Rock River Free Medical Clinic Inc in Jefferson, Wisconsin (WI)
Table of contents:
| Rock River Free Medical Clinic Inc | |
| Employer Identification Number (EIN) | 470898219 |
| Name of Organization | Rock River Free Medical Clinic Inc |
| In Care of Name | Gail M Scott Aka Gail Chamberlain |
| Address | 1541 Annex Rd, Jefferson, WI 53549-9803 |
| Subsection | Charitable Organization |
| Ruling Date | 04/2003 |
| Deductibility | Contributions are deductible |
| Foundation | Hospital or medical research organization |
| Organization | Corporation |
| Exempt Organization Status | Unconditional Exemption |
| Tax Period | 12/2014 |
| Assets | $25,000 to $99,999 |
| Income | $100,000 to $499,999 |
| Filing Requirement | 990 (all other) or 990EZ return |
| Asset Amount | $86,427 |
| Amount of Income | $104,767 |
| Form 990 Revenue Amount | $104,767 |
| National Taxonomy of Exempt Entities (NTEE) | Health - General and Rehabilitative: Health Treatment Facilities, Primarily Outpatient |
Non-representatives - add comments:
Amount of income in 2014: $104,767 (it was $91,996 in 2013)
| This organization: | $104,767 |
| Other organizations performing similar types of work: | $502,277 |
Assets in 2014: $86,427 (it was $53,697 in 2013)
| This organization: | $86,427 |
| Other organizations performing similar types of work: | $342,333 |
Expenses in 2013: $104,258
| This organization: | $104,258 |
| Other organizations performing similar types of work: | $551,906 |
Income to expenses ratio in 2013: 1.0
| This organization: | 1.0 |
| Other organizations performing similar types of work: | 1.0 |
Grants share in income in 2013: 100.0%
| This organization: | 100.0% |
| Other organizations performing similar types of work: | 8.9% |
Revenue for 2013
Support schedule
| Revenue, Expenses, and Changes in Net Assets or Fund Balances | |||
| 2011 | 2012 | 2013 | |
|---|---|---|---|
| Total revenue | $93,868 | $86,129 | $91,996 |
| Contributions, gifts, grants, and similar amounts received | $93,868 | $86,018 | $91,984 |
| Program service revenue including government fees and contracts | $0 | $0 | $0 |
| Membership dues and assessments | $0 | $0 | $0 |
| Investment income | $0 | $111 | $12 |
| Gain/Loss from sale of assets other than inventory | $0 | $0 | $0 |
| Net income/loss from gaming and fundraising events | $0 | $0 | $0 |
| Gross profit/loss from sales of inventory | $0 | $0 | $0 |
| Other revenue | $0 | $0 | $0 |
| Total expenses | $86,190 | $194,760 | $104,258 |
| Total net assets | $174,591 | $65,960 | $53,697 |
| Excess/Deficit for the year | $7,678 | $-108,631 | $-12,262 |
| Net assets or fund balances at beginning of year | $166,913 | $174,591 | $65,960 |
| Other changes in net assets or fund balances | $0 | $0 | $-1 |
| Net assets or fund balances at end of year | $65,960 | $53,697 | |
| Balance Sheets | |||
| 2011 | 2012 | 2013 | |
|---|---|---|---|
| Total assets | $174,591 | $65,960 | $53,697 |
| Total liabilities | $0 | $0 | $0 |
| Net assets or fund balances | $174,591 | $65,960 | $53,697 |
| Other Information | |||
| 2011 | 2012 | 2013 | |
|---|---|---|---|
| Did the organization engage in any significant activity not previously reported to the IRS? | No | No | |
| Were any significant changes made to the organizing or governing documents? | No | No | |
| Did the organization have unrelated business gross income of $1,000 or more during the year from business activities | No | No | No |
| Has the organization filed a Form 990-T for the year? | No | No | |
| Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? | No | No | |
| Amount of political expenditures, direct or indirect | $0 | $0 | |
| Did the organization file Form 1120-POL for this year? | No | No | |
| Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were any such loans made in a prior year and still outstanding at the end of the tax year covered by this return? | No | No | |
| Total amount involved | $0 | $0 | |
| Initiation fees and capital contributions | $0 | $0 | $0 |
| Gross receipts for public use of club facilities | $0 | $0 | $0 |
| Did the organization engage in any section 4958 excess benefit transaction during the year, or did it engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ? | No | No | |
| At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? | No | No | |
| Reason for Public Charity Status (for 2013) | |
| The organization is not a private foundation because it is: | An organization that normally receives: (1) more than 33 1/3 % of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions - subject to certain exceptions, and (2) no more than 33 1/3 % of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975 |
| Number of organizations supported | 0 |
| Sum of amounts of support | $0 |
| Support Schedule for Organizations Described in Section 509(a)(2) (for 2009 - 2013) | |
| 2009 - 2013 Total | |
|---|---|
| Public support | $421,203 |
| Subtotal | $421,203 |
| Gifts, grants, contributions, and membership fees received | $416,601 |
| Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | $732 |
| Gross receipts from activities that are not an unrelated trade or business under section 513 | $0 |
| Tax revenues levied for the organization's benefit and either paid to or expended on its behalf | $0 |
| The value of services or facilities furnished by a governmental unit to the organization without charge | $3,870 |
| Less | $0 |
| Amounts received from disqualified persons | $0 |
| Amounts received from other than disqualified persons that exceed the greater of $5,000 or 1% of the total support | $0 |
| Total support | $421,785 |
| Public support | $421,203 |
| Subtotal | $582 |
| Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources | $582 |
| Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975 | $0 |
| Net income from unrelated business activities, whether or not the business is regularly carried on | $0 |
| Other income | $0 |
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| Organizations performing similar types of work | |||||
| Id | Name | Address | State | Established | Total Income |
|---|---|---|---|---|---|
| 1 | Network Health System Inc, Affinity Medical Group | 11925 W Lake Park Drive, Milwaukee, WI 53224-3002 | WI | 1999-03 | $117,535,807 |
| 2 | Kenosha Community Health Center Inc | 625 57th St Ste 700, Kenosha, WI 53140-4146 | WI | 1994-10 | $11,474,713 |
| 3 | Green County Emergency Medical Service Inc | PO BOX 28, Monroe, WI 53566-0028 | WI | 2014-08 | $2,298,773 |
| 4 | West Bend Clinic Inc, Attn Finance | 1700 W Paradise Dr, West Bend, WI 53095-9795 | WI | 2001-12 | $77,985,391 |
| 5 | Froedtert & The Medical College Of Wisconsin Community Physicians Inc | N74 W12501 Leatherwood Ct, Menomonee Falls, WI 53051-4490 | WI | 2013-10 | $57,768,165 |
| 6 | Progressive Community Health Centers Inc | 4738 W Lisbon Ave, Milwaukee, WI 53208-1127 | WI | 2000-03 | $7,981,566 |
| 7 | Tri-County Community Dental Clinic Inc | 9 Tri Park Way, Appleton, WI 54914-1661 | WI | 2003-04 | $1,140,193 |
| 8 | Sheboygan Area Community Clinics, Lakeshore Community Health Center | 1011north 8th St, Sheboygan, WI 53081 | WI | 2009-12 | $1,109,564 |
| 9 | Waukesha County Community Dental Clinic Inc | 210 Nw Barstow St Ste 305, Waukesha, WI 53188-3771 | WI | 2007-11 | $1,101,984 |
| 10 | Community Clinics Of Manitowoc County Inc | 925 S 15th St, Manitowoc, WI 54220-5051 | WI | 2011-02 | $773,425 |
| 11 | Mennonite Dental Clinic Inc | W8182 Cty Hwy X, Thorp, WI 54771 | WI | 2013-03 | $758,140 |
| 12 | Wellness Center Of Door County Inc | PO BOX 85, Sturgeon Bay, WI 54235-0085 | WI | 2003-07 | $546,720 |
| 13 | Affordable Health Care | 113 East Main Street, Whitewater, WI 53190-2081 | WI | 2011-02 | $159,707 |
| 14 | Rock River Free Medical Clinic Inc | 1541 Annex Rd, Jefferson, WI 53549-9803 | WI | 2003-04 | $104,767 |
| 15 | Rural Medical Ambulance Service | PO BOX 132, Darlington, WI 53530-0132 | WI | 2014-08 | $74,685 |
| 16 | Professional Dental Hygiene Express Inc | 5388 State Highway 64, Bloomer, WI 54724-4788 | WI | 2013-07 | $72,624 |
| 17 | Tumaini Health Clinic Inc, Mount Meru Tumaini Helath Clinic Inc | 3500 Washington Ave, Racine, WI 53405 | WI | 2004-04 | $41,968 |
| 18 | Orbits Worldwide Inc | 501 Fargo Trail, Middleton, WI 53562 | WI | 2011-02 | $0 |
| 19 | Packard Ave Community Clinic Inc | 5854 S Packard Avenue, Cudahy, WI 53110 | WI | 2002-04 | $0 |
| 20 | Pathways To Wellness Inc | 224 E Court Street, Viroqua, WI 54665 | WI | 2003-04 | $0 |
| Number of organizations performing similar types of work | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Total | 1,490 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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