public Use$0GrossReceiptsForPublicUseAmt
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJENNY MOELLERPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 18934AddressLine1Txt
CitySPOKANECityNm
State AbbreviationWAStateAbbreviationCd
ZIP99228ZIPCd
FieldValueIRS element (for citing)
Phone5099937000PhoneNum
FieldValueIRS element (for citing)
Foreign Financial AccountfalseForeignFinancialAccountInd
Foreign OfficefalseForeignOfficeInd
Donor Advised FndsfalseDonorAdvisedFndsInd
Operate HospitalfalseOperateHospitalInd
Tanning Services ProvidedfalseTanningServicesProvidedInd
Form720 FiledfalseForm720FiledInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
School OperatingfalseSchoolOperatingInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Related Org Sect527 OrgfalseRelatedOrgSect527OrgInd
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)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$47,036CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,457CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$79,674CurrentTaxYearMinus1YearAmt
Current Tax Year$144,840CurrentTaxYearAmt
Total$290,007TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$47,036CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,457CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$79,674CurrentTaxYearMinus1YearAmt
Current Tax Year$144,840CurrentTaxYearAmt
Total$290,007TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$290,007PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$290,007TotalSupportAmt
First5 Years170Yes (X)First5Years170Ind
Public Support CY1700.00000PublicSupportCY170Pct

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1Annual BankquetEvent1Nm
Gross Receipts Event1$25,661GrossReceiptsEvent1Amt
Gross Revenue Event1$25,661GrossRevenueEvent1Amt
Non Cash Prizes Event1$1,921NonCashPrizesEvent1Amt
Rent Facility Costs Event1$11,043RentFacilityCostsEvent1Amt
Other Direct Expenses Event1$16,708OtherDirectExpensesEvent1Amt
Gross Receipts Total$25,661GrossReceiptsTotalAmt
Gross Revenue Total Events$25,661GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$1,921NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$11,043RentFcltyCostsTotalEventsAmt
Oth Direct Expnss Total Events$16,708OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$29,672DirectExpenseSummaryEventsAmt
Net Income Summary-$4,011NetIncomeSummaryAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Other Revenue.1Program Revenue $7134
Other Expenses.1CONTRACT SERVICES $16321
Other Expenses.2RENT $3243
Other Expenses.3SUPPLIES $2819
Other Expenses.4TRAVEL $2447
Other Expenses.5INSURANCE $2303
Other Expenses.6SMALL EQUIPMENT $2263
Other Expenses.7MATERIAL $2242
Other Expenses.8DINING $2112
Other Expenses.9CONTRIBUTION $1741
Other Expenses.10BANK SERVICE CHARGE $1547
Other Expenses.11PRINTING $1084
Other Expenses.12APPRECIATION $654
Other Expenses.13POSTAGE $536
Other Expenses.14BOARD MEETING $330
Other Expenses.15SUPPLIES $40
Total Liabilities.1Payroll Liabilities - Beginning $0 Payroll Liabilities - Ending $2514

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