POTOMAC HEALTH FOUNDATION: Form 990PF, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
POTOMAC HEALTH FOUNDATION (EIN 52-1340920)
Tax period
2014-11-01 to 2015-10-31
Filed
2016-03-09
IRS object ID
201610699349100606
Schema version
2014v6.0
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)
Return2016-03-09T12:52:26-06:00ReturnTs
Tax Period End2015-10-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14250 N FAIRFAX DRIVE SUITE 1020AddressLine1Txt
CityARLINGTONCityNm
State AbbreviationVAStateAbbreviationCd
ZIP22203ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2014-11-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN521340920EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1POTOMAC HEALTH FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPOTOBusinessNameControlTxt
Phone7035230620PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12296 OPITZ BLVD NO 200AddressLine1Txt
CityWOODBRIDGECityNm
State AbbreviationVAStateAbbreviationCd
ZIP22191ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSUSIE LEEPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone7035230620PhoneNum
Signature2016-03-07SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDAVID TRIMNERPreparerPersonNm
PTINP00444822PTIN
Phone5712279500PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$99,842,007FMVAssetsEOYAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$0ContriRcvdRevAndExpnssAmt
Schedule B Not RequiredYes (X)ScheduleBNotRequiredInd
Interest On Sav Rev And Expnss$315InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$315InterestOnSavNetInvstIncmAmt
Dividends Rev And Expnss$4,627,319DividendsRevAndExpnssAmt
Dividends Net Invst Incm$4,876,513DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss-$14,012NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$17,708,825GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$1,534CapGainNetIncmNetInvstIncmAmt
Other Income Rev And Expnss$105,336OtherIncomeRevAndExpnssAmt
Other Income Net Invst Incm$0OtherIncomeNetInvstIncmAmt
Total Rev And Expnss$4,718,958TotalRevAndExpnssAmt
Total Net Invst Incm$4,878,362TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$134,172CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$20,126CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$114,046CompOfcrDirTrstDsbrsChrtblAmt
Oth Empl Slrs Wgs Rev And Expnss$106,457OthEmplSlrsWgsRevAndExpnssAmt
Oth Empl Slrs Wgs Net Invst Incm$0OthEmplSlrsWgsNetInvstIncmAmt
Oth Empl Slrs Wgs Dsbrs Chrtbl$106,457OthEmplSlrsWgsDsbrsChrtblAmt
Pension Empl Bnft Rev And Expnss$43,899PensionEmplBnftRevAndExpnssAmt
Pension Empl Bnft Net Invst Incm$4,226PensionEmplBnftNetInvstIncmAmt
Pension Empl Bnft Dsbrs Chrtbl$39,673PensionEmplBnftDsbrsChrtblAmt
Legal Fees Rev And Expnss$100LegalFeesRevAndExpnssAmt
Legal Fees Net Invst Incm$0LegalFeesNetInvstIncmAmt
Legal Fees Dsbrs Chrtbl$100LegalFeesDsbrsChrtblAmt
Accounting Fees Rev And Expnss$47,482AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$0AccountingFeesNetInvstIncmAmt
Accounting Fees Chrtbl Prps$64,390AccountingFeesChrtblPrpsAmt
Other Prof Fees Rev And Expnss$438,423OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm$397,084OtherProfFeesNetInvstIncmAmt
Other Prof Fees Dsbrs Chrtbl$41,339OtherProfFeesDsbrsChrtblAmt
Taxes Rev And Expnss$41,922TaxesRevAndExpnssAmt
Taxes Net Invst Incm$0TaxesNetInvstIncmAmt
Taxes Dsbrs Chrtbl$0TaxesDsbrsChrtblAmt
Deprec And Dpltn Rev And Expnss$5,223DeprecAndDpltnRevAndExpnssAmt
Deprec And Dpltn Net Invst Incm$0DeprecAndDpltnNetInvstIncmAmt
Occupancy Rev And Expnss$29,764OccupancyRevAndExpnssAmt
Occupancy Net Invst Incm$0OccupancyNetInvstIncmAmt
Occupancy Dsbrs Chrtbl$0OccupancyDsbrsChrtblAmt
Trav Conf Meeting Rev And Expnss$10,507TravConfMeetingRevAndExpnssAmt
Trav Conf Meeting Net Invst Incm$0TravConfMeetingNetInvstIncmAmt
Trav Conf Meeting Dsbrs Chrtbl$11,568TravConfMeetingDsbrsChrtblAmt
Other Expenses Rev And Expnss$42,868OtherExpensesRevAndExpnssAmt
Other Expenses Net Invst Incm$40,352OtherExpensesNetInvstIncmAmt
Other Expenses Dsbrs Chrtbl$42,412OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$900,817TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$461,788TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$419,985TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$5,052,658ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$4,604,441ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$5,953,475TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$461,788TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$5,024,426TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses-$1,234,517ExcessRevenueOverExpensesAmt
Net Investment Income$4,416,574NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Sav And Temp Cash Invst BOY$337,890SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$155,096SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$155,096SavAndTempCashInvstEOYFMVAmt
Acct Rcvbl$46,835AcctRcvblAmt
Acct Rcvbl BOY$31,648AcctRcvblBOYAmt
Acct Rcvbl EOY$46,835AcctRcvblEOYAmt
Acct Rcvbl EOYFMV$46,835AcctRcvblEOYFMVAmt
Pledges Rcvbl$396,770PledgesRcvblAmt
Pledges Rcvbl BOY$447,367PledgesRcvblBOYAmt
Pledges Rcvbl EOY$396,770PledgesRcvblEOYAmt
Pledges Rcvbl EOYFMV$396,770PledgesRcvblEOYFMVAmt
Prepaid Expenses BOY$6,417PrepaidExpensesBOYAmt
Prepaid Expenses EOY$26,500PrepaidExpensesEOYAmt
Prepaid Expenses EOYFMV$26,500PrepaidExpensesEOYFMVAmt
Other Investments BOY$102,569,934OtherInvestmentsBOYAmt
Other Investments EOY$99,208,896OtherInvestmentsEOYAmt
Other Investments EOYFMV$99,208,896OtherInvestmentsEOYFMVAmt
Land Bldg Equip Cost Or Other Bss$36,148LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$28,238LandBldgEquipAccumDeprecAmt
Land BOY$10,549LandBOYAmt
Land EOY$7,910LandEOYAmt
Land EOYFMV$7,910LandEOYFMVAmt
Other Assets BOY$16,994OtherAssetsBOYAmt
Other Assets EOY$0OtherAssetsEOYAmt
Other Assets EOYFMV$0OtherAssetsEOYFMVAmt
Total Assets BOY$103,420,799TotalAssetsBOYAmt
Total Assets EOY$99,842,007TotalAssetsEOYAmt
Total Assets EOYFMV$99,842,007TotalAssetsEOYFMVAmt
Accounts Payable BOY$130,098AccountsPayableBOYAmt
Accounts Payable EOY$138,361AccountsPayableEOYAmt
Grants Payable BOY$1,391,995GrantsPayableBOYAmt
Grants Payable EOY$1,840,212GrantsPayableEOYAmt
Other Liabilities BOY$113,598OtherLiabilitiesBOYAmt
Other Liabilities EOY$98,154OtherLiabilitiesEOYAmt
Total Liabilities BOY$1,635,691TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,076,727TotalLiabilitiesEOYAmt
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind
Unrestricted BOY$101,785,108UnrestrictedBOYAmt
Unrestricted EOY$97,765,280UnrestrictedEOYAmt
Tot Net Ast Or Fund Balances BOY$101,785,108TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$97,765,280TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$103,420,799TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$99,842,007TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$101,785,108TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses-$1,234,517ExcessRevenueOverExpensesAmt
Other Increases$46,570OtherIncreasesAmt
Subtotal$100,597,161SubtotalAmt
Other Decreases$2,831,881OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$97,765,280TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (2 entries)

PropertyPropertyDescGross Sales PriceGrossSalesPriceAmtCost Or Other BasisCostOrOtherBasisAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmt
PUBLICLY TRADED SECURITIES$17,708,825$17,722,837-$14,012-$14,012
SEI CORE PROPERTY FUND, LLC$15,546$15,546
FieldValueIRS element (for citing)
Capital Gain Net Income$1,534CapitalGainNetIncomeAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

FieldValueIRS element (for citing)
Liable Section4942 Tax0LiableSection4942TaxInd
Adjusted Qlfy Distri Yr1$4,672,707AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1$100,774,355NetVlNoncharitableAssetsYr1Amt
Distribution Yr10.046368DistributionYr1Rt
Adjusted Qlfy Distri Yr2$4,370,054AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2$95,756,146NetVlNoncharitableAssetsYr2Amt
Distribution Yr20.045637DistributionYr2Rt
Adjusted Qlfy Distri Yr3$3,863,779AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3$90,901,681NetVlNoncharitableAssetsYr3Amt
Distribution Yr30.042505DistributionYr3Rt
Adjusted Qlfy Distri Yr4$4,515,859AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4$92,210,303NetVlNoncharitableAssetsYr4Amt
Distribution Yr40.048973DistributionYr4Rt
Adjusted Qlfy Distri Yr5$99,713AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5$84,790,383NetVlNoncharitableAssetsYr5Amt
Distribution Yr50.001176DistributionYr5Rt
Total Distribution0.184659TotalDistributionRt
Average Distribution0.036932AverageDistributionRt
Net Vl Noncharitable Assets$100,254,131NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets$3,702,586AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct$44,166NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct$3,746,752AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions$5,024,426QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Domestic Org Meeting Sect4940eYes (X)DomesticOrgMeetingSect4940eInd
Investment Income Excise Tax$44,166InvestmentIncomeExciseTaxAmt
Tax Under Section511$0TaxUnderSection511Amt
Subtotal$44,166SubtotalAmt
Subtitle A Tax$0SubtitleATaxAmt
Tax Based On Investment Income$44,166TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$53,238EstimatedPlusOvpmtIncmTxAmt
Total Payments And Credits$53,238TotalPaymentsAndCreditsAmt
Overpayment$9,072OverpaymentAmt
Applied To ES Tax$9,072AppliedToESTaxAmt
Refund$0RefundAmt

Statements Regarding Acty StatementsRegardingActyGrp

FieldValueIRS element (for citing)
Legislative Political Acty0LegislativePoliticalActyInd
More Than100 Spent0MoreThan100SpentInd
Form1120 POL Filed0Form1120POLFiledInd
Section4955 Organization Tax$0Section4955OrganizationTaxAmt
Section4955 Managers Tax$0Section4955ManagersTaxAmt
Tax Reimbursed$0TaxReimbursedAmt
Activities Not Previously Rpt0ActivitiesNotPreviouslyRptInd
Changes To Articles Or Bylaws0ChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Organization Dissolved Etc0OrganizationDissolvedEtcInd
Section508e Rqr SatisfiedYes (1)Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (1)AtLeast5000InAssetsInd
Org Report Or Register StateVAOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (1)Form990PFFiledWithAttyGenInd
Private Operating Foundation0PrivateOperatingFoundationInd
New Substantial Contributors0NewSubstantialContributorsInd
Own Controlled Entity0OwnControlledEntityInd
Donor Advised Fund0DonorAdvisedFundInd
Comply With Public Insp RqrYes (1)ComplyWithPublicInspRqrInd
Website AddressWWW.POTOMACHEALTHFOUNDATION.ORGWebsiteAddressTxt
Individual With BooksSUSIE LEEIndividualWithBooksNm
Phone7035230620PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line12296 OPITZ BLVD STE 200AddressLine1Txt
CityWOODBRIDGECityNm
State AbbreviationVAStateAbbreviationCd
ZIP22191ZIPCd
FieldValueIRS element (for citing)
Foreign Accounts Question0ForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

FieldValueIRS element (for citing)
Sale Or Exch Disqualified Prsn0SaleOrExchDisqualifiedPrsnInd
Brrw Or Lend Disqualified Prsn0BrrwOrLendDisqualifiedPrsnInd
Furn Goods Disqualified Prsn0FurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified Prsn0PayCompDisqualifiedPrsnInd
Transfer Ast Disqualified Prsn0TransferAstDisqualifiedPrsnInd
Payment To Government Official0PaymentToGovernmentOfficialInd
Uncorrected Prior Acts0UncorrectedPriorActsInd
Undistributed Income PY0UndistributedIncomePYInd
Business Holdings0BusinessHoldingsInd
Jeopardy Investments0JeopardyInvestmentsInd
Uncorrected PY Jeopardy Invst0UncorrectedPYJeopardyInvstInd
Influence Legislation0InfluenceLegislationInd
Influence Election0InfluenceElectionInd
Grants To Individuals0GrantsToIndividualsInd
Grants To Organizations0GrantsToOrganizationsInd
Noncharitable Purpose0NoncharitablePurposeInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (13 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
SUSIE LEE
2296 OPITZ BLVD 200WOODBRIDGEVA22191EXECUTIVE DIRECTOR40.00$134,172$28,176$1,000
CAROL S SHAPIRO MD
2296 OPITZ BLVD 200WOODBRIDGEVA22191VICE-CHAIR4.00$0$0$0
R MICHAEL SORENSEN
2296 OPITZ BLVD 200WOODBRIDGEVA22191TREASURER3.00$0$0$0
WAYNE MALLARD
2296 OPITZ BLVD 200WOODBRIDGEVA22191SECRETARY2.00$0$0$0
MARION M WALL
2296 OPITZ BLVD 200WOODBRIDGEVA22191CHAIR4.00$0$0$0
HOWARD L GREENHOUSE
2296 OPITZ BLVD 200WOODBRIDGEVA22191DIRECTOR1.00$0$0$0
DONNIE HYLTON
2296 OPITZ BLVD 200WOODBRIDGEVA22191DIRECTOR1.00$0$0$0
DEBORAH JOHNSON
2296 OPITZ BLVD 200WOODBRIDGEVA22191DIRECTOR1.00$0$0$0
SARAH PITKIN PHD
2296 OPITZ BLVD 200WOODBRIDGEVA22191DIRECTOR1.00$0$0$0
WILLIAM M MOSS
2296 OPITZ BLVD 200WOODBRIDGEVA22191DIRECTOR1.00$0$0$0
CARLOS CASTRO
2296 OPITZ BLVD 200WOODBRIDGEVA22191DIRECTOR1.00$0$0$0
SAM HILL EDD
2296 OPITZ BLVD 200WOODBRIDGEVA22191DIRECTOR1.00$0$0$0
MEGAN PERRY
2296 OPITZ BLVD 200WOODBRIDGEVA22191DIRECTOR1.00$0$0$0

Compensation Highest Paid Empl CompensationHighestPaidEmplGrp

FieldValueIRS element (for citing)
PersonTIMOTHY MCCUEPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12296 OPITZ BLVD SUITE 200AddressLine1Txt
CityWOODBRIDGECityNm
State AbbreviationVAStateAbbreviationCd
ZIP22191ZIPCd
FieldValueIRS element (for citing)
TitleDIRECTOR OF GRANTS PTitleTxt
Average Hrs Per Wk Devoted To Pos40.00AverageHrsPerWkDevotedToPosRt
Compensation$52,404CompensationAmt
Employee Benefits$11,756EmployeeBenefitsAmt
Expense Account$0ExpenseAccountAmt
FieldValueIRS element (for citing)
Other Employee Paid Over50k0OtherEmployeePaidOver50kCnt

Compensation Of Hghst Pd Cntrct CompensationOfHghstPdCntrctGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SEI GLOBAL INSTITUTIONAL GROUPBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 FREEDOM VALLEY DRIVEAddressLine1Txt
CityOAKSCityNm
State AbbreviationPAStateAbbreviationCd
ZIP19456ZIPCd
FieldValueIRS element (for citing)
Service TypeINVESTMENT MANAGEMENTServiceTypeTxt
Compensation$397,084CompensationAmt
FieldValueIRS element (for citing)
Contractor Paid Over50k0ContractorPaidOver50kCnt

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$101,485,462AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$295,382AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$101,780,844TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$101,780,844AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$1,526,713CashDeemedCharitableAmt
Net Vl Noncharitable Assets$100,254,131NetVlNoncharitableAssetsAmt
Minimum Investment Return$5,012,707MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$5,012,707MinimumInvestmentReturnAmt
Tax Based On Investment Income$44,166TaxBasedOnInvestmentIncomeAmt
Total Tax$44,166TotalTaxAmt
Distributable Before Adj$4,968,541DistributableBeforeAdjAmt
Recoveries Qualfied Distri$105,336RecoveriesQualfiedDistriAmt
Distributable Before Ded$5,073,877DistributableBeforeDedAmt
Deduction From Distributable$0DeductionFromDistributableAmt
Distributable As Adjusted$5,073,877DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$5,024,426ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Qualifying Distributions$5,024,426QualifyingDistributionsAmt
Pct Sect4940e Org Net Invst Incm$44,166PctSect4940eOrgNetInvstIncmAmt
Adjusted Qualifying Distri$4,980,260AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$5,073,877DistributableAsAdjustedAmt
Undistributed Income PY$4,859,761UndistributedIncomePYAmt
Total For Prior Years$0TotalForPriorYearsAmt
Total Excess Distribution Cyov$0TotalExcessDistributionCyovAmt
Qualifying Distributions$5,024,426QualifyingDistributionsAmt
Applied To Year1$4,859,761AppliedToYear1Amt
Applied To Prior Years$0AppliedToPriorYearsAmt
Treated As Distri From Corpus$0TreatedAsDistriFromCorpusAmt
Applied To Current Year$164,665AppliedToCurrentYearAmt
Remaining Distri From Corpus$0RemainingDistriFromCorpusAmt
Excess Distri Cyov App CY Corpus$0ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY$0ExcessDistributionCyovAppCYAmt
Total Corpus$0TotalCorpusAmt
Prior Year Undistributed Incm$0PriorYearUndistributedIncmAmt
Prior Year Deficiency Or Tax$0PriorYearDeficiencyOrTaxAmt
Taxable1$0Taxable1Amt
Taxable2$0Taxable2Amt
Undistributed Income CY$4,909,212UndistributedIncomeCYAmt
Corpus Distri170b1 E Or4942g3$0CorpusDistri170b1EOr4942g3Amt
Excess Distri Cyov From Yr5$0ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$0ExcessDistriCyovToNextYrAmt

Supplementary Information SupplementaryInformationGrp

Application Submission Info ApplicationSubmissionInfoGrp

FieldValueIRS element (for citing)
Recipient PersonTIMOTHY MCCUERecipientPersonNm

Recipient US Address RecipientUSAddress

FieldValueIRS element (for citing)
Address Line12296 OPITZ BLVD STE 200AddressLine1Txt
CityWOODBRIDGECityNm
State AbbreviationVAStateAbbreviationCd
ZIP22191ZIPCd
FieldValueIRS element (for citing)
Recipient Phone7035230630RecipientPhoneNum
Recipient Email AddressTIMOTHY@POTOMACHEALTHFOUNDATION.ORGRecipientEmailAddressTxt
Form And Info And MaterialsLETTER OF INTENT TO INCLUDE NARRATIVE AND BUDGET PLAN, COMPLETED AND SUBMITTED ONLINE.FormAndInfoAndMaterialsTxt
Submission DeadlinesJANUARY 24, 2015SubmissionDeadlinesTxt
Restrictions On AwardsTHE FOUNDATION AWARDS GRANTS TO TAX-EXEMPT ORGANIZATIONS THAT SERVE PERSONS IN EASTERN PRINCE WILLIAM COUNTY, NORTH STAFFORD COUNTY, AND LORTON, ALL OF VIRGINIA. PROJECTS MUST BE HEALTH RELATED, PROMOTING ACCESS TO CARE, PREVENTION, AND INNOVATION. PROJECTS ARE FUNDED FOR PERIOD OF 12-MONTHS. THE FOUNDATION DOES NOT FUND SPONSORSHIPS, INCLUDING FUNDRAISING EVENTS; ENDOWMENTS; LOBBYING; DIRECT SUPPORT TO INDIVIDUALS; PROGRAMS OF RELIGIOUS, FRATERNAL, ATHLETIC, OR VETERANS GROUPS WHEN THE PRIMARY BENEFICIARIES OF SUCH UNDERTAKINGS WOULD BE THEIR MEMBERS EXCLUSIVELY; GRANTS TO RETIRE ANY FORM OF DEBT; SCIENTIFIC RESEARCH GRANTS; AND INDIRECT COST PERCENTAGES. FOR DETAILS ON HOW TO APPLY, COMMUNITIES SERVED, FUNDING PRIORITIES AND OTHER FAQ, GO TO THE FOUNDATION WEBSITE WWW.POTOMACHEALTHFOUNDATION.ORGRestrictionsOnAwardsTxt

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (97 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmtAddress Line2RecipientUSAddress/AddressLine2Txt
ACTION IN COMMUNITY THROUGH SERVICE
3900 ACTS LANEDUMFRIESVA22026NONEPC15 MAP CAPACITY BUILDING AND ACCOUNTING SOFTWARE$22,500
ACTION IN COMMUNITY THROUGH SERVICE
3900 ACTS LANEDUMFRIESVA22026NONEPC14 MAP HELPLINE ASSISTANCE AND OUTREACH PROJECT & MEDICAL CAREGIVER PRGM$4,000
ACTION IN COMMUNITY THROUGH SERVICE
3900 ACTS LANEDUMFRIESVA22026NONEPCYEAR 3 HELPLINE ASSISTANCE AND OUTREACH PROJECT$13,265
ACTION IN COMMUNITY THROUGH SERVICE
3900 ACTS LANEDUMFRIESVA22026NONEPCYEAR 3 MEDICAL CAREGIVERS TRAINING PROGRAM$13,870
AMERICAN HEART ASSOCIATION
4301 FAIRFAX DRIVE SUITE 530ARLINGTONVA22203NONEPCYR1 CPR ANYTIME$20,160
AMERICAN HEART ASSOCIATION
4301 FAIRFAX DRIVE SUITE 530ARLINGTONVA22203NONEPCYR 2 CPR ANYTIME$55,737
ASPIRA ASSOCIATION INC
1444 I STREET NW SUITE 800WASHINGTONDC20005NONEPCYR1 PROMOTING HEALTH AND WELLNESS BY EMPOWERING LATINO YOUTH AND COMMUNITY$36,137
ASPIRA ASSOCIATION INC
1444 I STREET NW SUITE 800WASHINGTONDC20005NONEPCYR 2PROMOTING HEALTH AND WELLNESS BY EMPOWERING LATINO YOUTH AND COMMUNITY$54,204
BRAIN INJURY SERVICES
8136 OLD KEENE MILL ROADSPRINGFIELDVA22152NONEPCYEAR 3 NEUROBEHAVIORAL TREATMENT FOR BRAIN INJURY IN EASTERN PRINCE WILLIAM COUNTY$8,949
BRAIN INJURY SERVICES
8136 OLD KEENE MILL ROADSPRINGFIELDVA22152NONEPCMAP NEUROBEHAVIORAL TREATMENT FOR BRAIN INJURY$12,780
BRAIN INJURY SERVICES
8136 OLD KEENE MILL ROADSPRINGFIELDVA22152NONEPCCREST: COLLABORATIVE REHABILITATION TO ENHANCE STROKE TREATMENT$101,316
CHANGE IN ACTION INC
128884 HARBOR DRIVE SUITE 203WOODBRIDGEVA22192NONEPCBEHAVIORAL MANAGEMENT FOR TRAUMATIC EXPOSURE$111,952
CHANGEINACTIONINC
128884 HARBOR DRIVE SUITE 203WOODBRIDGEVA22192NONEPCYR3 BEHAVIORAL MANAGEMENT FOR HEALTHY RELATIONSHIPS$72,725
CHANGEINACTIONINC
128884 HARBOR DRIVE SUITE 204WOODBRIDGEVA22193NONEPC15 MAP$16,542
EMPLOYMENT SOLUTIONS FOR DEAF AND HARD OF HEARING
1984 OPTIZ BLVDWOODBRIDGEVA22191NONEPCYEAR 3 PAH$4,348
EMPLOYMENT SOLUTIONS FOR DEAF AND HARD OF HEARING
1984 OPTIZ BLVDWOODBRIDGEVA22191NONEPCMAP PAH$1,366
EMPOWERHOUSE
PO BOX 1007FREDRICKSBURGVA22402NONEPCINTERPERSONAL VIOLENCE HEALTHCARE PARTNERSHIP PROGRAM$45,602
GEORGE MASON UNIVERSITY
10900 UNIVERSITY BLVD MS 4E5MANASSASVA20110NONEPCYEAR 3 ACHIEVES$114,431
GEORGE MASON UNIVERSITY
10900 UNIVERSITY BLVD MS 4E5MANASSASVA20110NONEPCMIDDLE SCHOOL ACHIEVES$150,000
GEORGE MASON UNIVERSITY
10901 UNIVERSITY BLVD MS 4E5MANASSASVA20111NONEPCPOISED (PRECISION OUTREACH INTERVENTION , SCREENING SURVEILLANCE & EXERCISE FOR FALLS PREVENTION/ PRINCE WILLIAM$148,800
GEORGE WASHINGTON REGIONAL COMMISSIONTHE FARMER'S MARKET
406 PRINCESS ANNE STFREDRICKSBURGVA22402NONEPCFRESH FOOD ACCESS FOR COMMUNITY HEALTH$31,116
GANG RESPONSE INTERVENTION TEAM
4379 RIDGEWOOD CENTER DRIVE SUITEWOODBRIDGEVA22192NONEPCMAC TATTOO REMOVAL PROGRAM (GRIT)$9,689102
GREATER PRINCE WILLIAM COMMUNITY HEALTH CENTER
4379 RIDGEWOOD CENTER DRIVE SUITEWOODBRIDGEVA22192NONEPCYR3 EXPANDING ACCESS TO DENTAL SERVICES IN PRINCE WILLIAM COUNTY$28,204102
GREATER PW COMMUNITY HEALTH CENTER
4379 RIDGEWOOD CENTER DRIVE SUITEWOODBRIDGEVA22192NONEPC15 MAP$15,000102
GREATER PW COMMUNITY HEALTH CENTER
4379 RIDGEWOOD CENTER DRIVE SUITEWOODBRIDGEVA22192NONEPC14 HSN INTEGRATED & COORDINATED HEALTH CARE AHOME$15,000102
GREATER PW COMMUNITY HEALTH CENTER
4379 RIDGEWOOD CENTER DRIVE SUITEWOODBRIDGEVA22192NONEPC15 HSN - INTEGRATED AND COORDINATED HEALTH CARE HOME$135,000102
LLOYD F MOSS FREE CLINIC
1301 SAM PERRY BLVDFREDERICKSBURGVA22401NONEPC15 MAP$22,464
LLOYD F MOSS FREE CLINIC
1301 SAM PERRY BLVDFREDERICKSBURGVA22401NONEPC15 HSN - GENERAL OPERATING FUNDS$135,864
LLOYD F MOSS FREE CLINIC
1301 SAM PERRY BLVDFREDERICKSBURGVA22401NONEPC14 HSN GEN OPERATING FUNDS$15,000
MANASSAS MIDWIFERY
9171 KEY COMMONS COURTMANASSASVA20110NONEPC14 HSN IMPROVING BIRTH & EARLY CHILDHOOD OUTCOMES$2,500
MEDICAL CARE FOR CHILDREN PARTNERSHIP FOUNDATION
1616 ANDERSON ROADMCLEANVA22102NONEPCYR2 MCCP FOUNDATION PROJECT PEARLY WHITES - LORTON$16,803
MEDICAL CARE FOR CHILDREN PARTNERSHIP FOUNDATION
1616 ANDERSON ROADMCLEANVA22102NONEPCYR3 MEDICAL CARE FOR CHILDREN PARTNERSHIP FOUNDATION$18,863
MEDICAL CARE FOR CHILDREN PARTNERSHIP FOUNDATION
1616 ANDERSON ROADMCLEANVA22102NONEPCYR 3 MCCP FOUNDATION PROJECT PEARLY WHITES - LORTON$24,435
NATIONAL CAPITAL POISON CENTER
3201 NEW MEXICO AVENUE SUITE 310WASHINGTONDC20016NONEPCWEB POISON CONTROL$150,000
NATIONAL CAPITAL POISON CENTER
3201 NEW MEXICO AVENUE SUITE 310WASHINGTONDC20016NONEPC15 HSN POISON CTRL SVCS TO THE FDN'S SVC AREA$148,500
NATIONAL CAPITAL POISON CENTER
3201 NEW MEXICO AVENUE SUITE 310WASHINGTONDC20016NONEPC14 HSN POISON CTRL SVCS TO THE FDN'S SVC AREA$16,500
NAT'L COALITION OF 100 BLACK WOMEN - PWC CHAPTER
PO BOX 1166DUMFRIESVA22026NONEPCINCREASE AWARENESS ON PREVENTION, EARLY DETECTION, TREATMENT PROSTATE CANCER$58,800
NORTHERN VIRGINIA FAMILY SERVICE
10455 WHITE GRANITE DRIVE SUITE 100OAKTONVA22124NONEPCPEDIATRIC PRIMARY CARE PROJECT$3,500
NORTHERN VIRGINIA FAMILY SERVICE
10455 WHITE GRANITE DRIVE SUITE 100OAKTONVA22124NONEPCYR1 PRINCE WILLIAM HEALTHLINK$27,931
NORTHERN VIRGINIA FAMILY SERVICE
10455 WHITE GRANITE DRIVE SUITE 100OAKTONVA22124NONEPC15 HSN KIDS CONNECT$31,500
NORTHERN VIRGINIA FAMILY SERVICE
10455 WHITE GRANITE DRIVE SUITE 100OAKTONVA22124NONEPCIMPROVING NUTRITION FOR LOW-INCOME FAMILIES$109,800
NORTHERN VIRGINIA FAMILY SERVICE
10455 WHITE GRANITE DRIVE SUITE 100OAKTONVA22124NONEPCPRINCE WILLIAM HEALTHLINK$41,896
NOVA SCRIPTSCENTRAL INC
6400 ARLINGTON BLVD SUITE 120FALLS CHURCHVA22042NONEPC15 MAP$4,200
NOVA SCRIPTSCENTRAL INC
6400 ARLINGTON BLVD SUITE 120FALLS CHURCHVA22042NONEPC15 HSN - IMPROVING HLTH ACCESS IN PW, STAFFORD & LORTON$199,269
NOVA SCRIPTSCENTRAL INC
6400 ARLINGTON BLVD SUITE 120FALLS CHURCHVA22042NONEPC14 HSN - RX MEDICATIONS FOR LOW INCOME$20,000
NUEVA VIDA INC
5225 WISCONSIN AVE NW SUITE 503WASHINGTONDC20015NONEPCYR2 REDUCING FRAGMENTATION AND IMPROVING CONTINUITY OF CARE ACROSS THE BREAST CANCER CONTINUUM$36,430
NUEVA VIDA INC
5225 WISCONSIN AVE NW SUITE 503WASHINGTONDC20015NONEPCYR3 REDUCING FRAGMENTATION AND IMPROVING CONTINUITY OF CARE ACROSS THE BREAST CANCER CONTINUUM$56,831
PATHWAY HOMES
10201 FAIRFAX BLVDFAIRFAXVA22030NONEPCPERMANENT SUPORTIVE HOUSING FOR FORMERLY HOMELESS W/SERIOUS MENTAL ILLNESS$36,000
POTOMAC AND RAPPAHANNOCK TRANSPORTATION COMMISSION
14700 POTOMAC MILLS ROADWOODBRIDGEVA22192NONEPCYR3 TRANSPORTATION VOUCHER PROGRAM TO FACILITATE ACCESS TO HEALTH CARE NEEDS$157,635
PRINCE WILLIAM AREA FREE CLINIC
13900 CHURCH HILL DRIVEWOODBRIDGEVA22191NONEPC15 HSN UNIFIED HLTH CENTER$163,438
PRINCE WILLIAM AREA FREE CLINIC
13900 CHURCH HILL DRIVEWOODBRIDGEVA22191NONEPCYR 3 MEDICATION ACCESS CASE MANAGEMENT$8,639
PRINCE WILLIAM AREA FREE CLINIC
13900 CHURCH HILL DRIVEWOODBRIDGEVA22191NONEPCPRINCE WILLIAM AREA FREE CLINIC NAVIGATION$28,354
PRINCE WILLIAM AREA FREE CLINIC
13901 CHURCH HILL DRIVEWOODBRIDGEVA22192NONEPC14 HSN UNIFIED HEALTH CENTER$13,492
PRINCE WILLIAM COUNTY DEPT OF SOCIAL SERVICES
15941 DONALD CURTIS DRIVE SUITE 180WOODBRIDGEVA22191NONEPCYR3 CASE COORDINATOR FOR HEALTH AND SUPPORTING SERVICES: ACCESS FOR THE MOST VULNERABLE HOMELESS ADULTS$11,996
PRINCE WILLIAM COUNTY PUBLIC SCHOOLS
14715 BRISTOW ROADMANASSASVA20112NONEPCBIOMEDICAL SCIENCE/PROJECT LEAD THE WAY$34,560
PRINCE WILLIAM COUNTY PUBLIC SCHOOLS
14715 BRISTOW ROADMANASSASVA20112NONEPCYR1 COORDINATED MENTAL HEALTH SUPPORT FOR AT-RISK YOUTH$33,385
PRINCE WILLIAM COUNTY PUBLIC SCHOOLS
14715 BRISTOW ROADMANASSASVA20112NONEPCYR2 HUMAN TRAFFICKING PREVENTION, IDENTIFICATION, AND REFERRAL$37,217
PRINCE WILLIAM COUNTY PUBLIC SCHOOLS
14715 BRISTOW ROADMANASSASVA20112NONEPCYR3 PRINCE WILLIAM COUNTY SCHOOL OF PRACTICAL NURSING$12,600
PRINCE WILLIAM COUNTY PUBLIC SCHOOLS
14715 BRISTOW ROADMANASSASVA20112NONEPCYR3 HUMAN TRAFFICKING PREVENTION, IDENTIFICATION, AND REFERRAL$41,096
PRINCE WILLIAM COUNTY PUBLIC SCHOOLS
14716 BRISTOW ROADMANASSASVA20113NONEPCYR2 COORDINATED MENTAL HEALTH SUPPORT FOR AT-RISK YOUTH$48,291
PRINCE WILLIAM HEALTH DISTRICT
9301 LEE AVENUEMANASSASVA20110NONEPCYR3 BEAT CANCER BREAST EDUCATION AWARENESS & TREATMENT$37,075
PRINCE WILLIAM HEALTH DISTRICT
9301 LEE AVENUEMANASSASVA20110NONEPCYR2 BEAT CANCER BREAST EDUCATION AWARENESS & TREATMENT$24,171
PRINCE WILLIAM SOCCER INC
14716 MINNIEVILLE RDWOODBRIDGEVA22193NONEPCYR1 THE COURAGE F.U.N. PROJECT$10,311
PRINCE WILLIAM SOCCER INC
14717 MINNIEVILLE RDWOODBRIDGEVA22194NONEPCYR2 THE COURAGE F.U.N. PROJECT$41,313
PROJECT MEND-A-HOUSE INC
9500 TECHNOLOGY DRIVE SUITE 101MANASSASVA20110NONEPCYR3 PREVENTING FALLS FOR SENIORS AND PERSONS WITH DISABILITIES$25,500
PROJECT MEND-A-HOUSE INC
9501 TECHNOLOGY DRIVE SUITE 101MANASSASVA20111NONEPCYR2 PREVENTING FALLS FOR SENIORS AND PERSONS WITH DISABILITIES$8,500
PROJECT MEND-A-HOUSE INC
9502 TECHNOLOGY DRIVE SUITE 101MANASSASVA20112NONEPCMAP - BOARD AND EXECUTIVE LEADERSHIP STRENGTHENING$20,700
RAINBOW CENTER
5605 ANTIOCH RDHAYMARKETVA20169NONEPCYR 3 THE MANE EXPERIENCE$7,061
RAPPAHANNOCK AREA AGENCY ON AGING
460 LENDALL LANEFREDERICKSBURGVA22405NONEPCYR2 THE RAAA AQUIA GARRISONVILLE HEATHCARE PROJECT$19,500
RAPPAHANNOCK AREA AGENCY ON AGING
460 LENDALL LANEFREDERICKSBURGVA22405NONEPCYR3 THE RAAA AQUIA GARRISONVILLE HEALTHCARE PROJECT$13,654
RX PARTNERSHIP
2924 EMERYWOOD PARKWAY SUITE 300RICHMONDVA23294NONEPC15 HSN MEDICATION ACCESS FOR THE UNINSURED$22,500
RX PARTNERSHIP
2924 EMERYWOOD PARKWAY SUITE 300RICHMONDVA23294NONEPC15 MAP - STRATEGIC PLANNING$15,075
RX PARTNERSHIP
2924 EMERYWOOD PARKWAY SUITE 300RICHMONDVA23294NONEPC14 HSN MEDICATION ACCESS FOR THE UNINSURED$2,500
SCAN OF NORTHERN VIRGINIA
205 S WHITING STREET SUITE 205ALEXANDRIAVA22304NONEPCSAFE BABIES AND CHILD ABUSE PREVENTION$15,000
SENTARA NORTHERN VIRGINIA MEDICAL CENTER
2300 OPITZ BLVDWOODBRIDGEVA22191NONEPCYEAR 3 EVERY BABY, EVERY TIME!$12,239
SENTARA NORTHERN VIRGINIA MEDICAL CENTER
2300 OPITZ BLVDWOODBRIDGEVA22191NONEPC15 HSN FAMILY HEALTH CONNECTION MOBILE VANS$150,000
SENTARA NORTHERN VIRGINIA MEDICAL CENTER
2300 OPITZ BLVDWOODBRIDGEVA22191NONEPCYR3 FAMILY HEALTH CONNECTION OUTREACH WORKER$10,147
SENTARA NORTHERN VIRGINIA MEDICAL CENTER
2300 OPITZ BLVDWOODBRIDGEVA22191NONEPCYR3 HISPANIC DIABETES OUTREACH PROGRAM$18,194
SENTARA NORTHERN VIRGINIA MEDICAL CENTER
2300 OPITZ BLVDWOODBRIDGEVA22191NONEPCYR3 SENTARA POTOMAC WOMEN'S HEALTH MAMMOVAN$90,778
SENTARA NORTHERN VIRGINIA MEDICAL CENTER
2300 OPITZ BLVDWOODBRIDGEVA22191NONEPCDIABETES PREVENTION PROGRAM$27,851
SENTARA NORTHERN VIRGINIA MEDICAL CENTER
2300 OPITZ BLVDWOODBRIDGEVA22191NONEPCIN PERSON INTERPRETING SERVICES$120,780
STAFFORD SCHOOLS HEAD STARTVPIEARLY HEAD START
610 GAYLE STREETFALMOUTHVA22405NONEPCSTAFFORD CHILDREN'S INSURANCE OUTREACH PROGRAM$11,594
STREET LIGHT COMMUNITY OUTREACH MINISTRIES
1550 PRINCE WILLIAM PKWY SUITE BWOODBRIDGEVA22191NONEPCPERMANENT SUPPORTED HOUSING & RESPITE CARE FOR MEDICALLY FRAGILE HOMELESS ADULTS$29,994
STREET LIGHT COMMUNITY OUTREACH MINISTRIES
1551 PRINCE WILLIAM PKWY SUITE BWOODBRIDGEVA22192NONEPC15 MAP - FINANCIAL SUSTAINABILITY CAPACITY BUILDING$22,500
STREET LIGHT COMMUNITY OUTREACH MINISTRIES
1552 PRINCE WILLIAM PKWY SUITE BWOODBRIDGEVA22193NONEPCYR2 PERMANENT SUPPORTED HOUSING & RESPITE CARE FOR MEDICALLY FRAGILE HOMELESS ADULTS$22,854
THE ARC OF GREATER PRINCE WILLIAMINSIGHT INC
13505 HILLENDALE DRIVEDALE CITYVA22193NONEPCYR1 MEDICAL CASE MANAGEMENT$27,200
THE ARC OF GREATER PRINCE WILLIAMINSIGHT INC
13505 HILLENDALE DRIVEDALE CITYVA22194NONEPCYR2 MEDICAL CASE MANAGEMENT$40,800
THE ARC OF GREATER PRINCE WILLIAMINSIGHT INC
13505 HILLENDALE DRIVEDALE CITYVA22195NONEPCCOMPLETION OF THERAPEUTIC SERVICES$66,360
THE ARC OF GREATER PRINCE WILLIAMINSIGHT INC
13505 HILLENDALE DRIVEDALE CITYVA22196NONEPCVOSAC III DAY SUPPORT FOR THE MEDICALLY FRAGILE$150,000
THE CITY OF MANASSAS PARK
1 PARK CENTER COURTMANASSASVA20111NONEPCMASON AND PARTNERS BRIDGE CLINIC$150,000
THE HOUSE INC STUDENT LEADERSHIP CENTER
14001 CROWN COURTWOODBRIDGEVA22193NONEPCYEAR 3 FITTING IN$10,500
THE HOUSE INC STUDENT LEADERSHIP CENTER
14001 CROWN COURTWOODBRIDGEVA22193NONEPCMAP FITTING IN$1,200
THE HOUSE INC STUDENT LEADERSHIP CENTER
14001 CROWN COURTWOODBRIDGEVA22193NONEPCYR3 THE HOUSE, INC.'S EMPOWERMENT CENTER$63,600
THE HOUSE INC STUDENT LEADERSHIP CENTER
14001 CROWN COURTWOODBRIDGEVA22193NONEPCPROJECT PLAY$132,000
YOUNG INVINCIBLES
1411 K ST NWWASHINGTONDC20005NONEPCHEALTHY YOUNG AMERICA$70,000
YOUTH FOR TOMORROW
11834 HAZEL CIRCLE DRIVEBRISTOWVA22135NONEPCYEAR 3 YOUTH FOR TOMORROW CRISIS INTERVENTION COUNSELING PROGRAM$17,260
YOUTH FOR TOMORROW
11835 HAZEL CIRCLE DRIVEBRISTOWVA22136NONEPCYEAR 3 YFT DIAGNOSTIC AND ASSESSMENT CENTER$85,249
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$4,604,442TotalGrantOrContriPdDurYrAmt

Grant Or Contri Apprv For Fut GrantOrContriApprvForFutGrp (54 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmtAddress Line2RecipientUSAddress/AddressLine2Txt
ACTION IN COMMUNITY THROUGH SERVICE
3900 ACTS LANEDUMFRIESVA22026NONEPC15 MAP CAPACITY BUILDING AND ACCOUNTING SOFTWARE$2,500
AMERICAN HEART ASSOCIATION
4301 FAIRFAX DRIVE SUITE 530ARLINGTONVA22203NONEPCYR 2 CPR ANYTIME$37,158
ASPIRA ASSOCIATION INC
1444 I STREET NW SUITE 800WASHINGTONDC20005NONEPCYR 2PROMOTING HEALTH AND WELLNESS BY EMPOWERING LATINO YOUTH AND COMMUNITY$36,138
BRAIN INJURY SERVICES
8136 OLD KEENE MILL ROADSPRINGFIELDVA22152NONEPCCREST: COLLABORATIVE REHABILITATION TO ENHANCE STROKE TREATMENT$67,544
CHANGE IN ACTION INC
128884 HARBOR DRIVE SUITE 203WOODBRIDGEVA22192NONEPCBEHAVIORAL MANAGEMENT FOR TRAUMATIC EXPOSURE$74,634
CHANGEINACTIONINC
128884 HARBOR DRIVE SUITE 204WOODBRIDGEVA22193NONEPC15 MAP$1,838
EMPOWERHOUSE
PO BOX 1007FREDRICKSBURGVA22402NONEPCINTERPERSONAL VIOLENCE HEALTHCARE PARTNERSHIP PROGRAM$30,402
GEORGE MASON UNIVERSITY
10900 UNIVERSITY BLVD MS 4E5MANASSASVA20110NONEPCMIDDLE SCHOOL ACHIEVES$100,000
GEORGE MASON UNIVERSITY
10901 UNIVERSITY BLVD MS 4E5MANASSASVA20111NONEPCPOISED (PRECISION OUTREACH INTERVENTION , SCREENING SURVEILLANCE & EXERCISE FOR FALLS PREVENTION/ PRINCE WILLIAM$99,200
GEORGE WASHINGTON REGIONAL COMMISSIONTHE FARMER'S MARKET
406 PRINCESS ANNE STFREDRICKSBURGVA22402NONEPCFRESH FOOD ACCESS FOR COMMUNITY HEALTH$20,744
GANG RESPONSE INTERVENTION TEAM
4379 RIDGEWOOD CENTER DRIVE SUITEWOODBRIDGEVA22192NONEPCMAC TATTOO REMOVAL PROGRAM (GRIT)$6,459102
GREATER PW COMMUNITY HEALTH CENTER
4379 RIDGEWOOD CENTER DRIVE SUITEWOODBRIDGEVA22192NONEPC14 HSN INTEGRATED & COORDINATED HEALTH CARE AHOME$25,000102
LLOYD F MOSS FREE CLINIC
1301 SAM PERRY BLVDFREDERICKSBURGVA22401NONEPC15 MAP$2,496
LLOYD F MOSS FREE CLINIC
1301 SAM PERRY BLVDFREDERICKSBURGVA22401NONEPC15 HSN - GENERAL OPERATING FUNDS$15,096
MEDICAL CARE FOR CHILDREN PARTNERSHIP FOUNDATION
1616 ANDERSON ROADMCLEANVA22102NONEPCYR 3 MCCP FOUNDATION PROJECT PEARLY WHITES - LORTON$16,290
NATIONAL CAPITAL POISON CENTER
3201 NEW MEXICO AVENUE SUITE 310WASHINGTONDC20016NONEPCWEB POISON CONTROL$100,000
NATIONAL CAPITAL POISON CENTER
3201 NEW MEXICO AVENUE SUITE 310WASHINGTONDC20016NONEPC14 HSN POISON CTRL SVCS TO THE FDN'S SVC AREA$16,500
NAT'L COALITION OF 100 BLACK WOMEN - PWC CHAPTER
PO BOX 1166DUMFRIESVA22026NONEPCINCREASE AWARENESS ON PREVENTION, EARLY DETECTION, TREATMENT PROSTATE CANCER$39,200
NORTHERN VIRGINIA FAMILY SERVICE
10455 WHITE GRANITE DRIVE SUITE 100OAKTONVA22124NONEPC15 HSN KIDS CONNECT$3,500
NORTHERN VIRGINIA FAMILY SERVICE
10455 WHITE GRANITE DRIVE SUITE 100OAKTONVA22124NONEPCIMPROVING NUTRITION FOR LOW-INCOME FAMILIES$73,200
NORTHERN VIRGINIA FAMILY SERVICE
10455 WHITE GRANITE DRIVE SUITE 100OAKTONVA22124NONEPCPRINCE WILLIAM HEALTHLINK$27,931
NOVA SCRIPTSCENTRAL INC
6400 ARLINGTON BLVD SUITE 120FALLS CHURCHVA22042NONEPC15 MAP$2,800
NOVA SCRIPTSCENTRAL INC
6400 ARLINGTON BLVD SUITE 120FALLS CHURCHVA22042NONEPC15 HSN - IMPROVING HLTH ACCESS IN PW, STAFFORD & LORTON$22,141
NUEVA VIDA INC
5225 WISCONSIN AVE NW SUITE 503WASHINGTONDC20015NONEPCYR3 REDUCING FRAGMENTATION AND IMPROVING CONTINUITY OF CARE ACROSS THE BREAST CANCER CONTINUUM$37,888
PATHWAY HOMES
10201 FAIRFAX BLVDFAIRFAXVA22030NONEPCPERMANENT SUPORTIVE HOUSING FOR FORMERLY HOMELESS W/SERIOUS MENTAL ILLNESS$24,000
PRINCE WILLIAM AREA FREE CLINIC
13900 CHURCH HILL DRIVEWOODBRIDGEVA22191NONEPC15 HSN UNIFIED HLTH CENTER$18,160
PRINCE WILLIAM AREA FREE CLINIC
13900 CHURCH HILL DRIVEWOODBRIDGEVA22191NONEPCPRINCE WILLIAM AREA FREE CLINIC NAVIGATION$18,903
PRINCE WILLIAM COUNTY PUBLIC SCHOOLS
14715 BRISTOW ROADMANASSASVA20112NONEPCBIOMEDICAL SCIENCE/PROJECT LEAD THE WAY$23,040
PRINCE WILLIAM COUNTY PUBLIC SCHOOLS
14715 BRISTOW ROADMANASSASVA20112NONEPCYR2 HUMAN TRAFFICKING PREVENTION, IDENTIFICATION, AND REFERRAL$1,520
PRINCE WILLIAM COUNTY PUBLIC SCHOOLS
14715 BRISTOW ROADMANASSASVA20112NONEPCYR3 HUMAN TRAFFICKING PREVENTION, IDENTIFICATION, AND REFERRAL$29,888
PRINCE WILLIAM COUNTY PUBLIC SCHOOLS
14716 BRISTOW ROADMANASSASVA20113NONEPCYR2 COORDINATED MENTAL HEALTH SUPPORT FOR AT-RISK YOUTH$35,603
PRINCE WILLIAM HEALTH DISTRICT
9301 LEE AVENUEMANASSASVA20110NONEPCYR3 BEAT CANCER BREAST EDUCATION AWARENESS & TREATMENT$24,717
PRINCE WILLIAM SOCCER INC
14717 MINNIEVILLE RDWOODBRIDGEVA22194NONEPCYR2 THE COURAGE F.U.N. PROJECT$27,542
PROJECT MEND-A-HOUSE INC
9502 TECHNOLOGY DRIVE SUITE 101MANASSASVA20112NONEPCMAP - BOARD AND EXECUTIVE LEADERSHIP STRENGTHENING$2,300
RAPPAHANNOCK AREA AGENCY ON AGING
460 LENDALL LANEFREDERICKSBURGVA22405NONEPCYR3 THE RAAA AQUIA GARRISONVILLE HEALTHCARE PROJECT$9,101
RX PARTNERSHIP
2924 EMERYWOOD PARKWAY SUITE 300RICHMONDVA23294NONEPC15 HSN MEDICATION ACCESS FOR THE UNINSURED$2,500
RX PARTNERSHIP
2925 EMERYWOOD PARKWAY SUITE 300RICHMONDVA23295NONEPC15 MAP - STRATEGIC PLANNING$1,675
SCAN OF NORTHERN VIRGINIA
205 S WHITING STREET SUITE 205ALEXANDRIAVA22304NONEPCSAFE BABIES AND CHILD ABUSE PREVENTION$10,000
SENTARA NORTHERN VIRGINIA MEDICAL CENTER
2300 OPITZ BLVDWOODBRIDGEVA22191NONEPC14A HSN FAMILY HEALTH CONNECTION MOBILE VANS$15,000
SENTARA NORTHERN VIRGINIA MEDICAL CENTER
2300 OPITZ BLVDWOODBRIDGEVA22191NONEPCYR3 HISPANIC DIABETES OUTREACH PROGRAM$6,065
SENTARA NORTHERN VIRGINIA MEDICAL CENTER
2300 OPITZ BLVDWOODBRIDGEVA22191NONEPCYR3 SENTARA POTOMAC WOMEN'S HEALTH MAMMOVAN$36,046
SENTARA NORTHERN VIRGINIA MEDICAL CENTER
2300 OPITZ BLVDWOODBRIDGEVA22191NONEPCDIABETES PREVENTION PROGRAM$18,567
SENTARA NORTHERN VIRGINIA MEDICAL CENTER
2300 OPITZ BLVDWOODBRIDGEVA22191NONEPCIN PERSON INTERPRETING SERVICES$80,520
STAFFORD SCHOOLS HEAD STARTVPIEARLY HEAD START
610 GAYLE STREETFALMOUTHVA22405NONEPCSTAFFORD CHILDREN'S INSURANCE OUTREACH PROGRAM$7,729
STREET LIGHT COMMUNITY OUTREACH MINISTRIES
1550 PRINCE WILLIAM PKWY SUITE BWOODBRIDGEVA22191NONEPCPERMANENT SUPPORTED HOUSING & RESPITE CARE FOR MEDICALLY FRAGILE HOMELESS ADULTS$21,737
STREET LIGHT COMMUNITY OUTREACH MINISTRIES
1551 PRINCE WILLIAM PKWY SUITE BWOODBRIDGEVA22192NONEPC15 MAP - FINANCIAL SUSTAINABILITY CAPACITY BUILDING$2,500
THE ARC OF GREATER PRINCE WILLIAMINSIGHT INC
13505 HILLENDALE DRIVEDALE CITYVA22194NONEPCYR2 MEDICAL CASE MANAGEMENT$27,200
THE ARC OF GREATER PRINCE WILLIAMINSIGHT INC
13505 HILLENDALE DRIVEDALE CITYVA22195NONEPCCOMPLETION OF THERAPEUTIC SERVICES$44,240
THE ARC OF GREATER PRINCE WILLIAMINSIGHT INC
13505 HILLENDALE DRIVEDALE CITYVA22196NONEPCVOSAC III DAY SUPPORT FOR THE MEDICALLY FRAGILE$100,000
THE CITY OF MANASSAS PARK
1 PARK CENTER COURTMANASSASVA20111NONEPCMASON AND PARTNERS BRIDGE CLINIC$100,000
THE HOUSE INC STUDENT LEADERSHIP CENTER
14001 CROWN COURTWOODBRIDGEVA22193NONEPCPROJECT PLAY$88,000
YOUNG INVINCIBLES
1411 K ST NWWASHINGTONDC20005NONEPCHEALTHY YOUNG AMERICA$30,000
VA FDN FOR COMMUNITY COLLEGE EDUCATION
101 N14TH STRICHMONDVA23219PCCYCLE 14A FELLOWS PROGRAM$50,000
VIRGINIA FOUNDATION FOR COMMUNITY COLLEGE
101 N14TH STRICHMONDVA23219PCPOTOMAC HEALTH FOUNDATION FELLOWS PROGRAM$125,000
FieldValueIRS element (for citing)
Total Grant Or Contri Apprv Fut$1,840,212TotalGrantOrContriApprvFutAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$315ExclusionAmt

Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$4,627,319ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion-$14,012ExclusionAmt

Other Revenue Described OtherRevenueDescribedGrp

FieldValueIRS element (for citing)
DescRETURNED PAYMENTSDesc
Related Or Exempt Function Incm$105,336RelatedOrExemptFunctionIncmAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$0UnrelatedBusinessTaxblIncmAmt
Exclusion$4,613,622ExclusionAmt
Related Or Exempt Function Incm$105,336RelatedOrExemptFunctionIncmAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$4,718,958TotalIncomeProducingActyAmt

Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp

Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp

FieldValueIRS element (for citing)
Line Number11LineNumberTxt
Relationship StatementAMOUNTS PAID FOR GRANTS IN PRIOR YEAR AND RETURNED IN THE CURRENT YEARRelationshipStatementTxt

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

FieldValueIRS element (for citing)
Trnsfr Of Cash To Nonchrtbl EO0TrnsfrOfCashToNonchrtblEOInd
Trnsfr Other Asset Nonchrtbl EO0TrnsfrOtherAssetNonchrtblEOInd
Sales Or Exchanges Of Assets0SalesOrExchangesOfAssetsInd
Purchase Of Assets Nonchrtbl EO0PurchaseOfAssetsNonchrtblEOInd
Rental Of Facilities Oth Assets0RentalOfFacilitiesOthAssetsInd
Reimbursement Arrangements0ReimbursementArrangementsInd
Loans Or Loan Guarantees0LoansOrLoanGuaranteesInd
Performance Of Services Etc0PerformanceOfServicesEtcInd
Sharing Of Facilities Etc0SharingOfFacilitiesEtcInd
Relationships Nonchrtbl EO0RelationshipsNonchrtblEOInd

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryACCOUNTINGCategoryTxt
Amt$47,482Amt
Net Investment Income$0NetInvestmentIncomeAmt
Disbursements Charitable Prps$64,390DisbursementsCharitablePrpsAmt

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp (15 entries)

Category Or ItemCategoryOrItemTxtListed At Cost Or FMVListedAtCostOrFMVCdBook ValueBookValueAmtEOYFMVEOYFMVAmt
SEI CORE FIXED INCOME FUND 1,279,256.134 SHARESFMV$13,432,189$13,432,189
SEI SPECIAL SITUATIONS FUND LTD 2,903.787 SHARESFMV$3,782,322$3,782,322
SEI SMALL CAP FUND (SLPAX) 164,674.78 SHARESFMV$2,969,086$2,969,086
SEI INSTITUTIONAL INVESTMENT TRUST 307,131.879 SHARESFMV$2,715,046$2,715,046
SIIT EMERGING MARKETS DEBT FUND SEDAX 484,173.825 SHARESFMV$4,362,406$4,362,406
SIIT ULTRA SHORT DURATION BOND FUND 254,758.322 SHARESFMV$2,539,940$2,539,940
SEI CORE PROPERTY FUND 7,875.893 SHARESFMV$13,876,115$13,876,115
SEI US MANAGED VOL FUND 280,043.855 SHARESFMV$4,018,629$4,018,629
SIIT MULTI ASSET REAL RETURN FUND 775,881.785 SHARESFMV$6,509,648$6,509,648
GLOBAL MANAGED VOL FUND (SVTAX) 644,560.532 SHARESFMV$7,354,436$7,354,436
SEI LARGE CAP FUND (SLCAX) 715,312.62 SHARESFMV$15,972,931$15,972,931
SEI SIIT OPPORTUNISTIC INCOME FD-A 624,165.876 SHARESFMV$5,080,710$5,080,710
SEI WORLD EQUITY EX-US FUND (WEUSX) 796,509.739 SHARESFMV$9,096,141$9,096,141
EMERGING MARKETS EQUITY FUND (SIEMX) 271,852.311 SHARESFMV$2,468,419$2,468,419
SEI DYNAMIC ASSET ALLOC FUND 300,530.3480 SHARESFMV$5,030,878$5,030,878

Land Etc Schedule2 LandEtcSchedule2

Land Etc LandEtcGrp

FieldValueIRS element (for citing)
Category Or ItemFURNITURE & EQUIPMENTCategoryOrItemTxt
Cost Or Other Basis$36,148CostOrOtherBasisAmt
Accumulated Depreciation$28,238AccumulatedDepreciationAmt
Book Value$7,910BookValueAmt
EOYFMV$7,910EOYFMVAmt

Legal Fees Schedule LegalFeesSchedule

Legal Fees LegalFeesGrp

FieldValueIRS element (for citing)
CategoryLEGALCategoryTxt
Legal Fees$100LegalFeesAmt
Net Investment Income$0NetInvestmentIncomeAmt
Disbursements Charitable Prps$100DisbursementsCharitablePrpsAmt

Other Assets Schedule OtherAssetsSchedule

Other Assets Schedule OtherAssetsScheduleGrp

FieldValueIRS element (for citing)
DescEXCISE TAX OVERPAYMENTDesc
BOY Book Value$16,994BOYBookValueAmt

Other Decreases Schedule OtherDecreasesSchedule

Other Decreases Detail OtherDecreasesDetail

FieldValueIRS element (for citing)
DescUNREALIZED GAINDesc
Amt$2,831,881Amt

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (5 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
PROFESSIONAL DEVELOPMENT$14,074$0$20,414
TECH EXPENSE$15,118$0$15,544
OTHER EXPENSE$11,497$0$4,275
INSURANCE$2,179$0$2,179
SEI CORE PROPERTY FUND, LP OTHER DEDUCTIONS$0$40,352$0

Other Income Schedule2 OtherIncomeSchedule2

Other Income Detail OtherIncomeDetail

FieldValueIRS element (for citing)
DescRETURNED PAYMENTSDesc
Revenue And Expenses Per Books$105,336RevenueAndExpensesPerBooksAmt
Adjusted Net Income$105,336AdjustedNetIncomeAmt

Other Increases Schedule OtherIncreasesSchedule

Other Increases Detail OtherIncreasesDetail

FieldValueIRS element (for citing)
DescDONATED FACILITIESDesc
Amt$46,570Amt

Other Liabilities Schedule OtherLiabilitiesSchedule

Other Liabilities Detail OtherLiabilitiesDetail (2 entries)

DescDescBOY Book ValueBOYBookValueAmtEOY Book ValueEOYBookValueAmt
DUE TO RELATED PARTY$10,621$23,496
DEFERRED TAX LIABILITY$102,977$74,658

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail (2 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
INVESTMENT MANAGEMENT FEES$397,084$397,084$0
CONSULTANT FEES$41,339$0$41,339

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail

FieldValueIRS element (for citing)
CategoryEXCISE TAXCategoryTxt
Amt$41,922Amt
Net Investment Income$0NetInvestmentIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt

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