2018-11-06T13:32:10-06:00 2017-12-31 540737372 PBMARES LLP 558 SOUTH MAIN STREET HARRISONBURG VA 22801 990 2017-01-01 521366700 CULPEPER WELLNESS FOUNDATION INC CULP 5407122763 311 S EAST ST NO 100 CULPEPER VA 22701 SHARI J LANDRY PRESIDENT 5407122763 2018-11-06 1 KEVIN HUMPHRIES P00168667 5404345975 2018-11-06 X 209.10.80.132 2018-11-06 09:29:26 ES P 7EAC0F0A083D54EE046A9C15098E0D70F8B406AF DB70FE53214BD1484AD3DB8CE6BD236EC50D43FD 2017 2019-02-21 02:37:17Z SHARI J LANDRY 311 S EAST ST NO 100 CULPEPER VA 22701 4202853 0 X WWW.CULPEPERWELLNESSFOUNDATION.ORG X 1985 VA THE MISSION OF CULPEPER WELLNESS FOUNDATION IS TO IMPROVE HEALTH AND PROMOTE WELLNESS IN CULPEPER, MADISON AND ORANGE COUNTIES. 10 10 126 48 0 0 398274 560571 1819679 1910296 437616 780781 531559 519135 3187128 3770783 151277 197285 0 0 1838844 1794005 0 0 2461 1596342 1893347 3586463 3884637 -399335 -113854 33571108 35265868 233378 238354 33337730 35027514 THE MISSION OF CULPEPER WELLNESS FOUNDATION IS TO IMPROVE HEALTH AND PROMOTE WELLNESS IN CULPEPER, MADISON AND ORANGE COUNTIES. 0 0 2452319 1924474 THE POWELL WELLNESS CENTER HELPS INDIVIDUALS ACHIEVE PHYSICAL AND EMOTIONAL WELL-BEING THROUGH EXERCISE, PHYSICAL ACTIVITY, AND MEDICALLY INTEGRATED SERVICES. CULPEPER SPORT AND FITNESS HELPS INDIVIDUALS - WITH AN EMPHASIS ON YOUTH - IMPROVE THEIR HEALTH AND WELLNESS THROUGH PARTICIPATION IN FITNESS PROGRAMS AND ACTIVITIES. 748065 THE FREE CLINIC OF CULPEPER DELIVERS HIGH-QUALITY MEDICAL CARE TO UNINSURED ADULTS IN CULPEPER COUNTY. 197284 197284 THE FOUNDATION SEEKS TO IMPROVE HEATH AND PROMOTE WELLNESS THROUGH LOCAL COLLABORATIONS AND HEALTH-RELATED INITIATIVES AS WELL AS THROUGH GRANTS TO LOCAL NONRPOFITS WORKING IN SUPPORT OF ITS MISSION. 3397668 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 1 42 0 126 1 0 0 0 0 0 1 1 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X DEBRA DODSON 5404455412 311 S EAST STREET SUITE 100 CULPEPER VA 22701 CATHY DALRYMPLE PREVIOUS CHAIR 2.00 X 0 0 0 RICHARD HARRINGTON CHAIR 4.00 X X 0 0 0 CHARLES BARRELL VICE CHAIR 2.00 X X 0 0 0 TRIPP BUTLER TREASURER 4.00 X X 0 0 0 SHIRLEY ANN BAYNE DIRECTOR 2.00 X 0 0 0 JAMIE CLANCEY DIRECTOR 2.00 X 0 0 0 LAURA GRIGSBY DIRECTOR 2.00 X 0 0 0 DEBBIE BENNETT DIRECTOR 2.00 X 0 0 0 DAVID JONES DIRECTOR 2.00 X 0 0 0 DR THOMAS REYNOLDS MD SECRETARY 2.00 X X 0 0 0 SHARI J LANDRY PRESIDENT 40.00 X 141494 0 19741 141494 0 19741 1 0 1 0 0 7903 49816 12000 490852 316878 560571 MEMBERSHIP DUES 713940 1388971 1388971 OTHER FEE REVENUE 713940 521325 521325 1910296 390578 390578 749722 234805 514917 514917 514917 514537 122031 2303 392506 -2303 390203 390203 15498 49816 25458 -9960 -9960 61651 47473 14178 14178 3770783 1924474 0 1285738 197285 197285 163543 163543 1396989 1368435 28554 16538 16251 287 105742 121715 -15973 111193 99956 11237 2563 2313 250 61018 47459 13559 139947 139947 83146 62274 20872 56826 42363 12002 2461 136929 112343 24586 506336 446782 59554 14112 10741 3371 465371 457782 7589 59582 46361 13221 MEDICAL SUPPLIES AND DR 302441 302441 PROGRAM SUPPLIES 53203 53203 LAUNDRY 7074 7074 DUES & SUBSCRIPTIONS 4799 2890 1909 3884637 3397668 484508 2461 855562 550779 100000 0 3349000 2856000 23103 63357 19835 24492 43543 4267 19606970 7215820 12473020 12391150 16707045 19311179 55390 0 9254 33571108 35265868 162479 193783 34195 0 9367 18043 27337 26528 233378 238354 X 29988730 32171514 3349000 2856000 33337730 35027514 33571108 35265868 X -113854 1811586 -7948 X X 0 1 X 1 0 X 453777 861426 218962 398274 541751 2474190 2754573 1808690 456652 1880888 1971947 8872750 3208350 2670116 675614 2279162 2513698 11346940 0 0 0 11346940 1198371 1077263 752913 1032751 1140300 5201598 1198371 1077263 752913 1032751 1140300 5201598 4406721 3747379 1428527 3311913 3653998 16548538 0.68570 0.69950 0.31430 0.30050 X PART III, SECTION C, LINE 16 2016 WAS THE FIRST YEAR FOR WHICH THE ORGANIZATION FILED AS A PUBLIC CHARITY UNDER SECTION 509(A)(2). AS SUCH, THE PUBLIC SUPPORT SCHEDULE WAS COMPILED USING THE ORGANIZATION'S FORM 990 FOR THE PREVIOIUS FOUR YEARS. 2406784 127500 390095 125993 2796386 2413628 216855 223699 2406784 2399295 28018 13685 2413628 201667 -201667 195052 6615 201667 1.00000 0 0 2378632 2378632 15850371 6276141 9574230 141059 11465 129594 1080602 809776 270826 156306 118438 37868 12391150 ANNUITY PAYABLE 26528 26528 X 6237193 1811586 487035 307736 2606357 3630836 139947 139947 3770783 4547408 487035 315684 802719 3744689 139947 1 139948 3884637 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER CODE SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE). IN ADDITION, CWF QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A) OF THE CODE AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE ORGANIZATION UNDER CODE SECTION 509(A)(2). PWC IS A LIMITED LIABILITY COMPANY THAT HAS NOT ELECTED TO BE TAXED AS A CORPORATION UNDER CURRENT INTERNAL REVENUE SERVICE REGULATIONS. AS SUCH, PWC IS A DISREGARDED ENTITY FOR FEDERAL INCOME TAX PURPOSES AND DOES NOT HAVE TO FILE AN ANNUAL FEDERAL RETURN. RATHER, ITS TAX RESULTS ARE REFLECTED ON THE ANNUAL TAX FILINGS OF ITS MEMBER AS IF THE ACTIVITIES OF PWC WERE ACTIVITIES OF THE MEMBER. PRIOR TO OCTOBER 1, 2014, THE ORGANIZATION WAS CLASSIFIED AS A FUNCTIONALLY RELATED SUPPORTING ORGANIZATION OF CULPEPER REGIONAL HOSPITAL. DURING 2014, THE ORGANIZATION'S INTEREST IN THE HOSPITAL WAS ACQUIRED BY ANOTHER HOSPITAL SYSTEM. THE ORGANIZATION HAS SINCE TRANSITIONED TO SERVE A GREATER PUBLIC INTEREST AND RECEIVED A CHANGE IN EXEMPT CLASSIFICATION WITH THE INTERNAL REVENUE SERVICE TO ACCOMMODATE ITS CHANGE IN MISSION. MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND DETERMINED THAT THE ORGANIZATION HAS NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS AT DECEMBER 31, 2017. THE ORGANIZATION FILES FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, ANNUALLY WITH THE UNITED STATES DEPARTMENT OF THE TREASURY. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 234,805. FUNDRAISING EVENT EXPENSES 25,458. COST OF GOODS SOLD 47,473. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 234,805. FUNDRAISING EVENT EXPENSES 25,458. COST OF GOODS SOLD 47,473. LOSS ON UNCOLLECTIBLE PLEDGES 7,948. PART XII, LINE 4B - OTHER ADJUSTMENTS: ROUNDING 1. SCHEDULE D, PART V, LINE 4 QUASI-ENDOWMENT FUNDS ARE INTENDED TO PROVIDE INCOME TO SUPPLEMENT GRANTS AWARDED AND OTHER GENERAL FOUNDATION OPERATIONS. OYSTER FEST 65314 49816 15498 7445 15498 400 2115 65314 49816 15498 7445 15498 400 2115 25458 -9960 1 COUNTY OF CULPEPER-CULPEPER COUNTY PARKS & RECREATION DEPT 546001236 10000 THE BRIGHT SPOT INCLUSIVE PLAYGROUND CULPEPER MID-DAY LIONS 541147435 10000 SIGHT AND VISION SCREENING VAN REPLACEMEMT PROJECT GREAT PIEDMONT TRAUMA INFORMATED COMMUNITY NETWORK 475563707 6000 SUPPORT IMPLEMENTATION OF THE STRONG AND HEALTHY INITIATIVE HEALTHPLEX 232852429 13000 COMMUNITY CENTER FEASIBILITY STUDY MADISON EMERGENCY SERVICES ASSOCIATION 541226851 10000 EXPANSION OF SERVICES BY BARBARA'S HOUSE RESIDENTIAL TRANSITIONAL HOUSING PROGRAM NORTHERN PIEDMONT COMMUNITY FOUNDATION 311742955 26000 CULPEPER WELLNESS FOUNDATION HEALTH AND WELLNESS SCHOLARSHIP ORANGE COUNTY FREE CLINIC 251922019 11400 NEW EKG MACHINE AND DENTAL CARE PROGRAM PIEDMONT ENVIRONMENTAL COUNCIL 540935569 10000 PURCHASE OF A RESIDENTIAL PARCEL FOR INCORPORATION INTO VERLING PARK AND DIX MEMORIAL POOL COMPLEX. PIEDMONT REGIONAL DENTAL CLINIC 13296 JAMES MADISON HIGHWAY SUITE B ORANGE VA 22960 270625764 10000 DENTAL CARE FOR WINTER HEAT SHELTER PROGRAM PARTICIPANTS THE SALVATION ARMY OF CULPEPER VA 580660607 10000 UTILITIES ASSISSTANCE TOWN OF CULPEPER 546001234 10000 EXERCISE EQUIPMENT AT YOWELL MEADOW PARK PART I, LINE 2: THE ORGANIZATION MAINTAINS CLEAR CRITERIA FOR THE HEALTHY LIVING GRANT PROGRAM AND STRATEGIC GRANTS ARE MADE ONLY BY BOARD APPROVAL. THE ORGANIZATION MANDATES THAT FUNDS AWARDED MUST BE USED WITHIN 90 DAYS OF BEING GRANTED AND STAYS IN CLOSE COMMUNICATION WITH GRANTEES TO MONITOR THEIR USE. GRANTEES MUST PROVIDE A FINAL ACCOUNTING ON THE USE OF FUNDS, INCLUDING THE POPULATION SERVED AND HEALTH IMPACT. REPORTS MUST BE COMPLETED WITHIN 30 DAYS OF PROJECT COMPLETION. X 1 0 0 0 0 0 0 0 0 0 0 SHARI J LANDRY PRESIDENT 141494 0 0 0 0 0 2308 0 17433 0 161235 0 0 0 X 40 316878 FREE CLINIC RECORDS 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM, REVIEWED BY THE CHIEF EXECUTIVE OFFICER AND MADE AVAILABLE TO THE BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO AFFIRM THEIR COMMITMENT TO UPHOLD THE CONFLICT OF INTEREST POLICY ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD WILL REVIEW AND DETERMINE ANNUALLY COMPENSATION OF OFFICERS OR KEY EMPLOYEES. FOR THIS REPORTING PERIOD, COMPENSATION WAS DETERMINED BY BOARD APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: LOSS ON UNCOLLECTIBLE PLEDGES -7,948. FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS NOT CHANGED ITS PROCESS FOR THE SELECTION AND OVERSIGHT OF AN INDEPENDENT ACCOUNTANT. POWELL WELLNESS CENTER 1005 GOLF DRIVE CULPEPER VA 22701 204803079 WELLNESS CENTER VA -738901 8010784 CWF