FIVE MOUNTAINS HAWAII INC: Form 990EZ, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- FIVE MOUNTAINS HAWAII INC (EIN 99-0330168)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-07-02
- IRS object ID
- 201201849349200325
- 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 | 2012-07-02T18:52:55-07:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cynthia L Morse CPA | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 65-1291 Kawaihae Road 101D | AddressLine1 |
| City | Kamuela | City |
| State | HI | State |
| ZIP Code | 967438401 | 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 | 990330168 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Five Mountains Hawaii Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | FIVE | NameControl |
| Phone | 8088871284 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 437200 | AddressLine1 |
| City | Kamuela | City |
| State | HI | State |
| ZIP Code | 96743 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Georgine Busch | Name |
| Title | Secretary | Title |
| Date Signed | 2012-07-02 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Cynthia L Morse | Name |
| Phone | 8088854829 | Phone |
| Self Employed | X | SelfEmployed |
| 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 | www.fivemtn.org | WebSite |
| Organization501c3 | X | Organization501c3 |
| Gross Receipts | 190211 | GrossReceipts |
| Info In Schedule O Part I | X | InfoInScheduleOPartI |
| Contributions Gifts Grants Etc | 173924 | ContributionsGiftsGrantsEtc |
| Program Service Revenue | 16218 | ProgramServiceRevenue |
| Investment Income | 69 | InvestmentIncome |
| Cost Other Basis And Sales Expenses | 0 | CostOtherBasisAndSalesExpenses |
| Fundraising Gross Income | 0 | FundraisingGrossIncome |
| Special Events Direct Expenses | 0 | SpecialEventsDirectExpenses |
| Cost Of Goods Sold | 0 | CostOfGoodsSold |
| Total Revenue | 190211 | TotalRevenue |
| Salaries Other Comp Empl Benefits | 149588 | SalariesOtherCompEmplBenefits |
| Fees And Oth Pymt To Ind Contractors | 2083 | FeesAndOthPymtToIndContractors |
| Occupancy Rent Utilities And Maint | 25836 | OccupancyRentUtilitiesAndMaint |
| Printing Publications Postage | 15948 | PrintingPublicationsPostage |
| Other Expenses Total | 1061782 | OtherExpensesTotal |
| Total Expenses | 1255237 | TotalExpenses |
| Excess Or Deficit For Year | -1065026 | ExcessOrDeficitForYear |
| Net Assets Or Fund Balances BOY | 1159778 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 94752 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part II | X | InfoInScheduleOPartII |
Cash Savings And Investments CashSavingsAndInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 186124 | BOY |
| EOY | 85310 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 989950 | BOY |
| EOY | 20624 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1176074 | BOY |
| EOY | 105934 | EOY |
Sum Of Total Liabilities SumOfTotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16296 | BOY |
| EOY | 11182 | EOY |
Net Assets Or Fund Balances NetAssetsOrFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1159778 | BOY |
| EOY | 94752 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | Our mission is to improve community health in the Northwest region of Hawai'iIsland. We do this though collaboration with community organizations to addressidentified areas of critical need. Our most significant activities are currentlyfocused on improving health in youth, ages 11- 18. We promote a bended model ofhealth that includes mind, body, spirit, nature and community wellness. | PrimaryExemptPurpose |
Program Service Accomplishment ProgramServiceAccomplishment (3 entries)
| Description Program Service AccomDescriptionProgramServiceAccom | Grants And AllocationsGrantsAndAllocations |
|---|---|
| Lifeplan Institute Hawaii Island (LIHI) was established as a project of FiveMountains Hawaii in 2010. It is a partnership with the California Mentor Foundation,to address key teen risk factors through youth mentoring. LIHI has a mission to support 5,000 Hawaii Island teens in creating a "Life Plan" by 2015. Teens are lead through a discovery-based learning curriculum in peer groups and then each create plan for their future and form a personal Board of Directors with 5 adult mentors. By 12/31/2011, 500 teams had completed the program. Based on mentoring research, LIHI expects to show a positive impact on several targeted success indicators, including: an increased graduation rate, decreases in substance abuse and teen pregnancy, and increases in attendance in higher education programs. | 55734 |
| Three programs target improving the health of adults and families through education and access to resources that promote healthy lifestyles, good nutrition and physical activity. Get Fit Hawaii is a wellness initiative that promotes healthy lifestyle changes through a community-wide 10 week team competition. Funders have included AlohaCare, Kaiser Permanente, Hawaii Island Beacon Community and Walmart. At the end of 2011 over 1400 people had participated in this program in three years. Results included improved blood pressure, increased physical activity and weight loss. Two related programs provide local resources for finding health practitioners (Ke Kukui Resource Guide). | 12523 |
| The North Hawaii Drug-Free Coalition (NHDFC) is a collaborative program bringingcommunity organizations to effect positive population-based change related tosubstance abuse in youth, using environmental strategies and collective resources.NHDFC has two main goals: 1) Reducing substance abuse in youth and 2) Buildingcapacity within the coalition to increase community collaboration and impact. TheNHDFC network focuses efforts on four North Hawaii communities: Kohala, Hamakua,Waimea and Waikoloa. NHDFC receives federal funding through a drug-free communities(DFC) grant, in its ninth year in 2010, and requires matching funds and in-kind donations. | 210864 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | 279121 | TotalProgramServiceExpenses |
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 |
|---|---|---|---|---|---|---|
| Robin Mullin | ||||||
| 65-1230 Mamalahoa Hwy 20A | Kamuela | HI | 96743 | Executive Direc | 40.00 | 60669 |
| Jeanne Abe | ||||||
| 65-1230 Mamalahoa Hwy 20A | Kamuela | HI | 96743 | Director | 1.00 | 0 |
| Harold Hughes | ||||||
| 65-1230 Mamalahoa Hwy 20A | Kamuela | HI | 96743 | Director | 1.00 | 0 |
| Jean Sunderland | ||||||
| 65-1230 Mamalahoa Hwy 20A | Kamuela | HI | 96743 | Treasurer | 2.00 | 0 |
| Georgine Busch | ||||||
| 65-1230 Mamalahoa Hwy 20A | Kamuela | HI | 96743 | Secretary | 3.00 | 0 |
| Barbara Uechi | ||||||
| 65-1230 Mamalahoa Hwy 20A | Kamuela | HI | 96743 | Vice President | 1.00 | 0 |
| Earl Bakken | ||||||
| 65-1230 Mamalahoa Hwy 20A | Kamuela | HI | 96743 | President | 1.00 | 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 |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Robin Mullin | NamePerson |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 65-1230 Mamalahoa Hwy 20A | AddressLine1 |
| City | Kamuela | City |
| State | HI | State |
| ZIP Code | 96743 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8088871284 | 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) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 363203 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 270876 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 216649 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 228238 | CurrentTaxYearMinus1Year |
| Current Tax Year | 173925 | CurrentTaxYear |
| Total | 1252891 | Total |
Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 363203 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 270876 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 216649 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 228238 | CurrentTaxYearMinus1Year |
| Current Tax Year | 173925 | CurrentTaxYear |
| Total | 1252891 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 431495 | AmountsSubstContributorsTotal |
| Public Support Total170 | 821396 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 979 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 669 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1226 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 315 | CurrentTaxYearMinus1Year |
| Current Tax Year | 69 | CurrentTaxYear |
| Total | 3258 | Total |
Net UBI NetUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 500 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 221 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus1 Year | 6074 | CurrentTaxYearMinus1Year |
| Current Tax Year | 16218 | CurrentTaxYear |
| Total | 23013 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 1279162 | TotalSupport |
| Gross Receipts From Admissions Etc | 141327 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.64210 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.57070 | 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 O IRS990ScheduleO
General Explanation GeneralExplanation (26 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990-EZ, Part II, Line 26.1001 | Total Liabilities.1001 | Accounts Payable and Accrued Expenses - Beginning $16296 Accounts Payable and Accrued Expenses - Ending $11182 |
| Form 990-EZ, Part II, Line 24.2 | Other Assets.2 | Deposits - Beginning $1300 Deposits - Ending $1300 |
| Form 990-EZ, Part II, Line 24.1 | Other Assets.1 | Ben Int Charitable Lead Trust - Beginning $951043 Ben Int Charitable Lead Trust - Ending $0 |
| Form 990-EZ, Part II, Line 24.1011 | Other Assets.1011 | Prepaid Expenses and Deferred Charges - Beginning $1558 Prepaid Expenses and Deferred Charges - Ending $213 |
| Form 990-EZ, Part II, Line 24.1005 | Other Assets.1005 | Accounts Receivable - Beginning $31599 Accounts Receivable - Ending $16493 |
| Form 990-EZ, Part II, Line 24.1003 | Other Assets.1003 | Machinery and Equipment - Beginning $4325 Machinery and Equipment - Ending $2543 |
| Form 990-EZ, Part II, Line 24.1002 | Other Assets.1002 | Furniture and Fixtures - Beginning $125 Furniture and Fixtures - Ending $75 |
| Form 990-EZ, Part I, Line 16.14 | Other Expenses.14 | Volunteer Expense $137 |
| Form 990-EZ, Part I, Line 16.13 | Other Expenses.13 | Misc $329 |
| Form 990-EZ, Part I, Line 16.12 | Other Expenses.12 | Bank Fees $335 |
| Form 990-EZ, Part I, Line 16.11 | Other Expenses.11 | Dues & Subscriptions $840 |
| Form 990-EZ, Part I, Line 16.10 | Other Expenses.10 | Program Activities $957 |
| Form 990-EZ, Part I, Line 16.8 | Other Expenses.8 | Meeting Expense $2517 |
| Form 990-EZ, Part I, Line 16.7 | Other Expenses.7 | Special Events $2807 |
| Form 990-EZ, Part I, Line 16.6 | Other Expenses.6 | Equipment Lease $3108 |
| Form 990-EZ, Part I, Line 16.5 | Other Expenses.5 | Mileage Reimbursement $3260 |
| Form 990-EZ, Part I, Line 16.3 | Other Expenses.3 | Program Materials $19152 |
| Form 990-EZ, Part I, Line 16.2 | Other Expenses.2 | Professional Services $43808 |
| Form 990-EZ, Part I, Line 16.1 | Other Expenses.1 | Change in value of CRT $926705 |
| Form 990-EZ, Part I, Line 16.1012 | Other Expenses.1012 | Insurance $2239 |
| Form 990-EZ, Part I, Line 16.1009 | Other Expenses.1009 | Depreciation $1832 |
| Form 990-EZ, Part I, Line 16.1008 | Other Expenses.1008 | Interest $120 |
| Form 990-EZ, Part I, Line 16.1005 | Other Expenses.1005 | Travel $24469 |
| Form 990-EZ, Part I, Line 16.1003 | Other Expenses.1003 | Information Technology $1786 |
| Form 990-EZ, Part I, Line 16.1002 | Other Expenses.1002 | Office Expenses $7610 |
| Form 990-EZ, Part I, Line 16.1001 | Other Expenses.1001 | Advertising and Promotion $19771 |