CAT CAY MEDICAL CLINIC FOUNDATION: Form 990PF, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- CAT CAY MEDICAL CLINIC FOUNDATION (EIN 20-5221502)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-05-15
- IRS object ID
- 201321359349101157
- 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-PF
- Schedule B
- Depreciation Schedule
- Land Etc Schedule2
- Legal Fees Schedule
- Other Decreases Schedule
- Other Expenses Schedule
- Substantial Contributors Sch
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-15T08:50:41-07:00 | 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 | Lavelle & Finn LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 29 British American Boulevard | AddressLine1 |
| City | Latham | City |
| State | NY | State |
| ZIP Code | 121101405 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 205221502 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAT CAY MEDICAL CLINIC FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CATC | NameControl |
| Phone | 9543599575 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1050 LEE WAGENER BLVD | AddressLine1 |
| City | FT LAUDERDALE | City |
| State | FL | State |
| ZIP Code | 33315 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOSEPH L POLLIO JR | Name |
| Title | President | Title |
| Date Signed | 2013-05-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN H LAVELLE CPA LLM | Name |
| PTIN | P00063169 | PTIN |
| Phone | 5188696227 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exempt PF | X | ExemptPF |
| FMV Assets EOY | 65223 | FMVAssetsEOY |
| Method Of Accounting Cash | X | MethodOfAccountingCash |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Received Rev And Expnss | 19050 | ContriReceivedRevAndExpnss |
| Interest On Savings Rev And Expnss | 4 | InterestOnSavingsRevAndExpnss |
| Interest On Savings Net Invst Incm | 4 | InterestOnSavingsNetInvstIncm |
| Interest On Savings Adj Net Incm | 4 | InterestOnSavingsAdjNetIncm |
| Total Revenue And Expenses | 19054 | TotalRevenueAndExpenses |
| Total Net Investment Income | 4 | TotalNetInvestmentIncome |
| Total Adjusted Net Income | 4 | TotalAdjustedNetIncome |
| Legal Fees Rev And Expnss | 1710 | LegalFeesRevAndExpnss |
| Legal Fees Dsbrs Chrtbl Prps | 1710 | LegalFeesDsbrsChrtblPrps |
| Deprec And Depletion Rev And Expnss | 4592 | DeprecAndDepletionRevAndExpnss |
| Other Expenses Rev And Expnss | 7896 | OtherExpensesRevAndExpnss |
| Other Expenses Dsbrs Chrtbl Prps | 7829 | OtherExpensesDsbrsChrtblPrps |
| Tot Opr Expenses Rev And Expnss | 14198 | TotOprExpensesRevAndExpnss |
| Tot Opr Expenses Net Invst Incm | 0 | TotOprExpensesNetInvstIncm |
| Tot Opr Expenses Dsbrs Chrtbl Prps | 9539 | TotOprExpensesDsbrsChrtblPrps |
| Contri Gifts Paid Rev And Expnss | 0 | ContriGiftsPaidRevAndExpnss |
| Contri Gifts Paid Dsbrs Chrtbl Prps | 0 | ContriGiftsPaidDsbrsChrtblPrps |
| Total Expenses Rev And Expnss | 14198 | TotalExpensesRevAndExpnss |
| Total Expenses Net Invst Incm | 0 | TotalExpensesNetInvstIncm |
| Total Expenses Dsbrs Chrtbl Prps | 9539 | TotalExpensesDsbrsChrtblPrps |
| Excess Of Revenue Over Expenses | 4856 | ExcessOfRevenueOverExpenses |
| Net Investment Income | 4 | NetInvestmentIncome |
| Adjusted Net Income | 4 | AdjustedNetIncome |
Balance Sheets BalanceSheets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | 35422 | CashBOY |
| Cash EOY | 38450 | CashEOY |
| Cash EOYFMV | 38450 | CashEOYFMV |
| Land Building And Equipment Basis | 31365 | LandBuildingAndEquipmentBasis |
| Accum Deprec Land Bldg And Equip | 14266 | AccumDeprecLandBldgAndEquip |
| Land Building And Equipment BOY | 15272 | LandBuildingAndEquipmentBOY |
| Land Building And Equipment EOY | 17099 | LandBuildingAndEquipmentEOY |
| Land Building And Equipment EOYFMV | 26773 | LandBuildingAndEquipmentEOYFMV |
| Total Assets BOY | 50694 | TotalAssetsBOY |
| Total Assets EOY | 55549 | TotalAssetsEOY |
| Total Assets EOYFMV | 65223 | TotalAssetsEOYFMV |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Org That Do Not Follow SFAS117 | X | OrgThatDoNotFollowSFAS117 |
| Capital Stock BOY | 50694 | CapitalStockBOY |
| Capital Stock EOY | 55549 | CapitalStockEOY |
| Total Net Assets BOY | 50694 | TotalNetAssetsBOY |
| Total Net Assets EOY | 55549 | TotalNetAssetsEOY |
| Total Liabilities Net Assets BOY | 50694 | TotalLiabilitiesNetAssetsBOY |
| Total Liabilities Net Assets EOY | 55549 | TotalLiabilitiesNetAssetsEOY |
Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Net Assets Fund Balances BOY | 50694 | TotalNetAssetsFundBalancesBOY |
| Excess Of Revenue Over Expenses | 4856 | ExcessOfRevenueOverExpenses |
| Subtotal | 55550 | Subtotal |
| Other Decreases | 1 | OtherDecreases |
| Total Net Assets Fund Balances EOY | 55549 | TotalNetAssetsFundBalancesEOY |
Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | 0 | InvestmentIncomeExciseTax |
Statements Regarding Activities StatementsRegardingActivities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Activities | false | LegislativePoliticalActivities |
| More Than100 Spent | false | MoreThan100Spent |
| Form1120 POL Filed | false | Form1120POLFiled |
| Activities Not Prev Reported | false | ActivitiesNotPrevReported |
| Changes To Articles Or Bylaws | false | ChangesToArticlesOrBylaws |
| Unrelated Bus Income Over1000 | false | UnrelatedBusIncomeOver1000 |
| Form990 T Filed | false | Form990TFiled |
| Termination Etc | false | TerminationEtc |
| Requirements Of Sect508e | true | RequirementsOfSect508e |
| At Least5000 In Assets | true | AtLeast5000InAssets |
| States Filed With | SC | StatesFiledWith |
| States Filed With | FL | StatesFiledWith |
| Form990 PF Filed With AG | true | Form990PFFiledWithAG |
| Private Operating Foundation | true | PrivateOperatingFoundation |
| New Substantial Contributors | true | NewSubstantialContributors |
| Interest In Controlled Entity | false | InterestInControlledEntity |
| Applicable Insurance Contract | false | ApplicableInsuranceContract |
| Comply With Public Inspection Rqr | true | ComplyWithPublicInspectionRqr |
| Website Address | N/A | WebsiteAddress |
Books In Care Of Business Name BooksInCareOfBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Vicki L Smith | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Books In Care Of Phone Number | 9543599575 | BooksInCareOfPhoneNumber |
Books In Care Of US Address BooksInCareOfUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1050 LEE WAGENER BLVD | AddressLine1 |
| City | FT LAUDERDALE | City |
| State | FL | State |
| ZIP Code | 33315 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Bank | false | ForeignBank |
Statements Regarding Acty4720 StatementsRegardingActy4720
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exchange With Dsqfly Person | false | SaleOrExchangeWithDsqflyPerson |
| Borrow Or Lend With Dsqfly Person | false | BorrowOrLendWithDsqflyPerson |
| Furnished Goods With Dsqfly Person | true | FurnishedGoodsWithDsqflyPerson |
| Pay Compensation To Dsqfly Person | false | PayCompensationToDsqflyPerson |
| Transfer Assets To Dsqfly Person | false | TransferAssetsToDsqflyPerson |
| Payment To Government Offical | false | PaymentToGovernmentOffical |
| Acts Fail To Qualify As Exceptions | false | ActsFailToQualifyAsExceptions |
| Uncorrected Prior Acts | false | UncorrectedPriorActs |
| Undistributed Income Prior Years | false | UndistributedIncomePriorYears |
| Undistr Income4942a2 Not Applied | false | UndistrIncome4942a2NotApplied |
| Business Holdings | false | BusinessHoldings |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Jeopardy Investments | false | JeopardyInvestments |
| Uncorrected Jeopardy Investments | false | UncorrectedJeopardyInvestments |
| Influence Legislation | false | InfluenceLegislation |
| Influence Election | false | InfluenceElection |
| Grants To Individuals | false | GrantsToIndividuals |
| Grants To Organizations | false | GrantsToOrganizations |
| Noncharitable Purpose | false | NoncharitablePurpose |
| Tr Fail To Qualify As Exceptions | false | TrFailToQualifyAsExceptions |
| Maint Expend Responsibility | false | MaintExpendResponsibility |
| Rcv Funds To Pay Prsnl Bnft Contract | false | RcvFundsToPayPrsnlBnftContract |
| Pay Premiums Prsnl Bnft Contract | false | PayPremiumsPrsnlBnftContract |
| Prohibited Tax Shelter Transactn | false | ProhibitedTaxShelterTransactn |
| Proceeds Or Net Income | false | ProceedsOrNetIncome |
Ofcr Dir Trustees Key Employee Info OfcrDirTrusteesKeyEmployeeInfo
Ofcr Dir Trustees Or Key Employee OfcrDirTrusteesOrKeyEmployee (4 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | TitleTitle | Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition | CompensationCompensation |
|---|---|---|---|---|---|---|
| ROCHELLE HIGGS | ||||||
| 1050 LEE WAGENER BLVD 106 | FT LAUDERDALE | FL | 33315 | Director | 0.00 | 0 |
| JORGE FREELAND | ||||||
| 8901 HAMMOCK LAKE COURT | CORAL GABLES | FL | 33156 | Secretary | 0.00 | 0 |
| DR KEVIN HUTTON | ||||||
| 312 SOUTH CEDROS AVENUE 322 | SOLANA BEACH | CA | 920751981 | Director | 0.00 | 0 |
| JEFFREY J HICKS | ||||||
| 1040 ALFONSO AVENUE | CORAL GABLES | FL | 33146 | President | 0.00 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Highest Paid Empl NONE | NONE | CompOfHighestPaidEmplNONE |
| Comp Of Hghst Paid Cntrct NONE | NONE | CompOfHghstPaidCntrctNONE |
Summary Of Direct Charitable Acty SummaryOfDirectCharitableActy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | OPERATE A SMALL MEDICAL CLINIC THAT PROVIDES PRIMARY CARE AND EMERGENCY STABILIZATION CARE TO A REMOTE CAY IN THE NORTHERN BAHAMAS. | Description1 |
| Expenses1 | 0 | Expenses1 |
Minimum Investment Return MinimumInvestmentReturn
| Field | Value | IRS element (for citing) |
|---|---|---|
| Avg Monthly FMV Of Securities | 0 | AvgMonthlyFMVOfSecurities |
| Avg Monthly Cash Balances | 43910 | AvgMonthlyCashBalances |
| FMV All Other Noncharitable Assets | 0 | FMVAllOtherNoncharitableAssets |
| Total FMV Of Unused Assets | 43910 | TotalFMVOfUnusedAssets |
| Reduction Claimed | 0 | ReductionClaimed |
| Adj Total FMV Of Unused Assets | 43910 | AdjTotalFMVOfUnusedAssets |
| Cash Deemed Charitable | 659 | CashDeemedCharitable |
| Net Noncharitable Assets | 43251 | NetNoncharitableAssets |
| Minimum Investment Return | 2163 | MinimumInvestmentReturn |
Distributable DistributableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sect4942j3j5 Fndtn And Frgn Org | X | Sect4942j3j5FndtnAndFrgnOrg |
Qualifying Distributions QualifyingDistributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | 9539 | ExpensesAndContributions |
| Qualifying Distributions | 9539 | QualifyingDistributions |
| Adj Qualifying Distributions | 9539 | AdjQualifyingDistributions |
Private Operating Foundations PrivateOperatingFoundations
| Field | Value | IRS element (for citing) |
|---|---|---|
| Date Of Ruling | 2010-07-20 | DateOfRuling |
| Section4942j3 | X | Section4942j3 |
Lessor Adj Net Incm Min Invst Return LessorAdjNetIncmMinInvstReturn
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | 4 | CurrentYear |
| Total | 4 | Total |
Percent85 Of Lessor Percent85OfLessor
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | 3 | CurrentYear |
| Total | 3 | Total |
Qualifying Distributions QualifyingDistributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | 9539 | CurrentYear |
| Year1 | 18183 | Year1 |
| Year2 | 9946 | Year2 |
| Total | 37668 | Total |
Qlfy Distri Made Directly QlfyDistriMadeDirectly
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | 9539 | CurrentYear |
| Year1 | 18183 | Year1 |
| Year2 | 9946 | Year2 |
| Total | 37668 | Total |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Year1 | 54259 | Year1 |
| Year2 | 57546 | Year2 |
| Year3 | 50000 | Year3 |
| Total | 161805 | Total |
Total Assets Sect4942j3 Bi TotalAssetsSect4942j3Bi
| Field | Value | IRS element (for citing) |
|---|---|---|
| Year1 | 54259 | Year1 |
| Year2 | 57546 | Year2 |
| Year3 | 50000 | Year3 |
| Total | 161805 | Total |
Two Thirds Min Invst Return TwoThirdsMinInvstReturn
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Supplementary Information SupplementaryInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contributes To Preselected | X | OnlyContributesToPreselected |
Analysis Income Producing Acty AnalysisIncomeProducingActy
Int On Savings And Temp Cash Invst IntOnSavingsAndTempCashInvst
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion Code | 14 | ExclusionCode |
| Exclusion | $4 | ExclusionAmount |
Subtotals Part XVIA SubtotalsPartXVIA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | $4 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Part XVIA | 4 | TotalPartXVIA |
Trnsfr Tr Rln With Noncharitable EO TrnsfrTrRlnWithNoncharitableEO
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Noncharitable EO | false | TrnsfrOfCashToNoncharitableEO |
| Trnsfr Oth Assets Noncharitable EO | false | TrnsfrOthAssetsNoncharitableEO |
| Sales Or Exchanges Of Assets | false | SalesOrExchangesOfAssets |
| Purchase Assets Noncharitable EO | false | PurchaseAssetsNoncharitableEO |
| Rental Of Facilities Etc | false | RentalOfFacilitiesEtc |
| Reimbursement Arrangements | false | ReimbursementArrangements |
| Loans Or Loan Guarantees | false | LoansOrLoanGuarantees |
| Performance Of Services Etc | false | PerformanceOfServicesEtc |
| Sharing Of Facilities Etc | false | SharingOfFacilitiesEtc |
| Relationships Noncharitable E Os | false | RelationshipsNoncharitableEOs |
Schedule B IRS990ScheduleB
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | X | Organization501c3ExemptPF |
| General Rule | X | GeneralRule |
Contributor Info ContributorInfo (2 entries)
| Contributor NumberContributorNumber | Contributor Name IndividualContributorNameIndividual | Address Line1ContributorAddressUS/AddressLine1 | CityContributorAddressUS/City | StateContributorAddressUS/State | ZIP CodeContributorAddressUS/ZIPCode | Aggregate ContributionsAggregateContributions | Person Contribution TypePersonContributionType |
|---|---|---|---|---|---|---|---|
| 2 | Life's Requite Inc | 15900 Gulf Blvd | Redington Beach | FL | 33708 | 10000 | X |
| 1 | Kazickas Family Foundation Inc | 120 East 38th Street | New York | NY | 10016 | 5000 | X |
Depreciation Schedule DepreciationSchedule
Depreciation Depreciation (2 entries)
| Description Of PropertyDescriptionOfProperty | Date AcquiredDateAcquired | Cost Or Other BasisCostOrOtherBasis | Computation MethodComputationMethod | RateRate | Current Year ExpenseCurrentYearExpense | Prior Years DepreciationPriorYearsDepreciation |
|---|---|---|---|---|---|---|
| SAFETY EQUIPMENT | 2012-11-20 | 6419 | 57 | 0.0357 | 229 | |
| SONOSITE MED. EQUIPMENT | 2010-03-15 | 24946 | 57 | 0.1749 | 4363 | 9674 |
Land Etc Schedule2 LandEtcSchedule2
Land Etc LandEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category Or Item | Machinery and Equipment | CategoryOrItem |
| Cost Or Other Basis | 31365 | CostOrOtherBasis |
| Accumulated Depreciation | 14266 | AccumulatedDepreciation |
| Book Value | 17099 | BookValue |
| EOYFMV | 26773 | EOYFMV |
Legal Fees Schedule LegalFeesSchedule
Legal Fees LegalFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | LAVELLE & FINN, LLP | Category |
| Amount | $1,710 | Amount |
| Net Investment Income | 0 | NetInvestmentIncome |
| Adjusted Net Income | 0 | AdjustedNetIncome |
| Disbursements Charitable Prps | 1710 | DisbursementsCharitablePrps |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases OtherDecreases
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Rounding | Description |
| Amount | $1 | Amount |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | Revenue And Expenses Per BooksRevenueAndExpensesPerBooks | Disbursements Charitable PrpsDisbursementsCharitablePrps |
|---|---|---|
| Wachovia Bank Fee - acct closed | 61 | |
| SUPPLIES | 3354 | 3354 |
| Licenses, Permits & Fees | 225 | 225 |
| INSURANCE | 4250 | 4250 |
| BANK SERVICE CHARGES | 6 |
Substantial Contributors Sch SubstantialContributorsSch
Substantial Contributor SubstantialContributor (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode |
|---|---|---|---|
| Life's Requite Inc | |||
| 15900 Gulf Blvd | Redington Beach | FL | 33708 |
| Kazickas Family Foundation Inc | |||
| 120 East 38th Street | New York | NY | 10016 |