A PATTERN: Form 990EZ, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- A PATTERN (EIN 45-5094420)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-08-31
- IRS object ID
- 201812439349200116
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-08-31T12:07:12-04:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 271750037 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | R & J ACCOUNTING & TAX SERVICES | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2601 CR 3260 | AddressLine1Txt |
| City | SALEM | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65560 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 455094420 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | A PATTERN INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | APAT | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 RICHTER ROAD | AddressLine1Txt |
| City | BOURBON | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65441 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SCOTT GRIVAS JR | PersonNm |
| Person Title | SECRETARY | PersonTitleTxt |
| Phone | 8559761888 | PhoneNum |
| Signature | 2018-08-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DIANA J LETTMAN | PreparerPersonNm |
| PTIN | P01201478 | PTIN |
| Phone | 5737294532 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $102,347 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $32,895 | ContributionsGiftsGrantsEtcAmt |
| Investment Income | $133 | InvestmentIncomeAmt |
| Other Revenue Total | $69,319 | OtherRevenueTotalAmt |
| Total Revenue | $102,347 | TotalRevenueAmt |
| Salaries Other Comp Empl Bnft | $31,270 | SalariesOtherCompEmplBnftAmt |
| Occupancy Rent Utlts And Maint | $17,303 | OccupancyRentUtltsAndMaintAmt |
| Printing Publications Postage | $264 | PrintingPublicationsPostageAmt |
| Other Expenses Total | $23,830 | OtherExpensesTotalAmt |
| Total Expenses | $72,667 | TotalExpensesAmt |
| Excess Or Deficit For Year | $29,680 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $204,389 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $234,069 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,477 | BOYAmt |
| EOY | $96,402 | EOYAmt |
Land And Buildings LandAndBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $335,000 | BOYAmt |
| EOY | $335,000 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,330 | BOYAmt |
| EOY | $5,330 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $460,807 | BOYAmt |
| EOY | $436,732 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $256,418 | BOYAmt |
| EOY | $202,663 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $204,389 | BOYAmt |
| EOY | $234,069 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | Provide health and medical education | PrimaryExemptPurposeTxt |
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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $0 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (6 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| ANNEX LUBERISSE | ||||
| PRESIDENT | 0.00 | $0 | $0 | $0 |
| ANDREW S GRIVAS | ||||
| SECRETARY | 40.00 | $0 | $0 | $0 |
| JOYCE GRIVAS | ||||
| TREASURER | 40.00 | $0 | $0 | $0 |
| PAUL ROSS | ||||
| GENERAL BUSINESS MANAGER | 0.00 | $0 | $0 | $0 |
| MARTHA ROSS | ||||
| ADMINISTRATIVE DIRECTOR | 0.00 | $0 | $0 | $0 |
| CHARLES CLEVELAND | ||||
| ASSISTANT BS MANAGER | 0.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | false | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | false | OrganizationHadUBIInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Form1120 Pol Filed | false | Form1120PolFiledInd |
| Made Loans To From Officers | false | MadeLoansToFromOfficersInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANDREW S GRIVAS | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 RICHTER ROAD | AddressLine1Txt |
| City | BOURBON | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65441 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8559761888 | 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 |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| 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 Minus2 Years | $81,220 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $149,070 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $32,895 | CurrentTaxYearAmt |
| Total | $263,185 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $17,564 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $40,436 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $58,207 | CurrentTaxYearAmt |
| Total | $116,207 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $98,784 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $189,506 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $91,102 | CurrentTaxYearAmt |
| Total | $379,392 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $379,392 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $55 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $133 | CurrentTaxYearAmt |
| Total | $188 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $55 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $133 | CurrentTaxYearAmt |
| Total | $188 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $19,600 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,113 | CurrentTaxYearAmt |
| Total | $30,713 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus2 Years | $98,784 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $209,161 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $102,348 | CurrentTaxYearAmt |
| Total | $410,293 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First5 Years509 | Yes (X) | First5Years509Ind |
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 O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Description of other revenue Part I line 8 | Description AmountLIFESTYLE INCOME 54,611PHONE CONSULTATIONS 3,171REFUNDS 424RENTAL INCOME 11,113 |
| Description of other expenses Part I line 16 | Description AmountADVERTISING 993BANK FEES 877PURCHASED SERVICES 2,168TRAVEL 5,647TAXES 6,861INTEREST 7,284 |
| Description of other assets Part II line 24 | Category Beginning of Year End of YearSTEAM SHOWER 1,437 1,437EQUIPMENT 3,893 3,893 |
| Description of total liabilities Part II line 26 | Category Beginning of Year End of YearBUILDING AND LAND 253,618 201,903EQUIPMENT 2,800 760 |
| Other program services Part III line 31 | One 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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