STRATEGY STUDIO / PUBLIC DATA EXPLORER

ADDICTION COUNSELOR CERTIFICATION BOARD OF OREGON: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
ADDICTION COUNSELOR CERTIFICATION BOARD OF OREGON (EIN 93-0795138)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-05-20
IRS object ID
202011419349301326
Schema version
2019v5.1
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

FieldValueIRS element (for citing)
Return2020-05-20T14:23:14-04:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line13rd Generation Accounting IncBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11804 NE 43rd AveAddressLine1Txt
CityPortlandCityNm
State AbbreviationORStateAbbreviationCd
ZIP97213ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN930795138EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ADDICTION COUNSELOR CERTIFICATION BOARD OF OREGONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlADDIBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12054 N VANCOUVERAddressLine1Txt
CityPortlandCityNm
State AbbreviationORStateAbbreviationCd
ZIP972171917ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARK DAVISPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone5032318164PhoneNum
Signature2020-05-19SignatureDt
Discuss With Paid PreparerfalseDiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSusan G RobertsonPreparerPersonNm
PTINP00774160PTIN
Phone5032827247PhoneNum
Preparation2020-05-20PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address76.105.154.53IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-05-20IPDt
IP Tm14:24:27IPTm
Federal Original Submission Id933053202014132hcsqlFederalOriginalSubmissionId
Federal Original Submission Id2020-05-20FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id9CB09A75C68D58FE86123B3A3E6186BFE654C41AAtSubmissionCreationDeviceId
At Submission Filing Device Id9CB09A75C68D58FE86123B3A3E6186BFE654C41AAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2020-11-19 02:30:22ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARK DAVISPrincipalOfficerNm
Gross Receipts$1,171,170GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1977FormationYr
Legal Domicile StateORLegalDomicileStateCd
Activity Or MissionCERTIFICATION OF ADDICTION COUNSELORS FOR THE STATE OF OREGONActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee10TotalEmployeeCnt
Total Volunteers16TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$437,075PYContributionsGrantsAmt
CY Contributions Grants$345,677CYContributionsGrantsAmt
PY Program Service Revenue$421,653PYProgramServiceRevenueAmt
CY Program Service Revenue$792,321CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$35,995PYOtherRevenueAmt
CY Other Revenue$33,172CYOtherRevenueAmt
PY Total Revenue$894,723PYTotalRevenueAmt
CY Total Revenue$1,171,170CYTotalRevenueAmt
PY Grants And Similar Paid$2,750PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$10,000CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$246,671PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$368,279CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$654,146PYOtherExpensesAmt
CY Other Expenses$580,796CYOtherExpensesAmt
PY Total Expenses$903,567PYTotalExpensesAmt
CY Total Expenses$959,075CYTotalExpensesAmt
PY Revenues Less Expenses-$8,844PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$212,095CYRevenuesLessExpensesAmt
Total Assets BOY$120,556TotalAssetsBOYAmt
Total Assets EOY$326,011TotalAssetsEOYAmt
Total Liabilities BOY$9,506TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,629TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$111,050NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$324,382NetAssetsOrFundBalancesEOYAmt
MissionCERTIFICATION OF ADDICTION COUNSELORS FOR THE STATE OF OREGONMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$957,297ExpenseAmt
Grant$10,000GrantAmt
Revenue$792,321RevenueAmt
DescCERTIFICATION OF ADDICITON COUNSELORS WITHIN THE STATE OF OREGON WITH SEMI ANNUAL EXAMINATIONS AND CERTIFICATE RENEWALSDesc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$1,778ExpenseAmt
DescTHE ASSOCIATION PUBLISHES A QUARTERLY NEWSLETTER THAT IS MAILED TO ALL THOSE CERTIFIED BY THE BOARDDesc
FieldValueIRS element (for citing)
Total Program Service Expenses$959,075TotalProgramServiceExpensesAmt
Described In Section501c3falseDescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntYes (true)BusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document4IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee10EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldORStatesWhereCopyOfReturnIsFldCd
OtherYes (X)OtherInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMARK DAVISPersonNm
Phone5032318164PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12054 N VANCOUVERAddressLine1Txt
CityPortlandCityNm
State AbbreviationORStateAbbreviationCd
ZIP972171917ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeInd
MARK DAVIS
PRESIDENT2.000.00Yes (X)Yes (X)$0$0$0
JULIA MINES
TREASURER0.000.00Yes (X)Yes (X)$0$0$0
JOSE GARCIA
SECRETARY0.000.00Yes (X)Yes (X)$0$0$0
DEBRA BUFFALO BO BIGELOW
DIRECTOR0.000.00Yes (X)$0$0$0
ANDREA QUICKSALL
DIRECTOR0.000.00Yes (X)$0$0$0
KEITH WALKER
DIRECTOR0.000.00Yes (X)$0$0$0
AJA STONER
DIRECTOR0.000.00Yes (X)$0$0$0
MICHAEL BRANDSMA
DIRECTOR0.000.00Yes (X)$0$0$0
BOB FORSYTH
DIRECTOR0.000.00Yes (X)$0$0$0
HEATHER JEFFERIS
DIRECTOR0.000.00Yes (X)$0$0$0
MARK LEWINSOHN
DIRECTOR0.000.00Yes (X)$0$0$0
TANYA PRITT
DIRECTOR0.000.00Yes (X)$0$0$0
AMY ASHTON-WILLIAMS
DIRECTOR0.000.00Yes (X)$0$0$0
LANA WINNIE
DIRECTOR0.000.00Yes (X)$0$0$0
TONY VEZINA
DIRECTOR0.000.00Yes (X)$0$0$0
FREDERICK STATEN
DIRECTOR0.000.00Yes (X)$0$0$0
VAN R BURNHAM
KEY EMPLOYEE40.000.00$65,840$0$0Yes (X)
MICHAEL RAVAZI
KEY EMPLOYEE40.000.00$55,704$0$0Yes (X)
ERIC MARTIN
KEY EMPLOYEE0.000.00$54,016$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$175,560TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$345,677GovernmentGrantsAmt
Total Contributions$345,677TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EXAM FEES541900$782,796$782,796
RECIPROCITY FEES541900$7,875$7,875
ACCREDITATION541900$1,650$1,650
FieldValueIRS element (for citing)
Total Program Service Revenue$792,321TotalProgramServiceRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MISCELLANEOUS541900$4,883$4,883
REIMBURSEMENT541900$9,500$9,500
LATINO CONFERENCE541900$18,789$18,789
FieldValueIRS element (for citing)
Other Revenue Total$33,172OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,171,170TotalRevenueColumnAmt
Related Or Exempt Func Income$825,493RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$10,000TotalAmt
Program Services$10,000ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$306,973TotalAmt
Program Services$306,973ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$30,769TotalAmt
Program Services$30,769ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$30,537TotalAmt
Program Services$30,537ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,380TotalAmt
Program Services$1,380ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$495TotalAmt
Program Services$495ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,897TotalAmt
Program Services$3,897ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$336TotalAmt
Program Services$336ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$77,991TotalAmt
Program Services$77,991ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$33,638TotalAmt
Program Services$33,638ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$7,242TotalAmt
Program Services$7,242ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$41,077TotalAmt
Program Services$41,077ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$282,629TotalAmt
Program Services$282,629ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$21,359TotalAmt
Program Services$21,359ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
POSTAGE AND SHIPPING$5,432$5,432
EXAMINATION EXPENSE$93,500$93,500
MISCELLANEOUS$6,238$6,238
REIMBURSEMENTS$500$500

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$5,082TotalAmt
Program Services$5,082ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$959,075TotalAmt
Program Services$959,075ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt
FieldValueIRS element (for citing)
Joint CostsYes (X)JointCostsInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$119,272BOYAmt
EOY$325,929EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$71BOYAmt
EOY$82EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,213BOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$11,402LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$11,402LandBldgEquipAccumDeprecAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$120,556BOYAmt
EOY$326,011EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,506BOYAmt
EOY$1,629EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,506BOYAmt
EOY$1,629EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$111,050BOYAmt
EOY$324,382EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$111,050BOYAmt
EOY$324,382EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$120,556BOYAmt
EOY$326,011EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$212,095ReconcilationRevenueExpnssAmt
Prior Period Adjustments$1,237PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,402OtherCostOrOtherBasisAmt
Depreciation$11,402DepreciationAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedfalseGrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1THE ALANO CLUB OF PORTLAND OREGONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1909 NW 24TH AVEAddressLine1Txt
CityPortlandCityNm
State AbbreviationORStateAbbreviationCd
ZIP97210ZIPCd
FieldValueIRS element (for citing)
Recipient EIN930370227RecipientEIN
IRC Section501C3IRCSectionDesc
Cash Grant$10,000CashGrantAmt
Purpose Of GrantTHE BETTERMENT OF THE ADDICTION FIELDPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org10000Total501c3OrgCnt
Total Other Org1TotalOtherOrgCnt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonMETROPLUS ASSOC OF ADDICTION PEER CPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionKEY EMPLOYEE OWNS 50RelationshipDescriptionTxt
Transaction$278,832TransactionAmt
TransactionPAYMENT FOR SERVICESTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 governing body review Part VI line 11No review was or will be conducted.
Conflict of interest policy compliance Part VI line 12cEvery member of the board and key employees are required to fill out a conflict of interest form each year and disclose any conflicts of interest on this form.
Form 990 availability to public Part VI line 18No Documents available to the public.
Governing documents etc available to public Part VI line 19No documents available to the public.
Explanation of other changes in net assets or fund balances Part XI line 9TRIBAL LIABILITY ADJUSTMENT