SECRETARY

2013-05-15T09:06:05-05:00 2012-12-31 410746749 CLIFTONLARSONALLEN LLP 8215 GREENWAY BOULEVARD SUITE 600 MIDDLETON WI 53562 990 2012-01-01 390965289 WISCONSIN DENTAL ASSOCIATION FOUNDATION INC WISC 4142764520 6737 W WASHINGTON STREET NO 2360 WEST ALLIS WI 53214 MARK PAGET SECRETARY 4142764520 2013-05-07 1 KIMBERLY ANDERSON CPA P00188889 6086628600 2013-05-06 2012 2016-02-24 21:20:13Z VICTORIA BOHMAN 6737 W WASHINGTON STREET NO 2360 WEST ALLIS WI 53214 502563 0 X WWW.WDA.ORG/WDA-FOUNDATION X 1957 WI SUPPORT DENTAL HEALTH CARE INITIATIVES TO IMPROVE ORAL HEALTH CARE OF DISADVANTAGED RESIDENTS THROUGHOUT THE STATE OF WISCONSIN. 17 17 3 2360 0 0 413071 403460 0 0 53815 59064 25688 19337 492574 481861 59679 61885 0 0 97399 104945 0 0 3158 224320 277475 381398 444305 111176 37556 2234807 2395791 9852 21195 2224955 2374596 SUPPORT DENTAL HEALTH CARE INITIATIVES TO IMPROVE ORAL HEALTH CARE OF DISADVANTAGED RESIDENTS THROUGHOUT THE STATE OF WISCONSIN. 0 0 83465 DONATED DENTAL SERVICES - PROVIDED DENTAL SERVICES VALUED AT $829,898 FOR DENTAL TREATMENT OF DISABLED, ELDERLY AND MEDICALLY-COMPROMISED INDIVIDUALS WHO COULD NOT AFFORD THE DENTAL CARE NEEDED. 224718 PROVIDED FREE DENTAL CARE TO 3,595 UNINSURED, LOW-INCOME INDIVIDUALS VALUED AT $1,750,000 OVER A TWO-DAY PERIOD IN MADISON, WI. 61885 61885 ENHANCES EDUCATIONAL OPPORTUNITIES BY AWARDING SCHOLARSHIPS TO DENTAL AND DENTAL HYGIENE STUDENTS IN THE STATE OF WISCONSIN AND PROVIDED GRANTS IN SUPPORT OF STATEWIDE COMMUNITY DENTAL HEALTH PROJECTS AND CLINICS WHERE DENTAL CARE IS PROVIDED TO THE LOW INCOME POPULATION. 370068 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 26 0 1 3 1 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 WI X KELLY SICS 4147554102 6737 W WASHINGTON STREET WEST ALLIS WI 53214 DR ANTHONY SCIASCIA PRESIDENT 3.00 X X 0 0 0 DR LOREN SWANSON VICE PRESIDENT 1.50 X X 0 0 0 DR CHRISTINE TEMPAS TREASURER 1.50 X X 0 0 0 MR MARK PAGET SECRETARY 1.00 X X 0 0 0 DR PAUL OBERBRECKLING PAST PRESIDENT 1.50 X X 0 0 0 DR TIMMY COOPER DIRECTOR 1.00 X 0 0 0 DR JULIE FOX DIRECTOR 3.00 X 0 0 0 DR JOHN SADOWSKI DIRECTOR 0.40 X 0 0 0 DR PETER STEINERT DIRECTOR 1.00 X 0 0 0 DR JAMES VAN MILLER DIRECTOR 1.00 X 0 0 0 DR RON STIFTER DIRECTOR 1.50 X 0 0 0 DR JAMES MORGENROTH DIRECTOR 3.00 X 0 0 0 DR SUSAN CABLE DIRECTOR 1.50 X 0 0 0 DR FRANCESCA DE ROSE DIRECTOR 0.40 X 0 0 0 DR ROBB WARREN DIRECTOR 0.40 X 0 0 0 MR PAUL BATELY MEMBER AT-LARGE 0.30 X 0 0 0 MR DAVE C WAGNER MEMBER AT-LARGE 0.40 X 0 0 0 DR JOHN MOSER WDA TREASURER 0.30 X 0 0 0 DR ROGER COMEAU DIRECTOR EMERITUS 1.00 X 0 0 0 MR DENNIS MCGUIRE DIRECTOR EMERITUS 1.00 X 0 0 0 JEANNE RUDE MEMBER AT-LARGE 1.00 X 0 0 0 VICTORIA BOHMAN EXECUTIVE DIRECTOR 30.00 X 42447 0 4227 42447 0 4227 0 0 0 0 0 56209 347251 403460 59064 59064 40039 20702 19337 19337 481861 0 0 78401 48885 48885 13000 13000 46724 46724 47979 47432 547 3223 3223 119 119 6900 3437 3463 8000 8000 11700 11500 200 1000 1000 94273 85458 6215 2600 112457 109817 2640 8022 7443 355 224 4174 2911 929 334 908 667 241 390 390 MISCELLANEOUS 36176 36176 REGISTRATION 375 375 444305 370068 71079 3158 50268 65977 320970 280330 26209 88344 36406 31560 73680 35100 15483 15001 667 482 1722654 1893910 3953 88 2234807 2395791 9435 7692 417 13503 9852 21195 X 1935230 2075917 289725 298679 2224955 2374596 2234807 2395791 37556 112085 0 X 0 1 X 1 0 X 265597 266388 408538 413711 403460 1757694 265597 266388 408538 413711 403460 1757694 267390 1490304 38172 2984 24907 47694 59064 172821 1930515 0.77200 0.79190 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 15483 15001 482 482 614648 112085 20702 132787 481861 0 481861 465007 20702 20702 444305 0 444305 PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 20,702. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 20,702. GOLF OUTING 40039 40039 1389 19313 40039 40039 1389 19313 20702 19337 1 EDUCATIONAL SCHOLARSHIPS FOR DENTAL AND DENTAL HYGIENE STUDENTS 10 13000 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: RECIPIENTS FORWARD COPIES OF PAID RECEIPTS INCURRED FOR EXPENSES ASSOCIATED WITH THE GRANT TO BE RECEIVED. GRANT PAYMENTS MADE AFTER REVIEW OF THESE DOCUMENTS. FORM 990, PART VI, SECTION B, LINE 11 THE DRAFT OF THE 990 IS REVIEWED IN PERSON WITH THE ENTIRE BOARD BEFORE IT IS FILED. THE ORGANIZATION'S CPA FIRM WALKS THE BOARD THROUGH THE RETURN AT THE APRIL BOARD MEETING EACH YEAR. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE ASKED AT EACH MEETING IF THEY HAVE A CONFLICT WITH ANY ISSUE ON THE AGENDA. FORM 990, PART VI, SECTION B, LINE 15A MARK PAGET, SECRETARY, AND KELLY SICS, DIRECTOR OF FINANCE, DETERMINE THE SALARY OF THE EXECUTIVE DIRECTOR. THIS SALARY IS LATER APPROVED BY THE ENTIRE BOARD IN CONJUNCTION WITH THE APPROVAL OF THE BUDGET. COMPARABLE WAGE DATA IS OBTAINED FROM AN INDEPENDENT FIRM SPECIALIZING IN HUMAN RESOURCES. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST.