SAMUEL DIXON FAMILY HEALTH CENTER INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- SAMUEL DIXON FAMILY HEALTH CENTER INC (EIN 95-4278726)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-13
- IRS object ID
- 201321339349304872
- Schema version
- 2011v1.5
- Note
- A later return for the same period supersedes this one.
- 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 | 2013-05-13T15:59:16-07:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAGOP J MARKARIAN EA | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 16601 VENTURA BLVD 4TH FLOOR | AddressLine1 |
| City | ENCINO | City |
| State | CA | State |
| ZIP Code | 91436 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 954278726 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Samuel Dixon Family Health Center Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SAMU | NameControl |
| Phone | 6612574008 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25115 W Avenue Stanford | AddressLine1 |
| City | Valencia | City |
| State | CA | State |
| ZIP Code | 91355 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Cheryl Laymon | Name |
| Title | President & CEO | Title |
| Date Signed | 2013-05-06 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | HAGOP J MARKARIAN | Name |
| Phone | 8187891584 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Edward Bolden | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25115 W Avenue Stanford | AddressLine1 |
| City | Valencia | City |
| State | CA | State |
| ZIP Code | 91355 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1538464 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.sdfhc.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1990 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | To provide a community clinic offering cost-free or reduced cost medical services to uninsured and under insured persons and families for whom medical services would otherwise not be available due to financial hardship or disadvantage. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 25 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 1226025 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1219043 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 159157 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 163055 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 168 | InvestmentIncomePriorYear |
| Investment Income Current Year | 40 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 78597 | OtherRevenuePriorYear |
| Other Revenue Current Year | 81376 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 1463947 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1463514 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 770162 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 962892 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 132241 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 665436 | OtherExpensePriorYear |
| Other Expenses Current Year | 612997 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1435598 | TotalExpensesPriorYear |
| Total Expenses Current Year | 1575889 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 28349 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -112375 | RevenuesLessExpensesCY |
| Total Assets BOY | 1357703 | TotalAssetsBOY |
| Total Assets EOY | 1218843 | TotalAssetsEOY |
| Total Liabilities BOY | 479062 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 384066 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 878641 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 834777 | NetAssetsOrFundBalancesEOY |
| Mission Description | To provide a community clinic offering cost-free or reduced cost medical services to uninsured and under insured persons and families for whom medical services would otherwise not be available due to financial hardship or disadvantage. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 1256478 | Expense |
| Description | Provide medical services to all residents of the Santa Clarita Valley, with a special emphasis on the unserved and under served. The Family Health Center aims to build a healthier community. | Description |
| Total Program Service Expense | 1256478 | 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 | true | 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 | true | 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 | 11 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | false | ComplianceWithBackupWitholding |
| Number Of Employees | 25 | 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 |
| Form8886 T Filed | false | Form8886TFiled |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Non Deductible Disclosure | false | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| 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 |
| Form720 Filed | false | Form720Filed |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | 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 | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Policies Reference Chapters | false | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | CA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Tom Christensen | NamePerson |
| Telephone Number | 6612574008 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25115 W Avenue Stanford Suite A-104 | AddressLine1 |
| City | Valencia | City |
| State | CA | State |
| ZIP Code | 91355 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (15 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Gloria Mercado-Fortine | |||||||
| Director | 0.00 | X | 0 | 0 | 0 | ||
| Jan Wilde | |||||||
| Director | 0.00 | X | 0 | 0 | 0 | ||
| Maria Morales | |||||||
| Director | 0.00 | X | 0 | 0 | 0 | ||
| Irene Leon | |||||||
| Director | 0.00 | X | 0 | 0 | 0 | ||
| Timothy Lankford | |||||||
| Director | 0.00 | X | 0 | 0 | 0 | ||
| Matt Gunderman | |||||||
| Director | 0.00 | X | 0 | 0 | 0 | ||
| Matt Denny | |||||||
| Director | 0.00 | X | 0 | 0 | 0 | ||
| Amada Calderon | |||||||
| Director | 0.00 | X | 0 | 0 | 0 | ||
| Lori Bennett | |||||||
| Director | 0.00 | X | 0 | 0 | 0 | ||
| David Goldberg | |||||||
| Secretary | 0.00 | X | 0 | 0 | 0 | X | |
| PK Reibsamen | |||||||
| Treasurer | 0.00 | X | 0 | 0 | 0 | X | |
| Mike Fisher | |||||||
| Vice Chairman | 0.00 | X | 0 | 0 | 0 | X | |
| Edward Bolden | |||||||
| Chairman | 0.00 | X | 0 | 0 | 0 | X | |
| Cheryl Laymon | |||||||
| President & CEO | 40.00 | 125000 | 0 | 0 | X | ||
| Michael Gales | |||||||
| Physician's Assist | 40.00 | 139918 | 0 | 0 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 264918 | TotalReportableCompFromOrg |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Government Grants | 873299 | GovernmentGrants |
| All Other Contributions | 345744 | AllOtherContributions |
| Noncash Contributions | 6549 | NoncashContributions |
| Total Contributions | 1219043 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Program Service Fees | Description |
| Total Revenue Column | 163055 | TotalRevenueColumn |
| Related Or Exempt Function Income | 163055 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 163055 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 40 | TotalRevenueColumn |
| Exclusion | $40 | ExclusionAmount |
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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 156326 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 74950 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 81376 | 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 | 1463514 | TotalRevenueColumn |
| Related Or Exempt Function Income | 163055 | RelatedOrExemptFunctionIncome |
| Exclusion | $40 | 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 | 125000 | Total |
| Program Services | 97500 | ProgramServices |
| Management And General | 12500 | ManagementAndGeneral |
| Fundraising | 15000 | 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 | 742040 | Total |
| Program Services | 578791 | ProgramServices |
| Management And General | 74204 | ManagementAndGeneral |
| Fundraising | 89045 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27352 | Total |
| Program Services | 21335 | ProgramServices |
| Management And General | 2735 | ManagementAndGeneral |
| Fundraising | 3282 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68500 | Total |
| Program Services | 53430 | ProgramServices |
| Management And General | 6850 | ManagementAndGeneral |
| Fundraising | 8220 | 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 | 0 | Total |
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 | 14900 | Total |
| Program Services | 9685 | ProgramServices |
| Management And General | 4768 | ManagementAndGeneral |
| Fundraising | 447 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21028 | Total |
| Program Services | 16781 | ProgramServices |
| Management And General | 2973 | ManagementAndGeneral |
| Fundraising | 1274 | Fundraising |
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 | 6362 | Total |
| Program Services | 3817 | ProgramServices |
| Management And General | 1909 | ManagementAndGeneral |
| Fundraising | 636 | Fundraising |
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 | 8458 | Total |
| Program Services | 8458 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 120455 | Total |
| Program Services | 120455 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40517 | Total |
| Program Services | 33426 | ProgramServices |
| Management And General | 5065 | ManagementAndGeneral |
| Fundraising | 2026 | Fundraising |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Repairs and Maintenance | 23650 | 23650 | ||
| Supplies | 44019 | 44019 | ||
| Professional Fees | 62250 | 40462 | 19920 | 1868 |
| Rent | 202962 | 146135 | 46681 | 10146 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68396 | Total |
| Program Services | 58534 | ProgramServices |
| Management And General | 9565 | ManagementAndGeneral |
| Fundraising | 297 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1575889 | Total |
| Program Services | 1256478 | ProgramServices |
| Management And General | 187170 | ManagementAndGeneral |
| Fundraising | 132241 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 140139 | BOY |
| EOY | 39321 | 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) |
|---|---|---|
| BOY | 241155 | BOY |
| EOY | 229499 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16337 | BOY |
| EOY | 103550 | 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) |
|---|---|---|
| EOY | 0 | 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 | 14663 | BOY |
| EOY | 16187 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1538231 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 707945 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 945409 | BOY |
| EOY | 830286 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | 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) |
|---|---|---|
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1357703 | BOY |
| EOY | 1218843 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 93144 | BOY |
| EOY | 99693 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 40000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 255705 | BOY |
| EOY | 151949 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 130213 | BOY |
| EOY | 92424 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 479062 | BOY |
| EOY | 384066 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 878641 | BOY |
| EOY | 834777 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 878641 | BOY |
| EOY | 834777 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1357703 | BOY |
| EOY | 1218843 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -112375 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 68511 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
| Federal Grant Audit Performed | false | FederalGrantAuditPerformed |
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 | 947739 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1842102 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1119566 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1226025 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1219043 | CurrentTaxYear |
| Total | 6354475 | 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 | 947739 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1842102 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1119566 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1226025 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1219043 | CurrentTaxYear |
| Total | 6354475 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 0 | AmountsSubstContributorsTotal |
| Public Support Total170 | 6354475 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2665 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4875 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 121 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 168 | CurrentTaxYearMinus1Year |
| Current Tax Year | 40 | CurrentTaxYear |
| Total | 7869 | Total |
Net UBI NetUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | 13454 | CurrentTaxYearMinus1Year |
| Total | 13454 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 6375798 | TotalSupport |
| Public Support Pertcentage170 | 0.99670 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.99560 | 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 | 70978 | OtherCostOrOtherBasis |
| Book Value | 70978 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 474537 | OtherCostOrOtherBasis |
| Depreciation | 163607 | Depreciation |
| Book Value | 310930 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 255301 | OtherCostOrOtherBasis |
| Depreciation | 106442 | Depreciation |
| Book Value | 148859 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 737415 | OtherCostOrOtherBasis |
| Depreciation | 437896 | Depreciation |
| Book Value | 299519 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 830286 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Accrued Payroll and Related Liabilities | Description |
| Amount | $92,424 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 92424 | TotalOfAmounts |
| Total Revenue | 1463514 | TotalRevenue |
| Total Expenses | 1575889 | TotalExpenses |
| Excess Or Deficit For Year | -112375 | ExcessOrDeficitForYear |
| Prior Period Adjustments | 68511 | PriorPeriodAdjustments |
| Total Adjustments | 68511 | TotalAdjustments |
| Excess Or Deficit Per FS | -43864 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 1463514 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 1463514 | RevenueSubtotal |
| Total Revenue Per Form990 | 1463514 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 1575889 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 1575889 | ExpensesSubtotal |
| Total Expenses Per Form990 | 1575889 | TotalExpensesPerForm990 |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | X | MailSolicitations |
| Solicitation Of Non Govt Grants | X | SolicitationOfNonGovtGrants |
| Special Fundraising Events | X | SpecialFundraisingEvents |
| Agreement Ref Fundraising | false | AgreementRefFundraising |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Rubber Ducky | NameOfEvent1 |
| Gross Receipts Event1 | 133433 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 133433 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 74623 | OtherDirectExpensesEvent1 |
| Name Of Event2 | Elks Roast Auction | NameOfEvent2 |
| Gross Receipts Event2 | 22893 | GrossReceiptsEvent2 |
| Gross Revenue Event2 | 22893 | GrossRevenueEvent2 |
| Other Direct Expenses Event2 | 327 | OtherDirectExpensesEvent2 |
| Gross Receipts Total | 156326 | GrossReceiptsTotal |
| Gross Revenue Total Events | 156326 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 74950 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 74950 | DirectExpenseSummaryEvents |
| Net Income Summary | 81376 | NetIncomeSummary |
Schedule L IRS990ScheduleL
Loan Table LoanTable (3 entries)
| Loan From OrganizationLoanFromOrganization | Original PrincipalOriginalPrincipalAmount | Balance DueBalanceDue | DefaultDefault | Approved By BoardApprovedByBoard | Written AgreementWrittenAgreement |
|---|---|---|---|---|---|
| Pierce Reibsamen | |||||
| X | $10,000 | 10000 | false | false | false |
| Edward Bolden | |||||
| X | $10,000 | 10000 | false | false | false |
| Cheryl Laymon | |||||
| X | $20,000 | 20000 | false | false | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 40000 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990, Part VI, Line 19 | Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Upon Request |
| Form 990, Part VI, Line 15b | Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | Reviewed and established by executive director. |
| Form 990, Part VI, Line 12c | Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Monitored by Executive Director, conflicts presented to the executive committee for resolution. |
| Form 990, Part VI, Line 11 | Form 990, Part VI, Line 11: Form 990 Review Process | No review was or will be conducted. |
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