CLUB NOVA COMMUNITY INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization: CLUB NOVA COMMUNITY INC (EIN 27-0103430)
Tax period: 2017-07-01 to 2018-06-30
Filed: 2018-11-14
IRS object ID: 201803189349305230
Schema version: 2017v2.3
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule G
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-11-14T12:24:50-06:00	ReturnTs
Tax Period End	2018-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	561304727	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BLACKMAN & SLOOP CPAS PA	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	1414 RALEIGH RD SUITE 300	AddressLine1Txt
City	CHAPEL HILL	CityNm
State Abbreviation	NC	StateAbbreviationCd
ZIP	27517	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2017-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	270103430	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CLUB NOVA COMMUNITY INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	CLUB	BusinessNameControlTxt
Phone	9199686682	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	103 D WEST MAIN STREET	AddressLine1Txt
City	CARRBORO	CityNm
State Abbreviation	NC	StateAbbreviationCd
ZIP	27510	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	WILLIAM WISMER	PersonNm
Person Title	TREASURER	PersonTitleTxt
Phone	9197241710	PhoneNum
Signature	2018-11-14	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	ROBIN MCDUFFIE	PreparerPersonNm
PTIN	P00098611	PTIN
Phone	9199428700	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	45.20.211.129	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2018-11-14	IPDt
IP Tm	08:31:00	IPTm
IP Timezone	ES	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	1B3E3AB753DA12F362349F1C8D3AE4717844F47D	AtSubmissionCreationDeviceId
At Submission Filing Device Id	1B3E3AB753DA12F362349F1C8D3AE4717844F47D	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2017	TaxYr
Build TS	2019-02-21 02:37:17Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	WILLIAM WISMER	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	103-D WEST MAIN STREET	AddressLine1Txt
City	CARRBORO	CityNm
State Abbreviation	NC	StateAbbreviationCd
ZIP	27510	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$1,325,773	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.CLUBNOVA.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2004	FormationYr
Legal Domicile State	NC	LegalDomicileStateCd
Activity Or Mission	CLUB NOVA COMMUNITY, INC PROMOTES AND PROVIDES OPPORTUNITIES FOR INDIVIDUALS LIVING WITH SERIOUS MENTAL ILLNESS.	ActivityOrMissionDesc
Voting Members Governing Body	15	VotingMembersGoverningBodyCnt
Voting Members Independent	15	VotingMembersIndependentCnt
Total Employee	18	TotalEmployeeCnt
Total Volunteers	121	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$699,504	PYContributionsGrantsAmt
CY Contributions Grants	$721,057	CYContributionsGrantsAmt
PY Program Service Revenue	$514,685	PYProgramServiceRevenueAmt
CY Program Service Revenue	$602,958	CYProgramServiceRevenueAmt
PY Investment Income	$345	PYInvestmentIncomeAmt
CY Investment Income	$1,055	CYInvestmentIncomeAmt
PY Other Revenue	$8,214	PYOtherRevenueAmt
CY Other Revenue	$703	CYOtherRevenueAmt
PY Total Revenue	$1,222,748	PYTotalRevenueAmt
CY Total Revenue	$1,325,773	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$589,763	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$626,037	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$137,775	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$258,764	CYTotalFundraisingExpenseAmt
PY Other Expenses	$479,246	PYOtherExpensesAmt
CY Other Expenses	$345,523	CYOtherExpensesAmt
PY Total Expenses	$1,069,009	PYTotalExpensesAmt
CY Total Expenses	$1,109,335	CYTotalExpensesAmt
PY Revenues Less Expenses	$153,739	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$216,438	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,026,116	TotalAssetsBOYAmt
Total Assets EOY	$1,115,191	TotalAssetsEOYAmt
Total Liabilities BOY	$237,960	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$111,497	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$788,156	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$1,003,694	NetAssetsOrFundBalancesEOYAmt
Mission	CLUB NOVA PROVIDES OPPORTUNITIES FOR INDIVIDUALS LIVING WITH SERIOUS MENTAL ILLNESS TO LEAD MEANINGFUL AND PRODUCTIVE LIVES OF THEIR CHOICE IN THE COMMUNITY.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$772,221	ExpenseAmt
Revenue	$603,661	RevenueAmt
Desc	CLUB NOVA, CERTIFIED BY THE INTERNATIONAL CENTER FOR CLUBHOUSE DEVELOPMENT, PROVIDED THE FULL RANGE OF CLUBHOUSE MODEL SUPPORTS AND OPPORTUNITIES TO OVER 120 INDIVIDUALS LIVING WITH SERIOUS MENTAL ILLNESS. THESE SUPPORTS AND OPPORTUNITIES INCLUDED MEANINGFUL RELATIONSHIPS, MEANINGFUL WORK, EMPLOYMENT AT LOCAL BUSINESSES, SUPPORTED EDUCATION, EVENING/WEEKEND PROGRAM AND ASSISTANCE WITH COMMUNITY SUPPORT (HOUSING, BENEFITS, QUALITY MEDICAL CARE, AND CRISIS PREVENTION AND RESPONSE).	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Desc	CLUB NOVA HAS LAUNCHED AND IS IN THE MIDST OF A $5 M CAPITAL CAMPAIGN FOR EXPANSION. THE EXPANSION INCLUDES: 1) CONSTRUCTION OF AN APPROXIMATELY 9,727 SQ. FT. FACILITY TO BE COMPLETED BY THE END OF 2020; 2) EXPANSION OF CAPACITY AND PROGRAMMING TO MEET THE UNMET AND EMERGING NEEDS OF PEOPLE WITH SERIOUS MENTAL ILLNESS, EDUCATIONAL INSTITUTIONS, AND THE BROADER COMMUNITY; AND 3) OPPORTUNITY FOR SYSTEMIC IMPACT THROUGH STATE-WIDE REPLICATION OF THIS EVIDENCE-BASED MODEL. FUNDRAISING EXPENSES ARE SIGNIFICANTLY HIGHER THAN WOULD BE ANTICIPATED DURING YEARS WE ARE NOT IN THE MIDST OF A CAPITAL CAMPAIGN.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$772,221	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	Yes (1)	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	Yes (1)	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	0	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	2	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	18	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
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	15	GoverningBodyVotingMembersCnt
Independent Voting Member	15	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	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	NC	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	KAREN KINCAID DUNN	PersonNm
Phone	9199686682	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	103-D WEST MAIN ST	AddressLine1Txt
City	CARRBORO	CityNm
State Abbreviation	NC	StateAbbreviationCd
ZIP	27510	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd
ESPHUR FOSTER
BOARD MEMBER	2.00	Yes (X)	$0	$0	$0
ALYSSA DRAFFIN
BOARD MEMBER	2.00	Yes (X)	$0	$0	$0
JOHN JACK HAGGERTY
BOARD MEMBER	2.00	Yes (X)	$0	$0	$0
PAT DEVINE
BOARD MEMBER	2.00	Yes (X)	$0	$0	$0
DUSTIN RAWLINGS
BOARD MEMBER	2.00	Yes (X)	$0	$0	$0
MARY CAY CORR
BOARD MEMBER	2.00	Yes (X)	$0	$0	$0
MATTHEW COX
BOARD MEMBER	2.00	Yes (X)	$0	$0	$0
BLAKE TEDDER
BOARD MEMBER	2.00	Yes (X)	$0	$0	$0
JESSE MILLER
ADVISORY BOARD MEMBER (NON	2.00	Yes (X)	$0	$0	$0
GRETCHEN DAVIS
PRESIDENT	5.00	Yes (X)	$0	$0	$0	Yes (X)
SUE ESTROFF
VICE PRESIDENT	2.00	Yes (X)	$0	$0	$0	Yes (X)
BEBE SMITH
VICE PRESIDENT	4.00	Yes (X)	$0	$0	$0	Yes (X)
GARY D GADDY
VICE PRESIDENT	4.00	Yes (X)	$0	$0	$0	Yes (X)
WILLIAM BILL WISMER
TREASURER	4.00	Yes (X)	$0	$0	$0	Yes (X)
CHARLENE LEE
SECRETARY	3.00	Yes (X)	$0	$0	$0	Yes (X)
KAREN KINCAID DUNN
EXECUTIVE DIRECTOR	45.00		$76,632	$0	$15,984	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$76,632	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$15,984	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	0	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$5,623	FederatedCampaignsAmt
Government Grants	$145,500	GovernmentGrantsAmt
All Other Contributions	$569,934	AllOtherContributionsAmt
Total Contributions	$721,057	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICAID	623990	$466,612	$466,612
NET CLIENT SERVICES	623990	$82,076	$82,076
THRIFT SHOP SALES	453310	$45,244	$45,244
MEAL SALES	722210	$9,026	$9,026

Field	Value	IRS element (for citing)
Total Program Service Revenue	$602,958	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,055	TotalRevenueColumnAmt
Exclusion	$1,055	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	OTHER INCOME	Desc
Business	900099	BusinessCd
Total Revenue Column	$703	TotalRevenueColumnAmt
Related Or Exempt Func Income	$703	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$703	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,325,773	TotalRevenueColumnAmt
Related Or Exempt Func Income	$603,661	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$1,055	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$93,956	TotalAmt
Program Services	$38,190	ProgramServicesAmt
Management And General	$9,363	ManagementAndGeneralAmt
Fundraising	$46,403	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$437,837	TotalAmt
Program Services	$391,517	ProgramServicesAmt
Management And General	$11,112	ManagementAndGeneralAmt
Fundraising	$35,208	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$6,300	TotalAmt
Program Services	$6,300	ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$50,359	TotalAmt
Program Services	$46,256	ProgramServicesAmt
Management And General	$1,092	ManagementAndGeneralAmt
Fundraising	$3,011	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$37,585	TotalAmt
Program Services	$30,811	ProgramServicesAmt
Management And General	$1,376	ManagementAndGeneralAmt
Fundraising	$5,398	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$10,756	TotalAmt
Management And General	$10,756	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$137,775	TotalAmt
Fundraising	$137,775	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$42,098	TotalAmt
Management And General	$32,384	ManagementAndGeneralAmt
Fundraising	$9,714	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$3,708	TotalAmt
Program Services	$3,708	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$18,228	TotalAmt
Program Services	$17,184	ProgramServicesAmt
Management And General	$253	ManagementAndGeneralAmt
Fundraising	$791	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$28,870	TotalAmt
Program Services	$21,653	ProgramServicesAmt
Management And General	$7,217	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$13,798	TotalAmt
Program Services	$13,798	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$30,597	TotalAmt
Program Services	$11,627	ProgramServicesAmt
Fundraising	$18,970	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$5,164	TotalAmt
Program Services	$5,164	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$30,143	TotalAmt
Program Services	$30,143	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$24,163	TotalAmt
Program Services	$19,813	ProgramServicesAmt
Management And General	$2,997	ManagementAndGeneralAmt
Fundraising	$1,353	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt
FOOD AND PROVISIONS	$25,579	$25,579
BILLING SERVICE FEES	$22,850	$22,850
AUTO EXPENSE	$19,637	$19,637
CONTRACT LABOR	$14,250	$14,250

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$55,682	TotalAmt
Program Services	$53,741	ProgramServicesAmt
Management And General	$1,800	ManagementAndGeneralAmt
Fundraising	$141	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,109,335	TotalAmt
Program Services	$772,221	ProgramServicesAmt
Management And General	$78,350	ManagementAndGeneralAmt
Fundraising	$258,764	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$67,857	BOYAmt
EOY	$62,900	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$235,487	BOYAmt
EOY	$358,245	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$238,178	BOYAmt
EOY	$231,761	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$52,739	BOYAmt
EOY	$32,304	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$10,069	BOYAmt
EOY	$9,467	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$518,263	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$174,020	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$365,135	BOYAmt
EOY	$344,243	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$56,651	BOYAmt
EOY	$76,271	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,026,116	BOYAmt
EOY	$1,115,191	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$108,616	BOYAmt
EOY	$107,775	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$122,590	BOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$6,754	BOYAmt
EOY	$3,722	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$237,960	BOYAmt
EOY	$111,497	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$286,812	BOYAmt
EOY	$402,399	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$501,344	BOYAmt
EOY	$601,295	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$788,156	BOYAmt
EOY	$1,003,694	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,026,116	BOYAmt
EOY	$1,115,191	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$216,438	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	-$900	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
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	$224,519	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$215,146	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$461,295	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$699,504	CurrentTaxYearMinus1YearAmt
Current Tax Year	$721,057	CurrentTaxYearAmt
Total	$2,321,521	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$224,519	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$215,146	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$461,295	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$699,504	CurrentTaxYearMinus1YearAmt
Current Tax Year	$721,057	CurrentTaxYearAmt
Total	$2,321,521	TotalAmt

Field	Value	IRS element (for citing)
Substantial Contributors Tot	$381,964	SubstantialContributorsTotAmt
Public Support Total170	$1,939,557	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$238	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$261	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$205	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$345	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,055	CurrentTaxYearAmt
Total	$2,104	TotalAmt

Other Income170 OtherIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$8,895	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$12,473	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$9,052	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$8,214	CurrentTaxYearMinus1YearAmt
Current Tax Year	$703	CurrentTaxYearAmt
Total	$39,337	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$2,362,962	TotalSupportAmt
Public Support CY170	0.82080	PublicSupportCY170Pct
Public Support PY170	0.73080	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	$49,329	OtherCostOrOtherBasisAmt
Book Value	$49,329	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$180,000	OtherCostOrOtherBasisAmt
Depreciation	$28,846	DepreciationAmt
Book Value	$151,154	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$89,750	OtherCostOrOtherBasisAmt
Depreciation	$23,745	DepreciationAmt
Book Value	$66,005	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$103,737	OtherCostOrOtherBasisAmt
Depreciation	$71,623	DepreciationAmt
Book Value	$32,114	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$95,447	OtherCostOrOtherBasisAmt
Depreciation	$49,806	DepreciationAmt
Book Value	$45,641	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$344,243	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

Field	Value	IRS element (for citing)
Desc	CONSTRUCTION IN PROCESS	Desc
Book Value	$76,271	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$76,271	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	CAPITAL LEASE OBLIGATION	Desc
Amt	$3,722	Amt

Field	Value	IRS element (for citing)
Total Liability	$3,722	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$1,325,773	TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported	$0	RevenueNotReportedAmt
Revenue Subtotal	$1,325,773	RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt	$0	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$1,325,773	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$1,110,235	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$900	OtherExpensesIncludedAmt
Expenses Not Reported	$900	ExpensesNotReportedAmt
Expenses Subtotal	$1,109,335	ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt	$0	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$1,109,335	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART XII, LINE 2D - OTHER ADJUSTMENTS:	FormAndLineReferenceDesc
Explanation	BAD DEBT EXPENSE 900.	ExplanationTxt

Schedule G IRS990ScheduleG

Field	Value	IRS element (for citing)
Mail Solicitations	Yes (X)	MailSolicitationsInd
Email Solicitations	Yes (X)	EmailSolicitationsInd
Phone Solicitations	Yes (X)	PhoneSolicitationsInd
In Person Solicitations	Yes (X)	InPersonSolicitationsInd
Special Fundraising Events	Yes (X)	SpecialFundraisingEventsInd
Agrmt Prof Fundraising Acty	Yes (1)	AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	ActivityActivityTxt	Fundraiser Control Of FundsFundraiserControlOfFundsInd	Gross ReceiptsGrossReceiptsAmt	Retained By ContractorRetainedByContractorAmt	Net To OrganizationNetToOrganizationAmt
C02 INC
700 LYERLY RIDGE ROAD NW	CONCORD	NC	280279017	FUNDRAISING FOR CAPITAL CAMPAIGN	0	$339,173	$55,250	$283,923
CONVERGENT NONPROFIT SOLUTIONS LLC
2451 CUMBERLAND PKWY SE SUITE 3679	ATLANTA	GA	30339	FUNDRAISING FOR CAPITAL CAMPAIGN	0	$156,542	$82,525	$74,017

Field	Value	IRS element (for citing)
Total Gross Receipts	$495,715	TotalGrossReceiptsAmt
Total Retained By Contractors	$137,775	TotalRetainedByContractorsAmt
Total Net To Organization	$357,940	TotalNetToOrganizationAmt
Licensed States	NC	LicensedStatesCd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE G, PART I, LINE 2B, COLUMN (V)	FormAndLineReferenceDesc
Explanation	CLUB NOVA COMMUNITY PAID CONVERGENT NONPROFIT SOLUTIONS, LLC. AND C02, INC. TO MANAGE THEIR FUNDRAISING FOR THE CAPITAL CAMPAIGN GOING ON DURING THE FISCAL YEAR.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11B	THE 990 IS REVIEWED BY THE FINANCE COMMITTEE AND EXECUTIVE DIRECTOR BEFORE PROVIDING TO THE BOARD PRIOR TO APPROVAL AND SUBMISSION.
FORM 990, PART VI, SECTION B, LINE 12C	THE BOARD OF DIRECTORS RECEIVES THE CONFLICT OF INTEREST POLICY AS WELL AS CORPORATE COMPLIANCE POLICIES AND PROCEDURES. COMPLIANCE IS MONITORED BY THE BOARD AND EXECUTIVE DIRECTOR WHO ARE KEENLY AWARE OF THE IMPORTANCE OF THESE POLICIES.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION LEVELS ARE REVIEWED BY THE PRESIDENT AND HR COMMITTTEE WHO RESEARCH COMPENSATION LEVELS FOR EQUIVALENT POSITIONS AND DETERMINE IF ANY CHANGES ARE NECESSARY
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION MAKES DOCUMENTS AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9:	BAD DEBT EXPENSE -900.
FORM 990, PART XII, LINE 2C	FINANCE/AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FOR THE CURRENT YEAR.