CMH FOUNDATION: Form 990EZ, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- CMH FOUNDATION (EIN 32-0297285)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-15
- IRS object ID
- 201323199349201972
- 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 | 2013-11-15T10:52:28-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1201 Walnut Suite 1700 | AddressLine1 |
| City | Kansas City | City |
| State | MO | State |
| ZIP Code | 641062246 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 320297285 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CMH FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % WILLIAM H STORCK | InCareOfName |
| Name Control | CMHF | NameControl |
| Phone | 7855622311 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 708 NORTH 18TH STREET | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | MARYSVILLE | City |
| State | KS | State |
| ZIP Code | 66508 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CURTIS R HAWKINSON | Name |
| Title | CHIEF EXECUTIVE OFFICER | Title |
| Phone | 7855622311 | Phone |
| Date Signed | 2013-11-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Kevin Ensminger CPA | Name |
| Phone | 8162216300 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Initial Return | X | InitialReturn |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Web Site | www.cmhcare.org | WebSite |
| Organization501c3 | X | Organization501c3 |
| Gross Receipts | 122900 | GrossReceipts |
| Info In Schedule O Part I | X | InfoInScheduleOPartI |
| Contributions Gifts Grants Etc | 122900 | ContributionsGiftsGrantsEtc |
| Cost Other Basis And Sales Expenses | 0 | CostOtherBasisAndSalesExpenses |
| Gain Or Loss From Sale Of Assets | 0 | GainOrLossFromSaleOfAssets |
| Special Events Direct Expenses | 0 | SpecialEventsDirectExpenses |
| Special Events Net Income Loss | 0 | SpecialEventsNetIncomeLoss |
| Cost Of Goods Sold | 0 | CostOfGoodsSold |
| Gro Profit Loss Sales Of Inventory | 0 | GroProfitLossSalesOfInventory |
| Total Revenue | 122900 | TotalRevenue |
| Salaries Other Comp Empl Benefits | 35252 | SalariesOtherCompEmplBenefits |
| Other Expenses Total | 7855 | OtherExpensesTotal |
| Total Expenses | 43107 | TotalExpenses |
| Excess Or Deficit For Year | 79793 | ExcessOrDeficitForYear |
| Net Assets Or Fund Balances BOY | 15500 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 95293 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part II | X | InfoInScheduleOPartII |
Cash Savings And Investments CashSavingsAndInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15500 | BOY |
| EOY | 138400 | EOY |
Land And Buildings LandAndBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15500 | BOY |
| EOY | 138400 | EOY |
Sum Of Total Liabilities SumOfTotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 43107 | EOY |
Net Assets Or Fund Balances NetAssetsOrFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15500 | BOY |
| EOY | 95293 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Primary Exempt Purpose | To support and encourage health care services and education through providing financial and fund raising assistance for Community Memorial Healthcare. | PrimaryExemptPurpose |
Program Service Accomplishment ProgramServiceAccomplishment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Service Accom | The primary goal of the foundation is to provide financial and fundraising assistance to community memorial hospital. 2012 has been a year of organization with active fundraising to begin in 2013. | DescriptionProgramServiceAccom |
| Grants And Allocations | 0 | GrantsAndAllocations |
| Program Service Expenses | 43107 | ProgramServiceExpenses |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | 43107 | TotalProgramServiceExpenses |
Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (8 entries)
| TitleTitle | Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition | CompensationCompensation | Contri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtc | Expense Account Other AllowancesExpenseAccountOtherAllowances |
|---|---|---|---|---|
| JOHN HOWARD | ||||
| DIRECTOR/CHAIRMAN | 0.5 | 0 | 0 | 0 |
| BETTE LAMMERDING | ||||
| DIRECTOR/SECRETARY | 0.5 | 0 | 0 | 0 |
| JOYCE STRYKER | ||||
| DIRECTOR/VICE-CHAIRMAN | 0.5 | 0 | 0 | 0 |
| KEN KICKHAEFER | ||||
| DIRECTOR | 0.5 | 0 | 0 | 0 |
| TRENT MOSER | ||||
| DIRECTOR | 0.5 | 0 | 0 | 0 |
| JOHN SCHWARTZ | ||||
| DIRECTOR | 0.5 | 0 | 0 | 0 |
| JERRY ZANKER | ||||
| DIRECTOR | 0.5 | 0 | 0 | 0 |
| CURTIS HAWKINSON | ||||
| DIRECTOR | 1.0 | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRpt |
| Made Changes To Orgnzng Etc Doc | false | MadeChangesToOrgnzngEtcDoc |
| Organization Had UBI | false | OrganizationHadUBI |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Organization Dissolved Etc | false | OrganizationDissolvedEtc |
| Did Org File Form1120 POL This Year | false | DidOrgFileForm1120POLThisYear |
| Made Loans To From Officers | false | MadeLoansToFromOfficers |
| Initiation Fees And Capital Contri | 0 | InitiationFeesAndCapitalContri |
| Gross Receipts For Public Use | 0 | GrossReceiptsForPublicUse |
| Tax Imposed Under IRC4911 | 0 | TaxImposedUnderIRC4911 |
| Tax Imposed Under IRC4912 | 0 | TaxImposedUnderIRC4912 |
| Tax Imposed Under IRC4955 | 0 | TaxImposedUnderIRC4955 |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTrans |
| Amount Of Tax Imposed On Org Mgr | 0 | AmountOfTaxImposedOnOrgMgr |
| Amount Of Tax Reimbursed By Org | 0 | AmountOfTaxReimbursedByOrg |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| States Where Copy Of Return Is Filed | KS | StatesWhereCopyOfReturnIsFiled |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | WILLIAM H STORCK | NamePerson |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 708 NORTH 18TH STREET | AddressLine1 |
| City | MARYSVILLE | City |
| State | KS | State |
| ZIP Code | 66508 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7855622311 | TelephoneNumber |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccount |
| Foreign Office | false | ForeignOffice |
| Maintain Any Donor Advised Funds | false | MaintainAnyDonorAdvisedFunds |
| Does Org Have Hospital | false | DoesOrgHaveHospital |
| Tanning Services Provided | false | TanningServicesProvided |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction With Control Entity | false | TransactionWithControlEntity |
| Engage Political Cmpgn Activities | false | EngagePoliticalCmpgnActivities |
| Engage In Lobbying Activities | false | EngageInLobbyingActivities |
| Operating School | false | OperatingSchool |
| Trnsfrs Exempt Non Char Related Org | false | TrnsfrsExemptNonCharRelatedOrg |
| Part VI Of Comp Of Highest Paid Empl | NONE | PartVIOfCompOfHighestPaidEmpl |
| Tot Number Of Oth Empl Paid Over100k | 0 | TotNumberOfOthEmplPaidOver100k |
| Tot Num Cntrct Pd Over100 K Prof Ser | 0 | TotNumCntrctPdOver100KProfSer |
| Filed Schedule A | true | FiledScheduleA |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Written IRS Determination | X | WrittenIRSDetermination |
| Contrib By Controlling Individual | false | ContribByControllingIndividual |
| Contribution By Related Party | false | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY MEMORIAL HEALTHCARE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 480630224 | EIN |
| Type Of Organization | 03 | TypeOfOrganization |
| Listed In Governing Doc | true | ListedInGoverningDoc |
| Amount | $0 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| OTHER EXPENSES SCHEDULE | FORM 990EZ PART I LINE 16 | Description:PURCHASED SERVICES AND PROFESSIONAL FEES Amount:5560 |
| OTHER LIABILITIES SCHEDULE | FORM 990EZ PART II LINE 26 | Description:DUE TO/FROM RELATED AFFILIATES BOY Amount:EOY Amount:43107 |