PAROCHIAL MEDICAL CENTER: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
PAROCHIAL MEDICAL CENTER (EIN 23-2300834)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-03-20
IRS object ID
201520799349300102
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)
Return2015-03-20T08:21:26-05:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN251822544PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SNIEGOCKI & ASSOCIATES PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 606AddressLine1Txt
CityPALMYRACityNm
State AbbreviationPAStateAbbreviationCd
ZIP17078ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN232300834EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PAROCHIAL MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPAROBusinessNameControlTxt
Phone7175560702PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11065 WEST MAIN STREETAddressLine1Txt
CityNEW HOLLANDCityNm
State AbbreviationPAStateAbbreviationCd
ZIP17557ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMELVIN H HOOVERPersonNm
Person TitleTREASURERPersonTitleTxt
Phone7175560702PhoneNum
Signature2015-03-06SignatureDt

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSUE A HARVEYPreparerPersonNm
PTINP00284946PTIN
Phone7178382682PhoneNum
Preparation2015-03-13PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts$1,418,582GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1984FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionPROVIDE PHYSICAL AND MENTAL HEALTH CARE SERVICES TO THE UNINSURED AND PROMOTE HEALTH AND WELL BEING OF INDIVIDUALS IN SOUTH CENTRAL PENNSYLVANIA.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee18TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$46,732PYContributionsGrantsAmt
CY Contributions Grants$55,000CYContributionsGrantsAmt
PY Program Service Revenue$1,249,004PYProgramServiceRevenueAmt
CY Program Service Revenue$1,361,993CYProgramServiceRevenueAmt
PY Investment Income$2,237PYInvestmentIncomeAmt
CY Investment Income$1,589CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$1,297,973PYTotalRevenueAmt
CY Total Revenue$1,418,582CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$791,225PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$781,174CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$567,713PYOtherExpensesAmt
CY Other Expenses$635,701CYOtherExpensesAmt
PY Total Expenses$1,358,938PYTotalExpensesAmt
CY Total Expenses$1,416,875CYTotalExpensesAmt
PY Revenues Less Expenses-$60,965PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,707CYRevenuesLessExpensesAmt
Total Assets BOY$546,330TotalAssetsBOYAmt
Total Assets EOY$524,069TotalAssetsEOYAmt
Total Liabilities BOY$369,825TotalLiabilitiesBOYAmt
Total Liabilities EOY$345,857TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$176,505NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$178,212NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE PHYSICAL AND MENTAL HEALTH CARE SERVICES TO THE UNINSURED AND PROMOTE HEALTH AND WELL BEING OF INDIVIDUALS IN SOUTH CENTRAL PENNSYLVANIA.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,235,358ExpenseAmt
Revenue$1,361,993RevenueAmt
DescAPPROXIMATELY 7,300 PATIENTS OF THE PLAIN AND UNINSURED COMMUNITY RECEIVED HEALTH CARE SERVICES.Desc
Total Program Service Expenses$1,235,358TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other 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 ActivitiesfalseFundraisingActivitiesInd
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 OutstandingYes (true)LoanOutstandingInd
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
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredfalseScheduleORequiredInd
IRP Document5IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee18EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcfalseRegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMELVIN HOOVERPersonNm
Phone7175560702PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11065 WEST MAIN STREETAddressLine1Txt
CityNEW HOLLANDCityNm
State AbbreviationPAStateAbbreviationCd
ZIP17557ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
ALLEN HOOVER
DIRECTOR1.00Yes (X)$10,245$0$0
STEVE HUYARD
DIRECTOR1.00Yes (X)$0$0$0
BEN BEILER
DIRECTOR1.00Yes (X)$0$0$0
PAUL BURKHOLDER
DIRECTOR1.00Yes (X)$0$0$0
MERVIN M MARTIN
DIRECTOR1.00Yes (X)$0$0$0
SAMUEL HERSCHBERGER
DIRECTOR1.00Yes (X)$0$0$0
HENRY M HOOVER
DIRECTOR1.00Yes (X)$0$0$0
DANIEL LAPP
CHAIRMAN2.00$0$0$0Yes (X)
SAM KINSINGER
V CHAIRMAN1.00$0$0$0Yes (X)
MELVIN HOOVER
TREASURER4.00$0$0$0Yes (X)
ELAM STOLTZFUS
SECRETARY1.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$10,245TotalReportableCompFromOrgAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$55,000AllOtherContributionsAmt
Total Contributions$55,000TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
OFFICE VISITS$697,224$697,224
PROCEDURES/SUPPLIES$264,743$264,743
LAB WORK/E-RAY$227,206$227,206
MEDICATIONS$164,000$164,000
RENTAL$8,820$8,820
FieldValueIRS element (for citing)
Total Program Service Revenue$1,361,993TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,589TotalRevenueColumnAmt
Exclusion$1,589ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,418,582TotalRevenueColumnAmt
Related Or Exempt Func Income$1,361,993RelatedOrExemptFuncIncomeAmt
Exclusion$1,589ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$729,903TotalAmt
Program Services$671,481ProgramServicesAmt
Management And General$58,422ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$51,271TotalAmt
Program Services$51,271ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$7,273TotalAmt
Management And General$7,273ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$3,888TotalAmt
Program Services$3,888ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$19,678TotalAmt
Management And General$19,678ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$25,235TotalAmt
Program Services$25,235ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,141TotalAmt
Management And General$1,141ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$10,736TotalAmt
Program Services$10,736ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$29,310TotalAmt
Program Services$29,310ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
OUTSIDE PROFESSIONAL SERV$171,226$171,226
MEDICINES & SUPPLIES$80,306$80,306
OPERATING SUPPLIES$76,445$76,445
LAB FEES & SUPPLIES$62,346$62,346

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$148,117TotalAmt
Program Services$129,559ProgramServicesAmt
Management And General$18,558ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,416,875TotalAmt
Program Services$1,235,358ProgramServicesAmt
Management And General$181,517ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$33,871BOYAmt
EOY$40,094EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$47,176BOYAmt
EOY$27,498EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$973,009LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$522,372LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$459,443BOYAmt
EOY$450,637EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$5,840BOYAmt
EOY$5,840EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$546,330BOYAmt
EOY$524,069EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$251,825BOYAmt
EOY$229,857EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$103,000BOYAmt
EOY$101,000EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$15,000BOYAmt
EOY$15,000EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$369,825BOYAmt
EOY$345,857EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$176,505BOYAmt
EOY$178,212EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$176,505BOYAmt
EOY$178,212EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$546,330BOYAmt
EOY$524,069EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,707ReconcilationRevenueExpnssAmt
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
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

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

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$10,896CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$46,732CurrentTaxYearMinus1YearAmt
Current Tax Year$55,000CurrentTaxYearAmt
Total$112,628TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,088,449CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,216,843CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,095,942CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,249,004CurrentTaxYearMinus1YearAmt
Current Tax Year$1,361,993CurrentTaxYearAmt
Total$6,012,231TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,088,449CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,216,843CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,106,838CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,295,736CurrentTaxYearMinus1YearAmt
Current Tax Year$1,416,993CurrentTaxYearAmt
Total$6,124,859TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$6,124,859PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,972CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,707CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,998CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,237CurrentTaxYearMinus1YearAmt
Current Tax Year$1,589CurrentTaxYearAmt
Total$14,503TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,972CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,707CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,998CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,237CurrentTaxYearMinus1YearAmt
Current Tax Year$1,589CurrentTaxYearAmt
Total$14,503TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,092,421CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,220,550CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,109,836CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,297,973CurrentTaxYearMinus1YearAmt
Current Tax Year$1,418,582CurrentTaxYearAmt
Total$6,139,362TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99760PublicSupportCY509Pct
Public Support PY5090.99760PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

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$40,000OtherCostOrOtherBasisAmt
Book Value$40,000BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$766,076OtherCostOrOtherBasisAmt
Depreciation$384,755DepreciationAmt
Book Value$381,321BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$166,933OtherCostOrOtherBasisAmt
Depreciation$137,617DepreciationAmt
Book Value$29,316BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$450,637TotalBookValueLandBuildingsAmt

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)

Relationship With OrgRelationshipWithOrgTxtLoan PurposeLoanPurposeTxtLoan To OrganizationLoanToOrganizationIndOriginal PrincipalOriginalPrincipalAmtBalance DueBalanceDueAmtDefaultDefaultIndBoard Or Committee ApprovalBoardOrCommitteeApprovalIndWritten AgreementWrittenAgreementInd
S KINSINGER
VICE-CHAIRMANCASH FLOW NEEDSYes (X)$175,000$95,000falsefalsefalse
H HOOVER
DIRECTORCASH FLOW NEEDSYes (X)$8,000$6,000falsefalsefalse
FieldValueIRS element (for citing)
Total Balance Due$101,000TotalBalanceDueAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BNO REVIEW WAS OR WILL BE CONDUCTED.
FORM 990, PAGE 6, PART VI, LINE 19NO DOCUMENTS AVAILABLE TO THE PUBLIC
FORM 990, PART IX, LINE 24EEMPLOYEE INSURANCE 43,135 0 0 OUTSIDE PSYCHIATRIC SERVI 41,330 0 0 INSURANCE 22,365 0 0 CLEANING 12,311 0 0 BANK FEES 0 6,798 0 EDUCATION/SEMINARS 0 6,221 0 TELEPHONE 5,710 0 0 REPAIRS & MAINTENANCE 4,350 0 0 FREIGHT & POSTAGE 0 2,512 0 LICENSES AND PERMITS 0 1,719 0 DUES & SUBSCRIPTIONS 0 916 0 MISCELLANEOUS 0 392 0 OUTSIDE SERVICES 358 0 0

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