NORTHERN NEVADA DENTAL HEALTH PROGRAM: Form 990EZ, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- NORTHERN NEVADA DENTAL HEALTH PROGRAM (EIN 88-0411192)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2013-08-27
- IRS object ID
- 201322399349200612
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-27T13:42:03-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 454265538 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PAUL G MIERS CPA PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6560 S MCCARRAN BLVD SUITE B | AddressLine1 |
| City | RENO | City |
| State | NV | State |
| ZIP Code | 89509 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 880411192 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHERN NEVADA DENTAL HEALTH PROGRAM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NORT | NameControl |
| Phone | 7753370296 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 161 COUNTRY ESTATE CIRCLE NO 1B | AddressLine1 |
| City | RENO | City |
| State | NV | State |
| ZIP Code | 89511 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GREG PISANI | Name |
| Title | PRESIDENT | Title |
| Phone | 7753370296 | Phone |
| Date Signed | 2013-08-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | PAUL G MIERS | Name |
| PTIN | P00161496 | PTIN |
| Phone | 7754489923 | Phone |
| Date Prepared | 2013-08-14 | DatePrepared |
| 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 | N/A | WebSite |
| Organization501c3 | X | Organization501c3 |
| Gross Receipts | 140042 | GrossReceipts |
| Info In Schedule O Part I | X | InfoInScheduleOPartI |
| Contributions Gifts Grants Etc | 103340 | ContributionsGiftsGrantsEtc |
| Fundraising Gross Income | 36670 | FundraisingGrossIncome |
| Special Events Direct Expenses | 55612 | SpecialEventsDirectExpenses |
| Special Events Net Income Loss | -18942 | SpecialEventsNetIncomeLoss |
| Other Revenue Total | 32 | OtherRevenueTotal |
| Total Revenue | 84430 | TotalRevenue |
| Grants And Similar Amounts Paid | 145000 | GrantsAndSimilarAmountsPaid |
| Fees And Oth Pymt To Ind Contractors | 869 | FeesAndOthPymtToIndContractors |
| Other Expenses Total | 5340 | OtherExpensesTotal |
| Total Expenses | 151209 | TotalExpenses |
| Excess Or Deficit For Year | -66779 | ExcessOrDeficitForYear |
| Net Assets Or Fund Balances BOY | 111891 | NetAssetsOrFundBalancesBOY |
| Other Changes In Net Assets | 0 | OtherChangesInNetAssets |
| Net Assets Or Fund Balances EOY | 45112 | NetAssetsOrFundBalancesEOY |
Cash Savings And Investments CashSavingsAndInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 111891 | BOY |
| EOY | 45112 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 111891 | BOY |
| EOY | 45112 | EOY |
Sum Of Total Liabilities SumOfTotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Net Assets Or Fund Balances NetAssetsOrFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 111891 | BOY |
| EOY | 45112 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Primary Exempt Purpose | TO PROVIDE FUNDING FOR THE DENTAL HEALTH CARE NEEDS OF UNDERPRIVELEGED CHILDREN | PrimaryExemptPurpose |
Program Service Accomplishment ProgramServiceAccomplishment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Service Accom | ORGANIZING OF GOLF TOURNAMENT/CONCERT TO PROVIDE FUNDING OF DENTAL HEALTH CARE TO UNDERPRIVELEGED CHILDREN THROUGH THE COMMUNITY HEALTH ALLIANCE FOUNDATION. AMOUNT REPRESENT FUNDS MADE AVAILABLE FOR THE DENTAL PROGRAM. | DescriptionProgramServiceAccom |
| Grants And Allocations | 0 | GrantsAndAllocations |
| Program Service Expenses | 145000 | ProgramServiceExpenses |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | 145000 | TotalProgramServiceExpenses |
Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (4 entries)
| TitleTitle | Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition | CompensationCompensation | Contri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtc | Expense Account Other AllowancesExpenseAccountOtherAllowances |
|---|---|---|---|---|
| GREG PISANI | ||||
| PRESIDENT | 2.00 | 0 | 0 | 0 |
| BOB BARONE | ||||
| TREASURER | 2.00 | 0 | 0 | 0 |
| JOEL T GLOVER | ||||
| VICE PRESIDENT | 2.00 | 0 | 0 | 0 |
| GILBERT TRUJILLO | ||||
| SECRETARY | 2.00 | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRpt |
| Made Changes To Orgnzng Etc Doc | 0 | MadeChangesToOrgnzngEtcDoc |
| Organization Had UBI | 0 | OrganizationHadUBI |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtc |
| Direct Indirect Political Expend | 0 | DirectIndirectPoliticalExpend |
| Made Loans To From Officers | 0 | MadeLoansToFromOfficers |
| Tax Imposed Under IRC4911 | 0 | TaxImposedUnderIRC4911 |
| Tax Imposed Under IRC4912 | 0 | TaxImposedUnderIRC4912 |
| Tax Imposed Under IRC4955 | 0 | TaxImposedUnderIRC4955 |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTrans |
| Amount Of Tax Imposed On Org Mgr | 0 | AmountOfTaxImposedOnOrgMgr |
| Amount Of Tax Reimbursed By Org | 0 | AmountOfTaxReimbursedByOrg |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | LORRAINE BENVIN | NamePerson |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 161 COUNTRY ESTATES CIRCLE NO 1B | AddressLine1 |
| City | RENO | City |
| State | NV | State |
| ZIP Code | 89511 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7753370296 | TelephoneNumber |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Foreign Office | 0 | ForeignOffice |
| Maintain Any Donor Advised Funds | 0 | MaintainAnyDonorAdvisedFunds |
| Does Org Have Hospital | 0 | DoesOrgHaveHospital |
| Tanning Services Provided | 0 | TanningServicesProvided |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Engage Political Cmpgn Activities | 0 | EngagePoliticalCmpgnActivities |
| Engage In Lobbying Activities | 0 | EngageInLobbyingActivities |
| Operating School | 0 | OperatingSchool |
| Trnsfrs Exempt Non Char Related Org | 0 | TrnsfrsExemptNonCharRelatedOrg |
| Part VI Of Comp Of Highest Paid Empl | NONE | PartVIOfCompOfHighestPaidEmpl |
| Part VIA Hghst Paid Cntrct Prof Ser | NONE | PartVIAHghstPaidCntrctProfSer |
| Filed Schedule A | 1 | FiledScheduleA |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 46888 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 45760 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 112950 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 79685 | CurrentTaxYearMinus1Year |
| Current Tax Year | 103340 | CurrentTaxYear |
| Total | 388623 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 16496 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 13593 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 38408 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 36526 | CurrentTaxYearMinus1Year |
| Current Tax Year | 36670 | CurrentTaxYear |
| Total | 141693 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 63384 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 59353 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 151358 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 116211 | CurrentTaxYearMinus1Year |
| Current Tax Year | 140010 | CurrentTaxYear |
| Total | 530316 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 530316 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 42 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 35 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 66 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 60 | CurrentTaxYearMinus1Year |
| Current Tax Year | 32 | CurrentTaxYear |
| Total | 235 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 42 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 35 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 66 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 60 | CurrentTaxYearMinus1Year |
| Current Tax Year | 32 | CurrentTaxYear |
| Total | 235 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 63426 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 59388 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 151424 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 116271 | CurrentTaxYearMinus1Year |
| Current Tax Year | 140042 | CurrentTaxYear |
| Total | 530551 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99960 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99930 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00040 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00070 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
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 G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Person Solicitations | X | InPersonSolicitations |
| Special Fundraising Events | X | SpecialFundraisingEvents |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1 |
| Gross Receipts Event1 | 41125 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 20550 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 20575 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 3179 | NonCashPrizesEvent1 |
| Food And Beverage Event1 | 3591 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 5040 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 1975 | OtherDirectExpensesEvent1 |
| Name Of Event2 | CONCERT | NameOfEvent2 |
| Gross Receipts Event2 | 98885 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 82790 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 16095 | GrossRevenueEvent2 |
| Food And Beverage Event2 | 15987 | FoodAndBeverageEvent2 |
| Entertainment Event2 | 25840 | EntertainmentEvent2 |
| Total Number Of Other Events | 0 | TotalNumberOfOtherEvents |
| Gross Receipts Total | 140010 | GrossReceiptsTotal |
| Charitable Contributions Total | 103340 | CharitableContributionsTotal |
| Gross Revenue Total Events | 36670 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 3179 | NonCashPrizesTotalEvents |
| Food And Beverage Total Events | 19578 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 30880 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 1975 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 55612 | DirectExpenseSummaryEvents |
| Net Income Summary | -18942 | NetIncomeSummary |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| OTHER REVENUE | FORM 990-EZ, PART I, LINE 8 | DESCRIPTION: INTEREST INCOME. AMOUNT: 32. |
| GRANTS AND SIMILAR AMOUNTS PAID | FORM 990-EZ, PART I, LINE 10 | ACTIVITY CLASSIFICATION: DENTAL HEALTH CARE FOR NEEDY CHILDREN. GRANTEE NAME: COMMUNITY HEALTH ALLIANCE FOUNDATION. GRANTEE ADDRESS: 1450 RIDGEVIEW DRIVE #200 RENO, NV 89519. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 10/30/12. AMOUNT GIVEN: 25000. |
| GRANTS AND SIMILAR AMOUNTS PAID | FORM 990-EZ, PART I, LINE 10 | ACTIVITY CLASSIFICATION: DENTAL HEALTH CARE FOR NEEDY CHILDREN. GRANTEE NAME: COMMUNITY HEALTH ALLIANCE FOUNDATION. GRANTEE ADDRESS: 1450 RIDGEVIEW DRIVE #200 RENO, NV 89519. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 12/18/12. AMOUNT GIVEN: 120000. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 145000. |
| OTHER EXPENSES | FORM 990-EZ, PART I, LINE 16 | DESCRIPTION: OFFICE. AMOUNT: 3814. DESCRIPTION: MERCHANT ACCOUNT FEES. AMOUNT: 1526. TOTAL TO FORM 990-EZ, LINE 16: 5340. |
Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Declaration | THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT. | Declaration |
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