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 | |||||
|
Total |
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Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 1,226,034 | 3,550,411 | 3,631,876 | 3,420,916 | 3,785,232 | 15,614,469 |
| 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 | 1,226,034 | 3,550,411 | 3,631,876 | 3,420,916 | 3,785,232 | 15,614,469 |
| 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) .. | 6,725,289 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 8,889,180 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 1,226,034 | 3,550,411 | 3,631,876 | 3,420,916 | 3,785,232 | 15,614,469 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 19,230 | 16,337 | 19,708 | 26,200 | 20,977 | 102,452 |
| 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.).. | 35,427 | 28,952 | 222 | 3,213 | 410 | 68,224 |
| 11 | Total support. Add lines 7 through 10 | 15,806,820 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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) |
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| 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) |
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| 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): |
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| 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 2022 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-2022 |
(iii) Distributable Amount for 2022 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2022 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2022: | ||||
| a From 2017....... | ||||
| b From 2018....... | ||||
| c From 2019....... | ||||
| d From 2020....... | ||||
| e From 2021....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2022 distributable amount | ||||
|
i
Carryover from 2017 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2022 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2022 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2022, 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 2022. 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 2023. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2018..... | ||||
| b Excess from 2019..... | ||||
| c Excess from 2020..... | ||||
| d Excess from 2021..... | ||||
| e Excess from 2022..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
|---|---|
| PART II, LINE 10 | OTHER INCOME 68,224 |
| 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 - ORGANIZATION'S MISSION | THE HEMOPHILIA FOUNDATION OF MICHIGAN STRIVES TO IMPROVE THE QUALITY OF LIFE FOR ALL PEOPLE AFFECTED BY HEMOPHILIA, VON WILLEBRAND DISEASE, OTHER COAGULATION DISORDERS AND RELATED COMPLICATIONS, INCLUDING HIV/AIDS AND HEPATITIS. |
| FORM 990, PAGE 1, PART I, LINE 6 | VOLUNTEERS ASSIST WITH VARIOUS SPECIAL EVENTS DURING THE YEAR AND VOLUNTEERS ALSO COMPRISE THE ORGANIZATION'S BOARD OF DIRECTORS. |
| FORM 990, PAGE 2, PART III, LINE 4B | CLIENT SUPPORT SERVICES - ASSISTED CLIENTS AND THEIR FAMILIES IN DEALING WITH BURDEN OF LIVING WITH HEMOPHILIA, HIV/AIDS AND OTHER BLEEDING DISORDERS. FINANCIAL ASSISTANCE PROGRAM - THE HEMOPHILIA FOUNDATION OF MICHIGAN'S FINANCIAL ASSISTANCE PROGRAM ASSISTS THE MICHIGAN BLEEDING DISORDERS COMMUNITY DURING SOME OF ITS MOST CHALLENGING TIMES. THE PROGRAM GUIDELINES REQUIRE THAT THE APPLICANT BE A MICHIGAN RESIDENT, HAVE A CONGENITAL BLEEDING DISORDER, AND HAVE AN IMMEDIATE FINANCIAL CHALLENGE THAT INCLUDES BUT IT IS NOT LIMITED TO SITUATIONS SUCH AS EVICTION OR UTILITY SHUTOFF. THE PROGRAM IS FACILITATED IN PARTNERSHIP WITH THE HEMOPHILIA TREATMENT CENTER SOCIAL WORKERS. THE FUNDING FOR FA IS DETERMINED AT BUDGET TIME AND THAT AMOUNT IS GIVEN TO THE SOCIAL WORKER ON OUR STAFF WHO MONITORS FA. SHE TRACKS THE SPENDING ON AN ONGOING BASIS AND PERIODICALLY RECONCILES HER AMOUNTS WITH THE PROJECT THAT IS RECORDED IN OUR ACCOUNTING SYSTEM AS ACTUAL COSTS ARE INCURRED. DELTA DENTAL PROGRAM - LIKE THE FINANCIAL ASSISTANCE PROGRAM THE PROGRAM GUIDELINES REQUIRE THAT THE APPLICANT BE A MICHIGAN RESIDENT AND HAVE A CONGENITAL BLEEDING DISORDER. ONCE APPROVED THE INDIVIDUAL MUST USE THIS SERVICE AT LEAST ONCE ANNUALLY IN ORDER TO QUALIFY FOR THE PROGRAM THE NEXT YEAR. THE FUNDING FOR THE DENTAL PROGRAM IS DETERMINED AT BUDGET TIME. THIS PROGRAM IS FUNDED BY CASCADE; IT IS 100K FOR DENTAL COST AND 20 TO ADMINISTER THE PROGRAM FOR HFM. WE TRACK THE PROGRAM WITH A PROJECT IN OUR ACCOUNTING SYSTEM SO WE CAN TRACK THE COST ON AN ONGOING BASIS AS THEY ARE INCURRED. TUITION SCHOLARSHIP PROGRAM - APPLICANTS MUST BE INDIVIDUALS WITHIN THE BLEEDING DISORDERS COMMUNITY WHO RESIDE IN THE STATE OF MICHIGAN SEEKING A POST-SECONDARY EDUCATION, WHICH CAN INCLUDE A COMMUNITY COLLEGE, UNIVERSITY, GRADUATE LEVEL OR TRADE SCHOOL. THIS INCLUDES THOSE WITH BLEEDING DISORDERS (CLOTTING DISORDERS ARE NOT ELIGIBLE FOR THIS SCHOLARSHIP) AND IMMEDIATE FAMILY MEMBERS (PARENT, SIBLING, AND GRANDCHILD) OF THOSE WITH A BLEEDING DISORDER. APPLICANTS SUBMIT THEIR APPLICATION TO THE SCHOLARSHIP COMMITTEE, WHO THEY REVIEW ALL THE APPLICANTS AND CHOOSE ONE BASED ON PREVIOUSLY AGREED ON CRITERIA. THE AMOUNT OF THE SCHOLARSHIP IS PREDETERMINED AT BUDGET DEVELOPMENT. |
| FORM 990, PAGE 6, PART VI, LINE 6 | MEMBERS - SEE EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 7A. |
| FORM 990, PAGE 6, PART VI, LINE 7A | THERE IS ONE CLASS OF MEMBERS. THEY HAVE THE RIGHT TO VOTE AT ALL GENERAL MEMBERSHIP MEETINGS. ANY INDIVIDUAL FAILING TO PAY MEMBERSHIP DUES WILL FORFEIT HIS OR HER RIGHTS TO VOTE IN ANY MEMBERSHIP MATTERS. THEY ELECT THE MEMBERS OF THE BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 7B | THE MEMBERS OF THE FOUNDATION VOTE TO AMEND OR REVISE THE FOUNDATION'S BYLAWS. THESE AMENDMENTS AND REVISIONS ARE RECOMMENDED BY THE BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE 990 IS REVIEWED BY EXECUTIVE DIRECTOR BEFORE IT IS FILED. THE 990 IS MADE AVAILABLE TO THE ENTIRE BOARD FOR REVIEW AND COMMENTARY BEFORE FILED BUT APPROVAL IS ONLY REQUIRED FROM THE BOARD TREASURER. |
| FORM 990, PAGE 6, PART VI, LINE 12C | BOARD CONFLICT OF INTEREST, BOARD MEMBERS ARE ASKED TO COMPLETE A CONFLICT OF INTEREST FORM WHEN THEY FIRST JOIN THE BOARD AND PERIODICALLY THERE AFTER. THE FORMS ARE REVIEWED BY THE EXECUTIVE DIRECTOR AND PRESIDENT OF THE BOARD. IF THERE IS ANY QUESTION, IT IS FIRST DISCUSSED WITH THE INDIVIDUAL FOR FURTHER CLARIFICATION AND THEN PRESENTED TO THE BOARD IF NOT RESOLVED. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE EXECUTIVE DIRECTOR MEETS WITH THE FINANCE COMMITTEE AND PRESENTS THE BUDGET. AS A PART OF THE PROPOSED BUDGET, THERE ARE RECOMMEND SALARY INCREASES FOR THE STAFF. SALARY INCREASES ARE DETERMINED USING A COST OF LIVING INDEX, REGIONAL SALARIES FOR SIMILAR ORGANIZATIONS, AND PERSONAL CONTACTS WITH OTHER NONPROFIT ORGANIZATIONS. THE TREASURER PRESENTS THE BUDGET RECOMMENDATION TO THE FULL BOARD AT THE MEETING IN DECEMBER. THE BUDGET IS REVIEWED AND APPROVED INCLUDING SALARY RECOMMENDATION. THE EXECUTIVE COMMITTEE PERFORMS AN ANNUAL EVALUATION OF THE EXECUTIVE DIRECTOR PRIOR TO THE EMPLOYMENT ANNIVERSARY DATE AND MAKES A SALARY RECOMMENDATION USING COMPARISON DATA FROM OTHER SIMILAR ORGANIZATIONS. ANY SALARY INCREASES ARE APPROVED BY THE EXECUTIVE BOARD AND DOCUMENTED IN THE APPLICABLE MINUTES. |
| FORM 990, PAGE 6, PART VI, LINE 19 | DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST OR ON THE ORGANIZATION WEBSITE. |
| FORM 990, PART XI, LINE 9 | DIRECT EXPENSES 15,573 DIRECT EXPENSE -15,575 TOTAL -2 |
| Software ID: | |
| Software Version: |