Form 990EZ, Part I, Line 8
“DEPOSIT REFUND 1500.”
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Balance Sheet
Assets
Flat$379,355
Flat from 2017
Net Assets
Flat$234,683
Flat from 2017
Liabilities
Flat$144,672
Flat from 2017
Revenue And Expenses
Revenue
Flat$137,287
Flat from 2017
Expenses
Flat$123,290
Flat from 2017
Net Income
Flat$13,997
Flat from 2017
Historical Trend
Jump To
Filing Snapshot
- Filing Period
- Jan 1, 2017 to Dec 31, 2017
- Signed
- Oct 2, 2018
- Return Version
- 2017v2.2
- Gross Receipts
- $137,287
Mission and Program Overview
Mission
To improve the health and well being of underserved residents by partnering with the greater grand forks community as a resource for timely access to healthcare, medicine and other vital services
To provide medical, dental and vision care referrals for individuals without health insurance
Program Services
| Description | Grants | Expenses |
|---|---|---|
| DURING 2017, THIRD STREET CLINIC FACILITATED REFERRALS FOR 12 INDIVIDUAL PATIENTS FOR VISION CLINIC VISITS AND FOR 345 INDIVIDUAL PATIENTS FOR PRESCRIPTIONS FILLED | - | $123,290 |
Compensation and Service Providers
Employees
| Name | Title | Full / Part Time | Base | Other | Total |
|---|---|---|---|---|---|
| LYNNELL POPOWSKI | Executive Director | PT | $15,139 | $1,207 | $16,346 |
| LYN BOESE | Chair | - | $0 | - | - |
| MEGGEN SANDE | Vice Chair | - | $0 | - | - |
| IAN BJERKE | Treasurer | - | $0 | - | - |
| COLLEEN BROWN | Secretary | - | $0 | - | - |
| CARENLEE BARKDULL PHD | Past Chair | - | $0 | - | - |
| TIM CARLSON | Director | - | $0 | - | - |
| JOHN CLAYBURGH DDS | Director | - | $0 | - | - |
| YVONNE GOMEZ MD | Director | - | $0 | - | - |
| KAYLA HOCHSTETLER MSW | Director | - | $0 | - | - |
| CATHIE MESHESKI | Director | - | $0 | - | - |
| SUSAN SHIREK | Director | - | $0 | - | - |
| JUDY SWISHER | Director | - | $0 | - | - |
| DAVID THOMPSON | Director | - | $0 | - | - |
Filing and Contact Details
Filer
- Filer Name
- Third Street Clinic
- EIN
- 45-0433253
- Phone
- 7017721263
- Address
- 360 DIVISION AVE, GRAND FORKS, ND 58201
Signing Officer
- Name
- Susan Shirek
- Title
- President
- Phone
- 7017721263
- Signed
- 2018-10-02
Preparer
- Firm
- Overmoe & Nelson Ltd
- Address
- 200 1ST AVE N STE 30, GRAND FORKS, ND 58203
- Preparer
- Sandra Borhart CPA
- Phone
- 7017460437
Supplemental Narrative
Additional Explanations
Form 990EZ, Part I, Line 16
“ADVERTISING 1123.”
Form 990EZ, Part I, Line 16
“BANK SERVICE CHARGES 78.”
Form 990EZ, Part I, Line 16
“Depreciation 16658.”
Form 990EZ, Part I, Line 16
“DUES AND FEES 950.”
Form 990EZ, Part I, Line 16
“INSURANCE 1650.”
Form 990EZ, Part I, Line 16
“INTEREST 9332.”
Form 990EZ, Part I, Line 16
“Medical pharmacy and vision 52834.”
Form 990EZ, Part I, Line 16
“MISCELLANEOUS 2228.”
Form 990EZ, Part I, Line 16
“OFFICE SUPPLIES 1392.”
Form 990EZ, Part I, Line 16
“Software and supplies 81.”
Form 990EZ, Part I, Line 16
“Telephone and internet 161.”
Form 990EZ, Part I, Line 16
“TRAVEL 70.”
Form 990EZ, Part I, Line 16
“Giving hearts day - fundraising 4811.”
Form 990EZ, Part II, Line 24
“Prepaid expenses 627. 642.”
Form 990EZ, Part II, Line 24
“Equipment (net book value) 46575. 29917.”
Form 990EZ, Part II, Line 24
“Furniture and fixtures (net book value) 0. 0.”
Form 990EZ, Part II, Line 24
“Investment in corporation 159577. 159577.”
Form 990EZ, Part II, Line 24
“Note receivable from ipi 150445. 153977.”
Form 990EZ, Part II, Line 26
“Accounts payable 6660. 749.”
Form 990EZ, Part II, Line 26
“ACCRUED PAYROLL 1123. 0.”
Form 990EZ, Part II, Line 26
“Payroll taxes payable 2368. 199.”
Form 990EZ, Part II, Line 26
“Note payable 144645. 143724.”
Form 990, Part IX, Line 24E
“DUES”
Form 990, Part IX, Line 24E
“POSTAGE”
Form 990, Part IX, Line 24E
“PRINTING”
Form 990, Part IX, Line 24E
“MISCELLANEOUS”
Raw XML Appendix253 raw XML fields
This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.
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| IRS990EZ/OtherRevenueTotalAmt | 0 | 1500 |
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| IRS990EZ/PoliticalCampaignActyInd | 0 | false |
| IRS990EZ/PrimaryExemptPurposeTxt | 0 | TO PROVIDE MEDICAL, DENTAL AND VISION CARE REFERRALS FOR INDIVIDUALS WITHOUT HEALTH INSURANCE |
| IRS990EZ/PrintingPublicationsPostageAmt | 0 | 972 |
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| IRS990EZ/TransactionWithControlEntInd | 0 | false |
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| IRS990EZ/TypeOfOrganizationCorpInd | 0 | X |
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| IRS990ScheduleA/GrossInvestmentIncome170Grp/TotalAmt | 0 | 0 |
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| IRS990ScheduleA/GrossInvestmentIncome509Grp/CurrentTaxYearMinus1YearAmt | 0 | 6905 |
| IRS990ScheduleA/GrossInvestmentIncome509Grp/CurrentTaxYearMinus2YearsAmt | 0 | 7 |
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| IRS990ScheduleA/InvestmentIncomeCYPct | 0 | 0.01000 |
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| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 0 | DEPOSIT REFUND 1500. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 1 | ADVERTISING 1123. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 2 | BANK SERVICE CHARGES 78. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 3 | Depreciation 16658. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 4 | DUES AND FEES 950. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 5 | INSURANCE 1650. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 6 | INTEREST 9332. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 7 | MEDICAL PHARMACY AND VISION 52834. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 8 | MISCELLANEOUS 2228. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 9 | OFFICE SUPPLIES 1392. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 10 | SOFTWARE AND SUPPLIES 81. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 11 | TELEPHONE AND INTERNET 161. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 12 | TRAVEL 70. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 13 | GIVING HEARTS DAY - FUNDRAISING 4811. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 14 | PREPAID EXPENSES 627. 642. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 15 | EQUIPMENT (NET BOOK VALUE) 46575. 29917. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 16 | FURNITURE AND FIXTURES (NET BOOK VALUE) 0. 0. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 17 | INVESTMENT IN CORPORATION 159577. 159577. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 18 | NOTE RECEIVABLE FROM IPI 150445. 153977. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 19 | ACCOUNTS PAYABLE 6660. 749. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 20 | ACCRUED PAYROLL 1123. 0. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 21 | PAYROLL TAXES PAYABLE 2368. 199. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 22 | NOTE PAYABLE 144645. 143724. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 23 | DUES |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 24 | POSTAGE |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 25 | PRINTING |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 26 | MISCELLANEOUS |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | Form 990EZ, Part I, Line 8 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 1 | Form 990EZ, Part I, Line 16 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 2 | Form 990EZ, Part I, Line 16 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 3 | Form 990EZ, Part I, Line 16 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 4 | Form 990EZ, Part I, Line 16 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 5 | Form 990EZ, Part I, Line 16 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 6 | Form 990EZ, Part I, Line 16 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 7 | Form 990EZ, Part I, Line 16 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 8 | Form 990EZ, Part I, Line 16 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 9 | Form 990EZ, Part I, Line 16 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 10 | Form 990EZ, Part I, Line 16 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 11 | Form 990EZ, Part I, Line 16 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 12 | Form 990EZ, Part I, Line 16 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 13 | Form 990EZ, Part I, Line 16 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 14 | Form 990EZ, Part II, Line 24 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 15 | Form 990EZ, Part II, Line 24 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 16 | Form 990EZ, Part II, Line 24 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 17 | Form 990EZ, Part II, Line 24 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 18 | Form 990EZ, Part II, Line 24 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 19 | Form 990EZ, Part II, Line 26 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 20 | Form 990EZ, Part II, Line 26 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 21 | Form 990EZ, Part II, Line 26 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 22 | Form 990EZ, Part II, Line 26 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 23 | Form 990, Part IX, Line 24e |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 24 | Form 990, Part IX, Line 24e |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 25 | Form 990, Part IX, Line 24e |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 26 | Form 990, Part IX, Line 24e |
| ReturnHeader/BuildTS | 0 | 2019-02-21 02:37:17Z |
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| ReturnHeader/Filer/USAddress/CityNm | 0 | GRAND FORKS |
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| ReturnHeader/FilingSecurityInformation/AtSubmissionCreationDeviceId | 0 | 32084AFB6D70446705B042DA709937C77F9B1E95 |
| ReturnHeader/FilingSecurityInformation/AtSubmissionFilingDeviceId | 0 | 3FBE83A00C6EC397AB25CB41AC0461B949A32729 |
| ReturnHeader/FilingSecurityInformation/FilingLicenseTypeCd | 0 | P |
| ReturnHeader/FilingSecurityInformation/IPAddress/IPv4AddressTxt | 0 | 209.169.219.186 |
| ReturnHeader/FilingSecurityInformation/IPDt | 0 | 2018-11-14 |
| ReturnHeader/FilingSecurityInformation/IPTimezoneCd | 0 | PS |
| ReturnHeader/FilingSecurityInformation/IPTm | 0 | 10:35:49 |
| ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt | 0 | OVERMOE & NELSON LTD |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt | 0 | 200 1ST AVE N STE 30 |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm | 0 | GRAND FORKS |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd | 0 | ND |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd | 0 | 58203 |
| ReturnHeader/PreparerPersonGrp/PhoneNum | 0 | 7017460437 |
| ReturnHeader/PreparerPersonGrp/PreparationDt | 0 | 2018-11-14 |
| ReturnHeader/PreparerPersonGrp/PreparerPersonNm | 0 | SANDRA BORHART CPA |
| ReturnHeader/ReturnTs | 0 | 2018-11-14T10:35:59-08:00 |
| ReturnHeader/ReturnTypeCd | 0 | 990EZ |
| ReturnHeader/TaxPeriodBeginDt | 0 | 2017-01-01 |
| ReturnHeader/TaxPeriodEndDt | 0 | 2017-12-31 |
| ReturnHeader/TaxYr | 0 | 2017 |
Document Assets
No mirrored PDF or thumbnail assets are attached yet.
Filings
Displayed year
2017 • Form 990EZDetailed filing. Detailed filing data is available for this year.
- Assets
- $379,355
- Liabilities
- $144,672
- Net assets
- $234,683
- Revenue
- $137,287
- Expenses
- $123,290
- Net income
- $13,997