PATIENT ASSISTANCE FOUNDATION: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- PATIENT ASSISTANCE FOUNDATION (EIN 94-2944137)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-15
- IRS object ID
- 201713199349309571
- 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 | 2017-11-15T13:08:11-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 912007579 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LOUIE & WONG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 425 WASHINGTON ST 300 | AddressLine1Txt |
| City | SAN FRANCISCO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94111 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 942944137 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PATIENT ASSISTANCE FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PATI | BusinessNameControlTxt |
| Phone | 4159233155 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2100 WEBSTER STREET SUITE 100 | AddressLine1Txt |
| City | SAN FRANCISCO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94115 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SCOTT PLYMALE LCSW | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 4159233155 | PhoneNum |
| Signature | 2017-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ARTHUR LOUIE | PreparerPersonNm |
| PTIN | P00048258 | PTIN |
| Phone | 4159819999 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 68.65.79.67 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-09 | IPDt |
| IP Tm | 10:56:21 | IPTm |
| IP Timezone | PS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | ACC3C4B6F45B42E341E6A8837BEE13AB66178EE8 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | DB42EC80DBAA0B1FB46503341D92426CCD180435 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH RESOURCE CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SCOTT PLYMALE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2100 WEBSTER STREET STE 100 | AddressLine1Txt |
| City | SAN FRANCISCO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94115 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $768,941 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | CHRCSF.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE AND PROMOTE INNOVATIVE HEALTH CARE AND HEALTH MAINTENANCE PROGRAMS TO THE GREATER BAY AREA AS WELL AS PATIENTS SERVED BY CPMC. CHRC PROVIDES COUNSELING, EDUCATION AND COORDINATION OF MULTIPLE PATIENT SERVICES TO SUPPLEMENT THE CARE AND SUPPORT PROVIDED BY PHYSICIANS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 9 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $787,383 | PYContributionsGrantsAmt |
| CY Contributions Grants | $393,141 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $229,867 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $333,428 | CYProgramServiceRevenueAmt |
| PY Investment Income | $27,249 | PYInvestmentIncomeAmt |
| CY Investment Income | $28,829 | CYInvestmentIncomeAmt |
| PY Other Revenue | $14,515 | PYOtherRevenueAmt |
| CY Other Revenue | $13,543 | CYOtherRevenueAmt |
| PY Total Revenue | $1,059,014 | PYTotalRevenueAmt |
| CY Total Revenue | $768,941 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $516,902 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $635,481 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $50,033 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $350,439 | PYOtherExpensesAmt |
| CY Other Expenses | $384,213 | CYOtherExpensesAmt |
| PY Total Expenses | $867,341 | PYTotalExpensesAmt |
| CY Total Expenses | $1,019,694 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $191,673 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$250,753 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,169,905 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,980,106 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $18,395 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $24,163 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,151,510 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,955,943 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE AND PROMOTE INNOVATIVE HEALTH CARE AND HEALTH MAINTENANCE PROGRAMS TO THE GREATER BAY AREA AS WELL AS PATIENTS SERVED BY CPMC. CHRC PROVIDES COUNSELING, EDUCATION AND COORDINATION OF MULTIPLE PATIENT SERVICES TO SUPPLEMENT THE CARE AND SUPPORT PROVIDED BY PHYSICIANS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $423,249 | ExpenseAmt |
| Revenue | $4,330 | RevenueAmt |
| Desc | BEHAVIORAL/MENTAL HEALTH SERVICES AND NUTRITION COUNSELING -- THE ORGANIZATION HAS A TEAM OF LICENSED PROFESSIONALS OFFERING SUPPORT FOR INDIVIDUALS, GROUPS AND FAMILIES LOOKING FOR EMOTIONAL OR PRACTICAL GUIDANCE AND SUPPORT. LIKEWISE, THE ORGANIZATION HAS A TEAM OF REGISTERED DIETITIANS THAT PROVIDES NUTRITION COUNSELING SERVICES. THE ORGANIZATION'S NUTRITION SERVICES PROVIDE EDUCATION AND INSTRUCTION TO HELP SUPPORT ONE'S INDIVIDUAL VARIETY OF CONDITIONS, CONCERNS, GOALS AND LIFE STAGES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $326,048 | ExpenseAmt |
| Revenue | $316,398 | RevenueAmt |
| Desc | HEALTH EDUCATION -- THE ORGANIZATION OFFERS MONTHLY WELLNESS EVENTS THAT INCLUDE HEALTH SCREENINGS, COMMUNITY EDUCATION LECTURES AND EMPLOYEE WELLNESS PRESENTATIONS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $121,773 | ExpenseAmt |
| Revenue | $12,700 | RevenueAmt |
| Desc | HEALTH SCREENINGS -- THE ORGANIZATION PROVIDES BOTH GRANT-FUNDED AND CONTRACTED HEALTH SCREENING SERVICES AT EMPLOYEE HEALTH AFFAIRS, WELLNESS EVENTS, SCHOOLS AND COMMUNITY CENTERS. THE HEALTH SCREENING SERVICES, WHICH INCLUDE CHOLESTEROL, BLOOD GLUCOSE, BLOOD PRESSURE, BODY MASS INDEX, BONE DENSITY AND MEMORY SCREENS, ARE CONDUCTED BY REGISTERED NURSES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $871,070 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 21 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 9 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HYT & ASSOCIATES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4155645183 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1156 CLEMENT STREET | AddressLine1Txt |
| City | SAN FRANCISCO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94118 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| MARILYN KUTZSCHER MD | ||||||
| PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CHARLES SELLMAN | ||||||
| TREASURER - SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ARI BARON MD | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| PETER CALLANDER | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JILL CENTER | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| BARRY BARON MD | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JOAN DEHOVITZ BRAUN | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| HOLLY HOLTER MD | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| ANDREW KLOMPUS MD | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JEAN-LUC LAMIRADE | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| ELIZA MCCAW MD | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DAVID TONG MD | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| RUSSELL WOO MD | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| BROCK BERNSTEN MD | ||||||
| DIRECTOR - ADVISORY BOARD | 2.00 | Yes (X) | $0 | $0 | $0 | |
| NENA MONTGOMERY | ||||||
| DIRECTOR - ADVISORY BOARD | 2.00 | Yes (X) | $0 | $0 | $0 | |
| SCOTT PLYMALE LCSW | ||||||
| EXECUTIVE DIRECTOR | 40.00 | Yes (X) | $134,876 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $134,876 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $393,141 | AllOtherContributionsAmt |
| Total Contributions | $393,141 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROGRAM | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $333,428 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $333,428 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $333,428 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,829 | TotalRevenueColumnAmt |
| Exclusion | $28,829 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| RENTAL INCOME | 532000 | $12,000 | $12,000 |
| OTHER INCOME | 900099 | $1,543 | $1,543 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $13,543 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $768,941 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $333,428 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $42,372 | 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 | $134,876 | TotalAmt |
| Program Services | $118,910 | ProgramServicesAmt |
| Management And General | $7,794 | ManagementAndGeneralAmt |
| Fundraising | $8,172 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $372,371 | TotalAmt |
| Program Services | $326,305 | ProgramServicesAmt |
| Management And General | $22,486 | ManagementAndGeneralAmt |
| Fundraising | $23,580 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $128,234 | TotalAmt |
| Program Services | $113,053 | ProgramServicesAmt |
| Management And General | $7,411 | ManagementAndGeneralAmt |
| Fundraising | $7,770 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,360 | TotalAmt |
| Management And General | $43,360 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,446 | TotalAmt |
| Program Services | $131,168 | ProgramServicesAmt |
| Management And General | $2,893 | ManagementAndGeneralAmt |
| Fundraising | $385 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,486 | TotalAmt |
| Program Services | $26,599 | ProgramServicesAmt |
| Management And General | $5,346 | ManagementAndGeneralAmt |
| Fundraising | $541 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $141,972 | TotalAmt |
| Program Services | $133,339 | ProgramServicesAmt |
| Management And General | $4,228 | ManagementAndGeneralAmt |
| Fundraising | $4,405 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,644 | TotalAmt |
| Program Services | $9,053 | ProgramServicesAmt |
| Management And General | $290 | ManagementAndGeneralAmt |
| Fundraising | $301 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,355 | TotalAmt |
| Program Services | $10,653 | ProgramServicesAmt |
| Management And General | $3,347 | ManagementAndGeneralAmt |
| Fundraising | $355 | FundraisingAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Total | $7,950 | TotalAmt |
| Program Services | $1,990 | ProgramServicesAmt |
| Management And General | $1,436 | ManagementAndGeneralAmt |
| Fundraising | $4,524 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,019,694 | TotalAmt |
| Program Services | $871,070 | ProgramServicesAmt |
| Management And General | $98,591 | ManagementAndGeneralAmt |
| Fundraising | $50,033 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $313,468 | BOYAmt |
| EOY | $273,307 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,689,268 | BOYAmt |
| EOY | $2,466,782 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,353 | BOYAmt |
| EOY | $22,822 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,200 | BOYAmt |
| EOY | $17,790 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $82,114 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $33,329 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,429 | BOYAmt |
| EOY | $48,785 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,056,973 | BOYAmt |
| EOY | $1,144,406 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,214 | BOYAmt |
| EOY | $6,214 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,169,905 | BOYAmt |
| EOY | $3,980,106 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,395 | BOYAmt |
| EOY | $24,163 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,395 | BOYAmt |
| EOY | $24,163 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,494,708 | BOYAmt |
| EOY | $1,515,260 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,656,802 | BOYAmt |
| EOY | $2,440,683 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,151,510 | BOYAmt |
| EOY | $3,955,943 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,169,905 | BOYAmt |
| EOY | $3,980,106 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$250,753 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $55,186 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
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 | $703,585 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $438,385 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $366,958 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $787,383 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $393,141 | CurrentTaxYearAmt |
| Total | $2,689,452 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $176,218 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $162,982 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $171,676 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $229,867 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $333,428 | CurrentTaxYearAmt |
| Total | $1,074,171 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $879,803 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $601,367 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $538,634 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,017,250 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $726,569 | CurrentTaxYearAmt |
| Total | $3,763,623 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $3,763,623 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $28,755 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $18,701 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $26,882 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $27,249 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $28,829 | CurrentTaxYearAmt |
| Total | $130,416 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $28,755 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $18,701 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $26,882 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $27,249 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $28,829 | CurrentTaxYearAmt |
| Total | $130,416 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,652 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $30,966 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $44,188 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,515 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,543 | CurrentTaxYearAmt |
| Total | $122,864 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $928,210 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $651,034 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $609,704 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,059,014 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $768,941 | CurrentTaxYearAmt |
| Total | $4,016,903 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.93690 | PublicSupportCY509Pct |
| Public Support PY509 | 0.93400 | PublicSupportPY509Pct |
| Investment Income CY | 0.03250 | InvestmentIncomeCYPct |
| Investment Income PY | 0.02940 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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 D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,656,802 | BeginningYearBalanceAmt |
| Other Expenditures | $216,119 | OtherExpendituresAmt |
| End Year Balance | $2,440,683 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,656,802 | BeginningYearBalanceAmt |
| End Year Balance | $2,656,802 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $60,016 | OtherCostOrOtherBasisAmt |
| Depreciation | $24,533 | DepreciationAmt |
| Book Value | $35,483 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,098 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,796 | DepreciationAmt |
| Book Value | $13,302 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $48,785 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENTS - MARKETABLE SECURITIES | Desc |
| Book Value | $1,144,406 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $1,144,406 | TotalBookValueSecuritiesAmt |
| Total Rev Etc Audited Fincl Stmt | $824,127 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $55,186 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $55,186 | RevenueNotReportedAmt |
| Revenue Subtotal | $768,941 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $768,941 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,019,694 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,019,694 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,019,694 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4: | FormAndLineReferenceDesc |
| Explanation | TEMPORARILY RESTRICTED NET ASSET IS USED TO ACCOUNT FOR RESOURCES THAT ARE RESTRICTED BY THE DONOR FOR USE FOR PARTICULAR PUPOSE OR IN A PARTICULAR FUTURE PERIOD. WHEN A RESTRICTION EXPIRES, TEMPORARILY RESTRICED NET ASSETS ARE RECLASSIFIED TO UNRESTRICTED NET ASSETS AND REPORTED IN THE STATEMENT OF ACTIVITIES AS "NET ASSETS RELEASED FROM RESTRICTIONS." | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | ELECTRONIC COPY OF 990 IS DISTRIBUTED TO EACH BOARD MEMBER FOR REVIEW PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST IS REVIEWED BY EACH OFFICER, DIRECTOR, OR KEY EMPLOYEE AT THE BEGINNING OF EACH MEETING. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE DIRECTOR'S COMPENSATION IS APPROVED BY THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 18 | DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER: PROGRAM SERVICE EXPENSES 131,168. MANAGEMENT AND GENERAL EXPENSES 2,893. FUNDRAISING EXPENSES 385. TOTAL EXPENSES 134,446. |
| FORM 990,PART XII, LINE 2C | NO CHANGES FROM THE PRIOR YEAR |
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