FREE MEDICAL CLINIC OF NEWBERRY COUNTY INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- FREE MEDICAL CLINIC OF NEWBERRY COUNTY INC (EIN 20-0390941)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-08-15
- IRS object ID
- 201742279349302929
- 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 | 2017-08-15T15:39:23-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 421575695 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVIS AND COMPANY PA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 23327 | AddressLine1Txt |
| City | COLUMBIA | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29224 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200390941 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE FREE MEDICAL CLINIC OF NEWBERRY | BusinessNameLine1Txt |
| Business Name Line2 | COUNTY INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FREE | BusinessNameControlTxt |
| Phone | 8032766665 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | POST OFFICE BOX 783 | AddressLine1Txt |
| City | NEWBERRY | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 291080783 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BERT NEEL | PersonNm |
| Person Title | CHAIRMAN | PersonTitleTxt |
| Phone | 8032766665 | PhoneNum |
| Signature | 2017-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOHN F PETERSONCPA | PreparerPersonNm |
| PTIN | P00100818 | PTIN |
| Phone | 8037880702 | PhoneNum |
| Preparation | 2017-08-15 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 98.101.216.174 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-08-15 | IPDt |
| IP Tm | 09:04:19 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 49A133BE5BC6E5030CA4142C41885EE86AAF64A7 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 49A133BE5BC6E5030CA4142C41885EE86AAF64A7 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FREE MEDICAL CLINIC OF NEWBERRY COU | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BERT NEEL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2568 KINARD STREET | AddressLine1Txt |
| City | NEWBERRY | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29108 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $168,997 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://WWW.NEWBERRYCLINIC.ORG/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | SC | LegalDomicileStateCd |
| Activity Or Mission | TO SERVE THE NEEDS OF NEWBERRY COUNTY RESIDENTS WHO DO NOT HAVE ACCESS TO PROFESSIONAL HEALTHCARE DUE TO LACK OF INCOME OR ADEQUATE HEALTH INSURANCE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 4 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $103,047 | PYContributionsGrantsAmt |
| CY Contributions Grants | $168,686 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $247 | PYInvestmentIncomeAmt |
| CY Investment Income | $311 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $103,294 | PYTotalRevenueAmt |
| CY Total Revenue | $168,997 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $72,145 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $83,780 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $15,476 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $60,734 | PYOtherExpensesAmt |
| CY Other Expenses | $63,572 | CYOtherExpensesAmt |
| PY Total Expenses | $132,879 | PYTotalExpensesAmt |
| CY Total Expenses | $147,352 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$29,585 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $21,645 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $253,101 | TotalAssetsBOYAmt |
| Total Assets EOY | $278,672 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,993 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,919 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $251,108 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $272,753 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO SERVE THE NEEDS OF NEWBERRY COUNTY RESIDENTS WHO DO NOT HAVE ACCESS TO PROFESSIONAL HEALTHCARE DUE TO LACK OF INCOME OR ADEQUATE HEALTH INSURANCE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $97,982 | ExpenseAmt |
| Desc | MEDICAL CARE FOR RESIDENTS OF NEWBERRY COUNTY WHO DO NOT HAVE ACCESS TO PROFESSIONAL HEALTHCARE DUE TO LACK OF INCOME OR ADEQUATE HEALTH INSURANCE. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | TO SERVE THE NEEDS OF NEWBERRY COUNTY RESIDENTS WHO DO NOT HAVE ACCESS TO PROFESSIONAL HEALTHCARE DUE TO LACK OF INCOME OR ADEQUATE HEALTH INSURANCE. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $97,982 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 4 | EmployeeCnt |
| Employment Tax Returns Filed | 0 | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | 0 | ConflictOfInterestPolicyInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | SC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE FREE MEDICAL CLINIC OF NEWBERRY COUNTY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8032766665 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2568 KINARD STREET | AddressLine1Txt |
| City | NEWBERRY | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29108 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|
| CARLA ARMFIELD | |||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 |
| JESSE BAKER | |||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 |
| HAROLD MCMORRIS | |||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 |
| TERRI MURDOCK | |||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 |
| BERT NEEL | |||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 |
| BRUCE BALDWIN | |||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 |
| SHERRY SCOTT | |||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 |
| CAROYLN E TOBE | |||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 |
| REBECCA CLARY | |||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 |
| JOHN GLASGOW | |||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 |
| COREY HUNT | |||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 |
| GREG MARTIN | |||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $168,686 | AllOtherContributionsAmt |
| Total Contributions | $168,686 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $311 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $311 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $168,997 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $311 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,380 | TotalAmt |
| Program Services | $46,428 | ProgramServicesAmt |
| Management And General | $15,476 | ManagementAndGeneralAmt |
| Fundraising | $15,476 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,400 | TotalAmt |
| Program Services | $5,760 | ProgramServicesAmt |
| Management And General | $640 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,306 | TotalAmt |
| Program Services | $2,975 | ProgramServicesAmt |
| Management And General | $331 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,108 | TotalAmt |
| Program Services | $5,497 | ProgramServicesAmt |
| Management And General | $611 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,526 | TotalAmt |
| Management And General | $7,526 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,402 | TotalAmt |
| Program Services | $4,862 | ProgramServicesAmt |
| Management And General | $540 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| TELEPHONE | $11,230 | $10,107 | $1,123 |
| PHYSICIAN FEES | $11,060 | $11,060 | |
| PROFESSIONAL FEES | $6,623 | $1,041 | $5,582 |
| MEDICAL SUPPLIES | $4,572 | $4,572 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,745 | TotalAmt |
| Program Services | $5,680 | ProgramServicesAmt |
| Management And General | $2,065 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,352 | TotalAmt |
| Program Services | $97,982 | ProgramServicesAmt |
| Management And General | $33,894 | ManagementAndGeneralAmt |
| Fundraising | $15,476 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,840 | BOYAmt |
| EOY | $16,298 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $65,639 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $345,456 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $148,721 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $204,261 | BOYAmt |
| EOY | $196,735 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $253,101 | BOYAmt |
| EOY | $278,672 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,993 | BOYAmt |
| EOY | $5,919 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,993 | BOYAmt |
| EOY | $5,919 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $251,108 | BOYAmt |
| EOY | $272,753 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $251,108 | BOYAmt |
| EOY | $272,753 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $253,101 | BOYAmt |
| EOY | $278,672 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $21,645 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $249,683 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $113,028 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $149,376 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $103,047 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $168,686 | CurrentTaxYearAmt |
| Total | $783,820 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $249,683 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $113,028 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $149,376 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $103,047 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $168,686 | CurrentTaxYearAmt |
| Total | $783,820 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $783,820 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $52 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $88 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $247 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $311 | CurrentTaxYearAmt |
| Total | $720 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $52 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $88 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $247 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $311 | CurrentTaxYearAmt |
| Total | $720 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $249,735 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $113,050 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $149,464 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $103,294 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $168,997 | CurrentTaxYearAmt |
| Total | $784,540 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99910 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99680 | PublicSupportPY509Pct |
| Investment Income CY | 0.00090 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00320 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,000 | OtherCostOrOtherBasisAmt |
| Book Value | $25,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $237,576 | OtherCostOrOtherBasisAmt |
| Depreciation | $69,069 | DepreciationAmt |
| Book Value | $168,507 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $82,880 | OtherCostOrOtherBasisAmt |
| Depreciation | $79,652 | DepreciationAmt |
| Book Value | $3,228 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $196,735 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| PAYROLL LIABILITIES | $2,315 |
| A/P | $3,604 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,919 | TotalLiabilityAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION PROVIDED A COMPLETE COPY OF THE FORM 990 TO ALL MEMBERS OF THE GOVERNING BODY BEFORE FILING BY EMAIL DISTRIBUTION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE AT BOARD MEETINGS AND BY OPEN REQUEST BY THE GENERAL PUBLIC. |
Comments