STRATEGY STUDIO / PUBLIC DATA EXPLORER

FLORIDA DENTAL ASSOCIATION FOUNDATION INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
FLORIDA DENTAL ASSOCIATION FOUNDATION INC (EIN 59-2019148)
Tax period
2014-07-01 to 2015-06-30
Filed
2016-04-01
IRS object ID
201620929349300617
Schema version
2014v6.0
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

FieldValueIRS element (for citing)
Return2016-04-01T10:59:46-05:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Thomas Howell Ferguson PABusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12615 Centennial Blvd Suite 200AddressLine1Txt
CityTallahasseeCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32308ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN592019148EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FLORIDA DENTAL ASSOCIATION FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% GREGORY W GRUBERInCareOfNm
Business Name ControlFLORBusinessNameControlTxt
Phone8506813629PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11111 E TENNESSEE STAddressLine1Txt
CityTALLAHASSEECityNm
State AbbreviationFLStateAbbreviationCd
ZIP323086914ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonGREGORY W GRUBERPersonNm
Person TitleCFOPersonTitleTxt
Phone8506813629PhoneNum
Signature2016-04-01SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDeborah L LeonardPreparerPersonNm
PTINP00218358PTIN
Phone8506688100PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerGREGORY W GRUBERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11111 E TENNESSEE STAddressLine1Txt
CityTALLAHASSEECityNm
State AbbreviationFLStateAbbreviationCd
ZIP32308ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,017,228GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.FLORIDADENTAL.ORG/FOUNDATIONWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1980FormationYr
Legal Domicile StateFLLegalDomicileStateCd
Activity Or MissionTHE FLORIDA DENTAL ASSOCIATION FOUNDATION IS THE CHARITABLE ARM OF THE FLORIDA DENTAL ASSOCIATION, PROMOTING DENTAL HEALTH FOR ALL FLORIDIANS.ActivityOrMissionDesc
Voting Members Governing Body19VotingMembersGoverningBodyCnt
Voting Members Independent19VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers1800TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$273,172PYContributionsGrantsAmt
CY Contributions Grants$136,348CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$116,365PYInvestmentIncomeAmt
CY Investment Income$179,124CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$389,537PYTotalRevenueAmt
CY Total Revenue$315,472CYTotalRevenueAmt
PY Grants And Similar Paid$90,065PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$118,650CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$110,096PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$129,548CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$81,389CYTotalFundraisingExpenseAmt
PY Other Expenses$334,524PYOtherExpensesAmt
CY Other Expenses$130,472CYOtherExpensesAmt
PY Total Expenses$534,685PYTotalExpensesAmt
CY Total Expenses$378,670CYTotalExpensesAmt
PY Revenues Less Expenses-$145,148PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$63,198CYRevenuesLessExpensesAmt
Total Assets BOY$2,512,279TotalAssetsBOYAmt
Total Assets EOY$2,319,098TotalAssetsEOYAmt
Total Liabilities BOY$16,890TotalLiabilitiesBOYAmt
Total Liabilities EOY$34,690TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,495,389NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,284,408NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE FLORIDA DENTAL ASSOCIATION FOUNDATION IS THE CHARITABLE ARM OF THE FLORIDA DENTAL ASSOCIATION, PROMOTING DENTAL HEALTH FOR ALL FLORIDIANS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$139,998ExpenseAmt
Grant$105,425GrantAmt
DescPDC PROJECT: DENTISTS CARE IS A DENTAL ACCESS-TO-CARE PROGRAM WHICH CONSISTS OF NUMEROUS ORGANIZATIONS IN FLORIDA WHO PROVIDE A SAFETY NET OF PREVENTIVE AND RESTORATIVE CARE. PATIENTS WHO RECEIVE SERVICES UNDER PDC ARE TYPICALLY LOW-INCOME INDIVIDUALS THAT DON'T QUALIFY FOR PUBLIC ASSISTANCE BUT HAVE THE GREATEST UNMET NEEDS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$44,645ExpenseAmt
Grant$35,000GrantAmt
DescDENTAL HEALTH/EDUCATION PROGRAMS: DENTAL HEALTH AND EDUCATION PROGRAMS INCLUDING CONTRIBUTIONS, HUMANITARIAN AWARD TO HELP IN DENTAL HEALTH PROJECTS AND DENTAL CARE FOR INDIGENT OR UNDERSERVED CHILDREN AND ADULTS. THE DDS PROGRAMS HELP INDIVIDUALS WITH DISABILITIES OR THE ELDERLY OR MEDICALLY FRAGILE AND CANNOT AFFORD OR OTHERWISE ACCESS TREATMENT FOR SEVERE DENTAL CONDITIONS. QUALIFIED PATIENTS FILES ARE REVIEWED BY VOLUNTEER DENTISTS WHO ACCEPT OR DECLINE A PATIENT PRIOR TO TREATMENT. PATIENTS ARE THEN TREATED IN THE OFFICE OF THE VOLUNTEER AND THE DDS COORDINATOR ARRANGES FOR SPECIALIST OR LAB SERVICES.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$3,225ExpenseAmt
Grant$3,225GrantAmt
DescDENTAL/ALLIED EDUCATION SCHOLARSHIPS: SCHOLARSHIPS PROVIDED FOR DENTAL STUDENTS AND ALLIED DENTAL PROFESSIONS, ESPECIALLY ONE IN WHICH THERE IS A SHORTAGE OF HYGIENISTS, ASSISTANTS OR DENTAL LAB TECHNICIANS.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$187,868TotalProgramServiceExpensesAmt
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 EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
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 EntYes (true)BusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
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 ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members19GoverningBodyVotingMembersCnt
Independent Voting Member19IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsYes (true)ChangeToOrgDocumentsInd
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 BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonGREGORY W GRUBERPersonNm
Phone8503507111PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11111 E TENNESSEE STAddressLine1Txt
CityTALLAHASSEECityNm
State AbbreviationFLStateAbbreviationCd
ZIP323086914ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
LEWIS WALKER
DIRECTOR3.00.0Yes (X)$0$0$0
TERRY BUCKENHEIMER
DIRECTOR3.010.0Yes (X)$0$30,000$0
NOLAN ALLEN
DIRECTOR3.00.0Yes (X)$0$0$0
KIM JERNIGAN
DIRECTOR3.010.0Yes (X)$0$0$0
RALPH ATTANASI
DIRECTOR3.010.0Yes (X)$0$30,450$0
NATALIE CARR
DIRECTOR3.00.0Yes (X)$0$0$0
RICK STEVENSON
DIRECTOR3.010.0Yes (X)$0$30,450$0
BRUCE GORDY
DIRECTOR3.00.0Yes (X)$0$0$0
KAREN BUCKENHEIMER
DIRECTOR3.00.0Yes (X)$0$0$0
HARRY FUTRELL
DIRECTOR3.00.0Yes (X)$0$0$0
DAVID RUSSELL
PRESIDENT5.00.0Yes (X)$0$0$0Yes (X)
ROBERT PAYNE
1ST VICE PRESIDENT3.00.0Yes (X)$0$0$0Yes (X)
C WILLIAM D'AIUTO
SECRETARY3.00.0Yes (X)$0$0$0Yes (X)
IDALIA LASTRA
TREASURER3.00.0Yes (X)$0$0$0Yes (X)
ROBERT FERRIS
DIRECTOR3.00.0Yes (X)$0$0$0
CAROL STEWART
DIRECTOR3.00.0Yes (X)$0$0$0
NANCY HAVENS
DIRECTOR3.00.0Yes (X)$0$0$0
LEO CULLINAN
DIRECTOR3.00.0Yes (X)$0$0$0
AUDREY GALKA
DIRECTOR3.00.0Yes (X)$0$0$0
ANDREW JAMES EASON
CEO5.050.0$0$249,371$24,983Yes (X)
JACK MOORE
CFO (7/1/14 - 12/7/14)5.035.0$0$158,484$24,179Yes (X)
JAMES WALTON III
IMMEDIATE PAST PRESIDENT3.00.0$0$0$0Yes (X)
GREGORY GRUBER
CFO (12/8/14 - 6/30/15)8.035.0$0$4,803$8,570Yes (X)
HEATHER DEGAN
DIRECTOR OF FOUNDATION AFFAIRS35.05.0$0$12,491$1,068Yes (X)
RUSSELL PAYTON
COO8.035.0$0$171,755$12,990Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$687,804TotReportableCompRltdOrgAmt
Total Other Compensation$71,790TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Related Organizations$21,093RelatedOrganizationsAmt
All Other Contributions$115,255AllOtherContributionsAmt
Noncash Contributions$2,160NoncashContributionsAmt
Total Contributions$136,348TotalContributionsAmt
Total Program Service Revenue$0TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$119,467TotalRevenueColumnAmt
Exclusion$119,467ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$761,413SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$701,756SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$59,657SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$59,657TotalRevenueColumnAmt
Exclusion$59,657ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$315,472TotalRevenueColumnAmt
Exclusion$179,124ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$110,000TotalAmt
Program Services$110,000ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$8,650TotalAmt
Program Services$8,650ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$129,548TotalAmt
Program Services$32,387ProgramServicesAmt
Management And General$64,774ManagementAndGeneralAmt
Fundraising$32,387FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$8,700TotalAmt
Management And General$8,700ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,083TotalAmt
Fundraising$2,083FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$20,194TotalAmt
Fundraising$20,194FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$30,112TotalAmt
Management And General$21,421ManagementAndGeneralAmt
Fundraising$8,691FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$296TotalAmt
Management And General$296ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$19,037TotalAmt
Program Services$2,186ProgramServicesAmt
Management And General$11,796ManagementAndGeneralAmt
Fundraising$5,055FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,861TotalAmt
Management And General$1,861ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$155TotalAmt
Management And General$155ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtFundraisingFundraisingAmtManagement And GeneralManagementAndGeneralAmt
PROGRAM EXPENSES$34,645$34,645
SPONSORSHIPS$12,500$12,500
AWARDS$479$479
FEES& LICENSES$410$410

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$378,670TotalAmt
Program Services$187,868ProgramServicesAmt
Management And General$109,413ManagementAndGeneralAmt
Fundraising$81,389FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$307,482BOYAmt
EOY$283,880EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,051BOYAmt
EOY$1,327EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$6,333BOYAmt
EOY$926EOYAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$2,105,665BOYAmt
EOY$1,959,211EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$90,748BOYAmt
EOY$73,754EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,512,279BOYAmt
EOY$2,319,098EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$54BOYAmt
EOY$11,777EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$300BOYAmt
EOY$19,500EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$16,536BOYAmt
EOY$3,413EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$16,890BOYAmt
EOY$34,690EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,967,389BOYAmt
EOY$1,759,055EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$415,314BOYAmt
EOY$412,667EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$112,686BOYAmt
EOY$112,686EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,495,389BOYAmt
EOY$2,284,408EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,512,279BOYAmt
EOY$2,319,098EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$63,198ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$147,783NetUnrlzdGainsLossesInvstAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$355,232CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$319,752CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$329,770CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$273,172CurrentTaxYearMinus1YearAmt
Current Tax Year$131,832CurrentTaxYearAmt
Total$1,409,758TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$54,216CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$31,140CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$14,810CurrentTaxYearMinus2YearsAmt
Total$100,166TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,300CurrentTaxYearMinus4YearsAmt
Total$1,300TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$410,748CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$350,892CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$344,580CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$273,172CurrentTaxYearMinus1YearAmt
Current Tax Year$131,832CurrentTaxYearAmt
Total$1,511,224TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$51,370CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$32,980CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$38,030CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$32,520CurrentTaxYearMinus1YearAmt
Current Tax Year$28,263CurrentTaxYearAmt
Total$183,163TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$51,370CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$32,980CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$38,030CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$32,520CurrentTaxYearMinus1YearAmt
Current Tax Year$28,263CurrentTaxYearAmt
Total$183,163TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$1,328,061PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$147,726CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$46,698CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$133,886CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$116,365CurrentTaxYearMinus1YearAmt
Current Tax Year$179,124CurrentTaxYearAmt
Total$623,799TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$147,726CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$46,698CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$133,886CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$116,365CurrentTaxYearMinus1YearAmt
Current Tax Year$179,124CurrentTaxYearAmt
Total$623,799TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$122,210CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,053CurrentTaxYearMinus3YearsAmt
Total$124,263TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$680,684CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$399,643CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$478,466CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$389,537CurrentTaxYearMinus1YearAmt
Current Tax Year$310,956CurrentTaxYearAmt
Total$2,259,286TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.58782PublicSupportCY509Pct
Public Support PY5090.64420PublicSupportPY509Pct
Investment Income CY0.27610InvestmentIncomeCYPct
Investment Income PY0.19260InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

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

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$129,920BeginningYearBalanceAmt
Investment Earnings Or Losses-$2,928InvestmentEarningsOrLossesAmt
Administrative Expenses$126,992AdministrativeExpensesAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$230,561BeginningYearBalanceAmt
Investment Earnings Or Losses$73,442InvestmentEarningsOrLossesAmt
Other Expenditures$174,083OtherExpendituresAmt
Administrative Expenses$129,920AdministrativeExpensesAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.59000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.17000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.24000TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd
LandLandGrp
BuildingsBuildingsGrp
Leasehold ImprovementsLeaseholdImprovementsGrp
EquipmentEquipmentGrp
Other Land BuildingsOtherLandBuildingsGrp
Financial DerivativesFinancialDerivativesGrp
Closely Held Equity InterestsCloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescMUTUAL FUNDSDesc
Book Value$1,959,211BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$1,959,211TotalBookValueSecuritiesAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescINTERCOMPANY PAYABLESDesc
Amt$3,413Amt
FieldValueIRS element (for citing)
Total Liability$3,413TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$291,936TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$147,783NetUnrealizedGainsInvstAmt
Other Revenue$124,247OtherRevenueAmt
Revenue Not Reported-$23,536RevenueNotReportedAmt
Revenue Subtotal$315,472RevenueSubtotalAmt
Total Revenue Per Form990$315,472TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$502,917TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$124,247OtherExpensesIncludedAmt
Expenses Not Reported$124,247ExpensesNotReportedAmt
Expenses Subtotal$378,670ExpensesSubtotalAmt
Total Expenses Per Form990$378,670TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:WITH FEW EXCEPTIONS, THE FOUNDATION IS NO LONGER SUBJECT TO EXAMINATIONS BY MAJOR TAX JURISDICTIONS FOR YEARS ENDED JUNE 30, 2011 AND PRIOR.
PART XI LINE 2d:IN-KIND REVENUE: $ 124,247.
PART XII LINE 2d:IN-KIND EXPENSES: $ 124,427.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
ALACHUA COUNTY MEDICAL FOUNDATION INC
235 SW 2ND AVEGAINESVILLEFL32601592065918501(c)(3)$7,000FINANCIAL SUPPORT
ACORN CLINIC
23320 N STATE RD 235BROOKERFL32622591627845501(c)(3)$6,000FINANCIAL SUPPORT
BARNABAS CENTER INC
11 S 11TH STFERNANDINA BEACHFL32304592920275501(c)(3)$6,000FINANCIAL SUPPORT
CHAPMAN PARTNERSHIP
1550 NORTH MIAMI AVEMIAMIFL33136650425069501(c)(3)$6,000FINANCIAL SUPPORT
DENTAL CARE ACCESS FOUNDATION INC
800 N MILLS AVEORLANDOFL32803201531222501(c)(3)$7,000FINANCIAL SUPPORT
NEIGHBORHOOD HEALTH CLINIC INC
121 N GOODLETTE RDNAPLESFL34102593546884501(c)(3)$6,000FINANCIAL SUPPORT
WEST JAX OUTREACH
5042 TIMUQUANA ROADJACKSONVILLEFL32210593038067501(c)(3)$6,000FINANCIAL SUPPORT
MORE HEALTH INC
3821 HENDERSON BLVDTAMPAFL32629593397472501(c)(3)$25,000FINANCIAL SUPPORT
DENTAL LIFELINE NETWORK
1800 15TH STREET SUITE 100DENVERCO80202841533654501(C)(3)$35,000FINANCIAL SUPPORT
FieldValueIRS element (for citing)
Total501c3 Org8Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeWCCDA SCHOLARSHIP AWARDSGrantTypeTxt
Recipient10RecipientCnt
Cash Grant$3,325CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationGRANT RECIPIENTS COMPOSE AND SUBMIT A REPORT MIDWAY THROUGH THE TIME THE FUNDS WERE PROPOSED TO BE USED. AN AVERAGE OF ONE YEAR IS THE TIME SPAN FOR EACH GRANT AND AT THE END OF THEIR INTENDED TIME; EACH ORGANIZATION MUST SUBMIT A DETAILED REPORT OF HOW THE AWARDED GRANT WAS USED. IF THE ORGANIZATION FAILS TO SUBMIT THEIR FINAL REPORT, THEY WILL NOT BE CONSIDERED FOR THE NEXT GRANT CYCLE. EACH RECIPIENT MUST CONTINUE TO SUBMIT THEIR QUARTERLY REPORTS FOR THE YEAR.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ANDREW JAMES EASON
CEO$0$249,371$0$0$0$0$0$16,981$0$8,002$0$274,354$0$0
JACK MOORE
CFO (7/1/14 - 12/7/14)$0$124,178$0$0$0$34,306$0$15,848$0$8,331$0$182,663$0$0
RUSSELL PAYTON
COO$0$167,840$0$0$0$3,915$0$10,964$0$2,026$0$184,745$0$0

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonKAREN BUCKENHEIMERPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionON BOARD OF DIRECTORSRelationshipDescriptionTxt
Transaction$25,000TransactionAmt
TransactionGRANTTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART IV, LINE 1FormAndLineReferenceDesc
ExplanationDURING THE YEAR ENDED JUNE 30, 2015, FLORIDA DENTAL ASSOCIATION FOUNDATION, INC (FDAF) WAS RELATED TO MORE HEALTH, INC BY VIRTUE OF MORE HEALTH'S EXECUTIVE DIRECTOR BEING A MEMBER OF FDAF'S BOARD OF DIRECTORS. FDAF PROVIDED A $25,000 GRANT TO MORE HEALTH, INC A 501(C)(3) ORGANIZATION. THIS GRANT WAS FOR ORAL HEALTH EDUCATION FOR ELEMENTARY CHILDREN. IN ACCORDANCE WITH THE FOUNDATION'S CONFLICT OF INTEREST POLICY, NEITHER KAREN BUCKENHEIMER NOR TERRY BUCKENHEIMER WERE A PARTY TO THE BOARD DISCUSSION OR VOTE ON THIS GRANT.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART VI: GOVERANCE, MANAGEMENT, AND DISCLOSURESECTION A, LINE 2 TERRY AND KAREN BUCKHEIMER ARE BOTH BOARD MEMBERS AND MARRIED.
PART VI: GOVERNANCE, MANAGEMENT, AND DISCLOSURESECTION B, LINE 11 Form 990 and accompanying schedules are prepared by an independent accounting firm. The form 990 and accompanying schedules are reviewed by the association's staff for accuracy. The form 990 and accompanying schedules are then sent to the audit committee for review and then sent to the board members. All questions and issues are resolved with the independent accounting firm prior to filing with the internal revenue service center.
PART VI: GOVERNANCE, MANAGEMENT, AND DISCLOSURESECTION B, LINE 12C THE FOUNDATION VIA ITS CONFLICT OF POLICY PROCEDURE CONTINUOUSLY MONITORS ALL VOTING MEMBERS OF THE GOVERNING BODY AND MEMBERS OF ANY COMMITTEE OR WORK GROUP. THERE IS A WRITTEN REMINDER PROVIDED TO ALL MEMBERS OF FOUNDATION AGENCIES EACH YEAR FOR THEIR FIRST MEETING AS A REFERENCE GUIDE. THEN ALSO THERE IS A VERBAL REMINDER AT EACH MEETING AND INCLUDED ON THE AGENDA. ALL BOARD MEMBERS SIGN/DATE A WRITTEN STATEMENT THAT EITHER LISTS ANY BUSINESS INTERESTS THEY ARE INVOLVED WITH RELATED BANKS OR ORGANIZATIONS, ETC THAT COULD POTENTIALLY BE A CONFLICT OF INTEREST OR NOTE THAT THEY DON'T HAVE ANY CONFLICTS AND SIGN AND DATE THE STATEMENT ( EXAMPLES OF BANKS, OTHER BUSINESS ORGANIZATIONS WHO DEAL WITH THE FOUNDATION ARE PROVIDED TO THE BOARD MEMBERS AS EXAMPLES, ETC).
PART VI: GOVERNANCE, MANAGEMENT, AND DISCLOSURESECTION B, LINE 15B THE EXECUTIVE DIRECTOR WAS HIRED UTLITIZING A THIRD-PARTY SEARCH SERVICE AND BEGINNING FYE 6/30/14 MERCES CONSULTING COMPANY COMPARED EMPLOYEES' WAGES TO COMPARABLE JOBS IN COMPARABLE NON-PROFIT ASSOCIATIONS BY SIZE, ETC AND THE RESULTING PAY INCREASE OR FREEZE WAS BASED ON THIS THIRD PARTY COMPANY'S INDEPENDENT REVIEW AND REVISED EMPLOYEE EVALUATION FORM TO ACCOMPLISH THIS COMPARISON.
PART VI: GOVERNANCE, MANAGEMENT, AND DISCLOSURESECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1FLORIDA DENTAL ASSOCIATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11111 E TENNESSEE STAddressLine1Txt
CityTALLAHASSEECityNm
State AbbreviationFLStateAbbreviationCd
ZIP32308ZIPCd
FieldValueIRS element (for citing)
EIN590615479EIN
Primary ActivitiesBUS ASSOCPrimaryActivitiesTxt
Legal Domicile StateFLLegalDomicileStateCd
Exempt Code Section501(c)(6)ExemptCodeSectionTxt
Controlled OrganizationfalseControlledOrganizationInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1FDA SERVICES INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11111 E TENNESSEE STAddressLine1Txt
CityTALLAHASSEECityNm
State AbbreviationFLStateAbbreviationCd
ZIP32308ZIPCd
FieldValueIRS element (for citing)
EIN592963601EIN
Primary ActivitiesINSURANCE SALESPrimaryActivitiesTxt
Legal Domicile StateFLLegalDomicileStateCd
Entity TypeC CORPEntityTypeTxt
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1FLORIDA DENTAL ASSOCIATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypePTransactionTypeTxt
Involved$124,247InvolvedAmt
Method Of Amount DeterminationIN-KINDMethodOfAmountDeterminationTxt