PUBLIC HEALTH FOUNDATION OF NORTHWEST ILLINOIS INC: Form 990, tax year 2016
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- Organization
- PUBLIC HEALTH FOUNDATION OF NORTHWEST ILLINOIS INC (EIN 11-3676983)
- Tax period
- 2016-12-01 to 2017-11-30
- Filed
- 2018-08-28
- IRS object ID
- 201842409349300604
- Schema version
- 2016v3.0
- 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 | 2018-08-28T07:42:05-05:00 | ReturnTs |
| Tax Period End | 2017-11-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wipfli LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4949 Harrison Avenue Suite 300 | AddressLine1Txt |
| City | Rockford | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 611250407 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-12-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 113676983 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Public Health Foundation of Northwest Il | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PUBL | BusinessNameControlTxt |
| Phone | 8152358350 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10 West Linden | AddressLine1Txt |
| City | Freeport | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61032 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | John Kowalke | PersonNm |
| Person Title | Registered Agent | PersonTitleTxt |
| Phone | 8152358350 | PhoneNum |
| Signature | 2018-08-20 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Jerry R Funk | PreparerPersonNm |
| PTIN | P00082072 | PTIN |
| Phone | 8153997700 | PhoneNum |
| Preparation | 2018-08-20 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | John Kowalke | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10 West Linden | AddressLine1Txt |
| City | Freeport | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61032 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $413,678 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | n/a | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | Public Health Foundation of Northwest Illinois (Foundation) is a non-profit organization established for the advancement of public health awareness and to support the provision of public health services to Stephenson County and the surrounding counties in Northwest Illinois. The Foundation serves as a resource to assist the schools, local medical community, churches and other organizations and the general public in the area of understanding and applying basic public health principles such as disease and injury prevention, health promotion, epidemiology (the study of the causes, distribution and control of diseases in populations), science-based initiatives and social justice. The Foundation will provide funds to assist in the provision of health services to low income and medically under-served individuals. Some of these services are provided in conjunction with the County Health Department. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $135,885 | PYContributionsGrantsAmt |
| CY Contributions Grants | $412,765 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $566 | PYInvestmentIncomeAmt |
| CY Investment Income | $594 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$43 | PYOtherRevenueAmt |
| CY Other Revenue | $146 | CYOtherRevenueAmt |
| PY Total Revenue | $136,408 | PYTotalRevenueAmt |
| CY Total Revenue | $413,505 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $60,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $354,781 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $1,161 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $45 | PYOtherExpensesAmt |
| CY Other Expenses | $3,121 | CYOtherExpensesAmt |
| PY Total Expenses | $61,206 | PYTotalExpensesAmt |
| CY Total Expenses | $357,902 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $75,202 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $55,603 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $358,746 | TotalAssetsBOYAmt |
| Total Assets EOY | $532,488 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $382,148 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $358,746 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $150,340 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Public Health Foundation of Northwest Illinois (Foundation) is a non-profit organization established for the advancement of public health awareness and to support the provision of public health services to Stephenson County and the surrounding counties in Northwest Illinois. The Foundation serves as a resource to assist the schools, local medical community, churches and other organizations and the general public in the area of understanding and applying basic public health principles such as disease and injury prevention, health promotion, epidemiology (the study of the causes, distribution and control of diseases in populations), science-based initiatives and social justice. The Foundation will provide funds to assist in the provision of health services to low income and medically under-served individuals. Some of these services are provided in conjunction with the County Health Department. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $354,781 | ExpenseAmt |
| Grant | $354,781 | GrantAmt |
| Desc | Supported the Stephenson County Health Departments Doula, Universal Newborn, Making Changes and Community Foundation programs. The programs provide enhanced education and support to parents and family before, during and after childbirth as well as providing funds for new ipads for the Health Department. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,149 | ExpenseAmt |
| Desc | Paid for the cost of mamogram examinations for income eligible women | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $684 | ExpenseAmt |
| Desc | Provided funds for 3rd ward educational programs. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $235 | ExpenseAmt |
| Desc | Flood clean up and Wise Women Blood work | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $235 | TotalOtherProgSrvcExpenseAmt |
| Total Program Service Expenses | $357,849 | 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 | 0 | 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 | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | 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 | 0 | ConflictOfInterestPolicyInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | John Kowalke | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8152358350 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10 West Linden | AddressLine1Txt |
| City | Freeport | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61032 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| Robert Geller MD | ||||||
| Director | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Mark Diddens | ||||||
| Director | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Kathy Brenner RN | ||||||
| Director | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Marie Heimerdinger MD | ||||||
| Director | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Andrea Moring | ||||||
| director | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Lynn Miller | ||||||
| Director | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Dan Scheider | ||||||
| Director | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Clarence Parks MD | ||||||
| Director | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Stephen Lafferty | ||||||
| Director | 0.00 | Yes (X) | $0 | $0 | $0 | |
| John Kowalke | ||||||
| Registered Agent | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Craig Beintema | ||||||
| Director | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Bobbie Yount | ||||||
| President & Secretary | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Chad Reedy DDS | ||||||
| Vice President | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Stephanie Helms | ||||||
| Treasurer | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | 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 |
| Government Grants | $402,483 | GovernmentGrantsAmt |
| All Other Contributions | $10,282 | AllOtherContributionsAmt |
| Total Contributions | $412,765 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $594 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $594 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $319 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $173 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $146 | TotalRevenueColumnAmt |
| Exclusion | $146 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $413,505 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $594 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $146 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $354,781 | TotalAmt |
| Program Services | $354,781 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25 | TotalAmt |
| Management And General | $25 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28 | TotalAmt |
| Management And General | $28 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Mamograms | $2,149 | $2,149 |
| 3rd ward program expens | $684 | $684 |
| Flood Clean up | $200 | $200 |
| Wise women program bloo | $35 | $35 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $357,902 | TotalAmt |
| Program Services | $357,849 | ProgramServicesAmt |
| Management And General | $53 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $358,746 | BOYAmt |
| EOY | $432,803 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $99,685 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $358,746 | BOYAmt |
| EOY | $532,488 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $382,148 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $382,148 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $358,746 | BOYAmt |
| EOY | $150,340 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $358,746 | BOYAmt |
| EOY | $150,340 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $358,746 | BOYAmt |
| EOY | $532,488 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $55,603 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$264,009 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | 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 | 0 | 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 | $98,908 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $96,480 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $95,608 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $135,885 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $412,765 | CurrentTaxYearAmt |
| Total | $839,646 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $500 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $500 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $500 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $500 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $500 | CurrentTaxYearAmt |
| Total | $2,500 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $99,408 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $96,980 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $96,108 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $136,385 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $413,265 | CurrentTaxYearAmt |
| Total | $842,146 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $842,146 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $76 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $118 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $357 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $566 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $594 | CurrentTaxYearAmt |
| Total | $1,711 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $143 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $155 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $80 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $173 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $146 | CurrentTaxYearAmt |
| Total | $697 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $844,554 | TotalSupportAmt |
| Public Support CY170 | 0.99710 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99000 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Payable to Stephenson County Health Department | Desc |
| Amt | $382,148 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $382,148 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $413,505 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $413,505 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $413,505 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $357,902 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $357,902 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $357,902 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | The Foundation accounts for income taxes in accordance with Financial Accounting Standards Board Accounting for Uncertainty Income Taxes. The standard provides detailed guidance for the financial statement recognition, measurement and disclosure of uncertain tax positions recognized in an enterprise's financial statements and requires an entity to recognize the financial statement impact of a tax position when it is more likely than not that the position will be sustained upon examination. The Foundation recorded no liabilities for uncertain tax positions or unrecognized tax benefits. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Stephenson County Health Department | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10 West Linden | AddressLine1Txt |
| City | Freeport | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61032 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 366006654 | RecipientEIN |
| Cash Grant | $354,781 | CashGrantAmt |
| Purpose Of Grant | To support the Stephenson County Health Departments Doula, Universal Newborn and making change grants. Programs provide education and support to parent and family, before during and after childbirth. | PurposeOfGrantTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11b | A copy of the form 990 is presented to the board of directors for approval after the registered agent and President review the return which is prepared by the external accounting firm. The President, registered agent or any member of the board may sign the 990 document before submission to the IRS. |
| Form 990, Part VI, Section C, line 19 | The govering documents and 990's are available at all time upon request of the organization by the treasurer and/or secretary who maintain such documents |
| 990, part XII, line 1 | The organization changed from the cash basis method of accounting to the accrual basis of accounting for the fiscal year ended November 30, 2017. |