JAY COUNTY HOSPITAL AUXILIARY INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- JAY COUNTY HOSPITAL AUXILIARY INC (EIN 35-2139245)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-07-14
- IRS object ID
- 201711959349300401
- 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 | 2017-07-14T06:35:50-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 201695613 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BOLLENBACHER AND ASSOCIATES LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 915 N MERIDIAN STREET PO BOX 702 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47371 | 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 | 352139245 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAY COUNTY HOSPITAL AUXILIARY INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JAYC | BusinessNameControlTxt |
| Phone | 2607261878 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 W VOTAW | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47371 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CONNIE FEAR | PersonNm |
| Person Title | DIRECTOR OF VOLUNTEER SERVICES | PersonTitleTxt |
| Phone | 2607261878 | PhoneNum |
| Signature | 2017-06-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SCOTT A BOLLENBACHER CPA | PreparerPersonNm |
| PTIN | P00401897 | PTIN |
| Phone | 2607264207 | PhoneNum |
| Preparation | 2017-06-07 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 69.88.193.39 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-06-07 | IPDt |
| IP Tm | 13:58:46 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | FAE5F5393CA5954E8E3F52067EEEBBB42DBDDA40 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | CCD0BBEE044CD8F3DD41FBEA6B61EE65A9CF3118 | 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 | CONNIE FEAR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 W VOTAW | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47371 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $92,360 | 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 | IN | LegalDomicileStateCd |
| Activity Or Mission | THE JAY COUNTY HOSPITAL AUXILIARY IS A NOT-FOR-PROFIT ORGANIZATION WHOSE PRIMARY PURPOSE IS TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF THE JAY COUNTY HOSPITAL. FUNCTIONS OF THE ORGANIZATION INCLUDE SPONSORSHIP OF HOSPITAL BUILDINGS, EQUIPMENT, PROJECTS AND PROGRAMS TO IMPROVE PATIENT CARE, AND PROMOTION OF THE HOSPITAL'S PROGRAMS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 16 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,223 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,123 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,966 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,374 | CYInvestmentIncomeAmt |
| PY Other Revenue | $24,773 | PYOtherRevenueAmt |
| CY Other Revenue | $22,013 | CYOtherRevenueAmt |
| PY Total Revenue | $30,962 | PYTotalRevenueAmt |
| CY Total Revenue | $27,510 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $2,000 | 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 | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $30,714 | PYOtherExpensesAmt |
| CY Other Expenses | $28,779 | CYOtherExpensesAmt |
| PY Total Expenses | $32,714 | PYTotalExpensesAmt |
| CY Total Expenses | $30,779 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,752 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,269 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $228,090 | TotalAssetsBOYAmt |
| Total Assets EOY | $228,150 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $228,090 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $228,150 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE JAY COUNTY HOSPITAL AUXILIARY IS A NOT-FOR-PROFIT ORGANIZATION WHOSE PRIMARY PURPOSE IS TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF THE JAY COUNTY HOSPITAL. FUNCTIONS OF THE ORGANIZATION INCLUDE SPONSORSHIP OF HOSPITAL BUILDINGS, EQUIPMENT, PROJECTS AND PROGRAMS TO IMPROVE PATIENT CARE, AND PROMOTION OF THE HOSPITAL'S PROGRAMS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $30,779 | ExpenseAmt |
| Grant | $2,000 | GrantAmt |
| Desc | THE JAY COUNTY HOSPITAL AUXILIARY IS A NOT-FOR-PROFIT ORGANIZATION WHOSE PRIMARY PURPOSE IS TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF THE JAY COUNTY HOSPITAL. FUNCTIONS OF THE ORGANIZATION INCLUDE SPONSORSHIP OF HOSPITAL BUILDINGS, EQUIPMENT, PROJECTS AND PROGRAMS TO IMPROVE PATIENT CARE, AND PROMOTION OF THE HOSPITAL'S PROGRAMS. | Desc |
| Total Program Service Expenses | $30,779 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | 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 | 0 | 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 | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 16 | 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 | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAY COUNTY HOSPITAL AUXILARY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2607261878 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 W VOTAW ST | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47371 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| SANDY MCGRAW | ||||||
| MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| ROSE SNOW | ||||||
| MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| LINDA KENNEDY | ||||||
| MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| TONI SUTTON | ||||||
| MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| SHIRLEY HERRIN | ||||||
| MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| GLEN BRYANT | ||||||
| MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| SANDY CADWALLADER | ||||||
| MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| SHIRLEY EVANS | ||||||
| MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| KAY LEMASTER | ||||||
| MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| CAROL STEPHENS | ||||||
| MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| KAREN GORE | ||||||
| SECRETARY | 0.00 | $0 | $0 | $0 | Yes (X) | |
| BONNIE COFFEL | ||||||
| PRESIDENT ELECT | 0.00 | $0 | $0 | $0 | Yes (X) | |
| JOYCE ELDRIDGE | ||||||
| CORRESPONDING SECRETARY | 0.00 | $0 | $0 | $0 | Yes (X) | |
| EUNICE WHITE | ||||||
| PRESIDENT | 0.00 | $0 | $0 | $0 | Yes (X) | |
| SHARON GRIFFITH | ||||||
| ASSISTANT TREASURER | 0.00 | $0 | $0 | $0 | Yes (X) | |
| EMILY STEVESON | ||||||
| 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 |
| Membership Dues | $123 | MembershipDuesAmt |
| All Other Contributions | $4,000 | AllOtherContributionsAmt |
| Noncash Contributions | $4,000 | NoncashContributionsAmt |
| Total Contributions | $4,123 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,374 | TotalRevenueColumnAmt |
| Exclusion | $1,374 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $10,443 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $8,209 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,234 | TotalRevenueColumnAmt |
| Exclusion | $2,234 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $75,558 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $56,641 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,917 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $18,917 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $862 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $862 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $862 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,510 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,779 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,608 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,000 | TotalAmt |
| Program Services | $2,000 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,805 | TotalAmt |
| Program Services | $4,805 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $991 | TotalAmt |
| Program Services | $991 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $338 | TotalAmt |
| Program Services | $338 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,454 | TotalAmt |
| Program Services | $4,454 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,000 | TotalAmt |
| Program Services | $4,000 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,600 | TotalAmt |
| Program Services | $4,600 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| CHARITABLE CONTRIBUTION | $4,424 | $4,424 |
| MISCELLANEOUS EXPENSES | $3,819 | $3,819 |
| MILEAGE | $510 | $510 |
| BANK FEES | $314 | $314 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $524 | TotalAmt |
| Program Services | $524 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,779 | TotalAmt |
| Program Services | $30,779 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $116,872 | BOYAmt |
| EOY | $109,384 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,457 | BOYAmt |
| EOY | $12,752 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $68,417 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $27,150 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,702 | BOYAmt |
| EOY | $41,267 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,059 | BOYAmt |
| EOY | $64,747 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $228,090 | BOYAmt |
| EOY | $228,150 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $165,031 | BOYAmt |
| EOY | $163,402 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,540 | BOYAmt |
| EOY | $20,229 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,519 | BOYAmt |
| EOY | $44,519 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $228,090 | BOYAmt |
| EOY | $228,150 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $228,090 | BOYAmt |
| EOY | $228,150 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$3,269 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $3,329 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| 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 | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $68,417 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,150 | DepreciationAmt |
| Book Value | $41,267 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $41,267 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PORTLAND FOUNDATION SCHOLARSHIP FUND | Desc |
| Book Value | $64,747 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $64,747 | TotalBookValueOtherAssetsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE BOARD OF DIRECTORS REVIEWS THE TAX RETURN BEFORE IT IS FILED |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUAL CONFLICT OF INTEREST POLICY STATEMENTS ARE SIGNED BY EACH BOARD MEMBER. THESE ARE THEN REVIEWED BY THE BOARD OF DIRECTORS TO ENSURE COMPLIANCE. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. |