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ADA FOUNDATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
ADA FOUNDATION (EIN 36-6132046)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-05-30
IRS object ID
201201519349300230
Schema version
2011v1.2
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)
Timestamp2012-05-30T14:40:44-04:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1191 WEST NATIONWIDE BLVD STE 500AddressLine1
CityCOLUMBUSCity
StateOHState
ZIP Code432152568ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN366132046EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ADA FoundationBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% CYNTHIA FRONCZAKInCareOfName
Name ControlADAFNameControl
Phone3124403534Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1211 East Chicago AvenueAddressLine1
CityChicagoCity
StateILState
ZIP Code606112637ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCYNTHIA FRONCZAKName
TitleCHIEF FINANICAL OFFICERTitle
Date Signed2012-05-30DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone6142492300Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonCynthia FronczakNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1211 EAST CHICAGO AVENUEAddressLine1
CityCHICAGOCity
StateILState
ZIP Code606112637ZIPCode
FieldValueIRS element (for citing)
Gross Receipts9698461GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.adafoundation.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1965YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionADA FOUNDATION IS A CATALYST FOR UNITING PEOPLE AND ORGANIZATIONS TO MAKE A DIFFERENCE THROUGH BETTER ORAL HEALTH.ActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members17NbrIndependentVotingMembers
Total Nbr Employees35TotalNbrEmployees
Total Nbr Volunteers44TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year5702157ContributionsGrantsPriorYear
Contributions Grants Current Year5292033ContributionsGrantsCurrentYear
Program Service Revenue Prior Year62400ProgramServiceRevenuePriorYear
Program Service Revenue CY31578ProgramServiceRevenueCY
Investment Income Prior Year433369InvestmentIncomePriorYear
Investment Income Current Year573076InvestmentIncomeCurrentYear
Other Revenue Prior Year1851733OtherRevenuePriorYear
Other Revenue Current Year1614802OtherRevenueCurrentYear
Total Revenue Prior Year8049659TotalRevenuePriorYear
Total Revenue Current Year7511489TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year899647GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1557866GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year4849411SalariesEtcPriorYear
Salaries Etc Current Year3607052SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year116667TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2804530OtherExpensePriorYear
Other Expenses Current Year2630198OtherExpensesCurrentYear
Total Expenses Prior Year8670255TotalExpensesPriorYear
Total Expenses Current Year7795116TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-620596RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-283627RevenuesLessExpensesCY
Total Assets BOY27155765TotalAssetsBOY
Total Assets EOY23259667TotalAssetsEOY
Total Liabilities BOY2882145TotalLiabilitiesBOY
Total Liabilities EOY456213TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY24273620NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY22803454NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionAS DENTISTRY'S PREMIER PHILANTHROPIC AND CHARITABLE ORGANIZATION, THE ADA FOUNDATION IS A CATALYST FOR UNITING PEOPLE AND ORGANIZATIONS TO MAKE A DIFFERENCE THROUGH BETTER ORAL HEALTH. WE SECURE CONTRIBUTIONS AND PROVIDE GRANTS FOR SUSTAINABLE PROGRAMS IN DENTAL RESEARCH, EDUCATION, ACCESS TO CARE AND ASSISTANCE FOR DENTISTS AND THEIR FAMILIES IN NEED.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense3761184Expense
Grants5970Grants
Revenue1630887Revenue
DescriptionPERFORM RESEARCH ACTIVITIES TO ENCOURAGE THE IMPROVEMENT OF THE HEALTH OF THE PUBLIC & TO PROMOTE THE ART AND SCIENCE OF DENTISTRY.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense2231440Expense
Grants1462995Grants
Revenue0Revenue
DescriptionPROVIDE FUNDS TO EDUCATIONAL INSTITUTES AND OTHER ENTITIES TO ADVANCE DENTAL RESEARCH AND EDUCATIONAL PROGRAMS AND SUPPORT NATIONAL AND REGIONAL DENTAL ACCESS PROGRAMS TO MAKE DENTAL CARE AVAILABLE TO THE UNDERSERVED.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense241804Expense
Grants88901Grants
Revenue0Revenue
DescriptionPROVIDE CHARITABLE ASSISTANCE FOR DENTISTS AND THEIR FAMILIES IN NEED. THIS INCLUDES PROVIDING RELIEF GRANTS TO AID MEMBERS OF THE DENTAL PROFESSION AND THEIR DEPENDENTS WHO, BECAUSE OF AGE OR OTHER DISABLING CONDITIONS ARE NOT WHOLLY SELF-SUSTAINING, AND DISASTER GRANTS.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense6234428TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
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 EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgtrueTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109621NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees35NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members17NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledALStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledAKStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledAZStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledARStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledCOStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledCTStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledDCStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledFLStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledGAStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledKSStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledKYStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledMDStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledMAStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledMIStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledMNStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledMOStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledNHStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledNJStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledNMStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledNCStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledNDStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledOKStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledORStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
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States Where Copy Of Return Is FiledWAStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledWVStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonCYNTHIA FRONCZAKNamePerson
Telephone Number3125874717TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1211 EAST CHICAGO AVENUEAddressLine1
CityChicagoCity
StateILState
ZIP Code606112637ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (35 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Dr Orin Ellwein
VP-GRANTS1.0XX
Dr Robert Henderson
VP-Grants1.0XX
Mr Kent Fletcher
Director1.0X
Dr Ernest Garcia
Director1.0X
Dr Richard Simms
VP-Development1.0XX
Ms Sheila Hopkins
Director1.0X
Mr Timothy Sullivan
Director1.0X
Dr Leo Rouse
Director1.0X
Dr R Wayne Thompson
Director1.0X0454150
Dr Jane S Grover
Director1.0X
Dr Donald Seago
Director1.0X0642910
Dr Charles L Smith
Director1.0X
Dr Lewis C Walker
Director1.0X
Dr Linda Niessen
Director1.0X
MR PAUL D CHIBE
DIRECTOR1.0X
DR STEVEN GOUNARDES
DIRECTOR1.0X0600310
DR MICHAEL RETHMAN
VP-Science1.0XX97500
MR RONALD SZARYNSKI
VP-Finance1.0XX
MS PAMELA ZARKOWSKI
VP-Grants1.0XX
DR CHARLES H NORMAN
DIRECTOR1.0X0616730
Dr Ronald Bushick
Director1.0X
Ms Pam Hemmen
Director1.0X
Dr Fotinos Panagakos
Director1.0X
Ms Candy Ross
Director1.0X
Dr J Leslie Winston
Director1.0X
Dr Gary S Yonemoto
Director1.0X
DR DAVID A WHISTON
PRESIDENT5.0X135000
GENE WURTH
Executive Director40.0X13983009244
CYNTHIA FRONCZAK
CHIEF FINANCIAL OFFICER40.0X732400
DR GARY SCHUMACHER
DIR. OF ADMIN/CHIEF RESEARCHER40.016223005700X
DR RAFAEL BOWEN
DIST. SCIENTIST40.0184213019732X
DR LAWRENCE CHOW
ASSISTANT DIRECTOR40.0130427020232X
DR GERARD VOGEL
CHIEF RSRCH SCI. CARDIOLOGY40.0136295010814X
DR MING TUNG
SR. PROJECT LEADER40.0123060012246X
DR DRAGO SKRTIC
DIRECTOR OF RESEARCH40.011955507675X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1005259TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs231410TotalReportableCompFrmRltdOrgs
Total Other Compensation85643TotalOtherCompensation
Number Individuals GT100 K10NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
BANNER WITCOFF LTD
10 S WACKER DRIVECHICAGOIL60606LEGAL318565
BLACKMAN KALLICK PROJECTEMPS LLC
10 S RIVERSIDECHICAGOIL60606EXEC TEMP SVC307848
TATUM LLC
3715 Northside ParkwayATLANTAGA30308CONSULTANTS260808
KPMG LLP
3 Chestnut Ridge RoadMONTVALENJ07645AUDIT167689
Emmett Murphy
4507 Cornell AveDOWNERS GROVEIL60515INTERIM CFO149700
FieldValueIRS element (for citing)
Number Of Contractors GT100 K10NumberOfContractorsGT100K
Related Organizations3925382RelatedOrganizations
Government Grants999932GovernmentGrants
All Other Contributions366719AllOtherContributions
Total Contributions5292033TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
RESEARCH CONFERENCES5419003078030780
PUBLICATION AND PRODUCT SALES900099798798
FieldValueIRS element (for citing)
Total Program Service Revenue31578TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column372143TotalRevenueColumn
Exclusion$372,143ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column1599309TotalRevenueColumn
Related Or Exempt Function Income1599309RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities2288837Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities2087904Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities200933Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column200933TotalRevenueColumn
Exclusion$200,933ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events97600GrossIncomeFundraisingEvents
Fundraising Direct Expenses99068FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-1468TotalRevenueColumn
Exclusion-$1,468ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
MISCELLANEOUS INCOME90009912961$12,961
HONORARIA9000994000$4,000
FieldValueIRS element (for citing)
Total Other Revenue16961TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column7511489TotalRevenueColumn
Related Or Exempt Function Income1630887RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$588,569ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1033965Total
Program Services1033965ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total523901Total
Program Services523901ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total311708Total
Program Services195249ProgramServices
Management And General116459ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2048123Total
Program Services1488646ProgramServices
Management And General559477ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total602026Total
Program Services426786ProgramServices
Management And General175240ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total486568Total
Program Services344936ProgramServices
Management And General141632ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total158627Total
Program Services112453ProgramServices
Management And General46174ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total908734Total
Program Services402543ProgramServices
Management And General506191ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total416068Total
Program Services416068ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total130618Total
Program Services130618ProgramServices

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total15515Total
Management And General15515ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total3010Total
Program Services3010ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total140433Total
Program Services140433ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total234Total
Program Services234ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total157117Total
Program Services157117ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total21065Total
Program Services21065ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total207765Total
Program Services207765ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total22957Total
Program Services22957ProgramServices

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
INDIRECT COSTS300143300143
INVENTOR'S SHARE OF ROYALTIES242275242275
OTHER EXPENSES6426464264

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total7795116Total
Program Services6234428ProgramServices
Management And General1560688ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY984272BOY
EOY130118EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY6604BOY
EOY35960EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY896022BOY
EOY640447EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY6000BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY32957BOY
EOY7576EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis2542827LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2193075LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY557516BOY
EOY349752EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY24672394BOY
EOY21869595EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY226219EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY27155765BOY
EOY23259667EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY991194BOY
EOY352776EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY174890BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY47910BOY
EOY5000EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1668151BOY
EOY98437EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2882145BOY
EOY456213EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY12409999BOY
EOY12482307EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY9724779BOY
EOY8182305EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2138842BOY
EOY2138842EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY24273620BOY
EOY22803454EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY27155765BOY
EOY23259667EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-283627ReconcilationRevenueExpenses
Reconcilation Other Changes-1186539ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years7717109CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7591699CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6234930CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5702157CurrentTaxYearMinus1Year
Current Tax Year5292033CurrentTaxYear
Total32537928Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1372933CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1831744CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1842145CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1883656CurrentTaxYearMinus1Year
Current Tax Year1630887CurrentTaxYear
Total8561365Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9090042CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9423443CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8077075CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7585813CurrentTaxYearMinus1Year
Current Tax Year6922920CurrentTaxYear
Total41099293Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3435452CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3233193CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2918828CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3691640CurrentTaxYearMinus1Year
Current Tax Year3925382CurrentTaxYear
Total17204495Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3435452CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3233193CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2918828CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3691640CurrentTaxYearMinus1Year
Current Tax Year3925382CurrentTaxYear
Total17204495Total
FieldValueIRS element (for citing)
Public Support Total50923894798PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years656520CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years569850CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4440965CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year428567CurrentTaxYearMinus1Year
Current Tax Year372143CurrentTaxYear
Total6468045Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years656520CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years569850CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4440965CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year428567CurrentTaxYearMinus1Year
Current Tax Year372143CurrentTaxYear
Total6468045Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years45545CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years19948CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years64568CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7493CurrentTaxYearMinus1Year
Current Tax Year16961CurrentTaxYear
Total154515Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9792107CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10013241CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12582608CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8021873CurrentTaxYearMinus1Year
Current Tax Year7312024CurrentTaxYear
Total47721853Total
FieldValueIRS element (for citing)
Public Support Percentage5090.50071PublicSupportPercentage509
Prior Year Support Percentage0.54290PriorYearSupportPercentage
Investment Income Percentage0.13554InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.12960PriorYrInvestIncomePercentage
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

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance2390453BeginningOfYearBalance
Investment Earnings Or Losses-52824InvestmentEarningsOrLosses
Other Expenditures61692OtherExpenditures
Administrative Expenses1278AdministrativeExpenses
End Of Year Balance2274659EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance2108095BeginningOfYearBalance
Contributions305Contributions
Investment Earnings Or Losses283007InvestmentEarningsOrLosses
Administrative Expenses954AdministrativeExpenses
End Of Year Balance2390453EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1910954BeginningOfYearBalance
Contributions-289289Contributions
Investment Earnings Or Losses487518InvestmentEarningsOrLosses
Administrative Expenses1088AdministrativeExpenses
End Of Year Balance2108095EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2885412BeginningOfYearBalance
Contributions18142Contributions
Investment Earnings Or Losses-885993InvestmentEarningsOrLosses
Other Expenditures106607OtherExpenditures
End Of Year Balance1910954EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.94029PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.05971TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2542827OtherCostOrOtherBasis
Depreciation2193075Depreciation
Book Value349752BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings349752TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
DUE TO RELATED ORGANIZATIONS$0
DUE TO CONSTITUENT SOCIETIES$8,205
CHARITY GIFT ANNUITY PAYABLE$90,232
FieldValueIRS element (for citing)
Total Of Amounts98437TotalOfAmounts
Total Revenue7511489TotalRevenue
Total Expenses7795116TotalExpenses
Excess Or Deficit For Year-283627ExcessOrDeficitForYear
Net Unrealized GL On Investments-1186539NetUnrealizedGLOnInvestments
Total Adjustments-1186539TotalAdjustments
Excess Or Deficit Per FS-1470166ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt6420018TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-1186539NetUnrealizedGainsInvestments
Revenue Not Rptd F990-1186539RevenueNotRptdF990
Revenue Subtotal7606557RevenueSubtotal
Other Revenues Not Included-95068OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-95068RevenueNotRptdOnFinStmt
Total Revenue Per Form9907511489TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt7890184TotExpensesEtcAuditedFinclStmt
Other Expenses Included95068OtherExpensesIncluded
Expenses Not Rptd F99095068ExpensesNotRptdF990
Expenses Subtotal7795116ExpensesSubtotal
Total Expenses Per Form9907795116TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ENDOWMENT FUNDSSCHEDULE D, PART V, LINE 4THE FOUNDATION'S ENDOWMENTS CONSIST OF VARIOUS FUNDS TO SUPPORT ACCESS TO CARE AND EDUCATIONAL ACTIVITIES. NET ASSETS RELATED TO THE FOUNDATION ENDOWMENTS ARE DONOR-RESTRICTED FUNDS, CLASSIFIED AND REPORTED BASED UPON THE DONOR-IMPOSED RESTRICTIONS.
Part XII, Line 4bReclass of Special Event expense(99,068) Reclass of Fundraising expense 4,000 Reclass of Honoraria Income (95,068) Total
Part XIII, Line 2dReclass of Special Event expense99,068 Reclass of Fundraising expense 4,000 Reclass of Honoraria Income 95,068 Total
Part X, Line 2Tax Status and Accounting for Uncertainty in Income TaxesThe Foundation is an Illinois not for profit corporation recognized as exempt from federal income taxes under Section 501(a) of the Internal Revenue Code (Code) as an organization described in Section 501(c)(3) of the Code. The Foundation received a favorable determination letter from the Internal Revenue Service on September 4, 1997 stating that it is exempt from taxation on income related to its exempt purpose. ASC Topic 740, Accounting for Uncertainty in Income Taxes, clarifies the accounting for uncertainty in income taxes recognized in the financial statements and established recognition and measurement criteria for tax positions taken in a tax return. The adoption of the provisions of ASC topic 740 did not impact the Foundation's financial position or results of operations. There was no significant unrelated business income in 2011 and 2010, and therefore, no provision for income taxes has been recorded.

Schedule G IRS990ScheduleG

Fundraiser Activity Information FundraiserActivityInformation

FieldValueIRS element (for citing)
Name Of IndividualKETCHUM INC nka Pursuant GrouNameOfIndividual
ActivityINNOVATION CAMPAIGNActivity
Fundraiser Control Of FundsfalseFundraiserControlOfFunds

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Kids Smile GalaNameOfEvent1
Gross Receipts Event197600GrossReceiptsEvent1
Gross Revenue Event197600GrossRevenueEvent1
Food And Beverage Event131547FoodAndBeverageEvent1
Entertainment Event11225EntertainmentEvent1
Other Direct Expenses Event166296OtherDirectExpensesEvent1
Total Number Of Other Events0TotalNumberOfOtherEvents
Gross Receipts Total97600GrossReceiptsTotal
Gross Revenue Total Events97600GrossRevenueTotalEvents
Food And Beverage Total Events31547FoodAndBeverageTotalEvents
Entertainment Total Events1225EntertainmentTotalEvents
Other Direct Expenses Total Events66296OtherDirectExpensesTotalEvents
Direct Expense Summary Events99068DirectExpenseSummaryEvents
Net Income Summary-1468NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (11 entries)

Address Line1AddressUS/AddressLine1Address Line2AddressUS/AddressLine2CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
UNIVERSITY OF ILLINOIS
506 S WRIGHT STREET177 HENRY ADMINISTRATION BLDGURBANAIL61801376006007501(c)(3)6000PUBLIC SUPPORT
TEAM SMILE INC
2000 SWIFT STNORTH KANSAS CITYMO64116753250075501(c)(3)6250PUBLIC SUPPORT
NATIONAL ASSOCIATION OF SCHOOL NURSES
8484 GEORGIA AVENUESUITE 420SILVER SPRINGMD20910520886492501(c)(3)6250PUBLIC SUPPORT
VIRGINIA BROWN COMM ORTHODONTIC PTNSHP
2405 GRANDKANSAS CITYMO64108431913088501(c)(3)6250PUBLIC SUPPORT
UNIVERSITY OF MARYLAND
2242G BLDG 255COLLEGE PARKMD207422611522197313501(c)(3)6250PUBLIC SUPPORT
HEALTH VOLUNTEERS OVERSEAS
1900 L STREET NWSUITE 310WASHINGTONDC20036521485477501(c)(3)11700PUBLIC SUPPORT
BETHANY FOR CHILDREN AND FAMILIES
1830 6TH AVENUEMOLINEIL61265362166973501(c)(3)25000PUBLIC SUPPORT
VIRGINIA DENTAL HEALTH FOUNDATION
3460 Mayland CT STE 10RICHMONDVA23233541821602501(c)(3)18750PUBLIC SUPPORT
AMERICAN ACADEMY OF PEDIATRICS
141 NW POINT BLVDELK GROVE VILLIL60007362275597501(c)(3)61031PUBLIC SUPPORT
HENRY SCHEIN CARES FOUNDATION INC
135 DURYEA ROADMELVILLENY11747264137268501(c)(3)421500PUBLIC SUPPORT
AMERICAN DENTAL ASSOCIATION
211 EAST CHICAGO AVENUECHICAGOIL606112678360724690501(C)(6)343700PUBLIC SUPPORT
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants10TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (4 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrant
DISASTER FUND54270000
SCHOLARSHIPS59102500
MINORITY SCHOLARSHIPS2562500
RELIEF FUND2088901

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierSCHEDULE I, PART I, LINE 2Identifier
Return ReferenceMONITORING USE OF GRANTSReturnReference
ExplanationGRANTEES MUST SIGN A GRANT TERMS AGREEMENT WHICH SPECIFIES THEIR ACCEPTANCE OF THE GRANT AND OUTLINES GRANT USE REQUIREMENTS. FURTHER, GRANTEES MUST COMPLETE A FINAL REPORT FORM THAT SUMMARIZES THE PROJECT WITH A NARRATIVE DESCRIPTION, LISTS OBJECTIVES ACHIEVED AND HOW THOSE ACHIEVEMENTS WERE MEASURED, ALONG WITH THE ESTIMATED NUMBER OF PEOPLE SERVED, THE ESTIMATED NUMBER OF VOLUNTEERS USED, AND HOW THE GRANT FUNDS WERE EXPENDED.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DR RAFAEL BOWEN
1763510007862000197320203945000
DR LAWRENCE CHOW
128471000195605000197320150659000
DR GARY SCHUMACHER
16032400019060500052000167930000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierFORM 990, SCHEDULE J, PART IIIdentifier
ExplanationDEFERRED COMPENSATION IN COLUMN C INCLUDES, WHERE APPLICABLE, THE 2010 INCREASE IN ACTUARIAL VALUE OF THE DEFINED BENEFIT PLAN AND EMPLOYER CONTRIBUTIONS TO THE 401(K) DEFINED CONTRIBUTION PLAN. NONTAXABLE BENEFITS IN COLUMN D INCLUDES EMPLOYER-PAID HEALTH BENEFIT PLAN PREMIUMS AND THE VALUE OF EMPLOYER SELF-INSURED DENTAL BENEFITS.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (15 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, LINE 1BINDEPENDENT VOTING MEMBERSSOME OF THE MEMBERS OF THE ADA FOUNDATION BOARD OF DIRECTORS ARE NOT CONSIDERED INDEPENDENT BECAUSE THEY RECEIVE REIMBURSEMENT FROM THE AMERICAN DENTAL ASSOCIATION OF STATED AMOUNTS ON AN ANNUAL BASIS FOR SUCH GENERAL EXPENSES AS POSTAGE, TELEPHONE AND SECRETARIAL ASSISTANCE. SUBSTANTIATION OF SUCH EXPENSES IS NOT REQUIRED FOR REIMBURSEMENT. THESE AMOUNTS ARE REPORTED AS TAXABLE INCOME TO THE RECIPIENTS. ADDITIONALLY, THERE IS A DIFFERENCE IN VOTING RIGHTS. THE FOUNDATION'S PRESIDENT ONLY VOTES ON AN ISSUE IF THE BOARD MEMBERS' VOTE RESULTS IN A TIE.
FORM 990, PART VI, LINE 6MEMBERS OR STOCKHOLDERSTHE AMERICAN DENTAL ASSOCIATION IS THE SOLE MEMBER OF THE ADA FOUNDATION.
FORM 990 , PART VI , LINE 7AELECTIONS OF THE GOVERNING BODYTHE MEMBER ELECTS FOUR MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, LINE 11BFORM 990 REVIEWTHE FORM 990 WAS REVIEWED BY MANAGEMENT PRIOR TO FILING. FINANCIAL INFORMATION WAS COMPARED TO THE ORGANIZATION'S BOOKS AND RECORDS. RESPONSES TO QUESTIONS AND ADDITIONAL INFORMATION WERE REVIEWED FOR APPROPRIATENESS. ADDITIONALLY, THE FORM 990 WAS REVIEWED AND APPROVED BY THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. A COPY OF THE FORM 990 WILL BE SENT TO ALL BOARD MEMBERS AFTER FILING.
FORM 990, PART VI LINE 12CCONFLICT OF INTEREST POLICYTHERE IS AN ANNUAL REVIEW OF THE CONFLICT OF INTEREST POLICY. BOARD MEMBERS AND EXECUTIVE EMPLOYEES ARE REQUIRED TO SIGN THE CONFLICT OF INTEREST DISCLOSURE FORM EACH YEAR. IN-HOUSE LEGAL COUNSEL COLLECTS AND REVIEWS RESPONSES AND DETERMINES NECESSARY ACTION, IF ANY. INDIVIDUALS WHO HAVE A DISCLOSED CONFLICT RECUSE THEMSELVES FROM DISCUSSION, AND DO NOT VOTE IF THERE IS A DIRECT CONFLICT.
FORM 99O, PART VI, LINE 15BPROCESS FOR DETERMINING COMPENSATIONThe ADA Foundation was managed by interim staff for the first six months of 2011 until a new Executive Director was hired in July of 2011. The Executive Committee of the Board of Directors, acting as the Compensation Committee, determined the compensation of the Executive Director by reviewing comparability data for organizations of similar size, complexity, and the like.
FORM 990, PART VI, LINE 19ORGANIZATION DOCUMENTSTHE ADA FOUNDATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART XI, LINE 5UNREALIZED LOSS ON INVESTMENTS (1,186,539)
FORM 990, PART VI, LINE 7BThe Bylaws of the Foundation provide that the Member has the right to vote on the following: Amendment or repeal of the Articles of Incorporation of the Foundation; Any amendment of the Bylaws that would change any of the rights of the Member, including the right to elect the ADA Directors; The election and removal of ADA Directors; the removal of directors as provided in 805 ICLS 105/108.35(d) of the Illinois Not For Profit Corporation Act; Any merger of the Foundation; The dissolution of the Foundation The disposition of all or substantially all of the assets of the Foundation
FORM 990, PART VIIDr. David Whiston is the president of the organization. The president is not a standing voting director of the board of directors. The president only votes if there is a tie.
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Dr. R. Wayne Thompson TITLE:Director HOURS:10
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Dr. Donald Seago TITLE:Director HOURS:10
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:DR. STEVEN GOUNARDES TITLE:DIRECTOR HOURS:10
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:DR. CHARLES H. NORMAN TITLE:DIRECTOR HOURS:10
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Dr. Gary S. Yonemoto TITLE:Director HOURS:10

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1AMERICAN DENTAL ASSOCIATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1211 E CHICAGO AVEAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60611ZIPCode
FieldValueIRS element (for citing)
EIN360724690EIN
Primary ActivitiesTRADE ASSOC.PrimaryActivities
Legal Domicile StateILLegalDomicileState
Exempt Code Section501(C)(6)ExemptCodeSection
Public Charity StatusNONEPublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1ADA BUSINESS ENTERPRISES INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1211 E CHICAGO AVEAddressLine1
CityCHICAGOCity
StateILState
ZIP Code606112637ZIPCode
FieldValueIRS element (for citing)
EIN363679743EIN
Primary ActivityFIN. SERVICESPrimaryActivity
Legal Domicile StateILLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1ADABusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CORPTypeOfEntity
Share Of Total Income0ShareOfTotalIncome
Share Of EOY Assets0ShareOfEOYAssets
Percentage Ownership0.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
AMERICAN DENTAL ASSOCIATION
C3925382
AMERICAN DENTAL ASSOCIATION
O773592
AMERICAN DENTAL ASSOCIATION
Q300143
AMERICAN DENTAL ASSOCIATION
L, M912987
AMERICAN DENTAL ASSOCIATION
B343700
AMERICAN DENTAL ASSOCIATION
K12135

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierSCHEDULE R, PART V, LINE 2Identifier
ExplanationThe Foundation receives in-house legal, accounting, financial, and administrative services from the American Dental Association. As it relates specifically to federal grants, services provided from American Dental Association for indirect overhead were reimbursed in the amount of $300,143 from the Foundation. Additional services were provided by american dental association to the foundation that were not related to the federal grants, which was not reimbursed. in 2011, the value of these services was estimated at $881,058.Explanation