EVELYN LILLY LUTZ FOUNDATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
EVELYN LILLY LUTZ FOUNDATION (EIN 04-2103885)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-05-13
IRS object ID
201321339349303242
Schema version
2012v2.1
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)
Timestamp2013-05-13T14:01:08-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN043072365EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1GRANDMAISON & TRIPOLI LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line17 FEDERAL STREETAddressLine1
CityDANVERSCity
StateMAState
ZIP Code01923ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN042103885EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1THE EVELYN LILLY LUTZ FOUNDATIONBusinessNameLine1
Business Name Line2C/O BEVERLY HOSPITALBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlEVELNameControl
Phone9782361654Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line185 HERRICK STREETAddressLine1
CityBEVERLYCity
StateMAState
ZIP Code01915ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameFRANCIS CLEARYName
TitlePRESIDENTTitle
Phone9789223000Phone
Date Signed2013-05-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMICHAEL G GRANDMAISONName
PTINP00065017PTIN
Phone9787776122Phone
Date Prepared2013-04-25DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonFRANCIS CLEARYNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line185 HERRICK STREETAddressLine1
CityBEVERLYCity
StateMAState
ZIP Code01915ZIPCode
FieldValueIRS element (for citing)
Gross Receipts3950918GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteNOT APPLICABLEWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1949YearFormation
State Legal DomicileMAStateLegalDomicile
Activity Or Mission DescriptionTHE FOUNDATION IS ENGAGED IN RAISING FUNDS FOR MEDICAL EDUCATION AND RESEARCHActivityOrMissionDescription
Nbr Voting Members Governing Body36NbrVotingMembersGoverningBody
Nbr Independent Voting Members36NbrIndependentVotingMembers
Total Nbr Employees1TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year14800ContributionsGrantsPriorYear
Contributions Grants Current Year8366ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year174703InvestmentIncomePriorYear
Investment Income Current Year369084InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year189503TotalRevenuePriorYear
Total Revenue Current Year377450TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year20620SalariesEtcPriorYear
Salaries Etc Current Year20600SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year128442OtherExpensePriorYear
Other Expenses Current Year288002OtherExpensesCurrentYear
Total Expenses Prior Year149062TotalExpensesPriorYear
Total Expenses Current Year308602TotalExpensesCurrentYear
Revenues Less Expenses Prior Year40441RevenuesLessExpensesPriorYear
Revenues Less Expenses CY68848RevenuesLessExpensesCY
Total Assets BOY8289990TotalAssetsBOY
Total Assets EOY8826553TotalAssetsEOY
Total Liabilities BOY0TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY8289990NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY8826553NetAssetsOrFundBalancesEOY
Mission DescriptionTHE FOUNDATION IS ENGAGED IN SUPPORTING AND ENCOURAGING MEDICAL RESEARCH AND CONTINUING EDUCATION IN CONNECTION WITH BEVERLY HOSPITAL, MASSACHUSETTS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense262136Expense
Revenue8366Revenue
DescriptionMEDICAL EDUCATION AND RESEARCHDescription
Total Program Service Expense262136TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest1ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding0ComplianceWithBackupWitholding
Number Of Employees1NumberOfEmployees
Employment Tax Returns Filed0EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Form8899 Filed0Form8899Filed
Form1098 C Filed0Form1098CFiled
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members36NbrVotingGoverningBodyMembers
Number Independent Voting Members36NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy0ConflictOfInterestPolicy
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1TERRY DOWBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9782361654TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line185 HERRICK STREETAddressLine1
CityBEVERLYCity
StateMAState
ZIP Code01915ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (36 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
FRANCIS X CLEARY
PRESIDENT5.00X000
WILIAM J OTTO
TREASURER5.00X000
JOSEPH W HALEY
SECRETARY5.00X000
GREGORY A BAZLEWICZ
TRUSTEE5.00X000
STEPHAN A BARRAND
TRUSTEE0.00X000
JOHN L GOOD
TRUSTEE0.00X000
SUZANNE F GRAVES
TRUSTEE0.00X000
BRYANT BARNARD
TRUSTEE0.00X000
THOMAS W ADAMS
TRUSTEE0.00X000
FREDERICK KAUDERS
TRUSTEE0.00X000
CATHERINE C LASTAVICA
TRUSTEE0.00X000
MAHESH M PATEL
TRUSTEE0.00X000
MARK ALLARA
TRUSTEE0.00X000
HERBERT W BISTRONG
TRUSTEE0.00X000
WAYNE BURTON
TRUSTEE0.00X000
JAMES CHAFEY
TRUSTEE0.00X000
FORRESTER A CLARK
TRUSTEE0.00X000
HENRY FRISSORA
TREASURER0.00X000
PETER HERSEE
TRUSTEE0.00X000
CAROLINE HERTER
TRUSTEE0.00X000
JAMES S HEWSON
TRUSTEE0.00X000
MAYO JOHNSON
TRUSTEE0.00X000
JOHN KNOWLES
TRUSTEE0.00X000
DANIEL J MCCULLOUGH
TRUSTEE0.00X000
PATRICIA MAQUIRE MESERVEY
TRUSTEE0.00X000
RONALD NEWMAN
TRUSTEE0.00X000
GILBERT A NORWOOD
TRUSTEE0.00X000
HUGH O'FLYNN
TRUSTEE0.00X000
JAMES O'HOLLERAN
TRUSTEE0.00X000
JAQRUTI PATEL
TRUSTEE0.00X000
JEFFREY RUBEL
TRUSTEE0.00X000
RICHARD RUSSELL
TRUSTEE0.00X000
JONATHAN SCHREIBER
TRUSTEE0.00X000
DAVID SMAIL
TRUSTEE0.00X000
CARL SODERLAND
TRUSTEE0.00X000
RICHARD WYLIE
TRUSTEE0.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
All Other Contributions8366AllOtherContributions
Total Contributions8366TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column219871TotalRevenueColumn
Exclusion$219,871ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities3722681Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities3573468Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities149213Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column149213TotalRevenueColumn
Exclusion$149,213ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column377450TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$369,084ExclusionAmount

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total19136Total
Program Services13396ProgramServices
Management And General5740ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1464Total
Program Services1025ProgramServices
Management And General439ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total8275Total
Program Services5793ProgramServices
Management And General2482ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total33775Total
Management And General33775ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total6250Total
Program Services4375ProgramServices
Management And General1875ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL EDUCATION139000139000
MEDICAL CONFERENCES7854778547
MEDICAL RESEARCH2000020000
ADMINISTRATIVE11151115

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1040Total
Management And General1040ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total308602Total
Program Services262136ProgramServices
Management And General46466ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY15291BOY
EOY21590EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY8274699BOY
EOY8804963EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY8289990BOY
EOY8826553EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY2757725BOY
EOY2677360EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY5532265BOY
EOY6149193EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8289990BOY
EOY8826553EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8289990BOY
EOY8826553EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses68848ReconcilationRevenueExpenses
Reconciliation Unrealized Invest467715ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting CashXMethodOfAccountingCash
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Medical Research Org170b1 AiiiXMedicalResearchOrg170b1Aiii

Hospital Name And Address HospitalNameAndAddress

Name Name

FieldValueIRS element (for citing)
Business Name Line1BEVERLY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
CityBEVERLYCity
StateMAState

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Securities OtherSecurities (5 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
U.S TREASURY OBLIGATIONS584566F
COMMON STOCK4745991F
CORPORATE OBLIGATIONS374327F
MUTUAL FUNDS2850273F
MONEY MARKET FUND249806F
FieldValueIRS element (for citing)
Total Of Book Value Securities8804963TotalOfBookValueSecurities
Tot Revenue Etc Audited Fincl Stmt377450TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal377450RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990377450TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt308602TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal308602ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990308602TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATION REVIEWS THE INFORMATION RECORDED ON FORM 990 FOR ACCURACY.
FORM 990, PART VI, SECTION C, LINE 19BY REQUEST THE PUBLIC CAN VIEW THE FINANCIAL STATEMENTS
FORM 990, PART VIIFRANCIS X CLEARY - 8 JUNIPER VALLEY ROAD, BEVERLY, MA 01915. WILIAM J OTTO - ONE OVERLEDGE ROAD, MANCHESTER, MA 01944. JOSEPH W. HALEY - PAINE AVENUE, PRIDES CROSSING, MA 01965. GREGORY A. BAZLEWICZ - 9 SKYTOP ROAD, MANCHESTER, MA 01944. STEPHAN A. BARRAND - 25 THOREAU CIRCLE, BEVERLY, MA 01915.CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC
NO CHANGE FROM PREVIOUS YEAR

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