NATIONAL ASSOCIATION OF FREE AND CHARITABLE CLINICS INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- NATIONAL ASSOCIATION OF FREE AND CHARITABLE CLINICS INC (EIN 56-2273242)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-05
- IRS object ID
- 202043109349300629
- 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 | 2020-11-05T07:55:15-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 521645472 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEIL AKMAN BAYLIN & COLEMAN PA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 WEST PADONIA ROAD SUITE 600 | AddressLine1Txt |
| City | TIMONIUM | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 210932186 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 562273242 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NATIONAL ASSOCIATION OF FREE AND | BusinessNameLine1Txt |
| Business Name Line2 | CHARITABLE CLINICS INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NATI | BusinessNameControlTxt |
| Phone | 7036477427 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1800 DIAGONAL ROAD SUITE 600 | AddressLine1Txt |
| City | ALEXANDRIA | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22314 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NICOLE LAMOUREUX BUSBY | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 7036477427 | PhoneNum |
| Signature | 2020-11-05 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ALLAN C SANDERS CPA | PreparerPersonNm |
| PTIN | P00919875 | PTIN |
| Phone | 4105614411 | PhoneNum |
| Preparation | 2020-10-08 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 35.231.96.58 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-11-05 | IPDt |
| IP Tm | 08:54:52 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | A864DEC620253801F8657F799340172B0E8B86AE | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 90510813AA5067228D5E979B4B0D666F774FC41B | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | NICOLE LAMOUREUX | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1800 DIAGONAL ROAD SUITE 600 | AddressLine1Txt |
| City | ALEXANDRIA | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22314 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,253,817 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NAFCCLINICS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2003 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | TO ENSURE THAT THE MEDICALLY UNDERSERVED HAVE ACCESS TO AFFORDABLE QUALITY HEALTH CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 4 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,086,377 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,818,569 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $231,320 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $304,092 | CYProgramServiceRevenueAmt |
| PY Investment Income | $11,766 | PYInvestmentIncomeAmt |
| CY Investment Income | $42,284 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $3,329,463 | PYTotalRevenueAmt |
| CY Total Revenue | $3,164,945 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,199,647 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,838,118 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $413,535 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $438,807 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $41,726 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $767,955 | PYOtherExpensesAmt |
| CY Other Expenses | $714,312 | CYOtherExpensesAmt |
| PY Total Expenses | $3,381,137 | PYTotalExpensesAmt |
| CY Total Expenses | $2,991,237 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$51,674 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $173,708 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $679,428 | TotalAssetsBOYAmt |
| Total Assets EOY | $823,711 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $381,438 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $306,996 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $297,990 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $516,715 | NetAssetsOrFundBalancesEOYAmt |
| Mission | CREATE AND MAINTAIN A NATIONAL ORGANIZATION FOR THE BENEFIT OF FREE CLINICS THROUGHOUT THE COUNTRY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $250,465 | ExpenseAmt |
| Revenue | $304,092 | RevenueAmt |
| Desc | THE NAFC ANNUAL SYMPOSIUM IS THE ONLY NATIONAL MEETING SOLELY DEDICATED TO PROVIDING HEALTH EDUCATION AND TRAINING FOR NAFC STAFF AND VOLUNTEERS WHO PROVIDE HEALTH CARE TO THE MEDICALLY UNDERSERVED. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,444,613 | ExpenseAmt |
| Grant | $1,838,118 | GrantAmt |
| Desc | CLINICS ESTABLISH AND MAINTAIN SERVICES THAT SUPPORT AND BENEFIT THE WORK OF THE MEMBERS IN THEIR EFFORTS TO PROVIDE HEALTH CARE TO THE UNINSURED AND UNDERINSURED. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $2,695,078 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 9 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 4 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | VA | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | WV | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7036477427 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1800 DIAGONAL ROAD SUITE 600 | AddressLine1Txt |
| City | ALEXANDRIA | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22314 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| ANGIE MCLAUGHLIN | ||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |
| ANTHONY L YOUNG ESQ | ||||||
| GENERAL COUNSEL | 5.00 | Yes (X) | $0 | $0 | $0 | |
| ARIANA GORDILLO | ||||||
| DIRECTOR OF STRATEGIC INITIATIVES | 40.00 | Yes (X) | $66,020 | $0 | $0 | |
| BOBBY KAPUR MD | ||||||
| PAST-CHAIR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| ISI IKHAREBHA GREEN | ||||||
| SECRETARY | 3.00 | Yes (X) | $0 | $0 | $0 | |
| JOHANNA HENZ | ||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |
| KERRY THOMPSON | ||||||
| VICE PRESIDENT | 40.00 | Yes (X) | $111,313 | $0 | $0 | |
| LARRY ROBINS | ||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |
| MAUREEN TOMOSCHUK | ||||||
| VICE CHAIR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| NANCY W HUDSON | ||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |
| RANDY JORDAN | ||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |
| SHANNON WATSON | ||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |
| STEPHANIE NELSON GARRIS | ||||||
| CHAIR | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| BETH ARMSTRONG | ||||||
| TREASURER | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| ADAM BRADLEY | ||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |
| KAT MASTRANGELO | ||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |
| NICOLE LAMOUREUX | ||||||
| PRESIDENT/CHIEF EXECUTIVE OFFICER | 40.00 | $196,032 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $373,365 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LOEWS HOTEL & CO | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 667 MADISON AVENUE | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10065 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | TEMPORARY OCCUPANCY | ServicesDesc |
| Compensation | $184,647 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Membership Dues | $316,871 | MembershipDuesAmt |
| All Other Contributions | $2,501,698 | AllOtherContributionsAmt |
| Total Contributions | $2,818,569 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SYMPOSIUM | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $304,092 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $304,092 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $304,092 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,873 | TotalRevenueColumnAmt |
| Exclusion | $17,873 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $113,283 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $88,872 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $24,411 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,411 | TotalRevenueColumnAmt |
| Exclusion | $24,411 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,164,945 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $304,092 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $42,284 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,838,118 | TotalAmt |
| Program Services | $1,838,118 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $391,388 | TotalAmt |
| Program Services | $298,099 | ProgramServicesAmt |
| Management And General | $70,561 | ManagementAndGeneralAmt |
| Fundraising | $22,728 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,393 | TotalAmt |
| Program Services | $12,724 | ProgramServicesAmt |
| Management And General | $8,037 | ManagementAndGeneralAmt |
| Fundraising | $632 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,026 | TotalAmt |
| Program Services | $19,823 | ProgramServicesAmt |
| Management And General | $4,692 | ManagementAndGeneralAmt |
| Fundraising | $1,511 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,720 | TotalAmt |
| Management And General | $53,720 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $151,537 | TotalAmt |
| Program Services | $123,880 | ProgramServicesAmt |
| Management And General | $27,657 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,807 | TotalAmt |
| Program Services | $11,882 | ProgramServicesAmt |
| Management And General | $22,378 | ManagementAndGeneralAmt |
| Fundraising | $7,547 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,589 | TotalAmt |
| Program Services | $5,112 | ProgramServicesAmt |
| Management And General | $432 | ManagementAndGeneralAmt |
| Fundraising | $45 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,622 | TotalAmt |
| Program Services | $78,661 | ProgramServicesAmt |
| Management And General | $18,900 | ManagementAndGeneralAmt |
| Fundraising | $6,061 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,794 | TotalAmt |
| Program Services | $18,529 | ProgramServicesAmt |
| Management And General | $167 | ManagementAndGeneralAmt |
| Fundraising | $2,098 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,198 | TotalAmt |
| Program Services | $318 | ProgramServicesAmt |
| Management And General | $15,880 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,772 | TotalAmt |
| Management And General | $4,772 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,528 | TotalAmt |
| Management And General | $8,528 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| SYMPOSIUM EXPENSE | $250,465 | $250,465 | ||
| TELEPHONE & WEBSITE | $33,804 | $32,694 | $1,110 | |
| BANK FEES | $17,555 | $17,555 | ||
| POSTAGE/SHIPPING | $5,921 | $4,773 | $44 | $1,104 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,991,237 | TotalAmt |
| Program Services | $2,695,078 | ProgramServicesAmt |
| Management And General | $254,433 | ManagementAndGeneralAmt |
| Fundraising | $41,726 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,554 | BOYAmt |
| EOY | $57,186 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,369 | BOYAmt |
| EOY | $83,298 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,964 | BOYAmt |
| EOY | $46,467 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,321 | BOYAmt |
| EOY | $41,239 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $63,046 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $45,949 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,798 | BOYAmt |
| EOY | $17,097 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $455,352 | BOYAmt |
| EOY | $544,354 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,070 | BOYAmt |
| EOY | $34,070 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $679,428 | BOYAmt |
| EOY | $823,711 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $228,813 | BOYAmt |
| EOY | $135,161 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $152,625 | BOYAmt |
| EOY | $171,835 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $381,438 | BOYAmt |
| EOY | $306,996 | 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 | $297,990 | BOYAmt |
| EOY | $516,715 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $297,990 | BOYAmt |
| EOY | $516,715 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $679,428 | BOYAmt |
| EOY | $823,711 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $173,708 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $52,022 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$7,005 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,310,511 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $812,984 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,377,807 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,517,698 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,180,507 | CurrentTaxYearAmt |
| Total | $10,199,507 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,310,511 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $812,984 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,377,807 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,517,698 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,180,507 | CurrentTaxYearAmt |
| Total | $10,199,507 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $10,199,507 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $32,541 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $28,644 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $16,366 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,704 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $42,284 | CurrentTaxYearAmt |
| Total | $136,539 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $32,541 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $28,644 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $16,366 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,704 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $42,284 | CurrentTaxYearAmt |
| Total | $136,539 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,343,052 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $841,628 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,394,173 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,534,402 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,222,791 | CurrentTaxYearAmt |
| Total | $10,336,046 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98680 | PublicSupportCY509Pct |
| Public Support PY509 | 0.98710 | PublicSupportPY509Pct |
| Investment Income CY | 0.01320 | InvestmentIncomeCYPct |
| Investment Income PY | 0.01290 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $39,781 | OtherCostOrOtherBasisAmt |
| Depreciation | $25,885 | DepreciationAmt |
| Book Value | $13,896 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $23,265 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,064 | DepreciationAmt |
| Book Value | $3,201 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $17,097 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENTS | Desc |
| Book Value | $544,354 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $544,354 | TotalBookValueSecuritiesAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $3,572,909 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $52,022 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $361,938 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $413,960 | RevenueNotReportedAmt |
| Revenue Subtotal | $3,158,949 | RevenueSubtotalAmt |
| Other Revenues Not Included | $5,996 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $5,996 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $3,164,945 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $3,355,921 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $361,938 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $2,746 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $364,684 | ExpensesNotReportedAmt |
| Expenses Subtotal | $2,991,237 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $2,991,237 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE ASSOCIATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITION TAKEN, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE ASSOCIATION FILES ITS FORMS 990 IN THE U.S. FEDERAL JURISDICTION AND VARIOUS STATES. THE ASSOCIATION IS GENERALLY NO LONGER SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE FOR YEARS BEFORE 2015. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | STOCK SALES 5,996. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | BOOK TO TAX DEPRECIATION 2,746. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (30 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| UBI CARITAS | |||||||
| 4442 HIGHLAND AVE | BEAUMONT | TX | 77705 | 760558225 | 501(C)(3) | $150,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| IBN SINA FOUNDATION INC | |||||||
| 11226 SOUTH WILCREST DR | HOUSTON | TX | 77099 | 760698464 | 501(C)(3) | $150,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| TOMAGWA MINISTRIES INC | |||||||
| 455 SCHOOL SUITE 30 | TOMBALL | TX | 77375 | 760280324 | 501(C)(3) | $138,627 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| CHRIST CLINIC INC | |||||||
| 2207 SHAWNEE CT | FORT COLLINS | CO | 805251849 | 455300042 | 501(C)(3) | $150,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| SAN JOSE CLINIC | |||||||
| 2615 FANNIN STREET | HOUSTON | TX | 77002 | 760373703 | 501(C)(3) | $150,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| TEXAS INTERNATIONAL INSTITUTE OF HEALTH PROFESSIONALS | |||||||
| 8121 BROADWAY ST SUITE 103 | HOUSTON | TX | 77061 | 461267820 | 501(C)(3) | $150,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| CASA EL BUEN SAMARITANO | |||||||
| 4265 SAN FELIPE 110 | HOUSTON | TX | 77027 | 371546805 | 501(C)(3) | $108,175 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| PEDI PLACE | |||||||
| 502 S OLD ORCHARD LANE SUITE 126 | LEWISVILLE | TX | 75067 | 752512752 | 501(C)(3) | $38,200 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| UNITED HEALTH PARTNERS | |||||||
| 6846 ANTOINE DRIVE | HOUSTON | TX | 77091 | 611757254 | 501(C)(3) | $149,180 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| ST VINCENT DE PAUL CHARITABLE PHARMACY | |||||||
| 1125 BANK STREET | CINCINNATI | OH | 45214 | 300272954 | 501(C)(3) | $25,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| BEACON CHARITABLE PHARMACY | |||||||
| 408 9TH ST SW SUITE 150 | CANTON | OH | 44707 | 200797475 | 501(C)(3) | $25,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| LAKE COUNTY FREE CLINIC | |||||||
| 54 S STATE ST STE 302 | PAINESVILLE | OH | 44077 | 341081191 | 501(C)(3) | $25,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| LUKE'S HOUSE A CLINIC FOR HOPE AND HEALING | |||||||
| 143 CHURCH ST | PHOENIXVILLE | PA | 19460 | 233072363 | 501(C)(3) | $25,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| HANDS TOGETHER FAMILY HEALTH CENTER INC | |||||||
| 1960 W BYPASS RD STE 175 | HUMBLE | TX | 77388 | 473286543 | 501(C)(3) | $103,840 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| SMITHVILLE COMMUNITY CLINIC | |||||||
| 300 LYNCH ST | SMITHVILLE | TX | 78957 | 204515999 | 501(C)(3) | $96,996 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| HEALTH PARTNERS FREE CLINIC | |||||||
| 1300 N COUNTY RD 25A | TROY | OH | 45373 | 311596731 | 501(C)(3) | $20,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| PHYSICIANS CARECONNECTION | |||||||
| 1390 DUBLIN RD | COLUMBUS | OH | 43215 | 311373719 | 501(C)(3) | $25,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| HELPING HANDS HEALTH AND WELLNESS CENTER | |||||||
| 5100 KARL RD | COLUMBUS | OH | 43229 | 205937457 | 501(C)(3) | $15,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| LA CLINICA LATINASPANISH FREE CLINIC | |||||||
| 2231 N HIGH ST | COLUMBUS | OH | 43201 | 205260283 | 501(C)(3) | $25,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| OHIO UNIVERSITY | |||||||
| 1 OHIO UNIVERSITY | ATHENS | OH | 45701 | 316402113 | 501(C)(3) | $25,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| CLEVELAND IBN SINA CLINIC | |||||||
| 9362 SAGAMORE CIRCLE | STRONGSVILLE | OH | 44136 | 834347692 | 501(C)(3) PENDING | $15,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| THE COMMUNITY FOUNDATION OF UT | |||||||
| 2257 SOUTH 1100 EAST STE 205 | SALT LAKE CITY | UT | 84106 | 743211770 | 501(C)(3) | $25,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| CHARITABLE PHARMACY OF CENTRAL OHIO INC | |||||||
| 200 E LIVINGSTON AVENUE | COLUMBUS | OH | 43215 | 270147099 | 501(C)(3) | $25,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| COLUMBUS FREE CLINIC | |||||||
| 2231 N HIGH ST | COLUMBUS | OH | 43201 | 010575698 | 501(C)(3) | $25,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| LORAIN COUNTY FREE CLINIC INC | |||||||
| 3323 PEARL AVENUE | LORAIN | OH | 44055 | 341506180 | 501(C)(3) | $25,100 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| CHARITABLE HEALTHCARE NETWORK INCOHIO ASSOC OF FREE CLINICS | |||||||
| 88 E BROAD ST STE 1475 | COLUMBUS | OH | 43215 | 223769296 | 501(C)(3) | $25,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| SLO NOOR FOUNDATION A NON-PROFIT CORPORATION | |||||||
| 3071 S HIGUERA ST STE 110 | SAN LUIS OBISPO | CA | 93401 | 271412176 | 501(C)(3) | $25,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| HOPE CLINIC OF MCKINNEY | |||||||
| 103 E LAMAR ST | MCKINNEY | TX | 75069 | 813813928 | 501(C)(3) | $25,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTERDEAC CLINIC | |||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 510190238 | 501(C)(3) | $25,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. |
| CENTER FOR HEALING & HOPE | |||||||
| 902 S MAIN | GOSHEN | IN | 46527 | 020560511 | $25,000 | TO PROVIDE FINANCIAL ASSISTANCE WITH HEALTHCARE TO UNINSURED AND UNDERINSURED INDIVIDUALS. | |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | GRANT FUNDING CLINICS MUST SIGN A LETTER THAT STATES THEY UNDERSTAND THE REQUIREMENTS OF THE GRANT AND THEY MUST REPORT TWO TIMES A YEAR USING AN ELECTRONIC PORTAL. THEN, WE MAKE A REPORT SUMMARIZING THE FUNDS STATUS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NICOLE LAMOUREUX | PersonNm |
| Title | PRESIDENT/CHIEF EXECUTIVE OFFICER | TitleTxt |
| Base Compensation Filing Org | $196,032 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $196,032 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE MEMBERSHIP IS COMPOSED OF FREE CLINICS AROUND THE COUNTRY THAT PAY DUES TO BE A MEMBER. THE BOARD IS ELECTED AT AN ANNUAL MEETING OF THE MEMBERSHIP OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBERS ELECT OFFICERS AT THE ANNUAL MEETING OF THE MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 11B | DURING THE IRS'S DEVELOPMENT OF THIS FORM, THE AICPA SUGGESTED THAT COMPLIANCE AND FIDUCIARY DUTIES WOULD BE BEST MET IF A NON-PROFIT BOARD OF DIRECTORS, AUDIT COMMITTEE OR OTHER APPROPRIATE COMMITTEE RECEIVED CONFIRMATION FROM THE PARTY OR PARTIES RESPONSIBLE FOR FILING THE TAX RETURN THAT IT HAD BEEN PREPARED BY A QUALIFIED PERSON(S) OR FIRM AND HAD BEEN FILED IN A TIMELY MANNER, RATHER THAN REVIEWING THE FORM IN LINE-BY-LINE DETAIL WITH MANAGEMENT. WE ARE CONCERNED THAT THE VAST MAJORITY OF NON-PROFIT BOARD MEMBERS ARE NOT IN A POSITION TO REVIEW A FORM 990 AND FURTHER CONCERNED AS TO WHAT A REQUEST OF THIS NATURE MAY IMPLY ABOUT COMPLIANCE. MOST NON-PROFITS HIRE CPA FIRMS OR OTHER TAX PROFESSIONALS TO PREPARE FORMS 990 AND BOARD MEMBERS GENERALLY FEEL THIS IS THE APPROPRIATE FIDUCIARY PROCESS. THE BOARD OR AUDIT COMMITTEE'S ROLE THEN IS TO EVALUATE THE COMPETENCY OF THE PERSON(S) OR FIRM HIRED TO PREPARE THE RETURN AND TO DETERMINE IT IS APPROPRIATELY FILED. WE HAVE TAKEN THESE STEPS WITH OUR BOARD. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD MUST SIGN THE CONFLICT OF INTEREST FORM AND BOARD COMMITMENT FORM ANNUALLY AND RETURN TO THE NAFC STAFF. |
| FORM 990, PART VI, SECTION B, LINE 15 | THERE IS AN EXECUTIVE COMMITTEE ESTABLISHED WHO REVIEWS AND SETS THE GOALS FOR THE CEO POSITION. THE CEO IS THEN ASSESSED AND EVALUATED ANNUALLY BASED ON THESE GOALS. THE COMMITTEE RESEARCHES INDUSTRY WAGE REPORTS AND ANNUALLY REVIEWS SALARY LEVELS FOR COMPARABILITY. OTHER TOP MANAGEMENT POSITIONS ARE REVIEWED BY THE BOARD MEMBERS BASED ON ANNUAL GOAL CRITERIA. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL DOCUMENTS ARE MADE AVAILABLE AT THE OFFICES OF THE ORGANIZATION UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | BOOK TO TAX DEPRECIATION -1,009. STOCK SALES -5,996. |