2025-01-15T08:49:09-06:00 2024-06-30 370267575 FAIRFIELD NATIONAL BANK 220 E MAIN ST FAIRFIELD IL 62837 990 2023-07-01 371185754 FAIRFIELD MEMORIAL HOSPITAL FOUNDATION FAIR 6188422611 PO BOX 437 FAIRFIELD IL 62837 CHRIS CONARD VICE PRESIDENT 6188422611 2025-01-13 1 0 BRADLEY D JESOP P00011568 6188422183 2023 2024-10-15 13:58:12Z CHRIS CONARD 303 NW 11TH STREET FAIRFIELD IL 62837 919163 0 X WWW.FAIRFIELDMEMORIAL.ORG X 1985 IL SUPPORT FAIRFIELD MEMORIAL HOSPITAL, A 501(C)(3) ORGANIZATION, BY ASSISTING IN FUNDRAISING TO SUPPORT THE MAINTENANCE AND OPERATIONS OF ITS HEALTHCARE PROGRAMS, WHICH ARE PROVIDED TO THE PUBLIC WITHOUT CONSIDERATION OF THE ABILITY TO PAY FOR SERVICES. 13 13 0 30 0 0 92771 118612 0 0 12273 161678 2575 -4247 107619 276043 0 572781 0 0 0 0 0 0 0 3810 6810 3810 579591 103809 -303548 771318 467770 0 0 771318 467770 X ENHANCE THE HEALTHCARE SERVICES OF FAIRFIELD MEMORIAL HOSPITAL, A 501(C)(3) ORGANIZATION. THIS IS ACCOMPLISHED BY ACCEPTING DONATIONS OF PROPERTY AND FUNDS AND CONDUCTING FUNDRAISING ACTIVITIES TO ASSIST THE HOSPITAL IN PURCHASING NEW EQUIPMENT, BUILDING FACILITIES, AND EDUCATING THE PUBLIC IT SERVES. 0 0 264415 264415 FOUNDATION CONTRIBUTED FUNDS TO THE FAIRFIELD MEMORIAL HOSPITAL FOR HALF THE COST OF A DRAGER ANESTHESIA MACHINE. 200000 200000 FOUNDATION CONTRIBUTED FUNDS TO FAIRFIELD MEMORIAL HOSPITAL FOR OPERATING EXPENSES 100936 100936 FOUNDATION CONTRIBUTED FUNDS TO FAIRFIELD MEMORIAL HOSPITAL FOR ITS BUILDING PROJECT. 7430 7430 FOUNDATION CONTRIBUTED FUNDS TO FAIRFIELD MEMORIAL HOSPITAL TO REPLACE A PORTABLE TENT 7430 7430 572781 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 0 0 IL X MATT HEFLEY TREASURER 6188422902 204 SE THIRD ST FAIRFIELD IL 62837 PAUL BRUINSMA PRESIDENT 5.00 X X 0 0 0 CHRIS CONRAD VICE-PRESIDENT 5.00 X X 0 0 0 MICHELLE GARNER SECRETARY 5.00 X X 0 0 0 MATTHEW HEFLEY TREASURER 5.00 X X 0 0 0 LIBBY LINGAFELTER DIRECTOR 2.00 X 0 0 0 MORGAN DOGGETT DIRECTOR 2.00 X 0 0 0 DANA WILSON DIRECTOR 2.00 X 0 0 0 MATT RUSH DIRECTOR 2.00 X 0 0 0 MARTY VAUGHAN DIRECTOR 2.00 X 0 0 0 HENRY SIMMERS DIRECTOR 2.00 X 0 0 0 TIM SULLIVAN DIRECTOR 2.00 X 0 0 0 DOUG SKAGGS DIRECTOR 2.00 X 0 0 0 AMY GRAY EXECUTIVE DIRECTOR 5.00 35.00 X 0 85178 0 SUSAN SUDDARTH EXECUTIVE DIRECTOR 5.00 35.00 X 0 0 0 0 85178 0 0 0 0 0 0 16295 102317 118612 18002 18002 779299 635623 143676 143676 143676 3250 16295 7497 -4247 -4247 276043 0 0 157431 572781 572781 3100 3100 3491 3491 115 115 FOREIGN TAX ON INVESTME 104 104 579591 572781 6810 0 301692 55484 300000 469626 112286 771318 467770 0 0 X 771318 467770 771318 467770 771318 467770 -303548 0 X 0 1 X 0 0 X 40311 272165 67671 92771 118612 591530 40311 272165 67671 92771 118612 591530 382943 208587 11890 9190 10863 12237 18184 62364 4124 600 2400 4200 3250 14574 668468 0.31200 0.38260 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: GOLF FUNDRAISER CONDUCTED PRIMARILY BY VOLUNTEERS - 2019 AMOUNT: $ 4,124. 2020 AMOUNT: $ 600. 2021 AMOUNT: $ 2,400. 2022 AMOUNT: $ 4,200. 2023 AMOUNT: $ 3,250. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED GOLF TOURNAMENT 19545 16295 3250 2597 4900 19545 16295 3250 2597 4900 7497 -4247 0 FAIRFIELD MEMORIAL HOSPITAL ASSOCATION 303 NW 11TH STREET FAIRFIELD IL 62837 370661202 501(C)(3) 572781 0 THE FAIRFIELD MEMORIAL HOSPITAL FOUNDATION WAS ORGANIZED TO SUPPORT THE FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION, BY RAISING FUNDS TO ASSIST THE HOSPITAL IN PURCHASING NEW EQUIPMENT, BUILDING/RENOVATING FACILITIES AND EDUCATING THE PUBLIC REGARDING HEALTHCARE PROGRAMS. DURING FYE JUNE 30, 2024, THE FOUNDATION CONTRIBUTED FUNDS TOTALING $200,000 FOR HOSPITAL OPERATING EXPENSES, $100,936 TO THE HOSPITAL'S BUILDING PROJECT, $264,415 TO THE HOSPITAL FOR AN ANESTHESIA MACHINE AND $7,430 TO REPLACE A PORTABLE TENT. X 7 100937 QUOTED FMV OF SECURITY 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO ALL DIRECTORS FOR REVIEW AND INQUIRY AT A REGULAR DIRECTOR'S MEETING PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 15A THE FOUNDATION'S EXECUTIVE DIRECTOR IS A SHARED EMPLOYEE WITH THE FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION AND IS PAID ENTIRELY BY THE FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION. THE EXECUTIVE DIRECTOR'S COMPENSATION IS DETERMINED BY THE CEO OF THE FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION, UTILIZING ITS STANDARD PROCEDURES REGARDING PERFORMANCE EVALUATIONS AND CONSIDERATION OF INDUSTRY DATA. DOCUMENTATION OF COMPENSATION DECISIONS ARE MAINTAINED IN THE EMPLOYEE'S PERSONNEL FILE. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND FORM 990 AVAILABLE TO THE PUBLIC, UPON REQUEST, FROM THE EXECUTIVE DIRECTOR AT HER OFFICE LOCATED AT 303 NW 11TH ST. FAIRFIELD, IL. FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION 303 NW 11TH ST FAIRFIELD IL 62837 370661202 HOSPITAL IL 501(C)3 LINE 3 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION B 572781 AMOUNT OF CASH GRANTS FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION D 300000 AMOUNT OF CASH LOANED