STRATEGY STUDIO / PUBLIC DATA EXPLORER

WISCONSIN DENTAL ASSOCIATION FOUNDATION INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
WISCONSIN DENTAL ASSOCIATION FOUNDATION INC (EIN 39-0965289)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-08-12
IRS object ID
201402249349301250
Schema version
2013v3.0
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)
Return2014-08-12T10:08:23-05:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line18215 GREENWAY BOULEVARD SUITE 600AddressLine1
CityMIDDLETONCity
StateWIState
ZIP Code53562ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN390965289EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WISCONSIN DENTAL ASSOCIATION FOUNDATION INCBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlWISCBusinessNameControlTxt
Phone4142764520PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16737 W WASHINGTON STREET NO 2360AddressLine1
CityWEST ALLISCity
StateWIState
ZIP Code53214ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARK PAGETPersonNm
Person TitleSECRETARYPersonTitleTxt
Phone4142764520PhoneNum
Signature2014-06-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKIMBERLY ANDERSON CPAPreparerPersonNm
PTINP00188889PTIN
Phone6086628600PhoneNum
Preparation2014-05-12PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerVICTORIA BOHMANPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line16737 W WASHINGTON STREET NO 2360AddressLine1
CityWEST ALLISCity
StateWIState
ZIP Code53214ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$557,704GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.WDA.ORG/WDA-FOUNDATIONWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1957FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionSUPPORT DENTAL HEALTH CARE INITIATIVES TO IMPROVE ORAL HEALTH CARE OF DISADVANTAGED RESIDENTS THROUGHOUT THE STATE OF WISCONSIN.ActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent17VotingMembersIndependentCnt
Total Employee3TotalEmployeeCnt
Total Volunteers1900TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$403,460PYContributionsGrantsAmt
CY Contributions Grants$434,146CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$59,064PYInvestmentIncomeAmt
CY Investment Income$88,648CYInvestmentIncomeAmt
PY Other Revenue$19,337PYOtherRevenueAmt
CY Other Revenue$18,299CYOtherRevenueAmt
PY Total Revenue$481,861PYTotalRevenueAmt
CY Total Revenue$541,093CYTotalRevenueAmt
PY Grants And Similar Paid$61,885PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$72,684CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$104,945PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$105,029CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$2,576CYTotalFundraisingExpenseAmt
PY Other Expenses$277,475PYOtherExpensesAmt
CY Other Expenses$193,543CYOtherExpensesAmt
PY Total Expenses$444,305PYTotalExpensesAmt
CY Total Expenses$371,256CYTotalExpensesAmt
PY Revenues Less Expenses$37,556PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$169,837CYRevenuesLessExpensesAmt
Total Assets BOY$2,395,791TotalAssetsBOYAmt
Total Assets EOY$2,769,899TotalAssetsEOYAmt
Total Liabilities BOY$21,195TotalLiabilitiesBOYAmt
Total Liabilities EOY$27,661TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,374,596NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,742,238NetAssetsOrFundBalancesEOYAmt
MissionSUPPORT DENTAL HEALTH CARE INITIATIVES TO IMPROVE ORAL HEALTH CARE OF DISADVANTAGED RESIDENTS THROUGHOUT THE STATE OF WISCONSIN.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$76,982ExpenseAmt
DescDONATED DENTAL SERVICES - PROVIDED DENTAL SERVICES VALUED AT $831,280 FOR DENTAL TREATMENT OF DISABLED, ELDERLY AND MEDICALLY-COMPROMISED INDIVIDUALS WHO COULD NOT AFFORD THE DENTAL CARE NEEDED.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$142,111ExpenseAmt
DescPROVIDED FREE DENTAL CARE TO 2,072 UNINSURED, LOW-INCOME INDIVIDUALS VALUED AT $1,180,000 OVER A TWO-DAY PERIOD IN LAKE GENEVA, WI.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$72,684ExpenseAmt
Grant$72,684GrantAmt
DescENHANCES EDUCATIONAL OPPORTUNITIES BY AWARDING SCHOLARSHIPS TO DENTAL AND DENTAL HYGIENE STUDENTS IN THE STATE OF WISCONSIN AND PROVIDED GRANTS IN SUPPORT OF STATEWIDE COMMUNITY DENTAL HEALTH PROJECTS AND CLINICS WHERE DENTAL CARE IS PROVIDED TO THE LOW INCOME POPULATION.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$291,777TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document15IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee3EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members17GoverningBodyVotingMembersCnt
Independent Voting Member17IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
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 Line1KELLY SICSBusinessNameLine1
FieldValueIRS element (for citing)
Phone4147554102PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16737 W WASHINGTON STREETAddressLine1
CityWEST ALLISCity
StateWIState
ZIP Code53214ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
DR ANTHONY SCIASCIA
PRESIDENT3.00Yes (X)Yes (X)$0$0$0
DR LOREN SWANSON
VICE PRESIDENT1.50Yes (X)Yes (X)$0$0$0
DR CHRISTINE TEMPAS
TREASURER1.50Yes (X)Yes (X)$0$0$0
MR MARK PAGET
SECRETARY1.00Yes (X)Yes (X)$0$0$0
DR PAUL OBERBRECKLING
PAST PRESIDENT1.50Yes (X)Yes (X)$0$0$0
DR TIMMY COOPER
DIRECTOR1.00Yes (X)$0$0$0
DR JULIE FOX
DIRECTOR3.00Yes (X)$0$0$0
DR PETER STEINERT
DIRECTOR1.00Yes (X)$0$0$0
DR JAMES VAN MILLER
DIRECTOR1.00Yes (X)$0$0$0
DR RON STIFTER
DIRECTOR1.50Yes (X)$0$0$0
DR JAMES MORGENROTH
DIRECTOR3.00Yes (X)$0$0$0
DR SUSAN CABLE
DIRECTOR1.50Yes (X)$0$0$0
DR FRANCESCA DE ROSE
DIRECTOR0.40Yes (X)$0$0$0
DR ROBB WARREN
DIRECTOR0.40Yes (X)$0$0$0
MR PAUL BATELY
MEMBER AT-LARGE0.30Yes (X)$0$0$0
MR DAVE C WAGNER
MEMBER AT-LARGE0.40Yes (X)$0$0$0
DR ROGER COMEAU
DIRECTOR EMERITUS1.00Yes (X)$0$0$0
MR DENNIS MCGUIRE
DIRECTOR EMERITUS1.00Yes (X)$0$0$0
JEANNE RUDE
MEMBER AT-LARGE1.00Yes (X)$0$0$0
VICTORIA BOHMAN
EXECUTIVE DIRECTOR30.00Yes (X)$41,334$0$4,112
FieldValueIRS element (for citing)
Total Reportable Comp From Org$41,334TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$4,112TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Government Grants$58,357GovernmentGrantsAmt
All Other Contributions$375,789AllOtherContributionsAmt
Total Contributions$434,146TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$88,648TotalRevenueColumnAmt
Exclusion$88,648ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$34,910FundraisingGrossIncomeAmt
Fundraising Direct Expenses$16,611FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,299TotalRevenueColumnAmt
Exclusion$18,299ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$541,093TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$106,947ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$59,684TotalAmt
Program Services$59,684ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$13,000TotalAmt
Program Services$13,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$45,446TotalAmt
Management And General$45,446ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$48,892TotalAmt
Program Services$47,923ProgramServicesAmt
Management And General$969ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$4,150TotalAmt
Program Services$4,150ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$6,541TotalAmt
Program Services$3,339ProgramServicesAmt
Management And General$3,202ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$8,000TotalAmt
Management And General$8,000ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$7,466TotalAmt
Management And General$7,466ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$20,327TotalAmt
Program Services$18,727ProgramServicesAmt
Management And General$1,600ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,000TotalAmt
Management And General$1,000ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$88,600TotalAmt
Program Services$81,215ProgramServicesAmt
Management And General$5,318ManagementAndGeneralAmt
Fundraising$2,067FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$47,841TotalAmt
Program Services$45,361ProgramServicesAmt
Management And General$2,480ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,824TotalAmt
Program Services$1,164ProgramServicesAmt
Management And General$151ManagementAndGeneralAmt
Fundraising$509FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$2,118TotalAmt
Program Services$1,712ProgramServicesAmt
Management And General$406ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$241TotalAmt
Management And General$241ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$264TotalAmt
Management And General$264ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PROGRAM EVENT EXPENSES$14,691$14,691
VOLUNTEER RECOGNITION$811$811
REGISTRATION$360$360

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$371,256TotalAmt
Program Services$291,777ProgramServicesAmt
Management And General$76,903ManagementAndGeneralAmt
Fundraising$2,576FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$65,977BOYAmt
EOY$248,559EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$280,330BOYAmt
EOY$280,851EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$88,344BOYAmt
EOY$23,073EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$31,560BOYAmt
EOY$38,315EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$35,100BOYAmt
EOY$12,250EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$15,483LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$15,242LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$482BOYAmt
EOY$241EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,893,910BOYAmt
EOY$2,166,543EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$88BOYAmt
EOY$67EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,395,791BOYAmt
EOY$2,769,899EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,692BOYAmt
EOY$15,372EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$13,503BOYAmt
EOY$12,289EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$21,195BOYAmt
EOY$27,661EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,075,917BOYAmt
EOY$2,364,655EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$298,679BOYAmt
EOY$377,583EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,374,596BOYAmt
EOY$2,742,238EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,395,791BOYAmt
EOY$2,769,899EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$169,837ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$197,805NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$266,388CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$408,538CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$413,071CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$403,460CurrentTaxYearMinus1YearAmt
Current Tax Year$434,146CurrentTaxYearAmt
Total$1,925,603TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$266,388CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$408,538CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$413,071CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$403,460CurrentTaxYearMinus1YearAmt
Current Tax Year$434,146CurrentTaxYearAmt
Total$1,925,603TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$458,999SubstantialContributorsTotAmt
Public Support Total170$1,466,604PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,984CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$24,907CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$47,694CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$59,064CurrentTaxYearMinus1YearAmt
Current Tax Year$88,648CurrentTaxYearAmt
Total$223,297TotalAmt
FieldValueIRS element (for citing)
Total Support$2,148,900TotalSupportAmt
Gross Receipts Rltd Activities$145,618GrossReceiptsRltdActivitiesAmt
Public Support CY1700.68250PublicSupportCY170Pct
Public Support PY1700.77200PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

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

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,483OtherCostOrOtherBasisAmt
Depreciation$15,242DepreciationAmt
Book Value$241BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$241TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$748,043TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$197,805NetUnrealizedGainsInvstAmt
Other Revenue$16,611OtherRevenueAmt
Revenue Not Reported$214,416RevenueNotReportedAmt
Revenue Subtotal$533,627RevenueSubtotalAmt
Investment Expenses Not Incld$7,466InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$7,466RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$541,093TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$380,401TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$16,611OtherExpensesIncludedAmt
Expenses Not Reported$16,611ExpensesNotReportedAmt
Expenses Subtotal$363,790ExpensesSubtotalAmt
Investment Expenses Not Incld2$7,466InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$7,466ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$371,256TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:FUNDRAISING EXPENSES 16,611.
PART XII, LINE 2D - OTHER ADJUSTMENTS:FUNDRAISING EXPENSES 16,611.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Name Of Event1GOLF OUTINGNameOfEvent1Amt
Gross Receipts Event1$34,910GrossReceiptsEvent1Amt
Gross Revenue Event1$34,910GrossRevenueEvent1Amt
Non Cash Prizes Event1$50NonCashPrizesEvent1Amt
Rent Facility Costs Event1$16,561RentFacilityCostsEvent1Amt
Gross Receipts Total$34,910GrossReceiptsTotalAmt
Gross Revenue Total Events$34,910GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$50NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$16,561RentFcltyCostsTotalEventsAmt
Direct Expense Summary Events$16,611DirectExpenseSummaryEventsAmt
Net Income Summary$18,299NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeEDUCATIONAL SCHOLARSHIPS FOR DENTAL AND DENTAL HYGIENE STUDENTSGrantTypeTxt
Recipient9RecipientCnt
Cash Grant$13,000CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationRECIPIENTS FORWARD COPIES OF PAID RECEIPTS INCURRED FOR EXPENSES ASSOCIATED WITH THE GRANT TO BE RECEIVED. GRANT PAYMENTS MADE AFTER REVIEW OF THESE DOCUMENTS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11THE DRAFT OF THE 990 IS REVIEWED IN PERSON WITH THE ENTIRE BOARD BEFORE IT IS FILED. EACH BOARD MEMBER RECEIVES A DRAFT COPY OF THE RETURN PRIOR TO THE BOARD MEETING. THE ORGANIZATION'S CPA FIRM WALKS THE BOARD THROUGH THE RETURN AT THE MAY BOARD MEETING EACH YEAR.
FORM 990, PART VI, SECTION B, LINE 12COFFICERS, DIRECTORS AND KEY EMPLOYEES ARE ASKED AT EACH MEETING IF THEY HAVE A CONFLICT WITH ANY ISSUE ON THE AGENDA.
FORM 990, PART VI, SECTION B, LINE 15AMARK PAGET, SECRETARY, AND KELLY SICS, DIRECTOR OF FINANCE, DETERMINE THE SALARY OF THE EXECUTIVE DIRECTOR. THIS SALARY IS LATER APPROVED BY THE ENTIRE BOARD IN CONJUNCTION WITH THE APPROVAL OF THE BUDGET. COMPARABLE WAGE DATA IS OBTAINED FROM AN INDEPENDENT FIRM SPECIALIZING IN HUMAN RESOURCES.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART XII, LINE 2C:THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR.