THE GOVERNOR'S FOUNDATION FOR HEALTH AND: Form 990EZ, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
THE GOVERNOR'S FOUNDATION FOR HEALTH AND (EIN 45-3635908)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-05-06
IRS object ID
201341269349201029
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

FieldValueIRS element (for citing)
Timestamp2013-05-06T17:15:27-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN621517792EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PERSHING YOAKLEY & ASSOCIATES P CBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1ONE CHEROKEE MILLS 2220 SUTHERLANDAddressLine1
Address Line2AVEAddressLine2
CityKNOXVILLECity
StateTNState
ZIP Code379192363ZIPCode
FieldValueIRS element (for citing)
Return Type990EZReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN453635908EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1TENNESSEE HEALTH & WELLNESS FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlTENNNameControl
Phone8656730844Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12220 SUTHERLAND AVENUEAddressLine1
CityKNOXVILLECity
StateTNState
ZIP Code37919ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameEDWARD V PERSHINGName
TitleSECRETARYTitle
Phone8656730844Phone
Date Signed2013-05-06DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDEBORAH O ERNSBERGERName
PTINP00364912PTIN
Phone8656730844Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990-EZ IRS990EZ

FieldValueIRS element (for citing)
Initial ReturnXInitialReturn
Method Of Accounting CashXMethodOfAccountingCash
Schedule B Not RequiredXScheduleBNotRequired
Web SiteN/AWebSite
Organization501c3XOrganization501c3
Gross Receipts150GrossReceipts
Info In Schedule O Part IXInfoInScheduleOPartI
Other Revenue Total150OtherRevenueTotal
Total Revenue150TotalRevenue
Other Expenses Total870OtherExpensesTotal
Total Expenses870TotalExpenses
Excess Or Deficit For Year-720ExcessOrDeficitForYear
Net Assets Or Fund Balances BOY0NetAssetsOrFundBalancesBOY
Other Changes In Net Assets1000OtherChangesInNetAssets
Net Assets Or Fund Balances EOY280NetAssetsOrFundBalancesEOY

Cash Savings And Investments CashSavingsAndInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY280EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY280EOY

Sum Of Total Liabilities SumOfTotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Net Assets Or Fund Balances NetAssetsOrFundBalances

FieldValueIRS element (for citing)
BOY0BOY
EOY280EOY
FieldValueIRS element (for citing)
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Primary Exempt PurposeTO PROMOTE AND SUPPORT HEALTHY LIFESTYLES FOR TENNESSEANS WITH THE ULTIMATE GOAL OF HEALTHIER CITIZENS, REDUCING THE BURDEN OF CHRONIC DISEASE IN THE STATE OF TENNESSEE.PrimaryExemptPurpose

Program Service Accomplishment ProgramServiceAccomplishment

FieldValueIRS element (for citing)
Description Program Service AccomIN 2012, THE TENNESSEE HEALTH & WELLNESS FOUNDATION ACCOMPLISHED ADMINISTRATIVE TASKS SUCH AS SECURING TAX-EXEMPT STATUS FROM THE INTERNAL REVENUE SERVICE. THIS WILL ALLOW THE ORGANIZATION IN FUTURE YEARS TO FOCUS ON MEANINGFUL WAYS TO PROMOTE HEALTHY CHOICES AND PERSONAL RESPONSIBILITY TO DECREASE RATES OF ILLNESS SUCH AS HEALTH DISEASE AND DIABETES WITHIN THE STATE OF TENNESSEE.DescriptionProgramServiceAccom
Grants And Allocations0GrantsAndAllocations
Program Service Expenses0ProgramServiceExpenses
FieldValueIRS element (for citing)
Total Program Service Expenses0TotalProgramServiceExpenses

Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (3 entries)

TitleTitleAvg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPositionCompensationCompensationContri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtcExpense Account Other AllowancesExpenseAccountOtherAllowances
JOHN W LACEY III MD
PRESIDENT1.00000
EDWARD V PERSHING
SECRETARY1.00000
AUTRY OV PETE DEBUSK
DIRECTOR1.00000
FieldValueIRS element (for citing)
Info In Schedule O Part VXInfoInScheduleOPartV
Activities Not Previously Rpt0ActivitiesNotPreviouslyRpt
Made Changes To Orgnzng Etc Doc0MadeChangesToOrgnzngEtcDoc
Organization Had UBI0OrganizationHadUBI
Subject To Proxy Tax0SubjectToProxyTax
Organization Dissolved Etc0OrganizationDissolvedEtc
Direct Indirect Political Expend0DirectIndirectPoliticalExpend
Made Loans To From Officers0MadeLoansToFromOfficers
Tax Imposed Under IRC49110TaxImposedUnderIRC4911
Tax Imposed Under IRC49120TaxImposedUnderIRC4912
Tax Imposed Under IRC49550TaxImposedUnderIRC4955
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTrans
Amount Of Tax Imposed On Org Mgr0AmountOfTaxImposedOnOrgMgr
Amount Of Tax Reimbursed By Org0AmountOfTaxReimbursedByOrg
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1THE ORGANIZATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12220 SUTHERLAND AVENUEAddressLine1
CityKNOXVILLECity
StateTNState
ZIP Code37919ZIPCode
FieldValueIRS element (for citing)
Telephone Number8656730844TelephoneNumber
FieldValueIRS element (for citing)
Foreign Financial Account0ForeignFinancialAccount
Foreign Office0ForeignOffice
Maintain Any Donor Advised Funds0MaintainAnyDonorAdvisedFunds
Does Org Have Hospital0DoesOrgHaveHospital
Tanning Services Provided0TanningServicesProvided
Related Org Controlled Entity0RelatedOrgControlledEntity
Engage Political Cmpgn Activities0EngagePoliticalCmpgnActivities
Engage In Lobbying Activities0EngageInLobbyingActivities
Operating School0OperatingSchool
Trnsfrs Exempt Non Char Related Org0TrnsfrsExemptNonCharRelatedOrg
Part VI Of Comp Of Highest Paid EmplNONEPartVIOfCompOfHighestPaidEmpl
Part VIA Hghst Paid Cntrct Prof SerNONEPartVIAHghstPaidCntrctProfSer
Filed Schedule A1FiledScheduleA

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi
Public Support Total1700PublicSupportTotal170

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year150CurrentTaxYear
Total150Total
FieldValueIRS element (for citing)
Total Support150TotalSupport
First5 Years170XFirst5Years170

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
OTHER REVENUEFORM 990-EZ, PART I, LINE 8DESCRIPTION: MISCELLANEOUS. AMOUNT: 150.
OTHER EXPENSESFORM 990-EZ, PART I, LINE 16DESCRIPTION: ANNUAL REPORT FEE. AMOUNT: 20. DESCRIPTION: EXEMPTION APPLICATION FEE. AMOUNT: 850. TOTAL TO FORM 990-EZ, LINE 16: 870.
OTHER CHANGES IN NET ASSETSFORM 990-EZ, PART I, LINE 20DESCRIPTION: CONTRIBUTION OF CAPITAL. AMOUNT: 1,000.

Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl

FieldValueIRS element (for citing)
DeclarationTHE 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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