CLARKSVILLE MONTGOMERY COUNTYCOMMUNITY HEALTH FOUNDATION INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- CLARKSVILLE MONTGOMERY COUNTYCOMMUNITY HEALTH FOUNDATION INC (EIN 20-4862825)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-14
- IRS object ID
- 201413189349304981
- Schema version
- 2013v3.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-14T12:34:21-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 263683574 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THURMAN CAMPBELL GROUP PLC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 324 FRANKLIN ST | AddressLine1 |
| City | CLARKSVILLE | City |
| State | TN | State |
| ZIP Code | 37040 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 204862825 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARKSVILLE-MONTGOMERY COUNTY | BusinessNameLine1 |
| Business Name Line2 | COMMUNITY HEALTH FOUNDATION INC | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CLAR | BusinessNameControlTxt |
| Phone | 9315021131 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 31003 | AddressLine1 |
| City | CLARKSVILLE | City |
| State | TN | State |
| ZIP Code | 37040 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MIKE O'MALLEY | PersonNm |
| Person Title | CHAIRMAN OF THE BOARD | PersonTitleTxt |
| Phone | 9315021131 | PhoneNum |
| Signature | 2014-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFFERY PROCTOR | PreparerPersonNm |
| PTIN | P00854519 | PTIN |
| Phone | 9315527474 | PhoneNum |
| Preparation | 2014-11-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,541,151 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | COMMUNITYHEALTHFOUNDATION.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION IS OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE RESIDENTS OF CLARKSVILLE,TN; MONTGOMERY COUNTY, TN; AND THE COUNTIES OF NORTHERN MIDDLE TN AND FORT CAMPBELL, KY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $3,000,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,077,000 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $304,743 | PYInvestmentIncomeAmt |
| CY Investment Income | $519,913 | CYInvestmentIncomeAmt |
| PY Other Revenue | $619,645 | PYOtherRevenueAmt |
| CY Other Revenue | $779,988 | CYOtherRevenueAmt |
| PY Total Revenue | $3,924,388 | PYTotalRevenueAmt |
| CY Total Revenue | $2,376,901 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $534,083 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,005,286 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $23,710 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $24,655 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $98,013 | PYOtherExpensesAmt |
| CY Other Expenses | $109,864 | CYOtherExpensesAmt |
| PY Total Expenses | $655,806 | PYTotalExpensesAmt |
| CY Total Expenses | $1,139,805 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,268,582 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,237,096 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,566,354 | TotalAssetsBOYAmt |
| Total Assets EOY | $19,181,339 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $14,286 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,440 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $16,552,068 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,174,899 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE ORGANIZATION IS OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE RESIDENTS OF CLARKSVILLE,TN; MONTGOMERY COUNTY, TN; AND THE COUNTIES OF NORTHERN MIDDLE TN AND FORT CAMPBELL, KY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,006,089 | ExpenseAmt |
| Grant | $1,005,286 | GrantAmt |
| Revenue | $1,077,000 | RevenueAmt |
| Desc | HEALTH INITIATIVES, EDUCATION, AND PROJECTS SUPPORTING THE COMMUNITY. | Desc |
| Total Program Service Expenses | $1,006,089 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | false | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | false | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | false | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PAULA JOHNSON | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9315021131 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 651 DUNLOP LANE | AddressLine1 |
| City | CLARKSVILLE | City |
| State | TN | State |
| ZIP Code | 37040 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|
| MARCOS A ARANCIBIA | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| ANNE BLACK | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| CAROLYN BOWERS | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| KAY DREW | |||||
| SECRETARY/TR | Yes (X) | $0 | $0 | $0 | Yes (X) |
| JENNIFER ELLIS | |||||
| Yes (X) | $0 | $0 | $0 | ||
| BEN KIMBROUGH | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| KIM MCMILLAN | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| MIKE O'MALLEY | |||||
| CHAIRMAN | Yes (X) | $0 | $0 | $0 | Yes (X) |
| KHANDRA SMALLEY | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| JOEY SMITH | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| PRISCILLA G STORY | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| JACK B TURNER | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| SUZANNE UFFLEMAN | |||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Related Organizations | $1,077,000 | RelatedOrganizationsAmt |
| Noncash Contributions | $275,000 | NoncashContributionsAmt |
| Total Contributions | $1,077,000 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $519,913 | TotalRevenueColumnAmt |
| Exclusion | $519,913 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $797,786 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $164,250 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $633,536 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $633,536 | TotalRevenueColumnAmt |
| Exclusion | $633,536 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| GRANT REPAYMENTS | $143,088 | $143,088 | |
| OTHER INCOME | $3,364 | $3,364 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $146,452 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,376,901 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,364 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,296,537 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,005,286 | TotalAmt |
| Program Services | $1,005,286 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,655 | TotalAmt |
| Management And General | $24,655 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,722 | TotalAmt |
| Management And General | $3,722 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,250 | TotalAmt |
| Management And General | $32,250 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,046 | TotalAmt |
| Management And General | $63,046 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,105 | TotalAmt |
| Program Services | $803 | ProgramServicesAmt |
| Management And General | $4,302 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,258 | TotalAmt |
| Management And General | $2,258 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,483 | TotalAmt |
| Management And General | $3,483 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,139,805 | TotalAmt |
| Program Services | $1,006,089 | ProgramServicesAmt |
| Management And General | $133,716 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,397 | BOYAmt |
| EOY | $23,578 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,166,899 | BOYAmt |
| EOY | $1,255,912 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $796,651 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,020 | BOYAmt |
| EOY | $147,108 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,732,410 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $869,484 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,916,256 | BOYAmt |
| EOY | $2,862,926 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,936,640 | BOYAmt |
| EOY | $9,862,227 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,480,142 | BOYAmt |
| EOY | $4,232,937 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,566,354 | BOYAmt |
| EOY | $19,181,339 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,286 | BOYAmt |
| EOY | $6,440 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,286 | BOYAmt |
| EOY | $6,440 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,883,171 | BOYAmt |
| EOY | $15,028,207 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,190,025 | BOYAmt |
| EOY | $3,595,570 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $478,872 | BOYAmt |
| EOY | $551,122 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,552,068 | BOYAmt |
| EOY | $19,174,899 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,566,354 | BOYAmt |
| EOY | $19,181,339 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,237,096 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,385,735 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Community Trust | Yes (X) | CommunityTrustInd |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,001,897 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,662,636 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $337,364 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,000,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,077,000 | CurrentTaxYearAmt |
| Total | $9,078,897 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,001,897 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,662,636 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $337,364 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,000,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,077,000 | CurrentTaxYearAmt |
| Total | $9,078,897 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $9,078,897 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $673,495 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $948,640 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,088,835 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,081,805 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,317,699 | CurrentTaxYearAmt |
| Total | $5,110,474 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $728,896 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $142,088 | CurrentTaxYearAmt |
| Total | $873,984 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $15,063,355 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $3,364 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.60270 | PublicSupportCY170Pct |
| Public Support PY170 | 0.66940 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,480,142 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $657,995 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $148,233 | OtherExpendituresAmt |
| Administrative Expenses | $31,967 | AdministrativeExpensesAmt |
| End Year Balance | $3,957,937 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,241,066 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $384,072 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $116,596 | OtherExpendituresAmt |
| Administrative Expenses | $28,400 | AdministrativeExpensesAmt |
| End Year Balance | $3,480,142 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,492,585 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$113,744 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $115,422 | OtherExpendituresAmt |
| Administrative Expenses | $22,353 | AdministrativeExpensesAmt |
| End Year Balance | $3,241,066 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,143,325 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $476,046 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $110,108 | OtherExpendituresAmt |
| Administrative Expenses | $16,678 | AdministrativeExpensesAmt |
| End Year Balance | $3,492,585 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,591,410 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $684,199 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $115,747 | OtherExpendituresAmt |
| Administrative Expenses | $16,537 | AdministrativeExpensesAmt |
| End Year Balance | $3,143,325 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,294,037 | OtherCostOrOtherBasisAmt |
| Book Value | $2,294,037 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $34,073 | OtherCostOrOtherBasisAmt |
| Depreciation | $22,147 | DepreciationAmt |
| Book Value | $11,926 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,404,300 | OtherCostOrOtherBasisAmt |
| Depreciation | $847,337 | DepreciationAmt |
| Book Value | $556,963 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,862,926 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INTEREST IN TRUSTS HELD BY OTHERS | $3,406,815 |
| BENEFICIAL INTEREST IN PERPETUAL TRU | $551,122 |
| PROPERTY HELD FOR SALE | $275,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,232,937 | TotalBookValueOtherAssetsAmt |
| Total Rev Etc Audited Fincl Stmt | $3,762,636 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $1,385,735 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $1,385,735 | RevenueNotReportedAmt |
| Revenue Subtotal | $2,376,901 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $2,376,901 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,139,805 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $1,139,805 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $1,139,805 | TotalExpensesPerForm990Amt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (12 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Business Name Line2RecipientBusinessName/BusinessNameLine2 |
|---|---|---|---|---|---|---|
| AUSTIN PEAY FOUNDATION | ||||||
| PO BOX 4417 | CLARKSVILLE | TN | 37044 | $231,700 | NURSING EDUCATION | |
| CLARKSVILLE ACADEMY | ||||||
| 710 NORTH SECOND ST | CLARKSVILLE | TN | 37040 | $23,574 | FITNESS CIRCUIT | |
| CLARKSVILLE-MONTGOMERY COUNTY | ||||||
| 621 GRACEY AVE | CLARKSVILLE | TN | 37040 | $51,234 | SALARY/BENEFITS | SCHOOL SYSTEM |
| MISSION CLARKSVILLE | ||||||
| 1230 ROSSVIEW ROAD | CLARKSVILLE | TN | 37043 | $60,000 | FOOD INITIATIVE | |
| MISSION POINT HEALTH PARTNERS | ||||||
| 523 MAINSTREAM DR | NASHVILLE | TN | 37228 | $80,724 | DIABETES MGMT | |
| MONTGOMERY COUNTY EMS | ||||||
| 1608 HAYNES ST | CLARKSVILLE | TN | 37043 | $46,000 | OPERATION HEARTBEAT | |
| MONTGOMERY COUNTY VETERAN'S | ||||||
| 248 HAROLD DR | CLARKSVILLE | TN | 37040 | $12,000 | TRANSPORTION VETS | TRANSPORTATION SERVICE |
| PASTORAL COUNSELING CENTER | ||||||
| 100 VINE CT | NASHVILLE | TN | 37205 | $21,551 | MENTAL HEALTH | |
| REBRA BONE-DRAPER EVANGELISTIC | ||||||
| 402 JIM COURT | CLARKSVILLE | TN | 37043 | $7,500 | WOMEN HEALTH | MINISTRIES |
| SAFE SOLDIERS AND FAMILIES | ||||||
| PO BOX 4008 | CLARKSVILLE | TN | 37043 | $200,000 | COUNSELING | EMBRACED |
| TN TECHNOLOGY CENTER AT DICKSON | ||||||
| 740 HIGHWAY 46 | DICKSON | TN | 37055 | $206,585 | LPN LAB/CLASS | |
| YMCA OF CLARKSVILLE | ||||||
| 260 HILLCREST DR | CLARKSVILLE | TN | 37043 | $57,000 | ABC PROGRAM/RESTORE | |
Schedule M IRS990ScheduleM
Real Estate Other RealEstateOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $275,000 | NoncashContributionsRptF990Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | THE ORGANIZATION IS OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE RESIDENTS OF CLARKSVILLE,TN; MONTGOMERY COUNTY, TN; AND THE COUNTIES OF NORTHERN MIDDLE TN AND FORT CAMPBELL, KY. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE 990 WAS REVIEWED BY THE CHAIRMAN OF THE BOARD |
| FORM 990, PAGE 6, PART VI, LINE 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC |
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