FURP.ORG / PUBLIC DATA EXPLORER

FALLBROOK HEALTHCARE FOUNDATION INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
FALLBROOK HEALTHCARE FOUNDATION INC (EIN 95-3389263)
Tax period
2012-07-01 to 2013-06-30
Filed
2013-12-05
IRS object ID
201313399349300211
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-12-05T08:57:03-08:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Vander Spek & Corsello CPAsBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1350 West Fifth Ave Suite 300AddressLine1
CityEscondidoCity
StateCAState
ZIP Code920254813ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN953389263EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Fallbrook Healthcare Foundation IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlFALLNameControl
Phone7607237713Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 2155AddressLine1
CityFallbrookCity
StateCAState
ZIP Code92088ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBob FranzName
TitlePresidentTitle
Date Signed2013-12-05DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJames K Vander Spek CPAName
PTINP00234100PTIN
Phone7607412659Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonBob FranzNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line15789 Lake Vista DriveAddressLine1
CityBonsallCity
StateCAState
ZIP Code92003ZIPCode
FieldValueIRS element (for citing)
Gross Receipts672075GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionIts purpose is to engage in activities intended to identify, assess, promote and fund programs to solve health issues important to the communities comprising the Fallbrook Hospital District.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees17TotalNbrEmployees
Total Nbr Volunteers20TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year269430ContributionsGrantsPriorYear
Contributions Grants Current Year480891ContributionsGrantsCurrentYear
Program Service Revenue Prior Year90515ProgramServiceRevenuePriorYear
Program Service Revenue CY99995ProgramServiceRevenueCY
Investment Income Prior Year-3764InvestmentIncomePriorYear
Investment Income Current Year21768InvestmentIncomeCurrentYear
Other Revenue Prior Year16877OtherRevenuePriorYear
Other Revenue Current Year16285OtherRevenueCurrentYear
Total Revenue Prior Year373058TotalRevenuePriorYear
Total Revenue Current Year618939TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year301257SalariesEtcPriorYear
Salaries Etc Current Year352983SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year10868TotalFundrsngExpCurrentYear
Other Expense Prior Year255116OtherExpensePriorYear
Other Expenses Current Year190555OtherExpensesCurrentYear
Total Expenses Prior Year556373TotalExpensesPriorYear
Total Expenses Current Year543538TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-183315RevenuesLessExpensesPriorYear
Revenues Less Expenses CY75401RevenuesLessExpensesCY
Total Assets BOY1181214TotalAssetsBOY
Total Assets EOY1278162TotalAssetsEOY
Total Liabilities BOY27966TotalLiabilitiesBOY
Total Liabilities EOY28594TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1153248NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1249568NetAssetsOrFundBalancesEOY
Mission DescriptionIts purpose is to engage in activities intended to identify, assess, promote and fund programs to solve health issues important to the communities comprising the Fallbrook Hospital District.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense281402Expense
Grants61000Grants
Revenue95702Revenue
DescriptionAssisting the elderly and their family's with a varying degree of services.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense153428Expense
Grants32500Grants
Revenue56457Revenue
DescriptionProvide shuttle services for the elderly and their family's to assure that they can make health care appointments.Description
FieldValueIRS element (for citing)
Total Program Service Expense434830TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredfalseScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees17NumberOfEmployees
Employment Tax Returns FiledfalseEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodyfalseMinutesOfGoverningBody
Minutes Of CommitteesfalseMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Own WebsiteXOwnWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonRoxanne GreeneNamePerson
Telephone Number7607264316TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15256 S Mission Road Ste 205AddressLine1
CityBonsallCity
StateCAState
ZIP Code92003ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
Tom Somers
Director1.000.00X000
Bradley Resare
Director1.000.00X000
Bonnie Lentz
Director1.000.00X000
Tom Koehler
Director1.000.00X000
Allen Cook
Director1.000.00X000
Martha Choi
Director1.000.00X000
Jack Rockwell
Director1.000.00X000
Mike McReynolds
Treasurer2.000.00X000X
Doug Clements
Secretary2.000.00X000X
Roger Shaver
Vice President6.000.00X000X
Bob Halibozek
Vice President1.000.00X000X
Bob Franz
President6.000.00X000X
FieldValueIRS element (for citing)
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events23227FundraisingEvents
All Other Contributions457664AllOtherContributions
Noncash Contributions70559NoncashContributions
Total Contributions480891TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionFees- Care advocate & vanDescription
Total Revenue Column99995TotalRevenueColumn
Related Or Exempt Function Income99995RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue99995TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column21766TotalRevenueColumn
Related Or Exempt Function Income21766RelatedOrExemptFunctionIncome

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities2Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities2Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2TotalRevenueColumn
Related Or Exempt Function Income2RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Gross Income Fundraising Events69421GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events23227CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses53136FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column16285TotalRevenueColumn
Exclusion$16,285ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column618939TotalRevenueColumn
Related Or Exempt Function Income121763RelatedOrExemptFunctionIncome
Exclusion$16,285ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total323019Total
Program Services258415ProgramServices
Management And General58144ManagementAndGeneral
Fundraising6460Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total29964Total
Program Services23971ProgramServices
Management And General5394ManagementAndGeneral
Fundraising599Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total13625Total
Program Services10900ProgramServices
Management And General2453ManagementAndGeneral
Fundraising272Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total11313Total
Program Services9050ProgramServices
Management And General2037ManagementAndGeneral
Fundraising226Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total17532Total
Program Services14026ProgramServices
Management And General3155ManagementAndGeneral
Fundraising351Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total20364Total
Program Services16291ProgramServices
Management And General3666ManagementAndGeneral
Fundraising407Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total20493Total
Program Services16394ProgramServices
Management And General3689ManagementAndGeneral
Fundraising410Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total19055Total
Program Services15244ProgramServices
Management And General3430ManagementAndGeneral
Fundraising381Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total35521Total
Program Services28417ProgramServices
Management And General6394ManagementAndGeneral
Fundraising710Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Due & memberships2219177540044
Reading program639551161151128
Events & programs19397155183491388
Utilities21161169293809423

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total3480Total
Program Services2784ProgramServices
Management And General627ManagementAndGeneral
Fundraising69Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total543538Total
Program Services434830ProgramServices
Management And General97840ManagementAndGeneral
Fundraising10868Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY100210BOY
EOY134538EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3387BOY
EOY179EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis564383LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec154544LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY399132BOY
EOY409839EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY678485BOY
EOY733605EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
EOY1EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1181214BOY
EOY1278162EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY27966BOY
EOY28594EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY27966BOY
EOY28594EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1112720BOY
EOY1179405EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY4744BOY
EOY4744EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY35784BOY
EOY65419EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1153248BOY
EOY1249568EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1181214BOY
EOY1278162EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses75401ReconcilationRevenueExpenses
Reconciliation Unrealized Invest20919ReconciliationUnrealizedInvest
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit CommitteefalseAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years402379CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years181660CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years305615CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year269430CurrentTaxYearMinus1Year
Current Tax Year423635CurrentTaxYear
Total1582719Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

FieldValueIRS element (for citing)
Total0Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

FieldValueIRS element (for citing)
Total0Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years402379CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years181660CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years305615CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year269430CurrentTaxYearMinus1Year
Current Tax Year423635CurrentTaxYear
Total1582719Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total0AmountsSubstContributorsTotal
Public Support Total1701582719PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year-3764CurrentTaxYearMinus1Year
Current Tax Year21768CurrentTaxYear
Total18004Total

Net UBI NetUBI

FieldValueIRS element (for citing)
Total0Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Total Support1600723TotalSupport
Public Support Pertcentage1700.98880PublicSupportPertcentage170
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis315872OtherCostOrOtherBasis
Depreciation46225Depreciation
Book Value269647BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis132686OtherCostOrOtherBasis
Depreciation39024Depreciation
Book Value93662BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis97433OtherCostOrOtherBasis
Depreciation57400Depreciation
Book Value40033BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis18392OtherCostOrOtherBasis
Depreciation11895Depreciation
Book Value6497BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings409839TotalOfBookValueLandBuildings
Tot Revenue Etc Audited Fincl Stmt618939TotRevenueEtcAuditedFinclStmt
Revenue Subtotal618939RevenueSubtotal
Total Revenue Per Form990618939TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt543538TotExpensesEtcAuditedFinclStmt
Expenses Subtotal543538ExpensesSubtotal
Total Expenses Per Form990543538TotalExpensesPerForm990

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsXMailSolicitations
Solicitation Of Non Govt GrantsXSolicitationOfNonGovtGrants
Special Fundraising EventsXSpecialFundraisingEvents
Agreement Ref FundraisingfalseAgreementRefFundraising

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Care VanNameOfEvent1
Gross Receipts Event141954GrossReceiptsEvent1
Gross Revenue Event141954GrossRevenueEvent1
Other Direct Expenses Event12669OtherDirectExpensesEvent1
Name Of Event2Dinner w/Doc'sNameOfEvent2
Gross Receipts Event236777GrossReceiptsEvent2
Charitable Contributions Event223227CharitableContributionsEvent2
Gross Revenue Event213550GrossRevenueEvent2
Non Cash Prizes Event223227NonCashPrizesEvent2
Other Direct Expenses Event227240OtherDirectExpensesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Other Events13917GrossReceiptsOtherEvents
Gross Revenue Other Events13917GrossRevenueOtherEvents
Gross Receipts Total92648GrossReceiptsTotal
Charitable Contributions Total23227CharitableContributionsTotal
Gross Revenue Total Events69421GrossRevenueTotalEvents
Non Cash Prizes Total Events23227NonCashPrizesTotalEvents
Other Direct Expenses Total Events29909OtherDirectExpensesTotalEvents
Direct Expense Summary Events53136DirectExpenseSummaryEvents
Net Income Summary16285NetIncomeSummary

Schedule M IRS990ScheduleM

Other Non Cash Contributions Table OtherNonCashContributionsTable (2 entries)

DescriptionDescriptionNumber Of ContributionsNumberOfContributionsNoncash Contribs Rptd F990NoncashContribsRptdF990Method Of Determining RevenuesMethodOfDeterminingRevenues
volunteers2010800$9 hourly rate
door prizes6023227fmv
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableNo documents available to the public.
Form 990, Part VI, Line 15aForm 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top ManagementCompensation and wage increases for all categories are reviewed/approved by the Board of Directors.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsOfficers, directors and key employees are required to sign disclosure statements annually.
Form 990, Part VI, Line 11bForm 990, Part VI, Line 11b: Form 990 Review ProcessNo review was or will be conducted.