2013-05-21T09:30:03-05:00 2012-08-31 750786316 WEAVER AND TIDWELL LLP 2821 W 7TH STREET SUITE 700 FORT WORTH TX 76107 990 2011-09-01 752655008 UT SOUTHWESTERN MONCRIEF CANCER CENTER UTSO 8172889800 400 WEST MAGNOLIA AVENUE FORT WORTH TX 76104 ARNIM DONTES 8172889800 2013-05-09 1 DANIEL M STEWART P00415184 8173327905 2011 2016-02-25 16:41:14Z ARNIM DONTES 400 WEST MAGNOLIA AVENUE FORT WORTH TX 76104 18739179 0 X WWW.MONCRIEF.COM X 1958 TX TO PROVIDE COUNSELING AND SUPPORT RESOURCES TO CANCER PATIENTS AND THEIR FAMILIES WITHIN TARRANT COUNTY AND SURROUNDING AREAS. 4 1 40 0 0 0 4212746 16430869 744944 427371 645130 228829 840709 848315 6443529 17935384 216985 226466 0 0 2965907 3173667 0 0 0 2536722 2823020 5719614 6223153 723915 11712231 93467992 96438807 2419691 4146476 91048301 92292331 X TO PROVIDE COUNSELING AND SUPPORT RESOURCES TO CANCER PATIENTS AND THEIR FAMILIES WITHIN TARRANT COUNTY AND SURROUNDING AREAS. 0 0 491975 517536 BREAST AND CERVICAL CANCER SERVICES - PROVIDES CLINICAL BREAST EXAMS AND MAMMOGRAMS TO UNINSURED LOW INCOME WOMEN. THE PROGRAM ALSO PROVIDES ADDITIONAL DIAGNOSTIC SERVICES FOR WOMEN WITH POSITIVE MAMMOGRAM RESULTS. PROGRAM IS AIMED AT FINDING EARLY STAGE CANCERS WHICH HAVE THE HIGHEST RATE OF SUCCESSFUL TREATMENT OUTCOMES. 246075 252225 NUTRITIONAL SERVICES - REGISTERED AND LICENSED DIETITIANS ON STAFF TO HELP PATIENTS IN THEIR FIGHT WITH CANCER. NUTRITION PLAYS AN IMPORTANT ROLE IN CANCER TREATMENT AND RECOVERY. EATING A HEALTHY DIET KEEPS THE BODY STRONG TO FIGHT CANCER. IT ALSO HELPS CANCER PATIENTS FEEL BETTER DESPITE THE DISEASE AND TREATMENT. 438674 438674 KOMEN MOBILE MAMMOGRAPHY SCREENINGS - REGISTERED AND LICENSED MEDICAL STAFF PROVIDE APPROPRIATE PATIENTS WITH ADVANCED TECHNOLOGICAL MAMMOGRAPHY SERVICES TO DETECT, DIAGNOSE AND FIGHT CANCER. 3504652 711121 175800 TO PROVIDE OTHER COUNSELING AND SUPPORT RESOURCES TO CANCER PATIENTS AND THEIR FAMILIES WITHIN TARRANT COUNTY AND SURROUNDING AREAS. 3504652 711121 175800 4681376 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 61 0 1 40 1 0 0 0 0 0 0 0 0 0 0 X 4 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X LORI DREW 8172889800 400 W MAGNOLIA FORT WORTH TX 76104 WILLIS C MADDREY MD 1.00 X X 0 565746 45757 JOHN FREESE MD 1.00 X X 0 0 0 JAMES WILLSON MD 1.00 X X 0 580135 28978 ARNIM DONTES 1.00 X X 0 50060 1500 MICHAEL SERBER 1.00 X 0 304878 51862 JOHN ROAN 1.00 X 0 983851 39894 0 2484670 167991 0 1 1 0 LINBECK GROUP LLC 201 MAIN ST STE 1801 FORT WORTH TX 76002 CONSTRUCTION SERVICES 11629342 CBCCTI PO BOX 730761 DALLAS TX 75373 DIAGNOSTIC SERVICES 441662 HKS INC PO BOX 731121 DALLAS TX 75373 DESIGN SERVICES 244229 TEXAS HCP HOLDING LP HCPI FILE 50383 LOS ANGELES CA 90074 RENT 210245 FW RIVER PLAZA LP 1701 RIVER RUN STE 504 FORT WORTH TX 76107 RENT 205160 7 14815930 1614939 16430869 PATIENT COUNSELING 624100 427371 427371 427371 228829 228829 1634673 803795 830878 830878 830878 RECOVERED EXPENSES 624100 17437 17437 17437 17935384 444808 0 1059707 153030 153030 73436 73436 3173667 2273065 900602 10932 5466 5466 37600 37600 1683336 1550168 133168 139063 132712 6351 54927 41883 13044 43756 21878 21878 248802 42499 206303 76525 58303 18222 597 597 586 586 116178 58089 58089 59190 588 58602 MISCELLANEOUS 173217 103050 70167 CONSULTING FEES 148563 148563 CERTIFICATIONS AND CONT 27675 16573 11102 MEDICAL CONSULTANTS 2073 2073 6223153 4681376 1541777 0 250620 232039 2088514 1004380 86633 76773 38148623 9105365 14424214 29043258 4550041 4465022 72067970 61617335 93467992 96438807 2295176 4059463 100542 72750 23973 14263 2419691 4146476 X 14424214 29043258 5074199 2074100 71549888 61174973 91048301 92292331 93467992 96438807 X 11712231 -10468201 X 0 1 0 X 0 X X X 0 0 0 UT SOUTHWESTERN MEDICAL CENTER SYSTEM 756002868 7 1 1 1 4681376 1 4681376 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 70046141 4855085 15238754 59662472 67452447 6459043 3865349 70046141 65070987 8082480 5701020 67452447 1.00000 0 1 1 470212 470212 15096501 8525203 6571298 742062 580162 161900 21839848 21839848 29043258 OTHER RECEIVABLES 442362 INTEREST IN NET ASSETS OF MONCRIEF CANCER FOUNDATION 59662472 BENEFICIAL INTEREST IN PERPETUAL TRUST 1512501 61617335 CAPITAL LEASES 14263 14263 17935384 6223153 11712231 -93286 -10374915 -10468201 1244030 18637210 -93286 812549 719263 17917947 17437 17437 17935384 7009511 803795 803795 6205716 17437 17437 6223153 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: TAX POSITIONS TAKEN RELATED TO MONCRIEF'S UNRELATED BUSINESS INCOME AND ITS TAX EXEMPT STATUS AS A NONPROFIT ORGANIZATION FOR FEDERAL TAX PURPOSES HAVE BEEN REVIEWED, AND MANAGEMENT IS OF THE OPINION THAT MATERIAL POSITIONS TAKEN BY MONCRIEF WOULD MORE LIKELY THAN NOT BE SUSTAINED BY EXAMINATION. ACCORDINGLY, MONCRIEF HAS NOT RECORDED AN INCOME TAX LIABILITY FOR UNCERTAIN TAX BENEFITS. AS OF AUGUST 31, 2012, THE FOUNDATION'S TAX YEARS 2009 TO 2012 REMAIN SUBJECT TO EXAMINATION. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 8,754. CHANGE IN NET ASSETS OF MONCRIEF FOUNDATION -10,383,669. TOTAL TO SCHEDULE D, PART XI, LINE 8: -10,374,915. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 803,795. CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 8,754. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECOVERED EXPENSES 17,437. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 803,795. PART XIII, LINE 4B - OTHER ADJUSTMENTS: RECOVERED EXPENSES 17,437. 0 JEWEL CHARITY BALL PO BOX 472149 FORT WORTH TX 76147 752267609 501(C)(3) 5000 SUPPORT AND RESEARCH CAREITY FOUNDATION PO BOX 126038 FORT WORTH TX 76126 061704800 501(C)(3) 30000 SUPPORT AND RESEARCH SUSAN G KOMEN FOR THE CURE PO BOX 650309 DALLAS TX 75265 751835298 501(C)(3) 15000 SUPPORT AND RESEARCH AMERICAN CANCER SOCIETY PO BOX 831041 DALLAS TX 75283 131788491 501(C)(3) 10000 SUPPORT AND RESEARCH BRIDGE BREAST NETWORK 3600 GASTON AVE STE 401 DALLAS TX 75246 752436606 501(C)(3) 5000 SUPPORT AND RESEARCH CATHOLIC CHARITIES 249 WEST THORNHILL DRIVE FORT WORTH TX 76115 750808769 501(C)(3) 55000 SUPPORT AND RESEARCH NATIONAL OVARIAN CANCER COALITION 2501 OAK LAWN AVE STE 435 DALLAS TX 75219 650628064 501(C)(3) 5000 SUPPORT AND RESEARCH CANCER CARE SERVICES 623 SOUTH HENDERSON STREET FORT WORTH TX 76104 751025511 501(C)(3) 5000 SUPPORT AND RESEARCH 8 ASSISTANCE FOR INDIGENT CARE 350 73436 0 0 0 0 0 0 0 0 0 WILLIS C MADDREY MD 0 434826 0 130200 0 720 0 37604 0 8153 0 611503 0 0 JAMES WILLSON MD 0 447115 0 132300 0 720 0 20825 0 8153 0 609113 0 0 MICHAEL SERBER 0 188077 0 7500 0 109301 0 41898 0 9964 0 356740 0 0 JOHN ROAN 0 366782 0 150000 0 467069 0 31741 0 8153 0 1023745 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED INTIALLY BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION BEFORE BEING SUBMITTED TO THE BOARD FOR THEIR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C MONCRIEF CANCER CENTER HAS A WRITTEN CONFLICT OF INTEREST POLICY WHICH REQUIRES THE DIRECTORS AND OFFICERS TO SIGN CONFLICT OF INTEREST STATEMENTS WHICH ARE THEN REVIEWED BY THE BOARD. ANYONE WITH A CONFLICT IS RECUSED FROM DISCUSSION AND VOTING ON THE TRANSACTION, WITH THE CONFLICT BEING DOCUMENTED IN THE MINUTES. THE CONFLICT OF INTEREST STATEMENTS ARE A PART OF THE MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATIONS'S GOVERNING DOCUMENTS, AUDITED FINANCIAL STATEMENTS, FORM 1023 AND FORM 990 ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -93,286. CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 8,754. CHANGE IN NET ASSETS OF MONCRIEF FOUNDATION -10,383,669. TOTAL TO FORM 990, PART XI, LINE 5: -10,468,201. MONCRIEF CANCER FOUNDATION 5323 HARRY HINES BLVD DALLAS TX 75390 752429817 ORGANIZED AND OPERATED FOR THE BENEFIT OF UT SOUTHWESTERN MEDICAL CENTER TX 501(C)(3) 509(A)(3) 0 UT SOUTHWESTERN MEDICAL CENTER SYSTEM 5323 HARRY HINES BLVD DALLAS TX 75390 756002868 MEDICAL CARE PROVIDER TX 501(C)(3) LINE 6 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 UT SOUTHWESTERN MEDICAL CENTER SYSTEM N 3173667 CASH MONCRIEF CANCER FOUNDATION C 14815930 CASH UT SOUTHWESTERN MEDICAL CENTER SYSTEM M 1038603 CASH