CHILDRENS FREE DENTAL CLINIC INCORPORATED: Form 990EZ, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- CHILDRENS FREE DENTAL CLINIC INCORPORATED (EIN 20-1934160)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-15
- IRS object ID
- 201211369349204816
- Schema version
- 2010v3.2
- 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 | 2012-05-15T16:57:18-07:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pulliam & Associates Chartered | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7235 W Emerald Street Suite A | AddressLine1 |
| City | Boise | City |
| State | ID | State |
| ZIP Code | 837048600 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201934160 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHILDRENS FREE DENTAL CLINIC INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHIL | NameControl |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3210 EAST CHINDEN SUITE 115-413 | AddressLine1 |
| City | EAGLE | City |
| State | ID | State |
| ZIP Code | 83616 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Donna Johnson | Name |
| Title | Executive Director | Title |
| Date Signed | 2012-05-15 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Teresa L Pulliam CPA | Name |
| Phone | 2083228525 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Web Site | N/A | WebSite |
| Organization501c3 | X | Organization501c3 |
| Gross Receipts | 91687 | GrossReceipts |
| Info In Schedule O Part I | X | InfoInScheduleOPartI |
| Contributions Gifts Grants Etc | 91687 | ContributionsGiftsGrantsEtc |
| Cost Other Basis And Sales Expenses | 0 | CostOtherBasisAndSalesExpenses |
| Fundraising Gross Income | 0 | FundraisingGrossIncome |
| Special Events Direct Expenses | 0 | SpecialEventsDirectExpenses |
| Special Events Net Income Loss | 0 | SpecialEventsNetIncomeLoss |
| Cost Of Goods Sold | 0 | CostOfGoodsSold |
| Total Revenue | 91687 | TotalRevenue |
| Fees And Oth Pymt To Ind Contractors | 73 | FeesAndOthPymtToIndContractors |
| Printing Publications Postage | 511 | PrintingPublicationsPostage |
| Other Expenses Total | 86727 | OtherExpensesTotal |
| Total Expenses | 87311 | TotalExpenses |
| Excess Or Deficit For Year | 4376 | ExcessOrDeficitForYear |
| Net Assets Or Fund Balances BOY | 119139 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 123515 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part II | X | InfoInScheduleOPartII |
Cash Savings And Investments CashSavingsAndInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 62819 | BOY |
| EOY | 36145 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 106210 | BOY |
| EOY | 87370 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 169029 | BOY |
| EOY | 123515 | EOY |
Sum Of Total Liabilities SumOfTotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49890 | BOY |
Net Assets Or Fund Balances NetAssetsOrFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 119139 | BOY |
| EOY | 123515 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | Provide free dental care to indigent elementary school children. | PrimaryExemptPurpose |
Program Service Accomplishment ProgramServiceAccomplishment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Service Accom | Mobile Dental Services - treated approximately 1,314 children and performed over 1,920 procedures at no charge during the 2010-2011 school year. The value of work performed is approximated at $255,261. The estimated value of donated dental and support services is $36,051. | DescriptionProgramServiceAccom |
| Grants And Allocations | 61881 | GrantsAndAllocations |
| Program Service Expenses | 91687 | ProgramServiceExpenses |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | 61881 | TotalProgramServiceExpenses |
Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | TitleTitle | Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition | CompensationCompensation | Expense Account Other AllowancesExpenseAccountOtherAllowances |
|---|---|---|---|---|---|---|---|
| John S Kriz DDS | |||||||
| 5543 West School Ridge Road | Boise | ID | 83714 | President | 30.00 | 0 | |
| Jill Shelton Wagers DMD | |||||||
| 7235 West Emerald Suite B | Boise | ID | 83704 | Vice President | 5.00 | 0 | |
| Jerry Davis | |||||||
| 13376 North 3rd Avenue | Boise | ID | 83714 | Sec/Treas | 0 | 0 | |
| Donna Johnson | |||||||
| 3210 E Chinden Suite 115-413 | Eagle | ID | 83616 | Executive Direc | 20.00 | 0 | 29710 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRpt |
| Made Changes To Orgnzng Etc Doc | false | MadeChangesToOrgnzngEtcDoc |
| Organization Had UBI | false | OrganizationHadUBI |
| Organization Dissolved Etc | false | OrganizationDissolvedEtc |
| Did Org File Form1120 POL This Year | false | DidOrgFileForm1120POLThisYear |
| Made Loans To From Officers | false | MadeLoansToFromOfficers |
| Initiation Fees And Capital Contri | 0 | InitiationFeesAndCapitalContri |
| Gross Receipts For Public Use | 0 | GrossReceiptsForPublicUse |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTrans |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Children's Free Dental Clinic | NamePerson |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3210 East Chinden Suite 115-413 | AddressLine1 |
| City | Eagle | City |
| State | ID | State |
| ZIP Code | 83616 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2088532221 | TelephoneNumber |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccount |
| Foreign Office | false | ForeignOffice |
| Maintain Any Donor Advised Funds | false | MaintainAnyDonorAdvisedFunds |
| Does Org Have Hospital | false | DoesOrgHaveHospital |
| Tanning Services Provided | false | TanningServicesProvided |
| Form720 Filed | false | Form720Filed |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction With Control Entity | false | TransactionWithControlEntity |
| Engage Political Cmpgn Activities | false | EngagePoliticalCmpgnActivities |
| Engage In Lobbying Activities | false | EngageInLobbyingActivities |
| Operating School | false | OperatingSchool |
| Trnsfrs Exempt Non Char Related Org | false | TrnsfrsExemptNonCharRelatedOrg |
| Related Org Section527 Org | false | RelatedOrgSection527Org |
| Part VI Of Comp Of Highest Paid Empl | NONE | PartVIOfCompOfHighestPaidEmpl |
| Part VIA Hghst Paid Cntrct Prof Ser | NONE | PartVIAHghstPaidCntrctProfSer |
| Filed Schedule A | true | FiledScheduleA |
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 | 73499 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 97830 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 94193 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 99080 | CurrentTaxYearMinus1Year |
| Current Tax Year | 91687 | CurrentTaxYear |
| Total | 456289 | Total |
Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 73499 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 97830 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 94193 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 99080 | CurrentTaxYearMinus1Year |
| Current Tax Year | 91687 | CurrentTaxYear |
| Total | 456289 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 0 | AmountsSubstContributorsTotal |
| Public Support Total170 | 456289 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Net UBI NetUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 456289 | TotalSupport |
| Public Support Pertcentage170 | 1.00000 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 1.00000 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
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 O IRS990ScheduleO
General Explanation GeneralExplanation (21 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990-EZ, Part II, Line 26.1 | Total Liabilities.1 | Interest Payable - Beginning $174 Interest Payable - Ending $0 |
| Form 990-EZ, Part II, Line 26.1007 | Total Liabilities.1007 | Secured Mortgages and Notes Payable - Beginning $49716 Secured Mortgages and Notes Payable - Ending $0 |
| Form 990-EZ, Part II, Line 24.1011 | Other Assets.1011 | Prepaid Expenses and Deferred Charges - Beginning $1839 Prepaid Expenses and Deferred Charges - Ending $1853 |
| Form 990-EZ, Part II, Line 24.1010 | Other Assets.1010 | Inventories - Beginning $2500 Inventories - Ending $2500 |
| Form 990-EZ, Part II, Line 24.1006 | Other Assets.1006 | Pledges and Grants Receivable - Beginning $11538 Pledges and Grants Receivable - Ending $11538 |
| Form 990-EZ, Part II, Line 24.1003 | Other Assets.1003 | Machinery and Equipment - Beginning $25333 Machinery and Equipment - Ending $18479 |
| Form 990-EZ, Part II, Line 24.1001 | Other Assets.1001 | Automobiles - Beginning $65000 Automobiles - Ending $53000 |
| Form 990-EZ, Part I, Line 16.9 | Other Expenses.9 | Miscellaneous $69 |
| Form 990-EZ, Part I, Line 16.8 | Other Expenses.8 | Telephone $325 |
| Form 990-EZ, Part I, Line 16.6 | Other Expenses.6 | Meals & Entertainment $779 |
| Form 990-EZ, Part I, Line 16.5 | Other Expenses.5 | Repairs and Maintenance $1817 |
| Form 990-EZ, Part I, Line 16.4 | Other Expenses.4 | Auto Expense $3902 |
| Form 990-EZ, Part I, Line 16.3 | Other Expenses.3 | Supplies $6673 |
| Form 990-EZ, Part I, Line 16.2 | Other Expenses.2 | Fundraising Expense $6704 |
| Form 990-EZ, Part I, Line 16.1 | Other Expenses.1 | Contract Services $42060 |
| Form 990-EZ, Part I, Line 16.1012 | Other Expenses.1012 | Insurance $3525 |
| Form 990-EZ, Part I, Line 16.1009 | Other Expenses.1009 | Depreciation $18854 |
| Form 990-EZ, Part I, Line 16.1008 | Other Expenses.1008 | Interest $168 |
| Form 990-EZ, Part I, Line 16.1003 | Other Expenses.1003 | Information Technology $500 |
| Form 990-EZ, Part I, Line 16.1002 | Other Expenses.1002 | Office Expenses $536 |
| Form 990-EZ, Part I, Line 16.1001 | Other Expenses.1001 | Advertising and Promotion $815 |
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