TARAHUMARA CHILDRENS HOSPITAL FUND OF OREGON: Form 990EZ, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- TARAHUMARA CHILDRENS HOSPITAL FUND OF OREGON (EIN 26-1641869)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-14
- IRS object ID
- 201323189349203562
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-14T13:28:07-08:00 | 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 | THOMPSON KESSLER WIEST & BORQUIST PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 SW COLUMBIA STREET SUITE 750 | AddressLine1 |
| City | PORTLAND | City |
| State | OR | State |
| ZIP Code | 972015806 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 261641869 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TARAHUMARA CHILDRENS HOSPITAL FUND | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | TARA | NameControl |
| Phone | 5036594342 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14009 SE MATILDA DR | AddressLine1 |
| City | MILWAUKIE | City |
| State | OR | State |
| ZIP Code | 97267 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | John Brockamp | Name |
| Title | President | Title |
| Date Signed | 2013-11-14 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ROBERT P WIEST | Name |
| PTIN | P00678982 | PTIN |
| Phone | 5032251612 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Cash | X | MethodOfAccountingCash |
| Web Site | http://giveaminute.urself.org | WebSite |
| Organization501c3 | X | Organization501c3 |
| Gross Receipts | 158900 | GrossReceipts |
| Info In Schedule O Part I | X | InfoInScheduleOPartI |
| Contributions Gifts Grants Etc | 124444 | ContributionsGiftsGrantsEtc |
| Cost Other Basis And Sales Expenses | 0 | CostOtherBasisAndSalesExpenses |
| Fundraising Gross Income | 34456 | FundraisingGrossIncome |
| Special Events Direct Expenses | 13983 | SpecialEventsDirectExpenses |
| Special Events Net Income Loss | 20473 | SpecialEventsNetIncomeLoss |
| Cost Of Goods Sold | 0 | CostOfGoodsSold |
| Total Revenue | 144917 | TotalRevenue |
| Grants And Similar Amounts Paid | 161878 | GrantsAndSimilarAmountsPaid |
| Salaries Other Comp Empl Benefits | 8730 | SalariesOtherCompEmplBenefits |
| Printing Publications Postage | 1523 | PrintingPublicationsPostage |
| Other Expenses Total | 5994 | OtherExpensesTotal |
| Total Expenses | 178125 | TotalExpenses |
| Excess Or Deficit For Year | -33208 | ExcessOrDeficitForYear |
| Net Assets Or Fund Balances BOY | 41957 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 8749 | NetAssetsOrFundBalancesEOY |
Cash Savings And Investments CashSavingsAndInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41957 | BOY |
| EOY | 8749 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41957 | BOY |
| EOY | 8749 | EOY |
Net Assets Or Fund Balances NetAssetsOrFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41957 | BOY |
| EOY | 8749 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | TO PROVIDE FINANCIAL ASSISTANCE TO UNDER-PRIVILEGED TARAHUMARA INDIANS. | PrimaryExemptPurpose |
Program Service Accomplishment ProgramServiceAccomplishment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Service Accom | FUNDS ARE USED TO PURCHASE MEDICAL SUPPLIES AND EQUIPMENT, SCHOOL EQUIPMENT, FOOD AND WATER-WELL DRILLING FOR THE BENEFIT OF CHILDREN. ALL DONATIONS GO TO CLINICA SANTA TERESITA IN CREEL, MEXICO. | DescriptionProgramServiceAccom |
| Grants And Allocations | 161878 | GrantsAndAllocations |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | 161878 | TotalProgramServiceExpenses |
| Info In Schedule O Part IV | X | InfoInScheduleOPartIV |
Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (24 entries)
| TitleTitle | Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition | CompensationCompensation |
|---|---|---|
| DAVID KLOSTERMAN | ||
| COO | 7.00 | 7690 |
| DAN RAMIREZ | ||
| Director | 0 | 0 |
| LINDA WEBER | ||
| Director | 0 | 0 |
| MARY PAHL | ||
| Director | 0 | 0 |
| CAROL FELTZ | ||
| Director | 0 | 0 |
| JOAN BETTENDORF | ||
| DIRECTOR | 0 | 0 |
| LESLEY TOWNSEND | ||
| Director | 0 | 0 |
| JANICE PELSTER | ||
| Director | 0 | 0 |
| DAN PAHL | ||
| Director | 0 | 0 |
| LANA MCCULLOUGH | ||
| Director | 0 | 0 |
| NANCILEE BAKER | ||
| Director | 0 | 0 |
| PAT KIRK | ||
| Director | 0 | 0 |
| JULIE FLECK | ||
| Director | 0 | 0 |
| JIM FELTZ | ||
| Director | 0 | 0 |
| CLAIRE CARDER | ||
| Director | 0 | 0 |
| CHRIS BOWDISH | ||
| Director | 0 | 0 |
| CAROL BITZ | ||
| Director | 0 | 0 |
| JERRY BETTENDORF | ||
| Director | 0 | 0 |
| KATHY KESTER | ||
| Director | 0 | 0 |
| PAUL BAKER | ||
| Director | 0 | 0 |
| Peggy K Brockamp | ||
| Secretary | 10.00 | 0 |
| Paul D Kester | ||
| Treasurer | 0 | 0 |
| Rev Theodore Weber | ||
| Vice President | 1.00 | 0 |
| John Brockamp | ||
| President | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRpt |
| Made Changes To Orgnzng Etc Doc | false | MadeChangesToOrgnzngEtcDoc |
| Organization Had UBI | false | OrganizationHadUBI |
| Organization Filed990 T | false | OrganizationFiled990T |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Organization Dissolved Etc | false | OrganizationDissolvedEtc |
| Did Org File Form1120 POL This Year | false | DidOrgFileForm1120POLThisYear |
| Made Loans To From Officers | false | MadeLoansToFromOfficers |
| Initiation Fees And Capital Contri | 0 | InitiationFeesAndCapitalContri |
| Gross Receipts For Public Use | 0 | GrossReceiptsForPublicUse |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTrans |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| States Where Copy Of Return Is Filed | OR | StatesWhereCopyOfReturnIsFiled |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JOHN BROCKAMP | NamePerson |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14009 SE MATILDA DR | AddressLine1 |
| City | MILWAUKIE | City |
| State | OR | State |
| ZIP Code | 97267 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5036594342 | TelephoneNumber |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccount |
| Foreign Office | false | ForeignOffice |
| Maintain Any Donor Advised Funds | false | MaintainAnyDonorAdvisedFunds |
| Does Org Have Hospital | false | DoesOrgHaveHospital |
| Tanning Services Provided | false | TanningServicesProvided |
| Form720 Filed | false | Form720Filed |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction With Control Entity | false | TransactionWithControlEntity |
| Engage Political Cmpgn Activities | false | EngagePoliticalCmpgnActivities |
| Engage In Lobbying Activities | false | EngageInLobbyingActivities |
| Operating School | false | OperatingSchool |
| Trnsfrs Exempt Non Char Related Org | false | TrnsfrsExemptNonCharRelatedOrg |
| Related Org Section527 Org | false | RelatedOrgSection527Org |
| Part VI Of Comp Of Highest Paid Empl | NONE | PartVIOfCompOfHighestPaidEmpl |
| Part VIA Hghst Paid Cntrct Prof Ser | NONE | PartVIAHghstPaidCntrctProfSer |
| Filed Schedule A | true | FiledScheduleA |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | AUCTION | NameOfEvent1 |
| Gross Receipts Event1 | 105036 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 70915 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 34121 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 13983 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 105036 | GrossReceiptsTotal |
| Charitable Contributions Total | 70915 | CharitableContributionsTotal |
| Gross Revenue Total Events | 34121 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 13983 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 13983 | DirectExpenseSummaryEvents |
| Net Income Summary | 20138 | NetIncomeSummary |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990-EZ, Part I, Line 16.3 | Other Expenses.3 | BANK CHARGES $1023 |
| Form 990-EZ, Part I, Line 16.1 | Other Expenses.1 | ADMINISTRATIVE FEES $4971 |
| Form 990-EZ, Part I, Line 10.1 | Grants and Similar Amounts Paid In Excess of $5,000.1 | Class of Activity: GRANT | Donee's Name: CLINICA SANTA TERESITA | Relationship of Donee: N/A | Cash Amount Given: $161878 |