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NORTH JERSEY HEALTH COLLABORATIVE: Form 990EZ, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
NORTH JERSEY HEALTH COLLABORATIVE (EIN 46-3715246)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-07-05
IRS object ID
201731869349200028
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)
Return2017-07-05T11:58:35-07:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Peter H Dorman CPABusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1912 Pompton Ave Unit A-2AddressLine1Txt
CityCedar GroveCityNm
State AbbreviationNJStateAbbreviationCd
ZIP07009ZIPCd
FieldValueIRS element (for citing)
Return Type990EZReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN463715246EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NORTH JERSEY HEALTH COLLABORATIVE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlNORTBusinessNameControlTxt
Phone9738860481PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 150AddressLine1Txt
CityGREEN VILLAGECityNm
State AbbreviationNJStateAbbreviationCd
ZIP07935ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCHRIS KIRK PHDPersonNm
Person TitlePresidentPersonTitleTxt
Signature2017-07-05SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonPETER H DORMAN CPAPreparerPersonNm
PTINP00098551PTIN
Phone9738571100PhoneNum
Self EmployedYes (X)SelfEmployedInd
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990-EZ IRS990EZ

FieldValueIRS element (for citing)
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Website AddressN/AWebsiteAddressTxt
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Gross Receipts$91,341GrossReceiptsAmt
Info In Schedule O Part IYes (X)InfoInScheduleOPartIInd
Contributions Gifts Grants Etc$53,841ContributionsGiftsGrantsEtcAmt
Membership Dues$37,500MembershipDuesAmt
Cost Or Other Basis Expense Sale$0CostOrOtherBasisExpenseSaleAmt
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Special Events Direct Expenses$0SpecialEventsDirectExpensesAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt
Total Revenue$91,341TotalRevenueAmt
Fees And Other Pymt To Ind Cntrct$78,637FeesAndOtherPymtToIndCntrctAmt
Other Expenses Total$13,042OtherExpensesTotalAmt
Total Expenses$91,679TotalExpensesAmt
Excess Or Deficit For Year-$338ExcessOrDeficitForYearAmt
Net Assets Or Fund Balances BOY$147,694NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$147,356NetAssetsOrFundBalancesEOYAmt

Cash Savings And Investments CashSavingsAndInvestmentsGrp

FieldValueIRS element (for citing)
BOY$147,694BOYAmt
EOY$147,356EOYAmt

Form990 Total Assets Form990TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$147,694BOYAmt
EOY$147,356EOYAmt

Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp

FieldValueIRS element (for citing)
BOY$147,694BOYAmt
EOY$147,356EOYAmt
FieldValueIRS element (for citing)
Primary Exempt PurposeTO FOSTER THE HEALTH OF THE COMMUNITIES SERVED BY ENHANCING COOPERATION BETWEEN PARTNERS INVOLVED IN PUBLIC HEALTH, PROMOTING RESEARCH AND SHARING OF THE INFORMATION.PrimaryExemptPurposeTxt

Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp

FieldValueIRS element (for citing)
Description Program Srvc AccomSPONSOR AND ENGAGE IN RESEARCH RELATED TO THE DELIVERY OF HEALTHCARE AND HOSPICE SERVICES TO IMPROVE THE QUALITY, SAFETY AND EFFICIENY OF HEALTH SERVICES, SPONSOR AND SHARE INFORMATION WITH THE MEMBERSHIP AND PUBLIC.DescriptionProgramSrvcAccomTxt
Grants And Allocations$85,609GrantsAndAllocationsAmt
FieldValueIRS element (for citing)
Total Program Service Expenses$85,609TotalProgramServiceExpensesAmt

Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (4 entries)

TitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmt
CHRIS KIRK PHD
President12.00$0
KIRAN GAUDIOSO
Vice President12.00$0
FAITH SCOTT
Treasurer12.00$0
ARLENE STOLLER
Secretary12.00$0
FieldValueIRS element (for citing)
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
Activities Not Previously RptfalseActivitiesNotPreviouslyRptInd
Chg Made To Orgnzng Doc Not RptfalseChgMadeToOrgnzngDocNotRptInd
Organization Had UBIfalseOrganizationHadUBIInd
Organization Filed990 TfalseOrganizationFiled990TInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Organization Dissolved EtcfalseOrganizationDissolvedEtcInd
Form1120 Pol FiledfalseForm1120PolFiledInd
Made Loans To From OfficersfalseMadeLoansToFromOfficersInd
Initiation Fees And Cap Contri$0InitiationFeesAndCapContriAmt
Gross Receipts For Public Use$0GrossReceiptsForPublicUseAmt
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonPETER CORREALEPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1175 SOUTH STAddressLine1Txt
CityMORRISTWONCityNm
State AbbreviationNJStateAbbreviationCd
ZIP07960ZIPCd
FieldValueIRS element (for citing)
Phone9738860481PhoneNum
FieldValueIRS element (for citing)
Foreign Financial AccountfalseForeignFinancialAccountInd
Foreign OfficefalseForeignOfficeInd
Donor Advised FndsfalseDonorAdvisedFndsInd
Operate HospitalfalseOperateHospitalInd
Tanning Services ProvidedfalseTanningServicesProvidedInd
Form720 FiledfalseForm720FiledInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
School OperatingfalseSchoolOperatingInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Related Org Sect527 OrgfalseRelatedOrgSect527OrgInd
Part VI Of Comp Of Hghst Pd EmplNONEPartVIOfCompOfHghstPdEmplTxt
Part VI Hghst Pd Cntrct Prof SrvcNONEPartVIHghstPdCntrctProfSrvcTxt
Filed Schedule AYes (true)FiledScheduleAInd

Schedule A IRS990ScheduleA

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

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$62,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$113,540CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$141,492CurrentTaxYearMinus1YearAmt
Current Tax Year$91,341CurrentTaxYearAmt
Total$408,373TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$62,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$113,540CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$141,492CurrentTaxYearMinus1YearAmt
Current Tax Year$91,341CurrentTaxYearAmt
Total$408,373TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$408,373PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$62,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$113,540CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$141,492CurrentTaxYearMinus1YearAmt
Current Tax Year$91,341CurrentTaxYearAmt
Total$408,373TotalAmt
FieldValueIRS element (for citing)
First5 Years509Yes (X)First5Years509Ind
Public Support CY5090.00000PublicSupportCY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct

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 O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Other Expenses.1001Advertising and Promotion $312
Other Expenses.1002Office Expenses $400
Other Expenses.1005Travel $1132
Other Expenses.1007Conferences, Conventions, and Meetings $5278
Other Expenses.1Network Fee $5600
Other Expenses.2Meals $240
Other Expenses.3Bank Service Charges $55
Other Expenses.4Licenses $25

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