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MENNONITE DENTAL CLINIC INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
MENNONITE DENTAL CLINIC INC (EIN 26-3109382)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-03-22
IRS object ID
201640829349300734
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)
Return2016-03-22T15:47:27-05:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN411562398PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CARLSON HIGHLAND & CO LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1316 N WASHINGTON STAddressLine1Txt
CityTHORPCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54771ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN263109382EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MENNONITE DENTAL CLINIC INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMENNBusinessNameControlTxt
Phone7156693790PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1W8180 COUNTY ROAD XAddressLine1Txt
CityTHORPCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54771ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARK L HOOVERPersonNm
Person TitleTREASURERPersonTitleTxt
Phone7156693790PhoneNum
Signature2016-03-05SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCHRISTINA L URBAN CPAPreparerPersonNm
PTINP01269594PTIN
Phone7156695352PhoneNum
Preparation2016-03-14PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2016-09-27 15:27:22ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARK L HOOVERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1W6163 COLBY FACTORY ROADAddressLine1Txt
CityOWENCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54460ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$839,300GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2008FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionTO PROVIDE EXCELLENT DENTAL CARE AND DENTAL HEALTHCARE EDUCATION AT AFFORDABLE PRICES FOR OUR MENNONITE COMMUNITYActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent3VotingMembersIndependentCnt
Total Employee23TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$758,140PYProgramServiceRevenueAmt
CY Program Service Revenue$839,300CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$758,140PYTotalRevenueAmt
CY Total Revenue$839,300CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$143,859PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$147,202CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$536,100PYOtherExpensesAmt
CY Other Expenses$530,223CYOtherExpensesAmt
PY Total Expenses$679,959PYTotalExpensesAmt
CY Total Expenses$677,425CYTotalExpensesAmt
PY Revenues Less Expenses$78,181PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$161,875CYRevenuesLessExpensesAmt
Total Assets BOY$215,381TotalAssetsBOYAmt
Total Assets EOY$375,878TotalAssetsEOYAmt
Total Liabilities BOY$2,583TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,205TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$212,798NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$374,673NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE EXCELLENT DENTAL CARE AND DENTAL HEALTHCARE EDUCATION AT AFFORDABLE PRICES FOR OUR MENNONITE COMMUNITYMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$662,518ExpenseAmt
Revenue$839,300RevenueAmt
DescDENTAL CARE AND EDUCATIONDesc
Total Program Service Expenses$662,518TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
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 ActivitiesfalseFundraisingActivitiesInd
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 ContrifalseDeductibleNonCashContriInd
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 Document8IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee23EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
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 Members3GoverningBodyVotingMembersCnt
Independent Voting Member3IndependentVotingMemberCnt
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 BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnfalseAnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcfalseRegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MENNONITE DENTALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7156693790PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1W8180 CTY HWY XAddressLine1Txt
CityTHORPCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54771ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (3 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
MARK L HOOVER
TREASURER1.00Yes (X)Yes (X)$0$0$0
ENOS H MARTIN
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
LAMAR SHIRK
SECRETARY1.00Yes (X)Yes (X)$0$0$0
FieldValueIRS element (for citing)
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescDENTAL SERVICESDesc
Business621300BusinessCd
Total Revenue Column$839,300TotalRevenueColumnAmt
Related Or Exempt Func Income$839,300RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$839,300TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$839,300TotalRevenueColumnAmt
Related Or Exempt Func Income$839,300RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$134,519TotalAmt
Program Services$134,519ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$12,683TotalAmt
Program Services$12,683ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$11,610TotalAmt
Management And General$11,610ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$3,297TotalAmt
Management And General$3,297ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$480,460TotalAmt
Program Services$480,460ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$6,253TotalAmt
Program Services$6,253ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$6,157TotalAmt
Program Services$6,157ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,564TotalAmt
Program Services$1,564ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$18,392TotalAmt
Program Services$18,392ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,490TotalAmt
Program Services$2,490ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$677,425TotalAmt
Program Services$662,518ProgramServicesAmt
Management And General$14,907ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,279BOYAmt
EOY$129,304EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$51,530BOYAmt
EOY$67,731EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$247,948LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$73,134LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$156,050BOYAmt
EOY$174,814EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$4,522BOYAmt
EOY$4,029EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$215,381BOYAmt
EOY$375,878EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,583BOYAmt
EOY$1,205EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,583BOYAmt
EOY$1,205EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$212,798BOYAmt
EOY$374,673EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$212,798BOYAmt
EOY$374,673EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$215,381BOYAmt
EOY$375,878EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$161,875ReconcilationRevenueExpnssAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd

Schedule A IRS990ScheduleA

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

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$158,868CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$779,884CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$758,140CurrentTaxYearMinus1YearAmt
Current Tax Year$839,300CurrentTaxYearAmt
Total$2,536,192TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$158,868CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$779,884CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$758,140CurrentTaxYearMinus1YearAmt
Current Tax Year$839,300CurrentTaxYearAmt
Total$2,536,192TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$2,536,192PublicSupportTotal509Amt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$158,868CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$779,884CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$758,140CurrentTaxYearMinus1YearAmt
Current Tax Year$839,300CurrentTaxYearAmt
Total$2,536,192TotalAmt
FieldValueIRS element (for citing)
Public Support CY5091.00000PublicSupportCY509Pct
Public Support PY5091.00000PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$105,257OtherCostOrOtherBasisAmt
Depreciation$6,603DepreciationAmt
Book Value$98,654BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$142,691OtherCostOrOtherBasisAmt
Depreciation$66,531DepreciationAmt
Book Value$76,160BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$174,814TotalBookValueLandBuildingsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BTHE ORGANIZATION OFFICERS WILL REVIEW THE RETURN BEFORE IT IS FILED.
FORM 990, PAGE 6, PART VI, LINE 15ACOMPARABLE WAGE DATA
FORM 990, PAGE 6, PART VI, LINE 15BCOMPARABLE WAGE DATA
FORM 990, PAGE 6, PART VI, LINE 19DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST.
FORM 990, PART IX, LINE 11GBANK SERVICE CHARGES 3,805 0 0 EMPLOYEE BENEFITS 6,939 0 0 REPAIRS AND MAINTENANCE 6,818 0 0 JANITORIAL EXPENSES 1,586 0 0 LICENSES AND FEES 1,029 0 0 POSTAGE 2,394 0 0 REFERRAL DISCOUNT GIVEN 920 0 0 RENT 12,240 0 0 TELEPHONE 2,825 0 0 UTILITIES 7,273 0 0 INTEREST 897 0 0 DOCTOR FEES 278,675 0 0 PATIENT SUPPLIES 71,997 0 0 DENTAL SUPPLIES 34,937 0 0 DISCOUNTS 44,830 0 0 RECONCILIATION DISCREPANCIES 85 0 0 CONTINUING EDUCATION 2,896 0 0 MEDICAL RECORDS & SUPPLIES 314 0 0