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LAFOLLETTE MEDICAL FOUNDATION INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
LAFOLLETTE MEDICAL FOUNDATION INC (EIN 20-4901729)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-08-28
IRS object ID
201402409349300325
Schema version
2013v3.0
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)
Return2014-08-28T12:27:42-05:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN621142155PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PUGH & COMPANY PCBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1315 N CEDAR BLUFF RD SUITE 200AddressLine1
CityKNOXVILLECity
StateTNState
ZIP Code37923ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN204901729EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LAFOLLETTE MEDICAL FOUNDATION INCBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlLAFOBusinessNameControlTxt
Phone4239126963PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 128AddressLine1
CityJACKSBOROCity
StateTNState
ZIP Code37757ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDR JAMES FARRISPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone4239126963PhoneNum
Signature2014-08-26SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRE FOUSTPreparerPersonNm
PTINP00745365PTIN
Phone8657690660PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDR JAMES FARRISPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 128AddressLine1
CityJACKSBOROCity
StateTNState
ZIP Code37757ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$2,804,730GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.LAFOLLETTEMEDICALFOUNDATION.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2006FormationYr
Legal Domicile StateTNLegalDomicileStateCd
Activity Or MissionTHE FOUNDATION IS ORGANIZED AS A PUBLIC BENEFIT CORPORATION FOR THE CHARITABLE PURPOSE OF MAKING DISTRIBUTIONS TO QUALIFYING 501(C)(3) ORGANIZATIONS THAT PROVIDE FOR THE HEALTHCARE OF THE RESIDENTS OF LAFOLLETTE COMMUNITY, WHICH INCLUDES ALL OF CAMPBELL COUNTY.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$393,937PYInvestmentIncomeAmt
CY Investment Income$653,005CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$393,937PYTotalRevenueAmt
CY Total Revenue$653,005CYTotalRevenueAmt
PY Grants And Similar Paid$602,253PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$641,412CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$134,606PYOtherExpensesAmt
CY Other Expenses$140,397CYOtherExpensesAmt
PY Total Expenses$736,859PYTotalExpensesAmt
CY Total Expenses$781,809CYTotalExpensesAmt
PY Revenues Less Expenses-$342,922PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$128,804CYRevenuesLessExpensesAmt
Total Assets BOY$10,129,485TotalAssetsBOYAmt
Total Assets EOY$10,425,668TotalAssetsEOYAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$10,129,485NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$10,425,668NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE FOUNDATION IS ORGANIZED AS A PUBLIC BENEFIT CORPORATION FOR THE CHARITABLE PURPOSE OF MAKING DISTRIBUTIONS TO QUALIFYING 501(C)(3) ORGANIZATIONS THAT PROVIDE FOR THE HEALTHCARE OF THE RESIDENTS OF LAFOLLETTE COMMUNITY, WHICH INCLUDES ALL OF CAMPBELL COUNTY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$641,412ExpenseAmt
Grant$641,412GrantAmt
DescTHE FOUNDATION IS ORGANIZED AS A PUBLIC BENEFIT CORPORATION FOR THE CHARITABLE PURPOSE OF MAKING DISTRIBUTIONS TO QUALIFYING 501(C)(3) ORGANIZATIONS THAT PROVIDE FOR THE HEALTHCARE OF THE RESIDENTS OF LAFOLLETTE COMMUNITY, WHICH INCLUDES ALL OF CAMPBELL COUNTY.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
DescTHE FOUNDATION IS ORGANIZED AS A PUBLIC BENEFIT CORPORATION FOR THE CHARITABLE PURPOSE OF MAKING DISTRIBUTIONS TO QUALIFYING 501(C)(3) ORGANIZATIONS THAT PROVIDE FOR THE HEALTHCARE OF THE RESIDENTS OF THE LAFOLLETTE,TN COMMUNITY.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$641,412TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldTNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JUNE WILBURNBusinessNameLine1
FieldValueIRS element (for citing)
Phone4239126963PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1905 RIVERVIEW DRIVEAddressLine1
CityLAFOLLETTECity
StateTNState
ZIP Code37766ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
BRENDA ROBARDS
TREASURER1.00Yes (X)$0$0$0
MIKE STANFIELD
DIRECTOR1.00Yes (X)$0$0$0
LUCY LOBERTINI
DIRECTOR1.00Yes (X)$0$0$0
KATHY MYERS
SECRETARY1.00Yes (X)$0$0$0
JUDGE SHAYNE SEXTON
DIRECTOR1.00Yes (X)$0$0$0
ELIZABETH ASBURY
DIRECTOR1.00Yes (X)$0$0$0
DR JAMES FARRIS
PRESIDENT AND CHAIRMAN1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$277,932TotalRevenueColumnAmt
Exclusion$277,932ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,526,798SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$2,151,725SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$375,073SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$375,073TotalRevenueColumnAmt
Exclusion$375,073ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$653,005TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$653,005ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$641,412TotalAmt
Program Services$641,412ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$6,630TotalAmt
Management And General$6,630ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$12,000TotalAmt
Management And General$12,000ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$101,155TotalAmt
Management And General$101,155ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$15,000TotalAmt
Management And General$15,000ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,565TotalAmt
Management And General$3,565ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,047TotalAmt
Management And General$2,047ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$781,809TotalAmt
Program Services$641,412ProgramServicesAmt
Management And General$140,397ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$478,280BOYAmt
EOY$524,529EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$9,651,205BOYAmt
EOY$9,901,139EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$10,129,485BOYAmt
EOY$10,425,668EOYAmt

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$10,129,485BOYAmt
EOY$10,425,668EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,129,485BOYAmt
EOY$10,425,668EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,129,485BOYAmt
EOY$10,425,668EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$128,804ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$420,208NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$4,779OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit Committee0AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

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

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$1,498,158CurrentTaxYearMinus2YearsAmt
Total$1,498,158TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$1,498,158CurrentTaxYearMinus2YearsAmt
Total$1,498,158TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$1,498,158PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$231,982CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$251,778CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$260,522CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$279,611CurrentTaxYearMinus1YearAmt
Current Tax Year$277,932CurrentTaxYearAmt
Total$1,301,825TotalAmt
FieldValueIRS element (for citing)
Total Support$2,799,983TotalSupportAmt
Public Support CY1700.53510PublicSupportCY170Pct
Public Support PY1700.50530PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$1,073,213TotalRevEtcAuditedFinclStmtAmt
Other Revenue$420,208OtherRevenueAmt
Revenue Not Reported$420,208RevenueNotReportedAmt
Revenue Subtotal$653,005RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$653,005TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$777,030TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$777,030ExpensesSubtotalAmt
Other Expenses Not Included$4,779OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$4,779ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$781,809TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:GAAP REQUIRES MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FOUNDATION. MANAGEMENT HAS EVALUATED THE FOUNDATION'S TAX POSITIONS AND CONCLUDED THAT THE FOUNDATION MAINTAINED ITS TAX EXEMPT STATUS DURING THE YEARS ENDED DECEMBER 31,2013 AND 2012. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS.
PART XI, LINE 2D - OTHER ADJUSTMENTS:UNREALIZED GAINS ON INVESTMENTS 420,208.
PART XII, LINE 4B - OTHER ADJUSTMENTS:RECOVERIES OF PRIOR YEAR GRANTS 4,779.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (17 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtValuation Method UsedValuationMethodUsedDescPurpose Of GrantPurposeOfGrantTxt
THE SHEPHERD'S HOME INC
P O BOX 707JACKSBOROTN37757270988603501(C)(3)$70,368CASH GRANTHEALTH CARE
FOOD LIFE SERVICES OF CAMPBELL COUNTY
206 S INDIANA AVELAFOLLETTETN37766621812105501(C)(3)$65,000CASH GRANTHEALTH CARE
CAMPBELL COUNTY SENIOR CITIZENS
102 8TH STREETLAFOLLETTETN37766620988347501(C)(3)$66,902CASH GRANTHEALTH CARE
CAMPBELL COUNTY CHILDREN'S CENTER
2315 JACKSBORO PIKEJACKSBOROTN37766780251005501(C)(3)$80,503CASH GRANTHEALTH CARE
EAST TENNESSEE HUMAN RESOURCE AGENCY INC
9111 CROSS PARK DRIVE D-100KNOXVILLETN37923621493851501(C)(3)$22,000CASH GRANTHEALTH CARE
CHET - COMMUNITY HEALTH OF EAST TN
P O BOX 209 507 MAIN STJACKSBOROTN37757581470587501(C)(3)$38,551CASH GRANTHEALTH CARE
TN BAPTIST ADULT HOMES
PO BOX 728BRENTWOODTN37024620934533501(C)(3)$25,000CASH GRANTHEALTH CARE
CASA OF CAMPBELL COUNTY
PO BOX 1054JACKSBOROTN37757205755609501(C)(3)$18,500CASH GRANTHEALTH CARE
JELLICO COMMUNITY HOSPITAL
188 HOSPITAL LANEJELLICOTN37762620924706501(C)(3)$7,000CASH GRANTHEALTH CARE
CAMPBELL COUNTY LIONS CLUB CHARITIES
P O BOX 1205LA FOLLETTETN37766753241283501(C)(3)$21,500CASH GRANTHEALTH CARE
CUMBERLAND HOPE COMMUNITY CHURCH
942 TOWE STRING RDJACKSBOROTN37757861098276501(C)(3)$16,500CASH GRANTHEALTH CARE
CAMPBELL COUNTY RURAL FIRE SERVICE
P O BOX 341LA FOLLETTETN37766621315582501(C)(3)$9,250CASH GRANTHEALTH CARE
LAFOLLETTE LIFE SAVINGS AND RESCUE SQUAD INCORPORATED
P O BOX 282LA FOLLETTETN37766621128575501(C)(3)$15,000HEALTH CARE
HELEN ROSS MCNABB CENTER
201 W SPRINGDALE AVENUEKNOXVILLETN37917620548914501(C)(3)$59,756CASH GRANTHEALTH CARE
CATHOLIC CARITIES OF EAST TENNESSEE
3009 LAKE BROOK BLVDKNOXVILLETN37909621377551501(C)(3)$17,000CASH GRANTHEALTH CARE
CAMPBELL COUNTY BOARD OF EDUCATION
172 VALLEY STJACKSBOROTN37757606000507GOVERMENT AGENCY$74,458CASH GRANTHEALTH CARE
CITY OF LAFOLLETTE FIRE DEPARTMENT
105 EAST BEECH STLA FOLLETTETN37766626000328GOVERMENT AGENCY$34,124CASH GRANTHEALTH CARE
FieldValueIRS element (for citing)
Total501c3 Org19Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990; SCHEDULE I; PART I; LINE 2FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION SELECTS ORGANIZATIONS THAT ENGAGE IN ACTIVITIES AND MAKE DISTRIBUTIONS THAT PROVIDE FOR THE HEALTHCARE OF THE RESIDENTS OF THE LAFOLLETTE. THE PROPERTY, AFFAIRS AND BUSINESS OF THE FOUNDATION ARE TO BE MANAGED BY A BOARD OF DIRECTORS, WHOSE OPERATIONS IN GOVERNING THE FOUNDATION ARE DEFINED BY TENNESSEE STATUTE AND THE FOUNDATIONS BYLAWS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATION'S CONFLICT OF INTEREST POLICY CALLS FOR ANNUAL STATEMENTS TO BE SIGNED EACH YEAR. ARTICLE VII CALLS FOR PERIODIC REVIEWS OF COMPENSATION ISSUES AND RELATED PARTY AFFILIATIONS.
FORM 990, PART VI, SECTION B, LINE 11THE 990 IS PRESENTED TO EACH BOARD MEMBER PRIOR TO THE MEETING FOR MEMBERS TO VIEW PRIOR TO THE FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION'S CONFLICT OF INTEREST POLICY CALLS FOR ANNUAL STATEMENTS SHALL BE SIGNED EACH YEAR. ARTICLE VII CALLS FOR PERIODIC REVIEWS OF COMPENSATION ISSUES AND RELATED PARTY AFFILIATIONS.
FORM 990, PART VI, SECTION C, LINE 19AVAILABLE UPON REQUEST
FORM 990, PART XI, LINE 9:RECOVERIES OF PRIOR YEARS GRANTS 4,779.

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