LIFEQUEST USA INC: Form 990EZ, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- LIFEQUEST USA INC (EIN 26-4584308)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-06-18
- IRS object ID
- 201311699349200521
- 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 | 2013-06-18T18:54:54-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 263779008 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ETHAN GOODMAN CPA LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3533 THAXTON AVE SE | AddressLine1 |
| City | ALBUQUERQUE | City |
| State | NM | State |
| ZIP Code | 87106 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 264584308 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LIFEQUEST USA INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LIFE | NameControl |
| Phone | 5053419383 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4020 EDITH BLVD NE | AddressLine1 |
| City | ALBUQUERQUE | City |
| State | NM | State |
| ZIP Code | 87107 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DAVID GREBE | Name |
| Title | TREASURER | Title |
| Phone | 5053419383 | Phone |
| Date Signed | 2013-06-17 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ETHAN F GOODMAN CPA | Name |
| PTIN | P00235908 | PTIN |
| Phone | 5052560997 | 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) |
|---|---|---|
| Address Change | X | AddressChange |
| Method Of Accounting Cash | X | MethodOfAccountingCash |
| Web Site | WWW.LIFEQUESTUSA.ORG | WebSite |
| Organization501c3 | X | Organization501c3 |
| Gross Receipts | 82450 | GrossReceipts |
| Info In Schedule O Part I | X | InfoInScheduleOPartI |
| Contributions Gifts Grants Etc | 59678 | ContributionsGiftsGrantsEtc |
| Program Service Revenue | 22750 | ProgramServiceRevenue |
| Investment Income | 22 | InvestmentIncome |
| Total Revenue | 82450 | TotalRevenue |
| Salaries Other Comp Empl Benefits | 46322 | SalariesOtherCompEmplBenefits |
| Fees And Oth Pymt To Ind Contractors | 1577 | FeesAndOthPymtToIndContractors |
| Occupancy Rent Utilities And Maint | 5261 | OccupancyRentUtilitiesAndMaint |
| Printing Publications Postage | 1548 | PrintingPublicationsPostage |
| Other Expenses Total | 28501 | OtherExpensesTotal |
| Total Expenses | 83209 | TotalExpenses |
| Excess Or Deficit For Year | -759 | ExcessOrDeficitForYear |
| Net Assets Or Fund Balances BOY | 19802 | NetAssetsOrFundBalancesBOY |
| Other Changes In Net Assets | 0 | OtherChangesInNetAssets |
| Net Assets Or Fund Balances EOY | 19043 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part II | X | InfoInScheduleOPartII |
Cash Savings And Investments CashSavingsAndInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21911 | BOY |
| EOY | 20866 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21911 | BOY |
| EOY | 20866 | EOY |
Sum Of Total Liabilities SumOfTotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2109 | BOY |
| EOY | 1823 | EOY |
Net Assets Or Fund Balances NetAssetsOrFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19802 | BOY |
| EOY | 19043 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Primary Exempt Purpose | CHARACTER DEVELOPMENT AND EDUCATION FOR AT-RISK YOUTH | PrimaryExemptPurpose |
Program Service Accomplishment ProgramServiceAccomplishment (2 entries)
| Description Program Service AccomDescriptionProgramServiceAccom | Grants And AllocationsGrantsAndAllocations | Program Service ExpensesProgramServiceExpenses |
|---|---|---|
| THE ORGANIZATION PROVIDES CHARACTER DEVELOPEMENT AND EDUCATION FOR AT-RISK YOUTH. APPROXIMATELY 1,200 YOUTHS WERE ASSISTED IN 2012. | 0 | 76874 |
| THE ORGANIZATION PROVIDES CHRISTMAS CARE KITS TO INCARCERATED INDIVIDUALS. IN 2012, APPROXIMATELY 780 CARE KITS WERE DISTRIBUTED. | 0 | 6335 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | 83209 | TotalProgramServiceExpenses |
Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (5 entries)
| TitleTitle | Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition | CompensationCompensation | Contri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtc | Expense Account Other AllowancesExpenseAccountOtherAllowances |
|---|---|---|---|---|
| JOHN BIAVA | ||||
| CHAIRMAN | 6.00 | 0 | 0 | 0 |
| JUSTIN MARBURY | ||||
| PRESIDENT & EXEC DIRECTOR | 15.00 | 6359 | 0 | 0 |
| RICHARD ZEMKE | ||||
| SECRETARY & VICE CHAIRMAN | 1.00 | 0 | 0 | 0 |
| LARRY JEHLE | ||||
| DIRECTOR | 1.00 | 0 | 0 | 0 |
| DAVID GREBE | ||||
| TREASURER & DIRECTOR | 2.00 | 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 | NM | StatesWhereCopyOfReturnIsFiled |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4020 EDITH BLVD NE | AddressLine1 |
| City | ALBUQUERQUE | City |
| State | NM | State |
| ZIP Code | 87107 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5053419383 | 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 Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 33418 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 65965 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 69077 | CurrentTaxYearMinus1Year |
| Current Tax Year | 59678 | CurrentTaxYear |
| Total | 228138 | Total |
Gross Receipts From Non UBI GrossReceiptsFromNonUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 25000 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 25550 | CurrentTaxYearMinus1Year |
| Current Tax Year | 22750 | CurrentTaxYear |
| Total | 73300 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 33418 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 90965 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 94627 | CurrentTaxYearMinus1Year |
| Current Tax Year | 82428 | CurrentTaxYear |
| Total | 301438 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 3250 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 7145 | CurrentTaxYearMinus1Year |
| Current Tax Year | 10005 | CurrentTaxYear |
| Total | 20400 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 3250 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 7145 | CurrentTaxYearMinus1Year |
| Current Tax Year | 10005 | CurrentTaxYear |
| Total | 20400 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 281038 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | 1 | CurrentTaxYearMinus1Year |
| Current Tax Year | 22 | CurrentTaxYear |
| Total | 23 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | 1 | CurrentTaxYearMinus1Year |
| Current Tax Year | 22 | CurrentTaxYear |
| Total | 23 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 33418 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 90965 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 94628 | CurrentTaxYearMinus1Year |
| Current Tax Year | 82450 | CurrentTaxYear |
| Total | 301461 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First5 Years509 | X | First5Years509 |
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 (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| OTHER INVESTMENT INCOME | FORM 990-EZ, PART I, LINE 4 | INTEREST INCOME 22.. |
| OTHER EXPENSES | FORM 990-EZ, PART I, LINE 16 | DESCRIPTION: CONFERENCES & MEETINGS. AMOUNT: 357. DESCRIPTION: OFFICE EXPENSE. AMOUNT: 1,592. DESCRIPTION: PAYROLL TAXES. AMOUNT: 3,543. DESCRIPTION: PROGRAM EXPENSES. AMOUNT: 9,034. DESCRIPTION: TELEPHONE & COMMUNICATIONS. AMOUNT: 1,297. DESCRIPTION: TRAVEL EXPENSES. AMOUNT: 8,107. DESCRIPTION: TRAINING PROGRAM COMPUTERS. AMOUNT: 675. DESCRIPTION: SPECIFIC ASSISTANCE TO AT-RISK YOUTH. AMOUNT: 1,194. DESCRIPTION: ADVERTISEMENTS FOR DONATIONS. AMOUNT: 1,269. DESCRIPTION: INSURANCE. AMOUNT: 1,433. TOTAL TO FORM 990-EZ, LINE 16: 28,501. |
| OTHER LIABILITIES | FORM 990-EZ, PART II, LINE 26 | DESCRIPTION: PAYROLL TAX LIABILITY. BEG. OF YEAR AMOUNT: 2,109. END OF YEAR AMOUNT: 1,823. |
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 |
Comments