TELLURIAN INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- TELLURIAN INC (EIN 39-1482987)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-08-20
- IRS object ID
- 201902329349300515
- Schema version
- 2018v3.1
- 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 | 2019-08-20T10:30:56-05:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390974031 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEGNER CPAS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2921 LANDMARK PL STE 300 | AddressLine1Txt |
| City | MADISON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 537134236 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391482987 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TELLURIAN INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | TELL | BusinessNameControlTxt |
| Phone | 6082227311 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5900 MONONA DRIVE NO 300 | AddressLine1Txt |
| City | MONONA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53716 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEVIN FLOREK | PersonNm |
| Person Title | PRESIDENT/CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 6082227311 | PhoneNum |
| Signature | 2019-08-19 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SCOTT HAUMERSEN CPA | PreparerPersonNm |
| PTIN | P00084908 | PTIN |
| Phone | 6082744020 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 66.222.124.178 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-08-19 | IPDt |
| IP Tm | 11:03:16 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 50C9C09D56ED613F9D7879BDC11063DCF385CB9F | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | B169A553E6FC674180C4B0C62460B1C0CC916730 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KEVIN FLOREK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5900 MONONA DRIVE NO 300 | AddressLine1Txt |
| City | MONONA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53716 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,189,996 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.TELLURIAN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE A WIDE ARRAY OF HUMAN SERVICES THAT ADDRESS PROBLEMS RELATED TO SUBSTANCE ABUSE & ADDICTIONS, MENTAL ILLNESS, & HOMELESSNESS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 250 | TotalEmployeeCnt |
| Total Volunteers | 18 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $7,722,213 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,056,016 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,142,615 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,970,191 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,887 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,417 | CYInvestmentIncomeAmt |
| PY Other Revenue | $6,024 | PYOtherRevenueAmt |
| CY Other Revenue | $97,248 | CYOtherRevenueAmt |
| PY Total Revenue | $10,874,739 | PYTotalRevenueAmt |
| CY Total Revenue | $11,126,872 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $16,270 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,949,596 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,045,436 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $8,451 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,687,038 | PYOtherExpensesAmt |
| CY Other Expenses | $3,895,418 | CYOtherExpensesAmt |
| PY Total Expenses | $10,636,634 | PYTotalExpensesAmt |
| CY Total Expenses | $10,957,124 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $238,105 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $169,748 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,913,717 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,765,203 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,884,699 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,568,860 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,029,018 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,196,343 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF THE TELLURIAN FAMILY OF SERVICES IS TO PROVIDE A SAFE AND NURTURING ENVIRONMENT TO ALL THOSE AFFLICTED WITH SUBSTANCE ABUSE, ADDICTION, MENTAL ILLNESS, AND HOMELESSNESS, A BROAD RANGE OF INNOVATIVE PROGRAMS, TREATMENT AND SERVICES DESIGNED TO ALLOW EACH INDIVIDUAL THE OPPORTUNITY TO REBUILD THEIR LIFE AND RE-ENTER THE COMMUNITY AS A PRODUCTIVE MEMBER OF SOCIETY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,255,265 | ExpenseAmt |
| Grant | $3,542 | GrantAmt |
| Revenue | $142,577 | RevenueAmt |
| Desc | CRISIS STABILIZATION - TELLURIAN CURRENTLY OPERATES TWO CARE FACILITIES (CRISIS ASSESSMENT, RECOVERY AND EMPOWERMENT). THE TELLURIAN CARE CENTER IS LOCATED IN MADISON, WISCONSIN AND THE TELLURIAN CARE HOUSE IS LOCATED IN LACROSSE, WISCONSIN. THESE CARE FACILITIES ARE COMMUNITY-BASED RESIDENTIAL FACILITIES (CBRF) CREATED TO PROVIDE AN ALTERNATIVE TO INSTITUTIONAL OR HOSPITAL SETTINGS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,845,539 | ExpenseAmt |
| Grant | $7,393 | GrantAmt |
| Revenue | $140,705 | RevenueAmt |
| Desc | HOUSING - TELLURIAN PROVIDES TRANSITIONAL HOUSING SERVICES TO THE CHRONICALLY MENTALLY ILL AND HOMELESS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,470,777 | ExpenseAmt |
| Grant | $2,026 | GrantAmt |
| Revenue | $1,317,972 | RevenueAmt |
| Desc | ADULT RESIDENTIAL SERVICES - RESIDENTIAL TREATMENT IS THE MOST INTENSIVE FORM OF CARE, AND PROVIDES A SAFE, SECURE, AND STRUCTURED LIVING ENVIRONMENT ON OUR MAIN CAMPUS FOR UP TO 90 DAYS. TREATMENT INCLUDES INDIVIDUAL AND GROUP THERAPY, SPIRITUAL CARE GROUPS, HOLISTIC HEALING AND SPECIALIZED COUNSELING FOR PROBLEMS SUCH AS ANGER MANAGEMENT, DOMESTIC VIOLENCE, AND MENTAL HEALTH ISSUES. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (4 entries)
| ExpenseExpenseAmt | GrantGrantAmt | RevenueRevenueAmt | DescDesc |
|---|---|---|---|
| $1,453,312 | $2,327 | $491,849 | EMERGENCY SERVICES |
| $1,125,422 | $752 | $24,142 | CASE MANAGEMENT |
| $1,039,401 | $230 | $831,119 | OUTPATIENT |
| $66,037 | $0 | $21,828 | MEDICAL PSYCHIATRIC SERVICES |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $3,684,172 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $3,309 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $1,368,938 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $9,255,753 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | 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 | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | Yes (1) | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 48 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 250 | 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 | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | 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 | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LARA SWIERSZ | PersonNm |
| Phone | 6082227311 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5900 MONONA DR STE 300 | AddressLine1Txt |
| City | MONONA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53716 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| TOMMI THOMPSON | ||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| FATHER LARRY BAKKE | ||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MIKE CROOKS | ||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DR JAMES HALIKUS | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CATHERINE ZDEBLICK | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JENNY SIMON | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DENISE WAGNER | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MARCI KATZ | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| BETH MIELCAREK | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| GEOFFREY MCCLOSKEY | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| TOM SPITZ | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MINDY ROWLAND | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DENNIS HILL | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| KEVIN FLOREK | ||||||
| PRESIDENT/CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $149,115 | $0 | $3,086 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $149,115 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $3,086 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CRANBERRY CREEK LLC | |||||
| 1501 LAKE POINT DR | MADISON | WI | 53713 | CATERING SERVICES | $308,632 |
| DIVERSIFIED PHYSICIANS LLC | |||||
| 1102 MOHICAN PASS | MADISON | WI | 537112842 | MEDICAL SERVICES | $223,685 |
| SCHWENN'S 76 SERVICE | |||||
| 5601 MONONA DR | MONONA | WI | 537163132 | REPAIRS AND MAINTENANCE | $124,148 |
| T A ENGELS CONSULTING | |||||
| W10516 TIPPERARY RD | POYNETTE | WI | 539559419 | MARKETING | $114,487 |
| SHEILA JOHNSON | |||||
| 528 MELODY LANE | VERONA | WI | 53593 | CONSULTATION | $103,412 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $101,349 | FundraisingAmt |
| Government Grants | $7,845,642 | GovernmentGrantsAmt |
| All Other Contributions | $109,025 | AllOtherContributionsAmt |
| Noncash Contributions | $7,793 | NoncashContributionsAmt |
| Total Contributions | $8,056,016 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE FEES | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $2,970,191 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,970,191 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,970,191 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,417 | TotalRevenueColumnAmt |
| Exclusion | $3,417 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $20,586 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $101,349 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $62,140 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$41,554 | TotalRevenueColumnAmt |
| Exclusion | -$41,554 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $16,250 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $984 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,266 | TotalRevenueColumnAmt |
| Exclusion | $15,266 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $123,536 | TotalRevenueColumnAmt |
| Exclusion | $123,536 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $123,536 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,126,872 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,970,191 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $100,665 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,270 | TotalAmt |
| Program Services | $16,270 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $152,201 | TotalAmt |
| Program Services | $129,359 | ProgramServicesAmt |
| Management And General | $22,643 | ManagementAndGeneralAmt |
| Fundraising | $199 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,624,613 | TotalAmt |
| Program Services | $4,771,952 | ProgramServicesAmt |
| Management And General | $845,153 | ManagementAndGeneralAmt |
| Fundraising | $7,508 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,383 | TotalAmt |
| Program Services | $72,352 | ProgramServicesAmt |
| Management And General | $6,016 | ManagementAndGeneralAmt |
| Fundraising | $15 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $731,398 | TotalAmt |
| Program Services | $675,125 | ProgramServicesAmt |
| Management And General | $56,134 | ManagementAndGeneralAmt |
| Fundraising | $139 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $458,841 | TotalAmt |
| Program Services | $392,819 | ProgramServicesAmt |
| Management And General | $65,432 | ManagementAndGeneralAmt |
| Fundraising | $590 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,281 | TotalAmt |
| Management And General | $1,281 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,399 | TotalAmt |
| Management And General | $29,399 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30 | TotalAmt |
| Management And General | $30 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $906,006 | TotalAmt |
| Program Services | $706,381 | ProgramServicesAmt |
| Management And General | $199,625 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,211 | TotalAmt |
| Program Services | $13,524 | ProgramServicesAmt |
| Management And General | $58,687 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,053,244 | TotalAmt |
| Program Services | $961,869 | ProgramServicesAmt |
| Management And General | $91,375 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,288 | TotalAmt |
| Program Services | $22,083 | ProgramServicesAmt |
| Management And General | $60,205 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,155,436 | TotalAmt |
| Program Services | $1,072,448 | ProgramServicesAmt |
| Management And General | $82,988 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,543 | TotalAmt |
| Program Services | $132,009 | ProgramServicesAmt |
| Management And General | $32,534 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,119 | TotalAmt |
| Program Services | $103,741 | ProgramServicesAmt |
| Management And General | $65,378 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,747 | TotalAmt |
| Program Services | $90,784 | ProgramServicesAmt |
| Management And General | $32,963 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,711 | TotalAmt |
| Program Services | $61,181 | ProgramServicesAmt |
| Management And General | $8,530 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $20,209 | $20,209 | |
| DUES AND SUBSCRIPTIONS | $16,621 | $11,987 | $4,634 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,573 | TotalAmt |
| Program Services | $1,660 | ProgramServicesAmt |
| Management And General | $29,913 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,957,124 | TotalAmt |
| Program Services | $9,255,753 | ProgramServicesAmt |
| Management And General | $1,692,920 | ManagementAndGeneralAmt |
| Fundraising | $8,451 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $163,104 | BOYAmt |
| EOY | $133,933 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $231,462 | BOYAmt |
| EOY | $302,421 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $916,183 | BOYAmt |
| EOY | $578,113 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $262,372 | BOYAmt |
| EOY | $454,775 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,664 | BOYAmt |
| EOY | $50,219 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,480 | BOYAmt |
| EOY | $8,901 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,332 | BOYAmt |
| EOY | $87,247 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,315,548 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,174,936 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,226,752 | BOYAmt |
| EOY | $1,140,612 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,368 | BOYAmt |
| EOY | $8,982 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,913,717 | BOYAmt |
| EOY | $2,765,203 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $649,490 | BOYAmt |
| EOY | $677,687 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $31,563 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,235,209 | BOYAmt |
| EOY | $20,253 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $839,357 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,884,699 | BOYAmt |
| EOY | $1,568,860 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,023,772 | BOYAmt |
| EOY | $1,190,821 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,246 | BOYAmt |
| EOY | $5,522 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,029,018 | BOYAmt |
| EOY | $1,196,343 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,913,717 | BOYAmt |
| EOY | $2,765,203 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $169,748 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$2,423 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,089,263 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,031,989 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,107,062 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,722,213 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,056,016 | CurrentTaxYearAmt |
| Total | $35,006,543 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,089,263 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,031,989 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,107,062 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,722,213 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,056,016 | CurrentTaxYearAmt |
| Total | $35,006,543 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $35,006,543 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $469 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $511 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,990 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,887 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,417 | CurrentTaxYearAmt |
| Total | $14,274 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $67,077 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,072 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $21,652 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,024 | CurrentTaxYearMinus1YearAmt |
| Total | $97,825 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $35,118,642 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $14,133,284 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99680 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99580 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,800 | OtherCostOrOtherBasisAmt |
| Book Value | $30,800 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,375,429 | OtherCostOrOtherBasisAmt |
| Depreciation | $723,147 | DepreciationAmt |
| Book Value | $652,282 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $467,401 | OtherCostOrOtherBasisAmt |
| Depreciation | $142,262 | DepreciationAmt |
| Book Value | $325,139 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $331,619 | OtherCostOrOtherBasisAmt |
| Depreciation | $229,195 | DepreciationAmt |
| Book Value | $102,424 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $110,299 | OtherCostOrOtherBasisAmt |
| Depreciation | $80,332 | DepreciationAmt |
| Book Value | $29,967 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,140,612 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| FORGIVABLE LOAN | $277,500 |
| DEFERRED LOANS | $561,857 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $839,357 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $11,187,543 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$2,423 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$30 | OtherRevenueAmt |
| Revenue Not Reported | -$2,453 | RevenueNotReportedAmt |
| Revenue Subtotal | $11,189,996 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$63,124 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$63,124 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $11,126,872 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $11,020,218 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $63,124 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $63,124 | ExpensesNotReportedAmt |
| Expenses Subtotal | $10,957,094 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $30 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $30 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $10,957,124 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | INVESTMENT FEES -30. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | DIRECT EXPENSES REPORTED ON FORM 990, PART VIII, LINE 8B -62,140. DIRECT EXPENSES REPORTED ON FORM 990, PART VIII, LINE 9B -984. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | DIRECT EXPENSES REPORTED ON FORM 990, PART VIII, LINE 8B 62,140. DIRECT EXPENSES REPORTED ON FORM 990, PART VIII, LINE 9B 984. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF OUTING | Event1Nm |
| Gross Receipts Event1 | $121,935 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $101,349 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $20,586 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $15,041 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $7,242 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $24,800 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $15,057 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $121,935 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $101,349 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $20,586 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $15,041 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $7,242 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $24,800 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $15,057 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $62,140 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$41,554 | NetIncomeSummaryAmt |
Gaming Information GamingInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Revenue Other Gaming | $16,250 | GrossRevenueOtherGamingAmt |
| Cash Prizes Other Gaming | $500 | CashPrizesOtherGamingAmt |
| Oth Direct Expnss Other Gaming | $484 | OthDirectExpnssOtherGamingAmt |
| Volunteer Labor Other Gaming | Yes (1) | VolunteerLaborOtherGamingInd |
| Volunteer Labor Other Gaming | 1.00000 | VolunteerLaborOtherGamingPct |
| Gross Revenue Total Gaming | $16,250 | GrossRevenueTotalGamingAmt |
| Cash Prizes Total Gaming | $500 | CashPrizesTotalGamingAmt |
| Oth Direct Expnss Total Gaming | $484 | OthDirectExpnssTotalGamingAmt |
| Direct Expense Summary Gaming | $984 | DirectExpenseSummaryGamingAmt |
| Net Gaming Income Summary | $15,266 | NetGamingIncomeSummaryAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| States Where Gaming Conducted | WI | StatesWhereGamingConductedCd |
| Licensed | Yes (1) | LicensedInd |
| License Suspended Etc | 0 | LicenseSuspendedEtcInd |
| Gaming With Nonmembers | 0 | GamingWithNonmembersInd |
| Member Of Other Entity | 0 | MemberOfOtherEntityInd |
| Gaming Own Facility | 0.00000 | GamingOwnFacilityPct |
| Gaming Other Facility | 1.00000 | GamingOtherFacilityPct |
| Individual With Books | KELLY CROOKS | IndividualWithBooksNm |
Persons With Books US Address PersonsWithBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5900 MONONA DRIVE STE 300 | AddressLine1Txt |
| City | MONONA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53716 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct With3rd Prty For Game Rev | 0 | CntrctWith3rdPrtyForGameRevInd |
| Gaming Manager Person | KELLY CROOKS | GamingManagerPersonNm |
| Gaming Manager Compensation | $0 | GamingManagerCompensationAmt |
| Gaming Manager Is Employee | Yes (X) | GamingManagerIsEmployeeInd |
| Charitable Distribution Rqr | 0 | CharitableDistributionRqrInd |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TFI FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5900 MONONA DR STE 300 | AddressLine1Txt |
| City | MONONA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 537163561 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 391225145 | RecipientEIN |
| IRC Section | 501(C)(3)PF | IRCSectionDesc |
| Cash Grant | $15,000 | CashGrantAmt |
| Purpose Of Grant | GENERAL PURPOSES. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ONCE GRANT FUNDS ARE DISBURSED, THE ORGANIZATION DOES NOT HAVE ANY PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | KEVIN FLOREK | PersonNm |
| Title | PRESIDENT/CHIEF EXECUTIVE OFFICER | TitleTxt |
| Base Compensation Filing Org | $149,115 | 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 | $1,944 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $1,142 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $152,201 | 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 (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE PREPARED FORM 990 IS REVIEWED AND APPROVED BY THE CONTROLLER, THE PRESIDENT/CHIEF EXECUTIVE OFFICER, AND THE MEMBERS OF THE GOVERNING BODY BEFORE THE RETURN IS FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY ALL DIRECTORS AND OFFICERS COMPLETE AND SIGN A STATEMENT THAT PROVIDES INFORMATION REGARDING THEIR INTERESTS AND THOSE OF THEIR FAMILY MEMBERS THAT COULD GIVE RISE TO CONFLICTS. THE MEMBERS OF THE GOVERNING BODY MAKE DETERMINATIONS OF WHETHER A CONFLICT EXISTS AND REVIEW ACTUAL CONFLICTS. ANY PERSON WITH A CONFLICT IS PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS IN THE TRANSACTION. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE INDEPENDENT MEMBERSHIP OF THE BOARD OF DIRECTORS ANNUALLY CONDUCTS A PERFORMANCE REVIEW OF THE PRESIDENT/EXECUTIVE OFFICER. THE PRESIDENT/EXECUTIVE OFFICER'S COMPENSATION IS REVIEWED AND COMPARED TO PUBLIC INFORMATION ABOUT COMPENSATION IN POSITIONS AT SIMILAR ORGANIZATIONS. THE BOARD APPROVES COMPENSATION FOR THE EXECUTIVE DIRECTOR WITH AN OFFICIAL VOTE WITH DISCUSSION AND RESULTS RECORDED IN MEETING MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |