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NORTHWEST GEORGIA MEDICAL FOUNDATION INC: Form 990EZ, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
NORTHWEST GEORGIA MEDICAL FOUNDATION INC (EIN 45-3907541)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-05-14
IRS object ID
201541349349202404
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)
Return2015-05-14T12:26:43-05:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN461381910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WHITTINGTON JONES & RUDERT CPAS LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1264AddressLine1Txt
CityROMECityNm
State AbbreviationGAStateAbbreviationCd
ZIP301621264ZIPCd
FieldValueIRS element (for citing)
Return Type990EZReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN453907541EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NORTHWEST GEORGIA MEDICAL FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlNORTBusinessNameControlTxt
Phone7062918853PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1415 E 3RD AVEAddressLine1Txt
CityROMECityNm
State AbbreviationGAStateAbbreviationCd
ZIP30161ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDR AL DIAZPersonNm
Person TitleCHAIRMANPersonTitleTxt
Phone7062918853PhoneNum
Signature2015-05-01SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJILL MASLANKAPreparerPersonNm
PTINP01035911PTIN
Phone7062347571PhoneNum
Preparation2015-05-01PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990-EZ IRS990EZ

FieldValueIRS element (for citing)
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Website AddressN/AWebsiteAddressTxt
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization OtherYes (X)TypeOfOrganizationOtherInd
Type Of Organization OtherTAX-EXEMPTTypeOfOrganizationOtherDesc
Gross Receipts$58,500GrossReceiptsAmt
Info In Schedule O Part IYes (X)InfoInScheduleOPartIInd
Contributions Gifts Grants Etc$58,500ContributionsGiftsGrantsEtcAmt
Total Revenue$58,500TotalRevenueAmt
Fees And Other Pymt To Ind Cntrct$697FeesAndOtherPymtToIndCntrctAmt
Occupancy Rent Utlts And Maint$763OccupancyRentUtltsAndMaintAmt
Other Expenses Total$231OtherExpensesTotalAmt
Total Expenses$1,691TotalExpensesAmt
Excess Or Deficit For Year$56,809ExcessOrDeficitForYearAmt
Net Assets Or Fund Balances BOY$24,183NetAssetsOrFundBalancesBOYAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Net Assets Or Fund Balances EOY$80,992NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIYes (X)InfoInScheduleOPartIIInd

Cash Savings And Investments CashSavingsAndInvestmentsGrp

FieldValueIRS element (for citing)
BOY$22,601BOYAmt
EOY$76,421EOYAmt

Other Assets Total Detail OtherAssetsTotalDetail

FieldValueIRS element (for citing)
BOY$1,582BOYAmt
EOY$4,571EOYAmt

Form990 Total Assets Form990TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$24,183BOYAmt
EOY$80,992EOYAmt

Sum Of Total Liabilities SumOfTotalLiabilitiesGrp

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

Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp

FieldValueIRS element (for citing)
BOY$24,183BOYAmt
EOY$80,992EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
Primary Exempt PurposeTHE PRIMARY PURPOSE OF THE CORPORATION IS THE SOLICITATION OF CONTRIBUTIONS, GIFTS, BEQUESTS AND CONVEYANCES OF REAL AND PERSONAL PROPERTY, INCLUDING MONEY, TO BE USED FOR THE BENEFIT OF AND TO CARRY OUT THE MISSION AND PURPOSE OF EDUCATING STUDENTS OF THE GEORGIA HEALTH SCIENCES UNIVERSITY AT ITS ROME, GEORGIA CAMPUS.PrimaryExemptPurposeTxt

Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp

FieldValueIRS element (for citing)
Description Program Srvc AccomTO PROVIDE SUPPORT TO THE NORTHWEST GEORGIA CLINICAL CAMPUS OF THE MEDICAL COLLEGE OF GEORGIA.DescriptionProgramSrvcAccomTxt
Grants And Allocations$0GrantsAndAllocationsAmt
Program Service Expenses$0ProgramServiceExpensesAmt
FieldValueIRS element (for citing)
Total Program Service Expenses$0TotalProgramServiceExpensesAmt

Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (10 entries)

TitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
DR AL DIAZ
CHAIRMAN1.00$0$0$0
DR JOE BURCH
SECRETARY1.00$0$0$0
DR JULIE BARNES
TREASURER1.00$0$0$0
DR KEN DAVIS
DIRECTOR1.00$0$0$0
JOHN QUINLIVAN
DIRECTOR1.00$0$0$0
DR DEE RUSSELL
DIRECTOR1.00$0$0$0
DR JOHN DESMOND
DIRECTOR1.00$0$0$0
DR JOE BIUSO
DIRECTOR1.00$0$0$0
STEPHEN SPRIGGS
DIRECTOR AT-LARGE1.00$0$0$0
RENVA WATTERSON
DIRECTOR AT-LARGE1.00$0$0$0
FieldValueIRS element (for citing)
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
Activities Not Previously Rpt0ActivitiesNotPreviouslyRptInd
Chg Made To Orgnzng Doc Not Rpt0ChgMadeToOrgnzngDocNotRptInd
Organization Had UBI0OrganizationHadUBIInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Organization Dissolved Etc0OrganizationDissolvedEtcInd
Direct Indirect Pltcl Expend$0DirectIndirectPltclExpendAmt
Made Loans To From Officers0MadeLoansToFromOfficersInd
Tax Imposed Under IRC4911$0TaxImposedUnderIRC4911Amt
Tax Imposed Under IRC4912$0TaxImposedUnderIRC4912Amt
Tax Imposed Under IRC4955$0TaxImposedUnderIRC4955Amt
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
Tax Imposed On Organization Mgr$0TaxImposedOnOrganizationMgrAmt
Tax Reimbursed By Organization$0TaxReimbursedByOrganizationAmt
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DR JULIE BARNESBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1415 E 3RD AVENUEAddressLine1Txt
CityROMECityNm
State AbbreviationGAStateAbbreviationCd
ZIP30161ZIPCd
FieldValueIRS element (for citing)
Phone7062918853PhoneNum
FieldValueIRS element (for citing)
Foreign Financial Account0ForeignFinancialAccountInd
Foreign Office0ForeignOfficeInd
Donor Advised Fnds0DonorAdvisedFndsInd
Operate Hospital0OperateHospitalInd
Tanning Services Provided0TanningServicesProvidedInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
School Operating0SchoolOperatingInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Part VI Of Comp Of Hghst Pd EmplNONEPartVIOfCompOfHghstPdEmplTxt
Part VI Hghst Pd Cntrct Prof SrvcNONEPartVIHghstPdCntrctProfSrvcTxt
Filed Schedule AYes (1)FiledScheduleAInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
College OrganizationYes (X)CollegeOrganizationInd

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$27,000CurrentTaxYearMinus1YearAmt
Current Tax Year$58,500CurrentTaxYearAmt
Total$85,500TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$27,000CurrentTaxYearMinus1YearAmt
Current Tax Year$58,500CurrentTaxYearAmt
Total$85,500TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$85,500PublicSupportTotal170Amt
Total Support$85,500TotalSupportAmt
Public Support CY1701.00000PublicSupportCY170Pct
Public Support PY1701.00000PublicSupportPY170Pct
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 O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990-EZ, PART I, LINE 14DESCRIPTION: DEPRECIATION. AMOUNT: 763.
FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSESDESCRIPTION: LICENSES & PERMITS. AMOUNT: 10. DESCRIPTION: MISCELLANEOUS. AMOUNT: 221. TOTAL TO FORM 990-EZ, LINE 16: 231.
FORM 990-EZ, PART II, LINE 24 - OTHER ASSETSDESCRIPTION: OTHER DEPRECIABLE ASSETS. BEG. OF YEAR AMOUNT: 1,582. END OF YEAR AMOUNT: 4,571.

Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl

FieldValueIRS element (for citing)
DeclarationTHE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.DeclarationDesc

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