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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-12T16:05:12-04:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 204891915 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SullivanWebb PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 422 Kinetic DrP O Box 2745-25727 | AddressLine1 |
| City | Huntington | City |
| State | WV | State |
| ZIP Code | 25701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550745033 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EBENEZER MEDICAL OUTREACH INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | EBEN | NameControl |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1448 TENTH AVENUE | AddressLine1 |
| City | HUNTINGTON | City |
| State | WV | State |
| ZIP Code | 25701 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | YVONNE JONES | Name |
| Title | EXECUTIVE DIR | Title |
| Phone | 3045290753 | Phone |
| Date Signed | 2014-05-08 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRUCE I SULLIVAN CPA | Name |
| PTIN | P00177743 | PTIN |
| Phone | 3046970565 | Phone |
| Date Prepared | 2014-05-12 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | YVONNE JONES | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1448 TENTH AVENUE | AddressLine1 |
| City | HUNTINGTON | City |
| State | WV | State |
| ZIP Code | 25701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 13201740 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.EMOHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1996 | YearFormation |
| State Legal Domicile | WV | StateLegalDomicile |
| Activity Or Mission Description | PROVIDE MEDICAL SERVICES TO THE UNINSURED | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 19 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 19 | NbrIndependentVotingMembers |
| Total Nbr Employees | 35 | TotalNbrEmployees |
| Total Nbr Volunteers | 60 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 12502632 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 13102042 | ContributionsGrantsCurrentYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1925 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2565 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 41141 | OtherRevenuePriorYear |
| Other Revenue Current Year | 78378 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 12545698 | TotalRevenuePriorYear |
| Total Revenue Current Year | 13182985 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 879391 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 752047 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 30886 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 11791867 | OtherExpensePriorYear |
| Other Expenses Current Year | 12447328 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 12671258 | TotalExpensesPriorYear |
| Total Expenses Current Year | 13199375 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -125560 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -16390 | RevenuesLessExpensesCY |
| Total Assets BOY | 1029628 | TotalAssetsBOY |
| Total Assets EOY | 1016076 | TotalAssetsEOY |
| Total Liabilities BOY | 115901 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 115223 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 913727 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 900853 | NetAssetsOrFundBalancesEOY |
| Mission Description | PROVIDE MEDICAL SERVICES TO THE UNINSURED | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 13029874 | Expense |
| Description | PROVIDES 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 Expense | 13029874 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | false | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | true | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | true | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 35 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 19 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 19 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | false | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | false | RegularMonitoringEnforcement |
| Whistleblower Policy | false | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | YVONNE JONES | NamePerson |
| Telephone Number | 3045290753 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1448 TENTH AVENUE | AddressLine1 |
| City | HUNTINGTON | City |
| State | WV | State |
| ZIP Code | 25701 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| AARON BLEVINS | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| CHERYL HENDERSON | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| CHRISTIE KINSEY | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| DAVID FORINASH | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| DENISE LANDRY | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| DERON RUNYON | ||||||
| PRESIDENT | 0.00 | X | 0 | 0 | 0 | X |
| DOUG SHEILS | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| FRAN DEGIDIO | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| JANE FOTOS | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| JOAN WEISBERG | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| LEO FLECKENSTEIN | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| LEON WHITE | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| MARY ORTA | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| OSTIE MATHISEN | ||||||
| TREASURER | 0.00 | X | 0 | 0 | 0 | X |
| ROBERT LEVY | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| SARAH DENMAN | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| STEPHANIE HOLMAN | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| STEPHEN PETRANY | ||||||
| VICE PRESIDENT | 0.00 | X | 0 | 0 | 0 | X |
| SUE MCCLELLAND | ||||||
| SECRETARY | 0.00 | X | 0 | 0 | 0 | X |
| YVONNE JONES | ||||||
| EXECUTIVE DIR | 40.00 | 62633 | 0 | 0 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 62633 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Government Grants | 610506 | GovernmentGrants |
| All Other Contributions | 12491536 | AllOtherContributions |
| Noncash Contributions | 12060471 | NoncashContributions |
| Total Contributions | 13102042 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2565 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2565 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 45591 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 18755 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 26836 | TotalRevenueColumn |
| Exclusion | $26,836 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 51542 | TotalRevenueColumn |
| Related Or Exempt Function Income | 51542 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 51542 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 13182985 | TotalRevenueColumn |
| Related Or Exempt Function Income | 54107 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $26,836 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 62633 | Total |
| Program Services | 12527 | ProgramServices |
| Management And General | 50106 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 689414 | Total |
| Program Services | 608794 | ProgramServices |
| Management And General | 58408 | ManagementAndGeneral |
| Fundraising | 22212 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 240 | Total |
| Program Services | 240 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22299 | Total |
| Program Services | 16957 | ProgramServices |
| Management And General | 2300 | ManagementAndGeneral |
| Fundraising | 3042 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 204520 | Total |
| Program Services | 187902 | ProgramServices |
| Management And General | 16618 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3327 | Total |
| Program Services | 3327 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4554 | Total |
| Program Services | 1841 | ProgramServices |
| Management And General | 2713 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 917 | Total |
| Program Services | 917 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11429 | Total |
| Program Services | 11429 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7103 | Total |
| Program Services | 7103 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| DONATED DRUGS & SUPPLIES | 12117541 | 12112298 | 2411 | 2832 |
| PROFESSIONAL COSTS & OTHER | 31105 | 22246 | 6059 | 2800 |
| REPAIRS & MISC | 16232 | 16232 | ||
| PROGRAM COSTS | 9409 | 9409 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18652 | Total |
| Program Services | 18652 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13199375 | Total |
| Program Services | 13029874 | ProgramServices |
| Management And General | 138615 | ManagementAndGeneral |
| Fundraising | 30886 | Fundraising |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Joint Costs | X | JointCosts |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28848 | BOY |
| EOY | 16966 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25398 | BOY |
| EOY | 26725 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 165000 | BOY |
| EOY | 165000 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 657340 | BOY |
| EOY | 657340 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2636 | BOY |
| EOY | 2626 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 291846 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 243047 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57708 | BOY |
| EOY | 48799 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14574 | BOY |
| EOY | 16413 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78124 | BOY |
| EOY | 82207 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1029628 | BOY |
| EOY | 1016076 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 85901 | BOY |
| EOY | 115223 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30000 | BOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 115901 | BOY |
| EOY | 115223 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 870603 | BOY |
| EOY | 853646 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4155 | BOY |
| EOY | 4480 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38969 | BOY |
| EOY | 42727 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 913727 | BOY |
| EOY | 900853 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1029628 | BOY |
| EOY | 1016076 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -16390 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 3516 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3580309 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4243327 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 10614828 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 12516113 | CurrentTaxYearMinus1Year |
| Current Tax Year | 13102042 | CurrentTaxYear |
| Total | 44056619 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3580309 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4243327 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 10614828 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 12516113 | CurrentTaxYearMinus1Year |
| Current Tax Year | 13102042 | CurrentTaxYear |
| Total | 44056619 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 44056619 | PublicSupportTotal170 |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 12094 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 251 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 31950 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 17309 | CurrentTaxYearMinus1Year |
| Current Tax Year | 26836 | CurrentTaxYear |
| Total | 88440 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 44145059 | TotalSupport |
| Gross Receipts From Admissions Etc | 17080 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.99800 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.99740 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 43124 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 4083 | InvestmentEarningsOrLosses |
| End Of Year Balance | 47207 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 45329 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -2205 | InvestmentEarningsOrLosses |
| End Of Year Balance | 43124 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 40343 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 4986 | InvestmentEarningsOrLosses |
| End Of Year Balance | 45329 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 36841 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 3502 | InvestmentEarningsOrLosses |
| End Of Year Balance | 40343 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 41264 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -4423 | InvestmentEarningsOrLosses |
| End Of Year Balance | 36841 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 0.90500 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.09500 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | true | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 291846 | InvestmentCostOrOtherBasis |
| Depreciation | 243047 | Depreciation |
| Book Value | 48799 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 48799 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| BENEFICIAL INTEREST-DENTAL FUN | 47207 |
| INVESTMENT EMO INC | 35000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 82207 | TotalBookValueOtherAssets |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | D8 | Identifier |
| Return Reference | Endowment funds intended uses Part V line 4 | ReturnReference |
| Explanation | THE 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | DWTSS | NameOfEvent1 |
| Gross Receipts Event1 | 45591 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 45591 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 11044 | RentFacilityCostsEvent1 |
| Other Direct Expenses Event1 | 7711 | OtherDirectExpensesEvent1 |
| Name Of Event2 | None | NameOfEvent2 |
| Gross Receipts Total | 45591 | GrossReceiptsTotal |
| Gross Revenue Total Events | 45591 | GrossRevenueTotalEvents |
| Rent Facility Costs Total Events | 11044 | RentFacilityCostsTotalEvents |
| Other Direct Expenses Total Events | 7711 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 18755 | DirectExpenseSummaryEvents |
| Net Income Summary | 26836 | NetIncomeSummary |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DOUGLASS CENTRE LTD PARTNERSHP | NamePerson |
| Relationship With Organization | CONTROLLED ENTITY | RelationshipWithOrganization |
| Purpose Of Loan | RENOVATIONS | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $671,864 | OriginalPrincipalAmount |
| Balance Due | 657340 | BalanceDue |
| Default | false | Default |
| Approved By Board | true | ApprovedByBoard |
| Written Agreement | false | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 657340 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DOUGLASS CENTRE LTD PARTNERSHP | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | CONTROLLED ENTITY | Relationship |
| Amount Of Transaction | 149936 | AmountOfTransaction |
| Description Of Transaction | LEASE OF FACILITIES | DescriptionOfTransaction |
| Sharing Of Revenues | true | SharingOfRevenues |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Noncash Contribs Rptd F990 | 12060471 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | WHOLESALE VALUE | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| O01 | Form 990 governing body review Part VI line 11 | FORM 990 IS DISTRIBUTED TO THE GOVERNING BOARD VIA EMAIL FOR REVIEW BEFORE FILING. |
| O02 | CEO executive director top management comp Part VI line 15a | THE GOVERNING BODY REVIEWS AND APPROVES EXECUTIVE DIRECTOR9S COMPENSATION. |
| O03 | Governing documents etc available to public Part VI line 19 | GOVERNING 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOUGLASS CENTRE LP | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1448 TENTH AVE | AddressLine1 |
| City | HUNTINGTON | City |
| State | WV | State |
| ZIP Code | 25701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550784814 | EIN |
| Primary Activity | REAL ESTATE HOLDING | PrimaryActivity |
| Legal Domicile State | WV | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Predominant Income Type | 1 - Related | PredominantIncomeType |
| Share Of Total Income | -10 | ShareOfTotalIncome |
| Share Of EOY Assets | 4990888 | ShareOfEOYAssets |
| Disproportionate Allocations | false | DisproportionateAllocations |
| General Or Managing Partner | true | GeneralOrManagingPartner |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EMOS INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1448 TENTH AVENUE | AddressLine1 |
| City | Huntington | City |
| State | WV | State |
| ZIP Code | 25701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 562387395 | EIN |
| Primary Activity | LEASING OFFICE BUILDING | PrimaryActivity |
| Legal Domicile State | WV | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C Corp | TypeOfEntity |
| Share Of Total Income | -99072 | ShareOfTotalIncome |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOUGLASS CENTRE LIMITED PARTNERSHIP | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | j | TransactionType |
| Amount Involved | 149936 | AmountInvolved |
| Method Of Amt Determination | FMV | MethodOfAmtDetermination |
Comments