COLUMBIA COUNTY VOLUNTEERS INMEDICINE INC: Form 990EZ, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- COLUMBIA COUNTY VOLUNTEERS INMEDICINE INC (EIN 20-5695518)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-08-20
- IRS object ID
- 201322329349200102
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-20T05:36:13-07:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BREWER & COMPANY LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 420 W 5TH ST | AddressLine1 |
| City | BLOOMSBURG | City |
| State | PA | State |
| ZIP Code | 178151563 | 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 | 205695518 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA COUNTY VOLUNTEERS | BusinessNameLine1 |
| Business Name Line2 | IN MEDICINE CLINIC INC | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COLU | NameControl |
| Phone | 5707521780 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 310 E THIRD ST PO BOX 416 | AddressLine1 |
| City | MIFFLINVILLE | City |
| State | PA | State |
| ZIP Code | 18631 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JEAN GRECO | Name |
| Title | President | Title |
| Date Signed | 2013-08-20 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DANIEL K BREWER CPA | Name |
| PTIN | P00238299 | PTIN |
| Phone | 5707841111 | Phone |
| Self Employed | X | SelfEmployed |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Cash | X | MethodOfAccountingCash |
| Web Site | www.ccvim.org | WebSite |
| Organization501c3 | X | Organization501c3 |
| Gross Receipts | 195179 | GrossReceipts |
| Info In Schedule O Part I | X | InfoInScheduleOPartI |
| Contributions Gifts Grants Etc | 183374 | ContributionsGiftsGrantsEtc |
| Investment Income | 147 | InvestmentIncome |
| Cost Other Basis And Sales Expenses | 0 | CostOtherBasisAndSalesExpenses |
| Fundraising Gross Income | 11658 | FundraisingGrossIncome |
| Special Events Direct Expenses | 880 | SpecialEventsDirectExpenses |
| Special Events Net Income Loss | 10778 | SpecialEventsNetIncomeLoss |
| Cost Of Goods Sold | 0 | CostOfGoodsSold |
| Total Revenue | 194299 | TotalRevenue |
| Salaries Other Comp Empl Benefits | 133285 | SalariesOtherCompEmplBenefits |
| Fees And Oth Pymt To Ind Contractors | 2957 | FeesAndOthPymtToIndContractors |
| Occupancy Rent Utilities And Maint | 5138 | OccupancyRentUtilitiesAndMaint |
| Printing Publications Postage | 457 | PrintingPublicationsPostage |
| Other Expenses Total | 54544 | OtherExpensesTotal |
| Total Expenses | 196381 | TotalExpenses |
| Excess Or Deficit For Year | -2082 | ExcessOrDeficitForYear |
| Net Assets Or Fund Balances BOY | 188989 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 186907 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part II | X | InfoInScheduleOPartII |
Cash Savings And Investments CashSavingsAndInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 62711 | BOY |
| EOY | 60417 | EOY |
Land And Buildings LandAndBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 126079 | BOY |
| EOY | 121991 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4080 | BOY |
| EOY | 7619 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 192870 | BOY |
| EOY | 190027 | EOY |
Sum Of Total Liabilities SumOfTotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3881 | BOY |
| EOY | 3120 | EOY |
Net Assets Or Fund Balances NetAssetsOrFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 188989 | BOY |
| EOY | 186907 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | TO PROVIDE MEDICAL CARE TO THE WORKING UNINSURED OF THE ORGANIZATION'S SERVICE AREA BY OPERATING A VOLUNTEER MEDICAL CLINIC. | PrimaryExemptPurpose |
Program Service Accomplishment ProgramServiceAccomplishment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Service Accom | BY OPERATING A FREE MEDCIAL CLINIC, THE CLINIC PROVIDED FREE MEDICAL SERVICES TO WORKING UNINSURED INDIVIDUALS DURING THE 2,103 RECORDED PATIENT VISITS IN 2012. PROVIDED MEDICAL REFERRAL SERVICE TO A MULTITUDE OF INDIVIDUALS WHOSE DIRECT MEDICAL NEEDS COULD NOT BE MET BY A FREE MEDICAL CLINIC. | DescriptionProgramServiceAccom |
| Grants And Allocations | 152768 | GrantsAndAllocations |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | 152768 | TotalProgramServiceExpenses |
Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (14 entries)
| TitleTitle | Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition | CompensationCompensation |
|---|---|---|
| DENNIS SITLER | ||
| Director | 1.00 | 0 |
| CINDY LOMBARD | ||
| Director | 1.00 | 0 |
| ANDREW BURD - HARRIS | ||
| Director | 1.00 | 0 |
| DAVID KOVACH | ||
| Director | 1.00 | 0 |
| MARY KLEINER BSN RN CDE | ||
| Treasurer | 1.00 | 0 |
| JAMES GALLAGHER MD | ||
| Med. Director | 1.00 | 0 |
| JANET KRESGE RN | ||
| Director | 1.00 | 0 |
| ROSE SAVAGE | ||
| Director | 1.00 | 0 |
| CATHY CHUPKA RN | ||
| Director | 1.00 | 0 |
| DAVID GREY | ||
| Vice President | 1.00 | 0 |
| MARGERY KILLIAN | ||
| Director | 1.00 | 0 |
| BECKY AARDWEG | ||
| Secretary | 1.00 | 0 |
| JEAN GRECO | ||
| President | 2.00 | 0 |
| BETTE GREY | ||
| CLINIC DIRECTOR | 35.00 | 41600 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRpt |
| Made Changes To Orgnzng Etc Doc | false | MadeChangesToOrgnzngEtcDoc |
| Organization Had UBI | false | OrganizationHadUBI |
| Organization Filed990 T | false | OrganizationFiled990T |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Organization Dissolved Etc | false | OrganizationDissolvedEtc |
| Did Org File Form1120 POL This Year | false | DidOrgFileForm1120POLThisYear |
| Made Loans To From Officers | false | MadeLoansToFromOfficers |
| Initiation Fees And Capital Contri | 0 | InitiationFeesAndCapitalContri |
| Gross Receipts For Public Use | 0 | GrossReceiptsForPublicUse |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTrans |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| States Where Copy Of Return Is Filed | PA | StatesWhereCopyOfReturnIsFiled |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | BETTE GREY | NamePerson |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 310 E THIRD ST PO BOX 416 | AddressLine1 |
| City | MIFFLINVILLE | City |
| State | PA | State |
| ZIP Code | 18631 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5707521780 | TelephoneNumber |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccount |
| Foreign Office | false | ForeignOffice |
| Maintain Any Donor Advised Funds | false | MaintainAnyDonorAdvisedFunds |
| Does Org Have Hospital | false | DoesOrgHaveHospital |
| Tanning Services Provided | false | TanningServicesProvided |
| Form720 Filed | false | Form720Filed |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction With Control Entity | false | TransactionWithControlEntity |
| Engage Political Cmpgn Activities | false | EngagePoliticalCmpgnActivities |
| Engage In Lobbying Activities | false | EngageInLobbyingActivities |
| Operating School | false | OperatingSchool |
| Trnsfrs Exempt Non Char Related Org | false | TrnsfrsExemptNonCharRelatedOrg |
| Related Org Section527 Org | false | RelatedOrgSection527Org |
| Part VI Of Comp Of Highest Paid Empl | NONE | PartVIOfCompOfHighestPaidEmpl |
| Part VIA Hghst Paid Cntrct Prof Ser | NONE | PartVIAHghstPaidCntrctProfSer |
| Filed Schedule A | true | FiledScheduleA |
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 | 91146 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 218963 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 158114 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 316034 | CurrentTaxYearMinus1Year |
| Current Tax Year | 183374 | CurrentTaxYear |
| Total | 967631 | 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 | 91146 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 218963 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 158114 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 316034 | CurrentTaxYearMinus1Year |
| Current Tax Year | 183374 | CurrentTaxYear |
| Total | 967631 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 0 | AmountsSubstContributorsTotal |
| Public Support Total170 | 967631 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 64 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 662 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 588 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 394 | CurrentTaxYearMinus1Year |
| Current Tax Year | 147 | CurrentTaxYear |
| Total | 1855 | Total |
Net UBI NetUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 969486 | TotalSupport |
| Public Support Pertcentage170 | 0.99810 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.99790 | 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 O IRS990ScheduleO
General Explanation GeneralExplanation (14 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990-EZ, Part II, Line 26.1 | Total Liabilities.1 | PAYROLL TAX WITHHOLDINGS - Beginning $3881 PAYROLL TAX WITHHOLDINGS - Ending $3120 |
| Form 990-EZ, Part II, Line 24.1004 | Other Assets.1004 | Miscellaneous - Beginning $1604 Miscellaneous - Ending $0 |
| Form 990-EZ, Part II, Line 24.1003 | Other Assets.1003 | Machinery and Equipment - Beginning $2476 Machinery and Equipment - Ending $7619 |
| Form 990-EZ, Part I, Line 16.8 | Other Expenses.8 | MINOR EQUIPMENT $43 |
| Form 990-EZ, Part I, Line 16.7 | Other Expenses.7 | CONTRACT LABOR $338 |
| Form 990-EZ, Part I, Line 16.5 | Other Expenses.5 | DUES AND SUBSCRIPTIONS $512 |
| Form 990-EZ, Part I, Line 16.4 | Other Expenses.4 | FUNDRAISING & VOLUNTEER COSTS $570 |
| Form 990-EZ, Part I, Line 16.3 | Other Expenses.3 | REPAIRS & MAINTENANCE $775 |
| Form 990-EZ, Part I, Line 16.2 | Other Expenses.2 | TELEPHONE $2297 |
| Form 990-EZ, Part I, Line 16.1 | Other Expenses.1 | MEDICAL PROGRAM EXPENSES $27075 |
| Form 990-EZ, Part I, Line 16.1012 | Other Expenses.1012 | Insurance $13950 |
| Form 990-EZ, Part I, Line 16.1009 | Other Expenses.1009 | Depreciation $7049 |
| Form 990-EZ, Part I, Line 16.1007 | Other Expenses.1007 | Conferences, Conventions, and Meetings $25 |
| Form 990-EZ, Part I, Line 16.1002 | Other Expenses.1002 | Office Expenses $1910 |
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