GREATER ATLANTA DENTAL FOUNDATION INC: Form 990EZ, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- GREATER ATLANTA DENTAL FOUNDATION INC (EIN 26-2647331)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-07-19
- IRS object ID
- 202202009349200830
- 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 | 2022-07-19T14:36:11-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 141567370 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NUGENT & HAEUSSLER PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 BRACKEN ROAD | AddressLine1Txt |
| City | MONTGOMERY | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12549 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 262647331 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREATER ATLANTA DENTAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GREA | BusinessNameControlTxt |
| Phone | 7706130932 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6134 POPLAR BLUFF CIR 101 | AddressLine1Txt |
| City | NORCROSS | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30092 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TARA MORRISON | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 7706130932 | PhoneNum |
| Signature | 2022-07-18 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | TARA | PersonFirstNm |
| Person Last | MORRISON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 888008888 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CHRISTOPHER MELLEY CPA | PreparerPersonNm |
| PTIN | P00122888 | PTIN |
| Phone | 8454571100 | PhoneNum |
| Preparation | 2022-07-18 | 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 | 2022-09-23 18:48:47Z | 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 | WWW.NDDS.ORG/GADF/INDEX.HTML | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $89,463 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $21,940 | ContributionsGiftsGrantsEtcAmt |
| Membership Dues | $5,238 | MembershipDuesAmt |
| Investment Income | $4,949 | InvestmentIncomeAmt |
| Fundraising Gross Income | $57,336 | FundraisingGrossIncomeAmt |
| Special Events Direct Expenses | $31,990 | SpecialEventsDirectExpensesAmt |
| Special Events Net Income Loss | $25,346 | SpecialEventsNetIncomeLossAmt |
| Total Revenue | $57,473 | TotalRevenueAmt |
| Grants And Similar Amounts Paid | $25,000 | GrantsAndSimilarAmountsPaidAmt |
| Fees And Other Pymt To Ind Cntrct | $3,032 | FeesAndOtherPymtToIndCntrctAmt |
| Other Expenses Total | $2,837 | OtherExpensesTotalAmt |
| Total Expenses | $30,869 | TotalExpensesAmt |
| Excess Or Deficit For Year | $26,604 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $282,799 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | $13,207 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | $322,610 | NetAssetsOrFundBalancesEOYAmt |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $282,799 | BOYAmt |
| EOY | $322,610 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $282,799 | BOYAmt |
| EOY | $322,610 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $282,799 | BOYAmt |
| EOY | $322,610 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | ENHANCE DENTAL CARE IN THE COMMUNITY | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | OPERATION OF A FREE/LOW COST DENTAL CLINIC THAT ENHANCES HEALTHCARE IN THE COMMUNITY | DescriptionProgramSrvcAccomTxt |
| Grants And Allocations | $25,000 | GrantsAndAllocationsAmt |
| Program Service Expenses | $0 | ProgramServiceExpensesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $0 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (8 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| BEN JERNIGAN JR MD | ||||
| PRESIDENT | 1.00 | $0 | $0 | $0 |
| SIDNEY TOURIAL DDS | ||||
| VICE PRESIDENT | 1.00 | $0 | $0 | $0 |
| TROY SCHILMAN DDS | ||||
| SECRETARY/TREASURER | 1.00 | $0 | $0 | $0 |
| HENRY BENSON DDS | ||||
| TRUSTEE | 1.00 | $0 | $0 | $0 |
| RYAN VAUGHN DMD | ||||
| TRUSTEE | 1.00 | $0 | $0 | $0 |
| THOMAS JAGOR DDS | ||||
| TRUSTEE | 1.00 | $0 | $0 | $0 |
| AMY KUCMICHEL DMD | ||||
| TRUSTEE | 1.00 | $0 | $0 | $0 |
| VICTOR VAN GREUNINGEN DMD | ||||
| TRUSTEE | 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 | GA | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TARA MORRISON | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6134 POPLAR BLUFF CIRCLE SUITE 101 | AddressLine1Txt |
| City | PEACHTREE CORNERS | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30092 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7706130932 | 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 | $37,448 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $36,157 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $30,548 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,938 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,940 | CurrentTaxYearAmt |
| Total | $139,031 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $37,448 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $36,157 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $30,548 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,938 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,940 | CurrentTaxYearAmt |
| Total | $139,031 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $139,031 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $607 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $741 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $808 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,644 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,949 | CurrentTaxYearAmt |
| Total | $8,749 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $147,780 | TotalSupportAmt |
| Public Support CY170 | 0.94080 | PublicSupportCY170Pct |
| Public Support PY170 | 0.97970 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GALA FOR SMILES | Event1Nm |
| Gross Receipts Event1 | $78,636 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $21,300 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $57,336 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $16,135 | RentFacilityCostsEvent1Amt |
| Entertainment Event1 | $11,122 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $4,733 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $78,636 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $21,300 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $57,336 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $16,135 | RentFcltyCostsTotalEventsAmt |
| Entertainment Total Events | $11,122 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $4,733 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $31,990 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $25,346 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990-EZ, PART I, LINE 4 - OTHER INVESTMENT INCOME | DESCRIPTION: CAPITAL GAIN DISTRIBUTIONS. AMOUNT: 1,693. DESCRIPTION: DIVIDEND INCOME. AMOUNT: 3,256. TOTAL INCLUDED ON FORM 990-EZ, LINE 4: 4,949. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: DENTAL SERVICES. GRANTEE NAME: BEN MASSELL DENTAL CLINIC. GRANTEE ADDRESS: 700 14TH ST NW ATLANTA, GA 30318. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 10/15/21. AMOUNT GIVEN: 5,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: DENTAL SERVICES. GRANTEE NAME: GOOD SAMARITAN OF GWINNETT. GRANTEE ADDRESS: 5949 BUFORD HWY NORCROSS, GA 30071. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 10/15/21. AMOUNT GIVEN: 5,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: DENTAL SERVICES. GRANTEE NAME: GREEN WARREN DENTAL CLINIC. GRANTEE ADDRESS: 810 PINE STREET GAINESVILLE, GA 30501. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 10/18/21. AMOUNT GIVEN: 5,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: DENTAL SERVICES. GRANTEE NAME: DDD FOUNDATION. GRANTEE ADDRESS: 3103 CLAIRMONT ROAD, SUITE C ATLANTA, GA 30329. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 11/01/21. AMOUNT GIVEN: 5,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: DENTAL SERVICES. GRANTEE NAME: GOOD SAMARITAN OF ATLANTA. GRANTEE ADDRESS: 1015 DONALD LEE HOLLOWELL PKWY ATLANTA, GA 30318. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 11/01/21. AMOUNT GIVEN: 5,000. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 25,000. |
| FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES | DESCRIPTION: OPERATIONS EXPENSE. AMOUNT: 2,782. DESCRIPTION: TRAVEL EXPENSE. AMOUNT: 55. TOTAL TO FORM 990-EZ, LINE 16: 2,837. |
| FORM 990-EZ, PART I, LINE 20 - OTHER CHANGES IN NET ASSETS | DESCRIPTION: CHANGE IN VALUE OF INVESTMENT PORTFOLIO. AMOUNT: 13,207. |
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 |