2012-05-10T13:28:50-05:00 2011-09-30 EIDE BAILLY LLP 800 NICOLLET MALL STE 1300 MINNEAPOLIS MN 554027033 990EZ 2010-10-01 391823757 TOMAH MEMORIAL HOSPITAL FOUNDATION TOMA 6083722181 321 BUTTS AVENUE TOMAH WI 54660 RYAN STEELE 6083722181 2012-05-09 1 KIM HUNWARDSEN CPA 9529446166 2012-05-09 2010 2016-02-24 21:20:13Z X X N/A X 33973 X 23717 6517 410 3329 5392 -1653 28581 9750 1500 333 11583 16998 405676 -9750 412924 X 405236 412548 440 376 405676 412924 0 0 405676 412924 X SUPPORT OF TOMAH MEMORIAL HOSPITAL AND SURROUNDING COMMUNITY. THE MISSION OF TOMAH MEMORIAL HOSPITAL FOUNDATION IS TO SUPPORT THE COMMUNITY OF TOMAH AND THE HEALTHCARE PROVIDERS THAT SERVE ITS RESIDENTS. THE FOCUS OF ITS SUPPORT WILL BE COMMUNITY-BASED WELLNESS, FACILITY UPGRADES, AND THE DEVELOPMENT OF PROGRAMS THAT BENEFIT THE LOCAL HOSPITAL AND SURROUNDING COMMUNITIES. 9750 9881 9881 RYAN STEELE 321 BUTTS AVENUE TOMAH WI 54660 1.00 0 0 0 RAY HABELMAN JR 321 BUTTS AVENUE TOMAH WI 54660 1.00 0 0 0 JENNIFER MUBARAK 321 BUTTS AVENUE TOMAH WI 54660 1.00 0 0 0 MIKE MAYHEW 321 BUTTS AVENUE TOMAH WI 54660 1.00 0 0 0 LAURA DAMROW 321 BUTTS AVENUE TOMAH WI 54660 1.00 0 0 0 JENNIFER PARKER 321 BUTTS AVENUE TOMAH WI 54660 1.00 0 0 0 GLORIA DIPPEN 321 BUTTS AVENUE TOMAH WI 54660 1.00 0 0 0 THERESE CONWAY 321 BUTTS AVENUE TOMAH WI 54660 1.00 0 0 0 SANDRA HUMPHREY 321 BUTTS AVENUE TOMAH WI 54660 1.00 0 0 0 PETER REICHARDT 321 BUTTS AVENUE TOMAH WI 54660 1.00 0 0 0 X 0 0 0 0 0 0 0 0 0 0 0 0 0 WI JOSEPH ZEPS 321 BUTTS AVENUE TOMAH WI 54660 6083740286 0 0 0 0 0 0 0 0 0 0 0 NONE NONE 1 X 29985 29264 29496 24807 23717 137269 5270 6240 5270 4580 3329 24689 35255 35504 34766 29387 27046 161958 30000 725 30725 0 30000 725 30725 131233 14188 13571 10690 7854 6517 52820 14188 13571 10690 7854 6517 52820 49443 49075 45456 37241 33563 214778 0.61100 0.68790 0.24590 0.20270 X GOLF OUTING 20329 17000 3329 1280 4012 100 20329 17000 3329 1280 4012 100 5392 -2063 OTHER INVESTMENT INCOME FORM 990-EZ, PART I, LINE 4 INTEREST 3,186.. DIVIDENDS 3,331.. TOTAL INCLUDED ON FORM 990-EZ, LINE 4: 6,517. GRANTS AND SIMILAR AMOUNTS PAID FORM 990-EZ, PART I, LINE 10 ACTIVITY CLASSIFICATION: DONATION FOR FREE HEALTH CARE ACCESS. GRANTEE NAME: ST. CLAIRE HEALTH MISSION. GRANTEE ADDRESS: 916 FERRY STREET LACROSSE, WI 54601. GRANTEE RELATIONSHIP: NONE. AMOUNT GIVEN: 5,000. OTHER EXPENSES FORM 990-EZ, PART I, LINE 16 DESCRIPTION: DUES AND FEES. AMOUNT: 64. DESCRIPTION: NON-EVENT EXPENSES. AMOUNT: 131. DESCRIPTION: PRIOR YEAR AUCTION EXPENSE. AMOUNT: 138. TOTAL TO FORM 990-EZ, LINE 16: 333. OTHER CHANGES IN NET ASSETS FORM 990-EZ, PART I, LINE 20 DESCRIPTION: UNREALIZED LOSS. AMOUNT: -9,750. OTHER ASSETS FORM 990-EZ, PART II, LINE 24 DESCRIPTION: TOMAH HOSPITAL RECEIVABLE. BEG. OF YEAR AMOUNT: 440. END OF YEAR AMOUNT: 376. EXPLANATION FOR NOT REPORTING UBI ON FORM 990-T FORM 990-EZ, PART V, LINE 35 THE FOUNDATION HAD REVENUES RELATED TO SPECIAL EVENTS IT HELD IN FURTHERANCE OF ITS TAX EXEMPT PURPOSE. THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.