SCHEDULE O
(Form 990)

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.
right arrow Attach to Form 990 or 990-EZ.
right arrow Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2022
Open to Public
Inspection
Name of the organization
Pocatello Free Clinic
 
Employer identification number

82-0351133
Return Reference Explanation
Part VI Line 1a N/A
Part VI Line 1a N/A
Part VI Line 11b Members of the board receive a copy of the completed 990 to review and
Part VI Line 11b comment
Part VI Line 15a or b The board agrees upon the salary the Executive Director should
Part VI Line 15a or b receive annually.
Part VI Line 19 Available upon Request
Part XI Line 9 Due to issues in accounting records in the past
Part XI Line 9 we needed to adjust our accounting records to include correct numbers
Part III, Line 4A All other accomplishments: Medical, Dental, Chiropractic Services and
Part III, Line 4A Prescription Services.
Part VI, Line 11B Organization's process to review 990: The Executive Director
Part VI, Line 11B is responsible for review the 990 before filing. In addition, the 990
Part VI, Line 11B form is available for review by board members.
Part VI, Line 19 Goverment Document Disclosure: The 990 Form is available upon request.
Part IX, Line 24e Other Expenses:
Part IX, Line 24e Patient Care Education: $4,423
Part IX, Line 24e Staff Development: 1,417
Part IX, Line 24e Membership Dues: 2,950
Part IX, Line 24e Volunteer Incentives: 1,580
Part IX, Line 24e Janitorial and Cleaning Expenses: 3,473
Part IX, Line 24e Waste Disposal: 828
Part IX, Line 24e Miscellaneous Expenses: 435
Part IX, Line 24e Total Other Expenses: $15,106
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2022


Additional Data


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