Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
MID-AMERICA TRANSPLANT SERVICES |
277426306 | 10 | Yes | 0 | 0 | |
|
Total 1
|
0 | 0 | ||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 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).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2019 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| PART IV, SECTION A, LINE 6: | DONATE LIFE FOUNDATION PROVIDES GRANTS, THROUGH ITS CLINICAL INNOVATION FUND, TO SUPPORT INNOVATIVE RESEARCH THAT WILL ADDRESS CLINICAL ISSUES IN THE AREA OF ORGAN AND/OR TISSUE TRANSPLANTATION THAT WILL HAVE A MEASURABLE IMPACT ON THE FIELD IN TWO TO FOUR YEARS. THE FOUNDATION ALSO PROVIDES GRANTS TO ORGANIZATIONS THAT WORK TO RECOVER AND MAKE AVAILABLE HUMAN ORGANS AND TISSUES FOR THE PURPOSE OF TRANSPLANTATION; PROMOTE THE USE OF HUMAN ORGAN AND TISSUE TRANSPLANTS BY HOSPITALS AND OTHER MEDICAL CARE PROVIDERS; EDUCATE THE PUBLIC AND PROFESSIONAL COMMUNITY ABOUT THE USE AND BENEFITS OF HUMAN ORGAN AND TISSUE DONATIONS AND TRANSPLANTS; PROMOTE, IN COOPERATIONS WITH OTHER INTERESTED ORGANIZATIONS, HUMAN ORGAN AND TISSUE DONATIONS; AND, THROUGH THEIR COMMUNITY BENEFIT PROGRAMS, SUPPORT EFFORTS TO REDUCE THE NEED FOR HUMAN ORGAN AND TISSUE TRANSPLANTS. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | MID-AMERICA TRANSPLANT SERVICES, A MISSOURI NONPROFIT, IS THE SOLE MEMBER OF DONATE LIFE FOUNDATION D/B/A MID-AMERICA TRANSPLANT FOUNDATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | AS THE SOLE MEMBER OF DONATE LIFE FOUNDATION, MID-AMERICA TRANSPLANT SERVICES HAS THE EXCLUSIVE POWER TO ELECT ANY DIRECTOR TO THE CORPORATION'S BOARD. |
| FORM 990, PART VI, SECTION A, LINE 7B | AS THE SOLE MEMBER OF DONATE LIFE FOUNDATION (FOUNDATION), MID-AMERICA TRANSPLANT SERVICES HAS THE EXCLUSIVE POWER TO REMOVE, WITH OR WITHOUT CAUSE, ANY DIRECTOR FROM THE CORPORATION'S BOARD. MID-AMERICA TRANSPLANT SERVICES ALSO HAS POWER TO APPROVE THE FOLLOWING ACTIONS: (A)THE SETTLEMENT OR COMPROMISE OF ANY CLAIM, CASE, ACTION OR CONTROVERSY INVOLVING PROPERTY OR MONEY EQUAL IN AMOUNT OR FAIR MARKET VALUE TO $5,000 OR MORE; (B)THE DISSOLUTION OF THE FOUNDATION; (C)THE FOUNDATION'S FILING OF A BANKRUPTCY PETITION OR A PETITION FOR THE APPOINTMENT OF A RECEIVER UNDER STATE INSOLVENCY LAWS; (D)THE AMENDMENT OR RESTATEMENT OF THE FOUNDATION'S ARTICLES OF INCORPORATION OR BYLAWS; (E)THE MERGER OF THE FOUNDATION WITH OR INTO ANOTHER ENTITY; (F)THE SALE OF ALL, OR SUBSTANTIALLY ALL, OF THE FOUNDATION'S ASSETS; (G)THE SALE OF ANY OF THE FOUNDATION'S REAL PROPERTY; (H)THE FOUNDATION'S DOMESTICATION IN ANOTHER JURISDICTION OR CONVERSION INTO ANOTHER FORM OF BUSINESS ENTITY; AND (I)ANY EXTRAORDINARY TRANSACTION OR OTHER TRANSACTION OUTSIDE THE ORDINARY COURSE OF THE FOUNDATION'S BUSINESS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 WILL BE AVAILABLE TO ALL BOARD MEMBERS PRIOR TO FILING ON THE BOARD MEMBER INTERNET PORTAL. THE FORM 990 IS PREPARED BY THE INDEPENDENT CPA FIRM THAT ALSO CONDUCTS THE ANNUAL AUDIT. THE CEO AND CFO PERFORM AN IN DEPTH REVIEW OF THE 990 AS WELL AS RESPOND TO ALL QUESTIONS AND COMMENTS REGARDING THE 990 BY THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 12 | DONATE LIFE FOUNDATION ENFORCES THE CONFLICT OF INTEREST POLICY OF ITS SOLE CORPORATE MEMBER, MID-AMERICAN TRANSPLANT SERVICES. ALL OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY AND MUST ANNUALLY REVIEW THE CONFLICT OF INTEREST POLICY AND DISCLOSE ANY CONFLICTS OF INTEREST. THE GENERAL COUNSEL AND COMPLIANCE OFFICER SHALL REVIEW THE DISCLOSURE AND ACCOMPANYING FACTS WITH THE CEO AND CHIEF ADMINISTRATIVE OFFICER (TOGETHER REFERRED TO AS THE "COI REVIEW COMMITTEE") AND MAKE A DETERMINATION AS TO WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. DEPENDING UPON THE NATURE OF THE DISCLOSURE, THE MATTER MAY BE REVIEWED AND DISCUSSED WITH THE EXECUTIVE LEADERSHIP TEAM AND/OR THE BOARD OF DIRECTORS. IF NO CONCLUSION OR DETERMINATION CAN BE MADE, THE MATTER SHALL ELEVATE TO THE BOARD OF DIRECTORS FOR FINAL DISCUSSION AND DETERMINATION. ADDITIONALLY, IF A POTENTIAL OR ACTUAL CONFLICT OF INTEREST EXISTS WITH ONE OR MORE MEMBERS OF THE COI REVIEW COMMITTEE, THE MATTER SHALL BE REVIEWED BY THE BOARD OF DIRECTORS OF MID-AMERICA TRANSPLANT. RECOMMENDATIONS FOR DEALING WITH THE CONFLICT OF INTEREST, IN THE EVENT ONE IS DETERMINED TO EXIST, SHALL BE MADE BY THE FINAL REVIEWING PARTIES TO THE INTERESTED PERSON WITHIN SEVEN (7) BUSINESS DAYS FROM RECEIPT OF THE DISCLOSURE. |
| FORM 990, PART VI, SECTION B, LINE 15 | A POLICY IS IN PLACE THAT INCLUDES ANNUAL REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE OF MID-AMERICA TRANSPLANT SERVICES, A RELATED ORGANIZATION. THE COMPENSATION COMMITTEE IS COMPRISED OF INDIVIDUALS WITHOUT CONFLICTS OF INTEREST WITH RESPECT TO COMPENSATION REVIEW AND APPROVAL. AN INDEPENDENT EXTERNAL FIRM PROVIDES MARKET COMPETITIVE COMPENSATION DATA FROM COMPARABLE, TAX EXEMPT ORGANIZATIONS AND PUBLISHED SURVEYS AND CONDUCTS A COMPETITIVENESS ASSESSMENT OF DONATE LIFE FOUNDATION'S OFFICERS AND KEY EMPLOYEES TO THE MARKET. THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION DID NOT CHANGE THE OVERSIGHT OR THE SELECTION PROCESS FROM THE PRIOR YEAR. |
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