2014-08-28T12:27:42-05:00 2013-12-31 621142155 PUGH & COMPANY PC 315 N CEDAR BLUFF RD SUITE 200 KNOXVILLE TN 37923 990 2013-01-01 204901729 LAFOLLETTE MEDICAL FOUNDATION INC LAFO 4239126963 PO BOX 128 JACKSBORO TN 37757 DR JAMES FARRIS PRESIDENT 4239126963 2014-08-26 1 RE FOUST P00745365 8657690660 2013 2015-11-30 17:44:51Z DR JAMES FARRIS PO BOX 128 JACKSBORO TN 37757 2804730 0 X WWW.LAFOLLETTEMEDICALFOUNDATION.ORG X 2006 TN THE FOUNDATION IS ORGANIZED AS A PUBLIC BENEFIT CORPORATION FOR THE CHARITABLE PURPOSE OF MAKING DISTRIBUTIONS TO QUALIFYING 501(C)(3) ORGANIZATIONS THAT PROVIDE FOR THE HEALTHCARE OF THE RESIDENTS OF LAFOLLETTE COMMUNITY, WHICH INCLUDES ALL OF CAMPBELL COUNTY. 7 7 0 0 0 0 0 0 0 0 393937 653005 0 0 393937 653005 602253 641412 0 0 0 0 0 0 0 134606 140397 736859 781809 -342922 -128804 10129485 10425668 0 0 10129485 10425668 X THE FOUNDATION IS ORGANIZED AS A PUBLIC BENEFIT CORPORATION FOR THE CHARITABLE PURPOSE OF MAKING DISTRIBUTIONS TO QUALIFYING 501(C)(3) ORGANIZATIONS THAT PROVIDE FOR THE HEALTHCARE OF THE RESIDENTS OF LAFOLLETTE COMMUNITY, WHICH INCLUDES ALL OF CAMPBELL COUNTY. 0 0 641412 641412 THE FOUNDATION IS ORGANIZED AS A PUBLIC BENEFIT CORPORATION FOR THE CHARITABLE PURPOSE OF MAKING DISTRIBUTIONS TO QUALIFYING 501(C)(3) ORGANIZATIONS THAT PROVIDE FOR THE HEALTHCARE OF THE RESIDENTS OF LAFOLLETTE COMMUNITY, WHICH INCLUDES ALL OF CAMPBELL COUNTY. THE FOUNDATION IS ORGANIZED AS A PUBLIC BENEFIT CORPORATION FOR THE CHARITABLE PURPOSE OF MAKING DISTRIBUTIONS TO QUALIFYING 501(C)(3) ORGANIZATIONS THAT PROVIDE FOR THE HEALTHCARE OF THE RESIDENTS OF THE LAFOLLETTE,TN COMMUNITY. 641412 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 TN X JUNE WILBURN 4239126963 905 RIVERVIEW DRIVE LAFOLLETTE TN 37766 X BRENDA ROBARDS TREASURER 1.00 X 0 0 0 MIKE STANFIELD DIRECTOR 1.00 X 0 0 0 LUCY LOBERTINI DIRECTOR 1.00 X 0 0 0 KATHY MYERS SECRETARY 1.00 X 0 0 0 JUDGE SHAYNE SEXTON DIRECTOR 1.00 X 0 0 0 ELIZABETH ASBURY DIRECTOR 1.00 X 0 0 0 DR JAMES FARRIS PRESIDENT AND CHAIRMAN 1.00 X 0 0 0 0 0 0 0 0 0 0 0 277932 277932 2526798 2151725 375073 375073 375073 653005 0 0 653005 641412 641412 6630 6630 12000 12000 101155 101155 15000 15000 3565 3565 2047 2047 781809 641412 140397 0 478280 524529 9651205 9901139 10129485 10425668 0 0 X 10129485 10425668 10129485 10425668 10129485 10425668 X -128804 420208 4779 X 0 1 X 0 0 X 1498158 1498158 1498158 1498158 1498158 231982 251778 260522 279611 277932 1301825 2799983 0.53510 0.50530 X 0 X 1073213 420208 420208 653005 0 653005 777030 0 777030 4779 4779 781809 PART X, LINE 2: GAAP REQUIRES MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FOUNDATION. MANAGEMENT HAS EVALUATED THE FOUNDATION'S TAX POSITIONS AND CONCLUDED THAT THE FOUNDATION MAINTAINED ITS TAX EXEMPT STATUS DURING THE YEARS ENDED DECEMBER 31,2013 AND 2012. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: UNREALIZED GAINS ON INVESTMENTS 420,208. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECOVERIES OF PRIOR YEAR GRANTS 4,779. 1 THE SHEPHERD'S HOME INC P O BOX 707 JACKSBORO TN 37757 270988603 501(C)(3) 70368 CASH GRANT HEALTH CARE FOOD LIFE SERVICES OF CAMPBELL COUNTY 206 S INDIANA AVE LAFOLLETTE TN 37766 621812105 501(C)(3) 65000 CASH GRANT HEALTH CARE CAMPBELL COUNTY SENIOR CITIZENS 102 8TH STREET LAFOLLETTE TN 37766 620988347 501(C)(3) 66902 CASH GRANT HEALTH CARE CAMPBELL COUNTY CHILDREN'S CENTER 2315 JACKSBORO PIKE JACKSBORO TN 37766 780251005 501(C)(3) 80503 CASH GRANT HEALTH CARE EAST TENNESSEE HUMAN RESOURCE AGENCY INC 9111 CROSS PARK DRIVE D-100 KNOXVILLE TN 37923 621493851 501(C)(3) 22000 CASH GRANT HEALTH CARE CHET - COMMUNITY HEALTH OF EAST TN P O BOX 209 507 MAIN ST JACKSBORO TN 37757 581470587 501(C)(3) 38551 CASH GRANT HEALTH CARE TN BAPTIST ADULT HOMES PO BOX 728 BRENTWOOD TN 37024 620934533 501(C)(3) 25000 CASH GRANT HEALTH CARE CASA OF CAMPBELL COUNTY PO BOX 1054 JACKSBORO TN 37757 205755609 501(C)(3) 18500 CASH GRANT HEALTH CARE JELLICO COMMUNITY HOSPITAL 188 HOSPITAL LANE JELLICO TN 37762 620924706 501(C)(3) 7000 CASH GRANT HEALTH CARE CAMPBELL COUNTY LIONS CLUB CHARITIES P O BOX 1205 LA FOLLETTE TN 37766 753241283 501(C)(3) 21500 CASH GRANT HEALTH CARE CUMBERLAND HOPE COMMUNITY CHURCH 942 TOWE STRING RD JACKSBORO TN 37757 861098276 501(C)(3) 16500 CASH GRANT HEALTH CARE CAMPBELL COUNTY RURAL FIRE SERVICE P O BOX 341 LA FOLLETTE TN 37766 621315582 501(C)(3) 9250 CASH GRANT HEALTH CARE LAFOLLETTE LIFE SAVINGS AND RESCUE SQUAD INCORPORATED P O BOX 282 LA FOLLETTE TN 37766 621128575 501(C)(3) 15000 HEALTH CARE HELEN ROSS MCNABB CENTER 201 W SPRINGDALE AVENUE KNOXVILLE TN 37917 620548914 501(C)(3) 59756 CASH GRANT HEALTH CARE CATHOLIC CARITIES OF EAST TENNESSEE 3009 LAKE BROOK BLVD KNOXVILLE TN 37909 621377551 501(C)(3) 17000 CASH GRANT HEALTH CARE CAMPBELL COUNTY BOARD OF EDUCATION 172 VALLEY ST JACKSBORO TN 37757 606000507 GOVERMENT AGENCY 74458 CASH GRANT HEALTH CARE CITY OF LAFOLLETTE FIRE DEPARTMENT 105 EAST BEECH ST LA FOLLETTE TN 37766 626000328 GOVERMENT AGENCY 34124 CASH GRANT HEALTH CARE 19 FORM 990; SCHEDULE I; PART I; LINE 2 THE ORGANIZATION SELECTS ORGANIZATIONS THAT ENGAGE IN ACTIVITIES AND MAKE DISTRIBUTIONS THAT PROVIDE FOR THE HEALTHCARE OF THE RESIDENTS OF THE LAFOLLETTE. THE PROPERTY, AFFAIRS AND BUSINESS OF THE FOUNDATION ARE TO BE MANAGED BY A BOARD OF DIRECTORS, WHOSE OPERATIONS IN GOVERNING THE FOUNDATION ARE DEFINED BY TENNESSEE STATUTE AND THE FOUNDATIONS BYLAWS. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S CONFLICT OF INTEREST POLICY CALLS FOR ANNUAL STATEMENTS TO BE SIGNED EACH YEAR. ARTICLE VII CALLS FOR PERIODIC REVIEWS OF COMPENSATION ISSUES AND RELATED PARTY AFFILIATIONS. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS PRESENTED TO EACH BOARD MEMBER PRIOR TO THE MEETING FOR MEMBERS TO VIEW PRIOR TO THE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY CALLS FOR ANNUAL STATEMENTS SHALL BE SIGNED EACH YEAR. ARTICLE VII CALLS FOR PERIODIC REVIEWS OF COMPENSATION ISSUES AND RELATED PARTY AFFILIATIONS. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST FORM 990, PART XI, LINE 9: RECOVERIES OF PRIOR YEARS GRANTS 4,779.