SHEBOYGAN COUNTY CANCER CARE FUND INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization: SHEBOYGAN COUNTY CANCER CARE FUND INC (EIN 39-2002260)
Tax period: 2013-01-01 to 2013-12-31
Filed: 2014-07-02
IRS object ID: 201411839349300306
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
Form 990
Schedule A
Schedule B
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2014-07-02T08:49:14-05:00	ReturnTs
Tax Period End	2013-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	410746749	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	CLIFTONLARSONALLEN LLP	BusinessNameLine1

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	2124 KOHLER MEMORIAL DR STE 200	AddressLine1
City	SHEBOYGAN	City
State	WI	State
ZIP Code	53081	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2013-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	392002260	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SHEBOYGAN COUNTY CANCER CARE FUND	BusinessNameLine1

Field	Value	IRS element (for citing)
Business Name Control	SHEB	BusinessNameControlTxt
Phone	9204587433	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1621 N TAYLOR DR NO 100	AddressLine1
City	SHEBOYGAN	City
State	WI	State
ZIP Code	53081	ZIPCode

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	TIM RENZELMAN	PersonNm
Person Title	VICE PRESIDENT	PersonTitleTxt
Phone	9204587433	PhoneNum
Signature	2014-06-24	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	RYAN GARTMAN	PreparerPersonNm
PTIN	P00019895	PTIN
Phone	9204589151	PhoneNum
Preparation	2014-06-24	PreparationDt

Field	Value	IRS element (for citing)
Tax	2013	TaxYr
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	TIM RENZELMAN	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1621 N TAYLOR DR 100	AddressLine1
City	SHEBOYGAN	City
State	WI	State
ZIP Code	53081	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	$216,058	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	N/A	WebsiteAddressTxt
Type Of Organization Assoc	Yes (X)	TypeOfOrganizationAssocInd
Formation	2000	FormationYr
Legal Domicile State	WI	LegalDomicileStateCd
Activity Or Mission	TO PROVIDE SUPPORT TO CANCER VICTIMS	ActivityOrMissionDesc
Voting Members Governing Body	4	VotingMembersGoverningBodyCnt
Voting Members Independent	0	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$177,797	PYContributionsGrantsAmt
CY Contributions Grants	$215,591	CYContributionsGrantsAmt
PY Program Service Revenue	$0	PYProgramServiceRevenueAmt
CY Program Service Revenue	$0	CYProgramServiceRevenueAmt
PY Investment Income	$647	PYInvestmentIncomeAmt
CY Investment Income	$467	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	-$13,845	CYOtherRevenueAmt
PY Total Revenue	$178,444	PYTotalRevenueAmt
CY Total Revenue	$202,213	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$0	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$0	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$0	PYOtherExpensesAmt
CY Other Expenses	$114,028	CYOtherExpensesAmt
PY Total Expenses	$0	PYTotalExpensesAmt
CY Total Expenses	$114,028	CYTotalExpensesAmt
PY Revenues Less Expenses	$178,444	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$88,185	CYRevenuesLessExpensesAmt
Total Assets BOY	$492,598	TotalAssetsBOYAmt
Total Assets EOY	$580,783	TotalAssetsEOYAmt
Total Liabilities BOY	$0	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$0	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$492,598	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$580,783	NetAssetsOrFundBalancesEOYAmt
Mission	TO PROVIDE SUPPORT TO CANCER VICTIMS	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$89,517	ExpenseAmt
Desc	PROVIDING SUPPORT TO CANCER VICTIMS	Desc
Total Program Service Expenses	$89,517	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
Report Land Building Equipment	0	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	0	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	0	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	1	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	4	GoverningBodyVotingMembersCnt
Independent Voting Member	0	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	0	ConflictOfInterestPolicyInd
Whistleblower Policy	0	WhistleblowerPolicyInd
Document Retention Policy	0	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	WI	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	THE ORGANIZATION	BusinessNameLine1

Field	Value	IRS element (for citing)
Phone	9204587433	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1621 N TAYLOR DR NO 100	AddressLine1
City	SHEBOYGAN	City
State	WI	State
ZIP Code	53081	ZIPCode

Field	Value	IRS element (for citing)
No Listed Persons Compensated	Yes (X)	NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (4 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt
H MARSHALL MATTHEWS
PRESIDENT	1.00	0.00	Yes (X)	$0	$0	$0
TIM RENZELMAN
VICE-PRESIDENT	1.00	0.00	Yes (X)	$0	$0	$0
LOU ANN MEYER
SECRETARY	1.00	0.00	Yes (X)	$0	$0	$0
MARTIN STEPZINSKI
TREASURER	1.00	0.00	Yes (X)	$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$0	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$0	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	0	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
All Other Contributions	$215,591	AllOtherContributionsAmt
Total Contributions	$215,591	TotalContributionsAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$467	TotalRevenueColumnAmt
Exclusion	$467	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$13,845	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$13,845	TotalRevenueColumnAmt
Exclusion	-$13,845	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$202,213	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	-$13,378	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$1,400	TotalAmt
Management And General	$1,400	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$89,517	TotalAmt
Program Services	$89,517	ProgramServicesAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,200	TotalAmt
Management And General	$1,200	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$116	TotalAmt
Management And General	$116	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$20,605	TotalAmt
Management And General	$20,605	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,190	TotalAmt
Management And General	$1,190	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$114,028	TotalAmt
Program Services	$89,517	ProgramServicesAmt
Management And General	$24,511	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$51,705	BOYAmt
EOY	$139,423	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$440,893	BOYAmt
EOY	$441,360	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$492,598	BOYAmt
EOY	$580,783	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$492,598	BOYAmt
EOY	$580,783	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$492,598	BOYAmt
EOY	$580,783	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$492,598	BOYAmt
EOY	$580,783	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$88,185	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Cash	Yes (X)	MethodOfAccountingCashInd
Accountant Compile Or Review	Yes (1)	AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

Field	Value	IRS element (for citing)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
FS Audited	0	FSAuditedInd
Audit Committee	0	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

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

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$121,139	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$168,422	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$197,269	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$177,797	CurrentTaxYearMinus1YearAmt
Current Tax Year	$215,591	CurrentTaxYearAmt
Total	$880,218	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$121,139	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$168,422	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$197,269	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$177,797	CurrentTaxYearMinus1YearAmt
Current Tax Year	$215,591	CurrentTaxYearAmt
Total	$880,218	TotalAmt

Field	Value	IRS element (for citing)
Substantial Contributors Tot	$89,152	SubstantialContributorsTotAmt
Public Support Total170	$791,066	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$902	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$349	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$1,102	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$647	CurrentTaxYearMinus1YearAmt
Current Tax Year	$467	CurrentTaxYearAmt
Total	$3,467	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$883,685	TotalSupportAmt
Public Support CY170	0.89520	PublicSupportCY170Pct
Public Support PY170	0.99470	PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170	Yes (X)	ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11	FORM 990 IS PROVIDED TO THE GOVERNING BODY DURING REGULAR MEETINGS.
FORM 990, PART VI, SECTION C, LINE 19	RECORDS ARE AVAILABLE AT THE ORGANIZATION'S OFFICE DURING NORMAL BUSINESS HOURS.
FORM 990, PART VII	H MARSHALL MATTHEWS - 1621 N TAYLOR DRIVE, SHEBOYGAN, WI 53081. TIM RENZELMAN - 1621 N TAYLOR DRIVE, SHEBOYGAN, WI 53081. LOU ANN MEYER - 2920 SUPERIOR AVENUE, SHEBOYGAN, WI 53081. MARTIN STEPZINSKI - 2124 KOHLER MEMORIAL DRIVE, PO BOX 1008, SHEBOYGAN, WI XXX-XX-XXXX.
FORM 990, PART IX, LINE 11G	SUPPORT OF CANCER VICTIMS: PROGRAM SERVICE EXPENSES 89,517. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 89,517.