STRATEGY STUDIO / PUBLIC DATA EXPLORER

ADDICTION COUNSELOR CERTIFICATION BOARD OF OREGON: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
ADDICTION COUNSELOR CERTIFICATION BOARD OF OREGON (EIN 93-0795138)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-08-10
IRS object ID
202212229349301621
Schema version
2021v4.2
Note
A later return for the same period supersedes this one.
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)
Return2022-08-10T14:44:01-04:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line13rd Generation Accounting IncBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11804 NE 43rd AveAddressLine1Txt
CityPortlandCityNm
State AbbreviationORStateAbbreviationCd
ZIP97213ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN930795138EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ADDICTION COUNSELOR CERTIFICATION BOARD OF OREGONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlADDIBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12054 N VANCOUVERAddressLine1Txt
CityPortlandCityNm
State AbbreviationORStateAbbreviationCd
ZIP972171917ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARK DAVISPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone5032318164PhoneNum
Signature2022-08-10SignatureDt
Discuss With Paid PreparerfalseDiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMARKPersonFirstNm
Person LastDAVISPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSusan G RobertsonPreparerPersonNm
PTINP00774160PTIN
Phone5032827247PhoneNum
Preparation2022-08-10PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer0TrustedCustomerCd
OOB Security Verification11OOBSecurityVerificationCd
Authentication Assurance LevelAAL2AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARK DAVISPrincipalOfficerNm
Gross Receipts$1,495,217GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Type Of Organization AssocYes (X)TypeOfOrganizationAssocInd
Formation1977FormationYr
Legal Domicile StateORLegalDomicileStateCd
Activity Or MissionCERTIFICATION OF ADDICTION COUNSELORS FOR THE STATE OF OREGONActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee8TotalEmployeeCnt
Total Volunteers15TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$457,556PYContributionsGrantsAmt
CY Contributions Grants$398,476CYContributionsGrantsAmt
PY Program Service Revenue$589,953PYProgramServiceRevenueAmt
CY Program Service Revenue$985,873CYProgramServiceRevenueAmt
CY Investment Income$4CYInvestmentIncomeAmt
PY Other Revenue$97,670PYOtherRevenueAmt
CY Other Revenue$110,864CYOtherRevenueAmt
PY Total Revenue$1,145,179PYTotalRevenueAmt
CY Total Revenue$1,495,217CYTotalRevenueAmt
PY Grants And Similar Paid$10,500PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$10,000CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$413,283PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$453,122CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$725,697PYOtherExpensesAmt
CY Other Expenses$504,513CYOtherExpensesAmt
PY Total Expenses$1,149,480PYTotalExpensesAmt
CY Total Expenses$967,635CYTotalExpensesAmt
PY Revenues Less Expenses-$4,301PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$527,582CYRevenuesLessExpensesAmt
Total Assets BOY$321,849TotalAssetsBOYAmt
Total Assets EOY$1,075,604TotalAssetsEOYAmt
Total Liabilities BOY$1,768TotalLiabilitiesBOYAmt
Total Liabilities EOY$227,942TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$320,081NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$847,662NetAssetsOrFundBalancesEOYAmt
MissionCERTIFICATION OF ADDICTION COUNSELORS FOR THE STATE OF OREGONMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$962,573ExpenseAmt
Grant$10,000GrantAmt
Revenue$1,417,802RevenueAmt
DescCERTIFICATION OF ADDICITON COUNSELORS WITHIN THE STATE OF OREGON WITH SEMI ANNUAL EXAMINATIONS AND CERTIFICATE RENEWALSDesc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$5,062ExpenseAmt
DescTHE ASSOCIATION PUBLISHES A QUARTERLY NEWSLETTER THAT IS MAILED TO ALL THOSE CERTIFIED BY THE BOARDDesc
FieldValueIRS element (for citing)
Total Program Service Expenses$967,635TotalProgramServiceExpensesAmt
Described In Section501c3falseDescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
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 LiabilitiesfalseReportOtherLiabilitiesInd
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 OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntYes (true)BusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee8EmployeeCnt
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
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
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 PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldORStatesWhereCopyOfReturnIsFldCd
OtherYes (X)OtherInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMARK DAVISPersonNm
Phone5032318164PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12054 N VANCOUVERAddressLine1Txt
CityPortlandCityNm
State AbbreviationORStateAbbreviationCd
ZIP972171917ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeInd
TANYA PRITT
DIRECTOR0.000.00Yes (X)$0$0$0
AMY ASHTON-WILLIAMS
DIRECTOR0.000.00Yes (X)$0$0$0
BOB FORSYTH
DIRECTOR0.000.00Yes (X)$0$0$0
MARK LEWINSOHN
DIRECTOR0.000.00Yes (X)$0$0$0
BEAU RAPPAPORT
DIRECTOR0.000.00Yes (X)$0$0$0
RICARDO VERDEQUEZ
DIRECTOR0.000.00Yes (X)$0$0$0
LANA WINNIE
DIRECTOR0.000.00Yes (X)$0$0$0
FREDERICK STATEN
DIRECTOR0.000.00Yes (X)$0$0$0
KEITH WALKER
DIRECTOR0.000.00Yes (X)$0$0$0
JOSE GARCIA
DIRECTOR0.000.00Yes (X)$0$0$0
MICHAEL BRANDSMA
DIRECTOR0.000.00Yes (X)$0$0$0
MARK DAVIS
PRESIDENT2.000.00Yes (X)$0$0$0Yes (X)
JULIA MINES
TREASURER0.000.00Yes (X)$0$0$0Yes (X)
TONY VEZINA
SECRETARY0.000.00Yes (X)$0$0$0Yes (X)
DEBRA BUFFALO BO BIGELOW
VICE PRESIDENT0.000.00Yes (X)$0$0$0Yes (X)
MICHAEL RAVAZI
KEY EMPLOYEE40.000.00$0$0$0Yes (X)
VAN R BURNHAM
KEY EMPLOYEE40.000.00$0$0$0Yes (X)
ERIC MARTIN
KEY EMPLOYEE40.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$398,476GovernmentGrantsAmt
Total Contributions$398,476TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EXAM FEES541900$946,496$946,496
RECIPROCITY FEES541900$8,508$8,508
ACCREDITATION541900$1,369$1,369
RECOVERY HOUSING541900$29,500$29,500
FieldValueIRS element (for citing)
Total Program Service Revenue$985,873TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$4TotalRevenueColumnAmt
Related Or Exempt Func Income$4RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
MISCELLANEOUSS541900$25,774$25,774
LATINO CONFERENCE541900$500$500
PPP LOAN FORGIVENESS541900$77,415$77,415

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,175TotalRevenueColumnAmt
Related Or Exempt Func Income$7,175RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$110,864OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,495,217TotalRevenueColumnAmt
Related Or Exempt Func Income$1,019,326RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$77,415ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$10,000TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$379,868TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$10,376TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$27,769TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$35,109TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$1,304TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$60,762TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$32,795TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$11,991TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$37,236TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$2,915TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$26,863TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$254,924TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$11,788TotalAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
POSTAGE AND SHIPPING$5,012$5,012
EXAMINATION EXPENSE$58,005$58,005
MISCELLANEOUS$918$918

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$967,635TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$321,402BOYAmt
EOY$825,518EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$250,004EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$447BOYAmt
EOY$82EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$11,402LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$11,402LandBldgEquipAccumDeprecAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$321,849BOYAmt
EOY$1,075,604EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,768BOYAmt
EOY$10,933EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$217,009EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,768BOYAmt
EOY$227,942EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$320,081BOYAmt
EOY$847,662EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$320,081BOYAmt
EOY$847,662EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$321,849BOYAmt
EOY$1,075,604EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$527,582ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$1OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,402OtherCostOrOtherBasisAmt
Depreciation$11,402DepreciationAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedfalseGrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1WESTERN STATES CENTER DBA OREGON REBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11300 SE STARK ST SUITE 303AddressLine1Txt
CityPortlandCityNm
State AbbreviationORStateAbbreviationCd
ZIP97124ZIPCd
FieldValueIRS element (for citing)
Recipient EIN930952137RecipientEIN
IRC Section501C3IRCSectionDesc
Cash Grant$10,000CashGrantAmt
Purpose Of GrantTHE BETTERMENT OF THE ADDICTION FIELDPurposeOfGrantTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonMETROPLUS ASSOC OF ADDICTION PEER CPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionKEY EMPLOYEE OWNS 50RelationshipDescriptionTxt
Transaction$254,924TransactionAmt
TransactionPAYMENT FOR SERVICESTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Officer directors etc family relationship Part VI line 2ADDICTION COUNSELOR CERTIFICATION BOARD WORKS WITH METROPLUS ASSOCIATION OF ADDICITION PEER PROFESSIONALS WHICH ERIC MARTIN AND VAN BURNHAM, KEY EMPLOYEES ARE THE ONLY SHAREHOLDERS AND OFFICERS OF.
Form 990 governing body review Part VI line 11No review was or will be conducted.
Conflict of interest policy compliance Part VI line 12cEvery member of the board and key employees are required to fill out a conflict of interest form each year and disclose any conflicts of interest on this form.
Form 990 availability to public Part VI line 18No Documents available to the public.
Governing documents etc available to public Part VI line 19No documents available to the public.
Explanation of other changes in net assets or fund balances Part XI line 9An adjustment was made for -1 due rounding difference.