SAMUEL DIXON FAMILY HEALTH CENTER INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- SAMUEL DIXON FAMILY HEALTH CENTER INC (EIN 95-4278726)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-09
- IRS object ID
- 201221309349302087
- 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 | 2012-05-09T14:50:26-07:00 | 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 | Vasin Heyn & Company | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5000 N Parkway Calabasas 301 | AddressLine1 |
| City | Calabasas | City |
| State | CA | State |
| ZIP Code | 91302 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 954278726 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Samuel Dixon Family Health Center Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SAMU | NameControl |
| Phone | 6612572361 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25115 W Avenue Stanford | AddressLine1 |
| City | Valencia | City |
| State | CA | State |
| ZIP Code | 91355 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Cheryl Laymon | Name |
| Title | President & CEO | Title |
| Date Signed | 2012-05-09 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Rolland Vasin | Name |
| Phone | 8182223500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Edward Bolden | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25115 W Avenue Stanford | AddressLine1 |
| City | Valencia | City |
| State | CA | State |
| ZIP Code | 91355 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1547423 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | To provide a community clinic offering cost-free or reduced cost medical services to uninsured and under insured persons and families for whom medical services would otherwise not be available due to financial hardship or disadvantage. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 20 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 959184 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1226025 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 160382 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 159157 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 121 | InvestmentIncomePriorYear |
| Investment Income Current Year | 168 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 99583 | OtherRevenuePriorYear |
| Other Revenue Current Year | 78597 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 1219270 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1463947 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 972954 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 770162 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 111867 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 631964 | OtherExpensePriorYear |
| Other Expenses Current Year | 665436 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1604918 | TotalExpensesPriorYear |
| Total Expenses Current Year | 1435598 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -385648 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 28349 | RevenuesLessExpensesCY |
| Total Assets BOY | 1244544 | TotalAssetsBOY |
| Total Assets EOY | 1357703 | TotalAssetsEOY |
| Total Liabilities BOY | 394252 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 479062 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 850292 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 878641 | NetAssetsOrFundBalancesEOY |
| Mission Description | To provide a community clinic offering cost-free or reduced cost medical services to uninsured and under insured persons and families for whom medical services would otherwise not be available due to financial hardship or disadvantage. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 1136042 | Expense |
| Description | Provide medical services to all residents of the Santa Clarita Valley, with a special emphasis on the unserved and under served. The Family Health Center aims to build a healthier community. | Description |
| Total Program Service Expense | 1136042 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | 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 | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | 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 | true | 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 |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| 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 | false | 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 |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | false | ScheduleORequired |
| Number Forms Transmitted With1096 | 28 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | false | ComplianceWithBackupWitholding |
| Number Of Employees | 20 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Form990-T Filed | false | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Form8886 T Filed | false | Form8886TFiled |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Non Deductible Disclosure | false | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Licensed More Than One State | false | LicensedMoreThanOneState |
| Indoor Tanning Services | false | IndoorTanningServices |
| Form720 Filed | false | Form720Filed |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | 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 |
| Policies Reference Chapters | false | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | false | 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 |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| 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 | Charles Yacobian | NamePerson |
| Telephone Number | 6612572361 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25115 W Avenue Stanford Suite A-104 | AddressLine1 |
| City | Valencia | City |
| State | CA | State |
| ZIP Code | 91355 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Timothy Lankford | |||||||
| Director | 0.00 | X | 0 | 0 | 0 | ||
| PK Reibsamen | |||||||
| Treasurer | 0.00 | X | 0 | 0 | 0 | X | |
| Mike Fisher | |||||||
| Vice Chairman | 0.00 | X | 0 | 0 | 0 | X | |
| Michael Gales | |||||||
| Physician's Assist | 40.00 | 137599 | 0 | 0 | X | ||
| Matt Gunderman | |||||||
| Director | 0.00 | X | 0 | 0 | 0 | ||
| Matt Denny | |||||||
| Director | 0.00 | X | 0 | 0 | 0 | ||
| Maria Morales | |||||||
| Director | 0.00 | X | 0 | 0 | 0 | ||
| Lori Bennett | |||||||
| Director | 0.00 | X | 0 | 0 | 0 | ||
| Jan Wilde | |||||||
| Director | 0.00 | X | 0 | 0 | 0 | ||
| Irene Leon | |||||||
| Director | 0.00 | X | 0 | 0 | 0 | ||
| Edward Bolden | |||||||
| Chairman | 0.00 | X | 0 | 0 | 0 | X | |
| David Goldberg | |||||||
| Secretary | 0.00 | X | 0 | 0 | 0 | X | |
| Cheryl Laymon | |||||||
| President & CEO | 40.00 | 101874 | 0 | 0 | X | ||
| Amada Calderon | |||||||
| Director | 0.00 | X | 0 | 0 | 0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 239473 | TotalReportableCompFromOrg |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Government Grants | 739960 | GovernmentGrants |
| All Other Contributions | 486065 | AllOtherContributions |
| Noncash Contributions | 10884 | NoncashContributions |
| Total Contributions | 1226025 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Program Service Fees | Description |
| Total Revenue Column | 159157 | TotalRevenueColumn |
| Related Or Exempt Function Income | 159157 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 159157 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 168 | TotalRevenueColumn |
| Exclusion | $168 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 148619 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 83476 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 65143 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Loss Recovery | Description |
| Total Revenue Column | 13454 | TotalRevenueColumn |
| Related Or Exempt Function Income | 13454 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 13454 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1463947 | TotalRevenueColumn |
| Related Or Exempt Function Income | 237754 | RelatedOrExemptFunctionIncome |
| Exclusion | $168 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 101874 | Total |
| Program Services | 79462 | ProgramServices |
| Management And General | 10187 | ManagementAndGeneral |
| Fundraising | 12225 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 599733 | Total |
| Program Services | 467791 | ProgramServices |
| Management And General | 59974 | ManagementAndGeneral |
| Fundraising | 71968 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27887 | Total |
| Program Services | 21752 | ProgramServices |
| Management And General | 2789 | ManagementAndGeneral |
| Fundraising | 3346 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40668 | Total |
| Program Services | 31721 | ProgramServices |
| Management And General | 4067 | ManagementAndGeneral |
| Fundraising | 4880 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17606 | Total |
| Program Services | 6640 | ProgramServices |
| Management And General | 9613 | ManagementAndGeneral |
| Fundraising | 1353 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4923 | Total |
| Program Services | 2954 | ProgramServices |
| Management And General | 1477 | ManagementAndGeneral |
| Fundraising | 492 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17082 | Total |
| Program Services | 17082 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 120454 | Total |
| Program Services | 120454 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37871 | Total |
| Program Services | 31243 | ProgramServices |
| Management And General | 4734 | ManagementAndGeneral |
| Fundraising | 1894 | Fundraising |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Supplies | 35485 | 35485 | ||
| Repairs and Maintenance | 20123 | 20063 | 45 | 15 |
| Rent | 202217 | 145596 | 46510 | 10111 |
| Professional Fees | 61332 | 40772 | 19170 | 1390 |
| Outside Services | 84793 | 59490 | 23275 | 2028 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 63550 | Total |
| Program Services | 55537 | ProgramServices |
| Management And General | 5848 | ManagementAndGeneral |
| Fundraising | 2165 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1435598 | Total |
| Program Services | 1136042 | ProgramServices |
| Management And General | 187689 | ManagementAndGeneral |
| Fundraising | 111867 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4608 | BOY |
| EOY | 140139 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 150230 | BOY |
| EOY | 241155 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3747 | BOY |
| EOY | 16337 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20096 | BOY |
| EOY | 14663 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1532900 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 587491 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1065863 | BOY |
| EOY | 945409 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1244544 | BOY |
| EOY | 1357703 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10228 | BOY |
| EOY | 93144 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 230562 | BOY |
| EOY | 255705 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 153462 | BOY |
| EOY | 130213 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 394252 | BOY |
| EOY | 479062 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 766542 | BOY |
| EOY | 878641 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 83750 | BOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 850292 | BOY |
| EOY | 878641 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1244544 | BOY |
| EOY | 1357703 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 28349 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
| Federal Grant Audit Performed | false | FederalGrantAuditPerformed |
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 | 1319469 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 947739 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1842102 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1119566 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1226025 | CurrentTaxYear |
| Total | 6454901 | 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 | 1319469 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 947739 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1842102 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1119566 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1226025 | CurrentTaxYear |
| Total | 6454901 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 0 | AmountsSubstContributorsTotal |
| Public Support Total170 | 6454901 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 7421 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2665 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4875 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 121 | CurrentTaxYearMinus1Year |
| Current Tax Year | 168 | CurrentTaxYear |
| Total | 15250 | Total |
Net UBI NetUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | 13454 | CurrentTaxYear |
| Total | 13454 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 6483605 | TotalSupport |
| Public Support Pertcentage170 | 0.99560 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.99700 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 70978 | InvestmentCostOrOtherBasis |
| Book Value | 70978 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 474537 | InvestmentCostOrOtherBasis |
| Depreciation | 147788 | Depreciation |
| Book Value | 326749 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 252862 | InvestmentCostOrOtherBasis |
| Depreciation | 84280 | Depreciation |
| Book Value | 168582 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 734523 | InvestmentCostOrOtherBasis |
| Depreciation | 355423 | Depreciation |
| Book Value | 379100 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 945409 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Accrued Payroll and Related Liabilities | $53,268 |
| Accountability for Govt-Owned Assets | $76,945 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 130213 | TotalOfAmounts |
| Total Revenue | 1463947 | TotalRevenue |
| Total Expenses | 1435598 | TotalExpenses |
| Excess Or Deficit For Year | 28349 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 28349 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 1686362 | TotRevenueEtcAuditedFinclStmt |
| Donated Srvc And Use Of Facilities | 138939 | DonatedSrvcAndUseOfFacilities |
| Other Revenues | 83476 | OtherRevenues |
| Revenue Not Rptd F990 | 222415 | RevenueNotRptdF990 |
| Revenue Subtotal | 1463947 | RevenueSubtotal |
| Total Revenue Per Form990 | 1463947 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 1658013 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 138939 | DonatedServicesUseOfFacilities |
| Other Expenses Included | 83476 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 222415 | ExpensesNotRptdF990 |
| Expenses Subtotal | 1435598 | ExpensesSubtotal |
| Total Expenses Per Form990 | 1435598 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part XIII, Line 2d | Part XIII, Line 2d: Other expenses and losses per audited F/S | Special Event Direct Costs $83476 |
| Part XII, Line 2d | Part XII, Line 2d: Other revenue amounts included in F/S but not included on form 990 | Special Event Direct Costs $83476 |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | X | MailSolicitations |
| Solicitation Of Non Govt Grants | X | SolicitationOfNonGovtGrants |
| Special Fundraising Events | X | SpecialFundraisingEvents |
| Agreement Ref Fundraising | false | AgreementRefFundraising |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Rubber Ducky | NameOfEvent1 |
| Gross Receipts Event1 | 143269 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 143269 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 83476 | OtherDirectExpensesEvent1 |
| Name Of Event2 | Elks Roast Auction | NameOfEvent2 |
| Gross Receipts Event2 | 5350 | GrossReceiptsEvent2 |
| Gross Revenue Event2 | 5350 | GrossRevenueEvent2 |
| Gross Receipts Total | 148619 | GrossReceiptsTotal |
| Gross Revenue Total Events | 148619 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 83476 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 83476 | DirectExpenseSummaryEvents |
| Net Income Summary | 65143 | NetIncomeSummary |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990, Part VI, Line 19 | Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Upon Request |
| Form 990, Part VI, Line 15b | Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | Reviewed and established by executive director. |
| Form 990, Part VI, Line 12c | Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Monitored by Executive Director, conflicts presented to the executive committee for resolution. |
| Form 990, Part VI, Line 11 | Form 990, Part VI, Line 11: Form 990 Review Process | No review was or will be conducted. |
Comments