TRISTATE TRAUMA NETWORK: Form 990EZ, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- TRISTATE TRAUMA NETWORK (EIN 75-3256296)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-05-09
- IRS object ID
- 201721299349201742
- 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 | 2017-05-09T15:00:08-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 202213517 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RBSK PARTNERS PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 200 | AddressLine1Txt |
| City | GREENSBURG | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 472400200 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 753256296 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE PARTNERSHIP OF MENTAL HEALTH I | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PART | BusinessNameControlTxt |
| Phone | 8125323471 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 22 N PARK AVENUE | AddressLine1Txt |
| City | BATESVILLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47006 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JANE HERMS | PersonNm |
| Person Title | CHAIR | PersonTitleTxt |
| Phone | 8125323471 | PhoneNum |
| Signature | 2017-03-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOHN G SEALE CPACITP | PreparerPersonNm |
| PTIN | P00011210 | PTIN |
| Phone | 8126637567 | PhoneNum |
| Preparation | 2017-02-24 | PreparationDt |
Filing Security Information FilingSecurityInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| At Submission Creation Device Id | 2E30C34C23FC928CE6527A5FD889EDB09BC60595 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | B2BB5585633D9CEC42876CC1229D0C6C419A2363 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Website Address | WWW.TRISTATETRAUMANETWORK.ORG | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $198,935 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $86,458 | ContributionsGiftsGrantsEtcAmt |
| Program Service Revenue | $112,477 | ProgramServiceRevenueAmt |
| Total Revenue | $198,935 | TotalRevenueAmt |
| Salaries Other Comp Empl Bnft | $42,601 | SalariesOtherCompEmplBnftAmt |
| Fees And Other Pymt To Ind Cntrct | $29,752 | FeesAndOtherPymtToIndCntrctAmt |
| Occupancy Rent Utlts And Maint | $744 | OccupancyRentUtltsAndMaintAmt |
| Printing Publications Postage | $480 | PrintingPublicationsPostageAmt |
| Other Expenses Total | $48,973 | OtherExpensesTotalAmt |
| Total Expenses | $122,550 | TotalExpensesAmt |
| Excess Or Deficit For Year | $76,385 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $46,930 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $123,315 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,530 | BOYAmt |
| EOY | $123,834 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $400 | BOYAmt |
| EOY | $6,441 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,930 | BOYAmt |
| EOY | $130,275 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $6,960 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,930 | BOYAmt |
| EOY | $123,315 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Primary Exempt Purpose | PROMOTE MENTAL HEALTH THROUGH COMMUNITY EDUCATION, ADVOCACY AND COLLABORATION. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | THE PARTNERSHIP FOR MENTAL HEALTH, INC. PROMOTES MENTAL HEALTH THROUGH COMMUNITY EDUCATION, ADVOCACY AND COLLABORATION. | DescriptionProgramSrvcAccomTxt |
| Program Service Expenses | $102,015 | ProgramServiceExpensesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $102,015 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (10 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt |
|---|---|---|
| MELISSA ADAMCHIK | ||
| EXECUTIVE DI | 40.00 | $38,658 |
| JANE HERMS | ||
| CHAIR | 4.00 | $0 |
| TRICIA BURKE | ||
| BOARD MEMBER | 4.00 | $0 |
| LUCY GILLESPIE | ||
| SECRETARY | 4.00 | $0 |
| JODIE SHORT | ||
| TREASURER | 4.00 | $0 |
| JODI HARDING | ||
| VICE CHAIR | 4.00 | $0 |
| BRENDA KONRADI | ||
| BOARD MEMBER | 4.00 | $0 |
| MELANIE PALMER | ||
| BOARD MEMBER | 4.00 | $0 |
| CATHY PICHE | ||
| BOARD MEMBER | 4.00 | $0 |
| MARIA PIOMBO | ||
| BOARD MEMBER | 4.00 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | false | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | false | OrganizationHadUBIInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Form1120 Pol Filed | false | Form1120PolFiledInd |
| Made Loans To From Officers | false | MadeLoansToFromOfficersInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ONE COMMUNITY ONE FAMILY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 22 N PARK AVENUE | AddressLine1Txt |
| City | BATESVILLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47006 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8125323471 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Foreign Office | false | ForeignOfficeInd |
| Donor Advised Fnds | false | DonorAdvisedFndsInd |
| Operate Hospital | false | OperateHospitalInd |
| Tanning Services Provided | false | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| School Operating | false | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (true) | 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 Minus1 Year | $91,850 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $86,458 | CurrentTaxYearAmt |
| Total | $178,308 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $91,850 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $86,458 | CurrentTaxYearAmt |
| Total | $178,308 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $178,308 | PublicSupportTotal170Amt |
| Total Support | $178,308 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $112,477 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 1.00000 | PublicSupportCY170Pct |
| Public Support PY170 | 1.00000 | 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 O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990-EZ, PART I, LINE 16 | EXPENSES POSTAGE & MAILING - PFAU GRAN 8 OFFICE SUPPLIES 6,099 MILEAGE/PARKING 2,253 CONFERENCES/TRAINING 10,644 WORKER COMPENSATION - GREATER 409 WORKER COMPENSATION - MEMBERS 619 NATIONAL COUNCIL - LEARNING C 6,272 SUPPORT ADMINISTRATION CO 3,400 SUPPORT ADMINISTRATION CO 10,000 TRAINING/EVENT SUPPLIES 4,638 OTHER EXPNESES - MEMBERSH 463 OTHER EXPENSES - PARTNERS 946 OTHER EXPENSES - LEARNING 1,884 SUICIDE PREVENTION - PART 125 WEBSITE 1,213 TOTAL 48,973 |
| FORM 990-EZ, PART II, LINE 24 | ACCOUNTS RECEIVABLE 400 5,860 PREPAID EXPENSES AND DEFERRED CHARGES 0 581 TOTAL 400 6,441 |
| FORM 990-EZ, PART II, LINE 26 | ACCOUNTS PAYABLE AND ACCRUED EXPENSES 0 3,792 FEDERAL TAX WITHHOLDING 0 308 FICA TAX WITHHOLDING 0 315 STATE TAX WITHHOLDING 0 759 ACCRUED FICA TAX 0 315 ACCRUED PAYROLL 0 1,471 |
| FORM 990-EZ, PART III | PROMOTE MENTAL HEALTH THROUGH COMMUNITY EDUCATION, ADVOCACY AND COLLABORATION. |