Attach to Form 990 or Form 990-EZ.
See separate instructions.| (i) Name of supported organization |
(ii) EIN |
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) |
(iv) Is the organization in col. (i) listed in your governing document? |
(v) Did you notify the organization in col. (i) of your support? |
(vi) Is the organization in col. (i) organized in the U.S.? |
(vii) Amount of support? |
|||
|---|---|---|---|---|---|---|---|---|---|
| Yes | No | Yes | No | Yes | No | ||||
| Total | |||||||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | 377,952 | 388,387 | 354,341 | 300,012 | 315,415 | 1,736,107 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | 0 | |||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 4 | Total. Add lines 1 through 3.. | 377,952 | 388,387 | 354,341 | 300,012 | 315,415 | 1,736,107 |
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | 941,154 | |||||
| 6 | Public Support. Subtract line 5 from line 4. | 794,953 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 377,952 | 388,387 | 354,341 | 300,012 | 315,415 | 1,736,107 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 42,439 | 36,282 | 33,427 | 18,736 | 35,872 | 166,756 |
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | 0 | |||||
| 10 | Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets.. | 16,580 | 13,610 | 11,080 | 13,670 | 12,900 | 67,840 |
| 11 | Total support (Add lines 7 through 10). | 1,970,703 | |||||






| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public Support (Subtract line 7c from line 6.) | ||||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) | ||||||
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | ||||||




| Facts And Circumstances Test |
|---|
| Explanation |
|---|
| OTHER INCOME, SCHEDULE A, PART II, LINE 10, DESCRIPTION - OTHER INCOME, COLUMN A - 16580, COLUMN B - 13610, COLUMN C - 11080, COLUMN D - 13670, COLUMN E - 12900, COLUMN F - 54940;, |
| Software ID: | 11000230 |
| Software Version: | v2011.1.0 |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990, PART III, LINE 1 | (CONTINUED FROM PART III) THE MISSION STATEMENT OF THE FOUNDATION IS TO PROMOTE THE WELLNESS OF MANKIND THROUGH EDUCATION, RESEARCH, AND COMMUNITY SERVICE. ACCORDINGLY, THE FOUNDATION PROMOTES THE EDUCATION OF THE HEALTH CARE PROFESSIONAL, THE STUDENT OF HEALTH CARE SCIENCES, AND THE COMMUNITY. |
| Description of other program services | Form 990, Part III, Line 4d | THE FOUNDATION OFFERS CONTINUING MEDICAL EDUCATION PROGRAMS TO HEALTH CARE PROVIDERS AND IS ACCREDITED BY THE FLORIDA MEDICAL ASSOCIATION. THE PURPOSE IS TO EXPAND THE KNOWLEDGE BASE OF HEALTH CARE PROFESSIONALS, ENSURING THAT PATIENTS IN THE COMMUNITY RECEIVE THE MOST COMPREHENSIVE MEDICAL TREATMENT. MORE THAN 200 PROVIDERS ATTENDED THE 7 PHYSICIAN EDUCATION PROGRAMS CONDUCTED DURING THE YEAR. |
| Delegate broad authority to a committee | Form 990, Part VI, Section A, Line 1a | THE BOARD MAY ADOPT TWO OR MORE MEMBERS OF THE GOVERNING BODY TO THE EXECUTIVE COMMITTEE, WHICH HAS ALL THE POWERS OF THE BOARD OF DIRECTORS BETWEEN MEETINGS OF THE BOARD. COPIES OF MINUTES FROM EXECUTIVE COMMITTEE MEETINGS SHALL BE SENT TO EACH MEMBER OF THE GOVERNING BODY PROMPTLY AFTER EXECUTIVE COMMITTEE MEETINGS. |
| Classes of members or stockholders | Form 990, Part VI, Section A, Line 6 | THE FOUNDATION HAS TWO MEMBERS, EACH OF A DIFFERENT CLASS. THE FIRST CLASS IS THE PARTNERS OF WATSON CLINIC LLP, WHO HAVE THE RIGHT TO PARTICIPATE IN THE FOUNDATION'S GOVERNANCE. THE SECOND CLASS IS LAKELAND VOLUNTEERS IN MEDICINE WHICH WOULD RECEIVE THE FOUNDATION'S ASSETS UPON DISSOLUTION. |
| Members or stockholders electing members of governing body | Form 990, Part VI, Section A, Line 7a | THE PARTNERS OF WATSON CLINIC LLP CAN ELECT THE MEMBERS OF THE BOARD OF DIRECTORS. |
| Decisions requiring approval by members or stockholders | Form 990, Part VI, Section A, Line 7b | THE DECISIONS MADE BY THE BOARD OF DIRECTORS RELATED TO THE FOUNDATION'S BY-LAWS ARE SUBJECT TO THE APPROVAL OF THE WATSON CLINIC LLP PARTNERS. |
| Documentation of meetings held by committees of governing body | Form 990, Part VI, Section B, Line 8b | THE ORGANIZATION DOES NOT HAVE COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. THE INSTRUCTIONS INDICATE THIS SHOULD BE MARKED "NO" WHEN IT IS NOT APPLICABLE. |
| Review of form 990 by governing body | Form 990, Part VI, Section B, Line 11b | A COPY OF THE FOUNDATION'S FORM 990 IS SENT ELECTRONICALLY TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. IN ADDITION, THE FORM 990 IS REVIEWED IN DETAIL BY THE PRESIDENT OF THE FOUNDATION BEFORE IT IS FILED. |
| PROCESS FOR DETERMINING COMPENSATION FOR TOP OFFICIALS | FORM 990, PART VI, LINE 15A | THE ORGANIZATION DOES NOT HAVE ANY BOARD MEMBERS, OFFICERS, OR EMPLOYEES THAT ARE PAID BY THE FOUNDATION. THE INSTRUCTIONS INDICATE THESE SHOULD BE MARKED "NO" WHEN THEY ARE NOT APPLICABLE. |
| PROCESS FOR DETERMINING COMPENSATION FOR TOP OFFICIALS | FORM 990, PART VI, LINE 15B | THE ORGANIZATION DOES NOT HAVE ANY BOARD MEMBERS, OFFICERS, OR EMPLOYEES THAT ARE PAID BY THE FOUNDATION. THE INSTRUCTIONS INDICATE THESE SHOULD BE MARKED "NO" WHEN THEY ARE NOT APPLICABLE. |
| Governing documents, conflict of interest policy and financial statements available to the public | Form 990, Part VI, Section C, Line 19 | FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO IRC SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. |
| OFFICERS AND DIRECTORS | FORM 990, PART VII, SECTION A | A MAJORITY OF THE BOARD MEMBERS OF THE WATSON CLINIC FOUNDATION, INC. ARE EMPLOYED BY, OR ARE PARTNERS OF, THE WATSON CLINIC LLP. |
| Other changes in net assets or fund balances | Form 990, Part XI, Line 5 | NET UNREALIZED GAINS (LOSSES) ON INVESTMENTS - 12181; |
| Software ID: | 11000230 |
| Software Version: | v2011.1.0 |