COMMUNITY HEALTH FREE CLINIC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH FREE CLINIC (EIN 13-4228071)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-03-16
- IRS object ID
- 202120779349301417
- Schema version
- 2019v5.0
- 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 | 2021-03-16T11:48:50-07:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 134228071 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH FREE CLINIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 3193630416 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 947 14th Avenue SE | AddressLine1Txt |
| City | Cedar Rapids | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52401 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Laura Wirth | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Phone | 3193630416 | PhoneNum |
| Signature | 2021-05-15 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Laura Wirth | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 947 14th Ave SE | AddressLine1Txt |
| City | Cedar Rapids | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,110,555 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.COMMUNITYHFC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2002 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | TO ALLEVIATE HUMAN PAIN AND SUFFERING BY PROVIDING ACCESS TO AND THE DELIVERY OF COMPASSIONATE HEALTHCARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 23 | TotalEmployeeCnt |
| Total Volunteers | 293 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,234,957 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,054,445 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $40,822 | PYInvestmentIncomeAmt |
| CY Investment Income | $51,336 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $4,275,779 | PYTotalRevenueAmt |
| CY Total Revenue | $5,105,781 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $356,335 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $341,391 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $62,492 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,055,934 | PYOtherExpensesAmt |
| CY Other Expenses | $4,696,750 | CYOtherExpensesAmt |
| PY Total Expenses | $4,412,269 | PYTotalExpensesAmt |
| CY Total Expenses | $5,038,141 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$136,490 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $67,640 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,215,512 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,244,214 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $16,007 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $12,732 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,199,505 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,231,482 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO ALLEVIATE HUMAN PAIN AND SUFFERING BY PROVIDING ACCESS TO AND THE DELIVERY OF COMPASSIONATE HEALTHCARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,808,459 | ExpenseAmt |
| Revenue | $0 | RevenueAmt |
| Desc | Provided Free Health Care Services, including medical, dental and vision care for underserved and uninsured individuals in need of health care. Approximately 180 new patients were seen per month. The total of new and existing individuals served during the year was 9,525 with over 18,110 services provided. The Community Health Free Clinic served individuals all over the East Central Iowa area. | Desc |
| Total Other Prog Srvc Expense | $0 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $0 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $4,808,459 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | 0 | BackupWthldComplianceInd |
| Employee | 23 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CO | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | FL | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | MO | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | NJ | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | NV | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | WA | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARTY MILLER | PersonNm |
| Phone | 3192002540 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 715 10TH AVENUE SE | AddressLine1Txt |
| City | CEDAR RAPIDS | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52401 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| DARLENE SCHMIDT | |||||||
| CEO | 55.0 | 0 | Yes (X) | $76,804 | $0 | $0 | |
| BEN HOOVER | |||||||
| President | 1.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| KAY JACKSON | |||||||
| SECRETARY | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| LAURA WIRTH | |||||||
| TREASURER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| MICHAEL HALL | |||||||
| DIRECTOR | 1.0 | 0 | $0 | $0 | $0 | Yes (X) | |
| RO FOEGE | |||||||
| DIRECTOR | 1.0 | 0 | $0 | $0 | $0 | Yes (X) | |
| SANDRA MCINTOSH | |||||||
| DIRECTOR | 1.0 | 0 | $0 | $0 | $0 | Yes (X) | |
| JERRY TIEDT | |||||||
| DIRECTOR | 1.0 | 0 | $0 | $0 | $0 | Yes (X) | |
| JOHN BANKS | |||||||
| DIRECTOR | 1.0 | 0 | $0 | $0 | $0 | Yes (X) | |
| DARLENE DAVERMANN-REID | |||||||
| Vice President | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| GREG DEWOLF | |||||||
| DIRECTOR | 1.0 | 0 | $0 | $0 | $0 | Yes (X) | |
| JEANETTE WERLING | |||||||
| DIRECTOR | 1.0 | 0 | $0 | $0 | $0 | Yes (X) | |
| Heather Smith Friedman | |||||||
| Director | 1.0 | 0 | $0 | $0 | $0 | Yes (X) | |
| Sue Lowder | |||||||
| Director | 1.0 | 0 | $0 | $0 | $0 | Yes (X) | |
| Dennis Naughton | |||||||
| Director | 1.0 | 0 | $0 | $0 | $0 | Yes (X) | |
| Kevin Techau | |||||||
| Director | 1.0 | 0 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $76,804 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $262,620 | FederatedCampaignsAmt |
| Membership Dues | $0 | MembershipDuesAmt |
| Fundraising | $0 | FundraisingAmt |
| Related Organizations | $0 | RelatedOrganizationsAmt |
| Government Grants | $24,789 | GovernmentGrantsAmt |
| All Other Contributions | $4,767,036 | AllOtherContributionsAmt |
| Noncash Contributions | $4,260,744 | NoncashContributionsAmt |
| Total Contributions | $5,054,445 | TotalContributionsAmt |
| Total Program Service Revenue | $0 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,169 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $35,169 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,941 | SecuritiesAmt |
| Other | $15,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $894 | SecuritiesAmt |
| Other | $3,880 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,047 | SecuritiesAmt |
| Other | $11,120 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,167 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $16,167 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $0 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,105,781 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $51,336 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,939 | TotalAmt |
| Program Services | $58,454 | ProgramServicesAmt |
| Management And General | $15,588 | ManagementAndGeneralAmt |
| Fundraising | $3,897 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $242,427 | TotalAmt |
| Program Services | $143,674 | ProgramServicesAmt |
| Management And General | $64,197 | ManagementAndGeneralAmt |
| Fundraising | $34,556 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,025 | TotalAmt |
| Program Services | $13,265 | ProgramServicesAmt |
| Management And General | $5,236 | ManagementAndGeneralAmt |
| Fundraising | $2,524 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,329 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $15,329 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,992 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $5,992 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,204 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $3,204 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,358 | TotalAmt |
| Program Services | $21,033 | ProgramServicesAmt |
| Management And General | $14,570 | ManagementAndGeneralAmt |
| Fundraising | $2,755 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,190 | TotalAmt |
| Program Services | $24,095 | ProgramServicesAmt |
| Management And General | $9,511 | ManagementAndGeneralAmt |
| Fundraising | $4,584 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,111 | TotalAmt |
| Program Services | $18,998 | ProgramServicesAmt |
| Management And General | $7,499 | ManagementAndGeneralAmt |
| Fundraising | $3,614 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,299 | TotalAmt |
| Program Services | $38,675 | ProgramServicesAmt |
| Management And General | $15,266 | ManagementAndGeneralAmt |
| Fundraising | $7,358 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,002 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $14,002 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Donated Goods | $4,259,849 | $4,259,849 | $0 | $0 |
| Medications | $121,047 | $121,047 | $0 | $0 |
| Medical Services | $106,926 | $106,926 | $0 | $0 |
| Change in Inventory | -$4,765 | -$4,765 | $0 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,208 | TotalAmt |
| Program Services | $7,208 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,038,141 | TotalAmt |
| Program Services | $4,808,459 | ProgramServicesAmt |
| Management And General | $167,190 | ManagementAndGeneralAmt |
| Fundraising | $62,492 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $201,792 | BOYAmt |
| EOY | $278,096 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $288,080 | BOYAmt |
| EOY | $234,235 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $224,273 | BOYAmt |
| EOY | $219,024 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $942,131 | BOYAmt |
| EOY | $946,896 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,777 | BOYAmt |
| EOY | $8,959 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,070,811 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $880,476 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,232,927 | BOYAmt |
| EOY | $1,190,335 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,318,532 | BOYAmt |
| EOY | $1,366,669 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,215,512 | BOYAmt |
| EOY | $4,244,214 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,007 | BOYAmt |
| EOY | $12,732 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,007 | BOYAmt |
| EOY | $12,732 | 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 | $3,565,772 | BOYAmt |
| EOY | $3,611,821 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $633,733 | BOYAmt |
| EOY | $619,661 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,199,505 | BOYAmt |
| EOY | $4,231,482 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,215,512 | BOYAmt |
| EOY | $4,244,214 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $67,640 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$35,655 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | -$8 | DonatedServicesAndUseFcltsAmt |
| Prior Period Adjustments | $0 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
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 | $1,259,752 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,481,608 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,761,434 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,234,957 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,054,446 | CurrentTaxYearAmt |
| Total | $15,792,197 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,259,752 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,481,608 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,761,434 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,234,957 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,054,446 | CurrentTaxYearAmt |
| Total | $15,792,197 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $15,792,197 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $41,612 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $64,077 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $29,054 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $38,643 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $35,169 | CurrentTaxYearAmt |
| Total | $208,555 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,009 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $1,009 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $16,001,761 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $0 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.98690 | PublicSupportCY170Pct |
| Public Support PY170 | 0.98419 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests PY170 | Yes (X) | ThirtyThrPctSuprtTestsPY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part II, Line 10 | FormAndLineReferenceDesc |
| Explanation | Gross receipts from Fundraising Event $1,009 FYE 6/30/2016 Sched A Part II Line 10 Gain on Sale of Capital assets 16,167 (Sale of Land lot gain $11,120 /Sale of Stock $5.047) FYE 6/30/2020 | 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
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,081,358 | BeginningYearBalanceAmt |
| Contributions | $10,000 | ContributionsAmt |
| Investment Earnings Or Losses | -$3,598 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $13,814 | OtherExpendituresAmt |
| Administrative Expenses | $5,992 | AdministrativeExpensesAmt |
| End Year Balance | $1,067,954 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,010,118 | BeginningYearBalanceAmt |
| Contributions | $40,435 | ContributionsAmt |
| Investment Earnings Or Losses | $49,560 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $12,935 | OtherExpendituresAmt |
| Administrative Expenses | $5,820 | AdministrativeExpensesAmt |
| End Year Balance | $1,081,358 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $749,717 | BeginningYearBalanceAmt |
| Contributions | $222,211 | ContributionsAmt |
| Investment Earnings Or Losses | $55,823 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $12,611 | OtherExpendituresAmt |
| Administrative Expenses | $5,022 | AdministrativeExpensesAmt |
| End Year Balance | $1,010,118 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $679,386 | BeginningYearBalanceAmt |
| Contributions | $4,166 | ContributionsAmt |
| Investment Earnings Or Losses | $70,450 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $0 | OtherExpendituresAmt |
| Administrative Expenses | $4,285 | AdministrativeExpensesAmt |
| End Year Balance | $749,717 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $682,540 | BeginningYearBalanceAmt |
| Contributions | $20,500 | ContributionsAmt |
| Investment Earnings Or Losses | -$6,944 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $12,684 | OtherExpendituresAmt |
| Administrative Expenses | $4,026 | AdministrativeExpensesAmt |
| End Year Balance | $679,386 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.673 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.327 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.0 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $27,160 | OtherCostOrOtherBasisAmt |
| Book Value | $27,160 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $1,825,101 | OtherCostOrOtherBasisAmt |
| Depreciation | $676,306 | DepreciationAmt |
| Book Value | $1,148,795 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $218,550 | OtherCostOrOtherBasisAmt |
| Depreciation | $204,170 | DepreciationAmt |
| Book Value | $14,380 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,190,335 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Beneficial Interest in Assets Held by Community Foundation | $1,067,954 |
| Cash Surrender Value of Life Insurance | $25,282 |
| Long term Certificates of Deposit | $273,433 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,366,669 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
| Total Liability | $0 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $6,327,327 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$35,652 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $1,263,190 | DonatedServicesAndUseFcltsAmt |
| Recoveries Prior Year Grants | $0 | RecoveriesPriorYearGrantsAmt |
| Other Revenue | $0 | OtherRevenueAmt |
| Revenue Not Reported | $1,227,538 | RevenueNotReportedAmt |
| Revenue Subtotal | $5,099,789 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $5,992 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $0 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $5,992 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $5,105,781 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,295,346 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $1,263,197 | DonatedServicesUseFcltsAmt |
| Prior Year Adjustments | $0 | PriorYearAdjustmentsAmt |
| Losses Reported | $0 | LossesReportedAmt |
| Other Expenses Included | $0 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $1,263,197 | ExpensesNotReportedAmt |
| Expenses Subtotal | $5,032,149 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $5,992 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $0 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $5,992 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $5,038,141 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part V, Line 4 | CHFC Intends to use the earnings from the endowment funds for long term financial support of the clinic. |
| Schedule D, Part X, Line 2 | The organization is exempt from income taxes under section 501(c)(3) or the IRS tax code and a similar section of the IA Income tax law, which provides income tax exemption for corporations organized and operated exclusively for religious, charitable or educational purposes. The IRS has not classified the organization as a private foundation. The organization files information returns i the US Federal jurisdiction and follows the standard for evaluating uncertain tax positions. The organization has determined that it was not required to record a liablility related to uncertain tax postions. |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $894 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 240 | ContributionCnt |
| Noncash Contributions Rpt F990 | $4,259,849 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule M, Part I, Line 9 | Sched M Part ! Line 9 is the # of donors in this category. |
| Schedule M, Part I, Line 20 | Schedule M Part 1 Line 20 is an estimate of the number of donors in this category. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, Line 11b | The Federal Form 990 is prepared by the clinics Director of Finance and reviewed by the Board treasurer and a volunteer. The Federal form 990 is then marked draft and sent to the CHFC Board Members for review and approval (after any discussion or comments or necessary changes). The document is sent via email and all approvals are documented via email/ZOOM due to COVID. After all comments are addressed the Federal Form 990 is filed. |
| Form 990, Part VI, Section B, Line 12c | Upon first being elected to the Board of Directors, Appointed to a Board Committee or Elected as an Officer to the CHFC, The Board Member, Board Committee Member or Officer is required to complete the conflict of interest disclosures statement and submit the statement to the Board President. If the Board President has concerns about any statement, he/she shall submit the statement to the executive committee of the CHFC Board of Directors. Each statemtent shall be resubmitted with any necessary changes each year or as any additional conflicts or interest arise. Statements are retained by the executive director in CHFC offices. |
| Form 990, Part VI, Section B, Line 15 | In July of each year, the CEO/Clinic executive director drafts a list of annual goals & objectives and provides it to the President of the Board of Directors. The Board reviews the goals and objectives at the annual beginning of the fiscal year meeting in July. Any modifications suggested are incorparated as appropriate and the benchmark for the fiscal year is finalized in June (End of fiscal year). CEO provides the President of the BOD with a document that details his/her performance against annual goals & objectives against the annual goals approved the prior July. After a review with the CEO/Director the President of teh BOD assigns the performance review and overall grade of (A) fails to meet expectations, B Meets expectations or C exceeds expectations. During June and July the president of the BOD reviews comparable salaries and wage changes for the local area for the coming year and determines specific salary changes are appropriate based on performance for the year and budgetary constraints (normally stated as a %increase). The Board President seeks concurrence of the Executive Committee (independent of the CEO0 for the overall grade and suggested increase. The CEO/Directors overall grade and salary increase are voted on by the BOD. The specifics of the salary increase are not documented in the board meeting minutes to provide confidentiality. The Presidents communication with teh treasurer are sufficient documentation. Salary changes become effective the first day of the fiscal year . No other compensated individual meets the IRS definition of officer or key employee. |
| Form 990, Part VI, Section C, Line 19 | CHFC makes its governing documents, conflict of interest policy and financial statements available to the public upon request via both hard copy and/or electronic format. |