CONNECTMED INTERNATIONAL: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- CONNECTMED INTERNATIONAL (EIN 27-0804773)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-09-06
- IRS object ID
- 201742499349301494
- 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 | 2017-09-06T08:32:30-07:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FILIPOVITCH & CO | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5800 ARMADA DRIVE SUITE 290 | AddressLine1Txt |
| City | CARLSBAD | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 920084611 | 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 | 270804773 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CONNECTMED INTERNATIONAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CONN | BusinessNameControlTxt |
| Phone | 6198005349 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7040 AVENIDA ENCINAS STE 104 | AddressLine1Txt |
| City | CARLSBAD | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92011 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RITA ABBATI ALBERT | PersonNm |
| Person Title | Executive Director | PersonTitleTxt |
| Signature | 2017-09-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | EVAN FILIPOVITCH CPA | PreparerPersonNm |
| PTIN | P01537586 | PTIN |
| Phone | 7606028200 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $219,654 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| All Affiliates Included | false | AllAffiliatesIncludedInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.connectmed.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2009 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF THIS ORGANIZATION IS TO PROMOTE SUSTAINABLE MULTIDISCIPLINARY HEALTH CARE AND EDUCATION TO PATIENTS AND HEALTH CARE PROVIDERS IN UNDERSERVED AREAS AROUND THE WORLD THROUGH A COMBINATION OF DIRECT MEDICAL CARE AND THE ESTABLISHMENT OF AN INTERACTIVE TELEMEDICINE NETWORK BETWEEN INTERNATIONAL SITES | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 1 | TotalEmployeeCnt |
| Total Volunteers | 45 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| CY Contributions Grants | $135,459 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| CY Investment Income | $211 | CYInvestmentIncomeAmt |
| CY Other Revenue | $61,223 | CYOtherRevenueAmt |
| CY Total Revenue | $196,893 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $47,401 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $12,966 | CYTotalFundraisingExpenseAmt |
| CY Other Expenses | $148,337 | CYOtherExpensesAmt |
| CY Total Expenses | $195,738 | CYTotalExpensesAmt |
| CY Revenues Less Expenses | $1,155 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $350,331 | TotalAssetsBOYAmt |
| Total Assets EOY | $346,208 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,930 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,652 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $340,401 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $341,556 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF THIS ORGANIZATION IS TO PROMOTE SUSTAINABLE MULTIDISCIPLINARY HEALTH CARE AND EDUCATION TO PATIENTS AND HEALTH CARE PROVIDERS IN UNDERSERVED AREAS AROUND THE WORLD THROUGH A COMBINATION OF DIRECT MEDICAL CARE AND THE ESTABLISHMENT OF AN INTERACTIVE TELEMEDICINE NETWORK BETWEEN INTERNATIONAL SITES | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $162,488 | ExpenseAmt |
| Desc | PROMOTE SUSTAINABLE MULTIDISCIPLINARY HEALTH CARE AND EDUCATION TO PATIENTS AND HEALTH CARE PROVIDERS IN UNDERSERVED AREAS AROUND THE WORLD THROUGH A COMBINATION OF DIRECT MEDICAL CARE AND THE ESTABLISHMENT OF AN INTERACTIVE TELEMEDICINE NETWORK BETWEEN INTERNATIONAL SITES | Desc |
| Total Program Service Expenses | $162,488 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 1 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | false | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Org Filed In Lieu Of Form1041 | false | OrgFiledInLieuOfForm1041Ind |
| Licensed More Than One State | false | LicensedMoreThanOneStateInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | false | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | false | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | false | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LILI HUANG | PersonNm |
| Phone | 8185771884 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4747 EXECUTIVE DRIVE SUITE 1300 | AddressLine1Txt |
| City | SAN DIEGO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92121 | 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 | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| AMANDA GOSMAN | ||||||||
| President | 20.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JAMES GOSMAN | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JOYCE MCINTYRE | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| LILI HUANG | ||||||||
| Treasurer | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ALICIA SIGLER | ||||||||
| Vice President | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ZIA AGHA | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| AZMAIRA MAKER | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SHANKAR SITAPATI | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT HALL | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KRIZEL DAHLINE | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KARINA ICINKOFF | ||||||||
| Secretary | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RITA ABBATI ALBERT | ||||||||
| EXECUTIVE DIRECTOR | 29.00 | 0.00 | $43,850 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $43,850 | TotalReportableCompFromOrgAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $135,459 | AllOtherContributionsAmt |
| Total Contributions | $135,459 | TotalContributionsAmt |
| Total Program Service Revenue | $0 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $211 | TotalRevenueColumnAmt |
| Exclusion | $211 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $83,984 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $22,761 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $61,223 | TotalRevenueColumnAmt |
| Exclusion | $61,223 | ExclusionAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $196,893 | TotalRevenueColumnAmt |
| Exclusion | $61,434 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,850 | TotalAmt |
| Program Services | $26,310 | ProgramServicesAmt |
| Management And General | $8,770 | ManagementAndGeneralAmt |
| Fundraising | $8,770 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,551 | TotalAmt |
| Program Services | $1,776 | ProgramServicesAmt |
| Management And General | $710 | ManagementAndGeneralAmt |
| Fundraising | $1,065 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $750 | TotalAmt |
| Management And General | $750 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,248 | TotalAmt |
| Program Services | $1,248 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,046 | TotalAmt |
| Program Services | $583 | ProgramServicesAmt |
| Management And General | $604 | ManagementAndGeneralAmt |
| Fundraising | $1,859 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $745 | TotalAmt |
| Management And General | $745 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,000 | TotalAmt |
| Program Services | $68,000 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,308 | TotalAmt |
| Program Services | $1,308 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,054 | TotalAmt |
| Management And General | $3,054 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| DIRECT MEDICAL TRIP COSTS | $10,932 | $10,932 |
| VISITING SCHOLARS PROGRAM | $7,409 | $7,409 |
| DUES | $7,145 | $7,145 |
| CONSULTING | $6,749 | $6,749 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,951 | TotalAmt |
| Program Services | $31,028 | ProgramServicesAmt |
| Management And General | $5,651 | ManagementAndGeneralAmt |
| Fundraising | $1,272 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $195,738 | TotalAmt |
| Program Services | $162,488 | ProgramServicesAmt |
| Management And General | $20,284 | ManagementAndGeneralAmt |
| Fundraising | $12,966 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,185 | BOYAmt |
| EOY | $71,487 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $264,146 | BOYAmt |
| EOY | $265,990 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $3,500 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $6,539 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,308 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $5,231 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $350,331 | BOYAmt |
| EOY | $346,208 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,930 | BOYAmt |
| EOY | $4,652 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,930 | BOYAmt |
| EOY | $4,652 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $340,401 | BOYAmt |
| EOY | $341,556 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $340,401 | BOYAmt |
| EOY | $341,556 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $350,331 | BOYAmt |
| EOY | $346,208 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,155 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | 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 | $57,286 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $48,060 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $141,918 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $92,590 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $135,459 | CurrentTaxYearAmt |
| Total | $475,313 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $57,286 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $48,060 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $141,918 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $92,590 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $135,459 | CurrentTaxYearAmt |
| Total | $475,313 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $6,000 | CurrentTaxYearMinus1YearAmt |
| Total | $6,000 | 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) |
|---|---|---|
| Current Tax Year Minus1 Year | $6,000 | CurrentTaxYearMinus1YearAmt |
| Total | $6,000 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $469,313 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $140 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $234 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $189 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $236 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $211 | CurrentTaxYearAmt |
| Total | $1,010 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $140 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $234 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $189 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $236 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $211 | CurrentTaxYearAmt |
| Total | $1,010 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $57,426 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $48,294 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $142,107 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $92,826 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $135,670 | CurrentTaxYearAmt |
| Total | $476,323 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98530 | PublicSupportCY509Pct |
| Public Support PY509 | 0.98330 | PublicSupportPY509Pct |
| Investment Income CY | 0.00210 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00200 | 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
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,539 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,308 | DepreciationAmt |
| Book Value | $5,231 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,231 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| CREDIT CARD PAYABLE | $2,971 |
| PAYROLL LIABILITIES | $1,681 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,652 | TotalLiabilityAmt |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | false | AgrmtProfFundraisingActyInd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | DINNER/AUCTION | Event1Nm |
| Gross Receipts Event1 | $79,979 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $79,979 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $4,801 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $8,702 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $7,280 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $79,979 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $79,979 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $4,801 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $8,702 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $7,280 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $20,783 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $59,196 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (24 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et | JAMES GOSMAN (DIRECTOR) & AMANDA GOSMAN (PRESIDENT) - FATHER-DAUGHTER |
| Form 990, Part VI, Line 11b: Form 990 Review Process | DESIGNATED BOARD MEMBERS REVIEW FORM 990 WITH CPA PREPARER PRIOR TO FILING |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | THE EXEMPT APPLICATION AND COPIES OF FORM 990 ARE AVAILABLE UPON WRITTEN REQUEST TO THE ORGANIZATION'S ADDRESS OF RECORD |
| Form 990, Part IX, Line 24e: Other Expenses | BANK SERVICE CHARGES: Column (A) - Total = $28; Column (B) - Program Services = $0; Column (C) - Management & General = $28; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | CREDIT CARD FEES: Column (A) - Total = $95; Column (B) - Program Services = $0; Column (C) - Management & General = $95; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | EDUCATION CONFERENCES: Column (A) - Total = $4455; Column (B) - Program Services = $4455; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | INTERSHIP STIPEND: Column (A) - Total = $3077; Column (B) - Program Services = $626; Column (C) - Management & General = $1825; Column (D) - Fundraising = $626 |
| Form 990, Part IX, Line 24e: Other Expenses | MEDICAL EQUIPMENT: Column (A) - Total = $3140; Column (B) - Program Services = $3140; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | MEDICAL STAFF: Column (A) - Total = $1940; Column (B) - Program Services = $1940; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | MEDICAL SUPPLIES: Column (A) - Total = $3600; Column (B) - Program Services = $3600; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | MEDICAL TRAVEL SUPPLIES: Column (A) - Total = $3305; Column (B) - Program Services = $3305; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | MEDICAL TRAVEL: Column (A) - Total = $350; Column (B) - Program Services = $350; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | PHOTOGRAPHY/VIDEO : Column (A) - Total = $2037; Column (B) - Program Services = $2037; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Printing and Publications: Column (A) - Total = $2134; Column (B) - Program Services = $208; Column (C) - Management & General = $1484; Column (D) - Fundraising = $442 |
| Form 990, Part IX, Line 24e: Other Expenses | PROGRAM SUPPLIES: Column (A) - Total = $5; Column (B) - Program Services = $5; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | PROGRAMS & CONFERENCES: Column (A) - Total = $5975; Column (B) - Program Services = $5975; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | SCHOLARSHIP PROGRAM: Column (A) - Total = $2559; Column (B) - Program Services = $2559; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | SURGICAL EQUIPMENT: Column (A) - Total = $650; Column (B) - Program Services = $650; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | SURGICAL SUPPLIES: Column (A) - Total = $0; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | TAXES & LICENSES: Column (A) - Total = $10; Column (B) - Program Services = $0; Column (C) - Management & General = $10; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | TELEMEDICINE SERVICES & SUPPLI: Column (A) - Total = $840; Column (B) - Program Services = $840; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | TRAVEL: Column (A) - Total = $0; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | VOLUNTEER COSTS: Column (A) - Total = $1854; Column (B) - Program Services = $1260; Column (C) - Management & General = $390; Column (D) - Fundraising = $204 |
| Form 990, Part IX, Line 24e: Other Expenses | WEBSITE: Column (A) - Total = $1897; Column (B) - Program Services = $78; Column (C) - Management & General = $1819; Column (D) - Fundraising = $0 |
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