INTERNATIONAL PERFUSION ASSOCIATION: Form 990EZ, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- INTERNATIONAL PERFUSION ASSOCIATION (EIN 65-0763136)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-08-15
- IRS object ID
- 201632289349200238
- Schema version
- 2015v2.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-08-15T07:45:37-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 650225494 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MILLER HELMS & FOLK PA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6326 WHISKEY CREEK DRIVE SUITE A | AddressLine1Txt |
| City | FORT MYERS | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33919 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 650763136 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INTERNATIONAL PERFUSION ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | INTE | BusinessNameControlTxt |
| Phone | 2392439171 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17080 SAFETY STREET UNIT 109 | AddressLine1Txt |
| City | FORT MYERS | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33908 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRYAN V LICH | PersonNm |
| Person Title | S-T, BD CHR | PersonTitleTxt |
| Phone | 8668728065 | PhoneNum |
| Signature | 2016-08-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CRAIG R FOLK | PreparerPersonNm |
| PTIN | P00017430 | PTIN |
| Phone | 2394819696 | PhoneNum |
| Preparation | 2016-08-04 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2016-12-15 16:53:06Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Website Address | WWW.PERFUSION.COM | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $51,636 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $51,636 | ContributionsGiftsGrantsEtcAmt |
| Total Revenue | $51,636 | TotalRevenueAmt |
| Grants And Similar Amounts Paid | $3,000 | GrantsAndSimilarAmountsPaidAmt |
| Fees And Other Pymt To Ind Cntrct | $14,589 | FeesAndOtherPymtToIndCntrctAmt |
| Printing Publications Postage | $125 | PrintingPublicationsPostageAmt |
| Other Expenses Total | $16,848 | OtherExpensesTotalAmt |
| Total Expenses | $34,562 | TotalExpensesAmt |
| Excess Or Deficit For Year | $17,074 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $110,150 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $127,224 | NetAssetsOrFundBalancesEOYAmt |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $110,150 | BOYAmt |
| EOY | $127,224 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $110,150 | BOYAmt |
| EOY | $127,224 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $110,150 | BOYAmt |
| EOY | $127,224 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Primary Exempt Purpose | SURGICAL EQUIPMENT,SUPPLIES AND INFORMATION | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | OBTAINED DONATIONS OF HEART SURGERY MEDICAL EQUIPMENT AND SUPPLIES AND PROVIDED THEM FREE OF CHARGE TO A HUMANITARIAN PROGRAM WHICH DOES FREE HEART SURGERY FOR INDIGENT PATIENTS AT A PUBLIC HOSPTAL IN SANTIAGO, DOMINICAN REPUBLIC. | DescriptionProgramSrvcAccomTxt |
| Grants And Allocations | $3,000 | GrantsAndAllocationsAmt |
| Foreign Grants | Yes (X) | ForeignGrantsInd |
| Program Service Expenses | $34,484 | ProgramServiceExpensesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $34,484 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (5 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt |
|---|---|---|
| IRIS CHACON CCP | ||
| PRES, DIR | 0.50 | $0 |
| PETER ZUCK | ||
| VP, DIR | 0.50 | $0 |
| BRYAN V LICH | ||
| S-T, BD CHR | 1.00 | $0 |
| SAM DOMINICO CCP | ||
| DIR | 0.50 | $0 |
| ROBERT PASCOTTO MD | ||
| DIR | 0.50 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | false | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | false | OrganizationHadUBIInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Form1120 Pol Filed | false | Form1120PolFiledInd |
| Made Loans To From Officers | false | MadeLoansToFromOfficersInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VICTOR J LICH JR ATTORNEY | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17080 SAFETY STREET UNIT 109 | AddressLine1Txt |
| City | FORT MYERS | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33908 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2392439171 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Foreign Office | false | ForeignOfficeInd |
| Donor Advised Fnds | false | DonorAdvisedFndsInd |
| Operate Hospital | false | OperateHospitalInd |
| Tanning Services Provided | false | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| School Operating | false | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (true) | FiledScheduleAInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $33,360 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $81,549 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $49,851 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,450 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $51,636 | CurrentTaxYearAmt |
| Total | $230,846 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $167 | CurrentTaxYearMinus1YearAmt |
| Total | $167 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $33,360 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $81,549 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $49,851 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,617 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $51,636 | CurrentTaxYearAmt |
| Total | $231,013 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $100 | CurrentTaxYearMinus3YearsAmt |
| Total | $100 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $100 | CurrentTaxYearMinus3YearsAmt |
| Total | $100 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $230,913 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3 | CurrentTaxYearMinus1YearAmt |
| Total | $27 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3 | CurrentTaxYearMinus1YearAmt |
| Total | $27 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $33,365 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $81,557 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $49,862 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,620 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $51,636 | CurrentTaxYearAmt |
| Total | $231,040 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99950 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99940 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990-EZ, PART I | LINE 10 - GRANTS/SIMILAR AMOUNTS PAID TO ORGANIZATIONS NAME & ADDRESS DESCRIPTION OF PROPERTY JOSE MARIA CABRAL Y BAEZ HOSPITAL PERFUSION SUPPLIES SANTIAGO, DOMINICAN REPUBLIC, DR CASH - 0 NON-CASH - 3,000 |
| FORM 990-EZ, PART I, LINE 16 | EXPENSES MARKETING 1,871 OFFICE 27 TRAVEL 14,950 TOTAL 16,848 |
| FORM 990-EZ, PART III, LINE 28 | OBTAINED DONATIONS OF HEART SURGERY MEDICAL EQUIPMENT AND SUPPLIES AND PROVIDED THEM FREE OF CHARGE TO A HUMANITARIAN PROGRAM WHICH DOES FREE HEART SURGERY FOR INDIGENT PATIENTS AT A PUBLIC HOSPTAL IN SANTIAGO, DOMINICAN REPUBLIC. |
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