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)
Boca Raton Regional Hospital Inc |
591006663 | 3 | No | 432,439 | 0 | |
|
Total 1
|
432,439 | 0 | ||||
Calendar year
(or fiscal year beginning in)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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 on 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 0.015 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 0.035 | 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 | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2021 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
6
Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2022. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part IV, Section A, Line 1 Supported Orgs Listed By Name | DEBBIE-RAND MEMORIAL SERVICE LEAGUE, INC. HAS A HISTORIC AND CONTINUING RELATIONSHIP WITH ITS SUPPORTED ORGANIZATION, BOCA RATON REGIONAL HOSPITAL, INC. ("BRRH")-SPANNING OVER A 50-YEAR PERIOD. AS DESCRIBED BELOW, THERE IS A SUBSTANTIAL IDENTITY OF INTERESTS BETWEEN THE ORGANIZATIONS. THEREFORE, DEBBIE-RAND MEETS THE ORGANIZATIONAL REQUIREMENTS OF A TYPE III FUNCTIONALLY INTEGRATED SUPPORTING ORGANIZATION. DEBBIE-RAND WAS FORMED IN 1962 TO, AMONG OTHER THINGS, PROVIDE FUNDS FOR HOSPITAL FACILITIES AND PROVIDE FUNDS FOR ACTIVITIES CONNECTED WITH THE HEALTH AND WELFARE OF THE PERSONS RESIDING IN BOCA RATON. BRRH IS NAMED AS THE SUPPORTED ORGANIZATION OF DEBBIE-RAND IN ITS BYLAWS BECAUSE NEARLY ALL OF THE FUNDS GENERATED BY THE DEBBIE-RAND ARE USED TO PROVIDE HEALTHCARE TO THE COMMUNITY OF BRRH. DEBBIE-RAND'S PRIMARY ACTIVITIES HAVE BEEN SUPPORTING THE EXEMPT PURPOSES OF BRRH BY RAISING FUNDS THAT ARE USED TO DELIVER HEALTHCARE SERVICES BY BRRH. AS DEBBIE-RAND CONDUCTS ACTIVITIES TO RAISE FUNDS FOR BRRH, THESE ACTIVITIES HAVE BEEN PERCEIVED BY THE COMMUNITY TO BE DIRECTLY IN FURTHERANCE OF BRRH'S EXEMPT PURPOSES TO PROVIDE HEALTHCARE. IT IS ASSURED THAT A SUBSTANTIAL IDENTITY OF INTERESTS BETWEEN THE ORGANIZATIONS IS MAINTAINED AND WILL CONTINUE. |
| Schedule A, Part IV, Section D, Line 3 Supp. Org. Have Significant Voice In Investment Policies | THE Debbie-Rand Memorial Service TEAM ASSISTS WITH THE ACCOUNTING FOR THE DEBBIE-RAND AND IS INVOLVED WITH ASSISTING THE BOARD IN THE INVESTMENT POLICIES. BECAUSE ALL OF THE FUNDS RAISED BY DEBBIE-RAND ARE USED FOR THE BENEFIT OF THE HOSPITAL, BRRH IS INVOLVED IN DIRECTING THE USE OF THE ORGANIZATION'S INCOME AND ASSETS. |
| Schedule A, Part IV, Section E, Line 2a Org. Activities Directly Further The Exempt Purposes | DEBBIE-RAND MEMORIAL SERVICE LEAGUE, INC. WAS FORMED TO ASSIST BRRH. TO THAT END, THE ONLY ACTIVITY OF DRMSL IS COORDINATING VOLUNTEER SERVICES, RAISING FUNDS AND INITIATING OTHER BENEFICIAL ACTIVITIES IN SUPPORT OF THE BOCA RATON REGIIONAL HOSPITAL, INC. ALL ACTIVITIES DESCRIBED ABOVE FURTHER THE EXEMPT PURPOSE OF BRRH. |
| Schedule A, Part IV, Section E, Line 2b Activities That One Or More Supp. Org. Engaged In | Debbie-Rand Memorial Service League WAS FORMED TO ASSIST BRRH IN COORDINATING VOLUNTEER SERVICES, RAISING FUNDS, AND INITIATING OTHER BENEFICIAL ACTIVITIES IN SUPPORT OF BOCA RATON REGIONAL HOSPITAL, INC. THESE SERVICES WOULD NOT BE ENGAGED IN BY BRRH EITHER DIRECTLY OR THROUGH BRRH FOUNDATION IF NOT CONDUCTED BY DRMSL. |
| Software ID: | 21014044 |
| Software Version: | 2021v4.2 |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part VI, Line 15 PROCESS USED TO ESTABLISH COMPENSATION OF OFFICERS/KEY EMPLOYEES | THE ORGANIZATION DOES NOT HAVE COMPENSATED OFFICERS OR KEY EMPLOYEES; THEREFORE QUESTIONS 15A AND 15B DO NOT APPLY AND HAVE BEEN ANSWERED "NO" IN ACCORDANCE WITH THE IRS FORM 990 INSTRUCTIONS. |
| Form 990, Part VI, Line 13 WRITTEN WHISTLEBLOWER POLICY | DUE TO THE ORGANIZATION'S SIZE, MANAGEMENT DOES NOT BELIEVE THAT IT IS NECESSARY TO HAVE A WRITTEN WHISTLEBLOWER POLICY. |
| Form 990, Part VI, Line 14 DOCUMENT RETENTION AND DESTRUCTION POLICY | DUE TO THE ORGANIZATION'S SIZE, MANAGEMENT DOES NOT BELIEVE THAT IT IS NECESSARY TO HAVE A DOCUMENT RETENTION AND DESTRUCTION POLICY IN PLACE. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | MEMBERSHIP SHALL BE OPEN TO ALL PERSONS INTERESTED IN THE PURPOSE FOR WHICH THIS CORPORATION WAS FOUNDED AND WHO SATISFY THE REQUIREMENTS OF ONE OF THE CLASSIFICATIONS OF MEMBERSHIP, AS FOLLOWS: (A) GENERAL MEMBERS 1. GENERAL MEMBERS SHALL PAY ANNUAL DUES ESTABLISHED BY THE BOARD OF TRUSTEES. 2. THEY SHALL HAVE THE RIGHT TO VOTE ONLY AS EXPRESSLY SET FORTH HEREIN. 3. THEY SHALL BE OVER THE AGE OF 18. (B) LIFE 1. LIFE MEMBERS SHALL PAY AN AMOUNT ESTABLISHED BY THE BOARD OF TRUSTEES AND SHALL BE EXEMPT FROM ANY FUTURE DUES. 2. THEY SHALL HAVE THE RIGHT TO VOTE ONLY AS EXPRESSLY SET FORTH HEREIN. 3. THEY SHALL BE OVER THE AGE OF 18. (C) CHARTER MEMBERS CHARTER MEMBERS ARE EITHER GENERAL MEMBERS OR LIFE MEMBERS WHO HAVE BEEN THE MEMBERS SINCE THE LEAGUE'S INCEPTION. (D) JUNIOR/TEENAGE VOLUNTEERS (TAV) TAV MEMBERS SHALL BE BETWEEN THE AGES OF 15 AND 18 AND SHALL PAY A FEE AS ESTABLISHED BY THE BOARD OF TRUSTEES. THESE MEMBERS SHALL BE ABLE TO PARTICIPATE IN ACTIVITIES OF THE LEAGUE, BUT SHALL NOT HAVE THE RIGHT TO VOTE OR HOLD OFFICE. TAV MEMBERS MUST MEET MINIMUM STANDARDS AS SET FORTH BY THE BOARD OF TRUSTEES. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | The nominating committee recommends individuals for appointment to the board of directors and the members of the organization vote to appoint the board members. |
| Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body | There were no active committees with authority to act on behalf of the governing body during the year. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | The completed Form 990 is reviewed by the President and Treasurer of the Board prior to filing with the IRS. |
| Form 990, Part VI, Line 12c Conflict of interest policy | ANNUALLY, THE ORGANIZATION DISTRIBUTES A CONFLICT OF INTEREST QUESTIONNAIRE TO ALL INTERESTED PERSONS TO DETERMINE IF A POTENTIAL OR ACTUAL CONFLICT OF INTEREST EXISTS. POTENTIAL AND ACTUAL CONFLICTS OF INTEREST ARE MONITORED ON A CONTINUOUS BASIS BY THE BOARD OF DIRECTORS. IF THE BOARD DETERMINES THAT AN ACTUAL CONFLICT OF INTEREST EXISTS, THEN THE INTERESTED PERSON WITH THE CONFLICT IS PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS REGARDING THE TRANSACTION WHERE A CONFLICT EXISTS. |
| Form 990, Part VI, Line 19 Required documents available to the public | Documents are available to the public upon request. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Change in Inventory valuation - 95427; |
| Software ID: | 21014044 |
| Software Version: | 2021v4.2 |