EMERALD COAST COMMUNITY WELLNESS FOUNDATION: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- EMERALD COAST COMMUNITY WELLNESS FOUNDATION (EIN 46-2773334)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-09-30
- IRS object ID
- 201602749349300430
- Schema version
- 2015v2.1
- 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 | 2016-09-30T13:26:31-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 454084437 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Warren Averett LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 36474C Emerald Coast Pkwy Suite | AddressLine1Txt |
| Address Line2 | 3301 | AddressLine2Txt |
| City | Destin | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32541 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 462773334 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | White-Wilson Community Foundation Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WHIT | BusinessNameControlTxt |
| Phone | 8508638100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1005 Mar Walt Drive | AddressLine1Txt |
| City | Fort Walton Beach | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32547 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Alan Gieseman | PersonNm |
| Person Title | Vice President | PersonTitleTxt |
| Phone | 8508638207 | PhoneNum |
| Signature | 2016-09-22 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Lori K Kelley CPA | PreparerPersonNm |
| PTIN | P00111278 | PTIN |
| Phone | 8508370398 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Alan Gieseman | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1005 Mar Walt Drive | AddressLine1Txt |
| City | Fort Walton Beach | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32548 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $215,551 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | whitewilsoncommunityfoundation.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2012 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | White-Wilson Community Foundation strives to make its community the healthiest on Earth. The Foundation serves individuals and organizations in Okaloosa, Santa Rosa and Walton Counties. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $113,976 | PYContributionsGrantsAmt |
| CY Contributions Grants | $108,813 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $44,665 | PYOtherRevenueAmt |
| CY Other Revenue | $75,457 | CYOtherRevenueAmt |
| PY Total Revenue | $158,641 | PYTotalRevenueAmt |
| CY Total Revenue | $184,270 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $49,320 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $77,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $13,771 | PYOtherExpensesAmt |
| CY Other Expenses | $4,472 | CYOtherExpensesAmt |
| PY Total Expenses | $63,091 | PYTotalExpensesAmt |
| CY Total Expenses | $81,472 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $95,550 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $102,798 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $125,587 | TotalAssetsBOYAmt |
| Total Assets EOY | $220,453 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,097 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $165 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $117,490 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $220,288 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To improve the community's health and wellness through service and education. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Desc | The Little Black Dress Party was formed in 2010 to raise awareness regarding the importance of preventive healthcare, specifically in regards to women's health. There has been a drastic decline in preventive healthcare nationwide and we believe that the most effective way to offset diseases like breast cancer, heart disease and osteoporosis is through early detection. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $77,000 | ExpenseAmt |
| Grant | $77,000 | GrantAmt |
| Desc | Run for the Health of It 5K & 8K Run/Walk - All proceeds benefit the White-Wilson Community Foundation and will help support health education and services in our community. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $77,000 | 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 | 0 | 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 | 0 | 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 | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | 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 | 0 | ConflictOfInterestPolicyInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | FL | StatesWhereCopyOfReturnIsFldCd |
| Other | Yes (X) | OtherInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Organization | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8508638207 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1005 Mar Walt Drive | AddressLine1Txt |
| City | Fort Walton Beach | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32547 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| Marj Cummins CPA | ||||||
| Past Chairman of the Board | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Dr Jack Azzaretto | ||||||
| Chairman of the Board | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Alan Gieseman | ||||||
| Vice President | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Kenneth Haskin MD | ||||||
| Treasurer | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Gene Barker CPA | ||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Ray McGovern | ||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Bruce Marshall | ||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Dr Janet Niemi Chubb | ||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Dr Andrea Loder | ||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Dr Tama Van Decar | ||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | 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 |
| Fundraising | $7,388 | FundraisingAmt |
| All Other Contributions | $101,425 | AllOtherContributionsAmt |
| Noncash Contributions | $1,345 | NoncashContributionsAmt |
| Total Contributions | $108,813 | TotalContributionsAmt |
| Fundraising Gross Income | $81,738 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $7,388 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $31,281 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $50,457 | TotalRevenueColumnAmt |
| Exclusion | $50,457 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,000 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $25,000 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $25,000 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $184,270 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $25,000 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $50,457 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,000 | TotalAmt |
| Program Services | $77,000 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,300 | TotalAmt |
| Management And General | $1,300 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $305 | TotalAmt |
| Management And General | $305 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28 | TotalAmt |
| Management And General | $28 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $587 | TotalAmt |
| Management And General | $587 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $667 | TotalAmt |
| Management And General | $667 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|
| Meals and entertainment | $809 | $809 |
| Dues and subscriptions | $425 | $425 |
| Miscellaneous expense | $130 | $130 |
| Supplies | $88 | $88 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133 | TotalAmt |
| Management And General | $133 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,472 | TotalAmt |
| Program Services | $77,000 | ProgramServicesAmt |
| Management And General | $4,472 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,587 | BOYAmt |
| EOY | $220,453 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,587 | BOYAmt |
| EOY | $220,453 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,097 | BOYAmt |
| EOY | $165 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,097 | BOYAmt |
| EOY | $165 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,763 | BOYAmt |
| EOY | $215,729 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,540 | BOYAmt |
| EOY | $2,540 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,187 | BOYAmt |
| EOY | $2,019 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,490 | BOYAmt |
| EOY | $220,288 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,587 | BOYAmt |
| EOY | $220,453 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $102,798 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| 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 Minus2 Years | $67,889 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $178,403 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $212,242 | CurrentTaxYearAmt |
| Total | $458,534 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $67,889 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $178,403 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $212,242 | CurrentTaxYearAmt |
| Total | $458,534 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $458,534 | PublicSupportTotal170Amt |
| Total Support | $458,534 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $112,426 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 1.00000 | PublicSupportCY170Pct |
| Public Support PY170 | 1.00000 | 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 G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Little Black Dress Party | Event1Nm |
| Gross Receipts Event1 | $73,173 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $2,868 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $70,305 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $14,857 | RentFacilityCostsEvent1Amt |
| Other Direct Expenses Event1 | $11,136 | OtherDirectExpensesEvent1Amt |
| Event2 | Run for the Health of It | Event2Nm |
| Gross Receipts Event2 | $6,547 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $2,019 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $4,528 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $2,980 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 2 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $9,406 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $2,501 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $6,905 | GrossRevenueOtherEventsAmt |
| Oth Direct Expnss Other Events | $2,308 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $89,126 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $7,388 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $81,738 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $14,857 | RentFcltyCostsTotalEventsAmt |
| Oth Direct Expnss Total Events | $16,424 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $31,281 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $50,457 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| Mental Health Association of Okaloosa-Walton Counties Inc | |||||||
| 571 Mooney Road NE | Fort Walton Beach | FL | 32547 | 593282067 | 501(c)(3) | $6,208 | To help improve community's health and wellness. |
| Shelter House Inc | |||||||
| 102 Buck Drive | Fort Walton Beach | FL | 32548 | 592634092 | 501(c)(3) | $22,542 | To help improve community's health and wellness. |
| Florida Department of Health Santa Rosa County | |||||||
| 5527 Stewart St | Milton | FL | 32570 | 501(c)(3) | $9,800 | To help improve community's health and wellness. | |
| Florida Department of Health Walton County | |||||||
| 362 FL-83 | DeFuniak Springs | FL | 32433 | 501(c)(3) | $10,000 | To help improve community's health and wellness. | |
| Sight Savers America | |||||||
| 337 Business Cr | Pelham | AL | 35124 | 300188234 | 501(c)(3) | $10,000 | To help improve community's health and wellness. |
| Hope Medical Clinic | |||||||
| 150 Beach Drive | Destin | FL | 32541 | 263811078 | 501(c)(3) | $16,250 | To help improve community's health and wellness. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 3 | The organization has delegated management and administration functions to Leslie Moland and Andi Mahoney, who are employees of White Wilson Medical Center P.A. |
| Form 990, Part VI, Section B, line 11 | The organization sends a draft of the Form 990 to the Finance Committee for review before filing. |
| Form 990, Part VI, Section C, line 19 | The organizations governing and organizational documents are available upon request from the public. |