FOUNDATION FOR SURGICAL INNOVATION: Form 990EZ, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
FOUNDATION FOR SURGICAL INNOVATION (EIN 27-1729005)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-15
IRS object ID
201603209349206900
Schema version
2015v2.0
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)
Return2016-11-15T15:28:08-08:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Bashar & Johnson PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14970 SW Griffith Drive Suite 200AddressLine1Txt
CityBeavertonCityNm
State AbbreviationORStateAbbreviationCd
ZIP970052924ZIPCd
FieldValueIRS element (for citing)
Return Type990EZReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN271729005EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FOUNDATION FOR SURGICAL INNOVATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFOUNBusinessNameControlTxt
Phone5032810561PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14805 NE GLISAN ST SUITE 6N60AddressLine1Txt
CityPORTLANDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97213ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDR CHRISTY DUNSTPersonNm
Person TitleExecutive DirectorPersonTitleTxt
Signature2016-11-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRIAN D DOYLE CPAPreparerPersonNm
PTINP00623681PTIN
Phone5036434000PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990-EZ IRS990EZ

FieldValueIRS element (for citing)
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Schedule B Not RequiredYes (X)ScheduleBNotRequiredInd
Website Addresswww.tfsie.orgWebsiteAddressTxt
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Gross Receipts$164,944GrossReceiptsAmt
Info In Schedule O Part IYes (X)InfoInScheduleOPartIInd
Contributions Gifts Grants Etc$78,250ContributionsGiftsGrantsEtcAmt
Program Service Revenue$86,681ProgramServiceRevenueAmt
Investment Income$13InvestmentIncomeAmt
Cost Or Other Basis Expense Sale$0CostOrOtherBasisExpenseSaleAmt
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Special Events Direct Expenses$0SpecialEventsDirectExpensesAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt
Total Revenue$164,944TotalRevenueAmt
Salaries Other Comp Empl Bnft$89,540SalariesOtherCompEmplBnftAmt
Fees And Other Pymt To Ind Cntrct$7,750FeesAndOtherPymtToIndCntrctAmt
Occupancy Rent Utlts And Maint$1,525OccupancyRentUtltsAndMaintAmt
Printing Publications Postage$43PrintingPublicationsPostageAmt
Other Expenses Total$59,742OtherExpensesTotalAmt
Total Expenses$158,600TotalExpensesAmt
Excess Or Deficit For Year$6,344ExcessOrDeficitForYearAmt
Net Assets Or Fund Balances BOY$489,894NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$496,238NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIYes (X)InfoInScheduleOPartIIInd

Cash Savings And Investments CashSavingsAndInvestmentsGrp

FieldValueIRS element (for citing)
BOY$453,565BOYAmt
EOY$458,064EOYAmt

Other Assets Total Detail OtherAssetsTotalDetail

FieldValueIRS element (for citing)
BOY$36,329BOYAmt
EOY$38,174EOYAmt

Form990 Total Assets Form990TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$489,894BOYAmt
EOY$496,238EOYAmt

Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp

FieldValueIRS element (for citing)
BOY$489,894BOYAmt
EOY$496,238EOYAmt
FieldValueIRS element (for citing)
Primary Exempt PurposeTo support quality in research and education in the field of Minimally Invasive Surgery.PrimaryExemptPurposeTxt

Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp

FieldValueIRS element (for citing)
Description Program Srvc AccomSurgical continuing education course benefiting about 50 surgeons, nurses and allied health professionals focusing on minimally invasive surgical therapies for abdominal cancers.DescriptionProgramSrvcAccomTxt
Grants And Allocations$148,955GrantsAndAllocationsAmt
FieldValueIRS element (for citing)
Total Program Service Expenses$148,955TotalProgramServiceExpensesAmt

Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (6 entries)

TitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmt
DR LEE SWANSTROM
President0.25$0
DR MICHAEL M AWAD
Secretary0.25$0
DR CHRISTY DUNST
Executive Dir.4.00$0
DR KEVIN REAVIS
LAB DIRECTOR0.25$0
DR MIKE UJIKI
Director0.25$0
DR ROBERT GLASGOW
Director0.25$0
FieldValueIRS element (for citing)
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
Activities Not Previously RptfalseActivitiesNotPreviouslyRptInd
Chg Made To Orgnzng Doc Not RptfalseChgMadeToOrgnzngDocNotRptInd
Organization Had UBIfalseOrganizationHadUBIInd
Organization Filed990 TfalseOrganizationFiled990TInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Organization Dissolved EtcfalseOrganizationDissolvedEtcInd
Form1120 Pol FiledfalseForm1120PolFiledInd
Made Loans To From OfficersfalseMadeLoansToFromOfficersInd
Initiation Fees And Cap Contri$0InitiationFeesAndCapContriAmt
Gross Receipts For Public Use$0GrossReceiptsForPublicUseAmt
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
States Where Copy Of Return Is FldORStatesWhereCopyOfReturnIsFldCd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDR CHRISTY DUNSTPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line14805 NE GLISAN ST SUITE 6N60AddressLine1Txt
CityPORTLANDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97213ZIPCd
FieldValueIRS element (for citing)
Phone5032810561PhoneNum
FieldValueIRS element (for citing)
Foreign Financial AccountfalseForeignFinancialAccountInd
Foreign OfficefalseForeignOfficeInd
Donor Advised FndsfalseDonorAdvisedFndsInd
Operate HospitalfalseOperateHospitalInd
Tanning Services ProvidedfalseTanningServicesProvidedInd
Form720 FiledfalseForm720FiledInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
School OperatingfalseSchoolOperatingInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Related Org Sect527 OrgfalseRelatedOrgSect527OrgInd
Part VI Of Comp Of Hghst Pd EmplNONEPartVIOfCompOfHghstPdEmplTxt
Part VI Hghst Pd Cntrct Prof SrvcNONEPartVIHghstPdCntrctProfSrvcTxt
Filed Schedule AYes (true)FiledScheduleAInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$90,300CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$83,315CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$137,851CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$85,678CurrentTaxYearMinus1YearAmt
Current Tax Year$78,250CurrentTaxYearAmt
Total$475,394TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$224,156CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$143,105CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$145,286CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$141,952CurrentTaxYearMinus1YearAmt
Current Tax Year$86,681CurrentTaxYearAmt
Total$741,180TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$314,456CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$226,420CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$283,137CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$227,630CurrentTaxYearMinus1YearAmt
Current Tax Year$164,931CurrentTaxYearAmt
Total$1,216,574TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$1,216,574PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$176CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$33CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$16CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13CurrentTaxYearMinus1YearAmt
Current Tax Year$13CurrentTaxYearAmt
Total$251TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$176CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$33CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$16CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13CurrentTaxYearMinus1YearAmt
Current Tax Year$13CurrentTaxYearAmt
Total$251TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$19,210CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$451CurrentTaxYearMinus3YearsAmt
Total$19,661TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$333,842CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$226,904CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$283,153CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$227,643CurrentTaxYearMinus1YearAmt
Current Tax Year$164,944CurrentTaxYearAmt
Total$1,236,486TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.98390PublicSupportCY509Pct
Public Support PY5090.97910PublicSupportPY509Pct
Investment Income CY0.00020InvestmentIncomeCYPct
Investment Income PY0.00040InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Other Expenses.1001Advertising and Promotion $412
Other Expenses.1005Travel $1632
Other Expenses.1009Depreciation $12155
Other Expenses.1POEM COURSE $24048
Other Expenses.2SUMMER FUNDRAISER $8071
Other Expenses.3LAB FEES $7047
Other Expenses.4AWARDS AND GRANTS $3441
Other Expenses.5EQUIPMENT RENT $1109
Other Expenses.6SUPPLIES $930
Other Expenses.7MISCELLANEOUS EXPENSE $527
Other Expenses.8LICENSES AND FEES $220
Other Expenses.9DUES & SUBSCRIPTIONS $150
Other Assets.1003Machinery and Equipment - Beginning $36329 Machinery and Equipment - Ending $38174

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.