GOOD SAMARITAN HEALTH CENTER INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- GOOD SAMARITAN HEALTH CENTER INC (EIN 58-2373395)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-10
- IRS object ID
- 202123149349303057
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-10T08:45:47-08:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 582157642 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLAD & ASSOCIATES PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1832 Independence Square Ste A | AddressLine1Txt |
| City | Dunwoody | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30338 | 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 | 582373395 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE GOOD SAMARITAN HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GOOD | BusinessNameControlTxt |
| Phone | 6785534902 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1015 DONALD LEE HOLLOWELL PKWY | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30318 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | WILLIAM WARREN IV | PersonNm |
| Person Title | FOUNDER & CEO | PersonTitleTxt |
| Signature | 2021-11-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | WILLIAM WARREN | PersonFirstNm |
| Person Last | IV | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Robert S Blad CPA | PreparerPersonNm |
| PTIN | P00197666 | PTIN |
| Phone | 7705127600 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Federated Assurance Level | FAL1 | FederatedAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WILLIAM WARREN IV | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1015 DONALD LEE HOLLOWELL PKWY | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30318 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,111,048 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GOODSAMATLANTA.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1998 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | The mission of the Organization is spreading Christs love through quality healthcare to those in need. The Organization provides comprehensive primary care to low-income, uninsured individuals in greater metropolitan Atlanta. | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 18 | VotingMembersIndependentCnt |
| Total Employee | 64 | TotalEmployeeCnt |
| Total Volunteers | 100 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $2,569,035 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,109,935 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,019,478 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $778,801 | CYProgramServiceRevenueAmt |
| PY Investment Income | $319,281 | PYInvestmentIncomeAmt |
| CY Investment Income | $148,002 | CYInvestmentIncomeAmt |
| PY Other Revenue | $23,130 | PYOtherRevenueAmt |
| CY Other Revenue | $37,023 | CYOtherRevenueAmt |
| PY Total Revenue | $3,930,924 | PYTotalRevenueAmt |
| CY Total Revenue | $5,073,761 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,596,274 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,722,653 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $267,501 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,807,794 | PYOtherExpensesAmt |
| CY Other Expenses | $1,804,086 | CYOtherExpensesAmt |
| PY Total Expenses | $4,404,068 | PYTotalExpensesAmt |
| CY Total Expenses | $4,526,739 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$473,144 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $547,022 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,976,117 | TotalAssetsBOYAmt |
| Total Assets EOY | $14,292,988 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $417,627 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $666,023 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $12,558,490 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $13,626,965 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Spreading Christs love through quality healthcare to those in need. We are a non-profit 501(c)(3) organization that is a health care home providing comprehensive primary care to low-income, uninsured individuals in greater metropolitan Atlanta. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $3,994,077 | ExpenseAmt |
| Revenue | $778,801 | RevenueAmt |
| Desc | The Good Samaritan Health Center provides comprehensive primary medical care for the medically underserved working poor, uninsured, and homeless. Services are provided by staff and volunteer medical professionals. Medical services provided include comprehensive pediatric and adult primary care, diagnostic and referral services, mammograms, laboratory services, vaccines, well prenatal care, internal medicine, chronic disease management, and nutrition counseling. Specialty care services are also provided and include cardiology, gastroenterology, pulmonology, gynecology, diabetes foot care, ophthalmology, optometry, orthopedics, and radiology. Specialty clinics are offered for prosthetics and orthotics and for pediatric developmental care.The Good Samaritan Health Center provides comprehensive primary dental care for the underserved working poor, uninsured, and homeless. Services are provided by staff and volunteer dental professionals. Dental services include preventative and restorative care including general family and preventative dentistry, endodontics, oral surgery, and prosthodontics. The Good Samaritan Health Center provides mental health counseling care for the underserved working poor, uninsured, and homeless. Services are provided by staff licensed professional counselors and volunteer mental health professionals. Services include individual and family mental health counseling, play therapy, and group therapy.The Good Samaritan Health Center provides health education for the underserved working poor, uninsured, and homeless. Health education is provided by a staff registered dietitian, staff and volunteer healthcare professionals, and graduate student programs. Health education services include healthy cooking classes in an on-site teaching kitchen, diabetes education and management courses, and childbirth education.To quality for services, patients must be uninsured with a household income at or below 200% of the federal poverty level or eligible for Medicaid/Medicare. Patients pay for services on a reduced sliding fee scale that is based on income and household size. Those who are unable to pay receive care at no charge. | Desc |
| Total Program Service Expenses | $3,994,077 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| 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 | Yes (true) | 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 | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | 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 | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| 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 | false | 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 |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 38 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 64 | 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 |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| 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 | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 18 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | 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 | Yes (true) | 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 | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
| Other | Yes (X) | OtherInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NOVLETTE HENRY | PersonNm |
| Phone | 6785534902 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1015 DONALD LEE HOLLOWELL PKWY | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30318 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| DR JOHN SIEWEKE | |||||||
| Dental Serv Dir. | 40.00 | 0.00 | $159,127 | $0 | $13,603 | ||
| DR MELISSA SANCHEZ | |||||||
| Family Physician | 40.00 | 0.00 | $129,963 | $0 | $17,478 | ||
| BREANNA LATHROP | |||||||
| COO | 40.00 | 0.00 | $134,227 | $0 | $2,640 | Yes (X) | |
| VERONICA SQUIRES | |||||||
| CAO | 40.00 | 0.00 | $112,313 | $0 | $2,206 | Yes (X) | |
| DAVID PATTILLO | |||||||
| Director | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| KIRK MCALPIN JR | |||||||
| Director | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| KATHRYN B MILLER | |||||||
| Chairman | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| JAMES WELLMAN | |||||||
| Director | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| JEFFREY ADAMS | |||||||
| Treasurer | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) |
| DAN CALLAHAN | |||||||
| Director | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| BEN WILLS | |||||||
| Director | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| DOUG WILLIAMS | |||||||
| Director | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| WILLIAM HOYT | |||||||
| Director | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| MADISON COLE | |||||||
| DEVELOPM. CHAIR | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| S DOUGLAS KING | |||||||
| Director | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| PEYTON MCWHIRTER | |||||||
| Vice Chair | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| MONICA PARKER | |||||||
| Director | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| ANNE CULBERSON | |||||||
| Director | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| GLENN WARREN | |||||||
| Secretary | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) |
| WILLIAM WARREN IV | |||||||
| FOUNDER & CEO | 40.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) |
| MARK BRYANT CHANDLER SR | |||||||
| Director | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| STUDIE YOUNG | |||||||
| Director | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $535,630 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $35,927 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $344,910 | FundraisingAmt |
| Government Grants | $593,482 | GovernmentGrantsAmt |
| All Other Contributions | $3,171,543 | AllOtherContributionsAmt |
| Total Contributions | $4,109,935 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | HEALTHCARE SERVICES | Desc |
| Total Revenue Column | $778,801 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $778,801 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $778,801 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $148,002 | TotalRevenueColumnAmt |
| Exclusion | $148,002 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $72,410 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $344,910 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $37,287 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,123 | TotalRevenueColumnAmt |
| Exclusion | $35,123 | ExclusionAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER REVENUE | Desc |
| Total Revenue Column | $1,900 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,900 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,900 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,073,761 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $780,701 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $183,125 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $247,996 | TotalAmt |
| Program Services | $191,840 | ProgramServicesAmt |
| Management And General | $28,078 | ManagementAndGeneralAmt |
| Fundraising | $28,078 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,008,238 | TotalAmt |
| Program Services | $1,804,025 | ProgramServicesAmt |
| Management And General | $128,053 | ManagementAndGeneralAmt |
| Fundraising | $76,160 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,309 | TotalAmt |
| Program Services | $34,773 | ProgramServicesAmt |
| Management And General | $2,720 | ManagementAndGeneralAmt |
| Fundraising | $1,816 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245,260 | TotalAmt |
| Program Services | $216,957 | ProgramServicesAmt |
| Management And General | $16,972 | ManagementAndGeneralAmt |
| Fundraising | $11,331 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $181,850 | TotalAmt |
| Program Services | $160,865 | ProgramServicesAmt |
| Management And General | $12,584 | ManagementAndGeneralAmt |
| Fundraising | $8,401 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,859 | TotalAmt |
| Management And General | $24,859 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $293,260 | TotalAmt |
| Program Services | $202,877 | ProgramServicesAmt |
| Management And General | $3,809 | ManagementAndGeneralAmt |
| Fundraising | $86,574 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,274 | TotalAmt |
| Fundraising | $17,274 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,328 | TotalAmt |
| Program Services | $95,827 | ProgramServicesAmt |
| Management And General | $7,496 | ManagementAndGeneralAmt |
| Fundraising | $5,005 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,194 | TotalAmt |
| Program Services | $15,210 | ProgramServicesAmt |
| Management And General | $1,190 | ManagementAndGeneralAmt |
| Fundraising | $794 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $271,681 | TotalAmt |
| Program Services | $255,381 | ProgramServicesAmt |
| Management And General | $5,434 | ManagementAndGeneralAmt |
| Fundraising | $10,866 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,103 | TotalAmt |
| Program Services | $9,822 | ProgramServicesAmt |
| Management And General | $768 | ManagementAndGeneralAmt |
| Fundraising | $513 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $386,298 | TotalAmt |
| Program Services | $363,120 | ProgramServicesAmt |
| Management And General | $7,726 | ManagementAndGeneralAmt |
| Fundraising | $15,452 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,873 | TotalAmt |
| Program Services | $59,156 | ProgramServicesAmt |
| Management And General | $4,628 | ManagementAndGeneralAmt |
| Fundraising | $3,089 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| SUPPLIES | $392,862 | $392,862 | ||
| CLIENT ASSISTANCE | $129,148 | $129,148 | ||
| OTHER | $81,746 | $59,153 | $20,605 | $1,988 |
| Postage and Shipping | $3,460 | $3,061 | $239 | $160 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,526,739 | TotalAmt |
| Program Services | $3,994,077 | ProgramServicesAmt |
| Management And General | $265,161 | ManagementAndGeneralAmt |
| Fundraising | $267,501 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $520,524 | BOYAmt |
| EOY | $1,336,490 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $686,709 | BOYAmt |
| EOY | $515,308 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $391,227 | BOYAmt |
| EOY | $228,561 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,405 | BOYAmt |
| EOY | $146,551 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,330 | BOYAmt |
| EOY | $15,001 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,586 | BOYAmt |
| EOY | $9,123 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,311,584 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,921,891 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,181,438 | BOYAmt |
| EOY | $6,389,693 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,149,176 | BOYAmt |
| EOY | $5,609,539 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,722 | BOYAmt |
| EOY | $42,722 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,976,117 | BOYAmt |
| EOY | $14,292,988 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $157,627 | BOYAmt |
| EOY | $296,023 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $260,000 | BOYAmt |
| EOY | $370,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $417,627 | BOYAmt |
| EOY | $666,023 | 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 | $11,328,664 | BOYAmt |
| EOY | $12,704,578 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,229,826 | BOYAmt |
| EOY | $922,387 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,558,490 | BOYAmt |
| EOY | $13,626,965 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,976,117 | BOYAmt |
| EOY | $14,292,988 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $547,022 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $521,453 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | 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 | $3,141,890 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,435,834 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,100,326 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,569,035 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,109,935 | CurrentTaxYearAmt |
| Total | $15,357,020 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,141,890 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,435,834 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,100,326 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,569,035 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,109,935 | CurrentTaxYearAmt |
| Total | $15,357,020 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $1,225,410 | SubstantialContributorsTotAmt |
| Public Support Total170 | $14,131,610 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $72,866 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $91,428 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $87,057 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $121,239 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $110,510 | CurrentTaxYearAmt |
| Total | $483,100 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $15,840,120 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $476,877 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.89210 | PublicSupportCY170Pct |
| Public Support PY170 | 0.87640 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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 | $5,533,632 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $701,568 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $549,197 | OtherExpendituresAmt |
| Administrative Expenses | $29,084 | AdministrativeExpensesAmt |
| End Year Balance | $5,656,919 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,540,558 | BeginningYearBalanceAmt |
| Contributions | $450,000 | ContributionsAmt |
| Investment Earnings Or Losses | $999,108 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $425,167 | OtherExpendituresAmt |
| Administrative Expenses | $30,867 | AdministrativeExpensesAmt |
| End Year Balance | $5,533,632 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,209,017 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$327,504 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $308,634 | OtherExpendituresAmt |
| Administrative Expenses | $32,321 | AdministrativeExpensesAmt |
| End Year Balance | $4,540,558 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,757,863 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $717,457 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $232,780 | OtherExpendituresAmt |
| Administrative Expenses | $33,523 | AdministrativeExpensesAmt |
| End Year Balance | $5,209,017 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,713,196 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $292,130 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $222,915 | OtherExpendituresAmt |
| Administrative Expenses | $24,548 | AdministrativeExpensesAmt |
| End Year Balance | $4,757,863 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.82000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.18000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | false | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,644,897 | OtherCostOrOtherBasisAmt |
| Book Value | $2,644,897 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,724,965 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,117,651 | DepreciationAmt |
| Book Value | $3,607,314 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,700,571 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,573,709 | DepreciationAmt |
| Book Value | $126,862 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $241,151 | OtherCostOrOtherBasisAmt |
| Depreciation | $230,531 | DepreciationAmt |
| Book Value | $10,620 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $6,389,693 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $6,735,694 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $521,453 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $1,140,480 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $1,661,933 | RevenueNotReportedAmt |
| Revenue Subtotal | $5,073,761 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $5,073,761 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $5,667,219 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $1,140,480 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $1,140,480 | ExpensesNotReportedAmt |
| Expenses Subtotal | $4,526,739 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $4,526,739 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X : FIN48 Footnote | FormAndLineReferenceDesc |
| Explanation | The Organization recognizes the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authority, based on the technical merits of the position. As of December 31, 2020 and 2019, there are no known items which would result in a material accrual related to where the Organization has federal or state attributable tax positions. Generally, the taxing authorities have three years to examine a tax return from the later of the filing date or the extended due date. | ExplanationTxt |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agrmt Prof Fundraising Acty | false | AgrmtProfFundraisingActyInd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GALA | Event1Nm |
| Gross Receipts Event1 | $417,320 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $344,910 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $72,410 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $37,287 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $417,320 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $344,910 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $72,410 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $37,287 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $37,287 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $35,123 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DR JOHN SIEWEKE | PersonNm |
| Title | Dental Serv Dir. | TitleTxt |
| Base Compensation Filing Org | $159,127 | BaseCompensationFilingOrgAmt |
| Deferred Compensation Flng Org | $3,143 | DeferredCompensationFlngOrgAmt |
| Nontaxable Benefits Filing Org | $10,460 | NontaxableBenefitsFilingOrgAmt |
| Total Compensation Filing Org | $172,730 | TotalCompensationFilingOrgAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et | DR. WILLIAM WARREN, IV AND GLENN D. WARREN ARE BROTHERS. BOTH INDIVIDUALS SERVE ON THE ORGANIZATION'S BOARD. |
| Form 990, Part VI, Line 11b: Form 990 Review Process | THE ORGANIZATION PROVIDES A COPY OF FORM 990 TO THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL PRIOR TO FILING. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | ALL BOARD MEMBERS MUST SIGN THE CONFLICT OF INTEREST POLICY & DUTY TO DISCLOSE WHICH STATES "IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTANCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT."POLICY COMPLIANCE IS MONITORED BY THE ORGANIZATION'S GOVERNANCE AND EXECUTIVE COMMITTEE. |
| Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | THESE SALARIES ARE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS ON AN ANNUAL BASIS. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | THESE SALARIES ARE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS ON AN ANNUAL BASIS. |
| Form 990, Part VI, Line 18: Explanation of Other Means Forms Available For Public Inspection | THE ORGANIZATION PROVIDES A COPY OF THE FORM 990 SPECIFICALLY FOR PUBLIC INSPECTION. THIS COPY IS AVAILABLE ON THE ORGANIZATION'S WEBSITE AS WELL AS UPON REQUEST. THE ORGANIZATION ALSO POSTS A COPY OF FORM 990 ON THE GUIDESTAR WEBSITE. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | AVAILABLE UPON REQUEST. |