PACIFIC DENTAL SERVICES FOUNDATION: Form 990PF, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- PACIFIC DENTAL SERVICES FOUNDATION (EIN 45-5083789)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-13
- IRS object ID
- 201443179349101724
- Schema version
- 2013v3.1
- 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-PF
- Schedule B
- Depreciation Schedule
- Land Etc Schedule2
- Legal Fees Schedule
- Other Assets Schedule
- Other Expenses Schedule
- Other Liabilities Schedule
- Other Professional Fees Schedule
- Substantial Contributors Sch
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-13T17:03:29-08:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PACIFIC DENTAL SERVICES | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 6107 | AddressLine1 |
| City | Norco | City |
| State | CA | State |
| ZIP Code | 92860 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 455083789 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PDS Serve Foundation | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PDSS | BusinessNameControlTxt |
| Phone | 7148458757 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17000 RED HILL AVENUE | AddressLine1 |
| City | IRVINE | City |
| State | CA | State |
| ZIP Code | 92614 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHEN THORNE | PersonNm |
| Person Title | President | PersonTitleTxt |
| Signature | 2014-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Ken Blaisdell | PreparerPersonNm |
| PTIN | P00634226 | PTIN |
| Phone | 7148458680 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-12-30 17:16:21Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $539,506 | FMVAssetsEOYAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rcvd Rev And Expnss | $421,344 | ContriRcvdRevAndExpnssAmt |
| Interest On Sav Rev And Expnss | $104 | InterestOnSavRevAndExpnssAmt |
| Total Rev And Expnss | $421,448 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $0 | TotalNetInvstIncmAmt |
| Oth Empl Slrs Wgs Rev And Expnss | $8,748 | OthEmplSlrsWgsRevAndExpnssAmt |
| Oth Empl Slrs Wgs Adj Net Incm | $8,748 | OthEmplSlrsWgsAdjNetIncmAmt |
| Legal Fees Rev And Expnss | $15,239 | LegalFeesRevAndExpnssAmt |
| Legal Fees Adj Net Incm | $14,771 | LegalFeesAdjNetIncmAmt |
| Legal Fees Dsbrs Chrtbl | $468 | LegalFeesDsbrsChrtblAmt |
| Other Prof Fees Rev And Expnss | $5,072 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Adj Net Incm | $4,624 | OtherProfFeesAdjNetIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $448 | OtherProfFeesDsbrsChrtblAmt |
| Taxes Rev And Expnss | $1,009 | TaxesRevAndExpnssAmt |
| Taxes Adj Net Incm | $1,009 | TaxesAdjNetIncmAmt |
| Deprec And Dpltn Rev And Expnss | $31,360 | DeprecAndDpltnRevAndExpnssAmt |
| Trav Conf Meeting Rev And Expnss | $159,380 | TravConfMeetingRevAndExpnssAmt |
| Trav Conf Meeting Adj Net Incm | $869 | TravConfMeetingAdjNetIncmAmt |
| Trav Conf Meeting Dsbrs Chrtbl | $158,511 | TravConfMeetingDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $278,417 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Adj Net Incm | $19,657 | OtherExpensesAdjNetIncmAmt |
| Other Expenses Dsbrs Chrtbl | $258,760 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $499,225 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $0 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $49,678 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $418,187 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $0 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $0 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $499,225 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $0 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $49,678 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $418,187 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$77,777 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $68,276 | CashBOYAmt |
| Cash EOY | $21,178 | CashEOYAmt |
| Cash EOYFMV | $21,178 | CashEOYFMVAmt |
| Sav And Temp Cash Invst EOY | $250,104 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $250,104 | SavAndTempCashInvstEOYFMVAmt |
| Land Bldg Equip Cost Or Other Bss | $287,134 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $31,360 | LandBldgEquipAccumDeprecAmt |
| Land EOY | $255,774 | LandEOYAmt |
| Land EOYFMV | $255,774 | LandEOYFMVAmt |
| Other Assets BOY | $76,466 | OtherAssetsBOYAmt |
| Other Assets EOY | $12,450 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $12,450 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $144,742 | TotalAssetsBOYAmt |
| Total Assets EOY | $539,506 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $539,506 | TotalAssetsEOYFMVAmt |
| Accounts Payable BOY | $71,462 | AccountsPayableBOYAmt |
| Accounts Payable EOY | $1,458 | AccountsPayableEOYAmt |
| Other Liabilities EOY | $542,545 | OtherLiabilitiesEOYAmt |
| Total Liabilities BOY | $71,462 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $544,003 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
| Retained Earning BOY | $73,280 | RetainedEarningBOYAmt |
| Retained Earning EOY | -$4,497 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $73,280 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | -$4,497 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $144,742 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $539,506 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $73,280 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$77,777 | ExcessRevenueOverExpensesAmt |
| Subtotal | -$4,497 | SubtotalAmt |
| Tot Net Ast Or Fund Balances EOY | -$4,497 | TotNetAstOrFundBalancesEOYAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $0 | InvestmentIncomeExciseTaxAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | false | LegislativePoliticalActyInd |
| More Than100 Spent | false | MoreThan100SpentInd |
| Form1120 POL Filed | false | Form1120POLFiledInd |
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | false | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | false | Form990TFiledInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (true) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (true) | AtLeast5000InAssetsInd |
| Org Report Or Register State | CA | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (true) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | Yes (true) | PrivateOperatingFoundationInd |
| New Substantial Contributors | Yes (true) | NewSubstantialContributorsInd |
| Own Controlled Entity | false | OwnControlledEntityInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (true) | ComplyWithPublicInspRqrInd |
| Website Address | pacificdentalservices.com/giving/foundation | WebsiteAddressTxt |
Persons With Books Name PersonsWithBooksName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ken Blaisdell | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7148458680 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 6107 | AddressLine1 |
| City | Norco | City |
| State | CA | State |
| ZIP Code | 92860 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | false | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | false | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | false | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | false | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | false | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | false | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | false | PaymentToGovernmentOfficialInd |
| Acts Fail To Qlfy As Exceptions | false | ActsFailToQlfyAsExceptionsInd |
| Uncorrected Prior Acts | false | UncorrectedPriorActsInd |
| Undistributed Income PY | false | UndistributedIncomePYInd |
| Undistr Incm Sect4942a2 Not App | false | UndistrIncmSect4942a2NotAppInd |
| Business Holdings | false | BusinessHoldingsInd |
| Excess Business Holdings | false | ExcessBusinessHoldingsInd |
| Jeopardy Investments | false | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | false | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | false | InfluenceLegislationInd |
| Influence Election | false | InfluenceElectionInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Noncharitable Purpose | false | NoncharitablePurposeInd |
| Transactions Fail To Qlfy As Exc | false | TransactionsFailToQlfyAsExcInd |
| Maintained Expenditure Rspns | false | MaintainedExpenditureRspnsInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Proceeds Or Net Income | false | ProceedsOrNetIncomeInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt |
|---|---|---|---|---|---|---|
| STEPHEN THORNE | ||||||
| 1615 Liege Dr | Henderson | NV | 89012 | President | 0.00 | $0 |
| PAMELA THORNE | ||||||
| 1615 Liege Dr | Henderson | NV | 89012 | Secretary | 0.00 | $0 |
| BRADY AASE | ||||||
| 11 DENNIS LANE | LADERA RANCH | CA | 92694 | CFO & Treasurer | 0.00 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Hghst Pd Empl Or NONE | NONE | CompOfHghstPdEmplOrNONETxt |
| Comp Of Hghst Pd Cntrct Or NONE | NONE | CompOfHghstPdCntrctOrNONETxt |
Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | International Communities - providing free dentistry to underserved communities in Ethiopia and Fiji. | Description1Txt |
| Expenses1 | $268,260 | Expenses1Amt |
| Description2 | National Communities - providing oral health grants/scholarships/education; providing encouragement and resources in the areas of relationships, marriages and families. | Description2Txt |
| Expenses2 | $70,241 | Expenses2Amt |
| Description3 | Local Communities - Providing free dentistry to challenged urban areas and rural communities in need. | Description3Txt |
| Expenses3 | $79,685 | Expenses3Amt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $0 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $169,779 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $169,779 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Adjusted Total FMV Of Unused Ast | $169,779 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $2,547 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $167,232 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $8,362 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sect4942j3j5 Fndtn And Frgn Org | Yes (X) | Sect4942j3j5FndtnAndFrgnOrgInd |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $418,187 | ExpensesAndContributionsAmt |
| Qualifying Distributions | $418,187 | QualifyingDistributionsAmt |
| Adjusted Qualifying Distri | $418,187 | AdjustedQualifyingDistriAmt |
Private Operating Foundations PrivateOperatingFoundationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Section4942j3 | Yes (X) | Section4942j3Ind |
Lessor Adj Net Incm Min Invst Ret LessorAdjNetIncmMinInvstRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $0 | CurrentYearAmt |
| Total | $0 | TotalAmt |
Qualifying Distributions QualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $418,187 | CurrentYearAmt |
| Year1 | $239,280 | Year1Amt |
| Total | $657,467 | TotalAmt |
Qualifying Distri Made Drt QualifyingDistriMadeDrtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $418,187 | CurrentYearAmt |
| Year1 | $239,280 | Year1Amt |
| Total | $657,467 | TotalAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $538,712 | CurrentYearAmt |
| Year1 | $144,741 | Year1Amt |
| Total | $683,453 | TotalAmt |
Total Assets Sect4942j3 Bi TotalAssetsSect4942j3BiGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $538,712 | CurrentYearAmt |
| Year1 | $144,741 | Year1Amt |
| Total | $683,453 | TotalAmt |
Two Thirds Minimum Invst Ret TwoThirdsMinimumInvstRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Supplementary Information SupplementaryInformationGrp
Application Submission Info ApplicationSubmissionInfoGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Person | BARBARA VARTANIAN | RecipientPersonNm |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17000 RED HILL AVE | AddressLine1 |
| City | IRVINE | City |
| State | CA | State |
| ZIP Code | 92614 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Phone | 7148458757 | RecipientPhoneNum |
| Recipient Email Address | VARTANIANB@PACDEN.COM | RecipientEmailAddressTxt |
| Form And Info And Materials | APPLICATIONS SHOULD BE SUBMITTED EITHER IN WRITTEN FORM (ON 8.5" X 11") OR BY EMAIL TO VARTANIANB@PACDEN.COM. APPLICATIONS SHOULD INCLUDE - 1) NAME, ADDRESS, TELEPHONE NUMBER AND WEB SITE OF REQUESTING ORGANIZATION2) COPY OF MOST RECENT TWO YEARS' INDEPENDENT AUDITORS' REPORT ON REQUESTING ORGANIZATION, IF AVAILABLE3) A DESCRIPTION OF CHARITABLE ACTIVITIES FOR WHICH GRANT IS REQUESTED, INCLUDING LOCATION4) PERSONS OR CAUSES BENEFITED BY THE ACTIVITIES5) AMOUNT AND DATE(S) OF REQUESTED GRANT(S)6) INFORMATION ABOUT PRIOR CHARITABLE ACTIVITIES OF THE REQUESTING ORGANIZATION7) CONTACT INFORMATION (ADDRESS, PHONE # AND EMAIL) OF INDIVIDUAL SUBMITTING REQUEST | FormAndInfoAndMaterialsTxt |
| Submission Deadlines | AT LEAST 6 MONTHS PROR TO REQUESTED DATE | SubmissionDeadlinesTxt |
| Restrictions On Awards | REQUESTED GRANTS & AWARDS MUST BE CONSISTENT WITH THE FOUNDATION'S CHARITABLE PURPOSE | RestrictionsOnAwardsTxt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $104 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | $104 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $104 | TotalIncomeProducingActyAmt |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | false | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | false | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | false | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | false | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | false | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | false | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | false | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | false | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | false | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | false | RelationshipsNonchrtblEOInd |
Schedule B IRS990ScheduleB
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| General Rule | Yes (X) | GeneralRuleInd |
Contributor Information ContributorInformationGrp (11 entries)
| ContributorContributorNum | Address Line1ContributorUSAddress/AddressLine1 | CityContributorUSAddress/City | StateContributorUSAddress/State | ZIP CodeContributorUSAddress/ZIPCode | Total ContributionsTotalContributionsAmt | Noncash ContributionNoncashContributionInd | Person ContributionPersonContributionInd |
|---|---|---|---|---|---|---|---|
| Henry Schein Inc | |||||||
| 1 | 135 Duryea Road | Melville | NY | 11747 | $125,844 | Yes (X) | |
| Stephen Thorne | |||||||
| 2 | 1615 Liege Dr | Henderson | NV | 89012 | $25,000 | Yes (X) | |
| Bank of the West | |||||||
| 3 | 4400 MacArthur Blvd Suite 150 | Newport Beach | CA | 92660 | $25,000 | Yes (X) | |
| Bowana Foundation | |||||||
| 4 | 831 Pearl Street | Boulder | CO | 80302 | $10,000 | Yes (X) | |
| Minh Pham | |||||||
| 5 | 4733 Mountain View Drive 5 | San Diego | CA | 92116 | $6,000 | Yes (X) | |
| Sirona Dental Inc | |||||||
| 6 | 4835 Sirona Drive Suite 100 | Charlotte | NC | 28273 | $25,000 | Yes (X) | |
| Nobel Biocare | |||||||
| 7 | 22715 Savi Ranch Parkway | Yorba Linda | CA | 92887 | $10,000 | Yes (X) | |
| QSI Management | |||||||
| 8 | 18111 Von Karman Ave Ste 70 | Irvine | CA | 92612 | $25,000 | Yes (X) | |
| Sageview Advisory Group Inc | |||||||
| 9 | 1920 Main Street Ste 800 | Irvine | CA | 92614 | $10,000 | Yes (X) | |
| Tanisha Jackson | |||||||
| 10 | 734 Strada Casalingo Ct | Redlands | CA | 92373 | $5,100 | Yes (X) | |
| Wells Fargo Bank | |||||||
| 11 | 2030 Main St 9th Floor | Irvine | CA | 92614 | $25,000 | Yes (X) | |
Non Cash Property Contribution NonCashPropertyContributionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | 1 | ContributorNum |
| Noncash Property | Dental supplies & equipment | NoncashPropertyDesc |
| Fair Market Value | $125,844 | FairMarketValueAmt |
| Received | 2013-12-31 | ReceivedDt |
Depreciation Schedule DepreciationSchedule
Depreciation Property DepreciationPropertyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Property | Transportation Equipment | PropertyDesc |
| Acquired | 2013-07-15 | AcquiredDt |
| Cost Or Other Basis | $287,134 | CostOrOtherBasisAmt |
| Computation Method | 91 | ComputationMethodTxt |
| Life | 5.0000 | LifeRt |
| Current Year Expense | $31,360 | CurrentYearExpenseAmt |
Land Etc Schedule2 LandEtcSchedule2
Land Etc LandEtcGrp (2 entries)
| Category Or ItemCategoryOrItemTxt | EOYFMVEOYFMVAmt | Cost Or Other BasisCostOrOtherBasisAmt | Accumulated DepreciationAccumulatedDepreciationAmt | Book ValueBookValueAmt |
|---|---|---|---|---|
| Auto./Transportation Equip. | $255,774 | |||
| Miscellaneous | $287,134 | $31,360 | $255,774 |
Legal Fees Schedule LegalFeesSchedule
Legal Fees LegalFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legal Fees | $15,239 | LegalFeesAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $14,771 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $468 | DisbursementsCharitablePrpsAmt |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PREPAID INSURANCE | Desc |
| EOY Book Value | $12,450 | EOYBookValueAmt |
| EOYFMV | $12,450 | EOYFMVAmt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (12 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt | Adjusted Net IncomeAdjustedNetIncomeAmt |
|---|---|---|---|
| Advertising | $35 | $35 | |
| Automobile Expense | $22,159 | $22,159 | |
| Bank Charges | $3,234 | $3,234 | |
| Computer Expense | $40 | $40 | |
| Dues & Subscriptions | $1,707 | $957 | $750 |
| Education Expense | $105 | $105 | |
| Liability Expense | $36,068 | $21,014 | $15,054 |
| License & Permits | $976 | $1,204 | -$228 |
| Office Expense | $3,965 | $3,594 | $371 |
| Promo | $464 | $464 | |
| Storage Fees | $1,816 | $1,340 | $476 |
| Supplies | $207,848 | $207,848 |
Other Liabilities Schedule OtherLiabilitiesSchedule
Other Liabilities Detail OtherLiabilitiesDetail (3 entries)
| DescDesc | EOY Book ValueEOYBookValueAmt |
|---|---|
| Due To Affiliates | $538,078 |
| other liabilities | $4,466 |
| Rounding | $1 |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|---|
| Consulting | $4,624 | $0 | $4,624 | $0 |
| Other | $448 | $0 | $0 | $448 |
Substantial Contributors Sch SubstantialContributorsSch
Substantial Contributor Detail SubstantialContributorDetail (6 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode |
|---|---|---|---|
| STEPHEN E THORNE | |||
| 1615 Liege Dr | Henderson | NV | 89012 |
| Wells Fargo Bank | |||
| 2030 Main St 9th Floor | Irvine | CA | 92614 |
| QSI Management | |||
| 18111 Von Karman Ave Ste 700 | Irvine | CA | 92612 |
| Bank of the West | |||
| 4400 MacArthur Blvd Suite 150 | Newport Beach | CA | 92660 |
| Sirona Dental Inc | |||
| 4835 Sirona Drive Suite 100 | Charlotte | NC | 28273 |
| Henry Schein Inc | |||
| 135 Duryea Road | Melville | NY | 11747 |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Adjusted Net IncomeAdjustedNetIncomeAmt |
|---|---|---|
| FTB | $10 | $10 |
| Payroll | $999 | $999 |