HILLSBOROUGH COUNTY MEDICAL ASSOCIATION FOUNDATION INC: Form 990EZ, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- HILLSBOROUGH COUNTY MEDICAL ASSOCIATION FOUNDATION INC (EIN 59-3470072)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2013-10-22
- IRS object ID
- 201322959349200617
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-10-22T14:37:23-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560574444 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHERRY BEKAERT LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 METROPOLITAN AVENUE SUITE 1000 | AddressLine1 |
| City | CHARLOTTE | City |
| State | NC | State |
| ZIP Code | 28204 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 593470072 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HILLSBOROUGH COUNTY MEDICAL ASSOCIATION | BusinessNameLine1 |
| Business Name Line2 | FOUNDATION INC | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HILL | NameControl |
| Phone | 8132530471 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 606 SOUTH BOULEVARD | AddressLine1 |
| City | TAMPA | City |
| State | FL | State |
| ZIP Code | 336062630 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DEBBIE ZORIAN | Name |
| Title | PRESIDENT | Title |
| Phone | 8132530471 | Phone |
| Date Signed | 2013-10-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KELLIANNE F BENSON | Name |
| PTIN | P01345659 | PTIN |
| Phone | 7043771678 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Cash | X | MethodOfAccountingCash |
| Schedule B Not Required | X | ScheduleBNotRequired |
| Web Site | N/A | WebSite |
| Organization501c3 | X | Organization501c3 |
| Gross Receipts | 33518 | GrossReceipts |
| Info In Schedule O Part I | X | InfoInScheduleOPartI |
| Contributions Gifts Grants Etc | 30600 | ContributionsGiftsGrantsEtc |
| Investment Income | 614 | InvestmentIncome |
| Fundraising Gross Income | 2304 | FundraisingGrossIncome |
| Special Events Direct Expenses | 13754 | SpecialEventsDirectExpenses |
| Special Events Net Income Loss | -11450 | SpecialEventsNetIncomeLoss |
| Total Revenue | 19764 | TotalRevenue |
| Grants And Similar Amounts Paid | 9500 | GrantsAndSimilarAmountsPaid |
| Fees And Oth Pymt To Ind Contractors | 17467 | FeesAndOthPymtToIndContractors |
| Printing Publications Postage | 249 | PrintingPublicationsPostage |
| Other Expenses Total | 249 | OtherExpensesTotal |
| Total Expenses | 27465 | TotalExpenses |
| Excess Or Deficit For Year | -7701 | ExcessOrDeficitForYear |
| Net Assets Or Fund Balances BOY | 116744 | NetAssetsOrFundBalancesBOY |
| Other Changes In Net Assets | 0 | OtherChangesInNetAssets |
| Net Assets Or Fund Balances EOY | 109043 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part II | X | InfoInScheduleOPartII |
Cash Savings And Investments CashSavingsAndInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 116744 | BOY |
| EOY | 108793 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 250 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 116744 | BOY |
| EOY | 109043 | EOY |
Sum Of Total Liabilities SumOfTotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Net Assets Or Fund Balances NetAssetsOrFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 116744 | BOY |
| EOY | 109043 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Primary Exempt Purpose | CONTRIBUTIONS TO CHARITABLE ORGANIZATIONS RELATING TO MEDICAL PROGRAMS. | PrimaryExemptPurpose |
Program Service Accomplishment ProgramServiceAccomplishment (2 entries)
| Description Program Service AccomDescriptionProgramServiceAccom | Grants And AllocationsGrantsAndAllocations | Program Service ExpensesProgramServiceExpenses |
|---|---|---|
| THE FOUNDATION ACHIEVES ITS PURPOSE BY CONTRIBUTIONS TO 501(C)(3) CHARITIES RELATING TO MEDICAL PROGRAMS. | 8000 | 8000 |
| ANNUAL SCHOLARSHIP FOR A MEDICAL SCHOOL STUDENT. | 1500 | 1500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | 9500 | TotalProgramServiceExpenses |
| Info In Schedule O Part IV | X | InfoInScheduleOPartIV |
Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (12 entries)
| TitleTitle | Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition | CompensationCompensation | Contri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtc | Expense Account Other AllowancesExpenseAccountOtherAllowances |
|---|---|---|---|---|
| MICHAEL WASYLIK MD | ||||
| ACTING 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 |
| WILLIAM DAVISON MD | ||||
| BOARD MEMBER | 1.00 | 0 | 0 | 0 |
| HERNAN LEON 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 |
| CHRISTOPHER PITTMAN MD | ||||
| BOARD MEMBER | 1.00 | 0 | 0 | 0 |
| JOSEPH RASHKIN MD | ||||
| BOARD MEMBER | 1.00 | 0 | 0 | 0 |
| BRUCE SHEPHARD MD | ||||
| BOARD MEMBER | 1.00 | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRpt |
| Made Changes To Orgnzng Etc Doc | 0 | MadeChangesToOrgnzngEtcDoc |
| Organization Had UBI | 0 | OrganizationHadUBI |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtc |
| Direct Indirect Political Expend | 0 | DirectIndirectPoliticalExpend |
| Made Loans To From Officers | 0 | MadeLoansToFromOfficers |
| Tax Imposed Under IRC4911 | 0 | TaxImposedUnderIRC4911 |
| Tax Imposed Under IRC4912 | 0 | TaxImposedUnderIRC4912 |
| Tax Imposed Under IRC4955 | 0 | TaxImposedUnderIRC4955 |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTrans |
| Amount Of Tax Imposed On Org Mgr | 0 | AmountOfTaxImposedOnOrgMgr |
| Amount Of Tax Reimbursed By Org | 0 | AmountOfTaxReimbursedByOrg |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| States Where Copy Of Return Is Filed | FL | StatesWhereCopyOfReturnIsFiled |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARTHA BROOKS | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 606 S BOULEVARD | AddressLine1 |
| City | TAMPA | City |
| State | FL | State |
| ZIP Code | 33606 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8132530471 | TelephoneNumber |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Foreign Office | 0 | ForeignOffice |
| Maintain Any Donor Advised Funds | 0 | MaintainAnyDonorAdvisedFunds |
| Does Org Have Hospital | 0 | DoesOrgHaveHospital |
| Tanning Services Provided | 0 | TanningServicesProvided |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Engage Political Cmpgn Activities | 0 | EngagePoliticalCmpgnActivities |
| Engage In Lobbying Activities | 0 | EngageInLobbyingActivities |
| Operating School | 0 | OperatingSchool |
| Trnsfrs Exempt Non Char Related Org | 0 | TrnsfrsExemptNonCharRelatedOrg |
| Part VI Of Comp Of Highest Paid Empl | NONE | PartVIOfCompOfHighestPaidEmpl |
| Part VIA Hghst Paid Cntrct Prof Ser | NONE | PartVIAHghstPaidCntrctProfSer |
| Filed Schedule A | 1 | FiledScheduleA |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 25270 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 33700 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 41022 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 29810 | CurrentTaxYearMinus1Year |
| Current Tax Year | 30600 | CurrentTaxYear |
| Total | 160402 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 26143 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 12564 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1565 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2708 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2304 | CurrentTaxYear |
| Total | 45284 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 51413 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 46264 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 42587 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 32518 | CurrentTaxYearMinus1Year |
| Current Tax Year | 32904 | CurrentTaxYear |
| Total | 205686 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 205686 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1811 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1521 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 525 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 104 | CurrentTaxYearMinus1Year |
| Current Tax Year | 614 | CurrentTaxYear |
| Total | 4575 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1811 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1521 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 525 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 104 | CurrentTaxYearMinus1Year |
| Current Tax Year | 614 | CurrentTaxYear |
| Total | 4575 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 150 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 58 | CurrentTaxYearMinus2Years |
| Total | 208 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 53224 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 47935 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 43170 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 32622 | CurrentTaxYearMinus1Year |
| Current Tax Year | 33518 | CurrentTaxYear |
| Total | 210469 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.97730 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.97520 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.02170 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.02390 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1 |
| Gross Receipts Event1 | 27954 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 25650 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 2304 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 13754 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 27954 | GrossReceiptsTotal |
| Charitable Contributions Total | 25650 | CharitableContributionsTotal |
| Gross Revenue Total Events | 2304 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 13754 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 13754 | DirectExpenseSummaryEvents |
| Net Income Summary | -11450 | NetIncomeSummary |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| OTHER INVESTMENT INCOME | FORM 990-EZ, PART I, LINE 4 | INTEREST AND DIVIDENDS 614.. |
| OTHER EXPENSES | FORM 990-EZ, PART I, LINE 16 | DESCRIPTION: OFFICE EXPENSES. AMOUNT: 176. DESCRIPTION: LICENSES, FEES, AND PERMITS. AMOUNT: 61. DESCRIPTION: MEETING EXPENSES. AMOUNT: 12. TOTAL TO FORM 990-EZ, LINE 16: 249. |
| OTHER ASSETS | FORM 990-EZ, PART II, LINE 24 | DESCRIPTION: UNDEPOSITED FUNDS. BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: 250. |
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. | Declaration |