CHURCH HEALTH SERVICES INC: Form 990, tax year 2025

View the entire original 990 at ProPublica ↗

Organization
CHURCH HEALTH SERVICES INC (EIN 39-1759669)
Tax period
2025-01-01 to 2025-12-31
Filed
2026-08-20
IRS object ID
202622329349300537
Schema version
2025v4.2
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

FieldValueIRS element (for citing)
Return2026-08-20T10:49:40-05:00ReturnTs
Tax Period End2025-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN391742997PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1O'CONNOR WELLS & VANDER WERFF LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1111 E MAIN STREETAddressLine1Txt
CityWAUPUNCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53963ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2025-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391759669EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHURCH HEALTH SERVICES INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCHURBusinessNameControlTxt
Phone9208871766PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1115 N CENTER STREETAddressLine1Txt
CityBEAVER DAMCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53916ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARY VOGL-RAUSCHERPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone9208871766PhoneNum
Signature2026-08-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDIANE BANCROFT-DEYOUNGPreparerPersonNm
PTINP00195537PTIN
Phone9203249711PhoneNum
Preparation2026-08-10PreparationDt
Self EmployedYes (X)SelfEmployedInd
FieldValueIRS element (for citing)
Tax2025TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARY VOGL-RAUSCHERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1115 N CENTER STREETAddressLine1Txt
CityBEAVER DAMCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53916ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,004,311GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CHURCHCLINIC.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1993FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionCHURCH HEALTH SERVICES IS A FAITH BASED HEALTH CARE ORGANIZATION THAT CONDUCTS DENTAL AND MENTAL HEALTH CLINICS FOR THE POOR, UNINSURED OR UNDERINSURED.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee33TotalEmployeeCnt
Total Volunteers30TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$750,758PYContributionsGrantsAmt
CY Contributions Grants$534,037CYContributionsGrantsAmt
PY Program Service Revenue$461,662PYProgramServiceRevenueAmt
CY Program Service Revenue$470,268CYProgramServiceRevenueAmt
PY Investment Income$13PYInvestmentIncomeAmt
CY Investment Income$6CYInvestmentIncomeAmt
PY Other Revenue-$1,843PYOtherRevenueAmt
CY Other Revenue-$292CYOtherRevenueAmt
PY Total Revenue$1,210,590PYTotalRevenueAmt
CY Total Revenue$1,004,019CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,083,115PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$852,095CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$83,748CYTotalFundraisingExpenseAmt
PY Other Expenses$262,282PYOtherExpensesAmt
CY Other Expenses$261,809CYOtherExpensesAmt
PY Total Expenses$1,345,397PYTotalExpensesAmt
CY Total Expenses$1,113,904CYTotalExpensesAmt
PY Revenues Less Expenses-$134,807PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$109,885CYRevenuesLessExpensesAmt
Total Assets BOY$1,766,766TotalAssetsBOYAmt
Total Assets EOY$1,743,530TotalAssetsEOYAmt
Total Liabilities BOY$248,951TotalLiabilitiesBOYAmt
Total Liabilities EOY$304,990TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,517,815NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,438,540NetAssetsOrFundBalancesEOYAmt
MissionCHURCH HEALTH SERVICES IS A FAITH BASED HEALTH CARE ORGANIZATION THAT CONDUCTS DENTAL AND MENTAL HEALTH CLINICS FOR THE POOR, UNINSURED OR UNDERINSURED.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$787,908ExpenseAmt
Revenue$470,274RevenueAmt
DescCHURCH HEALTH SERVICES IS A FAITH BASED HEALTH CARE ORGANIZATION THAT CONDUCTS PRIMARY, DENTAL AND MENTAL HEALTH CLINICS FOR THE POOR, UNINSURED OR UNDERINSURED.Desc
Total Program Service Expenses$787,908TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document3IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee33EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc0RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MARY VOGL-RAUSCHERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9208871766PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1115 N CENTER STREETAddressLine1Txt
CityBEAVER DAMCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53916ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
THEA O'CONNOR
EXECUTIVE DIRECTOR (PRIOR)35.00Yes (X)$43,750$0$4,325
MARY VOGL RAUSCHER
EXECUTIVE DIRECTOR (CURRENT)35.00Yes (X)$25,625$0$0
RICK VANT HOFF
PRESIDENT/BOARD MEMBE1.00Yes (X)$0$0$0Yes (X)
RICH ZIEMAN
TREASURER/BOARD MEMBER1.00Yes (X)$0$0$0Yes (X)
JENNIFER CAMPBELL
SECRETARY/BOARD MEMBER1.00Yes (X)$0$0$0Yes (X)
DR CATHY NELSON
VICE PRESIDENT/BOARD MEMBER1.00Yes (X)$0$0$0Yes (X)
KAREN COLEY
BOARD MEMBER1.00Yes (X)$0$0$0
JOHN PRYME
BOARD MEMBER1.00Yes (X)$0$0$0
TYLER SCHULZ
BOARD MEMBER1.00Yes (X)$0$0$0
KAYLA EBERT
BOARD MEMBER1.00Yes (X)$0$0$0
DONNA PIVONKA
BOARD MEMBER1.00Yes (X)$0$0$0
MIKE AUGUSTSON
BOARD MEMBER1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$69,375TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$4,325TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$1,802FundraisingAmt
Government Grants$7,200GovernmentGrantsAmt
All Other Contributions$525,035AllOtherContributionsAmt
Total Contributions$534,037TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPROGRAM REVENUESDesc
Business624100BusinessCd
Total Revenue Column$470,268TotalRevenueColumnAmt
Related Or Exempt Func Income$470,268RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$470,268TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$6TotalRevenueColumnAmt
Related Or Exempt Func Income$6RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$1,802ContriRptFundraisingEventAmt
Fundraising Direct Expenses$292FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$292TotalRevenueColumnAmt
Exclusion-$292ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,004,019TotalRevenueColumnAmt
Related Or Exempt Func Income$470,274RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$292ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$69,375TotalAmt
Program Services$10,406ProgramServicesAmt
Management And General$34,688ManagementAndGeneralAmt
Fundraising$24,281FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$683,646TotalAmt
Program Services$593,828ProgramServicesAmt
Management And General$49,464ManagementAndGeneralAmt
Fundraising$40,354FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$15,573TotalAmt
Program Services$12,416ProgramServicesAmt
Management And General$1,558ManagementAndGeneralAmt
Fundraising$1,599FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$22,855TotalAmt
Program Services$10,841ProgramServicesAmt
Management And General$8,076ManagementAndGeneralAmt
Fundraising$3,938FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$60,646TotalAmt
Program Services$48,605ProgramServicesAmt
Management And General$6,865ManagementAndGeneralAmt
Fundraising$5,176FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$535TotalAmt
Management And General$535ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$11,335TotalAmt
Management And General$11,335ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$19,662TotalAmt
Program Services$7,219ProgramServicesAmt
Management And General$12,443ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$58,086TotalAmt
Program Services$29,043ProgramServicesAmt
Management And General$29,043ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$34,471TotalAmt
Program Services$10,245ProgramServicesAmt
Management And General$24,226ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,633TotalAmt
Management And General$1,633ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$2,821TotalAmt
Program Services$2,821ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$17,020TotalAmt
Program Services$8,510ProgramServicesAmt
Management And General$8,510ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$38,534TotalAmt
Program Services$20,094ProgramServicesAmt
Management And General$18,440ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$16,522TotalAmt
Management And General$16,522ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
CONTRACTED SERVICES$28,794$8,394$12,000$8,400
MEDICAL SUPPLIES/SERVIC$23,989$23,989
MISCELLANEOUS EXPENSE$6,327$1,497$4,830
PRINTING, PUBLICATIONS,$2,080$2,080

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,113,904TotalAmt
Program Services$787,908ProgramServicesAmt
Management And General$242,248ManagementAndGeneralAmt
Fundraising$83,748FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$65,419BOYAmt
EOY$48,807EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,007BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$17,800BOYAmt
EOY$6,800EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$48,590BOYAmt
EOY$77,288EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,664,460LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$390,985LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,312,009BOYAmt
EOY$1,273,475EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$319,941BOYAmt
EOY$337,160EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,766,766BOYAmt
EOY$1,743,530EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$38,951BOYAmt
EOY$6,151EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$160,000BOYAmt
EOY$298,839EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$50,000BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$248,951BOYAmt
EOY$304,990EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,517,815BOYAmt
EOY$1,438,540EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,517,815BOYAmt
EOY$1,438,540EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,766,766BOYAmt
EOY$1,743,530EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$109,885ReconcilationRevenueExpnssAmt
Donated Services And Use Fclts$309,842DonatedServicesAndUseFcltsAmt
Other Changes In Net Assets-$279,232OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$849,155CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,295,988CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,198,123CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,212,420CurrentTaxYearMinus1YearAmt
Current Tax Year$1,004,305CurrentTaxYearAmt
Total$5,559,991TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$849,155CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,295,988CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,198,123CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,212,420CurrentTaxYearMinus1YearAmt
Current Tax Year$1,004,305CurrentTaxYearAmt
Total$5,559,991TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$1,091,038SubstantialContributorsTotAmt
Public Support Total170$4,468,953PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$215CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$165CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$920CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13CurrentTaxYearMinus1YearAmt
Current Tax Year$6CurrentTaxYearAmt
Total$1,319TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,754CurrentTaxYearMinus3YearsAmt
Total$8,757TotalAmt
FieldValueIRS element (for citing)
Total Support$5,570,067TotalSupportAmt
Public Support CY1700.80230PublicSupportCY170Pct
Public Support PY1700.81280PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationLOSS ON SALE OF SECURITIES - GAIN ON SALE OF SECURITIES - 2021 AMOUNT: $ 3. 2022 AMOUNT: $ 8,754.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$319,941BeginningYearBalanceAmt
Contributions$600ContributionsAmt
Investment Earnings Or Losses$34,505InvestmentEarningsOrLossesAmt
Other Expenditures$13,991OtherExpendituresAmt
Administrative Expenses$3,895AdministrativeExpensesAmt
End Year Balance$337,160EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$308,398BeginningYearBalanceAmt
Contributions$1,500ContributionsAmt
Investment Earnings Or Losses$29,214InvestmentEarningsOrLossesAmt
Other Expenditures$15,387OtherExpendituresAmt
Administrative Expenses$3,784AdministrativeExpensesAmt
End Year Balance$319,941EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$595,727BeginningYearBalanceAmt
Investment Earnings Or Losses$66,458InvestmentEarningsOrLossesAmt
Other Expenditures$348,246OtherExpendituresAmt
Administrative Expenses$5,541AdministrativeExpensesAmt
End Year Balance$308,398EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$764,549BeginningYearBalanceAmt
Investment Earnings Or Losses-$125,997InvestmentEarningsOrLossesAmt
Other Expenditures$35,000OtherExpendituresAmt
Administrative Expenses$7,825AdministrativeExpensesAmt
End Year Balance$595,727EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$36,682BeginningYearBalanceAmt
Contributions$705,000ContributionsAmt
Investment Earnings Or Losses-$756InvestmentEarningsOrLossesAmt
Administrative Expenses$5,704AdministrativeExpensesAmt
End Year Balance$764,549EndYearBalanceAmt
FieldValueIRS element (for citing)
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$15,000InvestmentCostOrOtherBasisAmt
Book Value$15,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$1,510,098InvestmentCostOrOtherBasisAmt
Depreciation$251,623DepreciationAmt
Book Value$1,258,475BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$139,362InvestmentCostOrOtherBasisAmt
Depreciation$139,362DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,273,475TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescBENEFICIAL INTEREST IN FUNDS HELD BY COMMUNITY FOUNDATIONDesc
Book Value$337,160BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$337,160TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$1,344,763TotalRevEtcAuditedFinclStmtAmt
Donated Services And Use Fclts$309,842DonatedServicesAndUseFcltsAmt
Other Revenue$30,902OtherRevenueAmt
Revenue Not Reported$340,744RevenueNotReportedAmt
Revenue Subtotal$1,004,019RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$1,004,019TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,424,038TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$309,842DonatedServicesUseFcltsAmt
Other Expenses Included$292OtherExpensesIncludedAmt
Expenses Not Reported$310,134ExpensesNotReportedAmt
Expenses Subtotal$1,113,904ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$1,113,904TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE FUNDS ARE ESTABLISHED FOR THE THE PURPOSE OF SUPPORTING THE ORGANIZATION AS DEEMED NECESSARY ACCORDING TO THE SPENDING POLICY.
PART X, LINE 2:THE ORGANIZATION IS A NON-PROFIT CORPORATION THAT IS TAX-EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, EXCEPT TO THE EXTENT OF UNRELATED BUSINESS INCOME, IF ANY. THE ORGANIZATION HAD NO UNRELATED BUSINESS INCOME FOR THE YEARS ENDED DECEMBER 31, 2023 AND 2022. MANAGEMENT IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE THE ORGANIZATION'S TAX-EXEMPT STATUS. THE ORGANIZATION IS NOT AWARE OF ANY TAX POSITIONS IT HAS TAKEN THAT ARE SUBJECT TO A SIGNIFICANT DEGREE OF UNCERTAINTY.
PART XI, LINE 2D - OTHER ADJUSTMENTS:CHANGE IN BENEFICIAL INTEREST IN FUNDS HELD BY COMMUNITY FOUNDATION 30,610. SPECIAL EVENTS EXPENSE (NETTED IN REVENUE ON 990) 292.
PART XII, LINE 2D - OTHER ADJUSTMENTS:SPECIAL EVENTS EXPENSE (NETTED IN REVENUE ON 990) 292.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS REVIEWED AND SIGNED BY AN OFFICER AND EXECUTIVE DIRECTOR PRIOR TO ELECTONIC FILING. THE FORM 990 IS AVAILABLE FOR REVIEW BY ALL BOARD MEMBERS AT THE NEXT MEETING.
FORM 990, PART VI, SECTION C, LINE 19THE FINANCIAL DATA AND GOVERNING DOCUMENTS OF THE ORGANIZATION ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:DONATED SERVICES EXPENSE -309,842. CHANGE IN VALUE - BENEFICIAL INTEREST IN FUNDS HELD BY COMMUNITY FOUNDATION 30,610.

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