NIZHONI SMILES INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- NIZHONI SMILES INC (EIN 85-0397883)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2015-03-04
- IRS object ID
- 201530639349300513
- Schema version
- 2012v3.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2015-03-04T10:39:21-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 954895294 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | R SHANE CHANCE CPA PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 341 | AddressLine1 |
| City | AZTEC | City |
| State | NM | State |
| ZIP Code | 874100341 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 850397883 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NIZHONI SMILES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NIZH | NameControl |
| Phone | 5053685626 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3449 | AddressLine1 |
| City | SHIPROCK | City |
| State | NM | State |
| ZIP Code | 87420 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAMES M TUTT | Name |
| Title | CEO | Title |
| Phone | 5053685626 | Phone |
| Date Signed | 2014-07-21 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | R SHANE CHANCE | Name |
| PTIN | P00170250 | PTIN |
| Phone | 5053344375 | Phone |
| Date Prepared | 2014-07-21 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JAMES M TUTT | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3449 | AddressLine1 |
| City | SHIPROCK | City |
| State | NM | State |
| ZIP Code | 87420 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 4599579 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | NIZHONISMILES.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1992 | YearFormation |
| State Legal Domicile | NM | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE DENTAL AND ORTHODONTIC SERVICES TO INDIVIDUALS LIVING ON THE NAVAJO RESERVATION IN NW NEW MEXICO AND NE ARIZONA | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 5 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 5 | NbrIndependentVotingMembers |
| Total Nbr Employees | 36 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 2161087 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 1371501 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -787 | InvestmentIncomePriorYear |
| Investment Income Current Year | 462849 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 243527 | OtherRevenuePriorYear |
| Other Revenue Current Year | 76353 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 2403827 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1910703 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 745147 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 549396 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1856022 | OtherExpensePriorYear |
| Other Expenses Current Year | 1267049 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 2601169 | TotalExpensesPriorYear |
| Total Expenses Current Year | 1816445 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -197342 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 94258 | RevenuesLessExpensesCY |
| Total Assets BOY | 5441400 | TotalAssetsBOY |
| Total Assets EOY | 2334777 | TotalAssetsEOY |
| Total Liabilities BOY | 4454725 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1253844 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 986675 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1080933 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE DENTAL AND ORTHODONTIC SERVICES TO INDIVIDUALS LIVING ON THE NAVAJO RESERVATION IN NW NEW MEXICO AND NE ARIZONA | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 1556040 | Expense |
| Revenue | 1910703 | Revenue |
| Description | ORTHODONTIC AND DENTAL SERVICES PROVIDED TO INDIVIDUALS LIVING ON THE NAVAJO RESERVATION IN NW NEW MEXICO AND NE ARIZONA | Description |
| Total Program Service Expense | 1556040 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 1 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 8 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 36 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 5 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 5 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NM | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NIZHONI SMILES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5053685626 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | US HWY 491 N | AddressLine1 |
| City | SHIPROCK | City |
| State | NM | State |
| ZIP Code | 87420 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (6 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| PEGGY SUE NEZ | ||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 |
| THOMAS TODACHEENEY | ||||||
| PRESIDENT | 1.00 | X | X | 0 | 0 | 0 |
| HARRY SLOAN JR | ||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 |
| DR DARLENE SORRELL | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| DR MICHAEL BECK | ||||||
| DIRECTOR | 3.00 | X | X | 0 | 0 | 0 |
| JAMES TUTT | ||||||
| CEO | 40.00 | X | 52494 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 52494 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| DR HELLEN BUSH MDS | |||||
| 3107 ASPEN DR | FARMINGTON | NM | 87401 | ORTHODONTICS | 129225 |
| CRAIG LAYTON DBA FOUR CORNERS DENTAL CON | |||||
| 6601 TENNYSON ST NE APT 11205 | ALBUQUERQUE | NM | 87111 | DENTAL | 101343 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| REVENUE ORTHO-DENTAL SERVICES | 621110 | 1291409 | 1291409 |
| REVENUE-PRODUCTS &SERVICES | 621110 | 80092 | 80092 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 1371501 | TotalProgramServiceRevenue |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 76353 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 76353 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 76353 | TotalRevenueColumn |
| Related Or Exempt Function Income | 76353 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 3151725 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 2688876 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 462849 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 462849 | TotalRevenueColumn |
| Related Or Exempt Function Income | 462849 | RelatedOrExemptFunctionIncome |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1910703 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1910703 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52494 | Total |
| Management And General | 52494 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 441548 | Total |
| Program Services | 273225 | ProgramServices |
| Management And General | 168323 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -920 | Total |
| Program Services | 1135 | ProgramServices |
| Management And General | -2055 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7119 | Total |
| Program Services | 7050 | ProgramServices |
| Management And General | 69 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49155 | Total |
| Program Services | 28567 | ProgramServices |
| Management And General | 20588 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 640 | Total |
| Program Services | 640 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11267 | Total |
| Program Services | 11267 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 406111 | Total |
| Program Services | 406111 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3259 | Total |
| Program Services | 3259 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 47114 | Total |
| Program Services | 47028 | ProgramServices |
| Management And General | 86 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -2710 | Total |
| Program Services | -2710 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 78140 | Total |
| Program Services | 78140 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3013 | Total |
| Program Services | 751 | ProgramServices |
| Management And General | 2262 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 343707 | Total |
| Program Services | 332082 | ProgramServices |
| Management And General | 11625 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 235800 | Total |
| Program Services | 235800 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -3600 | Total |
| Program Services | -3600 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT EXPENSE | 78361 | 78361 | |
| LABORATORY | 31118 | 31118 | |
| CREDIT CARD SERVICE CHA | 23409 | 23409 | |
| SERVICE CHARGES | 5921 | 5921 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5499 | Total |
| Program Services | 4407 | ProgramServices |
| Management And General | 1092 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1816445 | Total |
| Program Services | 1556040 | ProgramServices |
| Management And General | 260405 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2248 | BOY |
| EOY | 234 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 452543 | BOY |
| EOY | 466413 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36884 | BOY |
| EOY | 18979 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 450 | BOY |
| EOY | 859 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 2704107 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1274128 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4350943 | BOY |
| EOY | 1429979 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 598332 | BOY |
| EOY | 418313 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5441400 | BOY |
| EOY | 2334777 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 216711 | BOY |
| EOY | 191453 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 598332 | BOY |
| EOY | 418313 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 120667 | BOY |
| EOY | 120667 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3413779 | BOY |
| EOY | 434511 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30300 | BOY |
| EOY | 30274 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 74936 | BOY |
| EOY | 58626 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4454725 | BOY |
| EOY | 1253844 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 986675 | BOY |
| EOY | 1080933 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 986675 | BOY |
| EOY | 1080933 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5441400 | BOY |
| EOY | 2334777 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 94258 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 0 | FSAudited |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 133327 | CurrentTaxYearMinus2Years |
| Total | 133327 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3631581 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3423465 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2674393 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2160683 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1371501 | CurrentTaxYear |
| Total | 13261623 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3631581 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3423465 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2807720 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2160683 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1371501 | CurrentTaxYear |
| Total | 13394950 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 13394950 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 27 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 7 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1 | CurrentTaxYearMinus2Years |
| Total | 35 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 27 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 7 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1 | CurrentTaxYearMinus2Years |
| Total | 35 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 178831 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 184901 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 187698 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 243527 | CurrentTaxYearMinus1Year |
| Current Tax Year | 76353 | CurrentTaxYear |
| Total | 871310 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3810439 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3608373 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2995419 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2404210 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1447854 | CurrentTaxYear |
| Total | 14266295 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.93890 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.94120 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00000 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00010 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
| General Explanation | SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: PER FORM INSTRUCTIONS, OTHER INCOME ON PART III LINE 12 DOES NOT INCLUDE $462,849 GAIN ON THE DISPOSTION OF FIXED ASSETS THAT WERE USED IN THE PERFORMANCE OF THE ORGANIZATIONS PRIMARY MISSION. THE DISPOSITION WAS BY THE TRUSTEE FOR THE NATIONAL BANK OF ARIZONA IN ADVANCE OF PENDING FORECLOSURE ACTIONS BY THE BANK. THE SALE INCLUDED LAND, OFFICE BUILDING, FURNITURE, FIXTURES AND EQUIPMENT LOCATED IN ST. MICHAELS, AZ. THE TRUSTEE APPLIED THE TOTAL PROCEEDS FROM THE SALE TO OUTSTANDING MORTGAGE OBLIGATONS OF THE ORGANIZATION THAT WERE SECURED BY THE ASSETS SOLD. THE GAIN INCLUDES CANCELLATION OF DEBT INCOME IN THE AMOUNT OF $451,725 AS REPORTED BY THE USDA ON FORM 1099-C IN 2012. | GeneralExplanation |
Schedule D IRS990ScheduleD
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1455379 | OtherCostOrOtherBasis |
| Depreciation | 247983 | Depreciation |
| Book Value | 1207396 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1248728 | OtherCostOrOtherBasis |
| Depreciation | 1026145 | Depreciation |
| Book Value | 222583 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1429979 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | L-T ORTHO CONTRACTS RECEIVABLE | Description |
| Book Value | 418313 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 418313 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ACCOUNTS PAYABLE TO RELATED PARTIES | Description |
| Amount | $58,626 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 58626 | TotalOfAmounts |
Schedule L IRS990ScheduleL
Loan Table LoanTable (3 entries)
| Relationship With OrganizationRelationshipWithOrganization | Purpose Of LoanPurposeOfLoan | Loan To OrganizationLoanToOrganization | Original PrincipalOriginalPrincipalAmount | Balance DueBalanceDue | DefaultDefault | Approved By BoardApprovedByBoard | Written AgreementWrittenAgreement |
|---|---|---|---|---|---|---|---|
| DR MICHAEL BECK | |||||||
| OFFICER AND DIRECTOR | TEMPORARY WORKING CAPITAL ADVANCE | X | $30,000 | 30000 | 0 | 1 | 1 |
| MR JAMES TUTT | |||||||
| OFFICER | TEMPORARY WORKING CAPITAL ADANCE | X | $4,000 | 4000 | 0 | 1 | 1 |
| DR MICHAEL BECK | |||||||
| OFFICER AND DIRECTOR | INSTALLMENT PAYOUT CEO FEES ACCRUED IN PRIOR YEARS | X | $86,667 | 86667 | 0 | 1 | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 120667 | TotalBalanceDue |
Schedule N IRS990ScheduleN
Disposition Table DispositionTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Asset | TRUSTEE SALE OF LAND, OFFICE BUILDING, FURNITURE, FIXTURES AND EQUIPMENT LOCATED IN ST MICHAELS, AZ USED IN PERFORMING THE ORGANIZATIONS PRIMARY MISSION.THE PROPERTY WAS SOLD TO AN UNRELATED THIRD PARTY. | DescriptionOfAsset |
| Date Of Distribution | 2012-09-20 | DateOfDistribution |
| FMV Of Asset | 2700000 | FMVOfAsset |
| Method Of FMV Determination | FAIR MARKET VALUE BASED ON ACTUAL GROSS SALE PRICE RECEIVED BY TRUSTEE FOR NATIONAL BANK OF ARIZONA. THE TRUSTEE DIRECTLY APPLIED THE PROCEEDS FROM THE SALE TO OUTSTANDING MORTGAGE OBLIGATIONS OF THE ORGANIZATION SECURED BY THE ASSETS SOLD. | MethodOfFMVDetermination |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | 0 | DirectorOfSuccessor2 |
| Employee Of Successor2 | 0 | EmployeeOfSuccessor2 |
| Owner Of Successor2 | 0 | OwnerOfSuccessor2 |
| Receive Compensation2 | 0 | ReceiveCompensation2 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | ORGANIZATION PRESENTS COPY OF FORM 990 TO ITS BOARD OF DIRECTORS FOR REVIEW, COMMENT AND APPROVAL AT REGUALAR BOARD MEETING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST DISCLOSURE STATEMENT FORMS ARE PREPARED BY OFFICERS, DIRECTORS AND KEY EMPLOYEES ON AN ANNUAL BASIS WHICH ARE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. COPIES OF THE FORMS ARE MAINTAINED IN THE ORGANIZATIONS RECORDS. | |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION OF OFFICERS, DIRECTORS, MANAGEMENT AND KEY EMPLOYEES IS BASED ON THE RESULTS OF ANNUAL PERFORMANCE EVALUATIONS AND COMPARATIVE REGIONAL COMPENSATION WHICH IS APPROVED BY THE BOARD OF DIRECTORS AND DOCUMENTED IN THE MINUTES OF MEETINGS OF THE BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAINTAINS ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AT ITS CORPORATE OFFICES IN SHIPROCK, NEW MEXICO. ALL SUCH DOCUMENTS ARE AVAILABLE FOR PUBLIC REVIEW AT THAT LOCATION. | |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL SERVICES DENTAL AND OR: PROGRAM SERVICE EXPENSES 406,111. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 406,111. | OTHER FEES |