COMMUNITY FREE CLINIC OF DECATUR- MORGAN COUNTY INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY FREE CLINIC OF DECATUR- MORGAN COUNTY INC (EIN 72-1526129)
Tax period
2015-07-01 to 2016-06-30
Filed
2016-11-15
IRS object ID
201623209349305682
Schema version
2015v2.1
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)
Return2016-11-15T11:15:50-06:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN631158335PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1TUCKER SCOTT & WATES LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1130AddressLine1Txt
CityDECATURCityNm
State AbbreviationALStateAbbreviationCd
ZIP356021130ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN721526129EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY FREE CLINIC OF DECATURBusinessNameLine1Txt
Business Name Line2MORGAN COUNTY INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone2563095617PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1245 JACKSON STREET SEAddressLine1Txt
CityDECATURCityNm
State AbbreviationALStateAbbreviationCd
ZIP35601ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJESSICA PAYNEPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone2563095617PhoneNum
Signature2016-11-10SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDARRELL W WATES CPA CGMAPreparerPersonNm
PTINP00360808PTIN
Phone2563551828PhoneNum
Preparation2016-11-10PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJESSICA PAYNEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1245 JACKSON STREET SEAddressLine1Txt
CityDECATURCityNm
State AbbreviationALStateAbbreviationCd
ZIP35601ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$2,092,511GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2002FormationYr
Legal Domicile StateALLegalDomicileStateCd
Activity Or MissionTO PROVIDE FREE, QUALITY HEALTHCARE TO LOW INCOME, MEDICALLY UNINSURED ADULT RESIDENTS OF DECATUR AND MORGAN COUNTY, THROUGH VOLUNTEERS SERVING THE COMMUNITY IN A MANNER THAT RESPECTS THE DIGNITY OF ALL PERSONS.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee7TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$2,496,333PYContributionsGrantsAmt
CY Contributions Grants$2,008,658CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income-$18,335PYInvestmentIncomeAmt
CY Investment Income$49,775CYInvestmentIncomeAmt
PY Other Revenue$19,568PYOtherRevenueAmt
CY Other Revenue$24,432CYOtherRevenueAmt
PY Total Revenue$2,497,566PYTotalRevenueAmt
CY Total Revenue$2,082,865CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$221,638PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$233,046CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$1,695CYTotalFundraisingExpenseAmt
PY Other Expenses$2,429,746PYOtherExpensesAmt
CY Other Expenses$1,894,869CYOtherExpensesAmt
PY Total Expenses$2,651,384PYTotalExpensesAmt
CY Total Expenses$2,127,915CYTotalExpensesAmt
PY Revenues Less Expenses-$153,818PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$45,050CYRevenuesLessExpensesAmt
Total Assets BOY$2,687,048TotalAssetsBOYAmt
Total Assets EOY$2,636,346TotalAssetsEOYAmt
Total Liabilities BOY$14,284TotalLiabilitiesBOYAmt
Total Liabilities EOY$10,361TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,672,764NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,625,985NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE MEDICAL CARE TO INDIVIDUALS UNABLE TO PAY FOR IT.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$2,093,774ExpenseAmt
DescPROVIDE MEDICAL CARE TO INDIVIDUALS UNABLE TO PAY FOR IT.Desc
Total Program Service Expenses$2,093,774TotalProgramServiceExpensesAmt
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 EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
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 ContriYes (true)DeductibleNonCashContriInd
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 Document2IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee7EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
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 Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
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 PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnfalseAnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcfalseRegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJESSICA PAYNEPersonNm
Phone2563095617PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1245 JACKSON STREET SEAddressLine1Txt
CityDECATURCityNm
State AbbreviationALStateAbbreviationCd
ZIP35601ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
JAMES GAUTHIER
MEDICAL DIREYes (X)Yes (X)$0$0$0
PAM HOWELL
PAST PRESIDEYes (X)Yes (X)$0$0$0
AMY ANDERSON
PRESIDENTYes (X)Yes (X)$0$0$0
DANNY CROWE
BOARD MEMBERYes (X)$0$0$0
TRUDY GRISHAM
VICE PRESIDEYes (X)Yes (X)$0$0$0
RANDALL SANDLIN DMD
DENTAL DIRECYes (X)Yes (X)$0$0$0
DALE TRAMMELL MD
DIRECTOR ATYes (X)Yes (X)$0$0$0
BETH PEARCE
BOARD MEMBERYes (X)$0$0$0
ROBERT ALLEN MD
BOARD MEMBERYes (X)$0$0$0
DAVID LANGSTON
BOARD MEMBERYes (X)$0$0$0
ANNE LEDBETTER
SECRETARYYes (X)Yes (X)$0$0$0
HON ARTHUR ORR
BOARD MEMBERYes (X)$0$0$0
ANNIE CORNELL
BOARD MEMBERYes (X)$0$0$0
CRYSTAL BROWN
BOARD MEMBERYes (X)$0$0$0
VENESSA EDMONDS
BOARD MEMBERYes (X)$0$0$0
REVEREND EVAN GARNER
BOARD MEMBERYes (X)$0$0$0
LEANETTE JACKSON
BOARD MEMBERYes (X)$0$0$0
DR SCOTT HARRIS
BOARD MEMBERYes (X)$0$0$0
DR PAUL MCCAIN
BOARD MEMBERYes (X)$0$0$0
DR DYRC SIBRANS
BAORD MEMBERYes (X)$0$0$0
ANGIE HARRIS
TREASURERYes (X)Yes (X)$0$0$0
JESSICA PAYNE
EXECUTIVE DIYes (X)$0$0$0
FieldValueIRS element (for citing)
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$108,220GovernmentGrantsAmt
All Other Contributions$1,900,438AllOtherContributionsAmt
Noncash Contributions$1,748,938NoncashContributionsAmt
Total Contributions$2,008,658TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$49,775TotalRevenueColumnAmt
Related Or Exempt Func Income$49,775RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$34,078FundraisingGrossIncomeAmt
Fundraising Direct Expenses$9,646FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$24,432TotalRevenueColumnAmt
Exclusion$24,432ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,082,865TotalRevenueColumnAmt
Related Or Exempt Func Income$49,775RelatedOrExemptFuncIncomeAmt
Exclusion$24,432ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$209,269TotalAmt
Program Services$202,991ProgramServicesAmt
Management And General$6,278ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$7,791TotalAmt
Program Services$7,557ProgramServicesAmt
Management And General$234ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$15,986TotalAmt
Program Services$15,506ProgramServicesAmt
Management And General$480ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$5,639TotalAmt
Program Services$3,383ProgramServicesAmt
Management And General$1,128ManagementAndGeneralAmt
Fundraising$1,128FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,778,627TotalAmt
Program Services$1,767,317ProgramServicesAmt
Management And General$11,310ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$567TotalAmt
Fundraising$567FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$6,788TotalAmt
Program Services$3,065ProgramServicesAmt
Management And General$3,723ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$80,759TotalAmt
Program Services$73,491ProgramServicesAmt
Management And General$7,268ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$752TotalAmt
Program Services$684ProgramServicesAmt
Management And General$68ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$17,928TotalAmt
Program Services$16,314ProgramServicesAmt
Management And General$1,614ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$3,809TotalAmt
Program Services$3,466ProgramServicesAmt
Management And General$343ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,127,915TotalAmt
Program Services$2,093,774ProgramServicesAmt
Management And General$32,446ManagementAndGeneralAmt
Fundraising$1,695FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$102,215BOYAmt
EOY$61,849EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$190,852BOYAmt
EOY$144,575EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,120BOYAmt
EOY$1,151EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$729,058LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$289,425LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$453,428BOYAmt
EOY$439,633EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,939,433BOYAmt
EOY$1,989,138EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,687,048BOYAmt
EOY$2,636,346EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,550BOYAmt
EOY$5,068EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$11,734BOYAmt
EOY$5,293EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$14,284BOYAmt
EOY$10,361EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,566,022BOYAmt
EOY$2,537,423EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$106,742BOYAmt
EOY$88,562EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,672,764BOYAmt
EOY$2,625,985EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,687,048BOYAmt
EOY$2,636,346EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$45,050ReconcilationRevenueExpnssAmt
Prior Period Adjustments-$1,729PriorPeriodAdjustmentsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

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

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$2,108,572CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,496,333CurrentTaxYearMinus1YearAmt
Current Tax Year$2,008,658CurrentTaxYearAmt
Total$6,613,563TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$203,631CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year-$18,335CurrentTaxYearMinus1YearAmt
Current Tax Year$49,775CurrentTaxYearAmt
Total$235,071TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$2,312,203CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,477,998CurrentTaxYearMinus1YearAmt
Current Tax Year$2,058,433CurrentTaxYearAmt
Total$6,848,634TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$6,848,634PublicSupportTotal509Amt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$18,142CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$18,568CurrentTaxYearMinus1YearAmt
Current Tax Year$23,432CurrentTaxYearAmt
Total$60,142TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$2,330,345CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,496,566CurrentTaxYearMinus1YearAmt
Current Tax Year$2,081,865CurrentTaxYearAmt
Total$6,908,776TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99130PublicSupportCY509Pct
Public Support PY5090.99240PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$106,972OtherCostOrOtherBasisAmt
Book Value$106,972BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$622,086OtherCostOrOtherBasisAmt
Depreciation$289,425DepreciationAmt
Book Value$332,661BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$439,633TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
INVESTMENT ACCOUNT - SANDLIN$1,989,138
BEQUEST RECEIVABLE
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,989,138TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
ACCRUED RETIRMENT PAYABLE$1,933
STATE WITHHOLDING PAYABLE$1,809
ACCRUED PAYROLL$1,490
PAYROLL LIABILITIES$61
FICA/MEDICARE/FWH PAYABLE
FieldValueIRS element (for citing)
Total Liability$5,293TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$2,082,865TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$2,082,865RevenueSubtotalAmt
Total Revenue Per Form990$2,082,865TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$2,127,915TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$2,127,915ExpensesSubtotalAmt
Total Expenses Per Form990$2,127,915TotalExpensesPerForm990Amt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1SPECIAL EVENTEvent1Nm
Gross Receipts Event1$34,078GrossReceiptsEvent1Amt
Gross Revenue Event1$34,078GrossRevenueEvent1Amt
Other Direct Expenses Event1$9,646OtherDirectExpensesEvent1Amt
Gross Receipts Total$34,078GrossReceiptsTotalAmt
Gross Revenue Total Events$34,078GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$9,646OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$9,646DirectExpenseSummaryEventsAmt
Net Income Summary$24,432NetIncomeSummaryAmt

Schedule M IRS990ScheduleM

Real Estate Commercial RealEstateCommercialGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$80,000NoncashContributionsRptF990Amt

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$1,060,527NoncashContributionsRptF990Amt

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$608,411NoncashContributionsRptF990Amt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BPRESENTED TO THE BOARD BY INDEPENDENT CPA
FORM 990, PAGE 6, PART VI, LINE 19DOCUMENTS ARE PROVIDED UPON REQUEST
FORM 990, PART IX, LINE 11GDISPENSED MEDICINES 1,125,305 0 0 DONATED SERVICES 608,412 0 0 UTILITIES 10,125 1,001 0 TELEPHONE 4,402 435 0 CLEANING AND JANITORIAL 0 5,105 0 PHARMACY SUPPLIES 3,137 0 0 REPAIRS & MAINTENANCE 11,341 1,122 0 CLINIC SUPPLIES 1,530 0 0 MISCELLANEOUS 204 20 0 DENTAL SUPPLIES 2,423 0 0 DUES AND SUBSCRIPTIONS 118 82 0 SECURITY 320 0 0 STRATEGIC PLANNING 0 3,545 0

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