2013-11-07T16:07:48-06:00 2012-12-31 203676004 CPWR LLP 5057 KELLER SPRINGS RD SUITE 425 ADDISON TX 75001 990EZ 2012-01-01 270804773 CONNECTMED INTERNATIONAL CONN 6198005349 1435 EOLUS AVE ENCINITAS CA 92024 AMANDA GOSMAN MD 6198005349 2013-11-07 RONALD E COLBURN P00021126 9729914566 2012 2016-03-07 17:11:31Z X WWW.CONNECTMED.ORG X 137467 X 69070 140 68257 21672 46585 115795 12837 12837 102958 91759 0 194717 X 85148 177171 6611 48321 91759 225492 0 30775 91759 194717 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, 2012 -- TRAVEL TO HOSPITAL INFANTIL DE LAS CALIFORNIAS IN TIJUANA, MEXICO AND PERFORMED CRANIOFACIAL RECONSTRUCTIVE SURGERIES ON 6 PATIENTS. TWO SURGEONS ON THIS TRIP. ALSO CONNECTED VIA TELECONFERENCE WITH 25 PARTICPATING STUDENTS AT UNIVERSITY OF CALIFORNIA SAN DIEGO TELEMEDICINE CENTER. ESTIMATED VALUE OF VOLUNTEER TIME FOR SERVICES PERFORMED IS $130,000 0 0 MAY 12, 2012 -- TRAVEL TO HOSPITAL INFANTIL DE LAS CALIFORNIAS IN TIJUANA, MEXICO AND PERFORMED CRANIOFACIAL RECONSTRUCTIVE SURGERIES ON TWO PATIENTS. TWO SURGEONS ON THIS TRIP. ALSO CONNECTED VIA TELECONFERENCE WITH 25 PARTICPATING STUDENTS AT UNIVERSITY OF CALIFORNIA SAN DIEGO TELEMEDICINE CENTER. ESTIMATED VALUE OF VOLUNTEER TIME FOR SERVICES PERFORMED IS $60,000. 0 0 DEC 08, 2012 -- TRAVEL TO HOSPITAL INFANTIL DE LAS CALIFORNIAS IN TIJUANA, MEXICO AND PERFORMED CRANIOFACIAL RECONSTRUCTIVE SURGERIES ON 4 PATIENTS. TWO SURGEONS ON THIS TRIP. ALSO CONNECTED VIA TELECONFERENCE WITH 25 PARTICPATING STUDENTS AT UNIVERSITY OF CALIFORNIA SAN DIEGO TELEMEDICINE CENTER. ESTIMATED VALUE OF VOLUNTEER TIME FOR SERVICES PERFORMED IS $120,000. 0 0 PLANNING TRIP TO MALAWI IN FEB 2012 TO ESTABLISH UNDERSTANDING WITH FOREIGN GOVERNMENT AND CHARITY HOSPITAL FOR PLANNED FEB 2013 TRIP WITH FULL VOLUNTEER TEAM ( 20+ MEMBERS) 0 4098 4098 SHERRY L COLBURN 15.00 0 0 0 AMANDA GOSMAN MD 20.00 0 0 0 RITA ABBATI 5.00 0 0 0 ELIZABETH STEVENS 5.00 0 0 0 RONALD COLBURN CPA 2.00 0 0 0 ALICIA SIGLER MD 2.00 0 0 0 ZIA AGHA MD 2.00 0 0 0 ROHIT KHOSLA MD 2.00 0 0 0 SHANKAR SITAPATI 2.00 0 0 0 EVELYN SNYDER RN 2.00 0 0 0 ROBERT HALL 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 131345 8610 65449 57286 131345 0 0 0 131345 140 140 140 140 8610 65449 57426 131485 X SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: INITIAL FILING YEAR IN 2010 WAS FOR A PERIOD OF LESS THAN TWELVE MONTHS SCHEDULE A, PART IV, LIST OF UNUSUAL GRANTS: CASH GRANT FOR MALAWI AFRICA CLINIC DATE: 03/23/12 AMOUNT: 10000. CASH GRANT FOR MALAWI AFRICA CLINIC DATE: 04/18/12 AMOUNT: 5000. CASH GRANT FOR GENERAL OPERATONS DATE: 12/01/12 AMOUNT: 25000. CASH GRANT FOR GENERAL OPERATONS DATE: 01/25/12 AMOUNT: 5000. CASH GRANT FOR GENERAL OPERATONS DATE: 01/01/12 AMOUNT: 5000. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 DINNER AND RAFFLE PALO ALTO CA 41077 41077 DINNER AND RAFFLE SAN DIEGO CAL 46080 18900 27180 5301 1250 1848 9691 440 3142 87157 18900 68257 14992 1690 4990 21672 46585 OTHER INVESTMENT INCOME FORM 990-EZ, PART I, LINE 4 INTEREST 140.. OTHER EXPENSES FORM 990-EZ, PART I, LINE 16 DESCRIPTION: OFFICE AND ADMINISTRATIVE. AMOUNT: 2,563. DESCRIPTION: INFORMATION TECHNOLOGY HOSTING . AMOUNT: 290. DESCRIPTION: PROGRAM SERVICE TRAVEL. AMOUNT: 6,420. DESCRIPTION: MEDICAL SUPPLIES. AMOUNT: 140. DESCRIPTION: PROMOTION. AMOUNT: 273. DESCRIPTION: PATIENT THERAPY. AMOUNT: 807. DESCRIPTION: BOARD MEETINGS. AMOUNT: 165. DESCRIPTION: STATE REGISTRATION FEES. AMOUNT: 10. DESCRIPTION: CREDIT CARD FEES AND BANK SERVICE FEES. AMOUNT: 2,169. TOTAL TO FORM 990-EZ, LINE 16: 12,837. OTHER ASSETS FORM 990-EZ, PART II, LINE 24 DESCRIPTION: PREPAID TRIP COSTS FOR 2013 PROGRAM SERVICE TRIP. BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: 24,461. DESCRIPTION: OTHER DEPRECIABLE ASSETS. BEG. OF YEAR AMOUNT: 6,611. END OF YEAR AMOUNT: 23,860. OTHER LIABILITIES FORM 990-EZ, PART II, LINE 26 DESCRIPTION: DEFERRED PROGRAM SERVICES TRIP FEE CONTRIBUTIONS. BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: 30,775. 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.