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HEALTHNOW FOUNDATION OF POLK COUNTY: Form 990PF, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
HEALTHNOW FOUNDATION OF POLK COUNTY (EIN 27-0542330)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-04-09
IRS object ID
201320999349100507
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

FieldValueIRS element (for citing)
Timestamp2013-04-09T14:32:38-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN410746749EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1811 EAST MAIN STREETAddressLine1
CityLAKELANDCity
StateFLState
ZIP Code33801ZIPCode
FieldValueIRS element (for citing)
Return Type990PFReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN270542330EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HEALTHNOW FOUNDATION OF POLK COUNTY INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHEALNameControl
Phone8636162191Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 S FLORIDA AVE SUITE 800AddressLine1
CityLAKELANDCity
StateFLState
ZIP Code33801ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARK GRAYName
TitleDIRECTORTitle
Phone8636162191Phone
Date Signed2013-04-04DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTORI LEHMANName
PTINP00313085PTIN
Phone8636877000Phone
Date Prepared2013-04-01DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Exempt PFXExemptPF
FMV Assets EOY34184FMVAssetsEOY
Method Of Accounting CashXMethodOfAccountingCash

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Not Required To Attach Schedule BXNotRequiredToAttachScheduleB
Interest On Savings Rev And Expnss40InterestOnSavingsRevAndExpnss
Interest On Savings Net Invst Incm40InterestOnSavingsNetInvstIncm
Capital Gain Net Incm Net Invst Incm0CapitalGainNetIncmNetInvstIncm
Total Revenue And Expenses40TotalRevenueAndExpenses
Total Net Investment Income40TotalNetInvestmentIncome
Comp Ofcr Dir Trst Rev And Expnss0CompOfcrDirTrstRevAndExpnss
Comp Ofcr Dir Trst Net Invst Incm0CompOfcrDirTrstNetInvstIncm
Comp Ofcr Dir Trst Dsbrs Chrtbl Prps0CompOfcrDirTrstDsbrsChrtblPrps
Legal Fees Rev And Expnss1500LegalFeesRevAndExpnss
Legal Fees Net Invst Incm0LegalFeesNetInvstIncm
Legal Fees Dsbrs Chrtbl Prps1500LegalFeesDsbrsChrtblPrps
Accounting Fees Rev And Expnss1200AccountingFeesRevAndExpnss
Accounting Fees Net Invst Incm0AccountingFeesNetInvstIncm
Accounting Fees Dsbrs Chrtbl Prps1200AccountingFeesDsbrsChrtblPrps
Taxes Rev And Expnss183TaxesRevAndExpnss
Taxes Net Invst Incm0TaxesNetInvstIncm
Taxes Dsbrs Chrtbl Prps183TaxesDsbrsChrtblPrps
Other Expenses Rev And Expnss61OtherExpensesRevAndExpnss
Other Expenses Net Invst Incm0OtherExpensesNetInvstIncm
Other Expenses Dsbrs Chrtbl Prps61OtherExpensesDsbrsChrtblPrps
Tot Opr Expenses Rev And Expnss2944TotOprExpensesRevAndExpnss
Tot Opr Expenses Net Invst Incm0TotOprExpensesNetInvstIncm
Tot Opr Expenses Dsbrs Chrtbl Prps2944TotOprExpensesDsbrsChrtblPrps
Contri Gifts Paid Rev And Expnss0ContriGiftsPaidRevAndExpnss
Contri Gifts Paid Dsbrs Chrtbl Prps0ContriGiftsPaidDsbrsChrtblPrps
Total Expenses Rev And Expnss2944TotalExpensesRevAndExpnss
Total Expenses Net Invst Incm0TotalExpensesNetInvstIncm
Total Expenses Dsbrs Chrtbl Prps2944TotalExpensesDsbrsChrtblPrps
Excess Of Revenue Over Expenses-2904ExcessOfRevenueOverExpenses
Net Investment Income40NetInvestmentIncome

Balance Sheets BalanceSheets

FieldValueIRS element (for citing)
Savings And Temp Cash Invst BOY37088SavingsAndTempCashInvstBOY
Savings And Temp Cash Invst EOY34184SavingsAndTempCashInvstEOY
Savings And Temp Cash Invst EOYFMV34184SavingsAndTempCashInvstEOYFMV
Total Assets BOY37088TotalAssetsBOY
Total Assets EOY34184TotalAssetsEOY
Total Assets EOYFMV34184TotalAssetsEOYFMV
Total Liabilities BOY0TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Org That Follow SFAS117XOrgThatFollowSFAS117
Unrestricted BOY37088UnrestrictedBOY
Unrestricted EOY34184UnrestrictedEOY
Total Net Assets BOY37088TotalNetAssetsBOY
Total Net Assets EOY34184TotalNetAssetsEOY
Total Liabilities Net Assets BOY37088TotalLiabilitiesNetAssetsBOY
Total Liabilities Net Assets EOY34184TotalLiabilitiesNetAssetsEOY

Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances

FieldValueIRS element (for citing)
Total Net Assets Fund Balances BOY37088TotalNetAssetsFundBalancesBOY
Excess Of Revenue Over Expenses-2904ExcessOfRevenueOverExpenses
Other Increases0OtherIncreases
Subtotal34184Subtotal
Other Decreases0OtherDecreases
Total Net Assets Fund Balances EOY34184TotalNetAssetsFundBalancesEOY

Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax

FieldValueIRS element (for citing)
Liable For4942 Tax0LiableFor4942Tax
Qualifying Distributions Year15010222QualifyingDistributionsYear1
Noncharitable Assets Year12292267NoncharitableAssetsYear1
Distribution Ratio Year12.185706DistributionRatioYear1
Qualifying Distributions Year2529685QualifyingDistributionsYear2
Noncharitable Assets Year25419683NoncharitableAssetsYear2
Distribution Ratio Year20.097734DistributionRatioYear2
Qualifying Distributions Year30QualifyingDistributionsYear3
Noncharitable Assets Year34972612NoncharitableAssetsYear3
Distribution Ratio Year30.000000DistributionRatioYear3
Total Distribution Ratio2.283440TotalDistributionRatio
Average Distribution Ratio0.761147AverageDistributionRatio
Net Noncharitable Assets34986NetNoncharitableAssets
Adjusted Noncharitable Assets26629AdjustedNoncharitableAssets
One Percent Net Investment Income0OnePercentNetInvestmentIncome
Adj Nonchrtbl Assets And One26629AdjNonchrtblAssetsAndOnePct
Qualifying Distributions2944QualifyingDistributions

Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm

FieldValueIRS element (for citing)
Investment Income Excise Tax1InvestmentIncomeExciseTax
Tax Under Section5110TaxUnderSection511
Subtotal1Subtotal
Subtitle A Tax0SubtitleATax
Tax Based On Investment Income1TaxBasedOnInvestmentIncome
Total Credits And Payments0TotalCreditsAndPayments
Tax Due1TaxDue

Statements Regarding Activities StatementsRegardingActivities

FieldValueIRS element (for citing)
Legislative Political Activities0LegislativePoliticalActivities
More Than100 Spent0MoreThan100Spent
Form1120 POL Filed0Form1120POLFiled
Sect4955 Tax On Organization0Sect4955TaxOnOrganization
Sect4955 Tax On Managers0Sect4955TaxOnManagers
Reimbursement Of Tax0ReimbursementOfTax
Activities Not Prev Reported0ActivitiesNotPrevReported
Changes To Articles Or Bylaws0ChangesToArticlesOrBylaws
Unrelated Bus Income Over10000UnrelatedBusIncomeOver1000
Termination Etc0TerminationEtc
Requirements Of Sect508e0RequirementsOfSect508e
At Least5000 In Assets1AtLeast5000InAssets
Form990 PF Filed With AG1Form990PFFiledWithAG
Private Operating Foundation0PrivateOperatingFoundation
New Substantial Contributors0NewSubstantialContributors
Interest In Controlled Entity0InterestInControlledEntity
Applicable Insurance Contract0ApplicableInsuranceContract
Comply With Public Inspection Rqr1ComplyWithPublicInspectionRqr
Website AddressN/AWebsiteAddress
Books In Care Of Person NameMARK GRAYBooksInCareOfPersonName
Books In Care Of Phone Number8636162191BooksInCareOfPhoneNumber

Books In Care Of US Address BooksInCareOfUSAddress

FieldValueIRS element (for citing)
Address Line1500 S FLORIDA AVENUE SUITE 800AddressLine1
CityLAKELANDCity
StateFLState
ZIP Code33801ZIPCode
FieldValueIRS element (for citing)
Foreign Bank0ForeignBank

Statements Regarding Acty4720 StatementsRegardingActy4720

FieldValueIRS element (for citing)
Sale Or Exchange With Dsqfly Person0SaleOrExchangeWithDsqflyPerson
Borrow Or Lend With Dsqfly Person0BorrowOrLendWithDsqflyPerson
Furnished Goods With Dsqfly Person0FurnishedGoodsWithDsqflyPerson
Pay Compensation To Dsqfly Person0PayCompensationToDsqflyPerson
Transfer Assets To Dsqfly Person0TransferAssetsToDsqflyPerson
Payment To Government Offical0PaymentToGovernmentOffical
Uncorrected Prior Acts0UncorrectedPriorActs
Undistributed Income Prior Years0UndistributedIncomePriorYears
Business Holdings0BusinessHoldings
Jeopardy Investments0JeopardyInvestments
Uncorrected Jeopardy Investments0UncorrectedJeopardyInvestments
Influence Legislation0InfluenceLegislation
Influence Election0InfluenceElection
Grants To Individuals0GrantsToIndividuals
Grants To Organizations0GrantsToOrganizations
Noncharitable Purpose0NoncharitablePurpose
Rcv Funds To Pay Prsnl Bnft Contract0RcvFundsToPayPrsnlBnftContract
Pay Premiums Prsnl Bnft Contract0PayPremiumsPrsnlBnftContract
Prohibited Tax Shelter Transactn0ProhibitedTaxShelterTransactn

Ofcr Dir Trustees Key Employee Info OfcrDirTrusteesKeyEmployeeInfo

Ofcr Dir Trustees Or Key Employee OfcrDirTrusteesOrKeyEmployee (4 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeTitleTitleAvg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPositionCompensationCompensationContri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtcExpense Account Other AllowancesExpenseAccountOtherAllowances
JUDY CLINE
2016 CASTLE COURTLAKELANDFL33813CHAIR1.00000
DAVID ROBINSON
PO BOX 93160LAKELANDFL33804PRESIDENT1.00000
ED GOODEMOTE
6023 PIER PLACE DRIVELAKELANDFL33813VICE PRES1.00000
MARK GRAY
500 S FLORIDA AVENUE SUITE 800LAKELANDFL33801TREASURER1.00000
FieldValueIRS element (for citing)
Comp Of Highest Paid Empl NONENONECompOfHighestPaidEmplNONE
Tot Number Of Oth Empl Paid Over50k0TotNumberOfOthEmplPaidOver50k
Comp Of Hghst Paid Cntrct NONENONECompOfHghstPaidCntrctNONE
Tot Number Of Cntrct Paid Over50k0TotNumberOfCntrctPaidOver50k

Sum Of Program Related Investments SumOfProgramRelatedInvestments

FieldValueIRS element (for citing)
Total0Total

Minimum Investment Return MinimumInvestmentReturn

FieldValueIRS element (for citing)
Avg Monthly FMV Of Securities0AvgMonthlyFMVOfSecurities
Avg Monthly Cash Balances35519AvgMonthlyCashBalances
FMV All Other Noncharitable Assets0FMVAllOtherNoncharitableAssets
Total FMV Of Unused Assets35519TotalFMVOfUnusedAssets
Reduction Claimed0ReductionClaimed
Acquisition Indebtedness0AcquisitionIndebtedness
Adj Total FMV Of Unused Assets35519AdjTotalFMVOfUnusedAssets
Cash Deemed Charitable533CashDeemedCharitable
Net Noncharitable Assets34986NetNoncharitableAssets
Minimum Investment Return1749MinimumInvestmentReturn

Distributable DistributableAmount

FieldValueIRS element (for citing)
Minimum Investment Return1749MinimumInvestmentReturn
Tax Based On Investment Income1TaxBasedOnInvestmentIncome
Total Tax1TotalTax
Distributable Amount Before Adj1748DistributableAmountBeforeAdj
Recoveries Qlfy Distributions0RecoveriesQlfyDistributions
Distributable Amount Before Ded1748DistributableAmountBeforeDed
Deduction Fr Distributable$0DeductionFrDistributableAmount
Distributable Amount As Adjusted1748DistributableAmountAsAdjusted

Qualifying Distributions QualifyingDistributions

FieldValueIRS element (for citing)
Expenses And Contributions2944ExpensesAndContributions
Program Related Investments Total0ProgramRelatedInvestmentsTotal
Qualifying Distributions2944QualifyingDistributions
One Pct Sect4940e Org Net Invst Incm0OnePctSect4940eOrgNetInvstIncm
Adj Qualifying Distributions2944AdjQualifyingDistributions

Undistributed Income UndistributedIncome

FieldValueIRS element (for citing)
Distributable Amount As Adjusted1748DistributableAmountAsAdjusted
Undistributed Income Prior Year0UndistributedIncomePriorYear
Total For Prior Years0TotalForPriorYears
Excess Distri Carryover Year2133804ExcessDistriCarryoverYear2
Excess Distri Carryover Year14895975ExcessDistriCarryoverYear1
Total Excess Distri Carryover5029779TotalExcessDistriCarryover
Qualifying Distributions2944QualifyingDistributions
Applied To Year10AppliedToYear1
Applied To Prior Years0AppliedToPriorYears
Treated As Distri From Corpus0TreatedAsDistriFromCorpus
Applied To Current Year1748AppliedToCurrentYear
Remaining Distri From Corpus1196RemainingDistriFromCorpus
Excess Distri Cyov App CY Corpus0ExcessDistriCyovAppCYCorpus
Excess Distri Cyov Applied CY0ExcessDistriCyovAppliedCY
Total Corpus5030975TotalCorpus
Prior Year Undistributed Income0PriorYearUndistributedIncome
Prior Year Deficiency Or Tax0PriorYearDeficiencyOrTax
Taxable Amount10TaxableAmount1
Taxable Amount20TaxableAmount2
Undistributed Income CY0UndistributedIncomeCY
Distri From Corpus170b1 E Or4942g30DistriFromCorpus170b1EOr4942g3
Excess Distri Cyov From Year50ExcessDistriCyovFromYear5
Excess Distri Cyov To Next Year5030975ExcessDistriCyovToNextYear
Excess From Year2133804ExcessFromYear2
Excess From Year14895975ExcessFromYear1
Excess From Current Year1196ExcessFromCurrentYear

Supplementary Information SupplementaryInformation

FieldValueIRS element (for citing)
Only Contributes To PreselectedXOnlyContributesToPreselected
Tot Grant Or Contri Paid During Year0TotGrantOrContriPaidDuringYear
Tot Grant Or Contri Approved Future0TotGrantOrContriApprovedFuture

Analysis Income Producing Acty AnalysisIncomeProducingActy

Int On Savings And Temp Cash Invst IntOnSavingsAndTempCashInvst

FieldValueIRS element (for citing)
Exclusion Code14ExclusionCode
Exclusion$40ExclusionAmount

Subtotals Part XVIA SubtotalsPartXVIA

FieldValueIRS element (for citing)
Unrelated Business Income$0UnrelatedBusinessIncomeAmount
Exclusion$40ExclusionAmount
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Part XVIA40TotalPartXVIA

Trnsfr Tr Rln With Noncharitable EO TrnsfrTrRlnWithNoncharitableEO

FieldValueIRS element (for citing)
Trnsfr Of Cash To Noncharitable EO0TrnsfrOfCashToNoncharitableEO
Trnsfr Oth Assets Noncharitable EO0TrnsfrOthAssetsNoncharitableEO
Sales Or Exchanges Of Assets0SalesOrExchangesOfAssets
Purchase Assets Noncharitable EO0PurchaseAssetsNoncharitableEO
Rental Of Facilities Etc0RentalOfFacilitiesEtc
Reimbursement Arrangements0ReimbursementArrangements
Loans Or Loan Guarantees0LoansOrLoanGuarantees
Performance Of Services Etc0PerformanceOfServicesEtc
Sharing Of Facilities Etc0SharingOfFacilitiesEtc
Relationships Noncharitable E Os0RelationshipsNoncharitableEOs

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees AccountingFees

FieldValueIRS element (for citing)
CategoryACCOUNTING FEESCategory
Amount$1,200Amount
Net Investment Income0NetInvestmentIncome
Disbursements Charitable Prps1200DisbursementsCharitablePrps

Legal Fees Schedule LegalFeesSchedule

Legal Fees LegalFees

FieldValueIRS element (for citing)
CategoryLEGAL FEESCategory
Amount$1,500Amount
Net Investment Income0NetInvestmentIncome
Disbursements Charitable Prps1500DisbursementsCharitablePrps

Other Expenses Schedule OtherExpensesSchedule

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionFILING FEEDescription
Revenue And Expenses Per Books61RevenueAndExpensesPerBooks
Net Investment Income0NetInvestmentIncome
Disbursements Charitable Prps61DisbursementsCharitablePrps

Taxes Schedule TaxesSchedule

Taxes Taxes

FieldValueIRS element (for citing)
CategoryTAXESCategory
Amount$183Amount
Net Investment Income0NetInvestmentIncome
Disbursements Charitable Prps183DisbursementsCharitablePrps

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