PUBLIC HEALTH FOUNDATION OF NORTHWEST ILLINOIS INC: Form 990EZ, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- PUBLIC HEALTH FOUNDATION OF NORTHWEST ILLINOIS INC (EIN 11-3676983)
- Tax period
- 2021-12-01 to 2022-11-30
- Filed
- 2023-04-20
- IRS object ID
- 202321109349200237
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-04-20T11:53:39-05:00 | ReturnTs |
| Tax Period End | 2022-11-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 363168081 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SIKICH LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1415 W DIEHL RD SUITE 400 | AddressLine1Txt |
| City | NAPERVILLE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 605632349 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2021-12-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 113676983 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PUBLIC HEALTH FOUNDATION OF NORTHWEST IL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PUBL | BusinessNameControlTxt |
| Phone | 8152358353 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10 WEST LINDEN ST | AddressLine1Txt |
| City | FREEPORT | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61032 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CRAIG BEINTEMA | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 8152358353 | PhoneNum |
| Signature | 2023-04-19 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | CRAIG | PersonFirstNm |
| Person Last | BEINTEMA | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | HEATHER BONIFAS CPA | PreparerPersonNm |
| PTIN | P01711657 | PTIN |
| Phone | 6305668400 | PhoneNum |
| Preparation | 2023-04-18 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Website Address | N/A | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $149,560 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $149,541 | ContributionsGiftsGrantsEtcAmt |
| Investment Income | $19 | InvestmentIncomeAmt |
| Total Revenue | $149,560 | TotalRevenueAmt |
| Grants And Similar Amounts Paid | $202,493 | GrantsAndSimilarAmountsPaidAmt |
| Other Expenses Total | $3,899 | OtherExpensesTotalAmt |
| Total Expenses | $206,392 | TotalExpensesAmt |
| Excess Or Deficit For Year | -$56,832 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $78,188 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | $21,356 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82,010 | BOYAmt |
| EOY | $21,356 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,952 | BOYAmt |
| EOY | $0 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $135,962 | BOYAmt |
| EOY | $21,356 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,774 | BOYAmt |
| EOY | $0 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,188 | BOYAmt |
| EOY | $21,356 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Primary Exempt Purpose | THE ADVANCEMENT OF PUBLIC HEALTH AWARENESS AND TO SUPPORT THE PROVISION OF PUBLIC HEALTH SERVICES TO STEPHENSON COUNTY AND THE SURROUNDING COUNTIES IN NORTHWEST ILLINOIS. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp (3 entries)
| Description Program Srvc AccomDescriptionProgramSrvcAccomTxt | Grants And AllocationsGrantsAndAllocationsAmt | Program Service ExpensesProgramServiceExpensesAmt |
|---|---|---|
| SUPPORTED THE STEPHENSON COUNTY HEALTH DEPARTMENT DOULA AND UNITED WAY AND COMMUNITY FOUNDATION PROGRAMS. THE PROGRAMS PROVIDE ENHANCED EDUCATION AND SUPPORT TO PARENTS AND FAMILY BEFORE, DURING AND AFTER CHILDBIRTH. | $202,493 | $202,493 |
| PAID FOR THE COST OF MAMMOGRAM EXAMINATIONS FOR INCOME ELIGIBLE WOMEN. | $0 | $903 |
| FREEPORT COMMUNITY FOUNDATION AWARD AND OTHER WOMEN'S WELLNESS PROGRAMS | $0 | $956 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $204,352 | TotalProgramServiceExpensesAmt |
| Info In Schedule O Part IV | Yes (X) | InfoInScheduleOPartIVInd |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (12 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| LISA FLYNN | ||||
| DIRECTOR (START 6/30/22) | 1.00 | $0 | $0 | $0 |
| KATHY BRENNER RN | ||||
| DIRECTOR | 1.00 | $0 | $0 | $0 |
| ROBERT GELLER MD | ||||
| DIRECTOR | 1.00 | $0 | $0 | $0 |
| STEPHEN LAFFERTY | ||||
| DIRECTOR | 1.00 | $0 | $0 | $0 |
| LYNN MILLER | ||||
| DIRECTOR | 1.00 | $0 | $0 | $0 |
| CLARENCE PARKS MD | ||||
| DIRECTOR | 1.00 | $0 | $0 | $0 |
| DAN SCHEIDER | ||||
| DIRECTOR | 1.00 | $0 | $0 | $0 |
| SHEVAWN SVEHLA | ||||
| DIRECTOR | 1.00 | $0 | $0 | $0 |
| SCOTT HELMS | ||||
| DIRECTOR | 1.00 | $0 | $0 | $0 |
| MICHELLE FOLGATE | ||||
| DIRECTOR (START 6/30/22) | 1.00 | $0 | $0 | $0 |
| CINDY LOWER | ||||
| DIRECTOR (THRU 6/30/22) | 1.00 | $0 | $0 | $0 |
| CHAD REEDY DDS | ||||
| PRESIDENT | 1.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | 0 | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | 0 | OrganizationHadUBIInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Direct Indirect Pltcl Expend | $0 | DirectIndirectPltclExpendAmt |
| Made Loans To From Officers | 0 | MadeLoansToFromOfficersInd |
| Tax Imposed Under IRC4911 | $0 | TaxImposedUnderIRC4911Amt |
| Tax Imposed Under IRC4912 | $0 | TaxImposedUnderIRC4912Amt |
| Tax Imposed Under IRC4955 | $0 | TaxImposedUnderIRC4955Amt |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| Tax Imposed On Organization Mgr | $0 | TaxImposedOnOrganizationMgrAmt |
| Tax Reimbursed By Organization | $0 | TaxReimbursedByOrganizationAmt |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALICIA MCSHANE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10 WEST LINDEN ST | AddressLine1Txt |
| City | FREEPORT | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61032 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8152358353 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Donor Advised Fnds | 0 | DonorAdvisedFndsInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Tanning Services Provided | 0 | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| School Operating | 0 | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (1) | FiledScheduleAInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $559,588 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $144,543 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $182,840 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $282,722 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $149,541 | CurrentTaxYearAmt |
| Total | $1,319,234 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $500 | CurrentTaxYearMinus4YearsAmt |
| Total | $500 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $560,088 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $144,543 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $182,840 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $282,722 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $149,541 | CurrentTaxYearAmt |
| Total | $1,319,734 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $1,319,734 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $403 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $74 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $57 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $28 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $19 | CurrentTaxYearAmt |
| Total | $581 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $1,320,315 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $120 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99960 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99920 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990-EZ, PART I, LINE 4 - OTHER INVESTMENT INCOME | DESCRIPTION: INTEREST. AMOUNT: 19. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: . GRANTEE NAME: STEPHENSON COUNTY HEALTH DEPARTMENT. GRANTEE ADDRESS: 10 WEST LINDEN FREEPORT, IL 61032. PROPERTY DESCRIPTION: CASH. AMOUNT GIVEN: 202,493. |
| FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES | DESCRIPTION: FILING FEE. AMOUNT: 10. DESCRIPTION: PROFESSIONAL FEES. AMOUNT: 2,000. DESCRIPTION: CHARITY BUREAU FUND FEE. AMOUNT: 30. DESCRIPTION: OTHER WOMEN'S WELLNESS PROGRAMS. AMOUNT: 1,859. TOTAL TO FORM 990-EZ, LINE 16: 3,899. |
| FORM 990-EZ, PART II, LINE 24 - OTHER ASSETS | DESCRIPTION: ACCOUNTS RECEIVABLE. BEG. OF YEAR AMOUNT: 53,952. END OF YEAR AMOUNT: 0. |
| FORM 990-EZ, PART II, LINE 26 - OTHER LIABILITIES | DESCRIPTION: ACCOUNTS PAYABLE. BEG. OF YEAR AMOUNT: 57,774. END OF YEAR AMOUNT: 0. |
Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Declaration | THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT. | DeclarationDesc |