TAYLORS FREE MEDICAL CLINIC INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- TAYLORS FREE MEDICAL CLINIC INC (EIN 20-1715911)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-05-10
- IRS object ID
- 201701309349300045
- 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 | 2017-05-10T15:29:46-04:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 272826067 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCKINLEY COOPER & CO LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 555 NORTH PLEASANTBURG DRIVE SUITE | AddressLine1Txt |
| City | GREENVILLE | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 296072191 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201715911 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TAYLORS FREE MEDICAL CLINIC INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | TAYL | BusinessNameControlTxt |
| Phone | 8642441134 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 W MAIN STREET | AddressLine1Txt |
| City | TAYLORS | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29687 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KAREN SALERNO | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 8642441134 | PhoneNum |
| Signature | 2017-05-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TONI R MCKINLEY | PreparerPersonNm |
| PTIN | P01030704 | PTIN |
| Phone | 8642331800 | PhoneNum |
| Preparation | 2017-05-10 | PreparationDt |
Filing Security Information FilingSecurityInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| At Submission Creation Device Id | 915E192B209F91D4361759CA624B59B6328C99DA | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | DF8A2A176837A5F0DCC1EDB08DF7E6959FC217C3 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KAREN SALERNO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 W MAIN STREET | AddressLine1Txt |
| City | TAYLORS | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29687 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,344,927 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.TAYLORSFMC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | SC | LegalDomicileStateCd |
| Activity Or Mission | THE CLINIC'S PRIMARY MISSION IS TO UNDERSTAND AND SERVE THE BODY, MIND, AND SPIRIT NEEDS OF THE MEDICALLY EXCLUDED INDIVIDUALS LIVING IN GREENVILLE COUNTY, SOUTH CAROLINA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 19 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 19 | VotingMembersIndependentCnt |
| Total Employee | 8 | TotalEmployeeCnt |
| Total Volunteers | 620 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $2,575,515 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,209,647 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $310 | PYInvestmentIncomeAmt |
| CY Investment Income | $170 | CYInvestmentIncomeAmt |
| PY Other Revenue | $112,241 | PYOtherRevenueAmt |
| CY Other Revenue | $68,810 | CYOtherRevenueAmt |
| PY Total Revenue | $2,688,066 | PYTotalRevenueAmt |
| CY Total Revenue | $2,278,627 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $379,825 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $347,622 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $7,882 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,119,020 | PYOtherExpensesAmt |
| CY Other Expenses | $1,968,615 | CYOtherExpensesAmt |
| PY Total Expenses | $2,498,845 | PYTotalExpensesAmt |
| CY Total Expenses | $2,316,237 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $189,221 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$37,610 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $536,262 | TotalAssetsBOYAmt |
| Total Assets EOY | $543,905 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $156,354 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $201,607 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $379,908 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $342,298 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE CLINIC'S PRIMARY MISSION IS TO UNDERSTAND AND SERVE THE BODY, MIND, AND SPIRIT NEEDS OF THE MEDICALLY EXCLUDED INDIVIDUALS LIVING IN GREENVILLE COUNTY, SOUTH CAROLINA. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $2,273,191 | ExpenseAmt |
| Desc | THE CLINIC PROVIDES FREE MEDICAL SERVICES INCLUDING PHARMACEUTICALS AND SPECIALTY CLINICS. PROGRAM INITIATIVES ARE TO ASSURE PREVENTATIVE HEALTH SERVICES TO THE UNINSURED IN THE COMMUNITY AND TO COORDINATE OUTREACH SERVICES WITH LOCAL HOSPITALS, PHYSICIANS AND SOCIAL SERVICES. SINCE OPENING JULY 2005, THE CLINIC HAS SCREENED AND PROVIDED MEDICAL SERVICES TO OVER 4,357 PATIENTS. IN 2016 THE CLINIC DISPENSED 21,386 PRESCRIPTIONS AND PROVIDED 4,571 PATIENT VISITS, INCLUDING 490 COUNSELING APPOINTMENTS. | Desc |
| Total Program Service Expenses | $2,273,191 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | 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 | Yes (true) | 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 | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | 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 | Yes (true) | 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 | Yes (true) | 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 |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 9 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 8 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| 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 |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 19 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 19 | 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 | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | SC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DENNIS BALLENTINE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8642441134 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 W MAIN STREET | AddressLine1Txt |
| City | TAYLORS | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29687 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| RUSSELL ASHMORE | ||||||
| CHAIRMAN | 8.00 | Yes (X) | $0 | $0 | $0 | |
| DR AMANDA SOMERS | ||||||
| VICE CHAIR | 8.00 | Yes (X) | $0 | $0 | $0 | |
| DENNIS BALLENTINE | ||||||
| TREASURER | 8.00 | Yes (X) | $0 | $0 | $0 | |
| BETTY BROWN | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| MIKE BURNS | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| SONYA ABLES | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| LARRY COPELAND | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| PEGGY HARMON | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| PATRICIA OSBON | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| QUEENIE SCOTT RN | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| ALLEN HODGES | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| MICHAEL GREER | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| MAURICE ASHMORE | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| PHILLIP E ELLENBURG | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DORIS B FOSTER | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JIM HAYES MD | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| BEN LEAPHART | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| RICHARD MCGAUGHEY | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| THOMAS R STRANGE SR | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| KAREN SALERNO | ||||||
| EXECUTIVE DI | 40.00 | $58,624 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $58,624 | TotalReportableCompFromOrgAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| All Other Contributions | $2,209,647 | AllOtherContributionsAmt |
| Noncash Contributions | $1,783,574 | NoncashContributionsAmt |
| Total Contributions | $2,209,647 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $170 | TotalRevenueColumnAmt |
| Exclusion | $170 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $135,110 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $66,300 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $68,810 | TotalRevenueColumnAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,278,627 | TotalRevenueColumnAmt |
| Exclusion | $170 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,624 | TotalAmt |
| Program Services | $41,037 | ProgramServicesAmt |
| Management And General | $11,725 | ManagementAndGeneralAmt |
| Fundraising | $5,862 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $253,335 | TotalAmt |
| Program Services | $253,335 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,748 | TotalAmt |
| Program Services | $6,973 | ProgramServicesAmt |
| Management And General | $620 | ManagementAndGeneralAmt |
| Fundraising | $155 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,915 | TotalAmt |
| Program Services | $26,569 | ProgramServicesAmt |
| Management And General | $897 | ManagementAndGeneralAmt |
| Fundraising | $449 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,000 | TotalAmt |
| Management And General | $10,000 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,143 | TotalAmt |
| Program Services | $11,627 | ProgramServicesAmt |
| Management And General | $1,678 | ManagementAndGeneralAmt |
| Fundraising | $838 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $910 | TotalAmt |
| Program Services | $728 | ProgramServicesAmt |
| Management And General | $182 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $989 | TotalAmt |
| Program Services | $692 | ProgramServicesAmt |
| Management And General | $198 | ManagementAndGeneralAmt |
| Fundraising | $99 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,331 | TotalAmt |
| Program Services | $5,065 | ProgramServicesAmt |
| Management And General | $1,266 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,967 | TotalAmt |
| Program Services | $3,974 | ProgramServicesAmt |
| Management And General | $993 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,821 | TotalAmt |
| Program Services | $24,078 | ProgramServicesAmt |
| Management And General | $1,743 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| DONATED LABS AND SERVICES | $851,775 | $851,775 |
| DONATED PHARACEUTICALS | $680,013 | $680,013 |
| DONATED MEDICAL SERVICES | $203,823 | $203,823 |
| SUPPLIES-PHARMACY | $88,021 | $88,021 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,822 | TotalAmt |
| Program Services | $75,481 | ProgramServicesAmt |
| Management And General | $5,862 | ManagementAndGeneralAmt |
| Fundraising | $479 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,316,237 | TotalAmt |
| Program Services | $2,273,191 | ProgramServicesAmt |
| Management And General | $35,164 | ManagementAndGeneralAmt |
| Fundraising | $7,882 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $255,380 | BOYAmt |
| EOY | $63,280 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $616,767 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $136,142 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $280,882 | BOYAmt |
| EOY | $480,625 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $536,262 | BOYAmt |
| EOY | $543,905 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,018 | BOYAmt |
| EOY | $25,899 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $148,336 | BOYAmt |
| EOY | $130,708 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,000 | BOYAmt |
| EOY | $45,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $156,354 | BOYAmt |
| EOY | $201,607 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $209,249 | BOYAmt |
| EOY | $315,331 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $170,659 | BOYAmt |
| EOY | $26,967 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $379,908 | BOYAmt |
| EOY | $342,298 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $536,262 | BOYAmt |
| EOY | $543,905 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$37,610 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | 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 | $489,652 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $617,117 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $614,819 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $867,505 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,209,647 | CurrentTaxYearAmt |
| Total | $4,798,740 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $489,652 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $617,117 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $614,819 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $867,505 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,209,647 | CurrentTaxYearAmt |
| Total | $4,798,740 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $4,798,740 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $101 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $163 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $310 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $170 | CurrentTaxYearAmt |
| Total | $758 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $4,799,498 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $135,110 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99980 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99980 | 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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $149,632 | OtherCostOrOtherBasisAmt |
| Book Value | $149,632 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $165,659 | OtherCostOrOtherBasisAmt |
| Depreciation | $47,606 | DepreciationAmt |
| Book Value | $118,053 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $91,052 | OtherCostOrOtherBasisAmt |
| Depreciation | $88,536 | DepreciationAmt |
| Book Value | $2,516 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $210,424 | OtherCostOrOtherBasisAmt |
| Book Value | $210,424 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $480,625 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $2,344,927 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $66,300 | OtherRevenueAmt |
| Revenue Not Reported | $66,300 | RevenueNotReportedAmt |
| Revenue Subtotal | $2,278,627 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $2,278,627 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,382,537 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $66,300 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $66,300 | ExpensesNotReportedAmt |
| Expenses Subtotal | $2,316,237 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $2,316,237 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 3, PART X | PENDLETON PLACE RECOGNIZES THE TAX BENEFITS FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE-LIKELY-THAN-NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE ORGANIZATIONS'S INCOME TAX FILINGS ARE SUBJECT TO AUDIT BY VARIOUS TAXING AUTHORITIES. MANAGEMENT BELIEVES THE ADOPTION OF ASC 740-10 RESULTED IN NO SIGNIFICANT IMPACT TO THE ORGANIZATION'S FINANCIAL STATEMENTS. |
| SCHEDULE D, PAGE 4, PART XI, LINE 2D | FUNDRAISING EXPENSE 66,300 |
| SCHEDULE D, PAGE 4, PART XII, LINE 2D | FUNDRAISING EXPENSE 66,300 |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | SPECIAL EVENTS | Event1Nm |
| Gross Receipts Event1 | $135,110 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $135,110 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $66,300 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $135,110 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $135,110 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $66,300 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $66,300 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $68,810 | NetIncomeSummaryAmt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 2 | ContributionCnt |
| Noncash Contributions Rpt F990 | $704,361 | NoncashContributionsRptF990Amt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 2 | ContributionCnt |
| Noncash Contributions Rpt F990 | $1,079,213 | NoncashContributionsRptF990Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE EXECUTIVE DIRECTOR AND TREASURER INDEPENDENTLY REVIEW THE 990 BEFORE FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | EACH MEMBER OF THE BOARD OF DIRECTORS IS REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY STATEMENT AT THE TIME OF THEIR APPOINTMENT TO THE BOARD. UNDER THE AGREEMENT, THE MEMBERS ARE TO IMMEDIATELY REPORT ANY CONFLICTS OF INTEREST THAT ARISE DURING THEIR TERM OF SERVICE. |
| FORM 990, PAGE 6, PART VI, LINE 19 | DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST |
| FORM 990, PART XI, LINE 9 | FUNDRAISING EXPENSE 66,300 FUNDRAISING EXPENSE -66,300 |