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NIZHONI SMILES INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
NIZHONI SMILES INC (EIN 85-0397883)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-06-26
IRS object ID
202331779349301378
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

FieldValueIRS element (for citing)
Return2023-06-26T20:29:22-07:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN850339983PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ROBERTSON ACCOUNTINGBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1840 RIO HONDO RD NEAddressLine1Txt
CityRIO RANCHOCityNm
State AbbreviationNMStateAbbreviationCd
ZIP87144ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN850397883EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Nizhoni Smiles IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlNIZHBusinessNameControlTxt
Phone5053685626PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 3449AddressLine1Txt
CityShiprockCityNm
State AbbreviationNMStateAbbreviationCd
ZIP87420ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDarlene SorrellPersonNm
Person TitlePresidentPersonTitleTxt
Phone5053685626PhoneNum
Signature2023-05-26SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstDarlenePersonFirstNm
Person LastSorrellPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (true)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJaclynn R RobertsonPreparerPersonNm
PTINP01480171PTIN
Phone5058914282PhoneNum
Preparation2023-06-26PreparationDt
Self EmployedYes (X)SelfEmployedInd

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
Federated Assurance LevelFAL1FederatedAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDr Mike BeckPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 3449AddressLine1Txt
CityShiprockCityNm
State AbbreviationNMStateAbbreviationCd
ZIP87420ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$227,046GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressNIZHONISMILES.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1992FormationYr
Legal Domicile StateNMLegalDomicileStateCd
Activity Or MissionTo provide dental and orthodontic services to individuals living on the Navajo reservation and in the community.ActivityOrMissionDesc
Voting Members Governing Body4VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee21TotalEmployeeCnt
Total Volunteers1TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
CY Contributions Grants$5,170CYContributionsGrantsAmt
PY Program Service Revenue$444,441PYProgramServiceRevenueAmt
CY Program Service Revenue$221,778CYProgramServiceRevenueAmt
PY Investment Income$7PYInvestmentIncomeAmt
CY Investment Income$98CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$444,448PYTotalRevenueAmt
CY Total Revenue$227,046CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$224,231PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$198,941CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$365,260PYOtherExpensesAmt
CY Other Expenses$295,438CYOtherExpensesAmt
PY Total Expenses$589,491PYTotalExpensesAmt
CY Total Expenses$494,379CYTotalExpensesAmt
PY Revenues Less Expenses-$145,043PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$267,333CYRevenuesLessExpensesAmt
Total Assets BOY$1,270,702TotalAssetsBOYAmt
Total Assets EOY$1,158,681TotalAssetsEOYAmt
Total Liabilities BOY$423,842TotalLiabilitiesBOYAmt
Total Liabilities EOY$560,145TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$846,860NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$598,536NetAssetsOrFundBalancesEOYAmt
MissionTo provide dental and orthodontic services to individuals living on the Navajo reservation and in the community.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$336,315ExpenseAmt
Grant$0GrantAmt
Revenue$221,778RevenueAmt
DescOrthodontic and dental services provided to individuals living on the Navajo Reservation and in the community in NW New Mexico and NE Arizona.Desc
Total Program Service Expenses$336,315TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingYes (true)LoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document5IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee21EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members4GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldNMStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Nizhoni Smiles IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5053685626PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1US Hwy 491 NAddressLine1Txt
CityShiprockCityNm
State AbbreviationNMStateAbbreviationCd
ZIP87420ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (5 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Dr Michael Beck
Board Member1.00Yes (X)Yes (X)$0$0$0
Dr DezBah Damon-Mallette
Board Member1.00Yes (X)$0$0$0
Dr Darlene Sorrell
President4.00Yes (X)Yes (X)$18,010$0$0
Felix Martinez
Board Member1.00Yes (X)$0$0$0
Mary Altenberg
Secretary1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$18,010TotalReportableCompFromOrgAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$5,170AllOtherContributionsAmt
Total Contributions$5,170TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
Revenue Ortho-Dental Services621110$135,069$0$0
Revenue Products & Services621110$86,709$0$0
FieldValueIRS element (for citing)
Total Program Service Revenue$221,778TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$98TotalRevenueColumnAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$227,046TotalRevenueColumnAmt
Related Or Exempt Func Income$221,876RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$18,010TotalAmt
Program Services$18,010ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$166,208TotalAmt
Program Services$84,345ProgramServicesAmt
Management And General$81,863ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$14,723TotalAmt
Program Services$7,472ProgramServicesAmt
Management And General$7,251ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$31,105TotalAmt
Program Services$0ProgramServicesAmt
Management And General$31,105ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$106,236TotalAmt
Program Services$106,236ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,475TotalAmt
Program Services$1,475ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$60,614TotalAmt
Program Services$26,867ProgramServicesAmt
Management And General$33,747ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$24,309TotalAmt
Program Services$22,364ProgramServicesAmt
Management And General$1,945ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$2,409TotalAmt
Program Services$2,409ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$31,212TotalAmt
Program Services$31,212ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$22,262TotalAmt
Program Services$20,481ProgramServicesAmt
Management And General$1,781ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Laboratory$7,783$7,783$0$0
Land Lease$271$271$0$0
Licenses, Dues & Fees$440$440$0$0
CC Comm Disc Charges$6,950$6,950$0$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$372TotalAmt
Program Services$0ProgramServicesAmt
Management And General$372ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$494,379TotalAmt
Program Services$336,315ProgramServicesAmt
Management And General$158,064ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$22,924BOYAmt
EOY$4,878EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$52,327BOYAmt
EOY$95,764EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$368,935BOYAmt
EOY$265,784EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$14,022BOYAmt
EOY$10,483EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$5,807BOYAmt
EOY$5,297EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,508,978LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,732,503LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$806,687BOYAmt
EOY$776,475EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,270,702BOYAmt
EOY$1,158,681EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$56,760BOYAmt
EOY$50,368EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$365,000BOYAmt
EOY$365,000EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
EOY$141,885EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,082BOYAmt
EOY$2,892EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$423,842BOYAmt
EOY$560,145EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$846,860BOYAmt
EOY$598,536EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$846,860BOYAmt
EOY$598,536EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,270,702BOYAmt
EOY$1,158,681EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$267,333ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind
Other Support Sum$0OtherSupportSumAmt
Public Support CY1700PublicSupportCY170Pct

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$51,609CurrentTaxYearMinus1YearAmt
Current Tax Year$5,170CurrentTaxYearAmt
Total$56,779TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$853,664CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$694,585CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$671,642CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$392,832CurrentTaxYearMinus1YearAmt
Current Tax Year$221,778CurrentTaxYearAmt
Total$2,834,501TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$853,664CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$694,585CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$671,642CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$444,441CurrentTaxYearMinus1YearAmt
Current Tax Year$226,948CurrentTaxYearAmt
Total$2,891,280TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$2,891,280PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$27CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$32CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$7CurrentTaxYearMinus1YearAmt
Current Tax Year$98CurrentTaxYearAmt
Total$164TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$27CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$32CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$7CurrentTaxYearMinus1YearAmt
Current Tax Year$98CurrentTaxYearAmt
Total$164TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Total$2,891,444TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99990PublicSupportCY509Pct
Public Support PY5091.00000PublicSupportPY509Pct
Investment Income CY0.00010InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Book Value$0BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$1,222,158OtherCostOrOtherBasisAmt
Depreciation$662,824DepreciationAmt
Book Value$559,334BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$104,899OtherCostOrOtherBasisAmt
Depreciation$98,950DepreciationAmt
Book Value$5,949BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$1,178,080OtherCostOrOtherBasisAmt
Depreciation$966,888DepreciationAmt
Book Value$211,192BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$3,841OtherCostOrOtherBasisAmt
Depreciation$3,841DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$776,475TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Paycheck Protection Program Loan$0
Payroll Tax Liabilities$2,892
FieldValueIRS element (for citing)
Total Liability$2,892TotalLiabilityAmt

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (5 entries)

Relationship With OrgRelationshipWithOrgTxtLoan PurposeLoanPurposeTxtLoan To OrganizationLoanToOrganizationIndOriginal PrincipalOriginalPrincipalAmtBalance DueBalanceDueAmtDefaultDefaultIndBoard Or Committee ApprovalBoardOrCommitteeApprovalIndWritten AgreementWrittenAgreementInd
Michael Beck
OfficerTemporaryYes (X)$30,000$0falseYes (true)Yes (true)
Michael Beck
OfficerTemporaryYes (X)$86,117$0falseYes (true)Yes (true)
James Tutt
OfficerInstallmentYes (X)$4,000$0falseYes (true)Yes (true)
James Tutt
OfficerInstallmentYes (X)$2,500$0falseYes (true)Yes (true)
Michael Beck
OfficerInstallmentYes (X)$365,000$365,000falseYes (true)Yes (true)
FieldValueIRS element (for citing)
Total Balance Due$365,000TotalBalanceDueAmt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part II, (1)Michael Beck, Officer, Temporary Working Capital Advance
Part II, (2)Michael Beck, Officer, Temporary Working Capital Advance
Part II, (3)James Tutt, Officer, Installment Loan on Working Capital
Part II, (4)James Tutt, Officer, Installment Loan on Working Capital
Part II, (5)Michael Beck, Officer, Installment Loan on Working Capital

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Pt VI, Line 11bForm 990 is presented to the Board of Directors for review, comment, and approaval at their regular board meetings.
Pt VI, Line 12cConflict of interest disclosure statements are prepared by officers, directors, and key employees annually.
Pt VI, Line 15aCompensation for all key employees is based on annual perforance evaluations reviewed and approved by the Board of Directors. No officers or directors receive compensation through payroll.
Pt VI, Line 15bCompensation for all top management employees is based on annual performance evaluations and approved by the Board of Directors.
Pt VI, Line 19Organization maintains all records at it's Shiprock office which are available for public review.
OtherPart IX, Line 11(g) Professional dental services and orthodonic services contracted