CORBETT MEDICAL FOUNDATION: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization: CORBETT MEDICAL FOUNDATION (EIN 83-0305129)
Tax period: 2017-01-01 to 2017-12-31
Filed: 2018-11-15
IRS object ID: 201843199349313429
Schema version: 2017v2.2
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 O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-11-15T13:15:56-08:00	ReturnTs
Tax Period End	2017-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ROGER J SCHNEIDER CPA	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 577	AddressLine1Txt
City	RAWLINS	CityNm
State Abbreviation	WY	StateAbbreviationCd
ZIP	82301	ZIPCd

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

Filer Filer

Field	Value	IRS element (for citing)
EIN	830305129	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CORBETT MEDICAL FOUNDATION	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	CORB	BusinessNameControlTxt
Phone	3073265760	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	P O BOX 343	AddressLine1Txt
City	SARATOGA	CityNm
State Abbreviation	WY	StateAbbreviationCd
ZIP	82331	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	MICHAEL GLODE	PersonNm
Person Title	PRESIDENT	PersonTitleTxt
Phone	3073265760	PhoneNum
Signature	2018-11-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	ROGER J SCHNEIDER	PreparerPersonNm
PTIN	P00541718	PTIN
Phone	3073242279	PhoneNum
Preparation	2018-11-15	PreparationDt
Self Employed	Yes (X)	SelfEmployedInd

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	65.131.95.101	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2018-11-15	IPDt
IP Tm	13:15:46	IPTm
IP Timezone	PS	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	B39A87EC04F2965E631D23747EB36E2ECD1E1F15	AtSubmissionCreationDeviceId
At Submission Filing Device Id	B39A87EC04F2965E631D23747EB36E2ECD1E1F15	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	MICHAEL GLODE	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	P O BOX 343	AddressLine1Txt
City	SARATOGA	CityNm
State Abbreviation	WY	StateAbbreviationCd
ZIP	82331	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$274,206	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	N/A	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2004	FormationYr
Legal Domicile State	WY	LegalDomicileStateCd
Activity Or Mission	RURAL HEALTH SERVICES	ActivityOrMissionDesc
Voting Members Governing Body	6	VotingMembersGoverningBodyCnt
Voting Members Independent	6	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	10	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$364,752	PYContributionsGrantsAmt
CY Contributions Grants	$256,000	CYContributionsGrantsAmt
CY Program Service Revenue	$0	CYProgramServiceRevenueAmt
PY Investment Income	$18,434	PYInvestmentIncomeAmt
CY Investment Income	$18,206	CYInvestmentIncomeAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$383,186	PYTotalRevenueAmt
CY Total Revenue	$274,206	CYTotalRevenueAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid	$0	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$249,723	PYOtherExpensesAmt
CY Other Expenses	$184,538	CYOtherExpensesAmt
PY Total Expenses	$249,723	PYTotalExpensesAmt
CY Total Expenses	$184,538	CYTotalExpensesAmt
PY Revenues Less Expenses	$133,463	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$89,668	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,614,324	TotalAssetsBOYAmt
Total Assets EOY	$1,703,992	TotalAssetsEOYAmt
Total Liabilities EOY	$0	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$1,614,324	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$1,703,992	NetAssetsOrFundBalancesEOYAmt
Mission	RURAL HEALTH SERVICES	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$184,538	ExpenseAmt
Revenue	$256,000	RevenueAmt
Desc	PROVIDE AREA WITH MAMMOGRAM AND CANCER DETECTION SERVICES.	Desc
Total Program Service Expenses	$184,538	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	false	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	false	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	false	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	false	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	false	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	false	OperateHospitalInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	false	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	false	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	false	TransactionWithControlEntInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	false	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	6	GoverningBodyVotingMembersCnt
Independent Voting Member	6	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	false	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	false	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	WILL SPEER	PersonNm
Phone	3073265760	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	P O BOX 343	AddressLine1Txt
City	SARATOGA	CityNm
State Abbreviation	WY	StateAbbreviationCd
ZIP	82331	ZIPCd

Field	Value	IRS element (for citing)
No Listed Persons Compensated	Yes (X)	NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt
MICHAEL GLODE
PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
LAURA BUCHOLZ
VICE PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
MEILISSA FAUST
SEC.TREASURER	1.00	Yes (X)	Yes (X)	$0	$0	$0
DULCIE SCHALK
DIRECTOR	1.00	Yes (X)		$0	$0	$0
TYLER TREVILLYAN
DIRECTOR	1.00	Yes (X)		$0	$0	$0
JUDD CAMPBELL
DIRECTOR	1.00	Yes (X)		$0	$0	$0

Field	Value	IRS element (for citing)
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	false	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd
All Other Contributions	$256,000	AllOtherContributionsAmt
Total Contributions	$256,000	TotalContributionsAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$18,206	TotalRevenueColumnAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$274,206	TotalRevenueColumnAmt
Related Or Exempt Func Income	$18,206	RelatedOrExemptFuncIncomeAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
OFFICE	$260	$260	$0	$0
SURETY	$500	$500	$0	$0
POSTAGE	$282	$282	$0	$0
LICENSES	$25	$25	$0	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$183,471	TotalAmt
Program Services	$183,471	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$184,538	TotalAmt
Program Services	$184,538	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$709,481	BOYAmt
EOY	$780,943	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$904,843	BOYAmt
EOY	$923,049	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,614,324	BOYAmt
EOY	$1,703,992	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Field	Value	IRS element (for citing)
Org Does Not Follow SFAS117	Yes (X)	OrgDoesNotFollowSFAS117Ind

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

Field	Value	IRS element (for citing)
BOY	$1,614,324	BOYAmt
EOY	$1,703,992	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,614,324	BOYAmt
EOY	$1,703,992	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,614,324	BOYAmt
EOY	$1,703,992	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$89,668	ReconcilationRevenueExpnssAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Cash	Yes (X)	MethodOfAccountingCashInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	false	FSAuditedInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	false	FederalGrantAuditPerformedInd

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	$329,460	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$305,871	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$484,388	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$364,752	CurrentTaxYearMinus1YearAmt
Current Tax Year	$256,000	CurrentTaxYearAmt
Total	$1,740,471	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$329,460	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$305,871	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$484,388	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$364,752	CurrentTaxYearMinus1YearAmt
Current Tax Year	$256,000	CurrentTaxYearAmt
Total	$1,740,471	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total170	$1,740,471	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$9,895	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$9,326	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$17,087	CurrentTaxYearMinus2YearsAmt
Total	$36,308	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$1,776,779	TotalSupportAmt
Public Support CY170	0.97960	PublicSupportCY170Pct
Public Support PY170	0.97250	PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170	Yes (X)	ThirtyThrPctSuprtTestsCY170Ind
Public Support Total509	$0	PublicSupportTotal509Amt
Public Support CY509	0	PublicSupportCY509Pct
Investment Income CY	0	InvestmentIncomeCYPct

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Pt VI, Line 12c	RURAL HEALTH ACTIVITIES
Pt XII, Line 3b	RURAL HEALTH ACTIVITIES
Pt VI, Line 11b	RURAL HEALTH ACTIVITIES
Form 990, Part IX, Line 24e	SUBCONTRACT MEDICAL 0. 0. 0. 0.
Form 990, Part IX, Line 24e	SERVICES 157500. 157500. 0. 0.
Form 990, Part IX, Line 24e	MAMMOGRAMS 3540. 3540. 0. 0.
Form 990, Part IX, Line 24e	INSURANCE 15650. 15650. 0. 0.
Form 990, Part IX, Line 24e	EQUIPMENT 6781. 6781. 0. 0.