MOLLYS HOUSE INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
MOLLYS HOUSE INC (EIN 65-0407242)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-03-09
IRS object ID
201610699349300306
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)
Return2016-03-09T08:02:06-06:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN591556056PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PROCTOR CROOK CROWDER & FOGAL PABusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line133 SW FLAGLER AVENUEAddressLine1Txt
CitySTUARTCityNm
State AbbreviationFLStateAbbreviationCd
ZIP34994ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN650407242EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MOLLY'S HOUSE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMOLLBusinessNameControlTxt
Phone7722236659PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1430 SE OSCEOLA STREETAddressLine1Txt
CitySTUARTCityNm
State AbbreviationFLStateAbbreviationCd
ZIP34994ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRAYMOND G ROBISONPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone7722874444PhoneNum
Signature2016-02-23SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCHRISTINE MYERSPreparerPersonNm
PTINP00404484PTIN
Phone7722832356PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2016-09-27 15:27:22ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerRAYMOND G ROBISONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1430 SE OSCEOLA STREETAddressLine1Txt
CitySTUARTCityNm
State AbbreviationFLStateAbbreviationCd
ZIP34994ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,355,980GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MOLLYSHOUSE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1996FormationYr
Legal Domicile StateFLLegalDomicileStateCd
Activity Or MissionPROVIDES A "HOME AWAY FROM HOME" TO FAMILIES AND PATIENTS RECEIVING HEALTHCARE ON THE TREASURE COAST.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee9TotalEmployeeCnt
Total Volunteers20TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$194,118PYContributionsGrantsAmt
CY Contributions Grants$152,819CYContributionsGrantsAmt
PY Program Service Revenue$25,694PYProgramServiceRevenueAmt
CY Program Service Revenue$27,458CYProgramServiceRevenueAmt
PY Investment Income$121,149PYInvestmentIncomeAmt
CY Investment Income$154,964CYInvestmentIncomeAmt
PY Other Revenue$53,074PYOtherRevenueAmt
CY Other Revenue$74,933CYOtherRevenueAmt
PY Total Revenue$394,035PYTotalRevenueAmt
CY Total Revenue$410,174CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$181,864PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$212,696CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$53,895CYTotalFundraisingExpenseAmt
PY Other Expenses$212,594PYOtherExpensesAmt
CY Other Expenses$175,924CYOtherExpensesAmt
PY Total Expenses$394,458PYTotalExpensesAmt
CY Total Expenses$388,620CYTotalExpensesAmt
PY Revenues Less Expenses-$423PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$21,554CYRevenuesLessExpensesAmt
Total Assets BOY$1,995,653TotalAssetsBOYAmt
Total Assets EOY$2,017,207TotalAssetsEOYAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,995,653NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,017,207NetAssetsOrFundBalancesEOYAmt
MissionPROVIDES A "HOME AWAY FROM HOME" TO FAMILIES AND PATIENTS RECEIVING HEALTHCARE ON THE TREASURE COAST.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$229,434ExpenseAmt
Revenue$27,458RevenueAmt
DescHOSPITAL HOSPITALITY HOUSE THAT PROVIDES TEMPORARY HOUSING AND SERVICES FOR PATIENTS AND FAMILIES IN A MEDICAL CRISIS. PROGRAMS INCLUDE CAREGIVER RESPITE, ADOPT A FAMILY AND ART AND HEALING.Desc
Total Program Service Expenses$229,434TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document2IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee9EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldFLStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MARNEY MCKEEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7722236659PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1430 SE OSCEOLA STREETAddressLine1Txt
CitySTUARTCityNm
State AbbreviationFLStateAbbreviationCd
ZIP34994ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
RYAN FURTWANGLER
DIRECTOR1.00Yes (X)$0$0$0
RAYMOND G ROBISON
PRESIDENT4.00Yes (X)$0$0$0Yes (X)
SHAUN WILLIAMS
VICE PRESIDENT1.00Yes (X)$0$0$0Yes (X)
PREETHI SEKHARAN
DIRECTOR1.00Yes (X)$0$0$0
CHRISTINE MYERS
DIRECTOR1.00Yes (X)$0$0$0
JUDGE ALAN FORST
DIRECTOR1.00Yes (X)$0$0$0
JESSICA MCLAIN
SECRETARY1.00Yes (X)$0$0$0Yes (X)
MARY DELATER
DIRECTOR1.00Yes (X)$0$0$0
DAN PARZ
DIRECTOR1.00Yes (X)$0$0$0
LOUISE MURTAUGH
EXECUTIVE DIRECTOR48.00Yes (X)$43,149$0$0
KATHRYN F PRIEST
DIRECTOR1.00Yes (X)$0$0$0
JAYE BAYLES
DIRECTOR1.00Yes (X)$0$0$0
BETSY HAROLD
DIRECTOR1.00Yes (X)$0$0$0
WILLIAM V WEST
CHEIF EXECUTIVE OFFICER48.00Yes (X)$44,087$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$87,236TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$152,819AllOtherContributionsAmt
Noncash Contributions$14,334NoncashContributionsAmt
Total Contributions$152,819TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescRENTDesc
Business624100BusinessCd
Total Revenue Column$27,458TotalRevenueColumnAmt
Related Or Exempt Func Income$27,458RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$27,458TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$19,427TotalRevenueColumnAmt
Exclusion$19,427ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,051,942SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$916,405SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$135,537SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$135,537TotalRevenueColumnAmt
Exclusion$135,537ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$104,334FundraisingGrossIncomeAmt
Fundraising Direct Expenses$29,401FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$74,933TotalRevenueColumnAmt
Exclusion$74,933ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$410,174TotalRevenueColumnAmt
Related Or Exempt Func Income$27,458RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$229,897ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$87,236TotalAmt
Program Services$26,077ProgramServicesAmt
Management And General$34,894ManagementAndGeneralAmt
Fundraising$26,265FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$109,914TotalAmt
Program Services$50,990ProgramServicesAmt
Management And General$42,113ManagementAndGeneralAmt
Fundraising$16,811FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$15,546TotalAmt
Program Services$6,077ProgramServicesAmt
Management And General$6,072ManagementAndGeneralAmt
Fundraising$3,397FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$8,983TotalAmt
Program Services$6,314ProgramServicesAmt
Management And General$1,518ManagementAndGeneralAmt
Fundraising$1,151FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$7,680TotalAmt
Management And General$7,680ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$33,168TotalAmt
Program Services$33,168ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$8,224TotalAmt
Program Services$6,579ProgramServicesAmt
Management And General$823ManagementAndGeneralAmt
Fundraising$822FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$9,948TotalAmt
Program Services$7,472ProgramServicesAmt
Management And General$934ManagementAndGeneralAmt
Fundraising$1,542FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$2,243TotalAmt
Program Services$2,019ProgramServicesAmt
Fundraising$224FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$29,598TotalAmt
Program Services$26,638ProgramServicesAmt
Management And General$2,960ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$195TotalAmt
Program Services$156ProgramServicesAmt
Management And General$19ManagementAndGeneralAmt
Fundraising$20FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,485TotalAmt
Program Services$1,192ProgramServicesAmt
Management And General$149ManagementAndGeneralAmt
Fundraising$144FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$21,490TotalAmt
Program Services$19,341ProgramServicesAmt
Management And General$2,149ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$6,469TotalAmt
Program Services$3,915ProgramServicesAmt
Management And General$1,542ManagementAndGeneralAmt
Fundraising$1,012FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
REPAIRS & MAINTENANCE$18,618$16,756$1,862
SUPPLIES$16,926$13,541$1,692$1,693
DUES AND SUBSCRIPTIONS$5,240$4,192$524$524
TELEPHONE EXPENSES$2,475$1,980$247$248

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$3,182TotalAmt
Program Services$3,027ProgramServicesAmt
Management And General$113ManagementAndGeneralAmt
Fundraising$42FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$388,620TotalAmt
Program Services$229,434ProgramServicesAmt
Management And General$105,291ManagementAndGeneralAmt
Fundraising$53,895FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$22,625BOYAmt
EOY$60,328EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,328,400LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$501,477LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$811,333BOYAmt
EOY$826,923EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$1,161,695BOYAmt
EOY$1,129,956EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,995,653BOYAmt
EOY$2,017,207EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$1,995,653BOYAmt
EOY$2,017,207EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,995,653BOYAmt
EOY$2,017,207EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,995,653BOYAmt
EOY$2,017,207EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$21,554ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$124,738CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$97,961CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$222,460CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$194,118CurrentTaxYearMinus1YearAmt
Current Tax Year$152,819CurrentTaxYearAmt
Total$792,096TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$124,738CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$97,961CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$222,460CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$194,118CurrentTaxYearMinus1YearAmt
Current Tax Year$152,819CurrentTaxYearAmt
Total$792,096TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$176,963SubstantialContributorsTotAmt
Public Support Total170$615,133PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$36,184CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$36,838CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$40,824CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$121,148CurrentTaxYearMinus1YearAmt
Current Tax Year$154,964CurrentTaxYearAmt
Total$389,958TotalAmt
FieldValueIRS element (for citing)
Total Support$1,182,054TotalSupportAmt
Gross Receipts Rltd Activities$459,851GrossReceiptsRltdActivitiesAmt
Public Support CY1700.52040PublicSupportCY170Pct
Public Support PY1700.56620PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$408,703OtherCostOrOtherBasisAmt
Book Value$408,703BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$820,830OtherCostOrOtherBasisAmt
Depreciation$403,095DepreciationAmt
Book Value$417,735BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$24,529OtherCostOrOtherBasisAmt
Depreciation$24,529DepreciationAmt
Book Value$0BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$74,338OtherCostOrOtherBasisAmt
Depreciation$73,853DepreciationAmt
Book Value$485BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$826,923TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescNORTHERN TRUSTDesc
Book Value$1,129,956BookValueAmt
Method ValuationCMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$1,129,956TotalBookValueSecuritiesAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1POLO EVENTEvent1Nm
Gross Receipts Event1$52,919GrossReceiptsEvent1Amt
Gross Revenue Event1$52,919GrossRevenueEvent1Amt
Rent Facility Costs Event1$8,846RentFacilityCostsEvent1Amt
Food And Beverage Event1$3,416FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$5,696OtherDirectExpensesEvent1Amt
Event2PRET A MANGEREvent2Nm
Gross Receipts Event2$29,712GrossReceiptsEvent2Amt
Gross Revenue Event2$29,712GrossRevenueEvent2Amt
Rent Facility Costs Event2$7,676RentFacilityCostsEvent2Amt
Food And Beverage Event2$214FoodAndBeverageEvent2Amt
Other Direct Expenses Event2$1,676OtherDirectExpensesEvent2Amt
Other Events Total6OtherEventsTotalCnt
Gross Receipts Other Events$21,703GrossReceiptsOtherEventsAmt
Gross Revenue Other Events$21,703GrossRevenueOtherEventsAmt
Food And Beverage Other Events$1,765FoodAndBeverageOtherEventsAmt
Oth Direct Expnss Other Events$112OthDirectExpnssOtherEventsAmt
Gross Receipts Total$104,334GrossReceiptsTotalAmt
Gross Revenue Total Events$104,334GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$16,522RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$5,395FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$7,484OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$29,401DirectExpenseSummaryEventsAmt
Net Income Summary$74,933NetIncomeSummaryAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11A COPY OF FORM 990 WAS HELD IN THE MAIN OFFICE LOCATION. DIRECTORS WERE INFORMED OF THE COMPLETION AND FILING OF FORM 990. THE PRESIDENT, TREASURER AND FINANCE COMMITTEE REVIEWS THE ANNUAL FORM 990.
FORM 990, PART VI, SECTION B, LINE 12CEACH YEAR BOARD MEMBERS ARE REQUIRED TO SUBMIT NEW CONFLICT OF INTEREST FORMS AT THE ANNUAL MEETING.
FORM 990, PART VI, SECTION B, LINE 15ANNUAL SALARY SURVEYS PROVIDE SPECIFIC COMPENSATION RANGES FOR THE EXECUTIVE DIRECTOR REVIEWED BY THE EXECUTIVE COMMITTEE. THE ANNUAL SALARY WAS APPROVED BY THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19A COPY OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE HELD IN THE LOCATION'S MAIN OFFICE. UPON REQUEST, THESE DOCUMENTS ARE PROVIDED FOR REVIEW.

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