GREATER ATLANTA DENTAL FOUNDATION INC: Form 990EZ, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- GREATER ATLANTA DENTAL FOUNDATION INC (EIN 26-2647331)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-05-15
- IRS object ID
- 201201369349202005
- Schema version
- 2011v1.2
- 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 | 2012-05-15T10:46:19-05:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560574444 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHERRY BEKAERT & HOLLAND LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1029 GREENE STREET | AddressLine1 |
| City | AUGUSTA | City |
| State | GA | State |
| ZIP Code | 30901 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 262647331 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREATER ATLANTA DENTAL FOUNDATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | GREA | NameControl |
| Phone | 7702710634 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4850 GOLDEN PARKWAY NO B-417 | AddressLine1 |
| City | BUFORD | City |
| State | GA | State |
| ZIP Code | 305185842 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JW HOLDERFIELD | Name |
| Title | EXECUTIVE DIRECTOR | Title |
| Phone | 7702710634 | Phone |
| Date Signed | 2012-05-10 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ELIZABETH MORRISON | Name |
| PTIN | P00231389 | PTIN |
| Phone | 7067243557 | Phone |
| Date Prepared | 2012-05-10 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Web Site | N/A | WebSite |
| Organization501c3 | X | Organization501c3 |
| Gross Receipts Less Than25000 | X | GrossReceiptsLessThan25000 |
| Gross Receipts | 58334 | GrossReceipts |
| Info In Schedule O Part I | X | InfoInScheduleOPartI |
| Contributions Gifts Grants Etc | 8125 | ContributionsGiftsGrantsEtc |
| Investment Income | 359 | InvestmentIncome |
| Fundraising Gross Income | 49850 | FundraisingGrossIncome |
| Special Events Direct Expenses | 23041 | SpecialEventsDirectExpenses |
| Special Events Net Income Loss | 26809 | SpecialEventsNetIncomeLoss |
| Total Revenue | 35293 | TotalRevenue |
| Grants And Similar Amounts Paid | 15500 | GrantsAndSimilarAmountsPaid |
| Fees And Oth Pymt To Ind Contractors | 725 | FeesAndOthPymtToIndContractors |
| Other Expenses Total | 3157 | OtherExpensesTotal |
| Total Expenses | 19382 | TotalExpenses |
| Excess Or Deficit For Year | 15911 | ExcessOrDeficitForYear |
| Net Assets Or Fund Balances BOY | 39002 | NetAssetsOrFundBalancesBOY |
| Other Changes In Net Assets | 0 | OtherChangesInNetAssets |
| Net Assets Or Fund Balances EOY | 54913 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part II | X | InfoInScheduleOPartII |
Cash Savings And Investments CashSavingsAndInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38402 | BOY |
| EOY | 50733 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 600 | BOY |
| EOY | 4180 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39002 | BOY |
| EOY | 54913 | EOY |
Net Assets Or Fund Balances NetAssetsOrFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39002 | BOY |
| EOY | 54913 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | ENHANCE DENTAL CARE IN THE COMMUNITY | PrimaryExemptPurpose |
Program Service Accomplishment ProgramServiceAccomplishment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Service Accom | OPERATION OF A FREE/LOW COST DENTAL CLINIC ENHANCES HEALTHCARE IN THE COMMUNITY. | DescriptionProgramServiceAccom |
| Grants And Allocations | 0 | GrantsAndAllocations |
| Program Service Expenses | 0 | ProgramServiceExpenses |
Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | TitleTitle | Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition | CompensationCompensation | Contri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtc | Expense Account Other AllowancesExpenseAccountOtherAllowances |
|---|---|---|---|---|---|---|---|---|
| RICHARD SMITH | ||||||||
| 4850 GOLDEN PKWY B-418 | BUFORD | GA | 30518 | TRUSTEE | 1.00 | 0 | 0 | 0 |
| TOM JAGOR | ||||||||
| 4850 GOLDEN PKWY B-418 | BUFORD | GA | 30518 | TREASURER | 1.00 | 0 | 0 | 0 |
| ROBERT O'DONNELL | ||||||||
| 4850 GOLDEN PKWY B-418 | BUFORD | GA | 30518 | PRESIDENT | 1.00 | 0 | 0 | 0 |
| CHRIS ADKINS | ||||||||
| 4850 GOLDEN PKWY B-418 | BUFORD | GA | 30518 | VICE PRESIDENT | 1.00 | 0 | 0 | 0 |
| BEN JERNIGAN | ||||||||
| 4850 GOLDEN PKWY B-418 | BUFORD | GA | 30518 | SECRETARY | 1.00 | 0 | 0 | 0 |
| JOHN MUSE | ||||||||
| 4850 GOLDEN PKWY B-418 | BUFORD | GA | 30518 | TRUSTEE | 1.00 | 0 | 0 | 0 |
| SIDNEY TOURIAL | ||||||||
| 4850 GOLDEN PKWY B-418 | BUFORD | GA | 30518 | TRUSTEE | 1.00 | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRpt |
| Made Changes To Orgnzng Etc Doc | 0 | MadeChangesToOrgnzngEtcDoc |
| Organization Had UBI | 0 | OrganizationHadUBI |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtc |
| Direct Indirect Political Expend | 0 | DirectIndirectPoliticalExpend |
| Made Loans To From Officers | 0 | MadeLoansToFromOfficers |
| Tax Imposed Under IRC4911 | 0 | TaxImposedUnderIRC4911 |
| Tax Imposed Under IRC4912 | 0 | TaxImposedUnderIRC4912 |
| Tax Imposed Under IRC4955 | 0 | TaxImposedUnderIRC4955 |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTrans |
| Amount Of Tax Imposed On Org Mgr | 0 | AmountOfTaxImposedOnOrgMgr |
| Amount Of Tax Reimbursed By Org | 0 | AmountOfTaxReimbursedByOrg |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| States Where Copy Of Return Is Filed | GA | StatesWhereCopyOfReturnIsFiled |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | J W HOLDERFIELD | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4850 GOLDEN PARKWAY B-417 | AddressLine1 |
| City | BUFORD | City |
| State | GA | State |
| ZIP Code | 30518 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7702710453 | TelephoneNumber |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Foreign Office | 0 | ForeignOffice |
| Maintain Any Donor Advised Funds | 0 | MaintainAnyDonorAdvisedFunds |
| Does Org Have Hospital | 0 | DoesOrgHaveHospital |
| Tanning Services Provided | 0 | TanningServicesProvided |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Engage Political Cmpgn Activities | 0 | EngagePoliticalCmpgnActivities |
| Engage In Lobbying Activities | 0 | EngageInLobbyingActivities |
| Operating School | 0 | OperatingSchool |
| Trnsfrs Exempt Non Char Related Org | 0 | TrnsfrsExemptNonCharRelatedOrg |
| Part VI Of Comp Of Highest Paid Empl | NONE | PartVIOfCompOfHighestPaidEmpl |
| Part VIA Hghst Paid Cntrct Prof Ser | NONE | PartVIAHghstPaidCntrctProfSer |
| Filed Schedule A | 1 | FiledScheduleA |
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 Minus2 Years | 65675 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 62752 | CurrentTaxYearMinus1Year |
| Current Tax Year | 8125 | CurrentTaxYear |
| Total | 136552 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 65675 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 62752 | CurrentTaxYearMinus1Year |
| Current Tax Year | 8125 | CurrentTaxYear |
| Total | 136552 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 136552 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 106 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 238 | CurrentTaxYearMinus1Year |
| Current Tax Year | 359 | CurrentTaxYear |
| Total | 703 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 137255 | TotalSupport |
| Gross Receipts From Admissions Etc | 79744 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.99490 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.99730 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Special Fundraising Events | X | SpecialFundraisingEvents |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GALA FOR SMILES | NameOfEvent1 |
| Gross Receipts Event1 | 49850 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 49850 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 23041 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 49850 | GrossReceiptsTotal |
| Gross Revenue Total Events | 49850 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 23041 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 23041 | DirectExpenseSummaryEvents |
| Net Income Summary | 26809 | NetIncomeSummary |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| OTHER INVESTMENT INCOME | FORM 990-EZ, PART I, LINE 4 | INTEREST INCOME 359.. |
| GRANTS AND SIMILAR AMOUNTS PAID | FORM 990-EZ, PART I, LINE 10 | ACTIVITY CLASSIFICATION: FREE DENTAL CLINIC. GRANTEE NAME: DDD FOUNDATION. GRANTEE ADDRESS: 52 EXECUTIVE PARK SOUTH NE, ATLANTA, GA 30329. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 12/09/11. AMOUNT GIVEN: 2,000. |
| GRANTS AND SIMILAR AMOUNTS PAID | FORM 990-EZ, PART I, LINE 10 | ACTIVITY CLASSIFICATION: FREE DENTAL CLINIC. GRANTEE NAME: GOOD SAMARITAN HEALTH CENTER. GRANTEE ADDRESS: 1015 DONALD LEE HOLLOWELL PKWY. ATLANTA, GA 30329. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 12/09/11. AMOUNT GIVEN: 3,000. |
| GRANTS AND SIMILAR AMOUNTS PAID | FORM 990-EZ, PART I, LINE 10 | ACTIVITY CLASSIFICATION: FREE DENTAL CLINIC. GRANTEE NAME: GREEN WARREN DENTAL CLINIC. GRANTEE ADDRESS: 810 PINE ST., GAINESVILLE , GA 30501. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 12/09/11. AMOUNT GIVEN: 4,000. |
| GRANTS AND SIMILAR AMOUNTS PAID | FORM 990-EZ, PART I, LINE 10 | ACTIVITY CLASSIFICATION: FREE DENTAL CLINIC. GRANTEE NAME: HEBRON DENTAL CLINIC . GRANTEE ADDRESS: 1000 MEDICAL CENTER BLVD. LAWRENCEVILLE, GA 30046. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 12/09/11. AMOUNT GIVEN: 1,000. |
| GRANTS AND SIMILAR AMOUNTS PAID | FORM 990-EZ, PART I, LINE 10 | ACTIVITY CLASSIFICATION: FREE DENTAL CLINIC. GRANTEE NAME: ST. JOSEPH'S MERCY CLINIC. GRANTEE ADDRESS: 424 DECATUR STREET ATLANTA, GA 30312. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 12/09/11. AMOUNT GIVEN: 3,000. |
| GRANTS AND SIMILAR AMOUNTS PAID | FORM 990-EZ, PART I, LINE 10 | ACTIVITY CLASSIFICATION: FREE DENTAL CLINIC. GRANTEE NAME: BEN MASSELL FOUNDATION. GRANTEE ADDRESS: 700 FOURTEENTH STREET ATLANTA, GA 30318. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 12/09/11. AMOUNT GIVEN: 2,500. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 15,500. |
| OTHER EXPENSES | FORM 990-EZ, PART I, LINE 16 | DESCRIPTION: CREDIT CARD FEES. AMOUNT: 2,443. DESCRIPTION: MEETINGS. AMOUNT: 664. DESCRIPTION: MISC GALA FOR SMILES EXPENSES. AMOUNT: 50. TOTAL TO FORM 990-EZ, LINE 16: 3,157. |
| OTHER ASSETS | FORM 990-EZ, PART II, LINE 24 | DESCRIPTION: ACCOUNT RECEIVABLE - 2010 GALA. BEG. OF YEAR AMOUNT: 600. END OF YEAR AMOUNT: 2,680. DESCRIPTION: DEPOSIT - 2012 GALA. BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: 1,500. |
Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Declaration | THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT. | Declaration |