EBENZER MEDICAL OUTREACH INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
EBENZER MEDICAL OUTREACH INC (EIN 55-0745033)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-12
IRS object ID
201431329349303308
Schema version
2012v2.1
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

FieldValueIRS element (for citing)
Timestamp2014-05-12T16:05:12-04:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN204891915EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1SullivanWebb PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1422 Kinetic DrP O Box 2745-25727AddressLine1
CityHuntingtonCity
StateWVState
ZIP Code25701ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN550745033EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1EBENEZER MEDICAL OUTREACH INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlEBENNameControl

US Address USAddress

FieldValueIRS element (for citing)
Address Line11448 TENTH AVENUEAddressLine1
CityHUNTINGTONCity
StateWVState
ZIP Code25701ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameYVONNE JONESName
TitleEXECUTIVE DIRTitle
Phone3045290753Phone
Date Signed2014-05-08DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBRUCE I SULLIVAN CPAName
PTINP00177743PTIN
Phone3046970565Phone
Date Prepared2014-05-12DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonYVONNE JONESNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11448 TENTH AVENUEAddressLine1
CityHUNTINGTONCity
StateWVState
ZIP Code25701ZIPCode
FieldValueIRS element (for citing)
Gross Receipts13201740GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.EMOHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1996YearFormation
State Legal DomicileWVStateLegalDomicile
Activity Or Mission DescriptionPROVIDE MEDICAL SERVICES TO THE UNINSUREDActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members19NbrIndependentVotingMembers
Total Nbr Employees35TotalNbrEmployees
Total Nbr Volunteers60TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year12502632ContributionsGrantsPriorYear
Contributions Grants Current Year13102042ContributionsGrantsCurrentYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year1925InvestmentIncomePriorYear
Investment Income Current Year2565InvestmentIncomeCurrentYear
Other Revenue Prior Year41141OtherRevenuePriorYear
Other Revenue Current Year78378OtherRevenueCurrentYear
Total Revenue Prior Year12545698TotalRevenuePriorYear
Total Revenue Current Year13182985TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year879391SalariesEtcPriorYear
Salaries Etc Current Year752047SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year30886TotalFundrsngExpCurrentYear
Other Expense Prior Year11791867OtherExpensePriorYear
Other Expenses Current Year12447328OtherExpensesCurrentYear
Total Expenses Prior Year12671258TotalExpensesPriorYear
Total Expenses Current Year13199375TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-125560RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-16390RevenuesLessExpensesCY
Total Assets BOY1029628TotalAssetsBOY
Total Assets EOY1016076TotalAssetsEOY
Total Liabilities BOY115901TotalLiabilitiesBOY
Total Liabilities EOY115223TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY913727NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY900853NetAssetsOrFundBalancesEOY
Mission DescriptionPROVIDE MEDICAL SERVICES TO THE UNINSUREDMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense13029874Expense
DescriptionPROVIDES FREE MEDICAL CARE TO THE UNEMPLOYED AND WORKING POOR WHO ARE WITHOUT HEALTH INSURANCE AND ARE AT OR BELOW THE FEDERAL INCOME POVERTY GUIDELINES. SERVICES PROVIDED INCLUDE GENERAL MEDICINE, BREAST/CERVICAL CANCER SCREENINGS, COUNSELING, LAB AND MEDICINES.Description
Total Program Service Expense13029874TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees35NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members19NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
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 PersonsfalseAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementfalseRegularMonitoringEnforcement
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonYVONNE JONESNamePerson
Telephone Number3045290753TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11448 TENTH AVENUEAddressLine1
CityHUNTINGTONCity
StateWVState
ZIP Code25701ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
AARON BLEVINS
BOARD MEMBER0.00X000
CHERYL HENDERSON
BOARD MEMBER0.00X000
CHRISTIE KINSEY
BOARD MEMBER0.00X000
DAVID FORINASH
BOARD MEMBER0.00X000
DENISE LANDRY
BOARD MEMBER0.00X000
DERON RUNYON
PRESIDENT0.00X000X
DOUG SHEILS
BOARD MEMBER0.00X000
FRAN DEGIDIO
BOARD MEMBER0.00X000
JANE FOTOS
BOARD MEMBER0.00X000
JOAN WEISBERG
BOARD MEMBER0.00X000
LEO FLECKENSTEIN
BOARD MEMBER0.00X000
LEON WHITE
BOARD MEMBER0.00X000
MARY ORTA
BOARD MEMBER0.00X000
OSTIE MATHISEN
TREASURER0.00X000X
ROBERT LEVY
BOARD MEMBER0.00X000
SARAH DENMAN
BOARD MEMBER0.00X000
STEPHANIE HOLMAN
BOARD MEMBER0.00X000
STEPHEN PETRANY
VICE PRESIDENT0.00X000X
SUE MCCLELLAND
SECRETARY0.00X000X
YVONNE JONES
EXECUTIVE DIR40.006263300X
FieldValueIRS element (for citing)
Total Reportable Comp From Org62633TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Government Grants610506GovernmentGrants
All Other Contributions12491536AllOtherContributions
Noncash Contributions12060471NoncashContributions
Total Contributions13102042TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2565TotalRevenueColumn
Related Or Exempt Function Income2565RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Gross Income Fundraising Events45591GrossIncomeFundraisingEvents
Fundraising Direct Expenses18755FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column26836TotalRevenueColumn
Exclusion$26,836ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUS REVENUEDescription
Business Code900099BusinessCode
Total Revenue Column51542TotalRevenueColumn
Related Or Exempt Function Income51542RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue51542TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column13182985TotalRevenueColumn
Related Or Exempt Function Income54107RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$26,836ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total62633Total
Program Services12527ProgramServices
Management And General50106ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total689414Total
Program Services608794ProgramServices
Management And General58408ManagementAndGeneral
Fundraising22212Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total240Total
Program Services240ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total22299Total
Program Services16957ProgramServices
Management And General2300ManagementAndGeneral
Fundraising3042Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total204520Total
Program Services187902ProgramServices
Management And General16618ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total3327Total
Program Services3327ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total4554Total
Program Services1841ProgramServices
Management And General2713ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total917Total
Program Services917ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total11429Total
Program Services11429ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total7103Total
Program Services7103ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
DONATED DRUGS & SUPPLIES121175411211229824112832
PROFESSIONAL COSTS & OTHER311052224660592800
REPAIRS & MISC1623216232
PROGRAM COSTS94099409

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total18652Total
Program Services18652ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total13199375Total
Program Services13029874ProgramServices
Management And General138615ManagementAndGeneral
Fundraising30886Fundraising
FieldValueIRS element (for citing)
Joint CostsXJointCosts

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY28848BOY
EOY16966EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY25398BOY
EOY26725EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY165000BOY
EOY165000EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY657340BOY
EOY657340EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2636BOY
EOY2626EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis291846LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec243047LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY57708BOY
EOY48799EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY14574BOY
EOY16413EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY78124BOY
EOY82207EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1029628BOY
EOY1016076EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY85901BOY
EOY115223EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY30000BOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY115901BOY
EOY115223EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY870603BOY
EOY853646EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY4155BOY
EOY4480EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY38969BOY
EOY42727EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY913727BOY
EOY900853EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1029628BOY
EOY1016076EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-16390ReconcilationRevenueExpenses
Reconciliation Unrealized Invest3516ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3580309CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4243327CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10614828CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12516113CurrentTaxYearMinus1Year
Current Tax Year13102042CurrentTaxYear
Total44056619Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3580309CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4243327CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10614828CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12516113CurrentTaxYearMinus1Year
Current Tax Year13102042CurrentTaxYear
Total44056619Total
FieldValueIRS element (for citing)
Public Support Total17044056619PublicSupportTotal170

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12094CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years251CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years31950CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year17309CurrentTaxYearMinus1Year
Current Tax Year26836CurrentTaxYear
Total88440Total
FieldValueIRS element (for citing)
Total Support44145059TotalSupport
Gross Receipts From Admissions Etc17080GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.99800PublicSupportPertcentage170
Public Support Pertcent Prior Year0.99740PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

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

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance43124BeginningOfYearBalance
Investment Earnings Or Losses4083InvestmentEarningsOrLosses
End Of Year Balance47207EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance45329BeginningOfYearBalance
Investment Earnings Or Losses-2205InvestmentEarningsOrLosses
End Of Year Balance43124EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance40343BeginningOfYearBalance
Investment Earnings Or Losses4986InvestmentEarningsOrLosses
End Of Year Balance45329EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance36841BeginningOfYearBalance
Investment Earnings Or Losses3502InvestmentEarningsOrLosses
End Of Year Balance40343EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance41264BeginningOfYearBalance
Investment Earnings Or Losses-4423InvestmentEarningsOrLosses
End Of Year Balance36841EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.90500PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.09500TermEndowmentEOYBalance
Endowments Held By Unrelated OrgstrueEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis291846InvestmentCostOrOtherBasis
Depreciation243047Depreciation
Book Value48799BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings48799TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
BENEFICIAL INTEREST-DENTAL FUN47207
INVESTMENT EMO INC35000
FieldValueIRS element (for citing)
Total Book Value Other Assets82207TotalBookValueOtherAssets

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierD8Identifier
Return ReferenceEndowment funds intended uses Part V line 4ReturnReference
ExplanationTHE PRINCIPAL VALUE OF THE ENDOWMENT IS TO BE PERMANENTLY RESTRICTED, THE ANNUAL NET INCOME AND ACCUMULATED INCOME FROM PRIOR YEARS IS AVAILABLE FOR USE IN DENTISTRY WITH THE APPROPRIATE APPROVALS.Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1DWTSSNameOfEvent1
Gross Receipts Event145591GrossReceiptsEvent1
Gross Revenue Event145591GrossRevenueEvent1
Rent Facility Costs Event111044RentFacilityCostsEvent1
Other Direct Expenses Event17711OtherDirectExpensesEvent1
Name Of Event2NoneNameOfEvent2
Gross Receipts Total45591GrossReceiptsTotal
Gross Revenue Total Events45591GrossRevenueTotalEvents
Rent Facility Costs Total Events11044RentFacilityCostsTotalEvents
Other Direct Expenses Total Events7711OtherDirectExpensesTotalEvents
Direct Expense Summary Events18755DirectExpenseSummaryEvents
Net Income Summary26836NetIncomeSummary

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonDOUGLASS CENTRE LTD PARTNERSHPNamePerson
Relationship With OrganizationCONTROLLED ENTITYRelationshipWithOrganization
Purpose Of LoanRENOVATIONSPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$671,864OriginalPrincipalAmount
Balance Due657340BalanceDue
DefaultfalseDefault
Approved By BoardtrueApprovedByBoard
Written AgreementfalseWrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due657340TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonDOUGLASS CENTRE LTD PARTNERSHPNamePerson
FieldValueIRS element (for citing)
RelationshipCONTROLLED ENTITYRelationship
Amount Of Transaction149936AmountOfTransaction
Description Of TransactionLEASE OF FACILITIESDescriptionOfTransaction
Sharing Of RevenuestrueSharingOfRevenues

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Noncash Contribs Rptd F99012060471NoncashContribsRptdF990
Method Of Determining RevenuesWHOLESALE VALUEMethodOfDeterminingRevenues
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
O01Form 990 governing body review Part VI line 11FORM 990 IS DISTRIBUTED TO THE GOVERNING BOARD VIA EMAIL FOR REVIEW BEFORE FILING.
O02CEO executive director top management comp Part VI line 15aTHE GOVERNING BODY REVIEWS AND APPROVES EXECUTIVE DIRECTOR9S COMPENSATION.
O03Governing documents etc available to public Part VI line 19GOVERNING DOCUMENTS ARE KEPT AT ADMINISTRATIVE OFFICE OF EBENEZER MEDICAL OUTREACH, INC. AND ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1DOUGLASS CENTRE LPBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11448 TENTH AVEAddressLine1
CityHUNTINGTONCity
StateWVState
ZIP Code25701ZIPCode
FieldValueIRS element (for citing)
EIN550784814EIN
Primary ActivityREAL ESTATE HOLDINGPrimaryActivity
Legal Domicile StateWVLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Predominant Income Type1 - RelatedPredominantIncomeType
Share Of Total Income-10ShareOfTotalIncome
Share Of EOY Assets4990888ShareOfEOYAssets
Disproportionate AllocationsfalseDisproportionateAllocations
General Or Managing PartnertrueGeneralOrManagingPartner

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1EMOS INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11448 TENTH AVENUEAddressLine1
CityHuntingtonCity
StateWVState
ZIP Code25701ZIPCode
FieldValueIRS element (for citing)
EIN562387395EIN
Primary ActivityLEASING OFFICE BUILDINGPrimaryActivity
Legal Domicile StateWVLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityC CorpTypeOfEntity
Share Of Total Income-99072ShareOfTotalIncome
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1DOUGLASS CENTRE LIMITED PARTNERSHIPBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypejTransactionType
Amount Involved149936AmountInvolved
Method Of Amt DeterminationFMVMethodOfAmtDetermination

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