HAVASU REGIONAL MEDICAL CENTER AUXILIARY: Form 990EZ, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- HAVASU REGIONAL MEDICAL CENTER AUXILIARY (EIN 23-7292187)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-03-27
- IRS object ID
- 201740869349200034
- 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 | 2017-03-27T21:11:40-04:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 860675074 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Metro Tax and Financial Svc Inc | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 149 Paseo Del Sol Ave | AddressLine1Txt |
| City | Lake Havasu City | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86403 | 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 | 237292187 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAVASU REGIONAL MEDICAL CENTER AUXILARY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HAVA | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 CIVIC CENTER LN | AddressLine1Txt |
| City | LAKE HAVASU CITY | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86403 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DON PERRYMAN | PersonNm |
| Person Title | President | PersonTitleTxt |
| Phone | 5084791090 | PhoneNum |
| Signature | 2017-03-16 | SignatureDt |
| Discuss With Paid Preparer | false | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Samantha L Eckhart EA | PreparerPersonNm |
| PTIN | P00841584 | PTIN |
| Phone | 9286801444 | PhoneNum |
| Preparation | 2017-03-27 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 74.40.255.134 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-03-27 | IPDt |
| IP Tm | 21:00:23 | IPTm |
| Federal Original Submission Id | 86109820170861b1lwip | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2017-03-27 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 0B859CF8D1B3055656EAAECD3CA1AF30E843015A | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 0B859CF8D1B3055656EAAECD3CA1AF30E843015A | 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 Cash | Yes (X) | MethodOfAccountingCashInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $57,103 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $820 | ContributionsGiftsGrantsEtcAmt |
| Membership Dues | $770 | MembershipDuesAmt |
| Investment Income | $60 | InvestmentIncomeAmt |
| Gaming Gross Income | $315 | GamingGrossIncomeAmt |
| Fundraising Gross Income | $27,400 | FundraisingGrossIncomeAmt |
| Special Events Net Income Loss | $27,715 | SpecialEventsNetIncomeLossAmt |
| Other Revenue Total | $27,738 | OtherRevenueTotalAmt |
| Total Revenue | $57,103 | TotalRevenueAmt |
| Grants And Similar Amounts Paid | $60,500 | GrantsAndSimilarAmountsPaidAmt |
| Printing Publications Postage | $2,550 | PrintingPublicationsPostageAmt |
| Other Expenses Total | $4,383 | OtherExpensesTotalAmt |
| Total Expenses | $67,433 | TotalExpensesAmt |
| Excess Or Deficit For Year | -$10,330 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $115,739 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $105,409 | NetAssetsOrFundBalancesEOYAmt |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $115,739 | BOYAmt |
| EOY | $105,409 | EOYAmt |
Land And Buildings LandAndBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $115,739 | BOYAmt |
| EOY | $105,409 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $115,739 | BOYAmt |
| EOY | $105,409 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | SERVICE TO THE COMMUNITY | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp (2 entries)
| Description Program Srvc AccomDescriptionProgramSrvcAccomTxt | Grants And AllocationsGrantsAndAllocationsAmt |
|---|---|
| PROVIDED COMMUNITY GRANTS TO 16 VOLUNTEER ORGANIZATIONS IN THE COMMUNITY | $30,500 |
| COMMUNITY SCHOLARSHIPS TO STUDENTS | $30,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $0 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (6 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| Donna Pineau | ||||
| TREASURER | 10.00 | $0 | $0 | $0 |
| DON PERRYMAN | ||||
| PRESIDENT | 10.00 | $0 | $0 | $0 |
| KATIE ONEAL | ||||
| V PRESIDENT | 10.00 | $0 | $0 | $0 |
| KATHLEEN FERGUSON | ||||
| SECRETARY | 10.00 | $0 | $0 | $0 |
| BOBBI HOBBS | ||||
| OFFICER | 10.00 | $0 | $0 | $0 |
| DOTTIE TOPPIN | ||||
| OFFICER | 10.00 | $0 | $0 | $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 | AZ | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Donna Pineau | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 CIVIC CENTER LANE | AddressLine1Txt |
| City | LAKE HAVASU CITY | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86403 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9285051022 | 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) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $1,044 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,015 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,590 | CurrentTaxYearAmt |
| Total | $3,649 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $118,993 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $77,769 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $55,452 | CurrentTaxYearAmt |
| Total | $252,214 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $120,037 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $78,784 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $57,042 | CurrentTaxYearAmt |
| Total | $255,863 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $255,863 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $66 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $64 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $60 | CurrentTaxYearAmt |
| Total | $190 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $66 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $64 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $60 | CurrentTaxYearAmt |
| Total | $190 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus2 Years | $120,103 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $78,848 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $57,102 | CurrentTaxYearAmt |
| Total | $256,053 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99930 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99650 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule C IRS990ScheduleC
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | false | AgrmtProfFundraisingActyInd |
| Licensed States | AZ | LicensedStatesCd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Craft Sales | Event1Nm |
| Gross Receipts Event1 | $11,400 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $11,400 | GrossRevenueEvent1Amt |
| Event2 | Lifeline Sal | Event2Nm |
| Gross Receipts Event2 | $20,000 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $20,000 | GrossRevenueEvent2Amt |
| Gross Receipts Total | $31,400 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $31,400 | GrossRevenueTotalEventsAmt |
| Net Income Summary | $31,400 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Description of other revenue Part I line 8 | Description AmountBlood Drive 263Miscellaneous operat Revenue 994Vending Machine Revenue 3,016Meeting Income 2,022Uniforms 754Book Sales 689Life Line 20,000 |
| List of grants and similar amounts paid Part I line 10 | Activity Donations Amount 60,500 |
| Description of other expenses Part I line 16 | Description AmountMeeting Expenses 2,362Hospital Projects 1,111AZ Corp Comm 10Uniform Expenses 637Blood Drive Expenses 263 |