HILLSBOROUGH COUNTY MEDICAL ASSOCIATION FOUNDATION INC: Form 990EZ, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- HILLSBOROUGH COUNTY MEDICAL ASSOCIATION FOUNDATION INC (EIN 59-3470072)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2015-11-13
- IRS object ID
- 201543179349202019
- Schema version
- 2014v5.0
- 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 | 2015-11-13T14:02:07-06:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 560574444 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHERRY BEKAERT LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 METROPOLITAN AVE STE 1000 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 593470072 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HILLSBOROUGH COUNTY MEDICAL ASSOCIATION | BusinessNameLine1Txt |
| Business Name Line2 | FOUNDATION INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HILL | BusinessNameControlTxt |
| Phone | 8132530471 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 606 SOUTH BOULEVARD | AddressLine1Txt |
| City | TAMPA | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 336062630 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DEBBIE ZORIAN | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 8132530471 | PhoneNum |
| Signature | 2015-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JANICE A RATICA | PreparerPersonNm |
| PTIN | P00358837 | PTIN |
| Phone | 7043771678 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-04-25 22:37:26Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Website Address | N/A | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Assoc | Yes (X) | TypeOfOrganizationAssocInd |
| Gross Receipts | $32,957 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $15,750 | ContributionsGiftsGrantsEtcAmt |
| Membership Dues | $4,450 | MembershipDuesAmt |
| Investment Income | $381 | InvestmentIncomeAmt |
| Fundraising Gross Income | $12,376 | FundraisingGrossIncomeAmt |
| Special Events Direct Expenses | $13,251 | SpecialEventsDirectExpensesAmt |
| Special Events Net Income Loss | -$875 | SpecialEventsNetIncomeLossAmt |
| Total Revenue | $19,706 | TotalRevenueAmt |
| Grants And Similar Amounts Paid | $10,000 | GrantsAndSimilarAmountsPaidAmt |
| Fees And Other Pymt To Ind Cntrct | $17,405 | FeesAndOtherPymtToIndCntrctAmt |
| Printing Publications Postage | $293 | PrintingPublicationsPostageAmt |
| Other Expenses Total | $1,666 | OtherExpensesTotalAmt |
| Total Expenses | $29,364 | TotalExpensesAmt |
| Excess Or Deficit For Year | -$9,658 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $111,240 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | $101,582 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $110,990 | BOYAmt |
| EOY | $108,032 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $250 | BOYAmt |
| EOY | $0 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $111,240 | BOYAmt |
| EOY | $108,032 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $6,450 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $111,240 | BOYAmt |
| EOY | $101,582 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Primary Exempt Purpose | CONTRIBUTIONS TO CHARITABLE ORGANIZATIONS RELATING TO MEDICAL PROGRAMS. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp (2 entries)
| Description Program Srvc AccomDescriptionProgramSrvcAccomTxt | Grants And AllocationsGrantsAndAllocationsAmt | Program Service ExpensesProgramServiceExpensesAmt |
|---|---|---|
| THE FOUNDATION MAKES CONTRIBUTIONS TO OTHER 501(C)(3) ORGANIZATIONS FOR MEDICAL PROGRAMS. | $8,500 | $8,500 |
| THE FOUNDATION FUNDS AN ANNUAL SCHOLARSHIP FOR A MEDICAL SCHOOL STUDENT. | $1,500 | $1,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $10,000 | TotalProgramServiceExpensesAmt |
| Info In Schedule O Part IV | Yes (X) | InfoInScheduleOPartIVInd |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (12 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| MICHAEL WASYLIK MD | ||||
| PRESIDENT | 1.00 | $0 | $0 | $0 |
| CARLOS DALENCE MD | ||||
| SECRETARY | 1.00 | $0 | $0 | $0 |
| LUIS MENENDEZ MD | ||||
| TREASURER | 1.00 | $0 | $0 | $0 |
| GENE BALIS MD | ||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| MATHIS BECKER MD | ||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| KEVIN ELDER MD | ||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| PETER LACKMAN CPA | ||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| HERNAN LEON MD | ||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| ASHLEY MARU MD | ||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| FRANK MASTANDREA MD | ||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| ANTHONY PIDALA MD | ||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| JOSEPH RASHKIN MD | ||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | 0 | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | 0 | OrganizationHadUBIInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Direct Indirect Pltcl Expend | $0 | DirectIndirectPltclExpendAmt |
| Made Loans To From Officers | 0 | MadeLoansToFromOfficersInd |
| Tax Imposed Under IRC4911 | $0 | TaxImposedUnderIRC4911Amt |
| Tax Imposed Under IRC4912 | $0 | TaxImposedUnderIRC4912Amt |
| Tax Imposed Under IRC4955 | $0 | TaxImposedUnderIRC4955Amt |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| Tax Imposed On Organization Mgr | $0 | TaxImposedOnOrganizationMgrAmt |
| Tax Reimbursed By Organization | $0 | TaxReimbursedByOrganizationAmt |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| States Where Copy Of Return Is Fld | FL | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEAN REPASS | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 606 S BOULEVARD | AddressLine1Txt |
| City | TAMPA | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33606 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8132530471 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Donor Advised Fnds | 0 | DonorAdvisedFndsInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Tanning Services Provided | 0 | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| School Operating | 0 | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (1) | FiledScheduleAInd |
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 | $41,022 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $29,810 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $30,600 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $36,150 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,200 | CurrentTaxYearAmt |
| Total | $157,782 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,565 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,708 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,304 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,035 | CurrentTaxYearMinus1YearAmt |
| Total | $8,612 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $42,587 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $32,518 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $32,904 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $38,185 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,200 | CurrentTaxYearAmt |
| Total | $166,394 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $2,200 | CurrentTaxYearAmt |
| Total | $2,200 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $2,200 | CurrentTaxYearAmt |
| Total | $2,200 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $164,194 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $525 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $104 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $614 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,321 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $381 | CurrentTaxYearAmt |
| Total | $2,945 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $525 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $104 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $614 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,321 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $381 | CurrentTaxYearAmt |
| Total | $2,945 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $58 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year | $12,376 | CurrentTaxYearAmt |
| Total | $12,434 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $43,170 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $32,622 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $33,518 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $39,506 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $32,957 | CurrentTaxYearAmt |
| Total | $181,773 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.90330 | PublicSupportCY509Pct |
| Public Support PY509 | 0.97820 | PublicSupportPY509Pct |
| Investment Income CY | 0.01620 | InvestmentIncomeCYPct |
| Investment Income PY | 0.02080 | 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 G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF TOURNAMENT | Event1Nm |
| Gross Receipts Event1 | $28,126 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $15,750 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $12,376 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $13,251 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $28,126 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $15,750 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $12,376 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $13,251 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $13,251 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$875 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990-EZ, PART I, LINE 4 - OTHER INVESTMENT INCOME | DESCRIPTION: INTEREST AND DIVIDENDS. AMOUNT: 381. |
| FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES | DESCRIPTION: OFFICE EXPENSES. AMOUNT: 718. DESCRIPTION: MEETING EXPENSES. AMOUNT: 32. DESCRIPTION: LICENSES, FEES & PERMITS. AMOUNT: 70. DESCRIPTION: MISCELLANEOUS. AMOUNT: 846. TOTAL TO FORM 990-EZ, LINE 16: 1,666. |
| FORM 990-EZ, PART II, LINE 24 - OTHER ASSETS | DESCRIPTION: UNDEPOSITED FUNDS. BEG. OF YEAR AMOUNT: 250. END OF YEAR AMOUNT: 0. |
| FORM 990-EZ, PART II, LINE 26 - OTHER LIABILITIES | DESCRIPTION: OTHER LIABILITIES. BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: 6,450. |
Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Declaration | 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. | DeclarationDesc |