HAILEY MAYZ FOUNDATION: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- HAILEY MAYZ FOUNDATION (EIN 80-0459455)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-08-07
- IRS object ID
- 201432199349301153
- 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 | 2014-08-07T12:14:24-05:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 810591018 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FA LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3100 BRISTOL ST STE 125 | AddressLine1 |
| City | COSTA MESA | City |
| State | CA | State |
| ZIP Code | 92626 | 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 | 800459455 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAILEY MAYZ FOUNDATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HAIL | BusinessNameControlTxt |
| Phone | 9496673631 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20902 BAKE PARKWAY | AddressLine1 |
| Address Line2 | ROOM/SUITE 100 | AddressLine2 |
| City | LAKE FOREST | City |
| State | CA | State |
| ZIP Code | 92630 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ERIK LARSEN | PersonNm |
| Person Title | CEO & PRESIDENT | PersonTitleTxt |
| Phone | 9496673631 | PhoneNum |
| Signature | 2014-07-15 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL MCGRATH | PreparerPersonNm |
| PTIN | P00176055 | PTIN |
| Phone | 7142410212 | PhoneNum |
| Preparation | 2014-07-18 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
| 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) |
|---|---|---|
| Principal Officer | ERIK LARSEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20902 BAKE PARKWAY SUITE 100 | AddressLine1 |
| City | LAKE FOREST | City |
| State | CA | State |
| ZIP Code | 92630 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,037,882 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.AMAYZING.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2009 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE FINANCIAL ASSISTANCE TO FAMILIES THAT CANNOT AFFORD MEDICAL & OTHER COSTS ASSOCIATED WITH CHILDREN SUFFERING FROM SPECIAL MEDICAL NEEDS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 4 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 12 | TotalEmployeeCnt |
| Total Volunteers | 17 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $14,919 | PYContributionsGrantsAmt |
| CY Contributions Grants | $21,467 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $398,015 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $966,709 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $21,758 | PYOtherRevenueAmt |
| CY Other Revenue | $34,658 | CYOtherRevenueAmt |
| PY Total Revenue | $434,692 | PYTotalRevenueAmt |
| CY Total Revenue | $1,022,834 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $200 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $396,652 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $491,416 | PYOtherExpensesAmt |
| CY Other Expenses | $555,155 | CYOtherExpensesAmt |
| PY Total Expenses | $491,616 | PYTotalExpensesAmt |
| CY Total Expenses | $951,807 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$56,924 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $71,027 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $47,439 | TotalAssetsBOYAmt |
| Total Assets EOY | $105,174 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $85,291 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $71,999 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$37,852 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $33,175 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE FINANCIAL ASSISTANCE TO FAMILIES THAT CANNOT AFFORD MEDICAL & OTHER COSTS ASSOCIATED WITH CHILDREN SUFFERING FROM SPECIAL MEDICAL NEEDS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $788,057 | ExpenseAmt |
| Desc | TO PROVIDE FINANCIAL ASSISTANCE WITH COSTS FOR THE FOLLOWING: - TRAVEL EXPENSES FOR THE CHILD & FAMILY TO A CITY OFFERING PROPER CARE - MEALS & LODGING WHILE THE FAMILY IS AWAYS FROM HOME TO OBTAIN CARE - SMALL ITEMS TO AID & COMFORT THE CHILD | Desc |
| Total Program Service Expenses | $788,057 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | 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 | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | 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 | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | 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 | Yes (true) | 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 | false | 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 | Yes (true) | ScheduleORequiredInd |
| IRP Document | 19 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 12 | EmployeeCnt |
| Employment Tax Returns Filed | false | EmploymentTaxReturnsFiledInd |
| 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 |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 4 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | 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 | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | false | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ERIK LARSEN | PersonNm |
| Phone | 9496005437 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20902 BAKE PARKWAY SUITE 100 | AddressLine1 |
| Address Line2 | 20902 BAKE PARKWAY SUITE 100 | AddressLine2 |
| City | LAKE FOREST | City |
| State | CA | State |
| ZIP Code | 92630 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (4 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| SEAN VASSILAROS | ||||||
| CHAIRMAN | 5.00 | Yes (X) | $0 | $0 | $0 | |
| CHRISTIAN ROBINSON | ||||||
| SECRTRY/GEN. | 5.00 | Yes (X) | $0 | $0 | $0 | |
| WENDY VASSILAROS | ||||||
| TREASURER | 5.00 | Yes (X) | $0 | $0 | $0 | |
| ERIK LARSEN | ||||||
| CEO & PRESID | 25.00 | $0 | $0 | $0 | Yes (X) | |
| 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 |
| All Other Contributions | $21,467 | AllOtherContributionsAmt |
| Total Contributions | $21,467 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $966,709 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $966,709 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $966,709 | TotalProgramServiceRevenueAmt |
| Fundraising Gross Income | $49,706 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $15,048 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,658 | TotalRevenueColumnAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,022,834 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $966,709 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $383,954 | TotalAmt |
| Program Services | $293,954 | ProgramServicesAmt |
| Management And General | $90,000 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,698 | TotalAmt |
| Program Services | $9,722 | ProgramServicesAmt |
| Management And General | $2,976 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $241,443 | TotalAmt |
| Program Services | $241,443 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1 | TotalAmt |
| Program Services | $1 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,385 | TotalAmt |
| Program Services | $3,732 | ProgramServicesAmt |
| Management And General | $19,653 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,672 | TotalAmt |
| Program Services | $69,729 | ProgramServicesAmt |
| Management And General | $22,943 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,949 | TotalAmt |
| Program Services | $6,949 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,546 | TotalAmt |
| Program Services | $5,546 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PROGRAM SERVICE PT | $96,758 | $96,758 | |
| PRACTICE SOFTWARE | $19,926 | $19,926 | |
| FINANCE CHARGES | $11,809 | $11,809 | |
| OFFICE MANAGER | $8,749 | $8,749 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,917 | TotalAmt |
| Program Services | $31,548 | ProgramServicesAmt |
| Management And General | $16,369 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $951,807 | TotalAmt |
| Program Services | $788,057 | ProgramServicesAmt |
| Management And General | $163,750 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,352 | BOYAmt |
| EOY | $82,075 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $35,579 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $12,480 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,087 | BOYAmt |
| EOY | $23,099 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,439 | BOYAmt |
| EOY | $105,174 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,453 | BOYAmt |
| EOY | $390 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,711 | BOYAmt |
| EOY | $51,875 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,127 | BOYAmt |
| EOY | $19,734 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $85,291 | BOYAmt |
| EOY | $71,999 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$37,852 | BOYAmt |
| EOY | $33,175 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$37,852 | BOYAmt |
| EOY | $33,175 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,439 | BOYAmt |
| EOY | $105,174 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $71,027 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $24,129 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $49,290 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,919 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,467 | CurrentTaxYearAmt |
| Total | $109,805 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $42,716 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $442,139 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,016,415 | CurrentTaxYearAmt |
| Total | $1,501,270 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $24,129 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $92,006 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $457,058 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,037,882 | CurrentTaxYearAmt |
| Total | $1,611,075 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $1,500 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,500 | CurrentTaxYearMinus2YearsAmt |
| Total | $10,000 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $1,500 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,500 | CurrentTaxYearMinus2YearsAmt |
| Total | $10,000 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $1,601,075 | PublicSupportTotal509Amt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $24,129 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $92,006 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $457,058 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,037,882 | CurrentTaxYearAmt |
| Total | $1,611,075 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99380 | PublicSupportCY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,882 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,154 | DepreciationAmt |
| Book Value | $8,728 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,283 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,907 | DepreciationAmt |
| Book Value | $8,376 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,414 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,419 | DepreciationAmt |
| Book Value | $5,995 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $23,099 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| US BANK EQUIPMENT LOAN | $20,000 |
| US BANK VISA | |
| CHASE BANK VISA | -$266 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $19,734 | TotalLiabilityAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1Amt |
| Gross Receipts Event1 | $33,591 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $33,591 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $2,500 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $5,042 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $6,221 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $60 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $1,128 | OtherDirectExpensesEvent1Amt |
| Name Of Event2 | CHIC FILET RACE | NameOfEvent2Amt |
| Gross Receipts Event2 | $16,115 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $16,115 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $97 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $49,706 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $49,706 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $2,500 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $5,042 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $6,221 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $60 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $1,225 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $15,048 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $34,658 | NetIncomeSummaryAmt |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)
| Relationship With OrgRelationshipWithOrgTxt | Loan PurposeLoanPurposeTxt | Loan To OrganizationLoanToOrganizationInd | Original PrincipalOriginalPrincipalAmt | Balance DueBalanceDueAmt | DefaultDefaultInd | Board Or Committee ApprovalBoardOrCommitteeApprovalInd | Written AgreementWrittenAgreementInd |
|---|---|---|---|---|---|---|---|
| ERIK LARSON | |||||||
| CEO | OPERATING EXPENSES | Yes (X) | $35,494 | $36,600 | false | Yes (true) | Yes (true) |
| SEAN VASSILAROS | |||||||
| COO | OPERATING EXPENSES | Yes (X) | $8,615 | $15,275 | false | Yes (true) | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $51,875 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE TAXPAYER'S ACCOUNTING FIRM PROVIDED THE FORM 990 TO THE COO AND CEO WHO FORWARDED THE RETURN TO THE BOARD MEMBERS FOR THEIR REVIEW. PRIOR TO FILING, BOARD MEMBERS WERE ENCOURAGED TO REVIEW THE FORM 990 AND TO FORWARD THEIR QUESTIONS TO THE COO OR CEO. THE COO, CEO OR ACCOUNTING FIRM ADDRESSED THE QUESTIONS FROM THE BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OUTSIDE SERVICES 210,036 0 0 CONTRACT SERVICES 3,029 0 0 BILLING SERVICES 28,378 0 0 |
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