EVELYN LILLY LUTZ FOUNDATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
EVELYN LILLY LUTZ FOUNDATION (EIN 04-2103885)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-05-04
IRS object ID
201211259349301301
Schema version
2011v1.2
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)
Timestamp2012-05-04T10:18:23-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

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 Date2011-01-01TaxPeriodBeginDate

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 Signed2012-04-23DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMICHAEL G GRANDMAISONName
PTINP00065017PTIN
Phone9787776122Phone
Date Prepared2012-04-23DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
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 Receipts1689304GrossReceipts
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 Body38NbrVotingMembersGoverningBody
Nbr Independent Voting Members38NbrIndependentVotingMembers
Total Nbr Employees1TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year4950ContributionsGrantsPriorYear
Contributions Grants Current Year14800ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year165418InvestmentIncomePriorYear
Investment Income Current Year174703InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year170368TotalRevenuePriorYear
Total Revenue Current Year189503TotalRevenueCurrentYear
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 Year19862SalariesEtcPriorYear
Salaries Etc Current Year20620SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year317765OtherExpensePriorYear
Other Expenses Current Year128442OtherExpensesCurrentYear
Total Expenses Prior Year337627TotalExpensesPriorYear
Total Expenses Current Year149062TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-167259RevenuesLessExpensesPriorYear
Revenues Less Expenses CY40441RevenuesLessExpensesCY
Total Assets BOY8327033TotalAssetsBOY
Total Assets EOY8289990TotalAssetsEOY
Total Liabilities BOY0TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY8327033NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY8289990NetAssetsOrFundBalancesEOY
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
Expense108156Expense
Revenue40361Revenue
DescriptionMEDICAL EDUCATION AND RESEARCHDescription
Total Program Service Expense108156TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
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
Transaction Related Entity0TransactionRelatedEntity
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 Members38NbrVotingGoverningBodyMembers
Number Independent Voting Members38NumberIndependentVotingMembers
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 (38 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
TRUSTEEX000
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
RONALD C PRUETT
TRUSTEE0.00X000
MARK ALLARA
TRUSTEE0.00X000
HERBERT W BISTRONG
TRUSTEE0.00X000
WAYNE BYRTON
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
SUSAN WILTSHIRE
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 Contributions14800AllOtherContributions
Total Contributions14800TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column208943TotalRevenueColumn
Exclusion$208,943ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1465561Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1499801Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-34240Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-34240TotalRevenueColumn
Related Or Exempt Function Income40361RelatedOrExemptFunctionIncome
Exclusion-$74,601ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column189503TotalRevenueColumn
Related Or Exempt Function Income40361RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$134,342ExclusionAmount

Comp Disqual Persons CompDisqualPersons

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

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1484Total
Program Services1039ProgramServices
Management And General445ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total4650Total
Program Services3255ProgramServices
Management And General1395ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total30593Total
Management And General30593ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total6000Total
Program Services4200ProgramServices
Management And General1800ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL CONFERENCES6263562635
MEDICAL EDUCATION2363123631
ADMINISTRATIVE723723
MISCELLANEOUS125125

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total85Total
Management And General85ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total149062Total
Program Services108156ProgramServices
Management And General40906ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY15996BOY
EOY15291EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY8311037BOY
EOY8274699EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY8327033BOY
EOY8289990EOY

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)
BOY2683045BOY
EOY2757725EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY5643988BOY
EOY5532265EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8327033BOY
EOY8289990EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8327033BOY
EOY8289990EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses40441ReconcilationRevenueExpenses
Reconcilation Other Changes-77484ReconcilationOtherChanges
Method Of Accounting CashXMethodOfAccountingCash
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
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 OBLIGATIONS588630F
COMMON STOCK3629323F
CORPORATE OBLIGATIONS636707F
MUTUAL FUNDS2748853F
MONEY MARKET FUND671186F
FieldValueIRS element (for citing)
Total Of Book Value Securities8274699TotalOfBookValueSecurities
Total Revenue189503TotalRevenue
Total Expenses149062TotalExpenses
Excess Or Deficit For Year40441ExcessOrDeficitForYear
Net Unrealized GL On Investments-77484NetUnrealizedGLOnInvestments
Total Adjustments-77484TotalAdjustments
Excess Or Deficit Per FS-37043ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt189503TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal189503RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990189503TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt149062TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal149062ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990149062TotalExpensesPerForm990

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
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -77,484.CHANGES IN NET ASSETS OR FUND BALANCES:

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.