WILL-GRUNDY MEDICAL CLINIC INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- WILL-GRUNDY MEDICAL CLINIC INC (EIN 36-3492306)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2017-12-04
- IRS object ID
- 201743389349300279
- 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 | 2017-12-04T10:15:13-06:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 463912191 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Brandt & Associates PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 Liberty St | AddressLine1Txt |
| City | Morris | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60450 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363492306 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Will Grundy Medical Clinic Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WILL | BusinessNameControlTxt |
| Phone | 8157263377 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 213 East Cass Street | AddressLine1Txt |
| City | JOLIET | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60432 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LaShawn West | PersonNm |
| Person Title | Director | PersonTitleTxt |
| Signature | 2017-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Brittany Brandt | PreparerPersonNm |
| PTIN | P01486603 | PTIN |
| Phone | 8155139184 | PhoneNum |
| Preparation | 2017-11-15 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 71.57.87.120 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 1569082017319g001617 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2017-11-30 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 28AA33A6D810AB830A763FB0CEF021111D9A6805 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 28AA33A6D810AB830A763FB0CEF021111D9A6805 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LaShawn West | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1606 Red Maple Dr | AddressLine1Txt |
| City | PLAINFIELD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60586 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $441,457 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Activity Or Mission | Providing free medical/dental care to adults who have no health insurance or medical care entitlements & meet prescibed income guidlelines. Care is provided | ActivityOrMissionDesc |
| Voting Members Governing Body | 39 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 18 | TotalEmployeeCnt |
| Total Volunteers | 390 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $321,671 | PYContributionsGrantsAmt |
| CY Contributions Grants | $425,652 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $8,644 | PYInvestmentIncomeAmt |
| CY Investment Income | $14,739 | CYInvestmentIncomeAmt |
| PY Other Revenue | $35,578 | PYOtherRevenueAmt |
| CY Other Revenue | $449 | CYOtherRevenueAmt |
| PY Total Revenue | $365,893 | PYTotalRevenueAmt |
| CY Total Revenue | $440,840 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $459,111 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $398,185 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $87,448 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $171,926 | PYOtherExpensesAmt |
| CY Other Expenses | $162,049 | CYOtherExpensesAmt |
| PY Total Expenses | $631,037 | PYTotalExpensesAmt |
| CY Total Expenses | $560,234 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$265,144 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$119,394 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,607,902 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,488,447 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $471 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $410 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,607,431 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,488,037 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Providing free health-care services to people in WIll and Grundy counties who are unable to receive care from other sources. These services are provided through dedicated healthcare professional | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $425,878 | ExpenseAmt |
| Desc | The clinic provides the facilities & services necessary for delivery | Desc |
| Total Program Service Expenses | $425,878 | 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 | Yes (true) | 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 |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| 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 |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 18 | 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 | false | NondeductibleContributionsInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 39 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | 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 | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | false | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | false | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | 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 | IL | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LaShawn West | PersonNm |
| Phone | 8157263377 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 213 E Cass St | AddressLine1Txt |
| City | JOLIET | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60432 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (39 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|
| An Le | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | ||
| Christine Lunn | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | ||
| Alicia McLaugh | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | ||
| Charles Meade | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | ||
| Shannon Morgan | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | ||
| Albert Marie | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | ||
| Lisa Pierson | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | ||
| Al Ray | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | ||
| Yolanda Reyes | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | ||
| Rosy Salazar | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | ||
| Chitan Sampat | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | ||
| Charles Slagle | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | ||
| Taylor Struckm | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | ||
| Denise Winfrey | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | ||
| LaShawn West | |||||||
| Executive Dire | 40 | $67,864 | $0 | $0 | 0 | Yes (X) | |
| Michael Rittof | |||||||
| President | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Lynn Hopkins | |||||||
| Immediate Pres | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Rosie Verdin | |||||||
| 1st Vice Pres | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Kathy Wolz | |||||||
| Secretary | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Tom Kenter | |||||||
| Treasurer | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Dale Airola | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Deb Bacharz | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Marne Bailey | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Penny Basso | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Reed Bible | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Edna Brass | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Mary Brenczews | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Timothy Broder | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Katrina Crone | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Frank Cserveny | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Carol Danielso | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Kathy Dunn | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Jennifer Frye | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Joe George | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Debbie Greene | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Maaza Jaan | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Nicholas Jawor | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Bob Kalnicky | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Haziq Khan | |||||||
| Director | 1 | Yes (X) | $0 | $0 | $0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $67,864 | TotalReportableCompFromOrgAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Fundraising | $81,121 | FundraisingAmt |
| All Other Contributions | $344,531 | AllOtherContributionsAmt |
| Total Contributions | $425,652 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,356 | TotalRevenueColumnAmt |
| Exclusion | $15,356 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $617 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$617 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$617 | TotalRevenueColumnAmt |
| Exclusion | $14,739 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Miscellaneous | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $449 | TotalRevenueColumnAmt |
| Exclusion | $449 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $449 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $440,840 | TotalRevenueColumnAmt |
| Exclusion | $30,544 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,864 | TotalAmt |
| Program Services | $21,038 | ProgramServicesAmt |
| Management And General | $23,752 | ManagementAndGeneralAmt |
| Fundraising | $23,074 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $290,188 | TotalAmt |
| Program Services | $282,662 | ProgramServicesAmt |
| Management And General | $1,248 | ManagementAndGeneralAmt |
| Fundraising | $6,278 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,133 | TotalAmt |
| Program Services | $9,342 | ProgramServicesAmt |
| Management And General | $971 | ManagementAndGeneralAmt |
| Fundraising | $1,820 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,000 | TotalAmt |
| Program Services | $21,560 | ProgramServicesAmt |
| Management And General | $2,240 | ManagementAndGeneralAmt |
| Fundraising | $4,200 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,560 | TotalAmt |
| Program Services | $2,079 | ProgramServicesAmt |
| Management And General | $216 | ManagementAndGeneralAmt |
| Fundraising | $5,265 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,231 | TotalAmt |
| Management And General | $5,231 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,027 | TotalAmt |
| Program Services | $3,897 | ProgramServicesAmt |
| Management And General | $1,586 | ManagementAndGeneralAmt |
| Fundraising | $13,544 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,047 | TotalAmt |
| Program Services | $12,524 | ProgramServicesAmt |
| Management And General | $6,084 | ManagementAndGeneralAmt |
| Fundraising | $2,439 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,567 | TotalAmt |
| Program Services | $4,287 | ProgramServicesAmt |
| Management And General | $445 | ManagementAndGeneralAmt |
| Fundraising | $835 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,654 | TotalAmt |
| Program Services | $22,064 | ProgramServicesAmt |
| Management And General | $2,293 | ManagementAndGeneralAmt |
| Fundraising | $4,297 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,969 | TotalAmt |
| Program Services | $2,285 | ProgramServicesAmt |
| Management And General | $238 | ManagementAndGeneralAmt |
| Fundraising | $446 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,567 | TotalAmt |
| Program Services | $6,597 | ProgramServicesAmt |
| Management And General | $685 | ManagementAndGeneralAmt |
| Fundraising | $1,285 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| TotalTotalAmt |
|---|
| $13,146 |
| $16,198 |
| $9,073 |
| $3,341 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,669 | TotalAmt |
| Fundraising | $21,669 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $560,234 | TotalAmt |
| Program Services | $425,878 | ProgramServicesAmt |
| Management And General | $46,908 | ManagementAndGeneralAmt |
| Fundraising | $87,448 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,792 | BOYAmt |
| EOY | $58,362 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $308,553 | BOYAmt |
| EOY | $201,417 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,377,281 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $639,642 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $740,608 | BOYAmt |
| EOY | $737,639 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $498,949 | BOYAmt |
| EOY | $491,029 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,607,902 | BOYAmt |
| EOY | $1,488,447 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $471 | BOYAmt |
| EOY | $410 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $471 | BOYAmt |
| EOY | $410 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,520,401 | BOYAmt |
| EOY | $1,403,959 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,030 | BOYAmt |
| EOY | $54,078 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,000 | BOYAmt |
| EOY | $30,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,607,431 | BOYAmt |
| EOY | $1,488,037 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,607,902 | BOYAmt |
| EOY | $1,488,447 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$119,394 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| 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 |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $409,699 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $324,589 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $337,501 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $321,671 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $344,531 | CurrentTaxYearAmt |
| Total | $1,737,991 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $409,699 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $324,589 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $337,501 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $321,671 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $344,531 | CurrentTaxYearAmt |
| Total | $1,737,991 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $1,737,991 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,941 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $32,555 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,358 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $20,508 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,356 | CurrentTaxYearAmt |
| Total | $97,718 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $91,557 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $67,566 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $58,264 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $60,750 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $81,121 | CurrentTaxYearAmt |
| Total | $359,258 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $2,194,967 | TotalSupportAmt |
| Public Support CY170 | 0.79180 | PublicSupportCY170Pct |
| Public Support PY170 | 0.79980 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Pt II Ln 10 | FormAndLineReferenceDesc |
| Explanation | Special Events 2011: 71,067. 2012: 91308. 2013: 67501 2014:57368. 2015 60750. Miscellaneous 2011: 440. 2012: 249. 2013: 65. 2014: 896. 2015: 249 | 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 D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Incl Escrow Custodial Acct Liab | false | InclEscrowCustodialAcctLiabInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $30,000 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $168 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $168 | AdministrativeExpensesAmt |
| End Year Balance | $30,000 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $30,000 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $167 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $167 | AdministrativeExpensesAmt |
| End Year Balance | $30,000 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $30,000 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $165 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $165 | AdministrativeExpensesAmt |
| End Year Balance | $30,000 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $30,000 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $150 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $150 | AdministrativeExpensesAmt |
| End Year Balance | $30,000 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $30,867 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $415 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $415 | AdministrativeExpensesAmt |
| End Year Balance | $30,867 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.44000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.20000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.36000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $90,000 | OtherCostOrOtherBasisAmt |
| Book Value | $90,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,133,341 | OtherCostOrOtherBasisAmt |
| Depreciation | $495,729 | DepreciationAmt |
| Book Value | $637,612 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $153,940 | OtherCostOrOtherBasisAmt |
| Depreciation | $143,913 | DepreciationAmt |
| Book Value | $10,027 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $737,639 | TotalBookValueLandBuildingsAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Annual Dinne | Event1Nm |
| Gross Receipts Event1 | $54,656 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $5,425 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $49,231 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $1,500 | CashPrizesEvent1Amt |
| Food And Beverage Event1 | $6,925 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $1,202 | OtherDirectExpensesEvent1Amt |
| Event2 | Autobahn | Event2Nm |
| Gross Receipts Event2 | $15,590 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $3,000 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $12,590 | GrossRevenueEvent2Amt |
| Food And Beverage Event2 | $3,600 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $85 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $921 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 2 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $10,875 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $800 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $10,075 | GrossRevenueOtherEventsAmt |
| Oth Direct Expnss Other Events | $7,436 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $81,121 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $9,225 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $71,896 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $1,500 | CashPrizesTotalEventsAmt |
| Food And Beverage Total Events | $10,525 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $85 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $9,559 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $21,669 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $50,227 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part VI, Line 2 | Family relationships within the Board of Directors are Mr. Charles Meade and Mrs. Mittchelena Meade, who are married. |
| Pt VI, Line 11b | A meeting is held by the Board of Directors to review the Form 990 prior to filing. |
| Pt VI, Line 15a | It is the policy of the clinic to pay no more than reasonable compensation for personal services rendered to the clinic. |
| Pt VI, Line 15b | Explanation consistent with Pt VI, Line 15a |
| Pt VI, Line 19 | The organization makes its governing documents, policies and financial statements available to the public by providing copies upon request. |
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