STRATEGY STUDIO / PUBLIC DATA EXPLORER

HOSPICE AND PALLIATIVE CARE OF THE WOOD RIVER VALLEY INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
HOSPICE AND PALLIATIVE CARE OF THE WOOD RIVER VALLEY INC (EIN 82-0397698)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-06-04
IRS object ID
202101559349301405
Schema version
2020v4.0
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

FieldValueIRS element (for citing)
Return2021-06-04T15:56:48-05:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN840437743PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BECKER CHAMBERS & CO PABusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 909AddressLine1Txt
CityHAILEYCityNm
State AbbreviationIDStateAbbreviationCd
ZIP833330909ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN820397698EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HOSPICE AND PALLIATIVE CARE OF THEBusinessNameLine1Txt
Business Name Line2WOOD RIVER VALLEY INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlHOSPBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 4320AddressLine1Txt
CityKETCHUMCityNm
State AbbreviationIDStateAbbreviationCd
ZIP83340ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLISA WILDPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone2087268464PhoneNum
Signature2021-06-01SignatureDt

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstLISAPersonFirstNm
Person LastWILDPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLINDA P CHAMBERSPreparerPersonNm
PTINP00157522PTIN
Phone2087889595PhoneNum
Preparation2021-06-04PreparationDt
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerLISA WILDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 4320AddressLine1Txt
CityKETCHUMCityNm
State AbbreviationIDStateAbbreviationCd
ZIP83340ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,016,457GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.HPCWRV.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1985FormationYr
Legal Domicile StateIDLegalDomicileStateCd
Activity Or MissionTO PROVIDE EXCELLENCE IN SERIOUS ILLNESS AND END-OF-LIFE CARE AND BEREAVEMENT SERVICES; AS WELL AS SUPPORT AND EDUCATION FOR PATIENTS, FAMILIES, AND CAREGIVERS.ActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee8TotalEmployeeCnt
Total Volunteers114TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$1,230,463PYContributionsGrantsAmt
CY Contributions Grants$946,037CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$147,797PYInvestmentIncomeAmt
CY Investment Income$70,420CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$1,378,260PYTotalRevenueAmt
CY Total Revenue$1,016,457CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$359,018PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$392,367CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$46,078CYTotalFundraisingExpenseAmt
PY Other Expenses$109,767PYOtherExpensesAmt
CY Other Expenses$94,474CYOtherExpensesAmt
PY Total Expenses$468,785PYTotalExpensesAmt
CY Total Expenses$486,841CYTotalExpensesAmt
PY Revenues Less Expenses$909,475PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$529,616CYRevenuesLessExpensesAmt
Total Assets BOY$4,529,351TotalAssetsBOYAmt
Total Assets EOY$5,868,609TotalAssetsEOYAmt
Total Liabilities EOY$68,577TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,529,351NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$5,800,032NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE EXCELLENCE IN SERIOUS ILLNESS AND END-OF-LIFE CARE AND BEREAVEMENT SERVICES; AS WELL AS SUPPORT AND EDUCATION FOR PATIENTS, FAMILIES, AND CAREGIVERS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$374,069ExpenseAmt
DescTHE HOSPICE PROVIDES CARE FOR THE TERMINALLY ILL, BEREAVEMENT PROGRAMS FOR BOTH ADULTS AND CHILDREN, AND PROVIDES EDUCATION AND RESOURCES REGARDING WELLNESS. IN 2020 THEY SERVED 1,209 INDIVIDUALS INCLUDING 142 HOSPICE PATIENTS AND THEIR FAMILIES. THEY PROVIDED EDUCATIONAL/TRAINING OPPORTUNITIES REACHING 188 INDIVIDUALS. RN'S MADE 1,462 VIRTUAL AND IN PERSON VISITS TO PATIENTS RESULTING IN 2,392 TELEPHONE CALL AND TELEMEDICINE APPOINTMENTS TO SUPPOT PATIENTS IN EVERY CORNER OF OUR SERVICE AREA. 34 SUPPORT GROUPS WERE OFFERED, FOCUSING ON CAREGIVING AND BEREAVEMENT. VOLUNTEERS PROVIDED 735 HOURS OF SERVICE.Desc
Total Program Service Expenses$374,069TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee8EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCRISS FALLOWFIELDPersonNm
Phone2087268464PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1507 1ST AVE NORTHAddressLine1Txt
CityKETCHUMCityNm
State AbbreviationIDStateAbbreviationCd
ZIP83340ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
ALAN STEVENSON
PRESIDENT1.50Yes (X)Yes (X)$0$0$0
LYNN CAMPION
VICE PRESIDE1.00Yes (X)Yes (X)$0$0$0
BRUCE COLLIER
SECRETARY1.50Yes (X)Yes (X)$0$0$0
ROBERT RENIERS
TREASURER2.00Yes (X)Yes (X)$0$0$0
MICKI CHAPIN
DIRECTOR1.00Yes (X)$0$0$0
PAM FAIRFAX
DIRECTOR1.00Yes (X)$0$0$0
LISA WILD
EXECUTIVE DI40.00Yes (X)$115,756$0$3,285
FieldValueIRS element (for citing)
Total Reportable Comp From Org$115,756TotalReportableCompFromOrgAmt
Total Other Compensation$3,285TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$946,037AllOtherContributionsAmt
Noncash Contributions$49,664NoncashContributionsAmt
Total Contributions$946,037TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$70,420TotalRevenueColumnAmt
Exclusion$70,420ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,016,457TotalRevenueColumnAmt
Exclusion$70,420ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$363,083TotalAmt
Program Services$290,467ProgramServicesAmt
Management And General$36,308ManagementAndGeneralAmt
Fundraising$36,308FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$7,154TotalAmt
Program Services$5,724ProgramServicesAmt
Management And General$715ManagementAndGeneralAmt
Fundraising$715FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$7,512TotalAmt
Program Services$6,010ProgramServicesAmt
Management And General$751ManagementAndGeneralAmt
Fundraising$751FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$14,618TotalAmt
Program Services$11,694ProgramServicesAmt
Management And General$1,462ManagementAndGeneralAmt
Fundraising$1,462FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$5,983TotalAmt
Management And General$5,983ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$10,166TotalAmt
Program Services$4,905ProgramServicesAmt
Management And General$2,233ManagementAndGeneralAmt
Fundraising$3,028FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$15,704TotalAmt
Program Services$10,993ProgramServicesAmt
Management And General$4,711ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$6,859TotalAmt
Program Services$6,859ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,729TotalAmt
Program Services$2,422ProgramServicesAmt
Management And General$3,307ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$8,483TotalAmt
Program Services$6,235ProgramServicesAmt
Management And General$2,248ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
PATIENT CARE$13,881$13,881
MINOR EQUIPMENT$8,976$8,976
BANK CHARGES$3,814$3,814
VOLUNTEER RECOGNITION$3,463$3,463

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$11,416TotalAmt
Program Services$11,416ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$486,841TotalAmt
Program Services$374,069ProgramServicesAmt
Management And General$66,694ManagementAndGeneralAmt
Fundraising$46,078FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$200,022BOYAmt
EOY$251,278EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$381,786BOYAmt
EOY$523,473EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$252,664LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$176,735LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$63,071BOYAmt
EOY$75,929EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$3,884,472BOYAmt
EOY$5,017,929EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,529,351BOYAmt
EOY$5,868,609EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
EOY$68,577EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$68,577EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,302,947BOYAmt
EOY$3,033,527EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,226,404BOYAmt
EOY$2,766,505EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,529,351BOYAmt
EOY$5,800,032EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,529,351BOYAmt
EOY$5,868,609EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$529,616ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$741,065NetUnrlzdGainsLossesInvstAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$814,876CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$713,199CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,214,247CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,230,463CurrentTaxYearMinus1YearAmt
Current Tax Year$946,037CurrentTaxYearAmt
Total$4,918,822TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$814,876CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$713,199CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,214,247CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,230,463CurrentTaxYearMinus1YearAmt
Current Tax Year$946,037CurrentTaxYearAmt
Total$4,918,822TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$1,282,120SubstantialContributorsTotAmt
Public Support Total170$3,636,702PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$22,872CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$25,553CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$48,419CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$53,700CurrentTaxYearMinus1YearAmt
Current Tax Year$70,917CurrentTaxYearAmt
Total$221,461TotalAmt
FieldValueIRS element (for citing)
Total Support$5,140,283TotalSupportAmt
Public Support CY1700.70750PublicSupportCY170Pct
Public Support PY1700.70190PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,163,992BeginningYearBalanceAmt
Contributions$77,000ContributionsAmt
Investment Earnings Or Losses$431,084InvestmentEarningsOrLossesAmt
End Year Balance$2,672,076EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,237,694BeginningYearBalanceAmt
Contributions$558,867ContributionsAmt
Investment Earnings Or Losses$372,152InvestmentEarningsOrLossesAmt
Other Expenditures$4,721OtherExpendituresAmt
End Year Balance$2,163,992EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$676,569BeginningYearBalanceAmt
Contributions$677,176ContributionsAmt
Investment Earnings Or Losses-$93,645InvestmentEarningsOrLossesAmt
Other Expenditures$22,407OtherExpendituresAmt
End Year Balance$1,237,694EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$462,679BeginningYearBalanceAmt
Contributions$195,358ContributionsAmt
Investment Earnings Or Losses$18,532InvestmentEarningsOrLossesAmt
End Year Balance$676,569EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$100,000BeginningYearBalanceAmt
Contributions$352,448ContributionsAmt
Investment Earnings Or Losses$7,045InvestmentEarningsOrLossesAmt
Other Expenditures$3,186OtherExpendituresAmt
End Year Balance$462,679EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$207,075OtherCostOrOtherBasisAmt
Depreciation$131,146DepreciationAmt
Book Value$75,929BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$45,589OtherCostOrOtherBasisAmt
Depreciation$45,589DepreciationAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$75,929TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
PPP LOAN$68,412
PAYROLL LIABILITES$165
FieldValueIRS element (for citing)
Total Liability$68,577TotalLiabilityAmt

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution2ContributionCnt
Noncash Contributions Rpt F990$49,664NoncashContributionsRptF990Amt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BEXECUTIVE DIRECTOR AND OFFICER WHO SIGNS RETURN REVIEWS THE 990.
FORM 990, PAGE 6, PART VI, LINE 12CCONFLICT OF INTEREST FORMS ARE COMPLETED AT THE START OF EACH BOARD MEMBER'S TERM AND MONITORED AT BOARD MEETINGS.
FORM 990, PAGE 6, PART VI, LINE 15ACOMPARABLE DATA IS OBTAINED AND CHANGES WERE CONSISTENT WITH OTHER STAFF.
FORM 990, PAGE 6, PART VI, LINE 19UPON REQUEST