2017-04-01T10:13:38-05:00 2016-12-31 161092347 MENGEL METZGER BARR & CO LLP 475 N MAIN STREET CANANDAIGUA NY 14424 990 2016-01-01 237216568 PENN YAN VOLUNTEER AMBULANCE CORPS INC PENN 3155362714 PO BOX 272 PENN YAN NY 14527 BRIAN CHAMPLIN PRESIDENT 3155362714 2017-03-21 1 KRISTINA STAMATIS P00967056 5854231860 2017-03-21 24.39.170.122 2017-03-21 10:27:30 ED P 47C8FC3DBD232B65738599601FF5DFA505C221FA A826D7F100B0D615BD79AA9ED228F6E5404D4862 2016 2021-01-29 14:40:06Z BRIAN CHAMPLIN PO BOX 272 PENN YAN NY 14527 469536 0 X PENNYANAMBULANCE.ORG X 1972 NY VOLUNTEER AMBULANCE SERVICES TO RESIDENTS OF PENN YAN NY AND THE SURROUNDING TOWNS AND VILLAGES VIA THE MUTUAL AID SYSTEM 11 11 2 45 0 0 4562 3315 452188 388262 53001 67561 0 0 509751 459138 0 0 0 0 45594 42321 0 0 0 390435 401257 436029 443578 73722 15560 2054745 2145882 15406 786 2039339 2145096 VOLUNTEER AMBULANCE SERVICES TO RESIDENTS OF PENN YAN NY AND THE SURROUNDING TOWNS AND VILLAGES VIA THE MUTUAL AID SYSTEM 0 0 290256 388262 PROVIDED EMERGENCY AND NON EMERGENCY TRANSPORTATION AND INITIAL MEDICAL ASSISTANCE TO MEMBERS OF THE SERVICED COMMUNITY 290256 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 10 0 2 1 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X BETH FAHNESTOCK 3156942625 3275 E SHERMAN HOLLOW RD PENN YAN NY 14527 X MICHAEL T HEALY DIRECTOR 5.00 X 0 0 0 NATE HOFFMAN DIRECTOR 5.00 X 0 0 0 CYNDI DAVIS DIRECTOR 3.00 X 0 0 0 JASON JOHNSON DIRECTOR 40.00 X 0 0 0 WESLEY YOUNGMAN DIRECTOR 5.00 X 0 0 0 BRIAN LAURSEN DIRECTOR 5.00 X 0 0 0 LEEANN OVENS DIRECTOR 5.00 X 0 0 0 BRIAN CHAMPLIN PRESIDENT 5.00 X 0 0 0 BETH FAHNESTOCK VICE PRESIDENT 8.00 X 0 0 0 DOMINIC FONTE TREASURER 8.00 X 0 0 0 KIM WILLIAMS SECRETARY 5.00 X 0 0 0 0 0 0 0 0 0 0 SOLDIERS & SAILORS MEMORIAL HOSPITAL 418 NORTH MAIN STREET PENN YAN NY 14527 STAFF LEASING 105800 1 3315 3315 PATIENT SERVICE REVENU 621910 388262 388262 388262 67959 67959 10000 10398 -398 -398 -398 459138 388262 0 67561 X 36484 36484 2250 2250 3587 3587 5058 5058 2135 2135 96773 96773 8220 8220 5629 5629 10037 10037 8366 8366 23278 23278 68454 67598 856 28107 28107 SUPPLIES 54193 54193 BILLING SERVICE COSTS 38197 38197 EQUIPMENT REPAIRS 35219 35219 SHARED FEES ALS 12840 12840 4751 4751 443578 290256 153322 0 -10727 -9083 97845 111730 49583 23000 26000 1387899 990154 423304 397745 1471740 1619490 2054745 2145882 15406 786 15406 786 X 2039339 2145096 2039339 2145096 2054745 2145882 15560 90197 0 X 0 0 0 X 6490 6140 1245 4562 3315 21752 383063 395396 388883 452188 388262 2007792 389553 401536 390128 456750 391577 2029544 0 0 0 2029544 123683 98799 60533 57832 67959 408806 123683 98799 60533 57832 67959 408806 513236 500335 450661 514582 459536 2438350 0.83230 0.84240 0.16770 0.15760 X 45532 45532 522984 396888 126096 218316 167953 50363 601067 425313 175754 397745 FORM 990, PART VI, SECTION B, LINE 11B OFFICERS REVIEW AND ACKNOWLEDGE REVIEW OF TAX RETURN PRIOR TO FILING FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY IS REVIEWED AT BOARD MEETING FORM 990, PART VI, SECTION B, LINE 15 AMONG OTHER INFORMATION, THE BOARD CONSIDERS WAGES PAID BY SIMILAR ORGANIZATIONS IN DETERMINING COMPENSATION FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST AT THE AMBULANCE OFFICE THE TAX DOCUMENTS CAN ALSO BE VIEWED AT GUIDESTAR ORG FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 96,773. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 96,773.