THE ROUSE FOUNDATION INC: Form 990PF, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- THE ROUSE FOUNDATION INC (EIN 46-4698448)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-15
- IRS object ID
- 202213199349103256
- 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
- Form 990-PF
- Schedule B
- Legal Fees Schedule
- Other Assets Schedule
- Other Decreases Schedule
- Other Expenses Schedule
- Other Professional Fees Schedule
- Substantial Contributors Sch
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-15T10:48:10-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 581653941 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOORE COLSON & COMPANY PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 GALLERIA PARKWAY SE SUITE 600 | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30339 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 464698448 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ROUSE FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ROUS | BusinessNameControlTxt |
| Phone | 4787571070 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 129 BANKHEAD HIGHWAY | AddressLine1Txt |
| City | CARROLLTON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30117 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHARLIE ROUSE | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 4787571070 | PhoneNum |
| Signature | 2022-11-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | CHARLIE | PersonFirstNm |
| Person Last | ROUSE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | STEPHANIE GEORGE | PreparerPersonNm |
| PTIN | P01787895 | PTIN |
| Phone | 7709890028 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | 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-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $48,841 | FMVAssetsEOYAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rcvd Rev And Expnss | $185,177 | ContriRcvdRevAndExpnssAmt |
| Cap Gain Net Incm Net Invst Incm | $0 | CapGainNetIncmNetInvstIncmAmt |
| Total Rev And Expnss | $185,177 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $0 | TotalNetInvstIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $78,510 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $0 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $0 | CompOfcrDirTrstDsbrsChrtblAmt |
| Legal Fees Rev And Expnss | $39 | LegalFeesRevAndExpnssAmt |
| Legal Fees Net Invst Incm | $0 | LegalFeesNetInvstIncmAmt |
| Legal Fees Dsbrs Chrtbl | $39 | LegalFeesDsbrsChrtblAmt |
| Other Prof Fees Rev And Expnss | $61,920 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $0 | OtherProfFeesNetInvstIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $61,290 | OtherProfFeesDsbrsChrtblAmt |
| Taxes Rev And Expnss | $500 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $0 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $500 | TaxesDsbrsChrtblAmt |
| Printing And Pub Rev And Expnss | $700 | PrintingAndPubRevAndExpnssAmt |
| Printing And Pub Net Invst Incm | $0 | PrintingAndPubNetInvstIncmAmt |
| Printing And Pub Dsbrs Chrtbl | $700 | PrintingAndPubDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $19,568 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $0 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Dsbrs Chrtbl | $17,245 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $161,237 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $0 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $79,774 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $16,781 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $16,781 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $178,018 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $0 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $96,555 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $7,159 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $45,402 | CashBOYAmt |
| Cash EOY | $31,841 | CashEOYAmt |
| Cash EOYFMV | $31,841 | CashEOYFMVAmt |
| Other Assets BOY | $0 | OtherAssetsBOYAmt |
| Other Assets EOY | $17,000 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $17,000 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $45,402 | TotalAssetsBOYAmt |
| Total Assets EOY | $48,841 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $48,841 | TotalAssetsEOYFMVAmt |
| Accounts Payable BOY | $3,528 | AccountsPayableBOYAmt |
| Accounts Payable EOY | $2,409 | AccountsPayableEOYAmt |
| Mortgages And Notes Payable BOY | $38,500 | MortgagesAndNotesPayableBOYAmt |
| Mortgages And Notes Payable EOY | $38,500 | MortgagesAndNotesPayableEOYAmt |
| Total Liabilities BOY | $42,028 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $40,909 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
| Capital Stock BOY | $0 | CapitalStockBOYAmt |
| Capital Stock EOY | $0 | CapitalStockEOYAmt |
| Additional Paid In Capital BOY | $0 | AdditionalPaidInCapitalBOYAmt |
| Additional Paid In Capital EOY | $0 | AdditionalPaidInCapitalEOYAmt |
| Retained Earning BOY | $3,374 | RetainedEarningBOYAmt |
| Retained Earning EOY | $7,932 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $3,374 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $7,932 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $45,402 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $48,841 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $3,374 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $7,159 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $10,533 | SubtotalAmt |
| Other Decreases | $2,601 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $7,932 | TotNetAstOrFundBalancesEOYAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $0 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $0 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $0 | 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 | $0 | 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 | 0 | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (1) | AtLeast5000InAssetsInd |
| Org Report Or Register State | GA | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (1) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | 0 | PrivateOperatingFoundationInd |
| New Substantial Contributors | Yes (1) | NewSubstantialContributorsInd |
| Own Controlled Entity | 0 | OwnControlledEntityInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (1) | ComplyWithPublicInspRqrInd |
| Website Address | ROUSEFOUNDATION.ORG | WebsiteAddressTxt |
| Individual With Books | CHARLIE ROUSE | IndividualWithBooksNm |
| Phone | 4787571070 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 129 BANKHEAD HIGHWAY | AddressLine1Txt |
| City | CARROLLTON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30117 | 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 | 0 | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | 0 | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | 0 | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | 0 | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | 0 | PaymentToGovernmentOfficialInd |
| 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 |
|---|---|---|---|---|---|---|---|---|
| CHARLIE ROUSE | ||||||||
| 129 BANKHEAD HIGHWAY | CARROLLTON | GA | 30117 | PRESIDENT | 4.00 | $0 | $0 | $0 |
| DEIRDRE HAYWOOD-ROUSE | ||||||||
| 129 BANKHEAD HIGHWAY | CARROLLTON | GA | 30117 | VICE PRESIDENT | 1.00 | $0 | $0 | $0 |
| CHATURIA ROUSE | ||||||||
| 129 BANKHEAD HIGHWAY | CARROLLTON | GA | 30117 | SECRETARY | 1.00 | $0 | $0 | $0 |
| CAMARAY ROUSE | ||||||||
| 129 BANKHEAD HIGHWAY | CARROLLTON | GA | 30117 | TREASURER | 1.00 | $0 | $0 | $0 |
| URSULA PHILLIPS | ||||||||
| 9978 BRIDGEWATER POINTE | VILLA RICA | GA | 30180 | DIRECTOR | 24.00 | $78,510 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Hghst Pd Empl Or NONE | NONE | CompOfHghstPdEmplOrNONETxt |
| Other Employee Paid Over50k | 0 | OtherEmployeePaidOver50kCnt |
Compensation Of Hghst Pd Cntrct CompensationOfHghstPdCntrctGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAM BECKNEL CONSULTING | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 941356 | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31141 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Service Type | CONSULTING | ServiceTypeTxt |
| Compensation | $57,480 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contractor Paid Over50k | 0 | ContractorPaidOver50kCnt |
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 | $0 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $34,394 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $17,000 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $51,394 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $51,394 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $771 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $50,623 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $2,531 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $2,531 | MinimumInvestmentReturnAmt |
| Total Tax | $0 | TotalTaxAmt |
| Distributable Before Adj | $2,531 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $2,531 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $2,531 | DistributableAsAdjustedAmt |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $96,555 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $96,555 | QualifyingDistributionsAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $2,531 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $0 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr5 | $833 | ExcessDistributionCyovYr5Amt |
| Excess Distribution Cyov Yr4 | $2,840 | ExcessDistributionCyovYr4Amt |
| Excess Distribution Cyov Yr2 | $4,869 | ExcessDistributionCyovYr2Amt |
| Total Excess Distribution Cyov | $8,542 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $96,555 | QualifyingDistributionsAmt |
| Applied To Year1 | $0 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $2,531 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $94,024 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $102,566 | TotalCorpusAmt |
| Prior Year Undistributed Incm | $0 | PriorYearUndistributedIncmAmt |
| Prior Year Deficiency Or Tax | $0 | PriorYearDeficiencyOrTaxAmt |
| Taxable1 | $0 | Taxable1Amt |
| Taxable2 | $0 | Taxable2Amt |
| Undistributed Income CY | $0 | UndistributedIncomeCYAmt |
| Corpus Distri170b1 E Or4942g3 | $0 | CorpusDistri170b1EOr4942g3Amt |
| Excess Distri Cyov From Yr5 | $833 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $101,733 | ExcessDistriCyovToNextYrAmt |
| Excess From Year4 | $2,840 | ExcessFromYear4Amt |
| Excess From Year2 | $4,869 | ExcessFromYear2Amt |
| Excess From Current Year | $94,024 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributing Manager | CHARLIE ROUSE | ContributingManagerNm |
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (10 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| HEART HEALTHY ESSAY | |||||||
| 129 BANKHEAD HIGHWAY | CARROLLTON | GA | 30117 | N/A | N/A | SCHOLARSHIP FOR HIGHER LEARNING | $3,348 |
| RAPHA CLINIC OF WEST GEORGIA | |||||||
| 253 EAST HIGHWAY 78 | TEMPLE | GA | 30179 | N/A | 501(C)(3) | CHARITABLE PURPOSE | $400 |
| ONE BODY MANY MEMBERS | |||||||
| 129 BANKHEAD HIGHWAY | CARROLLTON | GA | 30117 | N/A | 501(C)(3) | CHARITABLE PURPOSE | $1,400 |
| THE FRIENDS OF SOUTHERN HAITI | |||||||
| 5390 BROOKHOLLOW DRIVE | DOUGLASVILLE | GA | 30135 | N/A | 501(C)(3) | CHARITABLE PURPOSE | $250 |
| THE VILLAGE YOUTH SUMMIT | |||||||
| 129 BANKHEAD HIGHWAY | CARROLLTON | GA | 30117 | N/A | 501(C)(3) | CHARITABLE PURPOSE | $5,826 |
| ST JAMES UNITED METHODIST CHURCH | |||||||
| 4400 PEACHTREE DUNWOODY RD | ATLANTA | GA | 30342 | N/A | 501(C)(3) | OPERATING FUNDS | $1,000 |
| CARROLLTON FRATERNAL ORDER OF POLICE | |||||||
| 115 W CENTER STREET | CARROLLTON | GA | 30117 | N/A | 501(C)(3) | OPERATING FUNDS | $100 |
| KATESHA MASON SCHOLARSHIP | |||||||
| 129 BANKHEAD HIGHWAY | CARROLLTON | GA | 30117 | N/A | N/A | SCHOLARSHIP FOR HIGHER LEARNING | $1,200 |
| CARROLLTON FIRST BAPTIST CHURCH | |||||||
| 102 DIXIE STREET | CARROLLTON | GA | 30117 | N/A | 501(C)(3) | OPERATING FUNDS | $175 |
| BRUCE HOLLEY | |||||||
| 129 BANKHEAD HIGHWAY | CARROLLTON | GA | 30117 | N/A | N/A | CHARITABLE PURPOSE | $3,082 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $16,781 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $0 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $0 | TotalIncomeProducingActyAmt |
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 (2 entries)
| ContributorContributorNum | Address Line1ContributorUSAddress/AddressLine1Txt | CityContributorUSAddress/CityNm | State AbbreviationContributorUSAddress/StateAbbreviationCd | ZIPContributorUSAddress/ZIPCd | Total ContributionsTotalContributionsAmt | Person ContributionPersonContributionInd |
|---|---|---|---|---|---|---|
| TANNER HEALTH SYSTEMS | ||||||
| 1 | 705 DIXIE STREET | CARROLLTON | GA | 30117 | $5,000 | Yes (X) |
| WEST GEORGIA CARDIOLOGY | ||||||
| 2 | 129 BANKHEAD HWY | CARROLLTON | GA | 30117 | $162,042 | Yes (X) |
Legal Fees Schedule LegalFeesSchedule
Legal Fees LegalFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | LEGAL FEES | CategoryTxt |
| Legal Fees | $39 | LegalFeesAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $39 | DisbursementsCharitablePrpsAmt |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CONSTRUCTION IN PROGRESS | Desc |
| BOY Book Value | $0 | BOYBookValueAmt |
| EOY Book Value | $17,000 | EOYBookValueAmt |
| EOYFMV | $17,000 | EOYFMVAmt |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases Detail OtherDecreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PRIOR PERIOD ADJUSTMENT | Desc |
| Amt | $2,601 | Amt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (9 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| INTERNET | $355 | $0 | $355 |
| INSURANCE | $184 | $0 | $184 |
| SUPPLIES | $1,373 | $0 | $1,373 |
| TELEPHONE | $1,283 | $0 | $1,283 |
| MISCELLANEOUS EXPENSE | $873 | $0 | $870 |
| COVID VACCINES | $10,000 | $0 | $10,000 |
| EQUIPMENT | $1,680 | $0 | $1,680 |
| CONTRACT LABOR | $1,500 | $0 | $1,500 |
| INTEREST & PENALTIES | $2,320 | $0 | $0 |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | CONSULTING | CategoryTxt |
| Amt | $61,920 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $61,290 | DisbursementsCharitablePrpsAmt |
Substantial Contributors Sch SubstantialContributorsSch
Substantial Contributor Detail SubstantialContributorDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST GEORGIA CARDIOLOGY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 129 BANKHEAD HIGHWAY | AddressLine1Txt |
| City | CARROLLTON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30117 | ZIPCd |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | TAXES | CategoryTxt |
| Amt | $500 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $500 | DisbursementsCharitablePrpsAmt |