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/ Return of Organization

Return of Organization Exempt


Exempt From
FromIncome
IncomeTax
Tax OMB
OViB No. 1545-0047
No. 1545·0047
Form
Form 990 Under section
section 501(c)
501(c) (except black lu lung benefit trust
ng benefittru st or private
private foundation)
foundation)
of thee Internal
ofth Internal Revenue
RevenueCode Code or section
section4947(a)(l)trust
4947(a)(1) trust
Department
Departmentof
Internal
of the Treasury
Revenue ServIce
Internal Revenue Service
Note:
Note:YYruo urm;
mbeayrequired
be requred
to l.ffitoa us
(See separate Instructions.)
a:pfa ctcopy of this to
thisreturn return to statereporting
satisfysatisfy state reporting requrements
requirements Seetion
Seeinstruction
~®89
instruction
EE | E
For the
For th calendar
ecaenI daryearyear 1989
1989.. or
orfifiscal eglnnlng ..:::J
year beginning
sea lveerbeoi
year j U-.J~t I , 1989
,1989, , and
and en d'
Ing
ending /^^.u
I--(~u =?/
='1 . 19 ....
:.) .
vc>
Name
ame OTorganization
of organization A Empoyer
A Employeridentification
Identification number
number((see instruction$)S)
seeinstruction
Use IRS
UseIRS
label. -1lJiWc../".~ n.s."...,7"_'~ ,£i;~...Ji);~~ON ;:..Je. . *£3\ 7302/6/
...?.$: 7..303/0/
~bel.
ther.
Other­ "Address (number and street)crorP.o.
dress(numberandstreet) PO.box
boxnumber
number B
B State registrationnumber(seeinstruction
registrationnumber (see instruction E)
E)
wise.
wise.
please
please "':;.~(,.,7 .')/(:!.7Z>2.l.fA.eK4)Af_..:$UI'J'l.:r _' .//,
print
print City
City or town.state.andZIPoode
town. state. and ZP code I
or
or type.
type. .C If applicationfor
application for exemption
exemption is
is pending,
pending,ccheck
heck
C!/N--!. ;? /tP/c ■*ji£S*06
~.:;l()6 here ► . .'.
here s- . ■ . . . . . . . . 0 D
D Checktype
D Check typeof organization-Exempt under section ~► 3
oforganization-Exemptundersection 501(c)(:3
13501(c) ( 3 ))(insert
(insertnumber). Accounting method:BI
number), EE Accountingmethod: Cash D
E l Cash □ Accrual
Accrual
OR ►0
CR .... D section
section4947(a)(1) trust (see instruction C7 and question
4947(a}(1) trust(seeinstructionC7andquestion 92.)
92.1 D Other (specify) ►
Other(specifv)...
F Isthis
Is thisaagroupreturn(seeinstructionQ)
group return (see instructionQ)filed foraffiliates?
filedfor affiliates? Dyes I8I\b
DYes ETNo G If either answer in F is Yes" enterfour·digitgroup
G IfeitheranswerinFisYes" enter four-digit group
"Yes." enterthe
If 'Yes." enter the numberof
number of affiliatesforwhichthis
affiliates for which thisreturnis
return isfiled
filed .dJ~
AJ/& exemption number
exemptionnumber (GEN)
(GEN)" ►
Jsthis a separate
Isthis separatereturnfiledOf
return filed byagroupaffiliate?
a group affiliate?. o
QYES
Yes~ ElI\b
No
H Check here0
H Checkhere D ifif ~r
vourgross
grossreceiots
receotsare
arenormally
normallynotmorethan
not more than$25.000
$25.000(seeinstruction
(see instruction9111.
811).Yru
Y ou do not
do not havehave to file
to file a completed
a completed return with
returnwith IRS: IRS: but if you
but ifVOU
received aaForm
received Form990
990Package
Package nth;mail.
nth; mail.
'y{lUyou should
should fileafilereturnwithout
a return wthout financial
financial data (see instruction
daIa (seeinstruction A. Some
A) Serre states requireacompleted
statesrequirea completed return.return.
Note: Forrn990EZis
Note: Form990EZ isavailable
available fororganizations
for organizations withreceiots
with gross gross receipts less thanand
less than $100.000 $100.000 andless
total assets total
thanassets less than
$250.000at .250.000at
end of vear. end of vear.
501(c)(3) organizations 4947(a)(1) trusts
organizations and 4947(a)(1) trusts must
must also complete
complete and attach
attach Schedule
Schedule A(Form
A (Form 990).
990). (See instructions.)
instructions.)

'Wi'l Statement Revenue, Expenses


Statement of Revenue, Expenses and Changes
Changes in
inNNet
et Assets
Assets 0orr Fund Balances
Balanc

1 Contributions, gifts, grants, and similar amounts received:


Contributions, received
a publicsupport .
Direct publicsupport
b Indirect public support . . . . . . . . . . ..
Indirect
cc Govetnment grants*
GoveUlmentgrants .
d
d Total (add
Total (add lines
lines Il a
a through
through Ic)
lc) (attach
(attach schedule-see
schedule-see instructions)
instructions) .
2 revenue (from Part VII, line 93) . .
Program service revenue(from
3
3 Membership dues and assessments
Membershipdues assessments . . . . . •
4 savings and temporary
Interest on savingsand temporary cash
cash investments
investments .
5 Dividends and interest from securities.
securities
6a Grossrents . . . .
b Less: rental
rental expenses.
expenses . . . . .
c income (loss) . . . • .
Net rental income(loss)
7 Other investment income (describe ► ...
8a Gross amount
amount fromfrom sale of assets other I--t----..---t-......,.-----,r---
th an inventory . . . . . . . . . ~7_t.QoC.l~~O:::-f--I-=:~--- ......
than I--
b Less:cost
Less: cost or other basisandsalesexpenses
basis and sales expenses !-==-+~.:....;:::.;.~f--I....:.;~----I--
c Gain (loss) (attach
(attach schedule) . . . . .. . L..:=-..t.~"-K.....L.l:!:.L...L_......L.=...L.... _,__

9
9 Special fundraising eventsand
fundraising events and activities (attach schedule-see instructions):
schedule-see instructions):
a Grossrevenue(not
Gross revenue (not including $$ _
of contributions reported on line Ia) la)
b Less:direct
Less: direct expenses.
expenses . . . .
c Net income(line 9a less line
income (line9aless 9b) .
line9b)
lOa Grosssales less
10a Gross sales less returns and allowances .
b Less: cost ofof goods sold . . . . .
c Gross profit (toss)(attach
(toss) (attach schedule) .
11
11 Other revenue (from Partvil, line 103
m PartVlI,line 103)
12 Total revenue (add lines ld. 2,3,4,5,6c, 7,8d. 9c, 10c, and 11)
linesld.
13 Program services (from line
Programservices(from line44,column(B))(see instructions). ,
44, column (6») (see instructions).
::
lit 14 Management andgeneral (from line
Managementandgeneral(from 44, column(C»(seeinstructions)
line44, column(C))(see instructions)
c:
GJ 15 Fundraising (from line 44,
Fundraising(from 44, column (D))
(D)) (see instructions) .
! 16 Payments to affiliates (attach schedule-see
schedule-see instructions) .
17 Total expenses (add lines 16 and 44, column (A)).
18 Excess
lit (deficit) fortheyear(subtract
Excess(deficit) for the year (subtract line 17 from
from line 12) .
-; 'it 19 Net assets or fund balances at beginning of year (from line 74, column
balancesat (A))
column(A))
z.:2 20 Other changes in net assetsassets or fund balances
balances(attach
(attach <>vn"",n,::>TI
explanation)
21 Net assetsorfund
21 assets or fund balancesat
balances at end of year (add lines18
lines 18,19,and 20).
For
For Paperwork Reduction Act Notice, see page 1 of the Instructions.
ReductionAct Notice. seepage 1 of the Instructions. Form 990
Form 9 9 0 (1989)
(1989)
ft)
1ihl
form90(l989)
j'''ri9''I5:atement
Statement of
Functional
Functional Expenses
Expenses
Do not include amounts reported on line
AI Toosnu;!
501(c)(3) and
501{c) and (c){4)
complete "''''mAl
All organizations must 00)1lieIe
(cX4)organizationsand
organizations and44947(a)(1)
(A)ToUI
(B), (el'
Columns (8).
column (A). Cd.Jrrs (C), Old(D)..,
butOPlonalfor
trustsbut
7{a)(1) trusts optionalfor others. ee
others.(
r'i~ ~ ..~,
and (D) are required for section^ "-
(See instructions.)
instructions.)
IIII;
6b. 8b, 9b, 10b, or 16 of Part I.
22 Grants and allocations (attach schedule).
Grantsandallocations(attach schedule).
23 Specificassistance
Specificassistanceto to individuals.
individuals • .
24 Benefits paid to or for members. . . .
Benefitspaidto
25 Compensation
Compensationof of officers,
officers, directors, etc..
etc.
26 Other salariesand
salaries and wages.
wages ,.
27 Pension plan contributions
Pensionplan contributions .
28
28 Other employeebenefits
Other employee benefits.•
29
29 Payroll taxes.
Payroll taxes . . . .
30
30 Professional fundraising fees
Professionalfundraisingfees
31
31 Accounting fees
Accountingfees.
32
32 Legal fees • . . . . .
33
33 Supplies
Supplies. . . . . . . /*** j£&_ /<//£
34
34 Telephone rr 4/77.';"'~.$
Telephone &rzj~er9fi$ ##0/ &<?<?/
3 35
35 Postage and shipping
Postageandshipping. . . ??></7 ^3?7
c
36
36 Occupancy
Occupancy. . . . . . S *>A0 / c&£>
a 37 ;5<x>
37 Equipment rentaland maintenance
Equipmentrentaland maintenance . . g^n 2*3-
38
38 Printing and publications . . .
39
39 Travel
Travel. • . . • . . . . . 7 ^ / 3&LL
40
40 Conferences, conventions, and meetings
Conferences,conventions,and meetings . . . &a> <***>
41
41 Interest
Interest. • . • . • . . . . .
42
42 Depreciation, depletion, etc. (attach schedule).
Depreciation,depletion, schedule) .
43
43 Other expenses
expenses (itembe): a~.~J!m!lj~
ajSa/SfefcT.^AC^SWii.
b _~~ __••• __••••• _••••••••••••••••••••• _•••
e X6..'1H~"'[',s.. T¢.X'!l~l~ .V!':!! y !!tl'iT.I. O'Jo!
d ~JV~J~~~~_~~_ __._ _..
e ~CM:t:.".&Ir'H.(f.!lCfS.,:r~~!eF.~ ...
f ~~~ •••_•••••••••••••• __••••• _••••• _._.
44 Total functional expenses lines22 through 43)
columns these totals to lines13-15.

Describe wha
Describe VItf1a: was achieved in carryingout
wasachievedin carrying outyour
yourexemptpurposes.Fully
exempt purposes. Fullydesaibe
describethe
theservicesprovided;the
services provided; thenumber
numberof
of Expenses
persons benefited: or other
personsbenefited:or other relevant information for each
relevantinformation program title. Section
eachprogramtitle. 501(c)(3) and (4)
Section501(cX3) (4) organizations
organizationsmust RnuintftersKtieo
501<cX3) ind (4) crpna*.
also enter the amountof
alsoenterthe amount of grants to others.
grantsto others. tw-nt oplioml te ottun

a :nt~M~f..._~~~_';Z __~__:{~<.t
.Lev„ iJ*lt»S».>jRf?.wjr—, i r f 4 f .....y.tfV<?.S..
~.&/!_~n d.R.~
yK. sr&h. ...Zt?-.~t!??(P.?r..
*£&£2!£jZv?&?r. _ _~
- .^g**rv .•........•....
. . _ . . . . . . . . . . . . .__
..
!fr.~Clr;_/.:'~~/.;$/!e
^&Z?G.Jz£A&&jss..r>.A.i$. ,(_~./'~~.~i't'~_.JB7'.~'~.o:-!~ •.r.N..!'Z7~ •••••.•....•.•
S.'i'.4.TZ&Z??&. &p ./fe*#&.&i.?k>£7?.ZigZ.
lP.l:lP.~N ••~~~~~6:\ •.I.N..~.{/F.._~~...Y.~~.M'~~~ff.~tt.r.-r.~JC-=lK~~_'.
J:4MJut~!:I.~n#2u •.qt:.1d{:{. M""'l'k(),;;.••~.tfHc ••4.e. Y_'77,,~=
&&/IL. . (Grants and allocations I ) 75,197
b • RA!-?'!n:.l1.nt2t?#.t7A;.~ .. ~.??7'€-1!!:L-!... ..fe.~
«-cf.#£.J:-'t:.f':~~-;':'~?! ..
•~b.4.~~.~(C~.~~~.A.f: ••tJ!~ •• ~~.r.£~~~
"e._-,=-·v~"-.,,.--
'. ..
.7;)...t-S.~ __A(i7.&e?l8#iP'.~M._ /#f;.4(€#..€~~k:~,;;. ~~~~'
.K~de:.-,:, •.&'..9~.Ir ••••:?M.,LP!lI2_.Z:Z:.~/.~.,]!;JC
jfezuas/Ue:.„.49j&su.*r.
~~ , (rants* and allocation's" I 1 n.QQO
c .•• _•••••....•• _..••..••••..••••••••• _••_._.• _•••.•••••••..••••••••.••••• _••••••• _••.• _._•••.•• _.••••••
......_-- ...--------- ....-----_._---_._---------------._.----- ..----.-_._-_._----_.- .._-_.--- ...----_.-
--_.---------------------------------------------._-----_.---_ ..--_._------_.---_ _---_ _-----
.....----- - - - - ---....................... ... ·anifinoCiikins .
d ._ •••••••••• _•• _••• _•• _••••••••••••••• _••••••••••••••••••• __•• _•••••••••••• _•• _••••••••••••••••••••••• _
--------------------------------_._--------------------------_._--._ ..._--_._---_._._-------._--------.
--------------------------------------------------.-----------.------------------_ ..._-------_._-------
(Grants and allocations $'
e schedule). (Grants l
1 Total (add lines a through el (should column (B)). 2./1? /
Page 3
Page 3
f
«8»S
BalanceSheots
(A)
(A) (8)
(8)
E ^ ^ S i - s ^ f e ^ j ^ ^ j j ^ j e ^ f t i t e f and amounts <ntfiedescription column should Beginning
Beginning of
of year
year End of
End of year
year
.fUrJuhoimtsdnly-
¥.-■'':
Assets
45
"45 ^h^-npninterest-bearing . . . . ''itg-P'*
' 4 6 . ^Whgsandterhporary cash investments m.&i 46 /74./.4L,

~~~'~lS,~,!Vible. . . . . . .
4 7 « Accounts receivable 47a
47b 47c
LiSlS: :,alla,walnee·'for
.';T'"b Iftf*: doubtful accounts
allowance for doubtful accounts .
48a
48a ·,PledgeSreceivable
Pledges receivable . . . . . . .
b. 'Less::
Less: .allowance doubtful accounts
allowance for doubtful accounts . . . . 48b 48c
49 . Grants
Grants receivable
receivable. . . . . . . . . . . . . . . . .
Receivab1es due from offl'cers,directors,
50 Receivables due from officers, directors, trustees, and keytrustees, and key employees (attach
employees(attach
schedule)
schedule) . . . . . . . . . . . . ., . .50 ,
Other notesand loansreceivable(attach schedule)
51a Other notes and loans receivable (attach schedule) . I 51a[
51a . j-:5:;1~a:..j- --I-_-I
I
Less: allowance
bb Less: allowancefor for doubtful accounts
accounts . I 51b| I 5lc
Inventoriesfor
52 Inventories
52 saleor
for sale or use
use . . . . . .
53 Prepaid expensesand
53 Prepaid expenses and deferred deferredcharges
charges .. . .
54 Investments-securities (attach
54 Investments-securities (attach schedule) schedule) . .
Investments-land, buildings,
55a Investments-land,
55a buildings, and and equipment:
equipment:
basis. . . . . . . . . . . . . . .
basis 55a
bb Less:
Less: accumulated
accumulated depreciation
depreciation (attach (attach
schedule) . • . . . • . . . .
schedule)
56 Investments-other (attach
56 Investments—other schedule). . . . . .•
(attach schedule)
Land. buildings. and equipment:
57a Land, buildings, and equipment: basis basis . . . . .. .. 57a y.^^A
b Less: accumulated depreciation (attach
accumulated depreciation (attach schedule) schedule) . 57b / 3 » »
L.=..::...::J_~~::..L::::""'..L.._+- ~4_-+=~+-
JL 57c __ -o
-="'::::""_-+- __
58 f»h»r assets ~ _-.....:a.c~
Other assets/Hpcrrihofc. ....o.=.=-:..:..:.:;:.'-'-
S g ^ e i f i i ~&g7fas,- _
;o
59 Total assets (add lines 45 through 58) ■ /14.4O4 <Z/?<fr75'
Uablllties
Liabilities
60 Accounts
60 Accountspayable
payableand accruedexpenses
and accrued expenses . . . .
661 Grantspayable
1 Grants payable .• • . . . . • . . . . .
62 Supportandrevenuedesignated
62 Supportand'revenue designatedfor future periods
for future periods(attach schedule) , . .
(attach schedule)
63 Loans
63 Loansfrom officers,directors,
from officers, directors. trustees, andand key
key employees
employees(attach schedule)
(attach schedule)
64 Mortgages
64 Mortgages and and other
other notes
notes payable
payable (attach
(attach schedule)
schedule) . '
65
65 Other
Other liabilities
liabilities (describe ►... )) I-----+--f-=+---~:-I--
66 Total
66 Total liabilities (add lines 60 through 65)
Fund Balan~ or
Fund Balances or Net
Net Assets
Assets
OrganlzatJons that
Organizations th atuse
use fund
fund accounting,
accounting. check
check here
here ►... !!Sf0 and
andcomplete
completelines
lines
67 through
67 through 70 70 and
and tines
lines 74
74 and
and 75.
75.
67a Current
67a Currentunrestricted
unrestrictedfund fund . . . .
bb Current
Current restricted
restricted fund
fund. . . . .
Land,buildings,
68 Land,
68 buildings,and equipmentfund
and equipment fund
69 Endowment
69 Endowmentfund. fund . . . . . .
70 Other
70 Otherfunds(describe
funds (described.. _
Organlzatlonsthat
Organizations that do not use
donot use fund
fund accountln
accounting, •• check
checkhere
here^D ... 0 and
and complete
complete
lines71
lines through 75.
71 through 75.
Capitalstuck
71 Capital
71 stuckor ortrust principal. . . . .
trust principal
72
72 Paid-in
Pald·ln or
orcapital
capital surplus
surplus . . . . . .
73
73 Retained
Retained earnings
earnings or oraccumulated
accumulated income
income.
74
74 Total
Total fund
fund balances
balances or ornet
netassets
assets(see
(seeinstructions)
instructions) .
75 Total liabilities and fund balances/net assets assets (see instructions) . . .
5°-
'11
Form 990(1989)
List of Officers, Directors, and Trustees (List each one even if not compensated. See instructions.)
(B) Title and average (C) Compensation (0) Contnbutions (E) Expense
(A) Name and address hours per week (it not paid, to employee account and other
devoted to position enterteto) benefit plans allowances

. £>£.<f . j9f7K/r«£i .vS..tKOUK«= .


-- 6-
<5-
-o- -c'

Other Information

76 Did youengagein
Didyou engage inany anyactivity
activitynotnotpreviouslyreportedto
previously reported tothe theInternal
Internal Revenue Service? . .
RevenueService?
If" Yes,"
If' Yes," attach aadetaileddescriptionof
detailed description ofeachactivity.
each activity.
77 Were
Wereany any changesmadein
changes made inthe theorganizingor
organizing orgoverningdocuments,but
governing documents, but notnot reported IRS?
reportedto to IRS? .
If
If' "Yes,"
Yes," attach aaconformedcopyof
conformed copy ofthe thechanges.
changes.
78a
78a Did
Didyouryourorganizationhaveunrelatedbusinessgrossincomeof
organization have unrelated business gross income $1,000 of $ 1,000 or more during the
or moreduringthe year covered by return?
yearcoveredbythis this return?
b If
If' "Yes," have youfifiled
Yes," haveyou a taxreturn
fed atax returnononFormForm 990-T,
990· Exempt Organization
T, ExemptOrganization Business Income Tax Return,thisyear?
BusinessIncomeTall.Return,for for this year?
*I/JI
c At anytime
any time duringtheyear,
during the year,didyou did you CWlown a 50%greaterinterestinataxablecorporationor
a 50%or or greater interest in a taxable corporation or partnership?
partnership? . . . .
If Yes,"
Yes" completePartIX.
complete PartIX.
79 W
\J\Ji£asthere
thereaaliquidation,
liquidation,dissolution.termination,
dissolution. termination, oror substantial contraction
substantialcontraction during
during thethe year? (See
year?(See instructions.)
instructions.) . . .
If 'Yes,"
"Yes," attach a statement as described,
attach a statementas describeq inthe instructions. in the instructions.
80a
80a A
Pre reyou
yourelated(other
related (otherthan thanbybyassociation
association with
with a statewide or
a statewideor nationwide organization)
nationwideorganization) through
through common
common membership,
membership,
governing
govemingbodies, bodies,trustees,officers.etc••to
trustees, officers, etc., toanyany other
other exempt or
exemptor nonexempt
nonexempt organization?(See
organization?(See instructions.) . . . . .. .
instructions.).
b
b If"Yes."
If 'Yes." enter ent.he the name
nameof ofthetheorganization
organization_ •••••••••••••• _•••• _•••• _._•••• _•••••••••••••••••••••••••••
"" •••• "". ,,'_ •• _•• _••••••••• _••••••••••••••••• check whetherititisis 0
_ and checkwhether Q exerrlp~OR
exempt OR D'nonexempt.
81 a
81a Enter amount
amount of political
political expenditures.direct
expenditures. director orindirect,
indirect,as asdescribedinthe
described in theinstructions.
instructions. 1..:'
L§lsJ—A'//* __
=:..L-~~;'_

b Did you file


Didyou file Form
Form1120-POL,U.s.
1120-POL,U.S IncomeTax Income TaxReturn ReturnforforCertain
CertainPolitical
Political Organizations,
Orpnlzations. forfor
thisthis year?
year?
82a
82a Did youyou receive
receive donatedservicesor
donated services orthe theuseuseofofmaterials,
materials,equipment,
equipment,ororfacilities
facilitiesatatnonocharge
chargeororatatsubstantially
substantially
less
lessthan than fair
fair rental
rentalvalue?
value? • . • • . . • . • • • . . . • . • . • • • • 82a
b If 'Yes,"
"Yes" you may indicate the value of these items here. Do not include this amount as
revenueiin
revenue n Part
Partlorlor asasan anexpenseinPart
expense in Partll.SeeII. See instructions
instructionsfor forreportingi
reportingninPartlll.
P a r t l l l•. . . . 1 8 2 b I /J/A
83a
83a anyonerequestto
Did anyone request toseeeitheryour
see either yourannual annualreturn
returnororexemptionapplication(or
exemption application(orboth)? both)? •
b If Yes,"
Yes" did you youcomply
complyas asdescribedin
described inthe thelnstructlonsasee
instructions?(SeeGeneralInstruction
General Instruction L.)L.)•
84a Did youyousolicit
solicitany anycontributions
contributionsororgifts giftsthat
thatwere
werenottax
not taxdeductible?
deductible? • • • • • •
b IIffYes,"
Yes" did didyouyouinclude
includewithwitheverysolicitation
every solicitationananexpressstatement
express statement thatsuch
that such contributions
contributions oror gifts
gifts were
were notnottaxtax
deductible?(SeeGenerallnstruction
deductible?(See General InstructionN.) N) • • • . • • • . • • . • • • . • . • • . . • • •
85a
85a Section 501(c)(5) or (6) (6) organizations.—Did
otpnizations.-Oid you you spend any any
spend amounts
amounts in attempts
in attempts to influence
to influence public opinion
public opinion
aboutlegislativematters
about legislativemattersor or referendums?(Seeinstructions
referendums?(See instructions and Regulations section1.16
andRegulationssection 116220(c).),
b IfYes,"
If 'Yes," enter the total total amount spent for for this
this purpose.
purpose . 185b I *#*.
86 Section 50J(c)(7)
501(c)(7)organizations.
organizations.-Enter:
-Enter:
a Initiation fees
Initiation fees andandcapital
capitalcontributionsincluded
contributions includedonon line
line 12.12.•
b Gross receipts, included
Grossreceipts, includedon onlineline12,
12,for
forp.ublicuse
public use ofof club
club facilities
facilities (See instructions.)•
(Seeinstructions.)
c Does
Does the club's governing instrument or any written written policy statement provide for discrimination against any any
person because of race. color, or religion?(See
personbecauseof race.color, or religion?(Seeinstructions.) . instructions.)
87 Section501(c)(12) organizations.—Enter
Section50J(c)(l2)olpnizations.-Enter amount amount
of: of:
a Grossincome
Gross incomereceived receivedfrom frommembersor
members orshareholders.
shareholders . .
b Grossincome
Gross income receivedfromreceived fromother othersources(Do
sources (Donot notnetnetamounts
amountsdue dueoror paidpaidto to
other
othersources
sources
againstamounts
against amounts due dueor orreceivedfrom
received fromthem.). them.) • . . . • . . . . . • • , . . L:.:~--"'~~---:
.
88 Publicinterest
Public in te res tlawlaw//r/ns Attachinformationdescribedi
firms.-Attac:h info rmat io n d escribednthe instructions.
in the instructions.
89 Ustthestates
List the stateswith withwhich
whicha a copy
copy ofthis return
of this retuisrnfiled
is filed~ ••••
► ~~_.{$&/>. _••• _••••• __._. __ .-,_ ••• __••• _••
90 Duringthis
During thistaxtaxyeardidyoumaintain
year did you maintain part
anyany of youraceountinB/tax
part of your accounting/tax recordson
recordsacomputerized
on a computerized system?system? • . • • •
91
91 The booksare
books areinincare careofof_ A'c!VNt..~.~'7i'~~~~M
M&MUs&.JZJWT&tt.i.AH.&A, ..~ .lephone no. ►.s[:t:-.~:r;.=~"'A-n.u......
Telephoneno." j . ..9:Sy.r<5?ft^w n
Locatedat
Located at ._ e,.,Ha~1(d77.,.lPd/.t;}
£//S&6*<4£&72.+&?/,<&. ••••_.,•••,•••__•.
, .... .,_"
. . . . . .0'
.. ••••••••• _., •••••••• _- ••••. . . .__
. .••••
. . . _.
. . __•••••• --
92 Section
Section 4947(aXl)trusts
4947(aX1) trustsfilingfiling
FormFom 99Qjrfijffip&urt)£M ^
99QWrl~PWDf..J.fJJ.PI J comeJ come Tax Return.—.-*-.
Tax Retum.-.· Check
. . here ...
-. • • . • Checkhere ►D--
and enterthe
enter the amountoftax-exemptintereslrecelveiiofecsrU8
amount of tax-exempt interestreceiveooraccruli nn th th , ,,t» 192192 ,.{I""
) ///.- I
:•'.£** «jr«0 Jr«tf ^ A eetafk) 9 ? t t
feas/ / Page 5
I sSj I* YJ-tmOlf Analysis of Income-Producing Activities
£nt8rgross amounts unlessotherwise
£nt.rgross unless otherwise indicated. Unrelated business income Excluded by section 512,513. or 514

§):? servicerevenue:
93 program service revenue: (a) (b) (c) (d> Relate Je)
or exe!lll1:
Related (J" exempt
Business code Amount Exclusion code Amount function.ncome
function income

~)--------------------------
(»)
(b)
(b)
_

-------------_
(c)
(~)
(d)
(«J)
(e)
(f) _
-+ +- ~--------r_------_+---------
(0
(g) Fees from government
(g) Feesfrom government agencies
agencies • . . . . . f----+------+-----+-------t-----
94
94 Membershipdues
Membershipduesand and assessments.
assessments . . . . . I----+------+-----+-------if---:---
95 Interest
Interest on cash investments . t----+------+-----+--------ir--~-.r-~:::-..
savings and temporary cashinvestments
onsavingsandtemporary
96 Dividends
Dividendsandand interest on securities.
securities . .
97 Net rental
rental income (loss)
(loss) from
from real estate:
(a) debt-financed property.
(~) property . . . .
(b) not debt-financed property.
property . . .
98 Net rental
rental income (loss)
(loss) from
from personalproperty
personal property . .
99 Otherinvestmentincome
Other investment income . . . . . . .
100 Gain
100 Gain(loss)from sales ofassets
(loss) fromsalesof assetsotherthan
other thaninventory
inventory *L/>-/?>
101
1 0 1 Net income from special fundraising events
events . . .
102 Gross
102 profit (loss)
Grossprofit (loss) from sales of inventory . . . .
103 Other revenue:
103 Other revenue: (a)
(a) _
(b) _

(~)
(d) ------------_
(e) _
(e)
104
104 Si SL (add columns (b), (d). and(e».
(b),Cd). and (e)) . . /■3 &r
105 TOTAL (add line 104,
105 TOTAL(add 104, columns
columns (b),
(b) Cd),
(d), and
and (e))
(e)) ...................
(line 105 plus line ld.
(Line PartI,I should equalthe
Id, Part equal the amount on on iind 12, Part
iind 12 Part I.)
1:r.Ti.'JlI Relationship of
Relationship Activities to the
of Activities the Accomplishment
Accomplishment of of Exempt
Exempt Purposes
Purposes
UneNo.
Line No. Explain below how each activity for which income is re~ortedi
Explainbelow reported in column
n colu VII contributedi
mn (e) of Part VII contributed importantly to the
mportantlyto
• accomplishment of your exempt
accomplishmentofyour exempt purposes (other than byy providing
purposes(other funds for such purposes).
providingfunds

,JI A
r ! I

Name,address.
N a m e , a d d r e sandeQ1)loyeridentification
s . a n d employer identification Percentage
Percentage of
of Nature o
Natureof Total
Total End-of-year
nurmer of corporation
number corporationo(J"r partnership
partnership CWlershipinterest
ownership interest businessaeiivities
business activities inrome
in come assets

-/Hr-

I
Under penaltii declarejhaf I nave examined this return, including accompanying schedulesand statements. andtothe best of my knowledge and
Please
Please belief, it is tr e. r/ej^rationgj^pnlpa'er (other than officer) IS based on all information of which preparer has any knowledge.
Sign
Here *' bafe' f Title
Oate
Preparer's Check if
Paid
Preparer's
signature
Finn's name (or
222a! 4 g t A . » ^
* &
?!(*/*>
ZIP code
sell-employed* L I

Use Only yours it sell-employed)


and address
•U.S. Gov*rns*nt
.U.$. Gover frlntlnt Offlcti
...... tTln.ln~ HJ0-26J-ISUO006C
orrl.OI 1990-261-UII0006~
-. \ti\\_
, \,,~
SCHEDULEA
SCHEDULE A Organization Exempt
Organization Exempt Under SO 1(c)(3)
501(c)(3) OMBNO.l54~
990)
(Form 990) (Except prfvate
Private Foundation),
Foundation), 501(e),
501(e). 501(f), 501(k), or Section 4947(a)(1)
501(f). 501(k). 4947(a)(1) Trust
Department
Department ofof the
Internal Revenue
Internal
Treasury
the Treasury
RevenueServ'ce
Service
Supplementary Information
Attach to Form990
Information
Form 990 (oror Form990
Form990EZ).
i1@89 ~
Name
Name Employer Identification
, Employer Identlfteatlon number
number

Compensation of t h ee Five Highest


Compensation ofth Highest Paid Employees Other Other Than Officers.
Officers. Directors,
Directors, and Trustees
andTrustees
(See specific
specific Instructions.)
instructions.) (list eachone.
(List each arenone,enter'None.")
one. Ifthere are none, enter 'None.")
(b) Titleand average
(b)Titleand (d) Contributions
Contnbutions to
to (a) Expense account
account
(a) Name and address
(a) Name address of
of emDloyees
employees Daid
paid mOte
more than
than$30.000
$30,000 hours per week
hours per week (c) Compensation
(e) Compensation employee
employee and other
and other
devoted to
devoted to posItion
position benefit plans
benefit lans allowances
allowal\C:6

.......-- ...---.-------- .._----- ..------------.


------ ..._-_ ..... ---- ..-_. __ ._ .._-- ....--- ...--

Total number
number of other employees paid over
other employees over
$30,000.
$30,000 . ►...
.. iI61IM Compensation
Compensation of tthh ee Five Highest
Highest Paid
Paid Persons
Persons for Professional Services
Professional Services
(See specific
specific instructions.)
instructions.) (List
(List each one. If there arenone,enter'None.')
eachone.Ifthere are none, enter 'None.")
(a) Name and
Cal Name and address
address of
of persons
persons paid
paid more
morethan
than$30,000
$30,000 (b) Type 01
of service
service
(b) Type (c:) Compensation

-----_.------- ....-----_ .._---------------------_ ..--- .._-------_._-----

--••-------
••------------
••••••
---••••• ••• •• • ._••a.

^w^mi»"
Total number of others receiving over $30,000 for
professional services ►

Statements About Activities

1 hav'e you attempted to influence national, state, or local regislation,including


, During the year. hav'eyou legislation, including any attempt to to
influence public
public opinionon legislativematter
opinion on a legislative matter or referendum?
referendum? . . • . . . . . . . . • . . • • •
If "Yes,"
''Yes,'' enterthetotal expensespaidor
enter the total expenses paid or incurred
incurred in
in connectionwith
connection withthethe legislativeactivities.
legislative activities. $$ _
Complete Part VI of this form for organizations
CompletePart madean
organizations that made electionunder
an election sectionSOl(h)
under section other
501(h) on Form 5768 or other
statement. For
statement. other organizations
For other organizations checking'
checking "Yes," statement giving a detaileddescriptionof
Yes," attach a statementgivinga detailed description ofthe
thelegislative
legislative
activities and a classified
activitiesand schedule of the expenses
classifiedscheduleofthe expensespaidpaid or incurred.
orincurred.
During the year, haveyou,
2 Duringthe have you, either directly
directly or indirectly.
indirectly, engagedin
engaged in any of the followingacts
following acts with a trustee, director,
director,
principal officer, or creator
principalofficer, creator of your organization,or
organization, or anytaxableorganizationor
any taxable organization or corporation
corporationwithwith which such person
whichsuch personis is
affiliated as an officer,
officer, director,trustee,
director, trustee, majority owner,orprincipalbeneficiary:
owner, or principal beneficiary:
a Sale,exchange,or
Sale, exchange, or leasingof
leasing of property?
property?. . . •
b Lendingof
Lending of moneyor
money or other extensionof
extension of credit?
credit? . . . . . . . . . .
ec Furnishingofgoods,
Furnishing of goods, services.or
services, or facilities? . • • . . . . . . . . . , . . .
Payment of compensation(or
d Paymentof compensation (or paymentor
payment or reimbursementof
reimbursement of expensesif
expenses if morethan
more than $l,OOO)?•
$1,000)?
e Transfer of any part of your incomeor
income or assets?
assets? • • . . . . . . . • . . . • . .
If the answer
answerto questionis
to any question "Yes." attach a detailedstatementexplainingthe
is "Yes," detailed statement explaining the transactions.
transactions.
3 Doyou
Do you makegrants
make grants for scholarships.fellowships,
scholarships, fellowships, student
student loans,etc.?
loans, etc.? . . . . • . • •
4 Attacha
Attach a statement
statement explaininghowyoudeterminethat
explaining how you determine thatindividualsor
individuals ororganizations
organizationsreceivingdisbursementsfrom
receiving disbursements fromyou you
in furtherance of your charitable programs ms qualify to
to receive
receive payments. (See specific instructions.)
For Paperwork Reduction Act Notice, seepage 1 of the Instructions to Form 990 (or Form990EZ). Schedule A (Form 990) 1989

........ ~,.......... ~
Page 2

'.:mlnizatlcln not a private


:ion is not private foundation
foundation because it is (please check
check only ONE applicable
applicable box):
Q *1 A church,
church, convention
convention of churches,
churches, or association
association of churches.
churches. Section
Section 170(b)(1)(A)(i).
170(b)(l)(A)(i).
5
6

8
s□ 2
2 Ascheel.
3
3A
4
Aschool. Section
Ahospital
4 A Federal,
Section 170(bXl)(A)(ii).

Federal, state,
170(bXl)(A)(ii). (Also complete
hospital or a cooperative
cooperative hospital
state, or local
local government
complete PartV,
hospital service
Part V, page3.)
service organization.
page 3.)
organization. Section
government or governmental
governmental unit.
Section 170(b)(lXA)(iii).
unit. Section
170(b)(lKA)(iii).
Section 170(b)(lXAXv).
170(b)(l)(AXv).
9 □ 5
5 A medical
medical research
research organization
of hospital
of hospltal~►
organization operated
operated in
in conjunction
conjunction with
with a hospital.
hospital. Section
,
Section 170(b)(lXA)(iii).
170(b)(lXA)(iii). Enter
Enter name,
,
name, city,
city, and
and state
state
.
10 a
0 6
6 An organization
organization operated
operated for the
170(bXl)(A)(iv). (Also complete
170(b)(1)(A)(iv).
the benefit
benefit of a college
complete Support
college or university
Support Schedule.)
Schedule.)
university owned or operated
operated by a governmental
governmental unit. Section
Section

1 ESI 77 An
~ An organization
organization that
that normally
normally receives
receives a substantial
substantial part of its support
support from
from a governmental
governmental unit or from
from the
the general
general public.
Section 170(b)(1)(AXvi).
Section 170(b)(l)(AXvi). (Also complete
complete Support
Support Schedule.)
Schedule.)
12 a
0 8 An organization that normally receives: (a) no morethan of its support from gross investment income and unrelated business
An organization that normally receives: (a) no more than V}
l/;! of its support from gross investment income and unrelated business
taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975, and (b) more than If3
taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975, and (b) more than Vi
support from
of its support from contributions.
contributions. membership
membership fees. and gross receipts from from activities
activities related
related to its charitable,
charitable, etc..
etc..
functions-subject to certain
functions-subjectto certain exceptions.
exceptions. See section
section 509(a)(2).
509(a)(2). ((Also
Also complete
complete Support Schedule.)
Support Schedule.)
13 a
D 9
9 An organization
organization that
described
that is not controlled
controlled by any disqualified
(1) boxes 5 through
described in: (1) through 12
disqualified persons (other
12 above; or (2)
(2) section
(other than
section 501(c)(4).
than foundation
foundation managers)
managers) and supports organizations
501(c)(4), (5), or (6), if they
they meet the
the test
organizations
test of section
section 509(a)(2).
509(a)(2). See
section
sectio .n509(a)(3).
.5 0 , ,,).
following information
Provide the following about the supported
information about supported organizations.
organizations. (See instructions
instructions for PartIV,
Part IV, box 13.)
I (b)
(a) Name
(a) Name of supported
supported organizations
organizations
I Box number
from
number
from above

I
14 0 organization organized and operated
I I °0 An organization operated to test
test for public
public safety. Section
Section 509(a)(4).
509(a)(4). (See specific
specific instructions.)
instructions.)

S
Support Schedule (Complete only If you checked box 1 0 , 1 1 , or 12 above.) Use cash method of accounting.
year (or fiscal
Calendar year
Calendar
year beginningln)
year beginningin) ..
15 GII:s. grams, and contributions
Gits. grants contriburonsreceived.
received.(Do
(00
not include
rd unusualgrams.
includeunusual grantsSee
Seeline
line28.)
28) , . . . 1'80·
Membership fees received i .
11
17 G ro ssreceipts
C3m; receiptsfrm
fromadrrissOls,
admissions merchandise
17
sold cr senm
or services petnred furnishingcto f
performed ocrr fumishing
facilities av activity
facilities in any activity that
that is rd
not a business
urueIated
unrelated to tothe
theClPmzation's
organization'scharitable,
charitable,etc
etc
..
purpose
18 Gross
Gross income frm interest,
income from dividends.
nterest, dividends
amouris received
amounts receivedrom paymentsmon~securities
fom p3J1'THlIs
loans (secfun
loans (section 512(a)(5».
512(a)(5)), rents, loyalties. and
rentsroyalties, and
unrelaed bbusiness
unrelated usinesstaxablemrre (less
taxable in c o me section
(less section
taxes) from
511 taxes) rom businesses
businl!$$e$ acquiredby
acquired by the
organization after June30,1975
30,1975 ..
19 Net income
income from
from unrelated
unrelated business
riot included
actlvlti'es not
activities nne' 1 a8 .. ..
Included in line
20 Tax revenueslevied
Tax re\'ellue5 leviedfor benefitand
your benef~
foryour andeither
either
paid to you Of expended on your behalf. . . . .
paidtoyouorexpendedcnyourbehalf
211 Ire
2 value ct
The value of services r facilities
servicescor facilitiesfumished
furnishedtoto
you by
'PJ Of aa governmental
govemmentalunt unit without c:I1ag=.
withoutcharge.
Do rd not intlude va lue ctof selVices
the v.ir
include the services cr
or
facilities generally furnished to the public
facilitiesgenerallyfumishedto
without chai
2 2 Other income. Attach schedu le . Do not i n
dude gain (or lass)fromsale of capital asset
2 3 Total of lines 15 through 22
24 Line 23 minus line 17
25 Enter 1 % of line 2 3
2 6 Organizationsdescribed
Organizations described in box 10 or 111:
1:
8 Enter2%of
8 Enter 2 % of amount
amount in column
column (e), line 24
24 . . . . • . . • . • • . • • . . • . .
b Attach
Attach a list
list (not
(not open
open to
to public
public inspection)
inspection) ",nl'1"'''''<7
showing the name of and amount contributed by each person
t* 305
(other than a governmental
governmental unit
unit or publicly supported organization) whose total gifts for 1985 through 1988
Ii L_"_.,,, .. sum o f all excess amounts here
exceeded the amount shown in line 26a. Enter the Q
(Continued on page 3)
THE HEIMLICH INSTITUTE
THE HEIMLICH INSTITUTE FOUNDATION, INC.
FOUNDATION, INC. FORM
FORM 990
FISCAL YEAR 19~
199° 23-7303161
23-7303161

SCHEDULE A -
~ PART III
111 ~
- LINE 33
Patient need For financial assistance is determined on an
individual basis.
basis.
Each paciencls
pacienc's ability to meet medical and related
related expenses is
reviewed in terms o£ information or through investigation
of referral information
by itself.
by the Foundation itself.

PAR! VI - LIST OF OFFICERS, DIRECTORS AND TRUSTEES


PART

-
TITLE
TITLE COMPENSATION
COMPENSATION

Harry W
K Whittaker President
President None
Cincinnati, OH 45202

Philip M. Heimlich
Heimlich Vice-president None
Cincinnati, OH 45208
45208
Cedric W. Vogel Treasurer None
Cincinnati, OH 45202
45202

Joseph J. Dehner Secretary None


Cincinnati, OH 45202
M.D.
Henry J. Heimlich, M.D. Trustee None
Cincinnati, OH 45207
45207

Mrs. Winston C. Atteberry


Atteberry Trustee None
Eunice, LA 70535

Kathy and Ray Carr Trustee None


Cincinnati, OH 45244
Mrs. Mark P.
Mrs. P. Herschede (Joni)
(Joni) Trustee None
Cincinnati, OH 45202

Arthur and Kathryn Murray Trustee None


Honolulu, HI 96815

Monte L
1. Rovekamp Trustee None
Cincinnati, OH 45219-0129
William P. Sheehan Trustee None
45255
Cincinnati, OH 45255

Charles ~
J Squeri Trustee None
Cincinnati, OH 45203
Anson Williams Trustee None
Los Angeles, CA 90035

Winchell
Dr. Paul WinchelL Trustea
Trus tea None
Hone
Wesr.laWe. CA 91361
Wp.~r.1Ake.
zy-MQuuiizig
L~4(10jUU II Z, 9 QfjlB-NoT T*35-e^_
Return of
Return of Organization
Organization Exempt
Exempt From
From Income
Income Tax
Tax i ^- ^^
990 Under section 501(c)
Under section 501(c) ofof the
the Internal
Internal Revenue
Revenue Code Code (except
(except black
black lung
lung benefitr?'Lj
b e n e f i t ^ / / A/C ' \ | § f T ^
Department
Depart",ent of the Treasury -
the,Treasury- trust or
trust or private
private foundation)
foundation) or or section
section 4947(a)(1)
4947(aX1) nonexempt
nonexempt charitable
charitable trust 7
trust I ttl a ? ^ ~-_"'~
-- :
ffj^> r
^'
Internal Revenue S.~vlce
Service Note: The or anization ma have to use a co of this return to satis state re ortin
Note: The organization may have to use a copy of this return to satisfy state reporting requirements. re uirements.
A
A For the the 1995
1995 cale
calendar year OR tax vear
ndar vear year Deriod
period beainnina
beginning 06/01 1995.
1995 and ending
and endill_a 05/31
B Check if: if: C Name of organization
C organization o
D Employer
Employer Ider,
Iden _.~rnDer
Please
Please
0
□ Change of
use IRS
use IRS
THE.HFIHLICH INSTITUTE
THE~LICH INSTITUTE
address FOUNDATION
FOUNDATION 23-7303161
labalor
label or
Number and street
street (or P.O. box If mall Is not delivered
delivered to street address)
address) E State
0
□ Initial return
return print
print or
maills Room/suite
Room/suite E State registration
registration number
number

0
CH Final return type. See
See VICTORY PARKYAY
2368 VICTORY PARKWAY
Specific
0
O Amended return Specific
Instruc
Instruc
SUITE 410
SUITE
(required also for
tions.
tlons.
City, town, or post
City, town, post office,
office, state, and ZIP code FF Check ...
0|
^ | If exemption
application
application
State reporting)
State reporting) CINCINNATI^ OH 45206
CINCINNATI OH Is oendino
IS pending
► [Xl
G Type of organization ... 0 Exempt under section 501(C)(
501(c)( 3 ) 4 (Insert number) OR...
)~ 0
O R ^ CD section 4947(a)(1) nonexempt charitable trust
Note: Section 501(c)(3) exempt organizations and 4947(a)(1) nonexempt charitable trusts MUST attach a completed Schedule A (Form 990).
H (a)
H ( a ) Is this
this a group
group return
return flied
filed for
for affiliates?
affiliates? • • • • • • • • • • • □ ves S No I either box
If either box In
in H Is
is checked
checked "Yes;
"Yes," enter four
four digit
digit group
(b) If "Yes;
(b) "Yes," enter the
the number of affiliates
affiliates for
for which
which this
this return
return Is filed
flied: ► N/A exemption
exemption number (GEN) ► _
(C) Is this
(c) this a separate return
return filed
filed by
by an
an organization
organization JJ Accounting method:
Accounting method: Dcash E Accrual
covered bv a Qrouprullno? I I Yes M l No l~l Other fspecifv) ►

K Check here ►! I 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 it
received a Form 890 Package In the mall. It should file a return without financial data. Some states require a complete return.
Note- Form 990 EZ may be used bv organizations with gross receipts less than $100.000 and total assets less than S250.000 at end of year.
■JPiatrag.il Revenue. Expenses, and Changes in Net Assets or Fund Balances (See instructions.^
Contributions, gifts, grants, and similar
similar amounts received:
a
a Direct public support
support . . . . . . . 1a 64,010.
b
b Indirect public support
support. . . . . . . . . . . . . . . . . . . 1b 50,000.
c Government contributions (grants)
(grants). . . . . . . . . .... 1c
d Total (add lines 1a
ta through 1c)
tc) (attach schedule of contributors)
contributors) SEE 990 PT I - 1
(cash $
(cash 114,010.
114,010. noncash $ _-) Id 114,010.
2 Program service revenue including government fees and contracts (from Part VII, line 93).
3 Membership dues and assessments rTTTirr"r-r-«-~~t_.
4 j O J~ /*•» — V T j ~
5 Interest on savings and temporary cash investments .„...,'. ! v".^-f. . . ' T " / ^ . . . i . . . 24,398.
£a Dividends
Gross rentsand. interest
rents. . . . . from
. . . securities
. . . . . . .. . . . ..
:'fa OC7 2 JS_
b Less: expenses . . . . . . . . . . . .
Less: rental expenses / : : ?:a«:
Jb_
i s9 Net rental income or (loss) (subtract line 6b fromjline 6a57_r,~?l 6c
R
e r-
?■ Other investment income (describe ► ... L____ /'■■•"' '~-
v
e 8k
8.it Gross amount from sale sale of assets
assets other ( A ) Securities (B) Other
n
u
e
i n v e n t o r';J~?-.'?
than inventory yP?^. ^ T Tf:"."T
t f T .<1.9.0. ?t·:r:- V .
°^P. P + T T Y . 173,799. 8a
b Less: cost or other basis and sales expenses expenses . . 160.072. 8b
c Gain
Gain or (loss) (attach schedule) . 13,727. 8c
d Net gain or (loss)
(loss) (combine line 8c, columns (A) (A) and (B))
(8») SEE
SEE 99.0.
99.0.P.
T ..I.-.
PJ I. -. 2 8d 13,727.
9 Special events and activities (attach schedule):
Special
a Gross revenue (not including ""- $_ _ of
contributions reported on line 1a) 1a) 9a
b Less: direct expenses other than fundraisingfund raising expenses
expenses. . . . . . . . . . 9b
c Net income or (loss) from special events (subtract line 9b from line 9a). 9a)...... . . 9c
10a
lOa Gross sales
sales of inventory, less returns and allowances
allowances . . . . . . . . . . . . . .I-"!!!O-+-
10a ~
b Less: cost of goods sold . . . . . . . . . . . . . . . . . . . . . . . . . . . . . L...!.,!,!!!-l-.
10b -'

c Gross profit or (loss)(loss) from sales


sales of inventory (attach schedule) (subtract line 10b from line 10a)
10a~ . 10c
11 Other revenue (from Part Part VII,
VII, line 103)
103) . 11
12 Total revenue (add lines I d , 2. 3. 4. 5. 6c, 7. 8d, 9c. 10c. and 11) 12 152,135.
E 13 Program services (from line 44, column (B)) . . . . 13 151,304.
x
p 14 Management and general (from line 44, column (C)) 14 56,184.
e
n 15 Fundraising (from line 44, column (D)) 15
e 16 Payments to affiliates (attach schedule) 16
17 Total expenses (add lines 16 and 44. column (A)). , 17 207,488.
18 Excess or (deficit) for the year (subtract line 17 from line 12) 18 -55,353. )
N 5
e 19 Net assets or fund balances at beginning of year (from line 73, column (A)) 19 ^ 28,885.
t e
t 20 Other changes in net assets or fund balances (attach explanation) 20
21 Net assets or fund balances at end of year (combine lines 18, 19, and 20) . 21 473,532.
For Paperwork
Paperwork Reduction
Reduction Act
Act Notice,
Notice, see instructions.
instructions. 990
Form 9 9 0 (1995)
(1995)
JXB
JXB F 02/01/96
02/01/96
THE HEIMLICH INSTITUTE'
THE HEIHLICH INSTITUTE
Form 990>"S351
(19aS) FOUNDATION
FOUNDATION 23-7305161
23-7303161 Page 2
Mltililti Statement
S t a t e m e n t of
Of AM organizations must complete column (A). Columns (B), (C), and (D) are required for section 501(c)(3)
P.Jnctional
R jnctional E xpenses
E'lCII]RI'~'~~ and (4) organizations and section 4947(a)(1) nonexempt charitable trusts but optional for others. (See instr.
Do not
not include amounts reported on line
reported on ' (A) Total
( B ) Program ( C ) Management
( D ) Fundraislng
6b, se,
6b, 8b, 9b, 10b, or
or 16 of Part
Part I. services and general

??
22 Grants and allocations
allocations (attach schedule) ..... ■*

(cash S
$ noncash£
noncash $ ) 22 ' :
23
23 Specific assistance to individuals (attach schedule) . . . .
SpecifiCassistanceto 23
24
24 Benefits paid to or for schedule)
for members (attach schedule). 24
25 Compensation of officers, directors, etc . 25
26 Other salaries and wages . 26 72.500. 60,713. 11.787.
27
Xl Pension plan contributions. 27
28 Other employee benefits. . 28 14,976. 9,382. 5.594.
29 Payroll taxes . . . . . . .
Payrolltaxes. 29
30 Professionalfundraising fees. 30
31
31 Accounting fees . 31
32 Legal fees. 32
33
33 Supplies . 33
34 Telephone . 34
35 Postage and shipping 35
36 Occupancy ..... 36 15.600. 10,400. 5.200.
37
37 Equipment rental and maintenance 37
38 Printing and publications. . . . . . 38
39
39 Travel . 39
40 Conferences, conventions, and meetings 40
41 Interest . 41
42
42 Depreciation, depletion, etc. (attach schedule). 42 4,727. 4.727.
43
43 expenses (itemize):
Other expenses (Itemize): a _ 43a
b OUTSIDE
OUTSIDESERVICESSERVICES 43b 58,370. 44,364. 14.006.
c MISCELLANEOUS
MISCELLANEOUS 43c 41,315. 26,445. 14,870.
d 43d
e 43e
44 T o t a ! ffunctional
Total expenses
unctional e xpenses (add lines 22
(add lines 22through
through 43)
43) Organ-
Organ­

izations complettna columns ( B W D ) . carry these totals 44


I to lines 13-15 207,488. 151,304. 56,184.
184. NONE
Reporting
Reporting ofof Joint Costs. - Did you report in column (B)(B) (Program services) any joint costs from a combined
educational
educational campaign
campaign and fundraising solicitation? ..... ► Q Yes
Yes 0 .... 0
[X) No
No
(i) the aggregate
If 'Yes," enter (i) aggregate amount of these joint costs $
$, _ ; (ii) the amount allocated to Program services $
(iii) the amount allocated to Management and general $ : and (iv) the amount allocated to Fundraising $
.„ FaftMl, Statement of Program Service Accomplishments (See instructions/!
What is the organization's primary exempt purpose?►purpose?'" RESEARCH_AND_ D~~A.!I_9~ E~
~E~~~C~_A~D_~EDUCATION 0N_ ~A!!..~~
VARIOUS^~I~~~~
p_ISEASES _ Program Service
Program Service
Expenses
All organizations
organizations must describe their exempt purpose achievements. State State the
the number of clients served, publications issued, etc.
etc. (Required for 50
(Required for 501(cX3)
1(cX3)
Discuss achievements
achievements that are not not measurable. (Section 501(c)(3) and (4)
(4) organizations and 4947(a)(1) nonexempt charitable trusts and
and (4) organizations
(4) organizations
Discuss and
and 4947(aX1)
4947(aXl) trusts;
must also enter the amount of grants and allocations to others.! ut optional for
but for others.)
a
_Ti?5.i!?.'!!!''JE.'
a _T_!1~ 1 In 1
_ £ LiLute ~o~~~tJ~_!
~':.i~lJ~h_ ~~tJ!.u.!':. Foundation; _}~c..:
Inc. _i~
is~ a _
corporation ~designed
_c..?ry~r:_a!i..?~ to
':_S.!.g~':.d_ conduct _s~!_e~tJ!.i~!....
~ _c~~~c.! scientific, _
"cultural
^ L ^ C ? !and social research
- ^ social_ research into_
into issues
issues ofof
------------------------------------------------------------------
importance to to the medical
med and (Grants and allocations $
scientific _c~nJ!.i.!:~
b _s~.!.e~0!.i~ communities. _ _Its primary _e~~e~~.!:.s
..!!.s_p..:i.m~'2' endeavors _
_ include research ..!~t~
i~~l~~ _r~~e~r:=!: into .!!:e_ !!,=-a_!~~!' ~f_
the treatment of ~a~c::.!:..
cancer, _
lyme disease, emphysema, and cystic fibrosis.
-~-~~~~~-~~~~~~~-~~~~!.~~~~~-------------------------------------
(Grants and allocations £ 4,206.
4 206.
c AIDS research
AIDS research and
and education
education

(Grants and allocations $ 106,178.


d _E..9~c~!.i~n_
** _|ducat_ion_of_the ~f_0:. ~':.n.!:r:_a!.P ^ i ~~.!~
j9enera]_ p::b~ 1_r
_p":i.".!0g
c ^ JH*1?_PT !lITE _
and distribution
d i s t r i b u t i o n of
of educational
educational lliterature
i t e r a t u r e to to
------------------------------------------------------------------
public El~~e~~~o~!.
_p~~l..!.~ places about !h~_H.!:!_m~i~~~~:.~~.:.
the Heimlich Maneuver. _
(Grants and allocations $ 40,920.
e Other program services (attach schedule) , , (Grants .and all9catipns$
f Total of Program Service Expenses (should equal line 44, column (B), Program services). 151,304.
F 01/30/96
F 01/30/86
THE HEIHL1CH
HEIMLICH INSTITUTE
~E9~r~m~9~90~\~-19~9~5~1
Form99<K-1995) F~_OU~N~D~AT~1~O~N~
FOUNDATION 2=3~-~73~O~3~16~1~P~a~ge~3
25-7303161 Page 3

~jl.rlBalance Sheets
f»Qrt I V Balance Sheets (See instructions.)
instructions.)

Note:
Note: Where required,
required, attached schedules and amounts within the description column (A) (8)
(B)
should be for end of year amounts only, Beginning of year End of year

45 Cash non interest bearing 12.569. M. 48,171.


48
46 Savings
Savings and temporary cash investments JS.

47a Accounts receivable.


receivable . . . . . .,. . . 47a
b doubtful accounts .
Less: allowance for doubtful 47b 47c

48a Pledges receivable


Pledges receivable . . . . . . . . . . 48a
b allowance for doubtful
Less: allowance doubtful accounts 48b 4Sc
49 Grants receivable
receivable . . . . . . . . . . . . . . . . . . . _49_
50 Receivables directors, trustees, and key employees
Receivables from officers, directors,
A
(attach schedule) . . 1---------- 3L
51a Other notes and loans receivable (attach schedule)
schedule).. 51a
e allowance for doubtful
b Less: allowance doubtful accounts . . . . . . . .
t 51b 51c
52 Inventories for sale
sale or use . . . . . . . . . . . . . . . .52.
53 Prepaid
Prepaid expenses and deferred charges.
charges . . . . . . . . . . _53_
.:X e .~T!,"\:-t:
54 Investments securities (attach schedule) . ^ ^ . v 1 ) f \ T J ^ P . C t \Y~. J. 489,814. JKL 404,480.
55a
558 Investments land, buildings, and equipment:
equipment:
basis . I 55a
Less: accumulated depreciation (attach
b
schedule) . 55b £5c
56 Investments other (attach schedule) .
57a Land, buildings, and equipment: basis . 57a. 39,381. SEE 990 PT IV - 1
b Less: accumulated depreciation SEE .990. PJ. I.V.-. 2 57b 17,402. 24 t 340. 57c 21.979.
58 Other assets (describe ► SEE 990 PT IV - 3 8,133. .3L 5,811.
_59_ Total assets fadd lines 45 through 58) (must equal line 74) 534,856. -53. 480,441.

60 Accounts payable
payable and accrued expenses 5,971. _SP_ 6.909.
~ 61 Grants payable
payable -~ . M.
~ 62 Deferred revenue.
revenua . . . . . . . . . . . . 62
I
I 63 Loans from officers, directors,
Loans directors, trustees, and key employees . 31.
64a liabilities (attach schedule)
Tax-exempt bond liabilities . 64a
e b Mortgages and other notes payable (attach schedule).
schedule) . . . 64b
s
65 Other liabilities (described 65
■£§_ Total liabilities fadd lines 60 through 65). 5,971. 6,909.

N
8 Organizations
Organizations that
that follow
follow SFAS 117,
117, check
check here ►
.... [X] and complete
\j\
t
lines 67 through
through 69 and lines 73 and 74.
A
67 Unrestricted......
Unrestricted 458,668. JJZ. 478.478.
S
8 68 Temporarily restricted . 70,217. JBL
t
69 Permanently restricted . . . . . . . . . .
Permanently ja. -4.946.
o Organizations that
Organizations that do not
not follow
follow SFAS 117, check here ►
.... o
L H and complete
lines 70 through
through 74.
E
u 70 Capital stock, trust principal or current funds
funds. . . . . . . . . . . . . ZQ_
n
d 71 Paid-in or capital surplus, or land]
land; bldg., and equipment fund .... 71
B 72 Retained earnings, accumulated income, endowment, or other funds
Retained 72
a
I 73 Total
Total net assets
assets or fund
fund balances
balances (add lines 67 through 69 OR lines 70 through 72;
a
n column (A) must equal line 19 and column (B)
(8) must equal line 21) 528,885. 73_ 473.532.
1----=.=.:~=-=--_+..LJiI.4----:!.!..:!..C~.:...-
e
s
74 Total liabilities and net assets/fund balances (add lines 66 and 73). 534.856. 74 480.441.
E 02/16/96
F02/16/96
THE HEIKLICH
THE HEI~LICH INSTITUTE
INSTITUTE
Form 990 (IBas) FOUNDATION 23-7303161 paqe 4
■ 1 H Reconciliation of
Reconciliation of Revenue
Revenue per
per Audited
Audited Wifflmmm Reconciliation of
Reconciliation of Expenses
Expenses per
per Audited
Audited
financial Statements
Financial Statements with
with Revenue
Revenue per
per Financial Statements
Financial Statements with
with Expenses
Expenses per
per
Return Return
a. Totalrevenue,
Total revenue,gains,
gains,andandother
other support
support Totalexpenses
Total expensesand andlosses
lossesper per
peraudited
per auditedfinancial
financialstatements
statements . . . . . ....
► 227,135. auditedfinancial
audited financialstatements
statements . . ► .... 282,488.
b Amountsincluded
Amounts includedononlineline.a but
but not
not on
on Amountsincluded
Amounts includedon online
line a• but
butnot
noton
on
line12,
line 12,Form
Form990:
990: line17,
line 17,Form
Form990:
990:
(1) Net
(1) Netunrealized
unrealizedgains
gains (1) Donated
(1) Donatedservices
services
oninvestments
on investments . ... i ..._ _ anduse
and useofoffacilities
facilities $$ 75,000.
75,000.
(2) Donated
(2) Donatedservices
services (2) Prior
(2) Prioryear
year adjustments
adjustments
and use of facilities J$L
and use of facilities 75,000.
75,000. reported on line20,
reported on line 20,
(3) Recoveries
(3) Recoveries of of prior
prior Form
Form 990990 . $
year grants ...
year grants . . . . $ (3) Losses reported
(3) Losses reported on on
(4) Other
(4) Other (specify):
(specify): line20,
line 20,Form
Form990.
990 . . . $
(4) Other (specify):
(4) Other (specify):
----------
----------
Add amounts
Add amountson
on lines
lines(1)
(1)through
through(4)
(4) ► ... 75.000. $_
Add amounts
Add amounts on
on lines
lines(1)through(4)
(1) through(4) .. . .► 75.000.
c Une aaminus
Line minus line
linebb . 152,135. c Une aa minus
Line minus line
linebb. . . . . . ► £■ 207,488.
c
d Amounts included
Amounts included on on line
line 12,
12, d Amounts included
Amounts included on on line
line 17,
17,
d
Form 990 but not on line
Form 990 but not on line a: a: Form 990 but not on
Form 990 but not on line a:linea:
(1) Investment expenses
(1) Investment expenses (1) Investment
(1) Investment expenses
expenses
not included
not included onon line
line not included
not included onon line
line
ss,Form
6b, Form 990
990 .. . . _$ 6b, Form 990 . . .. . $
6b, Form 990 .
(2)
(2) Other (specify):
Other (specify): (2) Other (specify):
(2) Other (specify):

----------
---------- $_
Add amounts
Add amounts onon lines
lines(1)and
(1) and (2)
(2) Add amounts
Add amounts onon lines
lines(1)and
(1)and (2)
(2)
e Total revenue per line 12, Form 990 Total expenses per line 17, Form 990
fline c plus line d ) . 152J35. fline c plus line d) 207.488.
f i i i l l List of Officers, Directors, Trustees, anc K e y E m p l o y e e s fList each one even if not compensated: see instructions.')
(C) Compensation (D) Contributions to (E) Expense
(A) Name and address (B) Title and average hours per account and other
(if not paid, enter employee benefit plans &
week devoted to position allowances
-0-) deferred compensation

SEE STATEMENT
SEE STATEMENT 990
990 PART
PART VV - 1
NONE NONE
NONE NONE

75
75 Did any
Did any officer,
officer, director,
director, trustee,
trustee, or
or key
key employee
employee receive
receive aggregate
aggregate compensation
compensation of
of more
more than
than $100,000
$100,000 ffrom
r o m your
your
organization and
organization and all
all related
related organizations,
organizations, of
of which
which more
more than
than $10,000
$10,000 was
was provided
provided by
by the
the related
related organizations?
organizations? ►
... □ Yes
DYes Ii]
0 No
IfIf "Yes,"
"Yes," attach
attach schedule
schedule -- see
see instructions.
instructions.

F 02/07/96
F 02/07/96
HEIMLICH INSTITUTE
THE HEIHLICH INSTITUTE
F rm 990 f1995> FOUNDATION ' 23-7503161 Page 5
" .. ..
Illicit Other Information fSee instructions.-) XfiS.
76 Did the organization
Did engage in any
organization engage any activity not previously
previously reported to the IRS?
IRS? IfIf 'Yes,"
"Yes," attach
attach a detailed description of each
each activity Z6_
77 Were
Were any any changes
changes mademade in the organizing or governing documents, but not reported to the IRS? IRS? . . . . . . . . . . . 77
If 'Yes,"
If "Yes," attach
attach a conformed copy of the changes.
78a Did
78a Did the organization have have unrelated business gross income
income of $1,000
$1,000 or more during the year year covered by this return?
return? zsa.
b IfIf "Yes,"
"Yes," has it filed a tax return on Form
has it F o r m 990-
990-T T,, Exempt
Exempt Organization Business
Business Income
Income TaxTax Return, for this year?
year? .. Z£b_ N/A
79 Was there a liquidation, dissolution, termination, or substantial
Was substantial contraction during the year?
year? If ''Yes,''attach
'Yes," attach a statement
statement 79
Is the organization
BOa Is
80a related (other than by association
organization related association with a statewide
statewide or nationwide
nationwide organization)
organization) through common membership,
governing bodies, trustees, officers, etc., to any any other exempt or nonexempt organization?
organization? . 203,
b If "Yes," enter
If "Yes," enter the name organization ►
name of the organization ...
_______________________ = = = = = = = = = = = = = and
a~d ~h-;~k whether• it
check -wh;rthe~ is r::r
it i; CU - -exempt
- - - -OR-lJO -------
nonexempt.
81a
81a Enter the amount of political
Enter political expenditures, direct or indirect, as ms ...
as described in the instructions
instructions I 81a I NONE
b
b Did the organization file Form 112O-POL,U.S.
1120-POL, U.S. Income Tax Return for Certain Political
Political Organizations, for this year?year? N/A
82a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially m.
less
less than fair rental value?
value? . J&
b If 'Yes," you may indicate the value of these items here. Do not include this amount as
''Yes,''you
revenue in Part
Part I or as an expense in Part
Part II. (See
(See instructions for reporting in Part
Part III.)
111.). . . • . . . • . . 182b
.......__ -'-I __ ....:..::c.t..:::=:......_
75.000.
83a Did the organization comply with the public inspection requirements for returns and exemption applications?
applications"Z .22a
b Did the organization comply with the disclosure requirements relating to quid pro quo contributions"Z
contributions? . . . . _S2b
84a Did the organization solicit any contributions
contributions or gifts that were not tax deductible? . 84a
b If 'Yes,"
'Yes," did the organization include with every solicitation an express statement that such contributions
contributions or gifts were not
tax deductible? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ML N/A
85 Section 501(c)(4),
Section 501(c) (4), (5), or (6) organizations.
organizations.-a -a Were substantially
substantially all dues nondeductible by members? .851. N/A
b in-house lobbying
Did the organization make only In-house lobbying expenditures
expenditures of $2,000 or less? . 25JB. N/A
If 'Yes" was
''Yes''was answered to either 85a or
8Sa 8Sb,85b, do not complete 85c
8Sc through 85h
8Sh below unless
unless the organization received
a waiver for proxy tax owed for the prior year.
c Dues, assessments, and similar amounts from from members £5S_ N/A
d Section 162(e) lobbying and political expenditures ... 85d N/A
e
* Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices. notices £5JL N/A
f Taxable
Taxable amount of lobbying and political expenditures (line 8Sd 85d less line 85e).
85e) 85f N/A
g Does the organization elect to pay the section 6033(e) tax
tax on the amount in 8517
85f? . J559L N/A
h If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount in 8Sf85f to its reasonable
reasonable
estimate of dues allocable
estimate allocable to nondeductible lobbying and political expenditures for the following tax year? . JKb N/A
86
86 Section 501(c)(7) organizations. - Enter:
Section
a Initiation
Initiation fees
fees and capital
capital contributions included on line
line 12
12 . -8SA N/A
b
b Gross
Gross receipts, included on line
line 12,
12, for public use
use of club facilities
facilities. . . . . . . . . . . . . _SSb_ N/A
87a
87a Section 501
Section 501(c) (12) organizations. - Enter:a Gross
(c)(12) Gross income
income ffrom shareholders
r o m members or shareholders _SZ& N/A
b
b Gross income from other sources. (Do
Gross income (Do not net amounts
amounts due or paid
paid to other
sources against
sources against amounts
amounts due or received from
f r o m them.). _SZb_....___
them.) . . . . . . . . . . . . . . . . . . . . . . . . . ............. N/A __
..:.:.t...:..:.... ~

88
88 any time
At any time during the year,
year, did the organization own a 550% greater interest
0 % or greater interest in a taxable
taxable corporation or
partnership? If "Yes,"
partnership? "Yes," complete
complete Part
Part IX
IX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -88.
89
89 Public law firms. - Attach information described in the instructions.
Public interest law instructions.
90
90 Ust the states
List states with which a copy of this return is filed ►OHIO,
~H.!.~ _C~,=-I!.O~~I~
_CAL_I F0RNIA _
91
9 1 The books are
The books are in care
care of ►i°AN_STEI_NBUItt
"'~O~N_~T~~~U~~ Telephone no. ►
Telephone ... ~.!31_2~~~0~~
C_51_3_)_221_-0q02 _
Located at ►
Located ... 2368
2368 VICTORY
VICTORY PKWY,
PKWY, STE
STE 4410, CII NTI,
10, C N T I , OH ZIP code ►
ZIP ... 45206
45206
92
92 Section 4947(a)(1) ~~n;x-;~Pt
Section nonexempt ~ha;it;blet~;t;fili;g
charitable trusts filing-F~~-900i~
Form 990 in iie~
lieu ~fF~r~-1041
of F o r m 1041U~S~I~comeTax
U.S. Income Tax Ret .: tor
Return
:urn for IEst~t;; f~;-
Estates a-;;dTr~s~s~':-
and Trusts. - C h-;~kh;r~O
Check here^O
and enter the amount
and amoun of tax-exempt interest received or accrued during the tax veat I 92 I N/A
F02/12/86
F 02/12/86
THE HEIMLICH
HE1MLICH INSTITUTE
INSTITUTE
Form 990 M99S1 FOUNDATION 23-7303161
23-730316 Paqe 6
HiHH! Analysis of Income-Producing Activities fSee instructions.}
Enter gross amounts unless otherwise indicated. Unrelated business income Excluded bv section 512.513. or 514
(E)
(A) (8)
(B) (C) (D)
(D) Related or exempt
Business code
Business code Amount Exclusion
Exclusion code Amount function
function Income
93 Program service revenue:
a
b _
b
c
d
d __ ~-------------------------------
e
f
g
9 Fees and contracts from government agencies . . .
94 Membership dues and assessments
assessments. . . . . . . . .
95 Interest on savings
savings and temporary cash investments. . . .
96 Dividends and interest from securities
securities. . . . 14 24,398.
97 Net rental income or (loss)
(loss) from real estate: ,
a debt-financed
debt-financed property
property .
debt-financed property
b not debt-financed property .
ss rorn
98 Net rental income or (l°
(loss)) ffrom personal property
property . . . .
99 Other investment income . . . . . . . . . . . . .
100 Gain
Gain or (loss) from sales
sales of assets
assets other than inventory . . 18 13.727.
101 Net income or (loss) from special events. ..
102 Gross profit or (loss) from sales
sales of inventory
inventory.
103 Other revenue: aa
b
c
d ___
d
e __
e
104 Subtotal (add columns (8),(B), (D), and (E»
(E)) .... llljlllllllllf 38.125.
105 Total 104, columns (8),
Total (add line 104, (B), (D), and (E»
(E)) . 38,125.
38 125.
Note: (Line 105 plus line I d . Part I. should equal the amount on line 12. Part 1.1
ftarfVm Relationship of Activities to the Accomplishment of Exempt Purposes
Line No. Explain
Explain how each activity for which income is reported in column (E) of Part
Part VII contributed
contributed importantly to the
T accomplishment of the organization's exempt purposes (other than by providing funds for such purposes).
purposes). (See instructions.)
N/A

fiSHlX Information Regarding Taxable Subsidiaries (Complete this Part if the "Yes" box on line 88 is checked.)
Name, address,
address, and employer Identification
Identification Percentage of Nature of Total End-of-year
number of corporation
corporation or partnership
partnership ownership Interest business activities
business activities Income
Income assets

N/A

Under penalties of perjury,


perjury, I declare that
that I have examined this
this return,
return, including
Including accompanying
accompanying schedules
schedules and statements,
statements, and to the best of my knowledge
knowledge and belief
Please
PJ~Sd

y^-
':': Is true, corrett,
corr t, and complete.
complete. D Declaratlon-of (other than
cl atlorrof preparer (other than officer)
officer) Is based on all Information
allinformat which preparer
n of which has any knowledge.
prepare<'has knowledge. (See
(See Specific
Specific Instructions.)
instructions.)
Sign
Sigrl
Her©
Here t. Si .• ~
,f
!-h~IEl;f lie
Quaint
Type 0
I'm
title.
nt name and title.
lid, I Pl4Sch./
'

Preparer's Date Check


Cheek (f
If Preparer's social security
security no.
Paid
Preparer's
Preparer's
signature <\AJJU tOl0l% self-employed
self-employed ►|
.... | 296-64-1856
Firm's name (or ARTHUR ANDERSI EiN ►
EIN .... 36-0732690
Use Only yours If self-employed)
and address 425 WALNUT STREET ZIP code
ZIP code ► .... 45202

F 12/22/95
12/22/95 CINCINNATI, OH
CINCINNATI, OH
SCHEDULE
SCHEDULE A Organization
Organization Exempt Under Section
Section 501(c)(3) OMS No.
OMB No. 1545-0047
1545-0047

(Form 990) (Except Private


Private Foundation)
Foundation) and Section
Section 501(e), 501(f), 501(k),
or Section
Section 4947(a)(1)
4947(aX1) Nonexempt
Nonexempt Charitable
Charitable Trust
Trust
Department of the
Department of the Treasury
Treasury
Supplementary Information
Supplementary Information 1995
See separate
separate instructions.
instructions.
Internal Revenue Service anl io and attached
► Must be completed bv the above organizations d to
a their Form 990 (or Form 990-EZV
Name of the organization THE HEIMLICH INSTITUTE Employer Identification numbe

FOUNDATION
FOUNDATION 23-7303161
UtmU::: Compensation of the Five Highest
Compensation Highest Paid Employees Other Than Officers,
Officers, Directors,
Directors, and Trustees
Trustees
(See instructions. Ust each one. If there are none, enter "None.")
( d ) Contributions
Contributions to ( e ) Expense
Expense
((b)
b ) Title
Title and
and average
average
((a)
a ) Name and
and address
address of each
each employee
employee paid more
paid more employee benefit
employee benefit account
account
hours
hours per week ((c)
c ) Compensation
Compensation
than $50,000
than $50,000 plans deferred
plans & deferred and other
and other
devoted to position
devoted to position compensation allowances
allowances

NONE

Total
Total nnumber
u m b e r of other employees
employees paid
paid over
over
$50.000 ► NONE
Part II Compensation of the Five Highest Paid Independent
Compensation Independent Contractors
Contractors for Professional
Professional Services
Services
(See instructions. List each one (whether individuals or firms.') If there are none, enter "None.")
( a ) Name and address of each independent contractor paid more than $50,000 ( b ) Type of service ((c)
c ) Compensation
Compensation

NONE

Total
Total nnumber
u m b e r of others
others receiving
receiving over
over $50,000
$50,000 for
professional services , „ , _ , , ,„„,.,,,„ , ► NONE
Paperwork Reduction
For Paperwork Act Notice,
Reduction Act Notice, see instructions.
instructions. Schedule
Schedule A (Form 990) 1995
1995
JXB
JXB F 02/15/96
THE HESMLICH
HEiMLICH INSTITUTE
INSTITUTE
Schedule I) [form 9901 1995 FOUNDATION 23-7303161 page
23-7303161 2

P$ri ffl Statements About


About Activities
Activities Yes No

During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to
influence public opinion on a legislative
legislative matter or referendum?.
referendum? . . . . . . . . . . . . . . . . . . . . . . . . .
If "Yes," enter the total expenses paid or incurred in connection with the lobbying activities ... $ ...:.N:L/.o.;A'
activities. . . . . . ►$ M/A -- _
Organizations
Organizations that made an election under section 501(h) by filing Form 5768 must complete Part Part VI-A.
VI-A. Other
organizations checking 'Yes," must complete Part
''Yes,''must Part VI-B
VI-B AND attach a statement giving a detailed description of
the lobbying activities.
2 During the year, has the organization, either directly or indirectly, engaged in any of the following acts with any
of its trustees, directors, officers, creators, key employees, or members of their families, or with any taxable organization
affiliated as an officer, director, trustee, majority owner, or principal beneficiary:
with which any such person is affiliated
Sale, exchange, or leasing
a Sale, leasing of property? .... 2A.

b Lending of money or other extension of credit?


credit? JSCL

c Furnishing of goods, services, or facilities?


facilities?. . . 2c

d Payment
Payment of compensation (or payment or reimbursement of expenses if more than $1,000)? 2sL
e Transfer of any part of its income or assets?
assets? . . . . . . . . . . . . . . . . . . . . . . . . 2a.
If the answer to any question is 'Yes," attach a detailed statement explaining the transactions.
''Yes,''attach

3 fellowships, student loans, etc.? .....


Does the organization make grants for scholarships, fellowships, JLUL
4 Attach a statement to explain how the organization determines that individuals or organizations receiving grants or
loans from it in furtherance of its charitable programs qualify to receive payments. fSee instructions.)^ <e t.TKT ^ c h A. Pr SE-

~:R":]Mm Reason for


for Non-Private
Non-Private Foundation
Foundation Status
Status (See instructions.)
instructions.)
The organization is not a private foundation because it is (please
(please check only ONE applicable box):
5 D
[ H A church,
church, convention of churches,
churches, or association of churches.
churches. Section 170(b)(1)(A)Q).
170(b)(1) (A) (i).
6 D
□ A school.
school. Section 170(b)(1)(A)Qi).
170(b)(1)(A)(ii). (Also complete Part V, V, page 4.)
7 D
fZI A hospital or a cooperative hospital service organization. Section
Section 170(b)(1)(A)Qii).
170(b)(1)(A)(iii).
8 D
CD A Federal, state, or local government or governmental unit. Section 170(b)(1)(A)(v).
170(b)(1)(A)(v).
9 D
C ] A medical research
research organization operated in conjunction with a hospital. Section Section 170(b)(1)(A)(iii)Enter
170(b)(1)(A)Qii)Enter the
the hospital's
hospital's name, city,
city,
and state ... ►
10
10 D organizati~n-op;r;rt;df;
[~l An organization operated for th-;;b;n~f~
the benefit ~f~
of a~~I;g~~;
college or ~~;r;n;
university ;:;-';n;d-;
owned or ~pe;ated by
operated by a-g~~e;n;~~~
a governmental ~ntt~Se~i~;
unit. Section '-70(b)(1)(A)Q~)~
170(b)(1)(A)(iv). - - - --
(Also complete the Support
(Also Support Schedule
Schedule in Part
Part IV-A.)
IV-A.)
11a
11. IX]
E An organization that normally receives a substantial part of its support support from
from a governmental unit or fromfrom the general public.
public.
Section 170(b)(1)(A)(vi).
Section 170(b)(1)(A)(vi). (Also
(Also complete thESupport Schedule in Part
theSupport Schedule Part IV-A.)
11b D EH A community trust. Section
Section 170(b)(1)(A) (vi). (Also
170(b)(1)(A)(vi). (Also complete thSupport
thSupport Schedule
Schedulein in Part
Part IV-A.)
IV-A.)
12 D
[ D An organization that normally receives: (a) no more more than
than 33 1/3% of its support from gross investment income and unrelated business
taxable income (less section 511 tax) from businesses
taxable businesses acquired by the organization after June 30, 30,1975, more than 33 1/3%
1975, and(b) more
of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc., functions - subject
from contributions,
See section 509(a)(2).
to certain exceptions. See 509(a)(2). (Also
(Also complete theSupport
theSupport Schedule
Schedule in PartPart IV-A.)
IV-A.)
13 D
LJ An organization that is not controlled by any disqualified persons (other than foundation managers) managers) and supports organizations
organizations described
in: (1) lines 5 through 12 above: or(2) section 501(c)
in: 50Uc)f4), (5). or (6).
(4). (5), f6). if thev 509(a)(2). (See section 509(a)(3).)
they meet the test of section 509(a)(2). 509fa)(3).)
Provide the following
Provide organizations. (See instructions.)
followina information about the supported oraanizations.
(b) Line
Une number
(a) Name(s)
Name(s) of supported organization(s) from above

D An organization organized and operated to test for public safety. Section 509(a)(4). (See instructions.)
14 M
F 12/22/95
F 12122195
HE~MLICH INSTITUTE
THE HE!MLICH INSTITUTE
Schedule fFnrm 990)
Schedule A [FWm B90) 1995 FOUNDATION
FOUNDAT I ON 23-7303161 Pass
Paoe 3
3
]liri;nt;A:~ SSupport.
'^iii^ililiiii upport SSchedule
chedule 11, or 12.)
(Complete only if you checked a box on line 10, 11, 12.)Use method of accounting.
Use cash method accounting.
Note: You mav use the worksheet in the instructions for converting from the accrual to the cash method of accounting.
Calendar vear (or fiscal year beginning in) (a) 1994 (b) 1993 (c) 1992 (<i) 1991 (e) Total
15 Gifts, grants, and contributions received. (Do
not include unusual grants. See line 28.1 . . 85.274. 190,020. 499,123. 146,624. 921,041.
16 Membership fees received NONE
17 Gross receipts
Gross receipts from admissions,
admissions, merchandise
merchandise sold
or services
or services performed, or
or furnishing of facilities
facilities
in any
in any activity
activity that is
is not aa business
business unrelated
to the organization's charitable, etc.. purpose . NONE
18
18 Gross income
Gross income from interest,
interest, dividends, amounts
received ffrom
received payments on
r o m payments on securities
securities loans
(section 512(a)(5)),
(section 512(a)(5», rents,
rents, royalties,
royalties, and
and unrelated
business taxable
business taxable income
income (less
(less section
section 511
511 taxes)
from businesses
from businesses acquired
acquired by
by the
the organization
after June 30. 1975 28.994. 25,462. 18,962. 20,612. 94,030.
19
19 Net income
Net income from unrelated
unrelated business
business activities
not included in line 18 NONE
20
20 Tax revenues
Tax revenues levied
levied for the
the organization's
organization's benefit
and either paid to it or expended on its behalf. . NONE
221
1 The value
The value of
of services
services or
or facilities
facilities furnished
furnished to
to the
organization by
organization by aa governmental
governmental unit
unit without charge
Do not
Do not include
include the
the value
value of
of services
services or
or facilities
facilities
generally furnished to the public without charge. NONE
22
22 Other income.
Other income. Attach
Attach aa schedule.
schedule. Do
Do not
not include
gain or (loss) from sale of capital assets NONE
23 Total of lines 15 through 22 114,268. 215.482. 518.085. 167,236. 1,015.071.
24 Une 23 minus line 17 . . . 114,268. 215,482. 518,085. 167.236. 1,015,071.
25 Enter 1% of line 23 1.1*3- 2,155. 5.181. 1,672.
26 described in lines 10 or 11: a Enter 2% of amount in column (e), line 24
Organizations described 26a 20,301.
b Attach a list
Attach list (which
(which is
is not open to
to public inspection)
inspection) showing the name
name of
of and
and amount
amount contributed by each
each person
(other
(other than
than a governmental
governmental unit
unit or
or publicly supported organization)
organization) whose
whose total
total gifts
gifts for
for 1991
1991through
through 1994
1994
exceeded
exceeded thethe amount
amount shown in in line
line 26a.
26a. Enter
Enter the
the sum of all
all these
these excess
excess amounts
amounts. 26b 363,796.

c Total support
Total support for
for section
section 509(a)(1)
509(a)(1) test:
test: Enter
Enter line
line 24,
24, column
column (e),
(e) . 26c $ 1 , 0 1 5 , 0 7 1 .
d Add: Amounts
Add: Amounts from
from column
column (e)
(e) for
for lines:
lines: '18
18 $$ 94,030.
94.030. 19
19
22
22 $_ 26b £_
26b ~$ 3~6~3~,7~9~6~.
363,796. __ 26d 457,826.
ee Public support (line
Public (line 26c minus
minus line
line 26d total).
total), ► 26e 557,245.
J Public support percentage (line 26e (numerator) divided bv line 26c (denominator)) 2SL 54.90%
27
Zl Organizations described
Organizations described on on line
line 12:
12: aa For
For amounts
amounts included
included on
on lines
lines 15,
15, 16,
16, and
and 17
17that
that were
were received
received from
from aa "disqualified
"disqualified
person," attach
person," attach aa list
list to
to show
show the
the name
name of,
of, and
and total
total amounts
amounts received
received in
in each
each year
year from
from each
each "disqualified
"disqualified person."
person." Enter
Enter the
the sum
sum N/A
N/A
of
of such
such amounts
amounts for
for each
each year:
year:
(1994) _ _ _ _ _ _ _ _ _ _ _ _ _ _
(1994) (1993) _ _ _ _ _ _ _ _ _ _ _ _ _ _ (1992)
(1993) (1992) _ _ _ _ _ _ _ _ _ _ _ _ _ _ (1991) (1991) _
bb For any
For any amount
amount included in in line
line 17
17 that was
was received
received from a nondisqualified
nondisqualified person, attach
attach a list
list to show the name
name of,
of, and
and amount
amount
received for
received for each
each year,
year, that
that was
was more
more than
than the
the larger
larger of
of (1)
(1) the
the amount
amount on
on line
line 25
25 for
for the
the year
year or
or (2) $5,000. (Include
(2) $5,000. (Include in
in the
the list
list
organizations described
organizations described in
in lines
lines 55 through
through 11,
11,as
as well
well as
as individuals.)
individuals.) After
After computing
computing the
the difference
difference between
between the
the amount
amount received
received
and the
and the larger
larger amount
amount described
described in in (1)
(1) or
or (2),
(2), enter
enter the
the sum
sum ofof all
all these
these differences
differences (the
(the excess
excess amounts)
amounts) for
for each
each year:
year:

(1994)
(1994) (1993)
(1993) _ (1992)
(1992) (1991)
(1991)

c Add:
Add: Amounts
Amounts from
from column
column (e)
(e) for
for lines:
lines: 15 $_
15 "'- _ 16 £_
16
17
17 $ 20
20 $_ 21 3L
21 2Z£_
d Add:
Add: Line
Une 27a
27atotal
total. . $ and line
and line 27b
27b total
total . ► 2ZsL
e Publicsupport
Public support (line
Oine27c total minus
27c total minus 27d
27d total)
total) .. ► 2ZM.
Totalsupport
Total support forfor section
section 509(a)(2)
509(a)(2) test:
test: Enter
Enter amount
amount on on line
line 23,
23, column
column (e) (e). . . . . . . . ► ~ IZ7f |$
g Public support
Public support percentage
percentage (line
(line 27e
Zle (numerator)
(numerator) divided
divided byby line
line 27f
Zlf (denominator))
(denominator» ....•
iza.
Investment income percentage (line 18. column (e) (numerator) divided bv line 27f (denominator)) ZZh.
28
28 Unusual Grants:
Unusual Grants: For
For an
an organization
organization described
described in in line
line 10,
10, 11,
11,or
or 12
12that
that received
received any
any unusual
unusual grants
grants during
during 1991
1991through 1994,attach
through 1994, attach aa list
list
(which is
(which is not
not open
open toto public
public inspection)
inspection) for
for each
each year
year showing
showing thethe name
nameof of the
the contributor,
contributor, the
the date
date and
and amount
amount of
of the
the grant,
grant, and
and aa brief
brief
description of
description of the
the nature
nature of
of the
the grant.
grant. Do
Do not
not include
include these
these grants
grants in
in line
line 15.
15. (See
(See instructions.) t\J 0 "5:..
instructions.) t^Qne.
FF 12/22/95
12/22/95
THE HEIMLICH INSTITUTE
HEIMLICH INSTITUTE
/
ftcheifcl» A fForm 99011995 FOUNDATI ON 23-7303161p age /4
P*arfV,, Private School Questionnaire (See instructions.)
(To be completed ONLY bv schools that checked the box on line 6 in Part \Y\ N/A

29 Does the organization have a racially


racially nondiscriminatory policy toward students by statement in its charter, bylaws,
other governing instrument, or in a resolution of its governing body? . . . . . . . . . . . . . . . . . . . . . . . 3SL
30 Does the organization include a statement of its racially
racially nondiscriminatory policy toward students in all its brochures,
brochures,
catalogues, and other written communications with the public dealing with student admissions, programs, and
:::~a~~~~~~nd.
scholarships? o.th.e~~r~~n. c~~~u.ni~~ti~n.s '" ~e. P.U~Ii~~~al~n~~~. s~u~~n~~d~i~~io.n~,~r~~r~~s: a.n~ . . . . /~ , J3Q.
31 Has the organization publicized its racially
racially nondiscriminatory policy through
through newspaper or broadcast media during / /
the period of solicitation
solicitation for students, or during the registration period if it has no solicitation program, in a way / /
serves? . . . • . . . . . . . . ..
that makes the policy known to all parts of the general community it serves? .. /. . . . ,50.
If ''Yes,''please
'Yes," please describe; if "No," please explain. (If you need more space, attach a separate statement.) ./
/
/1
/ !
------------------------------------------------------~---------
- - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - ~_
- - - - - - - - - -- -i/ 7.':""
- - - - - - - - --

- -- - ------- - - - - - - - - - - -- - - - - -- -- - -- - - - - -- -- - - - - - - - - ~~7
/ -- - - - - - - - - --
^_
--------------------------------------------------~-------------
32 Does the organization maintain
maintain the following:
following: //
I
a Records indicating the racial cornposltion
composition of the student body,
body, faculty, and administrative staffJ!:
staff?..' . _32a_
b Re~ords documenting
Records documenting that scholarships and other financial assistance
assistance are awarded on a ra~jailY
racially
nondiscriminatory basis?
basis? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ./:./ . . . . . . . . . . . . . . . . .
c Copies of all catalogues, brochures, communications/to the public dealing
brochures, announcements, and other written communicati0l)1to
with student admissions, programs, and scholarships?
scholarships? . . . . . . . . . . . . . . ./. /- . . . . . . . . . . . . 33SL
d Copies of all material used by the organization or on its behalf to solicit contrlbutions?
contributions? . . . . . . . . . . . . . 3&

If you answered "No" to any of the above, please


please explain. (If you need more s(5ace,
/
ace, attach a separate statement.)

33 Does the organization discriminate by race in any way with respect to'
to;

a Students' rights or privileges? 33a

b Admissions policies? . . . . 33b_

c Employment of faculty or administrative staff? . 32c.

d Scholarships or other financial assistance?


assistance?. . 33d

e Educational policies?
p o l i c i e s. ? . . . . 33e

f Use of facilities?
facilities? . . 32L

g
9 Athletic programs? . 333.

h Other extracurricular activiti


activities'?.
?
m.
If you answered ''Yes''t
'Yes" tj/any please explain. (If you need more space, attach a separate statement.)
any of the above, please

-------;r-------------------------------------------------------
34a
34a
T
Does the organization receive any financial aid or assistance from a governmental agency? . . . . . . . . . . . . . . . . . .
Does the organization receive any financial aid or assistance from a governmental agency?
34a

b
/
/
b Has
Has the
the orqanlzation's
organization's right
right to
to such
such aid
aid ever
ever been
been revoked
revoked oror suspended?
suspended? ...........•.•............
If you answered ''Yes''to
'Yes" to either 34a or b, please
please explain using an attached statement.
m.
35 D~es
/
Does the organization certify that it has complied with the applicable requirements of sections 4.01
4.01 through
through 4.05 of Rev. Proc.
75-50. 1975-2 C.B. 587. covering racial nondiscrimination? If "No." attach an explanation .25.
F 12/22/95
12/22/95
THE HEIMUCH
THE HEIMLICH INSTITUTE
INSTITUTE
SchzduleAAfForm
Schedule 999)1995
fForm 990) 1995 FOUND AT I ON
FOUNDATION 23-7303161
23-7303161 pPage
e
M 55
Ha?:jid~nA~ii
iliiiTOi Lobbyir:'lgExpenditures
Lobbying Expenditures by
by Electing
Electing Public
Public Charities
Charities (See
(See instructions.)
instructions.)
(To be completed ONLY by an eligible organization that filed Form 5768) jyA.
Checkhere
Check here ►
.. aa CH if the organization belongs to an affiliated group.
Check here ► b D if vou checked " a " above and "limited control" provisions apply.
(a)
(a) (b)
(b)
Limits on
Limits on Lobbying
Lobbying Expenditures
Expenditures Affiliated group
Affiliated group Tobe
To becompleted
completed
(Theterm
(The term "expenditures"
"expenditures"means
meansamounts
amountspaid
paidor
or incurred.)
incurred.) totals
totals for
lorALL
ALLelecting
electing
organizations
36
38 Totallobbying
Total lobbying expenditures
expendituresto to influence
influencepublic public opinionopinion (grassroots
(grassrootslobbying)
lobbying).
37
37 Totallobbying
Total lobbyingexpenditures
expendituresto to influence
influenceaalegislative legislativebodybody (direct
(direct lobbying).
lobbying). 3L.
38
38 Totallobbying
Total lobbying expenditures
expenditures (add (addlineslines36 36and and37). 37). ..... .38_
39
39 Other exempt purpose expenditures
Other exempt purpose expenditures . . . . . . . . . . . . . . . . . . . ^9_
40
40 Total exempt purpose expenditures (add
Total exempt purpose expenditures (add lines 38 and lines 38 and39)39) .
41
41 Lobbying nontaxable amount. Enter the amount
Lobbying nontaxable amount. Enter the amount from the following table- from the following table-
IfIfthe
the amount
amount onon line
line 40
40is-
is- The lobbying
The lobbying nontaxable
nontaxable amountamount is-
is-
Not over $500,000.
Not over $500,000 . . . . . . . . . . . 20% of the amount on
20% of the amount on line 40 line 40. . . . . . . . . . . . .
Over $500,000 but not over $1,000,000 . . $100,000 plus
Over $500,000 but not over $1,000,000 . . . . $100,000 plus 15% of the excess over $500,000.15% of the excess over $500,000...
Over $1,000,000 but not over $1,500,000 . $175,000 plus 10%
Over $1,000,000 but not over $1,500,000 . . . $175,000 plus 10% of the excess over $1,000,000. of the excess over $1,000,000. 4JL
Over $1,500,000
Over $1,500,000but
but not
not over
over $17,000,000.
$17,000,000. . .. $225,000 $225,000plusplus 5%
5%ofof the
the excess
excessover
over $1,500,000
$1,500,000 .
Over $17,000,000
Over $17,000,000 $1,000,000
$1,000,000 .
42
42 Grassrootsnontaxable
Grassroots nontaxableamount
amount (enter(enter 25% 25% of of line
line41)41) .
43
43 Subtract line
Subtract line42
42from
from line
line36.
36. EEnter
n t e r --0-
0 - i fif line
line 42
42isismore
more than
than line
line 36
36.
44
44 Subtract line 41 from line 38. Enter -0- if line 41 is more than
Subtract line 41 from line 38. E n t e r - 0 - i f line 41 is more than line 38 line 38.

Caution: If there is an amount on either line 43 or line 44. file Form 4720.
4- Year Averaging
4-Year Averaging Period
Period Under
Under Section
Section 501(h)
501(h)
(Some organizations
(Some organizations that
that made
made aa section
section 501(h)
501(h) election
election do
do not
not have
haveto
to complete
complete all
all of
of the
the five
five columns
columns below.
below.

1e tne instructions Tor lines i a inrouan su.i . __


Lobbying Expenditures
Lobbying Expenditures During
During 4-Year
4-Year Averaging
Averaging Period
Period

Calendar year
Calendar year (or
(or (a)
(a) (b) (c)
(c) (d)
(A (e)
<•>
fiscal vear beainnina in) ► 1995 1994 1993 1992 Total

46 Lobbying ceiling amount C150% of line 45(el1. . .

47 Total lobbying expenditures

48 Grassroots nontaxable amount

49 Grassroots ceiling amount C150% of line 48 fell . .

5ft Gjassroofs lobbying expenditures


l ^ l i t ^ H l l Lobbying Activity
Activity by Nonelecting
Nonelecting Public Charities
Charities
(For reporting only bv organizations that did not complete Part Vl-A'i (See instructions.')
During the
During the year,
year, did the organization
organization attempt to influence influence national,
national, state
state or
or local
local legislation,
legislation, including any
any Yes Amount
No
attempt
attempt to influence public
influence public opinion on a legislative matter or referendum,
a legislative matter or referendum, through the use
the use of:
aa Volunteers
Volunteers........................................... *
b Paid
Paid staff
staff or management
management (Include compensation in In expenses
expenses reported on lines c through h.). . . .
c Media advertisements.
c Media advertisements . . . . . . . . . . . . . .
d Mailings
Mailings to members, legislators, or the public public. . .
e Publications,
Publications, or published or broadcast statements
f Grants
Grants to other organizations
organizations for lobbying purposes purposes.
g Direct
Direct contact with legislators,
legislators, their staffs, government officials, or a legislative legislative body
body.
h Rallies,demonstrations,
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means.
means
i Total lobbying expenditures (add lines c through
through h) h). . . . . . . . A/Q//f

Iff 'Yes"
'Xes" to anv
any of the above,
aboye. also
also attach
anach a statement giving a detailed description of the lobbying
Igbbying activrties.
actiyqies.
F 12/22/95
F 12/22/95
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE
Schedule A fform 9901.1995 FOUNDATION 23-7303161 Page 6
f*«tt V I I ' Information
Information Regarding Transfers To and Transactions
Regarding Transfers Transactions and Relationships
Relationships With Noncharitable
Noncharitable
Organizations
Exempt Organizations
51 Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section
501(c) of the Code (other than section 501(c)(3)
501(c) (3) organizations) or in section 527, relating to political organizations?
organizations?
a Transfers from the reporting organization to a noncharitable exempt organization of:
Transfers Yes No
(i) Cash ..... 51a(i) X
(ii) Other assets
assets. . . . . . . . . . . . . . . . . . . . . . afii) X
X
b Other transactions:
(i) Sales
Sales of assets
assets to a noncharitable exempt organization b(» X
(ii) Purchases
Purchases of assets
assets from a noncharitable exempt organization b(ii) X
Rental of facilities or equipment .
(iii) Rental bflii) X
Reimbursement arrangements.
(iv) Reimbursement arrangements . b(iv) X
(v) Loans
Loans or loan guarantees
guarantees. . . . b(v) X
Performance of services or membership or fundraising solicitations
(vi) Performance solicitations. b(v\) X
■ Sharingofoffacilities,
c ,'Sharing facilities,equipment,
equipment,mailing
mailinglists,
lists,other
otherassets,
assets,ororpaid
paidemployees.
employees c X
d If the answer
answer to any of the above is 'Yes,"
"Yes," complete the following schedule. Column (b) should alwaysalways show the fair market value of the
goods, other assets, or services given by the reporting organization. If the organization received less than fair market valuevalue in any transaction
or sharing
s'larina arrangement, show in column (dl (d) the value of the goods,
aoods other assets,
assets or services received:
(8)
(a) (b) (c) (d)
Line no,
Un?nOi Amount
Amount Involved Name ncncharltabte exemDt
of noncharitable
Nam~of ,>I,
exemet oroanlzation Descrlotion
in of transfers, transactions,.and
and shartnc.
sharlna arranaements
N/A

52a
52a Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt
tax-exempt organizations
described in section 501(c) of the Code
Code (other than section 501(c)(3))
501(c) (3» or in section 527?
52n ► 0
~ CD Yes [[]]3 No
b 'Yes." complete. tha
If "Yes." the following
_II, schedule:
I schedule:

(8)
(a) (b) (c)
Name of oraanlzatlon
Nameof oroanlzation TvDe oroanlzation
Tvoe of oreantzation DescriDtion,of
of relallonshlD
relationship
N/A

F02/16/86
F 02/16/86
SUPPLEMENTARY STATEMENTS
1995 SUPPLEMENTARY STATEMENTS

HEIMLICH INSTITUTE
THE HEIMLICH INSTITUTE FOUNDATION
FOUNDATION 23-7303161
23-7303161

STATEMENT: 990 PT I - 2
STATEMENT:

LINE 8c(A)
8c(A) - SECURITIES
SECURITIES ACQUIRED
ACQUIRED ACQUISITION
ACQUISITION SOURCE
SOURCE GAIN
GAIN
DESCR IPTION
DESCRIPTION SOLD PURCHASER
PURCHASER & IMPR
EXP & DEPR PROCEEDS
PROCEEDS BASIS
BASIS (LOSS)
(LOSS)

SALE OF INVESTMENTS
INVESTMENTS VARIOUS
VARIOUS JOHNSON
JOHNSON INVESTMENTS
INVESTMENTS
VARIOUS
VARIOUS 173,799.
173,799. 160,072.
160,072. 13,727.
13,727.

AMOUNT
TOTAL AMOUNT 173,799.
173,799. 160,072.
160,072. 13,727.
13,727.
E\Nl 2 3 - 7 3 0 3 1 6 !

REALIZED CAPITAL
CAPITAL GAINS AND
AND LOSSES A c c o u n t ft
Account 06390287
# 06390287

JUNE 1 . 1995
JUNE 1, MAY
1995 - M AY 3 1 , 1996
31, 1996 HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE FOUNDATION,
FOUNDATION, INCORPORATED
INCORPORATED

QUISITION
ACQUISITION PROCEEDS DOLLAR
DOLLAR DOLLAR
DOLLAR $ GAIN
GAIN I/
QUANTITY
QUANTITY ASSET DESCRIPTION
ASSET DESCRIPTION DATE
DATE DATE
DATE COST
COST PROCEEDS
PROCEEDS LOSS
lOSS
SHORT TERM
SHORT TERM CAPITAL
CAPITAL TRANSACTIONS
TRANSACTIONS
60 MINNESOTA
MINNESOT MINING & MANUFACTURING
A MINING MANUFACTURING COMPANY
COMPANY 1 2/22/94
12/22/94 0925/95
09 25/95 3,171.60
3,171.60 3,257.89
3,257.89 86.29
86.29
10,000 UNITED STATES
UNITED STATES TREASURY BOND
TREASURY BOND 09/28/94
09/28/94 0705/95
07 05/95 9,281.25
9,281.25 9,737.50
9.737.50 456.25
4 56.25
5.125 %% DUE 12/31/98
12/31/98 DATED 12/31/93
DATED 12/31/93
10,000
10,000 UNITED
UNITED STATES
STATES TREASURY BOND
TREASURY BOND 0 9/28/94
09/28/94 07 27/95
27/95 9,281.25
9 ,281.25 9,687.50
9 .687.50 406.25
4 06.25
5.125 % DUE
DUE 12/31/98
12131198DATED 12/31/93
DATED 12/31/93
TOTAL NET SHORT
TOTAL NET TERM CAPITAL
SHORT TERM CAPITAL GAINS
GAINS $21,734.10
$ 21,734.10 $22,682.89
$ 22,682.89 $948.79
$ 948.79

lONG TERM
LONG CAPITAL TRANSACTIONS
TERM CAPITAL TRANSACTIONS
100 ABBOTT LABORATORIES
ABBOTT lABORATORIES 1 0/08/92
10/08/92 05
05 02/96
02/96 2,820.50
2,820.50 3,978.37
3 ,978.37 1,157.87
1 ,157.87
20,000
20,000 BELL
BELL SOUTH CORPORATION
SOUTH CORPORATION 06/09/93
06/09/93 0801/95
06 01/95 19,837.S0
1 9,837.50 19,310.00
1 9,310.00 -527.80
-527.80
6.375 % DUE 06/15/04
06/15/04 DATED 06/15/93
DATED 06/15/93
10.000 CAROLINA TELEPHONE
CAROLINA TELEPHONE AND AND TELEGRAPH
TELEGRAPH 0 4/21/93
04/21/93 07 13/95
07 ~3195 9,857.00
9 ,857.00 9,560.00
9 ,560.00 --297.00
297.00
6.125 % DUE 05/01/03
05/01/03 DATED 05/05/93
DATED 05/05/93
10,000
10,000 FEDERAL LAND
FEDERAL LAND BANK DEBENTURE
BANK DEBENTURE 0 8/24/87
08/24/87 05 222/96
05 2/96 8,768.75
8 ,768.75 10,087.50
1 0,087.50 1,318.75
7.350 % DUE 01/20/97
7.350 01/20/97 DATED 01/20/77
DATED 01/20177
10,000 FEDERAL NATIONAL
FEDERAL NATIONAL MORTGAGE ASSOCIATION
MORTGAGE ASSOCIATION 1 2/19/91
12/19/91 0 4 03/96
Ot. :3/96 10,084.38
1 0,084.33 10,240.63
1 0,240.63 156.25
1 56.25
7.050 % DUE
7.050 DUE 12/10/98 DATED
DATED 12110/91
12/10/91
213 FEDERAL SIGNAL
FEDERAL CORPORATION
SIGNAL CORPORATION 1 2 / 2 1 / 9 2 02..
12/21/92 02. ' 22/96
/96 3,287.66
3 ,287.65 5,678.48
5 ,678.48 2,390.82
2 ,390.82
60 HEWLETT-PACKARD COMPANY
HEWLETT-PACKARD COMPANY 08/10/94 05 2JI96
0 8 / 1 0 / 9 4 05 20/96 2,412.00
2,412.00 6,596.18
6,596.18 4,184.18
4,184.18
15,000 INTERNATIONAL LEASE
INTERNATIONAL LEASE FINANCE
FINANCE CORPORATION
CORPORATION 12110/91 112J:95
1 2 / 1 0 / 9 1 11 3 0/95 14,989.65
14,989.6; 15,004.50
1 5,004.50 14.85
1 4.85
6.875 % DUE 12115/95
6.875 12/15/95 DATED
DATED 12110/91
12/10/91
120 MALLINCKRODT GROUP,
MALLINCKRODT INCORPORATED
GROUP, INCORPORATED 0 3/08/93
03/08/93 09
09 :3;95
05/95 3,534.6J
3,534.60 4,550.25
4,550.25 1,015.65
110 MAY DEPARTMENT
MAY DEPARTMENT STORES
STORES COMPANY
COMPANY 0 3/19/92
03119/92 11
11 •. 5f95
5.'95 3,256.C:)
3,256.CO 4,765.59
4,765.59 1,509.59
80 MEAD CORPORATION
MEAD CORPORATION 09118192
09/18/92 09 25f95
0925'95 2,950AJ
2,950.-10 4,633.84
4,633.84 "\,683.4~
1,683.44
50 MEAD CORPORATION
MEAD CORPORATION 03/22/94
03/22/94 OS 05/95
0925.95 2,174.2~
2,174.25 2,896,15
2 ,896.15 7 21.9C
721.90
20,000
20,000 NORWEST CORPORATION
NORWEST CORPORATION SUBORDINATED
SUBORDINATED NOTE 06/18/93
06/18/93 01 :?
01 : ; 96 20,103.6:
20,103.60 20,455.00
2 0,455.00 351.20
3 51.20
6.625 % DUE 03/15/03
6.625 03:15/03 DATED 03/15/93
DATED 03/15/93
140 PIEDMONT NATURAL
PIEDMONT NATURAL GAS COMPANY
GAS COMPANY 04/26/93
04/26/93 05
05 '':
•- 96 3,376.80
3,376.80 2.931,50
2 .931.50 ·445.30
-445.30
140 PIEDMONT NATURAL
PIEDMONT GAS COMPANY
NATURAL 'GAS COMPANY 0 7/16/93
07/16/93 05
05 •'':- 96 3,189.76
3,189.76 2,931.50
2,931.50 --258,26
258.26
1
11010 STEWART
STEWART & STEVENSON SERVICES
STEVENSON SERVICES 0 3/18/92
03/18/92 1C ::.
10 3- 95 2,887.5:
2,887.53 2,530.00
2 ,530.00 ·357.5C
-357.50
15,000 UNITED STATES
UNITED STATES TREASURY
TREASURY NOTE NOTE 10114192
10H4/92 07::"
07 3" 95 14,817.·,~
1 4,817.19 14,943.75
1 4,943.75 126.56
1 26.56
6.375
6.375 %% DUE 08.'15/02
08/15/02 DATED
DATED 08115/92
08/15/92
10,000 XEROX CREDIT
XEROX CORPORATION
CREDIT CORPORATION 0 4/14/89
04114/89 0': .::
04 - ; 96 9,990.C2
9 ,990.00 10,000.00
1 0,000.00 10.00
1 0.00
10.125
10.125 % % DUE
DUE 04/1
04115/99 04/15/89
DATED 04/1
5/99 DATED 5/89
TOTAL NET LONG
TOTAL NET LONG TERM
TERM CAPITAL GAINS
CAPITAL GAINS $138,338.0
$ 1 3 8 , 3 3 8 . 0 4.. $151,093.24
$ 151,093.24 s'2,755.20
S 12.755.20

CAPITAL DISTRIBUTIONS
CAPITAL DISTRIBUTIONS
0 JOHNSON OPPORTUNITY
JOHNSON OPPORTUNITY FUND
FUND 95
12 L ~ 95 23.08 23.05
23.03
TOTAL
TOTAL CAPITAL DISTRIBUTIONS
CAPITAL DISTRIBUTIONS $0.00 $23.08
$23.08 $23.08
$23.08

TOTAL GROSS
TOTAL GROSS PROCEEDS
PROCEEDS *fi/foO;Ol'd..
I 4 O , 0 n $173.799.21
$173,799.21 « | 3 .. 1'J7
<l ^ 7
1l13

This report summarizes


';'his summarizes the portfolio
portfolio transactions convenience.
transactions for your convenience.
V.'e do not guarantee
""'e guarantee its appropriateness
appropriateness for use in tax preparation.
preparation.

Johnson Investment Counsel, Inc.


Inc.
S+rrd- 990 ?t
•b-t-ivvt-^o P tIr -- 44
1995 SUPPLEMENTARY
SUPPLEMENTARY STATEMENTS
STATEMENTS

HEIMLICH INSTITUTE
THE HEIHLICH INSTITUTE FOUNDATION
FOUNDATION 23-7303161
23·7303161

STATEMENT: 990 PT IV -1
STATEMENT: ·1

LAND .- BASIS
BASIS
DESCRIPTION
DESCRIPTION BEG.YEAR
BEG.YEAR ADDITIONS
ADDITIONS RETIREMENTS
RETIREMENTS TRANS/OTH
TRANS/OTH END YEAR

EQUIPMENT
EQUIPMENT 37,015.
37,015. 2,366.
2,366. 39,381-
39,381.

TOTAL AMOUNT
AMOUNT 37,015.
37,015. 2,366.
2,366. 39,381-
39,381.

STATEMENT: 990 PT IV -2
STATEMENT:

LAND - DEPRECIATION
DEPRECIATION
DESCRIPTION
DESCRIPTION BEG. YEAR
BEG.YEAR ADDITIONS
ADDITIONS RETIREMENTS
RETIREMENTS TRANS/OTH
TRANS/OTH END YEAR

EQUIPMENT
EQUIPMENT 12,675.
12,675. 4,727.
4,727. 17,402.
17,402.

TOTAL AMOUNT
AMOUNT 12,675.
12,675. 4,727.
4,727. 17,402.
17,402.

STATEMENT: 990 PT IV -3
STATEMENT:

OTHER ASSETS
ASSETS END
;ND OF
DESCRIPTION
DESCRIPTION YEAR

ADVANCES AND OTHER ASSETS


ADVANCES ASSETS 5,811-
5,811

TOTALS
TOTALS 5,811-
5,811
').
>

--
INDUSTh. ANALYSIS
INDUSTh. ANALYSIS Account
Account tt 06390287
# 06390287
-s
v9 ~
,
('[) MAY
MAY 3 1 , 1996
31.1996 HEIMLICH
HEIMLICH INSTITUTE FOUNDATION, INCORPORATED
INSTITUTE FOUNDATION, INCORPORATED " > >-
o \-
t-
(V) AVG.
AVG. EST.
EST, YLD. TO (l-
YlD.
rr-
i
QUANTITY
QUANTITY ASSET DESCRIPTION
ASSET DESCRIPTION
TOTAL
TOTAL
COST
COST
UNIT
UNIT
COST
COST
MARKET
MARKET
PRICE
PRICE
MARKET
MARKET
VALUE
VALUE
UNIT
UNIT
INCOME
INCOME
ANNUAL
INCOME
INCOME
CURRENT
CURRENT
YIELD
YIELD
% OF
% OF
PORT.
PORT.
DUE 0-
DUE
DATE
DATE 0
o
0-
BONDS
BONDS·- TAXABLE o
Y) cr
(J
BANK
BANK AND FINANCE
FINANCE BONDS
BONDS
r6
.. 15,000
15,000 BANKERS TRUST
BANKERS
7.500%
TRUST OF NEW
7.500% DUE
NEW YORK
DUE 01/15/02
01/15/02
YORK
DATED 01/15/92
DATED 01115/92
1 4,432
14.432 96.21
96.21 100.75
1 00.75 1 5,113
15.113 75.00
7 5.00 1,125 7.4 2.9 7.3
t
$

2:
20,000
20,000 FIRST CHICAGO NBD
FIRST CHICAGO
(FORMERLY
{FORMERlY NBD
7.250%
7.250% DUE
NBD CORP
CORP
BANCORP)
NBD BANCORP)
DUE 08/15/04
08/15/04 DATED 08/24/92
DATED 08/24/92
20,789
2 0,789 1 03.95
103.95 98.75
9 8.75 19,750
19.]50 72.50
7 2.50 1,450
1.450 7.3
7.3 3.8 7.4
j1!P
LU 10,000
10,000 PNC FUNDING CORPORATION
PNC FUNDING CORPORATION 10,130
10,130 101.30
101.30 97.25
97.25 9,725
9,725 68.75
68.75 6688
88 7.0 1.9
1.9 7.4
SUBORDINATED DEBENTURE
SUBORDINATED DEBENTURE
6.875% DUE
6.875% 03/01/03 DATED
DUE 03/01/03 DATED 02123193
02/23/93
8ANK AND FINANCE
TOTAL BANK BONDS
FINANCE BONDS . $45,350
$45,350 $ 44,588
$44,588 $3,263
$ 3,263 8.6%
-s:6%

GOVERNMENT AGENCY BONDS


GOVERNMENTAGENCY BONDS
10,000
10,000 FEDERAL NATIONAL MORTGAGE
FEDERALNATIONAL MORTGAGE ASSOCIATION 9 ,486
9,486 94.86
94.86 91.13
9 1.13 9 ,113
9,113 58.75
5 8.75 5 88
588 6.4 1.8
1.8 7.1
7.1
5.875% DUE 02/02/06
5.875% DUE 02/02/06 DATED 02/02/96
DATED 02102196
1 5,000
15,000 FEDERAL NATIONAL MORTGAGE
FEDERALNATIONAL MORTGAGE ASSOCIATION
ASSOCIATION 14,747
1 4,747 98.31
9 8.31 98.16
98.16 1 4,723
14,723 72.00
72.00 1,080 7.3 2.8 7.6
7.200%
7.200% DUE
DUE 01/10/02
01/10102 DATED 01/10/92
DATED 01/10/92
1 0,000
10,000 FEDERAL NATIONAL MORTGAGE
FEDERALNATIONAL MORTGAGE ASSOCIATION
ASSOCIATION 10,000
1 0,000 1 00.00
100.00 105.53
1 05.53 1 0,553
10,553 87.00
87.00 870
870 8.2 2.0 6.6
8.700% DUE
8.700% DUE 06/10/99
06110/99 DATED
DATED 06/12/89
06/12/89
TOTAl GOVERNMENT
TOTAL GOVERNMENTAGENCY BONDS
AGENCY BONDS $34,233
$ 34,233 $34,389
$ 34,389 $2,538
$ 2,538 -s:6%6.6 %

GOVERNMENT
GOVERNMENT BONDS
BONDS
15,000
15,000 UNITED STATES
UNITED STATES TREASURY
TREASURY NOTE
NOTE 13,976
1 3.976 93.17
9 3.17 91.69
9 1.69 1 3,753
13,753 56.25
56.25 8 44
844 6.1 2.7 6.8
5.625%
5.625 % DUE
DUE 02/15/06
02115/06 DATED 02/15/96
DATED 02115/96
20,000
20,000 UNITED STATES
UNITED STATES TREASURY
TREASURY NOTE
NOTE 2 0,344
20,344 101.72
101.72 103.66
103.66 20,731
2 0,731 7 5.00
75.00 1,500 7.2 4 .0
4.0 6.6
7.500%
7.500% DUE
DUE 11/15/01
11/15/01 DATED
DATED 1 1/15/91
11115191
1 5,000
15,000 UNITED STATES
UNITED STATES TREASURY
TREASURY NOTES
NOTES 15,213
1 5,213 101.42
1 01.42 100.19
1 00.19 1 5,028
15,028 6 5.00
65.00 9 75
975 6.4 2.9 6.4
6.500% DUE
6.500% DUE 04/30/99
04/30/99 DATED 05/02/94
DATED 05/02/94
TOTAL GOVERNMENT
GOVERNMENT BONDSBONDS $49,533
$ 49,533 $49,512
$ 49,512 $3,319
$ 3,319 ~% 9 . 6 %

INDUSTRIAL
INDUSTRIAL BONDS
BONDS
15,000
15,000 AMOCO CANADA 15,167
1 5,167 101.12
1 01.12 97.13
97.13 1 4,569
14,569 67.50
6 7.50 1,013 6.9 2.8 7.2
6.750%
6.750% DUE
DUE 02/15/05
02/15/05 DATED 02/15/93
DATED 02115193
20,000
20,000 INTERNATIONAL BUSINESS MACHINES
INTERNATIONAL BUSINESS MACHINES CORP.
CORP. 20,025
2 0,025 100.13
1 00.13 98.88
98.88 19,775
19,775 63.75
63.75 1,275 6.4 3.8 6.6
6.375% DUE 06/15/00
6.375% DUE 06115/00 DATED
DATED 06/1 5/93
06/15/93
15,000
15,000 WAL-MART STORES,
WAL·MART STORES, INC. 14,967
1 4,967 99.78
9 9.78 96.25
96.25 14,438
14,438 65.00
65.00 975
975 6.7 2.8 7.1
7.1
6.500% DUE
6.500% DUE 06/01/03
06/01/03 DATED 06/01/93
DATED 06/01/93
INDUSTRIAL BONDS
TOTAL INDUSTRIAL BONDS $50,159
$ 50,159 $ 48,781
$48,781 $3,263
$ 3,263 ~% 9 . 4 %

Johnson Investment Counsel,


Johnson Investment Counsel, Inc.
Inc.
~
INDUSTh
INDUSTh ANALYSIS
ANALYSIS Account II 06390287
A c c o u n t tt 06390287

MAY
M 31,
AY 3 1 , 1996
1996 HEIMLICH
H E I M L I C H IINSTITUTE FOUNDATION,
NSTITUTE F O U N D A T I O N , INCORPORATED
INCORPORATED

AVG.
A VG. EST.
EST. YLD.
Y L D . TTO
O
TOTAL
TOTAL UNIT
UNIT MARKET
MARKET MARKET
MARKET UNIT
UNIT ANNUAL CURRENT
CURRENT %OF
% OF DUE
DUE
QUANTITY
QUANTITY ASSET DESCRIPTION
ASSET DESCRIPTION COST
COST COST
COST PRICE
PRICE VALUE
VALUE INCOME
INCOME INCOME
INCOME YIELD
YIELD PORT.
PORT. DATE
DATE
SOVEREIGNBONDS
SOVEREIGN BONDS
20.000
2 0,000 PROVINCEOF
PROVINCE ONTARIO GLOBAL
OF ONTARIO GLOBAL BOND
BOND 19,947
1 9,947 99.74
9 9.74 97.38
9 7.38 19,475
1 9,475 61.25
6 1.25 1,225
1,225 6.2
6.2 3.8
3.8 6.8
6.8
6.125%
6 DUE 006/28/00
. 1 2 5 % DUE DATED 06/17/93
6 / 2 8 / 0 0 DATED 06/17/93
TOTAL SOVEREIGN
TOTAL SOVEREIGNBONDS
BONDS $$19,947
19,947 $19.475
$ 19,475 $1,225
$ 1,225 ---:3:8%
3.8%

UTILITY BONDS
UTILITY BONDS
115.000
5,000 GTE WISCONSIN
GTE WISCONSIN 113,900
3,900 992.67
2.67 999.38
9.38 114,906
4,906 777.50
7.50 1,163
1,163 7.7
7.7 2.9
2.9 7.8
7.8
77.750% DUE 005/01/03
. 7 5 0 % DUE DATED 06/01173
6 / 0 1 / 0 3 DATED 06/01/73
110.000
0,000 HAWAIIAN
H TELEPHONECOMPANY
A W A I I A N TELEPHONE COMPANY 88,578
,578 885.78
5.78 999.88
9.88 99,988
,988 667.50
7.50 675
675 6.7
6.7 1.9
1.9 6.8
6.8
FIRST MORTGAGE
FIRST MORTGAGE
66.750% DUE 004/01/98
. 7 5 0 % DUE DATED 03/28/68
4 / 0 1 / 9 8 DATED 03/28/68
220.000
0,000 PUBLIC SERVICE
PUBLIC SERVICE ELECTRIC
ELECTRICAND GAS COMPANY
A N D GAS COMPANY 119,908
9,908 99.54
99.54 94.50
94.50 118,900
8,900 65.00
65.00 1,300
1,300 6.8
6.8 3.7
3.7 7.4
7.4
66.500% DUE 005/01/04
. 5 0 0 % DUE DATED 05/01/93
5 / 0 1 / 0 4 DATED 05/01/93
TOTAL UTILITY
TOTAL UTILITY BONDS
BONDS $$42,385
42,385 $$43,794
43,794 $$3,138
3,138 -a:5%8 . 5 %

TOTAL BONDS
TOTAL BONDS -- TAXABLE $$241,608
241,608 $$240,539
240,539 $$16,746
16,746 446.5%
6.5%
STOCKS -- COMMON
STOCKS COMMON
BASIC INDUSTRY
BASIC INDUSTRY
100
100 MINNESOTA MINING
MINNESOTA MINING && MANUFACTURING
MANUFACTURING COMPANY
COMPANY 44,734
,734 447.34
7.34 668.25
8.25 66,825
,825 1.88
1.88 188
188 2.7
2.7 1.3
1.3
2294
94 SONOCO PRODUCTS
SONOCO PRODUCTS COMPANY
COMPANY 55,880
,880 220.00
0.00 227.38
7.38 88,048
,048 0.66 194
194 2.4
2.4 1.6
1.6
TOTAL BASIC
TOTAL BASIC INDUSTRY
INDUSTRY $$10,614
10,614 $$14,873
14,873 $$382
382 ~% 2.9 %

CAPITAL GOODS
CAPITAL GOODS
125
125 DOVER CORPORATION
DOVER CORPORATION 55,639
,639 445.11
5.1 1 447.50
7.50 55,938
,938 00.60
.60 75
75 1.2
1.2 1.1
1.1
130
130 GENERALELECTRICCOMPANY
GENERAL ELECTRIC COMPANY 55,596
,596 443.05
3.05 882.75
2.75 110,758
0,758 1.84
1.84 2239
39 2.2
2.2 2.1
2.1
TOTAL CAPITAL
TOTAL CAPITAL GOODS
GOODS $$11,235
11,235 $$16,695
16,695 $$314
314 ~% 3 . 2 %

CONSUMER/CYCLICAL
CONSUMER/CYCLICAL
880
0 DISNEY (WALT)
DISNEY (WAL T) COMPANY
COMPANY 44,650
,650 558.12
8.12 660.75
0.75 44,860
,860 00.44
.44 35
35 0.7
0.7 0.9
0.9
1100
00 DONNELLEYIR.R.l
DONNELLEY (R.R.) & SONS COMPANY
& SONS COMPANY 22,959
,959 229.59
9.59 336.75
6.75 33,675
,675 00.72
.72 72
72 1.9
1.9 0.7
0.7
100
100 ECHLIN INCORPORATED
ECHLIN INCORPORATED 3,121
3,121 331.21
1.21 334.38
4.38 33.438
,438 00.88
.88 88
88 2.5
2.5 0.7
0.7
2200
00 SHERWIN WILLIAMS
SHERWIN WILLIAMS COMPANY
COMPANY 66,257
,257 331.28
1.28 444.88
4.88 88,975
,975 00.70
.70 140
140 1.5
1.5 1.7
1.7
2200
00 WALGREEN COMPANY
WALGREEN COMPANY 33,935
,935 119.68
9.68 331.88
1.88 66,375
,375 00.44
.44 88
88 1.3
1.3 1.2
1.2
TOTAL CONSUMER/CYCLICAL
TOTAL CONSUMER/CYCLICAL $$20,921
20,921 $$27,323
27,323 $$423
423 -s:2%
5.2%

CONSUMJ:;R/NON-CYCLICAL
CONSUMER/NON-CYCLICAL
1150
50 ALBERTSON'S, INC.
ALBERTSON'S, INC. 44,643
,643 330.96
0.96 339.88
9.88 5,981
5,981 00.60
.60 990
0 1.5
1.5 1.2
1.2
100
100 GILLETTE COMPANY
GILLETTE COMPANY 2:?<1G8
,168 2211.68
4.68 559.13
9.13 5.913
5,913 0.72
0.72 72
72 1.2
1.2 1.1
1.1

Johnson Investment
Johnson lnvostmont Counsel,
Counsel, Inc.
Inc.
INDUSTr. . ANALYSIS
INDUSTK. ANALYSIS
\ >r
06390287
Account
A ccount # 06390287

MAY
M A Y 31,1996
31,1996 HEIMLICH
H E I M L I C H INSTITUTE
I N S T I T U T E FOUNDATION,
F O U N D A T I O N , INCORPORATED
INCORPORATED

AVG.
AVG. EST.
EST. YLD.
YLD. TO
TO
TOTAL UNIT MARKET
MARKET MARKET
MARKET UNIT ANNUAL CURRENT
CURRENT %OF
% DUE
DUE
QUANTITY
QUANTITY ASSET DESCRIPTION
ASSET DESCRIPTION COST
COST COST
COST PRICE
PRICE VALUE
VALUE INCOME
INCOME INCOME
INCOME YIELD
YIELD PORT. DATE
CONSUMER/NON-CYCLICAL
CONSUMER/NON-CYCLICAL
200
200 MCDONALD'S CORPORATION
CORPORATION 7,289
7,289 36.45
36.45 48.13
48.13 9,625
9,625 0.30
0.30 60
60 0.6
0.6 1.9
1.9
140
140 PROCTER& GAMBLE COMPANY
PROCTER & GAMBLE COMPANY 6,930
6,930 49.50
49.50 87.88
87.88 12,303
12,303 1.60
1.60 224
224 1.8
1.8 2.4
2.4
TOTAL CONSUMER/NON-CYCLICAL
TOTAL CONSUMER/NON-CYCLICAL $21,330
$21,330 $33,821
$33,821 $446
$446 ---s:6%
6.6%

ENERGY
ENERGY
100
100 MOBIL
MOBIL CORPORATION
CORPORATION 9,815
9,815 98.15
98.15 112.88
112.88 11,288
1 1,288 4.00
4.00 400
400 3.5
3.5 2.2
2.2
75
75 ROYAL DUTCH
ROYAL DUTCH PETROLEUM
PETROLEUMCOMPANY
COMPANY 7.071
7,071 94.28
94.28 149.94
149.94 11.245
11,245 4.70
4.70 352
352 3.1
3.1 2.2
2.2
(NETHERLANDS)
(NETHERLANDS)
TOTAL
TOTAL ENERGY
ENERGY $16,886
$16,886 $22,533
$22,533 $752
$752 ~% 4.4 %

FINANCIAL
FINANCIAL SERVICES
SERVICES
120
1 20 COREST ATES FINANCIAL CORPORATION
CORESTATES CORPORATION 4.755
4,755 39.62
39.62 39.38
39.38 4,725
4,725 1.68
1.68 202
202 4.2
4.2 0.9
0.9
55
55 GENERALRE
GENERAL RE CORPORATION
CORPORATION 5.694
5,694 103.53
103.53 146.00
146.00 8,030
8,030 2.04
2.04 112
112 1.3
1.3 1.6
1.6
200
200 REGIONSFINANCIAL
REGIONS FINANCIAL CORPORATION
CORPORATION 6,400
6,400 32.00
32.00 47.25
47.25 9,450
9,450 1.40
1.40 280 2.9
2.9 1.8
1.8
TOTAL FINANCIAL
TOTAL FINANCIAL SERVICES
SERVICES $16,849
$16,849 $22,205
$22,205 $594
$594 --0%
4.3%

HEALTH CARE
HEALTH CARE
170
170 MYLAN LASORATORIES.INC.
M Y L A N LABORATORIES, INC. 3,956
3,956 23.27
23.27 19.00
19.00 3,230
3,230 0.16
0.16 27
27 0.8
0.8 0.6
0.6
170
170 SCHERING-PLOUGHCORPORATION
SCHERING-PLOUGH CORPORATION 5.531
5,531 32.53
32.53 58.63
58.63 9,966
9,966 1.32 224
224 2.2
2.2 1.9
1.9
80
80 SMITHKLINE
SMITHKLINE BEECHAM
BEECHAM PLC
PLC ADR
ADR 4,005
4,005 50.06
50.06 51.00
51.00 4,080
4,080 1.24
1.24 99
99 2.4
2.4 0.8
0.8
TOTAL HEALTH
TOTAL HEALTH CARE
CARE $13.492
$13,492 $17,276
$17,276 $350 ~% 3.3 %

MID-SIZED COMPANIES
MID-SIZED COMPANIES
498.432
4 98.432 JOHNSON
JOHNSON OPPORTUNITY
OPPORTUNITY FUND
FUND 7,840
7 ,840 15.73
15.73 21.68
21.68 10,806
10,806 0.08
0 .08 40
4 0 0.3
0.3 2.1
2.1
TOTAL MID-SIZED
TOTAL MID-SIZED COMPANIES
COMPANIES $7,840
$7,840 $10,806
$10,806 $40
$40 ~% 2.1 %

TECHNOLOGY
TECHNOLOGY
60
60 COMPUTER
COMPUTER ASSOCIATES
ASSOCIATES INTERNATIONAL,
INTERNATIONAL, IINC.
NC. 4.342
4,342 72.37
72.37 72.75
72.75 4,365
4,365 0.14
0.14 8 0.1
0.1 0.8
250
250 E M C CORPORATION
CORPORATION 5.523
5,523 22.09
22.09 22.00
22.00 5.500
5,500 0.00
0.00 0 1.1
200
200 GENERALMOTORS CORPORATIONCLASS
GENERAL MOTORS CORPORATION CLASS EE 6.686
6,686 33.43
33.43 56.38
56.38 11.275
11,275 0.60
0.60 120
120 1.0
1.0 2.2
2.2
(ELECTRONICDATA
(ELECTRONIC D A T A SYSTEMS)
SYSTEMS)
100
100 HEWLETT-PACKARD
HEWLETT-PACKARD COMPANY
COMPANY 4.020
4,020 40.20
40.20 106.50
106.50 10,650
10,650 0.80
0.80 80
80 0.7
0.7 2.1
2.1
70
70 MOTOROLA INC.
MOTOROLA INC. 3.927
3,927 56.10
56.10 66.75
66.75 4,673
4,673 0.40
0.40 28
28 0.5
0.5 0.9
0.9
TOTAL TECHNOLOGY
TOTAL TECHNOLOGY $24.498
$24,498 $36,463
$36,463 $236
$236 77.1
.1%%

TRANSPORTATION
TRANSPORTATION
i\
US ~i IlUl11INl
m iTON NOI1IIII
i l l ! INCiTON NOIlIIIIIINUN SAN
SAN I1/\ II
A I'L !,.II:I
!>. I 111 ()O.l!)
(iO. 1!) IJtI.7!i
IJ4.75 'I.LOtl
7,204 1.:10
1.20 102
102 1.'l
1.4 1.4
1.4
CUIlI'OIIAIION
COKI'OHATION
TOTAL TRANSPORTATION
TOTAL TRANSPORTATION $5,
$ 5 , 1113
13 $7,204
$ 7,204 $102
$ 102 ~% 1.4 %

Johnson Investment
Investment Counsel, Inc.
Inc.
\ s^
INDUSTh. ANALYSIS
INDUSTh . ANALYSIS Account## 06390287
Account 06390287

MAY 3 1 , 1996
MAY31.1996 HEIMLICH INSTITUTE
HEIIVILICH INSTITUTE FOUNDATION,
FOUNDATION, INCORPORATED

AVG.
A VG. EST.
EST. YlO. TO
YLD. TO
TOTAL
TOTAL UNIT
UNIT MARKET
MARKET MARKET
MARKET UNIT
UNIT ANNUAL
A NNUAL CURRENT
CURRENT % OF
% OF DUE
DUE
QUANTITY
QUANTITY ASSET DESCRIPTION
ASSET DESCRIPTION COST
COST COST
COST PRICE
PRICE VALUE
VALUE INCOME
INCOME INCOME
INCOME YIELD
YIELD PORT.
PORT. DATE
DATE
UTILITIES
UTILITIES
100 A TT && TT CORPORATION
CORPORATION 5.214
5 ,214 52.14
5 2.14 62.38
6 2.38 6.238
6 ,238 1.32
1.32 132
132 2.1
2.1 1.2
1.2
275
275 GTE
G T E CORPORATION
CORPORATION 8.881
8 ,881 32.79
3 2.29 42.75
4 2.75 111,756
1,756 1.88
1.88 517
5 17 4.3
4.3 2.3
2.3
TOTAL UTILITIES
TOTAL UTILITIES $14.095
$ 14,095 $$17.994
17,994 $649
$ 649 ---:3.5%
3.5%

TOTAL STOCKS
TOTAL STOCKS·- COMMON
COMMON $$162.872
162,872 $$227.192
227,192 $$4,288
4,288 444.0%
4.0 %
CASH
CASH AND
AND EQUIVALENTS
EQUIVALENTS
CASH AND
CASH AND EQUIVALENTS
EQUIVALENTS
5.669.290 ACCRUED
5,669.290 ACCRUEDINTEREST AND DIVIDENDS
INTEREST AND DIVIDENDS 55.669
,669 1.00
1.00 1.00
1.00 5.669
5,669 0.05
0.05 2259
59 4.5
4.5 1.1
1.1
43.234.050 CASH
43.234-.050 CASH AND
AND EQUIVALENTS
EQUIVALENTS 443.234
3,234 1.00
1.00 1.00
1.00 443.234
3,234 0.05
0.05 1,978
1,978 4.5
4.5 8.4
8.4
TOTAL CASH
TOTAL CASH AND
AND EQUIVALENTS
EQUIVALENTS $$48,903
48,903 $$48.903
48,903 $$2,237
2,237 ---s:5%
9:5%

TOTAL CASH
TOTAL CASH AND
AND EQUIVALENTS
EQUIVALENTS $$48.903
48,903 $$48.903
48,903 $$2.237
2,237 99.5%
.5%
PORTfOLIOTOTAL
I'ORTPOLIO TOTI\l. $$453.383
453,383 $$516.634
516,634 $ 223.271
3,271 44.5%
.5% 1100.0%
00.0%
Ie s.~ c 0<...\, n,,_J Ef (.)ilP-{(I)~~_' (.I/t; 103)
4W3 ■>

It£ V6\!U£ 0
L/C/~l!2()

Johnson Investment
Johnson Investment Counsel,
Counsel, Inc.
E\N: d.3-13031~J
E\M: 23-^303161

Revised 9/20/96
THE HEIMLICH
HEIHLICH INSTITUTE FOUNDATION, INC.
THE BOARD OF TRUSTEES
HEIMLICH 1995-1996
1995-1996
INSTITUTE
RlUNDAnOH, INC.
P.O.BOU858 w. Whittaker, Pres,
*Harry W. Pres. Soc. Sec. ##L
ClrCIIIlII.oH4520S 2497 Grandin Road Gradison & Co.
51J.22HI()(]2 Cincinnati, OH 45208
Cincinnati, 580 Walnut Street
III ~\ 3-221{JOO3 Cincinnati, OH 45202
cincinnati,
(513)
(513) 579-5000
Philip M. Heimlich, Vice Pres.
Pres. Soc. Sec. #^
6680 Lyceum Court Cincinnati CCity
ty Hall
Cincinnati,
Cincinnati, OH 45230 801 Plum Street
(513)
(513) 624-9155 Cincinnati, OH 45202
cincinnati,
(513)
(513) 352-3647
Joseph J. Dehner, Secretary Soc. Sec. #| #____
822 Yale Avenue
Avenue Frost & Jac~
Jacobs
Terrace Park, OH 45174 2500 Central Trust Tower
Cincinnati, OH 45202 45202
(513)
(513) 651-6800
(513) 6 5 1 - 6 1 6 6 - K a t h y Barrett
(513) 651-6166-Kathy Barrett
(513) 651-6819
(513) 6 5 1 - 6 8 1 9 Fax
*Cedric W. Vogel,
Vogel, Treasurer S o c . Sec.
Soc. S e c . ##|
2270 Madison Road 500 Atlas Bank Building
Cincinnati,
Cincinnati, OH 45208 524 Walnut Street
Cincinnati,
cincinnati, OH 45202
(513)
(513) 421-4225

Heimlich, M.D.
*Henry J. Heimlich, Soc. Sec. ##^^^^^^^^H.
17 Elmhurst Place Heimlich Institute
Cincinnati,
Cincinnati, OH 45208 2368 Victory Pkwy., #410
Cincinnati, OH 45206
(513)
(513) 221-0002
Mrs. Winston C. Atteberry Soc. Sec. # .
Box 629
Eunice, LA 70535
(318)
(318) 457-2705
Mr. George Blake Soc. Sec.
Cincinnati Enquirer (513) 768-8094 direct
(513)
312 Elm Street
Cincinanti,
Cincinanti, OH 45202
Benefiting Kathy Carr S oc. S
Soc. e c . #1
Sec. #
Humanity carr
Ray Carr
3057 Saddleback Drive
S oc. S
Soc.
K
K wk.
e c . #[
Sec.
Wk. (513)
#
(513) 871-2221
871-2221
Through Cincinnati,
cincinnati, OH 45244 R wk. (513) 621-4777
wk. (513) 621-4777
(513)
(513) 231-3010
Health
and
Peace
^TMT Sa,0PT V-l V
Mrs.
Mrs. Arthur
Arthur Murray
Murray (Kathryn)
(Kathryn) Soc. Sec. ##
Soc. Sec.
22877
877 Kalakuau
Kalakuau Avenue
Avenue
THE Honolulu,
Honolulu, HI
HI 96815
HEIMLICH (808)
(808) 924-4094
INSTITUTE
FOUNDATION, INC. Monte L.
Monte L. Rovekamp Soc.
Soc. Sec.
Sec.
PO sox 8858 2864 Crescent Springs Pike
2864 Pike P.O.
P.O. Box
Box 19129
19129
CIICllUlI. Ill!45208 Erlanger, KY
Erlanger, KY 41018 Cincinnati,
Cincinnati, OH
OH 45219-0129
45219-0129
513-271-0002 (606)
(606) 341-6050
III 513 221-0003
William P.
William P. Sheehan Soc.
Soc. Sec.
Sec. #|
41
1673 Braintree
1673 (614)
(614) 466-3206
466-3206
Cincinnati,
Cincinnati, OH
OH 45255
45255
(513)
(513) 231-7467
Charles
Charles J.
J. Sgueri
squeri (Chuck)
(Chuck) Soc.
Soc. Sec.
Sec. #|
41
c/o
c/o Squeri Food
Food Service
Service Inc
Inc Squeri
Squeri Foods
Foods
619
619 Linn
Linn Street 619
619 Linn
Linn Street
Street
Cincinnati, OH
OH 45203
45203 Cincinnati,
Cincinnati, OHOH 45203
45203
(513)
(513) 381-1106
381-1106

Anson Williams
Anson Williams Soc.
Soc. Sec. #1
24615 Skyline View Drive
24615 Drive (213)
(213) 850-2685
850-2685 (office)
(office)
Malibu, CA
Malibu, CA 90265 (213)
(213) 657-4861
657-4861 (home)
(home)

Dr. Paul
Dr. Paul winchell
Winchell Soc. Sec.
Soc. Sec.
32262
32262 Oakshore
Oakshore Drive
Westlake Village,
Village, CA
CA 91361
(818)
(818) 991-5754

* These trustees
* trustees have the discretion as to the distribution of
contributions.

Benefiting
Humanity
Through
Health
and
Peace
~/
THE HEIMLICH
THE HEIMLICH INSTITUTE
INSTITUTE
FOUNDATION
FOUNDATION 23-7303161
23-7303161

SUPPLEMENTARY STATEMENTS
SUPPLEMENTARY STATEMENTS
PART:III LINE:3
PART:III LINE:3

Patient need
Patient need for
for financial
financial assistance
assistance is
determined on
determined on an
an individual
individual basis.
basis.
Each patient's
Each patient's ability
ability to
to meet medical and
meet medical and
related expenses
related expenses is
is reviewed
reviewed in
in terms
terms of
of referral
referral
information or
information through investigation
or through investigation byby the
the
foundation itself.
foundation itself.

bTKT Sc(\A p + l £ - /
OMB
.
No. 15450047
OM B No. 1545 0047
.
990 Return of Organization Exempt From Income Tax
Form
Under section 501 (c) of the Internal Revenue Code (except black lung benefit
trust or private foundation) or section 4947(a)(1) nonexempt charitable truslt/
1996
Department of the Treasury This Form is Open to
Internal Revenue Service Note: The organization may have to use a copy of this return to satisfy state reporting requirements, ^^^JblicJnsjyscUon^^

A
B
For the 1996
1996 calendar
cale ndar year.
year OR tax year period perlod beginning
bealnnlnq 06/01
06/01 . 1996
1996. and
.
and ending
ending 05/31
05j31
o Employer
D
■1997
1997
Employer identification
identification number
number
Check if:
Please
Please
C Nameof
C Name of organization
organization
,..r·'--I
~~4C'O ~C·· n(n~~
,."
0
O Change of
Change of
use IRS
use IRS
THE ...!!.S.1.MU
THE HEIJUJCH CH INSTITUTE
INST ITUTE /4~
/ \- I..J • - _. J.J ....
address FOUNDATION
FOUNDATION 23-7303161
label or label or
0 Initial
Initial return print or
Number and street (or
Number and P.O. box
(or P.O. box if
if mail
mail is not delivered to street address)
address) Room/suite E State
E State registration number
number

0 Final
Final return type. See
See 2368
2368 VICTORY
VICTORY PARKWAY
PARKWAY
Specific
0
LJ Amended return
lInstruc
Instruc
SUITE 410
SUITE
((required
r e q u i r e d also
State
alSO for
for nsuuc

tions.
tiens.
City, town,
town, or
or post
post office, state,
state, and
and ZIP+4
ZIP+4 pF Check
Check ....
0
1^.! I If exemption
If exemption
application
application
State reporting) CINCINNATI OH 45206 'S
i i Pending,
Dendino
G ► ~
G Type of organization .... H Exempt under section 501(c)(
501 (c)( 33 ) ) <l1li
-4 (insert
(insert number)
number) OR....
OR ► LJ section
section 4947(a)(1)
4947(a)(1) nonexempt
nonexempt charitable 0
charitable trust
trust
Note: Section 501(c)(3) exempt organizations and 4947(a)(1) nonexempt charitable trusts MUST attach a completed Schedule A (Form 990).
H (a) Is trus
H this agroup return filed
filed for affiliates?
affiliates? ..... LjYes I x l No If
If either box
box in
in H
H is
is checked
checked "Yes,"
'Yea.' enter four digit
enter four digit group
group

(b) If
If "Yes/
'Yes,' enter
enter the number
number of affiliates
affiliates for which
w h i c h this return is filed:.
filed:. . ► N/A exemption number
number (GEN)
(GEN) ►

(c)
(C) Is separate return
Is this a separate return filed by
by an
an organization
organization J Accounting
Accounting method: | | Cash
OCash [X]
[Xj Accrual
Accrual
covered by agroup ruling? ;, „• • ■„.• ■ I I Yes iXiNo | | Other (specify) ►

K Check h e r e ^ l I if the organization's gross receipts are normally not more than $25,000. The organization need not file a re turn with the IRS; b u t i f i t

received a Form 990 Package in the mail, it should file a return without financial data. Some states require a complete return.
Note: Form 990 EZ mav be used by oraanizations with qross receipts less than $100,000 and total assets less than $250,000 at end of vear.
Part I Revenue. Expenses, and Changes in Net Assets or Fund Balances (See Specific instructions.)
1 Contributions, gifts,
Contributions, gifts, grants,
grants, and
and similar
similar amounts
amounts received:
•i a Direct public support.
Direct support . . . . . . . 1a 78,164.
\ b Indirect public support . 1b 200,000.

1
{
c (grants) . . . . . . . . . . . .
Government contributions (grants) 1c
d Total (add lines 1a through
Total through 1c) (attach
(attach schedule of contributors) SEE 990 PT I - 1
(cash $
(cash 278 164.
278,164. noncash $ _) 1d 278,164.
t 2 93)
2 Program service revenue including government fees and contracts (from Part VII, line 93). 2
3 assessments . . . . . . . .
Membership dues and assessments 3
i
4
4 Interest on savings and temporary cash investments
Interest 4

R
fi
e
5
6a

7
b
c
Gross
Gross rents
rents
securities . . . . . .
Dividends and interest from securities.

Less: rental expenses . . . . . . . . . . . .


.

(loss) (subtract line 6b from line 6a)


Net rental income or (loss)
Other investment income (describe ► ...
6a
6b

)

6c
23.410.

1
V
e 8a
Sa Gross amount from sale
sale of assets other
assets other (A) Securities (B) Other
n
u than inventory
inventory. . 114,466. 8a
e
b Less: cost or other basis and sales expenses 94,738. 8b
c (loss) (attach schedule) ....
Gain or (loss) 19,728. 8c
d Net gain or (loss)
(loss) (combine line 8c, columns (A)
(A) and (8))
(B)) .SEE. 990 .PT J . - . 2 19,728.

i
9 Special events and activities (attach
(attach schedule)
a includino. "'-
Gross revenue (not including $ _ of
contributions reported on line 1a) 9a
b Less: direct expenses other than fundraising expenses.
expenses . . . . . . . . 9b
c Net income pr_(loss)-fFomispecial
speclel events (subtract line 9b from line 9a)
9a) . . . . .
^lOa— tQiHk^PeWtftpflvintory, ifess returns and allowances . . . . . . . . . . . . . 10a
■ b,«--Lessr-cost-of goods sdldj).l 10b
1 \ ir*"H
s of inventory (attach schedule) (subtract line 10b from line 10a)
om 10a) 10C
\ cj Gross profit orOoss) frpM Sales of inventory (attach schedule) (subtract line 10b f
^ | { $ f ^ r $ e S u J ^ f r > Pkrfjill,I, line 103)
103). . . . . . 11
12 ! Total revenufi-iacW4if)e£ld. 2. 3. 4. 5, 6c, 7, 8d. 9c, 10c. and 11) 12 321,302.
E 13
E ^ i ^ f l ^ E e M c e l J f r ^ m Iina44, column (B)) 13 128,856.
p yi ^anaaeB»nt-afid-qeTreT5rffrom line 44, column (C)) 14 50,581.
e
15 Fundraising (from line 44, column (D)) 15
s
16 Payments to affiliates (attach schedule) 16
s
17 Total expenses (add lines 16 and 44, column (A)) 17 179,437.
A 18 Excess or (deficit) for the year (subtract line 17 from line 12) 18 141,865.
N Ss
N
e es 19 Net assets or fund balances at beginning of year (from line 73, column (A)) 19 473,532.
t
t 20 Other changes in net assets or fund balances (attach explanation) SEE
SEE .990.
99Q PT.
~T. I.L : 33. 20 105,890.
s
21 Net assets or fund balances at end of vear (combine line 3 18, 19, and 20) . . . -21 721,287.
For Paperwork Reduction
Reduction Act Notice, instructions.
Notice, see separate instructions. Form 990
9 9 0 (1996)
(1996)
JXB
JX8 P 12/17/96
F 12/17/96
THE HEIMLICH
THE HEIMLICH INSTITUTE
INSTITUTE
Form
Form 990
990 (1396)
(13961 FOUNDATION
FOUNDATION 23-7303161 Page 2
P a r t it Statement
S t a t e m e n t ofOf All organizations must complete column (A). Columns (B), (C), and (D) are required for section 501(c)(3)
Functional
F u n c t i o n a l Ex nses
Expen ses and (4) organizations and section 4947(a)(1) nonexempt charitable trusts but optional for others. (See Instr)
(C)
Do not include amounts reported on line
6b, 8b, 9b, 10b, or 16 of Part
Part I.
(A) Total
(B) Program
services rsr (D) Fundraising

11H
22 Grants and allocations (attach
Grants (attach schedule) . . . . .
(cash $
(cash £ noncash $
noncasb -') 22
23
23 Specific assistance
assistance to individuals (attach schedule)
schedule) . . . . 23
24
24 Benefits
Benefits paid to or for members (attach schedule)
schedule) . 24
25
25 Compensation of officers,
officers, directors, etc 25
26 Other
Other salaries
salaries and wages . 26 48.220. 40,333. 7.887.
27
27 Pension
Pension plan contributions
contributions. 27
28
28 Other employee benefits.
benefits . 28 8.811. 3,716. 5.095.
29 Payroll taxes . . . . . . .
Payroll taxes. 29 3.507. 2,933.
30 Professional
Professional fundraising fees
fees. 30 llillllllllllll
31
31 Accounting fees . 31
32
32 Legal fees
Legal fees. 32
33
33 Supplies . 33 4.770. 2,821. 1.949.
34 Telephone . 34 4.322. 2,868. 1.454.
35
35 Postage and shipping .
Postage 35 2.345. 2,030. 315.
36 Occupancy . 36 16.200. 10.800. 5.400.
37 Equipment rental and maintenance 37
38 Printing and publications. . . . . . 38
39
39 Travel
Travel. 39 17.625. 14.470. 3.155.
40 Conferences,
Conferences. conventions,
conventions. and meetings 40
41 Interest
Interest . 41
42
42 Depreciation, depletion, etc. (attach
(attach schedule) . 42 6.945. 6.945.
43 Other expenses (itemize):
Other expenses (itemize): a a 43a
b OFFICE INSURANCE
OFFICE INSURANCE 43b 6.375. 1,497. 4.878.
c OUTSIDE SERVICES
OUTSIDESERVICES 43c 51.867. 41,511. 10.356.
d
d MISCELLANEOUS
MISCELLANEOUS 43d 8.450. 5,877. 2.573.
e 43e
444
4 Total
T o t a l functional
f u n c t i o n a l expenses
e x p e n s e s (add
(add lines 22 through
through 43)
43) Organiza-
Organiza­

tions comDletina columns (B)-(D). carry these totals to lines 13-15 . . 44 179.437.
179 437. 128,856.
128 856. 50,581.
50 581. NONE
Reporting
Reporting of of Joint
Joint Costs. - Did yyou o u report
report in ccolumn
o l u m n (B) (Program
(Program services)
services) any joint costs
costs ffrom
r o m a combined
combined
educational c a m p a
educational campaign andi g n a n d fundraising solicitation?
solicitation? . . . . . ...... D
► LJ Yes ~
[x] No
No
If "Yes,"
"Yes," enter
enter (i) the aggregate
aggregate amount of these joint costs $ _ ; (ii) the amount allocated to Program services $
(iji) the amount allocated to Management and general $ ; and (iv) the amount allocated to Fundraising $
illafilrll Statement of Program Service Accomplishments (See Specific instructions.)
What is the organization's primary
primary exempt purpose?
purpose?'"► RESEARCH_AND_ ~~ Eli.
EDUCATION
~E~~~C!, _A!!~ ~D~~A.! 0N_ ~~!_o~~
yA_RK)US_ ~I~~A~E_S
DI_SEASE_S_ _ Program Service
Expenses
All organizations
organizations must describe their exempt purpose achievements. State
achievements. State the number of clients served, publications issued, etc. (Required for 501 (c)(3)
501(c)(3)
Discuss and
and (4) orgs.,.• and
(4)orgs
Discuss achievements
achievements that are not measurable. (Section
(Section 501(c)(3)
501 (c)(3) and (4)
(4) organizations
organizations and 4947(a)(1)
4947(a)(1) nonexempt charitable
charitable trusts 4947(a)(1)
4947(a)(l) trusts; but
must also enter the amount of grants and allocations to others.) . optional for 0others.)
tional for
I
a _T_!l!:_
_T_he .!!~i~lJ~h_
_He_imlJch_I_nsti tute_ Foundatj"on, _Inc.
I_n~tJ!.u.!~ ~o_I:J~d~0'?_nJ. _is _a_
J!2c_:_i~ _a _
corporation ~designed
_c_?ry.!?~a!i_?~ to
~2.g.!:1~d_ conduct scientific,
t_?_c.9~d~c..!_s_E:~e!20!.i_E:, _
cultural and social research into issues of
importance to the medical and (Grants and allocations $
s e c n 1 _s..!!.s_~!._m~ry_e.!:1~e~,:?!:,s
m e
b _ -5L I]i)ii5_ °'!FH Jl f^.-_il _PTL J[!y_ J?£l JYi Il _
_s~i.e.!:1!_iii~_c.!?'!!'1~nJ!.i~s_: e ) s _
b
_ include research J~t~
i.!:1~l_I:J<!e_r~~e~~~into ..!~e_!_r~a..!l!!e.!:1!_
the treatment ~f_ of ~a.!:1c:_e!:.,
cancer, _
lyme_ disease^ ^ernphyserna^
_ l_yf!!e_<!i~e~~eJ.
_e~p_!lts~~aL. and_cyst_ic_
~~d_c_y~tJ.c:_ f i b r e s i_s^
ii_P~o~~.:.. _
(Grants and allocations $ 38,750.
38 750.
c AIDS research
AIDS research and education
education

(Grants and allocations $ 56,136.


d _Ejl::!.c~!_i
_Edy_catjon_of_the
~n_'?_f_ jjenera^ p u b li~L.
~~ il~n~r:._al.p~~ i c ^ .!~e_p~!._n.!~nl1_
_the_p_ri_nting _
and d i s t r i
distributionb u t i o n of educational
educational l i t e r a t u r e to
literature to
------------------------------------------------------------------
_pubUc_ E~~e~
places _a~_I:J!_.!~_H~~m~
_p_I:J~lJ.c:_ _about^ the Heimlich Maneuver.
~~ !I~n~~~r..: _
(Grants and allocations S 33.970.
e Other program services (attach schedule) (Grants and allocations $
f Total of Program Service Expenses (should egual line 44, column (B), Program services) 128,856.
128,856.
F12/17/96
F 12/17/96
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE
Form 990 (~996) FOUNDATION
FOUNDATION 23-7303161
23· 7303161 Page
Pase 3

:::IIR:·:~.
PartiV . Balance Sheets
Balance Sheets (See
(See Specific Instructions.)
Specific Instructions.)

Note: Where attached schedules


Where required, attached schedules and amounts
amounts within the description 'column
description'column (A)
(A) (8)
(B)
should be for end of vear amounts onlv. Beginning of year End
End of
of year

45 Cash non interest bearing 48,171. 45 6,374.


46

47a
47a
b
Savings and temporary cash
Savinqs

Accounts receivable.
Less:
cash investments
investments

receivable . . . . . . . . .
allowance for doubtful accounts
Less: allowance
47a
47b
■ 37,725.

48a
48a Pledges receivable . . . . . . . . . .
Pledges receivable 48a
b Less: allowance for doubtful accounts
Less: allowance accounts 48b 48c
49
49 Grants
Grants receivable
receivable . . . . . . . . . . . . . . . . . . . 49
50
50 Receivables from officers,
Receivables officers, directors, trustees,
trustees, and key
key employees
employees
(attach
(attach schedule)
schedule). . . . . . . . . . . . . . . . . . . . 50
A
s
51a
51a Other notes
Other notes and loans receivable
receivable (attach
(attach schedule)
schedule) . . 51a
e 51c
b Less: allowance
Less: allowance for doubtful accounts
accounts . . . . . . . . 51b
s 52
52 Inventories
Inventories for sale
sale or use
use . . . . . . . .
53
53 Prepaid
Prepaid expenses
expenses and
and deferred
deferred charges
charges. 53
54
54 Investments securities (attach
Investments securities (attach schedule)
schedule) . See 970 P+ W'H 404.480. 54 664,543.
55a
55a

b
Investments
Investments land,
basis
basis
Less:
Less: accumulated
schedule)
schedule)
.
equipment:
land, buildings, and equipment:

accumulated depreciation (attach


(attach
.
55a

55b
1
56
56 Investments other
Investments other (attach schedule)
(attach schedule) .
57a
57a Land,
Land, buildings, and equipment: basis
basis . . . . . . . . 57a 55,616. SEE 990 PT IV - 1
b Less:
Less: accumulated SEE .99Q
accumulated depreciation SEE .990 PT. IV. -. 2
P.T.iv. 57b 24.347. 21,979. 57C 31,269.
58 Other assets
Other assets (describe
(describe P
► __ SEE 990 PT IV - 3
_.;:=.-.:...:...:::......;_:.......:-=-_=- ---' ) 5.811. 6,387.
59 Total assets (add lines 45 throuqh 58) (must equal line 74) 480.441. 59 746,298.

60
60 Accounts
Accounts payable
payable and accrued expenses
and accrued expenses 6,909. 60 25,011.
L
61
61 Grants
Grants payable
payable. 61
a
~ 62
62 Deferred revenue
Deterred revenue.
1 63 Loans from officers,
Loans officers, directors,
directors, trustees, and key
key employees
employe es 63
i
64a Tax-exempt bond liabilities
liabilities (attach
(attach schedule)
schedule) 64a
~ b Mortgages other notes
Mortgages and other notes payable
payable (attach
(attach schedule)
schedule) 64b
s


65 Other liabilities (describe ► ) 65
66 Total liabilities (add lines 60 throuqh 65) 6.909. 25,011.

N
N
e Organizations
Orgs follow SFAS
mizations that follow SFAS 117,
117, check here
h e r e ...
^ [X)
Q and complete
t
lines 67 through 69
lines 67 69 and lines
lines 73 and 74.
A
s 67
67 Unrestricted .....
Unrestricted 478,478. 682,368.
67
s
68 Temporarily restricted
Temporarily restricted .
t
s 69
69 Permanently
Permanently restricted
restricted . . . . . . . . . . -4,946. 69 38,919.

o
r

F
u
n
Orgs
Organizations

70
70
lines
lines 70
follow SFAS
nizations that do not follow
70 through 74.
Capital
SFAS 117,
117, check here ►

stock, trust principal, or current funds


Capital stock.
...

. . . . .
o
D and complete
■1
70
d
d 71
71 Paid-in or
or capital
capital surplus,
surplus, or
or land,
land, building, and
and equipment fund
. . 71
B 72
72 Retained earnings,
Retained earnings, endowment, accumulated
accumulated income, or other
other funds M,„
a
1
I
a
a
73
73 Total net assets or fund
fund balances (add
(add lines
lines 67
67 through 69
69 OR
OR lines
lines 70
70 through 72; mm
n
n column (A)
column (A) must equal line
must equal line 19
19 and column (8)
(B) must
must equal
equal line
line 21)
21) . 473,532. 721,287.
c
e
e
s
s
74 Total liabilities and net assets/fund balances (add lintss66 eind 73) 480,441. ™. 746,298.
F 02/12/97
F 02/12/97
THE
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE
Form 990 (1996) FOUNDATION
F 25-7303161
23-7303161 Page 4
J i l l } ! ! ! ! ! Reconciliation
Reconciliation of
of Revenue
Revenue per
per Audited
Audited Reconciliation of
Reconciliation of Expenses
Expenses per
per Audited
Audited
Financial
Finajrcial Statements
Statements with
with Revenue
Revenue per
per
mmmm Financial Statements
Financial Statements with
with Expenses
Expenses per
per
' Return (See Specific Instructions) Return
a Total revenue, gains, and other support Total
'Totalexpenses
expenses and
and losses
losses per
per
per
per audited
audited financial
financial statements
statements .. ,. .....
► J&, J£L830. audited
audited financial
financial statements
statements ....► JL 254,437.
b Amounts included
Amounts included on
on line
line aa but
but not
not on
on Amounts
Amounts included
included on
on line
line aa but
but not
not on
on
line
line 12,
12, Form
Form990:
990: line
line 17,
17, Form
Form990:
990:
(1)
0) Net unrealized
Net unrealized gains
gains (1)
0) Donated
Donated services
services
on investments .... $$
on investments 41,528.
41.528. and
and use
use of
of facilities
facilities ... . $$L_--=75-"..1.'-"'O.:::.OO,,_.,___
75.000.
(2)
(2) Donated
Donated services
services (2)
(2) Prior
Prior year
year adjustments
adjustments
and
and use
use of
of facilities
facilities $$ 75,000.
75.000. reported
reported on on line
line20,
20,
(3)
(3) Recoveriesof
Recoveries of prior
prior Form
Form 990
990 . $
year grants
year grants. .$ (3)
(3) Losses
Losses reported
reported on
on
(4)
(4) Other (specify):
Other (specify): line
line 20,
20, Form
Form 990990 .. . . $
(4)
(4) Other
Other (specify):
(specify):

Add amounts
Add amounts on
on lines
lines (1)
(1)through (4) ►
through (4) 116,528.
Add
Add amounts
amounts on
on lines
lines (1)
(1)through
through (4)
(4) >.... 75.000.
c Line aa minus
Line minus line
line bb .. .. .. .. . 321,302. c Line
Line aa minus
minus line
line bb. . . J79 437.
d Amounts included
Amounts included on on line
line 12,
12, d Amounts
Amounts included
included on line
on line 17,
17,
Form 990
Form 990 but
but not
not onon line
line a:a: Form 990
Form 990 but
but not
not on
on line
line a:
a:
(1) Investment
(1) Investment expenses
expenses (1) Investment
0) Investment expenses
expenses
not included
not included on
on line
line not included
not included onon line
line
6b, Form
6b, Form 990
990 . . . _$_ 6b,
6b, Form
Form 990
990 .. . . . 5
(2) Other
(2) Other (specify):
(specify): (2)
(2) Other
Other (specify):
(specify):

Add
Add amounts
amounts onon lines
lines (1)
(1) and
and (2)
(2) ► Add
Add amounts
amounts onon lines
lines (1) and (2)
(1)and (2) . . .
e Total
Total revenue
revenue per
per line
line 12,
12, Form
Form 990990 Total expenses per line 17, Form 990
(line
I c plus line d ) ► 321,302. (line c plus line d) 179.437.
j ! List of O f f i c e r s , D i r e c t o r s , T r u s t e e s , a n d K e y E m p l o y e e s (List each one even if not compensated; see Specific Instructions.)
(C) Compensation (D) Contributions to (E) Expense
(A) Name and address (B) Title and average hours per
(if not paid, enter employee benefit plans &. account and other
week devoted to position
-0-) deferred compensation allowances
SEE STATEMENT 990
SEE 990 PART V -- 11
NONE NONE NONE

75 Did anyany officer,


officer. director,
director, trustee, or key employee
employee receive
receive aggregate
aggregate compensation of more
more than $100,000
$100.000 from your
organization
organization and all all related
related organizations, of which more
more than $10,000
$10,000 was provided by the related
related organizations?
organizations? ►
... □ Yes
DYes E l No
~
IfIf "Yes,"
"Yes," attach
attach schedule
schedule - seesee Specific
Specific Instructions.
Instructions.

F 12/17/96
12/17/96
THE HEIMLICH INSTITUTE
THE INSTITUTE
Form 990 (1996) FOUNDATION 23-7303161 Page 5
Part VI Other I n f o r m a t i o n (See Specific Instructions.) Yes.
76 Did
Did the organization
organiz~tion engage
engage in any activityactivity notnot previously
previously reported
reported to the IRS?IRS? If "Yes,"
"Yes," attach
attach a detailed
detailed description
description of each activrty _Z§_
each activity.I-'-"-+-_-+----'-:.....
n Were
77 Were any changes
changes made made in the organizing
organizing or governing documents documents butbut not reported
reported ttoo the IRS?
IRS? . M*-
If "Yes,"
If "Yes," attach
attach a conformed
conformed copy copy of the changes.
78a Did
788 Did the organization
organization have unrelated business
have unrelated business gross gross income
income of $1,000
$1,000 or moremore during the year year covered
covered by this return?
return? . ISa
bb IfIf "Yes,"
"Yes," has it filed a tax return
return on Form F o r m ~T
9 9 0 - T for for this
this year?
year? . 78b
79 Was there
Was there a liquidation, dissolution, termination, or substantial substantial contraction
contraction during
during the year?year? If "Yes,"
"Yes," attach
attach a statement
statement. . 79
80a Is
SOa Is the organization
organization related
related (other than by association
(other than association with a statewide
statewide or nationwide
nationwide organization)
organization) through ccommono m m o n membership,
membership,
governing bodies,
bodies, trustees,
trustees, officers,
officers, etc., to any other other exempt
exempt or nonexempt
nonexempt organization?
organization? . . . . . . . . . . . . . . . . . . . 80a
b If "Yes," enter
If "Yes," enter the name
name of the organization
organization ► .... _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ and and check
check whether
whether it is L 0J exempt OR L0J nonexempt. nonexempt.
81a Enter
81a Enter the amount
amount of political
political expenditures,
expenditures, direct direct or indirect,
indirect, as described
described in the instructions
instructions. . . . . . . IL...X""""-'-
81a I __ "!!':= NONE _
bb Did
Did the organization
organization file F o r m 11120-POL
Form 1 2 0 - P O L ffor
o r this year?
year? . . . . . . . . . . . . . . . . . . . . . . . . .
82a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially
82a
m
less than fair
less fair rental
rental value?
value? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . £24
b IfIf "Yes,"
"Yes," you may indicate
indicate the valuevalue of these
these items
items here.
here. Do not
not include
include this
this amount
amount as as
revenue in Part
revenue Part I or as an expense
expense in Part Part II.
II. (See instructions
instructions for reporting
reporting in Part
Part III.)
111.) I 82b I __
w.!!Ad:!...J...... 75,000.
"'!"':::""":::=':"'__

83a Did Did the organization


organization comply
comply with with the public inspection
inspection requirements
requirements forfor returns
returns and exemption
exemption applications?
applications? 83a
bb Did
Did the organization
organization comply
comply with with the disclosure
disclosure requirements
requirements relating
relating to quid pro q u o contributions?
pro quo contributions? . . . . 83b
84a Did Did the organization
organization solicit
solicit any contributions or gifts gifts that
that were
were not tax deductible?
deductible? . . . . . . . . . . . . . . 84a
bb If If "Yes,"
"Yes," did the organization
organization include with every every solicitation
solicitation an express
express statement
statement that such such contributions
contributions or gifts
gifts werewere not
not
tax deductible? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
tax 84b
85
85 501(c)(4), (5), or (S)
501(c)(4), (6) organizations.
organizations. - a Were Were substantially
substantially all dues
dues nondeductible
nondeductible by members? members? . jB5a
b DidDid the organization
organization make make only
only iin-house
n - h o u s e lobbying expenditures
expenditures of $2,000
$2,000 or less?
less? . . . . . . . . . . . . . . . . . . 85b
If "Yes" was
If w a s answered
answered to eithereither 85a or 85b, d doon o t complete
not complete 85c through 85h below below unless
unless the organization received
organization received
a waiver
a waiver for proxy
proxy tax owed
o w e d for the prior year. year.
Dues, assessments.
cC Dues. assessments, and a n d similar
similar amounts
amounts from members members . 85c N/A
d Section
Section 162(e) lobbying and political
1S2(e)lobbying political expenditures
expenditures . 85d N/A
Aggregate nondeductible
e Aggregate nondeductible amount amount of sectionsection 6033(e)(1)(A)
S033(e)(1)(A) dues dues notices
notices. . . . 85e N/A
f Taxable amount of lobbying and political
Taxable amount political expenditures
expenditures (line (line 85d less
less line
line 85e)
85e) . 85f N/A
Does the organization
g9 Does organization elect
elect ttoo pay the section
section 6033(e)
S033(e) tax
tax oonn the amount
amount in 85f?
85f? . 85q
hh If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount in 85f to its reasonable
estimate
estimate of dues
dues allocable
allocable to nondeductible lobbying and political
political expenditures
expenditures for the following tax year?
year? . 85h
86
86 501(c)(7) organizations.
501(c)(7) organizations. - Enter:
Enter:
a Initiation
a Initiation fees
fees and capital
capital contributions
contributions included on lineline 12
12. 86a N/A
bb Gross receipts, included on line
Gross receipts, line 12, for
for public use of club facilities
facilities. 86b N/A
87
87 501 (c)(12) organizations.
501(c)(12) organizations. - Enter:
Enter: a Gross
Gross income
income from members
members or shareholders.
shareholders 87a N/A
bb Gross income from
Gross income from other
other sources.
sources. (Do not not net
net amounts
amounts due or paid paid to other
sources
sources against
against amounts
amounts due or received
received from them.)
them.) . 87b N/A
88
88 At any time
At time during the year,
year. did the organization
organization oown w n a 550%
0 % or greater
greater interest
interest in a taxable
taxable corporation
corporation or or
partnership?
partnership? If "Yes,"
"Yes," complete
complete Part
Part IX . . . . . . . . . . . . . . . . . . . . . 88
89a
89a 501(c)(3) organizations.
501(c)(3) organizations. - Enter: Amount of tax paid during the year
Enter: Amount under:
year under:
Section
Section 4911 ► .... NOAIE
A/QA/E ; section
section 4912 ► .... A/OP?
NQ}.IE section 4955
; section 4955 ► ....__ tl'--o-'N___:;E
fi/OfJG _
bb 501(c)(3)
501(c)(3) and
and 501(c)(4)
501(c)(4) organizations,
organizations, - Did the organization
organization engage
engage in any section
section 4958
4958 excess
excess benefit
transaction during the year?
transaction year? If "Yes,"
"Yes," attach a statement
statement explaining
explaining each
each transaction
transaction . 89b
cc NOIJ~
dd
Enter: Amount
Enter: Amount of tax paid by the organization
Enter: Amount
Enter:
organization managers
Amount of tax in 89c, above, reimbursed
managers or disqualified persons
reimbursed by the organization
persons during the yearyear under
under section
section 4958
organization. . . . . . . . . . . . . . . . . . . . . . . . . .
4958 . . . t
> NO/JE
NCIlE
/w^
90 List
List the states
states with which a copy of this return
return is filed ►OJU0_,_CAL_I F0_RN_IA
~Hl.0...!_C~,=-I£O!~I~ _
91
91 The
The books are in care care of ►J_0AN_STEI_NBURG_
....o!_O~N_
~T~I.!'I~U~~ Telephone
Telephone no. ► <..?.!31_2~!:QO~~
.... <Jl3J_221_-0002_ _
Located at ►
Located .... 2_368_VI£T0RY_PKWY_,
2l~8_'{_I~T'p~Y_ _STE_ 410,_
~~Y...!_S.!E_ CINTI_, _0H
~1~L .s.I~!.I..!_O!!_ ZIP+4 ►
ZIP+4.... J*|206
45206
92 Section 4947(a)(1)
Section 4947(a)(1) nonexempt
nonexempt charitable
charitable trusts filing Form
Form 990 in lieu
lieu of Form 1041-Check
1041- Check here here. - - - - - - - - - - - ~~~~~~~~~~ ~..:tJ
>D
and enter.the
enter.the amount
amount of tax-exempt
tax-exem interest received or accrued during the tax year ► I 92 I N/A
N/A
F 12/17/96
F 12/17/96
THE.HEIMLICH INSTITUTE
THE,HEIMLICH INSTITUTE
„ftB0/i99B>
,,990 '19961 FOUNDATION
FOUNDATION 2:
23-7303161
i-7303161 Paoe
Paae 66
Analvsis of
ipHSili Analysis of Income-Producing
Income-Producina Activities
Activities (See
(SeeSoecitic
Soecific instructions.}
In<>+, , .... inn' '.)

lter gross
-iter gross amounts
amounts.unless
,unlessotherwise
o1herwiseindicated.
indicated. Unr_el~t~,business
Unrelated business income
iocome Excluded
Excluded bv
b' section
eolion 512.
512.513.
513.or
or 514
514
(E)
(E)
(A)
(A) (6)
(B) (C)
(C) (0)
(D) Relatedor
Related or exempt
exempt
Business
Business code
code Amount
Amount Exclusion
Exctustcn code
code Amount
Amount function income
function income
33 Program service
Program service revenue:
revenue:
aa
hb
cc
dd
ee
ff
Feesand
g9 Fees and contracts
contracts from
from government
government agencies
agencies , , ,

Membership dues and assessments. . ...

-- --
35 Intereston
Interest on savings
savings and
and temporary
temporary cash cash iinvestments.
nvestments....
36 Dividends and
Dividends and interest
interest from
from securities
securities . , . , , . 14 23 410
23,410.
97 Net Net rental
rental income
income or or (loss)
(loss)from
from real
real estate:
estate: lil!i!!!ii iiilittiiliiiiiiiii ':::':'::'::::::::::::::

aa debt-financed
debt-financed property
property , , , , , . , ,

debt-financed property . , .
not debt-financed
bb not . , , . . .
98
98 NetNet rental
rental income
income or or (loss)
(loss) from
from personal
personal property
property .
99 Other investment
99 Other investment income
income
:00 Gain or
00 Gain or (loss)
(loss)from
from sales
sales of of assets
assets other
other than
than inventory
inventory . . _'8
18 19.728.
19,728
101
101 NetNet income
income or or (loss)
(loss)from
from special events. , .
special events
102 Gross profit
102 Gross profi1or (loss) from
or (loss) sales of
from sales of inventory
inventory .
103 Other revenue:
103 Other revenue: aa
bb
cc . ,, , ,

.-
dd
ee
104 Subtotal (add
104 Subtotal (add columns
columns (B),
(8), (D),
(D), and
and (E))
(E)). . . . . . llllllli 111111111 43.138.
43.138
105 Total
105 Total (add
(add line
line 104,
104, columns
columns (B),
(8), (D),
(0), and
and (E))
(E» , , . 43,138.
43 138.
Note: (Line 105 plus line 1d. Part I. should equal the amount on line 12. Part I
Part VIII Relationship of Activities to the Accomplishment of Exempt Purposes (See Specific instructions.)
Line No. Explain how
Explain how each
each activity
activity for
for which
which income
income is
is reported
reported in
in column
column (E)
(E) of
of Part
Part VII
VII contributed
contributed importantly
importantly to
to the
the
▼ accomplishment of
accomplishment of the organization's
organization's exempt
exempt purposes
purposes (other
(other than
than by
by providing funds
funds for
for such
such purposes).
purposes),
N/A

J i i i i i Information Regarding Taxable Subsidiaries (Complete this Part if the "Yes" box on line 88 is checked.1)
Name, address, and employer identification Percentage of Nature of Total End-of-year
numberof
number corporation or
of corporation or partnership
partnership ownership interest businessactivities
business activities income
income assets
assets

N/A

.Under pe erjury, i decJare that I have examined


examined this return,
return. including
including accompanying
accompanying schedules
schedules and
and statements,
statements. and
and to
to the
the best
best of
of my
my knowledge
knowledge and
and belief
betlle-f
Please
Ple~sEl it is true, i corr^lete/L^claratjj»rfo'f • preparer
preparer (other
lot her than
than officer)
officer) is based on
ISbased on all
all information of which preparer
in~orma(ionof has any
pre-parerhas any knowledge.
knowledge, (See
(See General instructions.)
General Instructions.)
Sign
Sign
Here ^MrJuL^
Date / ' W Type s r p r i n t name and title.

Date Check if Preparer's SSN


Preparer's
Paid
Paid signature self-employed ►P j 296-64-1856
Preparer's
Preparer's Firm's name (or NDERSEN LLP EIN ► 36-0732690
Use Only yours if self-employed)
and address 425 WALNUT STREET ZIP code ► 45202
F 12/17/96
F 12/17/96 CINCINNATI, OH
CINCINNATI, OH
--
Form
Form 2758 Ap» R a t i o n for
Ap():ation for Extension
Extension of
of Time
Time TqTlle
TOle
(Rev.May
(Rev. 1995)
May 1995) Certain Excise, Income, Information, and Other Returns
Certain Excise, Income, Information, and Other Returns OMB No. 1545-0148
OMB No. 1545-{)148
Departmentof
Department ofthe
the Treasury
Treasury
InternalRevenue
Internal RevenueService
Service ..... File aa separate
► separate application
application ffor each rreturn.
o r each eturn.
Name
Name Employer
Employer identification
identffic.atioQ number
number
Pleasetype
Please type oror
print.File
print. Filethe
the THE HEIMLICH
THE HEIMLICH INSTITUTE
INSTITUTE FOUNDATION
FOUNDATION 223-7303161
3-7303161
original and
original and Number,street,
Number, street. and
and room
room or
or suite
suite no.
no. (or
(or P.O.
P.O. box
boxno.
no.ifif mail
mail isis not
notdelivered
deliveredto
to street
street address)
address)
one copy
one copy by by the
the
duedate
due datefor filing
for filing
your return.
your return.See
See 2368
23 VICTORY PARKWAY,
68 VICTORY PARKWAY, SUITE
SUITE 410
410
instructionson
instructions on City,town
City, town or
or post
post office,
office, state,
state, and
andZIP
ZtP code.
code. For
Foraa foreign
foreignaddress,
address, see
see instructions.
instructions.
back.
back.
CINCINNATI,
CINCINNATI, OHIO
OHIO 45206
452 06
Note:
Note: Corporate
Corporate income
income tax tax return
return filers
filers must
must use
use Form
Form 7004 7004 to to request
request an an extension
extension of of time
time toto file.
file. Partnerships,
Partnerships, REMICs,
REMICs, andand
trusts must
trusts must use
use Form 8736 to
Form 8736 to request
request an an extension
extension of of time
time toto file
file Form
Form 1065,
1065, 1066,
1066, or or 1041.
1041.
11 II request
request an extension
extension of time time until J JANUARY
ANUARY 1 155 ,19J58
,19 98 ,,to file (check
(check only one):one):
o
□ Form 706-GS(D) 0□ Form Form990-T
990-T (401
(401(a) or 408(a)
(a) or 408(a)trust)
trust) 0 Form1120-ND
□ Form 1120-ND(4951 taxes)
(4951 taxes) □
o Form
Form8612
8612
o
□ Form Form 706-GS(T)
706-GS(T) 0
f j Form Form990-T
990-T (trust
(trust other
otherthan
thanabove)
above) 0
Q FormForm 3520-A
3520-A □
o Form
Form8613
8613
[X]
~ Form
o
Form990990 or
or 990-EZ
990-EZ 0
f j Form Form 1041
1041 (estate)
(estate) (see
(seeinstructions)
instructions) |0 Form4720
| Form 4720 □
o Form
Form8725
8725
□ Form990-BL
o
Form 990-BL 0
f j Form Form 1041-A
1041-A 0 Form 5227
□ Form 5227 □
o Form 8804
Form8804
□ Form990-PF
Form 990-PF 0□ Form Form 1042
1042 0□ Form
Form 6069
6069 □
o Form
Form8831
8831
0
IfIf the
the organization
organization does does notnot have
have an an office
office oror place
place of of business
business in in the
the United
United States,
States, check
check thisthis boxbox. ...► □
2a For
2a For calendar
calendar year
year 19 19 __ ,, or
or other
other tax
tax year
year beginning
beginning JUNE JUNE 11(, 11996 996 and
and ending
ending MAY MAY 331, 1 , 11997
997
bb IfIf this
this tax
tax year
year isis for
for less
less than
than 12 12 months,
months, check
check reason:
reason: j~J 0 Initial
Initial return 0 Final
return [~J return]"] Change
Final returnQ Change in in accounting
accounting period
period
33 Has Has an an extension
extension of of time
time to
to file
file been
been previously
previously granted
granted for for this
this tax
tax year?
year? 0 Yes
□ Yes \K\
~ NoNo
44 State in detail detail why
why you need the extension extension THE THE INFORMATION
INFORMATION NECESSARY NECESSARY TO TO FILE FILE A A
COMPLETE AND
COMPLETE AND ACCURATE
ACCURATE RETURN
RETURN IIS NOT YET
S NOT YET AVAILABLE.
AVAILABLE.

5a
5a IfIf this
this form
form isis for
for Form 706-GS(D),706-GS(r),990-BL,990-PF,990-T,1041 (estate),1042,1120-ND,4720,
Form706-GS(D),706-GS(T),990-BL,990-PF,990-T,1041 (estate),1042,1120-ND,4720,
6069,8612,
6069, 8612,8613,8725,8804,
8613, 8725, 8804, oror 8831,
8831,enter
enterthe
the tentative
tentativetax, lessany
tax, less any nonrefundable credits. See
nonrefundablecredits. See instructions
instructions $
$ N_O_N_E_
NONE
bb If this formform is for FormForm 990-PF,
990-PF, 990-T,
990-T, 1041
1041 (estate),
(estate), 1042,
1042, or 8804,
8804, enter
enter any refundable
refundable credits
credits and
and vrnKTTr
estimated tax
estimated tax payments
payments made.
made. Include
Include anyany prior
prior year
year overpayment
overpayment allowed
allowed asas aa credit
credit $
$ N_;O:._N_E_
NONE
cc Balance
Balance due. due. Subtract
Subtract line 5b from
from line 5a.Sa. Include
Include your payment
payment with this form,
form, or deposit FTD
deposit with FTD
coupon if
coupon if required.
required. SeeSee instructions
instructions $
$ NONE
NONE
Signature and Verification
Verification
Under penalties
Under penalties ofof perjury,
perjury, II declare
declare that
that II have
have examined
examined this
this form,
form, including
including accompanying
accompanying schedules
schedules and
and statements,
statements, and
and to
to the
the best
best of
of my
my knowledge
knowtedge and
and belief,
belief,
itrt is
is true,
true, correct,
correct, and
and complete;
complete; and
and that
that IIam
am authorized
authorized to
to prepare
prepare this
this form.
form.AARTHUR
R T H U R ^ANDERS
^ j ^EN LLLPL p I N .
EEIN: _ 0 732690
36-
36 07 3 2690

. 425
425 WALNUT STREET, CINCINNATI,
CINCINNATI, OHIO 45202 , . I
Signature^ '~f\
Signature..,. > A y,;".,;_' I:
' U " j I 11 ./ ) ; U
'XjJ^Q Trlle..,.'
Titled ( l~.
£]]_ Date..,.
Date» \Q ',~ I l^J
,;I... ^+-
FILE ORIGINAL
ORIGINAL AND
AND ONE
ONE COPY.
COPY. The
The IRS
IRS will show below whether or
or not your application
application is approved
approved and will return
return the copy/
copy.
Notice to Applicant—To
Applicant-To Be Completed by the IRS
IRS
o
□ WeWe HAVE
HAVE approved
approved your
your application.
application. Please
Please attach
attach this
this form
form to your
your return.
return.
o
JTJ We
We HAVE
HAVE NOT approved
approved your
your application.
application. However,
However, we have granted
granted a 10-day grace
grace period
period from the later of the date
shown
shown below
below or the due date of your returnreturn (including
(including any prior extensions).
extensions). This grace
grace period
period is considered
considered to be a valid
extension
extension of time for elections
elections otherwise
otherwise required
required to be made on a timely return.return. Please attach
attach this form
form to your return.
return.
o
[~J We
We HAVE
HAVE NOT approved
approved your
your application.
application. After
After considering
considering the reasons
reasons stated
stated in item 4, we cannot
cannot grant
grant your request
request for
an extension
extension of time
time to file. We
We are not granting
granting the 10-day
10-day grace period.
period.
o
(~J We
We cannot
cannot consider
consider your
your application
application because
because it was filed after the due date of the returnreturn for which
which an extension
extension was
was
requested,
requested.
o
□ Other:
Other: _

By: ___
By:
Director Date
Date

IfIf you
you want
want aa copy
copy of
of this
this form
form to
to be returned
retumed to
to an
an address
address other
other than
than that
that shown
shown above,
above,please enterthe
please enter address to
the address to which
which the
the copy
copy should
should be sent.
sent.
Name
Name

Please
Please
Type
Type
~~~~~--~----~--~~~----~~--~~~~~~77~~-------------------------------
surte no. (or P.O. box no. if mail is not
Number, street, and room or suite not delivered
delivered to street
street address)
address)

or
Print post office, state, and ZIP code. For a foreign address,
City, town or post address, see instructions.
instructions.

For Paperwork Reduction


Reduction Act Notice,
Notice, see back of form.
form. 2758
Form 2 7 5 8 (Rev. 5-95)
{Rev. 5-95)

ISA STf FED4663F


STFFED4663F
SCHEDULE
SCHEDULE A Organization
Organization Exempt Under Section
Section 501(c)(3) OMB No. 1545-0047
OMS No.

(Form 990) (Except Private Foundation)


Foundation) and Section 501(e), 501 (f), 501(k),
501(f), 501 (k),
501 (n), or
501(n), or Section
Section 4947(a)(1) Nonexempt Charitable
4947(a)(1) Nonexempt Trust
Charitable Trust 1996
1996
Supplementary Information
Supplementary Information
Department
Department of the Treasury See
See separate instructions.
instructions.
Internal Revenue
Internal Revenue Service ... Must be com Dieted bv the above oraanizations
completed oroanizations arid attached to their
and attached their Form 990 or 99O-EZI.
990 tor 990-EZ).
Name of the organization
Nameof organization THE HEIMLICH
THE HE I MLI CH IINSTITUTE
NST ITUTE Employer identification number
Employer iden1ifica1ionnumber

FOUNDATION
FOUNDATION 23-7303161
l::::P8itd)
liiliil Compensation of the Five Highest
Compensation Highest Paid Employees Other Than Officers,
Officers, Directors,
Directors, and Trustees
Trustees
(See instructions. List each one. If there are none, enter "None.")
(b) Title and
(b) average
and average
(d)
(d) Contributions
Contributions to (e) Expense
Expense
(a) Nameand
(a) Name and address of each
each employee paid more employee
employee benefit account
than $50,000
hours per week
per week (e) Oomperisation
(c) Compensation
plans deferred
plans & deferred and other
and other
devoted
devoted to position compensation allowances
allowances

NONE
NONE

Total number of
Total number of other
other employees
employees paid over
over
$50,000 . , ► NONE
Part II Compensation
Compensation of the Five Highest Paid Independent Contractors for Professional
Independent Contractors Services
Professional Services
(See instructions. List each one (whether individuals or firms). If there are none, enter "None.")

(a) Name and address of each independent contractor paid more than $50,000 (b) Type of service (c) Compensation
Compensation

NONE
NONE

Total number
Total number of
of others
others receiving over $50,000
receiving over $50,000 for
professionalI services ► NONE
For Paperwork Reduction
Reduction Act Notice, see Instructions.
Instructions. Schedule A (Form 990) 1996
990) 1996
JXB
JXS F 12/17/96
THE HEIMLICH
THE HEIMLICH INSTITUTE
INSTITUTE
Schedule A (Form 990) 1996 FOUNDATION 23-7305161 paae 2

P$tl Mi Statements About


Statements About Activities
Activities Yes No

During
Duringthe the year,
year, has
has the
the organization
organization attempted
attempted to to influence
influence national,
national, state,
state, or
or local
lo~allegislation,
legislation, including
including any
any attempt
attempt to to
influence
influence public
public opinion
opinion on on aa legislative
legislative matter
matter oror referendum?
referendum? .....
IfIf "Yes,"
"Yes,"enter
enter the
the total
total expenses
expenses paidpaid or
or incurred
incurred in
in connection
connection with
with the
the lobbying
lobbying activities
activities. . . . . . ► ....$$ ...:N:..t.I..:.A;.._
W/A _
Organizations
Organizationsthat
that made
made an
an election
election under
under section
section 501
501(h)
(h) by filing Form 5768 must complete Part VI-A.
Vl-A. Other
organizations
organizations checking
checking "Yes,"
"Yes,"must
must complete
complete Part
PartVl-B
VI-B AND
AND attach
attach aa statement
statement giving
giving aa detailed
detailed description
description of
of
the lobbying
the lobbying activities.
activities.
2 During the year,
During the year, has hasthethe organization,
organization, either
either directly
directly or
or indirectly,
indirectly, engaged
engaged inin any
any of
of the
the following
following acts
acts with
with any
any
of its trustees, directors, officers, creators, key employees, or members of their families, or with any taxable
of its trustees, directors, officers, creators, key employees, or members of their families, or with any taxable organization organization
with which any such person is affiliated as an officer, director, trustee, majority owner, or principal
with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary: beneficiary:
a Sale,
Sale, exchange,
exchange, oror leasing
leasing of
of property?
property? . . . . . . . . . . . . . . .. . _2a_

bb Lending
Lending of
of money
money or
or other
other extension
extension of
of credit?
credit? J2tL

cc Furnishing
Furnishing of
of goods,
goods, services,
services, or
or facilities?
facilities? . -2£_ x

dd Payment
Payment of
of compensation
compensation (or
(or payment
payment or
or reimbursement
reimbursement of
of expenses
expenses rfif more
more than
than $1,000)?.
$1,OOO)? 2A. x

ee Transfer
Transfer of of any
any part
part of
of its
its income
income oror assets?
assets? . 2s.
IfIf the
the answer
answer to
to any
any question
question is is "Yes,"
"Yes," attach
attach aa detailed
detailed statement
statement explaining
explaining the
the transactions.
transactions.

33 Does
Does the
the organization
organization make
make grants
grants for
for scholarships,
scholarships, fellowships,
fellowships, student
student loans,
loans, etc.?
etc.? . r^^r-.
~. -1 J ' f Y t S1-«l+, "l'1.o.
( 'P. %c-n A. .,Pt.
Sc.I--\ A r + . -II[-:-
Uf . \
I X
44 Attach
Attach aa statement
statement toto explain
explain how
how the
the organization
organization determines
determines that
that individuals
individuals or
or organizations
organizations receiving
receiving grants
grants or
or
loans from it in furtherance of its charitable programs qualify to receive payments. (See instructions.!

Pari JV Reason
Reason for Non-Private Foundation
Foundation Status
Status (See instructions.)
instructions.)
The
The organization
organization is
is not
not aa private
private foundation
foundation because
because itit is
is (please
(please check
check only
only ONE
ONE applicable
applicable box):
box):
55 0
0 A church, convention
convention of of churches, or association of churches. Section 170(b)(1)(A)(i).
or association of churches. Section 170(b)(1)(A)(i).
66 0 A school. Section
□ Section 170(b)(1)(A)
170(b)(1)(A)(ii).
(ii). (Also
(Also complete
complete Part
Part V, page
page 4.)
4.)
77 0 A hospital
I I hospital or a cooperative
cooperative hospital service
service organization. Section
Section 170(b)(1)(A)(iii).
170(b)(1)(A)(iii).
88 IDI A Federal,
Federal, state,
state, or local
local government or governmental
governmental unit. Section
Section 170(b)(1)(A)(v).
170(b)(1)(A)(v).
9 QD A medical
medical research
research organization
organization operated in conjunction with a hospital.
hospital. Section
Section 170(b)(1)(A)(iii). Enter the hospital's
170(b)(1)(A)(iii),Enter hospital's name, city,
city,
and state
state ►.... _
10
10 0D An organization
organization operated for the benefit of a college
college or university
university owned or operated by a governmental
governmental unit.
unit. Section
Section 170(b)(1)(A)(iv).
170(b)(1)(A)(iv).
(Also
(Also complete
complete the
the Support
Support Schedule
Schedule in
in Part
Part IV-A.)
11a
11a IKJ An
[x~l An organization
organization that
that normally
normally receives
receives a substantial
substantial part
part of
of its
its support from a governmental
governmental unit
unit or
or from the
the general
general public.
public,
Section
Section 170(b)(1)(A)(vi).
170(b)(1)(A)(vi). (Also
(Also complete thethe Support
Support Schedule in in Part
Part IV-A.)
IV-A.)
11b D
CD A community
community trust.
trust. Section
Section 170(b)(1)
170(b)(1)(A)(vi).
(A) (vi). (Also
(Also complete the Support
Support Schedule
Schedule in Part IV-A.)
12
12 1DI An organization that normally
normally receives: (1) more more than
than 33 1/3%of
1/3% of its support from contributions, membership fees, and gross
receipts
receipts from activities
activities related
related to its
its charitable,
charitable, etc.,
etc., functions - subject
subject to certain
certain exceptions,
exceptions, and (2) (2) no more than 33 33 1/3%
1/3%ofof
its
its support from gross
gross investment
investment income and unrelated
unrelated business
business taxable
taxable income
income (less
(less section
section 511
511 tax)
tax) from businesses
businesses acquired
acquired
by the organization
organization after
after June 30, 1975.
1975. See
See section
section 509(a)(2).
509(a)(2). (Also
(Also complete
complete thethe Support
Support Schedule
Schedule in PartPart IV-A.)
13
13 D
CD An
An organization
organization that is is not controlled by any any disqualified persons
persons (other
(other than foundation managers)
managers) and supports organizations
organizations described
in: (1)
in: (1) lines
lines 5 through 12 12 above:
above; oror (2)
(2) section
section 501
501(c)(4),
(c)(4), (5),
(5). or
or (6),
(6), ifif they
they meet
meet the
the test
test of
of section
section 509(a)(2).
509(a)(2). (See
(See section
section 509(a)(3).)
509(a)(3).)
Provide
Provide the following
followina information about the supported organizations.
oraanizations. (See (See instructions.)
instructions.)
(b)
(b) Line
Line number
number
(a)
(a) Name(s)
Name(s) of of supported organization(s)
organization(s) from above

14 0
14 | J An organization
organization organized and operated to test for public safety.
safety. Section 509(a)(4).
509(a)(4). (See
(See instructions.)
instructions.)
F 12/17196
12/17/96
THE
THE HEIML1CH
HEIMLICH INSTITUTE
INSTITUTE
SCheduleAAIForm9901
Schedule (FormS 1996 FOUNDATION
FOUNDATION 23-7303161
23-7303161 pPese
aae 33
::P:ia'n144
P&tt I V - A SSupport
u p p o r t SSchedule
c h e d u l e (Complete
(Complete only
only ifif you
you checked
checked aa box
box on
on line
line 10,
10, 11,
11,or
or 12.)
12.)Use
Use cash
cash method
method of
of accounting.
accounting.
Note: You may use the worksheet in the instructions for converting from the accrual to the cash method of accounting.
Calendar year (or fiscal year beginning In) (a) 1995 (b) 1994 (c) 1993 (d) 1992 (e) Total
15 Gifts, grants, and contributions received. (Do
not include unusual grants. See line 28.) . . 114,010. 85,274. 190,020. 499,123. 888,427.
16 Membership fees received. NONE
17 Gross receipts from admissions, merchandise sold
or services
or services performed,
performed, or
or furnishing
furnishing of
of facilities
facilities
in any
in any activity
activitythat
that isis not
not aa business
business unrelated
unrelated
to the oroanization's charitable, etc.. purpose . . NONE
18
18 Gross income
Gross income from
from interest,
interest. dividends,
dividends, amounts
amounts
received from
received from payments
payments on
on securities
securities loans
loans
(section 512(a)(5)),
(section 512(a)(5)), rents,
rents, royalties,
royalties. and
and unrelated
unrelated
businesstaxable
business taxable income
income (less
(less section
section 511
511 taxes)
taxes)
from businesses
from businesses acquired
acquired by
by the
the organization
organization
111,543.
after June 30. 1975 38,125. 28,994. 25,462. 18,962.
1"
19
19 Net income
Net income from
from unrelated
unrelated business
business activities
activities
not included in line 18 NONE
20
20 Tax revenues
Tax revenues levied
levied for
for the
the organization's
organization's benefit
benefit
and either paid to it or expended on its behalf. . NONE
21
21 The value
The value of
of services
services or
or facilities
facilities furnished
furnished to
to the
the
organization by
organization by aa governmental
governmental unit
unitwithout
without charge,
charge
Do not
Do not include
include the
the value of services
value of services or
or facilities
facilities
generally furnished to the public without charge. NONE
22
22 Other income.
Other income. Attach
Attach aa schedule.
schedule. Do
Do not
not include
include
gain or (loss) from sale of capital assets NONE
23 Total of lines 15 through 22 152,135. 114,268. 215,482. 518,085. 999,970.
24 Line 23 minus line 17 152,135. 114,268. 215,482. 518,085. 999.970.
25 Enter 1% of line 23 1,521. 1,143. 2,155. 5,181.
26
26 Organizations described in lines 10
Organizations described in lines 10 or 11: aor 11: a Enter 2% of amount in column (e), line 24 19,999.
bb Attach
Attach a list
list (which
(which is not open to public inspection)
inspection) showing the name name ofof and amount
amount contributed by each person m
(other
(other than
than aa governmental
governmental unit
unit or
or publicly
publicly supported
supported organization)
organization) whose
whose total
total gifts
gifts for
for 1992
1992through
throug~ 1995
1995 I
exceeded the
exceeded the amount
amount shown
shown inin line
line 26a.
26a. Enter
Enter the
the sum
sum ofof all
all these
these excess amounts 6
excess amounts. e e ScK
,See S c Y', .h.'?+ .\. ~ A.-- ,I
A TH \ v - 4 J6b, $ 3 0 0 , 0 0 6 .

c Total
Total support for section
section 509(a)(1)
509(a)(1) test:
test: Enter
Enter line
line 24,
24. column (e). . £§£. 999,970.
d Add: Amounts from column (e) (e) for lines:
lines: 1818 $$ 111,543.
'11 1543. 19
19
22
22 $ 26b ,.,$ __ 300,006.
-=3..::.0",,0,-,,0;..:;0,;:,6.:;..._ £&. 411,549.
e Public support (line
Public (line 26c
26c minus line
line 26d total)
total). ► 26e 588,421.
f Public support percentage (line 26e (numerator) divided by line 26c (denominator)) 2§L 58.84%
27
27 Organizations
Organizations described
described on line 12: a For For amounts
amounts included in
in lines
lines 15,
15, 16,
16, and
and 17
17 that
that were
were received
received from a "disqualified
"disqualified
person." attach
person," attach a list
list to show
show the
the name
name of,
of, and
and total amounts
amounts received
received inin each
each year
year from each
each "disqualified
"disqualified person." person." Enter
Enter the sum
sum N/A
N/A
of such
of such amounts
amounts forfor each
each year:
year:
(1995)
(1995) (1994)
(1994) (1993)
(1993) (1992)
(1992) _
b For
For any amount included in line 17
17 that was received from a nondisqualified person, attach a list to show the name of, and amount
received for each
received each year,
year, that was more than the larger of
of (1) the amount
amount on line
line 25 for the year
year or
or (2)
(2) $5,000.
$5,000. (Include
(Include in the list
list
organizations described in lines
organizations lines 5 through 11, as well
well as
as individuals.)
individuals.) After
After computing the difference
difference between the amount
amount received
received
and the larger
and larger amount
amount described in (1)
(1) or
or (2), enter
enter the sum of these
these differences
differences (the
(the excess
excess amounts)
amounts) for each
each year:
year:

(1995)
(1995) (1994)
(1994) (1993)
(1993) (1992)
(1992) _

c Amounts from column (e) for lines:


Add: Amounts lines: 15
15 16
16
17 $
17 20 21
21 ► 22S.
d Line 27a
Add: Line 27a total . $ line 27b total . .
and line $_ zra
e Public support
Public support (line
(line 27c
27c total
total minus
minus line
line 27d
27d total)
total)
f Total support
Total support for
for section
section 509(a)(2)
509(a)(2) test:
test: Enter
Enter amount
amount on
on line
line 23,
23, column
column (e)
(e) ...... 27f l $ m,
g support percentage
Public support percentage (line 27e27e (numerator)
(numerator) divided
divided by line 27f27f (denominator))
(denominator)). . . . 2ZSL
h 7f (denominator))
Investment income percentage (line 18. column (e) (numerator) divided bv line 27f de 0 _%
28
28 Unusual Grants: For an organization described in line 10, 11, or 12 that received any unusual grants during 1992 through 1995, attach a list
zm.
(which is
(which is not
not open
open to
to public inspection)
inspection) for
for each
each year
year showing
showing the
the name
name of
of the
the contributor,
contributor, the
the date
date and
and amount
amount of
of the
the grant,
grant, and
and aa brief
brief
description of
description of the
the nature
nature of
of the
the grant.
grant. Do
Do not
not include
include these
these grants
grants in
in line
line 15.
15. (See
(See instructions.)
instructions.) tV
A/OyVF
0 Jlf
F 12/17/96
F12/17/96
THE HEIMLICH INSTITUTE
THE HEIMLICH INSTITUTE
Schedule
Schedule A fForm
(Form 9901 1996
1996 FOUNDATION
FOUNDATION ag e 4
23-7303161 ;'age
::fMte~:
Par! V Private School
Private School Questionnaire
Questionnaire (See
(See instructions.)
instructions.)
(To be completed ONLY bv schools that checked the box on line 6 In Part \V) N/A

Yes
Yes No
No
29 Does the organization
organization have a racially
racially nondiscriminatory
nondiscriminatory policy toward students by statement
statement in its charter, bylaws,
other governing instrument, or in a resolution of its governing body? . .
other JSL
30 Does the organization
Does organization include a statement of its racially nondiscriminatory policy toward students in all its brochures,
racially nondiscriminatory
catalogues, and other written communications with the public dealing with student admissions, programs, and
scholarships? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
scholarships? M.
31 Has the organization
organization publicized its racially
racially nondiscriminatory policy through newspaper or broadcast media during
the period of solicitation
solicitation for students, or during the registration
registration period if it has no solicitation
solicitation program, in a way
that makes the policy known to all parts of the general community it serves? £L
"Yes," please
If "Yes," please describe; if "No," please explain. (If
(If you need more space, attach a separate
separate statement.)
statement.)

32 Does
Does the organization
organization maintain the following:
a Records indicating the racial composition of the student body, faculty, and administrative
administrative staff?
staff? . 222.
b Records documenting that scholarships and other financial assistance
assistance are awarded on a racially
nondiscriminatory basis? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
nondiscriminatory basis? 32b
c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing
with student admissions, programs, and scholarships?
scholarships? . . . . . . . . . . . . . . . . 32c.
d Copies of all material
material used by the organization or on its behalf to solicit contributions? . . . . . . . . . . . . 32d

If you answered "No" to any of the above, please


please explain. (If
(If you need more space, attach a separate statement.)
separate statement.)

33 Does the organization


Does organization discriminate by race in any way with respect
respect to:

a Students' rights or privileges?


privileges? 33a

b Admissions policies? .... 33b

c Employment
Employment of faculty or administrative staff? . 33c

d Scholarships or other financial assistance?


assistance? 33d

e Educational policies? 33e

f facilities?
Use of facilities? . 33f

g
9 Athletic programs? 33q

h Other extracurricular
extracurricular activities? 33h

If you answered "Yes"


"Yes" to any of the above, please
please explain. (If
(If you need more space, attach a separate statement.)
separate statement.)

34a Does
Does the organization
organization receive
receive any financial aid or assistance
assistance from a governmental agency? . Ma.

b Has the organization's right to such aid ever been revoked or suspended? . . . . . . 34b
If you answered "Yes"
"Yes" to either 34a or b, please
please explain using an attached statement.
statement.

35 Does the organization


Does organization certify
certify that it has complied with the applicable requirements
requirements of sections 4.01 through 4.05 of Rev.
Rev. Proc.
Proc.
75-50. 1975-2 C.B. 587, covering racialI nondiscrimination? If "No." attach an explanation 35
F12/17/96
F 12/17/96
THE HEIMLICH
HEIML1CH INSTITUTE
INSTITUTE
Sfrf]edule
iibedul. A IForm
(Form 990)
990) I1996
996 FOUNDATION
FOUNDAT ION 23-7303161
23-7303161 Pag. 5
Page 5
n~lia)ltiiA(
ftttVI-A Lobbying Expenditures by Electing Public Charities (See instructions.)
instructions.)
(To be completed
Ie e ONLY
ON Y bv an eligible organization that filed Form 5768)
7 8
Check
Check here ► a LJ if the organization belongs to an affiliated group.
...
Check here ► b G if vou checked "a" above and "limited control" provisions apply.
(a)
(a) (b)
Limits on Lobbying Expenditures Affiliated group
Affiliated group To be completed
To be completed
(The
(The term "expenditures" means amounts paid or incurred.) totals for ALL
ALL electing

36 Total lobbying expenditures to influence public opinion (grassroots


(grassroots lobbying) . 36
37 Total lobbying expenditures to influence a legislative
legislative body (direct lobbying) . 37
38 Total lobbying expenditures (add lines 36 and 37).....
37) 38
39 Other exempt purpose expenditures.
expenditures . . . . . . . . . . . . . . . . . . . 39
40 Total exempt purpose expenditures (add lines 38 and 39) . 49
41 Lobbying nontaxable amount. EnterEnter the amount from the following table-
table-
If the amount on line 40 Is-is- The lobbying
lobbying nontaxable amount is- is- *
Not over $500,000
$500,000 . . . . . . 20% of the amount on line 40
40. . . . . . . . . . . . .
Over $500,000 but not over $1,000,000
Over $500,000 $1,000,000 . . . . $100,000
$100,000 plus 15%
15% of the excess
excess over $500,000
$500,000 ... . . .
Over $1,000,000
Over $1,000,000 but not over $1,500,000.
$1,500,000. . . . $175,000
$175,000 plus 10% of the excess over $1,000,000
$1,000,000.. . . > 41
Over $1,500,000
Over $1,500,000 but not over $17,000,000
$17,000,000 . . . $225,000
$225,000 plus 5% of the excess over $1,500,000
$1,500,000 . . .
Over $17,000,000
Over $17,000,000 . . $1,000,000
$1,000,000 . . . . . '
42 Grassroots nontaxable
Grassroots nontaxable amount (enter
(enter 25% of line 41) . 42
43 Subtract line 42 from line 36. Enter
Enter --0-
0 - if line 42 is more than line 36 . 4?
44 Subtract line 41
41 from line 38. Enter
Enter --0-
0 - if line 41
41 is more than line 38 . 44

Caution: If there is an amount on either line 43 or line 44. file Form 4720.
4-Year Averaging Period Under
Under Section 501(h)
501(h)
(Some
(Some organizations that made a section 501(h)
501 (h) election do not have to complete all of the five columns below.
Sese the instructions for lines 45 through 50.)
Lobbying Expenditures During 4--YearAveraging
4-Year Averaging Period

Calendar
Calendar year (or
(or (a) (b) (c) (d) (e)
(•)
fiscal vear beainnina in) ► 1996 1995 1994 1993 Total

45 Lobbying nontaxable amount

46 Lobbying ceiling amount (150% of line 45(e)) . . . I


47 Total lobbying expenditures

48 Grassroots nontaxable amount

49 Grassroots ceiling amount (150% of line 48(e)) . . iI


50 Grassroots lobbying expenditures
l^itslriiiiEli Lobbying Activity by Nonelecting Public Charities
(For reporting only bv organizations that did not complete Part Vl-A) (See instructions.)
During the year, did the organization
organization attempt to influence national, state or local legislation,
legislation, including any Yes Amount
No
attempt to influence public opinion on a legislative
attempt legislative matter
matter or referendum, through the use
use of:
a Volunteers...........................................
Volunteers X.
b Paid staff or management (Include compensation in expenses reported on lines c through through h.)
h.).. . .
X.
c advertisements . . . . . . . . . . . . . . .
Media advertisements X
d Mailings to members, legislators, or the public.
Mailings public . . . z
e statements .
Publications, or published or broadcast statements x
f Grants to other organizations
Grants organizations for lobbying purposes.
purposes JL
g Direct contact with legislators, their staffs, government officials, or a legislative
Direct legislative body.
body X
h Rallies, demonstrations, seminars, conventions, speeches, lectures.
Rallies. lectures, or any other means.
means X,
i lobbying expenditures (add lines c through
Total lobbying through h) . A/Oo/g'

If "Yes" to any of the above,


"Yes"to above. also attach a statement
statement oivino
giving a detailed description of the lobbying activities.
activities.
F 12/17/96
12/17/96
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE
Schedule A
Schedule A (Form 990)
99011996
1996 FOUNDATION
FOUNDATION 23-7303161
23-7303161 p
Pase 6
aa£_g,
~~::~It
§|§§|$||| .Information Regarding
Regarding Transfers
Transfers To
To and
and Transactions
Transactions and
and Relationships
Relationships With
With Noncharitable
Noncharitable
Exempt Organizations
Exempt Organizations
51 Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section
501 (c) of the Code (other
501(c) (other than section 501(c)(3)
501 (c)(3) organizations)
organizations) or in section
section 527, relating to political organizations?
organizations?
a organization of:
Transfers from the reporting organization to a noncharitable exempt organization Ye? No
(i) Cash ..... 51am X
(ii) Other assets.
Oil assets . . . . . . . . . a(ii) x
X
b Other transactions:
(i) Sales of assets
assets to a noncharitable exempt organization b(i) x
X
(ii) Purchases
Oil Purchases of assets
assets from a noncharitable
noncharitable exempt organization bfm x
X
(Hi) Rental
Oil) Rental of facilities or equipment
equipment. b(im x
X
(iv) Reimbursement
Ov) Reimbursement arrangements
arrangements. . . . . . . . . . . . . . . . . b(iv) x
X
(v) Loans or loan guarantees . . . . . . . . . . . . . . . . . . . b(v) x
X
Performance of services or membership or fundraising
(vi) Performance fund raising solicitations
solicitations. b(vi) x
X
c employees
Sharing of facilities, equipment, mailing lists, other assets, or paid employees. c X
X
d "Yes," complete the following schedule. Column (b) should always show the fair market value of
If the answer to any of the above is "Yes," of the
assets, or services given by the reporting organization. If the organization
goods, other assets, organization received less than fair market
market value in any transaction
orssharino
or haring arranoernent
arrangement. show in column (d) (d) the value of the goods,
coods. other
other assets,
as ets or services received:
received:
(a) (b) (c) (d)
Line
I no.
ine no. Amount involved
involved Name of noncharitable
Nameof noncharitable exempt oraanizalion
exemot oruanizatton Description transfers, uansacuons
D~rlQtlon of tIlInsfers transactions, an_d
and sharino
sharina arranaements
arranaements
N/A
N/A

52a Is the organization


organization directly or indirectly affiliated
affiliated with, or related
related to, one or more tax-exempt
tax-exempt organizations
described in section 501(c)
501(c) of the Code (other
(other than section 501(c)(3))
501(c)(3)) or in section 527? ►
52?? . . . . . . . . . . . . . .... 0
D Yes
Yes ~C3 No
No
b "Yes." comolete
If "Yes" complete the followinc
following schedule:
(a) (b) (c)
Name oraanization
Name of oroaruzatton Tvoe
Tvce of oreani
oraanization
ation Description of
_D_escriQJian relationship
of relationshie
N/A

F12/17/96
F 12/17/96
REALIZED CAPITAL GAINS
REALIZED CAPITAL GAINS AND
AND LOSSES
LOSSES Account ## 06390287
Account 06390287

JUNE'1.
JUNE 1 , 1996
1996 - MAY
MAY 31.1997
3 1 , 1997 HEIMLICH INSTITUTE. INCORPORATED
HEIMLICH INSTITUTE. INCORPORATED

ACQUISITION PROCEEDS
ACQUISITION DOLLAR
DOLLAR DOLLAR
DOL-LAR ($GGAIN
A I N /I
QUANTITY
QUANTITY ASSET
ASSET DESCRIPTION
DESCRIPTION DATE
DATE DATE
DATE COST
COST PROCEEDS LOSS
lOSS
SHORT TERM
SHORT TERM CAPITAL
CAPITAL. TRANSACTIONS
TRANSACTIONS ~ ""
60 CITICORP
CITICORP 06/24/96
06/24/96 03/21/97
03/21197 4.920.66
4.920.66 6.950.44
6.950.44 2,029.78
2.029.78
0.500 COLUMBIA/HCA
0.500 COL.UM81A1HCA HEALTHCARE CORPORATION
HEAL THCARE CORPORATION 06/12/96
06/12/96 10/31/96
10/31196 17.57
17.57 17.78
17.78 0.21
0.21
127 COLUMBIA/HCA HEALTHCARE CORPORATION
COLUM81A1HCA H£ALTHCARE CORPORATION 06/12/96
06/12/9a 05/30/97
O~/30/97 4,463.21
4.463.21 4,672.89
4.872.89 209.68
209.68
70 E M C CORPORATION
CORPORATION 05/29/96
05/29196 04/07/97
04107197 1,546.30
1.546.30 2.698.92
2.898.92 1.162.62
1.152.82
70 ELECTRONIC DATA
ELECTRONIC DATA SYSTEMS CORPORATION
SYSTEMS CORPORATION 11/04/96
11/04196 05/20/97
05/20197 3.156.30
3.156.30 2.538-41
2.538.41 -617.89
-617.89
(f:ORMERL
(FORMERLY Y GENERAL
GENERAL MOTORS
MOTORS CORP
CORP CL.ASS EI
CLASS E)
TOTAL NET SHORT TERM CAPITAL
TOTAL NET SHORT TERM CAPITAL GAINSGAINS ♦ 14.104.04
.14.104.04 ♦ 16.878.44
.16.878.44 « . 774.40
n.774.40

LONG
LONG TERM
TERM CAPITAL TRANSACTIONS
CAPITAl TRANSACTIONS
100 AT&
AT &TT CORPORATION
CORPORATION 10/07/94
10/07/94 12/06/96
12106196 3,754.60
3.754.60 3,777.20
3.777.20 22.60
22.60
150 ALBERTSON'S, INC.
ALBERTSON'S. INC. 03/24/95
03/24/95 01/06/97
01/06197 4,643.25
4.643.25 6,428.32
5.428.32 785.07
785.07
100 DONNELLEV (R.R.) at
DONNELLEY IR.R.) & SONS
SONS COMPANY
COMPANY 09/30/92
09/30/92 11/07/96
11/07/96 2,959.00
2.959.00 3,090.90
3.090.90 131.90
131.90
125 ELECTRONIC
EL.ECTRONIC DATA
OATA SYSTEMS CORPORATION
SYSTEMS CORPORATION 11/16/93
11/16/93 05/20/97
05120197 3,491.88
3.491.88 4,532.87
4.532.87 1,040.99
1.040.99
(FORMERLY GENERAL
IFORMERL.Y MOTORS CORP
GENERAL MOTORS CLASS E)
CORP CLASS
75 ELECTRONIC DATA SYSTEMS
ELECTRONIC DATA SYSTEMS CORPORATION
CORPORATION 06113/95 05/20/97
06/13/95 05/20197 3.194.25
3.194.25 2.719.72
2.719.72 -474.53
-474.53
(FORMERLY
IFORM£RL GENERAL MOtORS
Y GENERAL MOTORS CO~P
CORP C\.ASS
CLASS E)
15.000
15,000 FEDERAL
FEDERAL NATIONAL MORTGAGE ASSOCIATION
NATIONAL MORTGAGE ASSOCIATION 02/05/92 01/10/97
02/05(92 01/10/97 14,746.88
14,746.88 15.000.00
15.000.00 253.12
253.12
7.200
7.200 % DUE 01/10/02 DATED
Due 01/10/02 DATED 01/10/92
01/10/92
75 G T E CORPORATION
GTE CORPORATION 08/16/93
08/16193 03/31/97
03/31/97 2,744.25
2,744.25 3.414.11
3.414.1' 669.86
669.86
25 G T E CORPOAATION
GTE CORPORATION 12/28/94
12/28/94 03/31/97
03/31/97 771.25
771.25 1,138.04
1,138.04 366.79
366.79
7 IMATION CORPORATION
IMATION CORPORATION 03/13/92
03/13192 08/06/96
08/06196 124.07
124.07 157.53
157.53 33.46
33.46
3 IMATION CORPORATION
IMATtON CORPORATION 12/22/94
12122/94 08/06/96
08/06196 62.50
62.50 67.51
67.51 5.01
0.408 LUCENT
0.408 LUCENT TECHNOLOGIES,
TECHNOL.OGIES, INC.INC. 10/07/94
10/07/94 10/23/96
10/23196 18.37
18.37 17.73
17.73 -0.64
.(1.54
32 LUCENT TECHNOLOGIES,
LUCENT TECHNOLOGIES. INC. INC. 10/07/94
10107/94 02/26/97
02/26197 1.441.03
1.441.03 1.758.02
1,758.02 316.99
316.99
70 MINNESOTA MINING
MINNESOTA MINING & MANUFACTURING
MANUFACTURING COMPANY
COMPANY 03/13/92
03(13/92 08/12/96
08(12(96 3,024.18
3.024.'8 4,604.80
4.604.80 1.580.62
1.580.62
30 MINNESOTA MINING
MINNESOTA MINING & MANUFACTURING
MANUFACTURING COMPANY
COMPANY 12/22/94
12/22194 08/12/96
08/12196 1,523.30
1,523.30 1,973.48
1.973.48 450.18
4!jO.18
70 MOTOROLA INC.
MOTOROLA INC. 03/09(95
03/09/95 01/02/97
01102/97 3.927.00
3.927.00 4,176.51
4.176.51 249.51
249.51
170
170 MYLAN LAaORATORIES.
MYLAN LABORATORIES, INC.INC. 09/06/95
09/06/95 12/06/96
12/06/96 3.956.43
3,956.43 2.407.80
2.407.80 -1.54863
.1.548.63
40
40 ROYAL
ROYAL DUTCH
~UTCH PETROLEUM
PETROLEUM COMPANY
COMPANY 11{25/92
11/25/92 05/16/97
05fI6/9? 3.313.00
3.313.00 7.528.86
7.528.86 4.215.86
4.215.86
(NETHERLANDS)
(NETHERLANDS)
35 ROYAL DUTCH
ROYAL DUTCH PETROLEUM
PETROLEUM COMPANY
COMPANY 12/22/94 05/16/97
12/22/9. 05/16/97 3,757.95
3,757.95 6.587.75
6.587.75 2,829.80
2.829.80
(NETHERLANDS)
(NETHERLANDS)
70 SCHERING-PLOUGH CORPORATION
SCHERING·PLOUGH CORPORATION 03/03/92
03/03/92 11/06/96
11106/96 2,087.40
2.087.40 4,728 14
4.728.14 2,640.74
2.640.74
94
94 SONOCO PRODUCTS
SONOCO PRODUCTS COMPANY
COMPANY 11/28/94
11128/94 09/09/96
09/09/96 1.88000
1.880.00 2.731.04
2.731.04 851.04
851.04
200
200 SONOCO
SONOCO PRODUCTS
PRODUCTS COMPANY
COMPANY 11/28/94
11/28/94 01/30/97
01130/97 4.000.00 5.387.82
5.387.82 1,387.82
1,387.82
15.000
15.000 UNITED
UNITED STATES TREASURY NOTES
STATES TREASURY NOTES 08/02/95
08102195 08/23/96
08/23/96 15.213.28
15.213.28 15,098.44
15,098.44 -114.84
-114.84
6.500
6.500 % % DUE
DUE 04/30199 DATED 05/02/94
04/30/99 DATED 05/02/94
TOTAL NET LONG
TOTAL NET LONG TERM
TERM CAPITAL
CAPITAL GAINS
GAINS $80.633.87
$80,63387 $96,326.59
$96.326.59 $15,692.72
115.692.72

CAPITAL DISTRIBUTIONS
CAPITAL DISTRIBUTIONS
0 JOHNSON OPPORTUNITY
JOHNSON OPPORTUNITY FUND
FUND 12/30/96
12/30196 1,260.63
1.260.63 1.260.63
1.2&0.63
TOTAL CAPITAL
TOTAL DISTRIBUTIONS
CAPITAl DISTRIBUTIONS SO.OO
$0.00 $1,260.63
$1.260.63 $1.260.63
$1,260.63

TOTALS
TOTAlS ~^'1 L{,
1 3., '32
2 $114,465.66
'114.465.66 ~\| 19,1)-'6
^ ^ 13^?

This report surntnlrizes


summarizes the portfolio
portfolio transactions for yoU( convenien«.
your convenience.
We do
dq not
",ot guarantee its appropriateness for use in tax
tall preparation.
preparation.

S+o__-\..e_ {Ylf'v'..l ~90


?~[+-:c - d-.
1996 SUPPLEMENTARY STATEMENTS
STATEMENTS

THE HEIMLICH iNSTITUTE


INSTITUTE FOUNDATION 23-7303161

STATEMENT:
STATEMENT: 990 PT I - 3

LINE 20 - OTHER CHANGES


DESCRIPTION AMOUNT
AMOUNT

UNREALIZED GAIN ON SECURITIES 41,528.


41,528.
ADJUSTMENT FOR THE ADOPTION OF FASB 124 BY THE 64,362.
HEIMLICH INSTITUTE FOR
FOR FISCAL YEAR 1996.
1996_

TOTAL AMOUNT 105,890.


1996 SUPPLEMENTARY STATEMENTS
1996 SUPPLEMENTARY STATEMENTS

THE
THE HEI'MLICH INSTITUTE FOUNDATION
INSTITUTE FOUNDATION 23-7303161
23-7303161

STATEMENT:
STATEMENT: 990
990 PT IV -1

LAND, BUILDINGS, and


LAND, BUILDINGS, and EQUIPMENT
EQUIPMENT : BASIS
BASIS
DESCRIPTION
DESCRIPTION IEG.YEAR
BEG.YEAR ADDITIONS
ADDITIONS RETIREMENTS
RETI REMENTS TRANS/OTH
TRANS/OTH END
END YEAR
YEAR

EQUIPMENT
EQUIPMENT 39,381.
39,381. 16,235.
16,235. 55,616.
55,616.

TOTAL AMOUNT
TOTAL AMOUNT 39,381.
39,381. 16,235.
16,235. 55,616.
55,616.

STATEMENT:
STATEMENT: 990
990 PT IV -2
-2

LAND,
LAND, BUILDINGS,
BUILDINGS, and
and EQUIPMENT
EQUIPMENT : ACCUMULATED
ACCUMULATED DEPRECIATION
DEPRECIATION
DESCRIPTION
DESCRIPTION BEG.YEAR
BEG. YEAR ADDITIONS
ADDITIONS RETIREMENTS
RETIREMENTS TRANS/OTH
TRANS/OTH END
END YEAR
YEAR

EQUIPMENT
EQUIPMENT 17,402.
17,402. 6,945.
6,945. 24,347.
24,347.

TOTAL AMOUNT
TOTAL AMOUNT 17,402.
17,402. 6,945.
6,945. 24,347.
24,347.

STATEMENT:
STATEMENT: 990
990 PT IV -3

OTHER ASSETS
OTHER ASSETS END
END OF
DESCRIPTION
DESCRIPTION YEAR ,AMOUNT
YEAR AMOUNT FMV

ACCRUED INTEREST RECEIVABLE


ACCRUED INTEREST RECEIVABLE 6 ,245.
6,245.
SECURITY DEPOSITS
SECURITY DEPOSITS 10.
10.
WORKER'S COMPENSATION
WORKER'S COMPENSATION DEPOSIT
DEPOSIT 132.
132.

TOTALS
TOTALS 6,387.
6,387.
iNVESTMENT PORTFOLIO
SNVESTMENT PORTFOLIO VALUATION
VALUATION Account' 06390287
Account # 0 6 3 8 0 2 8 7

MAY 331.
1 . ~997
1997 HEIMUCH INSTITUTE. INCORPORATED
HEIMUCH INSTITUTE, INCORPORATED

QUANTITY
QUANTITY ASSeT DESCRIPTION
ASSET DESCRIPTION MARKET PRICE I\IlARKET VALUE
MARKET PRICE MARKET VALUE
15.000
15,000 AMOCO
AMOCO CANADA CANADA 99.000 14.850.00
99.000 14,850.00
66.750% DUE 02/15/05
. 7 5 0 % DUE 02/15/05 DATED DATED 02/15/93
02/15/93
, 5.000
15,000 BANKERS TRUST
BANKERS TRUST OF OF NEWNEW YORKYORK 101.625 15.243.15
101.625 16.243.75
77.600% DUE 001115(02
. 5 0 0 % DUE 1 H 5/02 OATED 01"5/92
DATED 01M 5/92
15,000
15,000 CORESTATES CAPITAL
CORESTATES CAPITAL 96.380 14,45700
96.380 14.457.00
6~.625%
. 6 2 5 % DUEOUE 003115/05 DATED 03/18/93
3 / 1 5 / 0 5 DATED 03!'8/93
40,000
40,000 FEDERAL NATIONAL
FEDERAL NATIONAL MORTGAGE
MORTGAG£ ASSOCIATION
ASSOCIATION 93.093 37.237.60
93.093 37,237.60
5S.875l)b
. 8 7 5 % DUE Due 002/02/06 DATED 02/02/96
2 / 0 2 / 0 6 DATED 02/02/96
10,000
10,000 FEDERAL NATIONAL
FEDERAL NATIONAL MORTGAGE
MORTGAGE ASSOCIATION
ASSOCIATION 104.406 10.440.60
104.406 10,440.60
88.700%
. 7 0 0 % DUE DUE 0<>e/10/99 DATED 06/12/89
6 / 1 0 / 9 9 DATED 06/12/89
20,000
20,000 FIRST CHICAGO
FIRST CHICAGO NBD CORP NBO CORP 100.450 20,090.00
100.450 20,090.00
(FORMERLY NBD
(FORMERLY NBD BANCORP)
BANCORPI
7.250% DUE 08/15/04
7 . 2 5 0 % DUE 0 8 / 1 5 / 0 4 DATED DATED 08/24/92
08/24/92
15,000
15,000 GTE WISCONSIN
GTE WISCONSIN '01.125 15.168.75
101.125 15,168.75
77.750%
. 7 5 0 % DUE DUE06/01/03
06/01/03 DATED DATED 06/01/73
06/01/73
10.000
10.000 HAWAIIAN TELEPHONE
HAWAIIAN TELEPHONE COMPANY COMPANY 100.000 10.000.00
100.000 10,000.00
FIRST MORTGAGE
FIRST MORTGAGE
6.750%
6 . 7 5 0 % DUE DUE004/01198 DATED 03/28/68
4 / 0 1 / 9 8 DATED 03128/68
20,000
20.000 INTERNATIONAL BUSINESS
INTERNATIONAL BUSINESS MACHINES
MACHINES CORP.
CORP. 99.375 19,815.00
99.375 19,875.00
6~.375%
. 3 7 5 % DUE DUE006115/00 DATED 06/15/93
6 / 1 5 / 0 0 DATED 06/15/93
10.000
10,000 PNCFUNDING
PNC FUNDING CORPORATION
CORPORATION 98.625 9,862.50
98.625 9.862.50
sueORDINATED DEBENTURE
SUBORDINATED DEBENTURE
6.875% DUE 03/01103
6 . 8 7 5 % DUE 03/01/03 DATED DATED 02/23/93
02/23(93
20,000
20,000 PROVINCE OF OFONTARIO
ONTARIO GLOBAL GLOBAL BOND
BONO 99.000 19,800.00
PROVINCE 99.000 19,800.00
66.12!5%
. 1 2 5 % DUE OUE00i)/28/00 DATED 06/17/93
6 / 2 8 / 0 0 DATED 06117193
20,000
20,000 PUBLICSERVICE SERVICEELECTRIC
ELECTRICAND ANDGAS
GAS COMPANY
COMPANY 96.700 19.340.00
PUBLIC 96.700 19.340.00
66.500%
. 5 0 0 % DUE DUE05/01/04
05/01/04 DATED DATED 05/01/93
05/01/93
15,000 UNITEDSTATES STATESTREASURY
TREASURYBOND BONO 97.156 '4,573.40
15,000 UNITED 97.156 14,573.40
66.250%
. 2 5 0 % DUE Due 02/15/07
02/15/07 DATED DATED 02/15/97
02/15/97
15.000 UNITEDSTATES STATESTREASURY
TREASURYNOTE NOTE 93.093 13.963.95
15.000 UNITED 93.093 13,963.95
5 5.625%
. 6 2 5 % DUE DUE02/15/06
02/15/06 DATED DATED 02/15/96
02115198
20,000 UNITEDSTATES STATeS TREASURY
TREASURYNOTE NOTe 103.781 20.756.20
20,000 UNITED 103.781 20,756.20
7 7.500%
, 5 0 0 % DUE DUE11/15/01
11/15/01 DATED DATED 11/15/91
11/15/91
15.000 WAL·MART STORES, STORES,INC. INC. 98.250 14,137.50
15,000 WAL-MART 98.250 14,737.50
6 .e.5OO%
5 0 0 % DUE DUE06/01/03
06/01/03 DATED DATED 06/01/93
06/01/93
100 AIRPRODUCTS
PRODUCTSAND ANDCHEMICALS,
CHEMICALS, INC. INC. 77.750 7,775.00
100 AIR 77.750 7,775,00
2.800 BAlLARD MEDICAL MEDICAL PRODUCTS
PRODUCTS 19.250 53.900.00
2.800 BALLARD 19-250 53,900.00
BURLINGTONNORTHERN NORTHERNSANTA SANTAFEFE 83.000 7,055.00
8585 BURLINGTON 83.000 7,055.00
CORPORATION
CORPORATION
150 CINTASCORPORATION
CORPORATION 62.000 9,300.00
150 CINTAS 62.000 9,300.00
COMPUTERASSOCIATES ASSOCIATESINTERNATIONAL,
INTERNATIONAL, INC.
INC. 54.750 4,927.50
9090 COMPUTER 54.750 4,927.50
175 CONSECO.INC. INC. 40.000 7,000.00
175 CONSECO, 40.000 7,000.00
120 CORESTATESFINANCIAL FINANCIAL CORPORATION
CORPORATION 52.875 6,345.00
120 CORESTATES 52.875 6,345.00
DISNEY(WALT) (WALTI COMPANY
COMPANY 81.876 6,550.00
8080 DISNEY 81.875 6,550.00
170 DOVERCORPORATION
CORPORATION 57.375 9,753.76
170 DOVER 57.375 9,753.76
280 DRESSER INDUSTRIES,INCORPORATED
INCORPORATED 34.250 9.590.00
260 DRESSER INDUSTRIES, 34.250 9,590.00
lS0 E M C CORPORATION 39.875 7.177.50
180 E M C CORPORATION 39.875 7,177.50
100 ECHLININCORPORATED
INCORPORATEO 33.315 3,337.50
100 ECHLIN 33.375 3,337.50
44.'25 7,721.88
175
175 G GTE CORPORATION
T E CORPORATION 44.125 7,721.88
260
260 GENERALELECTRIC ELECTRICCOMPANY
COMPANY 60.375 15,697.50
GENERAL 60.375 15,697.50
GENERAL RERE CORPORATION 175.250 9,638.75
5555 GENERAL CORPORATION 175.250 9,638.75
100 GILLETTECOMPANY
GILLETTE COMPANY 88.875 8,887.50
100 88.875 8,887.50
200 HEWLETT ·PACKARDCOMPANY
HEWLETT-PACKARD COMPANY 51.500 10.300.00
200 51.500 10,300.00
130 JOHNSON& &JOHNSON
JOHNSON JOHNSON 60.000 7,BOO.00
130 60.000 7,800.00
1.200.095 JOHNSONOPPORTUNITY
JOHNSON OPPORTUNITYFUND FUND 24.360 29,234.33
1,200.095 24.360 29,234.33
200
200 MCDONALD'S CORPORATION
MCDONALD'S CORPORATION 50.250 '0,050.00
50.250 10,050.00
9,990.00
135
135 MEDTAONIC.INCORPORATED
MEDTRONIC, INCORPORATED 74.000
74.000 9.990.00

Johnson Investment Counsel, Inc.


Johnson Investment Counsel, Inc.

<'_'h~ ...,e/- 9'10


V U . W e A - WO
?+- \V-L( l/
INVESTMENT
If~VESTMENT PORTFOLIO VALUATION
PORTFOLIO VALUATION Account' ## 06390297
Account' 06390287

MAY 331.1997
MAY 1 , 1997 HEIMUCH INSTITUTE,
HEIMUCH INSTITUT!.INCORPORAT£O
INCORPORATED

QUANTITY
QUANTITY ASSET DESCRIPTION MARKET PRICE
MARKET PRICE MARKET VALUE
MARKET VALUE
100 MOBIL CORPORATION
MOBIL CORPORATION 139.875
139.875 13.987.50
13,987.50
140 PROCTER & GAMBLE
PROCTER GAMB~E COMPANY
COMPANY 137.875
137.875 19,302.50
19,302.50
200 REGIONS FINANCIAL
REGIONS FINANCIAL CORPORATION 59.750
59.750 , 1,950.00
11,950.00
130 ROCKWELL INTERNATIONAL
ROCKWELL INTERNATIONAL CORPORATION (NEW) 64.500
64.500 8,385.00
8,385.00
220 lEE CORPORATION
SARA LEE 40.875
40.875 8.992.50
8,992.50
100
100 SCHERING-PlOUGH CORPORATION
SCHERING-PLOUGH 90.750
90.750 9,075.00
9,075.00
400
400 SHERWIN WILLIAMS
5HERWIN WIlliAMS COMPANY
COMPANY 30.000
30.000 12.000.00
12.000.00
230
230 SIGMA-ALDRICH CORPORATION
SIGMA-ALDRICH 30.~25
30.625 7,043.75
7,043.75
80
80 SMITHI(UNE BEECHAM
SMITHKUNE BEECHAM PLC
PLC ADR
ADR 87.500
87.500 7,000.00
7,000.00
245
245 SYSCO CORPORATION
SYSCO 34.875
34.875 8,544.37
8,544.37
240
240 TECO ENERGY, INCORPORATED
TECO ENERGY. INCORPORATED 24.875
24.875 5.970.00
5,970.00
280
280 USX -• MARATHON
USX MARATHON GROUP
GROUP INCORPORATED 2S.87!;i
29.875 8.365.00
8,365.00
200
200 WALGREEN COMPANY
WALGREEN 46.750
46.750 9,350.00
9,350.00
160
160 WASHINGTON MUTUAL,
WASHINGTON MUTUAL. INC.
INC. 55.625
55.625 8,900.00
8,900.00
300
300 WMITMAN CORPORATION
WHITMAN 24.125
24.125 7,237.50
7,237.50
325
325 WORTHINGTON INDUSTRIES,
WORTHINGTON INDUSTRIES. INC.
INC. 18.500
18.500 6,012.50
6,012.50

TOTALPORTFOLIO
TOTAL PORTFOUO VALUE
VALUE
<W,^3

JohnsonInvestment
Johnson Counsel,inc.
InvesCrn8llt Counsel, Inc.

'::l+c....-kMe.-,f- '1'1<7
?-r\V-L/J/
Revised
Revised 9/20/96
THE HEIMLICH FOUNDATION, INC.
HEIMLICH INSTITUTE ~OUNDATION, tNC.
BOARD OF
BOARD OF TRUSTEES
TRUSTEES
MUCH 1995-1996
INSTITUTE
fwarouc
r1 lila *Harry w. Whittaker,
♦Harry H. Whittaker, Pres. Soc. t
Sec. #|
Soc. Sec.
wow, sea
QlaW1.'W 2497 Grandin Road
Grandin Road Gradison k Co.
Gra<1iaon ,
513-m-IIlC' Cincinnati, OK
Cincinnati, OH 45208 Walnut street
580 Walnut
1c51So11lG3 Cincinnati, OH 45202
Cincinnati,
)?hP ';J#::OO~~
(5131 579-5000 _
Philip M. Heimlich, Vice
M. Heimlich, Vice Free.
Pres. Soc. Sec. ~
Soc. Sec.
Lyceum Court
6680 Lyceum Court Cincinnati
Cincinnati~ City Hall
Cincinnati, OH 45230
Cincinnati, 801 Plum
Plua Street
Street
(513) 624-9155
624-9155 Cincinnati, OH 45202
Cincinnati,
(513) 352-3647

Joseph J. Dehner,
Joseph
Terrace
Dehner, Secretary
822 Yale Avenue
Avenue
Terrace Park, OH
OH 45174
Soc.
Soc.
Frost Sec.
Frost
2500
& t~""""
f^^^^^^^|
Jacobs
, Jacobs
2500 Central
Central Trust
Trust Tower
Cincinnati,
Cincinnati, OH 45202
(513) 651-6800
651-6800
(513) 651-6166-Kathy
651-6166-Kathy Barrett
(513)
(513) 651 6el~ Fax
651-6M*
"''$(
*Cedric w. Vogel, Treasurer
W. Voqal, Treasurer Soc. Sec.
Soc. Sec._
2270 Madison
Madison Road
Road 500 Atlas
Atlas Bank Building
Building
Cincinnati,
Cincinnati, OH 45208 524 Walnut
walnut street
Street
Cincinnati, O H 45202
Cincinnati, OH
(513) 421-4225
421-4225
*Henry J. Heimlich,
*Henry M.D.
Heimlich, M.D. Sec. I^H^I^^^I
Soc. Sec.
17 Elmhurst Place
Elmhurst Place Heimlich
Heimlich Institute
Institute
Cincinnati,
Cincinnati, OH 45208
45208 2368 Victory Pkwy,,
Pkwy., #410
'410
Cincinnati,
Cincinnati, OK
OM 45206
(513) 221-0002
Mrs.
Mrs. Winston Atteberry
Winston C. Atteberry Soc. Sec. f
Soc. Sec.
Box 629
Eunice,
Eunice, LA 70535
70535
(316) 457-2705
(318) 457-2705
Mr. George
Mr. George Blake
Blake Soc. S~C.
Soc. Sec.
Cincinnati Enquirer
Cincinnati Enquirer (513) 768-8094 direct
(513) 768-8094 direct
312 Elm Street
Street
Cincinanti,
Cincinanti, OH 45202
Benefiting Kathy Carr Soc. Sec.
Soc.
Humanity Ray Carr
3057 Saddleback
Sad41eback Drive
Drive
Soc. Sec.
tfOCt tfVvt
K wk. (513) 871-2221
~ wk.
Through Cincinnati,
Cincinnati, OH 45244
(513) 231-3010
231-3010
R wk.
wk. (513) 621-4777
HeaJth
Health
and S+o...-k.,.\(' / ~ q -10
Peace Po.f>
?0.r- V- v~\ \ V II
Mrs. Arthur
Mrs. Arthur Murray
MUrray(Kathryn)
(Kathryn) Soc.Sec.
Soc. Sec.
2877 Kalakuau Avenue
2877 Kalakuau Avenue
Honolulu, HI
Honolulu, HI 96815
96815
MS (808)924-4094
(808) 924-4094
mm Monte L.
Monte Rovekamp
L. RoveKamp Soc.Sec.
Soc. Sec.
msun.K
PI.~" 2864 Crescent Springs Pike
2864 crescent Springs Pike P.O.
P.O. Box
Box 19129
19129
aIU1.l. Erlanqer, XV 41018
Erlanger, KY 41018 cincinnati,
Cincinnati, OH 'OH 45219-0129
45219-0129
jMWM_
a»MIZ (606) 341-6050
341-6050
(606)
fa51Hll_
IjMMjB William P.
William P. Sbeehan
Sheehan Soc. sec.
soc. Sec.
1673 Braintree
1673 Braintree (614)
(614) 466-3206
466-3
cincinnati, OH
Cincinnati, 45255
OH 45255
(513) 231-7467
(513) 231-7467

Charles J.
Charles Squeri (Chuck)
J. Squeri (Chuck) Soc. Sec.
Soc. ~ec • .-
clo Squeri FOOd Service
c/o Squeri Food Service Inc Inc squerlF~Foods
Squeri
619 Linn street
619 Linn Street Linn Street
619 Linn
619 street
cincinnati, OH
Cincinnati, OH 45203
45203 Cincinnati,
Cincinnati, OH OH 45203
45203
(513) 381-1106
(513) 381-1106

Anson Williams
Anson Williams Soc. Sec.
24615 Skyline view
24615 Skyline View Drive
Drive (213) 850-2 5 (office)
(213) 850-2685
Malibu, CA
Malibu, 90265
CA 90265 (213)
(213) 657-4861
651-4861 (home)

Dr. Paul
Dr. Paul Winchell
Winchell Soc. t
Sec. #1
Soc. Sec.
32262 Oakshore Drive
32262 Oakshore Drive
Westlake Villaqe,
Westlake Village, CACA 91361
91361
(818) 991-5754
(818) 991-5754

*• These
These trustees
trustees have the
the discretion
discretion as to the distribution
distribution of
of
contributions.
contributions.

Benefiting
Benefiting
Hum~ity
Humanity
Through
Through
HeaJth S+a...le.ne t':- 4 ~0
Health i='cd +- v- I J/
and
and
I Peace
Peace
THE HEIMLICH
THE HEIMLICH INSTITUTE
INSTITUTE
FOUNDATION
FOUNDATION 23-7303161
23-7303161
SUPPLEMENTARY STATEMENTS
SUPPLEMENTARY STATEMENTS
PART:III
PART:III LINE:3
LINE:3

Patient
Patient need
need for
for financial
financial assistance
assistance is
determined
determined on
on an
an individual
individual basis.
basis.
Each
Each patient's
patient's ability
ability to meet
meet medical
medical and
related
related expenses
expenses is reviewed
reviewed in terms
terms of referral
referral
information
information or through
through investigation
investigation by the
foundation
foundation itself.
itself.

<^+rt*V <tto S c W A ?+ B E - (
-----------------------------------------------------------------------
• , OMB
OMB No1546-0047
No. 1545·0047
Return of
Return of Organization
Organization Exempt
Exempt From
From Income
Income Tax
Tax
-orm
r'orm 990
990 Undersection
Under section501(c)
501 (c)ofoltha Inlemal Revenue
the Internal
private foundation)
loundation) ororsection
RevenueCodB
section4947(a)(1)
Code(except
(except black
4947(a)(1) normxampt
black lung
nonexemptcharitable
lung benefit
lIenefillrusl
charitable trust
trust
trust oror j997
1997
Oeparlmenlof 111.T_IY
Department of Ui« Treasury
private This
ThIsForm
FormisIsOpBn
Open
IntemalRevenueService
Internal Revenue Sorvico
Nota:The
Note: Theorganization
organizationmay mayhavB
have to
to use copy 01
use aa copy of this
this return
return toto satisfy
satisfy state
state reportinq
reporting requirements.
requirements. totoPublic
PublicInspection
Inspection
A For
Forthe
the1997
1997calendar
calendaryear,
year.OR
ORtax
tax year
year period
period beginning
beginning 6/ 1
67~1 • 1997.and
,1997, andending
ending 55/31
/31 .1998
•~9 98
BCheck
Chodcit.
if:
OOChange
Please
Please
GCName
Nameofoforganization
organization DDEmployer
Employer identification
Jdentllicalion number
number
nsB ~.eIRS
jXjo?"of
addressuse IHS
label or
label or THE HEIMLICH
HE!MLICH INSTITUTE
INSTITUTE FOUNDATION
FOUNDATION 23-7303161
23-7303161
IHE
I
address
print or


print or
DIniHai type.
Initial
return typo- Numberand
Number andstreet
street(or
(orP.O.
P.O.box
boxififmail
maills notdelivered
is not delivlmd to
to street
street address)
address) Room/suite EEStata
Room/suite Stateregistration
registration number
number
DAnai return
□ F i n a l
See
See
Speclnc3
retum Specific
return
311 T R A I G H T SSTREET
1 1 SSTRAIGHT TREET
□ DAmonde<l
retum
return
tnstruc-
A m e n d e d Instruc­
liens.
tions.
City.town,
City, town, ororpost
postoffice,
office, state,
state. and
and ZIP+4
ZIP+4 FFCheck
Check ► ,... □ ififexemptionD
exemption
!~fb'0f1if:aISQ
for Stats CCINCINNATI,
I N C I N N A T I , O OH
H 45219
4 5 2 1 9 applicationisIspending
application pending
GG Type
reporting)
T~e ^'organization
Type ~)organilation - .......
of o > Q D Exempt 00
Exemptunder 501(e)( {33 H)....(insert
under501(c) (Insertnumber)
number)OR
OR► ,... □ section 0
section4947(a)(1)
4947(a)(1) nonexBmptchariitablB
nonexemptchartitable trust
trust
Note: Section 501(c)(3) exempt organizations and 4947(a)(1) nonexempt charitable trusts MUST attach a completed Schedule A (Form 990).
H(a) Is this a group return filed for affiliates? □ Yes [ X I No 1 If either box in H is checked "Yes." enter four-digit group
(b) If "Yes," enter the number of affiliates for which this exemption number (GEN) ► , .
return is filed: ► J Accounting method: C3 Cash O D Accrual
( e ) Is this a separate return tiled by an organization covered by a group ruling? □ Yes LX1 NO I I Other (specify) ►
K Check here ► O f f the organization's grossreceiptsare normally not more than $25,000. The organization need not file a return with the IRS; but
if it received a Form 990 Package in the mall,ftshould file a return without financial data. Some states require a complete return.
Note: Form 990-EZ may be usBd by organizations with gross receipts less than $100,000 and total assets less than $250.000 at end of year.
$ H i f l Revenue, Expenses, and Changes in Net Assets or Fund Balances
Contributions. gifts,
Contributions, Oifts.grants,
grants. and ann similar
similar amounts
amounts received:
received: £^
aa Direct public support
Direct public support .. 1a 24,749
bII Indirect public support
Indirect public support . 1b
cc Govemment contributions
Government contributions (grants)
(grants) . 16
dd Talal(add
Total (addlines
lines1ata through
through 1c) 1c)(attach
(attachschedule
schedule ofofcontributors)
contributors)
a (cash $
(casli$ 224,749.
4 , 7 4 9 . noncash$ noncash $ .) . it
24 749.
24,749.
22 Program
Program service
service revenue
revenue including
including government
govemment fees taes and
and contracts
contracts (from
(from Part
Part VII,
VII. line
line 93)
93) !-!:....:t---------
Q 3 Membership dues and
3 Membership dues and assessments assessments 1-~+---------
44 Interest
Interestononsavings
savlngs andandtemporary
temporary cash cash Investments
Investments .
55 Dividends and interest from
Dividends and interest from securities securities .. . 23,348,
o 5 a Gross
5 a Gross rentsrents .. 5a
bb Less:
Less: rental
rental expenses
expanses . Eb
ID cc Net
Netrental
rental income
income or or (loss)
(loss) (subtract
(subtract line
line 6b
6b from
from line
Hne6a)6a) " .. 6c
;:,
e 77 Otherinvestment
Olherinvestment Income Income (describe
(descrlbe ► ...
~II) 8Baa Gross
Gross amount
amount fromfrom sale
saleofofassets
assets other
other (A) Securities (B) Other
a: than Inventory
than Inventory . 198,782, 8a
b Less: cost or other basis and sales
b Less: cost or other basis and sales expenses expenses . 145^177, 8b
cc Gain
GaIn or
or (loss)
(loss) (attach
{attach schedule)
schedule) . 5 3 , 6 0 5 , 8c
d Net
Netgain
gain or
or (loss)
(loss) (combine
(combine line 8c, columns
line 8c, columns (Al (A) and
and (Bl)
(B)) § T M T ,.1 M 53 605.
53,605.
9 Special events
Special events andand activities
activities (attach
(attach schedule):
schedule):
a Gross
Gross revenue
revenue (not including $$
(not including ofofcontributions
contributions
reported on
reported on line
lina 1a)
la) . 9a
bb Less: direct
Less: direct expenses
expenses otherother than
than tundralslng
fundraisingexpenses
expenses . 9b
e; Net income
Net income or Dr (loss)
(loss) from
from special
spacial events
events (subtract
(subtractline
line9b
9bfrom
fromline
line9a)
9a) . 9e
10
10 aa Gross sales of
Gross of Inventory,
inventory, less
less returns
returns and
andallowances
allowances , . 10a
bb lass: cost of
Less:cost of goods
goods sold
sold .. 10b
cc Gross profit
Gross pro1it or
or (loss)
(Joss) from
from sales
sales of
ofinventory
inventory (attach
(attach schedule)
schedule) (subtract
(subtract line
line10b
10b trom
fromline
line 10a)
10a). . 10c
11 other revenue (from Part VII, Une
Other revenue (from Part VII, line 103) 103) .. 11
12 Total revenue (add lines Id. 2.3.4,5,6c. 7.8d, 9c, 10c/and^r7£U^s««»i^^CTcr7r. I. 12 101,702.
13 Program services (from line 44, column (B)) 13 114,665.
Management and general (from line 44, column (C))
o 14 60,018.
14 _£Q.
15 Fundraising (from line 44, column (D)) 15
:MJ1:!???::M 16
18
17
1B
Payments to affiliates (attach schedule)
Total expenses (add lines 16 and 44, column (A))
ma44,column«w
Excess or (deficit) fortho year (subtract Sn
i....rr.....„
i e 17 from line k)
,....,..yf
LKJUfcl^t U \ t
4.
1
t 17
18
174,683.
-72,981,
19 Net assets orfund
or fund balances
balances at beginning
beginning ofyaar
of year (from
(from liniTVm^^TZ. .. 19 721,287.
Z . [ft 20 Other changes
changes In
in net
net assets
assets or fund
fund balances
balances (attach
(attach explanation)
explanation) ~.¥.!.¥.! $..',J,lb'J'.¥.!.~¥.!.:w.';l;'
SJ3E...STJ\TJESffiNT >< _2_ ? .. 2D 55,342,
21 ortund
Nat assets or balances at
fund balances at end
end of year (combine
combine Jines
lines 118,19, and
and 20) . 21 703,648.
page 11 01
fc
LHA For For Paperwork
Paperwork Reduction
Ro~ucllDn ActAct Notice,
Notice, sea
see paga ofthe
thessparata
separateinstrUctions.
instructions. Form 990 (1997)
72J001
7230O1
OO·12·ga
03-12-98
1 1

11021001 758050 23-12053HEI


23-12053HEI 062 THE HEIMLICH
062 INSTITUTE FOUNDAT * 23-12051
HEIMLICH INSTITUTE
11021001
23-7303161 Page
Page22
Form 990 (1997) THE HEIMLICH INSTITUTE FOUNDATION
mizations must complete column (A). Columns (B), (C), and (D) are required for sectio n 501(c)(3) and
|;KSif%lE£ F u n c t i o n a l E x p e n s e s (4) organizations and section 4947(a)(1) nonexempt charitable trusts but optional for others.
Do not include amounts reported on line (B) Program 1 (C) Management (D) Fundraising
8b, 8b, 9b. 10b, or 16 Of Parti. ;§$ (A) Total services and general
22 Grants and allocations (attach schedule) s
22
cash $, _
cash S noncash $ 22
23 Specific
23 assistancetotoindividuals
Specificassistance Individuals (attach
(attachschedule)
schedule) t-=+--------+------~
23 ' \
■>^
V S

24 Benefits
24 paidtotoororfor
Benefitspaid formembers
members (attach
(attachschedule)
schedule) 24
25 Compensation
25 Compensation ofofofficers,
Officers,directors,
directors, etc.
etc. 25 0. 0.
r+-----;:,....""-:;-;:rl----=-=~=_=_=_+--__::_=__:::=_~I_------- 0. 0.
26 Othersalaries
26 other salariesand
andwages
wages 54,015. 40,511. 13,504.
,t=+------=.....::...c<--..:..::....:--j----=....::...L::.....::=-+--__;;;;;.;;;_L,.;;;,-=-=-=-J--------
26
27 Pension
27 Pensionplan
plancontributions
contributions . 27 !
2S Other
28 Otheremployee
employeebenefits
benefits . 2B 8,341. 6,256. 2,085.
29 Payroll
29 Payrolltaxes
taxes . 29 10,477. 7,858. 2,619.
3D Professional
30 Professional fundratsing
tundralsing fees
fees . 30
31 Accounting
31 Accounting fees
fees 31 1,975. 1,481. 494.
p+----~~~;:-::.J------:~~~=-t-----~~~I--------
32 Legal
32 tees
Legalfees 32 2,231. 1,673.' 558.
p+----~~-T;;..-:-J------:~i-;;07-=+-------=;;~~!--------
33 Supplies
33 Supplies . 33 2,747. 2,061. 686.
34 Telephone
34 Telephone .. 34 3,204. 2,403. 801.
35 Postage
38 Postageand
andshipping
shipping .. 35 2,871. 2,153. 718.
36 Occupancy
36 Occupancy p'+-__
36 14,952. 3,738.
__;;;;..;;:...~;;::_.:;~ 11,214.
--=:....!.....:.....;;...;;...+--__;;;:...;;;..~=-=-=-I--------
37
37 Equipment rental
Equipment rental and
and maintenance
maintenance 37
F-t--------i--------l----------'I--------
38 Printing and publications
3B Printing and publications . 38
39 Travel
39 Travel . .. _3jJ 29,776. 22,332.
7,444.
40 Conferences,
40 Conferences, conventions,
conventions, and meetings
meetings 1-'-'+-------1--------1----------'1--------
40
41 interest
41 Interest p'+-----;:--;:;--.;:::-!-------+---"'7--;::;:o-;~I--------
41
42 Depreciation,
42 Depreciation, depletion,
depletion, etc.
etc. (attach
(attach schedule)
schedule) 42 6,945. 6,945.
43 Other expanses (itemize):
43 Other expenses (itemize):
aaOFFICE
OFFICE IINSURANCE
NSURANCE 43a 7,325. 1,831. 5,494.
t,bOUTSIDE
OUTSIDE SERVICES
S ERVICES 43b 25,709. 19,282. 6,427.
cMISCELLANEOUS
BMISCELLANEOUS 43 c 4,115. 3,086. 1,029.
rjd
0
~T_----------_4------------_r------------+-------------
__ 43d
0 43e
44 Total
44 Totalfunctional
functio"" expenses
OXpen5as(add
(addlines
tines22
22through
through43)43)
OrgIIni2',tion'. completing
Organizations colmpll,Ung coliimns
columns (B)-p),
(9)-(0), carry
CNrf these
these
44 174,683. 114,665. 60,018. 0o.
.
Reporting ofofJoint
Reporting Joint Costs.
Cosls••■ Old
Old you
you report
report in
in column
column {B){B) (Program
(Program services)
services) any
any Joint
Jointcosts
costsfrom fromaacombhed
combinededucational
educationalcampaign
campaignandand
tundraising solicitation?
fundraising solicitation? ► □ 0 Yes 00
Yes [ X I No
No
IfIf"Yes,"
"Yes,' enter
enter [i)
(I) the
the aggregate
aggregate amount
amount of
of these
th9ssIoint costs $
joint costs $_ ; (Ii)) the
tile amount
amount allocated
allocated to Program services $$ .
Program services _
ill the
(iii) the amount
amount allocated
allocated to
to Management
Mana ement and 6n6ral $$
and general ;;and Iv the
and (tv) the amount
amount allocated
allocated to Fumlralsin $$
to Fundraising
J a W i i l l Statement of Program Service Accomplishments
What isis
What Ihe organization's
the organization's primary exemptpurpose?
primary exempt purposo?►
....
_S..;.,E..;;,E_.;_S...;,T...;,A;.;,;T.;.;..:.,E.:.,;M.;_E...:.N..:.:.;:T:__3;:;._
S EE STATEMENT 3 -;
Program
PrO!ll'am Service
Service
organization.must
All organizations must describe
describe their exempt purpose
lIleir exempt pUIl'OSOechl in aa clear
.....""""'1a in clear and
and concise
concise manner.
"Expenses
bpenses
manner. State
State ttie
tho number
number 01cllents.etved, """ed.•
All achievements of clients aeived, l'ubllClltions tc. DI5ctlss
publications (ssuBd, etc (Raqulreclfor501
Discuss (Required rorS01(cl(3j and
(c)(3) and
achillVe~ts that
achievements lIlat are
ant not measurabl .. (Sectlo" 5Dl(c)(3) and (4) organizations and 4947(al(1) nonexempt charilnble wat. "",5t also enter tho amount 01grants and
not measurabla (Section 501 (c)(3) and (4) organizations and 4947(a)(1) nonexempt ehahtabla trusts must also enter the amount of grants and (4) orgs.,
(4) and 4947(.)(1)
QIglI.. and 4947(a)(1)
allocations to others.) wsts; but
trusts; but optional
optlOl1a1lor others.)
for others.)
allocations to others.) „ _ _ ^ ^ — — ^ ^ — — - ^ — ^ — " —
aa SEE
SEE STATEMENT
STATEMENT 44

(Grants and allocations $ 34,400


34,400.
AIDS
bb AIDS RESEARCH
RESEARCH AND EDUCATION
AND EDUCATION

Grants and
(Grants and allocations $ 551,599.
1,599,
cEDUCATION
cEDUCATION OF THE
OF THE GENERAL
GENERAL PUBLIC,
PUBLIC, THE PRINTING
THE PRINTING AND
AND
DISTRIBUTION
DISTRIBUTION OF EDUCATION
OF EDUCATION LITERATURE
LITERATURE TO PUBLIC
TO PUBLIC PLACES
PLACES
ABOUT THE
ABOUT THE HEIMLICH
HEIMLICH MANEUVER.
MANEUVER.
Grants and
(Grants allocations $$
and allocations 228,666.
8,666.
d __-- ~

Grants and allocations


(Grants allocations $
e Other program services (attach schedule) (Grants and allocations $
f Total ol Program Service Expenses (should equal line 44, column (B). Program services) 114,665.
723011
03-27-98
11021001 758050 23-12053HEI 062 THE HEIMLICH INSTITUTE FOUNDAT 23-12051
.---_.------------------------------------------------------------------------------
Form980
Form 990(1997)
{19971 THE THE HEIMLICH
HEIMLICHINSTITUTE
INSTITUTEFOUNDATION
FOUNDATION 23-7303161
23-7303161 Pace 3
Page3
.-~.
titflt]JI: Balance Sheets
ffjjaljlill Balance Sheets
Note:Where
Note: Where required.attached
required, attached andamounts
!,,'!nl~I1I1IA~
schedules and amountswithin
withinthethedescription
descriptioncolumn
columnshould
shouldbebe (A) (B)
(B)
forend-of-year
for end-of-yearamounts
amountsonly. Beginning of year Endof
End of year

4545 Cash-non-interest-bearing
Cash- non-lnterest-bearlng 6,374. 45 458.
46 Savings and temporary cash investments , .. 37,725. 46 15,464.

4747a a Accounts
Accountsreceivable
receivable .. 47a
Lass:allowance
b b Lass: allowancetor doubtfulaccounts
for doubtful accounts ......•........... 47I) 47B
ill —
49
49
a a Pledges
4848 ·Pledgesreceivable
receivable
allowancefor
less:allowance
b b Less:
Grantsreceivable
Grants receivable
doubtfulaccounts
for doubtful
.•••.•.•
accounts ............•....•
I-'-"=-l!----------I
48a
48b
.
I
49
f
505D Receivablesfrom officers, directors, trustees, and key employees(attach
Receivables from officers, directors, trustees, and key employees (attach
schedule)
schedule) .. l--------~~+-------- 50
in
i
*-• 5151a a Other
Othernotes
notes andandloans
loansreceivable
recoivable
b less: allowancefor doubtful accounts
.. I 51a
.. | 51b no
IS!
8~ 52b Less: allowance for doubtful accounts
52 Inventoriesfor
Inventories torsale
saleoruse
oruse 1---------1-'''''-+--------
a. 5353 Prepaid
Prepaidexpensesand deferredcharges
expenses and deferred charges , 1- +-""'-+-
53 _
5454 Investments - securities (attach schedule)
Investments-securities (attach schedule) l---------tt 54
55aa Investments
Investments- -iand, buildings,and
ami
55 land, buildings,
*8
equipment:basis
equipment:
bb Less:
basis
less: accumulated
accumulateddepreciation
schedule)
schedule)
(attach
depreciation (attach
r=-t---------t
55a
1
;; T:1'T,;;=;i;'m~;;;:;;;;:rn::;::m;;-~-i---"C:;;::-;,,:;;--::;-r:~:---Z2'7\-;:;'i'i'i;-
55b
55 Investments -otner .. S E"".7.,
E STATEMENT ..O:.-:-:. 5 6 6 4 , 5 4 3 . 56 660,797.
J
55 Investments-other :"."':O::::~ •.,.,.;~:::':':,
57aa Land,
57 land, buildings,
buildings,and
andequipment:
equipment:basis
basIs l-"-~I-------;~...L...i~~
57a 55,616.
hb Less:
less: accumulated
accumulateddepreciation
depreciation 31,292. 31,269. 24,324.
T!1':r.~;,'rn;:;;r:;;;;rn~~7:...:::.:T---~7"'5'~rl-.::::=-t----"F"5'TI:
57b
58
58 Otherassets
Other assets(describe ....
(describe ► ----------~~~~~~~~---~
S SEE STATEMENT 6 ) 6,387. 5,316.

59 Total assets (add lines 45 through 58) (must equal line74) 746,298. 59 7706
0 6 , 3359.
59.
Accountspayable
60 Accounts
60 payableand accruedexpenses
and accrued exPenses 2 5 , 0 1 1 . 60
r--_=...L-c....::..:::..;+-,.,,_+- _
61 Grantspayabte l---------j--:::.!....+--------
61
\n l----------j--:"-!O..+--------
:ei!l 62 Deferredrevenue 62
B:ii Loansfrom
63 Loans
63 officers,directors,
from officers, directors,trustees,
trustees,and
andkey
!ceyemployees
employees .
~ 64 aa Tax-exempt
64 Tax-exemptbond liabllitJes
bond liabilities .. 64a
III Mortgagesand andother
othernotes
notespayable
payable .p~+-
bb Mortgages I- 64b ---.::--;=-:;--
65
BS OIherliabilHies(describe .... PAYROLL TAX WITHHOLDINGS
other liabilities describe ► P A Y R O L L T A X W I T H H O L D I N G S j )!- -+~-!-
65 2,711.
__;;:..L..:...::..;::...:..

25,011. 65 2,711.

in
Organizations til at follow SFAS117,
Organlzationsthatfollow

67
67
andlines
69 and
69 lines 73
Unrestrictad
Unrestricted
SFAS 117, chack
and74
73 and 74
checkhere
hero ► andcomplete
.... U L J and completelines
lines67 through
67 through

.. 682,368.
1 67
664,729.
s 68
68 Temporarilyrestricted
Temporarily restricted .
c
to 59 Permanentlyrestricted .. 38,919. 69 38,919.
c organlzallons that
Organizations donot
that do nat follow SFAS 117, check
lallow SFAS117, chackhero....
here ► 0 and
L~Z3 aM complete
complete lines
llnes
s. through 74
70through
70 74
0 70
70 Capitalstock,trust
Capital prinCipal,or
stock, trust principal, currenlfunds
or current funds 1- +-.:.:...+-
70 _
% 71
71 Pald-inor
Paid-in or capital
capitalsurplus,
surplus, or
orland, building, and
land, building, and equipment
equipmentfund
fu nd I---------I-.!..!..-:I--------
71
9 72
72 Retainedeamlngs,
Retained endowment,accumulated
earnings, endowment, accumulatedIncome, or othe
income, or funds
otherrfunds . 72

z
73
73 Total net
Total net assets
assets or
Drfund balances (add
fund balances (add lines
lines67 through 69
67through ORlines
69 3R through 72;
70 through
lines 70 72; II 703,648.
column (A)
column (A)must
must equal
equalllna and column
19 and
line 19 column (B) must eaual
(B) must equaliina 21)
line21) . 721,287. 73
74
74 llabillUes and
Total liabilities
Total nat assets
and net assets / fund
fund balances lines 56
balancDs (adti lines and73)
66 and 746,298. 706,359.
Form990
Form 990 isIs available
availablefor public inspection
for public Inspection and,
and,for
for some
some people,
people,serves
servesas
asthe
the primary
primary or
or sole
sole source
source of
of Information
Informallon about
about aa particular
particularorganization.
organization.How
Howthe
the public
public
perceivesan
perceives organizationin
an organization such cases
in such casesmay