PLEASANT VALLEY HOSPITAL AUXILIARY: Form 990EZ, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- PLEASANT VALLEY HOSPITAL AUXILIARY (EIN 23-7307666)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2017-09-19
- IRS object ID
- 201722629349200027
- 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 | 2017-09-19T10:48:03-07:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Accu-Service | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3615 E Barca Street | AddressLine1Txt |
| City | Camarillo | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 930103966 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237307666 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pleasant Valley Hospital Auxiliary | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PLEA | BusinessNameControlTxt |
| Phone | 8053895800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2309 Antonio Avenue | AddressLine1Txt |
| City | Camarillo | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93010 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Walt Wood | PersonNm |
| Person Title | President | PersonTitleTxt |
| Signature | 2017-09-19 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Tami Velasquez | PreparerPersonNm |
| PTIN | P00742167 | PTIN |
| Phone | 8054823669 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
| 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 |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Website Address | N/A | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Other | Yes (X) | TypeOfOrganizationOtherInd |
| Gross Receipts | $109,950 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $9,800 | ContributionsGiftsGrantsEtcAmt |
| Membership Dues | $969 | MembershipDuesAmt |
| Cost Or Other Basis Expense Sale | $0 | CostOrOtherBasisExpenseSaleAmt |
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Special Events Direct Expenses | $0 | SpecialEventsDirectExpensesAmt |
| Gross Sales Of Inventory | $99,181 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $63,587 | CostOfGoodsSoldAmt |
| Gross Profit Loss Sls Of Invntry | $35,594 | GrossProfitLossSlsOfInvntryAmt |
| Total Revenue | $46,363 | TotalRevenueAmt |
| Grants And Similar Amounts Paid | $44,250 | GrantsAndSimilarAmountsPaidAmt |
| Other Expenses Total | $7,196 | OtherExpensesTotalAmt |
| Total Expenses | $51,446 | TotalExpensesAmt |
| Excess Or Deficit For Year | -$5,083 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $16,208 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $11,125 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,716 | BOYAmt |
| EOY | $12,358 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,716 | BOYAmt |
| EOY | $12,358 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,508 | BOYAmt |
| EOY | $1,233 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,208 | BOYAmt |
| EOY | $11,125 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Primary Exempt Purpose | Gift shop and auxiliary proceeds are donated to St. John's Pleasant Valley Hospital, a non-profit 501 (c) corp for purchase of medical equipment | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | Gift shop and auxiliary proceeds are donated to St. John's Pleasant Valley Hospital, a non-profit 501 (c) corp for purchase of medical equipment | DescriptionProgramSrvcAccomTxt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (6 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt |
|---|---|---|
| Walt Wood | ||
| President | 0 | $0 |
| Lee Conner | ||
| Vice President | 0 | $0 |
| Gale Driver | ||
| Vice President | 0 | $0 |
| Franki Giffin | ||
| Treasurer | 0 | $0 |
| Elaine Snyder | ||
| Secretary | 0 | $0 |
| Marty Wisneski | ||
| Secretary | 0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | false | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | false | OrganizationHadUBIInd |
| Organization Filed990 T | false | OrganizationFiled990TInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Form1120 Pol Filed | false | Form1120PolFiledInd |
| Made Loans To From Officers | false | MadeLoansToFromOfficersInd |
| Initiation Fees And Cap Contri | $0 | InitiationFeesAndCapContriAmt |
| Gross Receipts For Public Use | $0 | GrossReceiptsForPublicUseAmt |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Catrina Schambra | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2309 Antonio Avenue | AddressLine1Txt |
| City | Camarillo | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93010 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8053895800 | 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 |
| Form720 Filed | false | Form720FiledInd |
| 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 |
| Related Org Sect527 Org | false | RelatedOrgSect527OrgInd |
| 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Grants and Similar Amounts Paid In Excess of $5,000.1 | | Donee's Name: St John's PV Hospital Aux Gift Shop | Donee's Address: 2309 Antonio Avenue Camarillo CA 93010 | Cash Amount Given: $44250 |
| Other Expenses.1 | Credit Card Discount Fees $2278 |
| Other Expenses.2 | Misc. Membership Expense $1848 |
| Other Expenses.3 | Projects $1264 |
| Other Expenses.4 | Tax Preparation $800 |
| Other Expenses.5 | Repairs $220 |
| Other Expenses.6 | Office Supplies $201 |
| Other Expenses.7 | Gifts $200 |
| Other Expenses.8 | Memorial Donations $172 |
| Other Expenses.9 | Flower Supplies $75 |
| Other Expenses.10 | Tri County Meetings $50 |
| Other Expenses.11 | Dues $45 |
| Other Expenses.12 | Bank Charges $19 |
| Other Expenses.13 | Printing and Reproduction $14 |
| Other Expenses.14 | Taxes Paid $10 |
| Total Liabilities.1 | 23 - Beginning $1508 23 - Ending $1233 |