Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990-EZ, PART I, LINE 8 - OTHER REVENUE | DESCRIPTION: INTEREST . AMOUNT: 15. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: MEDICAL RESEARCH. GRANTEE NAME: ANESTHESIA PATIENT SAFETY FOUNDATION. GRANTEE ADDRESS: 8007 SOUTH MERIDIAN STREET INDIANAPOLIS, IN 46217. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 10/13/15. AMOUNT GIVEN: 1,170. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: MEDICAL RESEARCH. GRANTEE NAME: FOUNDATION FOR ANESTHESIA EDUCATION RESEARCH. GRANTEE ADDRESS: 200 FIRST STREET, SW ROCHESTER, MN 55905. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 10/13/15. AMOUNT GIVEN: 2,390. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: LECTURE SUPPORT. GRANTEE NAME: FREDERICK P. HAUGEN LECTURE FUND. GRANTEE ADDRESS: 1121 S.W. SALMON STREET, SUITE 100 PORTLAND, OR 97205. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 10/13/15. AMOUNT GIVEN: 150. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: MEDICAL RESEARCH. GRANTEE NAME: ASA CHARITABLE FOUNDATION. GRANTEE ADDRESS: 520 N NORTHWEST HIGHWAY PARK RIDGE, IL 60068. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 10/13/15. AMOUNT GIVEN: 50. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 3,760. |
| FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES | DESCRIPTION: OFFICE EXPENSE . AMOUNT: 3,504. DESCRIPTION: MEETING EXPENSES . AMOUNT: 48,927. DESCRIPTION: LIABILITY INSURANCE . AMOUNT: 1,292. TOTAL TO FORM 990-EZ, LINE 16: 53,723. |
| FORM 990-EZ, PART I, LINE 20 - OTHER CHANGES IN NET ASSETS | DESCRIPTION: PRIOR PERIOD ADJUSTMENT. AMOUNT: 22,686. |
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