HEALTH STORY COLLABORATIVE INC: Form 990EZ, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
HEALTH STORY COLLABORATIVE INC (EIN 46-3707918)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-05-12
IRS object ID
201641339349202764
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

FieldValueIRS element (for citing)
Return2016-05-12T15:01:13-05:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410445819PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FIDUCIARY COUNSELLING INCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line130 E 7TH STREET SUITE 2000AddressLine1Txt
CitySAINT PAULCityNm
State AbbreviationMNStateAbbreviationCd
ZIP551014930ZIPCd
FieldValueIRS element (for citing)
Return Type990EZReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN463707918EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HEALTH STORY COLLABORATIVE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHEALBusinessNameControlTxt
Phone6177143201PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O FCI 30 7TH STREET E SUITE 2000AddressLine1Txt
CityST PAULCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55101ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonFREDERICK J WEYERHAEUSERPersonNm
Person TitleTREASURER, DIRECTORPersonTitleTxt
Phone6177143201PhoneNum
Signature2016-05-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKIM M MERTENSPreparerPersonNm
PTINP01059443PTIN
Phone6512280935PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2016-09-27 15:27:22ZBuildTS

Form 990-EZ IRS990EZ

FieldValueIRS element (for citing)
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Website AddressWWW.HEALTHSTORYCOLLABORATIVE.ORGWebsiteAddressTxt
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Gross Receipts$47,295GrossReceiptsAmt
Info In Schedule O Part IYes (X)InfoInScheduleOPartIInd
Contributions Gifts Grants Etc$47,272ContributionsGiftsGrantsEtcAmt
Investment Income$23InvestmentIncomeAmt
Total Revenue$47,295TotalRevenueAmt
Salaries Other Comp Empl Bnft$7,000SalariesOtherCompEmplBnftAmt
Fees And Other Pymt To Ind Cntrct$16,097FeesAndOtherPymtToIndCntrctAmt
Other Expenses Total$5,475OtherExpensesTotalAmt
Total Expenses$28,572TotalExpensesAmt
Excess Or Deficit For Year$18,723ExcessOrDeficitForYearAmt
Net Assets Or Fund Balances BOY$30,069NetAssetsOrFundBalancesBOYAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Net Assets Or Fund Balances EOY$48,792NetAssetsOrFundBalancesEOYAmt

Cash Savings And Investments CashSavingsAndInvestmentsGrp

FieldValueIRS element (for citing)
BOY$30,069BOYAmt
EOY$48,792EOYAmt

Form990 Total Assets Form990TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$30,069BOYAmt
EOY$48,792EOYAmt

Sum Of Total Liabilities SumOfTotalLiabilitiesGrp

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

Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp

FieldValueIRS element (for citing)
BOY$30,069BOYAmt
EOY$48,792EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
Primary Exempt PurposeTHE MISSION OF HEALTH STORY COLLABORATIVE IS TO KEEP THE PATIENT VOICE ALIVE IN HEALTHCARE AND TO HARNESS THE HEALING POWER OF STORIES.BY COLLECTING, HONORING, AND SHARING STORIES OF ILLNESS AND HEALING, WE STRIVE TO MAKE THE PROCESS OF NAVIGATING ILLNESS LESS ISOLATING AND TO EMPOWER INDIVIDUALS AND FAMILIES FACING HEALTH CHALLENGES.OUR BELIEF, SUPPORTED BY RESEARCH, IS THAT STORYTELLING IS HEALING FOR BOTH STORY SHARERS AND LISTENERS. STORIES HAVE THE POWER TO TRANSFORM INDIVIDUALS AS WELL AS THE HEALTHCARE SYSTEM.PrimaryExemptPurposeTxt

Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp (3 entries)

Description Program Srvc AccomDescriptionProgramSrvcAccomTxtGrants And AllocationsGrantsAndAllocationsAmtProgram Service ExpensesProgramServiceExpensesAmt
THE FOUNDATION CONTINUED TO BUILD WEBSITE CONTENT, INCLUDING ADDITIONS TO THE HEALING ART ARCHIVE, THE COMMUNITY VOICES PROGRAM, AND THE BLOG.$0$6,025
THE FOUNDATION DEVELOPED SIX AUDIO STORIES DURING THE YEAR. THE GOAL OF THIS PROGRAM IS TO GROW A COLLECTION OF AUDIO STORIES FROM PATIENTS AND THEIR LOVED ONES THAT CAN BE SHARED FOR THE BENEFIT OF OTHERS GOING THROUGH SIMILAR CIRCUMSTANCES.$0$4,190
THE FOUNDATION COMPLETED THE DEVELOPMENT OF THE SHARINGCLINIC SOFTWARE AND CONTINUED TO COLLECT AUDIO CLIPS FOR THE PROJECT, WHICH LAUNCHED IN JANUARY 2016. THE SHARINGCLINIC IS AN AUDIO KIOSK THAT RESIDES IN THE MASSACHUSETTS GENERAL HOSPITAL PAUL S. RUSSELL MUSEUM. A DOWNLOADABLE APP IS CURRENTLY IN DEVELOPMENT. THE GOAL OF THE PROJECT IS TO EMPOWER AND CONNECT INDVIDUALS FACING HEALTH CHALLENGES.$0$11,081
FieldValueIRS element (for citing)
Total Program Service Expenses$21,296TotalProgramServiceExpensesAmt

Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (5 entries)

TitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
ANNE C BREWSTER
PRESIDENT, EXECUTIVE DIREC25.00$7,000$0$0
FREDERICK J WEYERHAEUSER
TREASURER, DIRECTOR1.00$0$0$0
KATIE RIMER
CLERK, DIRECTOR1.00$0$0$0
NINA COSLOV
DIRECTOR1.00$0$0$0
NED RIMER
DIRECTOR1.00$0$0$0
FieldValueIRS element (for citing)
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
Activities Not Previously Rpt0ActivitiesNotPreviouslyRptInd
Chg Made To Orgnzng Doc Not Rpt0ChgMadeToOrgnzngDocNotRptInd
Organization Had UBI0OrganizationHadUBIInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Organization Dissolved Etc0OrganizationDissolvedEtcInd
Direct Indirect Pltcl Expend$0DirectIndirectPltclExpendAmt
Made Loans To From Officers0MadeLoansToFromOfficersInd
Tax Imposed Under IRC4911$0TaxImposedUnderIRC4911Amt
Tax Imposed Under IRC4912$0TaxImposedUnderIRC4912Amt
Tax Imposed Under IRC4955$0TaxImposedUnderIRC4955Amt
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
Tax Imposed On Organization Mgr$0TaxImposedOnOrganizationMgrAmt
Tax Reimbursed By Organization$0TaxReimbursedByOrganizationAmt
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
States Where Copy Of Return Is FldMAStatesWhereCopyOfReturnIsFldCd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonANNE C BREWSTERPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1105 COOLIDGE HILLAddressLine1Txt
CityCAMBRIDGECityNm
State AbbreviationMAStateAbbreviationCd
ZIP02138ZIPCd
FieldValueIRS element (for citing)
Phone6177143201PhoneNum
FieldValueIRS element (for citing)
Foreign Financial Account0ForeignFinancialAccountInd
Foreign Office0ForeignOfficeInd
Donor Advised Fnds0DonorAdvisedFndsInd
Operate Hospital0OperateHospitalInd
Tanning Services Provided0TanningServicesProvidedInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
School Operating0SchoolOperatingInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Part VI Of Comp Of Hghst Pd EmplNONEPartVIOfCompOfHghstPdEmplTxt
Part VI Hghst Pd Cntrct Prof SrvcNONEPartVIHghstPdCntrctProfSrvcTxt
Filed Schedule AYes (1)FiledScheduleAInd

Schedule A IRS990ScheduleA

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

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$42,372CurrentTaxYearMinus1YearAmt
Current Tax Year$47,272CurrentTaxYearAmt
Total$89,644TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$42,372CurrentTaxYearMinus1YearAmt
Current Tax Year$47,272CurrentTaxYearAmt
Total$89,644TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$89,644PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$3CurrentTaxYearMinus1YearAmt
Current Tax Year$23CurrentTaxYearAmt
Total$26TotalAmt
FieldValueIRS element (for citing)
Total Support$89,670TotalSupportAmt
First5 Years170Yes (X)First5Years170Ind

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 O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990-EZ, PART I, LINE 4 - OTHER INVESTMENT INCOMEDESCRIPTION: US BANK. AMOUNT: 23.
FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSESDESCRIPTION: STATE FILING FEES. AMOUNT: 50. DESCRIPTION: REIMBURSEMENT TO MEMBER FOR EXPENSES INCURRED. AMOUNT: 5,425. TOTAL TO FORM 990-EZ, LINE 16: 5,475.

Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl

FieldValueIRS element (for citing)
DeclarationTHE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.DeclarationDesc

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