COMMUNITY MEDICAL CLINIC OF KERSHAW COUNTY: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: COMMUNITY MEDICAL CLINIC OF KERSHAW COUNTY (EIN 57-1074191)
Tax period: 2010-01-01 to 2010-12-31
Filed: 2011-08-12
IRS object ID: 201132289349301578
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
Form 990
Schedule A
Schedule D
Schedule G
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-08-12T13:32:42-05:00	Timestamp
Tax Period End Date	2010-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CANTEY TILLER PIERCE & GREEN LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 862	AddressLine1
City	CAMDEN	City
State	SC	State
ZIP Code	29021	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2010-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	571074191	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	KERSHAW COUNTY COMMUNITY MED CLINIC	BusinessNameLine1
Business Name Line2	C/O SUSAN WITKOWSKI	BusinessNameLine2

Field	Value	IRS element (for citing)
Name Control	KERS	NameControl
Phone	8034321436	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	110 EAST DEKALB STREET	AddressLine1
Address Line2	ROOM/SUITE 1-B	AddressLine2
City	CAMDEN	City
State	SC	State
ZIP Code	29020	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	SUSAN WITKOWSKI	Name
Title	EXECUTIVE DIRECTOR	Title
Phone	8034321436	Phone
Date Signed	2011-08-08	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	HENRY D GREEN III	Name
Phone	8034321436	Phone
Date Prepared	2011-08-12	DatePrepared

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	SUSAN WITKOWSKI	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	110 EAST DEKALB STREET	AddressLine1
City	CAMDEN	City
State	SC	State
ZIP Code	29020	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	373471	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.CMCOFKC.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1998	YearFormation
State Legal Domicile	SC	StateLegalDomicile
Activity Or Mission Description	THE ORGANIZATION IS ENGAGED IN THE OPERATION OF A MEDICAL CLINIC FOR RESIDENTS OF CAMDEN AND KERSHAW COUNTY.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	16	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	16	NbrIndependentVotingMembers
Total Nbr Employees	5	TotalNbrEmployees
Total Nbr Volunteers	200	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	2298985	ContributionsGrantsPriorYear
Contributions Grants Current Year	347858	ContributionsGrantsCurrentYear
Program Service Revenue CY	0	ProgramServiceRevenueCY
Investment Income Prior Year	314	InvestmentIncomePriorYear
Investment Income Current Year	313	InvestmentIncomeCurrentYear
Other Revenue Prior Year	28050	OtherRevenuePriorYear
Other Revenue Current Year	22372	OtherRevenueCurrentYear
Total Revenue Prior Year	2327349	TotalRevenuePriorYear
Total Revenue Current Year	370543	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	214747	SalariesEtcPriorYear
Salaries Etc Current Year	229322	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	2102652	OtherExpensePriorYear
Other Expenses Current Year	110645	OtherExpensesCurrentYear
Total Expenses Prior Year	2317399	TotalExpensesPriorYear
Total Expenses Current Year	339967	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	9950	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	30576	RevenuesLessExpensesCY
Total Assets BOY	298213	TotalAssetsBOY
Total Assets EOY	328191	TotalAssetsEOY
Total Liabilities BOY	22249	TotalLiabilitiesBOY
Total Liabilities EOY	21651	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	275964	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	306540	NetAssetsOrFundBalancesEOY
Mission Description	THE ORGANIZATION IS ENGAGED IN THE OPERATION OF A MEDICAL CLINIC FOR RESIDENTS OF CAMDEN AND KERSHAW COUNTY.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	329892	Expense
Description	TO PROVIDE OUT-PATIENT HEALTH CARE SERVICES TO PERSONS IN KERSHAW COUNTY WHO CANNOT PAY FOR SUCH SERVICES OUT OF POCKET AND WHO DO NOT HAVE HEALTH INSURANCE	Description
Total Program Service Expense	329892	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	false	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
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	true	ScheduleORequired
Number Forms Transmitted With1096	3	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	5	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	16	NbrVotingGoverningBodyMembers
Number Independent Voting Members	16	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
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
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	SUSAN WITKOWSKI	NamePerson
Telephone Number	8037130806	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	110 E DEKALB ST	AddressLine1
City	CAMDEN	City
State	SC	State
ZIP Code	29020	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitle	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Average Hours Per WeekAverageHoursPerWeek	OfficerOfficer
ALICE BROOKS MD
CHAIRMAN	X	0	0	0
WILLIAM SUMMERS
BOARD MEMBER	X	0	0	0
KENNETH CARSON
BOARD MEMBER	X	0	0	0
DONNIE WEEKS
V CHAIR	X	0	0	0
GEORGE GIBSON
BOARD MEMBER	X	0	0	0
JIM BURNS
BOARD MEMBER	X	0	0	0
JOHN DUBOSE
BOARD MEMBER	X	0	0	0
META MARKLEY
BOARD MEMBER	X	0	0	0
TINA LOCKHART
SECRETARY	X	0	0	0
HARRIET HERIOT
BOARD MEMBER	X	0	0	0
ROY FAKOURY
BOARD MEMBER	X	0	0	0
JOANN CUSHMAN
BOARD MEMBER	X	0	0	0
HANK GREEN
TREASURER	X	0	0	0
LAURIE SLADE FUNDERBURK
BOARD MEMBER	X	0	0	0
NED TOWELL
BOARD MEMBER	X	0	0	0
MARY CLARK
BOARD MEMBER	X	0	0	0
SUSAN WITKOWSKI
EXEC. DIRECT		60825	0	0	40.00	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	60825	TotalReportableCompFromOrg
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources
Government Grants	11286	GovernmentGrants
All Other Contributions	336572	AllOtherContributions
Total Contributions	347858	TotalContributions

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	313	TotalRevenueColumn
Related Or Exempt Function Income	313	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	25300	GrossIncomeFundraisingEvents
Fundraising Direct Expenses	2928	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	22372	TotalRevenueColumn

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	370543	TotalRevenueColumn
Related Or Exempt Function Income	313	RelatedOrExemptFunctionIncome

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	60825	Total
Program Services	60825	ProgramServices

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	151497	Total
Program Services	151497	ProgramServices

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	17000	Total
Program Services	17000	ProgramServices

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	2500	Total
Management And General	2500	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	14826	Total
Program Services	14826	ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
MEDICATION	23484	23484
INSURANCE- GROUP	15675	15675
INSURANCE- MALPRACTICE	9311	9311
SUPPLIES	8719	8719
UTILITIES	7083	7083

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	29047	Total
Program Services	21472	ProgramServices
Management And General	7575	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	339967	Total
Program Services	329892	ProgramServices
Management And General	10075	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	231814	BOY
EOY	250251	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	12596	BOY
EOY	40074	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	5000	BOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	400	BOY
EOY	400	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	131143	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	93677	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	48403	BOY
EOY	37466	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	298213	BOY
EOY	328191	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	22249	BOY
EOY	21651	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	22249	BOY
EOY	21651	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	275964	BOY
EOY	306540	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	275964	BOY
EOY	306540	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	298213	BOY
EOY	328191	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	30576	ReconcilationRevenueExpenses
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	false	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 Minus4 Years	249585	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	284149	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	305216	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	324229	CurrentTaxYearMinus1Year
Current Tax Year	336572	CurrentTaxYear
Total	1499751	Total

Total170 Total170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	249585	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	284149	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	305216	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	324229	CurrentTaxYearMinus1Year
Current Tax Year	336572	CurrentTaxYear
Total	1499751	Total

Field	Value	IRS element (for citing)
Public Support Total170	1499751	PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	2868	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	2271	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	2133	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	314	CurrentTaxYearMinus1Year
Current Tax Year	313	CurrentTaxYear
Total	7899	Total

Field	Value	IRS element (for citing)
Total Support	1507650	TotalSupport
Gross Receipts From Admissions Etc	25613	GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage170	0.99480	PublicSupportPertcentage170
Public Support Pertcent Prior Year	0.99290	PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170	X	ThirtyThreePercntTestsCY170

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Disclosed Orgs Legal Control	false	DisclosedOrgsLegalControl
Disclosed For Charitable Purposes	false	DisclosedForCharitablePurposes
Written Policy Monitoring	false	WrittenPolicyMonitoring
Sect170h Requirements Satisfied	false	Sect170hRequirementsSatisfied
Solicited Assets For Sale	false	SolicitedAssetsForSale
Agent Trustee Etc	false	AgentTrusteeEtc
Included On FS	false	IncludedOnFS
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	false	AreRelatedOrgsListedScheduleR

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	131143	OtherCostOrOtherBasis
Depreciation	93677	Depreciation
Book Value	37466	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	37466	TotalOfBookValueLandBuildings
Total Revenue	370543	TotalRevenue
Total Expenses	339967	TotalExpenses
Excess Or Deficit For Year	30576	ExcessOrDeficitForYear
Excess Or Deficit Per FS	30576	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	2387543	TotRevenueEtcAuditedFinclStmt
Donated Srvc And Use Of Facilities	2017000	DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F990	2017000	RevenueNotRptdF990
Revenue Subtotal	370543	RevenueSubtotal
Total Revenue Per Form990	370543	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	2356967	TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities	2017000	DonatedServicesUseOfFacilities
Expenses Not Rptd F990	2017000	ExpensesNotRptdF990
Expenses Subtotal	339967	ExpensesSubtotal
Total Expenses Per Form990	339967	TotalExpensesPerForm990

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	SPECIAL EVENT	NameOfEvent1
Gross Receipts Event1	25300	GrossReceiptsEvent1
Gross Revenue Event1	25300	GrossRevenueEvent1
Other Direct Expenses Event1	2928	OtherDirectExpensesEvent1
Gross Receipts Total	25300	GrossReceiptsTotal
Gross Revenue Total Events	25300	GrossRevenueTotalEvents
Other Direct Expenses Total Events	2928	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	2928	DirectExpenseSummaryEvents
Net Income Summary	22372	NetIncomeSummary

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	THE FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR.
ENFORCEMENT OF CONFLICTS POLICY	FORM 990, PAGE 6, PART VI, LINE 12C	THIS IS REVIEWED ANNUALLY
COMPENSATION PROCESS FOR TOP OFFICIAL	FORM 990, PAGE 6, PART VI, LINE 15A	REVIEWED ANNUALLY BY THE BOARD
COMPENSATION PROCESS FOR OFFICERS	FORM 990, PAGE 6, PART VI, LINE 15B	REVIEWED ANNUALLY BY THE BOARD
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	AVAILABLE UPON REQUEST

COMMUNITY MEDICAL CLINIC OF KERSHAW COUNTY: Form 990, tax year 2010

Return header ReturnHeader

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Preparer Firm US Address PreparerFirmUSAddress

Filer Filer

Name Name

US Address USAddress

Officer Officer

Preparer Preparer

Form 990 IRS990

Address Principal Officer US AddressPrincipalOfficerUS

The Books Are In Care Of TheBooksAreInCareOf

Address US AddressUS

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

Investment Income InvestmentIncome

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Total Revenue TotalRevenue

Comp Current Officers Directors CompCurrentOfficersDirectors

Other Salaries And Wages OtherSalariesAndWages

Payroll Taxes PayrollTaxes

Fees For Services Accounting FeesForServicesAccounting

Depreciation Depletion DepreciationDepletion

Other Expenses OtherExpenses (5 entries)

All Other Expenses AllOtherExpenses

Total Functional Expenses TotalFunctionalExpenses

Cash Non Interest Bearing CashNonInterestBearing

Pledges And Grants Receivable PledgesAndGrantsReceivable

Inventories For Sale Or Use InventoriesForSaleOrUse

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Total Assets TotalAssets

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Total Liabilities TotalLiabilities

Unrestricted Net Assets UnrestrictedNetAssets

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Schedule A IRS990ScheduleA

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

Total170 Total170

Gross Investment Income170 GrossInvestmentIncome170

Schedule D IRS990ScheduleD

Equipment Equipment

Schedule G IRS990ScheduleG

Events Information EventsInformation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Comments