ALZHEIMERS RESEARCH AND PREVENTION FOUNDATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
ALZHEIMERS RESEARCH AND PREVENTION FOUNDATION (EIN 86-0735832)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-08-08
IRS object ID
201212219349301031
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)
Timestamp2012-08-08T14:32:16-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861010758EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ADDINGTON & ASSOCIATES PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line15431 N ORACLE RD SUITE 101AddressLine1
CityTUCSONCity
StateAZState
ZIP Code85704ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN860735832EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ALZHEIMER'S RESEARCH AND PREVENTION FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlALZHNameControl
Phone5207498374Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line16300 E EL DORADO PLAZA NO 400AddressLine1
CityTUCSONCity
StateAZState
ZIP Code85715ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCAROLYN SECHLER CPAName
TitleTREASURERTitle
Phone5207498374Phone
Date Signed2012-08-07DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NamePAUL ADDINGTON CPAName
PTINP00153454PTIN
Phone5208871120Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDHARMA SINGH KALSANameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line16300 E EL DORADO PL400AddressLine1
CityTUCSONCity
StateAZState
ZIP Code85715ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1017939GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.ALZHEIMERSPREVENTION.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1993YearFormation
State Legal DomicileAZStateLegalDomicile
Activity Or Mission DescriptionTHE RESEARCH AND PREVENTION OF ALZHEIMERS.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members3NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers50TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year919441ContributionsGrantsPriorYear
Contributions Grants Current Year1017267ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year1030InvestmentIncomePriorYear
Investment Income Current Year672InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year920471TotalRevenuePriorYear
Total Revenue Current Year1017939TotalRevenueCurrentYear
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 Year150000SalariesEtcPriorYear
Salaries Etc Current Year200000SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year15084TotalFundrsngExpCurrentYear
Other Expense Prior Year215797OtherExpensePriorYear
Other Expenses Current Year519795OtherExpensesCurrentYear
Total Expenses Prior Year365797TotalExpensesPriorYear
Total Expenses Current Year719795TotalExpensesCurrentYear
Revenues Less Expenses Prior Year554674RevenuesLessExpensesPriorYear
Revenues Less Expenses CY298144RevenuesLessExpensesCY
Total Assets BOY2385202TotalAssetsBOY
Total Assets EOY2680076TotalAssetsEOY
Total Liabilities BOY7804TotalLiabilitiesBOY
Total Liabilities EOY4534TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2377398NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2675542NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE RESEARCH AND PREVENTION OF ALZHEIMERS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense679397Expense
DescriptionIN 2011, THE ALZHEIMER'S RESEARCH AND PREVENTION FOUNDATION (ARPF) WAS INVOLVED IN SEVERAL RESEARCH PROJECTS: A DOUBLE BLIND STUDY IN CONJUNCTION WITH UCLA, DEPARTMENT OF PSYCHIATRY, TO RESEARCH THE EFFECTS OF A SIMPLE MEDITATION EXERCISE ON MEMORY FUNCTION, GENETICS, AND IMMUNOLOGY ON OLDER CAREGIVERS OF DEMENTIA PATIENTS. THE OTHER STUDY IS THE FINNISH GERIATRIC INTERVENTION STUDY TO PREVENT COGNITIVE IMPAIRMENT AND DISABILITY (FINGER), OF WHICH ARPF HAS DESIGNED AND FUNDED THE GENETICS RESEARCH ARM. THE GROUNDBREAKING POSITIVE RESULTS HAVE BEEN PRESENTED AT VARIOUS MEDICAL CONFERENCES AND WILL BE PUBLISHED IN PEER-REVIEWED MEDICAL JOURNALS. IN ADDITION, SEVERAL MEDICAL PAPERS ON THE RESULTS OF PREVIOUS RESEARCH WITH UNIVERSITY OF PENNSYLVANIA MEDICAL SCHOOL, AS WELL AS A BOOK CHAPTER, WERE PUBLISHED IN THE MEDICAL LITERATURE. ARPF ALSO HAS A STRONG EDUCATIONAL PROGRAM FOR THE GENERAL PUBLIC TO EMPOWER INDIVIDUALS TO MAKE THE RIGHT LIFESTYLE CHOICES TO REDUCE THEIR RISK OF DEVELOPING ALZHEIMER'S DISEASE. THROUGH THE BOARD OF DIRECTORS WORK, THE NEW TELESEMINAR SERIES, THE SCIENTIFIC ADVISORY COUNCIL, AND THE MANY VOLUNTEERS ACROSS THE COUNTRY, ARPF WAS ABLE TO EDUCATE SENIORS, CAREGIVERS, AND PEOPLE OF ALL WALKS OF LIKE IN MOST OF THE UNITED STATES. THE EDUCATION EFFORTS INCLUDE LIVE PRESENTATIONS, ANNUAL MEMORY SCREENINGS, THE DEVELOPMENT OF MATERIALS THAT ARE AVAILABLE BOTH AS HARD COPY AND AS DOWNLOADABLE FILES, AS WELL AS BLOGS AND ARTICLES IN THE NEWS, SUCH AS HUFFINGTON POST.Description
Total Program Service Expense679397TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
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 Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
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 Required1ScheduleJRequired
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 Rltnshp1OfficerEntityWithBsnssRltnshp
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 With10965NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members3NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
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 Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledAZStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonKIRTI KHALSANamePerson
Telephone Number5207498374TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16300 E EL DORADO PLAZA SUITE 400AddressLine1
CityTUCSONCity
StateAZState
ZIP Code85715ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (5 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
DHARMA SINGH KHALSA MD
PRESIDENT32.00XX000
RANDAL BROOKS
VICE PRESIDENT4.00XX000
KIRTI KHALSA
SECRETARY35.00XX000
CAROLYN S SECHLER CPA
TREASURER3.00XX000
CAROLYN LUCZ
DIRECTOR3.00X000
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 Sources1CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1KHALSA INTERNATIONALBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16300 EEL DORADO 400AddressLine1
CityTUCSONCity
StateAZState
ZIP Code85715ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesMEDICAL DIRECTOR/RESEARCHDescriptionOfServices
Compensation200000Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
All Other Contributions1017267AllOtherContributions
Noncash Contributions907NoncashContributions
Total Contributions1017267TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column672TotalRevenueColumn
Exclusion$672ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1017939TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$672ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total200000Total
Program Services200000ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1538Total
Program Services1538ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total11800Total
Management And General11800ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total165933Total
Program Services151644ProgramServices
Management And General4141ManagementAndGeneral
Fundraising10148Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total1065Total
Program Services1040ProgramServices
Fundraising25Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total28911Total
Program Services26411ProgramServices
Management And General1122ManagementAndGeneral
Fundraising1378Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total7586Total
Program Services4185ProgramServices
Management And General3401ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total18314Total
Program Services16909ProgramServices
Management And General1405ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total545Total
Program Services545ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total351Total
Management And General351ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
RESEARCH PROJECT273385273385
OTHER EXPENSES9152302830943030
WEB DEVELOPMENT1215712503

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total719795Total
Program Services679397ProgramServices
Management And General25314ManagementAndGeneral
Fundraising15084Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY582975BOY
EOY857830EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY571857BOY
EOY572329EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY1215038BOY
EOY1234936EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
EOY7000EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY12915BOY
EOY5915EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis6541LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec4475LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2417BOY
EOY2066EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2385202BOY
EOY2680076EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6275BOY
EOY3005EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1529BOY
EOY1529EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY7804BOY
EOY4534EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2374021BOY
EOY2671501EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3377BOY
EOY4041EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2377398BOY
EOY2675542EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2385202BOY
EOY2680076EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses298144ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years489144CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years622100CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years924595CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year919441CurrentTaxYearMinus1Year
Current Tax Year1017267CurrentTaxYear
Total3972547Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years489144CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years622100CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years924595CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year919441CurrentTaxYearMinus1Year
Current Tax Year1017267CurrentTaxYear
Total3972547Total
FieldValueIRS element (for citing)
Public Support Total1703972547PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years7098CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3306CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years564CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1030CurrentTaxYearMinus1Year
Current Tax Year672CurrentTaxYear
Total12670Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years112CurrentTaxYearMinus3Years
Total112Total
FieldValueIRS element (for citing)
Total Support3985329TotalSupport
Public Support Pertcentage1700.99680PublicSupportPertcentage170
Public Support Pertcent Prior Year0.99380PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule D IRS990ScheduleD

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis6541OtherCostOrOtherBasis
Depreciation4475Depreciation
Book Value2066BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings2066TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionIRS REFUNDDescription
Amount$1,529Amount
FieldValueIRS element (for citing)
Total Of Amounts1529TotalOfAmounts
Total Revenue1017939TotalRevenue
Total Expenses719795TotalExpenses
Excess Or Deficit For Year298144ExcessOrDeficitForYear
Excess Or Deficit Per FS298144ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt1017939TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal1017939RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9901017939TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt719795TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal719795ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990719795TotalExpensesPerForm990

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonDHARMA SINGH KHALSA MDNamePerson
Base Compensation Filing Org0BaseCompensationFilingOrg
Comp Based On Related Orgs200000CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org0DeferredCompFilingOrg
Deferred Comp Related Orgs0DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org0NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs0NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org0TotalCompensationFilingOrg
Total Compensation Related Orgs200000TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferencePART IIIReturnReference
ExplanationCOMPENSATION RECEIVED THROUGH KHALSA INTERNATIONAL. KHALSA INTERNATIONAL IS AN UNRELATED ORGANIZATION, OWNED BY THE PRESIDENT, THAT HAS NO CONTROL OVER THE ORGANIZATION. COMPENSATION PAID TO THE MEDICAL DIRECTOR IS DETERMINED BY THE EXECUTIVE COMMITTEE EXCLUDING, THE PRESIDENT AND HIS WIFE WHO IS ALSO THE SECRETARY.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1DR DHARMA SINGH KHALSABusinessNameLine1
FieldValueIRS element (for citing)
RelationshipPRESIDENTRelationship
Amount Of Transaction200000AmountOfTransaction
Description Of TransactionMEDICAL DIRECTORDescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION A, LINE 2DR. DHARMA KHALSA, PRESIDENT, AND KIRTI KHALSA, SECRETARY, ARE HUSBAND AND WIFE.
FORM 990, PART VI, SECTION B, LINE 11FORM 990. PAGE 6, PART VI, LINE 11: THE FORM 990 IS REVIEWED BY THE ENTIRE BOARD PRIOR TO SUBMISSION TO THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE LIST OF VENDORS ARE REVIEWED BY THE BOARD AT THEIR MEETINGS.
FORM 990, PART VI, SECTION B, LINE 15TWO SOURCES OF CORROBORATIVE INFORMATION IS REVIEWED BY THE EXECUTIVE COMMITTEE, EXCLUDING THE PRESIDENT AND SECRETARY, FOR SUPPORT FOR THE PAYMENTS TO THE PRESIDENT'S COMPANY FOR SERVICES AS THE MEDICAL DIRECTOR.
FORM 990, PART VI, SECTION C, LINE 19ORGANIZATIONAL AND OTHER GOVERNING DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.

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