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ALLIANCE MEDICAL MINISTRY INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
ALLIANCE MEDICAL MINISTRY INC (EIN 56-2168673)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-08-14
IRS object ID
201222279349301187
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

FieldValueIRS element (for citing)
Timestamp2012-08-14T09:47:59-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1GOSPODAREK & DREHER CPA PABusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line14101 LAKE BOONE TRL STE 215AddressLine1
CityRALEIGHCity
StateNCState
ZIP Code27607ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN562168673EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ALLIANCE MEDICAL MINISTRY INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlALLINameControl
Phone9192503320Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 DONALD ROSS DRIVEAddressLine1
CityRALEIGHCity
StateNCState
ZIP Code27610ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSEAN HARRISONName
TitleEXECUTIVE DIRECTORTitle
Phone9192503320Phone
Date Signed2012-08-13DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDAVE GOSPODAREKName
Phone9195109399Phone
Date Prepared2012-08-09DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSEAN R HARRISONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1101 DONALD ROSS DRIVEAddressLine1
CityRALEIGHCity
StateNCState
ZIP Code27610ZIPCode
FieldValueIRS element (for citing)
Gross Receipts2988170GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.ALLIANCEMEDICALMINISTRY.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2000YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE AFFORDABLE PRIMARY MEDICAL CARE TO LOW INCOME, UNINSURED WORKING FAMILIES.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees21TotalNbrEmployees
Total Nbr Volunteers146TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year1687760ContributionsGrantsPriorYear
Contributions Grants Current Year2309866ContributionsGrantsCurrentYear
Program Service Revenue Prior Year588113ProgramServiceRevenuePriorYear
Program Service Revenue CY588966ProgramServiceRevenueCY
Investment Income Prior Year944InvestmentIncomePriorYear
Investment Income Current Year458InvestmentIncomeCurrentYear
Other Revenue Prior Year90059OtherRevenuePriorYear
Other Revenue Current Year85720OtherRevenueCurrentYear
Total Revenue Prior Year2366876TotalRevenuePriorYear
Total Revenue Current Year2985010TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1278592SalariesEtcPriorYear
Salaries Etc Current Year1374814SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year49923TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY10536TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year102271TotalFundrsngExpCurrentYear
Other Expense Prior Year929858OtherExpensePriorYear
Other Expenses Current Year894615OtherExpensesCurrentYear
Total Expenses Prior Year2258373TotalExpensesPriorYear
Total Expenses Current Year2279965TotalExpensesCurrentYear
Revenues Less Expenses Prior Year108503RevenuesLessExpensesPriorYear
Revenues Less Expenses CY705045RevenuesLessExpensesCY
Total Assets BOY5081034TotalAssetsBOY
Total Assets EOY4893761TotalAssetsEOY
Total Liabilities BOY1515224TotalLiabilitiesBOY
Total Liabilities EOY622911TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY3565810NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY4270850NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE AFFORDABLE PRIMARY MEDICAL CARE TO LOW INCOME, UNINSURED WORKING FAMILIES.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense2034603Expense
Revenue588966Revenue
DescriptionPROVIDE MEDICAL SERVICES FOR UNINSURED LOW INCOME INDIVIDUALSDescription
Total Program Service Expense2034603TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10968NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees21NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicyfalseConflictOfInterestPolicy
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledNCStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSEAN R HARRISONNamePerson
Telephone Number9192503394TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1101 DONALD ROSS DRIVEAddressLine1
CityRALEIGHCity
StateNCState
ZIP Code27610ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (15 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
SEAN HARRISON
EXECUTIVE DI40.00XX15000008808
DAVID WILSON
BOARD CHAIR5.00XX000
SUSAN T WEAVER MD
DIRECTOR3.00X000
RICK GANNOTTA
DIRECTOR3.00X000
NEIL MORRIS
TREASURER5.00XX000
DANA SIMPSON JD
SECRETARY3.00XX000
JR SHEARIN
DIRECTOR3.00X000
EILEEN HENDREN
DIRECTOR3.00X000
ROBERT HERRINGTON
DIRECTOR3.00X000
MARC NEWMAN
DIRECTOR3.00X000
JAMIE WINSTON
DIRECTOR3.00X000
RICK MARCOTTE
DIRECTOR3.00X000
STEVEN PEEDIN
DIRECTOR3.00X000
GERALD PETKAU
DIRECTOR3.00X000
BOB VAN WORMER
DIRECTOR3.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org150000TotalReportableCompFromOrg
Total Other Compensation8808TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Fundraising Events440536FundraisingEvents
All Other Contributions1869330AllOtherContributions
Noncash Contributions280468NoncashContributions
Total Contributions2309866TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CONTRACT FEES621110373499373499
PATIENT FEES621110215467215467
FieldValueIRS element (for citing)
Total Program Service Revenue588966TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column458TotalRevenueColumn
Exclusion$458ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real83415Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real1230Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real82185Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column82185TotalRevenueColumn
Exclusion$82,185ExclusionAmount
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events440536CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses1930FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-1930TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUSDescription
Business Code900099BusinessCode
Total Revenue Column5465TotalRevenueColumn
Exclusion$5,465ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue5465TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column2985010TotalRevenueColumn
Related Or Exempt Function Income588966RelatedOrExemptFunctionIncome
Exclusion$88,108ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total150000Total
Program Services139500ProgramServices
Management And General4500ManagementAndGeneral
Fundraising6000Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1044720Total
Program Services971590ProgramServices
Management And General31342ManagementAndGeneral
Fundraising41788Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total31150Total
Program Services28970ProgramServices
Management And General935ManagementAndGeneral
Fundraising1245Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total58802Total
Program Services54686ProgramServices
Management And General1764ManagementAndGeneral
Fundraising2352Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total90142Total
Program Services83833ProgramServices
Management And General2704ManagementAndGeneral
Fundraising3605Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total12345Total
Management And General12345ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total10536Total
Fundraising10536Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total56945Total
Program Services56945ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total14411Total
Program Services4804ProgramServices
Management And General4803ManagementAndGeneral
Fundraising4804Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total27826Total
Management And General27826ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total104370Total
Program Services78277ProgramServices
Management And General26093ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total17785Total
Program Services16541ProgramServices
Management And General533ManagementAndGeneral
Fundraising711Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
TEMPORARY STAFF220464220464
LAB COSTS204526204526
UTILITIES4569445694
REPAIRS & MAINTENANCE44349147831478314783

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total145900Total
Program Services113990ProgramServices
Management And General15463ManagementAndGeneral
Fundraising16447Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total2279965Total
Program Services2034603ProgramServices
Management And General143091ManagementAndGeneral
Fundraising102271Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY603625BOY
EOY438347EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY134395BOY
EOY72081EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY82001BOY
EOY226000EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
EOY634EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY5388BOY
EOY4070EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis4617751LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec465122LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY4255625BOY
EOY4152629EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY5081034BOY
EOY4893761EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY35224BOY
EOY622911EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1480000BOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1515224BOY
EOY622911EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY3565810BOY
EOY4094850EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY176000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3565810BOY
EOY4270850EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5081034BOY
EOY4893761EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses705045ReconcilationRevenueExpenses
Reconcilation Other Changes-5ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2396326CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2483731CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2048726CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1687760CurrentTaxYearMinus1Year
Current Tax Year2309866CurrentTaxYear
Total10926409Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year616226CurrentTaxYearMinus1Year
Current Tax Year588966CurrentTaxYear
Total1205192Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2396326CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2483731CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2048726CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2303986CurrentTaxYearMinus1Year
Current Tax Year2898832CurrentTaxYear
Total12131601Total
FieldValueIRS element (for citing)
Public Support Total50912131601PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years24066CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7923CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2694CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year944CurrentTaxYearMinus1Year
Current Tax Year458CurrentTaxYear
Total36085Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years24066CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7923CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2694CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year944CurrentTaxYearMinus1Year
Current Tax Year458CurrentTaxYear
Total36085Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year78500CurrentTaxYearMinus1Year
Current Tax Year86650CurrentTaxYear
Total165150Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2420392CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2491654CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2051420CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2383430CurrentTaxYearMinus1Year
Current Tax Year2985940CurrentTaxYear
Total12332836Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98370PublicSupportPercentage509
Prior Year Support Percentage0.98800PriorYearSupportPercentage
Investment Income Percentage0.00000InvestmentIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis675000OtherCostOrOtherBasis
Book Value675000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3809364OtherCostOrOtherBasis
Depreciation375092Depreciation
Book Value3434272BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis133387OtherCostOrOtherBasis
Depreciation90030Depreciation
Book Value43357BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings4152629TotalOfBookValueLandBuildings
Total Revenue2985010TotalRevenue
Total Expenses2279965TotalExpenses
Excess Or Deficit For Year705045ExcessOrDeficitForYear
Other-$3OtherAmount
Total Adjustments-3TotalAdjustments
Excess Or Deficit Per FS705042ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt2985010TotRevenueEtcAuditedFinclStmt
Revenue Subtotal2985010RevenueSubtotal
Total Revenue Per Form9902985010TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt2279968TotExpensesEtcAuditedFinclStmt
Other Expenses Included3OtherExpensesIncluded
Expenses Not Rptd F9903ExpensesNotRptdF990
Expenses Subtotal2279965ExpensesSubtotal
Total Expenses Per Form9902279965TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RECONCILIATION OF CHANGES - OTHERSCHEDULE D, PAGE 4, PART XI, LINE 8BOOK / TAX DEPRECIATION DIFFERENCE -3
EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XIII, LINE 2DBOOK / TAX DEPRECIATION DIFFERENCE 3

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1BAND TOGETHERNameOfEvent1
Gross Receipts Event1440536GrossReceiptsEvent1
Charitable Contributions Event1440536CharitableContributionsEvent1
Other Direct Expenses Event11930OtherDirectExpensesEvent1
Gross Receipts Total440536GrossReceiptsTotal
Charitable Contributions Total440536CharitableContributionsTotal
Other Direct Expenses Total Events1930OtherDirectExpensesTotalEvents
Direct Expense Summary Events1930DirectExpenseSummaryEvents
Net Income Summary-1930NetIncomeSummary

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonSEAN HARRISONNamePerson
Base Compensation Filing Org150000BaseCompensationFilingOrg
Deferred Comp Filing Org4308DeferredCompFilingOrg
Nontaxable Benefits Filing Org4500NontaxableBenefitsFilingOrg
Total Compensation Filing Org158808TotalCompensationFilingOrg

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions28NumberOfContributions
Noncash Contribs Rptd F99016708NoncashContribsRptdF990

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions25NumberOfContributions
Noncash Contribs Rptd F990263760NoncashContribsRptdF990
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE 990 WILL BE DISTRIBUTED TO THE BOARD FOR REVIEW AND COMMENT AT THE BOARD MEETING FOLLOWING DISTRIBUTION.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE BOARD HAS OVERSIGHT AND APPROVES EXECUTIVE DIRECTOR COMPENSATION. THE EXECUTIVE DIRECTOR MAKES RECOMMENDATIONS ON KEY EMPLOYEE COMPENSATION WHICH IS APPROVED DURING THE BUDGET PROCESS.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BTHE BOARD HAS OVERSIGHT AND APPROVES EXECUTIVE DIRECTOR COMPENSATION. THE EXECUTIVE DIRECTOR MAKES RECOMMENDATIONS ON KEY EMPLOYEE COMPENSATION WHICH IS APPROVED DURING THE BUDGET PROCESS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST FOR INSPECTION. ALSO THE FINANCIAL STATEMENTS ARE INCLUDED IN THE ANNUAL REPORT SENT IN A NEWSLETTER TO SUPPORTERS(ALSO AVAILABLE UPON REQUEST). THE NEWSLETTER WITH THE ANNUAL REPORT MAY BE DOWNLOADED FROM THE ORGANIZATION'S WEBSITE.