FREE CLINIC OF ROCKINGHAM COUNTY INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- FREE CLINIC OF ROCKINGHAM COUNTY INC (EIN 56-2003143)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-07-29
- IRS object ID
- 202142109349300219
- Schema version
- 2020v4.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-07-29T06:40:02-07:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | J Michael Fargis & Associates LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1826 | AddressLine1Txt |
| City | Reidsville | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27323 | 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 | 562003143 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Free Clinic of Rockingham County Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FREE | BusinessNameControlTxt |
| Phone | 3363493220 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O Box 2668 | AddressLine1Txt |
| City | Reidsville | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27323 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Joan Weisenbeck | PersonNm |
| Person Title | President | PersonTitleTxt |
| Phone | 3363493220 | PhoneNum |
| Signature | 2021-07-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Joan | PersonFirstNm |
| Person Last | Weisenbeck | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Marie F Martin | PreparerPersonNm |
| PTIN | P00629714 | PTIN |
| Phone | 3363494372 | PhoneNum |
| Preparation | 2021-07-29 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | David French | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O Box 2668 | AddressLine1Txt |
| City | Reidsville | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27323 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $596,955 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | To provide for the basic medical and dental needs of the working poor of Rockingham County thru volunteer medical professionals. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 7 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $337,793 | PYContributionsGrantsAmt |
| CY Contributions Grants | $473,699 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,092 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,820 | CYProgramServiceRevenueAmt |
| PY Investment Income | $49,822 | PYInvestmentIncomeAmt |
| CY Investment Income | $41,041 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $389,707 | PYTotalRevenueAmt |
| CY Total Revenue | $516,560 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $249,963 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $321,953 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $30,424 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $71,593 | PYOtherExpensesAmt |
| CY Other Expenses | $55,885 | CYOtherExpensesAmt |
| PY Total Expenses | $321,556 | PYTotalExpensesAmt |
| CY Total Expenses | $377,838 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $68,151 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $138,722 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $622,606 | TotalAssetsBOYAmt |
| Total Assets EOY | $755,218 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $11,533 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,623 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $611,073 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $749,595 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To provide for the basic medical and dental needs of the working poor of Rockingham County thru volunteer medical professionals. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $225,947 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $516,560 | RevenueAmt |
| Desc | To provide dental, medical and pharmacy services to the working poor at a very nominal cost. | Desc |
| Total Program Service Expenses | $225,947 | 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 | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | 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 |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 7 | 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 | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicyInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kim Rider | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3363493220 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | South Main St | AddressLine1Txt |
| City | Reidsville | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27320 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|
| Kim Rider | ||||||
| Executive Director | 32.00 | Yes (X) | $81,025 | $0 | $0 | |
| Joan Weisenbeck | ||||||
| President | 1.00 | $0 | $0 | $0 | Yes (X) | |
| David French | ||||||
| Past President | 1.00 | $0 | $0 | $0 | Yes (X) | |
| Antoine Alston | ||||||
| Director | 1.00 | $0 | $0 | $0 | Yes (X) | |
| Zack Brown | ||||||
| Treasurer | 1.00 | $0 | $0 | $0 | Yes (X) | |
| Lynn Wilkins | ||||||
| Secretary | 1.00 | $0 | $0 | $0 | Yes (X) | |
| Morgan Moore | ||||||
| Director | 1.00 | $0 | $0 | $0 | Yes (X) | |
| Lorie McKinney | ||||||
| Director | 1.00 | $0 | $0 | $0 | Yes (X) | |
| John Ferguson | ||||||
| Medical Director | 2.00 | $0 | $0 | $0 | Yes (X) | |
| Beth Simmons | ||||||
| Director | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Amy G Smith | ||||||
| Director | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Savannah Mims | ||||||
| Director | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Scott Potter | ||||||
| Director | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Meryl Murphy | ||||||
| Vice President | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $81,025 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $175,931 | GovernmentGrantsAmt |
| All Other Contributions | $297,768 | AllOtherContributionsAmt |
| Noncash Contributions | $0 | NoncashContributionsAmt |
| Total Contributions | $473,699 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Patient Payments | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $1,820 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,820 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $36,953 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $36,953 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $77,489 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $73,401 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,088 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,088 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,088 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $6,994 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $19,552 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $6,994 | 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 |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $516,560 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,908 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $36,953 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,025 | TotalAmt |
| Program Services | $32,410 | ProgramServicesAmt |
| Management And General | $40,512 | ManagementAndGeneralAmt |
| Fundraising | $8,103 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $202,811 | TotalAmt |
| Program Services | $141,968 | ProgramServicesAmt |
| Management And General | $40,562 | ManagementAndGeneralAmt |
| Fundraising | $20,281 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,892 | TotalAmt |
| Program Services | $3,446 | ProgramServicesAmt |
| Management And General | $3,446 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,888 | TotalAmt |
| Program Services | $4,444 | ProgramServicesAmt |
| Management And General | $4,444 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,337 | TotalAmt |
| Program Services | $13,849 | ProgramServicesAmt |
| Management And General | $6,448 | ManagementAndGeneralAmt |
| Fundraising | $2,040 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,520 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $2,520 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,509 | TotalAmt |
| Program Services | $1,000 | ProgramServicesAmt |
| Management And General | $6,509 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,405 | TotalAmt |
| Program Services | $2,043 | ProgramServicesAmt |
| Management And General | $1,362 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,100 | TotalAmt |
| Program Services | $2,170 | ProgramServicesAmt |
| Management And General | $930 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,235 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $3,235 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,733 | TotalAmt |
| Program Services | $4,013 | ProgramServicesAmt |
| Management And General | $1,720 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Licenses | $520 | $520 | $0 | $0 |
| Medical Supplies | $7,612 | $7,612 | $0 | $0 |
| Telephone | $3,573 | $2,144 | $1,429 | $0 |
| Miscellaneous | $1,353 | $0 | $1,353 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,325 | TotalAmt |
| Program Services | $10,328 | ProgramServicesAmt |
| Management And General | $6,997 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $377,838 | TotalAmt |
| Program Services | $225,947 | ProgramServicesAmt |
| Management And General | $121,467 | ManagementAndGeneralAmt |
| Fundraising | $30,424 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,164 | BOYAmt |
| EOY | $7,057 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,791 | BOYAmt |
| EOY | $122,220 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $4,520 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,957 | BOYAmt |
| EOY | $3,291 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $390,807 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $320,994 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,546 | BOYAmt |
| EOY | $69,813 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $527,148 | BOYAmt |
| EOY | $548,317 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $622,606 | BOYAmt |
| EOY | $755,218 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,533 | BOYAmt |
| EOY | $5,623 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,533 | BOYAmt |
| EOY | $5,623 | 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 | $606,318 | BOYAmt |
| EOY | $744,840 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,755 | BOYAmt |
| EOY | $4,755 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $611,073 | BOYAmt |
| EOY | $749,595 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $622,606 | BOYAmt |
| EOY | $755,218 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $138,722 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$200 | PriorPeriodAdjustmentsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Audit Committee | false | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
| Other Support Sum | $0 | OtherSupportSumAmt |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $98,464 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $120,470 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $404,459 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $337,793 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $473,699 | CurrentTaxYearAmt |
| Total | $1,434,885 | 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 | $98,464 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $120,470 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $404,459 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $337,793 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $473,699 | CurrentTaxYearAmt |
| Total | $1,434,885 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $1,434,885 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $22,168 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $31,931 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,940 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $49,822 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $36,953 | CurrentTaxYearAmt |
| Total | $149,814 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,579 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,120 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,135 | CurrentTaxYearMinus2YearsAmt |
| Total | $16,834 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $1,601,533 | TotalSupportAmt |
| Public Support CY170 | 0.89590 | PublicSupportCY170Pct |
| Public Support PY170 | 0.86900 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
| Public Support Total509 | $0 | PublicSupportTotal509Amt |
| Public Support CY509 | 0 | PublicSupportCY509Pct |
| Investment Income CY | 0 | InvestmentIncomeCYPct |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Pt II Ln 10 | FormAndLineReferenceDesc |
| Explanation | Other Income Part II, Line 10 Description: Miscellaneous 2016: 1000. Description: Fees Paid 2016: 4579. 2017: 7120. 2018: 4135. | 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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Book Value | $0 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $115,795 | OtherCostOrOtherBasisAmt |
| Depreciation | $58,521 | DepreciationAmt |
| Book Value | $57,274 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $240,712 | OtherCostOrOtherBasisAmt |
| Depreciation | $231,602 | DepreciationAmt |
| Book Value | $9,110 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $34,300 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,871 | DepreciationAmt |
| Book Value | $3,429 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $69,813 | TotalBookValueLandBuildingsAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Rocktober Fest | Event1Nm |
| Gross Receipts Event1 | $15,897 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $13,094 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $2,803 | GrossRevenueEvent1Amt |
| Food And Beverage Event1 | $2,803 | FoodAndBeverageEvent1Amt |
| Event2 | Murder Mystery Dinner | Event2Nm |
| Gross Receipts Event2 | $10,649 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $6,458 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $4,191 | GrossRevenueEvent2Amt |
| Food And Beverage Event2 | $4,191 | FoodAndBeverageEvent2Amt |
| Other Events Total | 2 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $7,000 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $7,000 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $0 | GrossRevenueOtherEventsAmt |
| Food And Beverage Other Events | $0 | FoodAndBeverageOtherEventsAmt |
| Gross Receipts Total | $33,546 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $26,552 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $6,994 | GrossRevenueTotalEventsAmt |
| Food And Beverage Total Events | $6,994 | FoodAndBeverageTotalEventsAmt |
| Direct Expense Summary Events | $6,994 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $0 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Pt VI, Line 11b | FormAndLineReferenceDesc |
| Explanation | Executive Director & Executive Committee review | ExplanationTxt |