HOSPICE DEL VALLE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: HOSPICE DEL VALLE INC (EIN 74-2230859)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-11-15
IRS object ID: 201303199349309980
Schema version: 2012v2.0
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 O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-11-15T14:42:24-08:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Martinez & Associates Inc	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	514 Second Street	AddressLine1
City	Alamosa	City
State	CO	State
ZIP Code	81101	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	742230859	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	HOSPICE DEL VALLE INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	HOSP	NameControl

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	514 MAIN STREET	AddressLine1
City	ALAMOSA	City
State	CO	State
ZIP Code	81101	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	LOIS BOOTH	Name
Title	CEO	Title
Date Signed	2013-11-15	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	STEVEN P MARTINEZ CPA	Name
PTIN	P00309923	PTIN
Phone	7195894964	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Gross Receipts	1942052	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
All Affiliates Included	false	AllAffiliatesIncluded
Organization501c3	X	Organization501c3
Web Site	N/A	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Activity Or Mission Description	PROVIDES CARE TO TERMINALLY ILL PATIENTS OF THE SAN LUIS VALLEY, COLORADO	ActivityOrMissionDescription
Nbr Voting Members Governing Body	9	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	9	NbrIndependentVotingMembers
Total Nbr Employees	24	TotalNbrEmployees
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	104770	ContributionsGrantsPriorYear
Contributions Grants Current Year	107506	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	1397635	ProgramServiceRevenuePriorYear
Program Service Revenue CY	1772523	ProgramServiceRevenueCY
Investment Income Prior Year	66058	InvestmentIncomePriorYear
Investment Income Current Year	62023	InvestmentIncomeCurrentYear
Other Revenue Current Year	0	OtherRevenueCurrentYear
Total Revenue Prior Year	1568463	TotalRevenuePriorYear
Total Revenue Current Year	1942052	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	616555	SalariesEtcPriorYear
Salaries Etc Current Year	888413	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	11089	TotalFundrsngExpCurrentYear
Other Expense Prior Year	611793	OtherExpensePriorYear
Other Expenses Current Year	661078	OtherExpensesCurrentYear
Total Expenses Prior Year	1228348	TotalExpensesPriorYear
Total Expenses Current Year	1549491	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	340115	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	392561	RevenuesLessExpensesCY
Total Assets BOY	3355430	TotalAssetsBOY
Total Assets EOY	3840900	TotalAssetsEOY
Total Liabilities BOY	72201	TotalLiabilitiesBOY
Total Liabilities EOY	128234	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	3283229	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	3712666	NetAssetsOrFundBalancesEOY
Mission Description	PROVIDES CARE TO TERMINALLY ILL PATIENTS OF THE SAN LUIS VALLEY, COLORADO	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	1333211	Expense
Description	HOSPICE 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.	Description
Total Program Service Expense	1333211	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	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	false	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
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	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	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	false	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	false	ScheduleORequired
Number Forms Transmitted With1096	4	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	24	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Form990-T Filed	false	Form990-TFiled
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
Number Of8282 Filed	0	NumberOf8282Filed
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Form8899 Filed	false	Form8899Filed
Form1098 C Filed	false	Form1098CFiled
Excess Business Holdings	false	ExcessBusinessHoldings
Taxable Distributions	false	TaxableDistributions
Distribution To Donor	false	DistributionToDonor
Filed Lieu1041	false	FiledLieu1041
Licensed More Than One State	false	LicensedMoreThanOneState
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	9	NbrVotingGoverningBodyMembers
Number Independent Voting Members	9	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	false	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	false	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	false	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	HOSPICE DEL VALLE INC	NamePerson
Telephone Number	7195899019	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	514 MAIN STREET	AddressLine1
City	ALAMOSA	City
State	CO	State
ZIP Code	81101	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (10 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer
LOIS BOOTH
CEO	40.00	0.00	88996	0	0
TRACY RODGERS
Board Member	1.00	0.00	0	0	0	X
GREG MCAULIFFE
Director	1.00	0.00	0	0	0	X
AMANDA JOJOLA
Director	1.00	0.00	0	0	0	X
MARGUERITE HOAGLAND
Director	1.00	0.00	0	0	0	X
ROGER KNAPP
Vice President	1.00	0.00	0	0	0	X	X
KARLA WILSCHAU
TREASURER	1.00	0.00	0	0	0	X	X
GARY STEPHENS
Secretary	1.00	0.00	0	0	0	X	X
KRISTI CORTEZ
CO-Treasurer	1.00	0.00	0	0	0	X	X
LORRAINE ROSS
PRESIDENT	1.00	0.00	0	0	0	X	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	88996	TotalReportableCompFromOrg
Number Individuals GT100 K	0	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources
Number Of Contractors GT100 K	0	NumberOfContractorsGT100K
All Other Contributions	107506	AllOtherContributions
Total Contributions	107506	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	PATIENT CARE REVENUE	Description
Total Revenue Column	1772523	TotalRevenueColumn
Exclusion	$1,772,523	ExclusionAmount

Field	Value	IRS element (for citing)
Total Program Service Revenue	1772523	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	62023	TotalRevenueColumn
Related Or Exempt Function Income	62023	RelatedOrExemptFunctionIncome

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Field	Value	IRS element (for citing)
Total Other Revenue	0	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	1942052	TotalRevenueColumn
Related Or Exempt Function Income	62023	RelatedOrExemptFunctionIncome
Exclusion	$1,772,523	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	0	Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	88996	Total
Program Services	33818	ProgramServices
Management And General	46278	ManagementAndGeneral
Fundraising	8900	Fundraising

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	665038	Total
Program Services	614238	ProgramServices
Management And General	50800	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	0	Total

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	72342	Total
Program Services	62203	ProgramServices
Management And General	9285	ManagementAndGeneral
Fundraising	854	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	62037	Total
Program Services	53342	ProgramServices
Management And General	7963	ManagementAndGeneral
Fundraising	732	Fundraising

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	13250	Total
Management And General	13250	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	0	Total

Advertising Advertising

Field	Value	IRS element (for citing)
Total	0	Total

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	10044	Total
Program Services	3013	ProgramServices
Management And General	7031	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	0	Total

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	0	Total

Travel Travel

Field	Value	IRS element (for citing)
Total	3930	Total
Program Services	3219	ProgramServices
Management And General	711	ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	0	Total

Interest Interest

Field	Value	IRS element (for citing)
Total	0	Total

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	46036	Total
Program Services	11997	ProgramServices
Management And General	34039	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	36798	Total
Program Services	23735	ProgramServices
Management And General	12888	ManagementAndGeneral
Fundraising	175	Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
ASSOCIATION DUES	10998	6626	4372
AUTOMOBILE EXPENSE & MILEAGE	37961	33796	4165
DRUGS, OXYGEN, DME RENT	189487	189487
MEDICAL SUPPLIES & SERVICES	281913	281913

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	30661	Total
Program Services	15824	ProgramServices
Management And General	14409	ManagementAndGeneral
Fundraising	428	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	1549491	Total
Program Services	1333211	ProgramServices
Management And General	205191	ManagementAndGeneral
Fundraising	11089	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	1838361	BOY
EOY	2034156	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
EOY	0	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
EOY	0	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	169421	BOY
EOY	231518	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	261865	BOY
EOY	210764	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
EOY	0	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	4172	BOY
EOY	10289	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	782557	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	283879	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	484086	BOY
EOY	498678	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	585575	BOY
EOY	843544	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	11950	BOY
EOY	11951	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	3355430	BOY
EOY	3840900	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	62221	BOY
EOY	111515	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	9980	BOY
EOY	16719	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	72201	BOY
EOY	128234	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	3274407	BOY
EOY	3699884	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	8822	BOY
EOY	12782	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	3283229	BOY
EOY	3712666	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	3355430	BOY
EOY	3840900	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	392561	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	36876	ReconciliationUnrealizedInvest
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	true	AccountantCompileOrReview

Accountant Compile Or Review Basis AccountantCompileOrReviewBasis

Field	Value	IRS element (for citing)
Financial Statement Separate	X	FinancialStatementSeparate

Field	Value	IRS element (for citing)
FS Audited	false	FSAudited
Audit Committee	false	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	88750	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	113240	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	173583	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	104770	CurrentTaxYearMinus1Year
Current Tax Year	107506	CurrentTaxYear
Total	587849	Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

Field	Value	IRS element (for citing)
Total	0	Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

Field	Value	IRS element (for citing)
Total	0	Total

Total170 Total170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	88750	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	113240	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	173583	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	104770	CurrentTaxYearMinus1Year
Current Tax Year	107506	CurrentTaxYear
Total	587849	Total

Field	Value	IRS element (for citing)
Amounts Subst Contributors Total	0	AmountsSubstContributorsTotal
Public Support Total170	587849	PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	65775	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	57521	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	65789	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	66059	CurrentTaxYearMinus1Year
Current Tax Year	62023	CurrentTaxYear
Total	317167	Total

Net UBI NetUBI

Field	Value	IRS element (for citing)
Total	0	Total

Other Income170 OtherIncome170

Field	Value	IRS element (for citing)
Total	0	Total

Field	Value	IRS element (for citing)
Total Support	905016	TotalSupport
Public Support Pertcentage170	0.64950	PublicSupportPertcentage170
Public Support Pertcent Prior Year	0.69900	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

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	50000	OtherCostOrOtherBasis
Book Value	50000	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	436758	OtherCostOrOtherBasis
Depreciation	99363	Depreciation
Book Value	337395	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	295799	OtherCostOrOtherBasis
Depreciation	184516	Depreciation
Book Value	111283	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	498678	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	PAYROLL TAXES	Description
Amount	$16,719	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	16719	TotalOfAmounts

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Form 990, Part VI, Line 19	Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	No documents available to the public.
Form 990, Part VI, Line 11b	Form 990, Part VI, Line 11b: Form 990 Review Process	No review was or will be conducted.