HACKETT HEMWALL PATTERSON FOUNDATION INC: Form 990, tax year 2019
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- Organization
- HACKETT HEMWALL PATTERSON FOUNDATION INC (EIN 39-2013475)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-07-15
- IRS object ID
- 202031979349306253
- Schema version
- 2019v5.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-07-15T14:37:24-05:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 260207169 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DALE MILLER AND ASSOCIATES INC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5700 MONONA DR | AddressLine1Txt |
| City | MADISON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 537163135 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 392013475 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HACKETT HEMWALL PATTERSON FOUNDATIO | BusinessNameLine1Txt |
| Business Name Line2 | C/O JULIE OLSON | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HACK | BusinessNameControlTxt |
| Phone | 6083453875 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | C/O JULIE OLSON 7880 SWEENY RD | AddressLine1Txt |
| City | BARNEVELD | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53507 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JULIE OLSON | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 6083453875 | PhoneNum |
| Signature | 2020-07-15 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BLAIR J BUTTERS | PreparerPersonNm |
| PTIN | P00668810 | PTIN |
| Phone | 6082212332 | PhoneNum |
| Preparation | 2020-07-15 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 47.49.21.102 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-07-15 | IPDt |
| IP Tm | 14:37:24 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | A58F0FE42E2127AE02623BDD26EB496A8A47045B | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 1BB78DBC555281FCC77604040F7EF1808F332610 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JULIE OLSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7880 SWEENY ROAD | AddressLine1Txt |
| City | BARNEVELD | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53507 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $429,519 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HACKETTHEMWALL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE MEDICAL TREATMENT TO PERSONS WHO ARE UNABLE TO AFFORD TREATMENT, TO PROVIDE MEDICAL PROFESSIONALS AND OTHERS WITH TRAINING, EDUCATION AND CLINICAL EXPERIENCE AND TO CONDUCT AND DISSEMINATE RESEARCH CONCERNING THE EFFICACY OF CERTAIN MEDICAL PROCEDURES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 1 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $121,497 | PYContributionsGrantsAmt |
| CY Contributions Grants | $147,077 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $146,994 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $161,054 | CYProgramServiceRevenueAmt |
| PY Investment Income | $21,392 | PYInvestmentIncomeAmt |
| CY Investment Income | $16,114 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $289,883 | PYTotalRevenueAmt |
| CY Total Revenue | $324,245 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,630 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $8,572 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $373,597 | PYOtherExpensesAmt |
| CY Other Expenses | $324,314 | CYOtherExpensesAmt |
| PY Total Expenses | $375,227 | PYTotalExpensesAmt |
| CY Total Expenses | $332,886 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$85,344 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$8,641 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $710,284 | TotalAssetsBOYAmt |
| Total Assets EOY | $700,599 | TotalAssetsEOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $710,284 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $700,599 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE MEDICAL TREATMENT TO PERSONS WHO ARE UNABLE TO AFFORD TREATMENT, TO PROVIDE MEDICAL PROFESSIONALS AND OTHERS WITH TRAINING, EDUCATION AND CLINICAL EXPERIENCE AND TO CONDUCT AND DISSEMINATE RESEARCH CONCERNING THE EFFICACY OF CERTAIN MEDICAL PROCEDURES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $332,886 | ExpenseAmt |
| Grant | $8,572 | GrantAmt |
| Desc | TO PROVIDE MEDICAL TREATMENT TO PERSONS WHO ARE UNABLE TO AFFORD TRETMENT. TO PROVIDE MEDICAL PROFESSIONALS AND OTHERS WITH TRAINING AND CLINICAL EXPERIENCE. TO CONDUCT AND DISSEMINATE RESEARCH CONCERNING THE EFFICACY OF CERTAIN MEDICAL PROCEDURES. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | TO PROVIDE MEDICAL TREATMENT TO PERSONS WHO ARE UNABLE TO AFFORD TRETMENT. TO PROVIDE MEDICAL PROFESSIONALS AND OTHERS WITH TRAINING AND CLINICAL EXPERIENCE. TO CONDUCT AND DISSEMINATE RESEARCH CONCERNING THE EFFICACY OF CERTAIN MEDICAL PROCEDURES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $332,886 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | Yes (true) | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (true) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | false | ScheduleORequiredInd |
| IRP Document | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | Yes (true) | ForeignFinancialAccountInd |
| Foreign Country | HO | ForeignCountryCd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | Yes (true) | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicyInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JULIE OLSON | PersonNm |
| Phone | 6083453875 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7880 SWEENY ROAD | AddressLine1Txt |
| City | BARNEVELD | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53507 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| CHESTER HERMANSEN | ||||||
| DIRECTOR | 1.00 | Yes (X) | $12,000 | $0 | $0 | |
| MARY DOHERTY | ||||||
| SECRETARY | 2.00 | $12,000 | $0 | $0 | Yes (X) | |
| JULIE OLSON | ||||||
| TREASURER | 2.00 | $12,000 | $0 | $0 | Yes (X) | |
| ADAM BALIN | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| TRICIA DERGES | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JOHN FINKELSTADT | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| SHANNON GRIFFIN | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| TED HARRISON | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| AENEAS JANZE | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ANNETTE ZAHAROFF | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DAVID RAGAGO | ||||||
| VICE-PRESIDE | 2.00 | $0 | $0 | $0 | Yes (X) | |
| BRIAN RALSTON | ||||||
| PRESIDENT | 5.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $36,000 | TotalReportableCompFromOrgAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| All Other Contributions | $147,077 | AllOtherContributionsAmt |
| Total Contributions | $147,077 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| MEDICAL MISSIONS 50% | $71,865 | $71,865 |
| PROLOTHERAPY CONFERENCE 50% | $52,260 | $52,260 |
| OTHER INCOME | $36,929 | $36,929 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $161,054 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,419 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,419 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $100,969 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $105,274 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$4,305 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$4,305 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$4,305 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $324,245 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $177,168 | RelatedOrExemptFuncIncomeAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,572 | TotalAmt |
| Program Services | $8,572 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,520 | TotalAmt |
| Program Services | $27,520 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,454 | TotalAmt |
| Program Services | $3,454 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICAL MISSION COST | $92,574 | $92,574 |
| MEDICAL MISSION EXPENSES | $92,574 | $92,574 |
| PROLOTHERAPY CONFERENCE | $69,653 | $69,653 |
| OTHER | $21,719 | $21,719 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,820 | TotalAmt |
| Program Services | $16,820 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $332,886 | TotalAmt |
| Program Services | $332,886 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,376 | BOYAmt |
| EOY | $76,400 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $126,359 | BOYAmt |
| EOY | $140,446 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,850 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,850 | LandBldgEquipAccumDeprecAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $538,053 | BOYAmt |
| EOY | $441,367 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,496 | BOYAmt |
| EOY | $42,386 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $710,284 | BOYAmt |
| EOY | $700,599 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $710,284 | BOYAmt |
| EOY | $700,599 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $710,284 | BOYAmt |
| EOY | $700,599 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $710,284 | BOYAmt |
| EOY | $700,599 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$8,641 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$1,044 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $151,837 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $150,635 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $134,315 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $121,497 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $147,077 | CurrentTaxYearAmt |
| Total | $705,361 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $201,970 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $177,065 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $151,683 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $146,994 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $165,359 | CurrentTaxYearAmt |
| Total | $843,071 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $353,807 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $327,700 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $285,998 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $268,491 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $312,436 | CurrentTaxYearAmt |
| Total | $1,548,432 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $1,548,432 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,904 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $20,039 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $21,757 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $21,392 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,114 | CurrentTaxYearAmt |
| Total | $99,206 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,904 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $20,039 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $21,757 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $21,392 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,114 | CurrentTaxYearAmt |
| Total | $99,206 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $373,711 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $347,739 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $307,755 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $289,883 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $328,550 | CurrentTaxYearAmt |
| Total | $1,647,638 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.93980 | PublicSupportCY509Pct |
| Public Support PY509 | 0.94090 | PublicSupportPY509Pct |
| Investment Income CY | 0.06000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.06000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,850 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,850 | DepreciationAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LOAN | Desc |
| Book Value | $42,386 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $42,386 | TotalBookValueOtherAssetsAmt |
Schedule F IRS990ScheduleF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | false | GrantRecordsMaintainedInd |
Account Activities Outside US AccountActivitiesOutsideUSGrp (2 entries)
| RegionRegionTxt | Type Of Activities ConductedTypeOfActivitiesConductedTxt | Specific Services ProvidedSpecificServicesProvidedTxt | Region Total ExpendituresRegionTotalExpendituresAmt |
|---|---|---|---|
| NORTH AMERICA | PROGRAM SERVICES | MEDICAL MISSIONS | $22,650 |
| CENTRAL AMERICA | PROGRAM SERVICES | MEDICAL MISSIONS | $160,087 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Spent | $182,737 | SubtotalSpentAmt |
| Total Spent | $182,737 | TotalSpentAmt |
| Transfer To Foreign Corp | false | TransferToForeignCorpInd |
| Interest In Foreign Trust | false | InterestInForeignTrustInd |
| Foreign Corp Ownership | false | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | false | PassiveForeignInvestmestCoInd |
| Foreign Partnership | false | ForeignPartnershipInd |
| Boycott Countries | false | BoycottCountriesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE F, PAGE 1, PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | NORTH AMERICA 22,650 0 CENTRAL AMERICA 160,087 0 | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | false | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DR BOBBY NOURANI | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2628 ARBOR DR 300 | AddressLine1Txt |
| City | MADISON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53711 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash Grant | $8,572 | CashGrantAmt |
| Purpose Of Grant | ULTRASOUND TRAINING | PurposeOfGrantTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| MARY DOHERTY | |||
| OFFICER | $12,000 | FOR SERVICES RENDERE | false |
| CHESTER HERMANSEN | |||
| OFFICER | $12,000 | FOR SERVICES RENDERE | false |
| JULIE OLSON | |||
| OFFICER | $12,000 | FOR SERVICES RENDERE | false |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | TO PROVIDE MEDICAL TREATMENT TO PERSONS WHO ARE UNABLE TO AFFORD TREATMENT, TO PROVIDE MEDICAL PROFESSIONALS AND OTHERS WITH TRAINING, EDUCATION AND CLINICAL EXPERIENCE AND TO CONDUCT AND DISSEMINATE RESEARCH CONCERNING THE EFFICACY OF CERTAIN MEDICAL PROCEDURES. |
| FORM 990, PAGE 2, PART III, LINE 4D | TO PROVIDE MEDICAL TREATMENT TO PERSONS WHO ARE UNABLE TO AFFORD TRETMENT. TO PROVIDE MEDICAL PROFESSIONALS AND OTHERS WITH TRAINING AND CLINICAL EXPERIENCE. TO CONDUCT AND DISSEMINATE RESEARCH CONCERNING THE EFFICACY OF CERTAIN MEDICAL PROCEDURES. |
| FORM 990, PART V, LINE 4B | HONDURAS |
| FORM 990, PAGE 6, PART VI, LINE 9 | BRIAN RALSTON CHICAGO, IL 60611 DAVID RAGAGO 2330 SOMMERS AVE MADISON, WI 53704 MARY DOHERTY 4021 MINERAL POINT ROAD MADISON, WI 53705 CHESTER HERMANSEN 1745 BOYD AVE MADISON, WI 53704 ANNETTE ZAHAROFF 9631 HUEBNER RD SAN ANTONIO, TX 78240 ADAM BALIN 3045 OAK LEAF CIRCLE FITCHBURG, WI 53711 TRICIA DERGES 329 E SUNSHINE ST STE AA SPRINGFIELD, MA 65804 JOHN FINKELSTADT 475 IRVING AVE SYRACUSE , NY 13210 SHANNON GRIFFIN 491 BRYCE AVE LOS ALAMOS, NM 87547 TED HARRISON 1319 LANDS END RD SIDNEY, CA B81 5K1 AENEAS JANZE 6418 FRANKLIN SUMMIT DRIVE EL PASO, TX 79912 |
| FORM 990, PAGE 6, PART VI, LINE 11B | NO REVIEW WAS OR WILL BE CONDUCTED. |
| FORM 990, PAGE 6, PART VI, LINE 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC |
| FORM 990, PART XI, LINE 9 | ROUNDING 0 ADJUST BALANCE SHEET TO ACTUAL -1,044 TOTAL -1,044 |