SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2017
Open to Public
Inspection
Name of the organization
ATLANTIC COAST DENTAL RESEARCH
CLINIC
Employer identification number

59-6212360
Return Reference Explanation
FORM 990-EZ, PART I, LINE 16 EXPENSES OFFICE EXPENSES 615 MEETING COSTS 4,851 SEMINAR COSTS 1,367 REFRESHMENTS 194 INSURANCE 727 BANK SERVICE CHARGES 1,318 DENTAL SUPPLIES 6,512 IMPLANTS 5,792 LAB FEES 7,919 SPECIAL ALLOC/ SCHOLARSHP 2,300 MISCELLANEOUS 137 TOTAL 31,732
FORM 990-EZ, PART II, LINE 24 EQUIPMENT 12,952 12,952 TOTAL 12,952 12,952
FORM 990-EZ, PART II, LINE 26 FICA PAYABLE 1,736 0 FEDERAL WITHHOLDING PAYABLE 0 0 SUTA PAYABLE 9 0
FORM 990-EZ, PART III EDUCATION-COMMUNITY COLLEGE STUDENTS AND COMMUNITY SERVICE-PROVIDING LOW COST DENTAL SERVICES
FORM 990-EZ, PART III, LINE 28 DENTAL PROGRAM PROVIDES STUDENTS AT COMMUNITY COLLEGE WITH PRACTICAL EXPERIENCE WORKING WITH DOCTORS AND PATIENTS. PROVIDES COMMUNITY WITH DENTAL SERVICES AT LOW REASONABLE COSTS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2017


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