ROME-FLOYD CANCER INITIATIVE INC: Form 990EZ, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- ROME-FLOYD CANCER INITIATIVE INC (EIN 02-0657613)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-05-14
- IRS object ID
- 201241359349202609
- 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 | 2012-05-14T14:32:11-05:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 542079099 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WHITTINGTON JONES & RUDERT CPAS PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1264 | AddressLine1 |
| City | ROME | City |
| State | GA | State |
| ZIP Code | 301621264 | 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 | 020657613 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROME FLOYD CANCER INITIATIVE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ROME | NameControl |
| Phone | 7062956048 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 96 EAST CALLAHAN ST NO 479-01 | AddressLine1 |
| City | ROME | City |
| State | GA | State |
| ZIP Code | 301615473 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DR JOE BURCH | Name |
| Title | PRESIDENT | Title |
| Phone | 7062956048 | Phone |
| Date Signed | 2012-04-30 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LISA MCWHORTER | Name |
| PTIN | P01044722 | PTIN |
| Phone | 7062347571 | Phone |
| Date Prepared | 2012-04-30 | 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 | 36570 | GrossReceipts |
| Info In Schedule O Part I | X | InfoInScheduleOPartI |
| Contributions Gifts Grants Etc | 36440 | ContributionsGiftsGrantsEtc |
| Investment Income | 130 | InvestmentIncome |
| Total Revenue | 36570 | TotalRevenue |
| Grants And Similar Amounts Paid | 10000 | GrantsAndSimilarAmountsPaid |
| Fees And Oth Pymt To Ind Contractors | 10845 | FeesAndOthPymtToIndContractors |
| Printing Publications Postage | 3353 | PrintingPublicationsPostage |
| Other Expenses Total | 7600 | OtherExpensesTotal |
| Total Expenses | 31798 | TotalExpenses |
| Excess Or Deficit For Year | 4772 | ExcessOrDeficitForYear |
| Net Assets Or Fund Balances BOY | 22792 | NetAssetsOrFundBalancesBOY |
| Other Changes In Net Assets | 0 | OtherChangesInNetAssets |
| Net Assets Or Fund Balances EOY | 27564 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part II | X | InfoInScheduleOPartII |
Cash Savings And Investments CashSavingsAndInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27542 | BOY |
| EOY | 29314 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27542 | BOY |
| EOY | 29314 | EOY |
Sum Of Total Liabilities SumOfTotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4750 | BOY |
| EOY | 1750 | EOY |
Net Assets Or Fund Balances NetAssetsOrFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22792 | BOY |
| EOY | 27564 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Primary Exempt Purpose | TO IMPROVE CANCER AWARENESS AND EDUCATION AND THE QUALITY AND AVAILABILITY OF CANCER CARE FOR THOSE RESIDING IN AND AROUND NORTHWEST GEORGIA. | PrimaryExemptPurpose |
Program Service Accomplishment ProgramServiceAccomplishment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Service Accom | PROVIDE FINANCIAL AND ADMINISTRATIVE SUPPORT TO NORTHWEST GA REGIONAL CANCER COALITION | DescriptionProgramServiceAccom |
| Grants And Allocations | 0 | GrantsAndAllocations |
| Program Service Expenses | 31798 | ProgramServiceExpenses |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | 31798 | TotalProgramServiceExpenses |
Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (12 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 |
|---|---|---|---|---|---|---|---|---|
| DR JOE BURCH | ||||||||
| 1104 MARTHA BERRY BLVD | ROME | GA | 30165 | PRESIDENT | 1.00 | 0 | 0 | 0 |
| DR RUSTY ROBERTS | ||||||||
| 1104 MARTHA BERRY BLVD | ROME | GA | 30165 | DIRECTOR | 1.00 | 0 | 0 | 0 |
| DR TOMMY SIMPSON | ||||||||
| 318 WEST 5TH STREET | ROME | GA | 30165 | DIRECTOR | 1.00 | 0 | 0 | 0 |
| JOHN QUINLIVAN | ||||||||
| PO BOX 107001 | ROME | GA | 30164 | DIRECTOR | 1.00 | 0 | 0 | 0 |
| DR RICK SWIGER | ||||||||
| 311 WEST EIGHTH STREET | ROME | GA | 30161 | DIRECTOR | 1.00 | 0 | 0 | 0 |
| DR MATT MUMBER | ||||||||
| 321 WEST 5TH STREET | ROME | GA | 30161 | MEDICAL ADVISOR | 1.00 | 0 | 0 | 0 |
| DR CHRIS KILGORA | ||||||||
| 311 WEST EIGHTH STREET | ROME | GA | 30161 | DIRECTOR | 1.00 | 0 | 0 | 0 |
| DANNY SMITH | ||||||||
| PO BOX 107001 | ROME | GA | 30164 | SECRETARY/TREASURER | 1.00 | 0 | 0 | 0 |
| DR JC ABDOU | ||||||||
| 321 WEST 5TH STREET | ROME | GA | 30161 | VICE CHAIRMAN | 1.00 | 0 | 0 | 0 |
| KURT STUENKEL | ||||||||
| PO BOX 233 | ROME | GA | 30161 | DIRECTOR | 1.00 | 0 | 0 | 0 |
| DAN SEWITZER | ||||||||
| PO BOX 233 | ROME | GA | 30161 | CHAIRMAN | 1.00 | 0 | 0 | 0 |
| LISA GREEBY | ||||||||
| 96 EAST CALLAHAN ST | ROME | GA | 30161 | DIRECTOR | 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 | GENA AGNEW | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 96 EAST CALLAHAN STREET | AddressLine1 |
| City | ROME | City |
| State | GA | State |
| ZIP Code | 30161 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7062956048 | 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) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type2 | X | SupportingOrg509a3Type2 |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHWEST GEORGIA REGIONAL CANCER COALITION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020657616 | EIN |
| Type Of Organization | 12 | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| Supported Organization Notified | 0 | SupportedOrganizationNotified |
| Organized In US | 0 | OrganizedInUS |
| Amount | $10,000 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 10000 | SumOfAmounts |
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 (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| OTHER INVESTMENT INCOME | FORM 990-EZ, PART I, LINE 4 | INTEREST 130.. |
| PAYMENTS TO AFFILIATES | FORM 990-EZ, PART I, LINE 10 | AFFILIATE NAME: NORTHWEST GEORGIA CANCER COALITION, INC.. AFFILIATE ADDRESS: 96 EAST CALLAHAN ST ROME, GA 30161-5473. PURPOSE OF PAYMENT: PROVIDED FINANCIAL AND ADMINISTRATIVE SUPPORT TO NORTHWEST GEORGIA REGIONAL. AMOUNT OF PAYMENT: 10000. |
| OTHER EXPENSES | FORM 990-EZ, PART I, LINE 16 | DESCRIPTION: LICENSES AND PERMITS. AMOUNT: 50. DESCRIPTION: MAGNOLIA FOUNDATION. AMOUNT: 544. DESCRIPTION: BANK CHARGES. AMOUNT: 6. DESCRIPTION: MAGNOLIA COLORECTAL SCREENING. AMOUNT: 7000. TOTAL TO FORM 990-EZ, LINE 16: 7600. |
| OTHER LIABILITIES | FORM 990-EZ, PART II, LINE 26 | DESCRIPTION: DEFFERED REVENUE. BEG. OF YEAR AMOUNT: 4750. END OF YEAR AMOUNT: 1750. |
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 |