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FREE CLINIC OF ROME INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
FREE CLINIC OF ROME INC (EIN 20-5296305)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-08-13
IRS object ID
201542259349303234
Schema version
2014v5.0
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)
Return2015-08-13T17:17:04-04:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN582648047PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DEM Enterprises IncBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11101 East 2nd AvenueAddressLine1Txt
CityROMECityNm
State AbbreviationGAStateAbbreviationCd
ZIP30161ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN205296305EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Free Clinic of Rome Georgia IBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFREEBusinessNameControlTxt
Phone7062341331PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101-B John Maddox DriveAddressLine1Txt
CityROMECityNm
State AbbreviationGAStateAbbreviationCd
ZIP30165ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBarbara EarlePersonNm
Person TitleExecutive DirectorPersonTitleTxt
Signature2015-08-13SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonEvie McNiecePreparerPersonNm
PTINP00021755PTIN
Phone7062376070PhoneNum
Preparation2015-08-13PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBarbara EarlePrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101-B John Maddox DriveAddressLine1Txt
CityROMECityNm
State AbbreviationGAStateAbbreviationCd
ZIP30165ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$184,631GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2006FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTo serve the Rome community by providing quality healthcare services to people who have no access to basic healthcareActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee1TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$192,525PYContributionsGrantsAmt
CY Contributions Grants$184,572CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$496PYInvestmentIncomeAmt
CY Investment Income$59CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$193,021PYTotalRevenueAmt
CY Total Revenue$184,631CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$81,724PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$76,457CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$2,850CYTotalFundraisingExpenseAmt
PY Other Expenses$131,737PYOtherExpensesAmt
CY Other Expenses$83,960CYOtherExpensesAmt
PY Total Expenses$213,461PYTotalExpensesAmt
CY Total Expenses$160,417CYTotalExpensesAmt
PY Revenues Less Expenses-$20,440PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$24,214CYRevenuesLessExpensesAmt
Total Assets BOY$19,658TotalAssetsBOYAmt
Total Assets EOY$44,458TotalAssetsEOYAmt
Total Liabilities EOY$585TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$19,658NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$43,873NetAssetsOrFundBalancesEOYAmt
MissionTo serve the Rome community by providing quality healthcare services to people who have no access to basic healthcareMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$109,079ExpenseAmt
DescTo provide free, quality healthcare and treatment to individualsDesc
Total Program Service Expenses$109,079TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
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 Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee1EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
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 PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcfalseRegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonBarbara EarlePersonNm
Phone7062341331PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101-B John MaddAddressLine1Txt
CityROMECityNm
State AbbreviationGAStateAbbreviationCd
ZIP30165ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp

FieldValueIRS element (for citing)
PersonBarbara EarlePersonNm
TitleExec DirectorTitleTxt
Average Hours Per Week40AverageHoursPerWeekRt
Average Hours Per Week Rltd Org0AverageHoursPerWeekRltdOrgRt
Individual Trustee Or DirectorYes (X)IndividualTrusteeOrDirectorInd
OfficerYes (X)OfficerInd
Key EmployeeYes (X)KeyEmployeeInd
Highest Compensated EmployeeYes (X)HighestCompensatedEmployeeInd
Reportable Comp From Org$0ReportableCompFromOrgAmt
Reportable Comp From Rltd Org$57,000ReportableCompFromRltdOrgAmt
Other Compensation$0OtherCompensationAmt
FieldValueIRS element (for citing)
Tot Reportable Comp Rltd Org$57,000TotReportableCompRltdOrgAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$184,572AllOtherContributionsAmt
Total Contributions$184,572TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$59TotalRevenueColumnAmt
Related Or Exempt Func Income$59RelatedOrExemptFuncIncomeAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

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

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$184,631TotalRevenueColumnAmt
Related Or Exempt Func Income$59RelatedOrExemptFuncIncomeAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$57,000TotalAmt
Program Services$45,600ProgramServicesAmt
Management And General$8,550ManagementAndGeneralAmt
Fundraising$2,850FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$18,074TotalAmt
Program Services$18,074ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,383TotalAmt
Program Services$1,383ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$1,195TotalAmt
Management And General$1,195ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$746TotalAmt
Program Services$746ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,807TotalAmt
Management And General$2,807ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$18,635TotalAmt
Management And General$18,635ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$240TotalAmt
Management And General$240ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,720TotalAmt
Program Services$1,720ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

TotalTotalAmt
$5,212
$2,156
$927
$33,910

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$16,412TotalAmt
Program Services$7,646ProgramServicesAmt
Management And General$8,766ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$160,417TotalAmt
Program Services$109,079ProgramServicesAmt
Management And General$48,488ManagementAndGeneralAmt
Fundraising$2,850FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$18,720BOYAmt
EOY$43,520EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$938BOYAmt
EOY$938EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$7,087LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$7,087LandBldgEquipAccumDeprecAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$19,658BOYAmt
EOY$44,458EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
EOY$585EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$585EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$19,658BOYAmt
EOY$43,873EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$19,658BOYAmt
EOY$43,873EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$19,658BOYAmt
EOY$44,458EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$24,214ReconcilationRevenueExpnssAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
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$175,533CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$465,563CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$816,639CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$192,525CurrentTaxYearMinus1YearAmt
Current Tax Year$184,572CurrentTaxYearAmt
Total$1,834,832TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$175,533CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$465,563CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$816,639CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$192,525CurrentTaxYearMinus1YearAmt
Current Tax Year$184,572CurrentTaxYearAmt
Total$1,834,832TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$1,834,832PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$453CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$296CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus1 Year$496CurrentTaxYearMinus1YearAmt
Current Tax Year$59CurrentTaxYearAmt
Total$1,304TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$453CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$296CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus1 Year$496CurrentTaxYearMinus1YearAmt
Current Tax Year$59CurrentTaxYearAmt
Total$1,304TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$175,986CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$465,859CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$816,639CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$193,021CurrentTaxYearMinus1YearAmt
Current Tax Year$184,631CurrentTaxYearAmt
Total$1,836,136TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99930PublicSupportCY509Pct
Public Support PY5090.99880PublicSupportPY509Pct
Investment Income CY0.00070InvestmentIncomeCYPct
Investment Income PY0.00120InvestmentIncomePYPct
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 O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart VI Line 19 All documents are available upon requestFormAndLineReferenceDesc
ExplanationPart VI Line 15a The board sets all starting salaries and approves all raisesExplanationTxt