CARCINOID CANCER FOUNDATION: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
CARCINOID CANCER FOUNDATION (EIN 13-6277875)
Tax period
2013-03-01 to 2014-02-28
Filed
2014-08-19
IRS object ID
201442319349300324
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)
Return2014-08-19T12:13:50-05:00ReturnTs
Tax Period End2014-02-28TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN270181266PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FRANK A SALANDRA CPABusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1550 MAMARONECK AVENUE SUITE 509AddressLine1
CityHARRISONCity
StateNYState
ZIP Code10528ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-03-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN136277875EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CARCINOID CANCER FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlCARCBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1333 MAMARONECK AVEAddressLine1
Address Line2ROOM/SUITE 492AddressLine2
CityWHITE PLAINSCity
StateNYState
ZIP Code10605ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKEITH WARNERPersonNm
Person TitleCEOPersonTitleTxt
Signature2014-08-19SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonFRANK A SALANDRAPreparerPersonNm
PTINP00062174PTIN
Phone9143813503PhoneNum
Preparation2014-08-19PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerGRACE GOLDSTEINPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line19 AUDREY LANEAddressLine1
CityWHITE PLAINSCity
StateNYState
ZIP Code10605ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$239,415GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CARCINOID.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1968FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionEDUCATION OF MEDICAL PROFESSIONALS AND THE GENERAL PUBLIC; ADVOCACY AND SUPPORT OF PATIENTS AND FAMILIES OF PATIENTS; SUPPORT RESEARCH IN THE AREA OF CARCINOID AND NEUROENDOCRINE TUMORS.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$445,566PYContributionsGrantsAmt
CY Contributions Grants$239,177CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$295PYInvestmentIncomeAmt
CY Investment Income$238CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$445,861PYTotalRevenueAmt
CY Total Revenue$239,415CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$136,800PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$135,200CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$17,529CYTotalFundraisingExpenseAmt
PY Other Expenses$73,248PYOtherExpensesAmt
CY Other Expenses$66,608CYOtherExpensesAmt
PY Total Expenses$210,048PYTotalExpensesAmt
CY Total Expenses$201,808CYTotalExpensesAmt
PY Revenues Less Expenses$235,813PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$37,607CYRevenuesLessExpensesAmt
Total Assets BOY$487,654TotalAssetsBOYAmt
Total Assets EOY$268,107TotalAssetsEOYAmt
Total Liabilities BOY$39,211TotalLiabilitiesBOYAmt
Total Liabilities EOY$31TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$448,443NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$268,076NetAssetsOrFundBalancesEOYAmt
MissionEDUCATION OF MEDICAL PROFESSIONALS AND THE GENERAL PUBLIC; ADVOCACY AND SUPPORT OF PATIENTS AND FAMILIES OF PATIENTS; SUPPORT RESEARCH IN THE AREA OF CARCINOID AND NEUROENDOCRINE TUMORS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$123,426ExpenseAmt
DescPROVIDES INFORMATION AND EDUCATION FOR MEDICAL PROFESSIONALS, PATIENTS, CAREGIVERS, AND THE GENERAL PUBLIC; PROVIDES E-MAIL AND TELEPHONE SUPPORT; CONDUCTS CONFERENCES TO EDUCATE AND RAISE AWARENESS; WORKS TO IMPROVE ACCESS TO ACCURATE AND UP-TO-DATE INFORMATION.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
DescENCOURAGES AND SUPPORTS RESEARCH IN THE AREA OF CARCINOID AND NEUROENDOCRINE TUMORS; PROVIDES GRANTS FOR RELATED RESEARCH; SUPPORTS AND ENCOURANGES RESEARCH AND THE SHARING OF DATA AMONG PHYSICIANS.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$123,426TotalProgramServiceExpensesAmt
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 StmtYes (true)IndependentAuditFinclStmtInd
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
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
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document3IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
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 CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnfalseAnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcfalseRegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Own WebsiteYes (X)OwnWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonGRACE GOLDSTEINPersonNm
Phone9146831001PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line19 AUDREY LANEAddressLine1
CityWHITE PLAINSCity
StateNYState
ZIP Code10605ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
STANLEY PRESSMENT ESQ
SECRETARY/TR0.25Yes (X)$0$0$0
MICHAIL SHAFIR MD
BOARD MEMBER0.25Yes (X)$0$0$0
RICHARD RP WARNER MD
MEDICAL DIRE2.00Yes (X)$0$0$0
LORETTA BUCKMAN
BOARD MEMBER0.25Yes (X)$0$0$0
CHARLES SHAW
BOARD MEMBER0.25Yes (X)$0$0$0
GRACE GOLDSTEIN
COO40.00$83,200$0$0Yes (X)
KEITH WARNER
CEO16.25$52,000$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$135,200TotalReportableCompFromOrgAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Fundraising$8,199FundraisingAmt
All Other Contributions$230,978AllOtherContributionsAmt
Total Contributions$239,177TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$238TotalRevenueColumnAmt
Related Or Exempt Func Income$238RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$239,415TotalRevenueColumnAmt
Related Or Exempt Func Income$238RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$135,200TotalAmt
Program Services$102,960ProgramServicesAmt
Management And General$22,880ManagementAndGeneralAmt
Fundraising$9,360FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$2,824TotalAmt
Management And General$2,824ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,000TotalAmt
Management And General$1,000ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$5,750TotalAmt
Management And General$5,750ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,502TotalAmt
Management And General$2,629ManagementAndGeneralAmt
Fundraising$873FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$264TotalAmt
Program Services$264ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,283TotalAmt
Program Services$2,283ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,500TotalAmt
Management And General$1,500ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtFundraisingFundraisingAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
FUNDRAISING$6,682$6,682
BOOKKEEPING$6,600$6,600
WEBSITE EXPENSE$6,193$6,193
HEALTH EDUCATION$5,959$5,959

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$24,051TotalAmt
Program Services$5,767ProgramServicesAmt
Management And General$17,670ManagementAndGeneralAmt
Fundraising$614FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$201,808TotalAmt
Program Services$123,426ProgramServicesAmt
Management And General$60,853ManagementAndGeneralAmt
Fundraising$17,529FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$150,692BOYAmt
EOY$134,580EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$317,610BOYAmt
EOY$117,780EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$186,706LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$171,885LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$19,352BOYAmt
EOY$14,821EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$926EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$487,654BOYAmt
EOY$268,107EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$39,211BOYAmt
EOY$31EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$39,211BOYAmt
EOY$31EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$248,443BOYAmt
EOY$268,076EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$200,000BOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$448,443BOYAmt
EOY$268,076EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$487,654BOYAmt
EOY$268,107EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$37,607ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$26NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$218,000OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$307,271CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$169,307CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$232,372CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$445,566CurrentTaxYearMinus1YearAmt
Current Tax Year$230,978CurrentTaxYearAmt
Total$1,385,494TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$44,076CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$71,878CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,441CurrentTaxYearMinus2YearsAmt
Total$120,395TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$9,236CurrentTaxYearMinus2YearsAmt
Total$9,236TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$351,347CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$241,185CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$246,049CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$445,566CurrentTaxYearMinus1YearAmt
Current Tax Year$230,978CurrentTaxYearAmt
Total$1,515,125TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$47,000CurrentTaxYearMinus4YearsAmt
Total$47,000TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$87,000CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus1 Year$94,810CurrentTaxYearMinus1YearAmt
Total$181,810TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$134,000CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus1 Year$94,810CurrentTaxYearMinus1YearAmt
Total$228,810TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$1,286,315PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$33CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$120CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$233CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$295CurrentTaxYearMinus1YearAmt
Current Tax Year$238CurrentTaxYearAmt
Total$919TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$33CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$120CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$233CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$295CurrentTaxYearMinus1YearAmt
Current Tax Year$238CurrentTaxYearAmt
Total$919TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$17,984CurrentTaxYearMinus2YearsAmt
Total$17,984TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$351,380CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$241,305CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$264,266CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$445,861CurrentTaxYearMinus1YearAmt
Current Tax Year$231,216CurrentTaxYearAmt
Total$1,534,028TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.83850PublicSupportCY509Pct
Public Support PY5090.75830PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

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

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$186,706OtherCostOrOtherBasisAmt
Depreciation$171,885DepreciationAmt
Book Value$14,821BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$14,821TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO OTHER ORGANIZATIONSDesc
Amt$31Amt
FieldValueIRS element (for citing)
Total Liability$31TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$257,415TotalRevEtcAuditedFinclStmtAmt
Other Revenue$18,000OtherRevenueAmt
Revenue Not Reported$18,000RevenueNotReportedAmt
Revenue Subtotal$239,415RevenueSubtotalAmt
Total Revenue Per Form990$239,415TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$219,808TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$18,000OtherExpensesIncludedAmt
Expenses Not Reported$18,000ExpensesNotReportedAmt
Expenses Subtotal$201,808ExpensesSubtotalAmt
Total Expenses Per Form990$201,808TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 4, PART XI, LINE 2DIN-KIND DONATIONS 18,000
SCHEDULE D, PAGE 4, PART XII, LINE 2DIN-KIND DONATIONS 18,000
SCHEDULE D, PAGE 4, PART XIIIPART XII, LINE 2D-EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHER IN-KIND DONATIONS 18,000

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 2KEITH WARNER RICHARD R.P. WARNER CEO MEDICAL DIR.
FORM 990, PAGE 6, PART VI, LINE 11BA DRAFT OF FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING.
FORM 990, PAGE 6, PART VI, LINE 19FORM 990 AND THE FINANCIAL STATEMENTS ARE AVAILABLE ON THE FOUNDATION'S WEBSITE.
FORM 990, PART IX, LINE 24EVIDEO SERVICES 4,350 0 0 OTHER 0 4,233 0 TELEPHONE 1,222 2,444 0 STORAGE 0 3,216 0 POSTAGE & DELIVERY 0 2,723 0 COMPUTER EXPENSES 0 2,670 0 PY DEPRECIATION ADJUST 0 2,249 0 CREDIT CARD FEES 0 0 614 EDUCATION MATERIALS. 195 0 0 BANK & FINANCE CHARGES 0 135 0
FORM 990, PART XI, LINE 9IN-KIND DONATIONS 18,000 IN-KIND DONATIONS -18,000
FORM 990, PART XI, LINE 9IN KIND DONATION 18,000 PRIOR YEAR ADJUSTMENT: 0 PAYMENT OF RESTRICTED FUNDS 200,000

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