GREATER ATLANTA DENTAL FOUNDATION INC: Form 990EZ, tax year 2019
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- Organization
- GREATER ATLANTA DENTAL FOUNDATION INC (EIN 26-2647331)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-03-27
- IRS object ID
- 202020879349200802
- Schema version
- 2019v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-03-27T08:43:59-05:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 560574444 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHERRY BEKAERT LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1029 GREENE STREET | AddressLine1Txt |
| City | AUGUSTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30901 | 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 | 262647331 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREATER ATLANTA DENTAL FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GREA | BusinessNameControlTxt |
| Phone | 7702710634 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7000 PEACHTREE DUNWOODY NE NO 20 | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30328 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DR THOMAS JAGOR | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 7702710634 | PhoneNum |
| Signature | 2020-03-19 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KATHERINE MOOSARIPARAMBIL | PreparerPersonNm |
| PTIN | P01361871 | PTIN |
| Phone | 7067243557 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.173.220.64 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-03-19 | IPDt |
| IP Tm | 17:50:03 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 3A4BF1219698F5D6C2B7A21C22F2D88322611E38 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2020-09-22 18:59:49Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Website Address | HTTP://WWW.NDDS.ORG/GADF/INDEX.HTML | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $90,293 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $25,393 | ContributionsGiftsGrantsEtcAmt |
| Membership Dues | $5,155 | MembershipDuesAmt |
| Investment Income | $808 | InvestmentIncomeAmt |
| Fundraising Gross Income | $58,937 | FundraisingGrossIncomeAmt |
| Special Events Direct Expenses | $42,045 | SpecialEventsDirectExpensesAmt |
| Special Events Net Income Loss | $16,892 | SpecialEventsNetIncomeLossAmt |
| Total Revenue | $48,248 | TotalRevenueAmt |
| Grants And Similar Amounts Paid | $20,500 | GrantsAndSimilarAmountsPaidAmt |
| Fees And Other Pymt To Ind Cntrct | $1,449 | FeesAndOtherPymtToIndCntrctAmt |
| Printing Publications Postage | $480 | PrintingPublicationsPostageAmt |
| Other Expenses Total | $3,743 | OtherExpensesTotalAmt |
| Total Expenses | $26,172 | TotalExpensesAmt |
| Excess Or Deficit For Year | $22,076 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $249,305 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | $271,381 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $249,378 | BOYAmt |
| EOY | $276,215 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,560 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $249,378 | BOYAmt |
| EOY | $277,775 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73 | BOYAmt |
| EOY | $6,394 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $249,305 | BOYAmt |
| EOY | $271,381 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | ENHANCE DENTAL CARE IN THE COMMUNITY. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | OPERATION OF A FREE/LOW COST DENTAL CLINIC THAT ENHANCES HEALTHCARE IN THE COMMUNITY. | 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 (8 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| BEN JERNIGAN DMD | ||||
| PRESIDENT | 1.00 | $0 | $0 | $0 |
| SIDNEY TOURIAL DDS | ||||
| VICE PRESIDENT | 1.00 | $0 | $0 | $0 |
| TROY SCHULMAN DDS | ||||
| TREASURER | 1.00 | $0 | $0 | $0 |
| HENRY BENSON DDS | ||||
| TRUSTEE | 1.00 | $0 | $0 | $0 |
| VICTOR VAN GREUNINGEN DMD | ||||
| TRUSTEE | 1.00 | $0 | $0 | $0 |
| THOMAS JAGOR DDS | ||||
| TRUSTEE | 1.00 | $0 | $0 | $0 |
| AMY KUHMICHEL DMD | ||||
| TRUSTEE | 1.00 | $0 | $0 | $0 |
| RYAN VAUGHN DMD | ||||
| TRUSTEE | 1.00 | $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 | 0 | MadeLoansToFromOfficersInd |
| 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 | LISA VANZANDT | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7000 PEACHTREE DUNWOODY RD NE STE | AddressLine1Txt |
| Address Line2 | 200 | AddressLine2Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30328 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7702710453 | 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $66,191 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $89,312 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $37,448 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $36,157 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $30,548 | CurrentTaxYearAmt |
| Total | $259,656 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $66,191 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $89,312 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $37,448 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $36,157 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $30,548 | CurrentTaxYearAmt |
| Total | $259,656 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $259,656 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $371 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $472 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $607 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $741 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $808 | CurrentTaxYearAmt |
| Total | $2,999 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $262,655 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $177,175 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.98860 | PublicSupportCY170Pct |
| Public Support PY170 | 0.98970 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GALA FOR SMILES | Event1Nm |
| Gross Receipts Event1 | $84,187 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $25,250 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $58,937 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $21,533 | RentFacilityCostsEvent1Amt |
| Entertainment Event1 | $3,676 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $16,836 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $84,187 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $25,250 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $58,937 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $21,533 | RentFcltyCostsTotalEventsAmt |
| Entertainment Total Events | $3,676 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $16,836 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $42,045 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $16,892 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990-EZ, PART I, LINE 4 - OTHER INVESTMENT INCOME | DESCRIPTION: INTEREST INCOME. AMOUNT: 808. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: DENTAL SERVICES. GRANTEE NAME: DDD FOUNDATION. GRANTEE ADDRESS: 52 EXECUTIVE PARK S #5203 ATLANTA, GA 30324. GRANTEE RELATIONSHIP: NONE. AMOUNT GIVEN: 2,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: DENTAL SERVICES. GRANTEE NAME: GOOD SAMARITAN DENTAL CLINIC. GRANTEE ADDRESS: 1015 DONALD LEE HOLLOWELL PKWY NW ATLANTA, GA 30318. GRANTEE RELATIONSHIP: NONE. AMOUNT GIVEN: 3,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: DENTAL SERVICES. GRANTEE NAME: GREEN WARREN DENTAL CLINIC. GRANTEE ADDRESS: 810 PINE ST GAINESVILLE, GA 30501. GRANTEE RELATIONSHIP: NONE. AMOUNT GIVEN: 4,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: DENTAL SERVICES. GRANTEE NAME: BEN MASSELL DENTAL CLINIC. GRANTEE ADDRESS: 700 14TH ST NW ATLANTA, GA 30318. GRANTEE RELATIONSHIP: NONE. AMOUNT GIVEN: 3,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: DENTAL SERVICES. GRANTEE NAME: GOOD SAMARITAN HEALTH CENTER OF GWINNETT, INC.. GRANTEE ADDRESS: 3700 CLUB DR LAWRENCEVILLE, GA 30044. GRANTEE RELATIONSHIP: NONE. AMOUNT GIVEN: 4,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: DENTAL SERVICES. GRANTEE NAME: TRUTH'S COMMUNITY CHURCH. GRANTEE ADDRESS: 250 LANGLEY DRIVE, SUITE 1316 LAWRENCEVILLE, GA 30046. GRANTEE RELATIONSHIP: NONE. AMOUNT GIVEN: 2,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: DENTAL SERVICES. GRANTEE NAME: ST. JOSEPH'S MERCY CARE. GRANTEE ADDRESS: 424 DECATUR ST SE ATLANTA, GA 30312. GRANTEE RELATIONSHIP: NONE. AMOUNT GIVEN: 2,500. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 20,500. |
| FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES | DESCRIPTION: CREDIT CARD FEES. AMOUNT: 3,606. DESCRIPTION: TELEPHONE. AMOUNT: 137. TOTAL TO FORM 990-EZ, LINE 16: 3,743. |
| FORM 990-EZ, PART II, LINE 24 - OTHER ASSETS | DESCRIPTION: ACCOUNTS RECEIVABLE. BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: 560. DESCRIPTION: PREPAID GALA EXPENSE. BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: 1,000. |
| FORM 990-EZ, PART II, LINE 26 - OTHER LIABILITIES | DESCRIPTION: ACCOUNTS PAYABLE. BEG. OF YEAR AMOUNT: 73. END OF YEAR AMOUNT: 950. DESCRIPTION: DUE TO GDA. BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: 5,444. |
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 |