GREAT MINES HEALTH CENTER FOUNDATION: Form 990EZ, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- GREAT MINES HEALTH CENTER FOUNDATION (EIN 46-2016304)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-10-29
- IRS object ID
- 201843029349201074
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-10-29T16:31:44-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 430352985 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kerber Eck & Braeckel LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1116 West Main | AddressLine1Txt |
| City | Carbondale | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 629012335 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 462016304 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREAT MINES HEALTH CENTER FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GREA | BusinessNameControlTxt |
| Phone | 5734389355 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 SOUTHTOWNE DRIVE | AddressLine1Txt |
| City | POTOSI | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63664 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TR DUDLEY | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 5734389355 | PhoneNum |
| Signature | 2018-10-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Amber Halstead | PreparerPersonNm |
| PTIN | P01343727 | PTIN |
| Phone | 6185291040 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 64.83.254.138 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-10-29 | IPDt |
| IP Tm | 16:29:40 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 8FBDAAF724FD1D6222B37EDFD135E9DD0FF3B3E7 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 9C3F1C75AA4840757D9C507BC5FE6414ED34D4BB | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2018-06-14 16:35:46Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Website Address | N/A | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $9,697 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $9,637 | ContributionsGiftsGrantsEtcAmt |
| Other Revenue Total | $60 | OtherRevenueTotalAmt |
| Total Revenue | $9,697 | TotalRevenueAmt |
| Other Expenses Total | $7,919 | OtherExpensesTotalAmt |
| Total Expenses | $7,919 | TotalExpensesAmt |
| Excess Or Deficit For Year | $1,778 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $42,120 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | $43,898 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,969 | BOYAmt |
| EOY | $30,297 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,151 | BOYAmt |
| EOY | $13,601 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,120 | BOYAmt |
| EOY | $43,898 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,120 | BOYAmt |
| EOY | $43,898 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Primary Exempt Purpose | TO IMPROVE THE HEALTH OF OUR WHOLE COMMUNITY THROUGH EXCELLENCE IN PATIENT CARE AND HEALTH EDUCATION BY SERVICE AS A CHARITABLE ARM OF GREAT MINES HEALTH CENTER. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | TO IMPROVE THE HEALTH OF OUR WHOLE COMMUNITY THROUGH EXCELLENCE IN PATIENT CARE AND HEALTH EDUCATION BY SERVICE AS A CHARITABLE ARM OF GREAT MINES HEALTH CENTER. | DescriptionProgramSrvcAccomTxt |
| Grants And Allocations | $0 | GrantsAndAllocationsAmt |
| Program Service Expenses | $7,919 | ProgramServiceExpensesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $7,919 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (4 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| TR DUDLEY | ||||
| CHAIRMAN | 1.00 | $0 | $0 | $0 |
| ANGELLA DOTY | ||||
| VICE CHARIMAN | 1.00 | $0 | $0 | $0 |
| DEBBIE BUST | ||||
| SECRETARY | 1.00 | $0 | $0 | $0 |
| GREG ROEBACK | ||||
| PRESIDENT | 1.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | 0 | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | 0 | OrganizationHadUBIInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Direct Indirect Pltcl Expend | $0 | DirectIndirectPltclExpendAmt |
| Made Loans To From Officers | 0 | MadeLoansToFromOfficersInd |
| Tax Imposed Under IRC4911 | $0 | TaxImposedUnderIRC4911Amt |
| Tax Imposed Under IRC4912 | $0 | TaxImposedUnderIRC4912Amt |
| Tax Imposed Under IRC4955 | $0 | TaxImposedUnderIRC4955Amt |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| Tax Imposed On Organization Mgr | $0 | TaxImposedOnOrganizationMgrAmt |
| Tax Reimbursed By Organization | $0 | TaxReimbursedByOrganizationAmt |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREG ROEBACK | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 SOUTHTOWNE DRIVE | AddressLine1Txt |
| City | POTOSI | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63664 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5734389355 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Donor Advised Fnds | 0 | DonorAdvisedFndsInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Tanning Services Provided | 0 | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| School Operating | 0 | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (1) | FiledScheduleAInd |
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 | $31,116 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,775 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,234 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,637 | CurrentTaxYearAmt |
| Total | $57,762 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $31,116 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,775 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,234 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,637 | CurrentTaxYearAmt |
| Total | $57,762 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $57,762 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $11,600 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,603 | CurrentTaxYearMinus2YearsAmt |
| Total | $24,203 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $81,965 | TotalSupportAmt |
| Public Support CY170 | 0.70470 | PublicSupportCY170Pct |
| Public Support PY170 | 0.66540 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990-EZ, Part I, Line 8 - Other Revenue | Description: MISCELLANEOUS REVENUE. Amount: 60. |
| Form 990-EZ, Part I, Line 16 - Other Expenses | Description: PROPERTY INSURANCE. Amount: 2,319. Description: DONATIONS/GIFTS. Amount: 5,600. Total to Form 990-EZ, line 16: 7,919. |
| Form 990-EZ, Part II, Line 24 - Other Assets | Description: NOTE RECEIVABLE. Beg. of Year Amount: 25,151. End of Year Amount: 13,601. |
Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Declaration | The organization did not, during the year, receive any funds, directly,or indirectly, to pay premiums on a personal benefit contract.The organization, did not, during the year, pay any premiums, directly,or indirectly, on a personal benefit contract. | DeclarationDesc |