LANE COUNTY MEDICAL SOCIETY FOUNDATION: Form 990EZ, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- LANE COUNTY MEDICAL SOCIETY FOUNDATION (EIN 32-0080103)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-09-27
- IRS object ID
- 202242709349200744
- Schema version
- 2021v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-09-27T17:41:06-04:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 930819646 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JONES & ROTH PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 10086 | AddressLine1Txt |
| City | EUGENE | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97440 | 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 | 320080103 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LANE COUNTY MEDICAL SOCIETY FDN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LANE | BusinessNameControlTxt |
| Phone | 5416860995 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 7192 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97475 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHONDRA HOLLIDAY | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 5416860995 | PhoneNum |
| Signature | 2022-09-22 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SHONDRA | PersonFirstNm |
| Person Last | HOLLIDAY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KARI YOUNG | PreparerPersonNm |
| PTIN | P01325552 | PTIN |
| Phone | 5416872320 | PhoneNum |
| Preparation | 2022-09-22 | PreparationDt |
| 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 | N/A | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $24,478 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $17,951 | ContributionsGiftsGrantsEtcAmt |
| Investment Income | $6,527 | InvestmentIncomeAmt |
| Total Revenue | $24,478 | TotalRevenueAmt |
| Fees And Other Pymt To Ind Cntrct | $1,800 | FeesAndOtherPymtToIndCntrctAmt |
| Printing Publications Postage | $1,620 | PrintingPublicationsPostageAmt |
| Other Expenses Total | $37,607 | OtherExpensesTotalAmt |
| Total Expenses | $41,027 | TotalExpensesAmt |
| Excess Or Deficit For Year | -$16,549 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $436,668 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | $26,430 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | $446,549 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $436,666 | BOYAmt |
| EOY | $446,549 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2 | BOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $436,668 | BOYAmt |
| EOY | $446,549 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $436,668 | BOYAmt |
| EOY | $446,549 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Primary Exempt Purpose | THE LANE COUNTY MEDICAL SOCIETY FOUNDATION'S MISSION IS TO PROMOTE WELLNESS AND SECURITY FOR THE CITIZENS OF LANE COUNTY THROUGH PATIENT AND COMMUNITY EDUCATION, DIRECT SERVICE PROVISION AND PHYSICAL EDUCATION AND ORGANIZATION. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | TO PROMOTE PHYSICIAN WELLNESS AND SECURITY FOR THE PHYSICIAN COMMUNITY AND THE PATIENT COMMUNITY AT LARGE. | DescriptionProgramSrvcAccomTxt |
| Program Service Expenses | $37,135 | ProgramServiceExpensesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $37,135 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (14 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt |
|---|---|---|
| ALICE HORRELL DO | ||
| PRESIDENT | 2.00 | $0 |
| MARK MUELLER MD | ||
| PAST PRESIDE | 1.00 | $0 |
| KEVIN MODESTE MD | ||
| VICE PRESIDE | 3.00 | $0 |
| BENJAMIN VAZQUEZ MD | ||
| SECRETARY | 2.00 | $0 |
| PRIYA CARDEN MD | ||
| TREASURER | 2.00 | $0 |
| YUMI AIKAWA | ||
| TRUSTEE | 1.00 | $0 |
| RECHELLE ASIROT | ||
| TRUSTEE | 1.00 | $0 |
| SUDESHNA BANERJEE MD | ||
| TRUSTEE | 1.00 | $0 |
| WENDY BANERJEE | ||
| TRUSTEE | 1.00 | $0 |
| BRYAN MCVAY | ||
| TRUSTEE | 1.00 | $0 |
| LESLIE PELINKA | ||
| TRUSTEE | 1.00 | $0 |
| RICHARD BEYERLEIN | ||
| TRUSTEE | 1.00 | $0 |
| AMANDAJO SANDERS | ||
| TRUSTEE | 1.00 | $0 |
| SHONDRA HOLLIDAY | ||
| EXECUTIVE DI | 2.00 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | false | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | false | OrganizationHadUBIInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Form1120 Pol Filed | false | Form1120PolFiledInd |
| Made Loans To From Officers | false | MadeLoansToFromOfficersInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHONDRA HOLLIDAY | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 7192 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97475 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5416860995 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Foreign Office | false | ForeignOfficeInd |
| Donor Advised Fnds | false | DonorAdvisedFndsInd |
| Operate Hospital | false | OperateHospitalInd |
| Tanning Services Provided | false | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| School Operating | false | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (true) | 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 | $55,555 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,626 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,190 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $32,725 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $17,951 | CurrentTaxYearAmt |
| Total | $118,047 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $55,555 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,626 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,190 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $32,725 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $17,951 | CurrentTaxYearAmt |
| Total | $118,047 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $46,952 | SubstantialContributorsTotAmt |
| Public Support Total170 | $71,095 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,972 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,874 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,359 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,825 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,526 | CurrentTaxYearAmt |
| Total | $32,556 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $1,790 | CurrentTaxYearMinus2YearsAmt |
| Total | $1,790 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $152,393 | TotalSupportAmt |
| Public Support CY170 | 0.46650 | PublicSupportCY170Pct |
| Public Support PY170 | 0.79090 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II, LINE 10 | FormAndLineReferenceDesc |
| Explanation | MISCELLANEOUS INCOME 1,790 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990-EZ, PART I, LINE 16 | EXPENSES BUSINESS LICENSES AND FEE 144 WELLNESS COUNSELING 37,135 MISCELLANEOUS 103 FINANCE CHARGE 195 BANK FEES 30 TOTAL 37,607 |
| FORM 990-EZ, PART I, LINE 20 | UNREALIZED GAINS ON INVESTMENTS 26,430 |
| FORM 990-EZ, PART II, LINE 24 | UNDEPOSITED FUNDS 2 0 TOTAL 2 0 |
| FORM 990-EZ, PART III | THE LANE COUNTY MEDICAL SOCIETY FOUNDATION'S MISSION IS TO PROMOTE WELLNESS AND SECURITY FOR THE CITIZENS OF LANE COUNTY THROUGH PATIENT AND COMMUNITY EDUCATION, DIRECT SERVICE PROVISION AND PHYSICAL EDUCATION AND ORGANIZATION. |