WISCONSIN DENTAL ASSOCIATION FOUNDATION INC: Form 990, tax year 2016
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- Organization
- WISCONSIN DENTAL ASSOCIATION FOUNDATION INC (EIN 39-0965289)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-05-26
- IRS object ID
- 201731469349300118
- 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 | 2017-05-26T10:38:09-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8215 GREENWAY BOULEVARD SUITE 600 | AddressLine1Txt |
| City | MIDDLETON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53562 | 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 | 390965289 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WISCONSIN DENTAL ASSOCIATION | BusinessNameLine1Txt |
| Business Name Line2 | FOUNDATION INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WISC | BusinessNameControlTxt |
| Phone | 4142764520 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6737 W WASHINGTON STREET NO 2360 | AddressLine1Txt |
| City | WEST ALLIS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53214 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK PAGET | PersonNm |
| Person Title | SECRETARY | PersonTitleTxt |
| Phone | 4142764520 | PhoneNum |
| Signature | 2017-05-23 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KIMBERLY ANDERSON CPA | PreparerPersonNm |
| PTIN | P00188889 | PTIN |
| Phone | 6086628600 | PhoneNum |
| Preparation | 2017-05-23 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-05-23 | IPDt |
| IP Tm | 11:23:51 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | AEB561FE889C33FEC0A971B5B75B31039963007A | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 58AD9E9DE30FC512FEEF3CA8C51B131BFFB09503 | 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 | VICTORIA BOHMAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6737 W WASHINGTON STREET NO 2360 | AddressLine1Txt |
| City | WEST ALLIS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53214 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $421,878 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WDA.ORG/WDA-FOUNDATION | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1957 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | SUPPORT DENTAL HEALTH CARE INITIATIVES TO IMPROVE ORAL HEALTH CARE OF DISADVANTAGED RESIDENTS THROUGHOUT THE STATE OF WISCONSIN. | ActivityOrMissionDesc |
| Voting Members Governing Body | 19 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 19 | VotingMembersIndependentCnt |
| Total Employee | 3 | TotalEmployeeCnt |
| Total Volunteers | 1575 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $300,473 | PYContributionsGrantsAmt |
| CY Contributions Grants | $298,203 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $107,171 | PYInvestmentIncomeAmt |
| CY Investment Income | $92,110 | CYInvestmentIncomeAmt |
| PY Other Revenue | $20,063 | PYOtherRevenueAmt |
| CY Other Revenue | $15,999 | CYOtherRevenueAmt |
| PY Total Revenue | $427,707 | PYTotalRevenueAmt |
| CY Total Revenue | $406,312 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $62,100 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $67,940 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $122,429 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $128,442 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $1,645 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $179,844 | PYOtherExpensesAmt |
| CY Other Expenses | $199,580 | CYOtherExpensesAmt |
| PY Total Expenses | $364,373 | PYTotalExpensesAmt |
| CY Total Expenses | $395,962 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $63,334 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $10,350 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,858,990 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,959,297 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $33,926 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $14,335 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,825,064 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,944,962 | NetAssetsOrFundBalancesEOYAmt |
| Mission | SUPPORT DENTAL HEALTH CARE INITIATIVES TO IMPROVE ORAL HEALTH CARE OF DISADVANTAGED RESIDENTS THROUGHOUT THE STATE OF WISCONSIN. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $94,242 | ExpenseAmt |
| Desc | DONATED DENTAL SERVICES - PROVIDED DENTAL SERVICES VALUED AT $667,234 FOR DENTAL TREATMENT OF DISABLED, ELDERLY AND MEDICALLY-COMPROMISED INDIVIDUALS WHO COULD NOT AFFORD THE DENTAL CARE NEEDED. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $136,862 | ExpenseAmt |
| Desc | PROVIDED FREE DENTAL CARE TO 1,064 UNINSURED, LOW-INCOME INDIVIDUALS VALUED AT $964,000 OVER A TWO-DAY PERIOD IN EAU CLAIRE, WI. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $68,814 | ExpenseAmt |
| Grant | $67,940 | GrantAmt |
| Desc | ENHANCES EDUCATIONAL OPPORTUNITIES BY AWARDING SCHOLARSHIPS TO DENTAL AND DENTAL HYGIENE STUDENTS IN THE STATE OF WISCONSIN AND PROVIDED GRANTS IN SUPPORT OF STATEWIDE COMMUNITY DENTAL HEALTH PROJECTS AND CLINICS WHERE DENTAL CARE IS PROVIDED TO THE LOW INCOME POPULATION. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $299,918 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | 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 | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | 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 | 14 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 3 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| 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 | 19 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 19 | 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ABBY VAN KERKVOORDE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4147554102 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6737 W WASHINGTON STREET | AddressLine1Txt |
| City | WEST ALLIS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53214 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| DR LOREN SWANSON | ||||||
| PRESIDENT | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DR CHRISTINE TEMPAS | ||||||
| TREASURER | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MR MARK PAGET | ||||||
| SECRETARY | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DR ROGER COMEAU | ||||||
| EMERITUS MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR RONALD STIFTER | ||||||
| EMERITUS MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MR DENNIS MCGUIRE | ||||||
| EMERITUS MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR JAMES MORGENROTH | ||||||
| VICE PRESIDENT | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DR ANTHONY SCIASCIA | ||||||
| IMMEDIATE PAST PRESIDENT | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DR KENT VANDEHAAR | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR THOMAS PETERSEN | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR PETER STEINERT | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR JAMES VAN MILLER | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR JACK SADOWSKI | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR RUSSELL DUNKEL | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR THOMAS RAIMANN | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR JOSEPH BEST | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR PAUL OBERBRECKLING | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR ROBB WARREN | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR RACHEL STEELE | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MR PAUL BATLEY | ||||||
| DIRECTOR AT-LARGE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MR ANDY LEHMKUHL | ||||||
| DIRECTOR AT-LARGE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MS JEANNE RUDE | ||||||
| DIRECTOR AT-LARGE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MR TOM WITKOWSKI | ||||||
| DIRECTOR AT-LARGE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| VICTORIA BOHMAN | ||||||
| EXECUTIVE DIRECTOR | 32.00 | Yes (X) | $46,946 | $0 | $3,248 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $46,946 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $3,248 | 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 |
| Government Grants | $53,361 | GovernmentGrantsAmt |
| All Other Contributions | $244,842 | AllOtherContributionsAmt |
| Total Contributions | $298,203 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $92,110 | TotalRevenueColumnAmt |
| Exclusion | $92,110 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $31,565 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $15,566 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,999 | TotalRevenueColumnAmt |
| Exclusion | $15,999 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $406,312 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $108,109 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,440 | TotalAmt |
| Program Services | $54,440 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,500 | TotalAmt |
| Program Services | $13,500 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,194 | TotalAmt |
| Management And General | $50,194 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,039 | TotalAmt |
| Program Services | $67,039 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,873 | TotalAmt |
| Program Services | $3,873 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $410 | TotalAmt |
| Program Services | $87 | ProgramServicesAmt |
| Management And General | $323 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,926 | TotalAmt |
| Program Services | $4,657 | ProgramServicesAmt |
| Management And General | $2,269 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,550 | TotalAmt |
| Management And General | $8,550 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,805 | TotalAmt |
| Management And General | $8,805 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,720 | TotalAmt |
| Program Services | $7,585 | ProgramServicesAmt |
| Management And General | $135 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $500 | TotalAmt |
| Management And General | $500 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,621 | TotalAmt |
| Program Services | $58,972 | ProgramServicesAmt |
| Management And General | $4,184 | ManagementAndGeneralAmt |
| Fundraising | $1,465 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,686 | TotalAmt |
| Program Services | $65,476 | ProgramServicesAmt |
| Management And General | $5,210 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,269 | TotalAmt |
| Program Services | $2,585 | ProgramServicesAmt |
| Management And General | $504 | ManagementAndGeneralAmt |
| Fundraising | $180 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $601 | TotalAmt |
| Program Services | $190 | ProgramServicesAmt |
| Management And General | $411 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,414 | TotalAmt |
| Program Services | $5,305 | ProgramServicesAmt |
| Management And General | $13,109 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PROGRAM EVENT EXPENSES | $7,880 | $7,880 | |
| TREATMENT EXPENSE | $7,866 | $7,866 | |
| VOLUNTEER RECOGNITION | $463 | $463 | |
| REGISTRATION | $205 | $205 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $395,962 | TotalAmt |
| Program Services | $299,918 | ProgramServicesAmt |
| Management And General | $94,399 | ManagementAndGeneralAmt |
| Fundraising | $1,645 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $92,701 | BOYAmt |
| EOY | $33,254 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $367,267 | BOYAmt |
| EOY | $367,890 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,836 | BOYAmt |
| EOY | $28,924 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,711 | BOYAmt |
| EOY | $42,389 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,100 | BOYAmt |
| EOY | $600 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $15,483 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $15,483 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,296,307 | BOYAmt |
| EOY | $2,486,172 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68 | BOYAmt |
| EOY | $68 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,858,990 | BOYAmt |
| EOY | $2,959,297 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,926 | BOYAmt |
| EOY | $14,335 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,926 | BOYAmt |
| EOY | $14,335 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,449,747 | BOYAmt |
| EOY | $2,609,805 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $375,317 | BOYAmt |
| EOY | $335,157 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,825,064 | BOYAmt |
| EOY | $2,944,962 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,858,990 | BOYAmt |
| EOY | $2,959,297 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $10,350 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $109,548 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $403,460 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $434,146 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $354,031 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $300,473 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $298,203 | CurrentTaxYearAmt |
| Total | $1,790,313 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $403,460 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $434,146 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $354,031 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $300,473 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $298,203 | CurrentTaxYearAmt |
| Total | $1,790,313 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $382,007 | SubstantialContributorsTotAmt |
| Public Support Total170 | $1,408,306 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $59,064 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $88,648 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $110,843 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $107,171 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $92,110 | CurrentTaxYearAmt |
| Total | $457,836 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $2,248,149 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $192,536 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.62640 | PublicSupportCY170Pct |
| Public Support PY170 | 0.62150 | 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 D IRS990ScheduleD
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,483 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,483 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $534,621 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $109,548 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $12,000 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $15,566 | OtherRevenueAmt |
| Revenue Not Reported | $137,114 | RevenueNotReportedAmt |
| Revenue Subtotal | $397,507 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $8,805 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $8,805 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $406,312 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $414,723 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $12,000 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $15,566 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $27,566 | ExpensesNotReportedAmt |
| Expenses Subtotal | $387,157 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $8,805 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $8,805 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $395,962 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES 15,566. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES 15,566. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF OUTING | Event1Nm |
| Gross Receipts Event1 | $31,565 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $31,565 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $815 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $14,751 | RentFacilityCostsEvent1Amt |
| Gross Receipts Total | $31,565 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $31,565 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $815 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $14,751 | RentFcltyCostsTotalEventsAmt |
| Direct Expense Summary Events | $15,566 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $15,999 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | EDUCATIONAL SCHOLARSHIPS FOR DENTAL AND DENTAL HYGIENE STUDENTS | GrantTypeTxt |
| Recipient | 11 | RecipientCnt |
| Cash Grant | $13,500 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | RECIPIENTS FORWARD COPIES OF PAID RECEIPTS INCURRED FOR EXPENSES ASSOCIATED WITH THE GRANT TO BE RECEIVED. GRANT PAYMENTS MADE AFTER REVIEW OF THESE DOCUMENTS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE DRAFT OF THE 990 IS REVIEWED IN PERSON WITH THE ENTIRE BOARD OF DIRECTORS BEFORE IT IS FILED. KIM ANDERSON, CPA WALKS THE BOARD THROUGH IT AT THE MAY BOARD MEETING EACH YEAR. IT IS ALSO EMAILED OUT TO THE BOARD PRIOR TO THE MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE ASKED AT EACH MEETING IF THEY HAVE A CONFLICT WITH ANY ISSUE ON THE AGENDA. |
| FORM 990, PART VI, SECTION B, LINE 15A | MARK PAGET, SECRETARY, AND ABBY VAN KERKVOORDE, DIRECTOR OF FINANCE, DETERMINE THE SALARY OF THE EXECUTIVE DIRECTOR. THIS SALARY IS LATER APPROVED BY THE ENTIRE BOARD IN CONJUNCTION WITH THE APPROVAL OF THE BUDGET. COMPARABLE WAGE DATA IS OBTAINED FROM AN INDEPENDENT FIRM SPECIALIZING IN HUMAN RESOURCES. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR |