Empath Choices for Care Inc: Form 990EZ, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- Empath Choices for Care Inc (EIN 31-1699259)
- Tax period
- 2016-10-01 to 2017-09-30
- Filed
- 2018-08-10
- IRS object ID
- 201812229349200211
- Schema version
- 2016v3.0
- 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 | 2018-08-10T10:01:08-05:00 | ReturnTs |
| Tax Period End | 2017-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 350921680 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 West Wacker Drive Suite 2600 | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 606061224 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2016-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311699259 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Empath Choices for Care Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | EMPA | BusinessNameControlTxt |
| Phone | 7275864432 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5771 Roosevelt Boulevard | AddressLine1Txt |
| City | Clearwater | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33760 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mitchel Morel | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Signature | 2018-08-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | NICOLE BENCIK | PreparerPersonNm |
| PTIN | P00756195 | PTIN |
| Phone | 3128997000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Final Return | Yes (X) | FinalReturnInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Website Address | www.empathchoicesforcare.org | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $153,134 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $151,751 | ContributionsGiftsGrantsEtcAmt |
| Program Service Revenue | $1,383 | ProgramServiceRevenueAmt |
| Gain Or Loss From Sale Of Assets | $0 | GainOrLossFromSaleOfAssetsAmt |
| Special Events Net Income Loss | $0 | SpecialEventsNetIncomeLossAmt |
| Gross Profit Loss Sls Of Invntry | $0 | GrossProfitLossSlsOfInvntryAmt |
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
| Total Revenue | $153,134 | TotalRevenueAmt |
| Grants And Similar Amounts Paid | $0 | GrantsAndSimilarAmountsPaidAmt |
| Salaries Other Comp Empl Bnft | $141,705 | SalariesOtherCompEmplBnftAmt |
| Fees And Other Pymt To Ind Cntrct | $800 | FeesAndOtherPymtToIndCntrctAmt |
| Occupancy Rent Utlts And Maint | $1,732 | OccupancyRentUtltsAndMaintAmt |
| Other Expenses Total | $12,450 | OtherExpensesTotalAmt |
| Total Expenses | $156,687 | TotalExpensesAmt |
| Excess Or Deficit For Year | -$3,553 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $191,729 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | -$188,176 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $146,568 | BOYAmt |
| EOY | $0 | EOYAmt |
Land And Buildings LandAndBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,569 | BOYAmt |
| EOY | $0 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $212,137 | BOYAmt |
| EOY | $0 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,408 | BOYAmt |
| EOY | $0 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $191,729 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | to educate and empower people to communicate and document their health care choices so that their wishes are honored. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | EMPATH CHOICES FOR CARE, INC. WAS ESTABLISHED THROUGH A PARTNERSHIP OF PHYSICIANS, ELDER CARE PROVIDERS AND CONCERNED CITIZENS OF FLORIDA DEDICATED TO CHANGING THE DEATH-DEFYING, TECHNOLOGY-DRIVEN APPROACH TO END-OF-LIFE CARE TO A HOLISTIC, COMPASSIONATE ONE THAT RESPECTS HUMAN DIGNITY AND THE INDIVIDUAL'S BEST INTERESTS AND PERSONAL WISHES. EMPATH CHOICES FOR CARE, INC. OFFERS EDUCATION AND THE VEHICLES FOR ADVANCE CARE PLANNING FOR COMMUNITIES, THE GENERAL PUBLIC AND HEALTHCARE PROVIDERS. EMPATH CHOICES FOR CARE, INC. SEEKS TO CREATE COMMUNITIES PREPARED TO ADDRESS THE END OF LIFE, MEETING IT WITH DIGNITY, MEANING AND RESPECT FOR CHOICES. IT HELPS INDIVIDUALS AND FAMILIES CREATE AN ATMOSPHERE TO DISCUSS AND MAKE DECISIONS REGARDING MEDICAL PREFERENCES. EMPATH CHOICES FOR CARE, INC. PARTNERS WITH SUNCOAST HOSPICE, PHYSICIANS, ELDER CARE COUNSELORS AND CONCERNED CITIZENS TO CARRY OUT ITS MISSION. PROGRAMS ARE FOCUSED ON HELPING INDIVIDUALS COMMUNICATE AND IMPLEMENT THEIR END-OF-LIFE MEDICAL TREATMENT DECISIONS, THE PREMISE IS THAT ALL PERSONS ARE ENTITLED TO HUMANE, DIGNIFIED END-OF-LIFE CARE IN KEEPING WITH THEIR WISHES, VALUES AND SPIRITUAL BELIEFS. FURTHER, EMPATH CHOICES FOR CARE, INC. OFFERS EDUCATION TO ALL MEMBERS OF THE COMMUNITY REGARDING ADVANCE CARE PLANNING. EMPATH CHOICES FOR CARE, INC. WAS INSTRUMENTAL IN PROVIDING LEADERSHIP TO THE PHYSICIAN ORDERS FOR LIFE-SUSTAINING TREATMENT (POLST) PROGRAM WHICH IS DESIGNED TO ENSURE THAT PATIENT WISHES TO RECEIVE OR REFUSE LIFE-SUSTAINING TREATMENTS ARE HONORED BY CONVERTING PATIENT PREFERENCES INTO ACTIONABLE MEDICAL ORDERS. EMPATH CHOICES FOR CARE, INC. IS COORDINATING THE SUCCESSFUL IMPLEMENTATION OF A FLORIDA POLST PILOT PROJECT AT SUNCOAST HOSPICE BY PROVIDING TRAINING, RESOURCE MATERIALS AND SUPPORT. WE ANTICIPATE CAPTURING DATA ON PATIENT USE, FORMS COMPLETED, PROCESS EFFICIENCY AND PATIENT WISHES HONORED. EMPATH CHOICES FOR CARE, INC. CONTINUED ITS WORK IN THE RESPECTING CHOICES FACILITATOR TRAINING. THIS IS A COURSE DESIGNED FOR HEALTHCARE PROFESSIONALS (SOCIAL WORKERS, NURSES, PHYSICIANS, CHAPLAINS) THAT TEACHES THE NECESSARY SKILLS TO INITIATE ADVANCE CARE PLANNING CONVERSATIONS, ASSIST PATIENTS IN MAKING INFORMED HEALTHCARE DECISIONS AND CREATE EFFECTIVE WRITTEN DOCUMENTS LIKE LIVING WILLS. EMPATH CHOICES FOR CARE, INC. OFFERS RESPECTING CHOICES TRAINING COURSES BOTH INTERNALLY WITH SUNCOAST HOSPICE STAFF AND EXTERNALLY WITH LOCAL CARE PARTNERS. STUDENTS COMPLETE 6 ON-LINE MODULES AND PARTICIPATE IN A FULL DAY OF CLASSROOM INSTRUCTION. | DescriptionProgramSrvcAccomTxt |
| Program Service Expenses | $129,170 | ProgramServiceExpensesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $129,170 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (15 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| ruby hope | ||||
| Vice Chair | 2.000 | $0 | $0 | $0 |
| Donna Ceasare | ||||
| Secretary | 2.000 | $0 | $0 | $0 |
| James Steg | ||||
| Treasurer | 2.000 | $0 | $0 | $0 |
| Rafael Sciullo | ||||
| President and CEO | 2.000 | $0 | $0 | $0 |
| Dennis Rep DeLoach Esq | ||||
| Chair | 2.000 | $0 | $0 | $0 |
| Rev Celillon Alteme | ||||
| DIRECTOR | 2.000 | $0 | $0 | $0 |
| W Daniel Doty MD | ||||
| DIRECTOR | 2.000 | $0 | $0 | $0 |
| Henry j hank Foshee | ||||
| Director | 2.000 | $0 | $0 | $0 |
| Rebekah Apple | ||||
| Director | 2.000 | $0 | $0 | $0 |
| Millie Carreno | ||||
| Director (partial year) | 2.000 | $0 | $0 | $0 |
| Becky Falzone | ||||
| Director | 2.000 | $0 | $0 | $0 |
| Cate McCarty | ||||
| Director | 2.000 | $0 | $0 | $0 |
| Tracy Christner | ||||
| EXECUTIVE DIRECTOR | 40.000 | $66,067 | $11,570 | $0 |
| Anne Hochsprung | ||||
| Chief Financial Officer (partial year) | 2.000 | $0 | $0 | $0 |
| Mitchel Morel | ||||
| Chief Financial Officer (partial year - starting 6/2017) | 2.000 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | Yes (true) | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | false | OrganizationHadUBIInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Organization Dissolved Etc | Yes (true) | OrganizationDissolvedEtcInd |
| Direct Indirect Pltcl Expend | $0 | DirectIndirectPltclExpendAmt |
| Form1120 Pol Filed | false | Form1120PolFiledInd |
| Made Loans To From Officers | false | MadeLoansToFromOfficersInd |
| Tax Imposed Under IRC4911 | $0 | TaxImposedUnderIRC4911Amt |
| Tax Imposed Under IRC4912 | $0 | TaxImposedUnderIRC4912Amt |
| Tax Imposed Under IRC4955 | $0 | TaxImposedUnderIRC4955Amt |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| Tax Imposed On Organization Mgr | $0 | TaxImposedOnOrganizationMgrAmt |
| Tax Reimbursed By Organization | $0 | TaxReimbursedByOrganizationAmt |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| States Where Copy Of Return Is Fld | FL | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | mitchel morel | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5771 ROOSEVELT BLVD | AddressLine1Txt |
| City | CLEARWATER | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33760 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7275864432 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Foreign Office | false | ForeignOfficeInd |
| Donor Advised Fnds | false | DonorAdvisedFndsInd |
| Operate Hospital | false | OperateHospitalInd |
| Tanning Services Provided | false | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| School Operating | false | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Other Employee Paid Over100k | 0 | OtherEmployeePaidOver100kCnt |
| Filed Schedule A | Yes (true) | FiledScheduleAInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $157,802 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $151,869 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $143,938 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $144,421 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $151,751 | CurrentTaxYearAmt |
| Total | $749,781 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $22,210 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $27,535 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $18,139 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,500 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,383 | CurrentTaxYearAmt |
| Total | $76,767 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $180,012 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $179,404 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $162,077 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $151,921 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $153,134 | CurrentTaxYearAmt |
| Total | $826,548 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $826,548 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,112 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,700 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,331 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $63,380 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $68,523 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $181,124 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $181,104 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $164,408 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $215,301 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $153,134 | CurrentTaxYearAmt |
| Total | $895,071 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.9234 | PublicSupportCY509Pct |
| Public Support PY509 | 0.9132 | PublicSupportPY509Pct |
| Investment Income CY | 0 | InvestmentIncomeCYPct |
| Investment Income PY | 0.0 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part III, Line 12 Other Income | FormAndLineReferenceDesc |
| Explanation | DESCRIPTION - SPECIAL EVENTS RECEIPTS, COLUMN A - 1112.0, COLUMN B - 1700.0, COLUMN C - 2331.0, COLUMN D - 270.0, COLUMN E - 0.0, COLUMN F - 5413.0; DESCRIPTION - MISCELLANEOUS INCOME, COLUMN A - 0.0, COLUMN B - 0.0, COLUMN C - 0.0, COLUMN D - 63110.0, COLUMN E - 0.0, COLUMN F - 63110.0; | ExplanationTxt |
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 N IRS990ScheduleN
Liquidation Of Assets Table LiquidationOfAssetsTableGrp
Liquidation Of Assets Detail LiquidationOfAssetsDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Assets Distri Or Expnss Paid | CASH AND ACCOUNTS RECEIVABLE | AssetsDistriOrExpnssPaidDesc |
| Distribution | 2017-09-30 | DistributionDt |
| Fair Market Value Of Asset | $188,176 | FairMarketValueOfAssetAmt |
| Method Of FMV Determination | FMV | MethodOfFMVDeterminationTxt |
| EIN | 263605716 | EIN |
| Person | EMPATH HEALTH INC | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5771 ROOSEVELT BLVD | AddressLine1Txt |
| City | CLEARWATER | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33760 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRC Section | 501(C)(3) | IRCSectionTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor | Yes (true) | DirectorOfSuccessorInd |
| Employee Of Successor | Yes (true) | EmployeeOfSuccessorInd |
| Owner Of Successor | false | OwnerOfSuccessorInd |
| Receive Compensation | false | ReceiveCompensationInd |
| Assets Distributed | Yes (true) | AssetsDistributedInd |
| Required To Notify AG | Yes (true) | RequiredToNotifyAGInd |
| Attorney General Notified | Yes (true) | AttorneyGeneralNotifiedInd |
| Liabilities Paid | Yes (true) | LiabilitiesPaidInd |
| Bonds Outstanding | false | BondsOutstandingInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule N, Part I, Line 2a Interested person is a director or trustee of successor org. | RAFAEL SCIULLO IS A BOARD MEMBER OF EMPATH HEALTH, INC. |
| Schedule N, Part I, Line 2b Interested person is an employee or ind. contractor of successor org. | RAFAEL SCIULLO AND MITCHEL MOREL ARE EMPLOYEES OF EMAPTH HEALTH, INC. ANNE HOCHSPRUNG IS A FORMER EMPLOYEE OF EMPATH HEALTH, INC. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990-EZ, Part I, Line 16 Other Expenses | Other Expenses - 6077; Insurance - 4558; Conferences & Meetings - 937; Travel - 878; |
| Form 990-EZ, Part I, Line 20 Net Assets Change | TRANSFER TO AFFILIATE - -188176; |
| Form 990-EZ, Part II, Line 24 Other Assets | ACCOUNTS RECEIVABLE - BOY:63110,EOY:0; PREPAID EXPENSES - BOY:2379,EOY:0; DUE FROM AFFILIATES - BOY:80,EOY:0; |
| Form 990-EZ, Part II, Line 26 Total Liabilities | ACCOUNTS PAYABLE AND ACCRUED EXPENSES - BOY:16851,EOY:0; DUE TO AFFILIATES - BOY:2742,EOY:0; DEFERRED REVENUE - BOY:815,EOY:0; |
| Form 990-EZ, Part V, Line 34 Changes to governing documents | EMPATH CHOICES FOR CARE, INC., AFTER APPROVAL BY ITS BOARD OF DIRECTORS, HAS EXECUTED AND FILED ARTICLES OF DISSOLUTION PURSUANT TO FLORIDA STATUTE SECTION 617.1403. DISSOLUTION IS EFFECTIVE SEPTEMBER 30, 2017. THERE WERE NO ASSETS TO DISTRIBUTE. ALL ACTIVITIES WERE DISCONTINUED. |
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