HANDS UP FOR HAITI INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
HANDS UP FOR HAITI INC (EIN 45-2107443)
Tax period
2012-09-01 to 2013-08-31
Filed
2014-07-15
IRS object ID
201411969349300806
Schema version
2012v2.0
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)
Timestamp2014-07-15T07:51:27-07:00Timestamp
Tax Period End Date2013-08-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1RRC PRICE CPAS PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1133 Route 304AddressLine1
CityBardoniaCity
StateNYState
ZIP Code10954ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-09-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN452107443EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HANDS UP FOR HAITI INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHANDNameControl
Phone9147673313Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 569 ROUTES 22 138AddressLine1
CityGOLDENS BRIDGECity
StateNYState
ZIP Code10526ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameIRENE JILL RATNERName
TitlePRESIDENT & DIRECTORTitle
Date Signed2014-07-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJoel E Rosenberg CPAName
PTINP00182078PTIN
Phone9147673313Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts328730GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2011YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionTHE CORPORATION EXPECTS TO ACHIEVE THIS MISSION BY ESTABLISHING OR SUPPORTING EXISTING HEALTH CARE CLINICS, IMMUNIZATION PROGRAMS, NUTRITION AND DEVELOPMENT PROGRAMS, AND HEALTH EDUCATION PROGRAMS IN UNDERSERVED COMMUNITIES.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members3NbrIndependentVotingMembers
Total Nbr Employees1TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year121469ContributionsGrantsPriorYear
Contributions Grants Current Year150197ContributionsGrantsCurrentYear
Program Service Revenue Prior Year81646ProgramServiceRevenuePriorYear
Program Service Revenue CY111311ProgramServiceRevenueCY
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year6006OtherRevenuePriorYear
Other Revenue Current Year49780OtherRevenueCurrentYear
Total Revenue Prior Year209121TotalRevenuePriorYear
Total Revenue Current Year311288TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year5822SalariesEtcPriorYear
Salaries Etc Current Year5027SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year1426TotalFundrsngExpCurrentYear
Other Expense Prior Year164782OtherExpensePriorYear
Other Expenses Current Year306815OtherExpensesCurrentYear
Total Expenses Prior Year170604TotalExpensesPriorYear
Total Expenses Current Year311842TotalExpensesCurrentYear
Revenues Less Expenses Prior Year38517RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-554RevenuesLessExpensesCY
Total Assets BOY87336TotalAssetsBOY
Total Assets EOY91873TotalAssetsEOY
Total Liabilities EOY5091TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY87336NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY86782NetAssetsOrFundBalancesEOY
Mission DescriptionTO ALLEVIATE HUMAN SUFFERING AND DISTRESS BY ASSISTING MEDICAL PROFESSIONALS TO PROVIDE HEALTH CARE SERVICES TO THOSE LIVING IN IMPOVERISHED AREAS, INCLUDING BUT NOT LIMITED TO THE REPUBLIC OF HAITI.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense306432Expense
DescriptionA HEALTHCARE CLINIC WAS ESTABLISHED.NUMEROUS MEDICAL MISSIONS TO PROVIDE HEALTHCARE IN PEDIATRICS, OBSTETRICS AND GYNECOLOGY, OPTHMOLOGY AND INTERNAL MEDICINE. EDUCATED EXPECTANT MOTHERS ON NUTRITION AND HELD BREASTFEEDING CLINICS FOR NEW MOTHERS.Description
Total Program Service Expense306432TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingtrueGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees1NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members3NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonACCOUNTANTNamePerson
Telephone Number9147673313TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 569 ROUTES 22 138AddressLine1
CityGOLDENS BRIDGECity
StateNYState
ZIP Code10526ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
HOPE BECHARD
Director3.000.00XX000
NAOMI KOLLER
Director3.000.00XX000
MATTHER CHISIDE
ASST TREAS10.000.00XX000
KAREN AKST SCHECTER
Director10.000.00XX000
CHRISTINE SALMON
Secretary10.000.00XX000
STEVEN FORTIN
Treasurer10.000.00XX000
JUDY MCAVOY
Director3.000.00XX000
MARY ANN LOFRUMENTO
VP/DIRECTOR5.000.00XX000
LAMAR PARKIN
EXEC DIRECT5.000.00XX000
AMY PARKIN
Director3.000.00XX000
IRENE JILL RATNER
PRES/DIRECTOR10.000.00XX000
FieldValueIRS element (for citing)
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
All Other Contributions150197AllOtherContributions
Noncash Contributions110021NoncashContributions
Total Contributions150197TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionTRIP FEESDescription
Total Revenue Column111311TotalRevenueColumn
Related Or Exempt Function Income111311RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue111311TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Income Gaming67222GrossIncomeGaming
Gaming Direct Expenses17442GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column49780TotalRevenueColumn
Exclusion$49,780ExclusionAmount

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column311288TotalRevenueColumn
Related Or Exempt Function Income111311RelatedOrExemptFunctionIncome
Exclusion$49,780ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4500Total
Program Services4500ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total527Total
Program Services527ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1297Total
Program Services1194ProgramServices
Management And General103ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total3910Total
Program Services3910ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1986Total
Management And General1986ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total18050Total
Program Services18050ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total703Total
Management And General703ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4595Total
Program Services4595ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
PROJECT COSTS1539215392
MEDICAL SUPPLIES1792717927
DONATED MEDICAL EQUIPMENT110021110021
TRIP COSTS113111113111

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total19823Total
Program Services17205ProgramServices
Management And General1192ManagementAndGeneral
Fundraising1426Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total311842Total
Program Services306432ProgramServices
Management And General3984ManagementAndGeneral
Fundraising1426Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY81797BOY
EOY82207EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
EOY0EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis15985LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec6319LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY5539BOY
EOY9666EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY87336BOY
EOY91873EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
EOY5091EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY5091EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY72926BOY
EOY74472EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY14410BOY
EOY12310EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY87336BOY
EOY86782EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY87336BOY
EOY91873EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-554ReconcilationRevenueExpenses
Method Of Accounting CashXMethodOfAccountingCash
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year121469CurrentTaxYearMinus1Year
Current Tax Year150197CurrentTaxYear
Total271666Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Total0Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year121469CurrentTaxYearMinus1Year
Current Tax Year150197CurrentTaxYear
Total271666Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509271666PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Total0Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year87652CurrentTaxYearMinus1Year
Current Tax Year178533CurrentTaxYear
Total266185Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year209121CurrentTaxYearMinus1Year
Current Tax Year328730CurrentTaxYear
Total537851Total
FieldValueIRS element (for citing)
First5 Years509XFirst5Years509
Public Support Percentage5090.00000PublicSupportPercentage509
Investment Income Percentage0.00000InvestmentIncomePercentage

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis15985InvestmentCostOrOtherBasis
Depreciation6319Depreciation
Book Value9666BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings9666TotalOfBookValueLandBuildings
Tot Revenue Etc Audited Fincl Stmt311288TotRevenueEtcAuditedFinclStmt
Revenue Subtotal311288RevenueSubtotal
Total Revenue Per Form990311288TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt311842TotExpensesEtcAuditedFinclStmt
Expenses Subtotal311842ExpensesSubtotal
Total Expenses Per Form990311842TotalExpensesPerForm990

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsXMailSolicitations
In Person SolicitationsXInPersonSolicitations
Agreement Ref FundraisingfalseAgreementRefFundraising

Gaming Information GamingInformation

FieldValueIRS element (for citing)
Volunteer Labor BingofalseVolunteerLaborBingo
Volunteer Labor Pull TabsfalseVolunteerLaborPullTabs
Gross Revenue Other Gaming67222GrossRevenueOtherGaming
Other Direct Expenses Other Gaming17442OtherDirectExpensesOtherGaming
Volunteer Labor Other GamingfalseVolunteerLaborOtherGaming
Gross Revenue Total Gaming67222GrossRevenueTotalGaming
Other Direct Expenses Total Gaming17442OtherDirectExpensesTotalGaming
Direct Expense Summary Gaming17442DirectExpenseSummaryGaming
Net Gaming Income Summary49780NetGamingIncomeSummary
FieldValueIRS element (for citing)
LicensedtrueLicensed
License Suspended EtcfalseLicenseSuspendedEtc
Gaming With NonmembersfalseGamingWithNonmembers
Member Of Other EntityfalseMemberOfOtherEntity
Percentage Of Gaming Othr Facility1.00000PercentageOfGamingOthrFacility
Contract With3rd Party For Gam RevfalseContractWith3rdPartyForGamRev
Charitable Distrib RequiredfalseCharitableDistribRequired

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990110021NoncashContribsRptdF990
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableALL DOCUMENTS ARE MADE AVAILABLE UPON REQUEST
Form 990, Part VI, Line 11bForm 990, Part VI, Line 11b: Form 990 Review ProcessRETURN WILL BE REVIEWED BY TREASURER AND PRESENTED TO THE BOARD OF DIRECTORS FOR APPROVAL.
Form 990, Part VI, Line 2Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, EtTWO OF THE BOARD MEMBERS ARE MARRIED

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