LANE COUNTY MEDICAL SOCIETY FOUNDATION: Form 990EZ, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- LANE COUNTY MEDICAL SOCIETY FOUNDATION (EIN 32-0080103)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-05-22
- IRS object ID
- 202321429349201032
- Schema version
- 2022v5.0
- 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 | 2023-05-22T19:05:01-04:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 931274091 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHWEST TAX ASSOCIATES | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 EXECUTIVE PKWY STE 330 | AddressLine1Txt |
| City | EUGENE | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 974017121 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 320080103 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LANE COUNTY MEDICAL SOCIETY FDN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LANE | BusinessNameControlTxt |
| Phone | 5416860995 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 7192 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97475 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHONDRA HOLLIDAY | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 5415216069 | PhoneNum |
| Signature | 2023-05-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SHONDRA | PersonFirstNm |
| Person Last | HOLLIDAY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (true) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | PETER MAR EA LTC | PreparerPersonNm |
| PTIN | P00048891 | PTIN |
| Phone | 5416079200 | PhoneNum |
| Preparation | 2023-05-09 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| 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 | $85,210 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $75,931 | ContributionsGiftsGrantsEtcAmt |
| Investment Income | $9,279 | InvestmentIncomeAmt |
| Total Revenue | $85,210 | TotalRevenueAmt |
| Fees And Other Pymt To Ind Cntrct | $11,199 | FeesAndOtherPymtToIndCntrctAmt |
| Other Expenses Total | $60,388 | OtherExpensesTotalAmt |
| Total Expenses | $71,587 | TotalExpensesAmt |
| Excess Or Deficit For Year | $13,623 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $446,549 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | -$63,754 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | $396,418 | NetAssetsOrFundBalancesEOYAmt |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $446,549 | BOYAmt |
| EOY | $396,418 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $446,549 | BOYAmt |
| EOY | $396,418 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $446,549 | BOYAmt |
| EOY | $396,418 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Primary Exempt Purpose | THE LANE COUNTY MEDICAL SOCIETY FOUNDATION'S MISSION IS TO PROMOTE WELLNESS AND SECURITY FOR THE CITIZENS OF LANE COUNTY THROUGH PATIENT AND COMMUNITY EDUCATION, DIRECT SERVICE PROVISION AND PHYSICAL EDUCATION AND ORGANIZATION. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | TO PROMOTE PHYSICIAN WELLNESS AND SECURITY FOR THE PHYSICIAN COMMUNITY AND THE PATIENT COMMUNITY AT LARGE. | DescriptionProgramSrvcAccomTxt |
| Program Service Expenses | $44,112 | ProgramServiceExpensesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $44,112 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (13 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt |
|---|---|---|
| BENJAMIN VAZQUEZ MD | ||
| PRESIDENT | 3.00 | $0 |
| KEVIN MODESTE MD | ||
| PAST PRESIDE | 3.00 | $0 |
| LESLIE PELINKA | ||
| SECRETARY/VP | 3.00 | $0 |
| BRYAN MCVAY | ||
| TREASURER | 3.00 | $0 |
| CLAIRE MURPHY MD | ||
| TRUSTEE | 1.00 | $0 |
| LINDSEY FIX MD | ||
| TRUSTEE | 1.00 | $0 |
| EVA PRADHAM MD | ||
| TRUSTEE | 1.00 | $0 |
| WENDY FELDHOFF MD | ||
| TRUSTEE | 1.00 | $0 |
| RIE TAKAHASHI MD | ||
| TRUSTEE | 1.00 | $0 |
| CHRISTAL CROOKS MD | ||
| TRUSTEE | 1.00 | $0 |
| GULRUKH RIZVI MD | ||
| TRUSTEE | 1.00 | $0 |
| AMANDAJO SANDERS MD | ||
| TRUSTEE | 1.00 | $0 |
| SHONDRA HOLLIDAY | ||
| EXECUTIVE DI | 2.00 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | false | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | false | OrganizationHadUBIInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Form1120 Pol Filed | false | Form1120PolFiledInd |
| Made Loans To From Officers | false | MadeLoansToFromOfficersInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHONDRA HOLLIDAY | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 7192 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97475 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5416860995 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Foreign Office | false | ForeignOfficeInd |
| Donor Advised Fnds | false | DonorAdvisedFndsInd |
| Operate Hospital | false | OperateHospitalInd |
| Tanning Services Provided | false | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| School Operating | false | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (true) | 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 | $2,626 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,190 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $32,725 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $17,951 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $75,931 | CurrentTaxYearAmt |
| Total | $138,423 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,626 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,190 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $32,725 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $17,951 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $75,931 | CurrentTaxYearAmt |
| Total | $138,423 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $138,423 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,874 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,359 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,825 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,526 | CurrentTaxYearMinus1YearAmt |
| Total | $30,584 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $169,007 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $9,279 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.81900 | PublicSupportCY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990-EZ, PART I, LINE 16 | EXPENSES VETERANS LEGACY DONATION 9,611 OTHER DONATION 100 CONTRACT LABOR - FFF SURV 6,500 PHYSICIAN WELLNESS PROG 44,112 TAXES 65 TOTAL 60,388 |
| FORM 990-EZ, PART I, LINE 20 | UNREALIZED LOSS ON INVESTMENTS -63,754 |
| FORM 990-EZ, PART III | THE LANE COUNTY MEDICAL SOCIETY FOUNDATION'S MISSION IS TO PROMOTE WELLNESS AND SECURITY FOR THE CITIZENS OF LANE COUNTY THROUGH PATIENT AND COMMUNITY EDUCATION, DIRECT SERVICE PROVISION AND PHYSICAL EDUCATION AND ORGANIZATION. |