HOSPICE DEL VALLE INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
HOSPICE DEL VALLE INC (EIN 74-2230859)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-05-14
IRS object ID
201441349349307899
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

FieldValueIRS element (for citing)
Return2014-05-14T17:19:49-07:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Martinez & Associates IncBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1514 Second StreetAddressLine1
CityAlamosaCity
StateCOState
ZIP Code81101ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN742230859EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HOSPICE DEL VALLE INCBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlHOSPBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1514 MAIN STREETAddressLine1
CityALAMOSACity
StateCOState
ZIP Code81101ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonHELEN LESTERPersonNm
Person TitleCEOPersonTitleTxt
Signature2014-05-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSTEVEN P MARTINEZ CPAPreparerPersonNm
PTINP00309923PTIN
Phone7195894964PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts$926,446GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
All Affiliates IncludedfalseAllAffiliatesIncludedInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Activity Or MissionPROVIDES CARE TO TERMINALLY ILL PATIENTS OF THE SAN LUIS VALLEY, COLORADOActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee30TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$107,506PYContributionsGrantsAmt
CY Contributions Grants$125,366CYContributionsGrantsAmt
PY Program Service Revenue$1,772,523PYProgramServiceRevenueAmt
CY Program Service Revenue$731,829CYProgramServiceRevenueAmt
PY Investment Income$62,023PYInvestmentIncomeAmt
CY Investment Income$69,251CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$1,942,052PYTotalRevenueAmt
CY Total Revenue$926,446CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$888,413PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$818,695CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$5,920CYTotalFundraisingExpenseAmt
PY Other Expenses$661,078PYOtherExpensesAmt
CY Other Expenses$427,971CYOtherExpensesAmt
PY Total Expenses$1,549,491PYTotalExpensesAmt
CY Total Expenses$1,246,666CYTotalExpensesAmt
PY Revenues Less Expenses$392,561PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$320,220CYRevenuesLessExpensesAmt
Total Assets BOY$3,840,900TotalAssetsBOYAmt
Total Assets EOY$3,525,820TotalAssetsEOYAmt
Total Liabilities BOY$128,234TotalLiabilitiesBOYAmt
Total Liabilities EOY$64,739TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,712,666NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,461,081NetAssetsOrFundBalancesEOYAmt
MissionPROVIDES CARE TO TERMINALLY ILL PATIENTS OF THE SAN LUIS VALLEY, COLORADOMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,035,540ExpenseAmt
DescHOSPICE DEL VALLE, INC. PROVIDES CARE TO TERMINALLY ILL CHILDREN AND ADULTS OF THE SAN LUIS VALLEY. HOSPICE PROVIDES PATIENT CARE INCLUDING MEDICAL EQUIPMENT & PHARMACEUTICAL SERVICES. NURSES PROVIDE SKILLED NURSING, PAIN AND SYMPTOM MANAGEMENT.Desc
Total Program Service Expenses$1,035,540TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredfalseScheduleORequiredInd
IRP Document4IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee30EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Form990 T FiledfalseForm990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Excess Business HoldingsfalseExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Org Filed In Lieu Of Form1041falseOrgFiledInLieuOfForm1041Ind
Licensed More Than One StatefalseLicensedMoreThanOneStateInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesfalseMinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnfalseAnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcfalseRegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonHOSPICE DEL VALLE INCPersonNm
Phone7195899019PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1514 MAIN STREETAddressLine1
CityALAMOSACity
StateCOState
ZIP Code81101ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerInd
ANTHONY BAGWELL
Director1.000.00$0$0$0
NANCY SCHRADER
Director1.000.00$0$0$0
HELEN LESTER
CEO40.000.00$87,992$0$0
GARY STEPHENS
Secretary1.000.00$0$0$0Yes (X)Yes (X)
KARLA WILSCHAU
TREASURER1.000.00$0$0$0Yes (X)Yes (X)
ROGER KNAPP
President1.000.00$0$0$0Yes (X)Yes (X)
MARGUERITE HOAGLAND
Director1.000.00$0$0$0Yes (X)
GREG MCAULIFFE
Director1.000.00$0$0$0Yes (X)
TRACY RODGERS
Vice President1.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$87,992TotalReportableCompFromOrgAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$125,366AllOtherContributionsAmt
Total Contributions$125,366TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT CARE REVENUEDesc
Total Revenue Column$731,829TotalRevenueColumnAmt
Exclusion$731,829ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$731,829TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$69,251TotalRevenueColumnAmt
Related Or Exempt Func Income$69,251RelatedOrExemptFuncIncomeAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$926,446TotalRevenueColumnAmt
Related Or Exempt Func Income$69,251RelatedOrExemptFuncIncomeAmt
Exclusion$731,829ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$87,993TotalAmt
Program Services$31,971ProgramServicesAmt
Management And General$51,622ManagementAndGeneralAmt
Fundraising$4,400FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$616,449TotalAmt
Program Services$577,028ProgramServicesAmt
Management And General$39,421ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$60,028TotalAmt
Program Services$51,895ProgramServicesAmt
Management And General$7,758ManagementAndGeneralAmt
Fundraising$375FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$54,225TotalAmt
Program Services$46,878ProgramServicesAmt
Management And General$7,008ManagementAndGeneralAmt
Fundraising$339FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$22,343TotalAmt
Management And General$22,343ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$9,379TotalAmt
Program Services$2,814ProgramServicesAmt
Management And General$6,565ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$10,470TotalAmt
Program Services$8,933ProgramServicesAmt
Management And General$1,537ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$49,930TotalAmt
Program Services$26,945ProgramServicesAmt
Management And General$22,985ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$39,248TotalAmt
Program Services$25,004ProgramServicesAmt
Management And General$14,152ManagementAndGeneralAmt
Fundraising$92FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
DRUGS, OXYGEN, DME RENT$105,301$105,301
MEDICAL SUPPLIES & SERVICES$100,939$100,939
AUTOMOBILE EXPENSE & MILEAGE$26,257$23,384$2,873
REPAIRS & MAINTENANCE$18,598$5,203$13,395

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$45,506TotalAmt
Program Services$29,245ProgramServicesAmt
Management And General$15,547ManagementAndGeneralAmt
Fundraising$714FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,246,666TotalAmt
Program Services$1,035,540ProgramServicesAmt
Management And General$205,206ManagementAndGeneralAmt
Fundraising$5,920FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,034,156BOYAmt
EOY$1,632,025EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$231,518BOYAmt
EOY$94,883EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$210,764BOYAmt
EOY$167,605EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$10,289BOYAmt
EOY$4,086EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$770,770LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$301,611LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$498,678BOYAmt
EOY$469,159EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$843,544BOYAmt
EOY$1,146,110EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$11,951BOYAmt
EOY$11,952EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,840,900BOYAmt
EOY$3,525,820EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$111,515BOYAmt
EOY$60,586EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$16,719BOYAmt
EOY$4,153EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$128,234BOYAmt
EOY$64,739EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,699,884BOYAmt
EOY$3,452,456EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$12,782BOYAmt
EOY$8,625EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,712,666BOYAmt
EOY$3,461,081EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,840,900BOYAmt
EOY$3,525,820EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$320,220ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$74,411NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$5,776OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewYes (true)AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
FS AuditedfalseFSAuditedInd
Audit CommitteefalseAuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$113,240CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$173,583CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$104,770CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$107,506CurrentTaxYearMinus1YearAmt
Current Tax Year$125,366CurrentTaxYearAmt
Total$624,465TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$113,240CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$173,583CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$104,770CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$107,506CurrentTaxYearMinus1YearAmt
Current Tax Year$125,366CurrentTaxYearAmt
Total$624,465TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$624,465PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$57,521CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$65,789CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$66,059CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$62,023CurrentTaxYearMinus1YearAmt
Current Tax Year$69,251CurrentTaxYearAmt
Total$320,643TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$945,108TotalSupportAmt
Public Support CY1700.66070PublicSupportCY170Pct
Public Support PY1700.64950PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$50,000OtherCostOrOtherBasisAmt
Book Value$50,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$452,333OtherCostOrOtherBasisAmt
Depreciation$99,363DepreciationAmt
Book Value$352,970BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$268,437OtherCostOrOtherBasisAmt
Depreciation$202,248DepreciationAmt
Book Value$66,189BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$469,159TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
PAYROLL TAXES$1,814
SIMPLE IRA$2,339
FieldValueIRS element (for citing)
Total Liability$4,153TotalLiabilityAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 11b: Form 990 Review ProcessNo review was or will be conducted.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableFINANCIAL STATEMENTS AVAILABLE UPON REQUEST.
Other Changes In Net Assets Or Fund Balances - Other DecreasesPRIOR PERIOD ADJUSTMENT(PREPAID INSURANCE) = -$5776

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