HANNIBAL FREE CLINIC INC: Form 990, tax year 2025
View the entire original 990 at ProPublica ↗
- Organization
- HANNIBAL FREE CLINIC INC (EIN 14-1979983)
- Tax period
- 2025-01-01 to 2025-12-31
- Filed
- 2026-05-05
- IRS object ID
- 202631259349303283
- Schema version
- 2025v4.1
- 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) |
|---|---|---|
| Return | 2026-05-05T17:10:40-05:00 | ReturnTs |
| Tax Period End | 2025-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 431498457 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WADE STABLES PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 796 | AddressLine1Txt |
| City | HANNIBAL | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 634010796 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2025-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 141979983 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HANNIBAL FREE CLINIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HANN | BusinessNameControlTxt |
| Phone | 5732488307 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 160 PROGRESS ROAD | AddressLine1Txt |
| City | HANNIBAL | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 634010175 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHARON WEBSTER | PersonNm |
| Person Title | DIRECTOR | PersonTitleTxt |
| Phone | 5732488307 | PhoneNum |
| Signature | 2026-04-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | PAUL RICHARDS | PreparerPersonNm |
| PTIN | P00133939 | PTIN |
| Phone | 5732215998 | PhoneNum |
| Preparation | 2026-04-29 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2025 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SHARON WEBSTER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 160 PROGRESS ROAD | AddressLine1Txt |
| City | HANNIBAL | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $113,227 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HANNIBALFREECLINIC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2005 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | LOCAL MISSION THAT OFFERS FREE, NON EMERGENT MEDICAL AND DENTAL CARE IN SIX COUNTIES IN NE MISSOURI | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $106,638 | PYContributionsGrantsAmt |
| CY Contributions Grants | $111,833 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,576 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,394 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$22,383 | PYOtherRevenueAmt |
| CY Other Revenue | -$9,247 | CYOtherRevenueAmt |
| PY Total Revenue | $85,831 | PYTotalRevenueAmt |
| CY Total Revenue | $103,980 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $98,926 | PYOtherExpensesAmt |
| CY Other Expenses | $97,676 | CYOtherExpensesAmt |
| PY Total Expenses | $98,926 | PYTotalExpensesAmt |
| CY Total Expenses | $97,676 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$13,095 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,304 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $243,529 | TotalAssetsBOYAmt |
| Total Assets EOY | $249,833 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $243,529 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $249,833 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROMOTE HEALTH AND WELLNESS BY PROVIDING QUALITY SERVICES, AT NO CHARGE, TO PEOPLE WITHOUT ACCESS TO BASIC CARE.THIS IS ACCOMPLISHED BY: RESPECTING THE DIGNITY OF EACH INDIVIDUAL WORKING COLLABORATIVELY WITH VOLUNTEERS FOSTERING COMMUNITY PARTNERSHIPS RESPONDING TO CURRENT HEALTH NEEDS OF THE COMMUNITY | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $84,632 | ExpenseAmt |
| Desc | LOCAL MISSION OFFERING FREE, NON-EMERGENT MEDICAL AND DENTAL CARE TO LOW INCOME ADULTS IN SIX COUNTIES IN NE MISSOURI. AND COORDINATES WITH OTHER LOCAL AGENCIES TO PROVIDE ACCESS TO OTHER UNMET NEEDS. | Desc |
| Total Program Service Expenses | $84,632 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | 0 | ConflictOfInterestPolicyInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5732488307 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 160 PROGRESS ROAD | AddressLine1Txt |
| City | HANNIBAL | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 634010175 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| EVAN CANFIELD | ||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| NORMAN ELLERBROCK | ||||||
| CHAIRMAN | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ADAM SAMARATONI | ||||||
| MEDICAL DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| BRYAN BARTZ | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CHRISTOPHER BIENIEK | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DANA BLASE | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| AARON CURREY | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MARK DOWIL | ||||||
| VICE CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DAWN MCKENZIE | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JOHN SHEFFER | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| SHELLY NELSON | ||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ERIN OTTEN | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ANNA LEMON | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CRAIG PARSONS | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| NATHAN MEYERS | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DONNELY JUNG | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| KAREN SUTOR | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $44,410 | FundraisingAmt |
| All Other Contributions | $67,423 | AllOtherContributionsAmt |
| Total Contributions | $111,833 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,394 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,394 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $44,410 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $9,247 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$9,247 | TotalRevenueColumnAmt |
| Exclusion | -$9,247 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $103,980 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,394 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$9,247 | ExclusionAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,123 | TotalAmt |
| Management And General | $2,123 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,028 | TotalAmt |
| Management And General | $10,028 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,830 | TotalAmt |
| Program Services | $8,830 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,030 | TotalAmt |
| Program Services | $6,030 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,361 | TotalAmt |
| Program Services | $2,361 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| CONTRACT LABOR | $45,704 | $45,704 |
| PHARMACY SUPPLIES | $8,353 | $8,353 |
| REPAIRS/MAINTENANCE | $7,885 | $7,885 |
| DENTAL SUPPLIES | $4,151 | $4,151 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,211 | TotalAmt |
| Program Services | $1,318 | ProgramServicesAmt |
| Management And General | $893 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,676 | TotalAmt |
| Program Services | $84,632 | ProgramServicesAmt |
| Management And General | $13,044 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $215,901 | BOYAmt |
| EOY | $228,235 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $64,444 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $42,846 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,628 | BOYAmt |
| EOY | $21,598 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $243,529 | BOYAmt |
| EOY | $249,833 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $243,529 | BOYAmt |
| EOY | $249,833 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $243,529 | BOYAmt |
| EOY | $249,833 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $243,529 | BOYAmt |
| EOY | $249,833 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $6,304 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $107,273 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $142,492 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $170,008 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $106,638 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $111,833 | CurrentTaxYearAmt |
| Total | $638,244 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $107,273 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $142,492 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $170,008 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $106,638 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $111,833 | CurrentTaxYearAmt |
| Total | $638,244 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $638,244 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $93 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $373 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,301 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,576 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,394 | CurrentTaxYearAmt |
| Total | $4,737 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $642,981 | TotalSupportAmt |
| Public Support CY170 | 0.99260 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99490 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $64,444 | OtherCostOrOtherBasisAmt |
| Depreciation | $42,846 | DepreciationAmt |
| Book Value | $21,598 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $21,598 | TotalBookValueLandBuildingsAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | EVENT TICKET SALES | Event1Nm |
| Gross Receipts Event1 | $44,410 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $44,410 | CharitableContriEvent1Amt |
| Other Direct Expenses Event1 | $9,247 | OtherDirectExpensesEvent1Amt |
| Other Events Total | 5 | OtherEventsTotalCnt |
| Gross Receipts Total | $44,410 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $44,410 | CharitableContributionsTotAmt |
| Oth Direct Expnss Total Events | $9,247 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $9,247 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$9,247 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 IS PROVIDED TO THE BOARD FOR THEIR REVIEW BEFORE ITS FILING IF TIME ALLOWS. OTHERWISE IT IS FILED BY A BOARD MEMBER AND IF THE BOARD REVIEW DISCOVERS A CHANGE IS NECESSARY, AN AMENDED FORM WILL BE FILED. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE FORM 990 IS AVAILABLE ON GUIDESTAR.ORG AND ALSO UPON REQUEST IN ADDITION TO THE FORM 1023. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABLE UPON REQUEST |
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