Ellsworth Free Medical Clinic in Ellsworth, Maine (ME)
Table of contents:
| Ellsworth Free Medical Clinic | |
| Employer Identification Number (EIN) | 201746627 |
| Name of Organization | Ellsworth Free Medical Clinic |
| In Care of Name | Union Trust Company |
| Address | 248 State St Ste 16, Ellsworth, ME 04605-1850 |
| Subsection | Charitable Organization |
| Ruling Date | 05/2006 |
| Deductibility | Contributions are deductible |
| Foundation | Organization which receives a substantial part of its support from a governmental unit or the general public |
| Organization | Corporation |
| Exempt Organization Status | Unconditional Exemption |
| Tax Period | 12/2013 |
| Assets | $25,000 to $99,999 |
| Income | $25,000 to $99,999 |
| Filing Requirement | 990 - Required to file Form 990-N - Income less than $25,000 per year |
| Asset Amount | $28,636 |
| Amount of Income | $34,986 |
| Form 990 Revenue Amount | $34,986 |
| National Taxonomy of Exempt Entities (NTEE) | Health - General and Rehabilitative: Ambulatory Health Center, Community Clinic |
Non-representatives - add comments:
Amount of income in 2013: $34,986 (it was $17,635 in 2012)
| Ellsworth Free Medical Clinic: | $34,986 |
| Other organizations performing similar types of work: | $270,653 |
Assets in 2013: $28,636 (it was $26,111 in 2012)
| Ellsworth Free Medical Clinic: | $28,636 |
| Other organizations performing similar types of work: | $190,546 |
Expenses in 2013: $32,461
| Ellsworth Free Medical Clinic: | $32,461 |
| Other organizations performing similar types of work: | $250,316 |
Income to expenses ratio in 2013: 1.1
| Ellsworth Free Medical Clinic: | 1.1 |
| Other organizations performing similar types of work: | 0.9 |
Grants share in income in 2013: 100.0%
| Ellsworth Free Medical Clinic: | 100.0% |
| Other organizations performing similar types of work: | 98.8% |
Revenue for 2013
Support schedule
| Revenue, Expenses, and Changes in Net Assets or Fund Balances | |||
| 2011 | 2012 | 2013 | |
|---|---|---|---|
| Total revenue | $83,332 | $17,635 | $34,986 |
| Contributions, gifts, grants, and similar amounts received | $83,074 | $17,435 | $34,979 |
| Program service revenue including government fees and contracts | $245 | $170 | $0 |
| Membership dues and assessments | $0 | $0 | $0 |
| Investment income | $0 | $0 | $0 |
| 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 | $13 | $30 | $7 |
| Total expenses | $57,022 | $40,501 | $32,461 |
| Total net assets | $48,977 | $26,111 | $28,636 |
| Excess/Deficit for the year | $26,310 | $-22,866 | $2,525 |
| Net assets or fund balances at beginning of year | $22,667 | $48,977 | $26,111 |
| Other changes in net assets or fund balances | $0 | $0 | $0 |
| Net assets or fund balances at end of year | $26,111 | $28,636 | |
| Balance Sheets | |||
| 2011 | 2012 | 2013 | |
|---|---|---|---|
| Total assets | $48,977 | $26,111 | $28,636 |
| Total liabilities | $0 | $0 | $0 |
| Net assets or fund balances | $48,977 | $26,111 | $28,636 |
| 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 | $245,672 |
| Subtotal | $245,672 |
| Gifts, grants, contributions, and membership fees received | $245,672 |
| 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 | $0 |
| 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 | $0 |
| 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 | $245,722 |
| Public support | $245,672 |
| Subtotal | $50 |
| Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources | $50 |
| 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 | West Cecil Health Center Inc | 49 Rock Springs Rd, Conowingo, MD 21918-1352 | MD | 2008-12 | $4,273,877 |
| 2 | Valley Baptist Service Corporation | 2101 Pease St, Harlingen, TX 78550-8307 | TX | 2001-09 | $1,742,623 |
| 3 | Harris County Clinical Services Inc | 2801 Via Fortuna Ste 500, Austin, TX 78746-7573 | TX | 2010-06 | $258,669,147 |
| 4 | Tch Pediatric Associates Inc, Texas Childrens Pediatric Assoc | 1919 S Braeswood Blvd Floor 4, Houston, TX 77030-4444 | TX | 1997-05 | $173,335,852 |
| 5 | Tuba City Regional Health Care Corporation | PO BOX 600, Tuba City, AZ 86045-0600 | AZ | 2005-04 | $144,364,552 |
| 6 | City Of Hope Medical Foundation | 1500 Duarte Rd, Duarte, CA 91010-3012 | CA | 2012-11 | $128,602,720 |
| 7 | Bexar County Clinical Services Inc | 2801 Via Fortuna Ste 500, Austin, TX 78746-7573 | TX | 2010-08 | $86,400,000 |
| 8 | Deaconess Clinic Inc | 600 Mary St, Evansville, IN 47710-1658 | IN | 2010-02 | $69,230,291 |
| 9 | Penobscot Community Health Center, Chld Abus Prvtn Concl Of Out-Wyn Co | PO BOX 2100, Bangor, ME 04402-2100 | ME | 1998-02 | $58,101,123 |
| 10 | Mercy Clinic Fort Smith Communities | 645 Maryville Centre Dr Ste 100, Saint Louis, MO 63141-5846 | MO | 2013-07 | $46,236,096 |
| 11 | Roane County Medical Center | 1420 Centerpoint Blvd Bldg C, Knoxville, TN 37932-1960 | TN | 2009-09 | $43,702,544 |
| 12 | Signature Healthcare Medical Group Inc, Signature Medical Group | 680 Centre St, Brockton, MA 02302-3308 | MA | 1998-01 | $43,363,128 |
| 13 | Portland Community Health Center | 180 Park Avenue, Portland, ME 04102-2957 | ME | 2012-11 | $2,864,505 |
| 14 | Bucksport Bay Healthy Communities Coalition | PO BOX X, Bucksport, ME 04416-1224 | ME | 2012-05 | $102,514 |
| 15 | Haitian Ministries Inc | 26 Riverbend Dr, Glenburn, ME 04401-1146 | ME | 2011-02 | $95,152 |
| 16 | Access Health Inc, Leavitt Mill Health Center | PO BOX 47, Bar Mills, ME 04004-0047 | ME | 2003-05 | $70,568 |
| 17 | Ellsworth Free Medical Clinic | 248 State St Ste 16, Ellsworth, ME 04605-1850 | ME | 2006-05 | $34,986 |
| 18 | Goodall Health Partners | 25 June Street, Sanford, ME 04073 | ME | 2004-08 | $0 |
| 19 | Jackman Area Primary Care | 376 Main Street, Jackman, ME 04945 | ME | 2014-07 | $0 |
| 20 | Maine Volunteers In Medicine | 1 Canal Plz, Portland, ME 04101-4098 | ME | 2002-04 | $0 |
| Number of organizations performing similar types of work | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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