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        <City>Beloit</City>
        <State>WI</State>
        <ZIPCode>53511</ZIPCode>
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      <PersonNm>Richard Johnson</PersonNm>
      <PersonTitleTxt>President</PersonTitleTxt>
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      <SignatureDt>2014-11-03</SignatureDt>
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      <Desc>Alertline Services: The BMH Auxiliary is able to provide monitors for elderly and disabled citizens of the community in exchange for a subscriber fee. Any income generated by this program will be used for donations to the Beloit Health System Foundation, which in turn supports the Beloit Health System.</Desc>
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        <Desc>Gifts to Beloit Health System: Based on income generated from Patient Services, the Gift Shop, and various small fundraising events as well as the transfer of monies generated from the Alertline Program, the Auxiliary is able to donate money to the Beloit Health System Foundation, which main goal is to support the Beloit Health System.</Desc>
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        <Desc>Scholarships: Through tips received at the Hospital Snack Shop and other small contributions, the Auxiliary is able to award scholarships to graduating seniors within the community of Beloit, WI</Desc>
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        <BOYAmt>297062</BOYAmt>
        <EOYAmt>316349</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>298883</BOYAmt>
        <EOYAmt>318407</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>19287</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>0</NetUnrlzdGainsLossesInvstAmt>
      <DonatedServicesAndUseFcltsAmt>0</DonatedServicesAndUseFcltsAmt>
      <InvestmentExpenseAmt>0</InvestmentExpenseAmt>
      <PriorPeriodAdjustmentsAmt>0</PriorPeriodAdjustmentsAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingOtherInd methodOfAccountingOtherDesc="Modified Cash Basis">X</MethodOfAccountingOtherInd>
      <AccountantCompileOrReviewInd>1</AccountantCompileOrReviewInd>
      <AcctCompileOrReviewBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </AcctCompileOrReviewBasisGrp>
      <FSAuditedInd>0</FSAuditedInd>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="R000002" softwareId="13000241" softwareVersion="v1.00">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleG documentId="R000003" softwareId="13000241" softwareVersion="v1.00">
      <FundraisingEventInformationGrp>
        <NameOfEvent1Amt>Special Fundraisers</NameOfEvent1Amt>
        <GrossReceiptsEvent1Amt>24187</GrossReceiptsEvent1Amt>
        <CharitableContriEvent1Amt>0</CharitableContriEvent1Amt>
        <GrossRevenueEvent1Amt>24187</GrossRevenueEvent1Amt>
        <CashPrizesEvent1Amt>0</CashPrizesEvent1Amt>
        <NonCashPrizesEvent1Amt>0</NonCashPrizesEvent1Amt>
        <RentFacilityCostsEvent1Amt>0</RentFacilityCostsEvent1Amt>
        <FoodAndBeverageEvent1Amt>0</FoodAndBeverageEvent1Amt>
        <EntertainmentEvent1Amt>0</EntertainmentEvent1Amt>
        <OtherDirectExpensesEvent1Amt>3140</OtherDirectExpensesEvent1Amt>
        <FoodAndBeverageOtherEventsAmt>0</FoodAndBeverageOtherEventsAmt>
        <EntertainmentOtherEventsAmt>0</EntertainmentOtherEventsAmt>
        <GrossReceiptsTotalAmt>24187</GrossReceiptsTotalAmt>
        <CharitableContributionsTotAmt>0</CharitableContributionsTotAmt>
        <GrossRevenueTotalEventsAmt>24187</GrossRevenueTotalEventsAmt>
        <CashPrizesTotalEventsAmt>0</CashPrizesTotalEventsAmt>
        <NonCashPrizesTotalEventsAmt>0</NonCashPrizesTotalEventsAmt>
        <RentFcltyCostsTotalEventsAmt>0</RentFcltyCostsTotalEventsAmt>
        <FoodAndBeverageTotalEventsAmt>0</FoodAndBeverageTotalEventsAmt>
        <EntertainmentTotalEventsAmt>0</EntertainmentTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>3140</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>3140</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>21047</NetIncomeSummaryAmt>
      </FundraisingEventInformationGrp>
    </IRS990ScheduleG>
    <IRS990ScheduleO documentId="R000004" softwareId="13000241" softwareVersion="v1.00">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Auxiliary's financials statements are compiled by an independent accounting firm. An employee of Beloit Health System's accounting staff prepares the Auxiliary's Form 990 from those compiled statements. When Form 990 is completed, a draft copy of the return is given to the Auxiliary's Executive Committee for review at a regularly scheduled meeting.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Statements, documents, and policies are available upon request at the address of Beloit Health System</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="R000005" softwareId="13000241" softwareVersion="v1.00">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>Beloit Health System Inc</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>1969 West Hart Road</AddressLine1>
          <City>Beloit</City>
          <State>WI</State>
          <ZIPCode>53511</ZIPCode>
        </USAddress>
        <EIN>391028081</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>Beloit Health System Foundation Inc</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>1969 West Hart Road</AddressLine1>
          <City>Beloit</City>
          <State>WI</State>
          <ZIPCode>53511</ZIPCode>
        </USAddress>
        <EIN>391477854</EIN>
        <PrimaryActivitiesTxt>Support of Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>1</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1>Beloit Health System Foundation Inc</BusinessNameLine1>
        </OtherOrganizationName>
        <TransactionTypeTxt>b</TransactionTypeTxt>
        <InvolvedAmt>75000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Actual cash distributed to Beloit Health System Foundation</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>