ADDICTION COUNSELOR CERTIFICATION BOARD OF OREGON: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- ADDICTION COUNSELOR CERTIFICATION BOARD OF OREGON (EIN 93-0795138)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-05-11
- IRS object ID
- 202101319349302985
- Schema version
- 2020v4.1
- 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 | 2021-05-11T15:56:07-04:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 3rd Generation Accounting Inc | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1804 NE 43rd Ave | AddressLine1Txt |
| City | Portland | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97213 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930795138 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADDICTION COUNSELOR CERTIFICATION BOARD OF OREGON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ADDI | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2054 N VANCOUVER | AddressLine1Txt |
| City | Portland | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 972171917 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK L DAVIS | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 5032318164 | PhoneNum |
| Signature | 2021-05-10 | SignatureDt |
| Discuss With Paid Preparer | false | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MARK | PersonFirstNm |
| Person Last | DAVIS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Susan G Robertson | PreparerPersonNm |
| PTIN | P00774160 | PTIN |
| Phone | 5032827247 | PhoneNum |
| Preparation | 2021-05-11 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| OOB Security Verification | 00 | OOBSecurityVerificationCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARK DAVIS | PrincipalOfficerNm |
| Gross Receipts | $1,145,179 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Type Of Organization Assoc | Yes (X) | TypeOfOrganizationAssocInd |
| Formation | 1977 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | CERTIFICATION OF ADDICTION COUNSELORS FOR THE STATE OF OREGON | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 16 | VotingMembersIndependentCnt |
| Total Employee | 11 | TotalEmployeeCnt |
| Total Volunteers | 16 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $345,677 | PYContributionsGrantsAmt |
| CY Contributions Grants | $457,556 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $792,321 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $589,953 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $33,172 | PYOtherRevenueAmt |
| CY Other Revenue | $97,670 | CYOtherRevenueAmt |
| PY Total Revenue | $1,171,170 | PYTotalRevenueAmt |
| CY Total Revenue | $1,145,179 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $10,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $10,500 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $368,279 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $413,283 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $580,796 | PYOtherExpensesAmt |
| CY Other Expenses | $725,697 | CYOtherExpensesAmt |
| PY Total Expenses | $959,075 | PYTotalExpensesAmt |
| CY Total Expenses | $1,149,480 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $212,095 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,301 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $326,011 | TotalAssetsBOYAmt |
| Total Assets EOY | $321,849 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,629 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,768 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $324,382 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $320,081 | NetAssetsOrFundBalancesEOYAmt |
| Mission | CERTIFICATION OF ADDICTION COUNSELORS FOR THE STATE OF OREGON | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,143,183 | ExpenseAmt |
| Grant | $10,500 | GrantAmt |
| Revenue | $589,953 | RevenueAmt |
| Desc | CERTIFICATION OF ADDICITON COUNSELORS WITHIN THE STATE OF OREGON WITH SEMI ANNUAL EXAMINATIONS AND CERTIFICATE RENEWALS | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,297 | ExpenseAmt |
| Desc | THE ASSOCIATION PUBLISHES A QUARTERLY NEWSLETTER THAT IS MAILED TO ALL THOSE CERTIFIED BY THE BOARD | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $1,149,480 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | false | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| 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 | false | 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 | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| 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 | Yes (true) | 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 |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 11 | 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 |
| 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 | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 16 | 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 | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | 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 | OR | StatesWhereCopyOfReturnIsFldCd |
| Other | Yes (X) | OtherInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK DAVIS | PersonNm |
| Phone | 5032318164 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2054 N VANCOUVER | AddressLine1Txt |
| City | Portland | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 972171917 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|---|
| VAN R BURNHAM | ||||||||
| KEY EMPLOYEE | 40.00 | 0.00 | Yes (X) | $74,480 | $0 | $0 | ||
| MICHAEL RAVAZI | ||||||||
| KEY EMPLOYEE | 40.00 | 0.00 | Yes (X) | $70,176 | $0 | $0 | ||
| ERIC MARTIN | ||||||||
| KEY EMPLOYEE | 40.00 | 0.00 | Yes (X) | $58,245 | $0 | $0 | ||
| MARK LEWINSOHN | ||||||||
| DIRECTOR | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| TANYA PRITT | ||||||||
| DIRECTOR | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| AMY ASHTON-WILLIAMS | ||||||||
| DIRECTOR | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| FREDERICK STATEN | ||||||||
| DIRECTOR | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| BEAU RAPPAPORT | ||||||||
| DIRECTOR | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| LANA WINNIE | ||||||||
| DIRECTOR | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| TONY VEZINA | ||||||||
| DIRECTOR | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| BOB FORSYTH | ||||||||
| DIRECTOR | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| ANDREA QUICKSALL | ||||||||
| DIRECTOR | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| JOSE GARCIA | ||||||||
| SECRETARY | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| KEITH WALKER | ||||||||
| DIRECTOR | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| MICHAEL BRANDSMA | ||||||||
| DIRECTOR | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| JULIA MINES | ||||||||
| TREASURER | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| MARK DAVIS | ||||||||
| PRESIDENT | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| DEBRA BUFFALO BO BIGELOW | ||||||||
| VICE PRESIDENT | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| AJA STONER | ||||||||
| SECRETARY | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $202,901 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $457,556 | GovernmentGrantsAmt |
| Total Contributions | $457,556 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| EXAM FEES | 541900 | $582,428 | $582,428 |
| RECIPROCITY FEES | 541900 | $5,250 | $5,250 |
| ACCREDITATION | 541900 | $2,275 | $2,275 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $589,953 | TotalProgramServiceRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| MISCELLANEOUS | 541900 | $5,260 | $5,260 | |
| LATINO CONFERENCE | 541900 | $15,344 | $15,344 | |
| PPP LOAN FORGIVENESS | 541900 | $75,022 | $75,022 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,044 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,044 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $97,670 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,145,179 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $612,601 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $75,022 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,500 | TotalAmt |
| Program Services | $10,500 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $345,403 | TotalAmt |
| Program Services | $345,403 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,228 | TotalAmt |
| Program Services | $34,228 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,652 | TotalAmt |
| Program Services | $33,652 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,304 | TotalAmt |
| Program Services | $1,304 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,882 | TotalAmt |
| Program Services | $10,882 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $231 | TotalAmt |
| Program Services | $231 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,566 | TotalAmt |
| Program Services | $36,566 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,188 | TotalAmt |
| Program Services | $47,188 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,179 | TotalAmt |
| Program Services | $34,179 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,566 | TotalAmt |
| Program Services | $2,566 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,457 | TotalAmt |
| Program Services | $17,457 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53 | TotalAmt |
| Program Services | $53 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $491,421 | TotalAmt |
| Program Services | $491,421 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,663 | TotalAmt |
| Program Services | $11,663 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| POSTAGE AND SHIPPING | $8,714 | $8,714 |
| EXAMINATION EXPENSE | $55,755 | $55,755 |
| MISCELLANEOUS | $7,585 | $7,585 |
| REIMBURSEMENTS | $133 | $133 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,149,480 | TotalAmt |
| Program Services | $1,149,480 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Joint Costs | Yes (X) | JointCostsInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $325,929 | BOYAmt |
| EOY | $321,402 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82 | BOYAmt |
| EOY | $447 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,402 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,402 | LandBldgEquipAccumDeprecAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $326,011 | BOYAmt |
| EOY | $321,849 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,629 | BOYAmt |
| EOY | $1,768 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,629 | BOYAmt |
| EOY | $1,768 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $324,382 | BOYAmt |
| EOY | $320,081 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $324,382 | BOYAmt |
| EOY | $320,081 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $326,011 | BOYAmt |
| EOY | $321,849 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$4,301 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,402 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,402 | DepreciationAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | false | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| WESTERN STATES CENTER DBA OREGON RE | |||||||
| P O BOX 40305 | Portland | OR | 97240 | 930952137 | 501C3 | $10,000 | THE BETTERMENT OF THE ADDICTION FIELD |
| MIRACLES CLUB | |||||||
| 4200 NE MARTIN LUTHER KING JR BLVD | Portland | OR | 97212 | 931190084 | 501C3 | $500 | THE BETTERMENT OF THE ADDICTION FIELD |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | METROPLUS ASSOC OF ADDICTION PEER C | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | KEY EMPLOYEE OWNS 50 | RelationshipDescriptionTxt |
| Transaction | $476,421 | TransactionAmt |
| Transaction | PAYMENT FOR SERVICES | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990 governing body review Part VI line 11 | No review was or will be conducted. |
| Conflict of interest policy compliance Part VI line 12c | Every 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 18 | No Documents available to the public. |
| Governing documents etc available to public Part VI line 19 | No documents available to the public. |
| Explanation of other changes in net assets or fund balances Part XI line 9 | TRIBAL LIABILITY ADJUSTMENT |