STRATEGY STUDIO / PUBLIC DATA EXPLORER

ADDICTION COUNSELOR CERTIFICATION BOARD OF OREGON: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
ADDICTION COUNSELOR CERTIFICATION BOARD OF OREGON (EIN 93-0795138)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-05-15
IRS object ID
201801359349311285
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 ReturnHeader

FieldValueIRS element (for citing)
Return2018-05-15T17:41:13-04:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line13rd Generation Accounting IncBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11804 NE 43rd AveAddressLine1Txt
CityPortlandCityNm
State AbbreviationORStateAbbreviationCd
ZIP97213ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN930795138EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ADDICTION COUNSELOR CERTIFICATION BOARD OF OREGONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlADDIBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12054 N VANCOUVERAddressLine1Txt
CityPortlandCityNm
State AbbreviationORStateAbbreviationCd
ZIP972171917ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMark DavisPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone5032827247PhoneNum
Signature2018-05-15SignatureDt
Discuss With Paid PreparerfalseDiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSusan G RobertsonPreparerPersonNm
PTINP00774160PTIN
Phone5032827247PhoneNum
Preparation2018-05-15PreparationDt
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARK DAVISPrincipalOfficerNm
Gross Receipts$773,272GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1977FormationYr
Legal Domicile StateORLegalDomicileStateCd
Activity Or MissionCERTIFICATION OF ADDICTION COUNSELORS FOR THE STATE OF OREGONActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee7TotalEmployeeCnt
Total Volunteers12TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$18,404PYContributionsGrantsAmt
CY Contributions Grants$394,890CYContributionsGrantsAmt
PY Program Service Revenue$364,125PYProgramServiceRevenueAmt
CY Program Service Revenue$371,815CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$6,187PYOtherRevenueAmt
CY Other Revenue$6,567CYOtherRevenueAmt
PY Total Revenue$388,716PYTotalRevenueAmt
CY Total Revenue$773,272CYTotalRevenueAmt
PY Grants And Similar Paid$750PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$11,000CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$179,524PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$209,650CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$197,204PYOtherExpensesAmt
CY Other Expenses$565,648CYOtherExpensesAmt
PY Total Expenses$377,478PYTotalExpensesAmt
CY Total Expenses$786,298CYTotalExpensesAmt
PY Revenues Less Expenses$11,238PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$13,026CYRevenuesLessExpensesAmt
Total Assets BOY$150,879TotalAssetsBOYAmt
Total Assets EOY$127,973TotalAssetsEOYAmt
Total Liabilities BOY$18,099TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,079TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$132,780NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$119,894NetAssetsOrFundBalancesEOYAmt
MissionCERTIFICATION OF ADDICTION COUNSELORS FOR THE STATE OF OREGONMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$769,942ExpenseAmt
Grant$11,000GrantAmt
Revenue$371,815RevenueAmt
DescCERTIFICATION OF ADDICITON COUNSELORS WITHIN THE STATE OF OREGON WITH SEMI ANNUAL EXAMINATIONS AND CERTIFICATE RENEWALSDesc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$16,153ExpenseAmt
DescTHE ASSOCIATION PUBLISHES A QUARTERLY NEWSLETTER THAT IS MAILED TO ALL THOSE CERTIFIED BY THE BOARDDesc
FieldValueIRS element (for citing)
Total Program Service Expenses$786,095TotalProgramServiceExpensesAmt
Described In Section501c3falseDescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document9IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee7EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsYes (true)NondeductibleContributionsInd
Nondeductible Contri DisclfalseNondeductibleContriDisclInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldORStatesWhereCopyOfReturnIsFldCd
OtherYes (X)OtherInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMARK DAVISPersonNm
Phone5032318164PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12054 N VANCOUVERAddressLine1Txt
CityPortlandCityNm
State AbbreviationORStateAbbreviationCd
ZIP972171917ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeInd
MARK DAVIS
PRESIDENT2.000.00Yes (X)Yes (X)$0$0$0
SCOTT BUSER
DIRECTOR0.000.00Yes (X)$0$0$0
ROBERT FORSYTH
DIRECTOR0.000.00Yes (X)$0$0$0
JULIA MINES
TREASURER0.000.00Yes (X)Yes (X)$0$0$0
JOSE GARCIA
DIRECTOR0.000.00Yes (X)$0$0$0
JOHNNIE GAGE
VICE PREESIDENT0.000.00Yes (X)Yes (X)$0$0$0
DEBRA BUFFALO BO BIGELOW
SECRETARY0.000.00Yes (X)Yes (X)$0$0$0
THAD LABHART
DIRECTOR0.000.00Yes (X)$0$0$0
ANDREA QUICKSALL
DIRECTOR0.000.00Yes (X)$0$0$0
KEITH WALKER
DIRECTOR0.000.00Yes (X)$0$0$0
AJA STONER
DIRECTOR0.000.00Yes (X)$0$0$0
VAN R BURNHAM
KEY EMPLOYEE40.000.00$49,552$0$0Yes (X)
MICHAEL RAVAZI
KEY EMPLOYEE40.000.00$42,678$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$92,230TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$394,890GovernmentGrantsAmt
Total Contributions$394,890TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EXAM FEES541900$363,890$363,890
RECIPROCITY FEES541900$6,175$6,175
ACCREDITATION541900$1,750$1,750
FieldValueIRS element (for citing)
Total Program Service Revenue$371,815TotalProgramServiceRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MISCELLANEOUS541900$2,391$2,391
NEWSLETTER ADS541900$3,850$3,850
OTHER541900$326$326
FieldValueIRS element (for citing)
Other Revenue Total$6,567OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$773,272TotalRevenueColumnAmt
Related Or Exempt Func Income$378,382RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$500TotalAmt
Program Services$500ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$10,500TotalAmt
Program Services$10,500ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$172,472TotalAmt
Program Services$172,472ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$17,247TotalAmt
Program Services$17,247ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$19,931TotalAmt
Program Services$19,931ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$475TotalAmt
Program Services$475ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$17,800TotalAmt
Program Services$17,800ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$11,825TotalAmt
Program Services$11,825ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$29,273TotalAmt
Program Services$29,273ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$13,800TotalAmt
Program Services$13,800ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$7,699TotalAmt
Program Services$7,699ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$18,037TotalAmt
Program Services$18,037ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$353,247TotalAmt
Program Services$353,247ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$203TotalAmt
Management And General$203ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$5,729TotalAmt
Program Services$5,729ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
POSTAGE AND SHIPPING$11,949$11,949
NEWSLETTER$16,153$16,153
EXAMINATION EXPENSE$65,835$65,835
PAYPAL FEES$5,451$5,451

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$8,172TotalAmt
Program Services$8,172ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$786,298TotalAmt
Program Services$786,095ProgramServicesAmt
Management And General$203ManagementAndGeneralAmt
Fundraising$0FundraisingAmt
FieldValueIRS element (for citing)
Joint CostsYes (X)JointCostsInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$120,670BOYAmt
EOY$127,967EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$30,000BOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$11,402LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$11,396LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$209BOYAmt
EOY$6EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$150,879BOYAmt
EOY$127,973EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$5,031BOYAmt
EOY$8,079EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$13,068BOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$18,099BOYAmt
EOY$8,079EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$132,780BOYAmt
EOY$119,894EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$132,780BOYAmt
EOY$119,894EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$150,879BOYAmt
EOY$127,973EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$13,026ReconcilationRevenueExpnssAmt
Prior Period Adjustments$140PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,402OtherCostOrOtherBasisAmt
Depreciation$11,396DepreciationAmt
Book Value$6BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$6TotalBookValueLandBuildingsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 governing body review Part VI line 11No review was or will be conducted.
Form 990 availability to public Part VI line 18No Documents available to the public.
Governing documents etc available to public Part VI line 19No documents available to the public.
Explanation of other changes in net assets or fund balances Part XI line 9TRIBAL LIABILITY ADJUSTMENT