SIBLEY MEDICAL CENTER: Form 990EZ, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- SIBLEY MEDICAL CENTER (EIN 41-1801967)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-04-06
- IRS object ID
- 201110969349200401
- 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 | 2011-04-06T09:02:24-05:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4310 17TH AVE S PO BOX 2545 | AddressLine1 |
| City | FARGO | City |
| State | ND | State |
| ZIP Code | 581082545 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnType |
| Tax Period Begin Date | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411801967 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Sibley Medical Center Foundation | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SIBL | NameControl |
| Phone | 5079642271 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 West Chandler PO Box 620 | AddressLine1 |
| City | Arlington | City |
| State | MN | State |
| ZIP Code | 55307 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Aaron Scharpe | Name |
| Title | Board President | Title |
| Phone | 5079642271 | Phone |
| Date Signed | 2011-03-22 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LISA CHAFFEE CPA | Name |
| Phone | 7012398500 | Phone |
| Date Prepared | 2011-03-22 | 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 | 14831 | GrossReceipts |
| Investment Income | 2645 | InvestmentIncome |
| Special Events Gross Revenue | 12186 | SpecialEventsGrossRevenue |
| Special Events Net Income Loss | 12186 | SpecialEventsNetIncomeLoss |
| Total Revenue | 14831 | TotalRevenue |
| Grants And Similar Amounts Paid | 22800 | GrantsAndSimilarAmountsPaid |
| Printing Publications Postage | 2439 | PrintingPublicationsPostage |
| Other Expenses Total | 6340 | OtherExpensesTotal |
| Total Expenses | 31579 | TotalExpenses |
| Excess Or Deficit For Year | -16748 | ExcessOrDeficitForYear |
| Net Assets Or Fund Balances BOY | 254840 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 238092 | NetAssetsOrFundBalancesEOY |
Cash Savings And Investments CashSavingsAndInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 246064 | BOY |
| EOY | 237451 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8776 | BOY |
| EOY | 641 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 254840 | BOY |
| EOY | 238092 | 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 | 254840 | BOY |
| EOY | 238092 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | Support of Sibley Medical Center hospital and clinic | PrimaryExemptPurpose |
Program Service Accomplishment ProgramServiceAccomplishment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Service Accom | Provided financial support to Sibley Medical Center. | DescriptionProgramServiceAccom |
| Grants And Allocations | 22800 | GrantsAndAllocations |
| Program Service Expenses | 22800 | ProgramServiceExpenses |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | 22800 | TotalProgramServiceExpenses |
Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (11 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 |
|---|---|---|---|---|---|---|---|---|
| Aaron Scharpe | ||||||||
| 601 West Chandler PO Box 620 | Arlington | MN | 55307 | President | 0.50 | 0 | 0 | 0 |
| Gail Estenson | ||||||||
| 601 West Chandler PO Box 620 | Arlington | MN | 55307 | Vice-President | 0.50 | 0 | 0 | 0 |
| Kay Schumacher | ||||||||
| 601 West Chandler PO Box 620 | Arlington | MN | 55307 | Secretary | 0.50 | 0 | 0 | 0 |
| Mary Seeman | ||||||||
| 601 West Chandler PO Box 620 | Arlington | MN | 55307 | Director | 0.50 | 0 | 0 | 0 |
| Kim Quast | ||||||||
| 601 West Chandler PO Box 620 | Arlington | MN | 55307 | Director | 0.50 | 0 | 0 | 0 |
| Mary Hennies | ||||||||
| 601 West Chandler PO Box 620 | Arlington | MN | 55307 | Director | 0.50 | 0 | 0 | 0 |
| Don Lannoye | ||||||||
| 601 West Chandler PO Box 620 | Arlington | MN | 55307 | Director | 0.50 | 0 | 0 | 0 |
| Tom Frank | ||||||||
| 601 West Chandler PO Box 620 | Arlington | MN | 55307 | Director | 0.50 | 0 | 0 | 0 |
| Jeri Odenthal | ||||||||
| 601 West Chandler PO Box 620 | Arlington | MN | 55307 | Director | 0.50 | 0 | 0 | 0 |
| Chris Paulsen | ||||||||
| 601 West Chandler PO Box 620 | Arlington | MN | 55307 | Director | 0.50 | 0 | 0 | 0 |
| Deb Brinkman | ||||||||
| 601 West Chandler PO Box 620 | Arlington | MN | 55307 | Director | 0.50 | 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 | MN | StatesWhereCopyOfReturnIsFiled |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Darla Anderson | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 West Chandler Street | AddressLine1 |
| City | Arlington | City |
| State | MN | State |
| ZIP Code | 55307 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5079648424 | 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) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Sibley Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411384056 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| Supported Organization Notified | 1 | SupportedOrganizationNotified |
| Organized In US | 1 | OrganizedInUS |
| Amount | $22,800 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 22800 | SumOfAmounts |
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 |
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