2014-10-03T12:59:49-05:00 2013-12-31 203676004 CPWR LLP 5057 KELLER SPRINGS RD SUITE 425 ADDISON TX 75001 990EZ 2013-01-01 270804773 CONNECTMED INTERNATIONAL CONN 6198005349 1435 EOLUS AVE ENCINITAS CA 92024 AMANDA GOSMAN MD PRESIDENT AND CEO 6198005349 2014-09-29 RONALD E COLBURN P00021126 9729914566 2013 2015-11-30 17:44:51Z X WWW.CONNECTMED.ORG X X 178085 X 114460 234 63391 15555 47836 162530 9000 87278 96278 66252 194717 0 260969 X 177171 232778 48321 29250 225492 262028 30775 1059 194717 260969 X THE MISSION OF THIS ORGANIZATION IS TO PROMOTE SUSTAINABLE MULTIDISCIPLINARY HEALTH CARE AND EDUCATION TO PATIENTS AND HEALTH CARE PROVIDERS IN UNDERSERVED AREAS AROUND THE WORLD THROUGH A COMBINATION OF DIRECT MEDICAL CARE AND THE ESTABLISHMENT OF AN INTERACTIVE TELEMEDICINE NETWORK BETWEEN INTERNATIONAL SITES FEB 18, 2013 THRU FEB 22, 2013 TRAVEL TO LILONGWE, MALAWI AFRICA TO AFRICAN BIBLE COLLEGE COMMUNITY CLINIC WITH FULL SURGICAL TEAM OF 16 MEMBERS INCLUDING 2 SURGEONS. 40 CRANIOFACIAL RECONSTRUCTIVE SURGICAL CASES AND 25 SPEECH THERAPY EVALUATIONS AND CONSULTS. 0 78477 MAY 18, 2013 -- TRAVEL TO HOSPITAL INFANTIL DE LAS CALIFORNIAS IN TIJUANA, MEXICO AND PERFORMED CRANIOFACIAL RECONSTRUCTIVE SURGERIES ON 4 PATIENTS. ALSO, ATTENDING WERE 10 STUDENTS FROM UNIVERSITY OF CALIFORNIA SAN DIEGO. 0 500 NOV 23, 2013 -- TRAVEL TO HOSPITAL INFANTIL DE LAS CALIFORNIAS IN TIJUANA, MEXICO AND PERFORMED CRANIOFACIAL RECONSTRUCTIVE SURGERIES ON 5 PATIENTS. TWO SURGEONS ON THIS TRIP. ALSO ATTENDING WERE 50 STUDENTS FROM UNIVERSITY OF CALIFORNIA SAN DIEGO. 0 500 79477 SHERRY L COLBURN EXECUTIVE DIRECTOR 15.00 9000 0 0 AMANDA GOSMAN MD PRESIDENT AND CEO / BOARD 20.00 0 0 0 RITA ABBATI ALBERT VICE PRESIDENT/BOARD MEMBE 5.00 0 0 0 RONALD COLBURN CPA TREASURER/BOARD MEMBER 2.00 0 0 0 ALICIA SIGLER MD BOARD MEMBER 2.00 0 0 0 ZIA AGHA MD BOARD MEMBER 2.00 0 0 0 ROHIT KHOSLA MD BOARD MEMBER 2.00 0 0 0 SHANKAR SITIPATI BOARD MEMBER 2.00 0 0 0 ROBERT HALL BOARD MEMBER 2.00 0 0 0 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CA SHERRY L COLBURN 112 UTE LANE ESTES PARK CO 80517 9705861793 0 0 0 0 0 0 0 0 0 0 NONE NONE 1 X 8610 65449 57286 48060 179405 8610 65449 57286 48060 179405 0 0 0 179405 140 234 374 140 234 374 8610 65449 57426 48294 179779 0.99790 0.00210 X SCHEDULE A, PART IV, LIST OF UNUSUAL GRANTS: DESCRIPTION: CASH GRANT FOR MALAWI AFRICA CLINIC DATE: 01/01/13 AMOUNT: 11400. DESCRIPTION: CASH GRANT FOR GENERAL OPERATONS DATE: 11/15/13 AMOUNT: 35000. DESCRIPTION: CASH GRANT FOR MALAWI AFRICA CLINIC DATE: 12/30/14 AMOUNT: 20000. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X X DINNER AND AUCTION JULY 20 2013 63391 63391 2500 13055 63391 63391 2500 13055 15555 47836 FORM 990-EZ, PART I, LINE 4 - OTHER INVESTMENT INCOME DESCRIPTION: INTEREST. AMOUNT: 234. FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES DESCRIPTION: OFFICE AND ADMINISTRATIVE. AMOUNT: 1,412. DESCRIPTION: WEB SITE HOSTING. AMOUNT: 722. DESCRIPTION: PROGRAM SERVICE TRAVEL. AMOUNT: 79,477. DESCRIPTION: FEDERAL PAYROLL TAXES. AMOUNT: 688. DESCRIPTION: PROMOTION. AMOUNT: 500. DESCRIPTION: D & O INSURANCE. AMOUNT: 2,485. DESCRIPTION: BOARD MEETINGS. AMOUNT: 960. DESCRIPTION: STATE REGISTRATION FEES. AMOUNT: 130. DESCRIPTION: CREDIT CARD FEES AND BANK SERVICE FEES. AMOUNT: 768. DESCRIPTION: MEDICAL SUPPLIES. AMOUNT: 136. TOTAL TO FORM 990-EZ, LINE 16: 87,278. FORM 990-EZ, PART II, LINE 24 - OTHER ASSETS DESCRIPTION: PREPAID TRIP COSTS FOR 2013 PROGRAM SERVICE TRIP. BEG. OF YEAR AMOUNT: 24,461. END OF YEAR AMOUNT: 0. DESCRIPTION: OTHER DEPRECIABLE ASSETS. BEG. OF YEAR AMOUNT: 23,860. END OF YEAR AMOUNT: 29,250. FORM 990-EZ, PART II, LINE 26 - OTHER LIABILITIES DESCRIPTION: DEFERRED PROGRAM SERVICES TRIP FEE CONTRIBUTIONS. BEG. OF YEAR AMOUNT: 30,775. END OF YEAR AMOUNT: 0. DESCRIPTION: PAYROLL TAXES PAYABLE. BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: 1,059. THE 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.