PLEASANT VALLEY HOSPITAL AUXILIARY: Form 990EZ, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- PLEASANT VALLEY HOSPITAL AUXILIARY (EIN 23-7307666)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-06-21
- IRS object ID
- 202321729349200627
- Schema version
- 2021v4.1
- 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 | 2023-06-21T09:57:27-07:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 770467595 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Accu-Service | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3615 E Barca Street | AddressLine1Txt |
| City | Camarillo | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93010 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237307666 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pleasant Valley Hospital Auxiliary | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PLEA | BusinessNameControlTxt |
| Phone | 8053895800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2309 Antonio Avenue | AddressLine1Txt |
| City | Camarillo | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93010 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Walt Wood | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Signature | 2023-06-21 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Walt | PersonFirstNm |
| Person Last | Wood | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Tami Velasquez | PreparerPersonNm |
| PTIN | P00742167 | PTIN |
| Phone | 8054823669 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Federated Assurance Level | FAL1 | FederatedAssuranceLevelCd |
| 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 Other | Yes (X) | TypeOfOrganizationOtherInd |
| Gross Receipts | $142,209 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $2,494 | ContributionsGiftsGrantsEtcAmt |
| Membership Dues | $840 | MembershipDuesAmt |
| Cost Or Other Basis Expense Sale | $0 | CostOrOtherBasisExpenseSaleAmt |
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Special Events Direct Expenses | $0 | SpecialEventsDirectExpensesAmt |
| Gross Sales Of Inventory | $138,875 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $80,183 | CostOfGoodsSoldAmt |
| Gross Profit Loss Sls Of Invntry | $58,692 | GrossProfitLossSlsOfInvntryAmt |
| Total Revenue | $62,026 | TotalRevenueAmt |
| Grants And Similar Amounts Paid | $57,500 | GrantsAndSimilarAmountsPaidAmt |
| Total Expenses | $57,500 | TotalExpensesAmt |
| Excess Or Deficit For Year | $4,526 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $72,697 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $77,223 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,780 | BOYAmt |
| EOY | $50,598 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,917 | BOYAmt |
| EOY | $28,118 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,697 | BOYAmt |
| EOY | $78,716 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,493 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,697 | BOYAmt |
| EOY | $77,223 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | Gift shop and auxiliary proceeds are donated to St. John's Pleasant Valley Hospital, a non-profit 501(c)3 corp for purchase of medical equipment | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | Gift shop and auxiliary proceeds are donated to St. John's Pleasant Valley Hospital, a non-profit 501 (c)3 corp for purchase of medical equipment | DescriptionProgramSrvcAccomTxt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (6 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt |
|---|---|---|
| Mary Fish | ||
| President | 0 | $0 |
| Kathy Erlich | ||
| Vice President | 0 | $0 |
| Carla Scanzio | ||
| Vice President | 0 | $0 |
| Elaine Snyder | ||
| Secretary | 0 | $0 |
| Marty Wisneski | ||
| Secretary | 0 | $0 |
| Walt Wood | ||
| Treasurer | 0 | $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 |
| Tax Imposed Under IRC4911 | $0 | TaxImposedUnderIRC4911Amt |
| Tax Imposed Under IRC4912 | $0 | TaxImposedUnderIRC4912Amt |
| Tax Imposed Under IRC4955 | $0 | TaxImposedUnderIRC4955Amt |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| Tax Imposed On Organization Mgr | $0 | TaxImposedOnOrganizationMgrAmt |
| Tax Reimbursed By Organization | $0 | TaxReimbursedByOrganizationAmt |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Walt Wood | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2309 Antonio Avenue | AddressLine1Txt |
| City | Camarillo | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93010 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8053895800 | 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Grants and Similar Amounts Paid In Excess of $5,000.1 | | Donee's Name: St. John's PV Gift Shop | Donee's Address: 2309 Antonio Avenue Camarillo CA 93010 | Cash Amount Given: $57500 |
| Other Assets.1 | Inventory - Beginning $21917 Inventory - Ending $28118 |
| Total Liabilities.1 | Sales Tax - Beginning $0 Sales Tax - Ending $1493 |