CHIEF FINANCIAL OFFICER

2011-02-15T10:42:47-06:00 2010-03-31 JH COHN LLP 4 BECKER FARM ROAD ROSELAND NJ 070681739 990 2009-04-01 200547132 MONMOUTH FAMILY HEALTH CENTER MONM 7329237100 270 BROADWAY LONG BRANCH NJ 07740 LIBERT J AMATO CHIEF FINANCIAL OFFICER 7329237100 2011-02-14 1 Evan Zuckerman 9732283500 2009 2016-02-24 21:20:13Z LIBERT J AMATO 270 Broadway Long Branch NJ 07740 8677749 0 X N/A X 2005 NJ TO PROVIDE A BROAD RANGE OF HEALTH SERVICES TO A LARGELY MEDICALLY UNDER SERVED POPULATION IN MONMOUTH COUNTY, NEW JERSEY 10 10 90 84 0 0 1030860 2138095 5162565 6502927 4494 10649 40282 26078 6238201 8677749 0 0 3377398 3887504 0 0 2590272 2701653 5967670 6589157 270531 2088592 3228538 3514725 2948723 1146318 279815 2368407 To provide medical, dental, and other social services to the underserved population of Monmouth County. 0 0 4652512 6529005 TO PROVIDE A BROAD RANGE OF HEALTH SERVICES TO A LARGELY MEDICALLY UNDER SERVED POPULATION IN MONMOUTH COUNTY, NEW JERSEY 4652512 1 1 0 0 0 0 0 0 0 1 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 0 0 1 5 0 90 0 0 0 0 0 0 0 0 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 NJ X Libert Amato 7329237100 270 BROADWAY LONGBRANCH NJ 07740 CARL F JENNINGS TRUSTEE 1.00 X 0 0 0 DR MARY JANE CELLI TREASURER 1.00 X X 0 0 0 WILLIAM ARNOLD TRUSTEE 1.00 X 0 0 0 JOSEPH FOSTER TRUSTEE 1.00 X 0 0 0 AMBAR ABELAR TRUSTEE 1.00 X 0 0 0 RICHARD DEGROOTE MD TRUSTEE 1.00 X 0 0 0 Carl Vega Trustee 1.00 X 0 0 0 LAWRENCE KERRIGAN TRUSTEE 1.00 X 0 0 0 GRETA V BUTLER VICE CHAIRPERSON 1.00 X 0 0 0 ANA M DOWLAND CHAIRPERSON 1.00 X 0 0 0 MARTA SILVERBERG CHIEF EXECUTIVE OFFICER 40.00 X 169556 0 20849 Raksha Joshi MD chief Medical Director 40.00 X 278356 0 21771 LIBERT AMATO cfo 40.00 X 116888 0 21114 DR AAREFA SHAKIR PHYSICIAN 24.00 X 103410 0 0 DR WEBSTER TRAMMELL FORMER PRESIDENT/CHAIRMAN 0.00 X 0 0 0 668210 0 63734 4 0 1 0 0 1051452 1086643 2138095 HEALTH SERVICES 621990 6502927 6502927 6502927 10649 10649 OTHER REVENUE 621990 26078 26078 26078 8677749 6529005 0 10649 576546 402995 173551 2606995 1822244 784751 47446 33164 14282 390109 272678 117431 266408 186213 80195 1198 1198 18670 18670 89667 89667 465081 311372 153709 473358 416555 56803 1992 1334 658 26089 17466 8623 56245 49496 6749 125789 110694 15095 101426 89255 12171 CONSULTANTS AND CONTRAC 1192301 810911 381390 REPAIRS AND MAINTENANCE 84840 74659 10181 DUES & SUBSCRIPTIONS 34858 23337 11521 PROVISION FOR BAD DEBT 30139 30139 6589157 4652512 1936645 0 737101 1638820 191929 534316 1804416 676238 64395 35753 1013843 413355 427687 600488 3010 29110 3228538 3514725 2081793 1099394 866930 46924 2948723 1146318 X 279815 2368407 279815 2368407 3228538 3514725 X 0 1 1 X 1 1 X 908388 900659 1151319 1030860 2138095 6129321 908388 900659 1151319 1030860 2138095 6129321 6129321 1211 6644 10745 4494 10649 33743 4545 2675 10233 40282 26078 83813 6246877 18406019 0.98120 0.97500 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 427858 153936 273922 496191 259419 236772 89794 89794 600488 8677749 6589157 2088592 0 2088592 8677749 0 8677749 0 8677749 6589157 0 6589157 0 6589157 1 X 0 0 0 0 0 0 0 0 0 MARTA SILVERBERG 148058 0 0 0 21498 0 4485 0 16364 0 190405 0 30864 0 Raksha Joshi MD 256858 0 0 0 21498 0 7749 0 14022 0 300127 0 54864 0 Form 990, Part VI, Section B, line 11 The Organization provides the Board of Trustees with a copy of the Form 990 in advance of filing with the IRS. In addition, the tax preparer briefs the Board of Trustees on the preparation of the 990 and answers all questions that any member of the Board of Trustees may have. Form 990, Part VI, Section B, line 12c The Organization monitors on a regular basis the conflict of interest policy. Each year, the Organization requests from the Trustees, management, and key employees to disclose any conflict of interest that may arise. If a conflict of interest is identified, management then determines if the conflict is of a nature that must be referred to legal counsel for their determination and reccomendation as to action to be taken. In addition, the Board of Trustee members are informed of any potential conflicts and how the conflict was resolved. Form 990, Part VI, Section C, line 19 The Organization will provide all governing documents to any person or persons who request the documents either in writing or in person. Upon the request, the organization logs what was requested, by whom, and where and when the documents were sent. FORM 990, PART XI, LINE 2C THE ORGANIZATION HAS A FINANCE COMMITTEE WHO OVERSEES THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTS ITS INDEPENDENT ACCOUNTANTS.