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      </MinimumAssetAmountGrp>
      <DistributableAmountGrp>
        <CYAdjNetIncomeDistributableAmt>0</CYAdjNetIncomeDistributableAmt>
        <CYPct85AdjustedNetIncomeAmt>0</CYPct85AdjustedNetIncomeAmt>
        <CYTotalMinAstDistributableAmt>108066</CYTotalMinAstDistributableAmt>
        <CYGreaterAdjustedMinimumAmt>108066</CYGreaterAdjustedMinimumAmt>
        <CYIncomeTaxImposedPYAmt>0</CYIncomeTaxImposedPYAmt>
        <CYDistributableAsAdjustedAmt>108066</CYDistributableAsAdjustedAmt>
      </DistributableAmountGrp>
      <DistributionsGrp>
        <CYPaidAccomplishExemptPrpsAmt>143715</CYPaidAccomplishExemptPrpsAmt>
        <CYPdInExcessIncomeActivityAmt>0</CYPdInExcessIncomeActivityAmt>
        <CYAdministrativeExpensePaidAmt>0</CYAdministrativeExpensePaidAmt>
        <ExemptUseAssetsAcquisPaidAmt>0</ExemptUseAssetsAcquisPaidAmt>
        <QualifiedSetAsideAmt>0</QualifiedSetAsideAmt>
        <CYOtherDistributionsAmt>0</CYOtherDistributionsAmt>
        <CYTotalAnnualDistributionsAmt>143715</CYTotalAnnualDistributionsAmt>
        <CYDistriAttentiveSuprtOrgAmt>143715</CYDistriAttentiveSuprtOrgAmt>
        <CYDistributableAsAdjustedAmt>108066</CYDistributableAsAdjustedAmt>
        <CYDistributionYrRt>1.000000000000</CYDistributionYrRt>
      </DistributionsGrp>
      <DistributionAllocationsGrp>
        <CYDistributableAsAdjustedAmt>108066</CYDistributableAsAdjustedAmt>
        <UnderdistributionsAmt>14807</UnderdistributionsAmt>
        <ExcessDistributionCyovYr5Amt>0</ExcessDistributionCyovYr5Amt>
        <ExcessDistributionCyovYr4Amt>0</ExcessDistributionCyovYr4Amt>
        <ExcessDistributionCyovYr3Amt>0</ExcessDistributionCyovYr3Amt>
        <ExcessDistributionCyovYr2Amt>0</ExcessDistributionCyovYr2Amt>
        <ExcessDistributionCyovYr1Amt>0</ExcessDistributionCyovYr1Amt>
        <TotalExcessDistributionCyovAmt>0</TotalExcessDistributionCyovAmt>
        <CyovAppliedUnderdistriPYAmt>0</CyovAppliedUnderdistriPYAmt>
        <CyovAppliedUnderdistrCPYAmt>0</CyovAppliedUnderdistrCPYAmt>
        <CarryoverPYNotAppliedAmt>0</CarryoverPYNotAppliedAmt>
        <ExcessDistributionCyovAmt>0</ExcessDistributionCyovAmt>
        <CYTotalAnnualDistributionsAmt>143715</CYTotalAnnualDistributionsAmt>
        <CYDistribAppUnderdistriPYAmt>14807</CYDistribAppUnderdistriPYAmt>
        <CYDistriAppDistributableAmt>108066</CYDistriAppDistributableAmt>
        <ExcessDistributionAmt>20842</ExcessDistributionAmt>
        <RemainingUnderdistriPYAmt>0</RemainingUnderdistriPYAmt>
        <RemainingUnderdistriCYAmt>0</RemainingUnderdistriCYAmt>
        <ExcessDistriCyovToNextYrAmt>20842</ExcessDistriCyovToNextYrAmt>
        <ExcessFromYear5Amt>0</ExcessFromYear5Amt>
        <ExcessFromYear4Amt>0</ExcessFromYear4Amt>
        <ExcessFromYear3Amt>0</ExcessFromYear3Amt>
        <ExcessFromYear2Amt>0</ExcessFromYear2Amt>
        <ExcessFromYear1Amt>20842</ExcessFromYear1Amt>
      </DistributionAllocationsGrp>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>PART IV, SECTION D, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>SUPPLEMENTAL INFORMATION THE HENRY B. ALLEN FAMILY FOUNDATION (THE FOUNDATION) IS A SUPPORTING ORGANIZATION TO ALLEN MEMORIAL HOSPITAL (THE HOSPITAL), A SECTION 501(C)(3) ORGANIZATION. THE FOLLOWING INFORMATION ABOUT THE RELATIONSHIP BETWEEN THE FOUNDATION AND THE HOSPITAL IS PROVIDED: 1) DR. BEVERLY SMITH IS A MEMBER OF THE BOARD OF DIRECTORS OF THE FOUNDATION. SHE IS ALSO A MEMBER OF THE BOARD OF DIRECTORS OF THE HOSPITAL. 2) THE FOUNDATION PROVIDES A COPY OF ITS ANNUAL FORM 990 TO THE HOSPITAL. 3) THE FOUNDATION PROVIDES A COPY OF ITS MONTHLY INVESTMENT STATEMENT TO THE HOSPITAL. THIS STATEMENT SHOWS ALL OF THE ASSETS OF THE FOUNDATION. 4) THE FOUNDATION WAS FORMED IN 1969 AND HAS SUPPORTED THE HOSPITAL SINCE INCEPTION.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleI documentId="RetDoc2">
      <GrantRecordsMaintainedInd>true</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ALLEN MEMORIAL HOSPITAL CORPORATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1825 LOGAN AVENUE</AddressLine1Txt>
          <CityNm>WATERLOO</CityNm>
          <StateAbbreviationCd>IA</StateAbbreviationCd>
          <ZIPCd>50703</ZIPCd>
        </USAddress>
        <RecipientEIN>420698265</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>143715</CashGrantAmt>
        <PurposeOfGrantTxt>MONETARY SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE I, PAGE 1, PART I, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>ALLEN MEMORIAL HOSPITAL CORPORATION ("HOSPITAL") SUBMITS REQUESTS TO THE HENRY B. ALLEN FAMILY FOUNDATION ("FOUNDATION") FOR GRANTS TO SUPPORT THE HOSPITAL. THE BOARD OF DIRECTORS OF THE FOUNDATION EVALUATES THE SPECIFIC GRANT REQUESTS AND DETERMINES WHICH WILL BE FUNDED. THE PRESIDENT OF THE FOUNDATION SENDS A CHECK TO THE HOSPITAL WITH A COVER LETTER EXPLAINING THE GRANT AWARDS. THE HOSPITAL SENDS A LETTER TO THE FOUNDATION ACKNOWLEDGING RECEIPT OF THE FUNDS AND THE SPECIFIC PURPOSES FOR WHICH THEY ARE INTENDED.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleO documentId="RetDoc3">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 - ORGANIZATION'S MISSION</FormAndLineReferenceDesc>
        <ExplanationTxt>TO COLLECT INCOME FROM ANY PROPERTY, REAL OR PERSONAL, WHICH THE HENRY B. ALLEN FAMILY FOUNDATION MAY OWN, PAY ALL EXPENSES AND DISTRIBUTE NET INCOME ON AN ANNUAL BASIS TO ALLEN MEMORIAL HOSPITAL CORPORATION, WATERLOO, IOWA, FOR SO LONG AS IT OPERATES AS A HOSPITAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>A COPY OF THE FORM 990 WAS DISTRIBUTED TO ALL MEMBERS OF THE BOARD OF DIRECTORS AND WAS REVIEWED, DISCUSSED, AND APPROVED BY THEM PRIOR TO FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc4">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLEN MEMORIAL HOSPITAL CORPORATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1825 LOGAN AVENUE</AddressLine1Txt>
          <CityNm>WATERLOO</CityNm>
          <StateAbbreviationCd>IA</StateAbbreviationCd>
          <ZIPCd>50703</ZIPCd>
        </USAddress>
        <EIN>420698265</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>true</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>ALLEN MEMORIAL HOSPITAL CORPORATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>B</TransactionTypeTxt>
        <InvolvedAmt>143715</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>