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Douglas R. Browne, CDC Deputy Director & Save-A-Life Foundation corporate treasurer since 2004

Douglas R. Browne, CDC Deputy Director & Save-A-Life Foundation corporate treasurer since 2004

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Published by Gordon T. Pratt

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Published by: Gordon T. Pratt on Jul 27, 2010
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^Executive Board of Directors)*
PresidentCarol J. Spizzirri,
President and FounderSave A Life Foundation - IL
Treasurer
Douglas R. Browne,TreasurerDBMD, Centers for Disease Control& Prevention - GA
Advisory Board
Ken Alderson President, Illinois Municipal LeagueDerek L. Crawford, Regional Director of Government AffairsAltria - ILEdward Crews FF/EMT-P Vice President,Associated Fire Fighters of IllinoisJohn Donleavy, President and CEO VELCO - VTMark Friedman, MD, FACEP FACP - ILDarrell Patterson Safe Kids Coordinator - ILBob Ryan Vice President Gov’t Affairs Comcast - ILJeffrey Schwartz, DO - ILDick Stipher Retired Assistant School Superintendent - IL
SecretaryHonorable Rita Mullins, SecretaryMayor Palatine, IL, Exec. Bd,"U.S. Conference of Mayors,
Illinois Municipal League
Senior AdvisorAndrew Knapp,
Executive Board MemberVice Pres of Gov’t RelationsMagellan Health Services - D.C.
Illinois SALF Spokesperson
Emil Jones, Jr.Illinois Senate President
Medical Board Founding Members
Carol Spizzirri, R.N. President/FounderPeter Safar M.D. ScD (Dec’d) (Father of CPR)Safar Resuscitation Research Center -PAHenry Heimlich, M.D. ScD (Heimlich Maneuver)President Heimlich Institute - OH
Medical Advisory Board
Mark Mitchell, D.O.,SALF Executive Director - WIEMS Medical Director Wheaton Franciscan Health Care St.Josephs - WISteven Orebaugh, M.D., SALF Executive Director - PAAnesthesiology Director South Side HospitalErnesto A. Pretto, MD, MPH, SALF Executive Director - FLProfessor of Clinical Anesthesia Jackson Memorial Hospital -U of MiamiRobert
W.
Amler, MD Dean-School of Public Health N.Y. Medical CollegeSherlita Amler, MS FAAP, Health Commissioner, Putnam County- NY
Sponsors
^^
Abbott Laboratories * Adolph Kiefer and Assoc. * Ahlbeck & Company* Air Quality Maintenance * Alan and SourixatThavisouk * Albert Fernando Contemporary Marketing * Albrecht Enterprises * Alexian Brothers Health System, Inc.* Allstate Foundation * Altria Corporate Services, Inc. * American College of Osteopathic Emergency Physicians *Associated Fire Fighters of Illinois* Bank One * Blue Cross Blue Shield * Briskman & Briskman * Browning FerrisIndustries * Cambridge Homes * Caraher Management * Charlotte-Mecklenberg Police * Chicago Cubs* ChicagoWolves Pro Hockey * Chicagoland Speedway * Cisco Systems * City of Concord * City of Des Plaines * CLTV *ComCast * Commonwealth Edison Co. * Competition Telecom Inc. * Corporate Treats * Cremation Services Inc.*Currie Motors * Daily Herald * Dave Pate and Son’s * Degen & Rosato Construction Co. * Elkay * ESPN’s RPMTonight * Exelon - ComEd and PECO * Floran Technologies * GO ARMY Racing * Gurtz Electric * H & H Electric* Hilton Hotels World Headquarters * Household - HELP Charity Committee * IL State Rep., Lee Daniels * IrwinAndrew Porter Foundation * Italian American War Veterans #5 * Jade Gurss * Jay Howard Enterprises * John O.Brill * John Spot/Tim Lintner * Kimball Hill Homes * Kintetsu
Intl.
Travel Consultants * Kraft Racing * Krispy Kreme* Legends in Stone * Lowe’s Motor Speedway * McDonald’s Corporation * Midwest Equipment Rentals * Motorola* NEXTEL Communications * North Carolina CERT * North Carolina Citizens Corps.* North Carolina Governor’sOffice * Northwest Display Corp * OCTAGON Marketing * PACTIV Corporation * Parkway Bank and Trust * Pro Star* R. Carrozza Plumbing Co., Inc. * Racing Reflections* Red Bull Cheever Racing* Richard Petty Driving Experience* Ronald McDonald Global * Ronald McDonald House Charities Chicago/Northern Indiana * Rosemont ExpositionServices * Rosemont Suites * Ryan and Ryan * SBC Communications * Stoffel Seals Corporation * Storino, Ramello& Durkin * TCF Bank * United Airlines Foundation * Vahey Construction Co., Inc.* West Cook Municipal League *Westpoint Stevens * William A. McGinty Company
i
Save A Life Foundation Annual Report 
 
Form
990
Department
of the Treasury
Internal
Revenue Service
CHANGE
IN ACCOUNTING FhKlUL)
Return
of
Organization Exempt from Income
Tax
'
Under section 501(c), 527, or4947(aX1) of the Internal Revenue Code(except black lung benefit trust or private foundation)
The organization may have to use a copy of this return to satisfy state reporting requirements
OMBNo
1545-0047
^2003Too4
Open to PublicInspectionABFor the 2003 calendar year, or tax year beginning Jan
1
Check
if applicable
Address
change
Name
change
Initial
return
Final
return
Amended
return
Application
pending
Please
use
IRS
label
or
print
or
type.
See
specific
instructions.
C
Name of organization
Save
A
Life Foundation
-r-aew, and ending Jun 30
2004
Number
and street (or P O box if mail is not delivered to street addr) Room/suite
9950
Lawrence 300
City,
town or country
Schiller Park
State
IL
ZIP
code + 4
60176
Section 501(c)(3) organizations and 4947(a)(1) nonexemptcharitable trusts must attach a completed Schedule A(Form 990 or 990-EZ).G Web site:
|_|
527
J Organization type
r-,
r-|
(Check
Only one) » |XJ 501(c) 3
(insert no) |_J 4947(a)(1) or
K
Check here ► [J if the organization's gross receipts are normally not more than$25 000 The organization need not file a return with the IRS, but if the organizationreceived a Form 990 Package in the mail, it should file a return without financial data
Some states require a complete return.L
Gross receipts Add lines 6b, 8b, 9b, and 10b to line 12 1, 154, 755
,
2004
D
Employer
Identification
Number
36-3869459
Telephone
number
(847)
928-9683
methoS!'"
9
Qcash 0 Accrual
I 1
Other (specify)*
-
H
and 
\
are not applicable 
to
section 527 organizations 
H
(a) Is this a group return for affiliates'
H
(b) If
Yes.
1
enter number of affiliates **
H
(c) Are all affiliates
included
7
(If
'No.' attach a list See instructions)
H
(d) Is this a separate return filed by an
organization
covered by a group
ruling'
QYOS
0 No
O
Yes
Q
No|
|
yes
|Xl
No
I
Group Exemption Number
*■
M Check
*■
(J if the organization is not requiredto attach Schedule
B
(Form
990,
990-E2,
or 990-PF)
Parti
Revenue, Expenses,
and Changes in Net Assets or Fund Balances
(See
instructions)
S3
oo
CD
Q
Oil
SES
1 Contributions, gifts, grants, and similar amounts
a
Direct public support
b
Indirect public support
c
Government contributions (grants)eceived
d
Total (add lines <r
la
through lc) (cash * .
lalb
1c
87,988.
23456a
bc
78a
1
1
~)~I 
Q89 >.
x
,
x c
, 700. noncasn
1,040,000.
i
*
0.)
Program service revenue including government fees and contracts (from Part VII, line 93)Membership dues and assessmentsInterest on savings and temporary cash investmentsDividends and interest from securitiesGross rents
Less,
rental expensesNet rental income or (loss) (subtract line 6b from line 6a)Other investment income (describe
*> 
6a6b
Gross amount from sales of assets otherthan inventory
b
Less' cost or other basis and sales expenses
c
Gain or (loss) (attach schedule)
d
Net gain or (loss) (combine line 8c, columns (A) and (B))(A) Securities
o3
8b8c(B) Other
u
9 Special events and activities (attach schedule) If any amount is from
gaming,
check here
a
Gross revenue (not including $ 2 , 638 . of contributions
*
reported on line la)
b
Less, direct expenses other than fundraising expenses
c
Net income or (loss) from special events (subtract line 9b from line 9a)10
a
Gross sales of inventory, less returns and allowances
b
Less, cost of goods sold ,
c
Gross profit or (loss) from
sal*
of jnvMor^(attach schedule) (subtract line
10b
from line 10a)11 Other revenue (from pirt yiJ^lfjWM)^ - ^
12 Total revenue
(add li/efr/d, 2^T^^J4SBri.--9c,J0c, and 11)
9a
9b600.
600.
See
L-9 Stmt
10a10b
13 Program services (fr/i^/ne^14 Management and cjneri^from hffe tos^mn ($0,15 Fundraising (from/ine 44^coltimn^(p)) '16 Payments to affiliaTeV^atfJ^^fiedu^T*^^^ /«&,
17 Total expenses
(add hnes^i§jw, ccVrttnWi
Id
6c
8d
9c10c
1112
1,127,988.
27,856.
1,154,155.
H
mnlFJ»^femruSfi,
13
151,664.
14151617
21,328.7,215.180,207.
18 Excess or (deficit) for the year (subtf1^Nuje17 from line 12)19 Net assets or fund balances at beginning of^ea/(from line 73, column (A))
20
Other changes in net assets or fund balances (attach explanation)21 Net assets or fund balances at end of year (combine lines 18, 19, and 20)
18192021
973,948.
96,025
1,069,973.
BAA For Paperwork Reduction Act Notice, see the separate instructions.
TEEA010I
11/24/03
Form 99<M29e9T
20042004
1
 _ 
 
i 2004Form
990
.(30037" Save A Life Foundation
36-3869459
Page 4
Part IV-A
|
Recbnciliafion of Revenue per AuditedFinancial Statements with Revenueper Return
(See instructions.)
Part IV-B
I
Reconciliation of Expenses per AuditedFinancial Statements with Expensesper Return
a Total revenue, gains, and other supportper audited financial statements
^
b Amounts included on line a butnot on line 12, Form 990(1) Net unrealizedgains oninvestments
$
(2) Donated services and useof facilities
$
72,500.
(3) Recoveries of prioryear grants
$
(4) Other (specify)
 _ 
S e
e_Att^ache_d
$
1,100.
Add amounts on lines (1) through (4)c Line a minus line bd Amounts included on line 12,Form 990 but not on line a:(1) Investment expensesnot included on line6b, Form 990 $
(2) Other (specify)
$
Add amounts on lines (1) and (2)Total revenue per line 12, Form990 (line c plus line d)
1,227,755.
a Total expenses and losses per auditedfinancial statements
'
b Amounts included on line a but noton line 17, Form 990(1) Donated services and useof facilities
(2) Prior year adjustments reported online 20, Form 990(3) Losses reported online 20, Form 990
(4) Other (specify)'
J>§e Attached72,500.
1,100.
73,600.
1,154,155.
Add amounts on lines (1) through (4)c Line a minus line bd Amounts included on line 17,Form 990 but not on line a:(1) Investment expensesnot included on line6b,Form 990 $
(2) Other (specify).
$1,154,155.
Add amounts on lines (1) and (2)Total expenses per line 17, Form990 (line c plus line d)
253,807.73,600.
180,207,180,207,
Part V List of Officers, Directors,rustees, and Key Emi
oyees
(List each one even if not compensated, see instructions.)(A) Name and address(B) Title and average hoursper week devotedto position(C) Compensation(if
not paid,
enter -0-)
(D) Contributions toemployee benefitplans and deferredcompensation(E) Expenseaccount and otherallowances
 _C
a
r_oJ
Sp_i
i
zz_r
r i_ _ 
Chairman/Exec Dir40
20,000.
1,334.
0. _Rj
ta_
M
u_l_ljn
s_Chai rwoman
0.
 _f
e
6&y_
T.rj m b le
Vice Chairwoman
0. 0. _Nachne
_Lev
]_c_k_ 
Secretar\
0.0.-Pp.yjL § r_ 
o
.w.D?.
Treasurer
SeeJ.is^j)f_Ojtticers,Etc_ Statement0
, 0.
75 Did any officer, director, trustee, or key employee receive aggregate compensation of morethan $100,000 from your organization and all related organizations, of which more than$10,000 was provided by the related organizations
7
If 'Yes,' attach schedule
see instructions
BAA
TEEA0104 10/02/03
Q
Yes
0No
Form
990~(2003)
2004
ee

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