MOUNT MERU TUMAINI HEALTH CLINIC INC: Form 990EZ, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- MOUNT MERU TUMAINI HEALTH CLINIC INC (EIN 20-0380113)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2013-11-15
- IRS object ID
- 201303199349204160
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-15T15:47:11-06:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410746749 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1347 | AddressLine1 |
| City | RACINE | City |
| State | WI | State |
| ZIP Code | 534011347 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200380113 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOUNT MERU TUMAINI HEALTH CLINIC INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MOUN | NameControl |
| Phone | 2629308267 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3500 WASHINGTON AVE | AddressLine1 |
| City | RACINE | City |
| State | WI | State |
| ZIP Code | 534052934 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DENISE MBISE | Name |
| Title | PRESIDENT | Title |
| Phone | 2629308267 | Phone |
| Date Signed | 2013-11-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CHRISTINE M LUDWIG CPA | Name |
| PTIN | P01230006 | PTIN |
| Phone | 2626379351 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Cash | X | MethodOfAccountingCash |
| Web Site | MMTHC.ORG | WebSite |
| Organization501c3 | X | Organization501c3 |
| Gross Receipts | 28415 | GrossReceipts |
| Info In Schedule O Part I | X | InfoInScheduleOPartI |
| Contributions Gifts Grants Etc | 27829 | ContributionsGiftsGrantsEtc |
| Fundraising Gross Income | 586 | FundraisingGrossIncome |
| Special Events Net Income Loss | 586 | SpecialEventsNetIncomeLoss |
| Total Revenue | 28415 | TotalRevenue |
| Printing Publications Postage | 455 | PrintingPublicationsPostage |
| Other Expenses Total | 25003 | OtherExpensesTotal |
| Total Expenses | 25458 | TotalExpenses |
| Excess Or Deficit For Year | 2957 | ExcessOrDeficitForYear |
| Net Assets Or Fund Balances BOY | 2332 | NetAssetsOrFundBalancesBOY |
| Other Changes In Net Assets | 0 | OtherChangesInNetAssets |
| Net Assets Or Fund Balances EOY | 5289 | NetAssetsOrFundBalancesEOY |
Cash Savings And Investments CashSavingsAndInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2332 | BOY |
| EOY | 5289 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2332 | BOY |
| EOY | 5289 | EOY |
Sum Of Total Liabilities SumOfTotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Net Assets Or Fund Balances NetAssetsOrFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2332 | BOY |
| EOY | 5289 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Primary Exempt Purpose | MEDICAL SUPPORT OF CLINIC IN TANZANIA | PrimaryExemptPurpose |
Program Service Accomplishment ProgramServiceAccomplishment (3 entries)
| Description Program Service AccomDescriptionProgramServiceAccom | Grants And AllocationsGrantsAndAllocations | Program Service ExpensesProgramServiceExpenses |
|---|---|---|
| PROVIDING HEALTH CARE AND COMMUNITY SERVICES TO PEOPLE OF TANZANIA, WHICH INCLUDES PROVIDING STAFF, NURSES, DENTISTS, PHARMACY SUPPLIES, AND MAINTAINING A VEHICLE FOR AMBULANCE SERVICES. | 0 | 11858 |
| PROVIDING FAMINE RELIEF FOR OVER 500 FAMILIES ON MOUNT MERU IN TANZANIA. | 0 | 12600 |
| MAINTENANCE OF TWO WELLS IN NDOOMBO. | 0 | 1000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | 25458 | TotalProgramServiceExpenses |
Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (9 entries)
| TitleTitle | Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition | CompensationCompensation | Contri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtc | Expense Account Other AllowancesExpenseAccountOtherAllowances |
|---|---|---|---|---|
| DENISE MBISE | ||||
| PRESIDENT | 1.00 | 0 | 0 | 0 |
| REV WARREN WILLIAMS | ||||
| VICE-PRESIDENT | 1.00 | 0 | 0 | 0 |
| ELAINE LUCHT | ||||
| SECRETARY | 1.00 | 0 | 0 | 0 |
| JODIE LARSON | ||||
| TREASURER | 1.00 | 0 | 0 | 0 |
| BARB ELMER | ||||
| BOARD MEMBER | 1.00 | 0 | 0 | 0 |
| JILL WANGGAARD | ||||
| BOARD MEMBER | 1.00 | 0 | 0 | 0 |
| EXAUDH MBISE | ||||
| BOARD MEMBER | 1.00 | 0 | 0 | 0 |
| NANCY HOFER | ||||
| BOARD MEMBER | 1.00 | 0 | 0 | 0 |
| SIMON AKINDES | ||||
| BOARD MEMBER | 1.00 | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRpt |
| Made Changes To Orgnzng Etc Doc | 0 | MadeChangesToOrgnzngEtcDoc |
| Organization Had UBI | 0 | OrganizationHadUBI |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtc |
| Direct Indirect Political Expend | 0 | DirectIndirectPoliticalExpend |
| Made Loans To From Officers | 0 | MadeLoansToFromOfficers |
| Tax Imposed Under IRC4911 | 0 | TaxImposedUnderIRC4911 |
| Tax Imposed Under IRC4912 | 0 | TaxImposedUnderIRC4912 |
| Tax Imposed Under IRC4955 | 0 | TaxImposedUnderIRC4955 |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTrans |
| Amount Of Tax Imposed On Org Mgr | 0 | AmountOfTaxImposedOnOrgMgr |
| Amount Of Tax Reimbursed By Org | 0 | AmountOfTaxReimbursedByOrg |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DENISE MBISE | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3500 WASHINGTON AVE | AddressLine1 |
| City | RACINE | City |
| State | WI | State |
| ZIP Code | 53405 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2629308267 | TelephoneNumber |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Foreign Office | 0 | ForeignOffice |
| Maintain Any Donor Advised Funds | 0 | MaintainAnyDonorAdvisedFunds |
| Does Org Have Hospital | 0 | DoesOrgHaveHospital |
| Tanning Services Provided | 0 | TanningServicesProvided |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Engage Political Cmpgn Activities | 0 | EngagePoliticalCmpgnActivities |
| Engage In Lobbying Activities | 0 | EngageInLobbyingActivities |
| Operating School | 0 | OperatingSchool |
| Trnsfrs Exempt Non Char Related Org | 0 | TrnsfrsExemptNonCharRelatedOrg |
| Part VI Of Comp Of Highest Paid Empl | NONE | PartVIOfCompOfHighestPaidEmpl |
| Part VIA Hghst Paid Cntrct Prof Ser | NONE | PartVIAHghstPaidCntrctProfSer |
| Filed Schedule A | 1 | FiledScheduleA |
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 | 19071 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 19962 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 17653 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 24343 | CurrentTaxYearMinus1Year |
| Current Tax Year | 27829 | CurrentTaxYear |
| Total | 108858 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 19071 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 19962 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 17653 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 24343 | CurrentTaxYearMinus1Year |
| Current Tax Year | 27829 | CurrentTaxYear |
| Total | 108858 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 36344 | AmountsSubstContributorsTotal |
| Public Support Total170 | 72514 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1 | CurrentTaxYearMinus1Year |
| Total | 8 | Total |
Net UBI NetUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | 1490 | CurrentTaxYearMinus1Year |
| Current Tax Year | 586 | CurrentTaxYear |
| Total | 2076 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 110942 | TotalSupport |
| Public Support Pertcentage170 | 0.65360 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.43680 | 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 O IRS990ScheduleO
General Explanation GeneralExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | OTHER EXPENSES | Identifier |
| Return Reference | FORM 990-EZ, PART I, LINE 16 | ReturnReference |
| Explanation | DESCRIPTION: TANZANIA CLINIC - VEHICLE MAINTENANCE. AMOUNT: 1,105. DESCRIPTION: OFFICE SUPPLIES. AMOUNT: 50. DESCRIPTION: ANNUAL STATE FILING FEE. AMOUNT: 10. DESCRIPTION: WIRE TRANSFER BANK FEES. AMOUNT: 198. DESCRIPTION: MISSION TRIP PROJECT EXPENSES. AMOUNT: 5,800. DESCRIPTION: FOOD PURCHASES FOR DISTRIBUTION - NDOOMBO. AMOUNT: 12,600. DESCRIPTION: WELL MAINTENANCE AND REPAIR - NDOOMBO. AMOUNT: 1,000. DESCRIPTION: CLINIC SALARIES - NDOOMBO. AMOUNT: 3,737. DESCRIPTION: CLINIC ELECTRIC EXPENSES - NDOOMBO. AMOUNT: 503. TOTAL TO FORM 990-EZ, LINE 16: 25,003. | Explanation |
Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Declaration | THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT. | Declaration |
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