2011-11-14T14:35:23-06:00 2010-12-31 BAKER NEWMAN & NOYES PO BOX 507 PORTLAND ME 04112 990 2010-01-01 020489150 NORTHEAST DELTA DENTAL FOUNDATION NORT 6032231000 PO BOX 2002 CONCORD NH 033022002 THOMAS RAFFIO 6032231000 2011-11-14 1 E DREW CHENEY 2078972100 2010 2016-03-07 17:11:31Z THOMAS RAFFIO PO BOX 2002 CONCORD NH 033022002 636774 0 X WWW.NEDELTA.COM X 1996 NH PROMOTE DENTAL HEALTH AND EDUCATION IN NORTHERN NEW ENGLAND 11 11 0 20 0 0 353937 483853 0 0 -50041 56515 12920 11893 316816 552261 344596 308161 0 0 0 0 0 0 0 19900 15360 364496 323521 -47680 228740 2291528 2724991 67500 50000 2224028 2674991 X TO PROMOTE DENTAL HEALTH AND EDUCATION IN NORTHERN NEW ENGLAND 0 0 114793 114793 DENTAL EQUIPMENT AND SUPPLIES: CASH DONATIONS TO 16 NONPROFIT DENTAL CLINICS TO PURCHASE DENTAL EQUIPMENT AND SUPPLIES TO SERVE PATIENTS WHO CANNOT AFFORD DENTAL CARE. 3955 3955 FLUORIDE RINSE AND SEALANT PROGRAMS FOR CHILDREN: CASH DONATIONS TO 2 ORGANIZATIONS TO BE USED TO PROVIDE FLUORIDE RINSE OR SEALANTS FOR CHILDREN. THESE PROGRAMS ARE USUALLY PERFORMED IN SCHOOLS. 165655 160413 ORAL HEALTH EDUCATION PROGRAMS AND PUBLIC POLICY DEVELOPMENT: CASH DONATIONS TO 19 ORGANIZATIONS TO SPONSOR ORAL HEALTH EDUCATION PROGRAMS. DONATIONS OF PRINTED MATERIALS AND SUPPLIES TO SCHOOLS, NONPROFIT DENTAL CLINICS, AND OTHER ORGANIZATIONS TO PROVIDE ORAL HEALTH EDUCATION PROGRAMS.ALSO CONTRIBUTED TO 5 ORGANIZATIONS TO ASSIST IN ORAL HEALTH PUBLIC POLICY DEVELOPMENT AND TO PROMOTE THE IMPORTANCE OF ORAL HEALTH. 29000 29000 SCHOLARSHIPS: DONATIONS OF $29,000 TO TWO COLLEGES TO SUPPORT SCHOLARSHIPS FOR DENTAL HYGIENISTS. 29000 29000 313403 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 0 0 0 0 NH X KATHLEEN WALKER 6032231000 C/O ONE DELTA DRIVE CONCORD NH 033022002 X MELVIN J SEVERANCE III 1.00 X X 0 0 0 KATHLEEN B WALKER 6.00 X X 0 0 0 PETER W LEBERMAN ESQ 1.00 X X 0 0 0 ELIZABETH ANDREWS 3.00 X 0 0 0 DAVID M ANDERSON 1.00 X 0 0 0 FRANCIS H LABRANCHE JR DDS 1.00 X 0 0 0 BRENDA L NEEDHAM 1.00 X 0 0 0 MICHAEL PARDUE 1.00 X 0 0 0 THOMAS RAFFIO 2.00 X X 0 0 0 DOUGLAS C TERP 1.00 X 0 0 0 ELEANOR H VIEN 2.00 X 0 0 0 TERENCE A WARDROP 1.00 X 0 0 0 PETER A WELNAK DDS 1.00 X 0 0 0 0 0 0 0 0 0 0 0 483853 483853 50627 50627 76000 70112 5888 5888 5888 26294 14401 11893 11893 552261 0 0 68408 308161 308161 4000 4000 4131 4131 483 483 PROGRAM SERVICES 5242 5242 BANK SERVICE CHARGES 663 663 STATE OF NH FILING FEES 75 75 766 766 323521 313403 10118 0 228430 221244 154300 199800 1908798 2303947 2291528 2724991 67500 50000 67500 50000 X 2113213 2486463 110815 188528 2224028 2674991 2291528 2724991 X 228740 222223 X 0 0 0 X 772788 777839 392355 378517 512647 2834146 772788 777839 392355 378517 512647 2834146 2506470 327676 40652 112016 62388 50649 50627 316332 3150478 0.10400 0.10250 X THE ORGANIZATION MEETS THE "FACTS AND CIRCUMSTANCES" TEST FOR THE FOLLOWING REASONS:- THROUGH ITS ACTIVITIES, THE ORGANIZATION REGULARLY AND CONTINUOUSLY BENEFITS MANY THOUSANDS OF MEMBERS OF THE GENERAL PUBLIC.- IT ENCOURAGES DONATIONS FROM THE GENERAL PUBLIC, THROUGH THE WEBSITE OF NORTHEAST DELTA DENTAL (A GROUP OF NONPROFIT ORGANIZATIONS) AND THROUGH OTHER MEANS.- ITS BOARD DOES NOT REPRESENT ANY NARROW INTERESTS AND IS COMMITTED TO REPRESENTING ALL OF THE CITIZENS OF NORTHERN NEW ENGLAND WHO ARE MOST IN NEED OF DENTAL CARE ASSISTANCE. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2178074 277300 278419 91512 2642281 1866113 154300 338407 100000 80746 2178074 2181578 294600 -552093 57972 1866113 0.92870 0.00000 0.07140 0 0 0 GOLF TOURNAMENT 26294 26294 12699 1702 26294 26294 12699 1702 14401 11893 1 CATHOLIC MEDICAL CENTER 100 MCGREGOR STREET MANCHESTER NH 03102 020315693 501(C)(3) 10000 POISSON DENTAL FACILITY - ELECTRONIC MEDICAL RECORDS SYSTEM CONCORD HOSPITAL FAMILY HEALTH CENTER DENTAL CLINIC 250 PLEASANT STREET CONCORD NH 03301 222594672 501(C)(3) 8345 DENTAL SUPPLIES FAMILIES FIRST OF THE GREATER SEACOAST 100 CAMPUS DRIVE SUITE 12 PORTSMOUTH NH 03801 222757341 501(C)(3) 6000 DENTAL SUPPLIES EASTER SEALS NH 555 AUBURN STREET MANCHESTER NH 03103 020272825 501(C)(3) 10000 DENTAL CLINIC NHTI CONCORD'S COMMUNITY COLLEGE 31 COLLEGE DRIVE CONCORD NH 03301 020516490 501(C)(3) 6000 DENTAL HYGIENIST SCHOLARSHIPS NHTI CONCORD'S COMMUNITY COLLEGE 31 COLLEGE DRIVE CONCORD NH 03301 020516490 501(C)(3) 20000 DR. CARPENTER SCHOLARSHIP FUND MAINE HEALTH ACCESS FOUNDATION 150 CAPITOL STREET AUGUSTA ME 04330 010535144 501(C)(3) 10000 ORAL HEALTH PROGRAM SPECIALIST GREATER NASHUA DENTAL CONNECTION 31 CROSS STREET NASHUA NH 03064 020500866 501(C)(3) 8250 SCHOOL-BASED PROGRAM AND GENERAL SUPPORT HARBOR HOMES INC 45 HIGH STREET NASHUA NH 03060 020351932 501(C)(3) 10000 DENTAL PROGRAM OASIS HEALTH NETWORK INC 66 BARIBEAU DRIVE BRUNSWICK ME 04011 010497587 501(C)(3) 6000 EMERGENCY DENTAL CLINIC VT DENTAL SOCIETY 100 DORSET STREET SUITE 18 SOUTH BURLINGTON VT 05403 222514423 501(C)(3) 10000 DIABETES & ORAL HEALTH PROGRAM CHAMPLAIN VALLEY OFFICE OF ECONOMIC OPPORTUNITY 191 NORTH STREET BURLINGTON VT 05401 032026837 501(C)(3) 84000 VERMONT EARLY HEAD START TOOTH TUTOR PROGRAM NYU COLLEGE OF DENTISTRY 726 BROADWAY 2ND FLOOR NEW YORK NY 10003 135562308 501(C)(3) 25000 RURAL MAINE ORAL HEALTH OUTREACH MODEL DOWNEAST HEALTH SERVICES INC 52 CHRISTIAN RIDGE ROAD ELLSWORTH ME 04605 010317427 501(C)(3) 7000 DENTAL SUPPLIES AND EQUIPMENT NH DENTAL SOCIETY FOUNDATION 23 SOUTH STATE STREET CONCORD NH 03301 550865162 501(C)(3) 9500 DENTAL PROGRAMS FORM 990, PART VI, SECTION A, LINE 6 THE FOUNDATION HAS THREE MEMBERS: DELTA DENTAL PLAN OF NEW HAMPSHIRE,INC.; DELTA DENTAL PLAN OF VERMONT,INC.; AND MAINE DENTAL SERVICES CORPORATION. ALL THREE MEMBERS ARE TAX-EXEMPT UNDER INTERNAL REVENUE CODE SECTION 501(C)(4). FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS ELECT THE FOUNDATION'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B IN ADDITION TO ELECTING THE BOARD OF DIRECTORS, THE MEMBERS HAVE THE POWER TO REMOVE DIRECTORS, REPEAL OR CHANGE BYLAWS BY 2/3RD MEMBER VOTE (BOARD HAS PRIMARY AUTHORITY TO AMEND BYLAWS), AND TO DISSOLVE THE CORPORATION BY 2/3RD MEMBER VOTE. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED IN DETAIL BY KEY FINANCE EMPLOYEES OF NORTHEAST DELTA DENTAL. A FINAL DRAFT IS PRESENTED TO THE BOARD BEFORE THE FORM IS FILED. FORM 990, PART VI, SECTION B, LINE 12C A COPY OF THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED ANNUALLY TO ALL OFFICERS, DIRECTORS, AND THE MANAGEMENT TEAM. ALL ARE REQUIRED TO REPORT ANY CONFLICTS AND SIGN, DATE, AND RETURN THE POLICY, WHETHER OR NOT A CONFLICT EXISTS, TO CONFIRM COMPLIANCE. GENERAL COUNSEL REVIEWS THE RETURNED POLICIES AND REPORTS THE RESULTS TO THE ENTIRE BOARD OF DIRECTORS. BOARD MEMBERS ARE ASKED TO PROVIDE UPDATES OF ANY CHANGES THAT MAY OCCUR BETWEEN THEIR ANNUAL CONFLICT OF INTEREST FILINGS. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST, NORTHEAST DELTA DENTAL FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 222,223.