FAYETTE CARE CLINIC INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- FAYETTE CARE CLINIC INC (EIN 20-0314897)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-10-15
- IRS object ID
- 201802889349301425
- 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 | 2018-10-15T17:09:12-04:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Michelle L McGlaun CPA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2385 Emerald Drive | AddressLine1Txt |
| City | Jonesboro | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30236 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200314897 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Fayette CARE Clinic Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FAYE | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1260 Highway 54 West Ste 101 | AddressLine1Txt |
| City | Fayetteville | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30214 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Deb Pressley-Christensen | PersonNm |
| Person Title | Executive Direc | PersonTitleTxt |
| Phone | 7707194620 | PhoneNum |
| Signature | 2018-10-15 | SignatureDt |
| Discuss With Paid Preparer | false | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Michelle L McGlaun | PreparerPersonNm |
| PTIN | P01273842 | PTIN |
| Phone | 7708658067 | PhoneNum |
| Preparation | 2018-10-15 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 216.166.21.4 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-10-15 | IPDt |
| IP Tm | 17:10:09 | IPTm |
| Federal Original Submission Id | 582028201828805akiaa | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2018-10-15 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | EF54249DA924441C0D4981A4F90F3C9ED1E328D4 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | EF54249DA924441C0D4981A4F90F3C9ED1E328D4 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2018-06-14 16:35:46Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $402,999 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.fayettecareclinic.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2003 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | To provide a medical home in Fayette County for lower-income, uninsured adults and caring for them always with Compassion and Respect for everyone. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 15 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $376,760 | PYContributionsGrantsAmt |
| CY Contributions Grants | $307,972 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,636 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,652 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6 | PYInvestmentIncomeAmt |
| CY Investment Income | $5 | CYInvestmentIncomeAmt |
| PY Other Revenue | $52,799 | PYOtherRevenueAmt |
| CY Other Revenue | $78,385 | CYOtherRevenueAmt |
| PY Total Revenue | $436,201 | PYTotalRevenueAmt |
| CY Total Revenue | $388,014 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $296,001 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $287,092 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $38,116 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $230,293 | PYOtherExpensesAmt |
| CY Other Expenses | $178,708 | CYOtherExpensesAmt |
| PY Total Expenses | $526,294 | PYTotalExpensesAmt |
| CY Total Expenses | $465,800 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$90,093 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$77,786 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $226,110 | TotalAssetsBOYAmt |
| Total Assets EOY | $150,807 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,295 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,778 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $222,815 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $145,029 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To provide a medical home in Fayette County for lower-income, uninsured adults and caring for them always with Compassion and Respect for everyone. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $310,516 | ExpenseAmt |
| Desc | Fayette C.A.R.E. Clinic provides free health care for uninsured residents of Fayette County ages 18+ that are 200% or below the Federal Poverty Level.Building on the values and vital health care services that Fayette C.A.R.E. Clinic has provided to our community since 2005, our current strategic plan is not only a continuation of our mission and work but includes a new vision.Vision: Exemplary state of health and well-being for all in the Fayette County community.Vision: Exemplary state of health and well-being for all in the Fayette County community. Each of us must now work to make this vision of our Fayette County community being exemplary in its health and wellbeing for ALL to become a reality by making sure ALL have access to healthcare. Achieving our mission will fill the gap for health care for a population that would otherwise have none, and reaching our vision will depend on quality patient care, goals, outcomes, and tracking of outcomes. Our planning includes increasing not only patient access but the scope of services.Current Free Health Care Services: Primary care, dental, vision, cardiology, podiatry, gastroenterology, chiropractic, gynecology, physical therapy, mental health, non-narcotic prescription, dermatology, labs, and imaging. All patients that meet our eligibility criteria have access to all of these services free of charge. | Desc |
| Total Program Service Expenses | $310,516 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 8 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 15 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | Yes (true) | NondeductibleContributionsInd |
| Nondeductible Contri Discl | Yes (true) | NondeductibleContriDisclInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | false | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | false | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Janis Williams | PersonNm |
| Phone | 7707194620 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1260 Highway 54 West Ste 101 | AddressLine1Txt |
| City | Fayetteville | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30214 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| Janis Williams | |||||||
| Director | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Gregory Alvarez | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Nathan Nipper | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Alice Jones | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Mark Skibiel | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Malvin Miller | |||||||
| Representative | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Negelle Morris | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Geneva Weaver | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Brian Woods | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Nimish Dhruva | |||||||
| Board Chair | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Daye Bexley | |||||||
| Board Vice Chair | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Mary Pecoraro | |||||||
| Board Secretary | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| All Other Contributions | $307,972 | AllOtherContributionsAmt |
| Total Contributions | $307,972 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Clinic Fees | Desc |
| Business | 621300 | BusinessCd |
| Total Revenue Column | $1,652 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,652 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,652 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $93,370 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $14,985 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $78,385 | TotalRevenueColumnAmt |
| Exclusion | $78,385 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $388,014 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,657 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $78,385 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,815 | TotalAmt |
| Program Services | $27,388 | ProgramServicesAmt |
| Management And General | $31,427 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $205,728 | TotalAmt |
| Program Services | $141,047 | ProgramServicesAmt |
| Management And General | $37,698 | ManagementAndGeneralAmt |
| Fundraising | $26,983 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,549 | TotalAmt |
| Program Services | $14,357 | ProgramServicesAmt |
| Management And General | $5,892 | ManagementAndGeneralAmt |
| Fundraising | $2,300 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,295 | TotalAmt |
| Program Services | $1,849 | ProgramServicesAmt |
| Management And General | $17,150 | ManagementAndGeneralAmt |
| Fundraising | $296 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,598 | TotalAmt |
| Program Services | $60,269 | ProgramServicesAmt |
| Management And General | $329 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,220 | TotalAmt |
| Fundraising | $1,220 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,502 | TotalAmt |
| Program Services | $4,251 | ProgramServicesAmt |
| Management And General | $4,251 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $929 | TotalAmt |
| Management And General | $929 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,865 | TotalAmt |
| Program Services | $27,092 | ProgramServicesAmt |
| Management And General | $6,773 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,007 | TotalAmt |
| Program Services | $2,417 | ProgramServicesAmt |
| Management And General | $3,590 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,901 | TotalAmt |
| Program Services | $1,236 | ProgramServicesAmt |
| Management And General | $665 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,121 | TotalAmt |
| Program Services | $12,320 | ProgramServicesAmt |
| Management And General | $801 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|---|
| Medical and dental supplies | $10,926 | $10,926 | ||
| Fundraising expenses | $6,660 | $6,660 | ||
| Telephone & communication | $6,124 | $3,876 | $657 | $1,591 |
| Repairs & maintenance | $4,091 | $3,456 | $635 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,469 | TotalAmt |
| Program Services | $32 | ProgramServicesAmt |
| Management And General | $5,437 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $465,800 | TotalAmt |
| Program Services | $310,516 | ProgramServicesAmt |
| Management And General | $117,168 | ManagementAndGeneralAmt |
| Fundraising | $38,116 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $194,289 | BOYAmt |
| EOY | $118,091 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,080 | BOYAmt |
| EOY | $20,813 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,532 | BOYAmt |
| EOY | $2,557 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $110,095 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $100,749 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,209 | BOYAmt |
| EOY | $9,346 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $226,110 | BOYAmt |
| EOY | $150,807 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,295 | BOYAmt |
| EOY | $5,778 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,295 | BOYAmt |
| EOY | $5,778 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,738 | BOYAmt |
| EOY | $65,088 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $160,077 | BOYAmt |
| EOY | $79,941 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $222,815 | BOYAmt |
| EOY | $145,029 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $226,110 | BOYAmt |
| EOY | $150,807 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$77,786 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $274,061 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $189,500 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $419,707 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $376,760 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $271,473 | CurrentTaxYearAmt |
| Total | $1,531,501 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $274,061 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $189,500 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $419,707 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $376,760 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $271,473 | CurrentTaxYearAmt |
| Total | $1,531,501 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $676,904 | SubstantialContributorsTotAmt |
| Public Support Total170 | $854,597 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $5 | CurrentTaxYearAmt |
| Total | $5 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $66,463 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $64,822 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $48,179 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $77,664 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $80,037 | CurrentTaxYearAmt |
| Total | $337,165 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $1,868,671 | TotalSupportAmt |
| Public Support CY170 | 0.45730 | PublicSupportCY170Pct |
| Public Support PY170 | 0.82650 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $88,053 | OtherCostOrOtherBasisAmt |
| Depreciation | $78,853 | DepreciationAmt |
| Book Value | $9,200 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,042 | OtherCostOrOtherBasisAmt |
| Depreciation | $21,896 | DepreciationAmt |
| Book Value | $146 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,346 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $2,556,106 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $2,168,092 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $2,168,092 | RevenueNotReportedAmt |
| Revenue Subtotal | $388,014 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $388,014 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,633,892 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $2,168,092 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $2,168,092 | ExpensesNotReportedAmt |
| Expenses Subtotal | $465,800 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $465,800 | TotalExpensesPerForm990Amt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Spring Fling | Event1Nm |
| Gross Receipts Event1 | $61,073 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $4,600 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $56,473 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $9,744 | OtherDirectExpensesEvent1Amt |
| Event2 | Golf Tournam | Event2Nm |
| Gross Receipts Event2 | $23,105 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $1,518 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $21,587 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $4,041 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $9,192 | GrossReceiptsOtherEventsAmt |
| Gross Revenue Other Events | $9,192 | GrossRevenueOtherEventsAmt |
| Oth Direct Expnss Other Events | $1,200 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $93,370 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $6,118 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $87,252 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $14,985 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $14,985 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $72,267 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990 governing body review Part VI line 11 | A copy of the Form 990 is available for review by each Board Member. |
| CEO executive director top management comp Part VI line 15a | Compensation of the Executive Director is determined by the Executive Committee of the Board of Directors, reference is made to compensation paid by comparable organizations, but limited by budget restraints. |
| Other officer or key employee compensation Part VI line 15b | N/A |
| Form 990 availability to public Part VI line 18 | The Form 990 is available upon request and is publised on guidestar.com. |
| Governing documents etc available to public Part VI line 19 | Documents are available upon request. |
| List of other fees for services expenses Part IX line 11g | Fees for other services include:Program:Program Services subcontractors - $57,195Temp help - $962Data consultant - $1,112Other professional - $1,000Management and general:Other professional - $329 |