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Nonprofiteer
← AMBERWELL ATCHISON SUPPORT ORGANIZATION INC

Form 990 for tax year 2023

Filed by AMBERWELL ATCHISON SUPPORT ORGANIZATION INC.

Totals

Total revenue
$20,026
Total expenses
$10,000
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$0
Investment income
$20,026
Other revenue
$0
Total assets, end of year
$8,398,482
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$8,398,482
Program services expenses (Part IX)
$10,000
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
$10,000

Program services were 100.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 3 · Investment income

    total $20,026 · excluded $20,026

Functional expenses

Part IX, the statement of functional expenses.

  • 24a · Other expenses: LOAN ORIGINATION

    total $10,000 · program services $10,000

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $0 · end of year $562,182

  • 7 · Other notes and loans receivable

    beginning of year $0 · end of year $7,836,300

  • 27 · Net assets without donor restrictions

    beginning of year $0 · end of year $8,398,482

Mission and programs · 2023

Mission

NONE

Activities or mission (Part I)

SUPPORT AND BENEFIT AMBERWELL ATCHISON ASSOCIATION.

  • AMBERWELL ATCHISON SUPPORT ORGANIZATION WAS FORMED DURING 2023 AS A SUPPORTING ORGANIZATION OF AMBERWELL ATCHISON ASSOCIATION FOR THE NEW MARKET TAX CREDITS FOR THE PURPOSES OF SUPPORTING HOSPITAL OPERATIONS. THIS AGREEMENT ENABLED THE HOSPITAL TO ENTER INTO SEVERAL FEDERAL AND STATE QUALIFIED LOW-INCOME COMMUNITY INVESTMENT (QLICI) FINANCIAL AGREEMENTS IN ORDER TO FINANCE CONSTRUCTION PROJECTS.

    Expenses $10,000

As filed on the 2023 return.

Listed in Part VII

  • Larry Mears

    CHAIR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Jerry Henry

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Lorin Affield

    SECRETARY

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Susan Myers

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Reed Berger

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Jeffrey Perry

    CEO

    Total calculated
    $450,526
    From this org
    $0
    From related orgs
    $434,522
    Other
    $16,004
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $361,022 related
    Bonus
    $0 + $73,500 related
    Other
    $0
    Deferred
    $0 + $9,900 related
    Nontaxable benefits
    $0 + $6,454 related
    Filer's total
    $0 + $450,876 related

  • Chase Dudzinski

    CFO

    Total calculated
    $280,465
    From this org
    $0
    From related orgs
    $250,652
    Other
    $29,813
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $244,568 related
    Bonus
    $0 + $6,084 related
    Other
    $0
    Deferred
    $0 + $7,672 related
    Nontaxable benefits
    $0 + $22,491 related
    Filer's total
    $0 + $280,815 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

None.

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
COMPENSATION FOR JEFFREY PERRY, CEO, IS ESTABLISHED BY AMBERWELL ATCHISON ASSOCIATION, A RELATED ENTITY, USING THE FOLLOWING: INDEPENDENT COMPENSATION CONSULTANT, A COMPENSATION STUDY, FORM 990 OF OTHER ORGANIZATIONS, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2023
Filed
5 November 2024
IRS schema version
2023v5.1
Source object
202413129349301046

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