PHYSICIANS MEDICAL FORUM: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- PHYSICIANS MEDICAL FORUM (EIN 30-0086728)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2013-11-01
- IRS object ID
- 201333059349301428
- 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 | 2013-11-01T15:18:03-07:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRIGSBY FINANCE AND TAX SERVICES | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8050 HANSOM DRIVE | AddressLine1 |
| City | OAKLAND | City |
| State | CA | State |
| ZIP Code | 94605 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 300086728 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHYSICIANS MEDICAL FORUM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PHYS | NameControl |
| Phone | 5108747700 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2201 BROADWAY | AddressLine1 |
| City | OAKLAND | City |
| State | CA | State |
| ZIP Code | 94612 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WARREN STRUDWICK | Name |
| Title | BOARD OFFICER | Title |
| Phone | 5108747700 | Phone |
| Date Signed | 2013-10-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MITTIE GRIGSBY | Name |
| Phone | 5106384878 | Phone |
| Self Employed | X | SelfEmployed |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | STALFANA BELLO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2201 BROADWAY 212 | AddressLine1 |
| City | OAKLAND | City |
| State | CA | State |
| ZIP Code | 94612 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 276554 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2002 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | Encourage the recruitment and retention of African American physicians, and thereby help to eliminate health disparities, imporve access to care and improve the quality of life and medical care for citizens in the SF/Bay Area | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1 | TotalNbrEmployees |
| Total Nbr Volunteers | 25 | TotalNbrVolunteers |
| Total Gross UBI | 1054 | TotalGrossUBI |
| Contributions Grants Prior Year | 384600 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 275500 | ContributionsGrantsCurrentYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 8179 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1054 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 392779 | TotalRevenuePriorYear |
| Total Revenue Current Year | 276554 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 87791 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 60534 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 282577 | OtherExpensePriorYear |
| Other Expenses Current Year | 269315 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 370368 | TotalExpensesPriorYear |
| Total Expenses Current Year | 329849 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 22411 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -53295 | RevenuesLessExpensesCY |
| Total Assets BOY | 521978 | TotalAssetsBOY |
| Total Assets EOY | 467523 | TotalAssetsEOY |
| Total Liabilities BOY | 1160 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 520818 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 467523 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | Encourage the recruitment and | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 25000 | Expense |
| Description | THE PMF "DOCTOR ON BOARD" PROGRAM (DOB) IS A PIPELINE PROGRAM TO ENCOURAGE YOUNG, AFRICAN AMERICAN PRE-MED, COLLEGE/UNIVERSITY, COMMUNITY COLLEGE, POST-BACCALAUREATE STUDENTS AND HIGH SCHOOL JUNIORS AND SENIORS WHO WANT TO BECOME PHYSICIANS TO ATTEND AN INNOVATIVE ALL DAY CONFERENCE. STUDENTS RECEIVE INFORMATION ON APPLYING FOR MEDICAL SCHOOLS, MCAT, FINANCIAL AID, NETWORK WITH FACULTY, MEDICAL SCHOOL ADMINISTRATORS, PHYSICIANS IN THE COMMUNITY, ATTEND MOCK MEDICAL CLINICS AND MOCK KNOT TYING/SUTURING CLINICS, AND RECEIVE MATERIAL ON BECOMING PHYSICIANS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 25000 | Expense |
| Description | RECRUITMENT OF AFRICAN AMERICAN RESIDENTS AND MEDICAL STUDENTS THAT UPON THEIR COMPLETION OF THEIR ENDUCATION AND TRAINING, TO PURSE CAREERS AS PHYSICIANS AND REMAIN IN OR COME TO ALAMEDA, CONTRA COSTA OR SAN FRANCISCO COUNTIES TO PRACTICE MEDICINE. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 36654 | Expense |
| Description | TO MAINTAIN STRATEGIC OPERATONS, OUTREACH, EDUCATION AND FUND DEVELOPMENT TO SUPPORT THE ORGANIZATIONS' VISION, MISSION, GOALS AND OBJECTIVES OF AFRICAN AMERICANS PHYSICIANS, RESIDENTS, MEDICAL STUDENTS AND PIPELINE PROGRAMS PURSING CAREERS AS PHYSICIANS IN ALAMEDA, CONTRA COSTA AND SAN FRANCISCO COUNTIES | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 165181 | Expense |
| Description | Branding Development & Other Program Costs To strive to provide a sustainable network and To strive to provide a sustainable network and To strive to provide a sustainable network and To strive to provide a sustainable network and To strive to provide a sustainable network and To strive to provide a sustainable network and | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 165181 | TotalOfOtherProgramServiceExp |
| Total Program Service Expense | 251835 | 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 | false | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | false | 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 | false | 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 |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | 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 | true | 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 |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | 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 |
| Form990 Provided To Governing Body | true | 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 |
| 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 | STALFANO BELLO BROADHEAD | NamePerson |
| Telephone Number | 5106397670 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2201 ROADWAY 212 | AddressLine1 |
| City | OAKLAND | City |
| State | CA | State |
| ZIP Code | 94612 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (10 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Key EmployeeKeyEmployee | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer |
|---|---|---|---|---|---|---|---|
| STALFANA BELLO BROADHEAD | |||||||
| Executive Director | 37.50 | X | 54000 | 0 | 0 | ||
| ALBERT L BROOKS MD | |||||||
| President | 6.00 | 0 | 0 | 0 | X | X | |
| WARREN J STRUDWICK MD | |||||||
| Chief financial Officer | 6.00 | 0 | 0 | 0 | X | X | |
| ZEALOUS D WILEY MD | |||||||
| Vice-President | 4.00 | 0 | 0 | 0 | X | X | |
| MICHELLE SHUTE MD | |||||||
| Secretary | 2.00 | 0 | 0 | 0 | X | X | |
| THURMAN HUNT MD | |||||||
| Director | 2.00 | 0 | 0 | 0 | X | ||
| KATHRYN MALONE MD | |||||||
| Director | 4.00 | 0 | 0 | 0 | X | ||
| C RALPH MELTON MD | |||||||
| Director | 2.00 | 0 | 0 | 0 | X | ||
| CAROL MILLER MD | |||||||
| Director | 2.00 | 0 | 0 | 0 | X | ||
| GLENDA NEWELL MD | |||||||
| Director | 2.00 | 0 | 0 | 0 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 54000 | TotalReportableCompFromOrg |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| All Other Contributions | 275500 | AllOtherContributions |
| Noncash Contributions | 123000 | NoncashContributions |
| Total Contributions | 275500 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1054 | TotalRevenueColumn |
| Unrelated Business Revenue | 1054 | UnrelatedBusinessRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 276554 | TotalRevenueColumn |
| Unrelated Business Revenue | 1054 | UnrelatedBusinessRevenue |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54000 | Total |
| Program Services | 43200 | ProgramServices |
| Management And General | 10800 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 220 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 220 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6314 | Total |
| Program Services | 5051 | ProgramServices |
| Management And General | 1263 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4605 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 4605 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2366 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 2366 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1200 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 1200 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31531 | Total |
| Program Services | 18931 | ProgramServices |
| Management And General | 12600 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 480 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 480 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1301 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 1301 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3218 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 3218 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Bank charges | 1798 | 0 | 1798 | 0 |
| Dues and Subscriptions | 450 | 0 | 450 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 222366 | Total |
| Program Services | 184653 | ProgramServices |
| Management And General | 37713 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 329849 | Total |
| Program Services | 251835 | ProgramServices |
| Management And General | 78014 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 516952 | BOY |
| EOY | 464928 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2595 | BOY |
| EOY | 2595 | EOY |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2431 | BOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 521978 | BOY |
| EOY | 467523 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1160 | BOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1160 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 520818 | BOY |
| EOY | 467523 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 520818 | BOY |
| EOY | 467523 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 521978 | BOY |
| EOY | 467523 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -53295 | ReconcilationRevenueExpenses |
| Method Of Accounting Cash | X | MethodOfAccountingCash |
| Accountant Compile Or Review | true | AccountantCompileOrReview |
| FS Audited | false | FSAudited |
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
| Public Support Total170 | 0 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Pertcentage170 | 0 | PublicSupportPertcentage170 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 312750 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 327571 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 329050 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 387600 | CurrentTaxYearMinus1Year |
| Current Tax Year | 275500 | CurrentTaxYear |
| Total | 1632471 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 312750 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 327571 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 329050 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 387600 | CurrentTaxYearMinus1Year |
| Current Tax Year | 275500 | CurrentTaxYear |
| Total | 1632471 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 1632471 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 10734 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 9071 | CurrentTaxYearMinus3Years |
| Total | 19805 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 10734 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 9071 | CurrentTaxYearMinus3Years |
| Total | 19805 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1652276 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.98800 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.96230 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.01200 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.03770 | 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 M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | In-Kind contributions | Description |
| Number Of Contributions | 40 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 123000 | NoncashContribsRptdF990 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | true | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Pt VI, Line 11b | Accountants prepares return,Exec Dir & Pres &CFo review nad approve |
| Pt VI, Line 12c | Annual reviews are done with legal review |
| Pt VI, Line 15a | Yes, business attorney recommendation based on non-profit model |
| Pt VI, Line 19 | Interested parties contact org. and appt is set for review |
| Pt V, Line 14b | Organization does not provide this service |
| Pt V, Line 3b | Organization does not have this type of income |
| Pt VI, Line 15b | Review performed by board members |
| Form 990, Part III, Line 4d | BRANDING DEVELOPMENT & OTHER PROGRAM COSTS 165181. 0. 0. |
Comments