STRATEGY STUDIO / PUBLIC DATA EXPLORER

INTERFAITH CAREGIVERS OF WASHINGTON COUNTY INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
INTERFAITH CAREGIVERS OF WASHINGTON COUNTY INC (EIN 02-0657722)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-06-21
IRS object ID
201601739349300720
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

FieldValueIRS element (for citing)
Return2016-06-21T10:44:31-05:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390843014PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KIECKHAFER DIETZLER HAUSER HANSON LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 637AddressLine1Txt
CityWEST BENDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP530950637ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN020657722EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1INTERFAITH CAREGIVERS OF WASHINGTONBusinessNameLine1Txt
Business Name Line2COUNTY INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlINTEBusinessNameControlTxt
Phone2623650902PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1143AddressLine1Txt
CityWEST BENDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53095ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJANEAN BRUDVIGPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone2623650902PhoneNum
Signature2016-06-07SignatureDt

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJON J KIECKHAFERPreparerPersonNm
PTINP00151914PTIN
Phone2623342341PhoneNum
Preparation2016-06-07PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2016-09-27 15:27:22ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJANEAN BRUDVIGPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1143AddressLine1Txt
CityWEST BENDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53095ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$297,688GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.INTERFAITHWASHCO.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2003FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionHELPING SENIORS WITH MEDICAL TRANSPORTATION AND HOME CAREActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee5TotalEmployeeCnt
Total Volunteers196TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$205,395PYContributionsGrantsAmt
CY Contributions Grants$204,935CYContributionsGrantsAmt
CY Program Service Revenue$76,458CYProgramServiceRevenueAmt
PY Investment Income$1,000PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$13,493PYOtherRevenueAmt
CY Other Revenue$13,243CYOtherRevenueAmt
PY Total Revenue$219,888PYTotalRevenueAmt
CY Total Revenue$294,636CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$85,970PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$111,487CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$19,461CYTotalFundraisingExpenseAmt
PY Other Expenses$109,788PYOtherExpensesAmt
CY Other Expenses$121,057CYOtherExpensesAmt
PY Total Expenses$195,758PYTotalExpensesAmt
CY Total Expenses$232,544CYTotalExpensesAmt
PY Revenues Less Expenses$24,130PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$62,092CYRevenuesLessExpensesAmt
Total Assets BOY$152,392TotalAssetsBOYAmt
Total Assets EOY$263,139TotalAssetsEOYAmt
Total Liabilities BOY$3,826TotalLiabilitiesBOYAmt
Total Liabilities EOY$52,481TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$148,566NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$210,658NetAssetsOrFundBalancesEOYAmt
MissionHELPING SENIORS WITH MEDICAL TRANSPORTATION AND HOME CAREMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$43,130ExpenseAmt
DescELDER SERVICES - VOLUNTEERS ASSISTED WASHINGTON COUNTY SENIORS WITH VISITS, LIGHT HOUSEKEEPING, MINOR YARD MAINTENANCE AND HOME REPAIR, SNOW SHOVELING, MEAL PREPARATION AND MEAL/FOOD DELIVERY ON 4,515 OCCASIONS, WITH 2,297 VOLUNTEER HOURS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$132,531ExpenseAmt
DescTRANSPORTATION SERVICES-VOLUNTEERS PROVIDED 8,348 TRIPS TO MEDICAL APPOINTMENTS AND GROCERY STORES/FOOD PANTRIES WITH 8,420 HOURS OF THEIR TIME.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$175,661TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee5EmployeeCnt
Employment Tax Returns FiledfalseEmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJANEAN BRUDVIGPersonNm
Phone2623650902PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1143AddressLine1Txt
Address Line2PO BOX 1143AddressLine2Txt
CityWEST BENDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53095ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
LAURENCE SCHWARTZ
CHAIRPERSON1.00Yes (X)Yes (X)$0$0$0
WENDY COULTER
VICE CHAIRPE1.00Yes (X)Yes (X)$0$0$0
SARAH SPAULDING
TREASURER1.00Yes (X)Yes (X)$0$0$0
DOUG FITZGERALD
DIRECTOR1.00Yes (X)$0$0$0
MIKE HERRICK
DIRECTOR1.00Yes (X)$0$0$0
RENEE R JAHNKE MD
DIRECTOR1.00Yes (X)$0$0$0
JAN LANGE
DIRECTOR1.00Yes (X)$0$0$0
AMY MAURER
DIRECTOR1.00Yes (X)$0$0$0
JUDY PHILLIPS
DIRECTOR1.00Yes (X)$0$0$0
TAMI WINKLER
DIRECTOR1.00Yes (X)$0$0$0
JENNY ZAZKOWSKI
DIRECTOR1.00Yes (X)$0$0$0
KRISTIN FIORENTINO
DIRECTOR1.00Yes (X)$0$0$0
LORRAINE HENDRICKSON
DIRECTOR1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Fundraising$11,750FundraisingAmt
Government Grants$12,000GovernmentGrantsAmt
All Other Contributions$181,185AllOtherContributionsAmt
Noncash Contributions$26,893NoncashContributionsAmt
Total Contributions$204,935TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescCONTRACTSDesc
Total Revenue Column$76,458TotalRevenueColumnAmt
Exclusion$76,458ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$76,458TotalProgramServiceRevenueAmt
Fundraising Gross Income$16,273FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$11,750ContriRptFundraisingEventAmt
Fundraising Direct Expenses$3,052FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,221TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Total Revenue Column$22TotalRevenueColumnAmt
Related Or Exempt Func Income$22RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$22OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$294,636TotalRevenueColumnAmt
Related Or Exempt Func Income$22RelatedOrExemptFuncIncomeAmt
Exclusion$76,458ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$99,431TotalAmt
Program Services$65,625ProgramServicesAmt
Management And General$23,863ManagementAndGeneralAmt
Fundraising$9,943FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$12,056TotalAmt
Program Services$5,021ProgramServicesAmt
Management And General$6,275ManagementAndGeneralAmt
Fundraising$760FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$4,943TotalAmt
Program Services$4,943ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$1,335TotalAmt
Management And General$1,335ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,496TotalAmt
Management And General$279ManagementAndGeneralAmt
Fundraising$2,217FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$7,552TotalAmt
Program Services$4,304ProgramServicesAmt
Management And General$1,096ManagementAndGeneralAmt
Fundraising$2,152FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$6,900TotalAmt
Program Services$5,520ProgramServicesAmt
Management And General$690ManagementAndGeneralAmt
Fundraising$690FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$206TotalAmt
Program Services$156ProgramServicesAmt
Management And General$30ManagementAndGeneralAmt
Fundraising$20FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$25,609TotalAmt
Program Services$25,110ProgramServicesAmt
Management And General$352ManagementAndGeneralAmt
Fundraising$147FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,636TotalAmt
Program Services$1,636ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
VEHICLE$33,277$33,277
INKIND DONATIONS$27,115$23,055$2,030$2,030
VOLUNTEER RECRUITMENT$4,150$4,150
TELEPHONE$3,580$2,864$358$358

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,258TotalAmt
Management And General$1,114ManagementAndGeneralAmt
Fundraising$1,144FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$232,544TotalAmt
Program Services$175,661ProgramServicesAmt
Management And General$37,422ManagementAndGeneralAmt
Fundraising$19,461FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$67,361BOYAmt
EOY$184,489EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,263BOYAmt
EOY$2,264EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
EOY$2,479EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$150,861LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$76,954LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$82,768BOYAmt
EOY$73,907EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$152,392BOYAmt
EOY$263,139EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,219BOYAmt
EOY$2,481EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$50,000EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$1,607BOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,826BOYAmt
EOY$52,481EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$148,566BOYAmt
EOY$163,658EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
EOY$47,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$148,566BOYAmt
EOY$210,658EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$152,392BOYAmt
EOY$263,139EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$62,092ReconcilationRevenueExpnssAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewYes (true)AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
FS AuditedfalseFSAuditedInd
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$157,916CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$154,290CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$256,825CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$205,395CurrentTaxYearMinus1YearAmt
Current Tax Year$204,935CurrentTaxYearAmt
Total$979,361TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$157,916CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$154,290CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$256,825CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$205,395CurrentTaxYearMinus1YearAmt
Current Tax Year$204,935CurrentTaxYearAmt
Total$979,361TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$979,361PublicSupportTotal170Amt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year$76,458CurrentTaxYearAmt
Total$76,458TotalAmt
FieldValueIRS element (for citing)
Total Support$1,055,819TotalSupportAmt
Gross Receipts Rltd Activities$16,295GrossReceiptsRltdActivitiesAmt
Public Support CY1700.92760PublicSupportCY170Pct
Public Support PY1701.00000PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,033OtherCostOrOtherBasisAmt
Depreciation$9DepreciationAmt
Book Value$12,024BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$138,828OtherCostOrOtherBasisAmt
Depreciation$76,945DepreciationAmt
Book Value$61,883BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$73,907TotalBookValueLandBuildingsAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1SPECIAL EVENTSEvent1Nm
Gross Receipts Event1$28,023GrossReceiptsEvent1Amt
Charitable Contri Event1$11,750CharitableContriEvent1Amt
Gross Revenue Event1$16,273GrossRevenueEvent1Amt
Food And Beverage Event1$3,052FoodAndBeverageEvent1Amt
Gross Receipts Total$28,023GrossReceiptsTotalAmt
Charitable Contributions Tot$11,750CharitableContributionsTotAmt
Gross Revenue Total Events$16,273GrossRevenueTotalEventsAmt
Food And Beverage Total Events$3,052FoodAndBeverageTotalEventsAmt
Direct Expense Summary Events$3,052DirectExpenseSummaryEventsAmt
Net Income Summary$13,221NetIncomeSummaryAmt

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$26,893NoncashContributionsRptF990Amt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BTHE EXECUTIVE AND TREASURER REVIEWED THE FORM 990 PRIOR TO ISSUANCE. THE FORM 990 WILL BE PRESENTED TO THE BOARD OF DIRECTORS AT THE NEXT MEETING.
FORM 990, PAGE 6, PART VI, LINE 19FORM 990, GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST FROM THE BUSINESS OFFICE WITHIN 24 HOURS.