CREDIT UNION MIRACLE DAY COMMITTEE INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
CREDIT UNION MIRACLE DAY COMMITTEE INC (EIN 52-2341329)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-03-06
IRS object ID
201230669349300103
Schema version
2010v3.4
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)
Timestamp2012-03-06T06:28:00-06:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12900 SOUTH QUINCY ST SUITE 150AddressLine1
CityARLINGTONCity
StateVAState
ZIP Code22206ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN522341329EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CREDIT UNION MIRACLE DAY INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCREDNameControl
Phone7035730970Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 27637AddressLine1
CityWASHINGTONCity
StateDCState
ZIP Code200387637ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJURI VALDOVName
TitleCHAIRMANTitle
Phone7035730970Phone
Date Signed2012-03-06DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone7039985100Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJURI VALDOVNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 27637AddressLine1
CityWASHINGTONCity
StateDCState
ZIP Code200387637ZIPCode
FieldValueIRS element (for citing)
Gross Receipts840416GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MIRACLEDAY.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2001YearFormation
State Legal DomicileDCStateLegalDomicile
Activity Or Mission DescriptionWE RAISE MONEY TO SUPPORT CHILDREN'S MIRACLE NETWORK HOSPITALS. AFTER PAYMENT OF RACE TITLE SPONSORSHIP FEES AND MINIMAL OPERATING COSTS, ALL FUNDS COLLECTED ARE REDISTRIBUTED, SO EVERY DOLLAR GENERATED IS RETURNED TO THE CMN AFFILIATED HOSPITALS SERVING LOCAL COMMUNITIES.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1124247ContributionsGrantsPriorYear
Contributions Grants Current Year836206ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year4074InvestmentIncomePriorYear
Investment Income Current Year2965InvestmentIncomeCurrentYear
Other Revenue Prior Year-5204OtherRevenuePriorYear
Other Revenue Current Year-24921OtherRevenueCurrentYear
Total Revenue Prior Year1123117TotalRevenuePriorYear
Total Revenue Current Year814250TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year858684GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY578391GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year151562TotalFundrsngExpCurrentYear
Other Expense Prior Year253951OtherExpensePriorYear
Other Expenses Current Year240466OtherExpensesCurrentYear
Total Expenses Prior Year1112635TotalExpensesPriorYear
Total Expenses Current Year818857TotalExpensesCurrentYear
Revenues Less Expenses Prior Year10482RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-4607RevenuesLessExpensesCY
Total Assets BOY285544TotalAssetsBOY
Total Assets EOY252247TotalAssetsEOY
Total Liabilities BOY254628TotalLiabilitiesBOY
Total Liabilities EOY225938TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY30916NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY26309NetAssetsOrFundBalancesEOY
Mission DescriptionWE RAISE MONEY TO SUPORT CHILDREN'S MIRACLE NETWORK HOSPITALS. AFTER PAYMENT OF RACE TITLE SPONSORHSIP FEES AND MINIMAL OPERATING COSTS, ALL FUNDS COLLECTED ARE REDISTRIBUTED, SO EVERY DOLLAR GENERATED IS RETURNED TO THE CMN AFFILIATED HOSPITALS SERVING LOCAL COMMUNITIES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense578391Expense
Grants578391Grants
DescriptionRACE SPONSORSHIP: SUPPORT THE CHILDREN'S MIRACLE NETWORK WHICH PROVIDES FUNDS FOR CHILDREN'S HOSPITALS. OVER 10,000 RUNNERS PARTICIPATE IN THE CREDIT UNION CHERRY BLOSSOM 10 MILE RUN EACH YEAR. AFTER PAYMENT OF TITLE SPONSORSHIP FEES AND MINIMAL OPERATING COSTS, ALL REMAINING FUNDS GO TO THE CHILDREN'S HOSPITALS IN EACH DONOR'S LOCAL COMMUNITY.Description
Total Program Service Expense578391TotalProgramServiceExpense
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 Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
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 Organizations1GrantsToOrganizations
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
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
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 Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JAN ROCHEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7037065162TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11630 KING STREETAddressLine1
CityALEXANDRIACity
StateVAState
ZIP Code22314ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (9 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
JURI VALDOV
CHAIRMAN2.00XX000
THERESA MANN
VICE CHAIRMAN3.00XX000
JAN ROCHE
TREASURER3.00XX000
SARAH CANEPA BANG
DIRECTOR0.80X000
CHRIS ROE
DIRECTOR0.50X000
CASEY DUPLANTIER
DIRECTOR0.50X000
CHARLIE MALLON
SECRETARY1.50XX000
CHRIS MCDONALD
DIRECTOR0.50X000
DIANA DYKSTRA
DIRECTOR0.50X000
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 Contributions836206AllOtherContributions
Total Contributions836206TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2965TotalRevenueColumn
Exclusion$2,965ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events1245GrossIncomeFundraisingEvents
Fundraising Direct Expenses9822FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-8577TotalRevenueColumn
Exclusion-$8,577ExclusionAmount
FieldValueIRS element (for citing)
Cost Of Goods Sold16344CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-16344TotalRevenueColumn
Exclusion-$16,344ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column814250TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$21,956ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total578391Total
Program Services578391ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total75471Total
Management And General75471ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total7356Total
Management And General7356ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total8710Total
Management And General2672ManagementAndGeneral
Fundraising6038Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2Total
Management And General2ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total1165Total
Management And General1165ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total2236Total
Management And General2236ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalFundraisingFundraisingManagement And GeneralManagementAndGeneral
RACE SPONSORSHIP136494136494
BANK FEES808880862
FUNDRAISING FEES944944

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total818857Total
Program Services578391ProgramServices
Management And General88904ManagementAndGeneral
Fundraising151562Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY235852BOY
EOY236122EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY33348BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY16344BOY
EOY16125EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY285544BOY
EOY252247EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY644BOY
EOY528EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY253984BOY
EOY225410EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY254628BOY
EOY225938EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY30916BOY
EOY26309EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY30916BOY
EOY26309EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY285544BOY
EOY252247EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-4607ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review1AccountantCompileOrReview
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 Years545717CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years857576CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1230444CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1124247CurrentTaxYearMinus1Year
Current Tax Year873275CurrentTaxYear
Total4631259Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years545717CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years857576CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1230444CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1124247CurrentTaxYearMinus1Year
Current Tax Year873275CurrentTaxYear
Total4631259Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total1120812AmountsSubstContributorsTotal
Public Support Total1703510447PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years433CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2577CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13690CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4074CurrentTaxYearMinus1Year
Current Tax Year2965CurrentTaxYear
Total23739Total
FieldValueIRS element (for citing)
Total Support4654998TotalSupport
Gross Receipts From Admissions Etc168705GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.75410PublicSupportPertcentage170
Public Support Pertcent Prior Year0.70910PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

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
Total Revenue814250TotalRevenue
Total Expenses818857TotalExpenses
Excess Or Deficit For Year-4607ExcessOrDeficitForYear
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS-4607ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt878319TotRevenueEtcAuditedFinclStmt
Donated Srvc And Use Of Facilities54028DonatedSrvcAndUseOfFacilities
Other Revenues10041OtherRevenues
Revenue Not Rptd F99064069RevenueNotRptdF990
Revenue Subtotal814250RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990814250TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt882926TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities54028DonatedServicesUseOfFacilities
Other Expenses Included10041OtherExpensesIncluded
Expenses Not Rptd F99064069ExpensesNotRptdF990
Expenses Subtotal818857ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990818857TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierExplanationExplanation
PART XII, LINE 2D - OTHER ADJUSTMENTS:COST OF GOODS SOLD 219. GALA DINNER EXPENSE 9,822.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:COST OF GOODS SOLD 219. GALA DINNER EXPENSE 9,822.
CREDIT UNION MIRACLE DAY, INC. WAS AUDITED.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (19 entries)

Address Line1AddressUS/AddressLine1Address Line2AddressUS/AddressLine2CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
CHILDREN'S HOSPITAL & RESEARCH CENTER OAKLAND
CHILDRENS HOSPITAL RESEARCH CENTERFOUNDATION 2201 BROADWAY SUITE 600OAKLANDCA94612941657474501(C)(3)8287GENERAL PURPOSE DONATION
CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BOULEVARD MAIL STOP 29LOS ANGELESCA90027951690977501(C)(3)14992GENERAL PURPOSE DONATION
CHILDREN'S NATIONAL MEDICAL CENTER
CHILDRENS HOSPITAL FOUNDATION 801ROEDER ROAD SUITE 300SILVER SPRINGMD20910521640402501(C)(3)300992GENERAL PURPOSE DONATION
JOHNS HOPKINS CHILDREN'S CENTER
100 N CHARLES STREET SUITE 200BALTIMOREMD21201520591656501(C)(3)48829GENERAL PURPOSE DONATION
DUKE CHILDREN'S HOSPITAL & HEALTH CENTER
512 SOUTH MANGUM STREET SUITE 400DURHAMNC27701560532129501(C)(3)21552GENERAL PURPOSE DONATION
THE CHILDREN'S HOSPITAL AT MONTEFIORE
MONTEFIORE MEDICAL CENTERDEVELOPMENOFFICE 111 EAST 210TH STREETBRONXNY10467131740114501(C)(3)5074GENERAL PURPOSE DONATION
PENN STATE HERSHEY MEDICAL CENTER AND COLLEGE OF MEDICINE
OFFICE OF UNIVERSITY DEVELOPMENTA190 PO BOX 855HERSEYPA170330855246000376501(C)(3)10119GENERAL PURPOSE DONATION
CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS
601 CHILDRENS LANENORFOLKVA23507540506321501(C)(3)9407GENERAL PURPOSE DONATION
CHILDREN'S HOSPITAL OF WISCONSIN
CHILDRENS HOSPITAL AND HEALTHYSYSTEM FOUNDATION PO BOX 1997 MS 30MILWAUKEEWI53201391500075501(C)(3)15823GENERAL PURPOSE DONATION
CHOC FOUNDATION OF CHILDREN
455 SOUTH MAIN STREETORANGECA92868956097416501(C)(3)10476GENERAL PURPOSE DONATION
UF & SHANDS JACKSONVILLE
580 W 8TH STREET TOWER 1 SUITE 351JACKSONVILLEFL32209592622323501(C)(3)10000GENERAL PURPOSE DONATION
ALL CHILDREN'S HOSPITAL
PO BOX 31020ST PETERSBURGFL337318920592481738501(C)(3)5000GENERAL PURPOSE DONATION
RILEY HOSPITAL FOUNDATION
30 SOUTH MERIDIAN STREET SUITE 200INDIANAPOLISIN462043509350868147501(C)(3)10000GENERAL PURPOSE DONATION
THE FREEMAN HEALTH SYSTEM
1102 WEST 32ND STREETJOPLINMO64804431704371501(C)(3)13945GENERAL PURPOSE DONATION
GOLISANO CHILDREN'S HOSPITAL AT STRONG
PO BOX 278996ROCHESTERNY146278996161068101501(C)(3)6000GENERAL PURPOSE DONATION
STEVEN AND ALEXANDRA COHEN CHILDREN'S MEDICAL CENTER OF NY
972 BRUSH HOLLOW RD 5TH FLOORWESTBURYNY115901740112965575501(C)(3)12982GENERAL PURPOSE DONATION
CHILDREN'S HOSPITAL VCU CHILDREN'S MEDICAL CENTER
2924 BROOK ROADRICHMONDVA232201298510220692501(C)(3)6323GENERAL PURPOSE DONATION
GUNDERSON LUTHERAN MEDICAL CENTER
GUNDERSEN LUTHERAN MEDICALFOUNDATION 1836 SOUTH AVENUE C03-00LA CROSSEWI546019980391249705501(C)(3)15000GENERAL PURPOSE DONATION
MINISTRY ST JOSEPH'S CHILDREN'S HOSPITAL
611 SAINT JOSEPH AVENUEMARSHFIELDWI54449391684957501(C)(3)20000GENERAL PURPOSE DONATION

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: EACH GRANTEE IS CERTIFIED BY CHILDREN'S MIRACLE NETWORK (CMN) AND ALL CMN HOSPITALS ARE ELIGIBLE. THE HOSITALS GET ANY MONIES DONATED FROM THEIR CREDIT UNION'S IN THEIR ZIP CODE AND/OR AN EQUAL SHARE OF CORPORATE DONATIONS.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION B, LINE 11THE TREASURER, BOARD CHAIR AND MANAGEMENT CONSULTANT REVIEW THE 990 BOTH BEFORE AND AFTER IT IS FILED WITH THE IRS.
THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY STATEMENT THAT ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE ANNUALLY. IF POSSIBLE CONFLICTS EXIST, THE BOARD MEMBER SHALL REFRAIN FROM TAKING PART IN CUMD'S DECISION ANY MATTER ON WHICH HE OR SHE HAS OR MAY HAVE A CONFLICT OF INTEREST. THE CHAIR OR LEGAL COUNSEL IS CHARGED WITH THE RESPONSIBILITY OF OVERSEEING THIS CONFLICT OF INTEREST POLICY.FORM 990, PART VI, SECTION B, LINE 12C
THE ORGANIZATION DOES NOT MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION HAS AN AUDIT COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR.FORM 990, PART XIII, LINE 2C

Reasonable Cause Explanation ReasonableCauseExplanation

FieldValueIRS element (for citing)
ExplanationTHIS RETURN IS BEING FILED BETWEEN MARCH 1, 2012, AND MARCH 30, 2012, AS DIRECTED BY THE IRS IN NOTICE 2012-4, BECAUSE ELECTRONIC FILING WAS NOT AVAILABLE JANUARY 1, 2012 THROUGH FEBRUARY 29, 2012. WE REQUEST THAT PENALTIES BE WAIVED BECAUSE IT WOULD BE INEQUITABLE TO IMPOSE A PENALTY ON US DUE TO THE UNUSUAL CIRCUMSTANCES REQUIRING US TO DELAY THE FILING OF THIS RETURN.Explanation

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