Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | 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 | 12,318,703 | 12,347,101 | 11,742,133 | 9,999,299 | 10,274,089 | 56,681,325 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | 12,318,703 | 12,347,101 | 11,742,133 | 9,999,299 | 10,274,089 | 56,681,325 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | |||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 56,681,325 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 12,318,703 | 12,347,101 | 11,742,133 | 9,999,299 | 10,274,089 | 56,681,325 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 354,321 | 374,158 | 421,461 | 431,828 | 395,099 | 1,976,867 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 354,321 | 374,158 | 421,461 | 431,828 | 395,099 | 1,976,867 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 12,673,024 | 12,721,259 | 12,163,594 | 10,431,127 | 10,669,188 | 58,658,192 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2020 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2020 |
(iii) Distributable Amount for 2020 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2020 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2020: | ||||
| a From 2015....... | ||||
| b From 2016....... | ||||
| c From 2017....... | ||||
| d From 2018....... | ||||
| e From 2019....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2020 distributable amount | ||||
|
i
Carryover from 2015 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2020 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2020 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2020, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2020. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2021. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2016..... | ||||
| b Excess from 2017..... | ||||
| c Excess from 2018..... | ||||
| d Excess from 2019..... | ||||
| e Excess from 2020..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | ALL FACULTY MEMBERS WHO PROVIDE PATIENT CARE FOR THE DENTAL PRACTICE GROUP FOR WHICH FEES FOR SERVICE ARE COLLECTED SHALL BE ELIGIBLE FOR MEMBERSHIP IN THE DENTAL PRACTICE GROUP AND SHALL BE VOTING MEMBERS OF THE DENTAL PRACTICE GROUP. FACULTY MEMBERS GENERATING FEES FOR SERVICE IN ANY FISCAL YEAR OF THE DENTAL PRACTICE GROUP SHALL AUTOMATICALLY BE VOTING MEMBERS OF THE FISCAL YEAR OF THE DENTAL GROUP IN WHICH SUCH FEES ARE COLLECTED AND FOR THE FOLLOWING FISCAL YEAR OF THE DENTAL PRACTICE GROUP. A MEMBER'S MEMBERSHIP IN THE DENTAL PRACTICE GROUP SHALL END WHENENVER: (1) THAT MEMBER NO LONGER MEETS THE CRITERIA FOR ACTIVE MEMBERSHIP DESCRIBED HEREIN; (2) THAT MEMBER IS NO LONGER LICENSED BY THE STATE OF GEORGIA OR OTHERWISE AUTHORIZED BY LAW TO PRACTICE DENTISTRY; OR (3) THAT MEMBER LOSES THEIR FACULTY APPOINTMENT OR EMPLOYMENT WITH AUGUSTA UNIVERSITY DENTAL ASSOCIATES. |
| FORM 990, PART VI, SECTION A, LINE 7A | EVERY ACTIVE MEMBER SHALL BE ENTITLED TO ONE VOTE WHEN A VOTE IS GRANTED TO MEMBERS UNDER THE ARTICLES OF ASSOCIATION OR THE BYLAWS. EXCEPT AS PROVIDED HEREIN OR IN THE ARTICLES OF ASSOCIATION OR OTHERWISE PROVIDED BY LAW, ALL ACTIONS BY THE MEMBERS OF THE DENTAL PRACTICE GROUP SHALL BE DETERMINED BY A VOTE OF THE MAJORITY OF THE VOTES CAST BY THOSE MEMBERS PRESENT AT A MEETING OF THE MEMBERS ENTITLED TO VOTE THEREON. |
| FORM 990, PART VI, SECTION A, LINE 7B | DECISIONS THAT WOULD CHANGE THE INCOME DISTRIBUTION PLAN OR AMEND THE ARTICLES OF ASSOCIATION OR THE BY-LAWS REQUIRE MAJORITY APPROVAL BY THE MEMBERSHIP. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WAS REVIEWED IN DETAIL BY THE ORGANIZATION'S CHIEF FINANCIAL OFFICER AND THE ORGANIZATION'S INDEPENDENT AUDITORS. A COPY OF THE RETURN WAS PROVIDED TO ALL MEMBERS OF ITS GOVERNING BODY BEFORE FILING THE FORM. |
| FORM 990, PART VI, SECTION B, LINE 12C | AU DENTAL ASSOCIATES FOLLOWS THE DENTAL COLLEGE OF GEORGIA AT AUGUSTA UNIVERSITY'S CONFLICT OF INTEREST POLICY, WHISTLEBLOWER POLICY AND WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 24E | THE DENTAL COLLEGE OF GEORGIA DEPARTMENTAL SUPPORT: PROGRAM SERVICE EXPENSES 903,321. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 903,321. THE DENTAL COLLEGE OF GEORGIA DEAN'S FUND: PROGRAM SERVICE EXPENSES 602,214. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 602,214. PATIENT RELATED EXPENSE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 145,500. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 145,500. |
| FORM 990, PAGE 12, AUDIT COMMITTEE | AUGUSTA UNIVERSITY DENTAL COLLEGE OF GEORGIA'S FINANCE DEPARTMENT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND FOR SELECTION OF INDEPENDENT ACCOUNTANTS. |
| ORGANIZATION'S MISSION AND SIGNIFICANT ACTIVITIES: | THE OBJECTIVES AND PURPOSE OF THE DENTAL PRACTICE GROUP ARE TO ACQUIRE AND ADMINISTER FUNDS AND PROPERTY WHICH ARE DERIVED FROM FEES CHARGED FOR SERVICE RENDERED IN THE PRACTICE OF DENTISTRY AT THE SCHOOL OF THE DENTAL COLLEGE OF GEORGIA AT AUGUSTA UNIVERSITY BY MEMBERS OF THE FACULITY, RESIDENTS AND HYGIENISTS OF THE SCHOOL OF DENTISTRY. THE DENTAL PRACTICE GROUP IS NOT ORGANIZED AND SHALL NOT BE OPERATED FOR PECUNIARY GAIN OR PROFIT. NO PART OF THE PROPERTY OF THE DENTAL PRACTICE GROUP AND NO PART OF ITS NET EARNINGS SHALL INURE TO THE BENEFIT OF ANY MEMBER, TRUSTEE, OR OTHER PRIVATE INDIVIDUAL. THE DENTAL PRACTICE GROUP SHALL NEVER BE AUTHORIZED TO: ENGAGE IN ANY ACTIVITY EXCEPT IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT PURPOSES; NEVER ENGAGE IN PROPAGANDA; ATTEMPT TO INFLUENCE LEGISLATION; OR PARTICIPATE IN ANY POLITICAL CAMPAIGN ON BEHLAF OF ANY CANDIDATE FOR PUBLIC OFFICE, NOR SHALL ANY PART OF ITS PROPERTY OR ANY PART OF THE INCOME THEREFROM BE DEVOTED TO SUCH PURPOSES. |
| FORM 990, PART V, LINES 1C, 2B, 7G & 7H | BACKUP WITHHOLDING, FEDERAL EMPLOYMENT TAX RETURNS, FORM 8899 AND 1098-C THE ORGANIZATION DID NOT RECEIVE CONTRIBUTIONS OF QUALIFIED INTELLECTUAL PROPERTY AND WAS THEREFORE NOT REQUIRED TO FILE FORM 8899. LIKEWISE, THERE WERE NO CONTRIBUTIONS OF CARS, BOATS, AIRPLANES, OR OTHER VEHICLES, AND FORM 1098-C WAS NOT REQUIRED. THE ORGANIZATION DID NOT HAVE ANY REPORTABLE GAMING (GAMBLING) WINNINGS TO PRIZE WINNERS AND THEREFORE THE BACKUP WITHHOLDING RULES DID NOT APPLY. THE ORGANIZATION DID NOT HAVE ANY EMPLOYEES AND THEREFORE FEDERAL EMPLOYMENT TAX RETURNS WERE NOT FILED. |
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