PHOENIXVILLE FREE CLINIC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- PHOENIXVILLE FREE CLINIC (EIN 23-3072363)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-04-18
- IRS object ID
- 201621109349300317
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-04-18T00:00:00-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 231386942 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAMPBELL RAPPOLD & YURASITS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1033 S CEDAR CREST BLVD | AddressLine1Txt |
| City | ALLENTOWN | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 181035443 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 233072363 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE CLINIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | THEC | BusinessNameControlTxt |
| Phone | 6109351134 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 143 CHURCH STREET | AddressLine1Txt |
| City | PHOENIXVILLE | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19460 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JIM KOVALESKI | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 6109351134 | PhoneNum |
| Signature | 2016-04-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TARA L BENDER CPA | PreparerPersonNm |
| PTIN | P00299403 | PTIN |
| Phone | 6104357489 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2016-09-27 15:27:22Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JIM KOVALESKI | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 143 CHURCH STREET | AddressLine1Txt |
| City | PHOENIXVILLE | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19460 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,201,180 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.THECLINICPA.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY HEALTHCARE TO THE UNINSURED, IN AN ATMOSPHERE WHICH FOSTERS DIGNITY AND RESPECT FOR ITS PATIENTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 21 | TotalEmployeeCnt |
| Total Volunteers | 156 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $828,997 | PYContributionsGrantsAmt |
| CY Contributions Grants | $978,506 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $136,012 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $117,264 | CYProgramServiceRevenueAmt |
| PY Investment Income | $13,684 | PYInvestmentIncomeAmt |
| CY Investment Income | $15,826 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$3,204 | PYOtherRevenueAmt |
| CY Other Revenue | -$4,170 | CYOtherRevenueAmt |
| PY Total Revenue | $975,489 | PYTotalRevenueAmt |
| CY Total Revenue | $1,107,426 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $135,538 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $104,186 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $662,186 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $672,890 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $155,377 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $248,909 | PYOtherExpensesAmt |
| CY Other Expenses | $276,440 | CYOtherExpensesAmt |
| PY Total Expenses | $1,046,633 | PYTotalExpensesAmt |
| CY Total Expenses | $1,053,516 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$71,144 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $53,910 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,608,700 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,638,865 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $46,952 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $44,370 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,561,748 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,594,495 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE CLINIC'S MISSION IS TO PROVIDE QUALITY HEALTHCARE TO THE UNINSURED, IN AN ATMOSPHERE WHICH FOSTERS DIGNITY AND RESPECT FOR ITS PATIENTS. IT IS OUR PRIVILEGE TO DO SO. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $741,046 | ExpenseAmt |
| Grant | $104,186 | GrantAmt |
| Revenue | $122,923 | RevenueAmt |
| Desc | THE CLINIC HAD THE PRIVILEGE OF PROVIDING THE FOLLOWING QUALITY HEALTH CARE SERVICES TO THE COMMUNITY, WHICH ENCOMPASSED APPROXIMATELY 34 TOWNSHIPS/MUNICIPALITIES IN CHESTER AND MONTGOMERY COUNTIES (APPROX. 220 SQUARE MILES), DURING FY 2015: A) MEDICAL SERVICES INCLUDED: FAMILY AND INTERNAL MEDICINE, GYNECOLOGY, PEDIATRICS, CARDIOLOGY, UROLOGY, ORTHOPEDICS, PSYCHIATRY, ALLERGY, DERMATOLOGY AND DERMATOLOGIC SURGERY.B) OTHER CLINICAL SERVICES INCLUDED: PSYCHOLOGICAL SERVICES, HOLISTIC HEALTH COUNSELING, ACUPUNCTURE, AND CERTIFIED ADDICTIONS COUNSELING. C) OVERALL PATIENT VISITS WERE 7,100, OF PRIMARY AND SPECIALTY MEDICAL CARE TO INDIVIDUALS AND FAMILIES WHO WERE WITHOUT MEDICAL INSURANCE AND UNDERSERVED. D) THERE WERE 2,400 UNIQUE, UNDUPLICATED PATIENTS DURING 2015.E) THE PHARMACY ASSISTANCE PROGRAM COORDINATED THE PROVISION OF 907 ANNUAL REFILLS OF FREE MEDICATIONS. THE TOTAL VALUE OF THESE MEDICATIONS (AVERAGE WHOLESALE PRICE) TOTALED APPROXIMATELY $875,000.F) THE CLINIC'S CLINICAL LABORATORY PERFORMED, OR OUTSOURCED, THE PROVISION OF APPROXIMATELY 3,595 LABORATORY TESTS WHICH WERE A CRUCIAL COMPONENT OF ASSESSING/DIAGNOSING OF MEDICAL PROBLEMS NEEDED TO DEVELOP AN ACCURATE TREATMENT PLAN.G) THE CLINIC, IN PARTNERSHIP WITH A LOCAL COMMUNITY HOSPITAL'S CHARITY CARE PROGRAM, COORDINATED THE PROVISION OF APPROXIMATELY 1,040 FREE DIAGNOSTIC TESTS, PROCEDURES AND CONSULTS TO OUR PATIENTS. THESE PROCEDURES INCLUDED SUCH SERVICES AS: X-RAYS, ULTRASOUNDS, MRI'S, CAT SCANS, MAMMOGRAMS, G.I. AND SURGICAL CONSULTS, AND BIOPSIES. WE PROVIDE ALL OF THESE CLINICAL SERVICES WITH DIGNITY AND RESPECT FOR OUR PATIENTS. | Desc |
| Total Program Service Expenses | $741,046 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 6 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 21 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | PA | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LISA MATTHEWS | PersonNm |
| Phone | 6109351134 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 143 CHURCH STREET | AddressLine1Txt |
| City | PHOENIXVILLE | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19460 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| JOHN ENYART | ||||||
| VICE PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| GREG CARE | ||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JAMES KOVALESKI | ||||||
| PRESIDENT (CURRENT) | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ROBERT J DOLLFUS JR | ||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MARK BANFIELD | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| LEWIS OSTERHOUDT | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DOUGLAS HUGHES | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| ANA NEGRON MD | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| SANDY CRABTREE | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| THOMAS CARNEVALE | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DOUG DARLINGTON | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| SARAH STRZELECKI EDD MBA RN | ||||||
| PRESIDENT (FORMER) | 2.00 | Yes (X) | $0 | $0 | $0 | |
| THOMAS BURD | ||||||
| EXECUTIVE DIRECTOR | 50.00 | Yes (X) | $0 | $97,836 | $7,958 | |
| LORNA STUART MD | ||||||
| MEDICAL DIRECTOR | 50.00 | Yes (X) | $0 | $67,704 | $2,038 | |
| GEORGE SPYROPOULOS MD BEGAN 082015 | ||||||
| MEDICAL DIRECTOR | 50.00 | Yes (X) | $0 | $50,673 | $1,520 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $216,213 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $11,516 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $26,464 | FundraisingAmt |
| All Other Contributions | $952,042 | AllOtherContributionsAmt |
| Noncash Contributions | $26,122 | NoncashContributionsAmt |
| Total Contributions | $978,506 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LOW-COST MEDICAL SERVI | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $117,264 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $117,264 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $117,264 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,167 | TotalRevenueColumnAmt |
| Exclusion | $10,167 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $81,298 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $75,639 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,659 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,659 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,659 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $13,945 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $26,464 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $18,115 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$4,170 | TotalRevenueColumnAmt |
| Exclusion | -$4,170 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,107,426 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $122,923 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $5,997 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,186 | TotalAmt |
| Program Services | $104,186 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $227,729 | TotalAmt |
| Program Services | $174,833 | ProgramServicesAmt |
| Management And General | $26,448 | ManagementAndGeneralAmt |
| Fundraising | $26,448 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $360,158 | TotalAmt |
| Program Services | $248,665 | ProgramServicesAmt |
| Management And General | $54,898 | ManagementAndGeneralAmt |
| Fundraising | $56,595 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,854 | TotalAmt |
| Program Services | $5,004 | ProgramServicesAmt |
| Management And General | $1,624 | ManagementAndGeneralAmt |
| Fundraising | $1,226 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,257 | TotalAmt |
| Program Services | $10,702 | ProgramServicesAmt |
| Management And General | $9,135 | ManagementAndGeneralAmt |
| Fundraising | $7,420 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,892 | TotalAmt |
| Program Services | $35,434 | ProgramServicesAmt |
| Management And General | $6,978 | ManagementAndGeneralAmt |
| Fundraising | $7,480 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,065 | TotalAmt |
| Program Services | $898 | ProgramServicesAmt |
| Management And General | $18,167 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,932 | TotalAmt |
| Management And General | $2,932 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,422 | TotalAmt |
| Program Services | $2,847 | ProgramServicesAmt |
| Management And General | $130 | ManagementAndGeneralAmt |
| Fundraising | $445 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,178 | TotalAmt |
| Program Services | $18,808 | ProgramServicesAmt |
| Management And General | $6,646 | ManagementAndGeneralAmt |
| Fundraising | $10,724 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,279 | TotalAmt |
| Program Services | $27,959 | ProgramServicesAmt |
| Management And General | $7,456 | ManagementAndGeneralAmt |
| Fundraising | $1,864 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,183 | TotalAmt |
| Program Services | $43,638 | ProgramServicesAmt |
| Management And General | $11,635 | ManagementAndGeneralAmt |
| Fundraising | $2,910 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,408 | TotalAmt |
| Program Services | $4,719 | ProgramServicesAmt |
| Management And General | $1,532 | ManagementAndGeneralAmt |
| Fundraising | $1,157 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60 | TotalAmt |
| Management And General | $60 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,027 | TotalAmt |
| Program Services | $15,770 | ProgramServicesAmt |
| Management And General | $4,206 | ManagementAndGeneralAmt |
| Fundraising | $1,051 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,256 | TotalAmt |
| Program Services | $45,024 | ProgramServicesAmt |
| Management And General | $5,090 | ManagementAndGeneralAmt |
| Fundraising | $142 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | FundraisingFundraisingAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|---|
| FEASIBILITY | $32,250 | $32,250 | ||
| INDIRECT SPECIAL EVENTS | $5,660 | $5,660 | ||
| VOLUNTEER RECOGNITION | $2,290 | $2,290 | ||
| MISCELLANEOUS | $430 | $5 | $269 | $156 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,053,516 | TotalAmt |
| Program Services | $741,046 | ProgramServicesAmt |
| Management And General | $157,093 | ManagementAndGeneralAmt |
| Fundraising | $155,377 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $493,724 | BOYAmt |
| EOY | $549,982 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,000 | BOYAmt |
| EOY | $67,412 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,639 | BOYAmt |
| EOY | $6,142 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,973 | BOYAmt |
| EOY | $17,790 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $655,003 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $327,207 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $335,717 | BOYAmt |
| EOY | $327,796 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $301,480 | BOYAmt |
| EOY | $286,089 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $408,167 | BOYAmt |
| EOY | $383,654 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,608,700 | BOYAmt |
| EOY | $1,638,865 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,952 | BOYAmt |
| EOY | $44,370 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,952 | BOYAmt |
| EOY | $44,370 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,190,196 | BOYAmt |
| EOY | $1,176,097 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $181,510 | BOYAmt |
| EOY | $228,356 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $190,042 | BOYAmt |
| EOY | $190,042 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,561,748 | BOYAmt |
| EOY | $1,594,495 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,608,700 | BOYAmt |
| EOY | $1,638,865 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $53,910 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$21,163 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $963,638 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $832,846 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $818,945 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $790,220 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $941,532 | CurrentTaxYearAmt |
| Total | $4,347,181 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $146,115 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $152,434 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $155,435 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $136,012 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $117,264 | CurrentTaxYearAmt |
| Total | $707,260 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,109,753 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $985,280 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $974,380 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $926,232 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,058,796 | CurrentTaxYearAmt |
| Total | $5,054,441 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $297,500 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $175,100 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $240,525 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $266,275 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $328,200 | CurrentTaxYearAmt |
| Total | $1,307,600 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $297,500 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $175,100 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $240,525 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $266,275 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $328,200 | CurrentTaxYearAmt |
| Total | $1,307,600 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $3,746,841 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,351 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,826 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,541 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,762 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,167 | CurrentTaxYearAmt |
| Total | $52,647 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,351 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,826 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,541 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,762 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,167 | CurrentTaxYearAmt |
| Total | $52,647 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $945 | CurrentTaxYearMinus4YearsAmt |
| Total | $945 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,124,049 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $994,106 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $982,921 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $937,994 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,068,963 | CurrentTaxYearAmt |
| Total | $5,108,033 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.73350 | PublicSupportCY509Pct |
| Public Support PY509 | 0.76250 | PublicSupportPY509Pct |
| Investment Income CY | 0.01030 | InvestmentIncomeCYPct |
| Investment Income PY | 0.01050 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $269,259 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$11,861 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $257,398 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $255,241 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $14,018 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $269,259 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $227,861 | BeginningYearBalanceAmt |
| Contributions | $1,500 | ContributionsAmt |
| Investment Earnings Or Losses | $25,880 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $255,241 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $206,513 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $21,348 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $227,861 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $209,755 | BeginningYearBalanceAmt |
| Contributions | -$420 | ContributionsAmt |
| Investment Earnings Or Losses | -$2,822 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $206,513 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.73830 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.26170 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $455,505 | OtherCostOrOtherBasisAmt |
| Depreciation | $147,307 | DepreciationAmt |
| Book Value | $308,198 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $199,498 | OtherCostOrOtherBasisAmt |
| Depreciation | $179,900 | DepreciationAmt |
| Book Value | $19,598 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $327,796 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| CERTIFICATE OF DEPOSIT | $359,196 | F |
| INVESTED WITH CHESTER COUNTY COMMUNITY FOUNDATION | $24,458 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $383,654 | TotalBookValueSecuritiesAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $1,244,340 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$21,163 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $166,669 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | -$2,932 | OtherRevenueAmt |
| Revenue Not Reported | $142,574 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,101,766 | RevenueSubtotalAmt |
| Other Revenues Not Included | $5,660 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $5,660 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $1,107,426 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,211,593 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $166,669 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $166,669 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,044,924 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $8,592 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $8,592 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,053,516 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | TO PROVIDE FUTURE INCOME TO SUPPORT THE PROGRAMS OF THE CLINIC. |
| PART X, LINE 2: | THE CLINIC IS A NOT-FOR-PROFIT ORGANIZATION THAT IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND NONE OF ITS PRESENT OR ANTICIPATED FUTURE ACTIVITIES ARE SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. UNCERTAIN TAX POSITIONS ARE EVALUATED IN ACCORDANCE WITH FASB ASC 740-10. FASB ASC 740-10 CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN THE ORGANIZATION'S FINANCIAL STATEMENTS AND PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. FASB ASC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, AND DISCLOSURE. THE ORGANIZATION HAD NO MATERIAL UNRECOGNIZED TAX BENEFITS OR ACCRUED INTEREST OR PENALTIES. THE ORGANIZATION FILES INCOME TAX RETURNS IN THE UNITED STATES. THE ORGANIZATION IS NO LONGER SUBJECT TO U.S. TAX EXAMINATIONS BY TAXING AUTHORITIES FOR YEARS BEFORE 2012. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | INVESTMENT FEES, NETTED AGAINST INCOME ON BOOKS -2,932. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | DIRECT EXPENSES OF FUNDRAISING ACTIVITIES 5,660. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | INVESTMENT FEES, NETTED AGAINST INCOME ON BOOKS 2,932. DIRECT EXPENSES OF FUNDRAISING ACTIVITIES 5,660. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | ANNIVERSARY DINNER | Event1Nm |
| Gross Receipts Event1 | $19,570 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $13,185 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $6,385 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $6,385 | OtherDirectExpensesEvent1Amt |
| Event2 | GOLF EVENT | Event2Nm |
| Gross Receipts Event2 | $20,839 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $13,279 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $7,560 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $11,730 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $40,409 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $26,464 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $13,945 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $18,115 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $18,115 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$4,170 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | HEALTHCARE ASSISTANCE | GrantTypeTxt |
| Recipient | 7100 | RecipientCnt |
| Cash Grant | $78,065 | CashGrantAmt |
| Non Cash Assistance | $26,121 | NonCashAssistanceAmt |
| Valuation Method Used | FMV | ValuationMethodUsedDesc |
| Non Cash Assistance | PHARMECEUTICALS AND SUPPLIES GIVEN TO PATIENTS OF THE CLINIC | NonCashAssistanceDesc |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $26,121 | NoncashContributionsRptF990Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | A DRAFT OF THE FORM 990 AND ALL RELATED SCHEDULES IS PROVIDED TO THE AUDIT COMMITTEE FOR REVIEW AND ACCEPTANCE. ONCE THE COMMITTEE HAS APPROVED, IT IS PROVIDED TO THE BOARD OF DIRECTORS AND THE COMMITTEE RECOMMENDS APPROVAL FOR FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REQUIRES THAT BOARD MEMBERS DISCLOSE ANY CONFLICTS OF INTEREST. IN CONNECTION WITH ANY TRANSACTION OR ARRANGEMENT PRESENTED TO THE BOARD OF DIRECTORS, EACH INTERESTED PERSON IS REQUIRED TO MAKE FULL DISCLOSURE OF THE MATERIAL FACTS RELATING TO THE CONFLICT OR POTENTIAL CONFLICT. THE BOARD OF DIRECTORS, WITHOUT THE PARTICIPATION OF THE INTERESTED PARTY, MAKES A DETERMINATION WHETHER A CONFLICT OF INTEREST EXISTS. IF A CONFLICT EXISTS, THE INTERESTED PARTY WILL EXCUSE HIMSELF FROM THE MEETING AND SHALL NOT VOTE ON THE ISSUE AT HAND. IF THE BOARD HAS REASONABLE CAUSE TO BELIEVE THAT A DIRECTOR, OFFICER, OR COMMITTEE MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM SUCH PERSON OF THE BASIS FOR SUCH BELIEF AND AFFORD SUCH PERSON AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF SUCH PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD DETERMINES THAT THE PERSON HAS FAILED TO DISCLOSE A CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY OR CORRECTIVE ACTIONS. EACH DIRECTOR ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS THAT EACH PERSON HAS RECEIVED A COPY OF THE POLICY, HAS READ AND UNDERSTANDS THE POLICY, AND HAS AGREED TO COMPLY WITH THE POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION HAS A PERSONNEL COMMITTEE. THE COMMITTEE DETERMINES SALARIES BY USING THE COMPENSATION AND BENEFITS SURVEY BY THE NONPROFIT TIMES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE ON REQUEST. |
| FORM 990; PART 12; LINE C2 | THE PROCESS HAS NOT CHANGED FROM THAT OF PRIOR YEAR. |
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