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MINNESOTA ACADEMY OF FAMILY PHYSICIANS FOUNDATION: Form 990EZ, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
MINNESOTA ACADEMY OF FAMILY PHYSICIANS FOUNDATION (EIN 36-3611238)
Tax period
2013-07-01 to 2014-06-30
Filed
2015-02-02
IRS object ID
201510339349200111
Schema version
2013v4.0
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)
Return2015-02-02T08:34:15-08:00ReturnTs
Tax Period End2014-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Carpenter Evert & AssociatesBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line17760 France Ave S 940AddressLine1
CityBloomingtonCity
StateMNState
ZIP Code55435ZIPCode
FieldValueIRS element (for citing)
Return Type990EZReturnTypeCd
Tax Period Begin2013-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN363611238EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MINNESOTA ACADEMY OF FAMILY PHYSICIANSBusinessNameLine1
Business Name Line2FOUNDATIONBusinessNameLine2
FieldValueIRS element (for citing)
Business Name ControlMINNBusinessNameControlTxt
Phone9525420130PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 SOUTH HIGHWAY 169AddressLine1
CityST LOUIS PARKCity
StateMNState
ZIP Code55426ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKathleen KellerPersonNm
Person TitleTreasurerPersonTitleTxt
Signature2015-02-02SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonNeal O EvertPreparerPersonNm
PTINP00046853PTIN
Phone9528310085PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990-EZ IRS990EZ

FieldValueIRS element (for citing)
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Website Addresswww.mafp.org/foundation.aspWebsiteAddressTxt
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Gross Receipts$125,186GrossReceiptsAmt
Info In Schedule O Part IYes (X)InfoInScheduleOPartIInd
Contributions Gifts Grants Etc$123,582ContributionsGiftsGrantsEtcAmt
Investment Income$1,135InvestmentIncomeAmt
Cost Or Other Basis Expense Sale$0CostOrOtherBasisExpenseSaleAmt
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Special Events Direct Expenses$0SpecialEventsDirectExpensesAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt
Other Revenue Total$469OtherRevenueTotalAmt
Total Revenue$125,186TotalRevenueAmt
Grants And Similar Amounts Paid$33,050GrantsAndSimilarAmountsPaidAmt
Salaries Other Comp Empl Bnft$87,851SalariesOtherCompEmplBnftAmt
Fees And Other Pymt To Ind Cntrct$6,701FeesAndOtherPymtToIndCntrctAmt
Printing Publications Postage$3,296PrintingPublicationsPostageAmt
Other Expenses Total$8,471OtherExpensesTotalAmt
Total Expenses$139,369TotalExpensesAmt
Excess Or Deficit For Year-$14,183ExcessOrDeficitForYearAmt
Net Assets Or Fund Balances BOY$331,407NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$317,224NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIYes (X)InfoInScheduleOPartIIInd

Cash Savings And Investments CashSavingsAndInvestmentsGrp

FieldValueIRS element (for citing)
BOY$329,062BOYAmt
EOY$310,579EOYAmt

Other Assets Total Detail OtherAssetsTotalDetail

FieldValueIRS element (for citing)
BOY$3,904BOYAmt
EOY$19,500EOYAmt

Form990 Total Assets Form990TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$332,966BOYAmt
EOY$330,079EOYAmt

Sum Of Total Liabilities SumOfTotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,559BOYAmt
EOY$12,855EOYAmt

Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp

FieldValueIRS element (for citing)
BOY$331,407BOYAmt
EOY$317,224EOYAmt
FieldValueIRS element (for citing)
Primary Exempt PurposeTo support family physician health care delivery, research and education, and to develop patient care programs, provide education to patients and professionals, support practice-based research intiatives, and introduce medical students to the specialty of family medicine.PrimaryExemptPurposeTxt

Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp (5 entries)

Description Program Srvc AccomDescriptionProgramSrvcAccomTxtGrants And AllocationsGrantsAndAllocationsAmt
The Corporate Advisory Council program provides a means of communication between the corporate sector and the MAFP Foundation.$77,797
PATIENT SERVICES:Living Well with Chronic Conditions Workshops - this six week evidence-based class is for patients with chronic conditions to learn how to self-manage their illness, enhance their day-to-day living and lead healthier, more satisfying lives. The Foundation partners with the Minnesota Department Of Health to implement this peer led patient education initiative developed by Stanford University Center for Patient Education.Working Effectively with Professional Interpreters Workshop - developed to enhance communication between family physicians and patients with limited English proficiency.Pertussis Awareness and Vaccination Campaign - Family physicians and healthcare personnel are encouraged to get immunized against pertussis, and REDUCE THE potential to spread pertussis from physicians and healthcare personnel to patients.
MEDICAL STUDENTS & RESIDENTS:David Mersy, M.D. Student Externship Program- grants are awarded to medical students who want to gain career experience and knowledge of the specialty of family medicine by spending the summer at a family medicine clinic conducting a clinical research or non-research project with a family physician mentor.Resident Research Grant Program - grants are awarded to family medicine residents to design a research project and gain real-world research experience, develop skills in basic research methods and understand the importance of family medicine research. Residents are matched with a family physician research mentor.THE ANDERSON FUND HELPS new-to-practice physicians to practice in underserved communities in Minnesota.
Minnesota Academy of Family Physicians (MAFP) Research Network - a grant is awarded to the MAFP Research Network in support of 200+ family physicians conducting family medicine research in Minnesota.
Other Program Expenses The New Program Development initiative invites healthcare organizations to partner with the MAFP Foundation and explore future program opportunities that will improve the health of Minnesotans.
FieldValueIRS element (for citing)
Total Program Service Expenses$77,797TotalProgramServiceExpensesAmt
Info In Schedule O Part IVYes (X)InfoInScheduleOPartIVInd

Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (19 entries)

TitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmt
Jo Peterson
Executive Dir.40.00$77,000
Sue Inoue
Director1.00$0
Virginia Barzan
Executive Dir.8.00$0
Kathleen Keller
Treasurer1.00$0
Veronica Nelson
Director1.00$0
Kevin Gilliam
Director1.00$0
Georgann Gillund
Director1.00$0
Carolyn Kampa MD
Director1.00$0
Thomas King MD
President1.00$0
Lief Solberg
Director1.00$0
Lynne Ogawa MD
Vice President1.00$0
Heather Pett Taylor MD
Director1.00$0
Dave Clauer
Director1.00$0
Kenneth Kephart MD
Director1.00$0
Nora Ali
Director1.00$0
Paul Kleeberg MD
Director1.00$0
Eduardo Medina
Director1.00$0
ROSA MARROQUIN MD
Director1.00$0
Dania Kamp
Director1.00$0
FieldValueIRS element (for citing)
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
Activities Not Previously RptfalseActivitiesNotPreviouslyRptInd
Chg Made To Orgnzng Doc Not RptYes (true)ChgMadeToOrgnzngDocNotRptInd
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

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonBarbara SkrivanekPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 South Highway 169 Suite 1680AddressLine1
CitySt Louis ParkCity
StateMNState
ZIP Code55426ZIPCode
FieldValueIRS element (for citing)
Phone9525420130PhoneNum
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$200,039CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$82,862CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$150,932CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$131,104CurrentTaxYearMinus1YearAmt
Current Tax Year$57,563CurrentTaxYearAmt
Total$622,500TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,520CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,500CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,500CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,250CurrentTaxYearMinus1YearAmt
Total$12,770TotalAmt

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$203,559CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$86,362CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$154,432CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$133,354CurrentTaxYearMinus1YearAmt
Current Tax Year$57,563CurrentTaxYearAmt
Total$635,270TotalAmt

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$635,270PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,154CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,346CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,423CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,233CurrentTaxYearMinus1YearAmt
Current Tax Year$1,135CurrentTaxYearAmt
Total$6,291TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,154CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,346CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,423CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,233CurrentTaxYearMinus1YearAmt
Current Tax Year$1,135CurrentTaxYearAmt
Total$6,291TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$53,200CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$49,836CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$45,994CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$46,929CurrentTaxYearMinus1YearAmt
Current Tax Year$66,488CurrentTaxYearAmt
Total$262,447TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$257,913CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$137,544CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$201,849CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$181,516CurrentTaxYearMinus1YearAmt
Current Tax Year$125,186CurrentTaxYearAmt
Total$904,008TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.70270PublicSupportCY509Pct
Public Support PY5090.73860PublicSupportPY509Pct
Investment Income CY0.00700InvestmentIncomeCYPct
Investment Income PY0.00890InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

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 (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Other Revenue.1Miscellaneous Revenue $469
Grants and Similar Amounts Paid In Excess of $5,000.2| Donee's Name: Various Individuals - NONE OVER $5,000 | Cash Amount Given: $33050
Other Expenses.1002Office Expenses $727
Other Expenses.1005Travel $3317
Other Expenses.1012Insurance $125
Other Expenses.1MISCELLANEOUS $3736
Other Expenses.3TELECOMMUNICATION $388
Other Expenses.4Bank & Credit Card Fees $178
Other Assets.1005Accounts Receivable - Beginning $3904 Accounts Receivable - Ending $19500
Total Liabilities.1001Accounts Payable and Accrued Expenses - Beginning $1559 Accounts Payable and Accrued Expenses - Ending $12855
Changes to Organizing or Governing DocumentsBy-laws now include stuent and resident board members.

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