SAGE PATIENT ADVOCATES: Form 990PF, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- SAGE PATIENT ADVOCATES (EIN 47-2196367)
- Tax period
- 2020-11-01 to 2021-10-31
- Filed
- 2022-09-01
- IRS object ID
- 202232449349101113
- Schema version
- 2020v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990-PF
- Schedule B
- Accounting Fees Schedule
- Legal Fees Schedule
- Other Expenses Schedule
- Other Liabilities Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-09-01T17:45:00-05:00 | ReturnTs |
| Tax Period End | 2021-10-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 330851248 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OLIVA & ASSOCIATES CPAS | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4350 EXECUTIVE DR STE 350 | AddressLine1Txt |
| City | SAN DIEGO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92121 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2020-11-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 472196367 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAGE PATIENT ADVOCATES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SAGE | BusinessNameControlTxt |
| Phone | 8584146593 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12515 SEMILLON BLVD | AddressLine1Txt |
| City | SAN DIEGO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92131 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHEN KANDEL | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 8584146593 | PhoneNum |
| Signature | 2022-08-31 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | STEPHEN | PersonFirstNm |
| Person Last | KANDEL | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SHELLY M QUARISA | PreparerPersonNm |
| PTIN | P00730188 | PTIN |
| Phone | 8585540800 | PhoneNum |
| Preparation | 2022-08-31 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $656,352 | FMVAssetsEOYAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rcvd Rev And Expnss | $183,873 | ContriRcvdRevAndExpnssAmt |
| Interest On Sav Rev And Expnss | $2,169 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $2,169 | InterestOnSavNetInvstIncmAmt |
| Cap Gain Net Incm Net Invst Incm | $0 | CapGainNetIncmNetInvstIncmAmt |
| Total Rev And Expnss | $186,042 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $2,169 | TotalNetInvstIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $0 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $0 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $0 | CompOfcrDirTrstDsbrsChrtblAmt |
| Legal Fees Rev And Expnss | $15,125 | LegalFeesRevAndExpnssAmt |
| Legal Fees Net Invst Incm | $0 | LegalFeesNetInvstIncmAmt |
| Legal Fees Dsbrs Chrtbl | $15,125 | LegalFeesDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $2,812 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $0 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Chrtbl Prps | $2,812 | AccountingFeesChrtblPrpsAmt |
| Interest Rev And Expnss | $39 | InterestRevAndExpnssAmt |
| Interest Net Invst Incm | $0 | InterestNetInvstIncmAmt |
| Interest Dsbrs Chrtbl | $39 | InterestDsbrsChrtblAmt |
| Taxes Rev And Expnss | $180 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $0 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Trav Conf Meeting Rev And Expnss | $1,135 | TravConfMeetingRevAndExpnssAmt |
| Trav Conf Meeting Net Invst Incm | $0 | TravConfMeetingNetInvstIncmAmt |
| Trav Conf Meeting Dsbrs Chrtbl | $1,135 | TravConfMeetingDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $59,477 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $0 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Dsbrs Chrtbl | $58,777 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $78,768 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $0 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $77,888 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $58,036 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $58,036 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $136,804 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $0 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $135,924 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $49,238 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $2,169 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $57,071 | CashBOYAmt |
| Cash EOY | $84,916 | CashEOYAmt |
| Cash EOYFMV | $84,916 | CashEOYFMVAmt |
| Sav And Temp Cash Invst BOY | $549,022 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $571,436 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $571,436 | SavAndTempCashInvstEOYFMVAmt |
| Land Bldg Equip Cost Or Other Bss | $2,354 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,354 | LandBldgEquipAccumDeprecAmt |
| Total Assets BOY | $606,093 | TotalAssetsBOYAmt |
| Total Assets EOY | $656,352 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $656,352 | TotalAssetsEOYFMVAmt |
| Other Liabilities BOY | $60 | OtherLiabilitiesBOYAmt |
| Other Liabilities EOY | $1,081 | OtherLiabilitiesEOYAmt |
| Total Liabilities BOY | $60 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,081 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
| Capital Stock BOY | $0 | CapitalStockBOYAmt |
| Capital Stock EOY | $0 | CapitalStockEOYAmt |
| Additional Paid In Capital BOY | $0 | AdditionalPaidInCapitalBOYAmt |
| Additional Paid In Capital EOY | $0 | AdditionalPaidInCapitalEOYAmt |
| Retained Earning BOY | $606,033 | RetainedEarningBOYAmt |
| Retained Earning EOY | $655,271 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $606,033 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $655,271 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $606,093 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $656,352 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $606,033 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $49,238 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $655,271 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $655,271 | TotNetAstOrFundBalancesEOYAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $30 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $30 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $30 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $0 | EstimatedPlusOvpmtIncmTxAmt |
| Exempt Frgn Org Tax Wthld At Srce | $0 | ExemptFrgnOrgTaxWthldAtSrceAmt |
| Extsn Request Income Tax Paid | $0 | ExtsnRequestIncomeTaxPaidAmt |
| Backup Withholding Withheld | $0 | BackupWithholdingWithheldAmt |
| Total Payments And Credits | $0 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Tax Due | $30 | TaxDueAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | 0 | LegislativePoliticalActyInd |
| More Than100 Spent | 0 | MoreThan100SpentInd |
| Form1120 POL Filed | 0 | Form1120POLFiledInd |
| Section4955 Organization Tax | $0 | Section4955OrganizationTaxAmt |
| Section4955 Managers Tax | $0 | Section4955ManagersTaxAmt |
| Tax Reimbursed | $0 | TaxReimbursedAmt |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | 0 | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (1) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (1) | AtLeast5000InAssetsInd |
| Org Report Or Register State | CA | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (1) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | Yes (1) | PrivateOperatingFoundationInd |
| New Substantial Contributors | 0 | NewSubstantialContributorsInd |
| Own Controlled Entity | 0 | OwnControlledEntityInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (1) | ComplyWithPublicInspRqrInd |
| Website Address | N/A | WebsiteAddressTxt |
| Individual With Books | STEPHEN KANDEL | IndividualWithBooksNm |
| Phone | 8584146593 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12515 SEMILLON BLVD | AddressLine1Txt |
| City | SAN DIEGO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92131 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | 0 | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | 0 | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | 0 | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | 0 | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | Yes (1) | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | 0 | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | 0 | PaymentToGovernmentOfficialInd |
| Acts Fail To Qlfy As Exceptions | 0 | ActsFailToQlfyAsExceptionsInd |
| Uncorrected Prior Acts | 0 | UncorrectedPriorActsInd |
| Undistributed Income PY | 0 | UndistributedIncomePYInd |
| Business Holdings | 0 | BusinessHoldingsInd |
| Jeopardy Investments | 0 | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | 0 | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | 0 | InfluenceLegislationInd |
| Influence Election | 0 | InfluenceElectionInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Noncharitable Purpose | 0 | NoncharitablePurposeInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|---|---|---|---|
| STEPHEN KANDEL | ||||||||
| 12515 SEMILLON BLVD | SAN DIEGO | CA | 92131 | PRESIDENT | 1.00 | $0 | $0 | $0 |
| GENEVIEVE KANDEL | ||||||||
| 12515 SEMILLON BLVD | SAN DIEGO | CA | 92131 | SECRETARY | 1.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Hghst Pd Empl Or NONE | NONE | CompOfHghstPdEmplOrNONETxt |
| Other Employee Paid Over50k | 0 | OtherEmployeePaidOver50kCnt |
| Comp Of Hghst Pd Cntrct Or NONE | NONE | CompOfHghstPdCntrctOrNONETxt |
| Contractor Paid Over50k | 0 | ContractorPaidOver50kCnt |
Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | VOLUNTEER PATIENT ADVOCACY - TO RELIEVE HUMAN DISTRESS WITHIN THE MEANING OF TREASURY REGULATION SECTION 53.4942(B)-1(B)(2). | Description1Txt |
| Expenses1 | $0 | Expenses1Amt |
Sum Of Program Related Invst SumOfProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $25,539 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $0 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $25,539 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $25,539 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $383 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $25,156 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $1,258 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sect4942j3j5 Fndtn And Frgn Org | Yes (X) | Sect4942j3j5FndtnAndFrgnOrgInd |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $135,924 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $135,924 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $0 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $135,924 | AdjustedQualifyingDistriAmt |
Private Operating Foundations PrivateOperatingFoundationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Section4942j3 | Yes (X) | Section4942j3Ind |
Lessor Adj Net Incm Min Invst Ret LessorAdjNetIncmMinInvstRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $0 | CurrentYearAmt |
| Year1 | $0 | Year1Amt |
| Year2 | $0 | Year2Amt |
| Year3 | $0 | Year3Amt |
| Total | $0 | TotalAmt |
Pct85 Lessor Adj Incm Or Min Ret Pct85LessorAdjIncmOrMinRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $0 | CurrentYearAmt |
| Year1 | $0 | Year1Amt |
| Year2 | $0 | Year2Amt |
| Year3 | $0 | Year3Amt |
| Total | $0 | TotalAmt |
Qualifying Distributions QualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $135,924 | CurrentYearAmt |
| Year1 | $82,515 | Year1Amt |
| Year2 | $144,485 | Year2Amt |
| Year3 | $92,160 | Year3Amt |
| Total | $455,084 | TotalAmt |
Qualifying Distri Not Used Drt QualifyingDistriNotUsedDrtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $0 | CurrentYearAmt |
| Year1 | $0 | Year1Amt |
| Year2 | $0 | Year2Amt |
| Year3 | $0 | Year3Amt |
| Total | $0 | TotalAmt |
Qualifying Distri Made Drt QualifyingDistriMadeDrtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $135,924 | CurrentYearAmt |
| Year1 | $82,515 | Year1Amt |
| Year2 | $144,485 | Year2Amt |
| Year3 | $92,160 | Year3Amt |
| Total | $455,084 | TotalAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Assets Sect4942j3 Bi TotalAssetsSect4942j3BiGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Two Thirds Minimum Invst Ret TwoThirdsMinimumInvstRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Support TotalSupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Year1 | $247,663 | Year1Amt |
| Year2 | $333,974 | Year2Amt |
| Year3 | $170,600 | Year3Amt |
| Total | $752,237 | TotalAmt |
Public Support Type PublicSupportType
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Largest Support From EO LargestSupportFromEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Gross Investment Income GrossInvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (13 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt | Address Line2RecipientUSAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|---|---|
| MD ANDERSON CANCER CENTER | ||||||||
| 7007 BERTNER AVE | HOUSTON | TX | 77030 | NONE | EXEMPT | DONATION TO FIGHT CANCER | $250 | |
| TRIAGE CANCER | ||||||||
| 6348 N MILWAUKEE AVE 136 | CHICAGO | IL | 60646 | NONE | EXEMPT | DONATION TO FIGHT CANCER | $5,000 | |
| INFLAMMATORY BREAST CANCER INTERNATIONAL FOUNDATION | ||||||||
| 710 N FAIRBANKS COURT | CHICAGO | IL | 60611 | NONE | EXEMPT | DONATION TO FIGHT CANCER | $10,000 | |
| UNIVERSITY OF TEXAS CANCER CENTER | ||||||||
| 1515 HOLCOMBE BLVD | HOUSTON | TX | 77030 | NONE | EXEMPT | DONATION TO FIGHT CANCER | $16,075 | |
| SCRIPPS HEALTH FOUNDATION | ||||||||
| 4275 CAMPUS POINT CT | SAN DIEGO | CA | 92121 | NONE | EXEMPT | BREAST CANCER RESEARCH | $2,500 | |
| AMERICAN SOCIETY OF HEMOTOLGY | ||||||||
| 2021 L STREET NW 900 | WASHINGTON | DC | 20036 | NONE | EXEMPT | MEDICAL RESEARCH | $400 | |
| BAYLOR COLLEGE MEDICAL | ||||||||
| 1 MOURSUND STREET | HOUSTON | TX | 77030 | NONE | EXEMPT | RESEARCH | $2,500 | |
| EVERGREEN VALLEY UNITED METHODIST CHURCH | ||||||||
| 3520 SAN FELIPE ROAD | SAN JOSE | CA | 95135 | NONE | EXEMPT | GENERAL FUND | $5,000 | |
| AMERICAN CANCER SOCIETY | ||||||||
| 3380 CHASTAIN MEADOWS PARKWAY NW | KENNESAW | GA | 30144 | NONE | EXEMPT | RESEARCH | $211 | 200 |
| PENN ALUMNI RELATIONS | ||||||||
| 3533 LOCUST WALK | PHILADELPHIA | PA | 19104 | NONE | EXEMPT | GENERAL FUND | $100 | |
| MAYO CLINIC | ||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | NONE | EXEMPT | MEDICAL RESEARCH | $12,000 | |
| UC SAN FRANCISCO | ||||||||
| PO BOX 45339 | SAN FRANCISCO | CA | 94145 | NONE | EXEMPT | MEDICAL RESEARCH | $2,500 | |
| AMERICAN ASSOCIATION CANCER RESEARCH | ||||||||
| 615 CHESTNUT STREE 17TH FLOOR | PHILADELPHIA | PA | 19106 | NONE | EXEMPT | CANCER RESEARCH | $1,500 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $58,036 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $2,169 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $2,169 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $2,169 | TotalIncomeProducingActyAmt |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | 0 | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | 0 | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | 0 | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | 0 | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | 0 | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | 0 | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | 0 | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | 0 | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | 0 | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | 0 | RelationshipsNonchrtblEOInd |
Schedule B IRS990ScheduleB
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| General Rule | Yes (X) | GeneralRuleInd |
Contributor Information ContributorInformationGrp (4 entries)
| ContributorContributorNum | Address Line1ContributorUSAddress/AddressLine1Txt | CityContributorUSAddress/CityNm | State AbbreviationContributorUSAddress/StateAbbreviationCd | ZIPContributorUSAddress/ZIPCd | Total ContributionsTotalContributionsAmt | Person ContributionPersonContributionInd |
|---|---|---|---|---|---|---|
| ED UIHLEIN FAMILY FOUNDATION | ||||||
| 1 | 736 N LAKE FOREST | LAKE FOREST | IL | 60045 | $25,000 | Yes (X) |
| THE ABRAHAM STEIN 2001 LIVING TRUST | ||||||
| 2 | 10660 WILSHIRE BLVD 1501 | LOS ANGELES | CA | 90024 | $100,000 | Yes (X) |
| FIDELITY CHARITABLE GIFT FUND | ||||||
| 3 | PO BOX 770001 | CINCINNATI | OH | 45277 | $3,500 | Yes (X) |
| JP MORGAN GIFT FUND | ||||||
| 4 | 1585 BROADWAY FLOOR 29 | NEW YORK | NY | 10036 | $25,000 | Yes (X) |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | ACCOUNTING | CategoryTxt |
| Amt | $2,812 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $2,812 | DisbursementsCharitablePrpsAmt |
Legal Fees Schedule LegalFeesSchedule
Legal Fees LegalFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | LEGAL & PROFESSIONAL FEES | CategoryTxt |
| Legal Fees | $15,125 | LegalFeesAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $15,125 | DisbursementsCharitablePrpsAmt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (8 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| PROGRAM TRAVEL | $39,215 | $0 | $39,215 |
| EDUCATIONAL MATERIAL | $931 | $0 | $931 |
| SUPPLIES | $6,692 | $0 | $6,692 |
| POSTAGE & SHIPPING | $1,880 | $0 | $1,880 |
| PROMOTION | $204 | $0 | $204 |
| CONSULTING | $1,537 | $0 | $1,537 |
| DUES | $1,887 | $0 | $1,187 |
| PHYSICIAN APPRECIATION | $7,131 | $0 | $7,131 |
Other Liabilities Schedule OtherLiabilitiesSchedule
Other Liabilities Detail OtherLiabilitiesDetail (2 entries)
| DescDesc | BOY Book ValueBOYBookValueAmt | EOY Book ValueEOYBookValueAmt |
|---|---|---|
| CREDIT CARDS PAYABLE | $60 | $857 |
| DUE TO S. KANDEL | $0 | $224 |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| FILING FEES | $95 | $0 | $0 |
| TAX & LICENSES | $85 | $0 | $0 |