2015-05-12T16:47:34-05:00 2014-06-30 BDO USA LLP 100 PARK AVENUE NEW YORK NY 100175001 990PF 2013-07-01 203101239 NICK SIMONS FOUNDATION % FANG HAN NICK 6466540066 160 FIFTH AVENUE 7TH FLOOR Suite NEW YORK NY 10010 MARILYN SIMONS SECRETARY & TREASURER 6466540066 2015-05-12 true Paul Hammerschmidt P01384178 6466540066 2013 2016-02-25 16:41:14Z X 60891541 X 6950000 232 232 637942 -674903 0 611048 492886 118162 176 -262487 0 6393667 375687 0 317800 317800 369841 351844 267388 267388 79639 0 0 45029 108500 35805 0 95296 567388 0 0 514769 99383 15340 0 0 5694 97402 104040 384003 316033 830718 935580 0 1021769 3127756 986725 0 3033968 2682074 2732074 5809830 986725 0 5766042 583837 0 0 806697 1232495 1232495 233369 120156 120156 0 10000000 0 0 424922 545908 545908 29095 194370 194370 45102625 57753945 57753945 68502 5694 0 62808 62808 267205 981859 981859 56863913 60891541 60891541 276791 356588 485717 435717 31200 18650 72691 173012 866399 983967 X 859124 2117864 55138390 57789710 55997514 59907574 56863913 60891541 55997514 583837 3326223 59907574 59907574 PASS THROUGH FROM PARTNERSHIP K-1 P -114923 -114923 false 5170694 40296228 0.128317 5021464 25493121 0.196973 4076656 17169912 0.23743 3924982 5965184 0.657982 4630669 153289 30.208749 31.429451 6.28589 51923115 326382989 0 326382989 5766042 0 0 0 67049 67049 67049 67049 false false false false false false false true true NY true false false true false true N/A FANG HAN 6466540066 160 FIFTH AVENUE 7TH FL NEW YORK NY 10010 true false false true true false false false false false false false false false true false false true false false false false JAMES SIMONS 160 FIFTH AVENUE 7TH FLOOR NEW YORK NY 10010 PRESIDENT 1.0 0 0 0 MARILYN SIMONS 160 FIFTH AVENUE 7TH FLOOR NEW YORK NY 10010 SECRETARY & TREASURER 2.0 0 0 0 CAITLIN HEISING 160 FIFTH AVENUE 7TH FLOOR NEW YORK NY 10010 TRUSTEE 0.5 0 0 0 MARK HEISING 160 FIFTH AVENUE 7TH FLOOR NEW YORK NY 10010 TRUSTEE 0.5 0 0 0 AUDREY SIMONS 160 FIFTH AVENUE 7TH FLOOR NEW YORK NY 10010 TRUSTEE 0.5 0 0 0 LAURA BAXTER SIMONS 160 FIFTH AVENUE 7TH FLOOR NEW YORK NY 10010 TRUSTEE 0.5 0 0 0 LIZ SIMONS 160 FIFTH AVENUE 7TH FLOOR NEW YORK NY 10010 TRUSTEE 0.5 0 0 0 NAT SIMONS 160 FIFTH AVENUE 7TH FLOOR NEW YORK NY 10010 TRUSTEE 0.5 0 0 0 STEPHEN RUDY 160 FIFTH AVENUE 7TH FLOOR NEW YORK NY 10010 GRADIAN CEO 40.0 317800 83338 0 ERICA FRENKEL 160 FIFTH AVENUE 7TH FLOOR NEW YORK NY 10010 VP BUSINESS STRATEGY 40.0 115000 26397 0 LINA SAYED 160 FIFTH AVENUE 7TH FLOOR NEW YORK NY 10010 DIR MARKET STRATEGY 40.0 87150 20896 0 ISMAEL CORDERO 160 FIFTH AVENUE 7TH FLOOR NEW YORK NY 10010 BIOMEDICAL SVC MGR 40.0 62902 38989 0 EMILY RYAN 160 FIFTH AVENUE 7TH FLOOR NEW YORK NY 10010 ADMIN. MANAGER 40.0 60125 41563 0 0 The Johns Hopkins University 3400 N Charles STREET BALTIMORE MD 21218 CLINICAL TRIALS 477647 Speck Product Design Inc 3221 PORTER DRIVE PALO ALTO CA 94304 Product development 159582 Paul Fenton AGNAC FR 47800 PROGRAM CONSULTANT 97094 STEPHEN KNOBLE PO BOX 8975 EPC 1813 KATHMANDU NP PROGRAM CONSULTANT 73333 BHEKH THAPA 239 TANKA PRASAD ROAD BANESHWOR HEIGHT KATHMANDU NP PROGRAM CONSULTANT 71500 2 SEE GENERAL EXPLANATION ATTACHMENT 2625522 SEE GENERAL EXPLANATION ATTACHMENT 196824 50391815 2322007 0 52713822 0 52713822 790707 51923115 2596156 2596156 0 0 2596156 2596156 2596156 5766042 0 0 0 0 5766042 5766042 2596156 0 2011 2010 2009 0 4623005 3626723 3218164 3746956 3156293 18371141 5766042 0 2596156 3169886 21541027 0 0 0 0 4623005 16918022 3626723 3218164 3746956 3156293 3169886 JAMES SIMONS NONE X NICK SIMONS INSTITUTE BOX 8975 EPC 1813 JHAMSIKHEL BOX 8975, EPC 181 NP n/a PC PROGRAM & GENERAL OPERATING SUPPORT 1900108 Project Prakash Foundation 955 Massachusetts Avenue 351 Cambridge MA 02139 N/A PC GENERAL OPERATING SUPPORT 100000 THE AMERICAN HIMALAYAN FOUNDATION 900 MONTGOMERY STREET SUITE 400 SAN FRANCISCO CA 94133 N/A PC PROGRAM SUPPORT 234366 HIMALAYAN CATARACT PROJECT PO BOX 55 WATERBURY VT 05676 N/A PC GENERAL OPERATING SUPPORT 50000 PATAN HOSPITAL Lagankhel ROAD Lalitpur 44700 NP N/A NC Charitable Care Fund and Capital Needs 50000 ADVANCE GCFA COVENANT RELATIONSHIP OFFICE 475 RIVERSIDE DRIVE ROOM 320 NEW YORK NY 10115 N/A PC PURPOSE RESTRICTED SUPPORT 45000 FUTURE GENERATIONS HC 73 BOX 100 RT 33W NORTH MOUNTAIN FRANKLIN WV 26807 N/A PC GENERAL OPERATING SUPPORT 25000 IPAS PO Box 9990 Chapel Hill NC 27515 N/A PC PROGRAM SUPPORT 25000 FOUNDATION FOR THE PEOPLE OF BURMA PARTNERS ASIA 220 SECOND AVENUE SOUTH SEATTLE WA 98104 N/A PC GENERAL OPERATING SUPPORT 20000 FRIENDS OF PATAN HOSPITAL 1980 DAHLIA STREET DENVER CO 80220 N/A PC PROGRAM SUPPORT 5000 KATHAMANDU VALLEY PRESERVATION TRUST 136 WEST 21ST STREET 11TH FL NEW YORK NY 10011 N/A PC GENERAL OPERATING SUPPORT 5000 HOSPICE NEPAL LALITPUR LAGANKHEL NP N/A NC GENERAL OPERATING SUPPORT 5000 NEPAL AMBULANCE SERVICE Sitapaila KathmandU NP N/A NC GENERAL OPERATING SUPPORT 5000 LO GYALPO JIGME CC FOUNDATION PO BOX 10489 CHABAHIL KATHMANDU NP N/A NC GENERAL OPERATING SUPPORT 5000 RURAL HEALTH & EDUCATION SERVICE TRUST (RHEST) Post Box No 355 Bishal Nagar, Ward No. 5 Kathmandu NP N/A NC PROGRAM SUPPORT 2600 AMERICAN NEPAL MEDICAL FOUNDATION 2743 SOUTH VETERANS HOSPITAL PMB SPRINGFIELD IL 62704 N/A PC GENERAL OPERATING SUPPORT 2500 Nepal ko Yuwa 35 Chestnut St Belmont MA 02478 N/A PC GENERAL OPERATING SUPPORT 2500 NYAYA HEALTH 135 COLLEGE ST STE 323 NEW HAVEN CT 06510 N/A PC GENERAL OPERATING SUPPORT 100000 POSSIBLE 17 WEST 17TH STREET 7TH FLOOR NEW YORK NY 10011 N/A PC GENERAL OPERATING SUPPORT 150000 2732074 PROJECT PRAKASH FOUNDATION 955 Massachusetts Avenue 351 Cambridge MA 02139 N/A PC GENERAL OPERATING SUPPORT 200000 200000 14 232 18 -674903 118162 OTHER INCOME - NSF 01 110 OTHER INCOME - GHS 01 66 -674495 118162 -556333 10 SUBSIDIZED SALES OF UNIVERSAL ANESTHESIA MACHINES TO CHARITABLE OR NOT-FOR-PROFIT ORGANIZATIONS AS PART OF THE FOUNDATION'S MISSION TO IMPROVE HEALTHCARE IN DEVELOPING COUNTRIES. false false false false false false false false false false X X 1 JAMES SIMONS 160 FIFTH AVENUE 7TH FLOOR NEW YORK NY 10010 6950000 X BDO AUDIT AND TAX - NSF 40500 13365 0 26036 BDO AUDIT AND TAX - GHS 14000 4620 0 15260 FMA BOOKEEPING - GHS 54000 17820 0 54000 EQUIPMENT 2014-01-01 29147 0 SL 3 4858 CONSTRUCT IN PROG. 2014-01-01 30995 0 0 FURNITURE/EQUIP. 2000-01-01 8360 0 SL 5 836 NICK SIMONS INSTITUTE BOX 8975 EPC 1813 JHAMSIKHEL LALITPUR NP 2014-05-27 1900108 TO TRAIN AND SUPPORT SKILLED COMPASSIONATE HEALTHCARE WORKERS IN THE RURAL REGIONS OF NEPAL 1900108 NO 6/30/2014 The Foundation has no reason to doubt the accuracy or reliability of the report from the grantee so no independent verification of the report was required or made PATAN HOSPITAL Lagankhel ROAD Lalitpur 44700 NP 2013-07-24 50000 TO support capital improvements in hospital, including equipment and facility renovations 50000 NO 6/30/2014 The Foundation has no reason to doubt the accuracy or reliability of the report from the grantee so no independent verification of the report was required or made HOSPICE NEPAL 2014-03-14 5000 TO SUPPORT Hospice's important mission TO PROVIDE palliative care 5000 NO 6/30/2014 The Foundation has no reason to doubt the accuracy or reliability of the report from the grantee so no independent verification of the report was required or made NEPAL AMBULANCE SERVICE 2014-05-02 5000 TO Support Ambulatory Care to Kathmandu and Patan 5000 NO 6/30/2014 The Foundation has no reason to doubt the accuracy or reliability of the report from the grantee so no independent verification of the report was required or made LO GYALPO JIGME CC FOUNDATION PO BOX 10489 CHABAHIL KATHMANDU NP 2014-03-17 5000 TO SUPPORT FOUNDATION'S restoration and education PROJECT in Mustang 5000 NO 6/30/2014 The Foundation has no reason to doubt the accuracy or reliability of the report from the grantee so no independent verification of the report was required or made RURAL HEALTH & EDUCATION SERVICE TRUST Post Box No 355 Bishal Nagar, Ward No. 5 Kathmandu NP 2013-09-23 2600 TO SUPPORT The Global Health and Innovation CONFERENCE 2600 NO 6/30/2014 The Foundation has no reason to doubt the accuracy or reliability of the report from the grantee so no independent verification of the report was required or made FORM 990PF, PART IX-A - Summary of Direct Charitable Activities FORM 990PF, PART IX-A - Summary of Direct Charitable Activities LINE 1 TO SUPPORT DEVELOPMENT AND TECHNOLOGY OF THE UNIVERSAL ANESTHESIA MACHINE ("UAM"), A LOW COST, TROLLEY BASED WORKSTATION PROVIDING INHALATION ANESTHESIA USING AN OXYGEN CONCENTRATOR, AND INSTALLATION OF 46 UAMS IN 40 HOSPITALS IN 10 COUNTRIES. LINE 2 PARTNERSHIP WITH 11 HOSPITALS IN NEPAL AND SUPPORT TRAINING FOR 2,500 RURAL HEALTH CARE WORKERS, CURRICULA DEVELOPMENT, TRAINING SITE START-UP AND DEVELOPMENT, AND PROGRAMS THAT HELP RETAIN HEALTH CARE WORKERS IN THE FIELD. HEDGE FUNDS FMV 57753945 57753945 EQUIPMENT 29147 4858 24289 CONSTRUCT IN PROG.C 30995 0 30995 FURNITURE/EQUIP. 8360 836 7524 LEGAL FEES - NSF 3796 0 0 3796 LEGAL FEES - GHS 75843 0 0 41233 INVENTORY DEPOSITS 267205 888020 888020 SECURITY DEPOSITS 93839 93839 PARTNERSHIP EXP - RIEF 0 345834 0 0 PARTNERSHIP EXP - RIDA 0 589746 0 0 GHS PROGRAM EXPENSES 62154 0 0 20036 PRODUCTION DEV. COSTS - GHS 533081 0 0 696421 OFFICE EXPENSES - NSF 21925 0 0 21925 OFFICE EXPENSES - GHS 103088 0 0 193234 INSURANCE - NSF 17510 0 0 21216 INSURANCE - GHS 34216 0 0 37013 WARRANTY EXPENSE - GHS 32000 0 0 5180 BUSINESS DEVELOPMENT - GHS 6000 0 0 6000 MISCELLANEOUS - GHS 19244 0 0 19244 FILING FEES 1500 0 0 1500 OTHER INCOME - NSF 110 0 0 OTHER INCOME - GHS 66 0 0 FROM PARTNERSHIP INTERESTS - RIDA -262487 NET UNREALIZED GAIN ON INVESTMENTS 3326223 DEFERRED EXCISE TAX LIABILITY 72691 173012 CONSULTING FEES - GHS 282303 0 0 234685 BOARD DEVELOPMENT, TECHNICAL 0 0 0 0 ADVISORY AND COUNTRY 0 0 0 0 REPRESENTATION SERVICES - NSF 114000 114000 HEALTH CARE WORKER DEVELOPMENT 0 0 0 0 AND TRAINING - NSF 129130 0 0 124129 PAYROLL SERVICE FEES - GHS 12536 0 0 12536 VIDEO PRODUCTION - GHS 19075 0 0 19075 OTHER PROFESSIONAL FEES - GHS 10344 0 0 10344 UNIVERSAL ANAESTHESIA MACHINE 611048 611048 EXCISE TAX EXPENSE - NSF 99383 0 0 0 FOREIGN TAXES PAID 0 15340 0 0 NICK SIMONS INSTITUTE BOX 8975 EPC 1813 JHAMSIKHEL LALITPUR NP 000000000 TO TRAIN & SUPPORT HEALTHCARE WORKERS IN THE RURAL REGIONS OF NEPAL. 1900108 1900108