2012-04-12T14:34:18-05:00 2011-08-31 WEAVER AND TIDWELL LLP 2821 W 7TH STREET SUITE 700 FORT WORTH TX 76107 990 2010-09-01 752655008 UT SOUTHWESTERN MONCRIEF CANCER CENTER UTSO 8178384860 1701 RIVER RUN NO 500 FORT WORTH TX 76107 ARNIM DONTES 8178384860 2012-03-26 1 DANIEL M STEWART 8173327905 2010 2016-02-24 21:20:13Z ARNIM DONTES 1701 RIVER RUN NO 500 FORT WORTH TX 76107 8738580 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 32 0 0 0 5472400 4212746 389875 744944 409989 645130 916950 840709 7189214 6443529 206178 216985 0 0 2380486 2965907 0 0 0 1978473 2536722 4565137 5719614 2624077 723915 89041617 93467992 1415863 2419691 87625754 91048301 X TO PROVIDE COUNSELING AND SUPPORT RESOURCES TO CANCER PATIENTS AND THEIR FAMILIES WITHIN TARRANT COUNTY AND SURROUNDING AREAS. 0 0 309064 341119 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. 217060 233975 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. 295399 295399 KOMEN MOBILE MAMMOGRAPHY SCREENINGS - REGISTERED AND LICENSED MEDICAL STAFF PROVIDE APPROPRIATE PATIENTS WITH ADVANCED TECHNOLOGICAL MAMMOGRAPHY SERVICES TO DETECT, DIAGNOSE AND FIGHT CANCER. 3314466 838630 168050 TO PROVIDE OTHER COUNSELING AND SUPPORT RESOURCES TO CANCER PATIENTS AND THEIR FAMILIES WITHIN TARRANT COUNTY AND SURROUNDING AREAS. 3314466 838630 168050 4135989 1 1 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 29 0 1 32 1 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 8178384862 1701 RIVER RUN STE 500 FORT WORTH TX 76107 WILLIS C MADDREY MD 1.00 X X 0 565545 44995 JOHN FREESE MD 1.00 X X 0 0 0 JOHN ROAN 1.00 X X 0 509765 138439 JAMES WILLSON MD 1.00 X X 0 838307 28230 MICHAEL SERBER 1.00 X 0 176944 44964 0 2090561 256628 0 0 1 0 HKS INC PO BOX 731121 DALLAS TX 75373 DESIGN SERVICES 1160107 CONATSER CONSTRUCTION 5327 WICHITA ST FORT WORTH TX 76119 CONSTRUCTION SERVICES 434415 CBCCTI PO BOX 730761 DALLAS TX 75373 DIAGNOSTIC SERVICES 433440 ONCOR ELECTRIC 1616 WOODALL RODGERS FREEWAY DALLAS TX 75202 RELOCATE POWER LINES 230439 KELLY HART & HALLMAN LLP 201 MAIN STREET 2500 FORT WORTH TX 76102 PROFESSIONAL SERVICES 163338 8 3011840 1200906 4212746 PATIENT COUNSELING 624100 744944 744944 744944 235614 235614 1634673 804567 830106 830106 830106 1900000 1490484 409516 409516 409516 RECOVERED EXPENSES 624100 10603 10603 10603 6443529 755547 0 1475236 154778 154778 62207 62207 2965907 2036560 929347 59079 5908 53171 27600 27600 1284151 1164399 119752 110804 104993 5811 65398 50375 15023 35430 17715 17715 226609 15033 211576 67253 44310 22943 213 213 873 873 113594 56797 56797 62944 588 62356 RESEARCH PROJECTS 216109 216109 MISCELLANEOUS 143953 92569 51384 CONSULTING FEES 53238 53238 OUTSIDE LAB 43974 43974 CERTIFICATIONS AND CONT 25500 16436 9064 5719614 4135989 1583625 0 853729 250620 208074 2088514 90507 86633 22846402 8422188 12474845 14424214 6027884 4550041 69386578 72067970 89041617 93467992 1245150 2295176 137317 100542 33396 23973 1415863 2419691 X 12474845 14424214 6299653 5074199 68851256 71549888 87625754 91048301 89041617 93467992 X 723915 2698632 X 0 1 0 X 0 X X X 0 0 0 UT SOUTHWESTERN MEDICAL CENTER SYSTEM 756002868 7 1 1 1 4135989 1 4135989 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 67452447 6459043 3865349 70046141 65070987 8082480 5701020 67452447 1.00000 0 1 1 470212 470212 15096501 7907014 7189487 762459 515174 247285 6517230 6517230 14424214 OTHER RECEIVABLES 518082 INTEREST IN NET ASSETS OF MONCRIEF CANCER FOUNDATION 70046141 BENEFICIAL INTEREST IN PERPETUAL TRUST 1503747 72067970 CAPITAL LEASES 23973 23973 6443529 5719614 723915 2698632 2698632 3422547 7342431 909505 909505 6432926 10603 10603 6443529 6513578 804567 804567 5709011 10603 10603 5719614 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, 2011, THE FOUNDATION'S TAX YEARS 2008 TO 2011 REMAIN SUBJECT TO EXAMINATION. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 104,938. CHANGE IN NET ASSETS OF MONCRIEF FOUNDATION 2,593,694. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 804,567. CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 104,938. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECOVERED EXPENSES 10,603. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 804,567. PART XIII, LINE 4B - OTHER ADJUSTMENTS: RECOVERED EXPENSES 10,603. 0 AMERICAN RED CROSS 1515 S SYLVANIA FORT WORTH TX 76111 501(C)(3) 70350 SUPPORT AND RESEARCH CAREITY FOUNDATION PO BOX 126038 FORT WORTH TX 76126 501(C)(3) 30000 SUPPORT AND RESEARCH SUSAN G KOMEN FOR THE CURE PO BOX 650309 DALLAS TX 75265 501(C)(3) 10500 SUPPORT AND RESEARCH AMERICAN CANCER SOCIETY PO BOX 831041 DALLAS TX 75283 501(C)(3) 6000 SUPPORT AND RESEARCH BRIDGE BREAST NETWORK 3600 GASTON AVE STE 401 DALLAS TX 75246 501(C)(3) 5000 SUPPORT AND RESEARCH TEXAS CHRISTIAN UNIVERSITY 2800 SOUTH UNIVERSITY DRIVE FORT WORTH TX 76129 501(C)(3) 5500 SUPPORT AND EDUCATION NATIONAL OVARIAN CANCER COALITION 2501 OAK LAWN AVE STE 435 DALLAS TX 75219 501(C)(3) 5000 SUPPORT AND RESEARCH CANCER CARE SERVICES 623 SOUTH HENDERSON STREET FORT WORTH TX 76104 501(C)(3) 7500 SUPPORT AND RESEARCH 8 ASSISTANCE FOR INDIGENT CARE 110 62207 0 0 0 0 0 0 0 0 0 WILLIS C MADDREY MD 0 434625 0 130200 0 720 0 37590 0 7405 0 610540 0 0 JOHN ROAN 0 359045 0 150000 0 720 0 131034 0 7405 0 648204 0 0 JAMES WILLSON MD 0 435342 0 130150 0 272815 0 20825 0 7405 0 866537 0 0 MICHAEL SERBER 0 176944 0 0 0 0 0 35914 0 9050 0 221908 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: CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 104,938. CHANGE IN NET ASSETS OF MONCRIEF FOUNDATION 2,593,694. TOTAL TO FORM 990, PART XI, LINE 5: 2,698,632. 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 2965907 CASH MONCRIEF CANCER FOUNDATION C 3011840 CASH UT SOUTHWESTERN MEDICAL CENTER SYSTEM M 862432 CASH