CORBETT MEDICAL FOUNDATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: CORBETT MEDICAL FOUNDATION (EIN 83-0305129)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-11-04
IRS object ID: 201303089349301230
Schema version: 2012v2.0
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 O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-11-04T14:04:39-08:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ROGER J SCHNEIDER CPA	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 577	AddressLine1
City	RAWLINS	City
State	WY	State
ZIP Code	82301	ZIPCode

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

Filer Filer

Field	Value	IRS element (for citing)
EIN	830305129	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	CORBETT MEDICAL FOUNDATION	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	CORB	NameControl
Phone	3073265760	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	P O BOX 343	AddressLine1
City	SARATOGA	City
State	WY	State
ZIP Code	82331	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	WILL SPEER	Name
Title	DIRECTOR	Title
Phone	3073265760	Phone
Date Signed	2013-11-04	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	ROGER J SCHNEIDER	Name
Phone	3073242279	Phone
Date Prepared	2013-11-04	DatePrepared
Self Employed	X	SelfEmployed

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	WILL SPEER	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	P O BOX 343	AddressLine1
City	SARATOGA	City
State	WY	State
ZIP Code	82331	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	276999	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	N/A	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	2004	YearFormation
State Legal Domicile	WY	StateLegalDomicile
Activity Or Mission Description	RURAL HEALTH SERVICES	ActivityOrMissionDescription
Nbr Voting Members Governing Body	6	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	6	NbrIndependentVotingMembers
Total Nbr Employees	0	TotalNbrEmployees
Total Nbr Volunteers	10	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	250862	ContributionsGrantsPriorYear
Contributions Grants Current Year	263630	ContributionsGrantsCurrentYear
Program Service Revenue CY	270	ProgramServiceRevenueCY
Investment Income Prior Year	6696	InvestmentIncomePriorYear
Investment Income Current Year	13099	InvestmentIncomeCurrentYear
Other Revenue Current Year	0	OtherRevenueCurrentYear
Total Revenue Prior Year	257558	TotalRevenuePriorYear
Total Revenue Current Year	276999	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Current Year	0	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	180763	OtherExpensePriorYear
Other Expenses Current Year	142208	OtherExpensesCurrentYear
Total Expenses Prior Year	180763	TotalExpensesPriorYear
Total Expenses Current Year	142208	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	76795	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	134791	RevenuesLessExpensesCY
Total Assets BOY	787397	TotalAssetsBOY
Total Assets EOY	922188	TotalAssetsEOY
Total Liabilities EOY	0	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	787397	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	922188	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	RURAL HEALTH SERVICES	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	142207	Expense
Revenue	276999	Revenue
Description	PROVIDE AREA WITH MAMMOGRAM AND CANCER DETECTION SERVICES.	Description
Total Program Service Expense	142208	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	false	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	false	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	false	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	false	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	0	NumberOfEmployees
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	6	NbrVotingGoverningBodyMembers
Number Independent Voting Members	6	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	true	DocumentRetentionPolicy
Compensation Process CEO	false	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	WILL SPEER	NamePerson
Telephone Number	3073265760	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	P O BOX 343	AddressLine1
City	SARATOGA	City
State	WY	State
ZIP Code	82331	ZIPCode

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

Form990 Part VII Section A Form990PartVIISectionA (6 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer
MICHAEL GLODE
PRESIDENT	1.00	X	X
LAURA BUCHOLZ
VICE PRESIDENT	1.00	X	X
TABATHA FARVER
SEC.TREASURER	1.00	X	X
WILL L SPEER
DIRECTOR	1.00	X
DULCIE SCHALK
DIRECTOR	1.00	X
MARTY HUNTLEY
DIRECTOR	1.00	X

Field	Value	IRS element (for citing)
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources
All Other Contributions	263630	AllOtherContributions
Total Contributions	263630	TotalContributions

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	270	TotalRevenueColumn

Field	Value	IRS element (for citing)
Total Program Service Revenue	270	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	13099	TotalRevenueColumn

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	276999	TotalRevenueColumn
Related Or Exempt Function Income	13369	RelatedOrExemptFunctionIncome

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

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

Comp Disqual Persons CompDisqualPersons

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

Other Salaries And Wages OtherSalariesAndWages

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

Pension Plan Contributions PensionPlanContributions

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

Other Employee Benefits OtherEmployeeBenefits

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

Payroll Taxes PayrollTaxes

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

Fees For Services Management FeesForServicesManagement

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

Fees For Services Legal FeesForServicesLegal

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

Fees For Services Accounting FeesForServicesAccounting

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

Fees For Services Lobbying FeesForServicesLobbying

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

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total
Fundraising	0	Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	5071	Total
Program Services	5071	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Other FeesForServicesOther

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

Advertising Advertising

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

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	1173	Total
Program Services	1173	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Information Technology InformationTechnology

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

Royalties Royalties

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

Occupancy Occupancy

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

Travel Travel

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

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

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

Conferences Meetings ConferencesMeetings

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

Interest Interest

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

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	129543	Total
Program Services	129543	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Depreciation Depletion DepreciationDepletion

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

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
MAMMOGRAMS	5661	5661
SURETY	500	500
POSTAGE	235	235
LICENSES	25	25

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	142208	Total
Program Services	142208	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	127118	BOY
EOY	229217	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	660279	BOY
EOY	692971	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	787397	BOY
EOY	922188	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Field	Value	IRS element (for citing)
Do Not Follow SFAS117	X	DoNotFollowSFAS117

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

Field	Value	IRS element (for citing)
BOY	787397	BOY
EOY	922188	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	787397	BOY
EOY	922188	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	787397	BOY
EOY	922188	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	134791	ReconcilationRevenueExpenses
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Cash	X	MethodOfAccountingCash
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	false	FSAudited
Federal Grant Audit Required	false	FederalGrantAuditRequired
Federal Grant Audit Performed	false	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org170b1 Avi	X	PubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	124795	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	161825	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	187770	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	250862	CurrentTaxYearMinus1Year
Current Tax Year	263630	CurrentTaxYear
Total	988882	Total

Total170 Total170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	124795	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	161825	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	187770	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	250862	CurrentTaxYearMinus1Year
Current Tax Year	263630	CurrentTaxYear
Total	988882	Total

Field	Value	IRS element (for citing)
Public Support Total170	988882	PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	11856	CurrentTaxYearMinus4Years
Current Tax Year Minus1 Year	6696	CurrentTaxYearMinus1Year
Current Tax Year	13099	CurrentTaxYear
Total	31651	Total

Field	Value	IRS element (for citing)
Total Support	1020533	TotalSupport
Public Support Pertcentage170	0.96900	PublicSupportPertcentage170
Public Support Pertcent Prior Year	0.96850	PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170	X	ThirtyThreePercntTestsCY170
Public Support Total509	0	PublicSupportTotal509
Public Support Percentage509	0	PublicSupportPercentage509
Investment Income Percentage	0	InvestmentIncomePercentage

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifier	ExplanationExplanation
Pt III, Line 2	PROVIDE AREA WITH MAMMOGRAM AND CANCER DETECTION SERVICES.
Pt VI, Line 12c	PROVIDE AREA WITH MAMMOGRAM AND CANCER DETECTION SERVICES.
Pt XII, Line 3b	PROVIDE AREA WITH MAMMOGRAM AND CANCER DETECTION SERVICES.
Pt VI, Line 11b	PROVIDE AREA WITH MAMMOGRAM AND CANCER DETECTION SERVICES.
Form 990, Part IX, Line 24f	SUBCONTRACT MEDICAL TELEPHONE POSTAGE UTILITY