2011-05-12T10:39:10-05:00 2010-12-31 BOLLENBACHER & ASSOCIATES LLC 215 E PEARL ST PO BOX 702 PORTLAND IN 47371 990 2010-01-01 352139245 JAY COUNTY HOSPITAL AUXILIARY INC JAYC 2607261878 500 W VOTAW PORTLAND IN 47371 RACHEL STULTZ 2607261878 2011-05-10 1 SCOTT A BOLLENBACHER CPA 2607264207 2011-05-10 2010 2016-02-24 21:20:13Z RACHEL STULTZ 500 W VOTAW PORTLAND IN 47371 129493 0 X N/A X 2001 IN THE JAY COUNTY HOSPITAL AUXILIARY IS A NOT-FOR-PROFIT ORGANIZATION WHOSE PRIMARY PURPOSE IS TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF THE JAY COUNTY HOSPITAL. FUNCTIONS OF THE ORGANIZATION INCLUDE SPONSORSHIP OF HOSPITAL BUILDINGS, EQUIPMENT, PROJECTS AND PROGRAMS TO IMPROVE PATIENT CARE, AND PROMOTION OF THE HOSPITAL'S PROGRAMS. 16 16 0 134 0 0 4281 4333 73684 35562 -27952 -22711 24597 19166 74610 36350 37147 6903 0 0 0 0 0 0 0 37577 35958 74724 42861 -114 -6511 218621 240066 0 0 218621 240066 X THE JAY COUNTY HOSPITAL AUXILIARY IS A NOT-FOR-PROFIT ORGANIZATION WHOSE PRIMARY PURPOSE IS TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF THE JAY COUNTY HOSPITAL. FUNCTIONS OF THE ORGANIZATION INCLUDE SPONSORSHIP OF HOSPITAL BUILDINGS, EQUIPMENT, PROJECTS AND PROGRAMS TO IMPROVE PATIENT CARE, AND PROMOTION OF THE HOSPITAL'S PROGRAMS. 0 0 42861 6903 24639 THE JAY COUNTY HOSPITAL AUXILIARY IS A NOT-FOR-PROFIT ORGANIZATION WHOSE PRIMARY PURPOSE IS TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF THE JAY COUNTY HOSPITAL. FUNCTIONS OF THE ORGANIZATION INCLUDE SPONSORSHIP OF HOSPITAL BUILDINGS, EQUIPMENT, PROJECTS AND PROGRAMS TO IMPROVE PATIENT CARE, AND PROMOTION OF THE HOSPITAL'S PROGRAMS. 42861 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 0 0 0 0 0 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 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 IN X JAY COUNTY HOSPITAL AUXILARY 2607261878 500 W VOTAW ST PORTLAND IN 47371 X BETTY KRIEG X 0 0 0 VELMA ROOK X 0 0 0 CINDA MIXON X 0 0 0 GLEN COLPAERT X 0 0 0 KAREN COLPAERT X 0 0 0 MARIA HIATT X 0 0 0 ROSEMARY PENSINGER X 0 0 0 ROSE FENNING X 0 0 0 GAIL FRANKS X 0 0 0 KAREN GORE X 0 0 0 VERA HEFFNER X 0 0 0 DOLLY SNODGRASS X 0 0 0 RACHEL STULTZ X 0 0 0 CAROLE LEONHARD X 0 0 0 EMILY STEVESON X 0 0 0 EVA WYRICK X 0 0 0 0 0 0 0 0 0 0 0 333 4000 4000 4333 LIFELINE PROGRAM FEES 900000 27373 27373 MISCELLANEOUS INCOME 900000 8189 8189 35562 362 362 16695 39768 -23073 -23073 -23073 13745 6729 7016 7016 58796 46646 12150 12150 36350 24639 0 7378 6903 6903 4328 4328 689 689 10146 10146 MISCELLANEOUS EXPENSES 6186 6186 LIFELINE PROGRAM EXPENS 5903 5903 RENT 4000 4000 MILEAGE 3243 3243 ANNUAL DINNER 770 770 693 693 42861 42861 0 0 67439 77863 44301 44650 12812 14060 210160 159415 46086 50745 47983 52748 218621 240066 0 0 X 174102 187318 0 8229 44519 44519 218621 240066 218621 240066 X -6511 27956 X 0 1 0 X 0 X 210160 159415 50745 50745 PORTLAND FOUNDATION SCHOLARSHIP FUND 52748 52748 36350 42861 -6511 27956 27956 21445 64306 27956 27956 36350 0 36350 42861 0 42861 0 42861 CELEBRATION OF LIGHTS 9314 9314 4218 BOOK SALE 2667 2667 2283 1 1764 1764 228 13745 13745 6729 6729 7016 0 JAY COUNTY HOSPITAL 500 W VOTAW ST PORTLAND IN 47371 351143305 6903 TO ASSIST THE JAY COUNTY HOSPITAL IN ITS MISSION TO SERVE THE RESIDENCE OF JAY COUNTY, INDIANA WITH MEDICAL TREATMENT. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF DIRECTORS REVIEWS THE TAX RETURN BEFORE IT IS FILED FORM 990, PART VI, SECTION B, LINE 12C ANNUAL CONFLICT OF INTEREST POLICY STATEMENTS ARE SIGNED BY EACH BOARD MEMBER. THESE ARE THEN REVIEWED BY THE BOARD OF DIRECTORS TO ENSURE COMPLIANCE. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 27,956.