STRATEGY STUDIO / PUBLIC DATA EXPLORER

HACKETT HEMWALL PATTERSON FOUNDATION INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
HACKETT HEMWALL PATTERSON FOUNDATION INC (EIN 39-2013475)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-05-13
IRS object ID
201311339349300881
Schema version
2012v2.1
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

FieldValueIRS element (for citing)
Timestamp2013-05-13T09:04:07-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DALE MILLER AND ASSOCIATES INCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line15700 MONONA DRAddressLine1
CityMADISONCity
StateWIState
ZIP Code537163135ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN392013475EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HACKETT-HEMWALL FOUNDATION INCBusinessNameLine1
Business Name Line2C/O JULIE OLSONBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlHACKNameControl

US Address USAddress

FieldValueIRS element (for citing)
Address Line14606 SHORE ACRES ROADAddressLine1
CityMONONACity
StateWIState
ZIP Code53716ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJULIE OLSONName
TitleTREASURERTitle
Date Signed2013-05-09DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameBLAIR BUTTERSName
Phone6082212332Phone
Date Prepared2013-05-13DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts383798GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HACKETTHEMWALL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionTO 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.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year97373ContributionsGrantsPriorYear
Contributions Grants Current Year156472ContributionsGrantsCurrentYear
Program Service Revenue Prior Year103956ProgramServiceRevenuePriorYear
Program Service Revenue CY172364ProgramServiceRevenueCY
Investment Income Prior Year2123InvestmentIncomePriorYear
Investment Income Current Year2792InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year203452TotalRevenuePriorYear
Total Revenue Current Year331628TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year4388GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY20845GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year166733OtherExpensePriorYear
Other Expenses Current Year170566OtherExpensesCurrentYear
Total Expenses Prior Year171121TotalExpensesPriorYear
Total Expenses Current Year191411TotalExpensesCurrentYear
Revenues Less Expenses Prior Year32331RevenuesLessExpensesPriorYear
Revenues Less Expenses CY140217RevenuesLessExpensesCY
Total Assets BOY335947TotalAssetsBOY
Total Assets EOY476165TotalAssetsEOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY335947NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY476165NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO 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.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense191411Expense
Grants20845Grants
DescriptionTO 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.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
DescriptionTO 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.Description
FieldValueIRS element (for citing)
Total Program Service Expense191411TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationstrueMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredfalseScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccounttrueForeignFinancialAccount
Name Of Foreign CountryHONameOfForeignCountry
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicyfalseConflictOfInterestPolicy
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJULIE OLSONNamePerson
Telephone Number6082211462TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14606 SHORE ACRES ROADAddressLine1
CityMONONACity
StateWIState
ZIP Code53716ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

Individual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationTitleTitleOfficerOfficer
CHESTER HERMANSEN
X000
LISA CAMPBELL
X000
MICHAEL MCDONALD
X000
JAMES NOSAL
X000
JEFFREY PATTERSON
000PRESIDENTX
MARY DOHERTY
000SECRETARYX
JULIE OLSON
000TREASURERX
FieldValueIRS element (for citing)
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
All Other Contributions156472AllOtherContributions
Total Contributions156472TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PROLOTHERAPY CONFERENCE 50%7245872458
MEDICAL MISSIONS 50%6451564515
OTHER INCOME3539135391
FieldValueIRS element (for citing)
Total Program Service Revenue172364TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column4547TotalRevenueColumn
Related Or Exempt Function Income4547RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities50415Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities52170Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-1755Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-1755TotalRevenueColumn
Related Or Exempt Function Income-1755RelatedOrExemptFunctionIncome

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column331628TotalRevenueColumn
Related Or Exempt Function Income175156RelatedOrExemptFunctionIncome

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total500Total
Program Services500ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total20345Total
Program Services20345ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
MEDICAL MISSION EXPENSES5614156141
MEDICAL MISSION COST5614156141
PROLOTHERAPY CONFERENCE3512135121
OTHER1596315963

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total7200Total
Program Services7200ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total191411Total
Program Services191411ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY39690BOY
EOY24268EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY241767BOY
EOY154790EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY15360EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis5850LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec5850LandBldgEquipmentAccumDeprec

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY54490BOY
EOY281747EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY335947BOY
EOY476165EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY335947BOY
EOY476165EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY335947BOY
EOY476165EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY335947BOY
EOY476165EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses140217ReconcilationRevenueExpenses
Reconcilation Other Changes1ReconcilationOtherChanges
Method Of Accounting CashXMethodOfAccountingCash
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedfalseFSAudited

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years130517CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years67019CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years107024CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year97373CurrentTaxYearMinus1Year
Current Tax Year156472CurrentTaxYear
Total558405Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years119759CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years54653CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years117290CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year103956CurrentTaxYearMinus1Year
Current Tax Year176911CurrentTaxYear
Total572569Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years250276CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years121672CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years224314CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year201329CurrentTaxYearMinus1Year
Current Tax Year333383CurrentTaxYear
Total1130974Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years8000CurrentTaxYearMinus2Years
Total8000Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years8000CurrentTaxYearMinus2Years
Total8000Total
FieldValueIRS element (for citing)
Public Support Total5091122974PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5900CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2491CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2224CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2123CurrentTaxYearMinus1Year
Current Tax Year4547CurrentTaxYear
Total17285Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5900CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2491CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2224CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2123CurrentTaxYearMinus1Year
Current Tax Year4547CurrentTaxYear
Total17285Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years256176CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years124163CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years226538CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year203452CurrentTaxYearMinus1Year
Current Tax Year337930CurrentTaxYear
Total1148259Total
FieldValueIRS element (for citing)
Public Support Percentage5090.97800PublicSupportPercentage509
Prior Year Support Percentage0.96430PriorYearSupportPercentage
Investment Income Percentage0.02000InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.03000PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5850OtherCostOrOtherBasis
Depreciation5850Depreciation

Schedule F IRS990ScheduleF

Grants To Orgs Outside US GrantsToOrgsOutsideUS

FieldValueIRS element (for citing)
Purpose Of GrantPROLOTHERAPY RESEARCPurposeOfGrant
Amount Of Cash Grant19885AmountOfCashGrant
Manner Of Cash DisbursementCHECK/EFTMannerOfCashDisbursement
FieldValueIRS element (for citing)
Transfer To Foreign CorpfalseTransferToForeignCorp
Interest In Foreign TrustfalseInterestInForeignTrust
Own Foreign CorpfalseOwnForeignCorp
Passive Foreign Invest CofalsePassiveForeignInvestCo
Foreign PartnershipfalseForeignPartnership
Boycott CountriesfalseBoycottCountries

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990 - ORGANIZATION'S MISSIONTO 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.
ALL OTHER ACCOMPLISHMENT DESCRIPTIONFORM 990, PAGE 2, PART III, LINE 4DTO 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.
FINANCIAL ACCOUNTS IN FOREIGN COUNTRIESFORM 990, PART V, LINE 4BHONDURAS
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BNO REVIEW WAS OR WILL BE CONDUCTED.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19NO DOCUMENTS AVAILABLE TO THE PUBLIC
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 9ROUNDING 1 ROUNDING 0