TENNESSEE CAPTIVE INSURANCE ASSOCIATION: Form 990EZ, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- TENNESSEE CAPTIVE INSURANCE ASSOCIATION (EIN 45-2882002)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-15
- IRS object ID
- 201723199349203187
- 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 | 2017-11-15T11:47:49-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 721396621 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Carr Riggs & Ingram LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3011 Armory Drive Suite 190 | AddressLine1Txt |
| City | Nashville | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37204 | 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 | 452882002 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tennessee Captive Insurance | BusinessNameLine1Txt |
| Business Name Line2 | Association Inc | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | TENN | BusinessNameControlTxt |
| Phone | 8886683188 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 533 Church Street No 222 | AddressLine1Txt |
| City | Nashville | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37219 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Belinda Fortman | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Phone | 4195315531 | PhoneNum |
| Signature | 2017-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Ann M Hamza | PreparerPersonNm |
| PTIN | P10275296 | PTIN |
| Phone | 6156651811 | PhoneNum |
| Preparation | 2017-11-15 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 75.151.58.249 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-15 | IPDt |
| IP Tm | 10:57:18 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | FECC9FCC85B13CA61BE593328613D66EF60E2179 | 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) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Website Address | www.tncaptives.org | WebsiteAddressTxt |
| Organization501c | Yes (X) | Organization501cInd |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $199,975 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Program Service Revenue | $124,425 | ProgramServiceRevenueAmt |
| Membership Dues | $75,550 | MembershipDuesAmt |
| Total Revenue | $199,975 | TotalRevenueAmt |
| Fees And Other Pymt To Ind Cntrct | $98,776 | FeesAndOtherPymtToIndCntrctAmt |
| Printing Publications Postage | $955 | PrintingPublicationsPostageAmt |
| Other Expenses Total | $87,910 | OtherExpensesTotalAmt |
| Total Expenses | $187,641 | TotalExpensesAmt |
| Excess Or Deficit For Year | $12,334 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $52,089 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | $64,423 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,102 | BOYAmt |
| EOY | $73,381 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,194 | BOYAmt |
| EOY | $19,460 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,296 | BOYAmt |
| EOY | $92,841 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,207 | BOYAmt |
| EOY | $28,418 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,089 | BOYAmt |
| EOY | $64,423 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Primary Exempt Purpose | The Tennessee Captive Insurance Association's primary purpose is to promote the growth of the captive insurance industry in the state of Tennessee. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp (3 entries)
| Description Program Srvc AccomDescriptionProgramSrvcAccomTxt | Grants And AllocationsGrantsAndAllocationsAmt | Program Service ExpensesProgramServiceExpensesAmt |
|---|---|---|
| Educational Events: The organization's professional contractor and elected leadership produce educational events designed to inform attendees on how to establish and operate insurance companies in the state of Tennessee. | $0 | $0 |
| Promotion: The organization's professional contractor and elected leadership will produce and distribute information to business executives nationwide encouraging them to consider establishing captive insurance companies in Tennessee. | $0 | $0 |
| Legislative/Regulatory Advocacy: The organization's professional contractor and elected leadership shall advocate for the business interest of its members before the Tennessee State Legislature and State Regulatory agencies. | $0 | $0 |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (9 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| Kevin Doherty | ||||
| Chairman/President/Directo | 2.00 | $0 | $0 | $0 |
| Keith Fawcett | ||||
| DIRECTOR | 1.00 | $0 | $0 | $0 |
| Wm Gary Greene | ||||
| Director | 1.00 | $0 | $0 | $0 |
| Bill Beeler | ||||
| Director | 1.00 | $0 | $0 | $0 |
| Mary Francis Miller | ||||
| Director | 1.00 | $0 | $0 | $0 |
| Andrew CLayton | ||||
| SECRETARY | 2.00 | $0 | $0 | $0 |
| Belinda Fortman | ||||
| Treasurer | 2.00 | $0 | $0 | $0 |
| Scott Stone | ||||
| DirECTOR | 1.00 | $0 | $0 | $0 |
| SHIRLEY FULLER COOPER | ||||
| DIRECTOR | 1.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | 0 | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | 0 | OrganizationHadUBIInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Direct Indirect Pltcl Expend | $0 | DirectIndirectPltclExpendAmt |
| Made Loans To From Officers | 0 | MadeLoansToFromOfficersInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| States Where Copy Of Return Is Fld | TN | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jennifer Ivy Calmetto Mgt | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 883 NE MAin Street 2nd Floor | AddressLine1Txt |
| City | Simpsonville | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29681 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8649622201 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Donor Advised Fnds | 0 | DonorAdvisedFndsInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Tanning Services Provided | 0 | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990-EZ, Part I, Line 16 - Other Expenses | Description: General Administration. Amount: 15,660. Description: Annual Conference. Amount: 54,486. Description: Membership/Promotion. Amount: 3,107. Description: Networking events. Amount: 11,082. Description: Other. Amount: 3,575. Total to Form 990-EZ, line 16: 87,910. |
| Form 990-EZ, Part II, Line 24 - Other Assets | Description: ACCOUNTS RECEIVABLE. Beg. of Year Amount: 2,194. End of Year Amount: 19,460. |
| Form 990-EZ, Part II, Line 26 - Other Liabilities | Description: Accounts payable. Beg. of Year Amount: 1,357. End of Year Amount: 18,263. Description: DEFERRED REVENUE. Beg. of Year Amount: 850. End of Year Amount: 1,850. Description: Accrued Expenses. Beg. of Year Amount: 0. End of Year Amount: 8,305. |
Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Declaration | The organization did not, during the year, receive any funds, directly,or indirectly, to pay premiums on a personal benefit contract.The organization, did not, during the year, pay any premiums, directly,or indirectly, on a personal benefit contract. | DeclarationDesc |