COMMUNITY HEALTHCARE FOUNDATION INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: COMMUNITY HEALTHCARE FOUNDATION INC (EIN 83-0289853)
Tax period: 2010-01-01 to 2010-12-31
Filed: 2011-05-13
IRS object ID: 201111339349304696
Schema version: 2010v3.2
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
Form 990
Schedule A
Schedule D
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-05-13T14:31:44-07:00	Timestamp
Tax Period End Date	2010-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Dana F Cole & Company LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	121 E 20TH AVE	AddressLine1
City	TORRINGTON	City
State	WY	State
ZIP Code	822402811	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2010-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	830289853	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	COMMUNITY HEALTHCARE FOUNDATION INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	COMM	NameControl
Phone	3075324181	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2000 CAMPBELL DRIVE	AddressLine1
City	TORRINGTON	City
State	WY	State
ZIP Code	82240	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	DARIN YATES	Name
Title	Secretary	Title
Date Signed	2011-05-13	DateSigned

Preparer Preparer

Field	Value	IRS element (for citing)
Name	CAROL S CLARK	Name
Phone	3075324511	Phone

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	DARIN YATES	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	2935 WEST A	AddressLine1
City	TORRINGTON	City
State	WY	State
ZIP Code	82240	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	27059	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
All Affiliates Included	false	AllAffiliatesIncluded
Organization501c3	X	Organization501c3
Web Site	N/A	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1989	YearFormation
State Legal Domicile	WY	StateLegalDomicile
Activity Or Mission Description	THE PRIMARY EXEMPT PURPOSE IS TO RECEIVE AND ADMINISTER FUNDS FOR SCIENTIFIC, EDUCATIONAL, AND CHARITABLE PURPOSES TO SUPPORT AND BENEFIT THE SICK, ILL, AGED, AND INFIRMED AND TO IMPROVE THE HEALTH CARE SERVICES AVAILABLE TO THESE PEOPLE.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	15	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	15	NbrIndependentVotingMembers
Total Nbr Employees	0	TotalNbrEmployees
Total Nbr Volunteers	20	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	23596	ContributionsGrantsPriorYear
Contributions Grants Current Year	7764	ContributionsGrantsCurrentYear
Program Service Revenue CY	0	ProgramServiceRevenueCY
Investment Income Prior Year	6597	InvestmentIncomePriorYear
Investment Income Current Year	6442	InvestmentIncomeCurrentYear
Other Revenue Prior Year	8746	OtherRevenuePriorYear
Other Revenue Current Year	6111	OtherRevenueCurrentYear
Total Revenue Prior Year	38939	TotalRevenuePriorYear
Total Revenue Current Year	20317	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	34098	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	2400	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Current Year	0	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	538	OtherExpensePriorYear
Other Expenses Current Year	682	OtherExpensesCurrentYear
Total Expenses Prior Year	34636	TotalExpensesPriorYear
Total Expenses Current Year	3082	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	4303	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	17235	RevenuesLessExpensesCY
Total Assets BOY	186604	TotalAssetsBOY
Total Assets EOY	203839	TotalAssetsEOY
Total Liabilities EOY	0	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	186604	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	203839	NetAssetsOrFundBalancesEOY
Mission Description	THE PRIMARY EXEMPT PURPOSE IS TO RECEIVE AND ADMINISTER FUNDS FOR SCIENTIFIC, EDUCATIONAL, AND CHARITABLE PURPOSES TO SUPPORT AND BENEFIT THE SICK, ILL, AGED, AND INFIRMED AND TO IMPROVE THE HEALTH CARE SERVICES AVAILABLE TO THESE PEOPLE.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	2400	Expense
Grants	2400	Grants
Description	EQUIPMENT, CASH GRANTS, AND FURNISHINGS PURCHASED FOR COMMUNITY HOSPITAL (NON-PROFIT HOSPITAL),GOSHEN CARE CENTER (COUNTY OWNED NURSING HOME), FORT LARAMIE VOLUNTEER FIRE DEPARTMENT (VOLUNTEER AMBULANCE SERVICE), HAWK SPRINGS AMBULANCE SERVICE (VOLUNTEER AMBULANCE SERVICE), AND UNIVERSITY OF NEBRASKA MEDICAL CENTER (NON-PROFIT MEDICAL SCHOOL).	Description
Total Program Service Expense	2400	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	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	true	TermOrPermanentEndowments
Report Land Bldg Equip	false	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	false	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	false	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	false	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	false	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	false	ComplianceWithBackupWitholding
Number Of Employees	0	NumberOfEmployees
Employment Tax Returns Filed	false	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	15	NbrVotingGoverningBodyMembers
Number Independent Voting Members	15	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	true	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	false	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	false	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	false	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
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	CAROL CLARK	NamePerson
Telephone Number	3075324511	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	121 EAST 20TH AVENUE	AddressLine1
City	TORRINGTON	City
State	WY	State
ZIP Code	82240	ZIPCode

Field	Value	IRS element (for citing)
No Listed Persons Compensated	X	NoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (15 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer
TERRY WAGNER
Director	1.00	X	0	0	0
TENA BALDWIN
Director	1.00	X	0	0	0
STEVE FEAGLER
Director	1.00	X	0	0	0
SANDY BAUGH
Director	1.00	X	0	0	0
PATTY SCHANEMAN
Director	1.00	X	0	0	0
MIKE RAFFERTY
Director	1.00	X	0	0	0
KENDRA STEINMETZ
Director	1.00	X	0	0	0
KENDA KNUDSEN
Director	1.00	X	0	0	0
JOCELYN LEITHEAD
Director	1.00	X	0	0	0
JIM EDDINGTON
Director	1.00	X	0	0	0
JERI COVELLO
Director	1.00	X	0	0	0
EILEEN PATTERSON
President	2.00	X	0	0	0	X
DARIN YATES
Secretary	1.00	X	0	0	0	X
CAROL CLARK
Treasurer	1.00	X	0	0	0	X
BRIDGET SPENCER
Vice President	1.00	X	0	0	0	X

Field	Value	IRS element (for citing)
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
Fundraising Events	210	FundraisingEvents
All Other Contributions	7554	AllOtherContributions
Total Contributions	7764	TotalContributions
Total Program Service Revenue	0	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	6442	TotalRevenueColumn
Exclusion	$6,442	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

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	12853	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	210	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	6742	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	6111	TotalRevenueColumn
Exclusion	$6,111	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	20317	TotalRevenueColumn
Exclusion	$12,553	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	2400	Total
Program Services	2400	ProgramServices

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	0	Total

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	0	Total

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	0	Total

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	0	Total

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	0	Total

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	0	Total

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	307	Total
Management And General	307	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	0	Total

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	0	Total

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	0	Total

Insurance Insurance

Field	Value	IRS element (for citing)
Total	350	Total
Management And General	350	ManagementAndGeneral

Other Expenses OtherExpenses

Field	Value	IRS element (for citing)
Description	CORPORATION LICENSE	Description
Total	25	Total
Management And General	25	ManagementAndGeneral

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	0	Total

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	3082	Total
Program Services	2400	ProgramServices
Management And General	682	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
EOY	0	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	186604	BOY
EOY	203839	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

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
EOY	0	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)
EOY	0	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	186604	BOY
EOY	203839	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	36604	BOY
EOY	53839	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	150000	BOY
EOY	150000	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	186604	BOY
EOY	203839	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	186604	BOY
EOY	203839	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	17235	ReconcilationRevenueExpenses
Method Of Accounting Cash	X	MethodOfAccountingCash
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	false	FSAudited
Audit Committee	false	AuditCommittee
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	6305	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	6857	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	178250	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	23596	CurrentTaxYearMinus1Year
Current Tax Year	7764	CurrentTaxYear
Total	222772	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	6305	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	6857	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	178250	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	23596	CurrentTaxYearMinus1Year
Current Tax Year	7764	CurrentTaxYear
Total	222772	Total

Field	Value	IRS element (for citing)
Amounts Subst Contributors Total	0	AmountsSubstContributorsTotal
Public Support Total170	222772	PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	231	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	222	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	811	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	6597	CurrentTaxYearMinus1Year
Current Tax Year	6442	CurrentTaxYear
Total	14303	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	10244	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	12040	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	1080	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	8746	CurrentTaxYearMinus1Year
Current Tax Year	6111	CurrentTaxYear
Total	38221	Total

Field	Value	IRS element (for citing)
Total Support	275296	TotalSupport
Public Support Pertcentage170	0.80920	PublicSupportPertcentage170
Public Support Pertcent Prior Year	0.81470	PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170	X	ThirtyThreePercntTestsCY170

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	150000	BeginningOfYearBalance
End Of Year Balance	150000	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	150000	BeginningOfYearBalance
End Of Year Balance	150000	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Contributions	150000	Contributions
End Of Year Balance	150000	EndOfYearBalance

Field	Value	IRS element (for citing)
Permanent Endowment EOY Balance	1.00000	PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	false	AreRelatedOrgsListedScheduleR

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Form 990, Part VI, Line 19	Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	PROVIDED UPON WRITTEN REQUEST
Form 990, Part VI, Line 11	Form 990, Part VI, Line 11: Form 990 Review Process	No review was or will be conducted.
Form 990, Part VI, Line 8	Form 990, Part VI, Line 8 : Explanation of No Contemporaneously Documentation of Meetings	NO COMMITTEES HAVE AUTHOITY TO ACT ON BEHALF OF GOVERNING BODY.