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 0
|
0 | 0 | ||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 57,276 | 42,096 | 73,128 | 57,798 | 121,417 | 351,715 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | 0 | 0 | 0 | 0 | 0 | 0 |
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | 0 | 0 | 0 | 0 | 0 |
| 4 | Total. Add lines 1 through 3 | 57,276 | 42,096 | 73,128 | 57,798 | 121,417 | 351,715 |
| 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) .. | 117,100 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 234,615 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 57,276 | 42,096 | 73,128 | 57,798 | 121,417 | 351,715 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 0 | 0 | 0 | 0 | 0 | 0 |
| 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.).. | 0 | 0 | 0 | 0 | 0 | 0 |
| 11 | Total support. Add lines 7 through 10 | 351,715 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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 | ||||||
| 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 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| 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. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included on 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.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 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) |
||||
| 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): |
|||||
| 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 2021 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-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| 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 |
|---|---|
| Part I, Line 10 | Grants and similar amounts paid. 1. 5th Jan, 2021. Transfer of $2000 at N410 per $1 (N820,000.00) to Chief Matron Sr Theresa Afangideh for staff salaries, imprest, drugs, via BoxyPay 2. 8th Jan, 2021. Transfer of $1000 at N410 per $1 (N410,000.00) to Chief Matron Sr Theresa Afangideh for 1. Survey charges JUHRI 1. Payment for transport of GE Amx Lag to Afua, 2. 2nd Anniv Scholarships, 3. Materials for Xray film development 3. 8th Jan, 2021. Transfer of $2000 at N410 per $1 (N820,000.00)to Engr Eze Eze Otu for construction at JUHRI's 2nd Site (Esuk Mbat) via BoxyPay 4. 4th Feb, 2021. Transfer of $2000 at N410 per $1 (N820,000.00) to Chief Matron Sr Theresa Afangideh for staff salaries, imprest, drugs, via BoxyPay 5. 6th Feb, 2021. Transfer of $1000 at N410 per $1 (N410,000.00) to Chief Matron Sr Theresa Afangideh for Xray Development Rm, Maintenance 6. 8th Feb, 2021. Transfer of $2000 at N410 per $1 (N820,000.00)to Engr Eze Eze Otu for construction at JUHRI's 2nd Site (Esuk Mbat) via BoxyPay 7. 4th March, 2021. Transfer of $2000 at N410 per $1 (N820,000.00) to Chief Matron Sr Theresa Afangideh for staff salaries, imprest, drugs, via BoxyPay 8. 8th March, 2021. Transfer of $1000 at N410 per $1 (N410,000.00) to Chief Matron Sr Theresa Afangideh for car maintenance, balance for salaries/drugs 9. 11th March, 2021. Transfer of $5000 at N473/N470 per $1 (N2,355,500.00)to Engr Eze Eze Otu for construction at JUHRI's 2nd Site (Esuk Mbat) via World Remit, then Mr Olaoluwa Gbotosho for BDC at Lagos following new Nigerian Central Bank Regulation/permission. 10. 23rd March, 2021. Payment of $599.00 to USCFR subcontractor for reactivation of SAM/grants.gov towards in view of eligibility for funding applications for direct JUHRI charitable activities. 11. 4th April, 2021. Transfer of $3000 (3013) at N475 per $1 (N1,425,000.00) to Chief Matron Sr Theresa Afangideh for staff salaries, imprest, drugs, tank stand instal, via WorldRemit and Mr Olaoluwa Gbotosho. 12. 3rd May, 2021. Transfer of $5000 at N477 ($4900, N2,337,300 )and N450 ($82, N39,114 ) per $1: N954,000.00 to Engr Eze Eze Otu for construction at JUHRI's 2nd Site ($2000) and N1,402,414 ($3000) to Chief Matron Sr Theresa Afangideh for salaries, drugs, upgrades at Afua Site, via World Remit, then Mr Olaoluwa Gbotosho for BDC at Lagos following new Nigerian Central Bank Regulation/permission. 13. 4th May, 2021. Shipment fee Baltimore to Lagos, Wire Transfer $2313 + $30 to Sims and Waters, Ford 2012 Ambulance. 14. 4th May, 2021. Shipment fee Baltimore, Wire Transfer $2422 + $30 to Sims and Waters, Ford 2016 Ambulance. 15. 6th May, 2021. Check $3950 to United Vision Logistics, for delivery of 2 ambulances MN to Baltimore Port. 16. 27th May, 2021. Transfer of $5000 (N2,388,900) at N480 ($4800, N2,352,000 )and N450 ($82, N39,114 ) per $1 to Chief Matron Sr Theresa Afangideh for Clearing Agent Mr Sunny, via World Remit, then Mr Olaoluwa Gbotosho for BDC at Lagos following new Nigerian Central Bank Regulation/permission. 17. 28th May, 2021. Transfer of $2,516 (N1,205,000) at N482 per $1 to Chief Matron Sr Theresa Afangideh for Clearing Agent Mr Sunday Owodunna, via World Remit, then Mr Olaoluwa Gbotosho for BDC at Lagos following new Nigerian Central Bank Regulation/permission 18. 4th June, 2021. Transfer of $3016 at N488 per $1 (N1,464,000.00 less N15,000 tip, N1,449,000)to Engr Eze Eze Otu for construction at JUHRI's 2nd Site (Esuk Mbat) via World Remit, then Mr Olaoluwa Gbotosho for BDC at Lagos following new Nigerian Central Bank Regulation/permission. 19. 5th June, 2021. Transfer of $3015 at N495 per $1 (N1,485,000.00 less N20,000 tip, N1,465,000)to Chief Matron Sr Theresa Afangideh for JUHRI Afua salaries, drugs, imprest, 3rd Anniv expenses, via Western Union then Mr Olaoluwa Gbotosho for BDC at Lagos following new Nigerian Central Bank Regulation/permission. 20. 14th June, 2021. Transfer of $3015 at N496 per $1 (N1,488,000.00 less N20,000 tip, N1,468,000)to Chief Matron Sr ThereseAnn Afangideh for Ambulance Clearance via Western Union, then Mr Olaoluwa Gbotosho for BDC at Lagos following new Nigerian Central Bank Regulation/permission. 21. 21st June, 2021. Transfer of $2008 at N485 per $1 (N970,000.00 less N15,000 tip, N955,000) to Chief Matron Sr ThereseAnn Afangideh for Ambulance Clearance/trip from Lagos to Uyo/Calabar, via Western Union, then Mr Olaoluwa Gbotosho for BDC at Lagos following new Nigerian Central Bank Regulation/permission. 22. 2nd July, 2021. Transfer of $5000 ($15 fee) ($4,900 @ N498/$1, N2,440,200, $85 @ N480, N40,800, Total N2,481,000 - N15K tip N2,466,000) to Engr Eze Eze Otu for construction at JUHRI's 2nd Site via Western Union, then Mr Gbotosho for BDC at Lagos 23. 2nd July, 2021. Transfer of $3015 @ N498/$1, N1,494,000, - N15K tip N1,479,000) to Chief Matron Sr Theresa Afangideh salaries, drugs, imprest, upgrades, JUHRI Afua, via Western Union, then Mr Gbotosho for BDC at Lagos. 24. 2nd August, 2021. Transfer of $4015 (fee $15) at N505 per $1 (N2,020,000.00 less N15,000 tip, N2,005,000)to Chief Matron Sr ThereseAnn Afangideh for salaries, drugs, lab supplies, etc, at JUHRI Afua, via Western Union, then Mr Olaoluwa Gbotosho for BDC at Lagos following new Nigerian Central Bank Regulation/permission. 25. 3rd August, 2021. Transfer of $3015 (fee $15) at N498 per $1 (N1494,000.00 less N15,000 tip, N1,479,000) to Engr Eze Eze, via Western Union, then Mr Olaoluwa Gbotosho for BDC at Lagos, for construction at 2nd Site, Akpabuyo. 26. 3th Sept, 2021. Transfer of $4015 (fee $15) at N527 per $1 (N2,108,000.00 less N15,000 tip, N2,0933,000)to Chief Matron Sr ThereseAnn Afangideh for salaries, drugs, lab supplies, etc, at JUHRI Afua, via Western Union, then Mr Olaoluwa Gbotosho for BDC at Lagos following new Nigerian Central Bank Regulation/permission 27. 10th Sept, 2021. Transfer of $4015 (fee $15) at N540 per $1 (N2,160,000.00 less N15,000 tip, N2,145,000) to Engr Eze Eze, via Western Union, then Mr Olaoluwa Gbotosho for BDC at Lagos, for construction at 2nd Site, Akpabuyo. 28. 22nd Sept, 2021. Transfer of $2000 (fee $8) at N567 per $1 (N1134,000.00 to Admin Manager John Ikpeme, via Western Union, then Mr Olaoluwa Gbotosho for BDC at Lagos, for running JUHRI following death of Chief Matron. 29. 4th Oct, 2021. Transfer of $4015 (fee $15) at N570 per $1 (N2,280,000.00 less N15,000 tip, N2,265,000 to Admin Manager John Ikpeme, via Western Union, then Mr Olaoluwa Gbotosho for BDC at Lagos, for salaries, drugs, nutritional support/other JUHRI-KOICA activities. 30. 4th Oct, 2021. Transfer of $4015 (fee $15) at N570 per $1 (N2,280,000.00 less N15,000 tip, N2,265,000 to Admin Manager John Ikpeme, via Western Union, then Mr Olaoluwa Gbotosho for BDC at Lagos, for salaries, drugs, nutritional support/other JUHRI-KOICA activities. 31. 4th Nov, 2021. Transfer of $4037 (fee $37) at N558 per $1 (N2,232,000.00 less N15,000 tip, N2,217,000 to Admin Manager John Ikpeme, via Western Union, then Mr Olaoluwa Gbotosho for BDC at Lagos, for salaries, drugs, nutritional support/other JUHRI-KOICA activities. 32. 5th Nov, 2021. Transfer of $4037 (fee $37) at N559 per $1 (N2,236,000.00) to Engr Eze Eze, via Western Union, then Mr Olaoluwa Gbotosho for BDC at Lagos, for construction at 2nd Site, Akpabuyo. 33. 22nd Nov, 2021. Transfer of $4037 (fee $37) at N542 per $1 (N2,168,000.00 less N15,000 tip, N2,153,000 to Admin Manager John Ikpeme, via Western Union, then Mr Olaoluwa Gbotosho for BDC at Lagos, for salaries, drugs, nutritional support/other JUHRI-KOICA activities. 34. 8th Dec, 2021. Transfer of $6057 ($4037,fee $37 and $2020, fee $20) at N563 per $1 (N3,378,000.00 less N15,000 tip, N3,363,000 to Engr Eze Eze, via Western Union, then Mr Olaoluwa Gbotosho for BDC at Lagos, for construction at 2nd Site, Esuk Mbat. 35. 22nd Dec, 2021. Transfer of $518 (fee $18) at N563 per $1 (N282,500.00)to Admin Manager John, via Western Union, then Mr Olaoluwa Gbotosho for BDC at Lagos, for Christmas bonus to 19 paid staff. |
| Part I, Line 16 | 16. Other Expenses: Monthly charges for website by Wix.com. |
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| Software Version: |