TIBA FOUNDATION: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
TIBA FOUNDATION (EIN 20-1102853)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-09-17
IRS object ID
202022619349301102
Schema version
2019v5.1
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)
Return2020-09-17T09:24:03-05:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390974031PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WEGNER CPAS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1230 PARK AVE FL 3AddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP101690005ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN201102853EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TIBA FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlTIBABusinessNameControlTxt
Phone4143748370PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1BOX 1028 4200 PARK BLVDAddressLine1Txt
CityOAKLANDCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94602ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonARNE WAGNER JDPersonNm
Person TitleTREASURERPersonTitleTxt
Phone4143748370PhoneNum
Signature2020-09-08SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonYIGIT UCTUM CPAPreparerPersonNm
PTINP01269549PTIN
Phone2125511724PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address66.222.124.178IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-09-08IPDt
IP Tm10:50:26IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id6BE22992A1FE3C9B6F79F8315EFC85A5D6DFCE95AtSubmissionCreationDeviceId
At Submission Filing Device Id74B0C536FBDEA54BE69F712409E5EA3D5A3AE8D3AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDIANE DODGEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1BOX 1028 4200 PARK BLVDAddressLine1Txt
CityOAKLANDCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94602ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,123,323GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.TIBAFOUNDATION.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2004FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionTO BUILD COMMUNITY HEALTHCARE IN RURAL KENYA BY PROVIDING MEDICAL TREATMENT, TRAINING, FACILITIES AND EQUIPMENT, AND TO EMPOWER LOCAL COMMUNITIES TO TAKE CONTROL OVER THEIR OWN HEALTH AND WELL-BEING.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee3TotalEmployeeCnt
Total Volunteers46TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$766,215PYContributionsGrantsAmt
CY Contributions Grants$1,057,766CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$16,277PYInvestmentIncomeAmt
CY Investment Income$573CYInvestmentIncomeAmt
PY Other Revenue$155,144PYOtherRevenueAmt
CY Other Revenue-$62,397CYOtherRevenueAmt
PY Total Revenue$937,636PYTotalRevenueAmt
CY Total Revenue$995,942CYTotalRevenueAmt
PY Grants And Similar Paid$595,663PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$416,378CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$239,450PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$224,322CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$56,641CYTotalFundraisingExpenseAmt
PY Other Expenses$66,680PYOtherExpensesAmt
CY Other Expenses$69,431CYOtherExpensesAmt
PY Total Expenses$901,793PYTotalExpensesAmt
CY Total Expenses$710,131CYTotalExpensesAmt
PY Revenues Less Expenses$35,843PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$285,811CYRevenuesLessExpensesAmt
Total Assets BOY$517,227TotalAssetsBOYAmt
Total Assets EOY$807,303TotalAssetsEOYAmt
Total Liabilities BOY$6,658TotalLiabilitiesBOYAmt
Total Liabilities EOY$9,507TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$510,569NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$797,796NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO BUILD COMMUNITY HEALTHCARE IN RURAL KENYA BY PROVIDING MEDICAL TREATMENT, TRAINING, FACILITIES AND EQUIPMENT, AND TO EMPOWER LOCAL COMMUNITIES TO TAKE CONTROL OVER THEIR OWN HEALTH AND WELL-BEING.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$576,423ExpenseAmt
Grant$416,378GrantAmt
Revenue$0RevenueAmt
DescDURING 2019, TIBA SUPPORTED THE OPERATION OF THE MATIBABU HOSPITAL (CONSTRUCTION OF WHICH TIBA HAD PREVIOUSLY FINANCED), AND THREE OUTPATIENT CLINICS IN UGENYA DISTRICT, KENYA. THESE FACILITIES PROVIDE A WIDE RANGE OF HEALTHCARE SERVICES TO THE LOCAL COMMUNITY, INCLUDING LABOR AND CHILDBIRTH; HIV TESTING, TREATMENT AND COUNSELING; CERVICAL CANCER SCREENINGS AND ULTRASOUNDS FOR LOCAL WOMEN; PEDIATRIC SERVICES; LAB TESTS; MEDICATION PRESCRIPTIONS; AND TREATMENT FOR SUCH CONDITIONS AS MALARIA, HYPERTENSION, ETC. TIBA SUPPORTED A VARIETY OF COMMUNITY HEALTH PROGRAMS IN UGENYA DISTRICT, KENYA. ONE OF THESE IS A MOTHER AND CHILD NUTRITION PROGRAM THAT TRAINED LOCAL WOMEN TO PROVIDE NUTRITIONAL GUIDANCE TO MOTHERS, BENEFITING MANY THOUSANDS OF MOTHERS AND CHILDREN. ALSO A WOMEN'S EMPOWERMENT AND FAMILY PLANNING PROGRAM THAT PROVIDES CONTRACEPTIVE SUPPORT AND SUPPLIES; COUNSELING; AND PRE- AND POST-NATAL CARE. ALSO A DISABILITY AND MOBILITY PROGRAM, THAT PROVIDES PHYSICAL THERAPY, MOBILITY TOOLS, AND MEDICINE TO DISABLED PEOPLE, AS WELL AS PEER SUPPORT FOR THEM AND THEIR FAMILIES. TIBA ALSO SUPPORTED A LARGE CONTINGENT OF COMMUNITY HEALTHWORKERS WHO TRAVELED THROUGHOUT THE COMMUNITY EDUCATING RESIDENTS ABOUT SANITATION, CLEAN WATER, BEDNETS AND OTHER ISSUES OF HYGIENE, AS WELL AS IDENTIFYING INDIVIDUALS WHO NEED MEDICAL TREATMENT. TIBA ALSO PROVIDED SCHOLARSHIPS TO LOCAL NURSING STUDENTS. TIBA ARRANGED FOR SOME TWO DOZEN VOLUNTEERS, PRIMARILY U.S. PHYSICIANS AND NURSES, TO TRAVEL TO UGENYA TO PROVIDE TRAINING TO MEDICAL STAFF AT THE MATIBABU HOSPITAL, AND TO PERFORM SURGERIES ON LOCAL PATIENTS.Desc
Total Program Service Expenses$576,423TotalProgramServiceExpensesAmt
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 EquipmentYes (1)ReportLandBuildingEquipmentInd
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 ActivitiesYes (1)ForeignActivitiesInd
More Than5000 K To OrgYes (1)MoreThan5000KToOrgInd
More Than5000 K To IndividualsYes (1)MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
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 Document6IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee3EmployeeCnt
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 ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
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 Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
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 PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
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 FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonARNE WAGER JDPersonNm
Phone4143748370PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1BOX 1028 4200 PARK BLVDAddressLine1Txt
CityOAKLANDCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94602ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
GAIL WAGNER MD
PRESIDENT6.00Yes (X)Yes (X)$0$0$0
RAM RAMACHANDRA MD
DIRECTOR2.00Yes (X)$0$0$0
AMANDA SCHOENBERG MD
DIRECTOR3.00Yes (X)$0$0$0
PAUL OSESO
DIRECTOR1.00Yes (X)$0$0$0
JILL MCCARTHY
VICE PRESIDENT1.00Yes (X)Yes (X)$0$0$0
PETER SHERRIS MD
DIRECTOR1.00Yes (X)$0$0$0
NORMA BOZZINI MD
DIRECTOR1.00Yes (X)$0$0$0
ARNE WAGNER JD
TREASURER/SECRETARY6.00Yes (X)Yes (X)$0$0$0
BILL PLAUTZ MD
DIRECTOR2.00Yes (X)$0$0$0
DIANE DODGE
EXECUTIVE DIRECTOR40.00Yes (X)$170,000$0$12,704
FieldValueIRS element (for citing)
Total Reportable Comp From Org$170,000TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$12,704TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$453,450FundraisingAmt
All Other Contributions$604,316AllOtherContributionsAmt
Noncash Contributions$19,049NoncashContributionsAmt
Total Contributions$1,057,766TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$99TotalRevenueColumnAmt
Exclusion$99ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$54,258SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$53,784SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$474SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$474TotalRevenueColumnAmt
Exclusion$474ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$11,200FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$453,450ContriRptFundraisingEventAmt
Fundraising Direct Expenses$73,597FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$62,397TotalRevenueColumnAmt
Exclusion-$62,397ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$995,942TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$61,824ExclusionAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$416,378TotalAmt
Program Services$416,378ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$182,704TotalAmt
Program Services$109,422ProgramServicesAmt
Management And General$36,691ManagementAndGeneralAmt
Fundraising$36,591FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$28,981TotalAmt
Program Services$17,357ProgramServicesAmt
Management And General$5,820ManagementAndGeneralAmt
Fundraising$5,804FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$12,637TotalAmt
Program Services$7,568ProgramServicesAmt
Management And General$2,538ManagementAndGeneralAmt
Fundraising$2,531FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$24,966TotalAmt
Management And General$24,966ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$6,546TotalAmt
Program Services$1,296ProgramServicesAmt
Fundraising$5,250FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$11,207TotalAmt
Program Services$2,400ProgramServicesAmt
Management And General$2,342ManagementAndGeneralAmt
Fundraising$6,465FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$4,908TotalAmt
Program Services$2,429ProgramServicesAmt
Management And General$2,479ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,938TotalAmt
Program Services$1,938ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$176TotalAmt
Management And General$176ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$884TotalAmt
Program Services$442ProgramServicesAmt
Management And General$442ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,186TotalAmt
Program Services$573ProgramServicesAmt
Management And General$1,613ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescVOLUNTEER EXPENSESDesc
Total$16,620TotalAmt
Program Services$16,620ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$710,131TotalAmt
Program Services$576,423ProgramServicesAmt
Management And General$77,067ManagementAndGeneralAmt
Fundraising$56,641FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$324,123BOYAmt
EOY$284,425EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$121,835EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$173,084BOYAmt
EOY$384,333EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$15,271BOYAmt
EOY$15,145EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,653LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,088LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,449BOYAmt
EOY$1,565EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,300BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$517,227BOYAmt
EOY$807,303EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,408BOYAmt
EOY$9,507EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$5,250BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,658BOYAmt
EOY$9,507EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$496,119BOYAmt
EOY$493,796EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$14,450BOYAmt
EOY$304,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$510,569BOYAmt
EOY$797,796EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$517,227BOYAmt
EOY$807,303EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$285,811ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,416NetUnrlzdGainsLossesInvstAmt
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$354,420CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$732,356CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$273,495CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$766,215CurrentTaxYearMinus1YearAmt
Current Tax Year$1,057,766CurrentTaxYearAmt
Total$3,184,252TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$354,420CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$732,356CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$273,495CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$766,215CurrentTaxYearMinus1YearAmt
Current Tax Year$1,057,766CurrentTaxYearAmt
Total$3,184,252TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$1,932,442SubstantialContributorsTotAmt
Public Support Total170$1,251,810PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,200CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,701CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$88,467CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$14,041CurrentTaxYearMinus1YearAmt
Current Tax Year$99CurrentTaxYearAmt
Total$116,508TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$2,236CurrentTaxYearMinus1YearAmt
Total$2,236TotalAmt
FieldValueIRS element (for citing)
Total Support$3,302,996TotalSupportAmt
Gross Receipts Rltd Activities$789,793GrossReceiptsRltdActivitiesAmt
Public Support CY1700.37900PublicSupportCY170Pct
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

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,653OtherCostOrOtherBasisAmt
Depreciation$1,088DepreciationAmt
Book Value$1,565BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,565TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$997,358TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$1,416NetUnrealizedGainsInvstAmt
Revenue Not Reported$1,416RevenueNotReportedAmt
Revenue Subtotal$995,942RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$995,942TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$710,131TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$710,131ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$710,131TotalExpensesPerForm990Amt

Schedule F IRS990ScheduleF

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Account Activities Outside US AccountActivitiesOutsideUSGrp

FieldValueIRS element (for citing)
RegionAFRICARegionTxt
Offices0OfficesCnt
Employee0EmployeeCnt
Type Of Activities ConductedGRANTMAKING AND SCHOLARSHIPSTypeOfActivitiesConductedTxt
Region Total Expenditures$416,378RegionTotalExpendituresAmt
FieldValueIRS element (for citing)
Subtotal Offices0SubtotalOfficesCnt
Subtotal Employees0SubtotalEmployeesCnt
Continuation Total Office0ContinuationTotalOfficeCnt
Continuation Total Employee0ContinuationTotalEmployeeCnt
Total Office0TotalOfficeCnt
Total Employee0TotalEmployeeCnt
Subtotal Spent$416,378SubtotalSpentAmt
Continuation Spent$0ContinuationSpentAmt
Total Spent$416,378TotalSpentAmt

Grants To Org Outside US GrantsToOrgOutsideUSGrp

FieldValueIRS element (for citing)
RegionAFRICARegionTxt
Purpose Of GrantGENERAL OPERATIONS AND OPERATING ROOM CONSTRUCTIONPurposeOfGrantTxt
Cash Grant$402,928CashGrantAmt
Manner Of Cash DisbursementWIREMannerOfCashDisbursementTxt
FieldValueIRS element (for citing)
Total501c3 Org0Total501c3OrgCnt
Total Other Org1TotalOtherOrgCnt

Foreign Individuals Grants ForeignIndividualsGrantsGrp

FieldValueIRS element (for citing)
Type Of AssistanceSCHOLARSHIPSTypeOfAssistanceTxt
RegionNURSING SCHOOL SCHOLARSHIPSRegionTxt
Recipient2RecipientCnt
Cash Grant$13,450CashGrantAmt
Manner Of Cash DisbursementWIREMannerOfCashDisbursementTxt
FieldValueIRS element (for citing)
Transfer To Foreign Corp0TransferToForeignCorpInd
Interest In Foreign Trust0InterestInForeignTrustInd
Foreign Corp Ownership0ForeignCorpOwnershipInd
Passive Foreign Investmest Co0PassiveForeignInvestmestCoInd
Foreign Partnership0ForeignPartnershipInd
Boycott Countries0BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART III ACCOUNTING METHOD:FormAndLineReferenceDesc

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1ANNUAL GALAEvent1Nm
Gross Receipts Event1$464,650GrossReceiptsEvent1Amt
Charitable Contri Event1$453,450CharitableContriEvent1Amt
Gross Revenue Event1$11,200GrossRevenueEvent1Amt
Rent Facility Costs Event1$14,125RentFacilityCostsEvent1Amt
Food And Beverage Event1$44,790FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$14,682OtherDirectExpensesEvent1Amt
Gross Receipts Total$464,650GrossReceiptsTotalAmt
Charitable Contributions Tot$453,450CharitableContributionsTotAmt
Gross Revenue Total Events$11,200GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$14,125RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$44,790FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$14,682OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$73,597DirectExpenseSummaryEventsAmt
Net Income Summary-$62,397NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonDIANE DODGEPersonNm
TitleEXECUTIVE DIRECTORTitleTxt
Base Compensation Filing Org$170,000BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$2,408DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$10,296NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$182,704TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2GAIL WAGNER, M.D. AND ARNE WAGNER, J.D. - FAMILY RELATIONSHIP
FORM 990, PART VI, SECTION B, LINE 11BTIBA FOUNDATION REQUIRES ALL VOTING MEMBERS OF THE BOARD OF DIRECTORS TO HAVE ACCESS FOR REVIEW PURPOSES OF THE IRS FORM 990 PRIOR TO IT BEING FILED WITH THE INTERNAL REVENUE SERVICE. THE EXECUTIVE DIRECTOR WILL SUBMIT A DRAFT COPY OF THE FORM TO THE BOARD OF DIRECTORS AT THE EARLIER OF EITHER THE BOARD MEETING PRIOR TO THE DUE DATE OF THE RETURN OR 30 DAYS BEFORE THE RETURN IS DUE. EACH BOARD MEMBER WILL BE GIVEN THE OPPORTUNITY TO RESPOND IN WRITING OR BY E-MAIL TO THE EXECUTIVE DIRECTOR ASKING ANY QUESTIONS OR OBJECTING TO ANY INFORMATION PRESENTED ON THE FORM.
FORM 990, PART VI, SECTION B, LINE 12CEACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH PERSON: A. HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, B. HAS READ AND UNDERSTANDS THE POLICY, C. HAS AGREED TO COMPLY WITH THE POLICY, AND D. UNDERSTANDS THAT TIBA IS A TAX-EXEMPT ORGANIZATION, AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES.
FORM 990, PART VI, SECTION B, LINE 15ATHE BOARD APPROVES REASONABLE COMPENSATION AND BENEFITS FOR THE EXECUTIVE DIRECTOR NEAR THE END OF EACH YEAR. THE BOARD SETS COMPENSATION LEVELS TO BE COMPARATIVE WITH OTHER ORGANIZATIONS BASED ON COMPARISONS. THE EXECUTIVE DIRECTOR DOES NOT PARTICIPATE IN THE DISCUSSIONS OR DELIBERATIONS ABOUT COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
PG 12 PART XII 2CTHE BOARD OF DIRECTORS REVIEW AND APPROVE THE AUDITED FINANCIAL STATEMENTS BEFORE THEY ARE ISSUED AND AVAILABLE TO THE PUBLIC.

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