2017-11-08T15:32:49-06:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 1301 W 22ND ST STE 1100 OAK BROOK IL 60523 990EZ 2016-01-01 454946512 ASA CHARITABLE FOUNDATION ASAC 8475855586 1061 AMERICAN LANE SCHAUMBURG IL 601734973 ALEXANDER HANNENBERG MD PRESIDENT 8475855586 2017-11-03 1 GREGORY S ADAMS P00095597 6305738600 2017-10-30 67.137.57.251 2017-11-03 16:32:48 CD P 96D79D528C2215BE6F492FFEF68EA7E177A44A5C B0B82EE3E858863B5AFDA9227FC05760300C7D48 2016 2018-03-14 21:41:22Z X WWW.ASACHARITY.ORG X X 124343 X 124343 124343 91930 1928 56814 150672 -26329 129621 0 103292 X 129595 106604 26 26 129621 106630 0 3338 129621 103292 X THE FOUNDATION'S EXEMPT PURPOSE IS TO IMPROVE HEALTH AND MEDICAL CARE IN UNDER-SERVED COMMUNITIES BY ADVANCING THE QUALITY OF ANESTHESIA CARE, TO INCREASE ACCESS TO QUALITY ANESTHESIA CARE, TO SUPPORT THE ANESTHESIOLOGY PROFESSION'S RESPONSE TO DISASTERS AND HEALTH CRISES, AND TO PROMOTE EDUCATIONAL OPPORTUNITIES IN THE ANESTHESIOLOGY FIELD TO EDUCATE AND DEVELOP LEADERS OF THESE EFFORTS IN THE FUTURE. THE MISSION OF THE LIFEBOX FOUNDATION IS TO SAVE LIVES OF THOUSANDS OF PEOPLE UNDERGOING SURGERY IN UNDER-RESOURCED COUNTRIES THROUGH THE USE OF A PULSE OXIMETER WHICH MEASURES THE LEVEL OF OXYGEN IN A PATIENT'S BLOOD. PULSE OXIMETERS ARE USED AS A STANDARD IN MANY CLINICAL AREAS IN HOSPITALS THROUGHOUT HIGH INCOME COUNTRIES. APPROXIMATELY 70,000 OPERATING ROOMS IN LOW AND MIDDLE INCOME COUNTRIES ARE WITHOUT THESE EXTREMELY IMPORTANT DEVICES. 91930 0 0 ALEXANDER A HANNENBERG MD PRESIDENT 4.00 0 0 0 PETER DUNBAR CH B MBA SECRETARY-TREASURER 2.00 0 0 0 ARTHUR M BOUDREAUXMD BOARD MEMBER 1.00 0 0 0 KA KELLY MCQUEEN MD MPH BOARD MEMBER 1.00 0 0 0 MARY DALE PETERSONMD MHA BOARD MEMBER 1.00 0 0 0 STEVEN LSWEEN MD BOARD MEMBER 1.00 0 0 0 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 IL DENNIS RIZZO 1061 AMERICAN LANE SCHAUMBURG IL 601734973 8472689150 0 0 0 0 0 0 0 0 0 1 0 NONE NONE 1 X X X 1 AMERICAN SOCIETY OF ANESTHESIOLOGISTS 362181944 7 0 150672 0 1 150672 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PART IV, SECTION A, LINE 3B: ASA CHARITABLE FOUNDATION CONFIRMED THAT THE SUPPORTED ORGANIZATION, AMERICAN SOCIETY OF ANESTHESIOLOGISTS (ASA), IS A 501 (C)(6) TAX EXEMPT ORGANIZATION BY REVIEWING THEIR IRS DETERMINATION LETTER AND ALSO ANNUALLY COMPLETING A PRO FORMA SCHEDULE A, PART III TEST TO CONFIRM THAT ASA SATISFIES THE PUBLIC SUPPORT TESTS UNDER SECTION 509(A)(2). PART IV,SECTION A, LINCE 3C: THE ACTIVITIES OF ASACF ARE PERFORMED IN FURTHERANCE OF THEIR EXEMPT PURPOSE WHICH IS TO IMPROVE HEALTH AND MEDICAL CARE IN UNDER-SERVED COMMUNITIES BY ADVANCING THE QUALITY OF ANESTHESIA CARE, TO INCREASE ACCESS TO QUALITY ANESTHESIA CARE, TO SUPPORT THE ANESTHESIOLOGY PROFESSION'S RESPONSE TO DISASTERS AND HEALTH CRISES, AND TO PROMOTE EDUCATIONAL OPPORTUNITIES IN THE ANESTHESIOLOGY FIELD TO EDUCATE AND DEVELOP LEADERS OF THESE EFFORTS IN THE FUTURE. THESE ACTIVITIES ARE ALSO IN FURTHERANCE OF THEIR SUPPORTED ORGANIZATIONS ASA'S EXEMPT PURPOSE OF ADVANCING THE PRACTICE OF AND SECURING THE FUTURE OF ANESTHESIOLOGY. ASACF ENSURES THAT ALL SUPPORT PROVIDED TO ASA IS USED EXCLUSIVELY FOR CHARITABLE PURPOSES BY PERFORMING THESE ACTIVITIES AND FUNCTIONS ON BEHALF OF THEIR OWN MISSION WHICH IN TURN FURTHERS ASA'S MISSION, AS OPPOSED TO TRANSFERRING FUNDS TO THE SUPPORTED ORGANIZATION TO PERFORM THESE FUNCTIONS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: PROGRAM GRANTS. GRANTEE NAME: LIFEBOX FOUNDATION. GRANTEE ADDRESS: P.O. BOX 15342 BOSTON, MA 02215. AMOUNT GIVEN: 91,930. FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES DESCRIPTION: OFFICE EXPENSES. AMOUNT: 781. DESCRIPTION: CREDIT CARD FEES. AMOUNT: 1,086. DESCRIPTION: BANK FEES. AMOUNT: 670. DESCRIPTION: TRAVEL EXPENSES. AMOUNT: 15,568. DESCRIPTION: CONFERENCES,CONVENTIONS. AMOUNT: 38,709. TOTAL TO FORM 990-EZ, LINE 16: 56,814. FORM 990-EZ, PART II, LINE 24 - OTHER ASSETS DESCRIPTION: A/R OTHER . BEG. OF YEAR AMOUNT: 26. END OF YEAR AMOUNT: 26. FORM 990-EZ, PART II, LINE 26 - OTHER LIABILITIES DESCRIPTION: DUE TO ASA . BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: 3,338. THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.