2012-10-15T13:40:22-05:00 2011-12-31 363990892 Capin Crouse LLP 972 Emerson Parkway Ste A Greenwood IN 46143 990 2011-01-01 841543484 Samaritan Aviation SAMA 9702494341 PO Box 492 Montrose CO 814019606 Joey Burns 9702494341 2012-10-16 1 David C Moja P00747006 3178852620 2011 2016-02-24 21:20:13Z Joey Burns PO Box 492 Montrose CO 814019606 734018 0 X www.samaritanaviation.com X 1999 CO To promote the gospel by providing mission, medical, and aviation services. 10 7 8 20 0 0 577402 581620 30028 120409 87 84 1392 -8645 608909 693468 11055 20339 0 0 133987 201786 0 0 102349 359349 479648 504391 701773 104518 -8305 1155949 1148331 92373 99592 1063576 1048739 X Samaritan Aviation's mission is to care for people in need by providing medical and aviation services with the goal of sharing God's love. 0 0 397712 20339 120409 Samaritan Aviation provided medical, mission and aviation support in Papua New Guinea. In 2011 we air evacuated over 50 critically ill or injured individuals, almost half of these were mother's in distressed. Our float plane delivered lifesaving medicine to two villages with cholera outbreaks. We also supplied over 15 thousand pounds of medical supplies to 28 village aid posts.Samaritan Aviation provided Mercy Flights for 13 individuals, some more than once during 2011 that were too ill to travel by road or commercial airline. In several of the flights we were able to fly the patients to medical appointments which allowed them to return to the comfort of their own home in the same day. We also follow-up with flight patients & their families to offer our continuous support through our organization. 397712 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 1 8 1 0 1 PP 0 0 0 1 1 0 0 0 1 0 X 10 7 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 0 0 X Gina Davis 9702494341 PO Box 492 Montrose CO 814019606 Joey Burns 5.00 X X 0 0 0 Gary Bustin 40.00 X X 21500 0 35000 Steven Mark Palm 40.00 X X 17034 0 38816 Matthew Palm 1.00 X X 0 0 0 Jacob Carroll 8.00 X 0 0 0 Dr Dan Cranston 1.00 X 0 0 0 Scott Friedman 2.00 X 0 0 0 Patrick Clowes 5.00 X 0 0 0 Cameron Nevins 2.00 X 0 0 0 Dr David Brown 1.00 X 0 0 0 38534 0 73816 0 0 0 0 0 18947 562673 205884 581620 Young Samaritan Thrift 453310 92798 92798 PNG Mercy flights 900099 27611 27611 120409 84 84 13510 17502 -3992 -3992 -3992 18245 18947 23048 -4803 -4803 Other income 900099 150 150 150 693468 120409 0 -8561 8339 8339 12000 12000 112350 44940 33705 33705 83005 34862 34032 14111 6431 2701 2637 1093 2450 2450 1000 420 410 170 50311 21131 20627 8553 57337 24081 23509 9747 3426 1439 1405 582 23524 9880 9645 3999 80771 33924 33116 13731 2714 1140 1113 461 5112 2147 2096 869 79517 33397 32602 13518 10646 4471 4365 1810 Thrift store operations 74239 74239 Aircraft maintenance 45489 45489 Projects 31437 31437 Program shipping 11675 11675 701773 397712 201712 102349 118751 81187 44519 16672 862099 286627 517679 575472 475000 475000 1155949 1148331 23562 26092 68811 63500 10000 92373 99592 X 1018952 1048739 44624 0 1063576 1048739 1155949 1148331 X -8305 -6532 X 0 0 0 X 688240 488418 492311 577402 507381 2753752 688240 488418 492311 577402 507381 2753752 476319 2277433 27 1654 4931 87 13594 20293 35210 24199 18395 77804 2851849 152081 0.79860 0.77440 X Schedule A, Part II, Line 10, Explanation of Other Income: Special event income Other Income RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6593 6593 148316 8936 139380 701990 276247 425743 5200 1444 3756 575472 Deposit on Kodiak airplane 475000 475000 1 East Asia and the Pacific 1 1 Program service expense Medical, mission and aviation support in the region. 242162 East Asia and the Pacific 0 0 Grant to US 501c3 orgs for medical kits to be used in the region 2500 East Asia and the Pacific 0 0 Grants to recipients located in region 12000 1 1 0 0 1 1 256662 0 256662 East Asia and the Pacific Mercy Fights 12000 Cash 1 0 0 0 0 0 0 0 Procedure for Monitoring Grants Outside the U.S.: Schedule F, Part I, Line 2: Medical supplies and medications are given to hospitals and aid ports located in the jungle and sometimes cach is granted to NGO's to be used for similar purposes. The organization receiving goods delivers the goods to the remote locations and performs site visits. Organizations receiving cash grants use the grant funds for the designated purpose of the grant. The board of directors assesses their needs based on those site visits. Samaritan Aviation-USA (SA-USA) finance committee tracks and monitors Samaritan Aviation - Papau New Guinea with a budget that is compared to their actual expenses. Method Used to Acccount for Expenditures: Schedule F, Part I, Line 3: Expenses are accounted for based on the accrual method of accounting using expense reports, grant feedback and other appropriate documentation. Expenses consist of program expenses and travel to and around region. Dinner/Auction 37192 18947 18245 2728 5776 14544 37192 18947 18245 2728 5776 14544 23048 -4803 1 Young Life 1009 E 13th Street Delta CO 81416 840385934 501 (c) 3 5839 Assistance with youth programs. 1 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Grants are given to other organizations with similar ministry purpose. X 74239 FMV - Similar Sales X 1 120000 Appraisal FMV X 4 2500 Selling cost X Auction items 56 9145 FMV-Similar Sales 0 0 0 0 Method for Determining Number of Contributors: Part I, Column (b): The number of contributors reported is the number of contributions received, not the numbers of items contributed. Form 990, Part VI, Section A, line 2 Board members Steven Mark Palm and Matthew Palm are brothers. Form 990, Part VI, Section A, line 8b There are no committees with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11 The Form 990 is prepared by an independent CPA firm, reviewed by the executive and finance teams, and then made available to the board prior to being filed with the Internal Revenue Service. Form 990, Part VI, Section B, line 12c The conflict of interest policy is enforced through oversight by the Board of Directors and Executive Committee. Form 990, Part VI, Section B, line 15a Independent members of Samaritan Aviation's Board of Directors decides on the salary of top management and bases it on what they see as fair compensation using management and aviation industry experience. The process and voting is documented in the board minutes. Form 990, Part VI, Section C, line 19 These documents are available upon request. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Exchange rate -6,532. Total to Form 990, Part XI, Line 5: -6,532.