AMERY REGIONAL MEDICAL CENTER FOUNDATION INC: Form 990EZ, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- AMERY REGIONAL MEDICAL CENTER FOUNDATION INC (EIN 39-1726539)
- Tax period
- 2009-05-01 to 2010-04-30
- Filed
- 2011-03-14
- IRS object ID
- 201110739349200406
- Schema version
- 2009v1.7
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-03-14T12:15:36-05:00 | Timestamp |
| Tax Period End Date | 2010-04-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7601 FRANCE AVENUE SOUTH SUITE 400 | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55435 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnType |
| Tax Period Begin Date | 2009-05-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391726539 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Amery Regional Medical Center Foundation Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | AMER | NameControl |
| Phone | 7152688000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 265 Griffin Street East | AddressLine1 |
| City | Amery | City |
| State | WI | State |
| ZIP Code | 54001 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Dan Lien | Name |
| Title | Chairman | Title |
| Phone | 7152688000 | Phone |
| Date Signed | 2011-03-11 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Richard Ruvelson | Name |
| Phone | 9525483400 | Phone |
| Date Prepared | 2011-03-11 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Schedule B Not Required | X | ScheduleBNotRequired |
| Web Site | N/A | WebSite |
| Organization501c | X | Organization501c |
| Gross Receipts | 48995 | GrossReceipts |
| Contributions Gifts Grants Etc | 23675 | ContributionsGiftsGrantsEtc |
| Investment Income | 948 | InvestmentIncome |
| Special Events Gross Revenue | 24372 | SpecialEventsGrossRevenue |
| Special Events Direct Expenses | 10281 | SpecialEventsDirectExpenses |
| Special Events Net Income Loss | 14091 | SpecialEventsNetIncomeLoss |
| Total Revenue | 38714 | TotalRevenue |
| Grants And Similar Amounts Paid | 38670 | GrantsAndSimilarAmountsPaid |
| Other Expenses Total | 76 | OtherExpensesTotal |
| Total Expenses | 38746 | TotalExpenses |
| Excess Or Deficit For Year | -32 | ExcessOrDeficitForYear |
| Net Assets Or Fund Balances BOY | 105539 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 105507 | NetAssetsOrFundBalancesEOY |
Cash Savings And Investments CashSavingsAndInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 105539 | BOY |
| EOY | 105507 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 105539 | BOY |
| EOY | 105507 | EOY |
Sum Of Total Liabilities SumOfTotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Net Assets Or Fund Balances NetAssetsOrFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 105539 | BOY |
| EOY | 105507 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | RAISE MONEY TO SUPPORT HEALTHCARE ORGANIZATIONS. | PrimaryExemptPurpose |
Program Service Accomplishment ProgramServiceAccomplishment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Service Accom | The Amery Regional Medical Center Foundation, Inc. (Foundation) is a corporate member of amery regional medical center inc. (ARMC) and selects seven foundation members to serve on the board of directors for ARMC. The foundation exists to promote the health and wellness of the people in the communities served by ARMC and by participating in various fundraising activities. | DescriptionProgramServiceAccom |
| Grants And Allocations | 38670 | GrantsAndAllocations |
| Program Service Expenses | 0 | ProgramServiceExpenses |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | 0 | TotalProgramServiceExpenses |
Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (12 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | TitleTitle | Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition | CompensationCompensation | Contri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtc | Expense Account Other AllowancesExpenseAccountOtherAllowances |
|---|---|---|---|---|---|---|---|---|
| Daniel Lien | ||||||||
| 265 Griffin Street East | Amery | WI | 54001 | Chair | 0.10 | 0 | 0 | 0 |
| James A Leadholm | ||||||||
| 265 Griffin Street East | amery | WI | 54001 | Vice Chair | 0.10 | 0 | 0 | 0 |
| Michael D Jensen | ||||||||
| 265 Griffin Street East | amery | WI | 54001 | Treasurer | 0.10 | 0 | 0 | 0 |
| Joan M Byrnes | ||||||||
| 265 Griffin Street East | amery | WI | 54001 | Secretary | 0.10 | 0 | 0 | 0 |
| Beth L Heinz | ||||||||
| 265 Griffin Street East | amery | WI | 54001 | Director | 0.10 | 0 | 0 | 0 |
| Ann M Ryan MD | ||||||||
| 265 Griffin Street East | amery | WI | 54001 | Director | 0.10 | 0 | 0 | 0 |
| John C White MD | ||||||||
| 265 Griffin Street East | Amery | WI | 54001 | Director | 0.10 | 0 | 0 | 0 |
| Kathryn Isakson | ||||||||
| 265 Griffin Street East | amery | WI | 54001 | Director | 0.10 | 0 | 0 | 0 |
| Dylan nmi Coe MD | ||||||||
| 265 Griffin Street East | amery | WI | 54001 | Director | 0.10 | 0 | 0 | 0 |
| Ranae A Nygaard | ||||||||
| 265 Griffin Street East | amery | WI | 54001 | Director | 0.10 | 0 | 0 | 0 |
| Ross R Bullard | ||||||||
| 265 Griffin Street East | Amery | WI | 54001 | Director | 0.10 | 0 | 0 | 0 |
| Heidi Erspamer | ||||||||
| 265 Griffin Street East | amery | WI | 54001 | Director | 0.10 | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRpt |
| Made Changes To Orgnzng Etc Doc | 0 | MadeChangesToOrgnzngEtcDoc |
| Organization Had UBI | 0 | OrganizationHadUBI |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtc |
| Direct Indirect Political Expend | 0 | DirectIndirectPoliticalExpend |
| Made Loans To From Officers | 0 | MadeLoansToFromOfficers |
| Tax Imposed Under IRC4911 | 0 | TaxImposedUnderIRC4911 |
| Tax Imposed Under IRC4912 | 0 | TaxImposedUnderIRC4912 |
| Tax Imposed Under IRC4955 | 0 | TaxImposedUnderIRC4955 |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTrans |
| Amount Of Tax Imposed On Org Mgr | 0 | AmountOfTaxImposedOnOrgMgr |
| Amount Of Tax Reimbursed By Org | 0 | AmountOfTaxReimbursedByOrg |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Scott Edin | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 265 Griffin Street East | AddressLine1 |
| City | Amery | City |
| State | WI | State |
| ZIP Code | 54001 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7152688000 | TelephoneNumber |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Foreign Office | 0 | ForeignOffice |
| Maintain Any Donor Advised Funds | 0 | MaintainAnyDonorAdvisedFunds |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Engage Political Cmpgn Activities | 0 | EngagePoliticalCmpgnActivities |
| Engage In Lobbying Activities | 0 | EngageInLobbyingActivities |
| Operating School | 0 | OperatingSchool |
| Trnsfrs Exempt Non Char Related Org | 0 | TrnsfrsExemptNonCharRelatedOrg |
| Part VI Of Comp Of Highest Paid Empl | NONE | PartVIOfCompOfHighestPaidEmpl |
| Part VIA Hghst Paid Cntrct Prof Ser | NONE | PartVIAHghstPaidCntrctProfSer |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 46785 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 218056 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 53140 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 12201 | CurrentTaxYearMinus1Year |
| Current Tax Year | 23675 | CurrentTaxYear |
| Total | 353857 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 46785 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 218056 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 53140 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 12201 | CurrentTaxYearMinus1Year |
| Current Tax Year | 23675 | CurrentTaxYear |
| Total | 353857 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 353857 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2826 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 14295 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4366 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 379 | CurrentTaxYearMinus1Year |
| Current Tax Year | 948 | CurrentTaxYear |
| Total | 22814 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 5960 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 14358 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus1 Year | 6721 | CurrentTaxYearMinus1Year |
| Current Tax Year | 24372 | CurrentTaxYear |
| Total | 51411 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 428082 | TotalSupport |
| Public Support Pertcentage170 | 0.82660 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.73660 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Golf Tournament | NameOfEvent1 |
| Gross Receipts Event1 | 29037 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 4665 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 24372 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 1996 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 4616 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 1325 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 2344 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 29037 | GrossReceiptsTotal |
| Charitable Contributions Total | 4665 | CharitableContributionsTotal |
| Gross Revenue Total Events | 24372 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 1996 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 4616 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 1325 | FoodAndBeverageTotalEvents |
| Other Direct Expenses Total Events | 2344 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 10281 | DirectExpenseSummaryEvents |
| Net Income Summary | 14091 | NetIncomeSummary |
Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Declaration | 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. | Declaration |
Comments