ANMED HEALTH AUXILIARY: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: ANMED HEALTH AUXILIARY (EIN 57-6024205)
Tax period: 2011-01-01 to 2011-12-31
Filed: 2012-05-11
IRS object ID: 201211329349302611
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
Form 990
Schedule A
Schedule D
Schedule G
Schedule I
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-05-11T13:54:29-05:00	Timestamp
Tax Period End Date	2011-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ARGO AND ASSOCIATES LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	303 E CALHOUN ST	AddressLine1
City	ANDERSON	City
State	SC	State
ZIP Code	29621	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	576024205	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	ANMED HEALTH AUXILIARY	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	ANME	NameControl
Phone	8645121263	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	800 N FANT STREET	AddressLine1
City	ANDERSON	City
State	SC	State
ZIP Code	29621	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	JAN VERBECK	Name
Title	DIRECTOR	Title
Phone	8645121263	Phone
Date Signed	2012-05-10	DateSigned

Preparer Preparer

Field	Value	IRS element (for citing)
Name	MICHAEL L WILLOUGHBY	Name
Phone	8642267202	Phone
Date Prepared	2012-05-10	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	JAN VERBECK	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	800 N FANT STREET	AddressLine1
City	ANDERSON	City
State	SC	State
ZIP Code	29621	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	818582	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	N/A	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1958	YearFormation
State Legal Domicile	SC	StateLegalDomicile
Activity Or Mission Description	VOLUNTEER SERVICES	ActivityOrMissionDescription
Nbr Voting Members Governing Body	17	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	17	NbrIndependentVotingMembers
Total Nbr Employees	0	TotalNbrEmployees
Total Nbr Volunteers	165	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	385	ContributionsGrantsPriorYear
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	9792	ProgramServiceRevenuePriorYear
Program Service Revenue CY	9361	ProgramServiceRevenueCY
Investment Income Prior Year	1683	InvestmentIncomePriorYear
Investment Income Current Year	874	InvestmentIncomeCurrentYear
Other Revenue Prior Year	215617	OtherRevenuePriorYear
Other Revenue Current Year	211987	OtherRevenueCurrentYear
Total Revenue Prior Year	227477	TotalRevenuePriorYear
Total Revenue Current Year	222222	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	110500	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	145000	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	31292	SalariesEtcPriorYear
Salaries Etc Current Year	32169	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	54759	OtherExpensePriorYear
Other Expenses Current Year	39976	OtherExpensesCurrentYear
Total Expenses Prior Year	196551	TotalExpensesPriorYear
Total Expenses Current Year	217145	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	30926	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	5077	RevenuesLessExpensesCY
Total Assets BOY	532391	TotalAssetsBOY
Total Assets EOY	544328	TotalAssetsEOY
Total Liabilities BOY	47390	TotalLiabilitiesBOY
Total Liabilities EOY	54250	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	485001	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	490078	NetAssetsOrFundBalancesEOY
Mission Description	VOLUNTEER SERVICES	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	59300	Expense
Description	PROVIDED VOLUNTEER SERVICES TO ANMED HEALTH SYSTEM. VOLUNTEERS HELPED BY MAKING PEOPLE IN THE HOSPITAL AND THEIR FAMILIES MORE COMFORTABLE.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	108000	Expense
Grants	108000	Grants
Description	GRANTED MONEY TO ANMED HEALTH SYSTEM FROM PROCEEDS OF VOLUNTEER ACTIVITIES AND GIFT SHOP SALES.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	37000	Expense
Grants	37000	Grants
Description	PROVIDED MONEY TO ELIGIBLE STUDENTS FOR SCHOOL ASSISTANCE.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	204300	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	false	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	true	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	true	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	false	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	0	NumberOfEmployees
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	17	NbrVotingGoverningBodyMembers
Number Independent Voting Members	17	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	false	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	false	ConflictOfInterestPolicy
Whistleblower Policy	false	WhistleblowerPolicy
Document Retention Policy	false	DocumentRetentionPolicy
Compensation Process CEO	false	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	SC	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	THE ORGANIZATION	NamePerson
Telephone Number	8645121263	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	800 N FANT STREET	AddressLine1
City	ANDERSON	City
State	SC	State
ZIP Code	29621	ZIPCode

Field	Value	IRS element (for citing)
No Listed Persons Compensated	X	NoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitle	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
JANE DIMIN
1ST VICE PRE	X	X	0	0	0
CALVIN HOLTZCLAW
2ND VICE PRE	X	X	0	0	0
BARBARA WAHLEN
TREASURER	X	X	0	0	0
PEGGY KONOPA
REC. SEC.	X	X	0	0	0
BARBARA GREENBERG
CORR. SECRET	X	X	0	0	0
PAT WENTZ
	X		0	0	0
HATTIE LEVER
	X		0	0	0
JUDY STEVENSON
	X		0	0	0
PAT MCCARRAGHER
	X		0	0	0
JANE CARNEY
	X		0	0	0
DIANA SACKETT
	X		0	0	0
KITTY MOSS
	X		0	0	0
JANICE WOOTEN
	X		0	0	0
DAVE SCHONAUER
	X		0	0	0
PAT MARTIN
	X		0	0	0
FRANCES RICE
PRESIDENT	X	X	0	0	0
WILLIE MAE LEE
	X		0	0	0
JAN VERBECK
DIRECTOR OF		X	0	0	0

Field	Value	IRS element (for citing)
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	COMMISSIONS FROM PHOTOS, ETC.	Description
Business Code	900099	BusinessCode
Total Revenue Column	9361	TotalRevenueColumn
Related Or Exempt Function Income	9361	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	9361	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	874	TotalRevenueColumn
Related Or Exempt Function Income	874	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	228212	GrossIncomeFundraisingEvents
Fundraising Direct Expenses	180176	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	48036	TotalRevenueColumn

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	580135	GrossSalesOfInventory
Cost Of Goods Sold	416184	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	163951	TotalRevenueColumn
Related Or Exempt Function Income	163951	RelatedOrExemptFunctionIncome

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	222222	TotalRevenueColumn
Related Or Exempt Function Income	174186	RelatedOrExemptFunctionIncome

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	108000	Total
Program Services	108000	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	37000	Total
Program Services	37000	ProgramServices

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	29883	Total
Program Services	29883	ProgramServices

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	2286	Total
Program Services	2286	ProgramServices

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	5100	Total
Management And General	5100	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	5290	Total
Program Services	5290	ProgramServices

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	4477	Total
Program Services	4477	ProgramServices

Travel Travel

Field	Value	IRS element (for citing)
Total	3140	Total
Program Services	2433	ProgramServices
Management And General	707	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	3719	Total
Management And General	3719	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	1181	Total
Program Services	1181	ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
PROGRAM SUPPLIES	6670	6670
BANK CHARGES	5280	5280
AWARDS & RECOGNITION	3319		3319
CANCER CLINIC	1800	1800

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	217145	Total
Program Services	204300	ProgramServices
Management And General	12845	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	236746	BOY
EOY	302098	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	97044	BOY
EOY	67252	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	51347	BOY
EOY	53625	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	141840	BOY
EOY	117121	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	558	BOY
EOY	558	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	9745	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	6071	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	4856	BOY
EOY	3674	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	532391	BOY
EOY	544328	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	47390	BOY
EOY	54250	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	47390	BOY
EOY	54250	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	485001	BOY
EOY	490078	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	485001	BOY
EOY	490078	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	532391	BOY
EOY	544328	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	5077	ReconcilationRevenueExpenses
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	true	AccountantCompileOrReview
FS Audited	false	FSAudited
Audit Committee	false	AuditCommittee
Financial Statement Separate	X	FinancialStatementSeparate
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Supporting Organization509a3	X	SupportingOrganization509a3
Supporting Org509a3 Type3 Other	X	SupportingOrg509a3Type3Other
Certification Checkbox	X	CertificationCheckbox
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	ANMED HEALTH FOUNDATION	BusinessNameLine1
Business Name Line2	ANMED HEALTH FOUNDATION	BusinessNameLine2

Field	Value	IRS element (for citing)
EIN	570817544	EIN
Type Of Organization	3	TypeOfOrganization
Listed In Governing Doc	false	ListedInGoverningDoc
Supported Organization Notified	true	SupportedOrganizationNotified
Organized In US	true	OrganizedInUS
Amount	$108,000	Amount

Field	Value	IRS element (for citing)
Total Number Of Supported Orgs	1	TotalNumberOfSupportedOrgs
Sum Of Amounts	108000	SumOfAmounts

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Disclosed Orgs Legal Control	false	DisclosedOrgsLegalControl
Disclosed For Charitable Purposes	false	DisclosedForCharitablePurposes
Written Policy Monitoring	false	WrittenPolicyMonitoring
Sect170h Requirements Satisfied	false	Sect170hRequirementsSatisfied
Solicited Assets For Sale	false	SolicitedAssetsForSale
Agent Trustee Etc	false	AgentTrusteeEtc
Included On FS	false	IncludedOnFS
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	false	AreRelatedOrgsListedScheduleR

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	9745	OtherCostOrOtherBasis
Depreciation	6071	Depreciation
Book Value	3674	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	3674	TotalOfBookValueLandBuildings

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

Field	Value	IRS element (for citing)
Identifier	LIABILITY UNDER FIN 48 FOOTNOTE	Identifier
Return Reference	SCHEDULE D, PAGE 3, PART X	ReturnReference
Explanation	MANAGEMENT IS NOT AWARE OF ANY UNCERTAIN TAX POSITIONS.	Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	UNIFORM SALE 1	NameOfEvent1
Gross Receipts Event1	73138	GrossReceiptsEvent1
Gross Revenue Event1	73138	GrossRevenueEvent1
Other Direct Expenses Event1	59227	OtherDirectExpensesEvent1
Name Of Event2	UNIFORM SALE 2	NameOfEvent2
Gross Receipts Event2	69085	GrossReceiptsEvent2
Gross Revenue Event2	69085	GrossRevenueEvent2
Other Direct Expenses Event2	56039	OtherDirectExpensesEvent2
Total Number Of Other Events	3	TotalNumberOfOtherEvents
Gross Receipts Other Events	85989	GrossReceiptsOtherEvents
Gross Revenue Other Events	85989	GrossRevenueOtherEvents
Other Direct Expenses Other Events	64910	OtherDirectExpensesOtherEvents
Gross Receipts Total	228212	GrossReceiptsTotal
Gross Revenue Total Events	228212	GrossRevenueTotalEvents
Other Direct Expenses Total Events	180176	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	180176	DirectExpenseSummaryEvents
Net Income Summary	48036	NetIncomeSummary

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	ANMED HEALTH FOUNDATION	BusinessNameLine1
Business Name Line2	ANMED HEATLH SYSTEM	BusinessNameLine2

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	800 N FANT STREET	AddressLine1
Address Line2	800 N FANT STREET	AddressLine2
City	ANDERSON	City
State	SC	State
ZIP Code	29621	ZIPCode

Field	Value	IRS element (for citing)
EIN Of Recipient	570817544	EINOfRecipient
IRC Section	501	IRCSection
Amount Of Cash Grant	108000	AmountOfCashGrant
Purpose Of Grant	SEE PART IV	PurposeOfGrant

Form990 Schedule I Part III Form990ScheduleIPartIII

Field	Value	IRS element (for citing)
Type Of Grant	EDUCATION SCHOLARSHIPS	TypeOfGrant
Number Of Recipients	37	NumberOfRecipients
Amount Of Cash Grant	37000	AmountOfCashGrant
Description Of Non Cash Assistance	SEE PART IV	DescriptionOfNonCashAssistance

Form990 Schedule I Part IV Form990ScheduleIPartIV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES	SCHEDULE I, PAGE 1, PART I, LINE 2	PROCEDURES FOR MONITORING THE DISBURSEMENT OF SCHOLARSHIPS TO INDIVIDUALS ARE OUTLINED IN A WRITTEN DOCUMENT. EACH RECIPIENT MUST MEET THE GUIDLINES IN ORDER TO RECEIVE FUNDS. NO RECIPIENT MAY RECEIVE MORE THAN 1,000 PER SEMESTER. SCHOLARSHIPS MAY BE RENEWED. RENEWAL GUIDELINES MUST BE MET AS WELL FOR EACH RECIPIENT.
ADDITIONAL INFORMATION	SCHEDULE I, PAGE 4, PART IV	PART II, LINE 1 - PURPOSE OF ASSISTANCE IS FOR GENERAL SUPPORT FOR MEDICAL RELATED NEEDS. PART III, LINE 1 - PURPOSE OF ASSISTANCE TO STUDENTS IS FOR POST-SECONDARY STUDENTS WHO ARE ENROLLED IN A HEALTHCARE-RELATED FIELD OF STUDY. PAYMENTS ARE MADE PAYABLE TO AND MAILED DIRECTLY TO THE SCHOOL.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	THE DIRECTOR REVIEWS THE FORM 990 BEFORE IT IS FILED.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	THE PUBLIC CAN VIEW THE GOVERNING DOCUMENTS AT THE OFFICE OF THE ORGANIZATION.