HALIFAX STAFFING INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HALIFAX STAFFING INC (EIN 59-3222299)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-15
IRS object ID
201342279349303819
Schema version
2011v1.5
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)
Timestamp2013-08-15T15:34:46-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1OLIVARI & ASSOCIATES CPA'SBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1141 SAGE BRUSH TRAIL SUITE DAddressLine1
CityORMOND BEACHCity
StateFLState
ZIP Code32174ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN593222299EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HALIFAX STAFFING INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHALINameControl
Phone3862264560Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1303 NORTH CLYDE MORRIS BLVDAddressLine1
CityDAYTONA BEACHCity
StateFLState
ZIP Code32114ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKATHLEEN DULKOName
TitleCONTROLLERTitle
Phone3862264560Phone
Date Signed2013-08-14DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameJOHNNY SVAJKO CPAName
Phone3866720775Phone
Date Prepared2013-08-15DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJEFF FEASELNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1303 NORTH CLYDE MORRIS BLVDAddressLine1
CityDAYTONA BEACHCity
StateFLState
ZIP Code32114ZIPCode
FieldValueIRS element (for citing)
Gross Receipts220196840GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1994YearFormation
State Legal DomicileFLStateLegalDomicile
Activity Or Mission DescriptionHALIFAX STAFFING PROVIDES PAYROLL AND PAYROLL RELATED FUNCTIONS ON BEHALF OF ITS SUPPORTED ORGANIZATION, HALIFAX HOSPITAL MEDICAL CENTER D/B/A HALIFAX HEALTH (59-6001217)ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees3765TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year206978089ProgramServiceRevenuePriorYear
Program Service Revenue CY220196840ProgramServiceRevenueCY
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year206978089TotalRevenuePriorYear
Total Revenue Current Year220196840TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year206978089SalariesEtcPriorYear
Salaries Etc Current Year220196840SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expenses Current Year0OtherExpensesCurrentYear
Total Expenses Prior Year206978089TotalExpensesPriorYear
Total Expenses Current Year220196840TotalExpensesCurrentYear
Revenues Less Expenses CY0RevenuesLessExpensesCY
Total Assets EOY0TotalAssetsEOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances EOY0NetAssetsOrFundBalancesEOY
Mission DescriptionHALIFAX STAFFING PROVIDES PAYROLL AND PAYROLL RELATED FUNCTIONS ON BEHALF OF ITS SUPPORTED ORGANIZATION, HALIFAX HOSPITAL MEDICAL CENTER D/B/A HALIFAX HEALTH (59-6001217)MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense220196840Expense
Revenue220196840Revenue
DescriptionPROVIDE PAYROLL AND STAFFING FOR SUPPORTED ORGANIZATION, HALIFAX HOSPITAL MEDICAL CENTER.Description
Total Program Service Expense220196840TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees3765NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonKATHLEEN DULKONamePerson
Telephone Number3862264560TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1303 N CLYDE MORRIS BLVDAddressLine1
CityDAYTONA BEACHCity
StateFLState
ZIP Code32114ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
GLENN RITCHEY
COMMISSIONER1.00X000
JOHN JOHNSON
COMMISSIONER1.00X000
KAREN JANS
COMMISSIONER1.00X000
ART GILES
COMMISSIONER1.00X000
SUSAN SCHANDEL
COMMISSIONER1.00X000
HAROLD GOODEMOTE
COMMISSIONER1.00X000
JEFF FEASEL
CHIEF EXEC.40.0058336500X
ERIC PEBURN
CHIEF FINANC40.0035000000X
FEDERICO VINAS
PHYSICIAN40.00143722800X
ROHIT KHANNA
PHYSICIAN40.00114122900X
WILLIAM KUHN
PHYSICIAN40.00108669300X
ABDUL SORATHIA
PHYSICIAN40.0057243600X
PETER HARMAN
PHYSICIAN40.0054143700X
FieldValueIRS element (for citing)
Total Reportable Comp From Org5712388TotalReportableCompFromOrg
Number Individuals GT100 K170NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionEXPENSE REIMBURSEMENTDescription
Total Revenue Column220196840TotalRevenueColumn
Related Or Exempt Function Income220196840RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue220196840TotalProgramServiceRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column220196840TotalRevenueColumn
Related Or Exempt Function Income220196840RelatedOrExemptFunctionIncome

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total165637330Total
Program Services165637330ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total29733220Total
Program Services29733220ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total13868945Total
Program Services13868945ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total10957345Total
Program Services10957345ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total220196840Total
Program Services220196840ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses0ReconcilationRevenueExpenses
Method Of Accounting CashXMethodOfAccountingCash
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1HALIFAX HOSPITAL MEDICAL CENTER DBA HALIFAX HEALTHBusinessNameLine1
FieldValueIRS element (for citing)
EIN596001217EIN
Type Of Organization6TypeOfOrganization
Listed In Governing DoctrueListedInGoverningDoc
Supported Organization NotifiedtrueSupportedOrganizationNotified
Organized In UStrueOrganizedInUS
Amount$0Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
JEFF FEASEL
583365583365
ERIC PEBURN
350000350000
FEDERICO VINAS
14372281437228
ROHIT KHANNA
11412291141229
WILLIAM KUHN
10866931086693
ABDUL SORATHIA
572436572436
PETER HARMAN
541437541437

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BFORM 990 IS PROVIDED TO THE ORGANIZATION'S CONTROLLER FOR REVIEW PRIOR TO FILING.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CTHE ORGANIZATION FOLLOWS THE POLICIES AND PROCEDURES OF ITS SUPPORTED ORGANIZATION, HALIFAX HEALTH.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE ORGANIZATION FOLLOWS THE POLICIES AND PROCEDURES OF ITS SUPPORTED ORGANIZATION, HALIFAX HEALTH.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BTHE ORGANIZATION FOLLOWS THE POLICIES AND PROCEDURES OF ITS SUPPORTED ORGANIZATION, HALIFAX HEALTH.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19UPON REQUEST

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1HALIFAX HOSPITAL MEDICAL CENTERBusinessNameLine1
Business Name Line2D/B/A HALIFAX HEALTHBusinessNameLine2

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1303 N CLYDE MORRIS BLVDAddressLine1
CityDAYTONA BEACHCity
StateFLState
ZIP Code32114ZIPCode
FieldValueIRS element (for citing)
EIN596001217EIN
Primary ActivitiesHOSPITALPrimaryActivities
Legal Domicile StateFLLegalDomicileState
Exempt Code Section170(B)ExemptCodeSection
Public Charity Status6PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled OrgfalseControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1HALIFAX HEALTHBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeNTransactionType
Amount Involved220196840AmountInvolved
Method Of Amt DeterminationACTUAL AMOUNT PAIDMethodOfAmtDetermination

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.