BETA

FOUNDATION FOR SELF LEADERSHIP: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
FOUNDATION FOR SELF LEADERSHIP (EIN 20-1318139)
Tax period
2024-01-01 to 2024-12-31
Filed
2025-05-13
IRS object ID
202541339349304804
Schema version
2024v5.1
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)
Return2025-05-13T12:10:41-05:00ReturnTs
Tax Period End2024-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN362985770PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SELDEN FOX LTDBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1ONE PARKVIEW PLAZA SUITE 710AddressLine1Txt
CityOAKBROOK TERRACECityNm
State AbbreviationILStateAbbreviationCd
ZIP60181ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2024-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN201318139EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FOUNDATION FOR SELF LEADERSHIPBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFOUNBusinessNameControlTxt
Phone9083088531PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 3776AddressLine1Txt
CityOAK PARKCityNm
State AbbreviationILStateAbbreviationCd
ZIP60303ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTOUFIC HAKIMPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone3127186876PhoneNum
Signature2025-05-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOHN T WOJCIKPreparerPersonNm
PTINP01331805PTIN
Phone6309541400PhoneNum
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTOUFIC HAKIMPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line114 HARDGROVE COURTAddressLine1Txt
CityHILLSBOROUGHCityNm
State AbbreviationNJStateAbbreviationCd
ZIP08844ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$416,004GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressFOUNDATIONIFS.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2007FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionRESEARCH, PROGRAM DEVELOPMENT AND ADVOCACYActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee4TotalEmployeeCnt
Total Volunteers38TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$395,210PYContributionsGrantsAmt
CY Contributions Grants$415,476CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$391PYInvestmentIncomeAmt
CY Investment Income$516CYInvestmentIncomeAmt
PY Other Revenue$540PYOtherRevenueAmt
CY Other Revenue$12CYOtherRevenueAmt
PY Total Revenue$396,141PYTotalRevenueAmt
CY Total Revenue$416,004CYTotalRevenueAmt
PY Grants And Similar Paid$143,052PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$101,938CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$186,079PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$162,285CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$180,949PYOtherExpensesAmt
CY Other Expenses$95,753CYOtherExpensesAmt
PY Total Expenses$510,080PYTotalExpensesAmt
CY Total Expenses$359,976CYTotalExpensesAmt
PY Revenues Less Expenses-$113,939PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$56,028CYRevenuesLessExpensesAmt
Total Assets BOY$331,989TotalAssetsBOYAmt
Total Assets EOY$384,846TotalAssetsEOYAmt
Total Liabilities BOY$11,751TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,673TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$320,238NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$376,173NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE STATEMENTTHE FOUNDATION FOR SELF LEADERSHIP'S PURPOSE IS TO FOSTER GREATER EMOTIONAL,RELATIONAL AND SOCIETAL HEALING AND WELLBEING - LEADING TO A MORE PEACEFUL WORLD - THROUGH THE PRACTICE OF SELF LEADERSHIP AS IDENTIFIED BY IFS. THE FOUNDATION FUNDS INDEPENDENT, SCIENTIFIC RESEARCH OF THE EFFICACY OF IFS FOR PTSD, SUBSTANCE ABUSE AND OTHER CONDITIONS, AND IN DIFFERENT SETTINGS. THE FOUNDATION INCUBATES INNOVATIVE APPLICATIONS OF THE IFS MODEL IN VARIOUS SOCIETAL CONTEXTS (E.G., K12 SCHOOLS, ACTIVE DUTY MILITARY AND VETERANS, MARGINALIZED COMMUNITIES) AND EXPLORES APPLICATIONS IN PROFESSIONAL SETTINGS (E.G., LAW, MEDICINE, BUSINESS, FINANCE). THE FOUNDATION'S OPERATION AND PROGRAMS ARE ENTIRELY FUNDED BY CHARITABLE GIVING FROM MEMBERS OF THE EXTENDED IFS COMMUNITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$129,551ExpenseAmt
Grant$91,428GrantAmt
DescFUNDED THE REMAINING PHASE OF A RANDOMIZED CLINICAL TRIAL (RCT) TO EXAMINE THE EFFECTS OF IFS PROTOCOLS IN TREATING INDIVIDUALS EXPERIENCING COMPLEX PTSD AND A FEASIBILITY STUDY OF IFS AND SUBSTANCE-USE DEPENDENCY. THIS ONGOING, INDEPENDENT STUDY HAS BEEN CONDUCTED AT THE CAMBRIDGE HEALTH ALLIANCE (MA) COMMUNITY MENTAL HEALTH CENTER, LED BY RESEARCHERS FROM THE HARVARD MEDICAL SCHOOL DEPARTMENT OF PSYCHIATRY.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$45,221ExpenseAmt
Grant$10,510GrantAmt
DescEXPLORED THE NEXT PHASE OF THE IFS FELLOWS LEADERSHIP PROGRAM, WHICH WAS DESIGNED TO ADVANCE OUR VISION OF A WORLD WITH GREATER RACIAL AND SOCIAL EQUITY AND JUSTICE. PROVIDED ADDITIONAL SUPPORT TO MOVE THE UKRANIAN RELIEF INITIATIVE TO THE NEXT LEVEL OF SERVICE.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$123,908ExpenseAmt
DescADVOCATED FOR THE PARADIGM OF INTERNAL FAMILY SYSTEMS (IFS), DEDICATING EXTENSIVE HUMAN RESOURCES, AND RELATIVELY MODEST FISCAL RESOURCES, BY EXPANDING THE RELATIVELY NEW OPEN-ACCESS ONLINE MAGAZINE, PARTSANDSELF.ORG, AND ENGAGING IN DEEPENING CONNECTIONS WITH A GROWING COMMUNITY OF PRACTICE.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$298,680TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document16IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee4EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn0AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc0RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDANIEL FERMINPersonNm
Phone9022257365PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 3776AddressLine1Txt
CityOAK PARKCityNm
State AbbreviationILStateAbbreviationCd
ZIP60303ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
VICKI MCCOY MA
CHAIR1.50Yes (X)Yes (X)$0$0$0
TOUFIC HAKIM PHD
EXECUTIVE DIRECTOR25.00Yes (X)Yes (X)$90,000$0$0
REQUINA BARNES LICSW
DIRECTOR1.00Yes (X)$0$0$0
STEWART BROWN PHD
DIRECTOR1.00Yes (X)$0$0$0
CHUN REN
DIRECTOR1.50Yes (X)Yes (X)$0$0$0
KELLY GAULE CAP
DIRECTOR1.00Yes (X)$0$0$0
TARA UNVERZAGT
ACTING TREASURER1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$90,000TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$415,476AllOtherContributionsAmt
Total Contributions$415,476TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$231TotalRevenueColumnAmt
Exclusion$231ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$285OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$285OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$285TotalRevenueColumnAmt
Exclusion$285ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Business541700BusinessCd
Total Revenue Column$12TotalRevenueColumnAmt
Related Or Exempt Func Income$12RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$12OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$416,004TotalRevenueColumnAmt
Related Or Exempt Func Income$12RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$516ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$101,938TotalAmt
Program Services$101,938ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$90,000TotalAmt
Program Services$76,500ProgramServicesAmt
Management And General$13,500ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$64,360TotalAmt
Program Services$54,706ProgramServicesAmt
Management And General$9,654ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,935TotalAmt
Program Services$3,344ProgramServicesAmt
Management And General$591ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,990TotalAmt
Program Services$3,392ProgramServicesAmt
Management And General$598ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$19,299TotalAmt
Management And General$19,299ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$30,366TotalAmt
Program Services$29,675ProgramServicesAmt
Management And General$691ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,675TotalAmt
Management And General$4,675ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,642TotalAmt
Program Services$3,642ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,906TotalAmt
Management And General$1,906ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,430TotalAmt
Management And General$1,430ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
STAFF/GOVERNANCE$21,633$18,399$3,234
PRODUCTIONS/PUBS$7,084$7,084
SUBSCRIPTIONS$5,653$5,653
MISCELLANEOUS$65$65

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$359,976TotalAmt
Program Services$298,680ProgramServicesAmt
Management And General$61,296ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$81,555BOYAmt
EOY$120,558EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$234,207BOYAmt
EOY$259,668EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$16,227BOYAmt
EOY$4,620EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$331,989BOYAmt
EOY$384,846EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$11,751BOYAmt
EOY$8,673EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$11,751BOYAmt
EOY$8,673EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$111,383BOYAmt
EOY$132,185EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$208,855BOYAmt
EOY$243,988EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$320,238BOYAmt
EOY$376,173EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$331,989BOYAmt
EOY$384,846EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$56,028ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$93NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$265,430CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$566,738CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$316,627CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$395,210CurrentTaxYearMinus1YearAmt
Current Tax Year$415,476CurrentTaxYearAmt
Total$1,959,481TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$265,430CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$566,738CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$316,627CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$395,210CurrentTaxYearMinus1YearAmt
Current Tax Year$415,476CurrentTaxYearAmt
Total$1,959,481TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$1,016,996SubstantialContributorsTotAmt
Public Support Total170$942,485PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$128CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$378CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$356CurrentTaxYearMinus1YearAmt
Current Tax Year$271CurrentTaxYearAmt
Total$1,133TotalAmt
FieldValueIRS element (for citing)
Total Support$1,960,614TotalSupportAmt
Public Support CY1700.48070PublicSupportCY170Pct
Public Support PY1700.99950PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$415,911TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$93NetUnrealizedGainsInvstAmt
Revenue Not Reported-$93RevenueNotReportedAmt
Revenue Subtotal$416,004RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$416,004TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$359,976TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$359,976ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$359,976TotalExpensesPerForm990Amt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1CAMBRIDGE HEALTH ALLIANCEBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11035 CAMBRIDGE STREET SUITE 21AddressLine1Txt
CityCAMBRIDGECityNm
State AbbreviationMAStateAbbreviationCd
ZIP02141ZIPCd
FieldValueIRS element (for citing)
Cash Grant$91,248CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Purpose Of GrantRESEARCH STUDYPurposeOfGrantTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BA DRAFT OF THE FORM 990 IS PROVIDED TO MANAGEMENT AND THE BOARD FOR REVIEW AND APPROVAL PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12MEMBERS OF THE BOARD ARE REQUIRED TO DISCLOSE THE EXISTENCE OF A POTENTIAL CONFLICT OF INTEREST, AT WHICH TIME THE INDVIDUAL TO WHOM THE CONFLICT PERTAINS WILL BE EXCUSED FROM THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT OUT OF WHICH THE POSSIBLE CONFLICT OF INTEREST ARISES.
FORM 990, PART VI, SECTION B, LINE 15ATHE FOUNDATION EXECUTIVE DIRECTOR'S SALARY IS DETERMINED BY THE BOARD OF DIRECTORS BASED ON COMPENSATION PAID BY SIMILAR ORGANIZATIONS.
FORM 990, PART VI, SECTION C, LINE 19THE FOUNDATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST.
FORM 990 PART XII LINE 2CTHE BOARD OF DIRECTORS APPOINTS THE INDEPENDENT AUDITORS AND REVIEWS THE RESULTS OF THE AUDIT.

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