Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
AMERICAN ASSOCIATION OF NURSE ANESTHETISTS FOUNDATION
Employer identification number
36-3145692
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(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
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
767,657
700,906
726,371
844,204
867,660
3,906,798
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..
767,657
700,906
726,371
844,204
867,660
3,906,798
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)..
451
6
Public Support. Subtract line 5 from line 4.
3,906,347
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
767,657
700,906
726,371
844,204
867,660
3,906,798
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
337,963
281,673
84,179
161,613
99,878
965,306
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..
4,219
22,965
41,168
14,643
82,995
11
Total support (Add lines 7 through 10).
4,955,099
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
78.830 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
78.040 %
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(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.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(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.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
OTHER INCOME, SCHEDULE A, PART II, LINE 10, 2006: NONE 2007: MISC INCOME - $4,219 2008: FUNDRAISING INCOME - $22,594 MISC INCOME - $371 2009: FUNDRAISING INCOME - $34,028 MISC INCOME - $7,140 2010: FUNDRAISING INCOME - $14,625 MISC INCOME - $18,
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
10000128
Software Version:
v2010.1.0
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
AMERICAN ASSOCIATION OF NURSE ANESTHETISTS FOUNDATION
Employer identification number
36-3145692
Identifier
Return Reference
Explanation
Classes of members or stockholders
Form 990, Part VI, Section A, Line 6
THE SOLE MEMBER OF AANA FOUNDATION IS AANA, A RELATED TAX-EXEMPT ORGANIZATION. ALL ACTS REQUIRING ACTION OF THE MEMBER MAY ONLY BE TAKEN BY THE AANA BOARD OF DIRECTORS OF AN ENTITY AUTHORIZED ON BEHALF OF THE AANA BOARD OF DIRECTORS. PRIOR TO ELECTING BOARD OF TRUSTEES THE TRUSTEES OF AANA FOUNDATION MUST FIRST GET THE APPROVAL OF NOMINEES FORM THE AANA BOARD OF DIRECTORS.
Members or stockholders electing members of governing body
Form 990, Part VI, Section A, Line 7a
PRIOR TO FILING THE RETURN WITH THE IRS, A DRAFT OF THE COMPLETED FORM 990 IS REVIEWED BY THE ORGANIZATION'S FINANCE AND FOUNDATION DEPARTMENTS ALONG WITH ITS INDEPENDENT PAID TAX PREPARERS. AFTER REVIEW, COPIES OF FINAL FORM 990 ARE PRESENTED TO THE ORGANIZATION'S BOARD OF DIRECTORS, AND SUBSEQUENTLY FILED WITH THE IRS.
Decisions requiring approval by members or stockholders
Form 990, Part VI, Section A, Line 7b
SEE NARRATIVE FOR FORM 990, PART VI, LINE 7A.
Review of form 990 by governing body
Form 990, Part VI, Section B, Line 11a
PRIOR TO FILING THE RETURN WITH THE IRS, A DRAFT OF THE COMPLETED FORM 990 IS REVIEWED BY THE ORGANIZATION'S FINANCE AND FOUNDATION DEPARTMENTS ALONG WITH ITS INDEPENDENT PAID TAX PREPARERS. AFTER REVIEW, COPIES OF THE FINAL FORM 990 ARE PRESENTED TO THE ORGANIZATION'S BOARD OF DIRECTORS, AND SUBSEQUENTLY FILED WITH THE IRS.
Conflict of interest policy
Form 990, Part VI, Section B, Line 12c
ALL INTERESTED PERSONS ARE REQUIRED TO FILL OUT AN ELECTRONIC CONFLICT OF INTEREST QUESTIONNAIRE ON AN ANNUAL BASIS. THIS QUESTIONNAIRE ENCOURAGES DISCLOSURE OF ANY CONFLICTS THAT OCCUR BETWEEN THE ORGANIZATION AND THE INTERESTED PERSON. THE EXECUTIVE DIRECTOR MONITORS AND REVIEWS THE RESPONSES TO DETERMINE WHETHER A CONFLICT IS REQUIRED TO BE DISCLOSED. IF A BOARD MEMBER HAS A CONFLICT, THEY ARE ASKED TO ABSTAIN FROM VOTING ON AN ISSUE RELATED TO THAT CONFLICT.
Process used to establish compensation of top management official
Form 990, Part VI, Section B, Line 15a
THE ORGANIZATION RELIES UPON AANA, A RELATED TAX-EXEMPT ORGANIZATION, TO DETERMINE AND PAY THE COMPENSATION OF THE EXECUTIVE DIRECTOR. THE EXECUTIVE DIRECTOR PERFORMS SERVICES FOR BOTH AANA AND THE FOUNDATION. DETERMINING COMPENSATION FOR OTHER OFFICER, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES.
Public Disclosure
Form 990, Part VI, Section C, Line 19
NO DOCUMENTS AVAILABLE TO THE PUBLIC.
PROCESS USED TO ESTABLISH COMPENSATION FOR OTHER OFFICERS
FORM 990, PART VI, SECTION B, LINE 15B
THE ORGANIZATION DOES NOT COMPENSATE ANY OTHER OFFICERS, DIRECTORS, TRUSTEES OR KEY EMPLOYEES, THEREFORE THIS QUESTION HAS BEEN INTENTIONALLY MARKED NO ON THE RETURN.
COMPENSATION FOR OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, ETC.
FORM 990, PART VII, SECTION A, COLUMN B
WANDA WILSON, TRUSTEE, DEVOTES APPROXIMATELY 40HOURS A WEEK AS AN OFFICER TO AANA, A RELATED TAX-EXEMPT ORGANIZATION. JEFFREY BEUTLER, FORMER TRUSTEE, DID NOT DEVOTE ANY OTHER TIME TO AANA SINCE HE WAS CONSIDERED A FORMER OFFICER OF THAT ORGANIZTION DURING THE YEAR. LORRAINE JORDAN, EXECUTIVE DIRECTOR, DEVOTES APPROXIMATELY HALF HER TIME TO AANA, A RELATED TAX-EXEMPT ORGANIZATION.
Other changes in net assets or fund balances
Form 990, Part XI, Line 5
NET UNREALIZED GAINS (LOSSES) ON INVESTMENTS - 291465;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.