KIOWA COUNTY HEALTH FOUNDATION: Form 990PF, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- KIOWA COUNTY HEALTH FOUNDATION (EIN 48-1064221)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-05-15
- IRS object ID
- 201231369349102023
- 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
- Form 990-PF
- Accounting Fees Schedule
- Investments Other Schedule2
- Other Expenses Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-15T16:32:25-05:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481210879 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SMOLL & BANNING CPA'S LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2410 CENTRAL AVE | AddressLine1 |
| City | DODGE CITY | City |
| State | KS | State |
| ZIP Code | 67801 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481064221 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KIOWA COUNTY HEALTH FOUNDATION CO TOM CORNS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | KIOW | NameControl |
| Phone | 6207233341 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 304 S SPRUCE | AddressLine1 |
| City | GREENSBURG | City |
| State | KS | State |
| ZIP Code | 67054 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TOM CORNS | Name |
| Title | TREASURER | Title |
| Phone | 6207233341 | Phone |
| Date Signed | 2012-05-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | E KENT SMOLL CPAPFS | Name |
| PTIN | P00113696 | PTIN |
| Phone | 6202256100 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exempt PF | X | ExemptPF |
| FMV Assets EOY | 542443 | FMVAssetsEOY |
| Method Of Accounting Cash | X | MethodOfAccountingCash |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Received Rev And Expnss | 2173 | ContriReceivedRevAndExpnss |
| Not Required To Attach Schedule B | X | NotRequiredToAttachScheduleB |
| Interest On Savings Rev And Expnss | 6158 | InterestOnSavingsRevAndExpnss |
| Interest On Savings Net Invst Incm | 6158 | InterestOnSavingsNetInvstIncm |
| Capital Gain Net Incm Net Invst Incm | 0 | CapitalGainNetIncmNetInvstIncm |
| Total Revenue And Expenses | 8331 | TotalRevenueAndExpenses |
| Total Net Investment Income | 6158 | TotalNetInvestmentIncome |
| Comp Ofcr Dir Trst Rev And Expnss | 0 | CompOfcrDirTrstRevAndExpnss |
| Comp Ofcr Dir Trst Net Invst Incm | 0 | CompOfcrDirTrstNetInvstIncm |
| Comp Ofcr Dir Trst Dsbrs Chrtbl Prps | 0 | CompOfcrDirTrstDsbrsChrtblPrps |
| Accounting Fees Rev And Expnss | 786 | AccountingFeesRevAndExpnss |
| Accounting Fees Net Invst Incm | 590 | AccountingFeesNetInvstIncm |
| Accounting Fees Dsbrs Chrtbl Prps | 196 | AccountingFeesDsbrsChrtblPrps |
| Taxes Rev And Expnss | 197 | TaxesRevAndExpnss |
| Taxes Net Invst Incm | 0 | TaxesNetInvstIncm |
| Taxes Dsbrs Chrtbl Prps | 40 | TaxesDsbrsChrtblPrps |
| Other Expenses Rev And Expnss | 18 | OtherExpensesRevAndExpnss |
| Other Expenses Net Invst Incm | 0 | OtherExpensesNetInvstIncm |
| Other Expenses Dsbrs Chrtbl Prps | 18 | OtherExpensesDsbrsChrtblPrps |
| Tot Opr Expenses Rev And Expnss | 1001 | TotOprExpensesRevAndExpnss |
| Tot Opr Expenses Net Invst Incm | 590 | TotOprExpensesNetInvstIncm |
| Tot Opr Expenses Dsbrs Chrtbl Prps | 254 | TotOprExpensesDsbrsChrtblPrps |
| Contri Gifts Paid Rev And Expnss | 31756 | ContriGiftsPaidRevAndExpnss |
| Contri Gifts Paid Dsbrs Chrtbl Prps | 31756 | ContriGiftsPaidDsbrsChrtblPrps |
| Total Expenses Rev And Expnss | 32757 | TotalExpensesRevAndExpnss |
| Total Expenses Net Invst Incm | 590 | TotalExpensesNetInvstIncm |
| Total Expenses Dsbrs Chrtbl Prps | 32010 | TotalExpensesDsbrsChrtblPrps |
| Excess Of Revenue Over Expenses | -24426 | ExcessOfRevenueOverExpenses |
| Net Investment Income | 5568 | NetInvestmentIncome |
Balance Sheets BalanceSheets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Savings And Temp Cash Invst BOY | 508799 | SavingsAndTempCashInvstBOY |
| Savings And Temp Cash Invst EOY | 523404 | SavingsAndTempCashInvstEOY |
| Savings And Temp Cash Invst EOYFMV | 523404 | SavingsAndTempCashInvstEOYFMV |
| Other Notes And Loans Receivable | 3843 | OtherNotesAndLoansReceivable |
| Allwnc For Dbtfl Acct Other Rcvbl | 0 | AllwncForDbtflAcctOtherRcvbl |
| Other Notes And Loans Rcvbl BOY | 42874 | OtherNotesAndLoansRcvblBOY |
| Other Notes And Loans Rcvbl EOY | 3843 | OtherNotesAndLoansRcvblEOY |
| Other Notes And Loans Rcvbl EOYFMV | 3843 | OtherNotesAndLoansRcvblEOYFMV |
| Investments Other BOY | 15196 | InvestmentsOtherBOY |
| Investments Other EOY | 15196 | InvestmentsOtherEOY |
| Investments Other EOYFMV | 15196 | InvestmentsOtherEOYFMV |
| Total Assets BOY | 566869 | TotalAssetsBOY |
| Total Assets EOY | 542443 | TotalAssetsEOY |
| Total Assets EOYFMV | 542443 | TotalAssetsEOYFMV |
| Total Liabilities BOY | 0 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Org That Do Not Follow SFAS117 | X | OrgThatDoNotFollowSFAS117 |
| Capital Stock BOY | 331991 | CapitalStockBOY |
| Capital Stock EOY | 331991 | CapitalStockEOY |
| Paid In Or Capital Surplus BOY | 0 | PaidInOrCapitalSurplusBOY |
| Paid In Or Capital Surplus EOY | 0 | PaidInOrCapitalSurplusEOY |
| Retained Earnings BOY | 234878 | RetainedEarningsBOY |
| Retained Earnings EOY | 210452 | RetainedEarningsEOY |
| Total Net Assets BOY | 566869 | TotalNetAssetsBOY |
| Total Net Assets EOY | 542443 | TotalNetAssetsEOY |
| Total Liabilities Net Assets BOY | 566869 | TotalLiabilitiesNetAssetsBOY |
| Total Liabilities Net Assets EOY | 542443 | TotalLiabilitiesNetAssetsEOY |
Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Net Assets Fund Balances BOY | 566869 | TotalNetAssetsFundBalancesBOY |
| Excess Of Revenue Over Expenses | -24426 | ExcessOfRevenueOverExpenses |
| Other Increases | 0 | OtherIncreases |
| Subtotal | 542443 | Subtotal |
| Other Decreases | 0 | OtherDecreases |
| Total Net Assets Fund Balances EOY | 542443 | TotalNetAssetsFundBalancesEOY |
Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable For4942 Tax | 0 | LiableFor4942Tax |
| Qualifying Distributions Year1 | 9364 | QualifyingDistributionsYear1 |
| Noncharitable Assets Year1 | 557480 | NoncharitableAssetsYear1 |
| Distribution Ratio Year1 | 0.016797 | DistributionRatioYear1 |
| Qualifying Distributions Year2 | 7401 | QualifyingDistributionsYear2 |
| Noncharitable Assets Year2 | 553289 | NoncharitableAssetsYear2 |
| Distribution Ratio Year2 | 0.013376 | DistributionRatioYear2 |
| Qualifying Distributions Year3 | 14716 | QualifyingDistributionsYear3 |
| Noncharitable Assets Year3 | 542508 | NoncharitableAssetsYear3 |
| Distribution Ratio Year3 | 0.027126 | DistributionRatioYear3 |
| Qualifying Distributions Year4 | 20881 | QualifyingDistributionsYear4 |
| Noncharitable Assets Year4 | 184445 | NoncharitableAssetsYear4 |
| Distribution Ratio Year4 | 0.113210 | DistributionRatioYear4 |
| Qualifying Distributions Year5 | 22700 | QualifyingDistributionsYear5 |
| Noncharitable Assets Year5 | 105718 | NoncharitableAssetsYear5 |
| Distribution Ratio Year5 | 0.214722 | DistributionRatioYear5 |
| Total Distribution Ratio | 0.385231 | TotalDistributionRatio |
| Average Distribution Ratio | 0.077046 | AverageDistributionRatio |
| Net Noncharitable Assets | 546336 | NetNoncharitableAssets |
| Adjusted Noncharitable Assets | 42093 | AdjustedNoncharitableAssets |
| One Percent Net Investment Income | 56 | OnePercentNetInvestmentIncome |
| Adj Nonchrtbl Assets And One | 42149 | AdjNonchrtblAssetsAndOnePct |
| Qualifying Distributions | 32010 | QualifyingDistributions |
Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | 111 | InvestmentIncomeExciseTax |
| Tax Under Section511 | 0 | TaxUnderSection511 |
| Subtotal | 111 | Subtotal |
| Subtitle A Tax | 0 | SubtitleATax |
| Tax Based On Investment Income | 111 | TaxBasedOnInvestmentIncome |
| Total Credits And Payments | 0 | TotalCreditsAndPayments |
| Tax Due | 111 | TaxDue |
Statements Regarding Activities StatementsRegardingActivities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Activities | 0 | LegislativePoliticalActivities |
| More Than100 Spent | 0 | MoreThan100Spent |
| Form1120 POL Filed | 0 | Form1120POLFiled |
| Sect4955 Tax On Organization | 0 | Sect4955TaxOnOrganization |
| Sect4955 Tax On Managers | 0 | Sect4955TaxOnManagers |
| Reimbursement Of Tax | 0 | ReimbursementOfTax |
| Activities Not Prev Reported | 0 | ActivitiesNotPrevReported |
| Changes To Articles Or Bylaws | 0 | ChangesToArticlesOrBylaws |
| Unrelated Bus Income Over1000 | 0 | UnrelatedBusIncomeOver1000 |
| Termination Etc | 0 | TerminationEtc |
| Requirements Of Sect508e | 0 | RequirementsOfSect508e |
| At Least5000 In Assets | 1 | AtLeast5000InAssets |
| States Filed With | KS | StatesFiledWith |
| Form990 PF Filed With AG | 1 | Form990PFFiledWithAG |
| Private Operating Foundation | 0 | PrivateOperatingFoundation |
| New Substantial Contributors | 0 | NewSubstantialContributors |
| Interest In Controlled Entity | 0 | InterestInControlledEntity |
| Applicable Insurance Contract | 0 | ApplicableInsuranceContract |
| Comply With Public Inspection Rqr | 1 | ComplyWithPublicInspectionRqr |
| Website Address | N/A | WebsiteAddress |
| Books In Care Of Person Name | TOM CORNS | BooksInCareOfPersonName |
| Books In Care Of Phone Number | 6207232131 | BooksInCareOfPhoneNumber |
Books In Care Of US Address BooksInCareOfUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | GREENSBURG STATE BANK 240 SOUTH | AddressLine1 |
| Address Line2 | MAIN | AddressLine2 |
| City | GREENSBURG | City |
| State | KS | State |
| ZIP Code | 67054 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Bank | 0 | ForeignBank |
Statements Regarding Acty4720 StatementsRegardingActy4720
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exchange With Dsqfly Person | 0 | SaleOrExchangeWithDsqflyPerson |
| Borrow Or Lend With Dsqfly Person | 0 | BorrowOrLendWithDsqflyPerson |
| Furnished Goods With Dsqfly Person | 0 | FurnishedGoodsWithDsqflyPerson |
| Pay Compensation To Dsqfly Person | 0 | PayCompensationToDsqflyPerson |
| Transfer Assets To Dsqfly Person | 0 | TransferAssetsToDsqflyPerson |
| Payment To Government Offical | 0 | PaymentToGovernmentOffical |
| Uncorrected Prior Acts | 0 | UncorrectedPriorActs |
| Undistributed Income Prior Years | 0 | UndistributedIncomePriorYears |
| Business Holdings | 0 | BusinessHoldings |
| Jeopardy Investments | 0 | JeopardyInvestments |
| Uncorrected Jeopardy Investments | 0 | UncorrectedJeopardyInvestments |
| Influence Legislation | 0 | InfluenceLegislation |
| Influence Election | 0 | InfluenceElection |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Noncharitable Purpose | 0 | NoncharitablePurpose |
| Rcv Funds To Pay Prsnl Bnft Contract | 0 | RcvFundsToPayPrsnlBnftContract |
| Pay Premiums Prsnl Bnft Contract | 0 | PayPremiumsPrsnlBnftContract |
| Prohibited Tax Shelter Transactn | 0 | ProhibitedTaxShelterTransactn |
Ofcr Dir Trustees Key Employee Info OfcrDirTrusteesKeyEmployeeInfo
Ofcr Dir Trustees Or Key Employee OfcrDirTrusteesOrKeyEmployee (8 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | TitleTitle | Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition | CompensationCompensation | Contri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtc | Expense Account Other AllowancesExpenseAccountOtherAllowances |
|---|---|---|---|---|---|---|---|---|
| ROGER STAATS | ||||||||
| 418 S POPLAR | GREENSBURG | KS | 67054 | PRESIDENT | 1.00 | 0 | 0 | 0 |
| TOM CORNS | ||||||||
| 304 S SPRUCE | GREENSBURG | KS | 67054 | TREASURER | 1.00 | 0 | 0 | 0 |
| ELMER DAVIS | ||||||||
| RR 2 BOX 32 | HAVILAND | KS | 67059 | DIRECTOR | 1.00 | 0 | 0 | 0 |
| VERA CUTRIGHT | ||||||||
| 402 N EMPORIA | HAVILAND | KS | 67059 | VICE-PRESIDENT | 1.00 | 0 | 0 | 0 |
| KENNETH UNRUH | ||||||||
| RR 2 BOX 32 | LEWIS | KS | 67552 | DIRECTOR | 1.00 | 0 | 0 | 0 |
| PAUL KENDALL | ||||||||
| 318 E KINGMAN | MULLINVILLE | KS | 67109 | DIRECTOR | 1.00 | 0 | 0 | 0 |
| MARY SWEET | ||||||||
| 603 S SPRUCE | GREENSBURG | KS | 67054 | DIRECTOR | 1.00 | 0 | 0 | 0 |
| DORIS HEADRICK | ||||||||
| 120 N MAIN | MULLINVILLE | KS | 67109 | DIRECTOR | 1.00 | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Highest Paid Empl NONE | NONE | CompOfHighestPaidEmplNONE |
| Tot Number Of Oth Empl Paid Over50k | 0 | TotNumberOfOthEmplPaidOver50k |
| Comp Of Hghst Paid Cntrct NONE | NONE | CompOfHghstPaidCntrctNONE |
| Tot Number Of Cntrct Paid Over50k | 0 | TotNumberOfCntrctPaidOver50k |
Summary Of Direct Charitable Acty SummaryOfDirectCharitableActy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | GRANTS TO VARIOUS ORGANIZATIONS IN KIOWA COUNTY THAT PROVIDE HEALTH CARE IN KIOWA COUNTY. | Description1 |
| Expenses1 | 14256 | Expenses1 |
| Description2 | THE ORGANIZATION HAS PROVIDED SCHOLARSHIPS FOR AREA STUDENTS TAKING MEDICIAL RELATED STUDIES. | Description2 |
| Expenses2 | 10000 | Expenses2 |
| Description3 | MOVING EXPENSES TO RELOCATE TO THE COMMUNITY A DOCTOR THAT WILL PRACTICE AT THE LOCAL HOSPITAL. | Description3 |
| Expenses3 | 7500 | Expenses3 |
Sum Of Program Related Investments SumOfProgramRelatedInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Minimum Investment Return MinimumInvestmentReturn
| Field | Value | IRS element (for citing) |
|---|---|---|
| Avg Monthly FMV Of Securities | 15196 | AvgMonthlyFMVOfSecurities |
| Avg Monthly Cash Balances | 371812 | AvgMonthlyCashBalances |
| FMV All Other Noncharitable Assets | 167648 | FMVAllOtherNoncharitableAssets |
| Total FMV Of Unused Assets | 554656 | TotalFMVOfUnusedAssets |
| Reduction Claimed | 0 | ReductionClaimed |
| Acquisition Indebtedness | 0 | AcquisitionIndebtedness |
| Adj Total FMV Of Unused Assets | 554656 | AdjTotalFMVOfUnusedAssets |
| Cash Deemed Charitable | 8320 | CashDeemedCharitable |
| Net Noncharitable Assets | 546336 | NetNoncharitableAssets |
| Minimum Investment Return | 27317 | MinimumInvestmentReturn |
Distributable DistributableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | 27317 | MinimumInvestmentReturn |
| Tax Based On Investment Income | 111 | TaxBasedOnInvestmentIncome |
| Total Tax | 111 | TotalTax |
| Distributable Amount Before Adj | 27206 | DistributableAmountBeforeAdj |
| Recoveries Qlfy Distributions | 0 | RecoveriesQlfyDistributions |
| Distributable Amount Before Ded | 27206 | DistributableAmountBeforeDed |
| Deduction Fr Distributable | $0 | DeductionFrDistributableAmount |
| Distributable Amount As Adjusted | 27206 | DistributableAmountAsAdjusted |
Qualifying Distributions QualifyingDistributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | 32010 | ExpensesAndContributions |
| Program Related Investments Total | 0 | ProgramRelatedInvestmentsTotal |
| Qualifying Distributions | 32010 | QualifyingDistributions |
| One Pct Sect4940e Org Net Invst Incm | 0 | OnePctSect4940eOrgNetInvstIncm |
| Adj Qualifying Distributions | 32010 | AdjQualifyingDistributions |
Undistributed Income UndistributedIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable Amount As Adjusted | 27206 | DistributableAmountAsAdjusted |
| Undistributed Income Prior Year | 20777 | UndistributedIncomePriorYear |
| Total For Prior Years | 0 | TotalForPriorYears |
| Total Excess Distri Carryover | 0 | TotalExcessDistriCarryover |
| Qualifying Distributions | 32010 | QualifyingDistributions |
| Applied To Year1 | 20777 | AppliedToYear1 |
| Applied To Prior Years | 0 | AppliedToPriorYears |
| Treated As Distri From Corpus | 0 | TreatedAsDistriFromCorpus |
| Applied To Current Year | 11233 | AppliedToCurrentYear |
| Remaining Distri From Corpus | 0 | RemainingDistriFromCorpus |
| Excess Distri Cyov App CY Corpus | 0 | ExcessDistriCyovAppCYCorpus |
| Excess Distri Cyov Applied CY | 0 | ExcessDistriCyovAppliedCY |
| Total Corpus | 0 | TotalCorpus |
| Prior Year Undistributed Income | 0 | PriorYearUndistributedIncome |
| Prior Year Deficiency Or Tax | 0 | PriorYearDeficiencyOrTax |
| Taxable Amount1 | 0 | TaxableAmount1 |
| Taxable Amount2 | 0 | TaxableAmount2 |
| Undistributed Income CY | 15973 | UndistributedIncomeCY |
| Distri From Corpus170b1 E Or4942g3 | 0 | DistriFromCorpus170b1EOr4942g3 |
| Excess Distri Cyov From Year5 | 0 | ExcessDistriCyovFromYear5 |
| Excess Distri Cyov To Next Year | 0 | ExcessDistriCyovToNextYear |
Supplementary Information SupplementaryInformation
Appication Submission Info AppicationSubmissionInfo (2 entries)
| Recipient NameRecipientName | Address Line1RecipientUSAddress/AddressLine1 | CityRecipientUSAddress/City | StateRecipientUSAddress/State | ZIP CodeRecipientUSAddress/ZIPCode | Recipient Phone NumberRecipientPhoneNumber | Form And Info And MaterialsFormAndInfoAndMaterials | Submission DeadlinesSubmissionDeadlines | Restrictions On AwardsRestrictionsOnAwards |
|---|---|---|---|---|---|---|---|---|
| TOM CORNS | 304 S SPRUCE | GREENSBURG | KS | 67054 | 6207232131 | SCHOLARSHIP APPLICATIONS REQUIRE BASIC PERSONAL INFORMATION AND THE APPLICANT'S GRADE POINT AVERAGE. | THE SCHOLARSHIP DEADLINE IS SET ANNUALLY BY THE SCHOLARSHIP ADMINISTRATOR. | SCHOLARHIP RECIPIENTS MUST BE IN THE MEDICAL FIELD WITH THE POSSIBILITY OF BEING KIOWA COUNTY MEMORIAL HOSPITAL EMPLOYEES. SCHOLARSHIPS ARE LIMITED TO $1,000 PER RECIPIENT PER YEAR. |
| TOM CORNS | 304 S SPRUCE | GREENSBURG | KS | 67054 | 6207232131 | LETTERS ARE SUBMITTED BY THOSE REQUESTING GRANT AWARDS. | GRANT LETTERS ARE DUE PRIOR TO THE ANNUAL MEETING HELD IN JANUARY. | GRANT AWARDEES MUST PROVIDE SERVICES TO KIOWA COUNTY RESIDENTS. |
Grant Or Contri Paid During Year GrantOrContriPaidDuringYear (17 entries)
| Address Line1RecipientUSAddress/AddressLine1 | CityRecipientUSAddress/City | StateRecipientUSAddress/State | ZIP CodeRecipientUSAddress/ZIPCode | Recipient RelationshipRecipientRelationship | Purpose Of Grant Or ContributionPurposeOfGrantOrContribution | AmountAmount |
|---|---|---|---|---|---|---|
| BRANDON YOHN | ||||||
| 17252 G STREET | GREENSBURG | KS | 67054 | NONE | SCHOLARSHIP | $500 |
| BROOKE MAIER | ||||||
| 1222 S MAIN | GREENSBURG | KS | 67059 | NONE | SCHOLARSHIP | $1,000 |
| DELICIA TORRES | ||||||
| 410 S SYCAMORE | GREENSBURG | KS | 67054 | NONE | SCHOLARSHIP | $1,000 |
| DEZERE LUNA | ||||||
| 2221 N HILLSIDE 1226 | WICHITA | KS | 67219 | NONE | SCHOLARSHIPSCHOLARSHIP | $500 |
| JESSICA DAVIS | ||||||
| PO BOX 335 | HAVILAND | KS | 67059 | NONE | SCHOLARSHIP | $1,000 |
| JOSHUA KIMBLE | ||||||
| PO BOX 62 | MULLINVILLE | KS | 67109 | NONE | SCHOLARSHIP | $1,000 |
| KATELIN HOLLAND | ||||||
| 209 E 4TH | HAYS | KS | 67601 | NONE | SCHOLARSHIP | $500 |
| MACI COLCLAZIER | ||||||
| 603 S SPRUCE | GREENSBURG | KS | 67054 | NONE | SCHOLARSHIP | $1,000 |
| MORGAN FULTON | ||||||
| 1216 S MAIN | GREENSBURG | KS | 67054 | NONE | SCHOLARSHIP | $1,000 |
| MORGAN TYREE | ||||||
| PO BOX 266 | KINSLEY | KS | 67547 | NONE | SCHOLARSHIP | $500 |
| NICHOLE ROSE | ||||||
| 702 N WICHITA | HAVILAND | KS | 67059 | NONE | SCHOLARSHIP | $500 |
| SUSAN KAMES | ||||||
| 530 E WISCONSIN AVE | GREENSBURG | KS | 67054 | NONE | SCHOLARSHIP | $500 |
| LINDSEY HEFT | ||||||
| 410 S POPLAR | GREENSBURG | KS | 67054 | NONE | SCHOLARSHIP | $500 |
| TAYLOR ARDERY | ||||||
| 22159 11TH AVENUE | MULLINVILLE | KS | 67109 | NONE | SCHOLARSHIP | $500 |
| KIOWA COUNTY HEALTH DEPARTMENT | ||||||
| 721 W KANSAS | GREENSBURG | KS | 67054 | NONE | MEDICAL CARE | $500 |
| DR NIZAR KIBAR | ||||||
| 606 S SPRUCE | GREENSBURG | KS | 67054 | NONE | MOVING EXPENSES TO LOCATE DOCTOR TO COMMUNITY | $7,500 |
| KIOWA COUNTY MEMORIAL HOSPITAL | ||||||
| 721 W KANSAS | GREENSBURG | KS | 67054 | NONE | MEDICAL CARE | $13,756 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Grant Or Contri Paid During Year | 31756 | TotGrantOrContriPaidDuringYear |
| Tot Grant Or Contri Approved Future | 0 | TotGrantOrContriApprovedFuture |
Analysis Income Producing Acty AnalysisIncomeProducingActy
Int On Savings And Temp Cash Invst IntOnSavingsAndTempCashInvst
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion Code | 14 | ExclusionCode |
| Exclusion | $6,158 | ExclusionAmount |
Subtotals Part XVIA SubtotalsPartXVIA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Income | $0 | UnrelatedBusinessIncomeAmount |
| Exclusion | $6,158 | ExclusionAmount |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Part XVIA | 6158 | TotalPartXVIA |
Trnsfr Tr Rln With Noncharitable EO TrnsfrTrRlnWithNoncharitableEO
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Noncharitable EO | 0 | TrnsfrOfCashToNoncharitableEO |
| Trnsfr Oth Assets Noncharitable EO | 0 | TrnsfrOthAssetsNoncharitableEO |
| Sales Or Exchanges Of Assets | 0 | SalesOrExchangesOfAssets |
| Purchase Assets Noncharitable EO | 0 | PurchaseAssetsNoncharitableEO |
| Rental Of Facilities Etc | 0 | RentalOfFacilitiesEtc |
| Reimbursement Arrangements | 0 | ReimbursementArrangements |
| Loans Or Loan Guarantees | 0 | LoansOrLoanGuarantees |
| Performance Of Services Etc | 0 | PerformanceOfServicesEtc |
| Sharing Of Facilities Etc | 0 | SharingOfFacilitiesEtc |
| Relationships Noncharitable E Os | 0 | RelationshipsNoncharitableEOs |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees AccountingFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | ACCOUNTING | Category |
| Amount | $786 | Amount |
| Net Investment Income | 590 | NetInvestmentIncome |
| Disbursements Charitable Prps | 196 | DisbursementsCharitablePrps |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category Or Item | SOUTH CENTRAL COMMUNITY FOUNDATION | CategoryOrItem |
| Listed At Cost Or FMV | FMV | ListedAtCostOrFMV |
| Book Value | 15196 | BookValue |
| EOYFMV | 15196 | EOYFMV |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | SUPPLIES | Description |
| Revenue And Expenses Per Books | 18 | RevenueAndExpensesPerBooks |
| Net Investment Income | 0 | NetInvestmentIncome |
| Disbursements Charitable Prps | 18 | DisbursementsCharitablePrps |
Taxes Schedule TaxesSchedule
Taxes Taxes (2 entries)
| CategoryCategory | AmountAmount | Net Investment IncomeNetInvestmentIncome | Disbursements Charitable PrpsDisbursementsCharitablePrps |
|---|---|---|---|
| CORPORATE ANNUAL FEE | $40 | 0 | 40 |
| INVESTMENT EXCISE TAX | $157 | 0 | 0 |
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