PRESIDENT

2013-05-14T11:04:28-05:00 2012-12-31 391971296 CHAMBERLAIN & HENNINGFIELD CPAS PO BOX 1119 LAKE GENEVA WI 53147 990 2012-01-01 454475625 OPEN ARMS FREE CLINIC INC OPEN 2622756154 PO BOX 560 FONTANA WI 53125 DANIEL SANDERS PRESIDENT 2622756154 2013-05-10 1 DAVID J HENNINGFIELD CPA P00188242 2622491100 2013-05-10 2012 2016-02-24 21:20:13Z DANIEL SANDERS 797 EAST GENEVA STREET ELKHORN WI 53121 229919 0 X WWW.OPENARMSFREECLINIC.ORG X 2012 WI STRIVE TO BETTER UNDERSTAND AND SERVE THE HEALTH AND WELLNESS NEEDS OF THE UNINSURED, LOW INCOME AND UNDER-SERVED RESIDENTS OF WALWORTH COUNTY WITH COMPASSION AND UNDERSTANDING. 14 14 0 0 0 0 0 228908 0 0 0 25 0 292 0 229225 0 0 0 0 0 0 0 0 0 0 80084 0 80084 0 149141 0 149141 0 0 0 149141 STRIVE TO BETTER UNDERSTAND AND SERVE THE HEALTH AND WELLNESS NEEDS OF THE UNINSURED, LOW INCOME AND UNDER-SERVED RESIDENTS OF WALWORTH COUNTY WITH COMPASSION AND UNDERSTANDING. 0 0 10226 CLINIC SERVICES 10226 1 1 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 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 WI X CHRISTINA DEAN 2622756154 797 EAST GENEVA STREET ELKHORN WI 53121 X COLLEEN ANDERSON ASSISTAND MED DIRECTOR 0.00 X 0 0 0 REBECCA BRUSA SECRETARY 0.00 X 0 0 0 WILLIAM CLARK DIRECTOR 0.00 X 0 0 0 CHRISTINA DEAN TREASURER 0.00 X 0 0 0 BOB DILLMAN DIRECTOR 0.00 X 0 0 0 NICHOLAS EGERT DIRECTOR 0.00 X 0 0 0 ROBERT FASANO MEDICAL DIRECTOR 0.00 X 0 0 0 JUDY JOHNSON BOARD MEMBER 0.00 X 0 0 0 PATRICK KENNY BOARD MEMBER 0.00 X 0 0 0 PAM KNORR BOARD MEMBER 0.00 X 0 0 0 LISA KROLOW CATHOLIC CHARITIES 0.00 X 0 0 0 JAMES MEHLTRETTER VICE PRESIDENT 0.00 X 0 0 0 ORIOL REGALES BOARD MEMBER 0.00 X 0 0 0 DANIEL SANDERS PRESIDENT 0.00 X 0 0 0 0 0 0 0 0 0 0 0 228908 114773 228908 25 25 986 694 292 292 229225 25 0 292 234 234 3539 3539 4750 4750 53340 53340 1900 1900 PHARMACY 5204 5204 OFFICE EXPENSE 3841 2427 1414 TELEPHONE 2727 2727 BACKGROUND CHECKS 1710 1710 2839 885 1954 80084 10226 69858 0 99481 103000 53340 0 49660 0 149141 0 0 X 0 0 0 0 0 149141 0 149141 0 149141 149141 0 X 0 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 103000 53340 49660 49660 X 1200 COST X FURNITURE AND EQIUPMENT 105273 COMPARABLE SALES X PROFESSIONAL 2134 COST X OFFICE SUPPLIES 6166 COST 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED, SIGNED, AND FILED BY THE PRESIDENT WHO THEN PRESENTS A COPY TO EACH MEMBER OF THE BOARD OF DIRECTORS. SHOULD ANY MATERIAL REASON BE FOUND, AMENDMENTS TO THE RETURN WOULD BE MADE UNDER BOARD DIRECTION AND APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.