TRISTATE TRAUMA NETWORK: Form 990EZ, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: TRISTATE TRAUMA NETWORK (EIN 75-3256296)
Tax period: 2015-01-01 to 2015-12-31
Filed: 2016-05-31
IRS object ID: 201631529349200013
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
Form 990-EZ
Schedule A
Schedule B
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2016-05-31T07:27:50-05:00	ReturnTs
Tax Period End	2015-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	202213517	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	RBSK PARTNERS PC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 200	AddressLine1Txt
City	GREENSBURG	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	472400200	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990EZ	ReturnTypeCd
Tax Period Begin	2015-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	753256296	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	THE PARTNERSHIP OF MENTAL HEALTH I	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	PART	BusinessNameControlTxt
Phone	8125323471	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	22 N PARK AVENUE	AddressLine1Txt
City	BATESVILLE	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	47006	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JANE HERMS	PersonNm
Person Title	CHAIR	PersonTitleTxt
Phone	8125323471	PhoneNum
Signature	2016-05-19	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JOHN G SEALE CPACITP	PreparerPersonNm
PTIN	P00011210	PTIN
Phone	8126637567	PhoneNum
Preparation	2016-05-19	PreparationDt

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2016-09-27 15:27:22Z	BuildTS

Form 990-EZ IRS990EZ

Field	Value	IRS element (for citing)
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Website Address	WWW.TRISTATETRAUMANETWORK.ORG	WebsiteAddressTxt
Organization501c3	Yes (X)	Organization501c3Ind
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Gross Receipts	$116,343	GrossReceiptsAmt
Info In Schedule O Part I	Yes (X)	InfoInScheduleOPartIInd
Contributions Gifts Grants Etc	$91,850	ContributionsGiftsGrantsEtcAmt
Program Service Revenue	$24,493	ProgramServiceRevenueAmt
Total Revenue	$116,343	TotalRevenueAmt
Salaries Other Comp Empl Bnft	$24,600	SalariesOtherCompEmplBnftAmt
Fees And Other Pymt To Ind Cntrct	$6,391	FeesAndOtherPymtToIndCntrctAmt
Printing Publications Postage	$1,903	PrintingPublicationsPostageAmt
Other Expenses Total	$44,315	OtherExpensesTotalAmt
Total Expenses	$77,209	TotalExpensesAmt
Excess Or Deficit For Year	$39,134	ExcessOrDeficitForYearAmt
Net Assets Or Fund Balances BOY	$7,796	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$46,930	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part II	Yes (X)	InfoInScheduleOPartIIInd

Cash Savings And Investments CashSavingsAndInvestmentsGrp

Field	Value	IRS element (for citing)
BOY	$7,796	BOYAmt
EOY	$46,530	EOYAmt

Other Assets Total Detail OtherAssetsTotalDetail

Field	Value	IRS element (for citing)
EOY	$400	EOYAmt

Form990 Total Assets Form990TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$7,796	BOYAmt
EOY	$46,930	EOYAmt

Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp

Field	Value	IRS element (for citing)
BOY	$7,796	BOYAmt
EOY	$46,930	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Primary Exempt Purpose	PROMOTE MENTAL HEALTH THROUGH COMMUNITY EDUCATION, ADVOCACY AND COLLABORATION.	PrimaryExemptPurposeTxt

Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp

Field	Value	IRS element (for citing)
Description Program Srvc Accom	THE PARTNERSHIP FOR MENTAL HEALTH, INC. PROMOTES MENTAL HEALTH THROUGH COMMUNITY EDUCATION, ADVOCACY AND COLLABORATION.	DescriptionProgramSrvcAccomTxt
Program Service Expenses	$52,683	ProgramServiceExpensesAmt

Field	Value	IRS element (for citing)
Total Program Service Expenses	$52,683	TotalProgramServiceExpensesAmt

Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (16 entries)

TitleTitleTxt	Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt	CompensationCompensationAmt
MELISSA ADAMCHIK
EXECUTIVE DI	40.00	$24,600
JANE HERMS
CHAIR	4.00	$0
TRICIA BURKE
VICE CHAIR	4.00	$0
LUCY GILLESPIE
SECRETARY	4.00	$0
JODIE SHORT
TREASURER	4.00	$0
DANISHA BURNETT
BOARD MEMBER	4.00	$0
MARIA ESPINOLA
BOARD MEMBER	4.00	$0
JODI HARDING
BOARD MEMBER	4.00	$0
BRENDA KONRADI
BOARD MEMBER	4.00	$0
SCOTT O'REILLY
BOARD MEMBER	4.00	$0
MELANIE PALMER
BOARD MEMBER	4.00	$0
CATHY PICHE
BOARD MEMBER	4.00	$0
MARIA PIOMBO
BOARD MEMBER	4.00	$0
STEPHANIE POTTER
BOARD MEMBER	4.00	$0
JANICE WILKERSON
BOARD MEMBER	4.00	$0
JENNIFER ZIMMERMAN
BOARD MEMBER	4.00	$0

Field	Value	IRS element (for citing)
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
Activities Not Previously Rpt	false	ActivitiesNotPreviouslyRptInd
Chg Made To Orgnzng Doc Not Rpt	Yes (true)	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

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	MELISSA ADAMCHIK	PersonNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	22 N PARK AVENUE	AddressLine1Txt
City	BATESVILLE	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	47006	ZIPCd

Field	Value	IRS element (for citing)
Phone	8125323471	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)
Public Organization170	Yes (X)	PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

Field	Value	IRS element (for citing)
Current Tax Year	$91,850	CurrentTaxYearAmt
Total	$91,850	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year	$91,850	CurrentTaxYearAmt
Total	$91,850	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total170	$91,850	PublicSupportTotal170Amt
Total Support	$91,850	TotalSupportAmt
Gross Receipts Rltd Activities	$24,493	GrossReceiptsRltdActivitiesAmt
Public Support CY170	1.00000	PublicSupportCY170Pct
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 O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990-EZ, PART I, LINE 16	EXPENSES OFFICE SUPPLIES 882 MILEAGE/PARKING 2,174 CONFERENCES/TRAINING 15,017 UMBRELLA INSURANCE 739 ADMINISTRATION SUPPORT CO 20,000 TRAINING/EVENT SUPPLIES 2,532 MISCELLANEOUS EXPENSES 50 WEBSITE 2,921 TOTAL 44,315
FORM 990-EZ, PART II, LINE 24	ACCOUNTS RECEIVABLE 0 400 TOTAL 0 400
FORM 990-EZ, PART III	PROMOTE MENTAL HEALTH THROUGH COMMUNITY EDUCATION, ADVOCACY AND COLLABORATION.
FORM 990-EZ, PART V, LINE 34	ON MARCH 2, 2015 THE PARTNERSHIP OF MENTAL HEALTH, INC. REGISTERED THE FICTITIOUS NAME TRISTATE TRAUMA NETWORK. SEE ATTACHED STATE OF OHIO CERTIFICATE.