PACIFIC DENTAL SERVICES FOUNDATION: Form 990PF, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- PACIFIC DENTAL SERVICES FOUNDATION (EIN 45-5083789)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-15
- IRS object ID
- 202323199349108977
- 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
- Form 990-PF
- Schedule B
- Accounting Fees Schedule
- General Explanation Attachment
- Investments Corp Stock Schedule
- Legal Fees Schedule
- Other Assets Schedule
- Other Decreases Schedule
- Other Expenses Schedule
- Other Income Schedule2
- Other Liabilities Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-15T18:36:41-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 953001179 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WINDES INC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 87 | AddressLine1Txt |
| City | LONG BEACH | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 455083789 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PACIFIC DENTAL SERVICES FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PACI | BusinessNameControlTxt |
| Phone | 7148458757 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17000 RED HILL AVE | AddressLine1Txt |
| City | IRVINE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92614 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOANNA RODGERS | PersonNm |
| Person Title | VICE CHAIRMAN | PersonTitleTxt |
| Phone | 7148458757 | PhoneNum |
| Signature | 2023-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JOANNA | PersonFirstNm |
| Person Last | RODGERS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DONITA JOSEPH | PreparerPersonNm |
| PTIN | P00286656 | PTIN |
| Phone | 5624351191 | PhoneNum |
| Preparation | 2023-11-14 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| PF60 Month Term Sect507b1 B | Yes (X) | PF60MonthTermSect507b1BInd |
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $2,170,239 | FMVAssetsEOYAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rcvd Rev And Expnss | $1,317,372 | ContriRcvdRevAndExpnssAmt |
| Dividends Rev And Expnss | $2,000 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $2,000 | DividendsNetInvstIncmAmt |
| Dividends Adj Net Incm | $2,000 | DividendsAdjNetIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $452 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $452 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $452 | CapGainNetIncmNetInvstIncmAmt |
| Net ST Capital Gain Adj Net Incm | $0 | NetSTCapitalGainAdjNetIncmAmt |
| Other Income Rev And Expnss | $451,891 | OtherIncomeRevAndExpnssAmt |
| Other Income Net Invst Incm | $0 | OtherIncomeNetInvstIncmAmt |
| Other Income Adj Net Incm | $451,891 | OtherIncomeAdjNetIncmAmt |
| Total Rev And Expnss | $1,771,715 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $2,452 | TotalNetInvstIncmAmt |
| Total Adj Net Incm | $453,891 | TotalAdjNetIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $185,000 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $0 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Adj Net Incm | $114,154 | CompOfcrDirTrstAdjNetIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $70,846 | CompOfcrDirTrstDsbrsChrtblAmt |
| Oth Empl Slrs Wgs Rev And Expnss | $435,765 | OthEmplSlrsWgsRevAndExpnssAmt |
| Oth Empl Slrs Wgs Net Invst Incm | $0 | OthEmplSlrsWgsNetInvstIncmAmt |
| Oth Empl Slrs Wgs Adj Net Incm | $268,889 | OthEmplSlrsWgsAdjNetIncmAmt |
| Oth Empl Slrs Wgs Dsbrs Chrtbl | $166,876 | OthEmplSlrsWgsDsbrsChrtblAmt |
| Pension Empl Bnft Rev And Expnss | $15,725 | PensionEmplBnftRevAndExpnssAmt |
| Pension Empl Bnft Net Invst Incm | $0 | PensionEmplBnftNetInvstIncmAmt |
| Pension Empl Bnft Adj Net Incm | $9,848 | PensionEmplBnftAdjNetIncmAmt |
| Pension Empl Bnft Dsbrs Chrtbl | $5,478 | PensionEmplBnftDsbrsChrtblAmt |
| Legal Fees Rev And Expnss | $20,725 | LegalFeesRevAndExpnssAmt |
| Legal Fees Net Invst Incm | $0 | LegalFeesNetInvstIncmAmt |
| Legal Fees Adj Net Incm | $5,755 | LegalFeesAdjNetIncmAmt |
| Legal Fees Dsbrs Chrtbl | $14,970 | LegalFeesDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $8,000 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $0 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $2,222 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $5,778 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Rev And Expnss | $11,102 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $58 | OtherProfFeesNetInvstIncmAmt |
| Other Prof Fees Adj Net Incm | $3,067 | OtherProfFeesAdjNetIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $7,977 | OtherProfFeesDsbrsChrtblAmt |
| Taxes Rev And Expnss | $50,305 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $209 | TaxesNetInvstIncmAmt |
| Taxes Adj Net Incm | $30,685 | TaxesAdjNetIncmAmt |
| Taxes Dsbrs Chrtbl | $17,068 | TaxesDsbrsChrtblAmt |
| Deprec And Dpltn Rev And Expnss | $90,331 | DeprecAndDpltnRevAndExpnssAmt |
| Deprec And Dpltn Net Invst Incm | $0 | DeprecAndDpltnNetInvstIncmAmt |
| Deprec And Dpltn Adj Net Incm | $90,190 | DeprecAndDpltnAdjNetIncmAmt |
| Occupancy Rev And Expnss | $90,174 | OccupancyRevAndExpnssAmt |
| Occupancy Net Invst Incm | $0 | OccupancyNetInvstIncmAmt |
| Occupancy Adj Net Incm | $90,174 | OccupancyAdjNetIncmAmt |
| Occupancy Dsbrs Chrtbl | $0 | OccupancyDsbrsChrtblAmt |
| Trav Conf Meeting Rev And Expnss | $107,482 | TravConfMeetingRevAndExpnssAmt |
| Trav Conf Meeting Net Invst Incm | $0 | TravConfMeetingNetInvstIncmAmt |
| Trav Conf Meeting Adj Net Incm | $107,406 | TravConfMeetingAdjNetIncmAmt |
| Trav Conf Meeting Dsbrs Chrtbl | $76 | TravConfMeetingDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $237,333 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $0 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Adj Net Incm | $170,971 | OtherExpensesAdjNetIncmAmt |
| Other Expenses Dsbrs Chrtbl | $66,362 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $1,251,942 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $267 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $893,361 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $355,431 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $276,946 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $276,946 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $1,528,888 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $267 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $893,361 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $632,377 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $242,827 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $2,185 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $967,319 | CashBOYAmt |
| Cash EOY | $1,349,777 | CashEOYAmt |
| Cash EOYFMV | $1,349,777 | CashEOYFMVAmt |
| Acct Rcvbl | $122,890 | AcctRcvblAmt |
| Acct Rcvbl BOY | $138,404 | AcctRcvblBOYAmt |
| Acct Rcvbl EOY | $122,890 | AcctRcvblEOYAmt |
| Acct Rcvbl EOYFMV | $122,890 | AcctRcvblEOYFMVAmt |
| Rcvbl From Officers BOY | $19,459 | RcvblFromOfficersBOYAmt |
| Prepaid Expenses BOY | $27,087 | PrepaidExpensesBOYAmt |
| Prepaid Expenses EOY | $13,682 | PrepaidExpensesEOYAmt |
| Prepaid Expenses EOYFMV | $13,682 | PrepaidExpensesEOYFMVAmt |
| Corporate Stock BOY | $147,429 | CorporateStockBOYAmt |
| Corporate Stock EOY | $116,985 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $116,985 | CorporateStockEOYFMVAmt |
| Land Bldg Equip Cost Or Other Bss | $976,602 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $622,492 | LandBldgEquipAccumDeprecAmt |
| Land BOY | $442,477 | LandBOYAmt |
| Land EOY | $354,110 | LandEOYAmt |
| Land EOYFMV | $354,110 | LandEOYFMVAmt |
| Other Assets BOY | $1,051 | OtherAssetsBOYAmt |
| Other Assets EOY | $212,795 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $212,795 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $1,743,226 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,170,239 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $2,170,239 | TotalAssetsEOYFMVAmt |
| Accounts Payable BOY | $246,960 | AccountsPayableBOYAmt |
| Accounts Payable EOY | $115,724 | AccountsPayableEOYAmt |
| Loans From Officers EOY | $22,808 | LoansFromOfficersEOYAmt |
| Other Liabilities BOY | $0 | OtherLiabilitiesBOYAmt |
| Other Liabilities EOY | $325,245 | OtherLiabilitiesEOYAmt |
| Total Liabilities BOY | $246,960 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $463,777 | TotalLiabilitiesEOYAmt |
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
| No Donor Rstr Net Assests BOY | $1,466,912 | NoDonorRstrNetAssestsBOYAmt |
| No Donor Rstr Net Assests EOY | $1,706,462 | NoDonorRstrNetAssestsEOYAmt |
| Donor Rstr Net Assets BOY | $29,354 | DonorRstrNetAssetsBOYAmt |
| Donor Rstr Net Assets EOY | $0 | DonorRstrNetAssetsEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $1,496,266 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $1,706,462 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $1,743,226 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $2,170,239 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $1,496,266 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $242,827 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $1,739,093 | SubtotalAmt |
| Other Decreases | $32,631 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $1,706,462 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Property | CAPITAL GAINS DIVIDENDS | PropertyDesc |
| How Acquired | P | HowAcquiredCd |
| Gross Sales Price | $452 | GrossSalesPriceAmt |
| Gain Or Loss | $452 | GainOrLossAmt |
| Gains Minus Excess Or Losses | $452 | GainsMinusExcessOrLossesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $452 | CapitalGainNetIncomeAmt |
| Net Short Term Capital Gain Loss | $0 | NetShortTermCapitalGainLossAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $30 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $30 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $30 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $0 | EstimatedPlusOvpmtIncmTxAmt |
| Exempt Frgn Org Tax Wthld At Srce | $0 | ExemptFrgnOrgTaxWthldAtSrceAmt |
| Extsn Request Income Tax Paid | $0 | ExtsnRequestIncomeTaxPaidAmt |
| Backup Withholding Withheld | $0 | BackupWithholdingWithheldAmt |
| Total Payments And Credits | $0 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Tax Due | $30 | TaxDueAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | 0 | LegislativePoliticalActyInd |
| More Than100 Spent | 0 | MoreThan100SpentInd |
| Form1120 POL Filed | 0 | Form1120POLFiledInd |
| Section4955 Organization Tax | $0 | Section4955OrganizationTaxAmt |
| Section4955 Managers Tax | $0 | Section4955ManagersTaxAmt |
| Tax Reimbursed | $0 | TaxReimbursedAmt |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | 0 | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (1) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (1) | AtLeast5000InAssetsInd |
| Org Report Or Register State | CA | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (1) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | Yes (1) | PrivateOperatingFoundationInd |
| New Substantial Contributors | 0 | NewSubstantialContributorsInd |
| Own Controlled Entity | 0 | OwnControlledEntityInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (1) | ComplyWithPublicInspRqrInd |
| Website Address | PDSFOUNDATION.ORG | WebsiteAddressTxt |
| Individual With Books | JOANNA RODGERS | IndividualWithBooksNm |
| Phone | 7148458500 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17000 RED HILL AVE | AddressLine1Txt |
| City | IRVINE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92614 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | 0 | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | 0 | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | Yes (1) | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | 0 | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | Yes (1) | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | 0 | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | 0 | PaymentToGovernmentOfficialInd |
| Acts Fail To Qlfy As Exceptions | 0 | ActsFailToQlfyAsExceptionsInd |
| Uncorrected Prior Acts | 0 | UncorrectedPriorActsInd |
| Undistributed Income PY | 0 | UndistributedIncomePYInd |
| Business Holdings | 0 | BusinessHoldingsInd |
| Jeopardy Investments | 0 | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | 0 | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | 0 | InfluenceLegislationInd |
| Influence Election | 0 | InfluenceElectionInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Noncharitable Purpose | 0 | NoncharitablePurposeInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|---|---|---|---|
| STEPHEN THORNE | ||||||||
| 17000 RED HILL AVENUE | IRVINE | CA | 92614 | PRESIDENT | 1.00 | $0 | $0 | $0 |
| DR JACK DILLENBERG | ||||||||
| 17000 RED HILL AVENUE | IRVINE | CA | 92614 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| DR CAROLYN GHAZAL | ||||||||
| 17000 RED HILL AVENUE | IRVINE | CA | 92614 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| JOANNA RODGERS | ||||||||
| 17000 RED HILL AVENUE | IRVINE | CA | 92614 | VICE CHAIRMAN | 1.00 | $0 | $0 | $0 |
| MICHAEL LE | ||||||||
| 17000 RED HILL AVENUE | IRVINE | CA | 92614 | EXECUTIVE DIRECTOR | 60.00 | $185,000 | $366 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Hghst Pd Empl Or NONE | NONE | CompOfHghstPdEmplOrNONETxt |
| Other Employee Paid Over50k | 0 | OtherEmployeePaidOver50kCnt |
| Comp Of Hghst Pd Cntrct Or NONE | NONE | CompOfHghstPdCntrctOrNONETxt |
| Contractor Paid Over50k | 0 | ContractorPaidOver50kCnt |
Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | THE PDS FOUNDATION MOBILE DENTAL CLINIC SERVES CHALLENGED URBAN AREAS AND RURAL COMMUNITIES IN NEED. THE MOBILE DENTAL CLINIC ALSO PARTICIPATES IN MAJOR COMMUNITY HEALTHCARE EVENTS WITH PARTNERS TO PROVIDE FREE DENTAL CARE AND SPREAD ORAL HEALTH AWARENESS. | Description1Txt |
| Expenses1 | $7,534 | Expenses1Amt |
| Description2 | PACIFIC DENTAL SERVICES, LLC (PDS)-SUPPORTED DOCTORS AND TEAM MEMBERS SPEND A WEEK PROVIDING FREE DENTISTRY TO PEOPLE IN VILLAGES, CHURCHES, ORPHANAGES, AND HEALTH CLINICS. TO HELP ENACT LASTING CHANGE, THE FOUNDATION WORKS IN PARTNERSHIP WITH LOCAL MEDICAL COLLEGES TO PROVIDE CLINICAL TRAINING AND CRITICAL SUPPLIES AND EQUIPMENT TO LOCAL DENTAL PROFESSIONALS. | Description2Txt |
| Expenses2 | $188,688 | Expenses2Amt |
| Description3 | REALIZING THE IMPORTANCE OF CAREER DEVELOPMENT AND FINANCIAL STABILITY FOR DISADVANTAGED STUDENTS, THE SCHOLARSHIP PROGRAM WILL PROVIDE FINANCIAL ASSISTANCE TO STUDENTS SEEKING ECONOMIC INDEPENDENCE THROUGH EDUCATION, MENTORSHIP AND ON-THE-JOB TRAINING. AWARDS WILL BE GIVEN BASED ON APPLICATION EXCELLENCE, WRITTEN ESSAY, FORMAL INTERVIEW AND FINANCIAL NEED. | Description3Txt |
| Expenses3 | $277,046 | Expenses3Amt |
| Description4 | PROVIDING TRAINING TO DENTAL PROFESSIONALS AND ADVOCATING FOR THE SPECIAL NEEDS COMMUNITY. THE ARIZONA OFFICE IS A FIVE OPERATORY SENSORY INTEGRATED DENTAL OFFICE AND USES BEHAVIOR MANAGEMENT AND DESENSITIZATION TO PROVIDE INDIVIDUALIZED CARE TO PATIENTS OF ALL AGES. | Description4Txt |
| Expenses4 | $933,175 | Expenses4Amt |
Sum Of Program Related Invst SumOfProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $121,641 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $886,071 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $1,007,712 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $1,007,712 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $15,116 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $992,596 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $49,630 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sect4942j3j5 Fndtn And Frgn Org | Yes (X) | Sect4942j3j5FndtnAndFrgnOrgInd |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $632,377 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $632,377 | QualifyingDistributionsAmt |
Private Operating Foundations PrivateOperatingFoundationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Section4942j3 | Yes (X) | Section4942j3Ind |
Lessor Adj Net Incm Min Invst Ret LessorAdjNetIncmMinInvstRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $0 | CurrentYearAmt |
| Year1 | $0 | Year1Amt |
| Year2 | $0 | Year2Amt |
| Year3 | $0 | Year3Amt |
| Total | $0 | TotalAmt |
Pct85 Lessor Adj Incm Or Min Ret Pct85LessorAdjIncmOrMinRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $0 | CurrentYearAmt |
| Year1 | $0 | Year1Amt |
| Year2 | $0 | Year2Amt |
| Year3 | $0 | Year3Amt |
| Total | $0 | TotalAmt |
Qualifying Distributions QualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $632,377 | CurrentYearAmt |
| Year1 | $627,299 | Year1Amt |
| Year2 | $805,953 | Year2Amt |
| Year3 | $1,136,276 | Year3Amt |
| Total | $3,201,905 | TotalAmt |
Qualifying Distri Not Used Drt QualifyingDistriNotUsedDrtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $0 | CurrentYearAmt |
| Year1 | $0 | Year1Amt |
| Year2 | $0 | Year2Amt |
| Year3 | $0 | Year3Amt |
| Total | $0 | TotalAmt |
Qualifying Distri Made Drt QualifyingDistriMadeDrtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $632,377 | CurrentYearAmt |
| Year1 | $627,299 | Year1Amt |
| Year2 | $805,953 | Year2Amt |
| Year3 | $1,136,276 | Year3Amt |
| Total | $3,201,905 | TotalAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $2,170,239 | CurrentYearAmt |
| Year1 | $1,743,226 | Year1Amt |
| Year2 | $1,573,026 | Year2Amt |
| Year3 | $2,004,908 | Year3Amt |
| Total | $7,491,399 | TotalAmt |
Total Assets Sect4942j3 Bi TotalAssetsSect4942j3BiGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $2,170,239 | CurrentYearAmt |
| Year1 | $1,743,226 | Year1Amt |
| Year2 | $1,573,026 | Year2Amt |
| Year3 | $2,004,908 | Year3Amt |
| Total | $7,491,399 | TotalAmt |
Two Thirds Minimum Invst Ret TwoThirdsMinimumInvstRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $33,087 | CurrentYearAmt |
| Year1 | $31,330 | Year1Amt |
| Year2 | $33,153 | Year2Amt |
| Year3 | $30,059 | Year3Amt |
| Total | $127,629 | TotalAmt |
Total Support TotalSupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Public Support Type PublicSupportType
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Largest Support From EO LargestSupportFromEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Gross Investment Income GrossInvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributing Manager | STEPHEN THORNE | ContributingManagerNm |
| Contributing Manager | DR CAROLYN GHAZAL | ContributingManagerNm |
Application Submission Info ApplicationSubmissionInfoGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Person | JOANNA RODGERS | RecipientPersonNm |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17000 RED HILL AVENUE | AddressLine1Txt |
| City | IRVINE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92614 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Phone | 7148458500 | RecipientPhoneNum |
| Recipient Email Address | PDSFOUNDATION@PACDEN.COM | RecipientEmailAddressTxt |
| Form And Info And Materials | APPLICATIONS SHOULD BE SUBMITTED EITHER IN WRITTEN FORM (ON 8.5" X 11") OR BY EMAIL TO PDSFOUNDATION@PACDEN.COM. APPLICATIONS SHOULD INCLUDE - 1) NAME, ADDRESS, TELEPHONE NUMBER AND WEB SITE OF REQUESTING ORGANIZATION. 2) COPY OF MOST RECENT TWO YEARS' INDEPENDENT AUDITORS' REPORT ON REQUESTING ORGANIZATION, IF AVAILABLE. 3) A DESCRIPTION OF CHARITABLE ACTIVITIES FOR WHICH GRANT IS REQUESTED, INCLUDING LOCATION. 4) PERSONS OR CAUSES BENEFITED BY THE ACTIVITIES. 5) AMOUNT AND DATE(S) OF REQUESTED GRANT(S). 6) INFORMATION ABOUT PRIOR CHARITABLE ACTIVITIES OF THE REQUESTING ORGANIZATION. 7) CONTACT INFORMATION (ADDRESS, PHONE # AND EMAIL) OF INDIVIDUAL SUBMITTING REQUEST. | FormAndInfoAndMaterialsTxt |
| Submission Deadlines | AT LEAST 6 MONTHS PRIOR TO REQUESTED DATE | SubmissionDeadlinesTxt |
| Restrictions On Awards | REQUESTED GRANTS AND AWARDS MUST BE CONSISTENT WITH THE FOUNDATION'S CHARITABLE PURPOSE | RestrictionsOnAwardsTxt |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (22 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|
| ARIZONA COLLEGE OF ALLIED HEALTH LLC | ||||||
| 163 N DOBSON RD | MESA | AZ | 85201 | GOV | SCHOLARSHIP | $5,000 |
| ATLANTIC TECHNICAL COLLEGE | ||||||
| 4700 COCONUT CREEK PKWY | COCONUT CREEK | FL | 33063 | GOV | SCHOLARSHIP | $7,435 |
| CARRINGTON COLLEGE | ||||||
| 8909 FOLSOM BLVD | SACRAMENTO | CA | 95826 | GOV | SCHOLARSHIP | $35,000 |
| CHATTAHOOCHEE TECHNICAL COLLEGE | ||||||
| 980 S COBB DR | MARIETTA | GA | 30060 | GOV | SCHOLARSHIP | $3,152 |
| CONCORDE CAREER COLLEGE | ||||||
| 12951 S EUCLID STREET SUITE 101 | GARDEN GROVE | CA | 92840 | GOV | SCHOLARSHIP | $95,538 |
| DAKOTA COUNTY TECHNICAL COLLEGE | ||||||
| 1300 145TH STREET EAST | ROSEMOUNT | MN | 55068 | GOV | SCHOLARSHIP | $5,000 |
| DELTA COLLEGE | ||||||
| 105 GAUSE BLVD WEST | SLIDELL | LA | 70460 | GOV | SCHOLARSHIP | $5,000 |
| ELITE DENTAL ASSISTING ACADEMY LLC | ||||||
| 2415 SE 165TH AVE 103 | VANCOUVER | WA | 98683 | GOV | SCHOLARSHIP | $5,000 |
| FLORIDA CAREER COLLEGE | ||||||
| 16485 LAGUNA CANYON RD SUITE 300 | IRVINE | CA | 92618 | GOV | SCHOLARSHIP | $10,000 |
| GWINNETT TECHNICAL COLLEGE | ||||||
| 5150 SUGARLOAF PKWY | LAWRENCEVILLE | GA | 30043 | GOV | SCHOLARSHIP | $5,000 |
| HENNEPIN TECHNICAL COLLEGE FOUNDATION | ||||||
| 9000 BROOKLYN BLVD | BROOKLYN PARK | MN | 55445 | GOV | SCHOLARSHIP | $10,000 |
| HIGH DESERT MEDICAL COLLEGE | ||||||
| 2000 24TH ST | BAKERSFIELD | CA | 93301 | GOV | SCHOLARSHIP | $5,000 |
| HOUSTON COMMUNITY COLLEGE FOUNDATION | ||||||
| MC 1148 3100 MAIN ST 12B12 | HOUSTON | TX | 77002 | GOV | SCHOLARSHIP | $2,821 |
| MT DIABLO ADULT EDUCATION | ||||||
| 321 GOLF CLUB ROAD | PLEASANT HILL | CA | 94523 | GOV | SCHOLARSHIP | $5,000 |
| PASADENA CITY COLLEGE FOUNDATION | ||||||
| 1570 E COLORADO BLVD | PASADENA | CA | 91106 | GOV | SCHOLARSHIP | $3,000 |
| PIMA MEDICAL INSTITUTE | ||||||
| 9709 3RD AVE NE SUITE 400 | SEATTLE | WA | 98155 | GOV | SCHOLARSHIP | $15,000 |
| PRACTICAL DENTAL ASSISTING OF VA BEACH LLC | ||||||
| 348 SOUTHPORT CIR 102 | VIRGINIA BEACH | VA | 23452 | GOV | SCHOLARSHIP | $10,000 |
| SOCIETY FOR DENTAL ASSISTING | ||||||
| 7000 RIVERS AVENUE | CHARLESTON | SC | 29406 | GOV | SCHOLARSHIP | $10,000 |
| SOUTHEASTERN TECHNICAL INSTITUTE | ||||||
| 250 FOUNDRY ST | SOUTH EASTON | MA | 02375 | GOV | SCHOLARSHIP | $10,000 |
| THE COLLEGE OF HEALTH CARE PROFESSIONS | ||||||
| 2550 NORTH LOOP WEST SUITE 300 | HOUSTON | TX | 77092 | GOV | SCHOLARSHIP | $5,000 |
| THE SCHOOL BOARD OF POLK COUNTY FL | ||||||
| 3225 WINTER LAKE ROAD | LAKLAND | FL | 33830 | GOV | SCHOLARSHIP | $5,000 |
| UEI COLLEGE | ||||||
| 16485 LAGUNA CANYON RD STE 300 | IRVINE | CA | 92618 | GOV | SCHOLARSHIP | $20,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $276,946 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $2,000 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $452 | ExclusionAmt |
Other Revenue Described OtherRevenueDescribedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT REVENUE | Desc |
| Related Or Exempt Function Incm | $451,891 | RelatedOrExemptFunctionIncmAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $2,452 | ExclusionAmt |
| Related Or Exempt Function Incm | $451,891 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $454,343 | TotalIncomeProducingActyAmt |
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Line Number | 11A | LineNumberTxt |
| Relationship Statement | PATIENT REVENUE IN CONNECTION WITH PROVIDING DENTAL CARE | RelationshipStatementTxt |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | 0 | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | 0 | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | 0 | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | 0 | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | 0 | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | 0 | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | 0 | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | 0 | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | 0 | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | 0 | RelationshipsNonchrtblEOInd |
Schedule B IRS990ScheduleB
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| General Rule | Yes (X) | GeneralRuleInd |
Contributor Information ContributorInformationGrp (15 entries)
| ContributorContributorNum | Address Line1ContributorUSAddress/AddressLine1Txt | CityContributorUSAddress/CityNm | State AbbreviationContributorUSAddress/StateAbbreviationCd | ZIPContributorUSAddress/ZIPCd | Total ContributionsTotalContributionsAmt | Person ContributionPersonContributionInd |
|---|---|---|---|---|---|---|
| BANK OF THE WEST | ||||||
| 1 | 2527 CAMINO RAMON | SAN RAMON | CA | 94583 | $5,000 | Yes (X) |
| CAROLYN G GHAZAL LIVING TRUST | ||||||
| 2 | 1231 MONTE VISTA DR | REDLANDS | CA | 92373 | $100,000 | Yes (X) |
| EPIC SYSTEMS CORPORATION | ||||||
| 3 | 1979 MILKY WAY | VERONA | WI | 53593 | $7,000 | Yes (X) |
| HENRY SCHEIN INC | ||||||
| 4 | 135 DURYEA RD | MELVILLE | NY | 11747 | $5,000 | Yes (X) |
| MEDUSIND SOLUTIONS INC | ||||||
| 5 | 7083 GRAND NATIONAL DRIVE SUITE 102 | ORLANDO | FL | 32819 | $5,000 | Yes (X) |
| THORNE FOUNDATION TRUST | ||||||
| 6 | 2460 PASEO VERDE PKWY STE 145 | HENDERSON | NV | 89074 | $100,000 | Yes (X) |
| PACIFIC DENTAL SERVICES LLC | ||||||
| 7 | 17000 RED HILL AVE | IRVINE | CA | 92614 | $115,000 | Yes (X) |
| YOUNG SYSTEMS CORPORATION | ||||||
| 8 | 13125 MIDWAY PLACE | CERRITOS | CA | 90703 | $5,000 | Yes (X) |
| AMERICAN ONLINE GIVING FOUNDATION | ||||||
| 9 | 40 EAST MAIN STREET SUITE 887 | NEWARK | DE | 19711 | $105,226 | Yes (X) |
| ISABEL SIMPSON | ||||||
| 10 | 8068 W VIA DEL SOL | PEORIA | AZ | 85383 | $5,000 | Yes (X) |
| JENNY THOMAS | ||||||
| 11 | 11921 W CASITAS DEL RIO CT | SURPRISE | AZ | 85383 | $5,000 | Yes (X) |
| SAMANTHA SIMON | ||||||
| 12 | 1611 W COLLEGE DR | CHEYENNE | WY | 82007 | $5,072 | Yes (X) |
| RITTU GILL | ||||||
| 13 | 4950 ALMOND COURT | RANCHO CUCAMONGA | CA | 91737 | $6,400 | Yes (X) |
| JOANNA RODGERS | ||||||
| 14 | 3404 DWYER LANE | FLOWER MOUND | TX | 75022 | $13,550 | Yes (X) |
| AMARDEEP GILL | ||||||
| 15 | 26 ARDEA PLACE | SACRAMENTO | CA | 95835 | $7,415 | Yes (X) |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | ACCOUNTING | CategoryTxt |
| Amt | $8,000 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $2,222 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $5,778 | DisbursementsCharitablePrpsAmt |
General Explanation Attachment GeneralExplanationAttachment
General Explanation GeneralExplanationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | RELATED PARTY TRANSACTIONS | IdentifierTxt |
| Form And Line Reference | FORM 990-PF, PART II, LINE 6 AND 22 | FormAndLineReferenceDesc |
| Medium Explanation | THE FOUNDATION AND PDS HAVE SHARED OFFICERS AND DIRECTORS. AT DECEMBER 31, 2022 AND 2021, THE FOUNDATION HAS ADVANCES DUE TO PDS TOTALING $22,808 AND ADVANCES DUE FROM PDS TOTALING $19,459, RESPECTIVELY. THE ADVANCES ARE DUE ON DEMAND AND CURRENTLY CARRY NO INTEREST. | MediumExplanationTxt |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Stock | MUTUAL FUNDS | StockNm |
| EOY Book Value | $116,985 | EOYBookValueAmt |
| EOYFMV | $116,985 | EOYFMVAmt |
Legal Fees Schedule LegalFeesSchedule
Legal Fees LegalFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | LEGAL | CategoryTxt |
| Legal Fees | $20,725 | LegalFeesAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $5,755 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $14,970 | DisbursementsCharitablePrpsAmt |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp (2 entries)
| DescDesc | BOY Book ValueBOYBookValueAmt | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| CONSTRUCTION IN PROGESS | $1,051 | $1,051 | $1,051 |
| LEASE ASSET | $211,744 | $211,744 |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases Detail OtherDecreasesDetail (2 entries)
| DescDesc | AmtAmt |
|---|---|
| UNREALIZED LOSS | $32,626 |
| BASIS ADJUSTMENT | $5 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (9 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|---|
| AUTOMOBILE EXPENSE | $24 | $0 | $24 | $0 |
| BANK CHARGES | $34,674 | $0 | $32,216 | $2,458 |
| SUPPLIES AND INSTRUMENTS | $51,163 | $0 | $50,765 | $398 |
| INSURANCE EXPENSE | $52,597 | $0 | $35,412 | $17,185 |
| OFFICE EXPENSE | $62,725 | $0 | $22,144 | $40,581 |
| ADVERTISING AND PROMOTIONS | $12,412 | $0 | $10,306 | $2,106 |
| MISCELLANEOUS | $18,116 | $0 | $15,015 | $3,101 |
| REPAIRS AND MAINTENANCE | $5,089 | $0 | $5,089 | $0 |
| TRAINING | $533 | $0 | $0 | $533 |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT REVENUE | Desc |
| Revenue And Expenses Per Books | $451,891 | RevenueAndExpensesPerBooksAmt |
| Adjusted Net Income | $451,891 | AdjustedNetIncomeAmt |
Other Liabilities Schedule OtherLiabilitiesSchedule
Other Liabilities Detail OtherLiabilitiesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OPERATING LEASE LIABILITY | Desc |
| BOY Book Value | $0 | BOYBookValueAmt |
| EOY Book Value | $325,245 | EOYBookValueAmt |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|---|
| CONSULTING | $11,044 | $0 | $3,067 | $7,977 |
| INVESTMENT FEES | $58 | $58 | $0 | $0 |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|---|
| PAYROLL TAX | $50,096 | $0 | $30,685 | $17,068 |
| FOREIGN TAXES | $209 | $209 | $0 | $0 |