NORTHEAST DELTA DENTAL FOUNDATION INC: Form 990, tax year 2012
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- Organization
- NORTHEAST DELTA DENTAL FOUNDATION INC (EIN 02-0489150)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-14
- IRS object ID
- 201323189349304157
- 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 | 2013-11-14T13:18:27-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010494526 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER NEWMAN & NOYES | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 507 | AddressLine1 |
| City | PORTLAND | City |
| State | ME | State |
| ZIP Code | 04112 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020489150 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northeast Delta Dental Foundation | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NORT | NameControl |
| Phone | 6032231000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2002 | AddressLine1 |
| City | Concord | City |
| State | NH | State |
| ZIP Code | 033022002 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | THOMAS RAFFIO | Name |
| Title | President | Title |
| Phone | 6032231000 | Phone |
| Date Signed | 2013-11-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | E Drew Cheney | Name |
| PTIN | P00182972 | PTIN |
| Phone | 2078972100 | Phone |
| Date Prepared | 2013-11-13 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Thomas Raffio | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2002 | AddressLine1 |
| City | Concord | City |
| State | NH | State |
| ZIP Code | 033022002 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1027850 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.nedelta.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1996 | YearFormation |
| State Legal Domicile | NH | StateLegalDomicile |
| Activity Or Mission Description | Promote dental health and education in northern New England | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 648079 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 646257 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 83382 | InvestmentIncomePriorYear |
| Investment Income Current Year | 41392 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 731461 | TotalRevenuePriorYear |
| Total Revenue Current Year | 687649 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 315854 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 357302 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 7534 | OtherExpensePriorYear |
| Other Expenses Current Year | 4987 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 323388 | TotalExpensesPriorYear |
| Total Expenses Current Year | 362289 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 408073 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 325360 | RevenuesLessExpensesCY |
| Total Assets BOY | 2919515 | TotalAssetsBOY |
| Total Assets EOY | 3535663 | TotalAssetsEOY |
| Total Liabilities BOY | 50000 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 50000 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2869515 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3485663 | NetAssetsOrFundBalancesEOY |
| Mission Description | To promote dental health and education in northern New England | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 205400 | Expense |
| Grants | 205400 | Grants |
| Description | Dental equipment and supplies: cash donations to 35 nonprofit dental clinics to purchase dental equipment and supplies to serve patients who cannot afford dental care. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 133617 | Expense |
| Grants | 133617 | Grants |
| Description | Oral health education programs and public policy development: cash donations to 8 organizations to sponsor oral health education programs. Donations of printed materials and supplies to schools, nonprofit dental clinics, and other organizations to provide oral health education programs.Also contributed to 4 organizations to assist in oral health public policy development and to promote the importance of oral health.Also contributed to 13 organizations to fund dental residency scholarship programs. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 18285 | Expense |
| Grants | 18285 | Grants |
| Description | Fluoride rinse and sealant programs for children: cash donations to 6 organizations to be used to provide fluoride rinse or sealants for children. These programs are usually performed in schools. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 357302 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NH | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kathleen Walker | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6032231000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | c/o One Delta Drive | AddressLine1 |
| City | Concord | City |
| State | NH | State |
| ZIP Code | 033022002 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (12 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| MELVIN J SEVERANCE III | ||||||
| CHAIR & DIRECTOR | 1.00 | X | X | 0 | 0 | 0 |
| KATHLEEN B WALKER | ||||||
| TREASURER & DIRECTOR | 6.00 | X | X | 0 | 0 | 0 |
| PETER W LEBERMAN ESQ | ||||||
| ASST SECRETARY & DIRECTOR | 1.00 | X | X | 0 | 0 | 0 |
| ELIZABETH ANDREWS | ||||||
| SECRETARY & ASST TREASURER | 3.00 | X | 0 | 0 | 0 | |
| CLAYTON R ADAMS | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| CHARLES E BROWN | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| FRANCIS H LABRANCHE JR DDS | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| SUZANNE MCDOWELL | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| THOMAS RAFFIO | ||||||
| PRESIDENT & DIRECTOR | 2.00 | X | X | 0 | 0 | 0 |
| DOUGLAS C TERP | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| ELEANOR H VIEN | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| TERENCE A WARDROP | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Fundraising Events | 21222 | FundraisingEvents |
| All Other Contributions | 625035 | AllOtherContributions |
| Total Contributions | 646257 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 60763 | TotalRevenueColumn |
| Exclusion | $60,763 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 312181 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 331552 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -19371 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -19371 | TotalRevenueColumn |
| Related Or Exempt Function Income | -19371 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 8649 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 21222 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 8649 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 687649 | TotalRevenueColumn |
| Related Or Exempt Function Income | -19371 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $60,763 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 357302 | Total |
| Program Services | 357302 | ProgramServices |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2396 | Total |
| Management And General | 2396 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1502 | Total |
| Management And General | 1502 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 642 | Total |
| Management And General | 642 | ManagementAndGeneral |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral |
|---|---|---|
| Bank service charges | 372 | 372 |
| State of NH filing fees | 75 | 75 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 362289 | Total |
| Program Services | 357302 | ProgramServices |
| Management And General | 4987 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 237863 | BOY |
| EOY | 231449 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 405200 | BOY |
| EOY | 401900 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2276452 | BOY |
| EOY | 2902314 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2919515 | BOY |
| EOY | 3535663 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50000 | BOY |
| EOY | 50000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50000 | BOY |
| EOY | 50000 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2680699 | BOY |
| EOY | 3296847 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 188816 | BOY |
| EOY | 188816 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2869515 | BOY |
| EOY | 3485663 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2919515 | BOY |
| EOY | 3535663 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 325360 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 290788 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 0 | FSAudited |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
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 | 392355 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 378517 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 512647 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 650579 | CurrentTaxYearMinus1Year |
| Current Tax Year | 648757 | CurrentTaxYear |
| Total | 2582855 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 392355 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 378517 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 512647 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 650579 | CurrentTaxYearMinus1Year |
| Current Tax Year | 648757 | CurrentTaxYear |
| Total | 2582855 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 2266261 | AmountsSubstContributorsTotal |
| Public Support Total170 | 316594 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 62388 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 50649 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 50627 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 83382 | CurrentTaxYearMinus1Year |
| Current Tax Year | 60763 | CurrentTaxYear |
| Total | 307809 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 2890664 | TotalSupport |
| Public Support Pertcentage170 | 0.10950 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.10730 | PublicSupportPertcentPriorYear |
| Ten Percent Test Current Year | X | TenPercentTestCurrentYear |
| Facts And Circumstances Test | The Organization meets the "facts and circumstances" test for the following reasons:- Through its activities, the organization regularly and continuously benefits many thousands of members of the general public.- It encourages donations from the general public, through the website of Northeast Delta Dental (a group of nonprofit organizations) and through other means.- Its board does not represent any narrow interests and is committed to representing all of the citizens of northern New England who are most in need of dental care assistance. | FactsAndCircumstancesTest |
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
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2820677 | BeginningOfYearBalance |
| Contributions | 401900 | Contributions |
| Investment Earnings Or Losses | 332044 | InvestmentEarningsOrLosses |
| Other Expenditures | 105211 | OtherExpenditures |
| End Of Year Balance | 3449410 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2642281 | BeginningOfYearBalance |
| Contributions | 405200 | Contributions |
| Investment Earnings Or Losses | -130207 | InvestmentEarningsOrLosses |
| Other Expenditures | 96597 | OtherExpenditures |
| End Of Year Balance | 2820677 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2178074 | BeginningOfYearBalance |
| Contributions | 277300 | Contributions |
| Investment Earnings Or Losses | 278419 | InvestmentEarningsOrLosses |
| Other Expenditures | 91512 | OtherExpenditures |
| End Of Year Balance | 2642281 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1866113 | BeginningOfYearBalance |
| Contributions | 154300 | Contributions |
| Investment Earnings Or Losses | 338407 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 100000 | GrantsOrScholarships |
| Other Expenditures | 80746 | OtherExpenditures |
| End Of Year Balance | 2178074 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2181578 | BeginningOfYearBalance |
| Contributions | 294600 | Contributions |
| Investment Earnings Or Losses | -552093 | InvestmentEarningsOrLosses |
| Other Expenditures | 57972 | OtherExpenditures |
| End Of Year Balance | 1866113 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.94530 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.00000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.05470 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1 |
| Gross Receipts Event1 | 27909 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 27909 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 6958 | RentFacilityCostsEvent1 |
| Other Direct Expenses Event1 | 1691 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 27909 | GrossReceiptsTotal |
| Gross Revenue Total Events | 27909 | GrossRevenueTotalEvents |
| Rent Facility Costs Total Events | 6958 | RentFacilityCostsTotalEvents |
| Other Direct Expenses Total Events | 1691 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 8649 | DirectExpenseSummaryEvents |
| Net Income Summary | 19260 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (18 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant | Address Line2AddressUS/AddressLine2 |
|---|---|---|---|---|---|---|---|---|
| Easter Seals NH | ||||||||
| 555 Auburn Street | Manchester | NH | 03103 | 020272825 | 501(c)(3) | 10000 | Dental clinic | |
| Dental Lifeline Network of NH (Donated Dental Services) | ||||||||
| 1800 15th Street Suite 100 | Denver | CO | 80202 | 846129064 | 501(c)(3) | 10000 | Program support | |
| Greater Nashua Dental Connection | ||||||||
| 31 Cross Street | Nashua | NH | 03064 | 020200866 | 501(c)(3) | 10000 | Dental equipment | |
| Families First of the Greater Seacoast | ||||||||
| 100 Campus Drive Suite 12 | Portsmouth | NH | 03801 | 222757341 | 501(c)(3) | 6000 | Dental supplies | |
| City of Manchester - Health Dept | ||||||||
| Fiscal Agent - Mental Health Center | Manchester | NH | 03103 | 020258994 | 501(c)(3) | 10000 | Mobile dental van repairs | 401 Cypress Street |
| White Mountain Community Health Center | ||||||||
| PO Box 2800 White Mountain Highway | Conway | NH | 03818 | 020275078 | 501(c)(3) | 10000 | Children's dental program | |
| Foundation for Healthy Communities - Fiscal Agent | ||||||||
| NH Dept Health Human Services 29 | Concord | NH | 03301 | 020275078 | 501(c)(3) | 10000 | 3rd grade healthy smiles/healthy growth survey | Hazen St |
| Maine Dental Association | ||||||||
| PO Box 215 | Manchester | ME | 04351 | 271270353 | 501(c)(6) | 15000 | Workforce study | |
| St Apollonia Dental Clinic - Fiscal Agent | ||||||||
| Aroostock County Action Program PO | Presque Isle | ME | 04769 | 010315849 | 501(c)(3) | 10000 | New operatories | Box 1116 |
| Maine Health Access Foundation | ||||||||
| 150 Capitol Street Suite 4 | Augusta | ME | 04330 | 010535144 | 501(c)(3) | 13700 | Oral health program specialist | |
| City of Portland Children's Oral Health Program Public Health Division | ||||||||
| 1600 Forest Avenue | Portland | ME | 04103 | 016000032 | 501(c)(3) | 8000 | Bright Smiles Program | |
| Penobscot Community Health Center | ||||||||
| 1048 Union Street Suite 5 | Bangor | ME | 04401 | 010514750 | 501(c)(3) | 10000 | Dental residency program | |
| Eastport Health Care Inc | ||||||||
| PO Box H 30 Boynton Street | Eastport | ME | 04631 | 010354589 | 501(c)(3) | 10902 | Dental equipment | |
| Community Dental (Farmington) | ||||||||
| 276 Canco Road | Portland | ME | 04103 | 237129502 | 501(c)(3) | 10000 | Dental equipment | |
| Champlain Valley Head StartEarly Head Start | ||||||||
| c/o 255 South Champlain Street | Burlington | VT | 05402 | 030216837 | 501(c)(3) | 44000 | Tooth Tutor Program | |
| Vermont State Dental Society | ||||||||
| 1 Kennedy Drive Suite L3 | South Burlington | VT | 05403 | 222514423 | 501(c)(6) | 15000 | Diabetes project | |
| Community Health Center of Burlington | ||||||||
| 617 Riverside Avenue | Burlington | VT | 05401 | 237182584 | 501(c)(3) | 10000 | Expansion of dental programs/operatories | |
| Vermont Technical College | ||||||||
| 301 Lawrence Place | Williston | VT | 05495 | 030213787 | 13000 | Dental equipment for dental hygiene dental clinic | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 16 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 2 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: Donation recipients are required to send a report annually detailing how the money was spent, using statistics of patients served, utilization of machinery or other specifics. These reports are monitored by the Foundation Treasurer who tracks the receipt of the annual reports. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 6 | The Foundation has three members: Delta Dental Plan of New Hampshire, Inc.; Delta Dental Plan of Vermont, Inc.; and Maine Dental Services Corporation. All three members are tax-exempt under Internal Revenue Code Section 501(c)(4). |
| Form 990, Part VI, Section A, line 7a | The members elect the Foundation's Board of Directors. |
| Form 990, Part VI, Section A, line 7b | In addition to electing the Board of Directors, the members have the power to remove directors, repeal or change bylaws by 2/3rd member vote (Board has primary authority to amend bylaws), and to dissolve the Corporation by 2/3rd member vote. |
| Form 990, Part VI, Section B, line 11 | The Form 990 is reviewed in detail by key finance employees of Northeast Delta Dental. A final draft is presented to the Board before the Form is filed. |
| Form 990, Part VI, Section B, line 12c | A copy of the conflict of interest policy is distributed annually to all officers, directors, and the management team. All are required to report any conflicts and sign, date, and return the policy, whether or not a conflict exists, to confirm compliance. General Counsel reviews the returned policies and reports the results to the entire Board of Directors. Board members are asked to provide updates of any changes that may occur between their annual conflict of interest filings. |
| Form 990, Part VI, Section C, line 19 | Upon request, Northeast Delta Dental Foundation makes its governing documents, conflict of interest policy, or financial statements available to the public. |
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