LAKE AREA FREE CLINIC INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- LAKE AREA FREE CLINIC INC (EIN 39-2006388)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-08-16
- IRS object ID
- 201212299349300721
- 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 | 2012-08-16T08:58:42-07:00 | 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 | WINTER KLOMAN MOTER AND REPP SC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1040 OCONOMOWOC PKWY | AddressLine1 |
| City | OCONOMOWOC | City |
| State | WI | State |
| ZIP Code | 53066 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 392006388 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKE AREA FREE CLINIC INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LAKE | NameControl |
| Phone | 2625694990 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 856 Armour Road | AddressLine1 |
| City | OCONOMOWOC | City |
| State | WI | State |
| ZIP Code | 53066 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | AMANDA MCNUTT | Name |
| Title | Treasurer | Title |
| Date Signed | 2012-08-16 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | James K Holsen CPA | Name |
| Phone | 2625676540 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MARY REICH | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | W356 ALLEN RD | AddressLine1 |
| City | OCONOMOWOC | City |
| State | WI | State |
| ZIP Code | 53066 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 446414 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.lakeareafreeclinic.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2001 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE MEDICAL ATTENTION TO THE UNINSURED MEMBERS OF THE COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 28 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 5 | TotalNbrEmployees |
| Total Nbr Volunteers | 200 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 310796 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 294233 | ContributionsGrantsCurrentYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 996 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1131 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 61571 | OtherRevenuePriorYear |
| Other Revenue Current Year | 88016 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 373363 | TotalRevenuePriorYear |
| Total Revenue Current Year | 383380 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 120416 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 125794 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 6144 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 199191 | OtherExpensePriorYear |
| Other Expenses Current Year | 206572 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 319607 | TotalExpensesPriorYear |
| Total Expenses Current Year | 332366 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 53756 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 51014 | RevenuesLessExpensesCY |
| Total Assets BOY | 460527 | TotalAssetsBOY |
| Total Assets EOY | 511541 | TotalAssetsEOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 460527 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 511541 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE MEDICAL ATTENTION TO THE UNINSURED MEMBERS OF THE COMMUNITY. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 279935 | Expense |
| Description | DURING THE YEAR, OVER 4,720 PATIENTS WHO WHERE UNINSURED WERE GIVEN MEDICAL ATTENTION. | Description |
| Total Program Service Expense | 279935 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | 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 | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | 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 | true | 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 |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| 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 |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 4 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | false | ComplianceWithBackupWitholding |
| Number Of Employees | 5 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Form990-T Filed | false | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Form8886 T Filed | false | Form8886TFiled |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Non Deductible Disclosure | false | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Licensed More Than One State | false | LicensedMoreThanOneState |
| Indoor Tanning Services | false | IndoorTanningServices |
| Form720 Filed | false | Form720Filed |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 28 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | 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 | false | MinutesOfGoverningBody |
| Minutes Of Committees | false | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Policies Reference Chapters | false | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | false | RegularMonitoringEnforcement |
| Whistleblower Policy | false | WhistleblowerPolicy |
| Document Retention Policy | false | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | AMANDA MCNUTT | NamePerson |
| Telephone Number | 2625676540 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1040 OCONOMOWOC PARKWAY | AddressLine1 |
| City | OCONOMOWOC | City |
| State | WI | State |
| ZIP Code | 53066 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (28 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| Mark Zwaska | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Thomas Schroeder MD | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| MARY REICH | ||||||
| Executive Direc | 40.00 | X | 65920 | 0 | 0 | |
| KAREN JENSEN | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Shannon Sander | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| SANDRA STEARNS | ||||||
| V. Chairperson | 1.00 | X | 0 | 0 | 0 | X |
| SETH TEIGEN | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| WAYNE EUCLIDE | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| SALLY CHRISTIANSEN | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| DONNA VOIGT | ||||||
| CHAIRPERSON | 5.00 | X | 18020 | 0 | 0 | X |
| MAUREEN STAPLETON | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| CURT NEUDECKER | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| DR PETER GEISS | ||||||
| MEDICAL DIRECT | 5.00 | X | 0 | 0 | 0 | |
| MICHAEL RODE | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| MARY RODE | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| SUSAN RUSSLER MD | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| Kathy McCann | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| JAN NAVIN | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| Ellyn Helberg | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Rev David Dukovan | ||||||
| Secretary | 1.00 | X | 0 | 0 | 0 | |
| GINA MAGNUS | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| ELIZABETH SCHUMACHER | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| DAN MILLER MD | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| CHRIS BOTH | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| AMANDA MCNUTT | ||||||
| Treasurer | 5.00 | X | 0 | 0 | 0 | X |
| CORTNEY EWALD-IHDE | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| Dan Bonk | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| NICK ARGEROUDIS | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 83940 | TotalReportableCompFromOrg |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| All Other Contributions | 294233 | AllOtherContributions |
| Total Contributions | 294233 | TotalContributions |
| Total Program Service Revenue | 0 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1129 | TotalRevenueColumn |
| Exclusion | $1,129 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 46291 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 46289 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 104761 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 16745 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 88016 | TotalRevenueColumn |
| Exclusion | $88,016 | ExclusionAmount |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 383380 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2 | RelatedOrExemptFunctionIncome |
| Exclusion | $89,145 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18020 | Total |
| Program Services | 18020 | ProgramServices |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 92862 | Total |
| Program Services | 59902 | ProgramServices |
| Management And General | 32960 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5306 | Total |
| Program Services | 2653 | ProgramServices |
| Management And General | 2653 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9606 | Total |
| Program Services | 6751 | ProgramServices |
| Management And General | 2855 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3300 | Total |
| Program Services | 1100 | ProgramServices |
| Management And General | 1100 | ManagementAndGeneral |
| Fundraising | 1100 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7096 | Total |
| Program Services | 3548 | ProgramServices |
| Management And General | 3548 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 41802 | Total |
| Program Services | 41802 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2000 | Total |
| Program Services | 2000 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12737 | Total |
| Program Services | 12737 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3189 | Total |
| Program Services | 3189 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | FundraisingFundraising | Management And GeneralManagementAndGeneral |
|---|---|---|---|---|
| REPAIRS & MAINTENANCE | 5502 | 5502 | ||
| PROMOTIONAL ACTIVITIES | 3984 | 3984 | ||
| MEDICAL SUPPLIES | 117400 | 117400 | ||
| INTERPRETER | 3290 | 3290 | ||
| BANK & CREDIT CARD FEES | 2588 | 2588 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3684 | Total |
| Program Services | 2041 | ProgramServices |
| Management And General | 583 | ManagementAndGeneral |
| Fundraising | 1060 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 332366 | Total |
| Program Services | 279935 | ProgramServices |
| Management And General | 46287 | ManagementAndGeneral |
| Fundraising | 6144 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 266900 | BOY |
| EOY | 167333 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58282 | BOY |
| EOY | 219005 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 132776 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 34910 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 107469 | BOY |
| EOY | 97866 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27876 | BOY |
| EOY | 27337 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 460527 | BOY |
| EOY | 511541 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 389541 | BOY |
| EOY | 434221 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 70986 | BOY |
| EOY | 77320 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 460527 | BOY |
| EOY | 511541 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 460527 | BOY |
| EOY | 511541 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 51014 | ReconcilationRevenueExpenses |
| Method Of Accounting Cash | X | MethodOfAccountingCash |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | false | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| 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 | 178382 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 342475 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 372244 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 310796 | CurrentTaxYearMinus1Year |
| Current Tax Year | 294233 | CurrentTaxYear |
| Total | 1498130 | 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 | 178382 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 342475 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 372244 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 310796 | CurrentTaxYearMinus1Year |
| Current Tax Year | 294233 | CurrentTaxYear |
| Total | 1498130 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 0 | AmountsSubstContributorsTotal |
| Public Support Total170 | 1498130 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 5908 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3936 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1638 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 935 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1129 | CurrentTaxYear |
| Total | 13546 | Total |
Net UBI NetUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 1511676 | TotalSupport |
| Public Support Pertcentage170 | 0.99100 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.98850 | 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 D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 101260 | OtherCostOrOtherBasis |
| Depreciation | 15678 | Depreciation |
| Book Value | 85582 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 31516 | OtherCostOrOtherBasis |
| Depreciation | 19232 | Depreciation |
| Book Value | 12284 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 97866 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| SOFTWARE | 8537 |
| ARTWORK | 18800 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 27337 | TotalBookValueOtherAssets |
| Total Revenue | 383380 | TotalRevenue |
| Total Expenses | 332366 | TotalExpenses |
| Excess Or Deficit For Year | 51014 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 51014 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 383380 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 383380 | RevenueSubtotal |
| Total Revenue Per Form990 | 383380 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 332366 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 332366 | ExpensesSubtotal |
| Total Expenses Per Form990 | 332366 | TotalExpensesPerForm990 |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agreement Ref Fundraising | false | AgreementRefFundraising |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GALA | NameOfEvent1 |
| Gross Receipts Event1 | 104761 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 104761 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 16745 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 104761 | GrossReceiptsTotal |
| Gross Revenue Total Events | 104761 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 16745 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 16745 | DirectExpenseSummaryEvents |
| Net Income Summary | 88016 | NetIncomeSummary |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990, Part VI, Line 19 | Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | ALL DOCUMENTS & STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Form 990, Part VI, Line 11 | Form 990, Part VI, Line 11: Form 990 Review Process | FORM 990 IS SUBMITTED TO & REVIEWED BY THE GOVERNING BODY AT A BOARD MEETING. |