STRATEGY STUDIO / PUBLIC DATA EXPLORER

ADDICTION COUNSELOR CERTIFICATION BOARD OF OREGON: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
ADDICTION COUNSELOR CERTIFICATION BOARD OF OREGON (EIN 93-0795138)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-05-23
IRS object ID
201721439349300787
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

FieldValueIRS element (for citing)
Return2017-05-23T19:29:45-04:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN931162764PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line13rd Generation Accounting IncBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11804 NE 43rd AveAddressLine1Txt
CityPortlandCityNm
State AbbreviationORStateAbbreviationCd
ZIP97213ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN930795138EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ADDICTION COUNSELOR CERTIFICATION BOARD OF OREGONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlADDIBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12054 N VANCOUVERAddressLine1Txt
CityPortlandCityNm
State AbbreviationORStateAbbreviationCd
ZIP972171917ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARK DAVISPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone5032318164PhoneNum
Signature2017-05-22SignatureDt
Discuss With Paid PreparerfalseDiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSusan G RobertsonPreparerPersonNm
PTINP00774160PTIN
Phone5032827247PhoneNum
Preparation2017-05-23PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address76.105.154.53IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-05-23IPDt
IP Tm19:31:21IPTm
Federal Original Submission Id9330532017143appq05yFederalOriginalSubmissionId
Federal Original Submission Id2017-05-23FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id9CB09A75C68D58FE86123B3A3E6186BFE654C41AAtSubmissionCreationDeviceId
At Submission Filing Device Id9CB09A75C68D58FE86123B3A3E6186BFE654C41AAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARK DAVISPrincipalOfficerNm
Gross Receipts$388,716GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1977FormationYr
Legal Domicile StateORLegalDomicileStateCd
Activity Or MissionCERTIFICATION OF ADDICTION COUNSELORS FOR THE STATE OF OREGONActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee5TotalEmployeeCnt
Total Volunteers12TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$17,154PYContributionsGrantsAmt
CY Contributions Grants$18,404CYContributionsGrantsAmt
PY Program Service Revenue$345,557PYProgramServiceRevenueAmt
CY Program Service Revenue$364,125CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$10,200PYOtherRevenueAmt
CY Other Revenue$6,187CYOtherRevenueAmt
PY Total Revenue$372,911PYTotalRevenueAmt
CY Total Revenue$388,716CYTotalRevenueAmt
PY Grants And Similar Paid$1,800PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$750CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$133,973PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$179,524CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$204,899PYOtherExpensesAmt
CY Other Expenses$197,204CYOtherExpensesAmt
PY Total Expenses$340,672PYTotalExpensesAmt
CY Total Expenses$377,478CYTotalExpensesAmt
PY Revenues Less Expenses$32,239PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$11,238CYRevenuesLessExpensesAmt
Total Assets BOY$123,448TotalAssetsBOYAmt
Total Assets EOY$150,879TotalAssetsEOYAmt
Total Liabilities BOY$18,640TotalLiabilitiesBOYAmt
Total Liabilities EOY$18,099TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$104,808NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$132,780NetAssetsOrFundBalancesEOYAmt
MissionCERTIFICATION OF ADDICTION COUNSELORS FOR THE STATE OF OREGONMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$358,680ExpenseAmt
Grant$750GrantAmt
Revenue$364,125RevenueAmt
DescCERTIFICATION OF ADDICITON COUNSELORS WITHIN THE STATE OF OREGON WITH SEMI ANNUAL EXAMINATIONS AND CERTIFICATE RENEWALSDesc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$18,388ExpenseAmt
Revenue$4,050RevenueAmt
DescTHE ASSOCIATION PUBLISHES A QUARTERLY NEWSLETTER THAT IS MAILED TO ALL THOSE CERTIFIED BY THE BOARDDesc
FieldValueIRS element (for citing)
Total Program Service Expenses$377,068TotalProgramServiceExpensesAmt
Described In Section501c3falseDescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document6IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee5EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldORStatesWhereCopyOfReturnIsFldCd
OtherYes (X)OtherInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMARK DAVISPersonNm
Phone5032318164PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12054 N VANCOUVERAddressLine1Txt
CityPortlandCityNm
State AbbreviationORStateAbbreviationCd
ZIP972171917ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeInd
MARK DAVIS
PRESIDENT2.000.00Yes (X)Yes (X)$0$0$0
SCOTT BUSER
DIRECTOR0.000.00Yes (X)$0$0$0
RICHARD FORSYTH
DIRECTOR0.000.00Yes (X)$0$0$0
JULIA MINES
TREASURER0.000.00Yes (X)Yes (X)$0$0$0
JOSE GARCIA
DIRECTOR0.000.00Yes (X)$0$0$0
ANTHONY JORDON
DIRECTOR0.000.00Yes (X)$0$0$0
JOHNNIE GAGE
VICE PREESIDENT0.000.00Yes (X)Yes (X)$0$0$0
DEBRA BUFFALO BO BIGELOW
SECRETARY0.000.00Yes (X)Yes (X)$0$0$0
MICHAEL KENDER
DIRECTOR0.000.00Yes (X)$0$0$0
THAD LABHART
DIRECTOR0.000.00Yes (X)$0$0$0
ANDREA QUICKSALL
DIRECTOR0.000.00Yes (X)$0$0$0
KEITH WALKER
DIRECTOR0.000.00Yes (X)$0$0$0
VAN R BURNHAM
KEY EMPLOYEE40.000.00$45,912$0$0Yes (X)
MICHAEL RAVAZI
KEY EMPLOYEE40.000.00$44,680$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$90,592TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$18,404GovernmentGrantsAmt
Total Contributions$18,404TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EXAM FEESS541900$348,630$348,630
RECIPROCITY FEESS541900$11,850$11,850
ACCREDITATION541900$2,025$2,025
CONFERENCE541900$1,620$1,620
TRIBAL541900
FieldValueIRS element (for citing)
Total Program Service Revenue$364,125TotalProgramServiceRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MISCELLANEOUS541900$1,533$1,533
NEWSLETTER ADS541900$4,050$4,050
REIMBURSEMENT541900$604$604
FieldValueIRS element (for citing)
Other Revenue Total$6,187OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$388,716TotalRevenueColumnAmt
Related Or Exempt Func Income$370,312RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$750TotalAmt
Program Services$750ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$163,700TotalAmt
Program Services$163,700ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$15,824TotalAmt
Program Services$15,824ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$245TotalAmt
Program Services$245ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$475TotalAmt
Program Services$475ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,240TotalAmt
Program Services$5,240ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$41,088TotalAmt
Program Services$41,088ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,781TotalAmt
Program Services$3,781ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$13,800TotalAmt
Program Services$13,800ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$8,498TotalAmt
Program Services$8,498ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$12,615TotalAmt
Program Services$12,615ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$410TotalAmt
Management And General$410ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$3,599TotalAmt
Program Services$3,599ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
POSTAGE AND SHIPPING$12,251$12,251
PRINTING$11,595$11,595
EXAMINATION EXPENSE$63,285$63,285
DUES AND SUBSCRIPTIONS$11,998$11,998

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$8,324TotalAmt
Program Services$8,324ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$377,478TotalAmt
Program Services$377,068ProgramServicesAmt
Management And General$410ManagementAndGeneralAmt
Fundraising$0FundraisingAmt
FieldValueIRS element (for citing)
Joint CostsYes (X)JointCostsInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$122,829BOYAmt
EOY$120,670EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$30,000EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$11,402LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$11,193LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$619BOYAmt
EOY$209EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$123,448BOYAmt
EOY$150,879EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,712BOYAmt
EOY$5,031EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$13,928BOYAmt
EOY$13,068EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$18,640BOYAmt
EOY$18,099EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$104,808BOYAmt
EOY$132,780EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$104,808BOYAmt
EOY$132,780EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$123,448BOYAmt
EOY$150,879EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$11,238ReconcilationRevenueExpnssAmt
Prior Period Adjustments$16,734PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,402OtherCostOrOtherBasisAmt
Depreciation$11,193DepreciationAmt
Book Value$209BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$209TotalBookValueLandBuildingsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 governing body review Part VI line 11No review was or will be conducted.
Form 990 availability to public Part VI line 18No Documents available to the public.
Governing documents etc available to public Part VI line 19No documents available to the public.
Explanation of other changes in net assets or fund balances Part XI line 9TRIBAL LIABILITY ADJUSTMENT