2019-11-14T14:46:12-06:00 2018-12-31 621199757 LBMC PC PO BOX 1869 BRENTWOOD TN 370241869 990 2018-01-01 813029754 PERMOBIL FOUNDATION PERM 8007360925 300 DUKE DR LEBANON TN 37090 ASHLEY DAVIS EXECUTIVE DIRECTOR 8007360925 2019-11-08 1 JILL HUDSON P00061190 6153774600 2019-11-07 8.42.53.250 2019-11-08 11:33:01 CS P 682370FAB4196755C2C9EC08825DED97C024E1BF 923362CE4664FDCA77FD84C9E4A90E577E292CDE 2018 2020-03-31 21:24:44Z PEREMOBIL CARES ASHLEY DAVIS 300 DUKE DRIVE LEBANON TN 37090 1605855 0 X WWW.PEREMOBILFOUNDATION.ORG X 2016 TN THE PERMOBIL FOUNDATION IS DEDICATED TO ENHANCING THE QUALITY OF LIFE BY EMPOWERING STRENGTH AND INDEPENDENCE THROUGH COMMUNITY SUPPORT, EMPLOYEE ENGAGEMENT AND GRANT FUNDING. WE WORK IN PARTNERSHIP WITH NON-PROFIT ORGANIZATIONS AND AGENCIES TO PROVIDE SUPPORT AND SERVICES SO INDIVIDUALS CAN LIVE A LIFE WITHOUT LIMITATIONS. 6 3 0 50 0 0 982548 1476084 0 0 0 0 70285 65200 1052833 1541284 740507 1180626 0 0 108058 188424 0 0 0 67948 23528 916513 1392578 136320 148706 142610 300216 0 8900 142610 291316 X THE PERMOBIL FOUNDATION IS DEDICATED TO ENHANCING THE QUALITY OF LIFE BY EMPOWERING STRENGTH AND INDEPENDENCE THROUGH COMMUNITY SUPPORT, EMPLOYEE ENGAGEMENT AND GRANT FUNDING. WE WORK IN PARTNERSHIP WITH NON-PROFIT ORGANIZATIONS AND AGENCIES TO PROVIDE SUPPORT AND SERVICES SO INDIVIDUALS CAN LIVE A LIFE WITHOUT LIMITATIONS. 0 0 1180626 1180626 PARTNERSHIPS WITH NON-PROFIT ORGANIZATIONS THAT INCLUDE: DONATIONS FOR CHILDREN CAMPS, ACCESSIBLE PLAYGROUNDS, DURABLE MEDICAL EQUIPMENT, ETC. DONATIONS OF WHEELCHAIRS & REHAB TECHNOLOGY ACCESSORIES TO INDIVIDUALS DENIED BY INSURANCE COLLEGE SCHOLARSHIPS FOR WHEELCHAIR USERS 1180626 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 3 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 TN X X ASHLEY DAVIS 8007360925 300 DUKE DRIVE LEBANON TN 37090 CAMILLA JACKSON COMMUNITY LEADER 1.00 X 0 0 0 LARRY JACKSON DIRECTOR 1.00 X 0 0 0 GREG PACKER DIRECTOR 1.00 X 0 0 0 DAVE MCCAUSLAND BOARD CHAIR 2.00 X 0 0 0 TODD WALLING TREASURER 1.00 X 0 0 0 CHRIS JAVILLONAR SECRETARY 1.00 X 0 0 0 ASHLEY DAVIS EXECUTIVE DIRECTOR 40.00 X 95950 0 24608 95950 0 24608 0 0 0 0 0 1426598 49486 730049 1476084 129771 64571 65200 65200 1541284 0 0 65200 315550 315550 865076 865076 117559 117559 52473 52473 2077 2077 5375 5375 10940 10940 9000 9000 3978 3978 10289 10289 BANK FEES 261 261 1392578 1180626 211952 0 142610 300216 142610 300216 8900 0 8900 X 142610 291316 142610 291316 142610 300216 148706 0 X 0 1 X 0 0 X 982548 1476084 2458632 982548 1476084 2458632 2458632 2458632 216444 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 X 1605855 64571 64571 1541284 0 1541284 1457149 64571 64571 1392578 0 1392578 PART X, LINE 2: THE FOUNDATION IS AN EXEMPT ORGANIZATION FROM FEDERAL INCOME TAXES UNDER THE PROVISIONS OF INTERNAL REVENUE CODE SECTION 501(C)(3) AND ACCORDINGLY, NO PROVISION FOR FEDERAL INCOME TAXES IS INCLUDED IN THE FINANCIAL STATEMENTS. THE FOUNDATION RECOGNIZES THE TAX BENEFIT ASSOCIATED WITH A TAX POSITION TAKEN FOR TAX RETURN PURPOSES WHEN IT IS MORE LIKELY THAN NOT THE POSITION WILL BE SUSTAINED. THE FOUNDATION DOES NOT BELEIVE THERE ARE ANY MATERIAL UNCERTAIN TAX POSITIONS THAT QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. IT IS THE FOUNDATION'S POLICY TO RECOGNIZE INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE. AS OF DECEMBER 31, 2018, THE FOUNDATION HAS ACCRUED NO INTEREST AND NO PENALTIES RELATED TO UNCERTAIN TAX POSITIONS. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 64,571. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 64,571. 0 GOLF TOURNAMENT 129771 129771 64571 129771 129771 64571 64571 65200 1 ALS ASSOCIATION OF TENNESSEE CHAPTER 4300 SIDCO DRIVE SUITE 200 NASHVILLE TN 37204 943124723 501 (C)(3) 10000 TENNESSEE WALK ALS ASSOCIATION ARIZONA CHAPTER 360 E CORONADO RD SUITE 140 PHOENIX AZ 85004 860727136 501 (C)(3) 9000 GRANT THE ALS ASSOCIATION NATIONAL OFFICE 1275 K STREET NW SUITE 250 WASHINGTON DC 20005 133271855 501 (C)(3) 17500 CLINICAL CONFERENCE/PUBLIC POLICY AND SOCIAL MEDIA CAMPAIGN THE ALS ASSOCIATION ST LOUIS CHAPTER 2258 WELDON PARKWAY ST LOUIS MO 63146 431458163 501 (C)(3) 7500 GRANT MUSCULAR DYSTROPHY ASSOCIATION IN TENNESSEE 161 N CLARK STREET SUITE 3550 CHICAGO IL 60603 131665552 501 (C)(3) 54500 TN MUSCLE GALA, TN SUMMER CAMP, LIVE UNLIMITED, & ALS CLINIC BOOKS CRAIG HOSPITAL FOUNDATION 3425 S CLARKSON ST ENGLEWOOD CO 80113 237352287 501 (C)(3) 7500 GRANT TEAM GLEASON FOUNDATION PO BOX 24493 NEW ORLEANS LA 70184 453689316 501 (C)(3) 10000 2808 FMV CHAIR PARTS GRANT PARALYZED VETERANS OF AMERICA 801 EIGHTEENTH STREET NW WASHINGTON DC 200063517 131946868 501 (C)(3) 5000 GENERAL PURPOSES, INVICTUS GAMES VOLUNTEERS OF AMERICA 1660 DUKE STREET ALEXANDRIA VA 22314 131692595 501 (C)(3) 5000 GRANT CURE SMA 925 BUSSE ROAD ELK GROVE VILLAGE IL 60007 363320440 501 (C)(3) 6000 GRANT US OPEN WHEELCHAIR TENNIS TOURNAMENT CHRISTOPHER REEVE FOUNDATION 636 MORRIS TURNPIKE SUITE 3A SHORT HILLS NJ 07078 222939536 501 (C)(3) 5000 ERIC LEGRAND WALK TO BELEIVE ADAPTIVE SPORTS FOR KIDS PO BOX 332 NEDERLAND TX 77627 371659571 501 (C)(3) 7500 GRANT ELEVATOR SEATS AND CHAIR PARTS 201 730049 FMV ELEVATOR SEATS AND CHAIR PARTS PART I, LINE 2: PERIODIC REPORTS THROUGH CALENDAR SCHEDULES SET-UP AS GRANTS ARE RECEIVED TO ENSURE FUNDS ARE USED AS GRANT OUTLINES. X SEAT ELEVATORS AND PARTS 201 730049 FMV 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 LARRY JACKSON, PRESIDENT OF PERMOBIL INC. IS MARRIED TO CAMILLA JACKSON. BOTH SERVE AS BOARD MEMBERS TO THE FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11B PERMOBIL FOUNDATION WILL REVIEW FORM 990 AT MONTHLY BOARD MEETING WITH THE BOARD OF DIRECTORS AND THE 990 WILL BE USED TO ASSIST WITH APPLICATIONS FOR GRANT WRITING AND GUIDESTAR. FORM 990, PART VI, SECTION B, LINE 12C PERMOBIL FOUNDATION'S CONFLICT OF INTEREST POLICY IS MONITORED THROUGHOUT THE YEAR AS THE BOARD OF DIRECTORS MEET ON A MONTHLY BASIS. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE AVAILABLE ON THE ORGANIZATION'S WEBSITE AND UPON REQUEST. MAX MOBILITY LLC 300 DUKE DR LEBANON TN 37090 310163211 MANUFACTURER OF WHEELCHAIRS TN PERMOBIL INC 0 0 1.00000 PERMOBIL INC 300 DUKE DRIVE LEBANON TN 37090 043189589 MANUFACTURER OF WHEELCHAIRS TN N/A C 0 TRILITE 2701 W COURT STREET PASCO WA 99301 911895455 MEDICAL DEVICE MANUFACTURER WA N/A C 0 ROHO GROUP 100 N FLORIDA AVE BELLEVILLE IL 62221 204546288 MANUFACTURER OF SEATING AND POSITIONING SYSTEMS IL N/A C 0 COMFORT COMPANY 1960 S CALHOUN RD NEW BERLIN WI 53151 MANUFACTURER OF SEATING AND POSTURAL SUPPORT SYSTEMS WI N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 1 PERMOBIL INC C 367650 CASH PERMOBIL INC Q 139643 ADMINISTRATIVE EXPENSES PERMOBIL INC C 730049 FMV TRILITE INC C 74340 CASH ROHO GROUP C 79916 CASH COMFORT COMPANY C 25000 CASH MAX MOBILITY C 10000 CASH