HEALTH PARTNERS INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
HEALTH PARTNERS INC (EIN 52-1767044)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-04-13
IRS object ID
201711129349300401
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

FieldValueIRS element (for citing)
Return2017-04-13T11:23:35-04:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN521224305PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Bechanan & Company LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line122226 Creekview DriveAddressLine1Txt
CityGaithersburgCityNm
State AbbreviationMDStateAbbreviationCd
ZIP20882ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN521767044EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Health Partners IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHEALBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1P O Box 1865AddressLine1Txt
CityWaldorfCityNm
State AbbreviationMDStateAbbreviationCd
ZIP20604ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDan SansburyPersonNm
Person TitleTreasurerPersonTitleTxt
Phone3017521550PhoneNum
Signature2017-03-25SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonNancy BechananPreparerPersonNm
PTINP00070812PTIN
Phone3018693747PhoneNum
Preparation2017-04-13PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address69.250.37.157IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-04-22IPDt
IP Tm15:36:29IPTm
Federal Original Submission Id5218972017112sgb2gkzFederalOriginalSubmissionId
Federal Original Submission Id2017-04-22FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id762EAD84AF4030DA43FFFB963FDEB0648B4E9684AtSubmissionCreationDeviceId
At Submission Filing Device Id762EAD84AF4030DA43FFFB963FDEB0648B4E9684AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts$721,000GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1992FormationYr
Legal Domicile StateMDLegalDomicileStateCd
Activity Or MissionTo provide professional Medical and Dental services to the underserved residents of Charles County, Maryland and to create a medical and dental home for all persons seeking services under the Maryland State Medicaid programs.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee18TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$446,527PYContributionsGrantsAmt
CY Contributions Grants$392,772CYContributionsGrantsAmt
PY Program Service Revenue$156,357PYProgramServiceRevenueAmt
CY Program Service Revenue$251,545CYProgramServiceRevenueAmt
PY Investment Income$250PYInvestmentIncomeAmt
CY Investment Income$633CYInvestmentIncomeAmt
PY Other Revenue$73,830PYOtherRevenueAmt
CY Other Revenue$70,054CYOtherRevenueAmt
PY Total Revenue$676,964PYTotalRevenueAmt
CY Total Revenue$715,004CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$447,917PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$563,468CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$7,624CYTotalFundraisingExpenseAmt
PY Other Expenses$153,343PYOtherExpensesAmt
CY Other Expenses$197,746CYOtherExpensesAmt
PY Total Expenses$601,260PYTotalExpensesAmt
CY Total Expenses$761,214CYTotalExpensesAmt
PY Revenues Less Expenses$75,704PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$46,210CYRevenuesLessExpensesAmt
Total Assets BOY$539,815TotalAssetsBOYAmt
Total Assets EOY$499,834TotalAssetsEOYAmt
Total Liabilities BOY$20,046TotalLiabilitiesBOYAmt
Total Liabilities EOY$26,275TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$519,769NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$473,559NetAssetsOrFundBalancesEOYAmt
MissionTo provide professional Medical and Dental services to the underserved residents of Charles County, Maryland and to create a medical and dental home for all persons seeking services under the Maryland State Medicaid programs.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$696,884ExpenseAmt
Revenue$251,545RevenueAmt
DescHealth Partners is a charitable clinic primarily providing medical and dental care to the uninsured and underinsured citizens of Southern Maryland. In 2016, we provided 2,236 medical care visits for 720 clients and 4,730 dental services for 1,250 patients. Our transportable dental unit has expanded its reach in the community. We now provide dental services in various venues including community centers, senior centers and churches. With strong dedication from our volunteers and clothing donations from our community in 2016 our clothing closet provided clothing to over 622 people.Desc
Total Program Service Expenses$696,884TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee18EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDan SansburyPersonNm
Phone3016453556PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13070 Crain HighwayAddressLine1Txt
CityWaldorfCityNm
State AbbreviationMDStateAbbreviationCd
ZIP20601ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Dan Sansbury
Treasurer8.000.00Yes (X)Yes (X)$0$0$0
Kermit Wright
President8.000.00Yes (X)Yes (X)$0$0$0
William Leebel
Vice-President8.000.00Yes (X)Yes (X)$0$0$0
Sandy McGraw
Director2.000.00Yes (X)$0$0$0
Meindert Smith
Medical Director2.000.00Yes (X)$0$0$0
Audrey Dyson
Secretary8.000.00Yes (X)Yes (X)$0$0$0
Chrisie Mulcahey
Executive Director40.000.00Yes (X)$69,232$0$0
Jason Faherty
Director2.000.00Yes (X)$0$0$0
William Berry
Director2.000.00Yes (X)$0$0$0
Krishan Mathur
Director and Medical Advisory2.000.00Yes (X)$0$0$0
Nancy Bowling
Director2.000.00Yes (X)$0$0$0
George Nash
Director2.000.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$69,232TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$392,772AllOtherContributionsAmt
Total Contributions$392,772TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescMedical servicesDesc
Business621400BusinessCd
Total Revenue Column$251,545TotalRevenueColumnAmt
Related Or Exempt Func Income$251,545RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$251,545TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$633TotalRevenueColumnAmt
Exclusion$633ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$28,400RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$28,400RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$28,400TotalRevenueColumnAmt
Exclusion$28,400ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$46,319FundraisingGrossIncomeAmt
Fundraising Direct Expenses$5,996FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$40,323TotalRevenueColumnAmt
Exclusion$40,323ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescReimbursementsDesc
Business900099BusinessCd
Total Revenue Column$1,331TotalRevenueColumnAmt
Related Or Exempt Func Income$1,331RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,331OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$715,004TotalRevenueColumnAmt
Related Or Exempt Func Income$252,876RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$69,356ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$69,232TotalAmt
Program Services$55,385ProgramServicesAmt
Management And General$10,385ManagementAndGeneralAmt
Fundraising$3,462FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$428,350TotalAmt
Program Services$394,804ProgramServicesAmt
Management And General$30,275ManagementAndGeneralAmt
Fundraising$3,271FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$28,038TotalAmt
Program Services$25,368ProgramServicesAmt
Management And General$2,291ManagementAndGeneralAmt
Fundraising$379FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$37,848TotalAmt
Program Services$34,243ProgramServicesAmt
Management And General$3,093ManagementAndGeneralAmt
Fundraising$512FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$5,000TotalAmt
Program Services$5,000ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$7,672TotalAmt
Program Services$7,672ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,186TotalAmt
Program Services$1,968ProgramServicesAmt
Management And General$218ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$36,608TotalAmt
Program Services$32,947ProgramServicesAmt
Management And General$3,661ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$29,383TotalAmt
Program Services$28,619ProgramServicesAmt
Management And General$764ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$11,695TotalAmt
Program Services$10,655ProgramServicesAmt
Management And General$1,040ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical services$50,357$50,357
Repairs and maintenance$11,130$10,017$1,113
Utilities$11,751$10,576$1,175
Telephone$6,963$6,267$696

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$25,001TotalAmt
Program Services$23,006ProgramServicesAmt
Management And General$1,995ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$761,214TotalAmt
Program Services$696,884ProgramServicesAmt
Management And General$56,706ManagementAndGeneralAmt
Fundraising$7,624FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$151,418BOYAmt
EOY$41,100EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$25,000BOYAmt
EOY$25,329EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$27,500BOYAmt
EOY$97,048EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$741,657LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$405,300LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$335,897BOYAmt
EOY$336,357EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$539,815BOYAmt
EOY$499,834EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$20,046BOYAmt
EOY$26,275EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$20,046BOYAmt
EOY$26,275EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$353,056BOYAmt
EOY$417,419EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$166,713BOYAmt
EOY$56,140EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$519,769BOYAmt
EOY$473,559EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$539,815BOYAmt
EOY$499,834EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$46,210ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteefalseAuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$300,647CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$398,798CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$575,767CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$484,347CurrentTaxYearMinus1YearAmt
Current Tax Year$644,317CurrentTaxYearAmt
Total$2,403,876TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$400,000CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$400,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$400,000CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$400,000CurrentTaxYearMinus1YearAmt
Current Tax Year$400,000CurrentTaxYearAmt
Total$2,000,000TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$700,647CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$798,798CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$975,767CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$884,347CurrentTaxYearMinus1YearAmt
Current Tax Year$1,044,317CurrentTaxYearAmt
Total$4,403,876TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$394,687SubstantialContributorsTotAmt
Public Support Total170$4,009,189PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$425CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$313CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$279CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$250CurrentTaxYearMinus1YearAmt
Current Tax Year$633CurrentTaxYearAmt
Total$1,900TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$32,896CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$32,155CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$40,040CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$36,010CurrentTaxYearMinus1YearAmt
Current Tax Year$29,731CurrentTaxYearAmt
Total$170,832TotalAmt
FieldValueIRS element (for citing)
Total Support$4,576,608TotalSupportAmt
Public Support CY1700.87600PublicSupportCY170Pct
Public Support PY1700.86500PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$568,805OtherCostOrOtherBasisAmt
Depreciation$295,862DepreciationAmt
Book Value$272,943BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$172,852OtherCostOrOtherBasisAmt
Depreciation$109,438DepreciationAmt
Book Value$63,414BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$336,357TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$1,209,960TotalRevEtcAuditedFinclStmtAmt
Donated Services And Use Fclts$488,960DonatedServicesAndUseFcltsAmt
Other Revenue$5,996OtherRevenueAmt
Revenue Not Reported$494,956RevenueNotReportedAmt
Revenue Subtotal$715,004RevenueSubtotalAmt
Total Revenue Per Form990$715,004TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,256,170TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$488,960DonatedServicesUseFcltsAmt
Other Expenses Included$5,996OtherExpensesIncludedAmt
Expenses Not Reported$494,956ExpensesNotReportedAmt
Expenses Subtotal$761,214ExpensesSubtotalAmt
Total Expenses Per Form990$761,214TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Other revenues not included on Form 990 (Part XI, line 2d)Fundraising expenses total 5,996.
Other expenses not included on Form 990 (Part XII, line 2d)Fundraising expenses total 5,996.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GALAEvent1Nm
Gross Receipts Event1$29,974GrossReceiptsEvent1Amt
Gross Revenue Event1$29,974GrossRevenueEvent1Amt
Food And Beverage Event1$3,269FoodAndBeverageEvent1Amt
Event2HOPE CampaigEvent2Nm
Gross Receipts Event2$16,305GrossReceiptsEvent2Amt
Gross Revenue Event2$16,305GrossRevenueEvent2Amt
Other Direct Expenses Event2$2,025OtherDirectExpensesEvent2Amt
Other Events Total1OtherEventsTotalCnt
Gross Receipts Other Events$40GrossReceiptsOtherEventsAmt
Gross Revenue Other Events$40GrossRevenueOtherEventsAmt
Oth Direct Expnss Other Events$702OthDirectExpnssOtherEventsAmt
Gross Receipts Total$46,319GrossReceiptsTotalAmt
Gross Revenue Total Events$46,319GrossRevenueTotalEventsAmt
Food And Beverage Total Events$3,269FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$2,727OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$5,996DirectExpenseSummaryEventsAmt
Net Income Summary$40,323NetIncomeSummaryAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 governing body review Part VI line 11Treasurer and board reviewed the 990 in draft form.
Conflict of interest policy compliance Part VI line 12cConflicts of interest are to be disclosed.
Governing documents etc available to public Part VI line 19Documents are available upon request.

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