FUNCTIONAL HEALTH INC: Form 990EZ, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- FUNCTIONAL HEALTH INC (EIN 01-0967384)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-10-15
- IRS object ID
- 202012899349200111
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-10-15T08:45:31-05:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 581790414 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | J D REESE & ASSOCIATES INC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4360 CHAMBLEE DUNWOODY RD STE 510 | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30341 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010967384 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FUNCTIONAL HEALTH INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FUNC | BusinessNameControlTxt |
| Phone | 6785967384 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 E PACES FERRY RD NE NO 201 | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30305 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | HENRY JACOBS | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6785967384 | PhoneNum |
| Signature | 2020-10-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JUDENE D REESE | PreparerPersonNm |
| PTIN | P01441192 | PTIN |
| Phone | 7704571040 | PhoneNum |
| Preparation | 2020-10-02 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 45.24.186.161 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-10-02 | IPDt |
| IP Tm | 18:52:10 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 90226AC8EA3541C97F095E17B05CA84ABF68B7FD | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 90226AC8EA3541C97F095E17B05CA84ABF68B7FD | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Website Address | N/A | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $117,792 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $23,337 | ContributionsGiftsGrantsEtcAmt |
| Program Service Revenue | $94,455 | ProgramServiceRevenueAmt |
| Total Revenue | $117,792 | TotalRevenueAmt |
| Salaries Other Comp Empl Bnft | $55,004 | SalariesOtherCompEmplBnftAmt |
| Fees And Other Pymt To Ind Cntrct | $15,696 | FeesAndOtherPymtToIndCntrctAmt |
| Occupancy Rent Utlts And Maint | $16,800 | OccupancyRentUtltsAndMaintAmt |
| Other Expenses Total | $42,585 | OtherExpensesTotalAmt |
| Total Expenses | $130,085 | TotalExpensesAmt |
| Excess Or Deficit For Year | -$12,293 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | -$245,118 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | -$257,411 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,856 | BOYAmt |
| EOY | $1,514 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,856 | BOYAmt |
| EOY | $1,514 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $260,974 | BOYAmt |
| EOY | $258,925 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$245,118 | BOYAmt |
| EOY | -$257,411 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Primary Exempt Purpose | TESTING MULTIPLE SCLEROSIS PATIENTS FOR POSSIBLE TREATMENTS TO ALLEVIATE SYMPTOMS OF CHRONIC CEREBROSPINAL VENOUS INSUFFICIENCY AND TO PROVIDE WELLNESS EVALUATIONS. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | EXPENSES RELATED TO PROGRAM FUNCTIONS | DescriptionProgramSrvcAccomTxt |
| Grants And Allocations | $0 | GrantsAndAllocationsAmt |
| Program Service Expenses | $0 | ProgramServiceExpensesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $0 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (2 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| HENRY JACOBS | ||||
| CEO | 10.00 | $0 | $0 | $0 |
| STEVE CLARK | ||||
| CFO | 5.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | 0 | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | 0 | OrganizationHadUBIInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Direct Indirect Pltcl Expend | $0 | DirectIndirectPltclExpendAmt |
| Made Loans To From Officers | Yes (1) | MadeLoansToFromOfficersInd |
| Loans To From Officers | $167,899 | LoansToFromOfficersAmt |
| Tax Imposed Under IRC4911 | $0 | TaxImposedUnderIRC4911Amt |
| Tax Imposed Under IRC4912 | $0 | TaxImposedUnderIRC4912Amt |
| Tax Imposed Under IRC4955 | $0 | TaxImposedUnderIRC4955Amt |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| Tax Imposed On Organization Mgr | $0 | TaxImposedOnOrganizationMgrAmt |
| Tax Reimbursed By Organization | $0 | TaxReimbursedByOrganizationAmt |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRY JACOBS | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 255 E PACES FERRY STE 201 | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30305 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4042330208 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Donor Advised Fnds | 0 | DonorAdvisedFndsInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Tanning Services Provided | 0 | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| School Operating | 0 | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (1) | FiledScheduleAInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,010 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $23,337 | CurrentTaxYearAmt |
| Total | $56,347 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $81,009 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $128,761 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $120,960 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $144,770 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $94,455 | CurrentTaxYearAmt |
| Total | $569,955 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $84,019 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $138,761 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $130,960 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $154,770 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $117,792 | CurrentTaxYearAmt |
| Total | $626,302 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $626,302 | PublicSupportTotal170Amt |
| Total Support | $626,302 | TotalSupportAmt |
| Public Support CY170 | 1.00000 | PublicSupportCY170Pct |
| Public Support PY170 | 1.00000 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | HENRY JACOBS | PersonNm |
| Relationship With Org | CEO | RelationshipWithOrgTxt |
| Loan Purpose | TO ASSIST WITH NORMAL OPERATIONS | LoanPurposeTxt |
| Loan To Organization | Yes (X) | LoanToOrganizationInd |
| Original Principal | $47,000 | OriginalPrincipalAmt |
| Balance Due | $167,899 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $167,899 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES | DESCRIPTION: BANK FEES. AMOUNT: 553. DESCRIPTION: INTEREST EXPENSE. AMOUNT: 5,355. DESCRIPTION: LAB TESTING. AMOUNT: 22,582. DESCRIPTION: OFFICE SUPPLIES. AMOUNT: 701. DESCRIPTION: TAXES-PAYROLL. AMOUNT: 4,208. DESCRIPTION: TRANSPORTATION. AMOUNT: 2,175. DESCRIPTION: INSURANCE. AMOUNT: 3,753. DESCRIPTION: LICENSES/PERMITS. AMOUNT: 268. DESCRIPTION: EQUIPMENT MAINT/REPAIRS. AMOUNT: 2,990. TOTAL TO FORM 990-EZ, LINE 16: 42,585. |
| FORM 990-EZ, PART II, LINE 26 - OTHER LIABILITIES | DESCRIPTION: ACCOUNTS PAYABLE. BEG. OF YEAR AMOUNT: 156,887. END OF YEAR AMOUNT: 88,832. DESCRIPTION: LOANS FROM OFFICERS/DIRECTORS. BEG. OF YEAR AMOUNT: 103,611. END OF YEAR AMOUNT: 167,899. DESCRIPTION: PAYROLL LIABILITIES. BEG. OF YEAR AMOUNT: 476. END OF YEAR AMOUNT: 2,194. |
Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Declaration | THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT. | DeclarationDesc |