GOOD SAMARITAN HEALTH SERVICES INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
GOOD SAMARITAN HEALTH SERVICES INC (EIN 73-1559561)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-06-10
IRS object ID
201511619349300621
Schema version
2014v5.0
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)
Return2015-06-10T10:18:11-05:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN203911007PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Minert & Associates PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12250 E 73rd St Suite 650AddressLine1Txt
CityTulsaCityNm
State AbbreviationOKStateAbbreviationCd
ZIP74136ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN731559561EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GOOD SAMARITAN HEALTH SERVICES INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlGOODBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line17501 RIVERSIDE PARKWAYAddressLine1Txt
CityTulsaCityNm
State AbbreviationOKStateAbbreviationCd
ZIP74136ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN CROUCHPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone9187104222PhoneNum
Signature2015-05-14SignatureDt
Discuss With Paid PreparerfalseDiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTony MinertPreparerPersonNm
PTINP00290071PTIN
Phone9187421616PhoneNum
Preparation2015-06-10PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1GOOD SAMARITAN HEALTH SERVICESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerJOHN R CROUCH JR MDPrincipalOfficerNm
Gross Receipts$2,226,428GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.goodsamaritanhealth.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1999FormationYr
Legal Domicile StateOKLegalDomicileStateCd
Activity Or MissionGOOD SAMARITAN HEALTH SERVICES, INC PROVIDES QUALITY HEALTH CARE TO THE UNDERSERVED POPULATIONS WITHIN THE COMMUNITY. THE ORGANIZATION INTEGRATES SUPPORT FROM THE COMMUNITY AND EMPHASIZES A HOLISTIC APPROACH TO HEALTH CARE.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee23TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,134,246PYContributionsGrantsAmt
CY Contributions Grants$2,226,428CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$2,134,246PYTotalRevenueAmt
CY Total Revenue$2,226,428CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$468,026PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$624,170CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$202,484CYTotalFundraisingExpenseAmt
PY Other Expenses$1,523,434PYOtherExpensesAmt
CY Other Expenses$1,463,037CYOtherExpensesAmt
PY Total Expenses$1,991,460PYTotalExpensesAmt
CY Total Expenses$2,087,207CYTotalExpensesAmt
PY Revenues Less Expenses$142,786PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$139,221CYRevenuesLessExpensesAmt
Total Assets BOY$362,127TotalAssetsBOYAmt
Total Assets EOY$501,348TotalAssetsEOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$362,127NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$501,348NetAssetsOrFundBalancesEOYAmt
MissionGOOD SAMARITAN HEALTH SERVICES, INC PROVIDES QUALITY HEALTH CARE TO THE UNDERSERVED POPULATIONS WITHIN THE COMMUNITY. THE ORGANIZATION INTEGRATES SUPPORT FROM THE COMMUNITY AND EMPHASIZES A HOLISTIC APPROACH TO HEALTH CARE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,662,500ExpenseAmt
Grant$49,186GrantAmt
DescGood Samaritan Health Services (GSHS) provide nearly 6,000 free medical visits and essential medications by providing a medial home to over 2,300 patients. GSHS primarily targets persons and or areas in the community that are financially challenged and are unable to find or pay for their own medical care. GSHS two medical vehicles are outfitted with patient rooms, lab area and formulary to drive into the neighborhoods of most need in and around the Tulsa, OK area. Remodel began on a third medical vehicle to be put into operation in 2015. Partnership with local churches provide over 300 volunteers and the locations to connect patients with medical and companionate care including food and clothing pantries and face to face neighborly counsel at one of the 50 monthly health clinics. The GSHS mobile medical units have become a medical home for hundreds of people in the Tulsa and surrounding areas by meeting emotional and physical needs, providing health educationDesc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$26,031ExpenseAmt
Grant$14,479GrantAmt
DescThe Good Samaritan Health Services (GSHS) Well Women Clinics provide monthly specialty care for women in the greater Tulsa community including: Breast Exams, Mammograms (coupons donated through OK Project Woman), Pap Smears to check for cervical cancer, Education on breast health through printed materials, a film, question and answer time and on-on one instruction by the doctors. GSHS doctors see an average of 28 women per monthly clinic. A Breast Health Specialist was added in December 2014 through grant funding to provide specialized care to patients ensuring proper follow up on mammogram coupons and referrals as appropriate. Many of the patients have not had a breast exam or mammogram prior to coming to a Well Woman Clinic. Patients with a past history or family history of breast cancer are scheduled for follow-up exams. The GSHS Well Woman clinics primarily reach into the Hispanic, Caucasian, Russian, African American and Burmese communities; many of whomDesc
FieldValueIRS element (for citing)
Total Program Service Expenses$1,688,531TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document6IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee23EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldOKStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonBEN DODWELLPersonNm
Phone9187104222PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11441 E 75TH PL SOUTHAddressLine1Txt
CityTulsaCityNm
State AbbreviationOKStateAbbreviationCd
ZIP74136ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
MITCH DUININCK MD
EXECUTIVE DIRECTORCEO1.000.00Yes (X)$0$0$0
LOUISE WHITLEY
SECRETARY TREASURER1.000.00Yes (X)$0$0$0
REV THOMAS BOXLEY
TRUSTEE1.000.00Yes (X)$0$0$0
ANDREW L MURPHREE
TRUSTEE1.000.00Yes (X)$0$0$0
VANESSA NEAL
BOARD CHAIRMAN1.000.00Yes (X)$0$0$0
JOHN R CROUCH JR MD
PRESIDENT5.000.00$25,200$0$0Yes (X)
LAUREL WILLISTON MD
VICE PRESIDENT5.000.00$24,000$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$49,200TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Fundraising$162,360FundraisingAmt
All Other Contributions$2,064,068AllOtherContributionsAmt
Total Contributions$2,226,428TotalContributionsAmt
Contri Rpt Fundraising Event$162,360ContriRptFundraisingEventAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,226,428TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$64,689TotalAmt
Program Services$40,107ProgramServicesAmt
Management And General$11,644ManagementAndGeneralAmt
Fundraising$12,938FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$488,717TotalAmt
Program Services$303,005ProgramServicesAmt
Management And General$87,969ManagementAndGeneralAmt
Fundraising$97,743FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$24,744TotalAmt
Program Services$24,744ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$46,020TotalAmt
Program Services$28,532ProgramServicesAmt
Management And General$8,284ManagementAndGeneralAmt
Fundraising$9,204FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$106,200TotalAmt
Program Services$55,224ProgramServicesAmt
Management And General$41,418ManagementAndGeneralAmt
Fundraising$9,558FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$21,592TotalAmt
Program Services$16,194ProgramServicesAmt
Management And General$5,398ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,388TotalAmt
Management And General$1,388ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$2,539TotalAmt
Management And General$2,539ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$38,725TotalAmt
Program Services$38,725ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$56,723TotalAmt
Program Services$37,522ProgramServicesAmt
Management And General$13,614ManagementAndGeneralAmt
Fundraising$5,587FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtFundraisingFundraisingAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL EXPENSES$1,129,917$1,129,917
SPECIAL EVENTS$42,695$42,695
OTHER ADMINISTRATIVE$38,499$14,561$23,938
OTHER DEVELOPMENTAL EXPENSES$24,759$24,759

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,087,207TotalAmt
Program Services$1,688,531ProgramServicesAmt
Management And General$196,192ManagementAndGeneralAmt
Fundraising$202,484FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$184,514BOYAmt
EOY$336,193EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$707,126LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$541,971LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$177,613BOYAmt
EOY$165,155EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$362,127BOYAmt
EOY$501,348EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$332,127BOYAmt
EOY$427,123EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$30,000BOYAmt
EOY$74,225EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$362,127BOYAmt
EOY$501,348EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$362,127BOYAmt
EOY$501,348EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$139,221ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewYes (true)AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

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$931,781CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,538,681CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,874,655CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,113,246CurrentTaxYearMinus1YearAmt
Current Tax Year$2,226,818CurrentTaxYearAmt
Total$8,685,181TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$931,781CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,538,681CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,874,655CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,113,246CurrentTaxYearMinus1YearAmt
Current Tax Year$2,226,818CurrentTaxYearAmt
Total$8,685,181TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$849,822SubstantialContributorsTotAmt
Public Support Total170$7,835,359PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$528CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$689CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,366CurrentTaxYearMinus2YearsAmt
Current Tax Year$31CurrentTaxYearAmt
Total$4,614TotalAmt
FieldValueIRS element (for citing)
Total Support$8,689,795TotalSupportAmt
Public Support CY1700.90170PublicSupportCY170Pct
Public Support PY1700.76510PublicSupportPY170Pct
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

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$707,126OtherCostOrOtherBasisAmt
Depreciation$541,971DepreciationAmt
Book Value$165,155BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$165,155TotalBookValueLandBuildingsAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GALAEvent1Nm
Gross Receipts Event1$152,337GrossReceiptsEvent1Amt
Charitable Contri Event1$6,000CharitableContriEvent1Amt
Gross Revenue Event1$146,337GrossRevenueEvent1Amt
Cash Prizes Event1$378CashPrizesEvent1Amt
Food And Beverage Event1$23,082FoodAndBeverageEvent1Amt
Entertainment Event1$1,250EntertainmentEvent1Amt
Other Direct Expenses Event1$33,150OtherDirectExpensesEvent1Amt
Event2BREAKFASTEvent2Nm
Gross Receipts Event2$4,023GrossReceiptsEvent2Amt
Gross Revenue Event2$4,023GrossRevenueEvent2Amt
Food And Beverage Event2$2,895FoodAndBeverageEvent2Amt
Entertainment Event2$200EntertainmentEvent2Amt
Other Direct Expenses Event2$1,771OtherDirectExpensesEvent2Amt
Gross Receipts Total$156,360GrossReceiptsTotalAmt
Charitable Contributions Tot$6,000CharitableContributionsTotAmt
Gross Revenue Total Events$150,360GrossRevenueTotalEventsAmt
Cash Prizes Total Events$378CashPrizesTotalEventsAmt
Food And Beverage Total Events$25,977FoodAndBeverageTotalEventsAmt
Entertainment Total Events$1,450EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$34,921OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$62,726DirectExpenseSummaryEventsAmt
Net Income Summary$87,634NetIncomeSummaryAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 governing body review Part VI line 11THE BOARD WILL REVIEW THE 990 BEFORE IT IS SIGNED AND SUBMITTED TO THE IRS.
Conflict of interest policy compliance Part VI line 12cTHIS IS DICUSSED AT AN ANNUAL BOARD MEETING AND EACH MEMBER IS REQUIRED TO SIGN A DISCLOSURE STATEMENT.
CEO executive director top management comp Part VI line 15aCOMPENSATION DECISIONS ARE MADE BY THE BOARD.
Other officer or key employee compensation Part VI line 15bCOMPENSATION DECISIONS ARE MADE BY THE BOARD.
Governing documents etc available to public Part VI line 19GOVERNING DOCUMENTS ARE MADE TO THE PUBLIC UPON REQUEST.

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.