WALTON COUNTY HEALTH CARE FOUNDATION INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: WALTON COUNTY HEALTH CARE FOUNDATION INC (EIN 20-1376389)
Tax period: 2012-10-01 to 2013-09-30
Filed: 2014-08-06
IRS object ID: 201422189349300542
Schema version: 2012v2.3
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 D
Schedule I
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-08-06T12:24:20-05:00	Timestamp
Tax Period End Date	2013-09-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JENNINGS & ASSOCIATES LLC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	3235 SATELLITE BLVD STE 260	AddressLine1
City	DULUTH	City
State	GA	State
ZIP Code	30096	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-10-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	201376389	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	THE WALTON COUNTY HEALTH CARE	BusinessNameLine1
Business Name Line2	FOUNDATION INC	BusinessNameLine2

Field	Value	IRS element (for citing)
Name Control	WALT	NameControl
Phone	7702071408	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 1026	AddressLine1
City	MONROE	City
State	GA	State
ZIP Code	30655	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	TROY PRESTON	Name
Title	EXECUTIVE DIRECTOR	Title
Phone	7702071408	Phone
Date Signed	2014-06-30	DateSigned
Authorize Third Party	false	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	BRITT T JENNINGS	Name
Phone	7702327105	Phone
Date Prepared	2014-07-18	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	TROY PRESTON	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	PO BOX 1026	AddressLine1
City	MONROE	City
State	GA	State
ZIP Code	30655	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	23639802	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.WCHCFI.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	2003	YearFormation
State Legal Domicile	GA	StateLegalDomicile
Activity Or Mission Description	PROMOTE HEALTH OF CITIZENS OF WALTON COUNTY, GEORGIA	ActivityOrMissionDescription
Nbr Voting Members Governing Body	9	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	9	NbrIndependentVotingMembers
Total Nbr Employees	1	TotalNbrEmployees
Total Nbr Volunteers	8	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue CY	0	ProgramServiceRevenueCY
Investment Income Prior Year	2673893	InvestmentIncomePriorYear
Investment Income Current Year	1130514	InvestmentIncomeCurrentYear
Other Revenue Current Year	0	OtherRevenueCurrentYear
Total Revenue Prior Year	2673893	TotalRevenuePriorYear
Total Revenue Current Year	1130514	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	337811	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	505584	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	67758	SalariesEtcPriorYear
Salaries Etc Current Year	70196	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	252450	OtherExpensePriorYear
Other Expenses Current Year	232712	OtherExpensesCurrentYear
Total Expenses Prior Year	658019	TotalExpensesPriorYear
Total Expenses Current Year	808492	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	2015874	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	322022	RevenuesLessExpensesCY
Total Assets BOY	45586879	TotalAssetsBOY
Total Assets EOY	44330242	TotalAssetsEOY
Total Liabilities BOY	1739	TotalLiabilitiesBOY
Total Liabilities EOY	1723	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	45585140	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	44328519	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	PROMOTE HEALTH OF CITIZENS OF WALTON COUNTY, GEORGIA	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	114305	Expense
Grants	76383	Grants
Description	GRANTS WERE ISSUED TO A CHILD'S VOICE CHILD ADVOCACY CENTER TO FUND THE MEDICAL EXPENSES FOR ALLEGED VICTIMS OF ABUSE AND TO FUND RELOCATION EXPENSES.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	125264	Expense
Grants	83706	Grants
Description	A GRANT WAS ISSUED TO THE WALTON COUNTY BOARD OF COMMISSIONERS TO PURCHASE NEW AMBULANCE UNIT	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	127201	Expense
Grants	85000	Grants
Description	A GRANT WAS ISSUED TO WALTON WELLNESS TO EDUCATE THE COMMUNITY ON THE BENEFITS OF NUTRITION AND EXERCISE	Description

Activity Other ActivityOther

Field	Value	IRS element (for citing)
Expense	389824	Expense
Grants	260495	Grants
Description	TO FUND THE PURCHASE A VAN FOR WALTON COUNTY SENIOR CITIZENS COUNCIL, TO HELP FUND PURCHASE OF MEDICAL EQUIPMENT FOR FREE MEDICAL CARE, SHARE THE ROAD PROMOTION, AND OTHER PROGRAMS FOR THE HEALTH BENEFITS/EDUCATION OF WALTON COUNTY RESIDENCES.	Description

Field	Value	IRS element (for citing)
Total Of Other Program Service Exp	389824	TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt	260495	TotalOfOtherProgramServiceGrnt
Total Program Service Expense	756594	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	false	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	4	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	1	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	9	NbrVotingGoverningBodyMembers
Number Independent Voting Members	9	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	false	WhistleblowerPolicy
Document Retention Policy	false	DocumentRetentionPolicy
Compensation Process CEO	false	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	GA	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	JENNINGS ASSOCIATES LLC	NamePerson
Telephone Number	4042327105	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	208 BROOKSTONE PLACE	AddressLine1
City	SOCIAL CIRCLE	City
State	GA	State
ZIP Code	30025	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (9 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
JOHN T PRESTON III
EXECUTIVE DI	30.00	X	X	58895	0	0
ALAN DUVAL
DIRECTOR	1.00	X		0	0	0
BOBBY BOSS
DIRECTOR	1.00	X		0	0	0
CHARLOTTE GEORGE
DIRECTOR	1.00	X		0	0	0
RANDY GARRETT
DIRECTOR	1.00	X		0	0	0
T HENRY WALL
CHAIRMAN	1.00		X	0	0	0
SUE MCCULLERS
VICE CHAIRMA	1.00		X	0	0	0
BEN E GARRETT
SECRETARY	1.00		X	0	0	0
MYRA C SMITH
TREASURER	1.00		X	0	0	0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	58895	TotalReportableCompFromOrg
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	1276744	TotalRevenueColumn
Related Or Exempt Function Income	1276744	RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	22363058	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	22509288	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	-146230	Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-146230	TotalRevenueColumn
Related Or Exempt Function Income	-146230	RelatedOrExemptFunctionIncome

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	1130514	TotalRevenueColumn
Related Or Exempt Function Income	1130514	RelatedOrExemptFunctionIncome

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	505584	Total
Program Services	505584	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	58895	Total
Program Services	50061	ProgramServices
Management And General	8834	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	6795	Total
Program Services	5776	ProgramServices
Management And General	1019	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	4506	Total
Program Services	3830	ProgramServices
Management And General	676	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	544	Total
Program Services	462	ProgramServices
Management And General	82	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	20880	Total
Program Services	17748	ProgramServices
Management And General	3132	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	165976	Total
Program Services	141080	ProgramServices
Management And General	24896	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	647	Total
Program Services	550	ProgramServices
Management And General	97	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	2750	Total
Program Services	2337	ProgramServices
Management And General	413	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	4912	Total
Program Services	4084	ProgramServices
Management And General	828	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	9018	Total
Program Services	7665	ProgramServices
Management And General	1353	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	6841	Total
Program Services	5815	ProgramServices
Management And General	1026	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	5535	Total
Management And General	5535	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	632	Total
Program Services	538	ProgramServices
Management And General	94	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	7965	Total
Program Services	6770	ProgramServices
Management And General	1195	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
AUTO	3042	2586	456
MEALS & ENTERTAINMENT	2010	1708	302
DUES & SUBSCRIPTIONS	1760		1760
OTHER EXPENSES	170		170

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	30	Total
Management And General	30	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	808492	Total
Program Services	756594	ProgramServices
Management And General	51898	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	24515	BOY
EOY	18600	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	18360	BOY
EOY	16036	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	4246	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	2958	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	1447	BOY
EOY	1288	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	45542557	BOY
EOY	44294318	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	45586879	BOY
EOY	44330242	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	1739	BOY
EOY	1723	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	1739	BOY
EOY	1723	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	45585140	BOY
EOY	44328519	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	45585140	BOY
EOY	44328519	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	45586879	BOY
EOY	44330242	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	322022	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	-1724873	ReconciliationUnrealizedInvest
Reconcilation Other Changes	146230	ReconcilationOtherChanges
Method Of Accounting Cash	X	MethodOfAccountingCash
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Both	X	FinancialStatementBoth

Field	Value	IRS element (for citing)
Audit Committee	false	AuditCommittee
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Supporting Organization509a3	X	SupportingOrganization509a3
Supporting Org509a3 Type1	X	SupportingOrg509a3Type1
Certification Checkbox	X	CertificationCheckbox
Contrib By Controlling Individual	false	ContribByControllingIndividual
Contribution By Related Party	false	ContributionByRelatedParty
Contrib By35 Controlled Entity	false	ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	WALTON COUNTY HOSPITAL AUTHORITY	BusinessNameLine1

Field	Value	IRS element (for citing)
EIN	586001917	EIN
Type Of Organization	6	TypeOfOrganization
Listed In Governing Doc	true	ListedInGoverningDoc
Supported Organization Notified	true	SupportedOrganizationNotified
Organized In US	true	OrganizedInUS
Amount	$505,584	Amount

Field	Value	IRS element (for citing)
Total Number Of Supported Orgs	1	TotalNumberOfSupportedOrgs
Sum Of Amounts	505584	SumOfAmounts

Schedule D IRS990ScheduleD

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	4246	OtherCostOrOtherBasis
Depreciation	2958	Depreciation
Book Value	1288	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	1288	TotalOfBookValueLandBuildings

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable (10 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
A CHILD'S VOICE CHILD ADVOCACY CTR
216 BROOKSTONE PLACE	SOCIAL CIRCLE	GA	30025	753214817	501C3	76383	HEALTH SERVICE
WALTON COUNTY BOC
303 S HAMMOND DR	MONROE	GA	30655	586000902		83706	HEALTH SERVICE
WALTON WELLNESS
CHURCH STREET	MONROE	GA	30655	273659660	501C3	85000	EDUCATION
ATHENS TECH
800 US HWY 29	ATHENS	GA	30601	581824771		7168	EDUCATION
WALTON CO SENIOR CITIZENS COUNCIL
PO BOX 764	MONROE	GA	30655	581076363		56501	HEALTH SERVICES
FAITH IN SERVING HUMANITY MEDICAL
PO BOX 1838	MONROE	GA	30655	460901738		88587	HEALTH SERVICES/EQUI
CITY OF SOCIAL CIRCLE
PO BOX 310	SOCIAL CIRCLE	GA	30025	586000665		78075	HEALTH ACTIVITY
THE CANCER FOUNDATION OF NE GA
PO BOX 49309	ATHENS	GA	30604	203378035		10000	HEALTH SERVICES
MONROE DOWNTOWN DEVELOPMENT AU
PO BOX 1249	MONROE	GA	30655	432078193		5125	HEALTH ACTIVITY
GEORGIA PERIMETER COLLEGE FOUND
3251 PANTHERSVILLE RD A2810	DECATUR	GA	30034	581492364		15000	EDUCATION

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ALL OTHER ACCOMPLISHMENT DESCRIPTION	FORM 990, PAGE 2, PART III, LINE 4D	TO FUND THE PURCHASE A VAN FOR WALTON COUNTY SENIOR CITIZENS COUNCIL, TO HELP FUND PURCHASE OF MEDICAL EQUIPMENT FOR FREE MEDICAL CARE, SHARE THE ROAD PROMOTION, AND OTHER PROGRAMS FOR THE HEALTH BENEFITS/EDUCATION OF WALTON COUNTY RESIDENCES.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	EXECUTIVE DIRECTOR REVIEW THE FORM 990 WITH THE PREPARER AND DISTRIBUTES COPIES TO OFFICERS AND DIRECTORS FOR REVIEW
ENFORCEMENT OF CONFLICTS POLICY	FORM 990, PAGE 6, PART VI, LINE 12C	CONFLICT OF INTEREST POLICY IS INCLUDED IN THE BY-LAWS WHICH ARE REVIEWED ANNUALLY BY THE BOARD OF DIRECTORS AND MONITORED BY THE FOUNDATION STAFF
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	DOCUMENTS AVAILABLE UPON WRITTEN REQUEST.
RECONCILIATION OF CHANGES - OTHER	FORM 990, PART XI, LINE 9	LOSSES REPORTED ON RETURN -146,230

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	WALTON COUNTY HOSPITAL AUTHORITY	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	PO BOX 1026	AddressLine1
City	MONROE	City
State	GA	State
ZIP Code	30655	ZIPCode

Field	Value	IRS element (for citing)
EIN	586001917	EIN
Primary Activities	LOCAL GOVT	PrimaryActivities
Legal Domicile State	GA	LegalDomicileState
Exempt Code Section	170CA	ExemptCodeSection

Direct Controlling Entity Name DirectControllingEntityName

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

Field	Value	IRS element (for citing)
Controlled Org	false	ControlledOrg

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	false	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	false	DividendsRelatedOrganization
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	false	PerformOfServicesByOtherOrgs
Sharing Of Facilities	true	SharingOfFacilities
Sharing Of Paid Employees	false	SharingOfPaidEmployees
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg