2013-11-15T07:47:39-06:00 2013-06-30 352123203 KSM BUSINESS SERVICES INC PO BOX 40857 INDIANAPOLIS IN 462400857 990 2012-07-01 201093251 IU MEDICAL GROUP FOUNDATION INC IUME 3172783500 340 W 10TH ST NO FS5100 INDIANAPOLIS IN 46202 KIMBERLEE SHERBROOKE 3172783500 2013-11-18 1 STEVEN A WARNER P00369624 3175802000 2013-11-14 2012 2015-11-30 17:44:51Z KIMBERLEE SHERBROOKE 340 WEST TENTH STREET FS 5100 INDIANAPOLIS IN 46202 107968711 0 X N/A X 2004 IN SEE SCHEDULE O 6 0 0 7 0 0 0 0 78946656 105802595 1300092 2166116 0 0 80246748 107968711 0 0 0 0 0 0 0 0 0 67296149 121640213 67296149 121640213 12950599 -13671502 92723986 84467354 10924591 16569716 81799395 67897638 THE CORPORATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, OR TO CARRY OUT THE PURPOSES OF ITS SUPPORTED ORGANIZATIONS. 0 0 121465108 105802595 TO ACQUIRE, MANAGE AND DISTRIBUTE FUNDS FOR THE BENEFIT OF THE INDIANA UNIVERSITY SCHOOL OF MEDICINE AND INDIANA UNIVERSITY HEALTH CARE ASSOCIATES, INC. 121465108 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 IN X KIMBERLEE SHERBROOKE 3172783500 340 WEST TENTH STREET FS 5100 INDIANAPOLIS IN 46202 D CRAIG BRATER MD 1.00 X X 0 594187 0 JOHN FITZGERALD MD 1.00 X X 0 502543 0 ROBERT HAVLIK MD 1.00 X 0 191099 0 PETER JOHNSTONE MD 1.00 X X 0 261527 0 VALERIE JACKSON MD 1.00 X 0 283263 0 DAVID CRABB MD 1.00 X X 0 250438 0 KIMBERLEE SHERBROOKE 1.00 X 0 276573 0 0 2359630 0 0 0 1 0 PNC BANK PO BOX 609 PITTSBURGH PA 15230 INVESTMENT MANAGEMENT SERVICES 141906 1 PROGRAM SERVICE REVENUE 611710 105802595 105802595 105802595 2162667 2162667 3449 0 3449 3449 3449 107968711 105802595 0 2166116 2518 2518 6230 6230 141906 141906 IUSM SUPPORT 45867555 45867555 MEDICAL EDUCATION CONTR 34778772 34778772 FACULTY & DEPARTMENTAL 27818781 27818781 WISHARD SUPPORT 13000000 13000000 24451 24451 121640213 121465108 175105 0 2907732 3319235 25993828 14384569 6571450 10126197 731505 617104 55431520 50617679 1087951 5402570 92723986 84467354 9925635 16569716 998956 0 10924591 16569716 X 15306866 17201291 66492529 50696347 81799395 67897638 92723986 84467354 -13671502 -230255 0 X 0 0 0 X X 0 0 0 INDIANA UNIVERSITY SCHOOL OF MEDICINE 356001673 LINE 5 1 1 1 13605458 INDIANA UNIVERSITY HEALTH CARE ASSOCIATES INC 351747218 LINE 9 1 1 1 5218147 2 18823605 0 ACCRUED INTEREST RECEIVABLE 238178 INVESTMENT IN ANDARA/CYBERKINETICS 278 INVESTMENT IN FASTDIAG/PHARMACO 114693 ACCRUED ASSESSMENT REVENUE 2283714 INVESTMENT IN XYLOGENICS 172134 INVESTMENT IN APEX 132045 INVESTMENT IN INDIANA INNOVATE FUND 2461528 5402570 0 0 0 0 0 0 0 0 0 D CRAIG BRATER MD 0 594187 0 0 0 0 0 0 0 0 0 594187 0 0 JOHN FITZGERALD MD 0 502543 0 0 0 0 0 0 0 0 0 502543 0 0 ROBERT HAVLIK MD 0 191099 0 0 0 0 0 0 0 0 0 191099 0 0 PETER JOHNSTONE MD 0 261527 0 0 0 0 0 0 0 0 0 261527 0 0 VALERIE JACKSON MD 0 283263 0 0 0 0 0 0 0 0 0 283263 0 0 DAVID CRABB MD 0 250438 0 0 0 0 0 0 0 0 0 250438 0 0 KIMBERLEE SHERBROOKE 0 276573 0 0 0 0 0 0 0 0 0 276573 0 0 ORGANIZATION MISSION STATEMENT FORM 990, PART I, LINE 1 TO ACQUIRE, MANAGE AND DISTRIBUTE FUNDS FOR THE BENEFIT OF THE INDIANA UNIVERSITY SCHOOL OF MEDICINE AND INDIANA UNIVERSITY HEALTH CARE ASSOCIATES, INC. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WILL BE GIVEN TO THE BOARD CHAIRMAN FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C IT IS THE RESPONSIBILITY OF THE OFFICERS AND DIRECTORS TO COMPLETE THE POLICY'S WRITTEN DISCLOSURE FORM AT LEAST ONCE PER YEAR. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTERST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. PROCESS FOR DETERMINING COMPENSATION FORM 990, PART VI, LINE 15A/B: IU MEDICAL GROUP FOUNDATION, INC. DOES NOT COMPENSATE ANY EMPLOYEES, AND THEREFORE, DOES NOT HAVE A PROCESS FOR DETERMINING COMPENSATION FOR EMPLOYEES. INDIANA UNIVERSITY SCHOOL OF MEDICINE 340 WEST 10TH STREET FAIRBANKS HALL INDIANAPOLIS IN 46202 356001673 TO ADVANCE HEALTH IN THE STATE OF INDIANA IN 501(C)3 170(B)(1)(A)(IV) N/A 0 INDIANA UNIVERSITY HEALTH CARE ASSOCIATES 340 WEST TENTH STREET FS 5100 INDIANAPOLIS IN 46202 351747218 TO EDUCATE, INFORM AND ADVOCATE ON BEHALF OF HEALTHCARE PROVIDERS AND CONSUM IN 501(C)3 509(A)2 N/A 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 INDIANA UNIVERSITY HEALTH CARE ASSOCIATES INC C 105802595 INDIANA UNIVERSITY SCHOOL OF MEDICINE B 13605458 INDIANA UNIVERSITY HEALTH CARE ASSOCIATES INC B 5218147