MANIFEST MEDEX: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MANIFEST MEDEX (EIN 27-2367522)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-05-15
- IRS object ID
- 201211369349306051
- Schema version
- 2011v1.2
- 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 | 2012-05-15T14:43:19-05:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 330313836 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MACHER & CLARK CPA'S | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3689 ARLINGTON AVENUE | AddressLine1 |
| City | RIVERSIDE | City |
| State | CA | State |
| ZIP Code | 925063938 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 272367522 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INLAND EMPIRE EHR RESOURCE CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | INLA | NameControl |
| Phone | 9516863343 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3993 JURUPA AVENUE | AddressLine1 |
| City | RIVERSIDE | City |
| State | CA | State |
| ZIP Code | 92506 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | D GREEN | Name |
| Title | EXECUTIVE DIRECTOR | Title |
| Phone | 9516863343 | Phone |
| Date Signed | 2012-05-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DAVID C MACHER CPA | Name |
| PTIN | P00058198 | PTIN |
| Phone | 9517870330 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DOLORES GREEN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3993 JURUPA AVENUE | AddressLine1 |
| City | RIVERSIDE | City |
| State | CA | State |
| ZIP Code | 92506 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1106131 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Other | X | TypeOfOrganizationOther |
| Type Of Org Other Description | ELECTRONIC HEALTH RECORD RESOURCE CT | TypeOfOrgOtherDescription |
| Year Formation | 2010 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | THE SPECIFIC PURPOSE OF THIS CORPORATION IS TO RECEIVE AND ADMINISTER FUNDS AND OTHER PROPERTY TO ADVANCE AND SUPPORT THE ACCESSIBILITY AND USAGE OF ELECTRONIC HEALTH RECORDS THROUGHTOUT THE INLAND EMPIRE REGION OF CALIFORNIA, TO ADVANCE AND SUPPORT THE SUCCESSFUL IMPLEMENTATION OF ELECTRONIC HEALTH RECORDS IN THE MEDICAL COMMUNITY, AND TO DO ALL THINGS APPROPRIATE TO FURTHER SUCH PURPOSE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | 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 | 173288 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 471665 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 1746 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 634466 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 175034 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1106131 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 39928 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 206524 | 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 | 36907 | OtherExpensePriorYear |
| Other Expenses Current Year | 490237 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 76835 | TotalExpensesPriorYear |
| Total Expenses Current Year | 696761 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 98199 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 409370 | RevenuesLessExpensesCY |
| Total Assets BOY | 115510 | TotalAssetsBOY |
| Total Assets EOY | 934721 | TotalAssetsEOY |
| Total Liabilities BOY | 17311 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 427152 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 98199 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 507569 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO ADMINISTER FUNDS FROM GOVERNMENTAL AGENCIES AND COMMUNITY ORGANIZATIONS THAT WILL BE USED FOR THE SUCCESSFUL IMPLIMENTATION OF ELECTRONIC HEALTH RECORDS PROCEDURES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 692031 | Expense |
| Grants | 394558 | Grants |
| Revenue | 634466 | Revenue |
| Description | CALHIPSO AWARD, SACRAMENTO, CALIFORNIA AND HEALTH INFORMATION EXCHANGE SERVICE FEES. | Description |
| Total Program Service Expense | 692031 | 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 | 0 | 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 | 1 | 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 | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | 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 | 1 | 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 |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| 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 | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | 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 | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INLAND EMPIRE EHR RESOURCE CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9516863343 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3993 JURUPA AVENUE | AddressLine1 |
| City | RIVERSIDE | City |
| State | CA | State |
| ZIP Code | 92506 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (9 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| JOSEPH JC LEE MD | ||||||
| PAST CHAIRMAN | 2.50 | X | X | 0 | 0 | 0 |
| LEROY L OUNANIAN MD | ||||||
| SECRETARY/TREASURER | 2.50 | X | X | 0 | 0 | 0 |
| DOLORES L GREEN | ||||||
| EXECUTIVE DIRECTOR | 2.50 | X | X | 0 | 0 | 0 |
| PHILLIP BRANSTETTER | ||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |
| BRADLEY GILBERT MD | ||||||
| CHAIRMAN OF THE BOARD | 2.50 | X | 0 | 0 | 0 | |
| WILLIAM HENNING DO | ||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |
| TAREK MAHDI MD | ||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |
| C PAUL SINKHORN MD | ||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |
| JIM PETERSON | ||||||
| MEMBER | 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 |
| Government Grants | 394558 | GovernmentGrants |
| All Other Contributions | 77107 | AllOtherContributions |
| Noncash Contributions | 67107 | NoncashContributions |
| Total Contributions | 471665 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | H.I. EXCHANGE SERVICES | Description |
| Business Code | 519100 | BusinessCode |
| Total Revenue Column | 634466 | TotalRevenueColumn |
| Related Or Exempt Function Income | 634466 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 634466 | TotalProgramServiceRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1106131 | TotalRevenueColumn |
| Related Or Exempt Function Income | 634466 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 206524 | Total |
| Program Services | 206524 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30 | Total |
| Management And General | 30 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7100 | Total |
| Program Services | 2400 | ProgramServices |
| Management And General | 4700 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2600 | Total |
| Program Services | 2600 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5025 | Total |
| Program Services | 5025 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24750 | Total |
| Program Services | 24750 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 65659 | Total |
| Program Services | 65659 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7123 | Total |
| Program Services | 7123 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| CONSULTING FEES | 137620 | 137620 |
| PLATINUM SERVICE PARTNE | 117500 | 117500 |
| ON-SITE ASSESSMENTS | 77081 | 77081 |
| FIDUCIARY AGENT EXPENSE | 19883 | 19883 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25866 | Total |
| Program Services | 25866 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 696761 | Total |
| Program Services | 692031 | ProgramServices |
| Management And General | 4730 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 92194 | BOY |
| EOY | 688641 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18941 | BOY |
| EOY | 241972 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4375 | BOY |
| EOY | 4108 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 115510 | BOY |
| EOY | 934721 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17311 | BOY |
| EOY | 39459 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 387693 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17311 | BOY |
| EOY | 427152 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 98199 | BOY |
| EOY | 507569 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 98199 | BOY |
| EOY | 507569 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 115510 | BOY |
| EOY | 934721 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 409370 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| 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 Minus1 Year | 175034 | CurrentTaxYearMinus1Year |
| Current Tax Year | 404558 | CurrentTaxYear |
| Total | 579592 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | 175034 | CurrentTaxYearMinus1Year |
| Current Tax Year | 404558 | CurrentTaxYear |
| Total | 579592 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 579592 | PublicSupportTotal170 |
| Total Support | 579592 | 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 D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
| Total Revenue | 1106131 | TotalRevenue |
| Total Expenses | 696761 | TotalExpenses |
| Excess Or Deficit For Year | 409370 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 409370 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 1106131 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 1106131 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 1106131 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 696761 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 696761 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 696761 | TotalExpensesPerForm990 |
Schedule M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | NON CASH CONTRIBUTIONS | Description |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 67107 | NoncashContribsRptdF990 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Form990 Schedule M Part II Form990ScheduleMPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | NON REPORTING OF REVENUE: | Identifier |
| Return Reference | PART I, LINE 33: | ReturnReference |
| Explanation | RECOGNIZED FAIR VALUE OF SERVICES PERFORMED FOR THE ORGANIZATION. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE ORGANIZATION'S MANAGEMENT DUTIES ARE PERFORMED BY THE MANAGEMENT OF RIVERSIDE COUNTY MEDICAL ASSOCIATION (RCMA) MANAGEMENT PERSONNEL. THE ORGANIZATION REIMBURSES THE RCMA, OR ITS DESIGNEE, FOR THE SERVICES OF ADMINISTRATION AND PROGRAM SERVICE PERSONNEL. | |
| FORM 990, PART VI, SECTION B, LINE 11 | COPY OF FORM 990 IS SENT TO THE EXECUTIVE DIRECTOR WHO REVIEWS IT AND GIVES IT TO A BOARD MEMBER FOR REVIEW AND APPROVAL BEFORE IT IS FILED. | |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY OFFICERS/DIRECTORS ARE REQUIRED TO COMPLETE NEW DISCLOSURE DOCUMENTS. | |
| FORM 990, PART VI, SECTION C, LINE 18 | FORM 990 IS AVAILABLE AT THE CENTER'S OFFICE IN RIVERSIDE, CALIFORNIA UPON REQUEST | |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC AT THE CENTER'S OFFICE IN RIVERSIDE, CALIFORNIA UPON REQUEST | |
| 990, PART XII, LINE 2C | THE BOARD CONSIDERS THE FINANCIAL STATEMENT AND TAX RETURN FOR COMPLETENESS. | FINANCIAL STATEMENTS AND TAX RETURN |
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