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 | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 9,068,527 | 4,663,457 | 3,547,094 | 6,124,509 | 7,543,757 | 30,947,344 |
| 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 | 9,068,527 | 4,663,457 | 3,547,094 | 6,124,509 | 7,543,757 | 30,947,344 |
| 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) .. | 8,457,212 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 22,490,132 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 9,068,527 | 4,663,457 | 3,547,094 | 6,124,509 | 7,543,757 | 30,947,344 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 3,368 | 6,376 | 72,540 | 66,307 | 76,223 | 224,814 |
| 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.).. | 1,000 | 828 | 1,294 | 3,122 | ||
| 11 | Total support. Add lines 7 through 10 | 31,175,280 | |||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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) |
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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 2023 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-2023 |
(iii) Distributable Amount for 2023 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2023 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2023: | ||||
| a From 2018....... | ||||
| b From 2019....... | ||||
| c From 2020....... | ||||
| d From 2021....... | ||||
| e From 2022....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2023 distributable amount | ||||
|
i
Carryover from 2018 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2023 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2023 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2019..... | ||||
| b Excess from 2020..... | ||||
| c Excess from 2021..... | ||||
| d Excess from 2022..... | ||||
| e Excess from 2023..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | MISCELLANEOUS - 2019 AMOUNT: $ 1,000. 2020 AMOUNT: $ 0. 2021 AMOUNT: $ 828. 2022 AMOUNT: $ 1,294. 2023 AMOUNT: $ 0. |
| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
|---|---|
| FORM 990, PART III, LINE 1 | THE MISSION OF AMERICARES FREE CLINICS, INC. IS TO PROVIDE FREE HEALTH CARE TO LOW-INCOME UNINSURED RESIDENTS OF THE GREATER NORWALK, DANBURY, STAMFORD AND BRIDGEPORT CONNECTICUT AREAS IN A SETTING WHERE ALL INDIVIDUALS ARE TREATED WITH DIGNITY AND RESPECT. AMERICARES FREE CLINICS, INC. HELPS THOSE WHO ARE MAKING A SINCERE EFFORT TO HELP THEMSELVES AND THEIR FAMILIES, BUT DO NOT HAVE THE FINANCIAL RESOURCES FOR MEDICAL CARE. |
| FORM 990, PART III, LINE 4A | AMERICARES FOUNDER BOB MACAULEY OPENED OUR FIRST CLINIC IN 1994 TO EXPAND ACCESS TO CARE FOR THE WORKING POOR OVER THE YEARS, OUR PROGRAM HAS GROWN TO BECOME THE LARGEST FREE CLINIC NETWORK IN THE STATE WITH FOUR LOCATIONS SERVING NEARLY 2,000 PATIENTS ANNUALLY. TODAY, OUR CLINICS IN BRIDGEPORT, DANBURY, NORWALK AND STAMFORD ARE A LIFELINE FOR LOW-INCOME UNINSURED RESIDENTS FROM ACROSS FAIRFIELD COUNTY. WE CARE FOR PATIENTS WITH DIABETES, HYPERTENSION, HIGH CHOLESTEROL AND OTHER CHRONIC CONDITIONS, AS WELL AS PROVIDE TREATMENT FOR MINOR INJURIES AND SUDDEN ILLNESSES LIKE THE FLU. WITHOUT OUR SERVICES, MANY WOULD RELY ON EMERGENCY ROOMS FOR PRIMARY CARE SERVICES OR WORSE DELAY CARE UNTIL THEY HAVE A MEDICAL EMERGENCY. OVER THE YEARS, 28,000 OF OUR NEIGHBORS IN NEED HAVE RECEIVED FREE HEALTH CARE SERVICES VALUED AT $165 MILLION FROM OUR CLINICS AND COMMUNITY PARTNERS. SUPPORTED BY LOCAL PHILANTHROPY, OUR CLINICS ARE AN EXAMPLE OF A COMMUNITY COMING TOGETHER TO HELP PATIENTS IN NEED. OUR CLINICS ARE SUPPORTED BY VOLUNTEER DOCTORS, NURSES, INTERPRETERS AND ADMINISTRATIVE HELP, AND DRAW ON THE RESOURCES OF COMMUNITY HOSPITALS, LABORATORIES, SPECIALISTS AND PHARMACIES TO ENSURE COMPREHENSIVE OUTPATIENT CARE. PATIENTS RECEIVE ESSENTIAL PRESCRIPTION MEDICATIONS AT LITTLE OR NO CHARGE THROUGH PATIENT ASSISTANCE PROGRAMS, DONATED MEDICINES AND OUR RELATIONSHIPS WITH LOCAL PHARMACIES. |
| FORM 990, PART VI, SECTION A, LINE 6 | PER THE ORGANIZATION'S BYLAWS, ITS SOLE CORPORATE MEMBER IS AMERICARES FOUNDATION, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | PER THE ORGANIZATION'S BYLAWS, THE SOLE CORPORATE MEMBER IS RESERVED THE POWER TO ESTABLISH THE STRUCTURE OF THE BOARD OF DIRECTORS IN TERMS OF ITS SIZE AND COMPOSITION. THE SOLE MEMBER SHALL HAVE THE AUTHORITY TO REMOVE A BOARD MEMBER OR BOARD OFFICER WITH OR WITHOUT CAUSE. |
| FORM 990, PART VI, SECTION A, LINE 7B | PER THE ORGANIZATION'S BYLAWS, THE SOLE CORPORATE MEMBER IS RESERVED CERTAIN RIGHTS, INCLUDING THE RIGHT TO REVIEW THE ORGANIZATION'S ANNUAL BUDGET. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WAS PREPARED BY A NATIONALLY RENOWNED TAX ADVISORY FIRM IN CONJUNCTION WITH THE ORGANIZATION'S FINANCIAL DEPARTMENT. THE FORM 990 IS REVIEWED BY MANAGEMENT AND WAS DISTRIBUTED TO THE BOARD OF DIRECTORS FOR REVIEW AND COMMENT AND APPROVED FOR FILING SHORTLY THEREAFTER. |
| FORM 990, PART VI, SECTION B, LINE 12C | A DIRECTOR OR OFFICER SHALL DISCLOSE TO THE BOARD OF DIRECTORS ANY POTENTIAL CONFLICTS OF INTEREST IN CONNECTION WITH PROPOSED ACTIONS OF THE CORPORATION. WHEN ANY SUCH CONFLICT OF INTEREST IS RELEVANT TO A MATTER REQUIRING ACTION BY THE BOARD OF DIRECTORS, OR A COMMITTEE THEREOF, SUCH INTERESTED DIRECTOR OR OFFICER SHALL NOT VOTE ON THE MATTER. MOREOVER, THE INTERESTED DIRECTOR OR OFFICER SHALL RETIRE FROM THE ROOM IN WHICH THE BOARD OF DIRECTORS (OR THE COMMITTEE) IS MEETING AND SHALL NOT PARTICIPATE IN THE FINAL DELIBERATION OR DECISION REGARDING THE MATTER UNDER CONSIDERATION. HOWEVER, THE INTERESTED DIRECTOR OR OFFICER SHALL PROVIDE THE BOARD OF DIRECTORS OR COMMITTEE WITH ANY AND ALL MATERIAL INFORMATION. THE MINUTES OF THE MEETING OF THE BOARD OF DIRECTORS OR COMMITTEE SHALL REFLECT THAT A CONFLICT OF INTEREST WAS DISCLOSED AND THAT THE INTERESTED DIRECTOR OR OFFICER WAS NOT PRESENT DURING THE FINAL DISCUSSION OR VOTE AND DID NOT VOTE. WHEN THERE IS A DOUBT AS TO WHETHER A CONFLICT OF INTEREST EXISTS, THE MATTER SHALL BE RESOLVED BY A VOTE OF THE BOARD OF DIRECTORS, OR THE COMMITTEE, EXCLUDING THE INTERESTED DIRECTOR OR OFFICER CONCERNING WHOSE SITUATION THE DOUBT HAS ARISEN. THIS POLICY SHALL BE REVIEWED ANNUALLY FOR THE INFORMATION AND GUIDANCE OF DIRECTORS, OFFICERS AND STAFF MEMBERS; AND ANY NEW DIRECTORS, OFFICERS OR STAFF MEMBERS SHALL BE ADVISED OF THE POLICY AND FURNISHED A DISCLOSURE STATEMENT UPON UNDERTAKING THE DUTIES OF SUCH OFFICE. |
| FORM 990, PART VI, SECTION B, LINE 15 | PROCESS FOR DETERMINING COMPENSATION THE AMERICARES FOUNDATION, INC'S CHIEF EXECUTIVE, ALONG WITH THE SVP OF PROGRAMS AND CHIEF PEOPLE OFFICER, DETERMINES THE COMPENSATION OF THE EXECUTIVE DIRECTOR OF THE AMERICARES FREE CLINICS, INC. ANNUALLY, AN ACROSS-THE-BOARD INCREASE IS PROVIDED. UTILIZATION OF PERFORMANCE EVALUATION, AVAILABLE MARKET DATA, SALARY SURVEY RESULTS, AND OTHER AVAILABLE TOOLS ARE USED TO SUBSTANTIATE ANY COMPENSATION DECISIONS BEYOND THE ORGANIZATION'S ANNUAL STANDARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE TAXPAYER MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC BY RETAINING A COPY AT ITS PLACE OF BUSINESS AND BY POSTING IT ON THE AMERICARES FOUNDATION, INC. WEBSITE, WWW.AMERICARES.ORG, AND THE AMERICARES FREE CLINIC, INC. WEBSITE AMERICARESFREECLINIC.ORG. THE FORM 990 IS LIKEWISE PUBLISHED ON THE INTERNET AT WWW.GUIDESTAR.ORG. THE ORGANIZATION'S FINANCIAL ACTIVITIES ARE PRESENTED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ITS PARENT ORGANIZATION, AMERICARES FOUNDATION, INC. AND ARE SUMMARIZED IN THE ANNUAL REPORT, WHICH IS AVAILABLE ON THE AMERICARES FOUNDATION, INC. WEBSITE. GOVERNING DOCUMENTS ARE NOT ORDINARILY MADE AVAILABLE TO THE PUBLIC. BUT IF REQUESTED, WILL BE PROVIDED AT MANAGEMENT'S DISCRETION. |
| FORM 990, PART IX, PROGRAM EXPENSES | AMERICARES FREE CLINICS IS TREATING ALL EXPENDITURES INCURRED AS PROGRAMMATIC EXPENDITURES AS IT RELIES UPON THE FINANCIAL SUPPORT OF ITS PARENT ORGANIZATION, THE AMERICARES FOUNDATION. ALL ADMINISTRATIVE EXPENSES ARE INCURRED AND REPORTED ON THE FORM 990 OF AMERICARES FOUNDATION, LEAVING THE AMERICARES FREE CLINICS FREE TO FOCUS ON DELIVERING QUALITY HEALTHCARE OUTCOMES IN THE COMMUNITIES IT SERVICES. SEE ADDITIONAL DESCRIPTIONS OF THE CLINICS PROGRAMMATIC ACTIVITIES AS REPORTED IN FORM 990, PART III. |
| FORM 990, PART XI, LINE 9: | NET ASSETS RELEASED FROM RESTRICTION -84,500. |
| Software ID: | |
| Software Version: |