SAMARITAN HOUSE INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- SAMARITAN HOUSE INC (EIN 83-0378196)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2022-08-26
- IRS object ID
- 202222389349300307
- Schema version
- 2021v4.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-08-26T06:24:44-07:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 061681599 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MICHAEL A GRAY CPA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 944 | AddressLine1Txt |
| City | RUTHERFORDTON | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28139 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 830378196 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Samaritan House Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SAMA | BusinessNameControlTxt |
| Phone | 7043330110 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 611 Fortune St | AddressLine1Txt |
| City | Charlotte | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28205 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Eugene H Schlaman | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Phone | 7043330110 | PhoneNum |
| Signature | 2022-08-25 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Eugene | PersonFirstNm |
| Person Last | Schlaman | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Michael A Gray CPA | PreparerPersonNm |
| PTIN | P01083863 | PTIN |
| Phone | 8282878909 | PhoneNum |
| Preparation | 2022-08-26 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
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 |
| Federated Assurance Level | FAL1 | FederatedAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Samaritan House Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Eugene H Schlaman | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 611 Fortune St | AddressLine1Txt |
| City | Charlotte | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28205 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $291,236 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | Samaritan House provides a place where homeless inividuals can stay to recover from surgery or other illnesses. All homless individuals are referred to Samaritan house from any one of the Charlotte area hospitals | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 5 | TotalEmployeeCnt |
| Total Volunteers | 100 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $332,123 | PYContributionsGrantsAmt |
| CY Contributions Grants | $289,256 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $66 | PYInvestmentIncomeAmt |
| CY Investment Income | $72 | CYInvestmentIncomeAmt |
| PY Other Revenue | $40,334 | PYOtherRevenueAmt |
| CY Other Revenue | $1,908 | CYOtherRevenueAmt |
| PY Total Revenue | $372,523 | PYTotalRevenueAmt |
| CY Total Revenue | $291,236 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $208,524 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $187,499 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $16,971 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $102,681 | PYOtherExpensesAmt |
| CY Other Expenses | $116,386 | CYOtherExpensesAmt |
| PY Total Expenses | $311,205 | PYTotalExpensesAmt |
| CY Total Expenses | $303,885 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $61,318 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$12,649 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $344,323 | TotalAssetsBOYAmt |
| Total Assets EOY | $331,875 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $201 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $344,323 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $331,674 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Samaritan House provides a place where homeless inividuals can stay to recover from surgery or other illnesses. All homless individuals are referred to Samaritan house from any one of the Charlotte area hospitals | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $254,503 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $289,256 | RevenueAmt |
| Desc | For the year ending June 30,2022 Samaritan House provided 2637 guest days for homeless individuals. | Desc |
| Total Program Service Expenses | $254,503 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 5 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | false | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicyInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Eugene H Schlaman | PersonNm |
| Phone | 7045966870 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3204 Haicott LN | AddressLine1Txt |
| City | Charlotte | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28269 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Key EmployeeKeyEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|---|
| Rodney Tucker | ||||||||
| Executive Director | 50.00 | Yes (X) | $25,013 | $0 | $0 | |||
| Brad Goforth | ||||||||
| Executive Director-Retired | 50.00 | Yes (X) | $28,333 | $0 | $0 | Yes (X) | ||
| David Tipple | ||||||||
| President/Bd Member | 10.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| Dion Beary | ||||||||
| Vice President/Board Member | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| Mary Fluke | ||||||||
| Secretary/Bd Member | 6.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| Eugene Schlaman | ||||||||
| Treasure/Bd Member | 8.00 | $0 | $0 | $0 | Yes (X) | |||
| Christine DeLia | ||||||||
| Board Member | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| Laura Frohboese | ||||||||
| Board Member | 3.00 | $0 | $0 | $0 | Yes (X) | |||
| Katherine Caswell | ||||||||
| Temporary Executive Director | 50.00 | Yes (X) | $24,000 | $0 | $0 | Yes (X) | ||
| Antranique Neblett | ||||||||
| Board Member | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| Trevor Salzman | ||||||||
| Board Member | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| Barbara Yow | ||||||||
| Board Member | 4.00 | $0 | $0 | $0 | Yes (X) | |||
| Debra Rondeau | ||||||||
| Board Member | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $77,346 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| All Other Contributions | $289,256 | AllOtherContributionsAmt |
| Total Contributions | $289,256 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $72 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,908 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,908 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,908 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $291,236 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,980 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,346 | TotalAmt |
| Program Services | $54,142 | ProgramServicesAmt |
| Management And General | $15,469 | ManagementAndGeneralAmt |
| Fundraising | $7,735 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,397 | TotalAmt |
| Program Services | $88,727 | ProgramServicesAmt |
| Management And General | $3,269 | ManagementAndGeneralAmt |
| Fundraising | $1,401 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,694 | TotalAmt |
| Program Services | $2,586 | ProgramServicesAmt |
| Management And General | $739 | ManagementAndGeneralAmt |
| Fundraising | $369 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,062 | TotalAmt |
| Program Services | $11,287 | ProgramServicesAmt |
| Management And General | $1,183 | ManagementAndGeneralAmt |
| Fundraising | $592 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,250 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $8,250 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,729 | TotalAmt |
| Program Services | $4,010 | ProgramServicesAmt |
| Management And General | $1,334 | ManagementAndGeneralAmt |
| Fundraising | $385 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $515 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $515 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,175 | TotalAmt |
| Program Services | $10,175 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,809 | TotalAmt |
| Program Services | $11,809 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | See Attached | Desc |
| Total | $79,908 | TotalAmt |
| Program Services | $71,767 | ProgramServicesAmt |
| Management And General | $1,652 | ManagementAndGeneralAmt |
| Fundraising | $6,489 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $303,885 | TotalAmt |
| Program Services | $254,503 | ProgramServicesAmt |
| Management And General | $32,411 | ManagementAndGeneralAmt |
| Fundraising | $16,971 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,076 | BOYAmt |
| EOY | $89,077 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,670 | BOYAmt |
| EOY | $33,343 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $284,944 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $75,542 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $219,577 | BOYAmt |
| EOY | $209,402 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $53 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $344,323 | BOYAmt |
| EOY | $331,875 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $201 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $201 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $344,323 | BOYAmt |
| EOY | $331,674 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $344,323 | BOYAmt |
| EOY | $331,674 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $344,323 | BOYAmt |
| EOY | $331,875 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$12,649 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | Yes (true) | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
| Other Support Sum | $0 | OtherSupportSumAmt |
| Public Support CY170 | 0 | PublicSupportCY170Pct |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $229,345 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $267,641 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $221,147 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $332,083 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $289,256 | CurrentTaxYearAmt |
| Total | $1,339,472 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $229,345 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $267,641 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $221,147 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $332,083 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $289,256 | CurrentTaxYearAmt |
| Total | $1,339,472 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,300 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,500 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,925 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,252 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,373 | CurrentTaxYearAmt |
| Total | $16,350 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,300 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,500 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,925 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,252 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,373 | CurrentTaxYearAmt |
| Total | $16,350 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $1,323,122 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $218 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $358 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $284 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $66 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $72 | CurrentTaxYearAmt |
| Total | $998 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $218 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $358 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $284 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $66 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $72 | CurrentTaxYearAmt |
| Total | $998 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $815 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $710 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,515 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $40,334 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,908 | CurrentTaxYearAmt |
| Total | $48,282 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,388,752 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.95270 | PublicSupportCY509Pct |
| Public Support PY509 | 0.95100 | PublicSupportPY509Pct |
| Investment Income CY | 0.00070 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00080 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Pt III Ln 12 | FormAndLineReferenceDesc |
| Explanation | Other Income Part III, Line 12 Description: Refunds 2017: 815. 2018: 710. 2019: 1680. 2020: 1234. 2021: 1908. Description: Fund Raising Event 2019: 2835. Description: PPP Loan Forgivness 2020: 39100. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $121,268 | InvestmentCostOrOtherBasisAmt |
| Book Value | $121,268 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $131,305 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $60,000 | DepreciationAmt |
| Book Value | $71,305 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $7,758 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $7,758 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $24,613 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $7,784 | DepreciationAmt |
| Book Value | $16,829 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $209,402 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $291,236 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $291,236 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $291,236 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $303,885 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $303,885 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $303,885 | TotalExpensesPerForm990Amt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI, Line 11b | Copies of the tax return are given to Board Members for their review |
| Pt VI, Line 19 | All documents and financial statements are available to the public upon request |
| Pt VI, Line 8b | There are no sub-committees with authority to act on behalf of the governing body |