DUBOIS COUNTY LEUKEMIA ASSOCIATION INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
DUBOIS COUNTY LEUKEMIA ASSOCIATION INC (EIN 35-2100532)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-05-15
IRS object ID
201711359349302406
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)
Return2017-05-15T08:43:40-05:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN352029934PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1NONTE & COMPANY LLC CPA'SBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11 DCB PLAZA STE 301AddressLine1Txt
CityJASPERCityNm
State AbbreviationINStateAbbreviationCd
ZIP475462971ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN352100532EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DUBOIS COUNTY LEUKEMIA ASSOC INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlDUBOBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 75AddressLine1Txt
CityHUNTINGBURGCityNm
State AbbreviationINStateAbbreviationCd
ZIP47542ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonGARY BRICKPersonNm
Person TitleTREASURERPersonTitleTxt
Signature2017-05-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonGARY D BRICKPreparerPersonNm
PTINP00498819PTIN
Phone8124826330PhoneNum
Preparation2017-05-15PreparationDt

Filing Security Information FilingSecurityInformation

FieldValueIRS element (for citing)
At Submission Creation Device Id5C86FAEA19C2DF087BA50A384B1BD9E5AD1150C3AtSubmissionCreationDeviceId
At Submission Filing Device IdAE81B6C43B0CDBC75E768471EE3D8C8FBF78AC23AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Initial ReturnYes (X)InitialReturnInd
Principal OfficerGARY BRICKPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 DCB PLZ STE 301AddressLine1Txt
CityJASPERCityNm
State AbbreviationINStateAbbreviationCd
ZIP47546ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$258,803GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressDCLEUKEMIA.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2000FormationYr
Activity Or MissionTHE MISSION OF THE DUBOIS COUNTY LEUKEMIA ASSOCIATION IS TO EDUCATE, FINANCIALLY ASSIST, AND PROVIDE EMOTIONAL CARE TO VICTIMS OF LEUKEMIA AND OTHER BLOOD RELATED CANCERS. ALSO, TO OFFSET THE COSTS OF "BE THE MATCH" TESTING KITS ASSOCIATED WITH REGISTERING INDIVIDUALS INTO THE NATIONAL BONE MARROW REGISTRY. THESE SERVICE ARE PROVIDED PRIMARILY TO RESIDENTS OF DUBOIS COUNTY, INDIANA.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers20TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
CY Contributions Grants$258,798CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
CY Investment Income$5CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
CY Total Revenue$258,803CYTotalRevenueAmt
CY Grants And Similar Paid$129,690CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$26,674CYTotalFundraisingExpenseAmt
CY Other Expenses$32,641CYOtherExpensesAmt
CY Total Expenses$162,331CYTotalExpensesAmt
CY Revenues Less Expenses$96,472CYRevenuesLessExpensesAmt
Total Assets BOY$26,730TotalAssetsBOYAmt
Total Assets EOY$123,202TotalAssetsEOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$26,730NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$123,202NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE MISSION OF THE DUBOIS COUNTY LEUKEMIA ASSOCIATION IS TO EDUCATE, FINANCIALLY ASSIST, AND PROVIDE EMOTIONAL CARE TO VICTIMS OF LEUKEMIA AND OTHER BLOOD RELATED CANCERS. ALSO, TO OFFSET THE COSTS OF "BE THE MATCH" TESTING KITS ASSOCIATED WITH REGISTERING INDIVIDUALS INTO THE NATIONAL BONE MARROW REGISTRY. THESE SERVICE ARE PROVIDED PRIMARILY TO RESIDENTS OF DUBOIS COUNTY, INDIANA.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$4,680ExpenseAmt
DescPROVIDED FINANCIAL SUPPORT TO PATIENTS AND PAID FOR THE COSTS ASSOCIATED WITH PERSONS SIGNING UP ON THE NATIONAL BONE MARROW REGISTRYDesc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$130,035ExpenseAmt
Grant$129,690GrantAmt
DescSUPPORT PATIENTS WITH LEUKEMIA AND OTHER BLOOD RELATED DISEASES.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$130,035TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$129,690TotalOtherProgSrvcGrantAmt
Total Program Service Expenses$134,715TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
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 EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
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 CompliancefalseBackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
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 BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NONTE & COMPANY LLCBusinessNameLine1Txt
Business Name Line2NONTE & COMPANY LLCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Phone8124826330PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 DCB PLAZA STE 301AddressLine1Txt
Address Line21 DCB PLAZA STE 301AddressLine2Txt
CityJASPERCityNm
State AbbreviationINStateAbbreviationCd
ZIP47546ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (3 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
MICHAEL UEBELHOR
PRESIDENT1.00Yes (X)$0$0$0
BRENDA HARTKE
SECRETARY1.00Yes (X)$0$0$0
GARY BRICK
TREASURER1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$258,798AllOtherContributionsAmt
Total Contributions$258,798TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$5TotalRevenueColumnAmt
Related Or Exempt Func Income$5RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$258,803TotalRevenueColumnAmt
Related Or Exempt Func Income$5RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$115,650TotalAmt
Program Services$115,650ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$14,040TotalAmt
Program Services$14,040ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$23,773TotalAmt
Program Services$5,025ProgramServicesAmt
Fundraising$18,748FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$3,472TotalAmt
Fundraising$3,472FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,911TotalAmt
Management And General$457ManagementAndGeneralAmt
Fundraising$4,454FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$485TotalAmt
Management And General$485ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$162,331TotalAmt
Program Services$134,715ProgramServicesAmt
Management And General$942ManagementAndGeneralAmt
Fundraising$26,674FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$26,730BOYAmt
EOY$123,202EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$26,730BOYAmt
EOY$123,202EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$26,730BOYAmt
EOY$123,202EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$26,730BOYAmt
EOY$123,202EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$26,730BOYAmt
EOY$123,202EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$96,472ReconcilationRevenueExpnssAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year$258,798CurrentTaxYearAmt
Total$258,798TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year$5CurrentTaxYearAmt
Total$5TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year$258,803CurrentTaxYearAmt
Total$258,803TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$258,803PublicSupportTotal509Amt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year$258,803CurrentTaxYearAmt
Total$258,803TotalAmt
FieldValueIRS element (for citing)
Public Support CY5091.00000PublicSupportCY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1ENIS FURLEY FOUNDATION INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 100AddressLine1Txt
CitySMITHVILLECityNm
State AbbreviationINStateAbbreviationCd
ZIP47458ZIPCd
FieldValueIRS element (for citing)
Recipient EIN010564458RecipientEIN
IRC Section501IRCSectionDesc
Cash Grant$115,650CashGrantAmt
Purpose Of GrantSUPPORT OPERATIONSPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypePATIENT EXPENSE AID REIMBGrantTypeTxt
Recipient20RecipientCnt
Cash Grant$14,040CashGrantAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990 - ORGANIZATION'S MISSIONTHE MISSION OF THE DUBOIS COUNTY LEUKEMIA ASSOCIATION IS TO EDUCATE, FINANCIALLY ASSIST, AND PROVIDE EMOTIONAL CARE TO VICTIMS OF LEUKEMIA AND OTHER BLOOD RELATED CANCERS. ALSO, TO OFFSET THE COSTS OF "BE THE MATCH" TESTING KITS ASSOCIATED WITH REGISTERING INDIVIDUALS INTO THE NATIONAL BONE MARROW REGISTRY. THESE SERVICE ARE PROVIDED PRIMARILY TO RESIDENTS OF DUBOIS COUNTY, INDIANA.
FORM 990, PAGE 1, PART I, LINE 6VOLUNTEERS PERFORM THE FOLLOWING: 1. ASSIST IN PROVIDING EMOTIONAL SUPPORT & INFORMATION TO NEW LEUKEMIA PATIENTS AND THEIR FAMILY MEMBERS. 2. PLAN FUNDRAISING EVENTS 3. STAFF "BE THE MATCH" EVENTS/REGISTER FOR BLOOD/BONE MARROW DONOR REGISTRY FOR POSSIBLE BONE MARROW MATCH & SUBSEQUENT MARROW DONATION TO LEUKEMIA AND BLOOD DISEASE RELATED PATIENTS. 4. PROVIDE PLANNING AND DIRECTION TO SUSTAIN FUTURE OPERATIONS AND VIABILITY.
FORM 990, PAGE 2, PART III, LINE 4DSUPPORT PATIENTS WITH LEUKEMIA AND OTHER BLOOD RELATED DISEASES.
FORM 990, PAGE 6, PART VI, LINE 11BFORM 990 REVIEWED BY PREPARER CPA FIRM AND BY PRESIDENT
FORM 990, PAGE 6, PART VI, LINE 19UPON REQUEST
FORM 990, PART IX, LINE 11GBE THE MATCH REGISTRY KITS 4,680 0 0 MISC COSTS/SUPPORT 345 0 0 RENTAL & OTHER EVENT RELATED 0 0 18,748 TOTAL 5,025 0 18,748

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.