CO

Form AG990-IL Revised 3/95

#

Q1-Q?fi,498

CHARITABLE ORGANIZATION SUPPLEMENT
Attorney General JIM RYAN State of Illinois
Charitable Trust and Solicitations Bureau, 100 West Randolph Street, 12th Floor, Chicago, Illinois 60601 MO DAY D No YR MO DAY YR

REPORT FOR THE FISCAL PERIOD BEGINNING:
ARE CONTRIBUTIONS TO ORGANIZATION TAX DEDUCTIBLE? LEGAL

0 I \q\l\
0 Yes

[± V

AND ENDING:
FEDERAL ID NUMBER: 3N DATE ORGANIZATION WAS CREATED: A) ASSETS B) LIABILITIES C) ENDING FUND C) BALANCE PERCENTAGE A) S B) S C) S MO DAY YR

SAVE A LIFE FOUNDATION nr^r^r™^ V l i J j

NAME 17479 W. DARTMOOR DRIVE ^TT-r^ 1 1 MAILGRAYSLAKE, ILLINOIS eOOSO-**^*^ ^ ADDRESS

13

/V. 337
i%, °II I

CITY, STATE
ZIP CODE

JUL 2 5 1995

CHARITABLE TRUST AUOfrNCY GENERAL I. SUMMARY OF REVENUE ITEMS DURING THE YEAR:
D) PUBLIC SUPPORT, CONTRIBUTIONS & PROGRAM SERV. REV. (GROSS AMTS.) E) GOVERNMENT GRANTS & MEMBERSHIP DUES F) OTHER REVENUES G) TOTAL REVENUE. INCOME AND CONTRIBUTIONS RECEIVED (ADD D,E. & F)

(H r?v)
AMOUNT

J24.

fLf JLf
F) S

? 3,Yof -?..?7r
W3f

100%

211
H) S

77,7//
%i m-

II. SUMMARY OF EXPENDITURES DURING THE YEAR:
H) OPERATING CHARITABLE PROGRAM EXPENSE I) J) EDUCATION PROGRAM SERVICE EXPENSE GRANTS TO OTHER CHARITABLE ORGANIZATIONS

%

f^%
%

") s
J) S K) S L) S M) S N) S

i

K) TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD H, I & J) L) MANAGEMENT AND GENERAL EXPENSE M) FUNDRAISING EXPENSE N) TOTAL EXPENDITURES THIS PERIOD (ADD K, L, & M)

«?/-%

/f %
%
100 %

%> /?2\% /32

??3^y
/JlA ■

III. SUMMARY OF PAID FUNDRAISER ACTIVITIES DURING THE YEAR:
(Attach Attorney General Report of Individual Fundraising Campaign) O) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISER P) TOTAL FUNDRAISER FEES AND EXPENSES Q) NET RECEIVED BY THE CHARITY (O MINUS P=Q) 100 %

0) s
P) S

% %

0) s

IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS-DURING THE YEAR:
R) NAME. TITLE: S) NAME. TITLE T) NAME. TITLE fjffi, R) S S) S T) $

V. CHARITABLE PROGRAM DESCRIPTION:
CHARITABLE PROGRAM (3 HIGHEST BY $ EXPENDED) CODE CATEGORIES (List on back side of instructions) U) DESCRIPTION: V) DESCRIPTION; W) DESCRIPTION ?U4 ML U<L £bU*A-n0J 3V MA/L, U) # CODE

Ot.O O/ 2-

QUf/L

fhj<?Af,*J/ry-

WiArC/UALS fb/L

im

?<*4^c

V) # W)0

IF THE ANSWER TO ANY OF THE FOLLOWING IS YES, ATTACH A DETAILED EXPLANATION : 1. 2. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION, FINE, PENALTY OR JUDGMENT? HAS THE ORGANIZATION OR A CURRENT DIRECTOR. TRUSTEE, OFFICER OR EMPLOYEE THEREOF. EVER BEEN CONVICTED BY ANY COURT OF ANY MIDSDEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY? 1.

YES

2.

3.

DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS OR DIRECTORS OWNS AN INTEREST OR WAS A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS DIRECTORS. TRUSTEES. OR OFFICERS HAS A MATERIAL FINANCIAL INTEREST OR DID ANY OFFICER OR DIRECTOR RECEIVE ANYTHING OF VALUE NOT REPORTED AS COMPENSATION? 3. HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER. DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES? IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? DID THE ORGANIZATION ALLOCATE THE COST OF ANY MAILING. ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES? DID THE ORGANIZATION LEND FROM RESTRICTED FUNDS TO ITS UNRESTRICTED FUNDS FOR PURPOSES OTHER THAN THEIR RESTRICTED PURPOSES? HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION SUSPENDED OR REVOKED? DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER?

4.

4.

5.

5.

6.

6.

7.

7.

8.

8. 9.

9.

10. DO YOU HAVE ANY KNOWLEDGE OF ANY THEFT, DEFALCATION. MISAPPROPRIATION. COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS?

10.

11. LIST THE NAME AND ADDRESS OF THE BANKS, AND THE ACCOUNT #, WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST AMOUNTS:

6#Mh

A//lr/a«/At. &A/JIC

Rf Z./ <ct <Z*Ark> 4vt

Ltfinit

,(_

12. NAME AND TELEPHONE NUMBER OF CONTACT PERSON:

CAAJOL.

IftlT-'Ml

7<7£-5VT,-73S3

JNDER PENALTY OF PERJURY. I (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS SUPPLEMENT .ND THE ACCOMPANYING REPORT. INCLUDING ALL THE SCHEDULES AND STATEMENTS AND THE FACTS THEREIN STATED ARE RUE AND COMPLETE AND FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE TATE OF ILLINOIS RELY THEREUPON. I HEREBY FURTHER AUTHORIZE AND AGREE TO SUBMIT MYSELF AND THE REGISTRANT IEREBY TO THE JURISDICTION OF THE STATE OF ILLINOIS.

?M4i.~*
UBSCRIBED AND SWORN 0 BEFORE ME.THIS AY OF

STtzzifi-H\

PRESIDENT or TRUSTEE (PRINTNAME>

„ -.
SIGNATURE

TE

.19

TREASURER or TRUSTEECPRINTNAME)

DATE

•••(NOTARIZATION REQUIRED UNDER TRUST ACT ONLY)' (NOTARY PUBLIC)
SIGNATURE OF P R E P A R E R ( P R W T NAME)

SIGNATURE

DATE

Office of the Attorney General Charitable Trust and Solicitations Bureau Attn: Annual Report Section 100 W. Randolph St., 12th Floor Chicago, IL 60601 (312) 814-2595 June 26, 1995 Save A Life Foundation 17479 W. Dartmoor Drive Grayslake, IL 6003 0 CO#: 01-026,498 Dear Attorney General, On behalf of my client, I request an automatic 90 day extension of time to file until September 28, 1995 the Form AG990-IL of the organization named above for the calendar year ended December 31, 1994. An extension of time is needed to complete the federal 990. Signature of tax preparer: Cole, Martin & Co., Ltd. Steve Cole, CPA Re:

snort i-orm Return of Organization Exempt From Income Tax Form 990-EZ Under section 501(c) of the Internal Revenue Code (except black lung benefit trust or
private foundation) or section 4947(a)(1) nonexempt charitable trust ► For organizations with gross receipts less than $100,000 and total assets Depertmenl si lti< Treasury less than $250,000 at the end of the year. Internal Re«eage Str>icc The organization may have to use a copy of this return to satisfy state reporting requirements. A For the 1994 calendar year. O fiscal year beginning R 1994. and ending
B Pleese C Name of organization ote IRS I 'address libel or ryilniliil FOUNDATION/ INC prim or jSAVE A L I F E !■■" irelura type. Final Number and street (or P.O. box if mail is not delivered to street return See I lAiaendctf Specific Hum (required IntKuc>lso lor lions. City, town or post office, state, and ZIP code Sine reporting! Ctiect il

OMB No. 1S45-I ISO

1994
This Form is

Open to Public

i—}T"9'

Inspection 19 D Employer identification number

36-3869459
address)
Room/suite E State registration number

174 79 W. DARTMOOR DRIVE

01026498
Check ► I | if exemption application is pending H Enter four-digit group exemption number (GEN) Section 4947(a)(1) nonexempt charitable trust

SRAYSLAKE, IL
|_XJ Cash I

60030
|

G Accounting method: I

1 Accrual

| Other (specify) ► j <4 (insert number) O ► □ R

Type of organization - ► [ X ) Exempt under Section 501(c) ( 3

Note: Section 501(cll3l organizations and section 4947(a)(1) nonexempt charitable trusts MUST attach a completed Schedule A (Form 9901. J Check ► L J if the organization's gross receipts are normally not more than $25,000. The organization need not file a return with the IRS; but if the organization received a Form 990 Package in the mail, the organization should file a return without financial data. Some states requite a complete return. K Enter the organization's 1994 gross receipts (add back lines 5b, 6b, and 7b, to line 9) ► $ H $100.000 or more, the organization must file Form 990 instead of Form 990-EZ.

97711.

K

H I
1 2 3 4 5a b

Statement of Revenue, Expenses, and Changes in Net Assets or Fund Balances
Contributions, gifts, grams, and similar amounts received Program service revenue including government fees and contracts Membership dues and assessments Investment income Gross amount from sale of assets other than inventory Less: cost or other basis and sales expenses

Stmt 3

93405
2875

5a
5b 5c

I

6

c Gain or (loss) from sale of assets other than inventory (line 5a less line 5b) Special events and activities (attach schedule):

a Gross revenue (not including $ of contributions reported on line 1) b Less: direct expenses other than fundraising expenses c Net income or (loss) from special events and activities (line 6a less line 6b) 7a Gross sales of inventory, less returns and allowances b Less: cost of goods sold c Gross profit or (loss) from sales of inventory (line 7a less line 7b) 8 9 10 11 12 13 14 15 16 17 18 19 Other revenue (describe ► Total revenue (add lines 1. 2. 3. 4. 5c. 6c, 7c, and 8) Grants and similar amounts paid Benefits paid to or for members Salaries, other compensation, and employee benefits Professional fees and other payments to independent contractors Occupancy, rent, utilities, and maintenance Printing, publications, postage, and shipping

6a 6b
6c 7a 7b

14 31 1431
7c

96280
10 ii 12 13

I
41

See Statement 4

14

Other expenses (describe ►
Total expenses (add lines 10 through 16) Excess or (deficit) for the year (line S less line 17) Net assets or fund balances at beginning of year (from line 27. column |A)) (must agree with end-of-year figure reported on prior year's return) Other changes in net assets or fund balances (attach explanation) Net assets or fund balances at end of year (combine lines 18 through 20)

See Statement 1 j

1 5 1 6 17 1 8 1 9 20 21

8163 13770 46714 29246 97893 -1613 -12961 -14574
(Bl End of year

z
22 23 24 25 26 27

20 21

Balance Sheets
Cash, savings, and investments Land and buildings Other assets (describe ► Total assets

If Total assets on line 25. column IB) are $250.000 or more. Form 990 must be filed instead of Form 990-EZ (A) Beginning of year

-71 See Statement 2
SPIZZIRI

Total liabilities (describe ► DUE TO CAROL

w

Net assets or fund balances (line 27 of column (B) must agree with line 21)

2-54 S430 For Paperwork Reduction Act Notice, see page 1 of the separate instructions.

3931 3860 16821 -12961

22 23 24 25

830.

26
27

13507 14337 28911 -14574
Form 9 9 0 - E Z (1994)

Form 990-tZ 11994) SAVE A L I F E FOUNDATION, INC Statement of Program Service Accomplishments
What is the organization's primary exempt purpose? See Statement 6

36-3869459
Expenses

Pa9e2

Describe what was achieved in carrying out the organization's exempt purposes. Fully describe the services provided, the number of persons benefited, or other relevant information tor each program title.

(Requited loi SDKclU) and (4) Otganiraiions and 4947(a)(1) Irusis; optional lot ottieis.l

TO PROMOTE EDUCATION & CONTINUING EDUCATION IN CPR & FIRST AID NATIONALLY. TO PROMOTE, CONSISTENCY, UNIFORMITY & SAFETY IN THE APPLICATION OF FIRST AID & (rns $ Gat 2 CPR. TO ASSURE THAT THE BEST PROCEDURES AND HIGHEST 9 QUALITY MATLS ARE USED & ACCESSIBLE. TO PROMOTE GOOD SAMARITAN LAWS. " (Grants $
28
30 (Grants $ 31 Other program services (attach schedule) 32 Total program service expenses (add lines 28a through 31a) (B) Title and average hours (Cl Compensation per week devoted to (if not paid, enter position -0-I (Grants S

28a

29a

99324

30a 31a 32
(D) Contiibulioiii 10 employee beoelit plans & detente compensation

99324
(El Expense account and other allowances

■ i f T i i r i List of Officers. Directors, Trustees, and Key Employees (list each o e even if not compensated.) n
(Al Name and address

See Statement 5

k-SMm^ nther Information
33 34 35 Did the organization engage in any activity not previously reported to the IRS? If "Yes," attach a detailed description of each activity Were any changes made to the organizing or governing documents but not reported to the IRS? H ■»•»,- aiiaco a coniotmed copyol tat changes. If the organization had income from business activities, such as those reported on lines 2, 6. and 7 (among others), but NOT reported on Form 990-T. attach a statement explaining your reason for not reporting the income on Form 990-T.

Yes No

a Ounng the year covered by this return, did the organization have unrelated business gross income of $ 1.000 or more or incur liability for the section 6033(e) lax on lobbying and political expenditures? b If "Yes." has it filed a tax return on Form 990-T, Exempt Organization Business Income Tax Return, for this year? 36 Was there a liquidation, dissolution, termination, or substantial contraction during the year? (If "Yes," attach a statement) p> | 37a | 01 37a Enter amount of political expenditures, direct or indirect, as described in the instructions.

N7A

b Did the organization file Form 1120-POL, U.S. Income Tax Return for Certain Political Organizations, for this year? 38a Oid the organization borrow from, or make any loans to. any officer, director, trustee, or key employee, O were any such loans made in a prior R year and still unpaid at the Stan of the period covered by this return? b If "Yes." attach the schedule specified in the instructions and enter the amount involved 39 Section 501(c)(7) organizations " Enter: a Initiation fees and capital contributions included on line 9 b Gross receipts, included on line 9. for public use of club facilities | 38b | 2 89111

39a
I 395 I

N/A
N7A

c Does the club's governing instrument or any written policy statement prov.de for discrimination against any person because of race, color or religion? (If "Yes," attach statement) 40 41 42 List the states with which a copy of this return is filed. ► ILLINOIS

N/A

Telephone no. ► 7 0 8 - 5 4 9 - 7 3 5 3 ZIP code ► 60030 Section 4947(a)(1) nonexempt charitable trusts filing Form 990-EZ in lieu of Form 1041, U.S. Income Tax Return for Estates and Trusts.-Check here ► □ and enter the amount of tax-exempt interest received or accrued during the tax year ► | 42 | N/A I

The books are in care of >>CAROL S P I Z Z I R R I Locatedat»v 1 7 4 7 9 W. DARTMOOR DR. GRAYSLAKE,

IL

Please Sign Here

Under penalties al perjury. I declare Ihii I have tiamined init teluin. iacludi ng tccomponying schedules and statements. and 10 Ihe best ol my knowledge aod btliel. il is due. coitett. and complete. Oeclatalioo ol piepaiti (older loan ollicei) is bastd on all ioloimation ol which prepatei has any knowledge.

t
r Signature of officer Preparer's signature Firm's name (or

I
n-._ Date Date

L
^ Title

Paid Pieparer's Use Only
4J3431 .'2-12-94

Check if self -employed ►[Z^l E.I. No. ► ZIP codeaV

Preparer's SSN

yours if self-employed) ^
And arfdr^cc and address ^

SCHEDULE A (Form 990)
Department ol Ihe Treesury miticiil Aenenje Senice

Organization Exempt Under 501(c)(3)
(Except Private Foundation!, and Section 501(e), 501(11, SCMlkl, or Section 4 9 4 7 U I I I I Nonexempt Charitable Trust

0MB he. IS4S-004?

Supplementary Information
► Must be completed by the above organisations and attached to their Form 990 (or Form 990E2I.

1994

Mame

Employer identification number

36-3869459 C S B T Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees
( S e e i n s t r u c t i o n s . ) (List each one. If there are none, enter "None.") lal Name and address of employees paid more than $50,000 (bl Title and average hours per week devoted to position (cl Compensation
14) Cootribulions lo (el Expense employee beotlii plant & 4elened account and other

SAVE A LIFE FOUNDATION

INC.

toinpemiiion

allowances

None

Total number of other employees paid over$50.000 ► |
t

L £ ] | l i l Compensation of the Five Highest Paid Independent Contractors f o r Professional Services
( S e e i n s t r u c t i o n s . ) (List each one (whether individuals or firms.) (If there are none, enter "None.")) (al Name and address of each independent contractor paid more than $50,000 (blType of service I d Compensation

None

Total number of others receiving over $50.000 for professional services

Statement About A c t i v i t i e s
1 During the year, has the organisation attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? If "Yes," enter the total expenses paid or incurred in connection wilh the lobbying activites. ► $ Organisations that made an election under section 501(h) by filing Form 5768 must complete Part VI-A. Other organisations checking "Yes." must complete Part Vl-B AND attach a statement giving a detailed description of the lobbying activities. 2 During the year, has the oganisation, either directly or indirectly, engaged in any of the following acts with any of iis trustees, directors, officers, creators, key employees, or members of their families, or with any taxable organisation with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary: a Sale, exchange, or leasing of property? b Lending of money or other extension of credit? c Furnishing of goods, services, or facilities? d Payment of compensation (or payment or reimbursement of expenses if more than $1,000)? e Transfer of any part of its income or assets? If the answer to any question is "Yes." attach a detailed statement explaining the transactions. 3 4 Does the organisation make grants for scholarships, fellowships, student loans, etc.? Attach a statement explaining how the organisation determines that individuals or oranisations receiving grants or loans from it in furtherance of its charitable programs qualify to receive payments. (See instructions.) S430 For Paperwork Reduction Act Notice, see page 1 of the Instructions to Form 990 lor Form 990-E2I. 2 7 1 2 .

Yes

No

2a 2b
2c

2d 2e

Schedule A (Form 99011994

423101 12-12-94

9350713

758985

SAVE50

060

SAVE A LIFE FOUNDATION, INC.

18616924

Schedule A (Form 990) 1994

SAVE A LIFE FOUNDATION, INC

36-3869459

Page2

| j g | j ^ ^ | Rpggnn for Non-Private Foundation Status (See instructions for definitions I
The organization is not a private foundation because it is (please check only ONE applicable box): S 6 7 8 9

10
11a
11b 12

□ □ □ □ □ □ □

l

I

A church, convention of churches, or association of churches. Section 170(b)! 1)IA)|i). A school. Section 170(b)(1)(A)(ii). (Also complete Part V, page 3.) A hospital or a cooperative hospital service organization. Section 170(b)(1)(A)(iiil. A Federal, state, or local government or governmental unit. Section 170(b)(1)(A)(v). A medical research organization operated in conjunction with a hospital. Section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state ►

An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(1)(A)(iv). (Also complete the Support Schedule below.) An organization that normally receives a substantial part of its support from a governmental unit or from the general public. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule below.) A community trust. Section 170lb)(1)(A)(vi). (Also complete the Support Schedule below.) An organization that normally receives: (a) no more than 33 1/3% 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 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc., functions - subject to certain exceptions. See section 509(a)(2). (Also complete the Support Schedule below.)

DO

13

An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in: (1) lines 5 through 12 above; or (21 section 501(c)(4). (5). or (6). if they meet the test of section 509(a)(2). (See section 509(a)(3).)

Provide the following information about the supported organizations. (See instructions for Part IV. line 13.) (al Name(s) of supported organization(s) (b) Line number from above

14

\_i

An organization organized and operated to test for public safely. Section 509(a)(4). (See instructions.) (Complete only if you checked boxes on lines 10, 11, or 12 above.) Use cash method of accounting. ► (al 1993 (b) 1992 (cl 1991 (d) 1990 (el Total

Support Schedule

Calendar year (or fiscal year beginning inl
15 Cilti, gums, and conuibuiiont received. (Do not include unusual grams. See line 2 8 )

7199.

7199.

16
17

Membership fees received
Grots ttceipls Iron •emissions. aeichandise sold oi seivicrs peiloimed. or lumilhing ol lecililies in any activity thai it not a business unreined lo Ihe oiganiritioo's charitable. etc.. purpose Cross Income Irom imeictl. dividend!. mourns received lion payments on securities loans Iseclion SI2(a)(b)l, lenti. royalties, and unrelated business laiaule income [less section SI I lairs) Irom businesses acquired by Ihe organization alter Juae 30. 1975

18

19
Z0

Net income from unrelated business activities not included in line 18
Ta« revenges levied lor Ihe organization's stnelit and either paid lo il or eipended oo ill bthalf The value ol services or lacililies lurnished lo Ihe organization by a governmental unit without charge. Oo nol include ihe value ol seivices oi lacililies generally lurnished lo Ihe public without cbaige Other income. Attach a schedule. Oo nol include gain oi (loss) hom tale ol capital astelt

21

22

23 24 25 26

Total of lines 15 through 22 Line 23 minus line 17 . Enter 1 % of line 23 Organizations described in lines 10 or 11:

7199. 7199. 72.

0.

0.

0.

7199. 7199.

a Enter 2 % of amount in column (e). line 24 b Attach a list (which is not open to pub ic inspection) showing t le name of and amount :ontributed by each pers on (other than a governmental unit or publicly supporte d organization) whose tt tal gifts for 1990throu gh 1993 exceeded thee mount shown in line 26a. Enter the sum of all these excess amounts here
423111 12-12-94

N/A

N/A

(Support Schedule continued on page 3)

9350713

758985

SAVE50

060

4 SAVE A LIFE FOUNDATION, INC

18616924

Schedule A (form 9901 1964
leffllll 27

SAVE A L I F E FOUNDATION,

INC.

36-3869459
" '

pa9e 3

S u p p o r t S c h e d u l e (contmued) (Complete only if you checked a box on lines 10, 11, or 12.) ~~ ~~

Organizations described on line 12:

a Attach a list, for amounts shown on lines 15. 16. and 17. to show the name of, and total amounts received m each year from, each "disqualified person " Enter the sum of such amounts for each year:
119931

2_L (1992)

<L

(199D

0.

(19901

0.

, A h ™ w ° S h ° W ' '"[ !?'? " T 9 h 1 9 9 3 ' , h e """" ' ' • " n d * m 0 U n t i n C ' u d e d in N n e 1 7 , 0 r ' M e h p e f s o n , 0 , h e r , h a n a "disqualified person") from whom the organization rece.ved. during that year an amount that was more than the larger of (1l the amount on line 25 for the year or IZI $5 000 IncLie organizations described on lines 5 through 11. as well as individuals. After computing the difference between the amount received an"d the larger amount 3 descnbed in (1) or 12). enter the sum of all these differences (the excess amounts) lor each year,1993)

< L L H992I

(K

099,)

0 .

(1990)

0.

28

For an organization described in line 10.11. or 12. that received any unusual grants during 1990 through 1993. attach a list (which is not open to public inspection) lor each year showing the name of the contributor, the date and amount of the grant, and a brief description of the nature of the grant Do not include these grants in line 15. (See instructions.) None

B S D

Private School Questionnaire (To be completed ONLY by schools that checked the box on line 6 in Part IV)

N/A
Yes No
29 30

29 30 31

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

31

32

Ooes the organization maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative staff? b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? e Copies of all catalogues, brochures, announcements, and other written communications to the publ.c dealing with student admissions, programs, and scholarships? d Copies of all material used by the organization or on its behalf to solicit contributions? II you answered "No" to any of the above, please explain. (If you need more space, attach a separate statement.)

" 32a

32b
32c

32d

33

Does the organization discriminate by race in any way with respect to: a Students' rights or privileges? b Admissions policies? Employment of faculty or administrative staff? Scholarships or other financial assistance? Educational policies? Use of facilities? Athletic programs?

~ 33a 33b 33c

c d a f g

33d
33e 331

h Other extracurricular activities? If you answered "Yes" to any of the above, please explain. (If you need more space, attach a separate statement.)

33a
33h

34 a Does the organization receive any financial aid or assistance from a governmental agency? b Has the organization's right to such aid ever been revoked or suspended? If you answered "Yes" to either 34a or b. please explain using an attached statement
35

~ ~

34a 34b

W 1 B 7 W« 7 ^ f " 8

Cef,i,y ^ " h M C ° m P " e d W U h , h B 8 P P " e a b , e r e " " f e m e n , s • ' "<«'<"« 4.01 through 4.05 ol Rev. Pr.c. 7 5 - 5 0 . " • 587, covering racial nondiscrim.nation? If "No," attach an explanation. (See instructions for Part V.)

35

«23I21 12-12-94

350713

758985

SAVE50

060

SAVE A LIFE FOUNDATION, INC.

18616924

Seneduie AlForm 990) 1994
' fiETWJP^ _

SAVE A L I F E FOUNDATION, I N C .
a

36-3869459 N/A

p8qe4

I Ohhyinrf F w p

nHifr

a

, k y C l ^ ^ f i ^ j D..U|;^

^

h l r

j

T

j

r

-

(To be completed ONLY by an eligible organization that filed form 5768) I If the organization belongs to an affiliated group. | If you checked a and "limited control" provisions apply.

Check here ► a l Check here ► b [

Limits on Lobbying Expenses
(The term "expenditures" means amounts paid or incurred)

(al Affiliated group totals

lb)
To be completed for ALL electing organizations

N~7A
36 Total lobbying expenditures to influence public opinion (grassroots lobbying) 37 Total lobbying expenditures to influence a legislative body (direct lobbying) 38 Total lobbying expenditures (add lines 36 and 37) 39 Other exempt purpose expenditures (see Part Vl-A instructions) 4 0 Total exempt purpose expenditures (add lines 38 and 39) 4 1 Lobbying nontaxable amount. Enter the amount from the following table If the amount on line 40 is NolovorS 500.000 Ortf $600,000 bul noi Dvtr SI.OOO.000 0«ei S 1.000.000 bm col over SI.500.DO0 OiorS1.SOO.000 bul not o««f S17.000.0U0 Over $17.000.000

36
37 38 39 40

The lobbying nontaxable amount is 20% ol ihe jmouni on lint 40 $100,000 plus 15% ol Ihc ticcsi o>» $500,000 SI75.000 plus 10% ol Ihe m t i i o . t i $1,000,000 $225,000 plus Sk ol lot i i c t s t o«oi S 1.500.000 S 1,000.000

42 Grassroots nontaxable amount (enter 2 5 % of line 41) 43 Subtract line 42 from line 36. E n t e r - 0 - i f line 42 is more than line 36 44 Subtract line 41 from line 38. E n t e r - 0 - i f line 41 is more than line 38 Caution: File Form 4720 if there is an amount on either line 43 or line 44.

]

41

42 43 44

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501 (h) election do not have to complete all of the five columns below. See the instructions for lines 45 through 50.) Lobbying Expenditures During 4-Year Averaging Period Calendar year (or fiscal year beginning in) 45 Lobbying nontaxable amount 46 Lobbying ceiling amount (150% of line 45(e)) 47 Total lobbying expenditures 48 Grassroots nontaxable amount 49 Grassroots ceiling amount 1150% of line 48(e)) 50 Grassroots lobbying expenditures (a) 1S94

lb) 1993

N/A
(c) 1992 Id) 1991 (el Total

_0_ 0 0.

0.

Part Vl-B

Lobbying Activity by Nonelecting Public Charities
(For reporting by organizations that did not complete Part Vl-A)

During the year, did the organization attempt to influence national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of: a Volunteers b t Paid staff or management (include compensation in expenses reported on lines c through h) Media advertisements

Yes

No

Amount

d Mailings to members, legislators, or the public e Publications or published or broadcast statements f Grants to other organizations for lobbying purposes g Direct contact with legislators, their staffs, government officials, or alegislative body h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means i Total lobbying expenditures (add lines c through h) " " y e s " <° '"V o' the above, also attach a statement giving a detailed description of the lobbying activities.
423131 12-12-94

263.

2449 2712.

See Statement 7
18616924

3350713

758985

SAVE50

060

SAVE A LIFE FOUNDATION, INC.

36-3869459 paaes l i f l i W H Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations i i Did the reporting organization directly or indirectly engage many of the following with any other organization described in section Yes No
501(c) of the Code (other than section 501(c)(3l organizations) or in section 527, relating to political organizations? Transfers from the reporting organization to a noncharitable organization of: (il Cash (ii) Other assets Other transactions: (i) Sales of assets to a noncharitable exempt organization (ii) Purchases of assets from a noncharitable exempt organization liii) Rental of facilities or equipment liv) Reimbursement arrangements Iv) loans or loan guarantees Ivi) Performance of services or membership or fundraising solicitations Slali) alii)

Schedule A (Form 990) 1994

SAVE A L I F E

FOUNDATION,

INC

blil
blii) bliiil

X

b(iv)
b(vl

bfvil

Sharing of facilities, equipment, mailing lists or other assets, or paid employees If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always indicate the fair market value of the" goods, other assets, or services given by the reporting organization. If the organization received less than fair market value in any transaction or sharing arrangement, indicate in column (d) the value of the goods, other assets, or services received. N/A (al (bl Ic) (d) Line no. Amount involved Name of noncharitable exempt organization Description of transfers, transactions, and sharing arrangements

52 a Is the organization directly or .nd.rec.y affiliated with, or related to. one or more tax-exempt organizations described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527? es b '< "Yes," complete the following schedule. N/A

v

[X]Nc

Nime

~W

~

1

(bl
Type of organization

"' organization

(cl Description of relationship

423141 12-12-94

J350713

758985

SAVE50

060

SAVE A LIFE FOUNDATION, INC

18616924

SAVt A Lift* FOUNDATION, INC. Form 990-EZ Description CONFERENCE MEALS AND ENTERTAINMENT OFFICE SUPPLIES & EXPENSE MERCHANDISE PRODUCTS TRAVEL MISCELLANEOUS Total to Form 990-EZ, line 16 Other Expenses

36-3869459 Statement Amount 2011. 2465. 4502. 9569. 7861. 2838. 29246

Form 990-EZ Description

Other Assets Beg. of Year 3931 3931.

Statement End of Year 13507 13507

Other Depreciable Assets - Book Value Total to Form 990-EZ, line 24

9350713

758985

SAVE50

060

8 Statement(s) 1, 2 SAVE A LIFE FOUNDATION, INC. 18616924

SAVt; A LIFE FOUNDATION, INC. Form 990-EZ Description Depreciation/Amortization Other Expenses Total to Form 990-EZ, line 14 Occupancy, Rent, Utilities and Maintenance

36-3869459 Statement Amount 2731. 11039. 13770.

Form 990-EZ

Part IV - List of Officers, Directors, Trustees and Key Employees Average Hours per Week 100

Statement

Name and Address

Title

Compensation

Employee Ben Plan Expense Contrib Acct

CAROL SPIZZIRRI - 17479 W. PRESIDENT DARTMOOR DR, GRAYSLAKE IL STEPHEN J. COLE - 17377 W. DARTMOOR DR, GRAYSLAKE IL DONNA SIEGFRIED - 1121 SPRING LAKE DR, ITASCA, IL ADAM ZAKROCZYMSKI - 384 9 SWANSON CT, GURNEE, IL *ALPH SHENEFELT - 76 N. PARKSIDE AVE, GLEN ELLYN, IL

0.

0.

0.

0.

0.

0.

>orm 990-EZ

Statement of Organization's Primary Exempt Purpose Statement Part III

6

.'xplanation •ROMOTE EDUCATION & CONTINUING EDUCATION IN CPR & FIRST AID NATIONALLY, chedule A Statement of Lobbying Activities - Part VI-B
P

Statement

£ £ £ » iS ™" E AID G S A CPR N "W,n»«'« T H A T

°"^-

FIREFIGHTERS AND BE

J350713

758985

SAVE50

«^„ 060

Statement(s) 4, 5. 6, 7 SAVE A LIFE FOUNDATION, INC. 18616924

10

Form

4562

Depreciation and Amortization
(Including Information on Listed Property) 990 -EZ
► Attach this form to your return.

0MB No. 1615-0172

Ocpa'lmeni ol the Treasury Internal Revenue Service ISSI Nanelt) snona on return

1994
Attachment Sequence No. 6 7 Identifying number

SAVE A LIFE FOUNDATION, INC.
Busineis 01 activity lo which this form relates ~~

36-3869459

Form 990-EZ Page 1
I j f l j l l A c t i o n To Expense Cettain Tangible Properly (Section 179) (Notc:H you have any "listed Property," complete Part V belore vou complete Part ,) 1 Maximum dollar limitation (U an enterprise Jone business, see instructions.) 2 3 Total cost ol section 179 property placed in service during the tax year Threshold cost of section 179 property before reduction in limitation $200,000 $17.500

4 Reduction in limitation. Subtract line 3 from line 2. H zero or less, enter - 0 5 Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, enter - 0 - . (If married filing separately, see instructions.)
la) Description ol property ft)
COM

(c) fleeced coil

7 Listed property. Enter amount from line 26 8 Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7 9 Tentative deduction. Enter the smaller of line 5 or line 8 10 Carryover of disallowed deduction from 1993 11 Taxable income limitation. Enter the smaller of taxable income (not less than jero) or line 5 12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 13 Carryover of disallowed deduction to 1995. Add lines 9 and 10. less line 12 ►

10 11 12 13

Note: Do not use Part II or Part III below for listed property (automobiles, certain other vehicles, cellular telephones, certain computers, or property used for entertainment, recreation, or amusement). Instead, use Part V for listed property. !»»periy useo lor ■ I f f T i l l l MACRS Depreciation For Assets Placed in Service ONLY During Yout 1994 Tax Year IDo Not Include Listed Propertyl
(il Classification ol properly lb) Month and yeir pieced in stl«ict (c) Basis lot depreciation (Business/investment use only) Id) Recovery period le] Convention II) Method (gl Depreciation deduction

Section A • General Depreciation System (GPS) 14 a 3-year property b c d e f 5-year property 7-year property 10-year property 15-year property 20-year property 27.5 yrs. 27.5 yrs. h iMonresidential real property Section B - Alternative Depreciation System (ADS) 15 a Class life b c 12-year 40-year Other Depreciation (Do Not Include Listed Property) 12 yrs. 40 yrs.

12307

7 Yrs.

HY

FOOD!

1759

g Residential rental property

MM MM MM MM

S/L S/L S/L S/L S/L S/L

MM

S/L

m i H U

16 G0S and AOS deductions for assets placed in service in tax years beginning before 1994 17 Property subject to section 168(f)(1) election 18 ACRS and other depreciation

16

548

17
18 19 20
21

lifoif I J s..n,mjry
19 Listed property. Enter amount from line 25

~

—~

20 Total. Add deductions on line 12, lines 14 and 15 in column (g), and lines 16 through 19. Enter here and on the appropriate lines of your return. (Partnerships and S corporations - see instructions) 21 For assets shown above and placed in service during the current year, enter the portion of the basis attributable to section 263A costs
BZvl

2307.
Form 4562 (1994)

I

S430

For Paperwork Reduction Act Notice, see page 1 of the separate instructions.

-U-94

11

9350713

758985

SAVE50

060

SAVE A LIFE FOUNDATION, INC

18616924

r-ormiaiu t m o '
i m X i

, i i i £.% aft'factSBrsr^Scri asaj 8 ^ ra,eor deducn9easeexpense- com',e,e °ni> *»• "»•«*—«•-■—^ u. (
I Yes I I No (it Elected section 179 cost

*Vc£uoVXmTm™?n"-

C,

'Uin °'he'

VehiC

'"-

Cri

""»

Teleph<

"'"-

Ce

"ai"

C

Page 2 ° " " " " « " - ■■« P "»P"ty Used for EntertainmJt,

r Section A - Depreciation and Other Information (Caution: See instructions for l.mitauons for automobiles.) : • — - —■■■» w..n«»iun iv.«uuun; a e e instructions l o r limit 22a Do you have evidence to support the business/investment use claimed? I I Yes I I No 22b II "Yes." is the evidence written? L le) Basis for (al (bl Date (dl Business/ Ifl depreciation <gl (hi Type of property placed in Cost or (business/ investment Recovery Method / Depreciation (list vehicles first) investment use percentage other basis period service Convention use only) deduction 23 Property used more than 5 0 % in a qualified business use:

%
24 Properly used 60% or less in a qualified business use: S/L S/L S/L S/L 26 Section B - Information Regarding Use of Vehicles - If you deduct expenses for vehicles: • Always complete this section for vehicles used by a sole proprietor, partner, or other "more than 5% owner," or related person . If you provided vehicles to your employees, first answer the questions in Section C to see if you meet an exception to completing this section for those vehicles. 27 Total business/investment miles driven during the year (DO NOT include commuting miles) 28 Total commuting miles driven during the year 29 Total other personal (noncommuting) miles driven 30 Total miles driven during the year. Add lines 27 through 29 Yes 31 Was the vehicle available for personal use during off-duty hours? 32 Was the vehicle used primarily by a more than 5% owner or related person? 33 Is another vehicle available for personal use? Section C - Questions for Employers Who Provide Vehicles for Use by Their Employees Answer these questions to determine if you meet an exception to completing Section B. Note: Section B must always be completed for vehicles used by sole proprietors, partners, or other more than 5% owners or related persons. Yes 34 Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, by your employees? 35 0o you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your employees? (See instructions for vehicles used by corporate officers, directors, or 1 % or more owners.) 36 Oo you treat all use of vehicles by employees as personal use? 37 Do you provide more than five vehicles to your employees and retain the information received from your employees concerning the use of the vehicles? 38 Do you meet the requirements concerning qualified automobile demonstration use? ■ . u ! - " " V°Uf a"SWef'" I r f T i M l Am 0 r ii„tion
34

25 Add amounts in column (h). Enter the total here and on line 19, page 1 26 Add amounts in column d). Enter the total here and on line 7. page 1

25

(al Vehicle

lb) Vehicle

(cl Vehicle

(dl Vehicle

(e) Vehicle

(fl Vehicle

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

No

' "•

36

'

37

'

or 3 B is

"Yes/'

y o u n e e d no1 c o n

"" e l e ~

Sec,ion B

<°r " « " v « e d vehicles '
Id) Cote stcli'on (el Amortiittign ptiiod or piictnl»9« III Atnadizttion lor (hit y e n

(•I Otscription ol cons

(bl Date imoilililion

(c) Araoiti/tbl* atnounl

39 Amortitation of costs that begins during your 1994 tax year:

40 Amortisation of costs that began before 1994 41 Total. Enter here and on "Other Deductions" or "Other Expenses" line of your return
I2J2 21-94

40 41

424 424

5350713

758985

SAVE50

060

12 SAVE A LIFE FOUNDATION, INC

18616924

r^.
CO #
Form AG990-1L Revised 3/95

01-026,498

CHARITABLE ORGANIZATION SUPPLEMENT
Attorney General JIM RYAN State of Illinois
Charitable Trust and Solicitations Bureau, 100 West Randolph Street, 12th Floor, Chicago, Illinois 60601 MO DAY D No YR MO DAY YR

REPORT FOR THE FISCAL PERIOD BEGINNING:
ARE CONTRIBUTIONS TO ORGANIZATION TAX DEDUCTIBLE?

\o\ f\ \o\t
j 3 Yes

G

AND ENDING:
FEDERAL ID NUMBER: JL DATE ORGANIZATION WAS CREATED: A) ASSETS B) LIABILITIES C) ENDING FUND C) BALANCE PERCENTAGE

TEE] H T
36-3869459 MO DAY £3 OS

95
YR

LEGAL NAME MAIL ADDRESS CITY, STATE ZIP CODE

SAVE A LIFE FOUNDATION 17479 W. DARTMOOR DRIVE GRAYSLAKE, ILLINOIS 60030

9

? 3

A) s
B) S

y ? yra
30, /y?

c) $ <f/o, j r ? y
AMOUNT
D

I. SUMMARY OF REVENUE ITEMS DURING THE YEAR:
D) PUBUC SUPPORT, CONTRIBUTIONS & PROGRAM SERV. REV. (GROSS AMTS.) E) GOVERNMENT GRANTS & MEMBERSHIP DUES F) OTHER REVENUES G) TOTAL REVENUE, INCOME AND CONTRIBUTIONS RECEIVED (ADD D.E. & F)

n.->
Ai_
100%

>

S

t/0.
/,

~7& /
V/O

E) $ F) $
G

>S

//J, /7/

II. SUMMARY OF EXPENDITURES DURING THE YEAR:
H) OPERATING CHARITABLE PROGRAM EXPENSE I) J) EDUCATION PROGRAM SERVICE EXPENSE GRANTS TO OTHER CHARITABLE ORGANIZATIONS

% % % % % %
100 %

H) $

'>
K

s

&&,3&/ 60.3&Z
/// / ?7

J) $

K) TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD H, I & J) L) MANAGEMENT AND GENERAL EXPENSE M) FUNDRAISING EXPENSE N) TOTAL EXPENDITURES THIS PERIOD (ADD K, L, & M)

L) $
M) $ N $

_?-?, 3 / < f /Pl.ffi,

>

III. SUMMARY OF PAID FUNDRAISER ACTIVITIES DURING THE YEAR:
(Attach Attorney General Report ol Individual Fundraising Campaign) O) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISER P) TOTAL FUNDRAISER FEES AND EXPENSES Q) NET RECEIVED BY THE CHARITY (O MINUS P=Q) 100 % O) $ P) $ Q) S

At 14

%
%

IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS DURING THE YEAR:
R) NAME, TITLE: S) NAME, TITLE T) NAME. TITLE /l/j/j R) $ S) $ T) $

M•/£.

V. CHARITABLE PROGRAM DESCRIPTION:
CHARITABLE PROGRAM (3 HIGHEST BY S EXPENDED) CODE CATEGORIES (Ust on back side of instructions): CODE U) tf /?*,S17£ V) # W) D

U) DESCRIPTION:
V) DESCRIPTION. W) DESCRIPTION:

PtfMft
^Z/ZfA f0„fA

S/tpCJTJTO/J
TZ0AJ4L

&/M4JL
AMTf/W/S roSrSf

£>/& O /?

IF THE ANSWER TO ANY OF THE FOLLOWING IS YES. ATTACH A DETAILED EXPLANATION : 1. 2. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION. FINE. PENALTY OR JUDGMENT? HAS THE ORGANIZATION OR A CURRENT DIRECTOR. TRUSTEE. OFFICER OR EMPLOYEE THEREOF EVER BEEN CONVICTED BY ANY COURT OF ANY MIDSDEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY? 1.

YES

«

3.

DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS OR DIRECTORS OWNS AN INTEREST OR WAS A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS DIRECTORS. TRUSTEES, OR OFFICERS HAS A MATERIAL FINANCIAL INTEREST OR DID ANY OFFICER OR DIRECTOR RECEIVE ANYTHING OF VALUE NOT REPORTED AS COMPENSATION? 3. HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER. DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES? IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? DID THE ORGANIZATION ALLOCATE THE COST OF ANY MAILING. ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES? DID THE ORGANIZATION LEND FROM RESTRICTED FUNDS TO ITS UNRESTRICTED FUNDS FOR PURPOSES OTHER THAN THEIR RESTRICTED PURPOSES? HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION SUSPENDED OR REVOKED? DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER?

4.

4

5.

5

6.

6

7.

7

8.

0

9.

10. DO YOU HAVE ANY KNOWLEDGE OF ANY THEFT. DEFALCATION. MISAPPROPRIATION COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS?

10

11. LIST THE NAME AND ADDRESS OF THE BANKS. AND THE ACCOUNT #. WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST AMOUNTS:

6fi4*0

A/JIIT^AI MM.

#7JI

^t/L^/sO^

jtf. ■~^t~*<>-

.J~-£

12. NAME AND TELEPHONE NUMBER OF CONTACT PERSON:

£M#L

SfjTPlT*/?!

g?7-

f ^ . ^ r ;

JNDER PENALTY OF PERJURY. I (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS SUPPLEMENT \ND THE ACCOMPANYING REPORT. INCLUDING ALL THE SCHEDULES AND STATEMENTS AND THE FACTS THEREIN STATED ARE RUE AND COMPLETE AND FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE STATE OF ILLINOIS RELY THEREUPON. I HEREBY FURTHER AUTHORIZE AND AGREE TO SUBMIT MYSELF AND THE REGISTRANT IEREBY TO THE JURISDICTION OF THE STATE OF ILLINOIS.

"OFFICIAL SEAL"
MICHELLE L. CORN
NOTARY PUBLIC STATE OF ILLINOI uBscRiBeOoMuoiahrQR'KPires 03/03/9r
PRESIDENT or TRUSTEE (PRINT NAME)

/

SldkATVRJE/
SIGNATURE

|DATB"

TREASURER or TRUSTEE<PBWT NAME)

DATE

•ION REQUIRED UNDER TRUST ACT ONLY)*
i m s i n n 1 r \JUI-IUI y

ST&WCV
tncri(PftlNT NAME)

fte/f SIGNATURE

SIGNn,,

fit/*
DATE

Form

Department ol the Treasury Internal Revenue Service

Under section 501 (c) ol the Internal Revenue Code (except black lung benefit trust or private Inundation) or section 4947(a)(1) noneiempl charitable trust Note: The organization may have to use a copy ol this return to satisfy state reporting requirements. A For the 1995 calendar year. OR tax year period beginning ,1995. and ending
g Chock it

990

Return of Organization Exempt From Income Tax

OMB Mo 1S4S-0CM7

This Form Is Open to Public Inspection

1995

OS""

□ □ □

rtfioftno

bSsc

90 Please use IRS label or oddresft print or Initial typereturn See Final Specific Jn return Amended Instruc' return lions. (rtawedttse

C Name of organization [SAVE A L I F E FOUNDATION, INC.

,19 D Employer identification number

36-3869459
Room/suite E State registration number

Number and street (or P.O. box if mail is not delivered to street address)

17479 W. DARTMOOR DR.
City, town, or post office, state, and ZIP code

01026498
F Check ► C D if exemption application is pending 1 section 4947(a)(1) nonexempt chartitable trust

IGRAYSLAKE, I L

60030
)A (insert number) OR ►!

6 Type of organization

G O Exempt under 501(c) ( 3

Note: Section 501 (c)(3) exempt organliations 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? I I Yes l"X I Ha 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: ► I 1 Accrual 1 Accounting method: I X I Cash

ranirStatement of Revenue, Expenses, and Changes in Net Assets
a b c d 2 3 4 Contributions, gifts, grants, and similar amounts received: Direct public support Indirect public support la 1b

□ Yes I S NO Other (specify) ► K Check here ► C D 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 990 Package in the mail, it should file a return without financial data. Some states require a complete return. Note: Form 990-EZ may be used by organizations with gross receipts less than $100,000 and total assets less than $250,000 at end of year.
f C) tt Uira a separate return Hied by an omanteallon covered by a croup ruling?

110,761 2
1d

Government contributions (grants) 1c Total (add lines 1 a through 1 c) (attach schedule of contributors) S T M T 1 STMT (cash$ 4 2 , 9 1 1 . noncashS 67,850 ) Program service revenue including government fees and contracts (from Part VII, line 93) Membership dues and assessments

110,761, 1,410.

Interest on savings and temporary cash investments 5 Dividends and interest from securities 6 a Gross rents b Less: rental expenses c Net rental income or (loss) (subtract line 6b from line 6a) Other investment income (describe ► 8 a Gross amount from sale of assets other than inventory b Less: cost or other basis and sales expenses c Gain or (loss) (attach schedule) 7 (A) Securities

6a

6b
6c (B) Other 8a 8b 8c 8d of contributions

d

Net gain or (loss) (combine line 8c, columns (A) and (8)) Special events and activities (attach schedule): Gross revenue (not including $ reported on line 1a)

b Less: direct expenses other than fundraising expenses 9b c Net income or (loss) from special events (subtract line 9b from line 9a) 10 a Gross sales of inventory, less returns and allowances 10a b Less: cost ol goods sold 10b c Gross profit or (loss) from sales of inventor/ (attach schedule) (subtract line 10b from line 10a) 11 Other revenue (from Part VII. line 103) Total revenue (add lines 1d. 2.3.4.5.6c. 7.8d. 9c. 10c. and I D Program services (from line 44,column (B)) Management and general (from line 44, column (Q) Fundraising (from line 44. column (D)) Payments to affiliates (attach schedule) Total expenses (add lines 16 and 44. column (AH Excess or (deficit) for the year (subtract line 17 from line 12) Net assets at beginning of year (from line 73. column (A)) Other changes in net assets (attach explanation) Net assets at end of year (combine lines 16.19. and 20) SEE

9c

14 14
STMT .3 10c 11 12 13 14 15 16 17 18 19 20 21

12

8 &
c

to

13 14 15 16 17 18 19 20 21

112,171 62,445 14,711 33,318 110,474 1,697 <14,574 <7^_24 3 <20,120
Form 990 (1995)

STATEMENT

4

LHA
S23O01 01-03-96

For Paperwork Reduction Act Notice, see page 1 of the separate Instructions.

Form 990 (1995)

SAVE A LIFE FOUNDATION, INC.

■ti»»lll Statement of I K I U I I Functional E x p e n s e s Do not include amounts reported on line 6b. 8b, 9b. 10b. or 16 of Part I. 22 Grants and allocations (attach schedule)
cash S noneash $

36-39604^9 Page2 AH organizations must complete column (A). Columns (B). (C). and (0) are required for section 501(c)(3) and (4) organizations and section 4947(a)(1) nonexempt charitable trusts but optional for others. (B) Program (C) Management (A) Total (D) Fundraising services and general

22 (attach schedule) 23 (attach schodult) 24 2 5 Compensation of office's, directors. etc. 25 26 Other salaries and wages 26 27 Pension plan contributions 27 26 Other employee benefits 28 29 Payroll taxes 29 , 30 Professional fundraising fees. 30 31 Accounting fees 31 32 Legalfees 32 33 33 Supplies 34 Telephone 34 35 Postage and shipping 35 36 Occupancy 36 37 Equipment rental and maintenance 37 38 Printing and publications 38 39 Travel 39 40 Conferences, conventions, and meetings 40 41 Interest 41 42 42 Depreciation, depletion, etc. (attach schedule) 43 Cither expenses (itemize): a 43a 13b b c 43c d 13d e SEE STATEMENT 5 tI3e 23 Specific assistance to individuals 24 Benefits paid to or for membe rs
44 Total functional expenses (add lines 22 through 43) Organizations completing columns (B>(D), cony these totals to lines 13-15

/ 0. 0. 0.

'

'

' 0.

^■^S."

\ .W Vi V

f

Wft W

*

* f « ■

\

%

*

s

•.

150. 1,618. 3,788. 778. 1,200. 3,650. 9,293. 8,005. 1,773. 3,935.

150. 1,618. 3,788. 778. 1,200. 3,650. 9,293. 8,005. 1,773. 3,935.

76,284.

33,255.

9,711.

33,318. 33,318.
I yes Q T | No

110,474. 62,445. 44 14,711. Reporting of Joint Costs. - Did you report in column (B) (Program services) any joint costs from a combined educational campaign and fundraising solicitation? ► I If •Yes." enter (i) the aggregate amount of these joint costs $ ; (ii) the amount allocated to Program services $ ; (iii) the amount allocated to Management and general $ ;and r rv) . frv) the amount allocated lo Fundraising $ amo Statement of Program Service Accomplishments
What is the organization's primary exempt purpose? ► S E E S T A T E M E N T 6
Ail organiiotions must describe their exempt purpose achievements. State the number of cflenls served, publications Issued, etc. Oiscuss achievements that are not nwasurabla. (Section 501(c)(3) and (4) organliationa and 4947(a)(1) nonexempt charitable busts must also enter the amount ol grants and allocations to others.)

Program Service Expenses
(Required tor 501(c)(3) and (4) ergs., and 4947(a)(1) trusts; but optional far others.)

a

SEE STATEMENT 7
(Grants and allocations $

62,445

(Grants and allocations S

(Grants and allocations S

(Grants and allocations $ e Other program services (attach schedule) (Grants and allocations $ f Total of Program Service Expenses (should equal line 44. column (B). Program services)
523011 1?-»7.9S

62,445

Form 990(1995)

SAVE A LIFE FOUNDATION,

INC.

36-3869459

Paoea

Balance Sheets
Note: Wiiere required, attached schedules and amounts within the description column should be for end-of-year amounts only. 45 46 Cash - non-interest-bearing Savings and temporary cash investments (A) Beginning of year (B) End of year * 45

830

1,096.

47 a Accounts receivable b Less: allowance for doubtful accounts 48 a Pledges receivable b Less: allowance for doubtful accounts 49 Grants receivable SO J3

47a 47b 48a 48b

I
i

46

49 50

Receivables due fiom officers, directors, trustees, and key employees (attach schedule)

1

«

51 a Other notes and loans receivable b Less: allowance for doubtful accounts 52 Inventories for sale or use 53 Prepaid expenses and deferred charges 54 Investments - securities (attach schedule) 55 a Investments - land, buildings, and equipment: basis b Less: accumulated depreciation (attach schedule) 56 57 a b 58 59 60 61 Investments - other (attach schedule) Land, buildings, and equipment: basis . Less: accumulated depreciation S T A T E M E N T 8 Other assets (describe ► D E S I G N A T E D CASH Total assets (add lines 45 through 58) (must equal line 74) .. Accounts payable and accrued expenses Grants payable

51a Sib

111;
51c

53 54 55a
"*:>:v::'

55b 56

57a 57b 1

17,406. 7,091.
1

13,507.

ii!
57e

10,315. 8,477. 19,888.

1 4 , 3 3 7 . 59
60 61

62 Deferred revenue 63 Loans from officers, directors, trustees, and key employees JS 64 a Tax-exempt bond liabilities
jg*

8

28,911.

63
64 a

40,008.

65 66

b Mortgages and other notes payable Other liabilities (describe ► Total liabilities (add lines 60 throuoh 65) L K J and complete lines 67 through

)

64b 65

28,911.

c a

0

Organizations that follow SFAS 117, check here ► 69 and lines 73 and 74 67 Unrestricted 68 69 Temporarily restricted Permanently restricted

■v c Organizations that do not follow SFAS 117, check here ► a L. 70 through 74 0

&

< 1 4 , 5 7 4 . : "67 0. 0 . 64
I I and complete lines


70 71 72

66

40,008. <20,120.> 0. 0.

70 71 72 73
r

Capital stock, trust principal, or current funds

• in <
o Z

_L

Paid-in or capital surplus, or land, bldg., and equipment fund Retained earnings, accumulated income, endowment, or other funds Tnlal net assets or fund balancess (add lines 67 through 69 OR lines)r 0 through 72; column (A) must equal line 19 and column (B) must equal line 21) ... Total liabilities and net assets/fund balances (add lines 66 and 73)

4

r

<14,574.> 14,337.1 7 4

w

<20,120.> 19,888.

S23021 12-27-95

Form 990 (1995)

SAVE A LIFE FOUNDATION. INC

Part IV-A Reconciliation of Revenue per Audited Financial Statements with Revenue per Return
a b Total revenue, gains, and other support per audited financial statements

Part IV-B Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
a b Total expenses and losses per audited financial statements

36-3869459

Page 4

"NTA"

"N7A~

Amounts included on line a but not on line 12, Form 990: (1) Net unrealized gains on investments (2) Donated services and use of facilities (3) Recoveries of prior yeargrants (4) Other (specify): $ $ $

Amounts included on line a but not on line 17. Form 990: (1) Donated services and use of facilities (2) Prior year adjustments reported on line 20, Form 990 (3) Losses reported on line 20. Form 990 (4) Other (specify): $

L

Add amounts on lines (1) through (4) Add amounts on lines (1) through (4) Line a minus line b Amounts included on line 12, Form 990 but not on line a: (1) Investment expenses not included on e d Line a minus line b Amounts included on line 17, Form 990 but not on line a: Investment expenses not included on line 6b. Form 990 Other (specify): $

> ►

(1)

line 6b, Form 990
(2) Other (specify): (2) Add amounts on lines (1) and (2) . Total revenue per line 12. Form 990 (line c plus line d)

Add amounts on lines (1) and (2) Total expenses per line 17, Form 990 (line c plus tine d)

X

List of Officers, Directors, Trustees, and Key Employees (Ust each one even if not compensated.)

(A) Name and address

CAROL S P I Z Z I R R I 1 7 4 7 9 W. DARTMOOR DR, GRAYSLAKE, I L 100 STEPHEN J . COLE TREASURER 1 7 3 7 7 W. DARTMOOR DR, GRAYSLAKE, I L SANDY ENGBER SECRETARY 1 7 5 9 3 W. DARTMOOR DR, GRAYSLAKE, I L LEE JUNGKANS VICE PRES. 8 3 2 0 W. BLUE MOUND AVE, WAUWATOSA, WI

(B) Title and average hours (C) Compensation per week devoted to (If not paid, enter position PRESIDENT

(D)ContnDutiom to employee benefit plant 1 deferred

(E) Expense account and other allowances

0. O. 0. O.

0. 0. 0. 0.

8,000. 0. 0. 0.

Did any officer, director, trustee, or key employee receive aggregate compensation of more than $100.000 from your organization and all related organizations, of which more than $10,000 was provided by the related organizations? ► If "Yes," attach schedule (see instructions).

C D Yes QG No

623031 12-27-95

Form990(1995)
f iftjyil 76 77 78 a b 79 80 a b

SAVE A LIFE FOUNDATION, INC.

Other Information

36-3869459 76 77 78a
78li

Pgs ae Yes N o

Did the organization engage in any activity not previously reported to the IRS? II •Yes.* attach a detailed description of each activity Were any changes made in the organizing or governing documents, but not reported to IRS? II "Yes," attach a conformed copy of the changes. Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return? If "Yes," has it filed a tax return on Form 990T, Exempt Organization Business Income Tax Return, for this year? .N/A. Was there a liquidation, dissolution, termination, or substantial contraction during the year? it'Yes," attach a statement; Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc.,to any otherexempt or nonexempt organization? If "Yes," enter the name of the organization ►

79

80a

and check whether it is L3 exempt OR □ nonexempt. 81 a Enter the amount of political expenditures, direct or indirect, as described in the instructions for line 81 | gj3 | b Did the organization file Form 1120-P0L. U.S. Income Tax Return for Certain Political Organizations, for this year? 82 a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially less than fair rental value? b If •Yes.* you may indicate the value of these items here. Do not include this amount as revenue in Part I or as an expense in Part II. (See instructions for reporting In Part III) | Mb I 13,000. 83 a Did the organization comply with the public Inspection requirements for returns and exemption applications? b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? 84 a Did the organization solicit any contributions or gifts (hit were not tax deductible? b If *Yes.' did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? N/A 65 Section 501(c)(4). (5). or (6) organizations. - a Were substantially ail dues nondeductible by members? ...N/A Did the organization make only in-house lobbying expenditures of $2,000 or less? N/A If "Yes" to either 85a or 85b do not complete 65c through 85h below unless the organization received a waiver for proxy tax owed lor the prior year. Oues, assessments, and similar amounts from members N/A 85c Section 162(e) lobbying and political expenditures N/A 65d Aggregate nondeductible amount of section 6033(e)(1 )(A) dues notices 85e WA­ Taxable amount of lobbying and political expenditures (line 85d less B5e) N/A 851 Does the organization elect to pay the section 6033(e) tax on the amount in 851? .7ZZZZZI N/A II section 6033(e)(1)(A) dues notice were sent, does the organization agree to add the amount in 851 to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year? N/A Section 501 (c)(7) organizations. - Enter: Initiation fees and capital contributions included on line 12 N/A 66a Gross receipts, included on line 12. for public use of club facilities "N7A" 86b Section 501 (c)(12) organizations. - Enter: Gross income from members or shareholders WA" 87a Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) N/A 87b At any time during the year, did the organization own a 50% or greater interest In a taxable corporation or partnership? If ■Yes.* complete Part IX Public interest law firms. - Attach information described in the instructions. List the states with which a copy of this return is filed ► I L L I N O I S

81b 82a X %.-. 83a 83b 84a 84b 65a 85b

g h 86 a b 87 a b

85o
85h

89 90 91 92

86

T l p o e no. ► 8 4 7 - 5 4 9 - 7 3 5 3 ee h n ZIP C d ^ 6 0 0 3 0 oe Section 4947(a)(1) nonexempt charitable trusts filing Form 990 in lieu of Form 1041. U.S. Income Tax Return for Estates and Trusts, check here ► □ and enter the amount of tax-exempt interest received or accrued during the tax year **» I gz I N/A

The books are in care of ►CAROL SPIZZIRRI Located at ► J / 7 4 7 9 W. DARTMOOR D R . , GRAYSLAKE, I L

823041 M-27-9S

FOUNDATION, |*£ i|2{J| Analysis of Income-Producing Activities
Form990(1995) SAVE A LIFE
Enter gross amounts unless otherwise indicated. 93 Program service revenue: Business code

INC.
(C)
Exclu­ sion code

3 6 -- 3 8 6 9 4 5 9
Excluded by section 512. 513, or SI 4

Page6

Unrelated business income (B) Amount

rci

(D) Amount

Related or exempt function income

(al fbl 10 (dl (el (1)
(g)Fees and contracts from government agencies 94 Membership dues and assessments 95 Interest on savings and temporary cash investments 96 Dividends and interest from securities 97 Net rental income or (loss) from real estate: (a) debt-financed property (b)nol debt-financed property 98 Net rental income or (loss) from personal property 99 Other investment income 100 Gain or (loss) from sales of assets other than inventory 101 Net income or (loss) from special events 102 Gross profit or (loss) from sales of inventory 103 Other revenue: a

1,410.

-

b c d e
■M§MM 104 Subtotal (add columns (B).(D). and (E)) 105 TOTAL (add line 104, columns (B), (D), and (E)) Note: (Line 105 plus line I d . Part I. should equal the amount on line 12. Part I.) Line No.

0.

0.

1,410. 1,410.

Relationship of Activities to the Accomplishment of Exempt Purposes

94

r

Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment of the organization's exempt purposes (other than by providing funds for such purposes).

MEMBERSHIP DUES - CORPORATE AND INDIVIDUALS

I n f o r m a t i o n R e g a r d n g T a x a b l e S u b s i d i a r i e s (Complete this Part If the "res' box on BB Is checked.) Name, address, and employer identification Percentage of number of corporation or partnership ownership interest Nature of business activities Total income End-of-year assets

~N7A"
%

Under penalties or perjury, I declare that I have examined this relum, including accompanying schedules and statement*, and to the best ol my knowtedgs and twtief, it is true. correct, and complete. Declaration ol preparer (outer than officer) is based on all information of which prapsror has any knowledge.

Please Sign

Here
Paid Preparer*; Use Only
623161 1227 95

Signature of officer Preparer's ^ signature r

Date Date

Firms name (or yours COLE, MARTIN & C O . , L T D . if self-employed) L 7 3 0 1 N . LINCOLN A V E , S T E . 140
and address

Title Check if self. . employed ► I I E.I. NO. ►

Preparer's social security no.

LINCOLNWOOD, ILLINOIS

ZIPcode ►

60646

SCHEDULE A (Form 990)
Department or lha Treasury Internal Revenue Servica

Organization Exempt Under 501(c)(3)
(Except Private Foundation), and Section 501 (e). 501 (I), 501 (k). or Section 4947(a)(l) Nonexempl Charitable Trust Supplementary Information ► Must be completed by the above organization! and attached to their Form 990 (or Form 99QE2)

CMBNo 1S45-0O47

1995

Name of the organization

_

| M U

Employer identification number 3a fiQdSQ 3869459 Compensation of the Five Highest Paid Employees Other Than Offtcers, Directors, a n d Trustees (See instructions.) (List each one. If there are none, enter •Wone • irusiees (a) Name and address of each employee paid (b) Title and average hours . joni/ibuttons to e (e)Expense per week devoted to (c) Compensation i remptoyoo barteM account and other more than $50,000 position componmion allowances

SAVE A LIFE FOUNDATION, INC.

J 6 :j 36

hss

|

COI

Total number of other employees paid over $50,000 liMUl Compensation of the Five Highest Paid Independent Contractors for Professional ServTceT free instructions.) gist each one fwhelher individuals or firms) fit there are none enrer-Nnn. •» (a) Name and address of each independent contractor paid more than $50,000 (b) Type of service (c) Compensation

NONE

Total number of others receiving over $50.000 for professional services . LHA For Paperwork Reduction Act Notice, see page 1 ol the Instructions to Form 990 (or Form 990-E2).
623101 12-19-99

-;r
Schedule A (Form 990) 1995

Schedule A (Form 990) 1995

SAVE A L I F E

FOUNDATION,

INC.

3 6 - 3 8 6 ,9459

Pg 2 ae Yes No

Statement About Activities
During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? If "Yes.* enter the total expenses paid or incurred in connection with the lobbying activites. ► $ — Organizations that made an election under section 501(h) by filing Form 5768 must complete Part Vl-A. Other organizations checking Yes." must complete Part Vl-B AND attach a statement giving a detailed description of the lobbying activities. ! During the year, has the oganization. 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 with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary: a Sale, exchange, or leasing of property?

ft
2a 2b 2c 2d 2e 3

3r

X X X X X X

b Lending of money or other extension of credit? c Furnishing of goods, services, or facilities? d Payment of compensation (or payment or reimbursement of expenses if more than $1,000)? e Transfer of any part of its income or assets? If the answer to any question is Yes." attach a detailed statement explaining the transactions. 3 Does the organization make grants for sch olarships. fellowships, student loans, etc.? 4 Attach a statement explaining how the organization determines that individuals or organizations receiving grants or loans from it in y j£mu2nCe 0t 't5 Cha"tal)le Df0Qrams oualiftf "> receive payments. /See instructions.)

IrTiirl

Reason for Non-Private Foundation Status (See instructions for definitions i

The organization is not a private foundation because it is (please check only ONE applicable box): 5 A church, convention of churches, or association of churches. Section I70(b)(1 )(A)(i). 6 A school. Section 170(b)(1 )(A)(ii). (Also complete Part V, page 4.) 7 A hospital or a cooperative hospital service organization. Section 170(b)(1)(A)(iii). 6 A Federal, state, or local government or governmental unit. Section 170(b)(1)(A)(v). 9 A medical research organization operated in conjunction with a hospital. Section 170(b)(1)(A)(iii). Enter the hospital's name city and state ► ^ ^ _ _ ^ _ _ ' 10 An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(1)fA)(iv) (Also complete the Support Schedule In Part IV-A.) 11a An organization that normally receives a substantial part ot Its support from a governmental unit or from the general public Section i70(b)(1)(A)(vl). (Also complete the Support Schedule In Part IV-A.) 11b A community trust. Section i70(b)(l)(A)(vi). (Also complete the Support Schedule In Part IV-A) 12 EH An organization that normaily receives: (a) no more than 331/3% 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 331/3% of its support from contributes, membership fees, and gross receipts from activities related to its charitable, etc.. functions - subject to certain exceptions See section 509(a)(2). (Also complete the Support Schedule In Part IV-A.)

a □ □ □

D

□ □

An organization that is not controiled by any disqualified persons (other than foundation managers) and supports organizations described in(11 hies 5 through 12 above; -or ■-. section 501fc)f4,. .a\. ». iv,,. ii tthey nisei UIB IB of section 509ra)/2,. « M m m - 509(a)(3)) (2) nr ,6V if .i B y meet the test _ . ; — ; ■ .-..^... w „ lOWinO . . ?l°n*i- l J " >emuii 3U»(a||j).) Provide the following information about the supported organizations. (See!instructions 'on paoe 4.1 ~ information annul trip simnnrlort n«,»nh,ii...... / e „ . . . . _ . - . : (a) Name(s) of supported organization^) (b) Line number from above

13

14

An organization organized and operated to test for public safety. Section 509(a)(4). (See Instructions on page 4.)

623111 12-1996

Schedule A (Form 990) 1995

SAVE A L I F E

FOUNDATION,

INC.

36-3869459

Pages

Support Schedule (Complete only if you checked a box on lines 1 0 , 1 1 , or 12 above.) Use cash m e t h o d of accounting. Note: You may use the worksheet in the instructions tor converting from the accrual to the cash method of accounting. Calendar year (or fiscal year (a) 1994 beginning In) (b) 1993 (c) 1992 (d) 1991
"J 5 Oitta. grants, and contributions received. (Do not include unusual grants. S n tint 88.)

(e) Total

16 17

Membership fees received Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is not a business unrelated to the organization's charitable, etc.. purpose Gross income from interest. dividends, amounts received from payments on securities loans (sec­ tion 512(a)(5)). rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organization after June 30,1975 Net income from unrelated business activities not included in fine 18
Ta> revenues levied lor the organization's benefit and diner paid to it or upended on Its behalf

93,405. 2,875.

7,199.

100,604. 2,875.

18

19
20

21

The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge
Outer Income. Attach a schedule. Oe not include gain orfloss)from sole of capital assets

22

23 24 25

Total of lines 15 through 22 Line 23 minus line 17 Enter 1 % of line 23

96,280. 96,280 963.

7,199. 7,199. 72.

0.

0.
► 26a

103,479. 103,479 N/A
''■?'N

26

Organizations described In lines 10 or 11 :i Enter 2% of amount in column (e), line 24

Attach a list (which is not open to public inspection) showing the name of and amount contributed by each person (other than a governmental unit or publicly supported organization) whose total gifts for 1991 through 1994 exceeded the amount shown in line 26a. Enter the sum of all these excess amounts > c Total support for section 509(a)(1) test: Enter line 24, column (e) d Add: Amounts from column (e) for lines: 18 _ | 22 J

>'-

26b

N/A N/A
• MVVASW

.► 26c
19 J _ 26b X > >
26d
26e

e Public support (line 26c minus line 26d total) f Public support percentage (line 26e (numerator) divided by line 26c (denominator))

27

► 261
0 . . . (1991)

N/A ~N7A" N/A
0...

Organlialtons described on line 12: a For amounts included in lines 15.16, and 17 that were received from a "disqualified person.'atlach a list to show the name of. and total amountsjecieved in each year from each 'disqualified person,' Enter the sum of such amounts for each year. 0994) P..-.. (1993) 0 . . . (1992) For any amount included in line 17 that was received from a nondisqualified person, attach a list to show the name of, and amount received for each year. that was more than theiargerof (1) the amount on line 25 for the year or (2) $5,000. (Include in the list organizations described in lines 5 through 11. as weft as individuals.) After computing the difference between the amount received and the larger amount decribed in (1) or (2). enter the sum of these differences (the excess amounts) for each year: 099«) P./!. (1993) 15 | _ 20 $_ 0 . 0.,. (1992) Q.... (1991) 0...

Add: Amounts from column (e) for lines: 17 | Add:Line27atotal $

100,604.
and tine 27b total $_

16 L 21 $

2,875. _ 0_ .

Public support (lines 27c. total minus line 27d total) Total support for section 509(a)(2) test: Enter amount on line 23. column (e) 27! I S Public support percentage (line 27e (numerator) divided by line 27f, (denominator)) h Investment income percentage (line 18 column (e) (numerator) divided by line 27f (denominator)!

► 27c ► 27d ► 27e 103,479.
27g_

103,479. 0. 103,479. 100% .0000%

► 27h

28 Unusual Qrants: For an organization described in line 10.11. or 12. that received any unusual grants during 1991 through 1994. attach a list (which is not open to public inspection) for each year showing the name of the contributor, the date and amount of the grant, and a brief description of the nature of the orantOo not include these grants in line 15. (See instructions.)
(23121 01-06-96

NONE

Schedule A (Form 990) 1995

SAVE A LIFE FOUNDATION, INC.

Private School Questionnaire (To be completed ONLY by schools that checked the box on line 6 in Part IV)
29

36-3869459 N/A

Page 4

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

Yes No
29 30

30 31

31

'">?
32
Ooes the organization maintain the following: Records indicating the racial composition of the student body, faculty, and administrative staff? Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student admissions, programs.and scholarships? Copies of all material used by the organization or on its behalf to solicit contributions? If you answered W t o any of the above, please explain. (If you need more space, attach a separate 'statement!)

32a 32b 32c

32d

33

Does the organization discriminate by race in any way with respect to: a Students' rights or privileges? b Admissions policies? c Employment of faculty or administrative staff? d Scholarships or other financial assistance? e Educational policies? f Use of facilities?

9 Athletic programs? h Other extracurricular activities?
If you answered •Yes' to any of the above, please explain. (If you need more space, attach a separate statement!)

33a 33b 33c 33d 33e 33f 33a 33h

34 a Does the organization receive any financial aid or assistance from a governmental agency? b Has the organization's right to such aid ever been revoked or suspended? if you answered Yes' to either 34a or b, please explain using an attached statement. 35 Does the organization certify lhat it has complied with the applicable requirements of sections 4.01 through 4.05 of Rev. Proc. 75-50 1975-2 C.B. 587. covering racial nondiscrimination? If 'Mo.' attach an explanation

34a 34b

35

8*3131 12-19 95

Schedule A (Form 990) 1995 SAVE A L I F E FOUNDATION/ INC. Part Vl-A Lobbying Expenditures by Electing Public Charities
(To be completed ONLY by an eligible organization that filed Form 5768)
Check here ► a 0 If the organization belongs to an affiliated group. Check here ► b I — I If you checked "a* above and 'limited contror provisions apply.

36-3869459

PT<
N/A

Limits on Lobbying Expenditures
(The term 'expenditures' means amounts paid or incurred) 36 Tolal lobbying expenditures to influence public opinion (grassroots lobbying) 37 Tolal lobbying expenditures to influence a legislative body (direct lobbying) 38 Total lobbying expenditures (add lines 36 and 37) 39 Other exempt purpose expenditures 40 Total exempt purpose expenditures (add lines 38 and 39) 41 Lobbying nontaxable amount. Enter the amount from the following table • II the amount on line 40 is The lobbying nontaxable amount Is •
Not over SSOO.000 OverJ500.00OtiuInotowS1.O0O.000 Cw$1,000,00Obutrtotovw$1,S00,000 O»«$1.506,000butnotoverS17,000,00O Over $17,000,000 20*4 of tno tmount on lino 40 $100,000 p l j i 15K ol Out oxosu ovw $500,000 (175,000 pint I OK or tho w c « u ovw $1,000,000 $22S.Oobphi§ 5M or the oxcau ovw $1,500,000 $1,000,000

(a) Affiliated group totals

To be completed for ALL electing organizations

WA"
36 37 38 39 40

m
^ ^ 5
41 42 43 44

-$,-

'-$

42 Grassroots nontaxable amount (enter 25% of line 41) 43 Subtract line 42 from line 36. Enter -0- if line 42 is more than line 36 44 Subtract line 41 from line 38. Enter -0- if line 41 is more than line 38 Caution: if there is an amount on either line 43 or line 44. file Form 4720.

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501 (h) election do not have to complete an of the five columns below. See the instructions for lines 45 through 50.) Lobbying Expenditures During 4-Year Averaging Period Calendar year (or fiscal year beginning In) 45 Lobbying nontaxable amount 46 Lobbying ceiling amount (150% of line 45(e)) 47 Total lobbying expenditures . 48 Grassroots nontaxable amount 49 Grassroots ceiling amount (150% of line 48(e)) 50 Grassroots lobbying expenditures
AT

(a) 1995

1994

(c) 1993

1

N/A
(e) Total

(d) 1992

o.
«v,1

0. 0. 0. 0. 0. N/A

Part Vl-B Lobbying Activity by Nonelecting Public Charities
(For reporting only by organizations that did not complete Part Vl-A) During the year, did the organization attempt to Influence national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of: a Volunteers b Paid staff or management (include compensation in expenses reported on lines c through h) c Media advertisements d Mailings to members, legislators, or (he public e Publications or published or broadcast statements I Grants to other organizations for lobbying purposes g Direct contact with legislators, their staffs, government officials, or a legislative body h "allies, demonstrations, seminars, conventions, speeches, lectures, or any other means I Total lobbying expenditures (add lines c through h) If 'Yes' to any of the above, also attach a statement giving a detailed description of the■ Vobbyino activities!
(23141 12-19-SS

Yes

N o

Amount

0.

Sc^uleA(Form990)i995 SAVE A LIFE FOUNDATION, INC. 36-3869459 IJEHSUI Information Regarding Transfers To and Transactions and Relationships With Noncharitable 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) organizations) or in section 527, rebting to political organizations? Transfers from the reporting organization to a noncharitable exempt organization of: (I) Cash (ii) Other assets Other transactions: (I) Sales of assets to a noncharitable exempt organization (fi) Purchases of assets from a noncharitable exempt organization (iii) Rental of facilities or equipment (Iv) Reimbursement arrangements (v) Loans or loan guarantees (vi) Performance of services or membership or fundraising solicitations

Page 6

Yes No 51a(i) a(ii) b(i)

X X X X X X X X X

mil)
b(lii) T b(h>)r 7~ b(v) b(vi) c

Sharing of facilities, equipment, mailing Bsts, other assets, or paid employees If the answer to any of Uie above is -Yes; complete the following schedule. Column (b) should always indicate thei fair market: value of the goods, other assets, or services given by the reporting organization. If the organization received less than fair market value in any transaction or sharing arrangement, indicate In column (d) the value of the poods, other assets, or services received. N/A (a) (b) (c) Line no Amount involved Name of noncharitable exempt organization Description of transfers, transactions, and sharing arrangements

52 a Is the organization directly or indirectly affiliated with, or related to. one or more tax-exempt organizations described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527? \—] b If 'Yes.' complete the following schedule. N/A — (a) (b) Name of organization Type of organization Description of relationship

Y 6S

LXlNo

823151 12-19-95

Depreciation and Amortization Detail
Asset Number

FORM 990 PAGE 2
Description of property

990
Basis reduction Accumulated depreciation/amortization

in service

Dale placed

Method/ IRC sec.

Life or rate

Line No.

Cost or other basis

ORGANIZATION COSTS OFFICE EQUIPMENT
12,31,93|200DB|7.00 117 OFFICE EQUIPMENT i|06,30,94|2QODB|7.00 TT OFFICE EQUIPMENT ii106,30,95|200DB|7.00 |l5CT
**

Current year deduction

JJWiiP

60M

41

2,120. 2,236.

530.

424.

86777

391. 3,014 106.

12,307.

1,759

743 TOTAL 990" PAGE 2 DEPRECIATION & AMORTIZATION 17,406.

3,156.

3,935.

J L J L J L

«• Current year section 179

(D) - Asset disposed

SAVE A LIFE FOUNDATION, INC. FORM 990 INCOME AND COST OF GOODS SOLD INCLUDED ON PART I, LINE 10

36-3869459 STATEMENT 3

INCOME 1. GROSS RECEIPTS 2. RETURNS AND ALLOWANCES 3. LINE 1 LESS LINE 2 4. COST OF GOODS SOLD (LINE 15) 5. GROSS PROFIT (LINE 3 LESS LINE 4) COST OF GOODS SOLD 8. 9. 10. 11. 12. 13. INVENTORY AT BEGINNING OF YEAR MERCHANDISE PURCHASED COST OF LABOR MATERIALS AND SUPPLIES OTHER COSTS ADD LINES 8 THROUGH 12 14 14 14 14

14 14

14. INVENTORY AT END OF YEAR 15. COST OF GOODS SOLD (LINE 13 LESS LINE 14). .

STATEMENT(S) 3

SAVE A LIFE FOUNDATION, INC. FORM 990 DESCRIPTION 1994 FINANCIAL STATEMENTS RESTATED FOR ADDITIONAL TRAVEL EXPENSES TOTAL TO FORM 990, PART I, LINE 20 OTHER CHANGES IN NET ASSETS OR FUND BALANCES

36-3869459 STATEMENT AMOUNT <7,243.> <7,243.> 4

FORM 990 (A) DESCRIPTION BANK CHARGES DUES & SUBSCRIPTIONS MANAGEMENT FEE NEWSLETTER OFFICE EXPENSE OTHER TAXES MISCELLANEOUS PROMOTION RAFFLE PRIZES & AWARDS VIDEOS FOOD INSURANCE rOTAL TO FM 990, LN 43 TOTAL

OTHER EXPENSES (B) PROGRAM SERVICES (C) MANAGEMENT AND GENERAL 318 461. 8,000. 343. 382. 155. 84. 20,172. 12,740. 311. 33,255 9,711.

STATEMENT (D) FUNDRAISING

318. 461. 8,000. 343. 382. 155. 84. 20,172. 21,300. 12,740. 12,018. 311. 76,284.

21,300. 12,018. 33,318,

^ORM 990

STATEMENT OF ORGANIZATION'S PRIMARY EXEMPT PURPOSE PART III

STATEMENT

IXPLANATION • PROMOTE EDUCATION AND CONTINUING EDUCATION IN CPR AND FIRST AID 0 ATIONALLY.

STATEMENT(S) 4, 5, 6

SAVE A LIFE FOUNDATION, INC. FORM 990 STATEMENT TO PROMOTE EDUCATION & CONTINUING EDUCATION IN CPR & FIRST AID NATIONALLY. TO PROMOTE, CONSISTENCY, UNIFORMITY & SAFETY IN THE APPLICATION OF FIRST AID & CPR. TO ASSURE THAT THE BEST PROCEDURES AND HIGHEST QUALITY MATERIALS ARE USED AND ARE ACCESSIBLE. TO PROMOTE GOOD SAMARITAN LAWS STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS

36-3869459 STATEMENT 7

GRANTS TO FORM 990, PART III, LINE A

EXPENSES 62,445

FORM 990

DEPRECIATION OF ASSETS NOT HELD FOR INVESTMENT COST OR OTHER BASIS
2,120. 2,236. 12,307. 743.

STATEMENT

8

DESCRIPTION ORGANIZATION COSTS OFFICE EQUIPMENT OFFICE EQUIPMENT OFFICE EQUIPMENT TOTAL TO FORM 990, PART IV, LINE 57

ACCUMULATED DEPRECIATION
954. 1,258. 4,773. 106.

BOOK VALUE
1,166. 978. 7,534. 637.

17,406

7,091

10,315.

STATEMENT(S) 7, 8

foim

4562

Depreciation and Amortization
(Including Information on Listed Property)
►• Attach this farm to your return.

OMB No 1545-017J

Department of the Treasury Internal Revenue Service (99) Namefc) shown on return

990

Business or activity to which this torn reuiu

Attachment Sequence No 6 7 Identifying number

1995

SAVE A LIFE FOUNDATION, INC.

l
1 2 3 4

1 E

"*I"T ?.""" ' ""

Tn

C ranTn e Po et ( e l n 1 9 ( oe vl h v a t , i , d PMm c et a9 f p ry s c 7 ) N t : f a e nf Lse

FORM 990 PAGE 2

"'

""

Maximum dollar limitation (If an enterprise 2one business, see instructions.) Total cost of section 179 property placed in service durinp. the tax year Threshold cost of section 179 property before reduction in limitation Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -0-

° " »- v * 1* ^ = ~ , >
' ^~
wwr3fI

36-3869459
J 1 7 ,i 5 0 0 ,

$200.000

5 Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, enter -0-. If married filing separately. see instructions
(a) Description or property (b)Co»l (c) Elected cost

:v ^

?<f-\

_.
7 Listed property. Enter amount from line 27 6 Total elected cost ol section 179 property. Add amounts in column (c), lines 6 and 7 9 Tentative deduction. Enter the smaller of line 5 or line 8 10 Carryover of disallowed deduction from 1994 11 Taxable income limitation. Enter the smaller of taxable income (not less than zero) or line 5 12 Section 179 expense deduction. Add lines 9 and 10. but do not enter more than line 11 13 Carryover of disallowed deduction to 1996. Add lines 9 and 10. less line 12 ► !""»"

10 11 12

Pa ,is ,ed p r p e r y o „ 0 , ! f ; l 0 l 0 i , U S e P a 1 " o r or r t ' " b e l 0 w .!°f Instead,ouse tPart V 'for listed. property. ( » « « ™ l * « « t a i n other vehicles, cellular telephones, certain computers or property used for entertainment, recreation, amusement). . . « " • tuwuuwi*. m propeny useo ror

k i f l i l l l MACRS Depreciation For Assets Placed In Service ONLY During Your 1995 Tax Year (Do Not Include Listed Property) — Section A • General Asset Account Election 14 II you are making the election under section 168(i)(4) to group any assets placed in service during the tax year into one or more general asset accounts check this box. See instructions
(a) CltssiicaHon of property (b) Month and yew pieced in service (c) Basis (or depredation (Business/Investment use only) (d) Recovery period I (e) Convention (Q Method

>□

(gl Depreciation deduction

15 a 3-year property b 5-year property c 7-year property d 10-year property e 15-year property f 20-year property g Residential rental property h Nonresidential real property [

'
•* *

^ -.s
f
f

\f

v.

-> 'V *,, ',
s>
'

743.

7 YRS.

HY

200DB

106.

\^
' ' V

/
1 1 1

27.5 yrs. 27.5 yrs.

.
12 yrs. 40 yrs.

MM MM MM MM

S/l S/L S/L

S/L I
S/L S/L S/L
17 18 19

Section C -Alternative Peprecialion System (ADS) (See instructions) 16 a Class life b 12-year c 40-year l i f l j l l i l Other Depreciation (Do Wot Include Listed Properly) 17 GOS and ADS deductions for assets placed In service in tax years beginning before 1995 18 Property subject to section 168(f)(1) election 19 ACRS and olher depreciation I J S f f H U Summary ^ ^ ^ ^ 20 Listed property. Enter amount from line 26 21 Total. Add deductions on line 12. lines 15 and 16 in column (g). and lines 17 through 20. Enter here and on the appropriate lines of your return. Partnerships and S corporations - see instructions 22 For assets shown above and placed in service during the current year, enter the portion of the basis attributable to section 263A costs LHA For Paperwork Reduction Act Notice, see page 1 ol the separate Instructions. f |

MM

3,405.

20 21 22
Form 4562 (1995)

3,511.

Form 4562 (1995) Entertainment, Recreation, or Amusement ^flf^Xl^SWg™
mi,ea0e

Page 'a,e" d8dUC,in°lease
expense c o m

'

»le,e

m

» « * ■ ™- " ' " " i n s (a, through (c) of

Section A • Depreciation and Other Information (Caution: See instructions for limitations for automobiles.) 23a op you h av e evidence to support the business/investment use claimed? I I Yat I I Hn 23b If "Yes: is the evidence written? | | yPt | [ No (a) it) (e) Basis, for (b) Date (d) 0) (9) (h) depreciation (•) Business/ Type of property placed in Cost or Recovery .(business/ Method/ Elected Depreciation investment (list vehicles first) service other basis investment period Convention section 179 use percentage deduction use only) cost 24 Property used more than 50% in a qualified business use:

% % %
25 Property used 50% or less in a qualified business use

%

S/L-

sn.<
%
26 Add amounts in column (h). Enter the total here and on line 20. page 1 27 Add amounts in column (i). Enter the total here and on line 7. page 1 S/LS/L1

Section B • Information on Use of Vehicles Complete this section for vehicles used by a sole proprietor, partner, or other 'more than 5% owner ■ or related person II you provided vehicles to your employees, first answer the questions in Section C to see if you meet an exception to completing this section for those vehicles. (a) Vehicle (b) Vehicle (c) Vehicle (d) Vehicle
(B)

28 Total business/investment miles driven during the year (DO NOT include commuting miles) 29 Total commuting miles driven during the year 30 Total other personal (noncommuting) miles driven 3' Total miles driven during the year. Add lines 28 through 30 Was the vehicle available for personal use during off-duty hours? 33 Was the vehicle used primarily by a more than 5% owner or related person? 34 is another vehicle available for personal use? ..
32

Vehicle

(') Vehicle

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Section C • Questions tor Employers Who Provide Vehicles for Use by Their Employees Answer these quest.ons to determine if you meet an exception to completing Section B for vehicles used by employees who are not more than 5% owners or related persons ■ 3S DO you maintain a written policy statement that prohibits all personal use of vehicles, including commuting by your employees? 36 Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting by your employees? (See instructions for vehicles used by corporate officers, directors, or 1% or more owners.) 37 Do you treat all use of vehicles by employees as personal use? 38 Do you provide more than five vehicles to your employees, obtain information from your employees about the use of the vehicles, and retain the information received? 39 Do you meet the requirements concerning qualified automobile demonstration use? rJs&t^ZninZn > 0 3 5 ' 3 6 ' 3 7 ' 3 8 ' " " " " " (a) (b)
Description of costs fOileiinortaion topics
nWi> 0tCOm MBg

Yes

No

"

°

^'"Mtt"«"^''^''''*'' (d)
Coda soction

<0
Amoftfnbt* amount

(e)
Amoffottoei

40 Amortization of cosls that begins during your 1995 tax year:

Amortluliafl (of mil y«w

M

Amortization of costs that began before 1995

FornTAG990-iL . Revised 3/95

CHARITABLE ORGANIZATION SUPPLEMENT CO # 0 1 - 0 2 6 , 4 9 8 Attorney General JIM RYAN State of Illinois Charitable Trust and Solicitations Bureau, 100 West Randolph Street, 12th Floor, Chicago, Illinois 60601 M0 DAY YR M0 DAY YR REPORT FOR T H E FISCAL PERIOD BEGINNING: 01/01/96 A N D ENDING: 12/31/96 ARE CONTRIBUTIONS TO ORGANIZATIONS TAX DEDUCTIBLE? D O Yes □ No FEDERAL 10 NUMBER: I 3 6 - 3 8 6 9 4 5 9 LEGAL DATE ORGANIZATION WAS CREATEO: A)ASSETS B) LIABILITIES C) ENDING FUND BALANCE MO A) S B) S C) $ DAY YR

N M SAVE A L I F E FOUNDATION, A E MI AL ADDRESS 1 7 4 7 9 W. DARTMOOR DR. CT . S A E GRAYSLAKE, I L IY TT ZIPCOOE 6 0 0 3 0

INC.

02/09/93 23,406. 58,870. <35,464.>
AMOUNT D)$ E) $ F) $

I.

SUMARY OF REVENUE ITEMS DURING THE YEAR:
D) PUBLIC SUPPORT. CONTRIBUTIONS PROGRAM SERV. REV. (GROSS AMTS.) E) GOVERNMENT GRANTS & MEMBERSHIP DUES F) OTHER REVENUES

PERCENTAGE

96.094% 3.906%

37,566.
1,527.

FILE COPY
" "* '" • ''

G) TOTAL REVENUE. INCOME AND CONTRIBUTIONS RECEIVED (ADD D. E. & F)

100%

G)$
H)$

39,093.

II.

SUMMARY OF EXPENDITURES DURING THE YEAR:
H) OPERATING CHARITABLE PROGRAM EXPENSE

62.344%
I) EDUCATION PROGRAM SERVICE EXPENSE J) GRANTS TO OTHER CHARITABLE ORGANIZATIONS

i) $ JLL

33,938.

62.344%
K) TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD H, I & J) L) MANAGEMENT AND GENERAL EXPENSE M) FUNORAISING EXPENSE N) TOTAL EXPENDITURES THIS PERIOD (ADO K, L. & M) 100%

K)$

33,938. 18,474.
2,025. 54,437.

33.936% iLL
3.720%
MJJL

NIX

III.

SUMMARY OF PAID FUNDRAISER ACTIVITIES DURING THE YEAR:
(Attach Attorney General Report ot Individual Fundraising Campaign) 0) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISER P) TOTAL FUNDRAISER FEES AND EXPENSES 0) NET RECEIVED BY THE CHARITY (0 MINUS P=0) 100 %

0)$

£!L
% QLt BLL
US

IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS DURING THE YEAR:
R) NAME. TITLE: N O N E S) NAME. TITLE: T) NAME. TITLE:

III
CODE

V.

CHARITABLE PROGRAM DESCRIPTION:
CHARITABLE PROGRAM (3 HIGHEST PAID BY $ EXPENDED) CODE CATEGORIES (List on back side Ot instructions) U) DESCRIPTION:

U)#

PUBLIC EDUCATION BY MAIL
V) DESCRIPTION:

010
V) I

OTHER EDUCATIONAL MATERIALS FOR THE PUBLIC
W) DESCRIPTION:

012
W)#

IF THE ANSWER TO ANY OF THE FOLLOWING IS YES, ATTACH A DETAILED EXPLANATION:
1 WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION. FINE. PENALTY OR JUDGMENT? 1

YES

NO X

2

HAS THE ORGANIZATION OR A CURRENT DIRECTOR. TRUSTEE. OFFICER OR EMPLOYEE THEREOF. EVER BEEN CONVICTED BY ANY COURT OF AN Y MIS DEMEANOR INVOLVING THE MIS USE OR MISAP PROPRIATION OF FUNDS OR ANY FELONY? 2

3.

DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS OR DIRECTORS OWNS AN INTEREST OR WAS A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS DIRECTORS. TRUSTEES. OR OFFICERS HAS A MATERIAL FINANCIAL INTEREST OR 010 ANY OFFICER OR DIRECTOR RECEIVE ANYTHING OF VALUE NOT REPORTED AS COMPENSATION? 3

4.

HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER. DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES? 4

5.

IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? 5.

6.

OIO THE ORGANIZATION ALLOCATE THE COST OF ANY MAILING. ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES? 6

7.

DID THE ORGANIZATION LENO FROM RESTRICTED FUNDS TO ITS UNRESTRICTED FUNOS FOR PURPOSES OTHER THAN THEIR RESTRICTED PURPOSES? 7

X X X

8. 9.

HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAO ITS REGISTRATION SUSPENDED OR REVOKED? DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER?

8. 9

10 DO YOU HAVE ANY KNOWLEDGE OF ANY THEFT. DEFALCATION. MISAPPROPRIATION. COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS? 10.

11 LIST THE NAME AND ADDRESS OF THE BANKS. AND THE ACCOUNT #, WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST AMOUNTS:

GRAND NATIONAL BANK, GURNEEy IL

UNDER PENALTY OF PERJURY. I (WE) THE UNDERSIGNED DECURE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS SUPPLEMENT AND THE ACCOMPANYING REPORT. INCLUDING ALL THE SCHEDULES AND STATEMENTS AND THE FACTS THEREIN STATED ARE TRUE AND COMPLETE AND FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE STATE OF ILLINOIS RELY THEREUPON. I HEREBY FURTHER AUTHORIZE AND AGREE TO SUBMIT MYSELF AND THE REGISTRANT HEREBY TO THE JURISDICTION OF THE STATE

CAROL SPIZZIRRI
PRESIDENT or TRUSTEE (PR.NT NA.... SUBSCRIBED AND SWORN TO BEFORE ME. THIS DAY OF .19 TREASURER or TRUSTEE (PRINT NAME) •"(NOTARIZATION RE (NOTARY PUBLIC)

i • It
SIGNATURE

DATE

DATE

STEPHEN J . COLE
SIGNATURE OF PREPARER PRINT NAME

2

30805

SAVE50

070 SAVE A LIFE FOUNDATION, INC.

SAVE50 1

Form

990

Return of Organization Exempt From Income Tax
Under section 501 (c) ol the Internal Revenue Code (except black lung benefit trust or private foundation) or section 4947(a)(1) nonexempt charitable trust Note: The organization may have to use a copy of this return to satisfy state reporting requirements. , 1996. and ending C Name of organ iiation

3MB No 1S4S-0047

Department ol Ihe Treasury Internal Revenue Service

This Form Is Open to Public Inspection

1996

A For the 1996 calendar year, OR tax year period beginning

.19
O Employer identification number

□°L □
icpo

Please use IRS address label or print or Initial type. return See □ Final Specific return □ A m e n d e d Instruc­ return tions. [teoHtdiso

D Chech If: Change

SAVE A L I F E FOUNDATION, INC.
Number and street (or P.O. box if mail is not delivered to street address)

36-3869459
Room/suite E State registration number

17479 W. DARTMOOR DR.
City, town, or post office, state, and ZIP code

01-026,498
F Check section 4947(a)(l) nonexempt chartitable trust if exemption application is pending

SRAYSLAKE, I L

60030
)<4 (insert number) OR ► □

«organization - ► Q D Exempt under 501(c) ( 3 G Type of>

Note: Section S01 (c)(3) exempt ornanlzatlons and 4947(a)(1) nonexemptcharitable trusts M U S T attach a completed Schedule A (Form 090). H(a) is this a group return filed for affiliates? C U Yes Q O No I If either box in H Is checked "Yes,* enter four-digit group exemption number (GEN) ► _ (b) If "Yes.* enter the number of affiliates for which this J Accounting method: I X I Cash I I Accrual return is filed: ► □ Other (specify) ► ( t ) Is Iha a separate return Bled ay i n organiiilion covered by a group ruling? □ Yes [ E H No X Check here ► I 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 990 Packaoe in Ihe mail, it should file a return without financial data. Some states require a complete return. No e: Form 9S0-EZ may be used bv organizations with Ofoss receiots less than $100,000 and total assets less than $250,000 at end of year.

oH I U
1

Revenue, Expenses, a n d Changes in Net Assets or Fund Balances
a b c d Contributions, gifts, grants, and similar amounts received: Direct public support Indirect public support Government contributions (grants! Total (add.lines 1a through 1c) (attach schedule of contributors) S T M T 1 (cash$ 1 8 , 1 3 4 . noncash$ 1 9 , 4 3 2 . ) 1a 1b 1c

37,566.

:■

■■

id
3 4 5

37,566. 1,527.

a c
0

Program service revenue Including government fees and contracts (from Part VII, line 93) Membership dues and assessments Interest on savings and temporary cash investments Dividends and interest from secu rities 6a 6 a Gross rents b Less: rental expenses 6b c Net rental income or (loss) (subtract line 6b Irom line (ia) 7 Other investment income (describe ► 8 a Gross amount from sale of assets other than inventory b Less: cost or other basis and sales expenses c Gain or (loss) (attach schedule) d Net gain or (loss) (combine line 8c, columns (A) and (I )) 9 Special events and activities (attach schedule): a Gross revenue (not including $ b c 10 a rj 11 12 13 14 15 16 17 1B 19 20 . 21 (A) Securities 8a 8b 8c (B) Other

2 3 4 5

;■■'.

)

7
--'«•■ r'.'

> a

':'■ ■-.

~

of contributions 9a 9b . . 10a 10b

:<:':

:'■•■■'.

reported on line la) . . . . Less: direct expenses other than fundraising expenses Net income or (loss) from special events (subtract line 3b from line 9a) Gross sales of inventory, less returns and allowances Less: cost of aoods sold Other revenue (from Part VII, line 103) Total revenue (add lines Id. 2.3.4.5.6c. 7. 8d. 9c. 10c. and 11) Program services (from line 44, column (B)) Management and general (from line 44, column (C)) Fundraising (from line 44, column (0)) . Payments to affiliates (attach schedule) Total expenses (add lines 16 and 44. column (A)) Excess or (deficit) for the year (subtract line 17 from line 12) Net assets at beginning of yea r (from line 73, column (AI) Other changes in net assets (attach explanation) Net assets or fund balances at end of year (combine lines IB, 19. and 20)
2

9c
* • * . : ' ■ •

c Gross profit or (loss) from sales of inventory (attach schedule) (subtract line 10b from line 1Oa)

10c

in

c
K Ul

39,093. 33,938. 18,474. 2,025. 54,437. <15,344.> <20,120.> 0. <35,464.>
Form 990 (1996)

«f H
LHA
B230O1

20 -21 .

For Paperwork Reduction Act Notice, see page 1 ol the separate Instructions.

12-1396

OORflS

SAVE50

070

SAVE A L I F E FOUNDATION, I N C .

SAVE50 1

form 990 099*)

TEEfflW Statement of Functional Expenses

SAVE A LIFE FOUNDATION. INC.

Oo not include amounts reported on line 6b. Bb, 9b, 10b. or 16 of Part I. 22 Grants and allocations (attach schedule)
caah $

36-3869459 Page2 All organizations must complete column (A). Columns (B). (C). and (0) are required toi section 501(c)(3) and (4) organizations and section 4947(a)(1) nonexempt charitable trusts but optional for others. (B) Program (C) Management (A) Total (0) Fundraising services and general

23 24 25 26 27 28 29 30 31 32 33 34 35
36 37

38 39 40
41 42

43 a b c d
B
44

noncash $ 22 Specific assistance to individuals (attach schedule) 23 Benefits paid to or for members (attach schedule) 24 Compensation of officers, directors, etc. 25 Other salaries and wages 26 Pension plan contributions 27 Other employee benefits 28 Payroll taxes 29 Professional tundraising fees 30 Accounting fees 31 Legalfees 32 Supplies 33 Telephone 34 Postage and shipping 35 Occupancy 36 Equipment rental and maintenance 37 Printing and publications 38 Travel 39 Conferences, conventions, and meetings 40 Interest 41 Depreciation, depletion, etc. (attach schedule) 42 Other expenses (itemize): 43a 43b 43c 43d

0.

1,150 3,619. 1,954 1,200. 4,620 10,549. 3,372 5,277. 2,171 1,954 4,620 6,329. 3,372 4,853

1,150 1,448. 1,200 4,220 424

SEE STATEMENT 2
Total functional axpenae* (taa line. 22 through 43) Organization. completing columns (B)-(D), cany the** total* lo line. 13-18

43el

22,696.

10,639.

10,032

2,025. 2,025. Yes 1X1 No

54,437. 44 I 33,938. 18,474. Reporting ol Joint Costs. • Did you report in column (B) (Program services) any Joint costs from a combined educational campaign and fundraising solicitation? ► □ 11 *Yes.' enter (I) the aggregate amount of these joint costs $ ; (ii) the amount allocated to Program services $ [the amount allocated lo Management and general $ and (iv) the amount allocated to Fundraising $ Statement of Program Service Accomplishments
What is the organization's primary exempt purpose? ► S E E STATEMENT 3

vi orBanlMllon. mu.iao.o1B. their exempt purpote echievemenl. Stato Iho number of client, aerved, publication. issued, etc Olscun achievements that am not waiurable. (Suction 80110(3) tntf (4) organHallona «na 4947(a)(1) nonaxempt charllabl* Iruits mutt al.o enter the amount ol grant, ana allocation, to other.)

Program Service Expenses
|4) org... and 4947(e)(1) Iru.ta; but optional for other.)

(Required lor 501(4(3) and

a

SEE STATEMENT 4

'

(Grants and allocations $

33,938.

(Grants and allocations S

(Grants and allocations $

(Grants and allocations S i Other program services (attach schedule) (Grants and allocations $ Total ol Program Service Expenses (should equal line 14. column (8). Program services)
101 13-96

1L INC.

33,938, SAVE50 1

nprm

savKsn

070

SAVE A LIFE FOUNDATION,

Form990(1996)

SAVE A L I F E FOUNDATION,

INC.

36-3869459

Page3

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

45 46

Cash - non-interest-bearing Savings and temporary cash investments

1,096

45

7,167.

46
47a 47b 48a 48b 48c 47e

47 a Accounts receivable b Less: allowance tor doubtful accounts

48 a Pledges receivable b 49 SO Less: allowance for doubtful accounts Grants receivable

49 S O
51a 51b

Receivables from officers, directors, trustees, and key employees (attach schedule) Other notes and loans receivable Less: allowance for doubtful accounts Inventories for sale or use Prepaid expenses and deferred charges Investments - securities (attach schedule) Investments - land, buildings, and equipment: basis

a

Z

51 a b 52 53 54 55 a b

sic
52 53 54

SSa 55b
.. STMT 5

Less: accumulated depreciation (attach schedule)

55c

56 57 a b 58

Investments - other

56
57a 57b
C J\SH .

Land, buildings, and equipment: basis Less: accumulated depreciation Other assets (describe ► D E S I G N A T E D

28,606. 12,367. )

10,315. 8,477. 19,888.

57c 58

16,239. 0. 23,406.

59 60 61

Total assets (add lines 45 through 58) (must equal line 74) . Accounts payable and accrued expenses Grants payable Deferred revenue Loans from officers, directors, trustees, and key employees

59 60 61 62 63 64a
64b

8 •*
.3

62 63

40,008.

58,870.

64 a Tax-exempt bond liabilities b Mortgages and other notes payable 65 Other liabilities (describe ► )

65

65

Total liabilities (add lines 60 throuah 65) I X I and complete lines 67 through 69 and lines 73 and 74

40,008.

fiB

58,870.

Organlzatloni thai follow SFAS 117, check here ► v> ti

u c a

67 66 69

Unrestricted Temporarily restricted Permanently restricted I I and complete lines

3 •o
c
3

< 2 0 , 1 2 0 . = ►67 0 . 66 0 . 69

<35,464.> 0. 0.

Organliallons that do not lollow SFAS 117, check here ► 70 through 74 70 71 72 JZ Capital stock, trust principal, or current funds

u.

•>
0

< « z

1

Paid-in or capital surplus, or land, building, and equipment fund Retained earnings, endowment, accumulated Income, or other ftmds .... Total net assets or fund balances (add lines 67 through 69 OR ines 70 through 72; column (A) must equal line 19 and column (B) must equal line 2 D Total liabilities and net assets / lund balances (add tin es66< ind 73)

70 71 72

''4

< 2 0 , 1 2 0 . > 73 1 9 , 8 8 8 . 1 74

<35,464.> 23,406.

13021 J-13-86

mom;

cavern

070

SftVE a T.TFF. FOUNDATION.

TNC.

SAVE50

1

Form 990 (1996)

SAVE A LIFE FOUNDATION, INC.
Reconciliation of Revenue per Audited Financial Statements with Revenue per Return

36-3869459

Part IV-A
a b

Page 4

Total revenue, gains, and other support per audited linancial statements

~N7A~

Amounts included on line a but not on line 12, Form 990: (1) Net unrealized gains on investments $

R e c o n c i l i a t i o n of E x p e n s e s p e r A u d i t e d Financial Statements With Expenses per Return a Total expenses and losses per "N7A audited financial statements b Amounts included on line a but not on line 17. Form 990: (1) Donated services and use of facilities... $ (2) Prior year adjustments reported on line 20, Form 990 $ (3) Losses reported on line 20, Form 990 (4) Other (specify): ..$

(2) Donated services

0) («)
e d

and use ol facilities Recoveries of prior yeargrants Other (specify):

$ $

Add amounts on lines (1) through (4) Line a minus line b Amounts included on line 12, Form 990 but not on line a:

► ►

c d

Add amounts on lines (1) through (4) Line a minus line b Amounts included on line 17, Form 990 but not on line a:

► ►

(l) Investment expenses not included on line 6b. Form 990 $. |2) Other (specify): Add amounts on lines (1) and (2) Total revenue per line 12. Form 990 (line c plus line d) I ^ Ie

Investment expenses not included on line 6b, Form 990 ..$_ (2) Other (specify): Add amounts on lines (1) and (2) Total expenses per line 17, Form 990 (line c plus line d) (B) Title and average hours per week devoted to position (C) Compensation (II not paid, enter
(D)Contributiont to employes benefit >benefit pltnt&defMTSd JelefToc eornaeneatton

(D

e

m-*nmm

List of Officers, Directors, Trustees, and Key Employees (List each one even if not compensated)
(A) Name and address (E) Expense account and other allowances

CAROL SPIZZIRRI 174 79 W. DARTMOOR PR, GRAYSLAKE, STEPHEN J . COLE 17377 W. DARTMOOR PR, GRAYSLAKE, SANDY ENGBER 17593 W. DARTMOOR PR, GRAYSLAKE, LEE JUNGKANS ~" IL IL

PRESIDENT 100 TREASURER SECRETARY IL VICE PRES. 0. 0. 0. 0. 0. 0. 0. O. 0. 0. 7,864

3320 W. BLUE MOUNP AVE, WAUWATOSA, WI

Oid any officer, director, trustee, or key employee receive aggregate compensation of more than $100,000 from your organization and all related organisations, of which more than $10.000 was provided by the related organizations? It 'Yes: attach schedule. ► C H Yes Q T ] No

Form 990(1996}
76 77

SAVE A L I F E FOUNDATION, Other Information

INC

36-3869459

Page 5

Yes No

Oid the organization engage in any activity not previously reported to the IRS? It "Yes," attach a detailed description of each activity 76 Were any changes made in the organizing or governing documents but not reported to IfiS? 77 If "Yes." attach a conformed copy of the changes. 7Ba Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return? 78a N/A b If "Yes," has it filed a tax return on Form 990-T for this year? 78b Was there a liquidation, dissolution, termination, or substantial contraction during the year? 79 79 If "Yes," attach a statement; 80 a Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization? 80a If "Yes," enter the name of the organization ► and check whether it is | I exempt OR I I nonexempt. Enter the amount of political expenditures, direct or indirect, as described in the 81 a instructions for line 81 I 61 a I 0 < b Did the organization file Form 1120-POL for this year? 81b 62 a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially less than fair rental value? 82a b If "Yes," you may indicate the value of these items here. Do not include this amount as revenue in Part I or as an expense in Part II. (See instructions for reporting in Part III) I 82b I 3 ,OOP 83 a Did the organization comply with the public inspection requirements for returns and exemption applications? 83a b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? 83b 84 a Did the organization solicit any contributions or gifts that were not tax deductible? 84a b If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? N / A 84b 85 501(c)(4), (5), or (6) organizations, -a Were substantially all dues nondeductible by members? N/A.. 85a b Did the organization make only in-house lobbying expenditures of $2,000 or less? N / A B5b if "Yes" to either 85a oi 85b, do not complete 65c through 85h below unless the organization received a waiver for proxy tax owed for the prior year. N/A c Dues, assessments, and similar amounts from members 85c 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 B5e "NTA" I Taxable amount of lobbying and political expenditures (line 85d less 85e) . 851 g Does the organization elect to pay the section 6033(e) tax on the amount in 851? NTA" 8q 5 h If section 6033(e)(1 )(A) dues notice were sent, does the organization agree to add the amount in 851 to its reasonable estimate of dues ailocable to nondeductible lobbying and political expenditures for the following tax year? N/A_ B5h 501(c)(7) organizations. - Enter: N/A a Initiation fees and capital contributions included on line 12 86a "NTA" b Gross receipts, included on line 12, for public use of club facilities 86b 87 501(c)(12) organizations. -Enter: a Gross income from members or shareholders 87a NTA b Gross income from other sources. (Oo not net amounts due or paid to other sources N/A against amounts due or received from them.) 87b 88 At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or partnership? If "Yes," complete Part IX 88 89 a 501(c)(3) organizations. - Enter: Amount of tax paid during the year under: section4911 ► 0 ^ ; s e c t i o n 4912 ► 0 ^ ; s e c t i o n 4955 ► 0. b 501(c)(3) and 501(c)(4) organizations. - Oid the organization engage in any section 4958 excess benefit transaction during the year? If "Yes," attach a statement explaining each transaction 89b c Enter: Amount of tax paid by the organization managers or disqualified persons during the year under section 4958 ► t Enter: Amount of tax in 89c, above, reimbursed by the organization 90 list the states with which a copy of this return Is filed ► I L L I N O I S

0_ 0,

II

The books are in care of ► CAROL

SPIZZIRRI IL

Telephoneoo> 8 4 7 - 5 4 9 - 7 3 5 3 Zip +4 ► 6 0 0 3 0

Located at ► 1 7 4 79 W. DARTMOOR D R . , GRAYSLAKE,

Section 4947(a)(1) nonexempt charitable trusts filing Form 990 in' lieu of Form 1041.- Check here and enter the amount of tax-exempt interest received or accrued during the lax year

► □
92

N/A

?3041 1-1396

inarm

RAVES0

070

SAVE A LIFE FOUNDATION, INC

SAVE50 1

SAVE A LIFE FOUNDATION, INC lyijeVill Analysis of Income-Producing Activities
'orm 990 (1996) Enter gross amounts unless otherwise indicated 93 Program service revenue: (a) (b) Unrelated business income o '*' Business code IB) Amount

36-3869459
Excluded by section SI?, 513. Q' 514

Page 6

(C)
Exclu­ sion code

(0) Amount

(E) Related or exempt function income

(e) W (e)
(f) (g) Fees and contracts from government agencies 94 Membership dues and assessments 95 Interest on savings and temporary cash investments 96 Oividends and interest from securities 97 Net rental income or (loss) Irom real estate: (a)debt-financed property (b) not debt-financed property 98 Net rental income or (loss) Irom personal property 99 Other investment income 100 Gain or (loss) from sales of assets other than inventory 101 Net income or (loss) from special events 102 Gross profit or (loss) from sales of inventory 103 Other revenue: a b c d _ _ _ e 104 Subtotal (add columns (fl).(D), and (E)) 105 TOTAL (add line 104. columns (B), (0). and (E)) Hole: (Line 105 plus line 1d. Part I. should equal the amount on line 12. Part I.)

1,527.

O.

1,527. 1,527.

pjSBMIII Relationship of Activities to the Accomplishment of Exempt Purposes
Line No T
Explain how each activity for which income is reported in column (E) of Part VII contributed Importantly to the accomplishment of the organization's exempt purposes (other than by providing funds for such purposes),

94

MEMBERSHIP DUES - CORPORATE AND INDIVIDUALS

IJJHIKI

Information Regard ng Taxable Subsidiaries (Complete this Part HlneTes" box on 86 Is checked.)
Nature of business activities Total income End-of-year assets

Percentage of Name, address, and employer identification ownership interest number of corporation or partnership

N/A % % ja retum. Including accompanying schedules and statements, and to the best ol my knowledge and betlel. It Is true. Under penalties ol penury, I deeltrs that I havo examined this
correct, and compielo Declaration of prepamr (other than officer) is based on all information ol which preparer has any knowledge

Please Sign Here Signature of officer Preparer's ^ signature r Firm's name (or yours COLE , Date Date W Type or print name and title Check if Preparer's SSN selfemployed

Paid Preparer's Use Only
673161 1M3-96 / i n an i

MARTIN, & C O . , LTD. EN I it self-employed) ^ 7 3 0 1 N . LINCOLN A V E . , 140 and address 60646 ZIP+ 4 LINCOLNWOOD, I L 8 c A\7c«;n 070 RRVK A T.TFF. FOUNDATION, INC. SAVE50 1

► o

►i

SCHEDULEA (Form 990)
Department ot the Treasury Intemai Revenue Service

Organization Exempt Under 501(c)(3)
(Except Private Foundation), and Section 501(e), 501(0.501(h). 501(n) or Section 4947(a)(1) Nonexempt Charitable Trust

OMBNo 1S45-C047

Supplementary Information

1996
(e) Expense account and other allowances

Name of the organization

► Must be completed by the above organiialions and attached to their Form 990 (or Form 990EZ). Employer identification number

36 3 8 6 9 4 5 9 Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees

SAVE A LIFE FOUNDATION, INC.

(a) Name and address ot each employee paid more than $50,000 NONE __

(b) Title and average hours per week devoted to position

,c, Compensation

|0) Contributions to employee Benefit pt«m & dofemad compensation

Total number of other employees paid

0 Compensation of the Five Highest Paid Independent Contractors for Professional Services
(See instructions.) (List each one (whether Individuals orfirms.) (If there are none, ente "None.')) (b) Type of service (c) Compensation (a) Name and address of each independent contractor paid more than $50,000

NONE

Total number of others receiving over $50,000 for professional services LHA For Paperwork Reduction Act Notice, see page 1 ol the Instructions to Form 990 (or Form 990-EZ)
823101 IJ 16-96

Schedule A (Form 990) 1996

c nwir«;n

nm

.QM/P ft T.TFF. FOUNDATION.

INC.

SAVE50

1

.Schedule A (Form 990) 1996

SAVE A LIFE FOUNDATION, INC.

36-3869459

PageZ Yes No

Statement About Activities
During I tie year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? If "Yes,* enter the total expenses paid or incurred in connection with the lobbying activites. ► $ Organizations that made an election under section 501(h) by tiling Form 5768 must complete Part Vl-A. Other organizations checking 'Yes." must complete Part Vl-B ANO attach a statement giving a detailed description of the lobbying activities. 2 During the year, has the oganization. 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 with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary: a Sale, exchange, or leasing of property? b Lending of money or other extension of credit? c Furnishing of goods, services, or facilities? . d Payment of compensation (or payment or reimbursement ol expenses if more than $1.000)? e Transfer of any part of its income or assets? If the answer to any question is "Yes." attach a detailed statement explaining the transactions. 3 Does the organization make grants for scholarships, fellowships, student loans, etc.? 4 Attach a statement explaining how the organization determines that individuals or organizations receiving grants or loans from ft in furtherance of its charitable programs Qualify to receive payments. (See instructions.)

2a 2b 2c 2d

2e

fjEiMEM Reason for Non-Private Foundation Status (See instructions.)
The organization is not a private foundation because it is (please check only ONE applicable box): A church, convention of churches, or association of churches. Section 170(b)(1)(A)(i) 5 6 A school. Section I70(b)(l )(A)(ii). (Also complete Part V, page 4.) 7 A hospital or a cooperative hospital service organization. Section l70(b)(l)(A)(iii). 8 A Federal, state, or local government or governmental unit. Section I70(b)(l )(A)(v). 9 A medical research organization operated in conjunction with a hospital. Section 170(b)(1)(A)(iii). Enter the hospllal's name, city, and slate ► 10 An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(1)(A)(iv). (Also complete the Support Schedule in Part IV-A.) 11a An organization that normally receives a substantial part of its support from a governmental unit or from the general public. Section 170(b)(l)(A)(vi). (Also complete the Support Schedule in Part IV-A) 11b A community trust. Section 170(b)(1 )(A)(vi). (Also complete the Support Schedule in Part IV-A.) 12 An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc., functions - subject to certain exceptions, and (2) no more than 331/3% 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. See section 509(a)(2). (Also complete the Support Schedule in Part IV-A.)

(3

□ □ □ □ □ □ □ □

An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in: (1) lines 5 through 12 above: or (2) section 501(c)(4). (5). or 161. if they meet the test of section 509(a)(2). (See section 509(a)(3).) Provide the following information about the supported organizations. (See instructions on page 4 ) (a) Namefs) of supported organizational (b) Line number from above

13

14

|

J

An organization organized and operated to lest for public safety. Section 509(a)(4). (See instructions on page 4.]

Z3111 Z-16-96

Rnvpsn

070

10 RAVE A T.TFK FOUNDATION.

TNC

SAVE50 1

Schedule A (Form 990) 1996 36-3869459 Pages SAVE A LIFE FOUNDATION, INC. Support Schedule (Complete only if you checked a box on lines 1 0 . 1 1 . or 12 above.) Use cash method of 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 (a) 1995 (b) 1994 beginning In) (d) 1992 (c) 1993 (e) Total
1Q Gifts, grants, and contributions received. (Do nol include unusual grants See line 28)

16 17

Membership fees received Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is not a business unrelated to the organization's charitable, etc., purpose Gross income from interest. dividends, amounts received from payments on securities loans (sec lion 512(a)(5)), rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organization after June 30.1975 Net income from unrelated business activities not included in line 18
Tax revenues levied lot trie organization's benefit and either paid to it or expended on Its behalf ,

110,761 1,410

93,405. 2,875

7,199

211,365 4,285

18

19
20

21

The value of services or facilities furnished to the organization by a governmental unit without charge. Oo not include the value of services or facilities generally furnished to the public without charge
Other Income. Attach a schedule Oo not Include gain or (loss) from sale ol capital assets

22

23 24 25 26 b

Total of lines 15 through 22 112,171 96,280. 7^199. Line 23 minus fine 17 112,171. 96,280. ^199. Enter 1 % of line 23 72. 963. 1,122. Organizations described in lines 10 or 11:a Enter 2% of amount in column (e), line 24 ► 26a Attach a list (which is not open to public inspection) showing the name of and amount contributed by each person (other than a governmental unit or publicly supported organization) whose total gifts for 1992 through 1995 exceeded the amount shown in line 26a. Enter the sum of all these excess amounts ► 26b

215,650, 215,650. "N7A" N/A

N/A Total support for section 509(a)(1) test: Enter line 24, column (e) 26c Add: Amounts from column (e) for lines: 18 J 19 . N/A 22 J 26b 26d "NTA" Public support (line 26c minus line 26d total) 26e ~N7A" I Public support percentage (line 26e (numerator) divided by line 26c (denominator)) 261 27 Organizations described on line 12: a For amounts included in lines 15,16, and 17 that were received from a 'disqualified person,' attach a list to show the name of. and total amounts received in each year from each 'disqualified person.* Enter the sum of such amounts for each year. (1995) 0. (igg4) 0 . (1993) Q.... (1992) P •. b For any amount included in line 17 that was received from a nondisqualified person, attach a list to show the name of, and amount received for each year, that was more than thelargerof (1) the amount on line 25 for the year or (2) $5,000. (Include in the list organizations described in lines 5 through 11, as well as individuals.) After computing the difference between the amount received and the larger amount decribed in (1) or (2). enter the sum of these differences (the excess amounts) tor each year: (1995) P . . . (1994) 0 . (1993) P..-. (1992) P.-.
c Add: Amounts from column (e) for lines: 17 $ d Add: Line 27a total $ IS $ 20 $ 0 .

211,365.
and line 27b total $

16$
21 $

4,285. o. ► ► 215,650.
27c 27d 27e

e Public support (line 27c, total minus line 27d total) Total support for section 509(a)(2) test: Enter amount on line 23. column (e) ► 1 271 f S g Public support percentage (line 27e (numerator] divided by line 27f, (denominator)) h Investment income percentane (lino 18 column e) (numerator) divided by line 271 (denominator))

215,650. 0. 215,650. 100% .0000%

1

► 27fl ► 27h

•8 Unusual Grants: For an organization described in line 10.11, or 12, that received any unusual grants during 1992 through 1995, attach a list (which is not open to public inspection) for each year showing the name of the contributor, the date and amount of the grant, and a brief description of the nature of the grant.Oo not include these grants in line 15. (See instructions.) NONF
M121 3-2S-97

RBVPSO

11
070 SAVE A T.TFR FOUNDATTON. INC. SAVE50 1

Schedule A (Form 990) 1996

TT

SAVE A L I F E FOUNDATION, INC Private School Questionnaire (To be completed ONLY by schools that checked the box on tine 6 in Part IV)

36-3869459 N/A

Page 4

29 30 31

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

Yes No
29 30

31

32

Does the organization maintain the following: Records indicating the racial composition of the student body, faculty, and administrative staff? Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student admissions, programs, and scholarships? Copies of all material used by the organization or on its behalf to solicit contributions? If you answered W t o any of the above, please explain. (If you need more space, attach a separate statement.)

32a 32b 32c 32d

33

Does the organization discriminate by race in any way with respect to: Students'rights or privileges? Admissions policies? Employment of faculty or administrative staff? Scholarships or other financial assistance? Educational policies? Use of facilities?

33a 33b

33c
33d 33e 331 33o 33h

g Athletic programs? h Other extracurricular activities? If you answered "Yes" to any of the above, please explain. (If you need more space, attach a separate statement.)

M a Does the organization receive any financial aid or assistance from a governmental agency? b Has the organization's right to such aid ever been revoked or suspended? 15 If you answered "Yes" to either 34a or b, please explain using an attached statement. Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05 of Rev. Proc. 75-50. 1875-2 C.B. 5B7, covering racial nondlscrlmlnation? It •No." attach an explanation

34a 34b

36

1131 »fr96

">nn«;

savR^n

0 70

12 SAVR A T.TFR FOUNDATION.

INC.

SAVE50

1

Schedule A (Form 990) 1996

SAVE A LIFE FOUNDATION, INC.

36-3869459
N/A
(b) To be completed for ALL electing organizations

Part Vl-A Lobbying Expenditures by Electing Public Charities
(To be completed ONLY by an eligible organization that tiled Form 5768) Check here ► a C D II the organization belongs to an affiliated group. Check here ► b U3 It vou checked "a* above and limited control" provisions apply.

Limits on Lobbying Expenditures
(The term "expenditures' means amounts paid or incurred)

U)
Affiliated group totals

N/A
36 Total lobbying expenditures to influence public opinion (grassroots lobbying) 37 Total lobbying expenditures to influence a legislative body (direct lobbying) 38 Total lobbying expenditures (add lines 36 and 37) 39 Other exempt purpose expenditures 40 Totalexempt purpose expenditures (add tines 38 and 39) 41 Lobbying nontaxable amount. Enter the amount from the following table If the amount on line 40 is The lobbying nontaxable amount Is •
Not over $500,000 Over $500,000 bul not over 11.000,000 Over SI ,000,000 but not over Si .£00.000 Over SI.SOO.OOO out not over $17,000.030 OverS17,000,000 20M ot the amounl on lino 40 $100.000 pus 1 5 « ol lite excess over $500,000 S17S.000 plus 10H ol the excess over S1,000,000 $225,000 plus 9 W ol the excess over S1.9O0.O0O $1.000.000

36 37 38 39 40

41

42 Grassroots nontaxable amount (enter 25% of line 41) 43 Subtract line 42 from line 36. Enter-0-if line 42 Is more than line 36 44 Subtract line 41 fromline 38. Enter -0- if line 41 is more than line 38 Caution: if lhare is an amount on either line 43 or line 44. file Form 4720.

42 43 44

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 45 Ihrough 50.) Lobbying Expenditures During 4-Year Averaging Period Calendar year (or fiscal year beg Inning in) 45 Lobbying nontaxable amount 46 Lobbying ceiling amount (150% of line 45(e)) 47 Total lobbying expenditures 46 Grassroots nontaxable amount 49 Grassroots ceiling amount (150% of line 48(e)) SD Grassroots lobbying expenditures (a) 1996 (b) 1995 (c) 1994

N/A
(e) Total

«0
1993

0. 0. 0. 0. > \ •

-

0. 0.

Part Vi-B Lobbying Activity by Nonelecting Public Charities
(For reporting only by organizations that did not complete Part Vl-A) During the year, did the organization attempt to influence national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of: a b c d e I g h I Volunteers Paid staff or management (include compensation In expenses reported on lines c Ihrough h) Media advertisements Mailings to members, legislators, or the public Publications or published or broadcast statements Grants to other organizations for lobbying purposes Direct contact with legislators, theirstaffs, government officials, or a legislative body Rallies, demonstrations, seminars, conventions, speeches, lectures. or any other means Total lobbying expenditures (add lines c through h) II "Yes' lo any of the above, also attach a statement giving a detailed description of the lobbying activities.

N/A
Yes No
Amount

623141 12 16 36 f l A n o n e

CnVFRO

070

13 SAVE A LIFE FOUNDATION, INC.

SAVE50 1

Schedule A (form 990} 1996

SAVE A L I F E FOUNDATION,

INC.

36-3869459

Page 6

I t f l i ' l l l Information Regarding Transfers To and Transactions and Relationships With Noncharitabte Exempt Organizations
SI 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) organizations) or in section 527, relating to political organizations? a Transfers from the reporting organization to a noncharitable exempt organization of: (I) Cash (II) Other assets b Other transactions:

Yes No Sia(l) a(ii)

X X

(i) Sales of assets to a noncharitable exempt organization b(l) X (if) Purchases of assets from a noncharitable exempt organization b(ll) X (Hi) Rental of facilities or equipment b(lll) X (Iv) Reimbursement arrangements b(lv) X (») Loans or loan guarantees b(v) X (vl) Performance of services or membership or fundraising solicitations b(vl) X e Sharing of facilities, equipment, mailing lists, other assets, or paid employees c X d II the answer to any of the above is "Yes," complete the following schedule. Column (b) should always indicate the fair market value of the goods, other assets, or services given by the reporting organization. If the organization received less than fair market value in any transaction or sharing arrangement, indicate In column (d) the value of the goods, other assets, or services receivedN/A (a) (b) (e) (d) Amount involved Line no Description of transfers, transactions, and sharing arrangements Name of noncharitable exempt organization

52 a Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations described in section 501 (c) of the Code (other than section 501(c)(3)) or in section 527? a> | ) Y e s b If 'Yes,' complete the following schedule. N/A (a) Name of organization (b) Type of organization Description of relationship

[K] No

S23191 12-16-96

inRrm

RAVRSn

070

14 SAVR A T.TFK FOUNDATION.

INC.

SAVE50

1

SAVE A LIFE FOUNDATION, INC. ^ORM 990 (A)
ASCRIPTION SANK CHARGES )UES & SUBSCRIPTIONS )UTSIDE SERVICES INSURANCE

36-3869459 OTHER EXPENSES (B) PROGRAM SERVICES (C) MANAGEMENT AND GENERAL 69. 11. 5,059. 1,850. 3,035. 8. 2,025. 3,050.
10,639 10,032 2,025. STATEMENT

(D) FUNDRAISING

TOTAL 69. 11. 12,648. 1,850. 3,035. 8. 2,025. 3,050.
LN 4 3 22,696.

7,589.

)FFICE EXPENSE )THER TAXES
IAFFLE PRIZES & VWARDS iRT WORK AND SUPPLIES ?OTAL TO FM 9 9 0 ,

'ORM 990

STATEMENT OF ORGANIZATION'S PRIMARY EXEMPT PURPOSE PART I I I

STATEMENT

IXPLANATION 'O PROMOTE EDUCATION AND CONTINUING EDUCATION IN CPR AND FIRST AID IATIONALLY.

fiinnfln";

KAVP.SO

070

16 SAVE A LIFE FOUNDATION,

STATEMENT(S) 2 , 3 INC. SAVE50_1

SAVE A LIFE FOUNDATION, INC. ORM 990 STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS

36-3869459 STATEMENT 4

ESCRIPTION OF PROGRAM SERVICE ONE 0 PROMOTE EDUCATION & CONTINUING EDUCATION IN CPR & FIRST ID NATIONALLY. TO PROMOTE, CONSISTENCY, UNIFORMITY & AFETY IN THE APPLICATION OF FIRST AID & CPR. TO ASSURE HAT THE BEST PROCEDURES AND HIGHEST QUALITY MATERIALS ARE SED AND ARE ACCESSIBLE. TO PROMOTE GOOD SAMARITAN LAWS.

GRANTS 0 FORM 990, PART III, LINE A

EXPENSES 33,938.

DRM 990

DEPRECIATION OF ASSETS NOT HELD FOR INVESTMENT COST OR ACCUMULATED
DEPRECIATION 1,378. 1,537. 6,925. 288. 1,600. 300. 100. 240. 12,368.

STATEMENT

5

2SCRIPTION W3ANIZATION COSTS ?FICE EQUIPMENT iTICE EQUIPMENT •TICE EQUIPMENT )PIER )MPUTER IINTER )MPUTER )TAL TO FORM 9 9 0 , PART I V , LN 57

OTHER BASIS 2,120. 2,236. 12,307. 743. 8,000. 1,500. 500. 1,200. 28,606.

BOOK VALUE 742. 699. 5,382. 455. 6,400. 1,200. 400. 960. 16,238.

17
"»'"":n A-7CI C7\T7E> A T Tup ETtMKinBTTflM

STATEMENT(S) 4, 5
TVJC fi&VFSn 1

Depreciation and Amortization Detail pQRM 990 PAGE 2
Description of property Number Date placed in service Method/ IRC sec. or rate

990

Life

Line No.

Cost or other basis

reduction

Basis

Accumulated depreciation/amortization

Current year deduction 424. 279.

: ORGANIZATION COSTS 2,120. 1 S 12,31,93 60M 4 1 i D F F I C E EOUIPMENT 2,236. :lljl2,31,93 2 0 0 D B 7 . 0 0 1 7 O F F I C E EQUIPMENT 12,307. 06.30.94200DBI7.00 17 A 3 F F I C E EQUIPMENT 743. 06,30,95 2 0 0 D B I 7 . 0 0 1 7 c COPIER 8,000. 01|15|96200DB5.00 15B 6 COMPUTER | 1,500. |02|15|96200DB5.00 15B 7 PRINTER 500. ^|02,15,96200DB5.00 15B t COMPUTER 1,200. p4,15|96200DB5.00 15B * * TOTAL 9 9 0 PAGE 2 DEPRECIATION & AMORTIZATION 28,606. 1 1 1 ' , ■:.11 ,
i

954.
1,25B. 4,773.

2,152. 182. 1,600.
3 0 0 .

106.

100. 240. 7,091. 5,277.

, ,
i

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KAVRSO

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# - Current year section 179

^nnRnR

070

18 SAVE A LIFE FOUNDATION, INC.

(0) ■ Asset disposed

SAVE50 1

fotm

4562

Depreciation and Amortization
(Including Information on Listed Property) 990
► Attach this form to your return.
Business or activity lo which this form relates

OMB No 1545-017?

Department ol he Treasury Internal Revenue Sen/tec Nameis) shown on return

Attachment Sequence No. 6 7 Identifying number

1996

SAVE A LIFE FOUNDATION, INC.

FORM 9 9 0 PAGE 2

36-3869459

Election To Expense Certain Tangible Property (Section 179) (Note: If you have any listed property .'completePart V belore you complete Part I. 1 Maximum dollar limitation. If an enterprise zone business, see instructions 17,500 2 Totalcostof section 179 property placed in service 3 Threshold cost of section 179 property before reduction in limitation 4 Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter-05 Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, enter -0-. If married filing separately, see instructions
la) Description of properly

$200,000

(e) Cost (Dullness only)

(e| Elected cost

10 11 Business income limitation. Enter the smaller of business income (not less than zero) or line S 11 12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 12 13 Carryover of disallowed deduction to 1997. Add lines 9 and 10, less line 12 M 13 Note: Do not use Part II or Part III below for listed property (automobiles, certain other vehicles, cellular telephones, certain computers, or property used for entertainment, recreation, or amusement). Instead, use Part V for listed property. U f c m J MACRS Depreciation For Assets Placed In Service ONLY During Your 1996 Tax Year |Do Not Include Listed Property.) ~ Section A - General Asset Account Election 14 If you are making the election under section 168(f)(4) to group any assets placed in service during the tax year into one or more general asset accounts, check this box. See Instructions ► L J Section B - General Depreciation System (GPS) (See instructions.)
(a) Classification of property (b) Month and year placed In service (c) Basis for depredation (business/investment use only - see instructions) (6) Recovery penod (e) Convention (0 Method (g) Depreciation deduction

7 8 9 10

Listed property. Enter amount from line 27 Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7 Tentative deduction. Enter the smaller of line 5 or line 8 Carryover of disallowed deduction from 1995

15 a b c d e

3-year property 5-year property 7-year property 10-year property 15-year property

11,200.

5 YRS.

HY

200DB

2,240.

f 20-year property g 25-year property h Residential rental property 25 yrs. MM MM MM MM Section C • Alternative Depreciation System (ADS) (See instructions.)

/ / / /

27.5 yrs. 27.5 yrs.

S/L S/L S/L S/L S/L S/L S/L S/L 17 18

16 a Class life b 12-year 12 yrs. c 40-year / 40 yrs. Other Depreciation (Do Not Include Listed Property) 17 GDS and ADS deductions for assets placed In service in tax years beginning before 1996 18 Property subject to section 168(0(1) election 19 ACRS and other depreciation ■■rsliem Summary 20 Listed property. Enter amount from line 26 21 Total. Add deductions on line 12, lines 15 and 16 in column (g), and lines 17 through 20. Enter here and on the appropriate lines of your return. Partnerships and S corporations - see instructions 22 For assets shown above and placed in service during the current year, enter the portion of the basis attributable to section 263A costs . . . . 22 I LHA For Paperwork Reduction Act Notice, see page 1 of the separate instructions.

MM

2,613

19
20 21

4,853.

Form 4562 (1996)


'noon* RBVPSn 070 RAVK

19
A T.TFE FOUNDATION.

INC

SAVES0

1

Form 4562 (1996) Listed Property • Automobiles, Certain Other Vehicles, Cellular Telephones, Certain Computers, and Property Used for Entertainment, Recreation, or Amusement Note: For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete only 23a. 23b. columns (a) through (c) of Section A, all of Section B. and Section C if applicable. Section A - Depreciation and Other Information (Caution: See instructions for limitations for automobiles.) I Yes P H No 23a Do you have evidence to support the business/investment use claimed? I "1 Yes I I No 23blf 'Yes.' is the evidence written? I (i) <e) (h) (c) (0 (9) (d) (a) (b) Date Basil (or depreciation Recovery Elected Business/ Depreciation Method/ placed in Cost or Type of property (buitness/mveslmcnt section 179 investment deduction period Convention service other basis (list vehicles first) use only) cost use percentage 24 Property used more than 50% in a qualified business use % JL % % 25 Property used 50% or less in a aualified business use:

% % % %
26 Add amounts in column (h). Enter the total here and on line 20. page 1 27 Add amounts in column (i). Enter the total here and on line 7, page 1 Section B • Information on Use of Vehicles

S/LS/LS/LS/L26 27

^SM:0-:M^^M&ti&M ^iilmM'mi}
&£££&■ ^ : ->.

M^SmM^

Complete this section for vehicles used by a sole proprietor, partner, or other 'more than 5% owner.* or related person. If you provided vehicles to your employees, first answer the questions in Section C to see if you meet an exception to completing this section for those vehicles. (a) Vehicle (b) Vehicle (c) Vehicle (d) Vehicle (e) Vehicle (f) Vehicle

28 Total business/investment miles driven during the year (00 NOT include commuting miles) 29 Total commuting miles driven during the year 30 Total other personal (noncommuting) miles 31 Total miles driven during the year. Add lines 28 through 30

Yes 32 Was the vehicle available for personal use during off-duty hours? 33 Was the vehicle used primarily by a more than 5% owner or related person? 34 Is another vehicle available for personal

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Section C • Questions for Employers Who Provide Vehicles for Use by Their Employees Answer these questions to determine if you meet an exception to completing Section B for vehicles used by employees who are not more than 5% owners or related persons. No Yes 35 Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, by your employees? 36 Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your employees? See instructions for vehicles used by corporate officers, directors, or 1 % or more owners 37 Do you treat all use of vehicles by employees as personal use? 38 Do you provide more than five vehicles to your employees, obtain information from your employees about the use of the vehicles, and retain the Information received? 39 Do you meet the requirements concerning qualified automobile demonstration use? Note: If your answer to 35.36.37.38. or 39 Is 'Yes.' you need not complete Section B for the covered vehicles. Amortization (e) (b) (c) (d) (a)
Description ol costs Oifctmoruiecn beomj Amort n« bio amount Codo section

(f)
Amortization for this year

Arwttltion peitcd Of pcrcenBgt

40 Amortization of costs that begins during your 1996 tax year:

41 Amortization of costs that began before 1996 42 Total. Enter here and on "Other Deductions' or "Other Expenses" line of your return a 1-96

41 42

424. 424.
SAVE50 1

20
CMrrcn

mn

KBVF

n I.TFR

FntJNDATTON.

INC.

Fotm AG990-IL
Revised 3/9S

CHARITABLE ORGANIZATION SUPPLEMENT Attorney General JIM RYAN State of Illinois
M0 0AY No YR M0

CO* 0 1 - 0 2 6 , 4 9 8
DAY YR 9459 DAY YR

Charitable Trust and Solicitations Bureau, 100 West Randolph Street, 11th Floor, Chicago, Illinois 60601-3175

REPORT FOR THE FISCAL PERIOD BEGINNING:
ARE CONTRIBUTIONS TO ORGANIZATIONS TAX DEDUCTIBLE? LEGAL

01/01/97

AND ENDING:

12/31/97

Q D Yes □

FEDERAL ID NUMBER: # 3 6 ^ 3 8 6 DATE ORGANIZATION WAS CREATED: A) $ MO

NAME SAVE A LIFE FOUNDATION,
MAIL

INC.

ADDRESS 4 8 2 5 N . SCOTT STREET, NO. 74A A) ASSETS CITY,STATE SCHILLER PARK, IL m,,; B) $ I LIABILITIES ZIPCOOE 60176 RECEIVI-rY 1 , C) $ ' - v ^ t - i V COVWDING FUND J AA C 3CP 1 8 1998 B L N E I. SUMARY OF REVENUE ITEMS DURING THE YEAR: PERCENTAGE
D) PUBLIC SUPPORT. CONTRIBUTIONS PROGRAM SERV. REV. ( G R O S S ^ M T & R N E Y E) GOVERNMENT GRANTS & MEMBERSHIP DUES F) OTHER REVENUES G) TOTAL REVENUE, INCOME AND CONTRIBUTIONS RECEIVED (ADD D. E, & F) GENERAL

02/09/93 31,060. 60,070. <29,010.;
AMOUNT

CHARITABLE TRUST

99.460% 0.540%

D)$
E) $ F) $

101,330 550.

100 %

G)$

101,880. 64,992.

II-

SUMMARY OF EXPENDITURES DURING THE YEAR:
H) OPERATING CHARITABLE PROGRAM EXPENSE I) EDUCATION PROGRAM SERVICE EXPENSE J) GRANTS TO OTHER CHARITABLE ORGANIZATIONS K) TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD H. I & J) L) MANAGEMENT AND GENERAL EXPENSE M) FUNORAISING EXPENSE N) TOTAL EXPENDITURES THIS PERIOD (ADD K, L, & M)

68.107%

HLL
i) $ J) $

68.107.; %
24.332% 7.561%

K)$ US
M)$

64,992 23,219 7,215. 95, 426.

100% Iws

III. SUMMARY OF PAID FUNDRAISER ACTIVITIES DURING THE YEAR:
(Attach Attorney General Report ot Individual Fundraising Campaign) 0) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISER P) TOTAL FUNDRAISER FEES ANO EXPENSES Q) NET RECEIVEO BY THE CHARITY (0 MINUS P=Q) 100 %

0)S P)S

QLL
IRIS
S) $

IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS DURING THE YEAR:
R) NAME. TITLE: N O N E S) NAME. TITLE. T) NAME. TITLE:

ILL
CODE U) f V) t

CHARITABLE PROGRAM DESCRIPTION:
CHARITABLE PROGRAM (3 HIGHEST PAID BY $ EXPENDED) CODE CATEGORIES (List on back side of instructions) U) DESCRIPTION: V) DESCRIPTION: W) DESCRIPTION:

W)#

IF THE ANSWER TO ANY OF THE FOLLOWING IS YES, ATTACH A DETAILED EXPLANATION:
1. 2. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION. FINE. PENALTY OR JUDGMENT' HAS THE ORGANIZATION OR A CURRENT DIRECTOR. TRUSTEE. OFFICER OR EMPLOYEE THEREOF. EVER BEEN CONVICTED BY ANY COURT OF ANY MISDEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY? DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS OR DIRECTORS OWNS AN INTEREST OR WAS A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS DIRECTORS. TRUSTEES. OR OFFICERS HAS A MATERIAL FINANCIAL INTEREST OR DID ANY OFFICER OR DIRECTOR RECEIVE ANYTHING OF VALUE NOT REPORTEO AS COMPENSATION? HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER. DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES? IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? DID THE ORGANIZATION ALLOCATE THE COST OF ANY MAILING, ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNORAISING EXPENSES? DID THE ORGANIZATION LEND FROM RESTRICTED FUNDS TO ITS UNRESTRICTED FUNDS FOR PURPOSES OTHER THAN THEIR RESTRICTED PURPOSES? HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION SUSPENDED OR REVOKED? DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER?

YES

NO X

3.

4.

5.

5.

6.

7.

7. 8. 9.

X X X

8. 9.

10. DO YOU HAVE ANY KNOWLEDGE OF ANY THEFT. DEFALCATION. MISAPPROPRIATION. COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS? 11. LIST THE NAME AND ADDRESS OF THE BANKS. AND THE ACCOUNT #, WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST AMOUNTS:

10.1

GRAND NATIONAL BANK, GURNEE, IL

12. N M AND TELEPHONE NUMBER OF C N A T PERSON: CAROL S P I Z Z I R R I A E OTC

847-928-9683

.
UNDER PENALTY OF PERJURY, I (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS SUPPLEMENT AND THE ACCOMPANYING REPORT. INCLUDING ALL THE SCHEDULES AND STATEMENTS AND THE FACTS THEREIN STATED ARE TRUE AND COMPLETE AND FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE STATE OF ILLINOIS RELY THEREUPON. I HEREBY FURTHER AUTHORIZE AND AGREE TO SUBMIT MYSELF AND THE REGISTRANT HEREBY TO THE JURISDICTION OF THF RTATF ne .«.<:

'Hr
SUBSCRIBED AND SWORN TO BEFORE ME. THIS

\

-

,-.....
.19 TREASURER or TRUSTEE (PRINT NAME)

SIGNATURE

uli.

2\1-"X
DATE

DAY OF

SIGNATURE

DATE

•"•(NOTARIZATION REQUIRED UNDER TRUST ACT ONLY)" (NOTARY PUBLIC)

STEPHEN J .

COL]
._^,„..^ DATE

SIGNATURE OF PREPARER (PWN

97

230902

758985

SAVE50

050

SAVE A LIFE FOUNDATION, INC.

SAVE50 1

Form

990
admosi

Return of Organization Exempt From Income Tax
Under section 501 (c) of the Internal Revenue Code (except black lung benefit trust or private foundation) or section 4947(a)(1) nonexempt charitable trust Note: The organization may have to use a copy of this return to satisfy state reporting requirements 1997, and ending

OMBNo. 1S45-0M7

Department ol Iht Treasury Internal Revenue Service

1997
This Form is Open to Public Inspection

A For the 1997 calendar year. OR tax year period beginning
p Check if Please use IRS label ar print or Initial type return See □Final Specific return □ A"I Amended Instruc­ Jretum tions. uirednso lot State reportna)

19
0 Employer identification number

C Name of organization [SAVE A L I F E F O U N D A T I O N , INC.

36-3869459
Room/suite E State registration number

Number and street (or P.O. box if mail is not delivered to street address)

4825 N . SCOTT STREET
City, town, or post office, state, and ZIP+4 SCHILLER PARK, I L 60176
l_XJ Exempt under 501(c) ( 3 H (insert number) OR ► !

74A

01-026,498
F Check ► C D if exemption application is pending

G Type of organization

1 section 4947(a)(1) nonexempt chartitable trust

Note: Section 501(c)(3) e x e m p t organizations a n d 4947(a)(1) nonexempt charitable trusts M U S T a t t a c h a c o m p l e t e d S c h e d u l e A (Form 990) H(a) Is this a group return filed for affiliates? (b) If "Yes.* enter the number of affiliates for which this returnisWed: ► C Z l Yes I X I No If either box in H is checked "Yes,* enter four-digit group exemption number (GEN) Accounting method: ► I I Accrual I X I Cash ►

(C) Is this o separate, return filed by an organisation covered by a group ruling?

Yes [ g No

Other (specify)

K Check here ► CZD 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 990 Package in the mail, it should file a return without financial data. Some states require a complete return. Note: Form 990-EZ may be used by organizations with gross receipts less than $100.000 and total assets less than $250.000 al end of year

Revenue, Expenses, and Changes in Net Assets or Fund Balances
Contributions, gifts, grants, and similar amounts received: a b Direct public support Indirect public support la lb 1c 1 )

101,330. STMT 2
id

c Government contributions (grants)

d 2 3 4 5
6 a b c 7 8 a

Total (add lines 1a through 1c) (attach schedule of contributors) S T M T (cash$ 2 7 , 835 . noncash$

7 3 , 495 .

101,330 550.

Program service revenue including government fees and contracts (from Part VII, line 93) Membership dues and assessments Interest on savings and temporary cash investments Oividends and interest from securities Gross rents Less: rental expenses Net rental income or (loss) (subtract line 6b from line 6a) Other investment income (describe ► Gross amount from sale of assets other than inventory b Less: cost or other basis and sales expenses c Gain or (loss) (attach schedule) (A) Securities (B) Otter

6a 6b 6c

8a 8b 8c

d Net gain or (loss) (combine line 8c, columns (A) and (B)) Special events and activities (attach schedule): Gross revenue (not including $ reported on line 1a) b Less: direct expenses other than fundraising expenses c Net income or (loss) from special events (subtract line 9b from line 9a) 10 a Gross sales of inventory, less returns and allowances of contributions

Bd

9a 9b 9c
10a

b Less: cost of goods sold c 11 ■12 13 14

10b

3,339. 3,339.
STMT 3

Gross profit or (loss) from sales of inventory (attach schedule) (subtract line 10b from line 10a) Other revenue (from Part VII. line 103) Total revenue (add lines 1 d , 2 . 3 . 4 . 5 . 6 c . 7 . 8 d . 9 c , 10c, and 11) Program services (from line 44. column |B)) Management and general (from line 44, column (C)) Fundraising (from line 44, column (D)) Payments to affiliates (attach schedule) Total expenses (add lines 16 and 44. column (A)) . Excess o r (deficit) for the year (subtract line 17 from line 12) Net assets or fund balances at beginning of year (from line 73. column (A)) Other changes in net assets or fund balances (attach explanation) Net assets or fund balances at end of year (combine lines 18.19. and 20)
2

10c

1
15 16 17 19 20 21 LHA
723001

11 12 13

14
15 16

101,880. 64,992 23,219 7,215 95,426 6,454. <35,464.> <29,010.>
Form 990 (1997)

17
18 19 20
.

18

2

21

For Paperwork Reduction Act Notice, see page 1 ol the separate instructions.

230 902

75 8985

SAVE50

050

SAVE A LIFE FOUNDATION, INC.

SAVE50 1

furm 990(199?)

SAVE A LIFE FOUNDATION. INC

| j w | | | Statement of UMiiMMlM F u n c t i o n a l E x p e n s e s Do not include amounts reported on line 6b. 8b, 9b, 10b, or 16 of Parti. 22 Grants and allocations (attach schedule)
cash S noncash S

36-3869459 Paoe2 AH organizations must complete column (A). Columns (B), (C). and (0) are required for section 501(c)(3) and (4) organizations and section 4947(a)[1) nonexempt charitable trusts but optional for others. (B) Program (C) Management (A) Total (0) Fundraising services and qeneral 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43a 43b 43e 13d !3e

23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43

Specific assistance to individuals (attach schedule) Benefits paid to or for members (attach schedule) Compensation of officers, directors, etc. Other salaries and wages Pension plan contributions Other employee benefits Payroll taxes Professional (und/aising fees Accounting fees Legalfees Supplies Telephone . Postage and shipping Occupancy Equipment rental and maintenance Printing and publications Travel . Conferences, conventions, and meetings Interest Depreciation, depletion, etc. (attach schedule) Other expenses (itemize):

0.

0.

0.

0.

4,222. 2,034. 1,200. 18,080. 3,893. 2,622. 17,184. 9,308.

2,533. 2,034. 10,848. 3,893. 1,573. 17,184. 8,884.

1,689. 1,200. 7,232. 1,049. 424.

a
b e 0

e SEE STATEMENT 4
44 Total functional expenses (add lines 22 through 43) Organizations completing columns (6}-(DJ. cany these

36,883. 95,426.

18,043. 64,992.

11,625. 23,219.

7,215. 7,215.
___ __ I Yes I X I No ; .

44 1

Reporting of Joint Costs. - Did you report in column (B) (Program services) any joint costs from a combined educational campaign and tundraising solicitation? ► I If "Yes," enter (i) the 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 $

Statement of Program Service Accomplishments What is the organization's primary exempt purpose? ► SEE STATEMENT 5
AH organizations must describe their exempt purpose achievements in a clear and concise manner. State the number of clients served, pubricatrons issued, etc. Discuss achievements that are not measurable. (Section $0l(cX3) and (4) organizations and 4947(aX1) nonexempt choniable trusts must also enter the amount of grants and allocations to others.)

Program Service Expenses
(Required for 501(c)(3) and (4) orgs, and4947(oXn trusts; but optional far others.)

a

SEE STATEMENT 6
(Grants and allocations $

64,992.

(Grants and allocations $

(Grants and allocations $

(Grants and allocations $ (Grants and allocations $ e Other program services (attach schedule) f Total of Program Service Expenses (should equal line 44. column (8). Program services)
723011 12-09-97

64,992
SAVE50 1

30902

758985

SAVE50

050

SAVE A LIFE FOUNDATION, INC,

Form990(1997)

SAVE

A

LIFE

FOUNDATION,

INC.

36 - 3 8 6 9 4 5 9

Panea

| £ f t U ! | Balance Sheets
Note: Where required, attached schedules and amounts within the description column should be lor end-of-year amounts only.

(A)
Beginning of year

(B) End of year

45 46

Cash - non-interest-bearing Savings and temporary cash investments

7,167
47a 47b 48a 48b

45

6,719.

46

47 a Accounts receivable b 48 a b 49 SO a SI a b 52 S3 54 SS a b Less: allowance for doubtful accounts Pledges receivable Less: allowance for doubtful accounts Grants receivable

47c

48c 44 50

Receivables from officers, directors, trustees, and key employees (attach schedule) Other notes and loans receivable Less: allowance for doubtful accounts Inventories for sale or use Prepaid expenses and deferred charges Investments - securities (attach schedule) Investments • land, buildings, and equipment: basis Less: accumulated depreciation (attach schedule) 51 a

*

51b

51C

5? 53 54 55a 55b
1

56 57 a b 58

Investments - other Land, buildings, and equipment: basis Less: accumulated depreciation Other assets (describe ► STMT 7 [ 57b

57a I 1

46,016. 21,675. »

55c 56

16,239. 23,406.

57c 58 59 6ft 61 6?

24,341. 31,060.

59 60 61

Total assets (add lines 45 through 58) (must equal line 74) Accounts payable and accrued expenses Grants payable Deferred revenue Loans from officers, directors, trustees, and key employees

s
IS

62 63

58,870.
j

3

a

63 64a
641)

60,070.

64 a Tax-exempt bond liabilities b Mortgages and other notes payable 65 Other liabilities (describe ►

65

66

Total liabilities (add lines 60 throuoh 65) 69 and lines 73 and 74

. . L X J and complete lines 67 through

58,870.

66

60,070. <29,010.>

Organizations that follow SFAS117, check here ►

8
c § o
■o

67 68 >9

Unrestricted Temporarily restricted Permanently restricted I I and complete lines

< 3 5 , 4 6 4 . : "67
66 69

§ u.
0 o

Organizations that do not follow SFAS 117, check here ► 70 through 74 '0 Capital stock, trust principal, or current funds

s ■M 4 ■'2 r z '3
74

Paid-in or capital surplus, or land, building, and equipment fund Retained earnings, endowment, accumulated income, or other fu nds Total net asset* or fund balances (add lines 67 through 69 OR lines 70 through 72; column (A) must equal line 19 and column (B) must equal line 21) Total liabilities and net assets / fund balances (add lin » 6 6 a nd73)

70 71 72

< 3 5 , 4 6 4 . > 73 2 3 , 4 0 6 . 74

<29,010.> 31,060.

Form 990 is available for public inspection and. for some people, serves as the primary or sole source of information about a particular organization How the public perceives an organization in such cases may be determined by the information presented on its return. Therefore, please make sure the return is complete and accurate and fully describes, in Part III. the organization's programs and accomplishments.

723021 12-06-97

30902

758985

SAVE50

050

SAVE A LIFE FOUNDATION, INC.

SAVE50 1

Form 990(1997)

SAVE A LIFE FOUNDATION, INC.
Reconciliation of Revenue per Audited Financial Statements with Revenue per Return "N7A~ Part IV-B
a

Part IV-A
a b

36-3869459
Reconciliation of Expenses per Audited Financial Statements With Expenses per Return

Total revenue, gains, and other support per audited financial statements

Amounts included on line a but not on line 12. Form 990: (1) Net unrealized gains on investments $_ (2) Donated services and use of facilities (3) Recoveries of prior yeargrants (4) Other (specify): Add amounts on lines (1) through (4) Line a minusline b Amounts included on line 12, Form 990 but not on line a:

Total expenses and losses per audited financial statements b Amounts included on line a but not on line 17. Form 990: (1) Donated services and use of facilities $ (2) Prior year adjustments reported on line 20. Form 990 $ (3) Losses reported on line 20. Form 990 ...$ (4) Other (specify):

NTA

$

c d

► ►

Add amounts on lines (1) through (4) Line a minus line b Amounts included on line 17. Form 990 but not on line a: (1) Investment expenses not included on

(1) Investment expenses not included on line 6b. Form 990 (2) Other (specify): $ Add amounts on lines (1) and (2) e Total revenue per line 12. Form 990 (line c plus line d) I I $

line 6b. Form 990 (2) Other (specify):

$

Add amounts on lines (1) and (2) .... Total expenses per line 17. Form 990 (line e plus line d) (B) Title and average hours per week devoted to position C) Compensation If not paid, enter
(D)ContnDuticns to

■iEWWl

List of Officers, Directors, Trustees, and Key Employees (List each one even if not compensated.)
(A) Name and address
emsioyee benef
pran* 1 aafefln compensation

(E) Expense account and other allowances

CAROL SPIZZIRRI 4825 N. SCOTT ST, SCHILLER PARK, IL STEPHEN J. COLE 17377 W. DARTMOOR PR, GRAYSLAKE, IL SANDY ENGBER 17593 W. DARTMOOR PR, GRAYSLAKE, IL

PRESIDENT 100 TREASURER SECRETARY
0. 0. 0. 0.

0.

0.

LEE JUNGKANS VICE PRES. 8320 W. BLUE MOUND AVE, WAUWATOSA, WI
0.

75 Did any officer, director, trustee, or key employee receive aggregate compensation of more than $100,000 from your oroanization and all related organizations, of which more than $10.000 was provided by the related organizations? If 'Yes: attach schedule. ► P J Yes D P No

Form990(1997) SAVE A L I F E i j f f l W i l Other Information
76 77

FOUNDATION,

INC

36-3869459

Page5
Yes No

Did the organization engage in any activity not previously reported to the IRS? If 'Yes.' attach a detailed description ot each activity 76 Were any changes made in the organizing or governing documents but not reported to the IRS? 77 If 'Yes." attach a conformed copy of the changes. 78 a Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return? 78a b If "Yes," has it filed a tax return on Form 990-T for this year? N/A 76b 79 Was there a liquidation, dissolution, termination, or substantial contraction during the year? 79 If'Yes ."attach a statement; 66 a Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization? 80a If "Yes."enter the name of the organization ► and check whether it is I I exempt OR I I nonexempt. 81 a Enter the amount of political expenditures, direct or indirect, as described in the instructions for line 81 81 a b Did the organization file Form 1120-POL for this year? 81b 82 a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially less than fair rental value? 82a b If "Yes," you may indicate the value of these items here. Do not include this amount as revenue in Part I or as an expense in Part II. (See instructions for reporting in Part III) | 82b I 6,000 83 a Did the organization comply with the public inspection requirements for returns and exemption applications? 83a b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? 83b 84 a Did the organization solicit any contributions or gifts that were not tax deductible? b If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? N/A 84b 85 501(c)(4), (5), or (6) organizations.-a Were substantially all dues nondeductible by members? N/A 85a Did the organization make only in-house lobbying expenditures of $2,000 or less? N/A 85b If "Yes* was answered to either 85a or 85b. do not complete 85c through 85h below unless the organization received a waiver for proxy tax owed for the prior year. Dues, assessments, and similar amounts from members N/A 65c Section 162(e) lobbying and political expenditures N/A 85d Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices N/A 85e N/A Taxable amount of lobbying and political expenditures (line 85d less 85e) 851 Does the organization elect to pay the section 6033(e) tax on the amount in 85f? N/A 85JL If section 6033(e)(1)(A) dues notice were sent, does the organization agree to add the amount in 85f to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year? N/A 851) 501(c)(7) organizations. - Enter: N/A Initiation fees and capital contributions included on line 12 86a Gross receipts, included on line 12. for public use of club facilities N/A 86b 87 501(c)(12) organizations. - Enter: a Gross income from members or shareholders N/A 87a Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) N/A 87b 88 At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or partnership? If "Yes." complete Part IX 86 89 a 501(c)(3) organizations. • Enter: Amount of tax imposed during the year under: section 4911 ► 0 _ ^ ; section 4912 ► 0 « ; section 4955 ► 501(c)(3) and 501(c)(4) organizations. - Did the organization engage in any section 4958 excess benefit transaction during the yea r? If "Yes." attach a statement explaining each transaction 89b Enter: Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912.4955. and 4958 ► Enter: Amount of tax in 89c. above, reimbursed by the organization ► ILLINOIS go i List the states with which a copy ot this return is filed ► b Number of employees employed in the pay period that includes March 12,1997 | 9Qp |

0.

81

The books are in care of ►CAROL

SPIZZIRRI

Telephone no. ► 8 4 7 - 9 2 8 - 9 6 8 3 IL Z I P + 4
92

Locatedat^ 4 8 2 5 N . SCOTT STREET, STE 7 4 A , SCHILLER PARK,
92 Section 4947(a)(l) nonexempt charitable trusts filing Form 990 in lieu of Form 1041.- Check here and enter the amount of tax-exempt interest received or accrued during the tax year

►60176

► □
N/A SAVE50 1

723041

2309 9 02

758985

SAVE50

050

SAVE A LIFE FOUNDATION, INC

Form 990 (1997)

SAVE A LIFE FOUNDATION, INC.
Unrelated business income Business code (B) Amount (C)
Exclu­ sion code

■asflimi Analysisof Income-Producing Activities
Enter gross amounts unless otherwise indicated. 93 Program service revenue: (a) (b) (c) ID) Amount

36-3869459
Excluded by section 5:2, 513, or 514

Pages

(E) Related or exempt function income

(d) (e)
(f) Medicare/Medicaid payments (g) Fees and contracts from government agencies 94 Membership dues and assessments 95 Interest on savings and temporary cash investments 96 Dividends and interest from securities 97 Net rental income or (loss) from real estate: (a) debt-financed property (b) not debt-financed property 98 Net rental income or (loss) from personal property 99 Other investment income 100 Gain or (loss) from sales of assets other than inventory 101 Net income or (loss) from special events 102 Gross profit or (loss) from sales ol inventory 103 Other revenue: a b _____ c

550.

d e
104 Subtotal (add columns (B).(D). and (E)) 105 TOTAL (add line 104. columns (B).(O). and (E)) ... Note: (Line 105 plus line id. Part I. should equal the amount on line 12. Part I.)

L

1

_ _

0.

550. 550.

■sfcTiMiia Relationship of Activities to the Accomplishment of Exempt Purposes
Line No. T
Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment of the organization's exempt purposes (other than by providing funds for such purposes).

94

MEMBERSHIP DUES - CORPORATE AND INDIVIDUALS

"

■ifsnawj

Information Regarding Taxable Subsidiaries (Complete this Part II the "Yes" box on 88 Is checked.)
Nature of business activities Total income End-of-year assets

Name, address, and employer identification Percentage of number of corporation or partnership ownership interest

N7A

% %

Please Sign Here Paid Preparer's Ute Only
723161 1J05-97

k
V Signature of officer Preparer's _ t signature V

I
Date

_>
V Type or print name and title Check if Date Preparer's SSN sett. , employed ► _ _ J

Firm's name (or yours C O L E , M A R T I N , & C O . , L T D . if self-employed) ^ 7 3 0 1 N . LINCOLN A V E . , 140 and address VLINCOLNWOOD, IL

EIN

230902

758985

SAVE50

050

Z P 4 ► 60646 I+ 8 SAVE A LIFE FOUNDATION, INC. SAVE50 1

SCHEDULEA (Form 990)
Deoattmant cf the Treaau'y Internal Revenue Servtc*

Organization Exempt Under 501(c)(3)
(Except Private Foundation), and Section 501(e), 501(1), 501(h). 501(n) or Section 4947(a)(1) Nonexempt Charitable Trust

OMB No 1545 0047

Supplementary Information
►Must be completed by the above organizations and attached to their Form 990 (or Form 990EZ).

1997
(e)Expense account and other allowances

Name of the organization

Employer identification number

IjfjUU

36 3 8 6 9 4 5 9 Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees

SAVE A LIFE FOUNDATION, INC.

(See instructions.)

(a) Name and address of each employee paid more than $50,000

(List each one. If there are none, enter "None") (b) Title and average hours per week devoted to position

(c) Compensation

(d) Conlrioutions 10 employee benefit plans & tietafred compensation

NONE

Total number of other employees paid over$50.000

■JEHU! Compensation of the Five Highest Paid Independent Contractors for Professional Services
(See instructions.) (List each one (whether individuals or firms.) (If there are none, enter 'None.*!) (b) Type of service (c) Compensation (a) Name and address of each independent contractor paid more than $50,000

NONE

Total number of others receiving over $50.000 for professional services LHA For Paperwork Reduction Act Notice, see page 1 of the Instructions to Form 990 (or Form 990-EZ).
723101 12-05-97

Schedule A (Form 990) 1997

230902

758985

SAVE50

050

SAVE A LIFE FOUNDATION, INC

SAVE50 1

Schedule A (Form 990) 1997

SAVE A L I F E

FOUNDATION,

INC

36-3869459

Page2 Yes No

Statement About Activities
During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? If "Yes." enter the total expenses paid or incurred in connection with the lobbying activifes. ► $ Organizations that made an election under section 501 (h) by filing Form 5768 must complete Part Vl-A. Other organizations checking 'Yes; must complete Part Vl-B AND attach a statement giving a detailed description of the lobbying activities. ! During the year, has the oganization. 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 with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary: a Sale, exchange, or leasing of property? b Lending of money or other extension of credit? c Furnishing of goods, services, or facilities? d Payment of compensation (or payment orreimbursementof expenses if more than $1,000)? e Transfer of any part of its income or assets? If the answer to any question is "Yes.-attach a detailed statement explaining the transactions. 3 « Does the organization make grants for scholarships, fellowships, student loans, etc.? Attach a statement explaining how the organization determines that individuals or organizations receiving grants or loans from it in

2a 2b 2c 2d Ze

L J ^ ^ . t - " 0 8 " ' r t S c h a f i t a b l e Programs Qualify to receive payments. (See instructions.)

■ S E W M ] Reason for Non-Private Foundation Status (See instructions)
The organization is not a private foundation because it is (please check only ONE applicable box): 5 L _ J A church, convention of churches, orassociation of churches. Section 170(b)(1)(A)(i). 6 A school. Section 170(b)(1 )(A)(ii). (Also complete Part V. page 4.) 7 A hospital or a cooperative hospital service organization. Section 170(b)(1)(A)(iii). 6 A Federal, state, or local government or governmental unit. Section 170(b)[1 )(A)(v).

9
10 11a 11b 12

□ □ □ □ □

A medical research organization operated in conjunction with a hospital. Section 170(b)(1)(A)(iii). Enter the hospital's name, city and state ► An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(1 )(A)(iv) (Also complete the Support Schedule in Part IV-A.) An organization that normally receives a substantial part of its support from a governmental unit or from the general public. Section l70(b)(l)(A)(vi). (Also complete the Support Schedule in Part IV-A.) A community trust. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV-A) An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc.. functions • subject to certain exceptions, and (2) no more than 331/3% 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. See section 509(a)(2). (Also complete the Support Schedule in Part IV-A)

13

An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in(1) lines 5 through 12 above: or (2) section 501teW4V IS), or (6). if thev meet the test of section 509HU21. (Sea section 509(aW31) Provide the following information about the supported organizations. (See instructions on page 4.) (a)Name(s) of supported oroanization(s) (b) Line number from above

14

I

|

An organization organized and operated to test for public safety. Section 509(a)(4). (See instructions on page 4.)

723111 12-05-97

30902

758985

SAVE50

050

10 SAVE A LIFE FOUNDATION, INC,

SAVE50 1

Schedule A (Form 990) 1997

SAVE A L I F E FOUNDATION,
Com l ,e onl if v o u

INC.

w-? v. .J P ? . y.. checked a box on line 10.11. or 12 above.) Use cash method of accounting Note: You may use the worksheet in (he instructions tor converting Irom the acc.ual to the cash methodof accounting a c c o u n , i B 3 Calendar year (or liscal year beginning In) (a) 1996 (b) 1995 Jc) 1994 (d) 1993 (e) Total 15 Gifts, (pants, ana conlneutions received
(Do not include unusual grants See imeZB)

Part IV-A

p0

Schedule

36-3869459

Page3

16 17

Membership tees received Gross receipts from admissions. merchandise sold or services performed, or furnishing of facilities in any activity that is not a business unrelated to the organization's charitable, etc.. purpose Gross income from interest, dividends, amounts received from payments on securities loans (sec­ tion 512(a)(5)). rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organization after June 30.1975 Net income from un related business activities not included in line 18
T

37,566. 1,527.

110,761. 1,410.

93,405.

7,199.

2,875.

248,931. 5,812.

18

19
20

a * revenues levied lor tne organization's Benefit end either paid to it or expended on its behalf ..

21

The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge
Otner income Attach a schedule Oo not include gain or (loss) from safe of capital assets

22

23 24 25 26

Total of lines 15 through 22 Line 23 minus line 17 Enter 1% of line 23 Organizations described in lines 10 or 11:

39,093. 39,093. 391.

112,171. 112,171. 1,122.

96,280. 96,280. 963.

7,199 7,199. 72

254,743 254,743, "NTA" N/A N/A

" ► 26a b Attach a list (which is not open to public inspection) showing the name of and amount contributed by each person (other than a governmental unit or publicly supported organization) whose total gifts for 1993 through 1996 exceeded the amount shown in line 26a. Enter the sum of all these excess amounts i > 26b 26c 19 .

a Enter 2% ol amount in column (e). line 24

e Total support for section 509(a)(1) test: Enter line 24. column (e) d Add: Amounts from column (e) for lines: 16

22 26b N/A ► 26d e Public support (line 26c minus line 26d total) "N7A~ > 26e > Public support percentage (line 26a (numerator) divided by line 26c (denominator)) ► 261 N/A 27 Organizations described on line 12: a For amounts included in lines 15.16. and 17 that were received from a 'disqualified person.' attach a list to show the name ol. and total amounts received in each year from each -disqualified person.' Enter the sum of such amounts for each year <1996> P - (1995) 0 . (,g 9 4, 0 . (1993) 0. For any amount included in line 17 that was received from a nondisqualified person, attach a list to show the name of. and amount received for each year that was more than thelargerof (1) the amount on line 25 for the year or (2) $5,000. (Include in the list organizations described in lines 5 th rough 11 as well as individuals.) After computing the difference between the amount received and the larger amount decribed in (1) or (2). enter the sum of these differences (the excess amounts) for each year: ( 1996 > Q.«. (1995) ,5 20 '_ 0 . and line 27b total 0. ,,9941 (1994) 0. (,993,

0. 254,743. 0. 254,743.
100%

Add: Amounts from column (e) for lines: 17 Add: Line 27a total

248,931.

16 21

5,812 0. __ ► 27c ► 27d ► 27e 254,743. ►
17A

_

Public support (line 27c, total minus line 27d total)

Total support for section 509(a)(2) test: Enter amount on line 23. column (e) ► | 271 L Public support percentage (line 27e (numerator) divided by line 27f, (denominator)) — H Investment income percentage (line 18 column le) (numerator) divided bv line 27f (denominator
28

ffie^S
^
12-05-97

27h .0000% i/!J.Y?Val G ? n t , s ; F o r a ? o,0ani?K<"> described in line 10,11, or 12. that received any unusual grants during 1993 through 1996 attach alisY (which is not onen m

HONE

30902

758985

SAVE50

050

11 SAVE A LIFE FOUNDATION, INC.

SAVE50 1

Schedule A (Form 990) 1997

SAVE A LIFE FOUNDATION, INC.

36-3869459 N/A

Page4

Private School Questionnaire (To be completed ONLY by schools that checked the box on line 6 in Part IV) 29
30 31
Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, other governing instrument, or in a resolution of its governing body? Ooes the organization include a statement of its racially nondiscriminatory policy toward students in all its brochures, catalogues. and other written communications with the public dealing with student admissions, programs, and scholarships? Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during the period of solicitation for students, or during the registration period if it has no solicitation program, in a way that makes the policy known to all parts of the general community it serves? If "Yes," please describe; if "No.' please explain. (If you need more space, attach a separate statement.)

Yes No
29 30

31

32

Does the organization maintain the following: Records indicating the racial composition of the student body, faculty, and administrative staff? Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student admissions, programs, and scholarships? Copies of all material used by the organization or on its behalf to solicit contributions? If you answered "No" to any of the above, please explain. (If you need more space, attach a separate statement.)

32a

32b
32c 32d

33

Does the organization discriminate by race in any way with respect to: Students' rights or privileges? Admissions policies? Employment of faculty or administrative staff? Scholarships or other financial assistance? Educational policies? Use of facilities? Athletic programs? Other extracurricular activities? If you answered "Yes' to any of the above, please explain. (If you need more space, attach a separate statement.)

33a 33b 33c

33d 33e
33f 33q 33h

34 a Does the organization receive any financial aid or assistance from a governmental agency? b Has the organization's right to such aid ever been revoked or suspended? 35 If you answered 'Yes' to either 34a or b, please explain using an attached statement. Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.0S of Rev. Proc. 75-50, 1975-2 C.B. 587. covering racial nondiscrimination?lfNo.'attach an explanation

34a 34b

35

723131 12-04-97

1230902

758985

SAVE50

050

12 SAVE A LIFE FOUNDATION,

INC.

SAVE50 1

Schedule A (Form 990) 1997

SAVE A L I F E

FOUNDATION, I N C .

36-3869459 N/A

Page5

Part Vl-A Lobbying Expenditures by Electing Public Charities
(To be completed ONLY by an eligible organization that filed Form 5768) Check here ► a Check here ► b If the organization belongs to an affiliated group It you checked *a" above and 'limited control' provisions apply (b) To be completed for ALL electing organizations

Limits on Lobbying Expenditures
(The term 'expenditures' means amounts paid or incurred) 36 Total lobbying expenditures to influence public opinion (grassroots lobbying) 37 Total lobbying expenditures to influence a legislative body (direct lobbying) 38 Total lobbying expenditures (add lines 36 and 37) 39 Other exempt purpose expenditures 40 Total exempt purpose expenditures (add lines 38 and 39) 41 Lobbying nontaxable amount. Enter the amount trom the following table It the amount on line 40 is Not over $500,000 .. . . . . . Over $500,000 out not over $1,000,000 Over $1,000,000 Djl rot over $1.600.000 Over $1.500,000 bul not over $17.000.000 Over $17,000,000 .

(a) Affiliated group totals

N/A
36 37 38 39 40

The lobbying nontaxable amount is •
2 0 H of the amount on line 40 J 100.000 plus 15H oltneexcen over $500,000 S17S.000 plus 10% ol mo excess over $1,000,000 $225,000 plus 5% ol the excess over $1,500,000 $1,000,000 J "\ I >

41

42 Grassroots nontaxable amount (enter 25% of line 41) 43 Subtract line 42 from line 36. Enter -0- if line 42 is more than line 36 44 Subtract line 41 from line 38. Enter -0- if line 41 is more than line 38 Caution: If there is an amount on either line 43 or line 44, you must file Form 4720. \

42 43 44

4-Year Averaging Period Under Section 501 (h) (Some organizations that made a section 501 (h) election do not have to complete all of the five columns below. See the instructions for lines 45 through 50.) Lobbying Expenditures During 4-Year Averaging Period Calendar year (or fiscal year beginning in) 45 Lobbying nontaxable amount 46 Lobbying ceiling amount (150% of line 45(e)) 47 Total lobbying expenditures 48 Grassroots nontaxable amount 49 Grassroots ceiling amount (150% of line 48(e)) 50 Grassroots lobbying expenditures (a) 1997 (b) 1996 (c) 1995

N/A
(6) Total

W
1994

0. 0. 0. 0. 0. 0.

Part VI-B Lobbying Activity by Nonelecting Public Charities
(For reporting only by organizations that did not complete Part Vl-A) During the year, did the organization attempt to influence national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of: a Volunteers b Paid staff or management (include compensation in expenses reported on lines c through h) c Media advertisements d Mailings to members, legislators, orthe public e Publications or published or broadcast statements f Grants to other organizations for lobbying purposes g Direct contact with legislators, their staffs, government officials, or a legislative body h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means i Total lobbying expenditures (add lines c through h) If "Yes" to any of the above, also attach a statement giving a detailed description of the lobbying activities.
723141 12-05-97

N/A
Yes No
Amount

\--im^**£m-.

:"" : : ;

0.

230902

758985

SAVE50

050

13 SAVE A LIFE FOUNDATION, INC

SAVE50 1

Schedule A (form 990) 1997
PjfnWlll

SAVE A L I F E

FOUNDATION,
anri

INC.
Noncharitable

Information Renarrfinn Trancforc T »

T r a n « 3 M i » n . »„,< D . v t ^ t i ^ o t . i p , y ^ p

Exempt Organizations
Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section 501(c) ot the Code (other than section 501(c)(3) organizations) or in section 527. relating to political organizations? a Transfers from the reporting organization to a noncharitable exempt organization ol: Yes No (i) Cash 51a(i) X (ii) Other assets X a('i) b Other transactions: (i) Sales ot assets to a noncharitable exempt organization X b(D (ii) Purchases of assets from a noncharitable exempt organization X b(N) (ill) Rental ol facilities or equipment X b(lil) (iv) Reimbursement arrangements b(iv) X (v) Loans or loan guarantees b(v) X (vl) Performance of services or membership or fundraising solicitations b(vi) X c Sharing of facilities, equipment, mailing lists, other assets, or paid employees X « d It the answer to any of the above is "Yes." complete the following schedule. Column (b) should always indicate the fair market value ot the goods, other assets, or services given by the reporting organization. If the organization received less than fair market value in any transaction or sharing arrangement, show in column (d)the value of the goods, other assets, or services received. N/A (b) (a) (c) Line no Name of noncharitable exempt organization Amount involved Description of transfers, transactions, and sharing arrangements 51

52 a is the organization directly or indirectly affiliated with, or related to. one or more tax-exempt organizations described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527? I> d l Yes b It "Yes." complete the following schedule. N/A (a) Name ot organization (b) Type ot organization (c) Description of relationship

Q Q No

_..
12-05-97

J3O902

758985

SAVE50

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14 SAVE A LIFE FOUNDATION, INC

SAVE50 1

SAVE A LIFE FOUNDATION, INC. 'ORM 990 INCOME AND COST OF GOODS SOLD INCLUDED ON PART I, LINE 10

36-3869459 STATEMENT 3

NCOME . . . . . GROSS RECEIPTS RETURNS AND ALLOWANCES LINE 1 LESS LINE 2 COST OF GOODS SOLD (LINE 15) GROSS PROFIT (LINE 3 LESS LINE 4) 3,339 3,339 3,339

OST OF GOODS SOLD . . 0. 1. 2. 3. INVENTORY AT BEGINNING OF YEAR MERCHANDISE PURCHASED COST OF LABOR MATERIALS AND SUPPLIES OTHER COSTS ADD LINES 8 THROUGH 12 3,339

3,339 3,339

4. INVENTORY AT END OF YEAR 5. COST OF GOODS SOLD (LINE 13 LESS LINE 14). .

230902

758985

SAVE50

050

17 STATEMENT(S) 3 SAVE A LIFE FOUNDATION, INC. SAVE50_1

SAVE A LIFE FOUNDATION, 'ORM 9 9 0

INC.

36-3869459 OTHER EXPENSES STATEMENT (C) MANAGEMENT AND GENERAL 744 7,748, 825, 2,210. 8. 5,645 6,100 320, 90 18,043 11,625 7,215 1,570. (D) FUNDRAISING

(A) ASCRIPTION IANK CHARGES IUES & SUBSCRIPTIONS 'UTSIDE SERVICES NSURANCE TOTAL 0. 744. 19,371. 825. 2,210. 8. 5,645. 6,100. 1,570. 320. 90. LN 4 3 36,883.

(B) PROGRAM SERVICES

11,623

FFICE EXPENSE THER TAXES
AFFLE PRIZES & WARDS RT WORK AND UPPLIES ROMOTION EMINARS ISCELLANEOUS DTAL TO FM 9 9 0 ,

)RM 9 9 0

STATEMENT OF ORGANIZATION'S PRIMARY EXEMPT PURPOSE PART I I I

STATEMENT

CPLANATION > PROMOTE EDUCATION AND CONTINUING EDUCATION IN CPR AND FIRST AID iTIONALLY.

30902

758985

SAVE50

050

18 STATEMENT(S) 4 , 5 SAVE A LIFE FOUNDATION, I N C . SAVE50 1

SAVE A LIFE FOUNDATION, INC. "ORM 990 STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS

36-3869459 STATEMENT

JESCRIPTION OF PROGRAM SERVICE ONE ' PROMOTE EDUCATION & CONTINUING EDUCATION IN CPR & FIRST 0 -ID NATIONALLY. TO PROMOTE, CONSISTENCY, UNIFORMITY & AFETY IN THE APPLICATION OF FIRST AID & CPR. TO ASSURE HAT THE BEST PROCEDURES AND HIGHEST QUALITY MATERIALS ARE SED AND ARE ACCESSIBLE. TO PROMOTE GOOD SAMARITAN LAWS.

GRANTS D FORM 990, PART III, LINE A

EXPENSES 64,992.

DRM 990

DEPRECIATION OF ASSETS NOT HELD FOR INVESTMENT ' OR BASIS 2,120. 2,236. 12,307. 743. 8,000. 1,500. 500. 1,200. 8,000. 2,000. 850. 1,200. 2,698. 275. 1,937. 450. 46,016 ACCUMULATED DEPRECIATION 1,802. 1,737. 8,462. 418. 4,160. 780. 260. 624. 1,600. 400. 121. 240. 540. 55. 387. 90. 21,676.

STATEMENT

7

ASCRIPTION tGANIZATION COSTS 'FICE EQUIPMENT "FICE EQUIPMENT 'FICE EQUIPMENT 'PIER •MPUTER INTER MPUTER PIER MPUTER FICE EQUIPMENT MPUTER MPUTER MPUTER MONITER MPUTER INTER TAL TO FORM 990, PART IV, LN 57

BOOK VALUE 318. 499. 3,845. 325. 3,840. 720. 240. 576. 6,400. 1,600. 729. 960. 2,158. 220. 1,550. 360. 24,340.

30902

758985

SAVE50

050

19 STATEMENT(S) 6, 7 SAVE A LIFE FOUNDATION, INC. SAVE50 1

Depreciation and Amortization Detail p Q R M gQQ
Asset Number

pAGE

2

990

Description of property Date placed in service Method/ IRC sec. Life or rate Line No Cost or other basis Basis reduction Accumulated depreciation/amortization Current year deduction

1 ORGANIZATION COSTS 12,31,93 60M 41 OFFICE EQUIPMENT 12,31|93g00DB|7.00 [17 3OFFICE EQUIPMENT 06,30,94g00DBI7.00 |17 4 OFFICE EQUIPMENT 06,30|95T200DB|7.00 |17 5 COPIER 01il5|96|200DB[5.00 |17 6JCOMPUTER 02|15,96|20ODB|5.06~liT 7 PRINTER !02|15|96r200DB|5.00 |17 8POMPUTER P4,15,96[200DB|5.00]lT
9 COPIER

2,120. 2,236. 12,307.
743. 8,000.

1,378. 1,537 6,925.
288

424 200
1,537

130
2,560 480, 160,

1,600. 300J 100.
240

1,500.
500

1,200. 8,000
2,000.

384
1,600, 400. 121.

01il5,97|200DB|5.00 10 COMPUTER 02|05,97|200DB[5.00 11 OFFICE EQUIPMENT 02,15,97I200DB7.00 12ICOMPUTER ]04,17,97|200DB|5.00 13COMPUTER J05|18|97|200DB|5.00 14|COMPUTER MONITER 06|07,97|200DB15.00 15ICOMPUTER P8|01,97|200DB|5.00 16PRINTER 11|10,97|200DB|5.00 * TOTAL 990 PAGE
J L

I15B |15B |15C |15B |15B U5B| |15B|

850
1,200. 2,698,
275.

240
540.

55.
387.

1,937.

|15"lf 450. 2 DEPRECIATION & AMORTIZATION 46,016.

90.
12,368. 9,308.

J

L

J

L

eei

« • Current year section 179

(D) - Asset disposed

230902

07-97

758985

SAVE50

050

SAVE A LIFE FOUNDATION, INC

SAVE50 1

4562
Department of trie Treasury Internal Revenue Service Namefs) shown on return

Depreciation and Amortization
(Including Information on Listed Property)
► Attach this form to your return.
Business or activity to which this form relates

OMBMo 1545-0172

990

1997
Attachment Sequence No 6 7 Identifying number

SAVE A LIFE FOUNDATION, INC.
1 Maximum dollar limitation. If an enterprise zone business, see instructions 2 Total cost of section 179 property placed in service 3 Threshold cost of section 179 properly before reduction in limitation

FORM 990 PAGE 2

l l S m Election To Expense Certain Tangible Property (Section 179) (Note: If you have any 'listed property .'complete Part V before you complete Part I.)

36-3869459

18,000,
$200,000

4 Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -05 Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, enter -0-. If married filing separately, see instructions
(a) Description of property (C) Cost (Business use onry) (c) Elected cost

7 Listed property. Enter amount from line 27 8 Total elected cost of section 179 properly. Add amounts in column (c), lines 6 and 7 9 10 11 12 13 j Tentative deduction. Enter the smaller of line 5 or line B Carryover of disallowed deduction from 1996 10 Business income limitation. Enter the smaller of business income (not less than zero) or line 5 11 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 12 Carryover of disallowed deduction to 1998. Add lines 9 and 10. less line 12 13 g r ^ ce/Ufe/eprrones, certa/n coders.

orProPe«y

■ J E W ) ! MACRS Depreciation For Assets Placed in Service ONLY During Your 1997 Tax Year (Do Not Include Listed Property.) Section A - General Asset Account Election
14

"JS^^SlSSS^SiSSST ™m

,0

°™*

a

"V a s s e « s » — ' " « * ■ » during the tax year into one or more genera, asset

Section B - General Depreciation System (GPS) (See instructions.)
(a) Classification of property (b) Month and

► □

year placed
in service

(e) Basis for depreciation (Business/investment use only - see instructions)

(d) Recovery period

(e) Convention

(0 Method

(0) Depreciation deduction

15 a 3-year property b 5-year property c 7-year property d 10-year property e 15-year property f 20-year property g 25-year property h Residential rental property Non residential real property 25 yrs. 27.S yrs. 27.5 yrs. S/L S/L S/L S/L S/L S/L S/L S/L 17 18 19

16,560.
850.

5 YRS, 7 YRS.

HY HY

200DB 200DB

3,312. 121.

MM MM MM

MM Section C - Alternative Depreciation System (ADS) (See instructions.) 16 a Class life

b 12-year
c 40-year

12 yrs.
MM

40 yrs. Other Depreciation (Do Not Include Listed Properly.) (See instructions.) 17 GDS and ADS deductions for assets placed in service in tax years beginning before 1997 18 Property subject to section 168(f)(1) election 19 ACRS and other depreciation Summary (See instructions.) 20 Listed property. Enter amount from line 26 21 Total. Add deductions on line 12, lines 15 and 16 in column (g), and lines 17 through 20. Enter here and on the appropriate lines of your return. Partnerships and S corporations • see instructions 22 For assets shown above and placed in service during the current year, enter the I portion of the basis attributable to section 263A costs j 22 LHA For Paperwork Reduction Act Notice, see the separate instructions.

5,451

20 21

8,884.
Form 4562 (1997)

30902

758985

SAVE50

050

21 SAVE A LIFE FOUNDATION, INC

SAVE50

1

Form 4562 (1997) Page 2 |jg||!| |Js te d Property _• Automobiles, Certain Other Vehicles, Cellular telephones, Certain Computers, and Property Used for Entertainment, Recreation, or Amusement Note: For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete only 23a, 23b, columns (a) through (c) of Section A, all of Section B, and Section C if applicableSection A - Depreciation and Other Information (Caution: See instructions for limits for passanger automobiles.) 23a Do you have evidence to support the business/investment use claimed? C D Yes U3 No 23blf 'Yes.' is the evidence written? \_3 Yes E H No (c) (a) (0 (i) (d) (b) Date to (9) (h) Business/ placed in Elected Type of property Basis lor depredation Recovery Cost or Method/ Depreciation investment (business/investment service section 179 (list vehicles first) period other basis Convention deduction use percentage use only) cost __ 24 Property used more than 50% in a qualified business use 96

_%. %
96 25 Property used 5096 or less in a Qualified business use:

%
96 96 96 26 Add amounts in column (h). Enter the total here and on line 20, page 1 27 Add amounts in column (i). Enter the total here and on line 7, page 1

S/LS/LS/LS/L26 27
■ '

-- -:: : •.
-.:-■-:.-: r - -.-:: .
. : ' . . . - . ■ ■ - ■ ■ ' : ' ; ; . . : ' ■ ' :

;:\&iM-K:w:. •":".'

Section B - Information on Use of Vehicles Complete this section for vehicles used by a sole proprietor, partner, or other "more than 596 owner," or related person. If you provided vehicles to your employees, first answer the questions in Section C to see if you meet an exception to completing this section for those vehicles. (a) Vehicle (b) Vehicle (c) Vehicle (d) Vehicle (e) Vehicle

m
Vehicle

28 Total business/investment miles driven during the year (DO NOT include commuting miles) 29 Total commuting miles driven during the year 30 Total other personal (noncommuting) miles driven 31 Total miles driven during the year. Add lines 28 through 30

Yes 32 Was the vehicle available for personal use during off-duty hours? 33 Was the vehicle used primarily by a more than 5% owner or related person? 34 Is another vehicle available for personal use?

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Section C - Questions for Employers Who Provide Vehicles for Use by Their Employees Answer these questions to determine if you meet an exception to completing Section B for vehicles used by employees who are not more than 596 owners or related persons.

Yes
35 Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, by your employees? 36 Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your employees? See instructions for vehicles used by corporate officers, directors, or 196 or more owners 37 Do you treat all use of vehicles by employees as personal use? 38 Do you provide more than five vehicles to your employees, obtain information from your employees about the use of the vehicles, and retain the information received? 39 Do you meet the requirements concerning qualified automobile demonstration use? Note: If your answer to 35.36,37.38, or 39 is 'Yes,' you need not complete Section B for the covered vehicles. Amortization (a)
Description ol costs

No

(b)
DtfctfflOftafion btQins

(c)
Amertizools amount

id)
Code secbon

(e)
Amgrtaton period Of peonage

Amortization tor tni» yew

(0

40 Amortization of costs that begins du ring your 1997 tax year:

41 Amortization of costs that began before 1997 42 Total. Enter here and on 'Other Deductions' or 'Other Expenses* line of your return
1-98

41 42

424. 424.

230902

758985

SAVE50

050

22 SAVE A LIFE FOUNDATION, INC.

SAVE50 1

CO » 0 1 - 0 2 6 4 9 8
Attorney General JIM RYAN State ol Illinois Charitable Trust and Solicitations Bureau, 100 West Randolph Street, 12th Roor, Chicago. Illinois 60601 MO DAY YR REPORT FOR THE FISCAL PERIOD BEGINNING 01/01/98 AND ENDING: ARE CONTRIBUTIONS TO ORGANIZATION TAX DEDUCTIBLE? g Yes [ J No FEDERAL ID NUMBER: LEGAL NAME MAIL DATE ORGANIZATION )N WAS CREATED: A) ASSETS B) LIABILITIES C) ENDING FUND BALANCE A)$ B)$ C)S Form AG990-IL Revised 3/95

y
YR

CHARITABLE ORGANIZATION SUPPLEMENT
MO DAY

I 12/31/98
YR

Save a Life

Foundation Street IL #74A

# 36-3869459 MO DAY

02/09/93 525.550. 87,830. 437.720.
AMOUNT

ADDRESS 4 8 2 5 N . S c o t t
CITY,STATE

Schiller ZIP CODE 6 0 1 7 6

Park,

I.

SUMMARY OF REVENUE ITEMS DURING THE YEAR: D) PUBLIC SUPPORT. CONTRIBUTIONS & PROGRAM SERV. REV. (GROSS AMTS.) E) GOVERNMENT GRANTS & MEMBERSHIP DUES F) OTHER REVENUES G) TOTAL REVENUE, INCOME AND CONTRIBUTIONS RECEIVED (ADD D. E. & F)

PERCENTAGE

3.3984% D) $ 95.7795°/. E) $ 8221% F) S 100 % G)S

21,289 600,000 5,150. 626,439

II. SUMMARY OF EXPENDITURES DURING THE YEAR:

RECEXVfiO
H) OPERATING CHARITABLE PROGRAM EXPENSE

83.1506%

H) s I) s J) $

132,799

APR 2 6 1399
I) EDUCATION PROGRAM SERVICE EXPENSE CHARITABLE i RUST, ATTORNEY. GENERAL J) GRANTS TO OTHER CHARITABLE ORGANIZATIONS

K) TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD H, I, & J) L) MANAGEMENT AND GENERAL EXPENSE M) FUNDRAISING EXPENSE N) TOTAL EXPENDITURES THIS PERIOD (ADD K, L, & M) III. SUMMARY OF PAID FUNDRAISER ACTIVITIES DURING THE YEAR: (Attach Attorney General Report of Individual Fundraislng Campaign) O) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISER P) TOTAL FUNDRAISER FEES AND EXPENSES Q) NET RECEIVED BY THE CHARITY (O MINUS P=Q)

83.1506% 15.6729% 1.17 65%

K) S L) $ M)$

132,799. 25,031 1,879. 159,709

100 % N) $

100 % Q ) $ % P) $

%Q)$

IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS DURING THE YEAR: R) NAME.TITLE: CAROL S P I Z Z I R I PRESIDENT S) NAME, TITLE: STACY FON - SECRETARY T) NAME. TITLE: L I N D A P I W I N S K I PROGRAM SCHED. V. CHARITABLE PROGRAM DESCRIPTION: CHARITABLE PROGRAM (3 HIGHEST BY $ EXPENDED) CODE CATEGORIES (Ust on back side of inst.): CODE U) DESCRIPTION V) DECSRIPTION W) DESCRIPTION IL9901
NTF4935

R) $ S) $

35,000 5,376

COORDINATOR

L I F E SAVING FIRST AID TRAINING

u) * 0 1 1
V) » W)ff

&ycc$/y

-fy

Save a Life Foundation
IL A.G990-IL (Revised 3/95) I F THE ANSWER TO ANY OF THE FOLLOWING IS YES, ATTACH A DETAILED EXPLANATION:

36-3869459
Page 2
YES NO 1.

1. 2.

WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION, FINE. PENALTY OR JUDGEMENT? HAS THE ORGANIZATION OR A CURRENT DIRECTOR. TRUSTEE, OFFICER OR EMPLOYEE THEREOF, EVER BEEN CONVICTED BY ANY COURT OF ANY MISDEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY?

2.

3.

DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS OR DIRECTORS OWNS AN INTEREST OR WAS A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS DIRECTORS. TRUSTEES. OR OFFICERS HAS A MATERIAL FINANCIAL INTEREST OR DID ANY OFFICER OR DIRECTOR RECEIVE ANYTHING OF VALUE NOT REPORTED AS COMPENSATION? 3.

4.

HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER. DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES? IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? DID THE ORGANIZATION ALLOCATE THE COST OF ANY MAILING. ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES? DID THE ORGANIZATION LEND FROM RESTRICTED FUNDS TO ITS UNRESTRICTED FUNDS FOR PURPOSES OTHER THAN THEIR RESTRICTED PURPOSES? HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION SUSPENDED OR REVOKED?

4.

5.

5.

X

6.

6.

7.

7.

8.

8

9. 10. 11.

DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER? DO YOU HAVE ANY KNOWLEDGE OF ANY THEFT, DEFALCATION, MISAPPROPRIATION. COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS? LIST THE NAME AND ADDRESS OF THE BANKS, AND THE ACCOUNT «. WHERE THE ORGANIZATION MAINTAIMC ITS THREE LARGEST AMOUNTS:

g.

X

10

NORTHERN TRUST, 50 LASALLE ST, CHICAGO, IL 60675 GRAND NATIONAL BANK, 4840 GRAND AVE, CHICAGO, IL 60031,
12. NAME AND TELEPHONE NUMBER OF CONTACT PERSON: C A R O L SPIZZIRRI 847 - 928-9683

J
NDER PENALTY OF PERJURY, I (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS SUPPLEMENT AND THE CCOMPANYING REPORT, INCLUDING ALL THE SCHEDULES AND STATEMENTS AND THE FACTS THEREIN STATED ARE TRUE AND COMPLETE AND ILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE STATE OF ILUNOIS RELY THEREUPON. I EREBY FURTHER AUTHORIZE AND AGREE TO SUBMIT MYSELF AND THE REGISTRANT HEREBY TO THE JURISDICTION OF THE STATE OF 1INOIS.

CAROL S P I Z Z I R R I
PRESIDENT or TRUSTEE (PRINT NA»* M UBSCRIBED AND SWORN 0 BEFORE ME. THIS AY OF

\
.19
TREASURER or TRUSTEE (PRINT NAME)

T
SIGNATURE

--VTE

m
TTCl I

DATE

•••(NOTARIZATION (NOTARY PUBLIC)

A h l b e c k & Company
SIGNATURE OF PREPARER (PRINT NAI..U,

99
SIGNATURE DAlt

ILSS02

Form

990

Return of Organization Exempt From Income Tax
Under section 501(c) of the Internal Revenue Code (except black lung benefit trust or private foundation) or section 4947(a)(1) nonexempt charitable trust

OMB No. 1545-0047

1998

This Form Is Open to Public Note: The organization may havetouse a copy of this return to satisfy state reporting requirements Inspection A Fof the 1998 calendar year. OR tax year period beginning . i 8 S g. and endin 19 B Check ft Please C Name of organization, number and street, city. town, state, and ZIP code Chang* of Employer Identification number use IRS addraaa Foundation label or Save a L i f e 36-3869459 print or Initial return type. Telephone number Final return See 4825 N. Scott Street #74A Specific (847)928-9683 Amandad nturn Instate Schiller Park, IL 60176 (required aba for Check ► [J if exemption application tlons. (tat* reporting) is pending Q Type of organization Xj Exempt , under section 501 (c){ 3 ) (insert number) OR ► | J section 4947(a)(1) nonexempt charitable trust .„^.„ . „ , , „ , , . MfllM Note. Section S01(c)(3) exempt organizations and 4947(aKl) nonexempt charitable trusts MUST attach a completed Schedule A (Form 990) H(a) is thfcagroup return frted for abates? [ J ^ftN o I, Mmm^^HwJL^^^^^
Dapartrean t ollha Treasury Internal Ravanvi Sarviea

group exemption no. (GEN>P» J Accounting method: [ ] Cash |Xj Accrual (C) l«thitaitparat»returnfil.d by an organisation cavarad by a group ruling? . . |~ Yes M No r i o u w (specify) ► K Check here ► \J if the organization's gross receipts axe normally not more than $25,000. The organization need not file a return with the IRSbut tf tt received a Form 990 Package in the mail, it should file a return without financial data Some states require a complete return Note; Form 980-EZ may be used by organizations with gross receipts less than $100.000 and total assets less than S2SOC0O at a ^ T T ^ (b) If "Yes,* enter number of affiliates for which return is filed: ►

Revenue, Expenses, and Changes In Net Assets or Fund Balances (See Specific instructions onTaiTJIT a b c d 2 3 4 5 6a b c 7 8a b
Contributions, gifts, grants, and similar amounts received: Direct public support Indirect public support Government contributions (grants) Total (add lines l a through 1c) (attach schedule of contributors)

1a lb 1c

21.289. 600.000.

(ens

621.28 9.

noncaah $

•venue

c

Program service revenue including government fees and contracts (from Part VII. line 93) Membership dues and assessments Interest on savings and temporary cash investments Dividends and interest from securities Gross rents Less: rental expenses Net rental income or (loss) (subtract line 6b from line 6a} Other investment income (describe ► Gross amount from sale of assets other than inventory Less: cost/other basis & sales expenses. Gain or (loss) (attach schedule) g j

d Net gain or (loss) (combine line 8c. columns (A) and (B)) 9 Special events and activities (attach schedule) a Gross revenue (not including $ of

c

b Less: direct expenses other than fundralsing expenses

10a b c Gross profit or (loss) from sales of inventory (attach schedule) (subtract line 10b from line 10a) 11 Other revenue (from Part VII, line 103) 13 14 wises 15 16 17 18 19 i«ts 20 21
Total revenue (add lines i d . 2. 3.4, s. 6c. 7, 8d. 9c. 10c. and 11) Program services (from line 44, column (B)) Management and general (from line 44, column (C)) Fundralsing (from line 44, column (D)) Payments to affiliates (attach schedule) Total expenses (add lines 16 and 44, column (A)) Excess or (deficit) for the year (subtract line 17 from line 12) Net assets or fund balances at beginning of year (from lira 73, column (A)) Other changes in net assets or fund balances (attach explanation) Net assets or fund balances at end of year (combine lines 1B. 19, and 20) For Paperwork Reduction Act Notice, see page 1 of the separate Instructions, CAA

I 9a I I 9b | Net income or (loss) from special events (subtract line 9b from line 9a) Gross sales of inventory, less returns and allowances Less: cost of goods sold

contributions reported on line 1a)

6 134 1 660~. HgS"

12

99012

NTF 10758

GLD 4224

Form 9 9 0 (1998)

ii.n 9 9 0 (1!»98)

Save a Life Foundation
All o , g a n i , . t , . n .
ra„,t

*

Statement of Functional Expenses

36-3869459

Page 2
d

c o m p l . t . colu«.n(A). CotomwCBUCJ. » d | 0 ) » . , . , „ „ . „ , „ , , . c l , „ n S 0 1 < e X 3 > a n d ( 4 J o , , . 0 , M „ 0 „ , „

.action 4 9 4 y U X 1 H . . B . » n . p l charitaDIa t r u . t i but optional lor othori. (S.a Spoc.lic InHroctioni or. paga U . )

Do not include amounts reported on line 6b, 8b, 9b, 10b, or 16 of Part I 2 ) I 5 » ' I I I '. Grants and allocations (attach schedule) . . .
<cach S nencat h $ )

Specific assistance to individuals (attach »chi. Benefits paid to or for members lattachich.) . Compensation of officers, directors, etc . . . . Other salaries and wages Pension plan contributions Other employee benefits Payroll taxes Professional fundraising fees Accounting fees Legal fees Supplies Telephone Postage and shipping Occupancy Equipment rental and maintenance Printing and publications Travel Conferences, conventions, and meetings.. Interest Depreciation, depletion, etc. (attach <ch>dui«j Other expenses (itemize): a Stm t A11

b c d
B Total functional expenses (add tints 22 through £)OrauilzaUons completing columns , carry these totals to lines 13-15

JMLE—

"

ortlng of Joint Costs. - Did you report in column (B) (Program services) any Joint costs from a combined educational p aign and fundraising solicitation? es,'enter (I) the aggregate amount of these joint costs . . . $ he amount allocated u, Management ano genera $ ■M. W W H » « , to w a n a B B m e m and general 3 t is the organization's primary exempt purpose? ► P r o m o t e L i f e ; (II) ami allocated to Prog, services . . S ; and (rv) ami allocated to FundrafeHno S Saving F i r s t ~Aid

.► Q Yes

gN o

Statement of Program Service Accomplishments (SeeSpecific instructions on page 20)
rganizations must describe their exempt purpose achievements in a clear and concise manner. State the number of clients nl.publications issued etc. Discuss achievements that are not measurable. (Section 501(c)(3) and (4) organizations and (a)(l) nonexempt charitable trusts must also enter the amount of grants and allocations to others.) Program Service Expenses
(FUqgiradfor S01(cX3) and (4) org*., and «»4r(aXl) truats; but optional lorothart.)

CL PILOT PROGRAM-Teach Life Saving First Aid t ~ CL School Children ~ "
3000 T a u g h t
(Grants and allocations $

"
132,799

(Grants and allocations $

(Grants and allocations $

(Grantt and allocations $ (Grants and allocations $ otal of Program Service Expenses (should equal line 44. column (B), Program services) " 8 99012 NTF M7SB GLO 4224 ' ther program services (attach schedule)

~~t

132,799.

Form990(1998)

Save a L i f e

Foundation

36-3869459

Page 3

Balance Sheets (See Specific Instructions on page 20.) Note: Where required, attached schedules and amounts within the description column should be for end-ot-year amounts only. 45 46 Cash — non-interest-bearing Savings and temporary cash investments

47a Accounts receivable b Less: allowance for doubtful accounts Pledges receivable Less: allowance for doubtful accounts Grants receivable Receivables from officers, directors, trustees, and key employees (attach schedule) 51a Other notes and loans receivable (attach schedule) 151 a b Less: allowance for doubtful accounts 151b 5 2 Inventories for sale or use 5 3 Prepaid expenses and deferred charges 5 4 Investments — securities (attach schedule) 55a Investments — land, buildings, and equipment basis b Less: accumulated depreciation (attach schedule) 5 6 Investments — other (attach schedule) 57a Land, buildings, and equipment: basis b Less: accumulated depreciation (attach schedule) 5 6 Oth«r ^
•stati (dcscriba ■*'

48a b 49 50

Is sets

Total assets (add lines 45 through SB) (must equal line 74) Accounts payable and accrued expenses Grants payable Deferred revenue Loans from officers, directors, trustees, and key employees (attach schedule) 64a Tax-exempt bond liabilities (attach schedule) b Mortgages and other notes payable (attach schedule)
liabilities (daicriba

59 60 61 62 63

► Stmt Attchd

st ssets Fund ■lances

6 6 Total liabilities (add lines 60 through 65) OrganizaUons that follow SFAS 117, check here through 69 and lines 73 and 74. 6 7 Unrestricted 6 8 Temporarily restricted 6 9 Permanently restricted Organizations that do not follow SFAS 117, check here lines 70 through 74. 70 Capital stock, trust principal, or current funds 71 Paid-in or capital surplus, or land, building, and equipment fund 72 Retained earnings, endowment, accumulated Income, or other funds 73 Total net assets or fund balances (add lines 67 through 69 OR lines 70 through 72; column (A) must equal line 19 and column (B) must equal line 21) 74 Total liabilities and net assets / fund balances (add lines 66 and 73)

o r o a S t o n » Z ' S tb f c je r c e i v 5T n ^ " £ « ' 8 ? m e p 8 0 p ! e - s w v e 8 M * • P"™"* o r 8 0 ' 8 s o u r c « ° ' Information about a particular" S ^ ^ a Z £ L . ^ .K P" .P * organization in such cases may be determined by the information presented onteretumTh«refore c* aVsSt
r

N ^ , ^ . 0 ^ 8 L r ^ l a s C C U r a , 8 " " , " * deSCfiDe8'h ^

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'

Form990(i99B)

Save a L i f e F o u n d a t i o n Reconciliation of Revenue per Audited Financial Statements with Revenue per
R e t u r n (See Specific Instructions, page 22.) a b

36-3869459

Page 4

Reconciliation of Expenses per Audited Financial Statements with Expenses per Return
Total expenses a n d losses per audited financial statements »> Amounts included o n line a but not on line 17, Form 990:

a b

Total revenue, gains, and other support per audited financial statements ► Amounts included o n line a but not o n line 12, Form 990:

(1) Net unrealized gains on investments .. $ (2) Donated services & use of facilities. $ (3) Recoveries of prior year grants $ (4) Other (specify):

42,500.

(1) Donated services & use of facilities.. % (2) Prior year adjust­ ments reported on line 20, Form 990 . $ (3) Losses reported on line 20, Form 990 . $ (4) Other (specify):

42, 500.

Materials $ 30,945. Add amounts on lines (1) through (4) .. ► C Line a minus line b d Amounts included on line 12, Form 990 but not on line a: (1) Investment expenses not included on line 6b, Form 990 $ (2) Other (specify): ►
C d

Materials

30,945

Add amounts o n lines (1) through ( 4 ) . . > Line a minus line b p» Amounts included o n line 17, Form 990 but not o n line a:

(1) Investment expenses not included on line 6b, Form 990 . $ (2) Other (specify):

e

Add amounts on lines (1) and ( 2 ) . . Total revenue per line 12, Form 990 (Bne e plus line d)
Instructions o n page 22.) (A) Name and address

Add amounts on lines (1) and (2) Total expenses per line 17, Form 990 (line c plus line d)

► >
.

List of Officers, Directors, Trustees, and Key Employees (List each one even rf not compensated; see Specific
r •.

159,709.

(B) Title and average hours per week devoted to position

See A t t a c h e d

(C) Compensation (If not p ' " nof paid, enter -0-.)

(Ol Contributions to >mplo .JO benefit plans

referred comp

(E) Expense account and other allowances

0.

75 Did any officer, director, trustee, or key employee receive aggregate compensation of more than $100,000 from your
organization and an related organizations, of which more than $10,000 was provided by the related organizations? If "Yes," attach schedule — see Specific Instructions on page 22.
CAA 8 99034 NTF i s r e i GLD 4225

► H Yes

H No

m
76 77

Form990(1998)

Save a L i f e

Foundation

Other Information (See Specific Instructions on page 23.) Did organization engage in any activity not previously reported to IRS? If "Yes." attach detailed description of each activity' Were any changes made in the organizing or governing documents but not reported to the IRS? If "Yes." attach a conformed copy of the changes.

36-3869459

Page 5 Yes

78a Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return? . O If "Yes,* has it filed a tax return on Form 990-T for this year? 79 Was there a liquidation, dissolution, termination, or substantial contraction during the year? If ^es," attach a statement 60a Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc.. to any other exempt or nonexempt organization?. D If "Yes,* enter the name of the organization ► and check whether H is \J exempt OR ( J nonexempt 81a Enter the amount of political expenditures, direct or indirect, as described In the instructions for line 81 |81a| b Did the organization file Form 1120-POL for this year? 82a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially less than fair rental value? b If "Yes." you may indicate the value of these hems here. Do not include this amount as revenue in Part I or as an expense in Part II. (See instructions for reporting in Part III.) |82b| ? 3 83a b 84a b 85

82a X
4 4

Did the organization comply with the public inspection requirements for returns and exemption applications? ' Did the organization comply with the disclosure requirements relating to quid pro quo contributions? Did the organization solicit any contributions or gifts that were not tax deductible? W -Yes.' did the organization include won every solicitation an express statement that such'contributions or gifts were not' tax deductible?

E30I
83b X

501(c)(4), (S). or (6) organizations. - a Were substantially all dues nondeductible by members?.... b Did the organization make only in-house lobbying expenditures of $2,000 or less?.. If "Yes" was answered to either 8Sa or 8Sb. do not complete 85c through 85h below 'unless'the organization' received' a ' ' waiver for proxy tax owed for the prior year. Dues, assessments, and similar amounts from members 85c Section 162(e) lobbying and political expenditures 85d Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices 85e Taxable amount of lobbying and political expenditures (One B5d less 85e) 85f Does the organization elect to pay the section 6033(e) tax on the amount in 8Sf? .

85aN/j

E232IE

C d B f g

h If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the arnountin'ssf to itsreasonable" estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year? 86 501(c)(7) organizations. - Enter a Initiation fees and capital contributions included on line 12 __

86b 0 Gross receipts, included on line 12, for public use of club facilities 87 501(C)(12) organizations. —Enter: 87a a Gross Income from members or shareholders b Gross income from other sources. (Do not net amounts due or paid to other sources 87b against amounts due year, did the organization 88 At^anytimeduringtheor received from them.) own a 50% or greater interest in a taxable corporation or partnership?
89a 501(c)(3) organizations. ~ Enter: Amount of tax imposed on the organization during ihe year under section 4911> ; section 4912 ► ; section 495S ► b 501(c)(3) and 501(c)(4) organizations. - Did the organization engage in any section 4958 excess benefit transaction" during the year? If "Yes," attach a statement explaining each transaction. 89b C Enter Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 49S5. and 4958 d Enter: Amount of tax on line B9c, above, reimbursed by the organization > 90a Ust the states with which a copy of this return is filed ► I L L I N O I S b Number of employees employed in the pay period that Includes March112,1998 (See instructions.) I gg^j 0 91 The books are in care of ► C A R O L S P I Z Z I R R I Telephoneno>847-928-968 3 Located at ► 4 8 2 5 N SCOTT STREET, SCHILLER PARK ZIP 4 * 6 0 92 Section 4947(a)(1) nonexempt charitable trusts filing Form 990 in lieu of Form 1041 — Check *here ~ —1.7 6 ' and enter the amount of tax-exempt interestreceivedor accrued during the tax year '■■■■!.► I 9 2 I CAA NTF 18782 8 99056 GLD2877

. _

,

. ,

86a

*n

Form 990 (1998)

Save a Life Foundation

Analysis of Income-Producing Activities (See specific instructions on page 27)
Enter gross amounts unless otherwise indicated. 93 Program service revenue:

36-3869459

Page 6

w Business
code

Unrelated business income (B) Amount

Excluded by section 512,513. or 514 (C) Exclusion code (D) Amount

(E) Related or exempt function income

a b c
d

e
f Modicaie/Madicaidpaymants g F a a i and contracts from govt. agsncias , 94 95 96 97 M a m b a i s h i p d u a l and asaastrasnts . . . '"torna! on savings and temporary cash investments. Oividendsandintarestfrom security*. . . Nat rantal incoma Of (lo«») Irom laal astata: S debt-financed property 98 99 100 101 102 D n o t dabt-financad proparty N e t rental income or(lo«s)t»orn personal proparty O t h a r i n v a c t m a n t incoma Gain or(lo«») flora sates of assets othar t h a n inventory N e t income or|loss)fromspecialevents. . Gross profit/(lgss) from salas of invantory

103 Other revenue: a

b c
d

e
104 S u b t o t a l (add columns |BI.(D). and (E».

105 Total (add line 104, columns (B). (D), and (E)) Note: (Une 105 phis line I d , Part I. should equal the amount on line 12, Part I.)

Relationship of Activities to the Accomplishment of Exempt Purposes (See specific instructions on pg.2BT
Line No. Explain how each activity tar which income is reported in column (E) of Part VII contributed importantly to the accomplishment of the organization's exempt purposes (other than by providing funds for such purposes).

95

101

INCIDENTAL ITEMS FROM PROGRAM OPERATIONS INCIDENTAL ITEMS FROM PROGRAM OPERATIONS

Information Regarding Taxable Subsld aries (Complete this Part if "Yes" box on line 68 Is checked.)
i r n s s a n r l e m n l n u a r identification Name, address, and employer Mantrf?r>gKnn number of corporation or partnership

age P e r c e n t a g e Of ownership interest

Nature of business activities

• ._.

,

Total income

_

. .

I

End-of-year

_

.

%

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a n d arfrfmfie CAA 8 99056 NTFIOTM r

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Date Date

Type or print narra r~'
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04/22/99

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EIN ► 36-2991500
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IL

60016

Software by T a i and Accounting Soltwara Corp.

SCHEDULE A (Form 990)
Dapvtmant of tha Traasury tntntnal Ravanua Service

Organization Exempt Under Section 501(c)(3)
(Except Private Foundation) and Section 501(e), 501(f), 501(10. S01(n), or Section 4947(a)(1) Nonexempt Charitable Trust

OMB No. 1545-0047

Supplementary Information

See separate Instructions. ► Must be completed by the above organtartlons and attached to their Form 990 or 990-EZ. Name of the organization Employer identification number

1998

Save a L i f e

Foundation

36-3869459
(d) Contribuliom to ■npl banafll plant* dafarrad cempanaation

Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees
(See Instructions on paga 1. List each one. If there are none, enter "NonQ (a) Name and address of each employee paid more (b) Title and average hours than $50,000 per week devoted to position (c) Compensation ■■«««•»» (e) Expense account and other allowances

NONE

Total number of other employees paid over
$50,000

Compensation of the Five Highest Paid Independent Contractors for Professional Services
(See Instructions on page 1. List each one (whether individuals or firms). If there are none, enter 'None.T (a) Name and address of each independent contractor paid more than $50,000 (b) Type of service (c) Compensation

NONE

Total number ol others receiving over $50,000 for professional services For Paperwork Reduction Act Notice, see page 1 of the Instructions for Form 990 and Form 990
CAA 8 990A12 NTF1B4S7 G L O 3274

Schedule A (Form 990) 1998

Supplemental Schedules -1998 Company: Save a Life Foundation
Form 990 - Exempt Organization Tax Return Line 9a - Special Fundraising Events and Activities Description of Event Various Fundraisers TOTAL Gross Rec 6,134 6,134 Contrib. 0. 0.

Page: 1 EIN: 36-3869459

Exp. 1,660. 1,660.

Form 990 - Exempt Organization Tax Return Line 42 - Depreciation, Depletion, Etc. Description (A) Total (B)Program Services 0. 0. (C) Mgmt. & General 12,209. 318. 12,527 (D)Fundraising 0. 0.

Depreciation Amortization TOTAL

12,209. 318. 12,527

Form 990 - Exempt Organization Tax Return Line 43 - Other Expenses Description (A) Total (B)Program Services
561. 13,547. 7,215. 3,200. 0. 0. 6,135. 1,598. 0. 0. 0. 0.

(C) Mgmt. & General
0. 6,640. 0. 0. 2,390. 90 0. 0. 660. 340. 39. 323.

(D)Fundraising
0. 0. 0. 0. 0. 0. 0. n 0. 0.

Auto expense Computer expenses Consulting fees Instructor fees Insurance Licenses & permits Marketing Recruitment Miscelleanous Awards Bank charges Dues & subscriptions

561. 20,187. 7,215. 3,200. 2,390. 90. 6,135. 1,598. 660. 340. 39. 323.

o
0.

TOTAL

42,738

32,256.

10,482

Continued on Page 2

Form 990 (1998) PartV

Save a Life Foundation

36-3869459

List of Officers, Trustees, and Directors Contributions to employee benefit plans 0 Expense account and other allowances

Name and Address Judge Sam Amirante 4825 N. Scott Street Schiller Park, IL 60176 Mr. Rick Bronstein 4825 N. Scott Street Schiller Park, IL60176 Ms. Carol Spizzirri 4825 N. Scott Street Schiller Park, IL 60176

Title & Average Hours per Week Compensation Director 0

Director

0

0

Executive Director 40 HRS

$

35,000

0

The above individuals put in time at Save a Life Foundation as heeded, except where indicated otherwise.

Schedule A (Form 990) 1998 Save a L i f e Statements About Activities

Foundation

36-38694

During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? If "Yes," enter total expenses paid or incurred in connection with the lobbying activities ► $ Organizations that made an election under section 501(h) byfflingForm 5768 must complete Part Vl-A. Other organizations checking "Yes," must complete Part Vl-B AND attach a statement giving a detailed description of the lobbying activities. 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 thair families, or with any taxable organization with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary: a Sale, exchange, or leasing of property? b Lending of money or other extension of credit? C Furnishing of goods, services, or facilities? See P a r t d Payment of compensation (or payment or reimbursement of expenses if more than $1,000)? e Transfer of any part of its income or assets? If the answer to any question is "Yes," attach a detailed statement explaining the transactions. 3 Does the organization make grants for scholarships, fellowships, student loans, etc.? 4 a Do you have a section 403(b) annuity plan for your employees? b 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. (See instructions on page 2.) V Form 990

2a 2b 2c 2d 2e 3 4a X

X X X

X X X

Reason for Non-Private Foundation Status (See instructions on pages 2 through 4.)
The organization is not a private foundation because it is: (Please check only ONE applicable box.)

5
6 7 8 9 10

A church, convention of churches, or association of churches. Section 170(b)(l)(A)(i). A school. Section l70(b)(l)(A)(R). (Also complete Part V, page 4.) A hospital or a cooperative hospital service organization. Section l70(b)(1)(A)(iii). A Federal, state, or local government or governmental unit Section l70(b)(1)(A)(v). A medical research organization operated In conjunction with a hospital. Section 170(b)(l)(A)(lii). Enter the hospital's name, city, and state ►

Q An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(l)(A)(iv). (Also complete the Support Schedule in Part IV-A) 1 1 a g An organization that normally receives a substantial part of its support from a governmental unit or from the general public. Section i70(b)(l)(A)(vi). (Also complete the Support Schedule in Part iV-A) 1 1 b [ I A community trust Section l70(b)(l)(A)(vi). (Also complete the Support Schedule in Part IV-A.) 12 ( J An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc.. functions — subject to certain exceptions, and (2) no more than 33 1/3% 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. See section 509(a)(2). (Also complete the Support Schedule in Part IV-A) [ J An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in: (1) lines 5 through 12 above; or (2) section 501(c)(4), (5), or (6), if they meet the test of section 509(a)(2). (See section 509(a)(3).) Provide the following information about the supported organizations. (See instructions on page 4.) (a) Name(s) of supported organization(s) (b) Line number from above

13

14 I ! An organization organized and operated to test for public safety. Section 509(a)(4). (See instructions on oaae 4 I CA A 8 S90A12 GLD 3274

Schedule A (Form 990) 1998

Save a L i f e

Foundation

36-3869459
(C) 1995 (d) 1994

Pat»3

Support Schedule (Complete only if you checked a box on line 10,11, or 12.) Use cash method of accounting. Note: You may use the worksheet in the instructions for converting from the accrual to the cash method of accounting.
Calandar yaar lor fiscal yaar beginning m)l>

(a) 1997

(b) 1996

15
16 17

G i f t * , pants, and contributions racoivad. (Do not inctudt unusual grants. Sao lino 2s.) Mornbsrship tsaa racoivad . . Gross rscsipts from admissions, nstrchsndisa sold or sarvicas parfornad, or furnishing of iacilitisi in any activity that is not a b u s i n n s unrtlatad to tha organisation's charitabla, a t e , purposs Gross hcoroa from intarast, dividosds, amounts rscoivod frora iaymasts on sscuritias loans tactios SIKaXS)}, rants, royartiis, and unrslatad businass taaabtaineomaltass saction $11 taaas)f'om businassos acquh-ad by tho organization aftor Juna 30. 1979

(e) Total

101,330.
550

37,566 1,527.

110,761 1,410

93,405.
2,875

343,062

6,362.

18

f
'f g

N a t In coma from unrslatad businais activitias not includsd in Una IB Tax ravsnuss laviad tor tha organization's bonsfitand ailhar paid to it or axpandod on its bahalf T h a vatua of sarvicas or facilitias furnished to l h a organization by a QovarnraantaJunit without charga. Do aotinchida tha vahia of sarvicas or facilitias ganaralty lurnishsd to tho public without charga Othar iftcoras. Attach a schadula. Oo not inctuda gain or (loss) from sala of capital assata Totalof Imal 1J through 2 2 . Lino 23 minus Ima 17 . Entar 1% of tins 23

20

21

22
23 24 25

101,880. 101,880 1,019.

39,093 39,093

26

Organizations described on lines 10 or 11: a Enter 2% of amount in column (e), line 24 ~77~p>" b Attach a list (which is not open to public Inspection) showing the name of and amount contributed by each person (other than a governmental unit or publicly supported organization) whose total gifts for 1994 through 1997 exceeded the amount shown in line 26a. Enter the sum of all these excess amounts ► b > 19

39TJ

112,171 112,171 1,122

96,280 96,280.

349,424 349.424

963

C Total support for section 509(a)(1) test: Enter line 24, column (e) d Add: Amounts from column (e) for lines: 18

22

26b

e Public support (line 26c minus line 26d total) b > f Public support percentage (line 26e (numerator) divided by line 26c (denominator)) 0 27 Organizations described on line 12: a For amounts included In lines 15.16, and 17 that were received from a "disqualified person' attach a list to show the name of, and total amounts received in each year from, each "disqualified person." Enter the sum of such amounts for each year:
(1997) (1996) (1995) (1994) b For any amount included in line 17 that was received from a nondisqualified person, attach a list to show the name of. and amount received for each year, that was more than the larger of (1) the amount on line 25 for the year or (2) $5,000. (Include in the list organizations described in lines 5 through 11. as well as individuals.) After computing the difference between the amount received and the larger amount described in (1) or (2), enter the sum of these differences (the excess amounts) for each year:

3,012

(1997)

(1996)

(1995)

(1994)

C Add: Amounts from column (e) for lines:

17
d e f g h 28
CAA

15 20

Add: Une 27a total and line 27b total. Public support (line 27c total minus line 27d total) Total support for section 509(a)(2) test: Enter amount on line 23, col. (e) ► | 27f | Public support percentage (line 27e (numerator) divided by line 27f (denominator)) Investment Income percentage (line IB, column (e) (numerator) divided by line 27f (denominator))

16 21

27c 27d •> 27e
► *> ►

27g 27h

% %

Unusual Grants: For an organization described in line 10,11, or 12 that received any unusual grants during 1994 through 1997, attach a list (which is not open to public inspection) for each year showing the name of the contributor, the date and amount of the grant, and a brief description of the nature of the grant Do not Include these grants in line 15. (See instructions on page 4.)
8 93QA34 NTF isaea GLD 3275 ~"—'

schedule A (Form 990) 1998 Save a L i f e

Foundation

36-3869459

Page 4

Private School Questionnaire (See instructions on page 4.)

(To be completed ONLY by schools that checked the box on line 6 in Part IV)
No 29 30 Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, other governing instrument, or in a resolution of its governing body? Does the organization include a statement ol Its racially nondiscriminatory policy toward students In all its brochures, catalogues, and other written communications with the public dealing with student admissions, programs, and scholarships? Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during the period of solicitation for students, or during the registration period if it has no solicitation program, in a way that makes the policy known to all parts of the general community it serves? If "Yes," please describe; H "No," please explain. (If you need more space, attach a separate statement)

29 30 31

31

32

Does the organization maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative staff? b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? C Copies of an catalogues, brochures, announcements, and other written communications to the public dealing with student admissions, programs, and scholarships? d Copies of all material used by the organization or on its behalf to solicit contributions? If you answered "No" to any of the above, ptease explain. (If you need more space, attach a separate statement)

32a

32c

33

Does the organization discriminate by race in any way with respect to: a Students' rights or privileges? b Admissions policies? C Employment of faculty or administrative stafl? d Scholarships or other financial assistance? e Educational policies? f Use of facilities? g Athletic programs? h Other extracurricular activities? If you answered "Yes" to any of the above, please explain. (If you need more space, attach a separate statement.)

33b 33c 33d 33e 33f 3& 33h

34a Does the organization receive anyfinancialaid or assistance from a governmental agency?. b Has the organization's right to such aid ever been revoked or suspended? If you answered "Yes" to either 34a or b, please explain using an attached statement 35
CAA

Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.0S of Rev. Proc. 75-50.1975-2 C.B. 5B7, covering racial nondiscrfmlnation7 H "No." attach an explanation
B 990A34 N T F 1B4B0 GLD 3275

Schedule A (Form 990) 1998 S a v e

a

re*"
Check here ► a Check here ► b

Lobbying Expenditures by Electing Public Charities (See instructions on page e.)
(To be completed O N L Y by an eligible organization that filed Form 5768) if the organization belongs to an affiliated group. if you checked ' a * above and "limited control" provisions apply.

Life Foundation

36-3869459

Page 5

®
Affiliated group totals

{5}
To be completed for ALL electing organizations

Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or Incurred.) 3 6 Total lobbying expenditures to influence public opinion (grassroots lobbying) 3 7 Total lobbying expenditures to influence a legislative body (direct tobbying). 3 8 Total lobbying expenditures (add lines 38 and 37) 3 9 Other exempt purpose expenditures 4 0 Total exempt purpose expenditures (add lines 3B and 39) 41 Lobbying nontaxable amount. Enter the amount from the following table — If the amount on line 40 is The lobbying nontaxable amount la - Not over $500,000 20% of the amount on Dne40 Over $500,000 but not over $1,000.000... noo.ooo P iu. i s * of i h . . « . < • ov«»soo.ooo Over $1,000,000 but not over $1,500,000 . sus.ooopiu. io%of it,. . . « « • o*« $1,000,000 Over $1,500,000 but not over $17,000,000 1229.000 Pius»%.f th. • « . « . ov« n.soo.000 Over $17.000,000 $1,000,000 _ 4 2 Grassroots nontaxable amount (enter 25% of tine 41) 4 3 Subtract line 42 from line 36. Enter - 0 - if line 42 is more than line 36 44 Subtract line 41 from line 38. Enter - 0 - if line 41 Is more than line 38 Caution: If there is an amount on either line 43 or line 44. you must We Form 4720.

"

4-Year Averaging Period Under Section 501(h)

(Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 45 through SO on page 7.) Lobbying Expenditures During 4-Year Averaging Period Calendar year (or fiscal year beginning In) ► 4 5 Lobbying nontaxable amount. 4 6 Lobbying a amount [150% of line 45(e)) 4 7 Total lobbying expenditures 4 8 Grassroots nontaxable amount 4 9 Grassroots ceiling amount (150% of line 48(e)) 5 0 Grassroots lobbying expenditures

Lobbying Activity by Nonelectjng Public Charities
(For reporting only by organizations that did not complete Part Vl-A) (See instructions on page 8.) During the year, did the organization attempt to Influence national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use ot

a b c d e f g h i
CAA

Volunteers Paid staff or management (Include compensation in expenses reported on lines c through h.) Media advertisements Mailings to members, legislators, or the public Publications, or published or broadcast statements Grants to other organizations tor lobbying purposes Direct contact with legislators, their staffs, government officials, or a legislative body Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means Total lobbying expenditures (add lines c through h) If "Yes" to any of the above, also attach a statement giving a detailed description of the lobbying activities.
8 990A56 NTF 18491 GLO 3276

Page 6 Schedule A (Form 990) 199s S a v e a L i f e F o u n d a t i o n 36-3869459 Information Regarding Transfers To and Transactions and Relationships With Noncharitable 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) organizations) or in section 527, relating to political organizations? Yea No a Transfersfromthe reporting organization to a noncharitable exempt organization of: S1a(i) X (I) Cash a(ii) X (II) Other assets b Other transactions: X (I) Sales of assets to a noncharitable exempt organization b<i) b(li) X (II) Purchases of assets from a noncharitable exempt organization X (III) Rental of facilities or equipment bfll) b(lv) X (Iw) Reimbursement arrangements b(v) X (v) Loans or loan guarantees b(vi) X (vl) Performance of services or membership or fundraising solicitations c X C Sharing of facilities, equipment, mailing lists, other assets, or paid employees d If the answer to any of the above Is "Yes," complete the following schedule. Column (b) should always show the fair market value of the goods, other assets, or services given by the reporting organization. H (he organization received less than fair market value in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received: f» Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, & sharing arrangements

(a) Line no.

52a Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527? ► [ ] Yes b If "Yes." complete the following schedule: (c) 0>) (a) Description of relationship Type of organization Name of organization

(XjNo

Form 990 (1998) Part IV Line 57

Save a Life Foundation

36-2171716

Land, Buildings, and Equipment

Asset Office Equipment Vehicle Total

Basis 43,896 31,998 75,894

Accum Depr 19,873 0 19,873

Book Value 24,023 31,998 56,021

Supplemental Schedules -1998 Company: Save a Life Foundation
Form 990 - Part IV - Balance Sheets Line 64b - Mortgages and Other Notes Payable Descript Lon Vehicle ] Loan Date of 1Loan: 09/07/98 Maturity Date: 09/07/02 Original Amount: 21,668 TOTAL

Page: 2 EIN: 36-3869459

Amount 19,907.

19,907.

Form 990 - Part IV - Balance Sheets Line 65 -- Other Liabilities Lon Descript. Payroll Liabilities Interest Due to State of IL
TOTAL

Amount -747. 5,675.
4,928.

Supplemental Schedules -1998 Company: Save a Life Foundation Form 990 - Schedule A - Part IV - Line 26b People Whose Gifts Exceeded Amount on Line 26a Name Schedule D Foundation TOTAL Amount 10,000. 10,000. 2% of 24e 6,988.

Page: 3 EIN: 36-3869459

Difference 3,012. 3,012.

SAVE A LIFE FOUNDATION, INC. AUDITED FINANCIAL STATEMENTS DECEMBER 31, 1998

AHLBECK&COMPANY
CERTIFIED PUBLIC ACCOUNTANTS

AHLBECK&COMPANY

SAVE A LIFE FOUNDATION, INC. TABLE OF CONTENTS DECEMBER 31, 1998 Auditor's Report Exhibit Financial Statements Comparative Statement of Financial Position December 31, 1998 and December 31, 1997 Statements of Activities for the years ended December 31, 1998 and December 31, 1997 Comparative Statement of Functional Expenses for the years ended December 31, 1998 and December 31, 1997 Statements of Cash Flows for the years ended December 31, 1998 and December 31, 1997 Notes to Financial Statements A B

C D

AHLBECK&COMPANY
CERTIFIED PUBLIC ACCOUNTANTS 1665 ELK BOULEVARD DESPLAINES. ILLINOIS 60016-4798 TELFPHONE 8*7/824-4000 FACSIMILE 847/824-4012

February 26, 1999

To the Board of Directors Save A Life Foundation, Inc. Schiller Park, Illinois

INDEPENDENT AUDITOR'S REPORT We have audited the accompanying statement of financial position of SAVE A LIFE FOUNDAITON, INC. (an Illinois not-for-profit corporation) as of December 31, 1998, and the related statement of activities, statement of functional expenses, and statement of cash flows for the year then ended. These financial statements are the responsibility of management. Our responsibility is to express an opinion on these financial statements based on our audit. We conducted our audit in accordance with generally accepted auditing standards. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audit provides a reasonable basis for our opinion. In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of SAVE A LIFE FOUNDATION, INC. as of December 31, 1998, and the results of its activities and its cash flows for the year then ended in conformity with generally accepted accounting principles. The 1997 financial statements were compiled by other accountants, and their report thereon, dated August 26, 1998, stated they did not audit or review those financial statements and, accordingly, expressed no opinion or other form of assurance on them.

- 1-

SAVE A LIFE FOUNDATION, INC. COMPARATIVE STATEMENT OF FINANCIAL POSITION December 31, 1998 and Unaudited December 31, 1997 1998

EXHIBIT A

1997 (Unaudited)

A S S E T S CURRENT ASSETS Cash and Cash Equivalents Total Current Assets FIXED ASSETS AT BOOK VALUE Office Equipment Vehicle Net Fixed Assets OTHER ASSETS Organization Costs Accum. Amort. Organization Costs Total Other Assets TOTAL ASSETS

481.738 481.738

6.719 6.719

14,974 28.838 43,812

24,023 0 24,023

2,120 (2.120) 0 525.SSO

2,120 (1.802) 318 31.060

L I A B I L I T I E S CURRENT LIABILITIES Accounts Payable Payroll Liabilities Interest Due To State Of II Current Portion Loan Payable Total Current Liabilities LONG TERM LIABILITIES Vehicle Loan Less: Current Portion Total Long Term Liabilities OTHER LIABILITIES Due To Carol Spizzirri Total Other Liabilities TOTAL LIABILITIES NET ASSETS Unrestricted Temporarily Restricted TOTAL NET ASSETS

A N D

N E T

A S S E T S

1,474 (747) 5,675 4.743 11.145

$

0 0 0 0 0

19,907 4.742 15,164 61.521 61.521 87.830

0 0

60.070 60.070

137,720 300.000 437.720 525.550 $

(29,010) 0 (29.010) 31.060

TOTAL LIABILITIES AND NET ASSETS

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

- 2-

SAVE A LIFE FOUNDATION, INC. STATEMENT OF ACTIVITIES - UNAUDITED For the Year Ended December 31, 1997 Temporarily Unrestricted

EXHIBIT B

INCOME
Contributions Kids Program Private Grants Conferences Fundraisers/Sales Sponsorships In-Kind Contributions Other TOTAL INCOME EXPENSES Program Fundraising Management and General TOTAL EXPENSES EXCESS INCOME OVER EXPENSES FROM ACTIVITIES INVESTMENT INCOME Interest Income TOTAL INVESTMENT INCOME CHANGE IN NET ASSETS BEGINNING NET ASSETS ENDING NET ASSETS 6,454 (35,464) (29,010)
$ 1,813 14,500 3,081 4,202 550 79,495 7,579 111,219

Restricted.
$ _ $

X&al
1,813 14,500 3,081 4,202 550 79,495 7,579 111,219

68,331 7,215 29,219 104,765

-

68,331 7,215 29,219 104,765

6,454

-

6,454

6,4 54 (35,464) $ (29,010)

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

- 4 -

SAVE A LIFE . JjJDATION, INC. STATEMENT OF FUNCTIONAL EXPENSES For the Year ended December 31, 199B with Unaudited Totals for the Year ended December 31, 1997

& , .*MT .

C

Salaries & Wages Employee Benefits Payroll Taxes Accounting Fees Amortization Automobile Expense Awards & Recognitions Bank Charges Computer Expenses Conferences Consulting Fees Depreciation Expense Dues & Subscriptions I Instructor Fees In Insurance Interest Expense Legal Fees

IL Pilot Program $ 58,169 262 1,709 1,191 561 ~ ~ 13,547 1,455 7,215 ~ ~ 3,200 ~ 10,000 6,135 4,630

Licenses & Permits Marketing
Miscellaneous Office Supplies Penalties Postage & Delivery Printing & Reproduction Recruitment Rent Repairs Telephone Training Supplies Travel Total Expenses 1997 Unaudited Totals $ $

Fundraising 1,250 $ 3,000 15 54 6 20 199 334 4,879 7,215

941 7,412 1,598 275 170 6.2S6 2,362 5,713 132,799 68,331 $ $

support Management and General $ 625 318 340 39 6,640 745 33,750 12,209 323 2,390 154 90 2B.0SB 660 27 8,783 10 100 215 95,476 $ $ 29,219

$

Total 1,875 318 340 39 6,640 745 33,750 12,209 323 2,390 154 90 3,000 28,073 660 81 8.7B9 30 299 -

Org anization Total 60,044 $ 262 1,709 1,191 318 561 340 39 20.1B7 2,200 40,965 12,209 323 3,200 2,390 154 10,000 90 9,135 32,703 660 1,022 7,412 1,598 9,065 200 6,555 2,362 6,263 233,154 104,765

1997 Unaudited Totals $ _ . . 424 18,080 5,645 _ . 20,843 25,371 8,884 744 . 825 . . 8 8,520 90 2,210 . 2,034 3,043 . 1,200 _ 4,222 _ 2,622 $ 104,765

$ $

549 100,355 36,434

$ $

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

EXHIBIT D SAVE A LIFE FOUNDATION, INC. STATEMENT OF CASH FLOWS FOR THE YEAR ENDED DECEMBER 31, 1998 Cash Flows from Operating Activities: Change in Net Assets Adjustments to reconcile change in net assets to net cash provided by (used in) operating activities: Depreciation and amortization Changes in assets and liabilities: Increase (decrease) in accounts payable Increase (decrease) in other payables Total adjustments Net cash provided by (used in) operating activities Cash Flows from Investing Activities: Purchase of fixed assets Net cash provided by (used in) investing activities Cash Flows from Financing Activities: Proceeds on issuance of debt Repayments on debt Net cash provided by (used in) financing activities Net increase (decrease) in cash and cash equivalents Cash and cash equivalents at beginning of period Cash and cash equivalents at end of period Supplemental Disclosures: Interest paid S S (31.998) (31,998) $ 12,527 $ 466,730

1,474 6. 379 20.380 487,110

21,668 (1, 761) 19.907 475,019 6-719 481.738 154

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

- 6-

EXHIBIT D SAVE A LIFE FOUNDATION, INC. STATEMENT OF CASH FLOWS - UNAUDITED FOR THE YEAR ENDED DECEMBER 31, 1997 Cash Flows from Operating Activities: Change in Net Assets Adjustments to reconcile change in net assets to net cash provided by (used in) operating activities: Depreciation and amortization
9,308 6,454

Changes in assets and liabilities: Increase (decrease) in other payables Total adjustments Net cash provided by (used in) operating activities Cash Flows from Investing Activities: Purchase of fixed assets Net cash provided by (used in) investing activities — Cash Flows from Financing Activities: (17.410) (17,410)
1.200

10.508 16,962

Net cash provided by (used in) financing activities Net increase (decrease) in cash and cash equivalents Cash and cash equivalents at beginning of period Cash and cash equivalents at end of period S (448) 7.167 6.719

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

- 7-

SAVE A LIFE FOUNDATION, INC. NOTES TO FINANCIAL STATEMENTS DECEMBER 31, 1998 NOTE 1 - Summary of Significant Accounting Policies Nature of Activities Save A Life Foundation, Inc. (SALF) works to promote the training of life supporting first aid skills; to promote consistency, uniformity, and safety in the application of those skills; to expand knowledge of w Good Samaritan" laws to encourage people to provide help; and to assure that skills are accessible to all. SAL received 96% of its total income in the year ended December 31, 1998 from the State of Illinois Department of Commerce and Community Affairs. The remainder of SALF's income is from private contributions and fundraising projects.

Basis of Accounting The financial statements of SALF have been prepared on the accrual basis of accounting and accordingly reflect all significant receivables, payables, and other liabilities. The net assets of SALF are classified as follows: Unrestricted, which represent the portion of expendable net assets that are available for operations. Temporarily Restricted, which represent grants which are for future periods. Upon termination of the restriction, a reclassification is made to unrestricted net assets. Fixed Assets Fixed assets are carried at cost if purchased or fair value if contributed for current additions. Depreciation is computed on the straight-line method over 3-5 years for vehicles, computer equipment, furniture and office equipment. Maintenance, repairs and minor costs are expensed as incurred. When properties are retired or otherwise disposed of, the related cost and accumulated depreciation are removed from the respective accounts and any profit or loss on disposition is credited or charged to operations.

Estimates The process of preparing financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions. These estimates and assumptions affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and reported amounts of income and expenses during the reporting period. Actual results could differ from those estimates.

- 8-

SAVE A LIFE FOUNDATION, INC. NOTES TO FINANCIAL STATEMENTS DECEMBER 31, 1998 Cash and Cash Equivalents For purposes of the statement of cash flows, SALF considers all checking accounts and certificates of deposit to be cash equivalents.

Income Taxes SALF is exempt from income taxes under Section 501 (c)(3) of the Internal Revenue Code. In addition, SALF qualified for the charitable contribution deduction under Section 170(b)(l)(A)(vi) and has been classified as an organization other than a private foundation under Internal Revenue Code Section 509(a) (2) .

Functional Allocation of Expenses In the Statement first charged to actual expense. as time spent in of Functional Expenses, salaries and related expenses are the various programs and supporting services on the basis of Expenses are then allocated based on various criteria, such various areas.

NOTE 2 - Donated Materials and Services In-kind donations of materials and fixed assets are recorded at their estimated fair value at the date of donation. Such donations are reported as unrestricted support unless the donor has restricted the donated asset to a specific purpose. Conditional transfers of assets are recognized when the conditions upon which they depend are substantially met. During the fiscal years ended December 31, 1998 and 1997, SALF received $30,945 and $49,495, respectively, in donations of this type. Donations of services are recorded if they create or enhance a nonfinancial asset or are specialized skills that would be purchased if they were not donated. SALF received donations of this type in the fiscal years ended December 31, 1998 and 1997 of $33,750 and $30,000, respectively. SALF rents its office space at a lease amount substantially below market value. During the year ended December 31, 1998, SALF received $8,7 50 in office space.

NOTE 3 - Policy on Contributions Contributions received are recorded as unrestricted, temporarily restricted, or permanently restricted support, depending on the existence and/or nature of any donor restrictions. Support that is restricted by the donor is reported as an increase in unrestricted net assets if the restriction expires in the reporting period in which the support is recognized. All other donorrestricted support is reported as an increase in temporarily or permanently restricted net assets, depending on the nature of the restriction. When a restriction expires (that is, when a stipulated time restriction ends or purpose restriction is accomplished), temporarily restricted net assets are

- 9-

SAVE A LIFE FOUNDATION, INC. NOTES TO FINANCIAL STATEMENTS DECEMBER 31, 1998 reclassified to unrestricted net assets and reported in the Statement of Activities as net assets released from restrictions. Federal grant awards are not recorded until expended for the purpose of the grants since they are conditional promises to give.

NOTE 4 - Cash and Cash Equivalents The total cash held by the SALF as of December 31, 1998 and 1997 includes $381,738 and $0, respectively, in moneys that are not covered by insurance provided by the federal government. It is the opinion of management that the solvency of the referenced financial institutions is not of particular concern at this time.

NOTE 5 - Fixed Assets At December 31, 1998 and 1997, the costs of such assets were as follows:
December 31 / 1997 1998 43,896 43,896 $ 31,998 75,894 32,082 $ 43,812 $ 43,896 19,873 24,023 $ Increase (Decrease) $ 31,998 31.998 12,209 19,789

Office Equipment Vehicles Less accumulated depreciation Net book value

$

Depreciation expense for fiscal years ending December 31, 1998 and 1997 was $12,209 and $8,884, respectively.

NOTE 6 - Vehicle Loan On September 7, 1998, a vehicle was financed through Ford Motor Company for $21,668 at a 2.9% annual rate of interest. The balance on this loan as of December 31, 1998 was $19,907. The principal balance due over the next four years is: Year Ending December 31, 1999 2000 2001 2002 Less current portion Balance Due $ 4,742 5,375 5,533 4,257 19,907 (4,742) $ 15,164

- 10 -

SAVE A LIFE FOUNDATION, INC. NOTES TO FINANCIAL STATEMENTS DECEMBER 31, 1998

NOTE 7 - Due to Related Party The organization's founder and current executive director, Carol Spizzirri, loaned SALF start up funding. As of December 31, 1998 and 1997 the amount of this loan is $61,521 and $60,070, respectively. NOTE 8 - Lease Obligation and Rental Expense The estimated future minimum rental and lease obligation for the succeeding years under non-cancelable leases for office facilities in effect at December 31, 1998 are as follows: Y e a r ending December 31, 1999 Rent 30

Rental expense under the operating lease was $120 for the year ended December 31, 1998. Prior to that lease, office space was rented from the President for a total of $1,200 for the year ended December 31, 1997.

NOTE 9 - Fundraifiinor Projects . Special fundraising event income is shown in the Statement of Activities at net of expenses. The following schedule breaks out the components expenses as follows:
n ^ m h e r - 3 1 . 1998 Revenue Expenses ^ $ 6.134 $ 1,660 $ 4,474 $ 6,134 $ 1,660 $ 4,474 P T T 1 ™ ^ 31Revenue Expenses $ 3,339 $ " 863 -_ $ 4,202 $_
1997

V a r i o u s Mdse Other

$

Hfifc 3,339 863 $ 4,202

i n - Prior Period Information v^^,« fnr As described in the accountant's report, the information provided herein for the year ended December 31, 1997 is unaudited.
MOTB

- 11 -

a^asgss-,^*
*

ILLINOIS CHARITABLE ORGANIZATION ANNUAL REPORT
Attorney General JIM RYAN State of Illinois
Charitable Trust Bureau, 100 West Randolph 3rd Floor, Chicago, Illinois 60601 Report for the Fiscal Period: Beginning & Fnriing 01 / 01 12/31
MO
DAY

Revised 4/99

tfr

<b

/ 99 / 99
~YR

CO# 01-026498 Check a// items attached: B Copy of IRS Return tnkwchteki Bl Audited Financial Statements f*ybn*> D Copy of Form IFC *J"J Bte H $15.00 AnnuaMteport Filing Fee BuntuFwd n $100.00 Late Report Filing Fee
MO
DAY

Federal ID # 36-3869459 Are contributionstothe organization tax deductible?
LEGAL NAME MAIL ADDRESS CITY. STATE ZIP CODE

VH

| Yet D No

Date Organization was created: 02 / ng / Q^ Year-end amounts

Save a L i f e Foundation

m

2 3 Z000

A) ASSETS B) LIABILITIES C) NET ASSETS

A)S 617 ,345 B)S 69 ,641 C)$ 547, ,704 AMOUNT 37,874 600.000 25.074

4825 N. Scott Street #74AATrORWPyoet C R, Schiller Park, IL ^ ^BLETRlfTL 60176

"I. SUMMARY OF ALL REVENUE ITEMS DURING THE YEAR:
D) PUBLIC SUPPORT. CONTRIBUTIONS & PROGRAM SERVICE REV. {GROSS AMTS.) E) GOVERNMENT GRANTS & MEMBERSHIP DUES F) OTHER REVENUES G) TOTAL REVENUE. INCOME AND CONTRIBUTIONS RECEIVED (ADD D.E. & F)

PERCENTAGE ~~ 5.7* 90.5* 3.8* 100% 90.1 * % 90.1*
5 %

O)*
E

>*

P>*

G)$ 662.948 H>$ 498.438 OS J)» 498,438

II. S'JMMARY OF ALL EXPENDITURES DURING THE YEAR:
H) OPERATING CHARITABLE PROGRAM EXPENSE i) EDUCATION PROGRAM SERVICE EXPENSE

J) TOTAL CHARITABLE PROGRAM SERVICE EXPENSE (ADO H & I) J1) JOINT COSTS ALLOCATED TO PROGRAM SERVICES (INCLUDED IN J): K) GRANTS TO OTHER CHARITABLE ORGANIZATIONS L) TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD JftK) M) MANAGEMENT AND GENERAL EXPENSE N) FUNDRAISING EXPENSE O) TOTAL EXPENDITURES THIS PERIOD (ADD L, M,ftN)

K)S «-)* 498,438
M

90.1 * 3.3 6.6*
100%

>$

17,958 36,568

N>*

°>* 552,964

IN. SUMMARY OF ALL PAID FUNDRAISER AND CONSULTANT ACTIVITIES
(Attach Attorney General Report of Individual Fundraising. Campaign- Form IFC. Onetoreach PFR.J

PROfEWICfjAL FVHPRAJSERS;
P) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISERS Q) TOTAL FUNDRAISERS FEES AND EXPENSES R) NET RECEIVED BY THE CHARITY (P MINUS Q=R) PROFESSIONAL FUNDRAISING CONSULTANTS: S) TOTAL AMOUNT PAID TO PROFESSIONAL FUNDRAISING CONSULTANTS

100%

P)$
Q)$

%

R)5 S)$

IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS DURING THE YEAR: T) NAME. TITLE: U) NAME. TITLE: Carol S o i z z i r r i . P r e s i d e n t Robert Myer, School S c h e d u l e r T)*
U)$

83.359 20,719

V ) S 19,569 V) NAME.TITLE: F r a n c i s F u l l e r , Computer T e c h n i c i a n List on back side of instructions CODE I. C H A R I T A B L E P R O G R A M DESCRIPTION:c«Aflmifli£«?oe»i«r»M«HE5rBriBtPEwoEojcooECA7EGo«Es

W) DESCRIPTION: L i f e Saving F i r s t Aid T r a i n i n g
X) DESCRIPTION:
vt nFRr.RiPTiON-

.

Wj#
X)# Y)*

oil

If.' THE ANSWER TO ANY OF THE FOLLOWING IS YES, ATTACH A DETAILED EXPLANATION: 1. 2. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION. FINE. PENALTY OR JUDGMENT? HAS THE ORGANIZATION OR A CURRENT DIRECTOR. TRUSTEE. OFFICER OR EMPLOYEE THEREOF. EVER BEEN CONVICTED BY ANY COURT OF ANY MIDSDEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY? \.

'ES

2.

3.

DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES OWNS AN INTEREST; OR WAS IT A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES HAS A MATERIAL FINANCIAL INTEREST; OR DID ANY OFFICER. DIRECTOR OR TRUSTEE RECEIVE ANYTHING OF VALUE NOT REPORTED AS COMPENSATION? 3. HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER. DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES? IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? 5.

4

4.

5.

8.

DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER?( ATTACH FORM IFC). . . 8.

7a. DID THE ORGANIZATION ALLOCATE THE COST OF ANY SOLICITATION. MAILING. ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES?.

7

-

7b. IF "YES". ENTER (I) THE AGGREGATE AMOUNT OF THESE JOINT COSTS | ;(ii) THE AMOUNT ALLOCATED TO PROGRAM SERVICES 5 ; (III) THE AMOUNT ALLOCATED TO MANAGEMENT AND GENERAL S ; AND (iv) THE AMOUNT ALLOCATED TO FUNDRAISING 1 8 DID THE ORGANIZATION EXPEND ITS RESTRICTED FUNDS FOR PURPOSES OTHER THAN RESTRICTED PURPOSES? HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION OR TAX EXEMPTION SUSPENDED OR REVOKED BY ANY GOVERNMENTAL AGENCY? 9.

B.

9.

10. WAS THERE OR DO YOU HAVE ANY KNOWLEDGE OF ANY KICKBACK. BRIBE. OR ANY THEFT. DEFALCATION MISAPPROPRIATION. COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS?. 10. 11. LIST THE NAME, ADDRESS AND THE ACCOUNT # OF THE FINANCIAL INSTITUTION 0 * * « • = » * THE ORGANIZATION MAINTAINS ITS THREE LARGEST ACCOUNTS:

Northern Trust Bank, 50 LaSalle S t . , Chicago, IL LaSalle Bank. 135 S. LaSalle S t . , Chicago, IL
12. NAME AND TELEPHONE NUMBER OF CONTACT PERSON:

60675

60603
847-928-9b«J

Cartk S p i z z i r r i

ALL ATTACHMENTS MUST ACCOMPANY THIS REPORT - SEE INSTRUCTIONS iNDER PENALTY OF PERJURY. I (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS ANNUAL REPORT ND THE ATTACHED DOCUMENTS. INCLUDING ALL THE SCHEDULES AND STATEMENTS AND THE FACTS THEREIN STATED ARE RUE AND COMPLETE AND FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE TATE OF ILLINOIS RELY THEREUPON. I HEREBY FURTHER AUTHORIZE AND AGREE T O SUBMIT MYSELF AND THE REGISTRANT EREBY TO THE JURISDICTION OF THE STATE OF ILLINOIS. E SURE TO INCLUDE ALL FEES DUE: ) REPORTS ARE DUE WITHIN SIX MONTHS OF YOUR FISCAL YEAR END. ) REPORTS WITH ASSETS OR REVENUES GREATER THAN $15,000 MUST SUBMIT $15.00 FILING FEE. ) REPORTS THAT ARE LATE OR INCOMPLETE ARE SUBJECT TO A $100.00 PENALTY.

C.ftrnl S p i z z i r r i
PRESIDENT or TRUSTEE {PRINT NAME)

SlUNAIUKb WilUAMVI CO- .

TREASURER or TRUSTEE [PRINT ■ P i ft* T. AHiBge*PREPARER (PRINT NANit)

aE
SIGNATURE DATE

Form

990

Return of Organization Exempt from Income Tax
Under section 501(c) of the Internal Revenue Code (except black lung benefit trust or private foundation) or section 4947(aX1) nonexempt charitable trust

OMBNo. 1545-0O47

1999

Department of the Treasury Internal Revenue Service

A B

This Form is Open Note: The organization may have to use a copy of this return to satisfy state reporting requirements to Public Inspection For the 1999 calendar year, Or tax year period beginning ,1999. and ending C Name of organization Check if: Employer Identification Number
Change of address Initial return Final return Amended return (required also for state reporting) Please use IRS label or print or type. See specific Instruc­ tions.

Save A Li fe Foundation
Number & street (or P.O. box if mail is not delivered to street addr) Room/suite

36-3869459
Telephone number

4825 N. S c o t t
City, Town or Country

Street
State

74A
ZIP + 4

(847)

928-9683

S c h i l l e r Park
jXj Exempt under section 501(c)

IL

G0176

Check.. *" L j jf exemption application is pending

G Type of organization '

_3_ •'(insert number) or *" | _ | section 4947(a)(1) nonexempt charitable trust

Note: Section S01(cX3) exempt organizations and4947(aXV nonexempt charitable trusts Must attach a completed Schedule A (Form 990). H (a) Is this a group return filed for affiliates?
( b ) If Yes," enter the number of affiliates for which this return is filed

(_J Yes

| x ] No

I

If either box in H is checked 'Yes,' enter four-digit group exemption number (GEN) *"

K

' J Accounting method: [ J c a s h | x j Accruaf (c) Is this a separate return filed by an organization covered by a group ruling? !Yes No | | Other (specify) Check here . L J if the organization's gross receipts are normally not more than $25,000. The organization need not file a return with the IRS; but if it received a Form 990 package in the mail, it should file a return without financial data. Some states require a complete return.
99Q EZmavbe

^Xyl>F£-™, 1

-

used

& organizations with gross receipts less than $100,000 and total assets less than $250.000 at end of year.

f j Revenue, Expenses, and Changes in Net Assets or Fund Balances (see instructions)
Contributions, gifts, grants, and similar amounts received: a Direct public support b Indirect public support c Government contributions (grants) d Total (add lines 1a through 1c) (attach schedule of contributors) (cash $ 6 2 1 , 0 4 3 . noncash $

la lb 1c

21.043. 600.000.
Id

0) LT I d . S t i n t . Program service revenue including government fees and contracts (from Part VII, line 93). Membership dues and assessments Interest on savings and temporary cash investments

621.043. 16.831 24.575.

Dividends and interest from securities 6a Gross rents b Less: rental expenses c Net rental income or (loss) (subtract line 6b from line 6a) 7 Other investment income (describe •» (B) Other 8a 8b 8c 8d (A) Securities 8 a Gross amount from sale of assets other than inventory b Less: cost or other basis and sales expenses c Gam or (loss) (attach schedule) d Net gain or (loss) (combine line 8c, columns (A) and (B)) 9 Special events and activities (attach schedule) a Gross revenue (not including . . . $ 9 , Q38 of contributions reported on line la) b Less: direct expenses other than fundraising expenses c Net income or (loss) from special events (subtract line 9b from line 9a) 10a Gross sales of inventory, less returns and allowances b Less: cost of goods sold 11 12 13 14 15 16 17 18 19 20 21 c Gross profit or (loss) from sales of inventory (attach schedule) (subtract line 10b from line 10a) Other revenue (from Part VII, line 103) Total revenue (add lines Id, 2, 3, 4, 5, 6c. 7, 8d, 9c, 10c, and 11) Program services (from line 44, column (B)) Management and general (from line 44, column (C)) 6a

6b 6c

9a

25,637

9b
10a 10b

25.578 .See..Lr3. Stint.

9c

59.

10c 11 12 13 14 15 16 17 18 19 20 | 21
TEEA0101 08/10/99

440.

Fundraising (from line 44, column (D)) Payments to affiliates (attach schedule) Total expenses (add lines 16 and 44, column (A)) . . . Excess or (deficit) for the year (subtract line 17 from line 12) Net assets or fund balances at beginning of year (from line 73, column (A)) Other changes in net assets or fund balances (attach explanation) Net assets or fund balances at end of year (combine lines 18, 19, and 20) BAA For Paperwork Reduction Act Notice, see separate instructions.

662.948. 498,438. 17.958 36,568 552.964. 109.984 437,720.
547,704 Form 990 (1999)

S5-19-SS

sa

G4

£orm 990 (] 999)

AHLBECK A N D

B4?e244012 COMPANY

WtF I 1 ■ * l i f e Foundari o n lEle-fJ Statement of Functional F*«
required far secf.cn m f f x % * E H ?

ID=847B244Q12

P . S2

22 Crjr,ts and aJlocatons (»tt»ch seheduJej teasr. $ non-cash $ "

***SWflX?ta

ir^lf!!!^^^^^^

^ss^^s^ffiasaSftaSa,,,

e™on plan contributions 28 Other employee benefits 29 Payroll taxes

23 Speak asi«t«« toindwduah(JlSrtBh) 24 25 Compenaton of offers, directors, etc 26 Otfiw salaries and wages 27 p

rZ:

Professional fundraising few 31 Accounting feos 32 Utoal fees 33 Supplies 34 Telephone

30

35 Postage and shipping
Occupancy 37 38 39 40 41 42 43 Shipment rental and maintenance Printing and publications . . . . Travel CcnfelBnws. eowMtions. M d «,„,„„«

Interest ...
Deprecate fcp,,,^
{ K (iRjfih

^

.

Otiwr.«pm!„(itemiaL
b A

- !Jto_£xp enSe _

d B

- 3Q.'L Charges
ttrnrthw S*S^ 'S »f? '"n'li(B)
p 8l, l

44

« See Other F > p . . n L r s t m t ~

w » « aggiegata amount: of these joint costs I <•«!) the amount allocated to

(ti) the arrount a l l o c a t eto' t a t S * * * services N " ^ aiiovaieo d program J and (iv) the amount allocated

0

.Otter Program saiv la »«

(Grants and allocations" <

TEEA0IB2 12H9/9S

Form 990 (1999;

F^rm990,'1999)

Save A L i f e

Foundatinn 36-3869459 .Page 3

a>aitlV 1 Balance Sheets (See instructions) Note: Where required attached schedules and amounts within the descnnU column should be for endof-year amounts only aescnpi 45 Cash - non-interest-bearing 46 Savings and temporary cash investments 47a Accounts receivable b Less: allowance for doubtful accounts 48a Pledges receivable b Less: allowance for doubtful accounts 49 Grants receivable ? a f f i schedule) I C e r S ' d ' r e c , o r s < t r u s t e e s - a n " key employees (attachS E , ? Z 3 °" 51 a Other notes & loans receivable (attach schedule) .. I 51 a b Less: allowance for doubtful accounts (51^ 52 Inventories for sale or use 53 Prepaid expenses and deferred charges 54 Investments - securities (attach schedule) 55a Investments - land, buildings, & equipment: basis b Less: accumulated depreciation (attach schedule) 56 Investments - other (attach schedule) 57a Land, buildings, and equipment: basis
50

I 47

I 57

f

a

b Less: accumulated depreciation (attach schedule) L -57. Strut 58 Other assets (describe - D e p o s i t s 59 Total assets (add lines 45 through 58) (must equal line 74) 60 Accounts payable and accrued expenses 61 Grants payable 62 Deferred revenue 63 Loans from officers, directors, trustees, and key employees (attach schedule) 64a Tax-exempt bond liabilities (attach schedule) b Mortgages and other notes payable (attach schedule) 65 Other liabilities (describe + See L i n e 65 66 Total liabilities (add lines 60 through 65) Organizations that follow SFAS 117, check here through 69 and lines 73 and 74. 67 Unrestricted 68 Temporarily restricted 69 Permanently restricted Organizations that do not follow SFAS 117, check here + 70 through 74. 70 Capital stock, trust principal, or current funds 71 Paid-in or capital surplus, or land, building, and equipment fund 72 Retained earnings, endowment, accumulated income, or other funds 73 Total net assets or fund balances (add lines 67 through 69 or lines 70 throunh 72; column (A) must equal line 19 and column (B) must equal Mne 21) ... 74 Total liabilities and net assets/fund balances (add lines 66 and 73)

° p i z ^ ^ P-ease make sure the return is complete and9accurate A l S j / K E K M BAA

R

W

* T e " " * " * « " about a particular" & & 3 £ S ^ ^

TEEA0103

08/04/99

«.j

i ZJ

-«*

UIO.ISO

HttLBtCK

AND

COMPANY

1D = 84?824-4Q12 36-3869459 i Reconciliation of Expenses per Audited Financial Statements with Expenses per Return
a b Total expenses and losses per audited financial statements Amounts included on line a but not online i 7 , Form 990:

P. S3 Pane 4

fx,namc.xs) Save A u f e f o u n d a t i o n I f i a r t J E ^ I Reconciliation of Revenue per Audited Financial Statements with Revenue per Return (Sae instructions.)
a b Toisi revenue, gams, ana oth« support M audited financa statement' Amounts included on linE a but not on line 12. rorm 990. (1) Net unrealized osine on investments . . $ (2) >.nated servKit and use at facilities

566^214.

0 ) Donated serv­ ices and use of facilities .

$

8.750.

$

( 9 Prieryear adjust menb reported on In* 20, Form 990 .. $
(3) Losses reported on line 20. Form 930 . . $ (4) Other (specify):

(3) fttttttetuii of pricr )W grants $ (4) Ctnar (specify):

Jup_pljes

"s

$y BPJ i £s
S Add amounts on lines O) through (4) Line a minus line b d Amounts included on line 17 Form 990 but not on line a: 4.400

Add amounts on lines f l ) throuoh (4) c d -irik- a minus line b . . . Amounts included or, line 12 Form 990 but not on line a: ' (1) investment expanses not included on l:nfi 6b, Form 990 (2) Otnw (specfy):

13.150. 5S2.964.

$

(1) Investment expenses not included on line 6b, Form 990 . . . $_ (?) Other (specify):

Ai'd amounts on lines (1) and (2) * !««•'revenue per line 12, Form •-;?" pine c plus Imed', *"*(A) Name and address
c a

J
Add amounts on lines f l ) and (2) . . . ► ■ SE? *AR I bb^, 348,|
n g c

fcfcyw»dList of Queers! P,rector* r Trustees, a n d k e w E L I , ^ ^ ^ T ™ V ^

Totelexpensespet line 17. Form 990 (line c plus line d)

*■

* '

[

552. 96A.

_c3L°J_Spizzirr

' « ™ Y ^ m p t o y e e s (L,st each one even rf not compensated: see instruction^ {B>1 (C 2 5 week S S K - h 0 W 8 l >i°- m P e -Q?5 t i 0 " I <*» contributions to (E> Expense per S 2 i k devoted (if not paid, employee benefit to position account and other enter -D-) plans and deferred allowances compensation

LL

-DI^_siarLly.dlo
Carlos Costes

fres/Exec Dir 40*. Director Director

83.359 20.832.

372,

Sam _L_. Amirante r>c9_tt_ Anders on PeLqrj s j r _Bu_rnam7_ Director ?fL _s?qt_t_ Bet zel_os_I"_ Job _Con rpy [Director |D1rector 1.666. |Director Director

*s LUX Of Officers. Etc. Statement '5 fromavo^,o^•n?«tv!^r, W
6

K*duZSZSSSS?

d a e ,8te<, 0r9Bn at 0nS

"/ .

' FJSP

erT,

P.l°yee receive aggregate compensation of more tnan $100 000

.' ! '. ° f wh,Ch T"

man $ ,

° ' 0 0 0 Was P ^ e d by tAV'

It Ves,1 attach schedule - see instructions.

•*QY«S

0No

form990/1999)
9>»rtVtW}Owier

Save A L i f e

Foundation
36-3869459 W t e d to me IRS? „ -Yes/ attach a de,a„ed descr.pt.on "

i n f o r m a t i o n rSee spec.fic instructs.) °nen9a9e '" a n y
aC V,,y n

7 7
76 79

o ^ S r

r^r^^^
d,SS0,u,l0n

"

°'^

Statement " q U , d a , , 0 n -

'

te

™*''™.

° ' substantial contraction dunng the year? If 'Yes/attach

"•ssajagTK^s^s^r^^^"™'--".
83a Did the organization comply with the public inspection

equipment, or facilities at no charge or at

requirements for returns and exemption applications? b Did the organization comp.y with the d.sclosure requirements relating to quid pro quo contributions? C ntr,bU, 0nS? 84a Did the organization solic, any contributions or gifts that were not tax deductible? ° '
b

M&'&StfTT6?.inClUde W,th

6Very S ,iC,ta,IOn a

°

"

e

^ « statement that such contributions or g.fts

^ b Z T t (5)' °\ ^ °rgan,2atl0nS a W e r e substantially a., dues nondeductib.e by members' . i V ° r 9 a n , 2 a t , o n m a k e o n , y i n " ° ^ lobbying expenditures of $2,000 or less? .. S ' f o ^ x ^ " * compw. 85c through 85h below uniess the organization received

c Dues, assessments, and similar amounts from members d Section 162(e) lobbying and political expenditures.. e Aggregate nondeductible amount of Section 6033(e)(1)(A) dues notices t Taxable amount of lobbying and pol.t.cal expend.tures (line 85d less 85e) g Does the organization elect to pay me Sedon 6033(e) tax on the amount ,n 85f> ^ ^ ^ ^ - u n t in 85f to

8 6

ZT.TT?.**''"ln,,iat,onfeesa^^^

b Gross receipts, included on line 12, for public use of club facilities 87 501(0(12) organzauons Enter: a Gross income from members or shareholders

8 8

^Sina^

^SLi^
SeC 0n 495fi excess S£SSSWSS^X " * " • « transaction" SS I f " ™ 1 tran SMt»n from a prior year? If 'Yes.1 attach a statement 0 n mana9erS 0

89a 501(c)(3) organizations. Enter: Amount of tax imposed on the organization during the year under Section 4911 . = 0 0 . ; Section 4912n ; Se ct,on4955 " S^L%?i^iSSSSBS.'S explaining each transaction ° I K i £ S g % £ S S " .
t , ,

.°TT

° r d ' S q U a , , f , e d P^sons durmg the year under ^ T*nZ\ I 90b| -<H7)_928_-96_8_3_ _ _ .j
92

J f T l A m ° U m ° f t a X ° n " n e 89C " a b 0 V e ' « * " * ™ « i by the organization fc 90a List the states with which a copy of this return is filed - I l l i n o i s 91 T H T „ * '° '° ™lud-es~Ma7ch ^ l i ^ s e e ™t7uction"sf ,rucr,ons; 91 The books are in care of ► C a r o l S o i z z i r r i i Te ephone numb Located a. ►_4825_N, S c g " t " t " s t " # 7 4 A T c h i T l i r " • p i F k " " ~ ' % * _ . and enter the amount of t a x - e x e m p t , ^ , ^ i v e d or accrued ^ e . J % ,
b U r emP yeeS emP y e d ln Ule P a y P e r i 0 d ,hat

2

,;,,.;

|

^ Form 990 (1999)

TEEAOIOS ,2120m

g r n j g n w g ) Save A Li to
Enter gross amounts unless otherwise indicated. 93 Program service revenue:

Pn,Hation
. ^ ^

' t a t M l l A„alvs,s of I n c o m - P ^ l . . ^ A c t | V | f t e s ^

36-3869459

« Program Feps b "

f Medicare/Medicaid payments 9 Fees & contracts from government agencies 94 Membership dues and assessments 95 Interest on savings & temporary cash invmnts 96 Dividends & interest from securities 97 Net rental income or (loss) from real estate: a debt-financed property b not debt-financed property 98 Net rental income or (loss) from pers piop . . . 99 Other investment income 700 Gam or (loss) from sales of assets other than inventory 101 Net income or (loss) from special events 102 Gross profit or (loss) from sales ol inventory 103 Other revenue: a

I — » , B^mtm, I...bl, Sn^rto, and U.™^..
Name address, and EIN of corporation, partnership, or disregarded entity Percentaoeof | ownershiD?ntereS|j
(C) . Nature of activities

— . . r ^ g —
N/A
I | <°> Total income ' <E) End-of-year assets

%\

XI

iere 'aid >retarer's Ise >nly AA

'

•-Typo or Prml Name and Title

I

Finn's Name (or yours it sell-employed) and Address

A h l b e c k & Company
1665 Elk finijlpv/arrl

DesPlaines
TEEAOI06 12/27/99

36-29915QO 60016-4798
Form 990(1999)

Department of the Treatury Internal Rovenue Service

(Form 990)

Schedule A

Organization Exempt Under 1 9 9 9 Section 501(c)(3)

IRS use only - Do not

w

„i,c,

stapl

[n

^

^ ^ OMB Na 1M5 0047

.."

MU5t bC C m

° P ' e t e d b y t h e a b o v e °"-g»"i»tions and attached to their Form 990 or 990-EZ.
Employer Identification Number

Name of the Organisation

Save A Life Foundation

(a) Name and address of each employee paid more than $50,000

(b) Title and average hours per week devoted to position

(e) Compensation

(d) Contributions to employee benefit plans & deferred compensation

(e) Expense account and other allowances

None

Total number of other employees paid over$50.000 „y w

i J .,

>■- ^ - , v,*, ,.*„-, ,-**, *,<,, .»>. „* ■ ***,!. >^ ? i-^^^^^^%^&^^^x^<^^i

WWmi

Compensation of the Five Highest Paid independent Contractors for P r o f Z l n ^ (See instructions. List each one (whether individuals oTfWsMf there are none, enter 'None.') Professional (b) Type of service

Services
(c) Compensation

'

(a) Name and address of each independent contractor paid more than $50,000

None

Jote'number of others receiving over »50,000 for professional services BAA For Paperwork Reduction Act Notice, see the instructions for Form 990 and Fo J 990 EZ.
TEEA040I 08/04/99

Schedule A (Form 990) 1999

Save A Life Foundation iPaftWlil;} Statements About Activities
1

Schedule A (Form 990) 1999

36-3869459
Yes

D

age2 No

F^tS^S!^^

or loca, legis.ation. i n c | u d l n g $

any a

„empt

If 'Yes,' enter the total expenses paid or incurred in connection with the lobbying activities o f e ^ lobbying activities.
2

Form 5768 must complete Part V.-A. Other complete Part V I B and attach a statement giving a detailed description of the


2a

S l ^ o ^ *.th which any such person ,s

of the following acts with any of „s . l * ^ r & £ . ^

a Sale, exchange, or leasing of property? b Lending of money or other extension of credit? 2b c Furnishing of goods, services, or facilities? 2c d Payment of compensation (or payment or reimbursement of expenses if more than $1,000)? S e e . P.t V , e Transfer of any part of its income or assets? II the answer to any quest.on is 'Yes,1 attach a detailed statement explaining the transactions. 3 Does the organization make grants for scholarships, fellowships, student loans, etc' 4a Do you have a section 403(b) annuity plan for your employees? '....'. 4a
i « « ^ ^

x

Fftl 9 9 0

2d X
2e

,

H i g i Reason for Non-Private Foundation Status (See instructions.)
The organization is not a private foundation because it is (please check only One applicable box):

5 6 7 8 9

A church, convention of churches, or association of churches. Section 170(b)(1)(A)(i) A school. Section l70(b)(1)(A)(.i). (Also complete Part V, page 4.) A hospital or a cooperative hospital service organization. Section 170(b)(l)(A)(n). A federal, state, or local government or governmental unit. Section 170(b)(l)(A)(v).

u A^medical research organization operated ,n conjunction with a hospital. Section 170(b)(l)(A)(„ ). Enterthe hospital s name, city,
l D

10

V l S S S S ^ ^ ^ S ^ ^

S

.

^

U

" n 7 v e " r ^ " ° - V d o-pVat-ed-b-ya ^ n i i n V i , ! i e ^ o n F T V M I ^

0*

118 0

S

^

S

^

^

°

~

*

' - t or from the genera, publ.c.

11 b □

A community trust. Section 170(b)(l)(A)(vi). (Also complete the Support Schedule in Part IV-A)

from gross investment ™ ° m e ™ d " u n r e l ^ 33-1/3% of & support organization after June 30, 1975. See section 509(a)(2). (AlsocSmpTeli mef I S ^ S c h & l T p ^ v l A . ) 8 ^ " ' ^ " y * ' 13
D

^ c f f i ^ section 509(a)(3).)

a

'

w

s e c i , o n 3UI

S R S a ^ o T S , ?f U ,n? , , 0 n T W ? ? n d * W * organizations W ( 4 ) , (5), or (6), if they meet the test of section 509(a)(2). (See

Provide the following information about the supported organizations. (See instructions.) (a)Name(s) of supported organization(s) (b) Line number from above

14 [~| A " organization organized and operated to test for public safety. Section 509(a)(4). (See instructions} BAA „ ,
TEEAO402 )2/20S99

Schedule A (Form 990) 1999

Schedule A (Form 990) 1999 Save A L i f e Foundation PattW* S u p p o r t S c h e d u l e (Complete only il you checked a
Calendar year (or fiscal year beginning in) 15 Gifts, grants, and contributions received. (Do not include unusual grants. See line 28.) .. 16 Membership fees received 1998

36-3869459

Page 3

box on line 10. 11. or 12.) Use cash method of account/no Note: You may use the worksheet in the instructions for converting from the accrual to the cash method of accounting 1997 1 & $ 5

Je)
Total

621.289.

101.330. 550.

37.566 1.527

110,761
1.410.

870.946.
3,487.

17 Gross receipts Irom admissions, merchandise sold or services performed, or furnishing of lacihties in any activity that is not a business unrelated to the organizations charitable, etc, purpose . 18 Gross income from interest, dividends, amounts received from payments on securities loans (Section 512(aX5)), rents, royalties, and unrelated business taxable income (less Section 511 taxes) from businesses acquired by the organ­ ization alter June 30,1975 19 Net income from unrelated business activities not included in line 18 20 Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf

6,134.

6.134.

676

676.

21 The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge 22 Other income. Attach a schedule. Do not include gam or (loss) from sale of capital assets 23 Total of lines 15 through 2 2 . 24 Line 23 minus line 17 25 Enter 1 % of line 23 26

628.099. 621,965. 6.281

101.880. 101,880. 1.019.

39.093 39.093

Organizations described on lines 10 or 11:

391

a Enter 2% of amount in column (e), line 24

112.171 112.171 1.122. 26a 26 b 26c
26 d 26e 26 f

881.243. 875.109.

nm&£ 17.502.
875.109.
676. 874,433.

b Attach a list (which is not open to public inspection) showing the name of and amount contributed by each ? £ £ o n ( ° , h e r ' " a " a governmental unit or publicly supported organization) whose total gifts for 1995 throuah 1998 exceeded the amount shown in line 26a. Enter the sum of all these excess amounts c Total support for Section 509(a)(1) test: Enter line 24, column (e) dAdd: Amounts from column (e) for lines: 18 19 676. 22 e Public support (line 26c minus line 26d total) f Public support percentage (line 26e (numerator) divided by line 26c (denominator)) 27 Organizations described on line 12: 26b

99.92 %

a For amounts included in lines 15, 16, and 17 that were received from a 'disqualified person.' attach a list to show the name of and total amounts received in each year from, each 'd.squal.fied person.' Enter the sum of such amounts for each year C"8)
b

(1997)

(1996)

(1995)

^r™La£r0**lLn^2e<L'n, " n e ' 7 , h a L w a S l e C ? , v e c l , r o . m ,? nondisquahfied person, attach a list" to show the name of ."and amount received for each year that was more than the larger of (1) the amount on line 25 for the year or (2) $5 000 (Include in the list organizations described ,n lines 5 through 11, as well as individuals.) After computing the ^ m ^ M ^ ^ ^ V r l ^ e a rece,vea and the larger amount described in (1)or (2). enter the sum of these differences (the excess amounts)Tfor each year ('998) (1997) (1996) (1995) c Add: Amounts from column (e) for lines: 15 16 17 20 21 27c dAdd: Line 27a total and line 27b total 27d e Public support (line 27c total minus line 27d total) 27e f Total support for section 509(a)(2) test: Enter amount on line 23, column (e) H Z7t | g Public support percentage (line 27e (numerator) divided by line 27f (denominator)) 27fl h Investment income percentage (line 18. column (e) (numerator) divided by line 27f (denominator)) Unusual Grants: For an organization described in line 10, 11, or 12 that received any unusual grants during 1995 throuah 1998, attach a list fwhich is not open to public inspection) for each year showing the name of the contributor, the date and amount of ttie grant, and a the brief description of the nature of the qrant. Do not include these orants in line 15 rSee inctn irhnnc ^ grant. grants 15. (See instructions.) §AA~
TEEAM03 12/20/99

%

Schedule A (Form 990) 1999

• Schedule A (Form 990) 1999 Save A L i f e Foundation Ipaft V I Private School Questionnaire (See instructions.^

36-3869459 N/A

Page 4

' (To be completed Only by schools that checked the box on line 6 in Part IV)

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

30
JX*

31

32 Does the organization maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative staff? b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student admissions, programs, and scholarships? d Copies of all material used by the organization or en its behalf to solicit contributions? If you answered 'No' to any of the above, please explain. (If you need more space, attach a separate statement.)

32a 32b 32c

32d

33 Does the organization discriminate by race in any way with respect to: a Students' rights or privileges? b Admissions policies? c Employment of faculty or administrative staff? d Scholarships or other financial assistance? e Educational policies? f Use of facilities? gAthletic programs? h Other extracurricular activities? If you answered 'Yes' to any of the above, please explain. (If you need more space, attach a separate statement.)

33a
33b 33c 33d

33e
33f

33fl 33h

&

34a Does the organization receive any financial aid or assistance from a governmental agency? b Has the organization's right to such aid ever been revoked or suspended? If you answered 'Yes' to either 34a or b, please explain using an attached statement.

34a 34b

M M
35 Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05 of Rev Proc75-50, 1975-2 C.B. 587, covering racial nondisenmination? If 'No,' attach an explanation 35 3AA TEE AM W 1200/99 Schedule A (Form 990) 1999

ScheduleA(Form990) 1999

Save A Li f e Foundation

36-3869459
N/A

Page5

(To be completed Only by an eligible organization that filed Form 5768) Check here ► • Check here » ■ " T i f t h e organization belongs to an affiliated group. b ~ if you checked 'a' above and 'limited control' provisions apply. a

Limits on Lobbying Expenditures
(The term 'expenditures' means amounts paid or incurred.) 36 Total lobbying expenditures to influence public opinion (grassroots lobbying) 37 Total lobbying expenditures to influence a legislative body (direct lobbying) 38 Total lobbying expenditures (add lines 36 and 37) 39 40 41 Other exempt purpose expenditures Total exempt purpose expenditures (add lines 38 and 39) Lobbying nontaxable amount. Enter the amount from the following table If the amount on line 40 is Not over $500,000
Over $500,000 but not over $1,000,000 Over $1,000,000 but no! over $1,500,000 Over $1,500,000 but nol over $17,000,000 Over $17,000,000

The lobbying nontaxable amount is 20% of the amount on line 40
$100,000 plus 15% of the excess orer $500,000 $175,000plus 10% ot the excess over $1,000,000 $225,000 plus 5% of the excess over $1,500,000 $1,000,000 ' . . ' . _

42 Grassroots nontaxable amount (enter 25% of line 41) 43 Subtract line 42 from line 36. Enter -0- if line 42 is more than line 36 44 Subtract line 41 from line 38. Enter -0- if line 41 is more than line 38 Caution: If there is an amount on either line 43 or line 44. you must file Form 4720
4

,c

..

„_

-Year Averaging Period Under Section 501(h)

(Some organizations that made a section 501(h) election do not have to complete all of the five columns below See the instructions for lines 45 through 50.) Lobbying Expenditures During 4 -Year Averaging Period Calendar year (or fiscal year beginning in) ► 45 Lobbying nontaxable amount
46 Lobbying ceiling amount (150% of hue 45(e)) . Total lobbying expenditures . Grassroots nontaxable a m o u n t . Grassroots ceiling amount (150% of line 48(e)) . . . Grassroots lobbying expenditures

(■) 1999

(b)
1998

(c)
1997

(d) 1996

(e)
Total

4&x

0^Mm.

47

m,
1^

<£&&Vfc^ ■W?** yOt"

48

49

^

.*»

w

'i

^

'

*

>

<

* « *

50

fcipJSBIf

Lobbying Activity by Nonelecting Public Charities
(For reporting only by organizations that did not complete Part V I A ) (See instructions.)

S K / t o .nt,?» d ' d ^ °rgan.zat.on attempt to influence national, state or local legislation, including any attemot to influence public opinion on a legislative matter or referendum, through the use of: a Volunteers b Paid staff or management (include compensation in expenses reported on lines c through h.) c Media advertisements d Mailings to members, legislators, or the public e Publications, or published or broadcast statements f Grants to other organizations for lobbying purposes g Direct contact with legislators, their staffs, government officials, or a legislative body h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means I Total lobbying expenditures (add lines c through h) II 'Yes' to any of the above, also attach a statement giving a detailed description of the lobbying activitu 3AA
TEE AMOS 12/20/99

Yes

No

:

Amount

.?mm

Schedule A (Form 990) 1999

Schedule A (Form 990) 1999

Save A L i f e

Foundation

gPartVH

5

iT»rpfo°g, ni?ff.'^^^
51 a (i) ■(M) b(i)

R

36-3869459

Paoe6

' KVor,srss«^^^^
a Transfers from the reporting organization to a nonchantable exempt organization of(i)Cash ' (ii)Other assets b Other transactions: (i)Sales or exchanges of assets with a nonchantable exempt organization (ii)Purchases of assets from a nonchantable exempt organization (Hi)Rental of facilities, equipment, or other assets (tv) Reimbursement arrangements (v)Loans or loan guarantees rz~ I Yes No

ban
b(iii) b(iv) b(v) b(vi) _X_ X

(vi)Performance of services or membership or fundraismg solicitations c Sharing of facilities, equipment, mailing lists, other assets, or paid employees

Line no.

L % % » ^ §TTe _jnylan 5 act, 0 n or sharing arrangement. ^ o V in* (») <b) I
amouMmvoLed

d

S

Nam. .1 n . n c h m l M , l . e > C T p l ^ m , ,

S S 1 'cXA^T^% (c)

^

M ^ d a l ^ f s h ™ * • '*r market value of V ^ a S ^ X ^ ^ ^ J ^ J ! ^ ! P ^ value ?n°f
fc^M „„„,,„, „ „ & , ,M
sMr,„,

„ „ , „ „ „

i 'Yes.' followina scheduleb If 'Yes,' complete the following schedule: <"> Name of organization Type of organization

l _ | res |xj NO (c) Description of relationship

IAA

TEEAM06 12/20/99

Schedule A (Form 990) 1999

Form 990 Line Id Statement

Schedule of Contributors Donating $5,000 or More in Money, Securities, or Other Property
(Not Open For Public Inspection.)
*■ Attach to return

1999

Name as Shown on Return

Save A Life Foundation

Employer Identification Number 36-3869459 Page Number

Contributor's Name and Address

Description

Date Received

Amount Received

IL Dept, of Commerce & Communi ty Af fat rs 6 2 0 East Adams S t r e e t

Cash
various 300.000.

Springfield

IL

62701

IL State Board of Education 100 N. First St. Springfield 62777 IL Abbott Laboratories Dept 379-Ap Bide 14C Abbott Park IL Abbott Laboratories Dept 379-AP Bide 14C Abbott Park IL

Cash
various 300.000.

Cash 60064 Cash 60064

04/05/99

4,000.

12/09/99

4.000.

TEEW0301 SCR 09/15/99

Save A Life Foundation

36-3869459

Form 990, Page 1, Part I, Line 9 Special Events and Activities Statement List of Three Largest Events and Type and Number of Others Dinner Event Various Merchandise Total Net Income (Loss) 0. 59. 59.

Gross Receipts 34.525. 150. 34.675.

Less Contributions 9,038.

Gross Revenue 25.487. 150. 25.637.

Less Direct Expenses 25.487. 91. 25.578.

9,038.

Form 990. Page 2, Part II, Line 43 Other Expenses Stmt (A) Total Other expenses (itemize) Computer E x p e n s e s C o n s u l t i n g Fees C o n t r a c t Labor Dues & S u b s c r i p t i o n s Equipment R e n t a l I n s t r u c t o r s Fees Insurance L i c e n s e s 8r P e r m i t s Marketing Memorial Fund Expenses Miscellaneous Recruitment Research/Evaluation Total 22.542. 36.765. 1.697. 800. 1.740. 64.015. 7.072. 1.063. 9.534. 370. 1,157. 2.321. 1.123. 150,199. (B) Program services 21.592. 33.615. 1.564. 419. 1.584. 64.015. 6.435. 1.044 . 8.849. 0. 443. 2.193. 1.042. 142.795. (C) Management and qeneral 388. 3.150. 25. 381. 52. 0. 212. 17. 45. 370. 713. 39. 30. 5,422. (D) Fundraising

562. 0. 108. 0. 104. 0. 425. 2. 640. 0. 1. 89. 51. 1.982.

Form 990. Page 3, Part IV, Lines 57a & 57b Land, Buildings and Equipment Statement

(a) Cost/Other Basis O f f i c e Equipment Vehicles Total 75.025. 31.998. 107.023.

(b) Accumulated Depreciation 38.020. 8.160. 46. 180.

(c) Book Value

37.005. 23.838. 60.843.

Form 990, Page 3, Part IV, Line 65 Other Liabilities Statement Beginning of Year -747. 5.675. End of Year 0. 0.

Line 65 - Other Liabilities: Payroll Liabilities I n t e r e s t due t o S t a t e o f

IL

Save A Life Foundation

36-3869459 Continued

2

Form 990, Page 3, Part IV, Line 65 Other Liabilities Statement Beginning of Year

Line 65 - Other Liabilities:

End of Year

4.928.
Form 990, Page 4, Part V List of Officers, Etc. Statement

0.

(A) Name and address

(B) Title and average hours per week devoted to position

(C) Compensation (if not paid, enter -0-)

(D) Contributions to employee benefit plans and deferred compensation

(E) Expense account and other allowances

Note: The individuals above. except as noted, spend time as needed in t h e i r capacity on t h e Board, They can be c o n t a c t e d c / o Save a L i f e foundation, 4825 N. Scott St. U74A. Schiller Park. IL 60176

Total

Save A Life Foundation

36-3869459

3

Supporting Statement of: Form 990 p 2 / L i n e 42(B) Description O f f i c e Equipment-Program D e p r e c i a t i o n Vehicles-Program Depreciation Total Amount 8.316 4.570. 12.886,

Supporting Statement of: Form 990 p 2 / L i n e 42(C) Description O f f i c e Eouipment-Mgmt & Genrl D e p r e c i a t i o n Vehicles-Mgmt & Genrl D e p r e c i a t i o n Total Amount 260.

143.
403.

Supporting Statement of: Form 990 p 2 / L i n e 42(D) Description O f f i c e Equipment-Fundraising Depreciation Vehicles-Fundraising Depreciation Total Amount

521
287, 808.

Supporting Statement of: Form 990 p 3 / L i n e 63. column (B) Description Due t o Carol Total Spizzirri

Amount
65.475. 65,475

SAVE A LIFE FOUNDATION, INC. AUDITED FINANCIAL STATEMENTS DECEMBER 31, 1999

AHLBECK&COMPANY
CERTIFIED PUBLIC ACCOUNTANTS

SAVE A LIFE FOUNDATION, INC. TABLE OF CONTENTS DECEMBER 31, 1999 Auditor's Report Financial Statements Comparative Statement of Financial Position December 31, 1999 and December 31, 1998 Statements of Activities for the years ended December 31, 1999 and December 31, 1998 Comparative Statement of Functional Expenses for the years ended December 31, 1999 and December 31, 1998 Statements of Cash Flows for the years ended December 31, 1999 and December 31, 1998 Notes to Financial Statements

AHLBECK&COMPANY
CERTIFIED PUBLIC ACCOUNTANTS 1665 ELK BOULEVARD DES PLA1NES. ILLINOIS 60016-4798 TELEPHONE: 847/824-1000 FACSIMILE 847/824-40U WEB: wwwahlbcckco com

February 16, 2000

To The Board of Directors Save A Life Foundation, Inc. Schiller Park, Illinois

INDEPENDENT AUDITOR'S REPORT We have audited the accompanying statements of financial position of SAVE A LIFE FOUNDATION, INC. (an Illinois not-for-profit corporation) as of December 31, 1999 and 1998, and the related statements of activities, statements of functional expenses, and statements of cash flows for the years then ended. These financial statements are the responsibility of management. Our responsibility is to express an opinion on these financial statements based on our audits. We conducted our audits in accordance with generally accepted auditing standards. Those standards require that we plan and perform the audits to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion. In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of SAVE A LIFE FOUNDATION, INC. as of December 31, 1999 and 1998, and the results of its activities and its cash flow for the years then ended in conformity with generally accepted accounting principles.

- 1-

SAVE A LIFE FOUNDATION, INC. COMPARATIVE STATEMENT OF FINANCIAL POSITION December 31, 1999 and December 31, 1998 1999 A S S E T S CURRENT ASSETS Cash and Cash Equivalents Prepaid Legal Fees Inventory Accounts Receivable Deposits Prepaid Expenses Total Current Assets FIXED ASSETS AT BOOK VALUE Office Equipment Vehicle Net Fixed Assets TOTAL ASSETS

EXHIBIT A

1998

509,,770 17,,500 26,,593 ,750 1. 162 727 556, 502

481 ,738 0 0 0 0 0 481 ,738

37, 006 23. 838 60, 843 617, 345

14,,974 28. 838 4 3 . 812 S2S. 550

L I A B I L I T I E S CURRENT LIABILITIES Accounts Payable Payroll Liabilities Interest Due To State Of II Current Portion Loan Payable Total Current Liabilities LONG TERM LIABILITIES Vehicle Loan Less: Current Portion Total Long Term Liabilities OTHER LIABILITIES Due To Carol Spizzirri Total Other Liabilities TOTAL LIABILITIES NET ASSETS Unrestricted Temporarily Restricted TOTAL NET ASSETS

A N D

N E T

A S S E T S

4,167 0 0 0 4,167

*?

1,474 (747) 5,675 4.743 11,145

0 0

19,907 4.742

15,164 65.475 65.475 69.642 61.521 61.521 87,830

247,,704 300.,000 547. 704 617, 345

137,720 300.000 437.720 525.550

TOTAL LIABILITIES AND NET ASSETS

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

- 2-

SAVE A LIFE FOUNDATION, INC. STATEMENT OF ACTIVITIES For the Year Ended December 31, 1999

EXHIBTT R

Unrestricted XNCQMS
Contributions Program Fees Government Grants Private Grants Conferences Fundraisers/Sales (net) Sponsorships In Kind Contributions Special Events (net) Other TOTAL INCOME EXPENSES Program Kid's Program Other Training Programs Total Programs Fundraising Management & General TOTAL EXPENSES RECLASSIFICATIONS EXCESS INCOME OVER EXPENSES FROM ACTIVITIES INVESTMENT INCOME Interest Income TOTAL INVESTMENT INCOME CHANGE IN NET ASSETS BEGINNING NET ASSETS ENDING NET ASSETS $ 1,825 16,831 300,000 9,500 59 680 13,150 9,038 440 351,523

Temporarily Restricted
$ . 300 ,000 300, 000 $

l££al
1,825 16,831 600,000 9,500 59 680 13,150 9,038 440 651,523

466 ,901 43 ,503 510 ,404 37 ,357 18, ,353 566, ,114 300, 000 (300,000)

466 ,901 43 ,503 510 ,404 37 ,357 18, ,353 566, ,114

85, 409

85, 409

24, 575 24. 575 109,984 137,720 247,704 $ 300,000 300,000 $

24, 575 24, 575 109,984 437,720 547,704

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

- 3 -

SAVE A LIFE FOUNDATION, INC. STATEMENT OF ACTIVITIES For the Year Ended December 31, 1998 Tempo rairily Restricted $ . 300, ,000 300, 000 $

EXHIBIT R

Unrestricted INCOME Contributions Government Grants Private Grants Conferences Fundraisers/Sales Sponsorships In Kind Contributions Other TOTAL INCOME EXPENSES Program Fundraising Management & General TOTAL EXPENSES EXCESS INCOME OVER EXPENSES FROM ACTIVITIES INVESTMENT INCOME Interest Income TOTAL INVESTMENT INCOME CHANGE IN NET ASSETS BEGINNING NET ASSETS ENDING NET ASSETS 676 676 166,730 (29,010) 137,720 $ 1,200 300,000 19,500 16S 4,474 140 73,445 284 399,208

Total
1,200 600,000 19,500 165 4,474 140 73,445 284 699,208

132,799 4,879 95,476 233,154

-

132,799 4,879 95,476 233,154

166,054

300, 000

466,054

676 676 300,000 466,730 (29,010) $ 300,000 $ 437,720

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

- 4-

SAVE A LIFE jMDATION, INC. STATEMENT OF FUNCTIONAL EXPENSES For the Year ended December 31, 1999 Program
Kid's Program Other Training 5 Programs 13,872 116 1.431 783 160 20 529 68 42 673 87 12,912 354 211 2 118 Total Program $ 189,643 2,071 16,674 19.292 2,909 199 371 21,592 479 33,615 1.564 12,886 419 1.584 64,015 6,435 3,888 1,044 8.849 522 446 13.560 5,736 33,086 2,193 22,862 1,144 1,042 14,009 7,802 20,476 510,104 104 424 211 2 641 15 107 608 Fundraising $ 21,682 116 1.832 781 192 535 24 562 445

I Ln I

Salaries & Wages Employee Benefits Payroll Taxes Accounting Fees Amortization Automobile Expense Awards & Recognitions Bank Charges Computer Expenses Conferences Consulting Fees Contract Labor Depreciation Expense Dues & Subscriptions Equipment Rental Instructor Fees Insurance Interest Expense Legal Fees Licenses & Permits Marketing Meetings Memorial Fund Expenses Miscellaneous Office Supplies Penalties Postage k Delivery Printing & Reproduction Recruitment Rent Repairs Research/Evaluation Telephone Training Supplies Travel Total Functional Expenses

$

175,772 1,955 15,243 18,508 2,749 199 351 21,063 411 33,615 1,522 12,213 419 1.497 51,103 6,082 3,677 1,042 8,730 522 406 12.659 5,440 30,529 2.153 21,668 1,081 991 13,299 5,115 16,889 466,901

Support Management and General S 6,525 915 531 1.271 96 12 387 450 3,150 25 404 381 52 212 127 16 45 319 370 713 342 186 170 39 708 38 31 426 413 16,353 $

Total 28.207 1.031 2.363 2.051 288 535 37 950 895 3.150 133 1,211 381 157 636 338 19 686 334 370 713 1,226 564 4,771 128 2,150 113 82 1,277 917 5S.710

Organization Total S 217,850 3.101 19,037 21,343 3,197 734 40B 22,542 1,374 36,765 1,697 14.097 800 1.740 64,015 7,072 4,226 1.063 9,534 856 370 1.159 14,785 6.300 37,857 2,321 25.012 1.257 1.123 15,286 7,802 $ 566,114

40 901 296 2,557 39 1.194 63 51 710 2,687 3,587 43,503

BB3 378 4,601 89 1,441 75 51 B51 504 37,357

Management and General Allocation Total Expenses S

15,126 482,027 $

528 44.031

1S.6S4 $ 526,058 $

1,935 39.292

(17,589)
?

(15,654) $ 40.056 566.114

64

ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE

SAVE A LIFE ..JNDATION, INC. STATEMENT OF FUNCTIONAL EXPENSES For the Year ended December 31, 199B Support
IL P i l o t Program Fundraising Management General and Total 625 $ 1,875 Organization Total

l l

Salaries & Wages Employee Benefits Payroll Taxes Accounting Fees Amortization Automobile Expense Awards & Recognitions Bank Charges Computer Expenses Conferences Consulting Fees Depreciation Expense Dues & Subscriptions Instructor Fees Insurance Interest Expense Legal Fees Licenses & Permits Marketing Miscellaneous Office Supplies Penalties Postage & Delivery Printing & Reproduction Recruitment Rent Repairs Telephone Training Supplies Travel Total Expenses

$

58,169

$

1,250

$

$

60,044

262
1,709 1,191

~ " " ~ ~ ~ ~ 3,000

318 340 39
6,640

. . 318 340 39
6,640

262
1, 709 1,191

561

318 561 340 39
20,187 2,200 40.965 12,209

13,547 1,455 7,215

745
33.750 12,209

745
33,750 12,209

3,200

323 2,390

323 2,390

323
3,200 2,390

154 90 28,058

10,000

154 90
3,000

154
10,000

6,135

90
9,135

4,630

IS 54 6 20 199 334 $
4.B79

28,073

32,703

941
7,412 1,598

660 27 8,783

660 81 . .
8,789

660
1,022 7.412 1.598 9,065

275 170
6,256 2,362 5,713 $ 132,799

10 100 215 $
95,476 $

30 299 54 9 100,355

200
6,555

2,362
6,263 $ 233,154

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

EXHIBIT D SAVE A LIFE FOUNDATION, INC. STATEMENT OF CASH FLOWS FOR THE YEAR ENDED DECEMBER 31, 1999 Cash Flows from Operating Activities: Change in Net Assets Adjustments to reconcile change in net assets to net cash provided by (used in) operating activities: Depreciation and amortization Changes in assets and liabilities: Decrease (increase) Decrease (increase) Decrease (increase) Increase (decrease) Total adjustments in in in in accounts receivable inventory other current assets other payables (1,750) (26,593) (18,389) l.719 (30.916) 79,068 $ 14,097 S 109,984

Net cash provided by (used in) operating activities Cash Flows from Investing Activities: Purchase of fixed assets Net cash provided by (used in) investing activities Cash Flows from Financing Activities: Payments on loan Net cash provided by (used in) financing activities Net increase (decrease) in cash and cash equivalents Cash and cash equivalents at beginning of period Cash and cash equivalents at end of period Supplemental Disclosures: Interest paid (19,907) (31.129)

(31,129)

(19,907) 28,032 481.738 S 509.770 S 4.226

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

- 7-

EXHIBIT D SAVE A LIFE FOUNDATION, INC. STATEMENT OF CASH FLOWS FOR THE YEAR ENDED DECEMBER 31, 1998 Cash Flows from Operating Activities: Change in Net Assets Adjustments to reconcile change in net assets to net cash provided by (used in) operating activities: Depreciation and amortization Changes in assets and liabilities: Increase (decrease) in accounts payable Increase (decrease) in other payables Total adjustments Net cash provided by (used in) operating activities Cash Flows from Investing Activities: Purchase of fixed assets Net cash provided by (used in) investing activities Cash Flows from Financing Activities: Proceeds on issuance of debt Repayments on debt Net cash provided by (used in) financing activities Net increase (decrease) in cash and cash equivalents Cash and cash equivalents at beginning of period Cash and cash equivalents at end of period Supplemental Disclosures: Interest paid $ $ 21,668 (i, 7gp 19.907 475,019 6. 719 481.73B 154 (31.998) (31,998) $ 12,527 1,474 s, 379
2Q,380

$

466

73Q

487,110

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

- 8 -

SAVE A LIFE FOUNDATION, INC.
t

NOTES TO FINANCIAL STATEMENTS DECEMBER 31, 1999 NOTE 1 - Summary of Significant Accounting Policies Nature of Activities Save A Life Foundation, Inc. (SALF) works to promote the training of life supporting first aid skills; to promote consistency, uniformity, and safety i the application of those skills; to expand knowledge of " Good Samaritan" laws to encourage people to provide help; and to assure that skills are accessible to all. SAL received 45% of its total income in the year ended December 31, 1999 from the State of Illinois Department of Commerce and Community Affairs and 45% from the State of Illinois Board of Education. The remainder of SALF's income is from program fees, private contributions and fundraising projects.

Basis of Accounting The financial statements of SALF have been prepared on the accrual basis of accounting and accordingly reflect all significant receivables, payables, and other liabilities. The net assets of SALF are classified as follows: Unrestricted, which represent the portion of expendable net assets that are available for operations. Temporarily Restricted, which represent grants which are for future periods. Upon termination of the restriction, a reclassification is made to unrestricted net assets. Fixed Assets Fixed assets are carried at cost if purchased or fair value if contributed for current additions. Depreciation is computed on the straight-line method over 3-5 years for vehicles, computer equipment, furniture and office equipment. Maintenance, repairs and minor costs are expensed as incurred. When properties are retired or otherwise disposed of, the related cost and accumulated depreciation are removed from the respective accounts and any profit or loss on disposition is credited or charged to operations.

Estimates The process of preparing financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions. These estimates and assumptions affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and reported amounts of income and expenses during the reporting period. Actual results could differ from those estimates.

- 9-

SAVE A LIFE FOUNDATION, INC. NOTES TO FINANCIAL STATEMENTS DECEMBER 31, 1999

Cash and Cash Equivalents For purposes of the statement of cash flows, SALF considers all checking accounts, certificates of deposit and petty cash to be cash equivalents. Income Taxes SALF is exempt from income taxes under Section 501 (c)(3) of the Internal Revenue Code. In addition, SALF qualified for the charitable contribution deduction under Section 170(b)(1)(A) <vi) and has been classified as an organization other than a private foundation under Internal Revenue Code Section 509(a)(2).

Functional Allocation of Expenses In the Statement first charged to actual expense. as time spent in of Functional Expenses, salaries and related expenses are the various programs and supporting services on the basis of Expenses are then allocated based on various criteria, such various areas.

NOTE 2 - Donated Materials and Services In-kind donations of materials and fixed assets are recorded at their estimated fair value at the date of donation. Such donations are reported as unrestricted support unless the donor has restricted the donated asset to a specific purpose. Conditional transfers of assets are recognized when the conditions upon which they depend are substantially met. During the fiscal years ended December 31, 1999 and 1998, SALF received $12,895 and $30,945, respectively, in donations of this type. Donations of services are recorded if they create or enhance a nonfinancial asset or are specialized skills that would be purchased if they were not donated. SALF received donations of this type in the fiscal years ended December 31, 1999 and 1998 of $0 and $33,750, respectively. SALF rents its office space at a lease amount substantially below market value. During the years ended December 31, 1999 and 1998, SALF received $8,750 in office space each year.

NOTE 3 - Policy on Contributions Contributions received are recorded as unrestricted, temporarily restricted, or permanently restricted support, depending on the existence and/or nature of any donor restrictions. Support that is restricted by the donor is reported as an increase in unrestricted net assets if the restriction expires in the reporting period in which the support is recognized. All other donorrestricted support is reported as an increase in temporarily or permanently restricted net assets, depending on the nature of the restriction. When a restriction expires (that is, when a stipulated time restriction ends or

- 10 -

SAVE A LIFE FOUNDATION, INC. NOTES TO FINANCIAL STATEMENTS DECEMBER 31, 1999 purpose restriction is accomplished), temporarily restricted net assets are reclassified to unrestricted net assets and reported in the Statement of Activities as net assets released from restrictions. Federal grant awards are not recorded until expended for the purpose of the grants since they are conditional promises to give.

NOTE 4 - Cash and Cash Equivalents SALF maintains the majority of its cash at a single financial institution. These accounts are insured by the Federal Deposit Insurance Corporation U D to $100,000. NOTE 5 - Fixed Assets At December 31, 1999 and 1998, the costs of such assets were as follows:
Decemt l e r 3 1 ,
1999 1998 $ 43.B96 31,998 75,894 32,082 $ 43,812 $

Increase (Decrease)
$ 31,129 31,129 14,098 17,031

Office Equipment Vehicles Less accumulated depreciation Net book value

$

75,025 31,998 107,023 46,180

$

60,843

Depreciation expense for fiscal years ending December 31, 1999 and 1998 was $14,098 and $12,209, respectively. NOTE 6 - Vehicle Loan On September 7, 1998, a vehicle was financed through Ford Motor Company for $21,668 at a 2.9% annual rate of interest. The balance on this loan as of December 31, 1998 was $19,907. The loan was paid in full during the year ending December 31, 1999.

NOTE 7 - Due to Related Party The organization's founder and current executive director, Carol Spizzirri, loaned SALF start up funding. As of December 31, 1999 and 1998 the amount of this loan is $65,475 and $61,521, respectively.

NOTE B - Lease Obligation and Rental Expense The estimated future minimum rental and lease obligation for the succeeding years under non-cancelable leases for office facilities in effect at December 31, 1999 are as follows: Year Ending December 31. 2000 2001 fignt. $ 12,792 996

- 11 -

SAVE A LIFE FOUNDATION, INC. NOTES TO FINANCIAL STATEMENTS DECEMBER 31, 1999

Rental expense under the operating leases was $16,262 for the year ended December 31, 1999 and $120 for the year ended December 31, 1998. NOTE 9 - Fundraising Projects Special fundraising event income is shown in the Statement of Activities at net of expenses. The following schedule breaks out the components expenses as follows: pecember 3*- * 9 ? 9 Revere Expenses UsL Dinner Event $34,525 $25,487 $ 9,038 Various Merchan 150 9£ 59 $34,675 $25,578 $ 9,097 December 31. iggR Revenue Expenses Net $ - $ - $ 6,134 1,660 4,474 $ 6,134 $ 1,660 $ 4,474

- 12 -

fr» <yflc» U f l Only

PMT#

(iKM ^

ILLINOIS CHARITABLE ORGANIZATION ANNUAL REPORT Attorney General JIM RYAN State of Illinois
Charitable Trust Bureau, 100 West Randolph 3rd Floor, Chicago, Illinois 60601 Report for the Fiscal Period: Beginning o i / o i / oo 12 31 . 2000 12.
7 /
DAY

Form AG990-IL Revised 4/99

AMT

dj>£
^ ^

mM(,,n(. CO U 01026498

INIT

Federal ID #

363869459

& Ending

B M»k» anon E) pjyibteio □ SMX°" H BtmtuFviut □

Cheek all items attached: Copy of IRS Return Audited Financial Statements Copy of Form IFC $15.00 Annual Report Filing Fee $100.00 Late Report Filing Fee
MO
DAY

MO

YR

Are contributionstothe organization tax deductible? LEGAL NAME MAIL ADDRESS CITY. STATE ZIP CODE I.

B Yes Q No

Date Organization was created: Year-end amounts

02

/ 09 / 9 3

SAVE A LIFE FOUNDATION 402SNOCOTTCTIUIETff71A fffp SCHILLER PARK.IL 60176

UJ-itUUA£AJ££

AJ&0

A)ASSETS B) LIABILITIES C) NET ASSETS

A)$ B)$ C)$

455,579 74,681 380,898

SUMMARY OF ALL REVENUE ITEMS DURING THE YEAR: D) PUBLIC SUPPORT, CONTRIBUTIONS & PROGRAM SERVICE REV. (GROSS AMTS.) E) GOVERNMENT GRANTS & MEMBERSHIP OUES F) OTHER REVENUES G) TOTAL REVENUE. INCOME AND CONTRIBUTIONS RECEIVED (ADO D.E. & F)

PERCENTAGE

AMOUNT 0}$ E)$ F)$

10 89

% %

72,064 650,000 9.512 731,576 711,626

100%

G)S

II. SUMMARY OF ALL EXPENDITURES DURING THE YEAR: H) I) J) OPERATING CHARITABLE PROGRAM EXPENSE EDUCATION PROGRAM SERVICE EXPENSE RECEIVED
M

80

* %

H) l)$

«y

922001

TOTAL CHARITABLE PROGRAM SERVICE EXPENSE (ADD H & I) „,,.... ATTORNEY GENERAL

711,626
K)$
L

Ji) JOINT COSTS ALLOCATED TO PROGRAM SERVICES ^ M f f i F A S t Q M R U S T K) GRANTS TO OTHER CHARITABLE ORGANIZATIONS L> TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD J & K) M) MANAGEMENT AND GENERAL EXPENSE N) FUNDRAISING EXPENSE O) TOTAL EXPENDITURES THIS PERIOD (ADD L, M, & N) III. SUMMARY OF ALL PAID FUNDRAISER AND CONSULTANT ACTIVITIES: (Attach Attorney General Report of Individual Fundraising Campaign- Form IFC. One for each PFR.) PROFESSIONAL FUNDRAISERS: P) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISERS Q) TOTAL FUNDRAISERS FEES AND EXPENSES R) NET RECEIVED BY THE CHARITY (P MINUS Q=R) PROFESSIONAL FUNDRAISING CONSULTANTS: S) TOfAL AMOUNT PAID TO PROFESSIONAL FUNDRAISING CONSULTANTS IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS DURING THE YEAR: T) NAME.TITLE: U) NAME.TITLE: V) NAME.TITLE:
C a r o l S p 1

% 80 %

>*

711,626 143,155 43,601 898,382

16
100%

M)$

N)$

°

)$

100% % %

P)$
Q)$

R)$ S)S

,,g-irri.

President Computer Marketing Technician f. P u b l i c Relations HIGHEST BY IEXPEHDEOI CODE CATEGORIES

T

>*

104.900.00
34,985.60

FranclB
M a r r v

Fuller.

U ) $

AnHranrg.

V ) $

V. CHARITABLE P R O G R A M DESCRIPT\ON:cHAmrABL£pitoGMu(i W) DESCRIPTION: X) DESCRIPTION: Y) DESCRIPTION: Life Saving First Aid T r a i n i n g

26.701.86 List on back side of instructions CODE

W)# o i l
X)# Y)#

IF THE ANSWER TO ANY OF THE FOLLOWING IS YES, ATTACH A DETAILED EXPLANATION: 1. 2. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION. FINE. PENALTY OR JUDGMENT? HAS THE ORGANIZATION OR A CURRENT DIRECTOR, TRUSTEE. OFFICER OR EMPLOYEE THEREOF. EVER BEEN CONVICTED BY ANY COURT OF ANY MIDSDEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY? I.

2.

DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS. DIRECTORS OR TRUSTEES OWNS AN INTEREST; OR WAS IT A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS OFFICERS. DIRECTORS OR TRUSTEES HAS A MATERIAL FINANCIAL INTEREST; OR DID ANY OFFICER. DIRECTOR OR TRUSTEE RECEIVE ANYTHING OF VALUE NOT REPORTED AS COMPENSATION? 3. HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER. DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES? IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? 6. DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER?{ ATTACH FORM IFC ).

4.

5. 6.

7a. DID THE ORGANIZATION ALLOCATE THE COST OF ANY SOLICITATION, MAILING. ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES?
7

-

;(ii) THE AMOUNT 7b. IF 'YES". ENTER (i) THE AGGREGATE AMOUNT OF THESE JOINT COSTS $ ALLOCATED TO PROGRAM SERVICES $ ; (ill) THE AMOUNT ALLOCATED TO MANAGEMENT AND GENERAL S 1 _ : AND (iv) THE AMOUNT ALLOCATED TO FUNDRAISING £ 8. DID THE ORGANIZATION EXPEND ITS RESTRICTED FUNDJ5 FOR PURPOSES OTHER THAN RESTRICTED PURPOSES? .' .' ; . . .-•.'. HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION OR TAX EXEMPTION SUSPENDED OR REVOKED BY ANY GOVERNMENTAL AGENCY? 9.

8.

10. WAS THERE OR DO YOU HAVE ANY KNOWLEDGE OF ANY KICKBACK, BRIBE. OR ANY THEFT, DEFALCATION MISAPPROPRIATION. COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS? 10. 11. LIST THE NAME, ADDRESS AND THE ACCOUNT* OF THE FINANCIAL INSTITUTIONS WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST ACCOUNTS:

LaSalle Bank. 135 S. LaSalle S t . . Chicago. IL 60603

// 58002&2272

12. NAME AND TELEPHONE NUMBER OF CONTACT PERSON: C a r o l S p i z z i r r i ALL ATTACHMENTS MUST ACCOMPANY THIS REPORT - SEE INSTRUCTIONS

847-928-9683

UNDER PENALTY OF PERJURY, I (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS ANNUAJL REPORT AND THE ATTACHED DOCUMENTS. INCLUDING ALL THE SCHEDULES AND STATEMENTS AND THE FACTS THEREIN STATED ARE TRUE AND COMPLETE AND FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE STATE OF ILLINOIS RELY THEREUPON. I HEREBY FURTHER AUTHORIZE AND AGREE TO SUBMIT MYSELF AND THE REGISTRANT HEREBY TO THE JURISDICTION OF THE STATE OF ILLINOIS. BE SURE TO INCLUDE ALL FEES DUE: 1.) REPORTS ARE DUE WITHIN SIX MONTHS OF YOUR FISCAL YEAR END. 2.) REPORTS WITH ASSETS OR REVENUES GREATER THAN $15.000 MUST SUBMIT $15.00 FILING FEE. 3.) REPORTS THAT ARE LATE OR INCOMPLETE ARE SUBJECT TO A $100.00 PENALTY.

Carol S p i z z i r r i
PRESIDENT or TRUSTEE {PRINT NA-

Q\

TREASURER or TRUSTEE <PRINT N A u m — ^

£CL<>7TA'ffVG&#tJ

--

v—v^-etXE^L^w..

SIGNATURE

DATE

S^V

PREPARER (PRINTNAME)" "

SIGNATURE

DATE

form *7«7U

Return of Organization Exempt from Income Tax
Under section 501(c) of the Internal Revenue Code (except black lung benefit trust or private foundation), section 527, or section 4947(a)(1) nonexempt charitable trust

OMB No. 1545-0047

2000
Open to Public inspection

Department of tho Tmaay Internal Revtnu* Servie*

A B

*■ The organization may have to use a copy of this return to satisfy state reporting requirements. For the 2000 calendar year, or tax year period beginning ,2000, and ending
C Name of orjanitatwn IRS label wwe. Sc* •pcdSe taftivc* float.
OIBjiBt

.20

Chock If apptablo: Chang* of tddnxa Chang* of m m Initial ratam Finis refcjni AnMftPBa nriurn

Employer IdcaMcatai Nambof

Save A L i f e Foundation
Number aVatroat (or P.O. boxrt rr^ b net dcoVand to stnKt addr) Room/suite

36-3869459
H Tc|cpfcoti& ottmpny >

9950 Lawrence
City, Town or Country

300
State ZIP sod*

(847) 928 9683
F Check.

Schiller Park

IL 60176
(insert no.)

n

if appfiaSon pending

G

Otgaruiatfan typ* <eh*cfc only an*) *

® SM_

Note: H and I are not applicable to section 527 orgs.
3 * 4W7&00) H ( 8 ) lathtaaorauproojm foraffirao»? H (b) If •yn,' *n«H number of afrKabaa*\^}r<a ( * ] No

• Section SOIfcffl organizations and 4947(aX1)nonexempt charitable trusts must attach a completed Schedule A (form 990 or$90-E2X J Accounting method:

) Cash |XJ Accrual U Other (spBcirvV K Check here *■ [_] if the organization's gross receipts are normally not more than $25,000. The organization need not file a return with the IRS; but if the organization received a Form 990 Package in the mail, it should file a return without financial data. Some states require a complete return.

H (c) Are all affiliates included? QY** (If *no,' attach a list See instructiens)
H (d) hi Ms a separatareturnNod by on orgartobon eovtred by a group ruling? j~~ly** I Enter 4-oVtt group oxempbon no. (GEN)^"

Q NO

(XJ No

Chock t w box if flw organization is aot raquind to attach SA»dul«B (Form 990 or 990£Z) » f~] ■

I Revenue. Expenses, and Changes in Net Assets or Fund Balances (see instructions)
1 i Contributions, gifts, grants, and similar amounts received:

la lb 1c
l ! M ( » t a * » none*! >• 2 Program service revenue including government fees and contracts (from Part VII, It 4 Interest on savings and temporary cash investments.
d

32.878. 650.000. Id 2 3 4 5 682.878. 39.186. 8.725.

Gal 6b|
c Net rental income or (loss) (subtract line 6b from line (5a)

)
R V E N U E

6c 7

8a Gross amount from sales of assets other than inventory b Less: cost or other basis and sates expenses c Cain or (loss) (attach schedule) d Net gain or (loss) (combine line 8c, columns (A) and 03)) 9 Special events and activities (attach schedule) a Gross revenue (not including... $ 6 . 5>40. b Less: direct expenses other than fundraising expenses c Net income or (loss) from special events (subtract line 10a Gross sales of inventory, less returns and allowances

(A) Securities 8a 8b 8c

(B) Other

8d

9a 9b 10a 10b

15.579. 14.928. See.ua.Stmt...

9c

651.

c Gross profit or (loss) from sates of inventory (attach schedule) (subtract line 10b from line 10a).. 12 13 14 15 Total revenue (add lines 1d, 2 , 3 , 4 , 5, 6c, 7, Bd, 9c, 10c, and 11) Program services (from line 44, column (B)) Management and general (from line 44, column (C)) . Fundraising (from line 44, column (D))

X E N S

s

si

Net assets or fund balances at end of year (combine li BAA For Paperwork Reduction Act Notice, see separate Instructions.

M 21 s

18 Excess or (deficit) for the year (subtract line 17 from li 19 Net assets or fund balances at beginning of year (from line 73, column (A)) , 20 Other changes In net assets or fund balances (attach <
TEEA0101 12/2000

10c 11 12 13 14 15 16 17 18 19 20 21

136. 731.576. 711.626. 143.155. 43.601. 898.382. -166.806. 547.704. 380.898.
Form 990 (2000)

Form990coco) Save A L i f e Foundation "" Statement of Functional Expenses . . . _. „,, , ,.v
Do not include amounts reported on line 6b. 8b. 9b. 10b. or 16 of Part I. 22 Grants and allocations {attach schedule)

36-3869459

Page 2

All organizations must complete column (A). Columns (B), ( O . and (D) are required for section 501 (c)(5) and (4) organizations and section 4947(a)(1) nonexempt charitable trusts but optional for others.

(cash non-cash 23 24 25 26 27 28 29 30 31 32 33 34 35
37 33

$ $

Specific assistance b individuals (attach sen) Benefit; paid to or for members (attach sen) Compensation of officers, directors, etc Other salaries and wages Pension plan contributions Other employee benefits Payroll taxes Professional fundraising fees Accounting fees Legal fees Supplies Telephone Postage and shipping Occupancy Equipment rental and maintenance

Printing and publications 39 Travel 40 Conferences, conventions, and meetings 41 Interest 4 2 Depreciation, depletion, etc (attach schedule) 43 Other expenses (itemize):

»_ _i _ ______ .
b

Jl __ c ____€ ZZZ ZZ~Z c Jl ___ I __ _&____• I _ *
44 d Corojjyter] Expenses oJeeJWier Expenses Stmt

~_
~ ~

To___t_ul •»]»__ (a_"lin__"
tarry a t _ m a n _ uws la - is . . . . Reporting of Joint Costs - Did you report in column 03) (program services) any joint costs from a combined educational campaign and fundraising solicitation? If Yes,' enter (i) ttw aggregate amount of these joint costs 5 to fundraising $ J'XOmpte J j f e Saving_f1rst aid $ $ ►-[""] Yes ( x l No ; (II) the amount allocated to program services ; and (hf) the amount allocated

; (i») the amount allocated to management and general

[Statement of Program Service Accomplishments
What is the organization's primary exempt purpose? * *r ° _ ^ ! _ _ ! _ n s ! _ _ _ J e s c * l b 8 ^ « r «»mpt purpose achievements~in*aclear arid concise manner StateHtonumber oif" ~ clients served, publH»hpns issued, etc. Discuss achievements that are rwt measurable. (Section 501 _?f_) V M o r a a n . rations 8. section 4947(a)(1) nonexempt charitable tnsts must also entertteaTrlotinlt o r g g r i t s " S W ^ W S S B K * s m 0 Program Semite Eipesm ftqulrad toe SOI<O0> mil tiginlailemajI7SM1) tnnh; but alfefoCmv)

• Kid's i^L _tnP£L^ i_t.ft Jnpt1j)n_ajid_teaching of_l_ife saving_first 3i _ 19 _I_1J Inpi s _s chqol _chj Tdren ~£ 10.0,228~ chfl d rerf taught}_ _ ~
b
(Grants and allocations $

~Z ~_ _ 521.220.

__ _______.CPJ7___z__T____on_ and_ teaching_of_ . l i t e saving J:iLS_t_a1jl_tp_jndJviduatr othej"fhan~s"chool-age chUdren__~ JIG7G_clJents_served)_ ~ """"
(Grants and allocations $

c

0. )

41.808.

J _ __ Angels .Program _-_Promotion jand_teaching of l_i f e_saving_f 1 rst J _ _ _ _ _ _ _ J _ _ i _ _ I _ _the State_of iflinoTs ~ ~
(Grants and aflocations S , 0. )

d

i£_!ch_Q_5velj)pmenjt^ -_Expand_ to satellite.office Jnside_a_nd outside the State of Illinbis ~ "
(Grants and allocations $ (Grants and allocations $

11.653.

e Other program services.. . S e e . a t t a c h e d

_L_
_____

134.644.

f Total of Program Service Expense. (should equal line 44, column (B). program services) BAA TEEM1Q2 090000

2.301. 711.626.
Form 990 (2000)

Form930(2000)

Save A L i f e Foundation

36-3869459

Page 3

Balance Sheets (See instructions) Note: Where required, attached schedules and amounts within the description column should beforend-of-year amounts only. 45 Cash - non-interest-bearing 46 Savings and temporary cash investments 47a Accounts receivable bless: allowance for doubtful accounts 48a Pledges receivable bless: allowance for doubtful accounts 49 Grants receivable 47a 47b 48a 3.987 (A) Beginning of year ,- CB) End of year 45

8.925
500.845

500.

46

332.812. 3.987.

1.750

47c

48b

48c 49

50 Receivables from officers, directors, trustees, and key employees (attach schedule) 51 a Other notes & loans receivable (attach schedule) .. |_51 a bless: allowance tor doubtful accounts | 51b 52 Inventories for sale or use 53 Prepaid expenses and deferred charges 54 Investments - securities (attach schedule) * Q Cost Q FMV 55a Investments - land, buildings, & equipment basis. 55a bLess: accumulated depreciation (attach schedule) 56 Investments — other (attach schedule) 57 a Land, buildings, and equipment: basis .

50
51c

26.593
18.227

52 53
54

52.188.
11.305.

55b 57a

55c

56

117.663 60.843
162 57c 58

b Less: accumulated depreciation (attach schedule) L.-.57. .Stm.t. 57b 63.038 58 Other assets (describe ► D e p o s i t s .)• S3 Total assets (add lines 45 through 58) (must equal line 74), 60 Accounts payable and accrued expenses 61 Grants payable 62 Deferred revenue 63 Loans from officers, directors, trustees, and key employees (attach schedule) .. 64a Tax-exempt bond liabilities (attach schedule) b Mortgages and other notes payable (attach schedule) 65 Other liabilities (describe > See L i n e 65 Stffit ). 66 Total liabilities (add lines 60 through 65) |X I and complete lines 67 Organizations that follow SFAS117, check here through 69 and lines 73 and 74. 67 Unrestricted 68 Temporarily restricted 69 Permanently restricted Organizations that do not follow SFAS 117, chock here f~l and complete lines 70 through 74. 70 Capital stock, trust principal, or current funds 77 Paid-in or capital surplus, or land, building, and equipment fund 72 Retained earnings, endowment, accumulated income, or other funds .

617.345 59 4.166. 65.475.
61 62 63

54.625. 162. 455.579. 8.648. 65.450.
583. 74,681

69,641

64a 64b 65 66

49.294. 67

498.410. 68
69

•27.648. 408.546.

71 72

73 Total net assets or fund balances (add lines 67 through 69 or lines 70 through 72; column (A) must equal line 19 and column (B) must equal line 21) 5 4 7 . 7 0 4 . 73 380.898. 74 Total liability i and net assets/fund balances (add lines 66 and 73). 617.345 74 455.579. Form 990 is available for public inspection and, for some people, serves as the primary or sole source of information about a particular organization. How the public perceives an organization in such cases may be determined by the information presented on its return. Therefore, please make sure the return is complete ana accurate and fully describes, in Part III, the organization's programs and accomplishments. BAA

TEEAOHB 12/22/00

Save A L i f e Foundation
Reconciliation of Revenue per Audited Financial Statements with Revenue per Return (See instructions.)
Total revenue, gains, and other support par audited financial statements > Amounts included on line a but not on line 12, Form 990:

36-3869459
I Reconciliation of Expenses per Audited Financial Statements with Expenses per Return
Total eroenses and losses per audited financial statements • Amounts included on line a but not online 17, Form990: (1) Donated serv­ ices and use of facilities (2) Prior year adjust­ ments reported on line 20, Form 990 (3) Losses reported on line 20, Form 990 (4) Other (specify): Donated Ftatcriats

Page 4

A**

?j*

786.251

(1) Net unrealized gains on investments (SS) Donated serv­ ices and use of facilities

$
P f*tH:

$

(3) Recoveries of prior yeargrants >_ (4) Other (specify): Oonatcd flatcrlstt 54.675 Add amounts on lines 0 ) through (4) Uno a minus line b Amounts included on line 12, Form 990 but not on line a: 0 ) mvestmenl expenses not included on line 6b, Form 990 $ (2) Other (specify):
Uifrj>.i.iifiiiAjfSjtt..tiM3t.t

c d

54.675 731.576

Add amounts on lines O) through (4) Line a minus tine b Amounts included on line 17, Farm 990 but not on line a: (1) Investment expenses not included on line fi>, Form 990 $ (2) Other (specify):

Add amounts on lines (1) and (2) Total revenue per line 12, Form 990 (line c plus line d)

Add amounts on lines (1) and (2) . Total expenses per line 17, Form 990 (line c plus line d) r u s t e e s . a n d K e y E m p o y e o s (List each one even it not compensated; see instructions. (B) Title and average hours (C) Compensation (D) Contributions to (E) Expense per week devoted employee benefit (if not paid, account and other to position plans and deferred allowances enter-0-) compensation

731.576,

I List of Officers. Directors,
(A) Name and address

JF2 L°)_ In11 z trx i
S>L i. Ji§n. J?y_dloI. _Jr j
Carlos A. Azcoltia

Pres/Exec 01r

40

104,900

568.

Director
Director

0.

Sam L. Amirante Director Scott Anderson Director Oeloris H. Burnam Director Dr. Scott Betzelos Director Martin a. Sandoval Director Michael E. Lavalle Director
See List of Officers. Etc. Statement 75 Did any officer, director, trustee, or key employee receive aggregate compensation of more than $100,000 from your organization and all related organizations, of which more than $10,000 was provided by the related organizations? If 'Yes,' attach schedule — see instructions.
1EEAD1H 09/21/00

J), JL JL JL
JO. _p_. 0.

*QY«

0No
Form 990 (2000)

BAA

Form990(2000) Save A L i f e F o u n d a t i o n Other Information (See specific instructions.)

36-3869459

Page 5 N/A Yes No 76 77 78a 78b 79 80a

76 Did the organization engage in any activity not previously reported to the IRS? If 'Yes,' attach a detailed description of each activity 77 Were any changes made in the organizing or governing documents but not reported to the IRS? If 'Yes,' attach a conformed copy of the changes. 78a Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return? ... b If 'Yes,' has it filed a tax return on Form 990-T for this year? 79 Was there a liquidation, dissolution, termination, or substantial contraction during the year? If 'Yes,' attach a statement 80 a Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc, to any other exempt or nonexempt organization? b If "Yes/enter the name of the organization ► ■ _ and check whether it Is [ j exempt or j ) nonexempt. 81 a Enter the amount of political expenditures, direct or indirect, as described In the Instructions I 81 a| b Did the organization file Form 1120-POL for this year? 82 a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially less than fair rental value? b If *Yes,' you may indicate the value of these items here. Do not include this amount as revenue in Part I or as an expense in Part II. (See instructions for reporting in Part III.) • Iffibl 83a Did the organization comply with the public Inspection requirements for returns and exemption applications? b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? 84a Did the organization solicit any contributions or gifts that were not tax deductible?

81b 82a

54.675.
83a 83b 84a 84b 85a 8Sb

b If "res/ did the organization include with every solicitation an express statement that such contributions or gifts were m t tax deductible? not tax deductible? 85 501(cX4), (5). or (G) organizations, a Were substantially all dues nondeductible by members? b Did the organization make only in house lobbying expenditures of $2,000 or less? If 'Yes' was answered to either 85a or 85b, do not complete 85c through 85h below unless the organization received a waiver for proxy tax owed for the prior year. c Dues, assessments, and similar amounts from members d Section 162(e) lobbying and political expenditures e Aggregate nondeductible amount of Section 6033(e)(1)(A) dues notices f Taxable amount of lobbying and political expenditures (line 85d less 85e) g Does the organization elect to pay the Section 6033(e) tax on the amount in 851? fiSc 85d 85a 85f

85fl

h If Section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount in 85f to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year? 86 501(c)(7) organizations. Enter: a Initiation fees and capital contributions included on 86a line 12 86b b Gross receipts, included on line 12, for public use of club facilities 87 501(c)(12) organizations. Enter: a Gross income from members or shareholders 87a 87b 88 At any time during the year, did the organizaton own a 50% or greater interest In a taxable corporation or partnership, or an entity disregarded as separate from the organization under Regulations Sections 301.7701-2 and 301.7701-3? If -Yes,' complete Part IX 7 89a 501(c)(3) organizations. Enter: Amount of tax imposed on the organization during the year under: Section4911 *■ 0 . .Section4912*■ 0 . ;Section4955►• 0. b 501(c)(3) anti 501(c)(4) organizations. Did the organization engage ny: Section 4958 excess benefit transaction in any during the year or did it become aware of an excess benefit transaction from a prior year? If Yes,' attach a statement explaining each transaction 89b b Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.)

c Enter: Amount of tax imposed on the organization managers or disqualified persons during the year under Sections 4912,4955, and 4958 d Enter: Amount ol tax on line 89c, above, reimbursed by the organization *" 90 a List the states with which a copy ol this return is filed ► J l V j j V O l s ■ _ _ _ b Number of employees employed in the pay period that includes March 12, 2000 (see instructions) ^Obl 91 The books are in care of ► J I a r o J _ S j 3 l Z 2 l J T i • Telephone number *■ _<847J 9 2 8 - 9 6 8 3

located at ► 9950_ L a x r e n « " f u l t e 3 M i _ s c h H J e r i ? a M T r r

J i _ 2Pode »•""60176"
*"T3 H 92 I Form 990 (2000)

92 Section 4947(a)(1) nonexempt charitable trusts tiling Form 990 in lieu of Form 1041 - Check here and enter the amount of tax-exempt interest received or accrued during the tax year BAA
TEEA010S 12/20*0

Form990(2000) Save A l i f e Foundation Analysis of Income-Producing Activities (See instructions.)
Unrelated business income Enter gross amounts unless otherwise Indicated. 93 Program service revenue:
0
W

36-3869459
Excluded by section 512, 513. or 514 Exclusion code Amount

Page 6

„ .

Business code

<B) Amount

(E) Related or exempt function income

a Program Fees b Conferences
c d' e f Medicare/Medicaid payments g Fees & contracts (ram government agencies . . 94 Membership dues and assessments. 95 Interest on savings & temporary cash invmnts. 96 Dividends & interest from securities . 97 Net rental income or (loss) from real estate: a debt-financed property b not debt-financed property 98 Netrentalincome or (loss) (iwnpers prop . . . 99 Other investment income 100 Gain or (loss) from sales of assets other than inventory 101 Net income or (loss) from special events 102 Gross profit or (loss) from sates of inventory... 103 Other revenue: a

38.386. 800.

14

8.725.

651

bMiscellaneous c
d

e 104 Subtotal (add columns (B), (D), and ( E » . . . 105 Total (add tine 104. columns (B), (D), and (£)) Note: Line 105 plus line Id. Part I, should equal the amount on line 12, Part I. 8.725,

39.973. 48.698.

Relationship of Activities to the Accomplishment of Exempt Purposes (See instructions.)
UneNo. Explain how each activity (or which income is reported in column (E) of Part VII contributed importantly to the accomplfshment of the organization's exempt purposes (other than by providing funds lor such purposes).

93a Promote and teach life saving first aid programs 101 To supplement funding required to perform and carry out the life
103a saving first aid programs Information Regarding Taxable Subsidiaries and Disregarded Entities (See instructions.)
<A) Name, address, and EIN of corporation, partnership, or disregarded entity (B) Percentage of ownership interest <C) Nature of activities <D)

N/A
End-of-year assets

Total income

% % %

[Information Regarding Transfers Assodated with Personal Benefit Contracts (See instructions.)
a Did the organization, during the year, receive any funds, directiy or indirectly, to pay premiums on a personal benefit contract? b Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? "=—~ ' . 7 s n . / C A 0 . Jnttnirfions). a Note: It yes'*" ,—, M Yos [ J Yes __ l|Nt> [ H No

Please Sign Here Paid Prearer's
Prep at

d stttemmts. and, to the b«st fit my (mowtfdeo snd behaf, H is prapamrnts tny krawUgo. (So* mstnKtSm.)~ j

^ ( V e l X. S f U y V f t , fees fcttrtOwA
Typa or Print N a n 4 * n i * ~ ' ' [

Sfenrt

Gse
BAA

Ah 1 beck & Company
iddrttt, ii ^^J^PS

Only

»> 1665 Elk Boulevard Des Plaines
TEEA010G 12/21/00

60016

36-2991500 |phon.n. - (847) 8 2 4 - 4 0 0 0
Form 990 (2000)

Department ol the Treasury Intern) Revenue Service

Schedule A Organization Exempt Under Cform990 orKKMZ) Section 501 (c)(3)

2000
WS w e only — Dp not write or staple in Ihrt tpeco. [ OMB No. 1M5-0M7

(Except Private Foundation) and Section 501(e), 501(f), 501 (k), 501<n), or Section 4947(aX1) Nonexempt Charitable Trust Supplementary Information — (see separate Instructions.) *■ Must be completed by the above organizations and attached to their Form 990 or 990-EZ.
Nam* of the Oiyamnban

Save A Life Foundation 36-3869459 I Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees
(See instructions. List each one. If there are none, enter 'None.*) (a) Name and address of each

I

Employer Identification Number

employee paid more
than $50,000

(b) Title and average hours per week devoted to position

(c) Compensation

to employe* benefit
plans s deferred compensation

(d) Contributions

(e) Expense account and other allowances

None

Total number of other employees paid over $50,000

None I Compensation of the Five Highest Paid Independent Contractors for Professional Services
(See instructions. List each one (whettier individuals or firms). If there are none, enter 'None.1) (b) Type of service (c) Compensation

(a) Name and address of each independent contractor paid more than $50,000

None

Total number of others receiving over $50,000 for professional services H None BAA For Paperwork Reduction Act Notice, see the instructions for Form 990 and Form 990-EZ.
TOAM01 09/15/00

Schedule A (form 990 or 990-EZ) 2000

Schedule A (Form 990 or 990EZ) 2000

Save A L i f e

Foundation

36-3869459

Page 2

Statements About Activities
1 During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? If "Yes," enter the total expenses paid or incurred in connection with the lobbying activities ► S > Organizations that made an election under section 501(h) by filing Form 5768 must complete Part VI A. Other organizations checking "Yes/ must complete Part Vl-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 oftheir families, or with any taxable organization with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary: a Sale, exchange, or leasing of property? b Lending of money or other extension of credit? , c Furnishing of goods, services, or facilities? d Payment of compensation (or payment or reimbursement of expenses if more than $1,000)? S e e . P.t. V , . . Fm. 9 9 0 e Transfer of any part of its income or assets? If the answer to any question is 'Yes,' attach a detailed statement explaining the transactions. 3 Does the organization make grants for scholarships, fellowships, student loans, etc? 4a Do you have a section 403(b) annuity plan for your employees? b 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. (See instructions.)

Reason for Non-Private Foundation Status (See instructions.)
The organization is not a private foundation because it is (please check only One applicable box): 5 A church, convention of churches, or association of churches. Section 170(b)(l)(A)(i). 6 A school. Section l70(b)(1)(A)(ii). (Also complete Part V, page 5.) 7 A hospital or a cooperative hospital service organization. Section 170(b)(l)(A)(iii). 8 A federal, state, or local government or governmental unit Section 170(b)0)(A)(v). 9 A medical research organization operated in conjunction with a hospital. Section 170(b)(1)(A)(iii). Enter the hospital's name, dty, andstato*_ 10 |_J An organization operated for the benefit ot a college or university owned or operated by a governmental uniL Section 170(b)fl)(ATfivr (Also complete the Support Schedule in Part IV-A.) An organization that normally receives a substantial part of its support from a governmental unit or from the general public. Section ?70(b)(l)(A)(vi). (Also complete the Support Schedule in Part IV-A.)

11 a 0

11 b Q A community bust Section 170(b)(l)(A)(vj). (Also complete the Support Schedule in Part IV-A.) 12 D An organization lhat normally receives: f l ) more than 33-1/3% of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc, functions - subject to certain exceptions, and (2) no more than 33-1/3% 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. See section 509(a)(2). (Also complete the Support Schedule in Part IV-A.) Q An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations descrlbedin: O) lines 5 through 12 above; or (2) section 501(e)(4), £ ) , or (6), if ttiey meet the test of section 509(a)®. (See section 509(a)(3).) Provide the following information about the supported organizations. (See instructions.) (a) Name(s) of supported organization(s) (b) Line number from above

13

14 BAA

f l An organization organized and operated to test for public safety. Section 509(a)(4). (See instructions.)
TEEA0402 12/11/00

Schedule A (Form 990 or Form 990-EZ) 2000

Schedule A (Form 990 or 990-EZ) 2000

Save A L i f e

Foundation

36-3869459

Page 3

S u p p o r t Schedule (Complete only if you checked a box on line 10,11, or 12.) Use cash method of 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) *■ 15 Gifts, grants, and contributions received. (Do not include unusual grants. See line 28.) . . .

A
621.043.

1998

A
101.330. 550.

A
37.566. 1.527.

>> Total 1.381.228. 2.077.

621.289.

17 Cross reetipb from admissions, merchandise sold or services performed. or furnishing of facilities in any activity that is rot a business unrelated to the organization's charitable, etc, purpose .. 18 Gross income from interest, dividends, amountsreceivedfrom payments on securities loans (Section SlttaXS)), rents, royalties, and unrelated business taxable income (less Section 511 taxes) from businesses acquired by the organ­ ization after June 30, 1975 19 Net income from unrelated business 20 Tax revenues levied for the organization's benefit and either paid to it or expended 21 The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to 22 Other Income. Attach a schedule. Do not include gain or (joss) from sale of capital assets 23 Total of lines 15 through 22

41.158.

6.134.

47.292.

24.57S.

676.

25.251.

686.776. 645.618. 6.868.

628.099. 621.965. 6.281.

101.880. 101.880. 1.019.

26 Organizations described on lines 10 or 11: a Enter 2% of amount in a b Attach a list (which is not open to public inspection) showing the name of and amount contributed by each 1999 exceeded the amount shown in line 26a. Enter the sum of all these excess amounts c Total support for Section 509(a)(1) test Enter line 24, < d Add: Amounts from column (e) for lines: 18 25.251. 19 22 26b e Public support (line 26c minus lin ( Public support percentage (line 2

39.093. 39.093. 191. ► 26a

1.455 . 8 4 8 . l j 4 0 8 ,556. 28.171.

96 through

26b •> 26c 26d 26e 26f

cJL 40 JL! 5G 25.251. 1.383 305 9 8 . 21 %

» ■

27 Organizations described on line 12; a For amounts included in lines 15, 16, and 17 that were received from a 'disqualified person,' attach a list (which Is not open to public inspection} to show the name of, and total amounts received in each year from, each 'disqualified person.' Enter the sum of such amounts for each year: (1999) (1998) (1997) (1996) bFor any amount included in line 17 that was received from a nondisqualified person, attach a list to show the name of, and amount received for each year, that was more than the larger of (1) the amount on line 25 for the year or (2) $5,000. (Include in the list organizations described in lines 5 through 11, as well as individuals.) After computing the difference between the amount received and the larger amount described in (1) or (2). enter the sum of these differences (One excess amounts) for each year: (1999) (1998) (1997) (1996) c Add: Amounts from column (e) for lines: 15 16 17 20 21 27c d Add: Line 27a total and line 27b total 27d o Public support Cine 27c total minus line 27d total) 27e ( Total support for section 509(a)(2) test: Enter amount on line 23, column (e) »»| 27f g Public support percentage (line 27e (numerator) divided by Una 27> (denominator)) 27fl h Investment income percentage (line 18, column (e) (numerator) divided by line 27f (denominator)). 27h 28 Unusual Grants: For an organization described in line 10, 11, or 12 that received any unusual grants during 1996 through 1999, attach a list (which is not open to public inspection) for each year showing the name of the contributor, the date and amount of the grant, and a brief description of the nature of the grant. Do not Include these grants in line 15. (See instructions.) TEEA0403 12/10JO0 BAA Schedule A (Form 990 or 990-EZ) 2000

Schedule A (Form 990 or 990-EZ) 2000 Save A L i f e Foundation I Private School Questionnaire Gee instructions.)

36-3869459
N/A

Page 4

(To be completedI IOnly by schools that checked the box on line 6 In Part IV)

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

No

31

32 Does the organization maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative staff? b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscrimlnatory basis? c Copies of all catalogues, brochures, announcements, and other written communications to (he public dealing with student admissions, programs, and scholarships? d Copies of all material used by the organization or on its behalf to solicit contributions? If you answered 'No' to any of the above, please explain. (If you need more space, attach a separata statement.)

32a 32b

32c
32d

33 Does the organization discriminate by race in any way with respect to: a Students' rights or privileges? b Admissions policies? c Employment of faculty or administrative staff? d Scholarships or olher financial assistance? e Educational policies? f Use of facilities? B Athletic programs? h Other extracurricular activities? If you answered 'Yes' to any of the above, please explain, (if you need more space, attach a separate statement}

33b 33c 33d

33e
33f 33g

34a Does the organization receive any financial aid or assistance from a governmental agency? b Has the organization's right to such aid ever been revoked or suspended? If you answered 'Yes' to either 34a or b, please explain using an attached statement.

34a 34b

35 Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05 of Rev Proc75-50. 1975-2 C.B. 587. covering racial nondiscrimination? If 'No.' attach an explanation. 35 Schedule A (Komi 990 or 990-EZ) 2000 TEEAMM l2niX»

Schedule A (Form 990 or 990-EZ) 2000 Save A L i f e Foundation I Lobbying Expenditures by Beefing Public Charities see instructions.)
(To be completed Only by an eligible organization that filed Form 5768) Check here » ■ Check here •> if the organization belongs to an affiliated group. if you checked 'a' above and 'limited control' provisions apply,

36-3869459

Page 5

Limits on Lobbying Expenditures
(The term 'expenditures' means amounts paid or incurred.) 36 37 38 39 40 41 Total lobbying expenditures to influence public opinion (grassroots lobbying) Total lobbying expenditures to influence a legislative body (direct lobbying) Total lobbying expenditures (add lines 36 and 37) Other exempt purpose expenditures Total exempt purpose expenditures (add lines 38 and 39) Lobbying nontaxable amount. Enter the amount from the following table — If the amount on line 40 is The lobbying nontaxable amount is Not over $500,000 20% of the amount on line 40 Over $500,000 but not ever $1,000,000 $100,000 plus 15% of the excess ever $500,000 Over $1,000,030 but net over $1,500,000 $175,000 plus 10% of the excess over $1,000,000 Over $1,500,000 but not over $17,000,000 $225,000 plus 5% of the excels over $1,500,000 Over $17,000,000 $1,000,000 42 Grassroots nontaxable amount (enter 25% of line 41) 43 Subtract line 42 from line 36. Enter -0- if line 42 is more than line 36 44 Subtract tine 41 from line 38. Enter -0- if line 41 is more than line 38 Caution: If theretean amount on either line 43 or line 44. you must tile Form 4720.

4 -Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501 (h) election do not have to complete all of the five columns below. See the instructions for lines 45 through 50.) Lobbying Expenditures During 4 -Year Averaging Period Calendar year for fiscal year beginning In) *(a) 2000

(b) 1999

(c) 1998

«0
1997 Total

45 Lobbying nontaxable amount.

47 Total lobbying expenditures . 48 Grassroots nontaxable amount. 49 Grassroots ceiling amount (150% of ling 46(e)).... 50 Grassroots lobbying expenditures

I Lobbying Activity by Noneleding Public Charities
(For reporting only by organizations that did not complete Part Vl-A) (See instructions.) During the year, did the organization attempt to influence national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of: a Volunteers b Paid staff or management (include compensation in expenses reported on lines c through h.) c Media advertisements d Mailings to members, legislators, or the public e Publications, or published or broadcast statements I Grants to other organizations for lobbying purposes g Direct contact with legislators, their staffs, government officials, or a legislative body h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means i Total lobbying expenditures (add lines c through h) If 'Yes' to any of the above, also attach a statement giving a detailed description of the lobbying activities.
BAA

Yes No

Amount

^ * ■ *« * f e t V 5 »!

TCEA04O5

«/n/oo

Schedule A (Form 990 or 990-EZ) 2000

schedule A (Form 990 or 990EZ) 2000 Save A L i f e F o u n d a t i o n 36-3869459 I Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations (See instructions)

Page 6

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) organizations) or in section 527, relating to political organizations? a Transfers from the reporting organization to a noncharitable exempt organization of: Yes No (QCash 5i«m (IQOther assets _?J!ft b Other transactions: (l)Sales or exchanges of assets with a noncharitable exempt organization _bJD_ (Ii)Purchases of assets from a noncharitable exempt organization _M& (ill)Rental of facilities, equipment, or other assets _bj& (tv)Reimbursement arrangements b(h0 (v)Loans or loan guarantees b& (vQPerformance of services or membership or fundraising solicitations _bjw& c Sharing of facilities, equipment, mailing lists, other assets, or paid employees d If the answerto< fair market value of the ilr market value in any received: (a) <D « Amount involved >lee Name of noncharitable exempt organization Description of transfers, transactions, and sharing arrangements Line no.

Jt

52a Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations described in secb'on 501(c) of the Code (other than section 501(c)(3)) or in section 527? »• [ J Yes |x] No b If "Yes,* complete the following schedule: (a) (b) (c) Name of organization Type of organization Description of relationship

BAA

1EEA04C8 OUZOflO

Schedule A (Form 990 or 990-E2) 2000

Save A Life Foundation

36-3869459

Form 990, Page 1. Part I, Line 9 Spedai Events and Activities Statement List of Three Largest Events and Type and Number of Others Dinner Event Various Merchandise Net Income (Loss) 0. 651.

Gross Receipts 20.800. 1.319.

Less Contributions 6.540.

Gross Revenue 14.260. 1.319.

Less Direct Expenses 14.260. 668.

Total

22.119.

6.540.

15.579.

14.928.

651.

Form 990, Page 2, Part il. Line 43 Other Expenses Stmt (A) Total Other expenses (itemize) Consulting Fees Dues & Subscriptions Education Equipment Rental Instructors Fees Insurance Licenses & Permits Marketing Miscellaneous Professional Fees-Other Program Coordinator Promotional Recruitment Reinbursed Program Fees Research/Evaluation Temporary Help Total 38.391. 577. 1.606. 4.719. 112.152. 5.500. 680. 7.648. 676. 390.
1.666.

(B) Program services 37.891. 187. 1.156. 4.323. 112.152. 0. 570. 7.648. 204. 240.
1.666.

(C) Management and general 500. 285. 450. 396. 0. 5.325. 110. 0. 94. 150.
0.

<D) Fundraising

0. 105. 0. 0. O. 175. 0. 0. 378. 0.
O.

5.507. 527. 70. 493. 32.141. 212.743.

5.278. 218. 70. 493. 32.141. 204.237.

229. 309. 0. 0. 0. 7.848.

0. 0. 0. 0. 0. 658.

Form 990, Page 3, Part IV, Lines 57a & 57b Land, Buildings and Equipment Statement

(a) Cost/Other Basis Office Equipment Vehicles Total 85.665. 31.998.

(b) Accumulated Depreciation 49.878. 13.160.

(c) Book Value

35.787. 18.838.

117.663.

63.038. .

54.625.

Save A Life Foundation 36-3869459 Form 990, Page 2, Part III, Line E Statement of Program Service Accomplishments Line E - Other Program Services

New Program Oevelopment - Research & development for new ways to serve the community Program Service Expenses

$2,301

Save A Life Foundation

36-3869459

2

Form 990, Page 3, Part IV, Line 65 Other Liabilities Statement Beginning of Year End of Year

Line 65-Other Liabilities:

Instructor Deposits Due to Horelli Fund
Total

0.
(L

190. 393.
583.

Form 990, Page 4, Part V List of Officers, Etc. Statement

(A)
Name and address

<B) Title and average hours per week devoted to position

(C) Compensation Of not paid, enter-0-)

0>)
Contributions to employee benefit plans and deferred compensation

(E) Expense account and other allowances

Note: The Individuals above. except as noted, spend time as needed in their capacity on the Board, They can be contacted c/o Save a L i f e Foundation. 9950 Lawrence Ste300. SchiUer Park. IL 60176

Total

Save A Life Foundation

36-3869459

3

Supporting Statement of: Form 990 p 2 / L i n e 42 column (C)

Description Office Equipment - Mgmt & Genl Depreciation Vehicles - Mgmt & Genl Depreciation Total

Amount 11.858. 5.000. 16.858.

Supporting Statement of: Form 990 p 3 / L i n e 63, column (A)

Description Due to Carol S p i z z i r r i
Total

Amount 65.475. 65.475.

SAVB A I.IFB FOUNDATION, INC. AODITBD FINANCIAL STATBMBNTS DBCBHBBR 3 1 , 2000 AMD DBCBHBBR 3 1 , 1999

^ — — — — — _ _ _ _ « « A HI RFf Iffirf*ftMPAMY #%ni»DBVI*.<i£VWI'ir'Jlf«¥
CERTIFIED PUBLIC ACCOUNTANTS

SAVE A LIFE FOUNDATION, INC. TABLE OF CONTENTS DECEMBER 31, 2000 AND DECEMBER 31, 1999

Auditor's Report Exhibit Financial Statements Comparative Statement of Financial Position December 31, 2000 and December 31, 1999 Statements of Activities for the years ended December 31, 2000 and December 31, 1999 Statements of Functional Expenses for the years ended December 31, 2000 and December 31, 1999 Statements of Cash Flows for the years ended December 31, 2000 and December 31, 1999 Notes to Financial Statements

AHLBECK&COMPANY
CERTIFIED
P U B U C

ACCOUNTANTS

166J ELK BOULEVARD DES PLAINES. ILLINOIS 60016-4798

TELEPHONE: 8<7/824-40O0 FACSIMILE: 847/824-4012 WEB: wx^w.thlbtckcoxoB,

March 1, 2001 To The Board of Directors Save A Life Foundation, Inc. Schiller Park, Illinois niDKPBtlDBNT AUDITOR'S REPORT »e have audited the accompanying statements of financial position of SAVB A LIFE FOUNDATION, INC. (an Illinois not-for-profit corporation) as of December 31, 2000 and 1999, and the related statements of activities, statements of functional expenses, and statements of cash flowB for the years then ended. These financial statements are the responsibility of management. Our responsibility is to express an opinion on these financial statements based on our audits. Ve conducted our audits in accordance with generally accepted auditing standards. Those standards require that we plan and perform the audits to obtain reasonable assurance about whether the financial statements are free of naterlal mlsstatement. An audit includes examining, on a teat basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion. In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of SAVB A LIFE FOUNDATION, INC. as of December 31, 2000 and 1999, and the results of its activities and its cash flow for the years then ended in conformity with generally accepted accounting principles. As discussed in Note 10 to the financial statements, temorarily restricted net assets released from restriction in the year ended December 31, 1999 were overstated. Accordingly, the 1999 financial statements have been restated to correct the error.

- 1-

SAVE A LIFB FOUNDATION, INC. COMPARATIVE STATEMENT OF FINANCIAL POSITION December 31, 2O0O and December 31, 1999 2000 ASSETS CURRENT ASSETS Cash and Cash Equivalents Prepaid Legal Fees Inventory Accounts Receivable Deposits Prepaid Expenses Total Current Assets FIXED ASSETS AT NET BOOK VALDB Office Equipment Vehicle Net Fixed Assets TOTAL ASSETS
333,312 9,420 52,188 3,987 162 1.885 400.954 $

EXHIBIT A

1999

509,770 17,500 26,593 1,750 162 72.7 556.502

35,788 18.838 54.625 , 455.579

S

37,006 23.838 60.843 617.345

L I A B I L I T I E S CURRENT, LIABILITIES Accounts Payable Sales Tax Payable Instructor Deposits Health Insurance W/H Due To Morelli Fund Total Current Liabilities OTHER LIABILITIES Due To Carol Spizzirri Total Other Liabilities TOTAL LIABILITIES NET ASSETS Unrestricted Temporarily Restricted TOTAL NET ASSETS

AND

NBT

ASSETS 8,485
9 190 155 393 9.232

4,1670 0 0

P
4.167

65.450 65.449 74.681

65.47S
65,4-75 69.642

(27,648) 498,5*6 380.898 455.579

49,294 498.410 547.704

TOTAL LIABILITIES AND NET ASSETS

$

617

l?45.

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

- 2

SAVE A LIFE FOUNDATION, INC. STATEMENT OF ACTIVITIES For t h e Year Ended December 3 1 , 2000

EXHIBIT fl

unrestricted.
Contributions Government Grants Private Grants Conferences Fundraisers/Sales Special Events (net) Program Pees In Kind Contributions Other TOTAL INCOME tXBBSSBS. Kids Program New Program Development Corporate Program Blue Angels Expansion Program Branch Development Total Programs Fundraising Management & General TOTAL EXPENSES Released from Restrictions ISBE Released from Restrictions IDPH Released from Restrictions DCCA $ 19,839
-

Temporarily Restricted
$ -

Total $ 19,839 650,000 6,500
800 449

650,000
-

6,500
800 449

6,742 38,386 54,675
136

6,742 38,386 54,675
136

127,526

650,000

777,526

532,900 2,301 44,369 11,807 17,410 155,750 764,538 45,131 143,388 953,057 498,409 234,625 6,830

-

532,900 2,301 44,369 11,807 17,410 155,750 764,538 45,131 143,388 953,057
-

(498,409) (234,625) (6,830)

EXCESS INC0MB OVER EXPENSES FROM ACTIVITIES INVESTMENT INCOME I n t e r e s t Income TOTAL INVESTMENT INCOMB CHANGE IN NET ASSBTS BEGINNING NET ASSETS ENDING NET ASSBTS

(85,667)

(89,864)

(175,531)

8,725 8,725 (76,942) 49,294 (27,648) $ (89,864) 498,410 408,546 $

8,72S

8,725
(166,806) 547,704 380,898

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

- 3 -

SAVE A LIFB FOUNDATION, INC. STATEMENT OF ACTIVITIES For the Year Ended December 31, 1999 Temporarily Unrestricted INCOMB Contributions Program Fees Government Grants Private Grants Conferences Fundraisers/Sales (net) Sponsorships In Rind Contributions Special Events (net) Other TOTAL INCOME RTPBUHRH Program Kid's Program Other Training Programs Total Programs Pundraising Management & General TOTAL EXPENSES Released from Restriction-ISBB Released from Restriction-DCCA EXCESS INCOME OVER EXPENSES FROM ACTIVITIES INVESTMENT INCOME Interest Income TOTAL INVESTMENT INCOME CHANGE IN NET ASSETS BEGINNING NET ASSETS ENDING NET ASSETS
$ 1,825 16,831

EXHIBIT B

Restricted
$ 600, 000
• -

Total
$ 1,825 16,831 600,000 9.500 59 680 13,150 9,038 440

9,500

59 680
13,150 9,038

440

-

51,523

600,000

6S1.523

466,901 43,503 510,404 37.357 18,353 566,114 101,590 300,000 (101, 590) (300, 000) , .

466,901 43,503

-

510,404 37,357 18,353 566,114

(113,001)

198, 410

85,409

24,575 24,575 (88,426) 137,720 49,294 $ 198,410 300,000 498,410 $

24,575 24,575 109,984 437,720 547,704

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

- 4-

8AV8 X U P S v^^CATIOM, IRC. BTxtaan or roscnoHU QPHSSIS Por the Tear ended Decesteer 11, 3000

.ITBTT C

,

I
in I

Salaries c Kages Ecployec Benefit* Payroll T U M Accounting Pees Autoooblle Expense Bank Charge* Branch Dsvelopaant Cosputer Sxpensea Conference* Consulting fee* Depreciation Bxpenee But* 5 Subscriptions BCjulpeant Rental Education Instructor Pact Insurance Interest Expense Legal Pee* Licenses a Pemlta Marketing Meeting* Mlscellineous Office supplies Promt lonal postage a Delivery Prograoi Coordinator Profaasional f e a e - o t h e r Printing a Reproduction Reiefeursed Prograa Pee* Recruitment Rant Repair* Research/Evaluation Telephone Temporary Help Training suppllo* Travel Total Functional expenses

Kid's Prograa S 157,lit i2.*i» 1.417 1.521 ,231 a, 1 ( 1 2 ( .025
It II 4 .121 1 .151 13 . M O 1.Ml 2* .•20 529 7

New Prograa Development f 1.575 (314) 101

Piugiaa Corporato Slue Angela Pxogrens Prograa I 7.5(2 I 8,155
COS •71

Support Expansion Prograoi | 15.715
1.212

Branch Dsvelopaent I )«,*!•
2,174

Total Prograa 1227.744 II,If* 1,5*1 1,552 11,125 41,145 1,171 17,151 117 4,121 1.155 113,153

Pundralslng I 12,2*2 2.(2* 101 10

Management and oeneral 5 12,121

Total
Support t (4,5(1 l,*)4 5.1)4 10.J3J 1,547
715

Organisation
I Total 2*2,307 l,**4 21,703 11.121 1,547 2.111 12.125 51,001 1,542 11,1*1 1(,I55
577

• ,»•!
2,705 10,221 1.547 755
5 .•SI 417 500 1(

12,125 5,117 10 4,145 5,100

5.151
571 500

214

»»
15.313 If taa 117 50 1215) 10
241

.151
255 1*( 450

K.tSI
1*0 IK 450

105

150

5(7 1,035

,••« 1 ,«*»

204 13 1 1 2 452 7 1(1

42t

1

((<

12.440 70 (10)
(7

240 1*. JI7 241 5, 4 ( ( 1, 411

750

(14)

(«»

21. I I I 12, 1 4 1

*,

4 , 201 211

(211 *♦

512,100

2,101

44,170

275 1,75* 155,750

2,1)4 15,512 570 7,541 1,711 204 11,212 1.452 1,050 1.C5C 240 51,541 70 211 5.5)3 1,5(5 4*1 31,154 12,141 4,450 10,PI* 7(4,5)1

175 410 71)

5 .125 S40 11

.411
110 147

5.500 1,030 14,200
110

4,71* 1,(01 112,152 5,500 1.954 4*.712
(10


147 47]

7,(41 1,*05
(77

17*
1

14

,1(4
373

1.1(4
172 503

500
7.477

ISO

a • •

17.34* 1.124 1,5*3


ISO

!,(((
1*0

(721
10*

7,405

5*,**7
70 527

101

(7

10 5 ) 1

10,500
12(

ia«
4,55*

15,412 1.715
41)


4,5(5

s
45,111 141,115 111,51*

• -

31.4(1 12.141 4,450 10,0*3 »S1,057

Management sod Oeneral Allocation Total expenses I

15.777 (11.577 t

1,»7( 4,277 t

1.551 47,»23 5 11,107 8 24,114

17,277 1171,027

115,»*( III0.S24 I

1(.(5* «1.7l> I

(112.(44) 10.744 I

(115.til) 73,5)1 951,057

TUB ACCCHPASnWl KJTBS ARE AS rSfTBORAL PART OP THESE 8TATBMSBTS

SAVE A LIFE VACATION, INC. STATEMENT OP FUNCTIONAL EXPENSES Por the Yeur ended December 31, 1999

Program Program $ 175,773 1,955 15,343 Other Training Programs $ 13.872 lit 1,431 783 Total Program $ 189,(43 2,071 16,474 19,292 Pundraising $ 31,683 116 1,833 781

Support Management and General S 6.S2S 913 531 1,371
m

Orgnniaatti 9 Total 3B.207 1,031 3,363 3,051 386 535 37 950 895 3,150 133 1,211 381 157 9 Total 317,BSO 3.101 19.037 31,343 3,197 734 408 33,542 1,374 36,765 1.697 14.097 600 1,740 64,015 7,073 4,236

Salarlea & W a g e s Employee Benefits Payroll T a x e s Accounting F e e * Amortization Automobile Expense Awards a Recognitions Bank charges Computer Expenses conferences Consulting F e e s Contract L a b o r Depreciation Expense D u e s * Subscriptions Equipment Rental Instructor F e e s Insurance Interest Expense Legal Fees Licenses fc Permits Marketing Meetings Meoorial Fund Expenses Miscellaneous Of rice Supplies Penalties Postage a Delivery Printing k Reproduction Recruitment Rent Repairs Research/Evaluat ion Telephone Training Supplies Travel Total Functional Expenses

ie,soe •
3,749 199 351 21,063 411 33,615 1,522 12,313 419 1,497 51,103 6,062 3,677

.
160

.
2,909 199 171 31,592 479 33,(15 1,564 12,886 419 1,584 64,015 6,435 3.118

.
193 535 34 563 44S

96

20 529 68

.
12 387 4S0 3,150 25 404 381 52

42 673


107 808

87 12,912 3S4 211

.
104

.
424 211

212 127

. »
636 336

1,043 B.730 522

2 118

1,044 8,849 522

.
2 641 15

16 45 319 370 713 342

»
19 686 334 370 713 1,226

.
1.063 9,534 856 370 1.159 14,785

406 12,659

40 901

446 13,560

• •
883

5,440 30,529 2,153 21,668 1,081 991 13,399 5,115 16.889 466,901

296 2,557 39 1,194 63 51 710 3,687 3.587 43.503

5,736 33,086 2,193 22,(62 1,144 1,043 14,009 7,102 30,476 510,404

376 4,601 69 1,441 75 51 651

106 170 39 708 38 31 436

.
56« 4.771 128 2,150 113 83 1,377

6,300 37,857 3,331 35,012 1.357 1,123 15,386 7,803 31.393 $ 566,114

504 37,357

413 16,353

.
917 55,710

Management and General Allocation Total Expenses $

15,126 493,037 S

538 44,031

IS,654 8 536,058 $

1.935 39,393 $

(17,589) 764 $

(15,654) 40,056 $ 566,114

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

EXHIBIT D SAVE A LIFE FOUNDATION, INC. STATEMENT OF CASH FLOWS FOR THE YEAR ENDED DBCEMBER 31, 2000 Cash Flows from Operating Activities: change in Net Assets Adjustments to reconcile change in net assets to net cash provided by (used in) operating activities: Depreciation Changes in assets and Decrease (increase) Decrease (increase) Decrease (increase) Increase (decrease) Increase (decrease) Total adjustments liabilities: in accounts receivable in inventory in other current assets in accounts payable in other payables $ 16,8SB $ (166,806)

(2,237) (25,595) 6,922 4,318 747 1.013 (165,793)

Net cash provided by (used in) operating activities Cash
FJ,OWB

from Investing Activities: (10.640) (10,640)

Purchase of fixed assets Net cash provided by (used in) investing activities Cash Flows from Financing Activities: Repayments on debt Net cash provided by (used in) financing activities Net increase (decrease) in cash and cash equivalents Cash and cash equivalents at beginning of period Cash and cash equivalents at end of period Supplemental Disclosures: Interest paid

(25) (25) (176,458) 509.770

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

- 7

EXHIBIT D SAVE A LIFE FOUNDATION, INC. STATEMENT OF CASH FLOWS FOR THB YEAR ENDED DBCEMBRR 31, 1999 Cash Flows from Operating Activities: Change in Net Assets Adjustments to reconcile change in net assets to net cash provided by (used in) operating activities: Depreciation and amortization $ 14,097 $ 109,984

Changes in assets and liabilities: Decrease (increase) Decrease (increase) Decrease (increase) Increase (decrease) Total adjustments in in in in accounts receivable inventory other current assets other payables (1,7SO) (26,593) (18,389) 1,719 (30.9161 79,068

Net cash provided by (used in) operating activities Cash Flows from Investing Activities: Purchase of fixed assets Net cash provided by (used in) investing activities Cash Flows from Financing Activities: Payments on loan Net cash provided by (used in) financing activities Net increase (decrease) in cash and cash equivalents Cash and cash equivalents at beginning of period Cash and cash equivalents at end of period Supplemental Disclosures; Interest paid (19.907) (31.129)

(31,129)

(19.907) 28,032 481.738 S S09.77O $ 4r226

THB ACCOMPANYING NOTES ARE AN INTBGRAI. PART OF THESB STATEMENTS

- 8-

SAVE A LIFE FOUNDATION, INC. NOTES TO FINANCIAL STATEMENTS DECEMBER 31, 2000 AND DECEMBER 31, 1999 NOTB 1 - Summary of Significant Accounting Policies Nature of Activities Save A Life Foundation, Inc. (SALF) works to promote the training of life supporting first aid skills; to promote consistency, uniformity, and safety in the application of those skills; to expand knowledge of "Good Samaritan" laws to encourage people -to provide help; and to assure that skills are accessible to all. SALF received 76% of its total income in the year ended December 31, 2000 from the State of Illinois Department of Public Health. The remainder of SALF'a income is from program fees, private contributions and fundraising projects.

Basis of Accounting The financial statements of SALF have been prepared on the accrual basis of accounting and accordingly reflect all significant receivables, payables, and other liabilities. The net assets of SALF are classified as follows: Unrestricted, which represent the portion of expendable net assets that are available for operations. Temporarily Restricted, which represent grants which are for future periods, upon termination of the restriction, a reclassification is made to unrestricted net assets. Fixed Assets Fixed assets are carried at cost if purchased or fair value if contributed for current additions. Depreciation is computed on the straight-line method over 3-5 years for vehicles, computer equipment, furniture and office equipment. Maintenance, repairs and minor costs are expensed as incurred. When properties are retired or otherwise disposed of, the related cost and accumulated depreciation are removed from the respective accounts and any profit or loss on disposition is credited or charged to operations. Estimates The process of preparing financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions. These estimates and assumptions affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and reported amounts of income and expenses during the reporting period. Actual results could differ from those estimates.

- 9 -

SAVE A LIFE FOUNDATION, INC. NOTES TO FINANCIAL STATEMENTS DECEMBER 31, 2000 AND DECEMBER 31, 1999

Cash and Cash Equivalents For purposes of the statement of cash flows, SALF considers all checking accounts, certificates of deposit and petty cash to be cash equivalents.

Income Taxes SALF is exempt from income taxes under Section SOl (c) (3) of the Internal Revenue Code, in addition, SALF qualified for the charitable contribution deduction under Section 170(b) (1) (A) (vi) and has been classified as an organization other than a private foundation under Internal Revenue Code Section 509(a)(2) .

Functional Allocation of Expenses In the Statement first charged to actual expense. as time spent in of Functional Expenses, salaries and related expenses are the various programs and supporting services on the basis of Expenses are then allocated based on various criteria, such various areas.

NOTE 2 - Donated Materials and Services In-kind donations of materials and fixed assets are recorded at their estimated fair value at the date of donation. Such donations are reported as unrestricted support unless the donor has restricted the donated asset to a specific purpose. Conditional transfers of assets are recognized when the conditions upon which they depend are substantially met. During the fiscal years ended December 31, 2000 and 1999, SALF received $54,675 and $12,895 respectively, in donations of this type. Donations of services are recorded if they create or enhance a nonflnancial asset or are specialized skills that would be purchased if they were not donated. SALF received donations of this type in the fiscal years ended December 31, 2000 and 1999 of $0 and $0, respectively. SALF rents its office space at a lease amount substantially below market value. During the years ended December 31, 2000 and 1999, SALP received $8,750 in office space each year.

NOTE 3 - Policy on Contributions Contributions received are recorded as unrestricted, temporarily restricted, or permanently restricted support, depending on the existence and/or nature of any donor restrictions. Support that is restricted by the donor is reported as an increase in unrestricted net assets if the restriction expires in the reporting period in which the support is recognized. All other donorrestricted support is reported as an increase in temporarily or permanently restricted net assets, depending on the nature of the restriction. When a restriction expires (that is, when a stipulated time restriction ends or purpose restriction is accomplished), temporarily restricted net assets are

- 10 -

SAVE A LIFE FOUNDATION, INC. NOTES TO FINANCIAL STATEMENTS DECEMBER 31, 2000 AND DECEMBER 31, 1999 reclassif ied to unrestricted net assets and reported in the Statement of Activities as net assets released from restrictions. Federal grant awards are not recorded until expended for the purpose of the grants since they are conditional promises to give. NOTE 4 - Cash and Cash Equivalents SAU? maintains the majority of its cash at a Bingle financial institution. These accounts are insured by the Federal Deposit Insurance Corporation up to $100,000. NOTB 5 - Fixed Assets At December 31, 2000 and 1999, the costs of such assets were as follows:
Decetnb er 3 1 , 1999 2000 85,665 $ 75,025 31,998 31,998 117,663 107,023 46.180 63,037 54,626 $ 60,B43 Increase (Decrease) $ 10,640 10,640 16,657 $ (6,217)

Office Equipment Vehicles

$

Less accumulated depreciation Net book value $

Depreciation expense for fiscal years ending December 31, 2000 and 1999 was $16,858 and $14,098, respectively. NOTB 6 - Vehicle Loan On September 7, 1998, a vehicle was financed through Ford Motor Company for $21,668 at a 2.9% annual rate of interest. The loan was paid in full during the year ending December 31, 1999. NOTB 7 - Due to Related Party The organization's founder and current executive director, Carol Spizzirri, loaned SALF start up funding. As of December 31, 2000 and 1999 the amount of this loan is $65,450 and $65,475, respectively. NOTB 8 - Lease Obligation and Rental Expense The estimated future minimum rental and operating lease obligation for the succeeding years under non-cancelable leases for office facilities in effect at December 31, 2000 are as follows:
Efint 40,046 39,020 19,510

2001 2002 2003

- 11 -

SAVE A LIFB FOUNDATION, INC. .* . NOTES TO FINANCIAL STATEMENTS
f

DECEMBER 31, 2000 AND DBCEMBER 31, 1999

Rental expense under the operating leases was $36,432 for the year ended December 31, 2000 and $16,262 for the year ended December 31, 1999.

NOTE 9 - Fundraising Projects Special fundraising event income is shovm in the Statement of Activities at net of expenses. The following schedule breaks out the components expenses as follows : .December 31, 3QQQ ReveflWe Expenses H@£ $ 1.4,260 $ 7,720 $ 6,540 B70 668 202 $ 15,3(30 $ 8,388 $ 6,742 December 31. 1999 Revenue Expenses gg£ $ 34,525 $ 25,487 $ 9,038 150 91 59 $ 34,675 $ 25,578 $ 9,097

Dinner Event Various Merchandise

NOTE 10 - Restatement Temporarily restricted net assets are released from restriction as the expenses for the grants are incurred. In the year ended December 31, 1999, the release from restriction was overstated by $198,410. This error has been corrected in the comparative data presented herein.

- 12 -

f

M

II O H

PMT#

WWb
4 |5.J>°

ILLINOIS CHARITABLE ORGANIZATION ANNUAL REPORT

AMT

Attorney General J I M R Y A N State o f Illinois Charitable Trust Bureau 100 West Randolph 3rd Floor Chicago Illinois 60601 C O # oi026498 Report for the Fiscal Period Beginning oi
& Ending
MO

Form AG990 IL Revised 6/01

INIT

M
L

/0i
DAY

/ oi
/ 01
vn

1 2 / 3 1

Cheek all items attached r £ Copy of IRS Return M * a> k Ly Audited Financial Statements J/Ww ' D Copy of Form IFC en t/ C£ $15 00 Annual Report Filing Fee a P O O $100 00 Late Report Films Fee
MO
OAV

Federal ID# 3 6 - 3 8 6 9 4 5 9
Are contributions to the organization tax deductible?

YR

E Yes D No

Pate Organization was created 0 2

/

09/93

f?.~ Save A Life Foundation 9950 Lawrence - Suite 300

NAME MAIL A0DRESS

RECEIVED
MAf J 7 2002

CITY STATE „ . . , , , „ , -,,.«,-* ZIP CODE S c h i l l e r Park, IL 60176

I

ATTORNEY GENERAL CHARITABLE TRUST SUMMARY OF ALL REVENUE ITEMS DURING THE YEAR
0) PUBLIC SUPPORT CONTRIBUTIONS & PROGRAM SERVICE REV (GROSS AMTS )

E) GOVERNMENT GRANTS & MEMBERSHIP DUES F) OTHER REVENUES G) TOTAL REVENUE INCOME AND CONTRIBUTIONS RECEIVED (ADD D E & F)

II SUMMARY OF ALL EXPENDITURES DURING THE YEAR
H) OPERATING CHARITABLE PROGRAM EXPENSE If EDUCATION PROGRAM SERVICE EXPENSE

J) TOTAL CHARITABLE PROGRAM SERVICE EXPENSE (ADD H & I) Ji) JOINT COSTS ALLOCATED TO PROGRAM SERVICES (INCLUDED IN J) K) GRANTS TO OTHER CHARITABLE ORGANIZATIONS L) TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD J ft K) M) MANAGEMENT AND GENERAL EXPENSE N) FUNDRAISING EXPENSE O) TOTAL EXPENDITURES THIS PERIOD {ADD L M & N) $

III SUMMARY OF ALL PAID FUNDRAISER AND CONSULTANT ACTIVITIES
(Attach Attorney General Report of Individual Fundraising Campaign Form IFC One tar each PFR )| PROFESSIONAL FUNDRAISERS P) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISERS Q) TOTAL FUNDRAISERS FEES AND EXPENSES R) NET RECEIVED BY THE CHARITY (P MINUS Q»R) PROFESSIONAL FUHDRAISMB CONSULTANTS S) TOTAL AMOUNT PAID TO PROFESSIONAL FUNDRAISING CONSULTANTS

IV COMPENSATION TO THE (3) HIGHEST PAID PERSONS DURING THE YEAR T) NAME TITLE Carol S p i z z i r r i , President u) NAME TITLE Laura F i l l p p e l l i , National Project Coordinator V) NAME TITLE Linda Post, finance Director
V CHARITABLE PROGRAM DESCRIPTION cHMtTAoi£fitocMU(iwsHEsT&yiExPEHMO)coi)ecArzooiuEs W) DESCRIPTION L i f e X) DESCRIPTION Y) DESCRIPTION Saving F i r s t Aid Training

IF THE ANSWER TO ANY OF THE FOLLOWING IS YES ATTACH A DETAILED EXPLANATION 1 2 WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION FINE PENALTY OR JUDGMENT? HAS THE ORGANIZATION OR A CURRENT DIRECTOR TRUSTEE OFFICER OR EMPLOYEE THEREOF EVER BEEN CONVICTED BY ANY COURT OF ANY MIDSDEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY? DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS DIRECTORS OR TRUSTEES OWNS AN INTEREST OR WAS IT A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS OFFICERS DIRECTORS OR TRUSTEES HAS A MATERIAL FINANCIAL INTEREST OR DID ANY OFFICER DIRECTOR OR TRUSTEE RECEIVE ANYTHING OF VALUE NOT REPORTED AS COMPENSATION? HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER DIRECTOR OR TRUSTEE OWNS MORE THAN 10 / OF THE OUTSTANDING SHARES? IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER? (ATTACH FORM IFC) I

2

3

3

4

4

5

5 6

6

7a DID THE ORGANIZATION ALLOCATE THE COST OF ANY SOLICITATION MAILING ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES?

7

7b IF YES ENTER (i) THE AGGREGATE AMOUNT OF THESE JOINT COSTS £ (n) THE AMOUNT $ (in) THE AMOUNT ALLOCATED TO MANAGEMENT AND GENERAL S AND (w) THE AMOUNT ALLOCATED TO FUNDRAISING S 8 DID THE ORGANIZATION EXPEND ITS RESTRICTED FUNDS FOR PURPOSES OTHER THAN RESTRICTED PURPOSES? 8

9

HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION OR TAX EXEMPTION SUSPENOED OR REVOKED BY ANY GOVERNMENTAL AGENCY? 9

10 WAS THERE OR DO YOU HAVE ANY KNOWLEDGE OF ANY KICKBACK BRIBE OR ANY THEFT DEFALCATION MISAPPROPRIATION COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS? 10
11

LIST THE NAME ADDRESS AND THE ACCOUNT # OF THE FINANCIAL INSTITUTIONS WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST ACCOUNTS

Royal American Bank. 1000 Tower Lane - S u i t e 125, B e n s e n v i l l e , IL 60106 Account // 2 0 0 - 9 1 3 - 2 & 3 0 1 - 4 2 7 - 1
12 NAME AND TELEPHONE NUMBER OF CONTACT PERSON P a r n l Sp-fg^rri f»A7) 928-9683

ALL ATTACHMENTS MUST ACCOMPANY THIS REPORT SEE INSTRUCTIONS UNDER PENALTY OF PERJURY I (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS ANNUAL REPORT AND THE ATTACHED DOCUMENTS INCLUDING ALL THE SCHEDULES AND STATEMENTS AND THE FACTS THEREIN STATED ARE TRUE AND COMPLETE AND FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE STATE OF ILLINOIS RELY THEREUPON I HEREBY FURTHER AUTHORIZE AND AGREE TO SUBMIT MYSELF AND THE REGISTRANT HEREBY TO THE JURISDICTION OF THE STA '•'"««!.

te.£iRttj
BE SURE TO INCLUDE ALL FEES DUE 1 ) REPORTS ARE DUE WITHIN SIX MONTHS OF YOUR FISCAL YEAR END 2 ) FOR FEES DUE SEE INSTRUCTIONS 3 ) REPORTS THAT ARE LATE OR INCOMPLETE ARE SUBJECT TO A $100 00 PENALTY

/ft/M
TMTF

flGNATURE TREASURER or THUS I t t (PRIHT N J

bSL ?h*k

PREPARER (PRINT NAME)

SIGNATURE

DATE

Form

990

Return of Organization Exempt from Income Tax
Under Section 501(c), SZ7, or 4947(e)(1) of the Internal Revenue Code (except blade lung benefit trust or private foundation)

0MB No. IMS4M7

2001
Open to Public Inspection

OaetttmCTt ol tm T n o u y Internal Rcmnu* Sarvio

A B

► The organization may have to use a copy of this return to satisfy state reporting requirements. , 2001. and ending For the 2001 calendar year, or tax year beginning
Chock a •pslkabh: Mint* <tung» Nnmdunga Maintain Final rekjm Afttonoao rakMH
Aopucobon poncinQ v N m of GfBsiuxotion

D fa»to»»rlointtfl<JBoo rfcbtr
Roomfcuito

RShM or pilot tsedflc
toofrucBon. SM

Save A Life Foundation
Numbtr »ti»ot<orP.O. box if m i l b not oabVond'to s b w t addr)

9950 Lawrence
Oty, Town or Country
State

300
2Peod» + 4

36-3869459 E TdtphoM (847) 928-9683
r"|ch»(ip«crM>-

Schiller Park

IL

60176

E

Accnnl

e Section 501(c)(3) organizations and 4947<a)(l) rtonexempt charitable trusts must attach a completed Schedule A (Form 990 or 990-E2).

H onrfl an nefappfciMo to Sacftbn 337 onjanHaobRi. H ( a ) btibjagroupratnnhrolfiiiteT . . . Q v t * H ( b ) lfVn,'«0»rnuinWof*ffifatM^H ( C ) AmaSsfl9rt»MudMl7 01 "no; itteeh • B»t S M ■mtrudiona i 0
Y c

0 Q

No "°

G Website: * - w w w . s a l f . o r g Organization type (check only o n e ) . 3 " Cwrtno.) D 4*7(1)0) S27 501(0 Check here **■ Q i t the organization's gross receipts are normally not more than 529,000. The organization need not file a return with the IRS; but if the organization received B Form 990 Package in the mall, it should file a return without financial data. Some states require a complete return.

*

K

m.

a-O

H (d) It Ms • Meant* nrtum IBotf by an orgmioBcneowradby a groupni8no,7 | [ y

| X | M»

I

Enter 4-dioitgroup GEN. -diatgroup Check *•[ )Mth»Ma»iizatiDn it mt required to attach Schedule B (Form 99ft 990-Ei or 990-PF).

L

Gross receipts: Add lines 6b, to. 9b. and 10b to line 12 * 1 . 7 5 8 . 8 9 9 . 1 Contributions, gifts, grants, and similar amounts received: a Oirect public support b Indirect public support c Government contributions (grants)

Revenue, Exponsos. and Changes In Net Assets or Fund Balances (see instructions)
la lb 1c )

88.699 1.470.470
Id

*M&fr+*$
2 3 4 5 6a b c 7

»—* t

Program service revenue including government fees and contracts (from Part VII, line 93) Membership dues and assessments Interest on savings and temporary cash investments Dividends and interest from securities Gross rents 6a Less: rental expenses I 6b Net rental income or (loss) (subtract line 6b from line 6a) Other investment income (describe ■* (A) Securities (B) Other Be Gross amount from sates of assets other 8a lhan inventory b Less: cost or other basis and sales expenses 8b c Gain or (toss) (attach schedule) 8c d Net gain or (loss) (combine line 8c, columns (A) and (B)) 9 Special events and activities (attach schedule) a Gross revenue (not inctuding S 4 4 . 5 6 4 . of contributions reported on line la) | 3a 73.491 b Less: direct expenses other than fundralsing expenses I 9b 70.761 c Net income or (loss) from special events (subtract line 9b from line 9a) S e e . L T 9 . StOlt. 10a Gross sales of inventory, less returns and allowances | 10a| b Less: cost of goods sold 1 10b| c Gross profit or (has) from sales of inventory (attach schedule) (subtract line 10s from line 10a) 11 Other revenue (from Part VII, line 103) 12 Total revenue (add lines Id. 2f 3. 4, 5, 6c, 7. 8d, 9c. 10c, and 11) Program services (from line 44, column (B)) Management and general (from line 44, column (C)) . Fundraising (from line 44, column (D)) Payments to affiliates (attach schedule) Total expenses (add lines 16 and 44, column (A)) 18 Excess or (deficit) for the year (subtract line 17 from line 12) 19 Net assets or fund balances at beginning of year (from line 73, column (A)) 20 Other changes in net assets or fund balances (attach explanation) 21 Net assets or fund balances at end of year (combine lines 18. 19. and 20) . TEEA010I 01/I67DZ BAA For Paperwork Reduction Act Notice, see the separate instructions.

1.559.169. 115.423. 3.275.

6c

9c

2.730.

10c 11 12 13 14 15_ 16_ 17 18_ 19. 20_ 21

7.541

1.688.138.
749.494. 111.917.

13.630.
875.040.

813.098.
380.898.

1.193.996,
Form 990 (2001)

Save A Life Foundation
Do net include amounts reported on line 6b, 8b. 9b, 10b, or 16 of Part I.

36-3869459

Page 2

S t a t e m e n t o f F u n c t i o n a l E x p e n s e s Ail organizations must complete column (A). Columns (BJ, (C), and p ) are required for section 501 (c)(3) and (4) organizations and section 4947(a)(1) nonexempt charitable trusts but optional for others. (C) Management and general (D) Fundraising

22 Grants and alkwbons (att sch)
(cash $

non-cash
23 24 25 26 27 29 30 31 32 33

$

.)

Specific assistatoj to litdMduals (att sdi) . . Benefits paid b erf or numbers (att s c h ) . . . Compensation rf officers, directors, etc Other salaries and wages Pension plan contributions Payroll taxes Professional fundraising fees Accounting fees Legal fees Supplies

26
27 28

94.309, 1S6.361 11.384 25.050. 22.593 16.100. 8^054 24.430. 5.355 40.289 10.519. 8^611 10.020, 3.677 3.305 16.662 1.233 2.070. 14.648. 22.572. 377.798 875.040.

93,366 133.800. 1Q.S11 23.357 6.621 15.481 14.082 22.493 1.681 7.371 7.297 17.359 15.691 1.519

13.191 653 579 15.972 165 2.457 220. 3.090 32.918 3.222 ■8.783 •5.935 1.298 3.305 16.662 30, 1.650

472 9.370. 220. 1.114. 454. 8.485.
1.717.

28 Other employee benefits

29
30 31 32 33 34

34 Telephone 35 Postage and shipping
36 37 38 39 40 41 Occupancy Equipment rental and maintenance Printing and publications Travel Conferences, conventions, and meetings Interest —

35
37 38 40 41 42 43a 43b 43c 43d 43e 44

584. 35. 264. 860.

42 Depredation, dtphtion, ate (attach schedule). 43 Other expenses not covered above (itani»):

■Auto. Expense b JaQX. Jeryj ce_ Fee_s_. c J ra nc h _Dey elopraent _ djCornpjiter_ JxjTens es_.
4 4 total fuMtJaul nptaiaT (aid linef22 • 4 3 1 ' Orgaahjtton centMlng column (B) • (o), tarry t h w b o b to line* 13-15 Joint Costs. Check . * Q

1.203 387. 14.648. 22.572 340.055 749.494.

33. 6.992. 13.630.
* f | Yea [KJ No

30.751 111.917

if you are following SOP 98-2. $ ; (ii) Ihe amount allocated to program services ; and flv) the amount allocated

Are any joint costs from a combined educational campaign and fundraising solicitation reported in (B) Program senrices? If "Yes/ enter © the aggregate amount of these joint costs to fundraising S ; (Hi) the amount allocated to management and general

[Statement of Program Service Accomplishments
What b the organization's primary exempt purpose? »• . f l Q f n p t e \ j f e _ S 3 V I n g _ f J r S_t_ a i_d Ail organizations must describe their exempt purpose achievements in a clear and concise manner. State the number of clients served, publications issued, etc. Discuss achievements that are not measurable. (Section 501(c)(3) & (4) organizations & section 4947(a)(1) nonexempt charitable trusts must also enter the amount of grants & allocations to others.) Program Service Eapenwt
(Ruuind fix S01(c)(3) u i l ffienpr' organizations tnd *9«7(oV truiti; but iSf7(«X)) option*! tor r — fid for often.) •

■Kid '.?_ PCPBiaras_-_ Prompt ton_a_nd_ teach 1ng_qf_ l i f e .saying f i r s t J i l 3 i l 0 i I»ipJ£Isch<rol~chJ Idren1(66~1J6_chiTdren Jtaught^
(Grants and allocations $

bJorqprate_Prpgram. - ^jooption. and_ teaj:h1ng_qf. 1 if_e_ saying Jl L%t_ a 1d_ t p_ j ndj vTduais. ,pt her_than _schqql - age, chij d ren
(Brants and allocations S

^J.

236.180.

c B

_ iye.Angels .Program_-_Pxogiot_1 onjand_teach_1 ng_pf _lj.fi_savinj_fijrst

±A

7.413.

J i l 3-9-%&§_R°3 ICA. I i IE?. 3£3*?_°.f. I UJD_,l?
(Grants and allocations S ^J. d Jra/u:h_Dj!velj>£mejit/r^xpansjon program j_Expand, to _sateU_te_ of fj ce _ i n f i d i andoutsfde the~State of I l l i n o i s (Grants and allocations S

31.604.

JL_L

e Other prooram services.. . S e e . a t t a c h e d BAA

(Grants and allocations $
lEEAOtoe oinnnz

f Total of Program Service Ekpenses (should equal line 44, column (B). program services)

i_L

472.489. 1■808. 749.494.
Form 930 (2001)

Form990(2001)

Save A L i f e

Foundation

36-3869459

Page 3

Balance Sheets (See instructions)
Note: Where requited, attached schedules and amounts within the description column should be for end-of-year amounts only. 45 Cash — non-interest-bearing 46 Savings and temporary cash Investments 47a Accounts receivable bLess: allowance tor doubtful accounts 48a Pledges receivable b Less: allowance for doubtful accounts 49 Grants receivable

Beginning of year 500 332.812 45 46

_ (B) End of year 115.104. 300.464.

47a 47b 48a 48b

2.907. 3.987 20.000. 48c 49 50 51c 52 53 54 20.000. 718.887. 47c 2.907.

50 Receivables from officers, directors, trustees, and key employees (attach schedule) 51 oOttwr notes & loans receivable (attach »lt) 51a b Less: allowance for doubtful accounts 51b
52 Inventories for sale or use

53 Prepaid expenses and deferred charges. 54 Investments - securities (attach schedule) * Q Cost[[] FMV 55a Investments - land, buildings, & equipment: basis 55a b Less: accumulated depreciation (attach schedule) 56 Investments - other (attach schedule) 57a Land, buildings, and equipment: basis . b Less: accumulated depreciation (attach schedule) L.-.57.. Stmt. 55b 57a 57b 118.338 79.699. .)•

52.188 11.305

47.209. 17.398.

55c 56

58 Olher assets (describe •> S e e l i n e 5 8 S t m t 59 Total assets (add lines 45 through 58) (must equal line 74) 60 Accounts payable and accrued expenses 61 Grants payable 62 Deferred revenue 63 Loans from officers, directors, trustees, and key employees (attach schedule) 64a Tax-exempt bond liabilities (attach schedule) b Mortgages and ether notes payable (attach schedule) 65 Other liabilities (describe » S e e L i n e 6 5 S t m t 66 Total liabilities (add lines 60 through 65) Organizations that follow SFAS117, check here [Xjand complete lines 67 through 69 and lines 73 and 74. 67 Unrestricted

54.625 162 455.579 8.648

65.450

583. 74.681

57c 58 59 60 61 62 63 64* 64b 65 66

38.639. 11.185. 1.271.793. 8.702.

68.755.

340. 77,797.

68 Temporariry restricted 69 Permanently restricted Organizations that do not follow SFAS 117, check here Q and complete lines 70 through 74. 70 Capital stock, trust principal, or current funds 71 Paid-in or capital surplus, or land, building, and equipment fund 72 Retained earnings, endowment, accumulated income, or other funds. 73 Total net assets or fund balances (add lines 67 through 69 or lines 70 through 72; column (A) must equal line 19 and column (B) must equal line 21) 74 Total liabilities and net assets/hind balances (add lines 66 and 73).

■27.648 408.546

68 69

112.566. 1.081.430.

70 71 72

380.898 1.193.996. 4 5 5 . 5 7 9 . 74 1.271.793. Form 990 is available for public Inspection and, for some people, serves as the primary or sole source of information about a particular organization. How the public perceives an organization in such cases may be determined by the information presented on its return. Therefore, please make sure the return is complete ana accurate and fully describes, in Part III, the organization's programs and accomplishments. BAA

1EEA0I03

09/2SOI

Form 990 I

Save A Life Foundation I Reconciliation of Revenue per Audited Financial Statements with Revenue per Return (See instructions.)
■ b

36-3869459 Reconciliation of Expenses per Audited Financial Statements with Expenses per Return
Total expenses and losses per audited financial statements • Amounts included o n line a but not on line 17, Form 990:

Page 4

Total revenue, gains, and other support per audited financial statements i Amounts included on line a but not on line 12, Form 990: 0 ) Net unrealized gains on investments (2) Donated serv­ ices and use of facilities . . . (3) Recoveries of prior year grants (4) Other (specify): See A t t a c h e d S,

1.025.403.

$

(1) Donated serv­ ices and use of facilities (2) Prior year adjust­ ments reported on lint 20, Form 990. (3) Losses reported on lino 20, Form 990.. (4) Other (specify): See A t t a c h e d

S

$. $ 150.363

150.364,
Add amounts on lines O ) through (4) Line a minus line b Amounts included on line 12, Form 990 but not o n line a: 0 ) Investment expenses not included on line 60, Form 990 $_ (2) Other (specify): Line a minus line b

Add amounts on lines (1) through (4).

Amounts Included o n line 17, Form 990 but not on line a : 0 ) Investment osxnses net included en line 6b, Form 930 (2) Other (specify):

$

Add amounts on lines (1) and ( 2 ) a Total revenue per line 12, Form 990 (line c plus line d) e

Add amounts on lines f l ) and (2) • • Total expenses per line 17, Form 990 (line c plus line d) ( C ) Compensation (If not paid, entofO-) «(E) Expense account and other allowances

Wm List of Officers, Directors. Trustees, and Key Employees gist each oneeven If not compensated; see instructions.)
(A) Name and address (B) Title and average hours per week devoted to posib'on ( D ) Contributions to employee benefit plans and deferred compensation

jCa r_oJ_ Sp_i 2 zi_rf i. Pres/Exec Dir Sam Amirante Vice President Daniel Caravello Treasurer Martin A. Sandoval Secretary Carlos M. Azcotia Director _0. 0, 40 94.309 2.290 _0,

JL JL JL JL JL
0. 0,
DY«* BNo
Form 990 (2001)

.Pi■-_s£«LnJey. Jl* \P_
Director Dr. Scott Betzelos Director Deloris M. Burnam Director Michael Lavalle
Director See List of Officers. Etc. Statement 75 Did any officer, director, trustee, or key employee receive aggregate compensation of more than $100,000 from your organization and all related organizations, of which more than $10,000 was provided by the related organizations? If 'Yes.' attach schedule — see instructions. BAA
TEEA0104 10/18X11

Form 990 i

Save A Life Foundation
I O t h e r I n f o r m a t i o n (See specific instructions.)

76 Oid Ihe organization engage in any activity not previously reportedtothe IRS? If 'Yes,' attach a detailed description of each activity 77 Were any changes made in the organizing or governing documents but not reported to the IRS? If 'Yes,' attach a conformed copy of the changes. 78a Did Ihe organization have unrelated business gross income of $1,000 or more during the year covered by this return? .. b If "Yes," has it filed a tax return on Form 990-T tor this year? 79 Was there a liquidation, dissolution, termination, or substantial contraction during the year? If 'Yn« ' vaar? If 'Yes,' attach a statement a 80a Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc, to any other exempt or nonexempt organization? blf 'Yes,' enter the name of the organization *■ and check whether it is \_\ exempt or (jfnonexempt. 81 a Enter direct or indirect political expenditures. See line 81 instructions | 81a| Q. b Did (he organization file Form 1120-POL for this year? 82 a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially less than fair rental value? b If 'Yes,' you may indicate the value of these items here. Do not include this amount as , , revenue m Part I or as an expense in Part II. (See instructions in Part III.) } 82b| 83a Did the organization comply with the public inspection requirements for returns and exemption applications? b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? 84a Did the organization solicit any contributions or gifts that were not tax deductible? b If 'Yes,' did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? 85 501(e)(4), (5), or (6) organizations, a Were substantially all dues nondeductible by members? b Did the organization make only in-house lobbying expenditures of $2,000 or less? if 'Yes' was answered to either 65a or 85b, do not complete 85c through 85h below unless the organization received a waiver for proxy tax owed for the prior year. c Dues, assessments, and similar amounts from members dSection 162(e) lobbying and political expenditures • Aggregate nondeductible amount of Section 6033(e)(1)(A) dues notices f Taxable amount of lobbying and political expenditures Cine 85d less 85e) g Does the organization elect to pay the Section 6033(e) tax on the amount on line 85f? h If Section6033(e)(IXA) dun notices wre sent, does the organization agree to add the amount on line 8Sftaits reasonable estimate of dues aliocablotonondeductible lobbying and political expenditures for the following tax year? 86 501(c)(7) organizations. Enter: a Initiation fees and capital contributions included on line 12 b Gross receipts, included on line 12, for public use of club facilities 87 501(c)(12) organizations. Enter: a Gross income from members or shareholders b Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) 88 At any tme dunng the year, did the organization own a 50% or greater interest in a taxable corporation or partnership. or an entity disregarded as separate from the organization under Regulations Sections 301.7701-2 and 301:7701-3? If Yes,' complete Part IX 89a 501(c)(3) organizations. Enter: Amount of tax Imposed on the organization during the year under: Section4911 *■ 0 . ; Section4912►■ 0 . ; Section 4955 •b 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any Section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year? If 'Yes,' attach a statement explaining each transaction c Enter: Amount of tax imposed on the organization managers or disqualified persons during the year under Sections 4912.4955, and 4958 " !?. « ► d Enter Amount of tax on line 89c, above, reimbursed by the organization •»■ SO• List the states with which a copy of this return is filed ► _11 \} no 1 S b Number of employees employed in the pay period that includes March 12,20017see instructions) .. 7 . 7 7 7 7 7 7 7 . 7 7. f 9 0 b | " 91 The books are in care of * j : a r o _ l _ S p J z z i j * r i Telephone number •> _(847) 9 2 8 - 9 6 8 3 _ 0.

L c t d at ^ i95Q_ La^enM_Strite J00 Jk:hUJer__Park o ae

IL_ ZIP+4 ►60176
. 7 7 7 7.7 *•"[] H 92 | Form 990 (2001)

92 Section4947(a)(1) nonexemptcharitable frusfs King Form~99oWileVof Form 1041 - Check here".7.7 and enter the amount of tax-exempt interest received or accrued during the tax year BAA
TEEAOIOS 01/01/02

Form 990 goot) Save A L i f e Foundation 36-3859459 Page 6 Analysis of Income-Producing Activities (See instructions.) Unrelated business income Excluded by section 5 ) 2 , 5 1 3 , or 514 Note: Enter gross amounts unless Related or exempt otherwise indicated. Business code Amount Amount function income 93 Program service revenue: » Program Fees 17.979. b Course M a t e r i a l s 97.444. c

fe,«JS««|

it

f Medicare/Medicaid payments g Fees 4 contacts from government agencies .. 94 Membership dues and assessments. 95 Interest on savings & temporary cash invmnts. 96 Dividends & interest from securities . 97 Net renlal income or (loss) from real estate: a debt-financed property b not debt-financed property 98 Met rental income or (loss) from pers prep . . . 99 Other investment income 100 Gain or (loss) from sales of assets other than inventory 101 Net innme or (loss) from special events
102 GrottpreGtofOott) from t»ta» of imantocy...

14

3.275

2.730.

103 Other revenue: a bMiscellaneous c d

7.541.

104 Subtotal (add columns (6), <D), and (£)). 6.005 122.964. 105 Total (add line 104, columns (B), (D), and (E)>. 128.969. Note:[Une JOS plus line Id. Part I. should equal the amount on line IZ Part I. Relationship of Activities to the Accomplishment of Exempt Purposes (See instructions.) Una No. Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment of the organization s exempt purposes (other than by providing funds for such purposes). 93a.93b Promote and teach l i f e saving f i r s t aid programs. 103a To supplement funding required to perform and carry out the saving f i r s t a i d programs. life

Information Regarding Taxable Subsidiaries and Disregarded Entities (See instructions.) (A) (B) (D) Name, address, and EIN of corporation, Percentage of Total Nature of activities partnership, or disregarded entity ownership interest income %

N/A End-of-' asse'

tr

% % Information Regarding Transfers Associated with Personal Benefit Contracts (See instructions.) a Did the onjanaalion, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? M y bDid the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? {"j Yes Note: If "Yes' to (b% file Form 8870 and Form 4720 (see instructions).
Undar

w

No No

Please Sign Here Paid Prearer's se Only

USMA'feL^^
Data

knoarlado* and baGaf, i t »

Signibtra of Offico

Typa or Print Nam* and Titta Praparw'a Signature Firm'i turn* (or younif

Data

Ctwckif aalf-

E

I

and k w i . H . and Z I P * *

Ahlbeck & Company 1665 Elk Blvd. Pes Plaines

£1 P00237637
(847)
0)101/02

EIN ► 136-2991500 IL 600164721
Phonano 824-4000
TEEA010S

BAA

Form 990 (2001)

Schedule A
(Form 990 or 990-EZ)

Organization Exempt Under Section 501(c)(3)
(Except Private Foundation) and Section 901(e), 501(f), 501(1* 501(n), or Section 4947(8)0) Nonexempt Charitable Trust Supplementary Information - (See separate instructions.) Supplementary Information - (see separate Instructions) *■ Must be completed by the above organizations and attached to their Form 990 or 990-EZ.

OMB No. IWS-0047

2001

Dopwtimfitof to Treasury Internal Ravaflw Sanica Maim < th* Oigtnizalien K

Entpteyw Idtntifieitien Monbw

Save A L i f e Foundation 36-3869459 Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees
(See instructions. List each one. If there are none, enter 'None.') (a) Name and address of each employee paid more than $50,000 (b) Title and average hours per week devoted to position (c) Compensation (d) Contribution! (e) Expense to employe* benefit account and other pteu * deferred allowances compensation

Laura F i l i p j j e U i V i l l a Park. IL 60181
NM. Protect Coordinator. 4 0

58.000.

0.

0.

Total number of other employees paid
xEffiS£l3bQS$ft

I Compensation of the Five Highest Paid Independent Contractors for 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

None

Total number of others receiving over $50,000 for professional services *■ BAA For Paperwork Reduction Act Notice, see the instructions for Form 990 and Form 930*EZ.
TEEA040I 0IQ4XB

Schedule A (Form 990 or 990-EZ) 2001

Schedule A (Form 990 or 990-EZ) 2001

Save A L i f e

Foundation

36-3869459
Yes No

| Statements About Activities (See instructions.)
1 During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? If "res,' enter Die total expenses paid or incurred in connection with the lobbying activities •*■ $ (Must equal amounts on line 38, Part VI-A,orlim I of Part WB.) Organizations that made an election under section 501 (h) by filing Form 5768 must complete Part VIA. Other - ■ Part " " ■ ■ -jcn organizations checking 'Yes,' must complete ■ * - - "Vl-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 substantial contributors, trustees, directors, officers, creators, key employees, or members of their families, or with any taxable organization with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary? (If the answer to any question is Yes,' attach a detailed statement explaining the transactions.) a Sale, exchange, or leasing of property? b Lending of money or other extension of credit? c Furnishing of goods, services, or facilities? 2b

1

2c

See Pt V, Fm 990
d Payment of compensation (or payment or reimbursement of expenses if more than $ 1,000)? e Transfer of any part of its income or assets? 3 Does the organization make grants for scholarships, fellowships, student loans, etc? (See Note below.). 4 Do you have a section 403(b) annuity plan tor your employees? Note: 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. 2d _2e X

| Reason for Non-Private Foundation Status (See instructions.)
The organization is not a private foundation because it is (please check only One applicable box): 5 _ A church, convention of churches, or association of churches. Section 170(b)(1)(A)(i). 6 " A school. Section l70(b)(t)(A)(ii). (Also complete Part V.) 7 A hospital or a cooperative hospital service organization. Section l70(b)(l)(A)(iii). 8 A federal, state, or local government or governmental unit Section 170(b)(l)(A)(v). 9 10 [ J A medical research organization operated In conjunction with a hospital. Section 170(b)(1)(A)(iii). Enter the hospital's name, city, end state ^ Q An organization operated for the benefit of a college or university owned or operated by a governmental unit Section 170(b)OKA)(iv)7 (Also complete the Support Schedule in Part IV-A.)

11 a K ] An organization that normally receives a substantial part of its support from a governmental unit or from the general public Section l70(b)(1)(A)(vf). (Also complete the Support Schedule in Part IV-A.) 11 b Q A community trust Section 170(b)(l)(A)(vi). (Also complete the Support Schedule in Part IV-A.) 12 D An organization that normally receives: (1) more than 33>1f3% of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc, functions - subject to certain exceptions, and (2) no more than 33-1/3% ot 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. See section 509(a)(2). (Also complete the Support Schedule in Part IV-A.) L j An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in: (1) lines 5 through 12 above; or (2) section 501(c)(4), (5), or (6), if they meet the test of section 509(a)l2). (See section 509(a)(3).) Provide the following information about the supported organizations. (See instructions.) (e)Name(s) of supported organizationfs) (b) Line number from above

13

14

M An organization organized and operated to test for public safety. Section 509(a)(4). (See instructions.)
1EEA0402 01/2102

BAA

Schedule A (Form 990 or Form 990-EZ) 2001

schedule A (Form 990 or 990-EZ) 2001

Save A L i f e Foundation

36-3869459

Page 3

j S u p p o r t S c h e d u l e (Complete only if you checked a box on line 10,11, or 12.) Use cash method of accounting. N o t e : You may use the worksheet in the instructions for converting from the accrual to the cash method of accounting. Calendar year (or fiscal year 2000 15 Gifts, grants, and contributions received. (Do not include unusual grants. S e e line 28.) . . . 16 Membership fees received 17 Crow receipts from admissions, merchandise sold or services performed, or furnishing of facilities m any activity that is related to the organization's

•ft
621.043.

lft
621.289.

A
101.330. 550.

to)
Total 2.026.540. 550.

682.878.

52.664.
18 Grass income from interest, dividends, amountsreceivedfrom payments on securities loans (Section S12UX5)). rents, royalties, and unrelated business taxable income (lets Section 511 tans) from businesses acquired by the orpan-

41.158.

6.134.

99.956.

8.725.
19 Nat income from unrelated business activities not included in line 18 20 Tax revenues levied for the organization's benefit and either paid to it or expended The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charqe 22 Other income. Attach a schedule. Do not Include gain or (loss) from sale of capital assets 23 Total of lines 15 through 22 2 4 Line 23 minus line 17 26 21

24.575.

676.

33.976.

744.267. 691.603. 7.443.

Organisations described on lines 10 or 1 1 : 41.221. b Prepare a list for your records to show the name of and amount contributed by each person (other a governmental unit c publicly ir than wtthvoar retain. Enter the total of all these excess a 26b > 26c » c Total support for Section 509(a) (1) test: Enter line 24, ( 2.06 1,066. d Add: Amounts from column (e) for lines: 18 33,976. 19 »» 26d r ^ 3 3 . 9 7 6 . 22 26b ►» 26e e Public support (line 26c minus lini; 26d total) 2.027.090. » 26f > f Public support percentage (fine 2iSo (numerator) divided by line 26c (denominator)) 98.35 % 27 Organizations described on line 12: a For amounts included in lines 15,16. and 17 that were received from a 'disqualified person,' prepare a list for your records to show the name of, and total amounts received in each year from, each 'disqualified person.' Do not file this list with your ratum. Enter the sum of such amounts for each year: (2000) (1999) (1998) (1997) bFor any amount included in line 17 that was received from each person (other than 'disqualified persons'), prepare a list for your records to show the name of, and amount received for each year, that was more than the larger of (1) the amount on line 25 for the year or (2) $5,000. (Include in the list organizations described in lines 5 through 11, as well as individuals.) Do not file this list with your ratum. After computing the difference between the amount received and the larger amount described in (T) or (2), enter the sum of these differences (the excess amounts) for each year: (2000) (1999). (1998) (1997). c Add: Amounts from column (e) for lines: 15 16 17 20 21 and line 27b total d Add: Line 27a total e Public support (line 27c total minus line 27d total) f Total support for section 509(a)(2) test: Enter amount from tine 23, column (e) ' g Public support percentage (line 27e (numerator) divided by line 27f (denominator)) h Investment Income percentage (line 18, column (e) (numerator) divided by line 271 (denominator)). 28

628.099. 621.965. 6.281. a Enter 2 % of amount in cc ilumn (e), line 24 ...

686.776. 645.618. 6.868.

101.880. 101.880. 1.019. *• 26a

2.161.022. 2jj)6lJD66.

27c 27d 27e

ZTfl 27h

%

Unusual Grants: For a n organization described in line 10, 1 1 , or 12 that received any unusual grants during 1997 through 2000, prepare a list for your records to show, for each year, the name of the contributor, the date and amount of the grant, and a brief description of the nature of the grant. D o not file this list w i t h your ratum. Do not include these grants in llna 15. TEEAM03 12/31/01 BAA Schedule A (Form 990 or 990-EZ) 2001

ScheduleAform990or990-EZ)2001 Save A L i f e Foundation ] Private School Questionnaire (See instructions.)
(To be completed Only by schools that checked the box on line 6 in Part IV)

36-3869459

Page 4

N/A
Yes No 29

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

30

32 Does the organization maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative staff? b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student admissions, programs, and scholarships? dCopies of all material used by the organization or on its behalf to solicit contributions? If you answered 'No' to any of the above, please explain. (If you need more space, attach a separate statement.)

32a 32b 32c 32d

33 Does the organization discriminate by race in any way with respect to: a Students'rightsor privileges? b Admissions policies? c Employment of faculty or administrative staff? d Scholarships or other financial assistance? • Educational policies? f Use of facilities? g Athletic programs? h Other extracurricular activities? If you answered 'Yes' to any of the above, please explain. (If you need more space, attach a separate statement) 33a 33b 33c

33d 33e
33f 33a 33h

34a Does the organization receive anyfinancialaid or assistance from a governmental agency? b Has the organization's right to such aid ever been revoked or suspended? If you answered 'Yes' to either 34a or b, please explain using an attached statement. 35 Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05 of Rev Proc 75-50, 1975-2 C.B. 587, covering racial nondiscrtmination? If 'No,' attach an explanation.
TEEAO40* OS/ZSAI

34a
34b

35
Schedule A (Form 990 or 990-EZ) 2001

scheduiBA(Form990or990EZ)200i Save A l i f e Foundation ]Lobbying Expenditures by Electing Public Charities (See instructions.)
(To be completed Only by an eligible organization that filed Form 5768) Check - a | (if the organization belongs to an affiliated group.

36-3869459

Check *■ b | | if you checked V and'limited control'provisions apply, To be completed for all electing organizations

Limits on Lobbying Expenditures
(The term'expenditures' means amounts paid or incurred.) 36 37 38 39 40 41 Total lobbying expenditures to influence public opinion (grassroots lobbying) Total lobbying expenditures to influence a legislative body (direct lobbying) Total lobbying expenditures (add lines 36 and 37) Other exempt purpose expenditures Total exempt purpose expenditures (add lines 38 and 39) Lobbying nontaxable amount Enter the amount from the following table -

O)

II the «mount on line 40 I s -

The lobbying nontaxable amount Is—

Not over $500,000 20% of the amount on line 40 Over $500,000 butrotover $1,000,000 $100,000 plus 15% of fits excess ever 1500,000 Over $1,000,000 but not over $1,500,000 $175,000 plus 10% of the excess over $1,000,000 Over $1,500,000 but not over $17,000,000 $225,000 plus 5% of the excess over $1,500,000 Over $17,000,000 $1,000,000 42 Grassroots nontaxable amount (enter 25% of line 41) 43 Subtract line 42 from line 36. Enter 0- rf line 42 is more than line 36 44 Subtract line 41 from line 38. Enter -0- If line 41 is more than line 38 Caution: tf there is an amount on either tine 43 or line 44, you must tile Form 4720.

4 -Year Averaging Period Under Section 501 (h)
(Some organizations that made a section 501 (h) election do not have to complete ail of the five columns below. See the instructions for lines 45 through 50.) Lobbying Expenditures Owing 4 -Year Averaging Period Calender year (orfiscalyear beginning In) * (a) 2001

2000

1999

<«0
1998

(•) Total

45 Lobbying nontaxable
amount.

47 Total lobbying expenditures .

48 Grassroots non-

taxable amount.

49 Grassroots ceiling amount (150% of line 48(e)) — Grassroots lobbying expenditures

Lobbying Activity by Nonetecting Public Charities
(For reporting only by organizations that aid not complete Part VIA) (See instructions.) During the year, did the organization attempt to Influence national, state or local legislation, Including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Yes No

Amount

b Paid staff or management (include compensation in expenses reported on lines c through h.)

X X X X X X X X

0. 0. 0. 0. 0. 0. 0.

BAA

If 'Yes' to any of the above, also attach a statement giving a detailed description of Ihe lobbying activities. Schedule A (Form 990 or 990EZ) 2001
TEEA0405 12/31/01

Schaduie A (Form 990 or 990-E2) 2001 Save A L i f e foundation 36-3869459 I Information Regarding Transfers To and Transactions and Relationships With NoncharitaUe Exempt Organizations (See instructions) •
of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations? a Transfers from the reporting organization to a noncharitable exempt organization of: (DCash (ii)Other assets b Other transactions: (QSales or exchanges of assets with a noncharitable exempt organization OQPurchases of assets from a noncharitable exempt organization (HQRental of facilities, equipment, or other assets (IwJReimbursement arrangements OOLoans or loan guarantees (vflperformance of services or membership or fundraising solicitations c Sharing of facilities, equipment, mailing lists, other assets, or paid employees

Page I

51 Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section 501(c) Yes
51a(l) ■ 01) b(l> bflf) b(HD bflv) b(v) b<V0

No X X X X X X X X X

c
show the fair market value of ess than fair market value in services received:

Line no.

ntin Amount involved

Name of noncharitable exempt organization

A

Description of transfers, transactions, and sharing arrangements

52a Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations described in section 501(c) of the Code (other than section 501 (c)(3)) or in section 527? b If *Yes,' complete the following schedule: (a) Name of organization

._. __ *■■[_] Yes |Xj No

0>)
Type of organization

Description of relationship

BAA

TEEA0M6

09/2SAH

Schedule A (Form 990 or 990EZ) 2001

Save A Life Foundation

36-3869459

1

Form 990, Page 1. Part I, Line 9 Special Events and Activities Statement List of Three Largest Events and Type and Number of Others Dinner Event Other Net Income (Loss) 0. 2.730.

Gross Receipts 115.325. 2.730.

Less Contributions 44.564.

Gross Revenue 70.761. 2.730.

Less Direct Expenses 70.761.

Total

118.055.

44.564.

73.491.

70.761.

2.730.

Form 990, Page 2. Part II, Line 43 Other Expenses Stint (A) Total <B) Program services 111.567. 22. 104.998. 7.302. 105. 6.809. 245. 4.211. 966. 1.238. 100.669. 1.923. (C) Management and qeneral 8.466. 137. 480. 1.902. 1.665. 980. 6.380. 52. 9.675. 0. -1.243. 2.257. (P) Fundraising 6.522. 25. 0. 34. 0. 246. 82. O. 83. 0. 0. 0.

Other expenses not covered above (itemize): Consul t i n e Fees Dues & Subscriptions Instructors Fees Insurance Licenses & Permits Marketinn Miscellaneous Recruitment Cost of Goods Sold Training & Development Training Supplies Website

126.555. 184. 105.478. 9.238. 1.770. 8.035. 6.707. 4.263. 10.724. 1.238. 99.426. 4.180.

Total

377.798.

340.055.

30.751.

6.992.

Form 990. Page 3, Part, IV, Lines 57a & S7b Land, Buildings and Eqidpment Statement

(a) Cost/Other Basis Office Equipment Vehicles 86.340. 31.998.

0») Accumulated Depreciation 61.539. 18.160.

(c) Book Value

24.801. 13.838.

Total
Form 990, Page 3, Part IV. Line 58 Other Assets Statement

118.338.

79.699.

38.639.

Line SB • Other Assets: Deposits Credit Card Deposits Outstanding

Beginning of Year 162. 0.

End of Year 0. 11.185.

Save A Life Foundation

36-3869459 Continued

2

Form 990, Page 3, Part IV, Line 58 Other Assets Statement Beginning of Year

Line 58 - Other Assets:

End of Year

Total

162.

11.185.

Form 990, Page 3, Part IV, Line 65 Other Liabilities Statement Beginning of Year 190. 393. 583. End of Year 340. 0. 340.

Line 65 - Other Liabilities: Instructor Deposits Due t o M o r e l l t Fund Total

Form 990, Page 4, Part V List of Officers, Etc. Statement

Name and address

(B) Title and average hours per week devoted to position

<C) Compensation Qt not paid, enter-0-)

(P> Contributions to employee benefit plans and deferred compensation

(E) Expense account and other allowances

Robert

Conrov Director 0. 0. 0. 0. 0. 0.

Wayne R o b e r t s Director Note: The Individuals above. except as noted, spend time as needed in their capacity on the Board, Thev can be contacted c/o Save a L i f e Foundation, 9950 Lawrence
Ste 300, Schiller Park, I I 60176

Total

0.

0.

0.

Save A Life Foundation

36-3869459

3

Supporting Statement of:

Form 990 p 2/line 42 column (C) Description Depreciation Expense - Office Equipment Depreciation Expense - Vehicle Total Amount 11.662. 5.000. 16.662.

Supporting Statement of: Form 990 p 2 / 0 t h e r Program Service Exp

Description New Program Development - Research and development for new wavs to serve the community.
Total

Amount 1.808.
3.808.

Supporting Statement of: Form 990 p 3/Line 63, column (B)

Description Due to Carol Splzzlrrl, President/Exec. Director Interest Rate - Variable
Total

Amount 68.755. 68.755.

Supporting Statement of: Form 990 p 4 / P a r t IV-A, Line b(4)

Description Donated Materials, Services, and Facilities Special Events Expense
Total

Amount 79.602. 70.762.
150.364.

Save A Life Foundation

36*3869459

4

Supporting Statement of: Form 990 p 4 / P a r t IV-B, Line b(4)

Description Donated Materials, Services, and Facilities Special Events Expenses
Total

Amount 79.602. 70.761. 150.363.

SAVE A LIFE FOUNDATION, INC. AUDITED FINANCIAL STATEMENTS DECEMBER 31.2001 AND DECEMBER 31, 2000

AHLBECK&COMPANY
CERTIFIED PUBLIC ACCOUNTANTS

SAVE A LIFE

FOUNDATION,

INC.

TABLE

OF

CONTENTS

December 31, 2001 and December 31, 2000

AUDITOR'S REPORT FINANCIAL STATEMENTS Comparative Statement of Financial Position December 31,2001 and December 31, 2000 Comparative Statement of Activities For the Years Ended December 31,2001 and December 31,2000 Statements of Functional Expenses For the Years Ended December 31.2001 and December 31.2000 Comparative Statement of Cash Flows For the Years Ended December 31,2001 and December 31, 2000 NOTES TO FINANCIAL STATEMENTS 4

8

12

13

AHLBECK&COMPANY
CERTIFIED PUBLIC ACCOUNTANTS 1663 ELK BOULEVARD DES PLAINES. ILLINOIS 60016-4798 TELEPHONE: 847/B24-4000 FACSIMILE: 647/824-4011 WEB: www.ihlbeckco.com

February 20,2002 To the Board of Directors Save A Life Foundation, Inc. Schiller Park, Illinois INDEPENDENT AUDITOR'S REPORT

We have audited the accompanying statement of financial position of SAVE A LIFE FOUNDATION, lNC.(an Illinois not-for-profit corporation) as of December 31, 2001 and December 31, 2000, and the related statements of activities, functional expenses, and cash flows for the years then ended. These financial statements are the responsibility of the organization's management. Our responsibility is to express an opinion on these financial statements based on our audits. We conducted our audits in accordance with U.S. generally accepted auditing standards. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant. estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion. In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of SAVE A LIFE FOUNDATION. INC. as of December 31, 2001 and December 31,2000, and the results of their activities and their cash flows for the years then ended in conformity with U.S. generally accepted accounting principles.

T-^ar1

SAVE A LIFE

FOUNDATION,

INC.

COMPARATIVE STATEMENT OF FINANCIAL POSITION December 31,2001 and December 31,2000
2001 ASSETS Current Assets Cash and Cash Equivalents Inventory Trade Receivables Grants Receivable Credit Card Deposits Outstanding Prepaid Legal Fees Other Prepaid Expenses $ 415,568 47.209 2,907 718,887 11,185 16,398 1,000 $ 333,312 52,189 3,987
. •

2000

9,420 1.884

Total Current Assets Fixed Assets at Net Book Value Office Equipment Vehicles Total Net Fixed Assets Other Assets Promises to Give Deposits its
Total Other Assets

1,213,154

400,792

24,801 13.838 38,639

35.788 18.838 54,626

20.000
-

162 162

20,000

TOTAL ASSETS

1,271,793

455,580

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS
2

SAVE

A LIFE

FOUNDATION.

INC.

COMPARATIVE STATEMENT OF FINANCIAL POSITION December 31,2001 and December 31, 2000
2001 2000

LIABILITIES Current Liabilities Accounts Payable Sales Tax Payable Instructor Deposits Health Insurance Withheld Due to Morelli Fund Total Current Liabilities Other Liabilities Due to Carol Spizzirri Total Other Liabilities TOTAL LIABILITIES Net Assets Temporarily Restricted Unrestricted Total Net Assets

AND

NET $

ASSETS 8,702 340 . 9,042 $ 8,485 9 190 155 393 9,232

68,755 68,755 77,797

65,450 65,430 74,682

1,081,430 112,566 1,193,996 1,271,793

408,546 (27,648) 380,898 455,580

TOTAL LIABILITIES & NET ASSETS

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 3

SAVE A LIFE

FOUNDATION,

INC.

STATEMENT OF ACTIVITIES
For the Year Ended December 31,2001 Unrestricted INCOME Public Support Contributions Private Grants Contributions In Kind Special Events Gross Income Total Public Support Government Contracts State of Illinois - IDPH Federal - HHS/CDC Total Government Contracts Other Income Program Service Fees Miscellaneous Course Materials Fundraisers/Sales Total Other Income
1,475 22,660 79,602 117,346 20,000 20,000 $ 21,475 22,660 79,602 117.346

Temporarily Restricted

Total

221,083

241,083

-

600,000 870,470 1,470,470

600,000 870,470 1,470,470

17,979 7,542 97,444

17,979 7,542 97,444

709
123,674 344,757

-

709
123,674

TOTAL INCOME (balances carried forward)

1,490,470

1,835,227

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 4

SAVE A LIFE

FOUNDATION,

INC.

STATEMENT OF ACTIVITIES
For the Year Ended December 31,2001 TOTAL INCOME (balances brought forward) 344,757 Unrestricted EXPENSES Program Kids Program New Program Development Corporate Program Blue Angels Expansion Program Branch Development Total Program Management and General Fundraising Total Functional Expenses Special Event Expenses TOTAL EXPENSES Release from Restrictions - HHS/CDC Release from Restrictions - 1DPH Release from Restrictions - DCCA Excess Income Over Expenses Investment Income Interest Income Total Investment Income Change in Net Assets Beginning Net Assets Ending Net Assets 236,180 1,808 7,413 31,604 202,816 348,774 828,595 112,417 13,630 954,642 70,761 1,025,403 202,272 573,283 42,030 136,939 (202,272) (573,283) (42,030) 672,885 809,824 236,180 1,808 7,413 31,604 202,816 348,774 828,595 112,417 13,630 954,642 70,761 1,025,403 1,490,470 Temporarily Restricted 1,835,227 Total

3,275 3,275 140,214 (27,648) 112,566

672,885 408,545 1,081,430

3,275 3,275 813,099 380,897 1,193,996

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS
5

SAVE A LIFE FOUNDATION, INC. STATEMENT OF ACTIVITIES For the Year Ended December 31, 2000 Unrestricted INCOME Public Support Contributions Private Grants Contributions In Kind Special Events Gross Income Total Public Support Government Contracts State of Illinois - 1DPH State of Illinois - DCCA Total Government Contracts Other Income Program Service Fees Miscellaneous Conferences Fundraisers/Sales Total Other Income 19,839 6,500 54,675 15,130 96,144 $ 19,839 6,500 54,675 15,130 96,144 Temporarily Restricted Total

600,000 50.000 650,000

600,000 50.000 650,000

38,386 136 800 449 39,771

38.386 136 800 449 39,771

TOTAL INCOME (balances carried forward)

135,915

650,000

785,915

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 6

SAVE A LIFE FOUNDATION.

INC.

STATEMENT OF ACTIVITIES
For the Year Ended December 31, 2000 TOTAL INCOME (balances brought forward) 133,915 Unrestricted EXPENSES Program Kids Program New Program Development Corporate Program Blue Angels Expansion Program Branch Development Total Program Management and General Fundraising Total Functional Expenses Special Event Expenses TOTAL EXPENSES Release from Restrictions - ISBE Release from Restrictions - IDPH Release from Restrictions - DCCA Excess Income Over Expenses Investment Income Interest Income Total Investment Income Change in Net Assets Beginning Net Assets Ending Net Assets 532,899 2,302 44,370 11,807 17,409 155,750 764,538 143,389 45.131 953,058 8,388 961,446 498,409 234,625 6.830 (83,667) (498,409) (234,625) (6,830) (89,864) (175,531) 532,899 2,302 44,370 11,807 17,409 155.750 764,538 143,389 45,131 933,058 8,388 961,446 650,000 Temporarily Restricted 785,915 Total

8,725 8,725 (76,942) 49,294 (27,648) (89,864) 498,410 408X6

8,725 8,725 (166,806) 547,704 380,898

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS
7

SAVE

A LIFE

FOUNDATION,

INC.

STATEMENT OF FUNCTIONAL EXPENSES
For the Year Ended December 31, 2001 PROGRAM

Kid's Program Salaries & Wages Employee Benefits Payroll Taxes Automobile Bank Service Fees Branch Development Computer Expenses Conferences & Meetings Cost of Good Sold Depreciation Dues & Subscriptions Equipment Rental Instructor Fees Insurance Legal & Accounting Licenses & Permits Marketing & Promotional Meetings Miscellaneous Operating Interest Office Supplies Postage Printing & Reproduction Professional Fees Recruitment Reimbursed Program Fees Rent Repairs & Maintenance Research & Evaluation Telephone Training & Development Training Supplies Travel Web Site Total Program Expenses Administration Allocation Total Expenses $ 74,910 3,981 8,807 674 332 54 135 22 2.663 55,288 173 2,168 25 1,497 656 110 1,986 67 16,414 36,314 61 678 6,744 1.000 17.603 3,774 44 236,180 39,232 275,412

New Program Development $

Corporate Program

Bine Angels

Expansion Program

1.100 2 155 . 11 . . • 417 . • . 123 • . 1,808 713 2,521

1.500 774

$

83.978 1.789 7,247 107 23,100

11

955 1.264

4,251

9,263 238

2,427 8.483

3,132

945 1,167 . 17 1,022 7,413 7,413

13 • 1,000 ■

7.363 715 26,661 2,012 17,081 625 7,321 968 6,688 1,855 202,816 202,816

. 17.861 - • 31,604 1.826 33,430

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS
8

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SAVE A LIFE

FOUNDATION.

INC.

STATEMENT OF FUNCTIONAL EXPENSES
For the Year Ended December 31,2000 PROGRAM

Kid's Program

New Program Development

Corporate Program

Blue Angels

Expansion Program

Salaries & Wages Employee Benefits Payroll Taxes Automobile Bank Service Fees Branch Development Computer Expenses Conferences & Meetings Depreciation Dues & Subscriptions Equipment Rental Instructor Fees Insurance Legal & Accounting Licenses fir Permits Marketing & Promotional Meetings Miscellaneous Operating Interest Office Supplies Postage Printing & Reproduction Professional Fees Recruitment Reimbursed Program Fees Rent Repairs & Maintenance Research & Evaluation Telephone Training fir Development Training Supplies Travel Web Site Total Program Expenses Administration Allocation Total Expenses

$

157,328 12,920 1.523 12.109 8,861 88 4.323 92.940 30,117 520 16,336 1,659 205 1,991 13,382 7,661 38,387 60.071 248 5.466 1,669 493 23,894 1.156 4,203 8.231 27,119 532,900 85,777 618,677

$

1.575 S (283) . 30 888 9 16 67 . 2,302 1,976 4,278

7,562 604 . _ 10 99 19.212 50 117 12,440 4.165 (30) 70 . • (28) 99 44,370 3,552 47,922

$

8,855 873
m

$

_ . . . . . . . 429 750 900 , . . . . . _ 11,807 11,807

15,735 1,281 _ _ . . . . . . . _ 150 • _ . . 243 . . . _ _ , . . _ . . . . 17,409 7,404 24,813

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 10

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SAVE

A LIFE

FOUNDATION,

INC.

COMPARATIVE STATEMENT O F CASH FLOWS For the Years Ended December 31.2001 and December 31.2000 2001 Cash Flows from Operating Activities: Change in net assets Adjustments to reconcile change in net assets to net cash provided by (used in) operating activities: Depreciation Changes in current assets and liabilities: Decrease (increase) in accounts receivable Decrease (increase) in inventory Decrease (increase) in other current assets Decrease (increase) in other assets Increase (decrease) in accounts payable Increase (decrease) in other payables Net cash provided by (used in) operating activities Cash Flows from Investing Activities: Purchase of fixed assets Net cash provided by (used in) investing activities Cash Flows from Financing Activities: Repayment of debt Net cash provided by (used in) investing activities Net increase (decrease) in cash & cash equivalents Cash & cash equivalents at beginning of period Cash & cash equivalents at end of period Supplemental Disclosures: Interest paid 82,256 333,312 415,568 (25) (25) (176,458) 509,770 333,312 (675) (675) (10.640) (10,640) $ 813.099 $ (166.806) 2000

16,662

16.858

1,080 4,980 (736,167) (19,838) 217 2,898 82,931

(2,237) (25.595) 6,922 4.318 747 (165,793)

3,305

$

3.954

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS
12

SAVE A

LIFE

FOUNDATION.

INC.

NOTES TO FINANCIAL STATEMENTS
For the Years Ended December 31,2001 and December 31,2000

NOTE I - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Nature of Activities Save A Life Foundation, Inc. (SALF) works to promote the training of life supporting first aid skills; to promote consistency, uniformity, and safety in the application of those skills; to expand knowledge of "Good Samaritan" laws to encourage people to provide help; and to assure that skills are accessible to all. SALF received 47% of its total income in the year ended December 31, 2001 from the U.S. Department of Health and Human Services/Center for Disease Control. The remainder of SALFs income is from the State of Illinois Department of Public Health, program fees, private contributions and fundraising projects. Basis of Accounting The financial statements of SALF have been prepared on the accrual basis of accounting and accordingly reflect all significant receivables, payables, and other liabilities. The net assets of SALF are classified as follows: • Unrestricted, which represent the portion of expendable net assets that are available for operations. Temporarily Restricted, which represent grants which are for future periods. Upon termination of the restriction, a reclassification is made to unrestricted net assets.

Fixed Assets Fixed assets are carried at cost if purchased or fair value if contributed for current additions. Depreciation is computed on the straight-line method over 3-5 years for vehicles, computer equipment, furniture and office equipment. Maintenance, repairs and minor costs are expensed as incurred. When properties are retired or otherwise disposed of, the related cost and accumulated depreciation are removed from the respective accounts and any profit or loss on disposition is credited or charged to operations. Estimates The process of preparing financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions. These estimates and assumptions affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and reported amounts of income and expenses during the reporting period. Actual results could differ from those estimates. Cash and Cash Equivalents For purposes of the statement of cash flows, SALF considers all checking accounts, money market accounts, undeposiled funds, and petty cash to be cash equivalents.

13

V SAVE A LIFE FOUNDATION. INC.

NOTES TO FINANCIAL STATEMENTS
For the Years Ended December 31, 2001 and December 31,2000 Income Taxes SALF is exempt from income taxes under Section 501 (c)(3) of the Internal Revenue Code. In addition, SALF qualified for the charitable contribution deduction under Section 170(b)(l)(A)(vi) and has been classified as an organization other than a private foundation under Internal Revenue Code Section 509(a)(2). Functional Allocation of Expenses In the Statement of Functional Expenses, salaries and related expenses are first charged to the various programs and supporting services on the basis of actual expense. Expenses are then allocated based on various criteria, such as time spent in various areas.

NOTE 2 - DONATED MARTEB1ALS AND SERVICES In-kind donations of materiab and fixed assets are recorded at their estimated fair value at the date of donation. Such donations are reported as unrestricted support unless the donor has restricted the donated asset to a specific purpose. Conditional transfers of assets are recognized when the conditions upon which they depend are substantially met. During the fiscal years ended December 31,2001 and 2000, SALF received $1,451 and $54,675 respectively, in donations of this type. Donations of services are recorded if they create or enhance a nonfinancial asset or are specialized skills that would be purchased if they were not donated. SALF received donations of this type in the fiscal years ended December 31, 2001 and 2000 of $37,000 and $0, respectively. SALF rents its office space at a lease amount substantially below market value. During the years ended December 31, 2001 and 2000, SALF received in-kind contributions of rent for $41,151 and $8,750, respectively.

NOTE 3 - POLICY ON CONTRIBUTIONS Contributions received are recorded as unrestricted, temporarily restricted, or permanently restricted support, depending on the existence and/or nature of any donor restrictions. Support that is restricted by the donor is reported as an increase in unrestricted net assets if the restriction expires in the reporting period in which the support is recognized. All other donor-restricted support is reported as an increase in temporarily or permanently restricted net assets, depending on the nature of the restriction. When a restriction expires (that is, when a stipulated time restriction ends or purpose restriction is accomplished), temporarily restricted net assets are reclassified to unrestricted net assets and reported in the Statement of Activities as net assets released from restrictions. Federal grant awards are not recorded until expended for the purpose of the grants since they are conditional promises to give.

NOTE 4 - CASH AND CASH EQUIVALENTS SALF maintains the majority of its cash at a single financial institution. These accounts are insured by the Federal Deposit Insurance Corporation up to $100,000. 14

* /
SAVE A LIFE FOUNDATION, INC.

NOTES TO FINANCIAL STATEMENTS
For the Years Ended December 31, 2001 and December 31,2000

NOTE 5 - PROMISES TO GIVE SALF has received a promise to contribute to their school sponsorship program. Theses amounts are classified as temporarily restricted until received. The total amount of these promises is $20,000 at December 31, 2001 and $0 at December 31, 2000. The difference between the actual amount to be received and the present value of the promise is immaterial; therefore no adjustment has been made. Promises to give as of December 31, 2001 can be summarized as follows: Receivables in less than one year Receivables in one to five years $ 5,000 15,000

NOTE 6 - FIXED ASSETS At December 31,2001 and 2000, the costs of such assets were as follows: December 31
2001

Office Equipment Vehicles Less accumulated depreciation Net book value

$

86.340 31.998 118,338 79.699

$

2QQQ 85,665 31,998 117,663 63.037

Increase (Decrease* $ 675 675 16.662 $ (15.987)

S

38,639

$

54.626

Depreciation expense for fiscal years ending December 31,2001 and 2000 was $16,662 and $16,858, respectively.

NOTE 7 - DUE TO RELATED PARTY The organization's founder and current executive director, Carol Spizzirri, loaned SALF start up funding. As of December 31, 2001 and 2000 the amount or this loan is $68,755 and $65,450. respectively.

15

SAVE

A LIFE

FOUNDATION,

INC

NOTES TO FINANCIAL STATEMENTS
For the Years Ended December 31,2001 and December 31,2000 NOTE 8 - LEASE OBLIGATION AND RENTAL EXPENSE The estimated future minimum rental and operating lease obligation for the succeeding years under non-cancelable leases for office facilities in effect at December 31. 2001 are as follows: Year Ending December 31, 2002 2003 Rent 40,191 20,095

Rental expense under the operating leases was $81,440 for the year ended December 31, 2001 and $36,432 for the year ended December 31, 2000.

NOTE 9 - SPECIAL EVENTS Special event income is shown at the gross amount in the Statement of Activities. Special event expense is also shown in the Statement of Activities. The following schedule details the gross income and expense components for each event:

Dinner Event Various Merchandise Other

December 31 2001 Revenue Expense* £& $ 115.325 $ 70,761 $ 44.564 2.021 $ 117,346 $ 70,761 2,021 $ 46,585

December 11 7000 R£Y£nU£ Expenses Njtf $ 14,260 $ 7.720 $ 6,540 870 668 202 $ 15,130 $ 8,388 $ 6,742

NOTE 10 - RECLASSIFICATIONS Certain items in the Financial statements for the year ended December 31, 2000 have been reclassified for presentation purposes.

16

ILLINOIS CHARITABLE ORGANIZATION ANNUAL REPORT
Attorney General L I S A M A D I G A N State o f Illinois Charitable trustBureau, 100 WestRandolph' 3rd Floor, Chicago, Illinois 60601 CO # 01026498
r-> ~ _* * LU t. r^ • -. Check all Items

Form AG990Revised I.

attached

Federal ID #

363869459

Report for the. Fiscal Period:. Beginning oi / o i /2002 12 , 31 / 2002 & Ending.
C3 Yes Q No

E copy of IRS Return Make Cheeks 83 Audited Financial Statements
ctarfv BurnuFu** L-1 $15.00 Annual Report Filing Fi a S100.00 Late Report Filing Fe.

,

.

Are contributions to the organization tax deductible? LEGAL NAME MAIL ADDRESS CITY. STATE ZIP CODE

SAVE A LIFE FOUNDATION 9950 W. LAWRENCE #300 SCHILLER PARK. IL 60176

RECEIVbD
AUG 1 9 2003
ATTORNEY GENERAL CHARITABLE TRUST
A) ASSETS B) LIABILITIES C) NET ASSETS A)$ B)$ C)S

972,4U 99,127 873,291
AMOUNT

I. SUMMARY OF ALL REVENUE ITEMS DURING THE YEAR:
D) PUBLIC SUPPORT. CONTRIBUTIONS & PROGRAM SERVICE REV. (GROSS AMTS.) E) GOVERNMENT GRANTS & MEMBERSHIP DUES F) OTHER REVENUES G) TOTAL REVENUE, INCOME AND CONTRIBUTIONS RECEIVED (ADD D.E. & F)

PERCENTAGE

24.77 % 77.76 % (2.53) %
100%

D)S E)$

272.QOP 856.81? (27,745 1,101.982 1.19?..rH6

F)$
G)$

II. SUMMARY OF ALL EXPENDITURES DURING THE YEAR:
H) OPERATING CHARITABLE PROGRAM EXPENSE I) J) EDUCATION PROGRAM SERVICE EXPENSE TOTAL CHARITABLE PROGRAM SERVICE EXPENSE (ADD H & I) $

J1) JOINT COSTS ALLOCATED TO PROGRAM SERVICES (INCLUDED IN J): K) GRANTS TO OTHER CHARITABLE ORGANIZATIONS L) TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD J & K) M) MANAGEMENT AND GENERAL EXPENSE N) FUNDRA1SING EXPENSE O) TOTAL EXPENDITURES THIS PERIOD (ADD L, M, & N)

III. SUMMARY OF ALL PAID FUNDRAISER AND CONSULTANT ACTIVITIES
(Attach Attorney General Report of Individual Fundralsing Campaign- Form IFC. One for each PFR )| PROFESSIONAL FUNDRAISERS: ' P) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISERS Q) TOTAL FUNDRAISERS FEES AND EXPENSES R) NET RECEIVED BY THE CHARITY (P MINUS Q=R) PROFESSIONAL FUNDRAISING CONSULTANTS: S) TOTAL AMOUNT PAID TO PROFESSIONAL FUNDRAISING CONSULTANTS

IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS DURING THE YEAR:
T N M , TT E carol S n i z z i r r i . President) A E IL:
T)S U)$

95.33C 41,215
39.61J

U) NAME. TITLE: Linda P o s t . Finance D i r e c t o r
V) NAME. TITLE: D a n e
N e a l

.

Dire(ltor

o f

M e d l a

Re

iat:jnng

V)$

List on back side of instructions V . C H A R I T A B L E P R O G R A M QESCR\PJ\0\i:CHAmTABt£PROGMk,(3mGHESTBrtEXPEHOEmCODECATeOOHies CODE

W) DESCRIPTION:
X) DESCRIPTION: Y) DESCRIPTION:

L 1 £ e

Savine F i r s t Aid Training

W)# X)# Y)#

-OJJ

IF THE ANSWER TO ANY OF THE FOLLOWING IS YES, ATTACH A DETAILED EXPLANATION: 1. 2. . WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION, FINE. PENALTY OR JUDGMENT? HAS THE ORGANIZATION OR A CURRENT DIRECTOR. TRUSTEE. OFFICER OR EMPLOYEE THEREOF EVER BEEN CONVICTED BY ANY COURT OFANYMIDSQEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY? DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF- ITS OFFICERS. DIRECTORS OR TRUSTEES OWNS AN INTEREST; OR WAS IT A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES HAS A MATERIAL FINANCIAL INTEREST: OR DID ANY OFFICER. DIRECTOR OR TRUSTEE RECEIVE ANYTHING OF VALUE NOT REPORTED AS COMPENSATION? HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER, DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES? IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER? (ATTACH FORM IFC )

NO

3.

4

5.

6.

7a. DID THE ORGANIZATION ALLOCATE THE COST OF ANY SOLICITATION, MAILING, ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES? 7b. IF-"YES". ENTER (i) THE AGGREGATE AMOUNT OF THESE JOINT COSTS $ :(ii) THE AMOUNT ALLOCATED TO PROGRAM SERVICES $ ; (Hi) THE AMOUNT ALLOCATED TO MANAGEMENT AND GENERAL S ; AND (iv) THE AMOUNT ALLOCATED TO FUNDRAISING S_ B. DID THE ORGANIZATION EXPEND ITS RESTRICTED FUNDS FOR PURPOSES OTHER THAN RESTRICTED PURPOSES? 9. HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION OR TAX EXEMPTION SUSPENDED OR REVOKED BY ANY GOVERNMENTAL AGENCY? 10. WAS THERE OR DO YOU HAVE ANY KNOWLEDGE OF ANY KICKBACK. BRIBE. OR ANY THEFT DEFALCATION MISAPPROPRIATION, COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS? 11. 9 X i

8.

10

LIST THE NAME, ADDRESS AND THE ACCOUNT # OF THE FiNANCIAL INSTITUTIONS WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST ACCOUNTS:

Roval American Bank. 1000 Tower Lane. B e n s e n v i l l e . IL 60106 Account # 200-913-2 & 301-427-1
12. NAME AND TELEPHONE NUMBER OF CONTACT PERSON: C a r o l S p i z z i r r l ALL ATTACHMENTS MUST ACCOMPANY THIS REPORT • SEE INSTRUCTIONS UNDER PENALTY OF PERJURY, I (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS ANNUAL REPORT AND THE ATTACHED DOCUMENTS. INCLUDING ALL THE SCHEDULES AND STATEMENTS AND THE FACTS THEREIN STATED ARE TRUE AND COMPLETE AND FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE STATE OF ILLINOIS RELY THEREUPON. I HEREBY FURTHER AUTHORIZE AND AGREE TO SUBMIT MYSELF ANO THE REGISTRANT HEREBY TO THE JURISDICTION OF THE STATE OF ILLINOIS. (847) 928-9683

BE SURE TO INCLUDE ALL FEES DUE: 1.) REPORTS ARE DUE WITHIN SIX MONTHS OF YOUR FISCAL YEAR EN 2.) FOR FEES DUE SEE INSTRUCTIONS.. ?.) REPORTS THAT ARE LATE OR INCOMPLETE ARE SUBJECT TO A $100.00 PENALTY.

SIGNATURE

(

DATf

/■

"TRFASUREFTBrPROSTEElPRIFirNSfl'

M M / ) ^ B-ktiuat
SIGNATURE

foiiA
DATE 1

l>3:/t.

yAM-JEg,

., PREP ARER (PRINT NW ■if., ^ffitSfci . •

Form

990

Return of Organization Exempt from Income Tax
Under section 501(c), 527, or 4S47(aX1) of the Internal Revenue Code (except black lung benefit trust or private foundation) The organization may have to use a copy of this return to satisfy state reporting requirements. , 2002, and ending
0

CM8 No. 15454047

2002
Open to Public Inspection
Employer Identification Number

Department of the Treasury Internal Revenue Service

A For the 2002 calendar year, or tax year beginning C Name of organization B Check if applicable:
Address change Name change Initial return Final return Amended return Application pending please U M IRS label or print or type. See spedSc instruc­ tions.

Save A Life Foundation
Number street (or P.O. box H mail is not delivered to street aOdr) Room/suite E

36-3869459
Telephone number

9950 Lawrence
City, town or country State

300
ZIP code* 4

Schiller Park

IL

60176

F aso?n9 Qc^r0
l l Other (specify)*Q Yes

(847)

928-9683

Accrual

• Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A (Form 990 or 990-EZ).

H andl ate net aopncaMe to section 527 orotnoations
H ( a ) Is this a grotp return for affiliates? . . . | _ J Yes H ( b ) If "res." enter numser of affiliates *" H ( c ) Are all aff.liates included? Q No i X j No

G Website:^ WWW.salf.org
Organization type . • * ~ | X ] 501(c) 3 ■* (insert no.) | _ | <947fa)t;n or M S27 (check only one) K Check here *" [ | if the organization's gross receipts are normally not more than $25,000. The organization need not file a return with the IRS; but if the organization received a Form 990 Package in the mail, it should file a return without financial data. Some states require a complete return. L Gross receipts: Add lines 6b. 8b, 9b. and 10b to line 12 > - 1 , 1 6 4 , 6 1 9 . 1 Contributions, gifts, grants, and similar amounts received: a Direct public support b Indirect public support c Government contributions (grants)

(If 'No.' attach a list. See instructions.) H ( d ) Is this a separate return filed by an organization covered by a group ruling? I I yn R(]
Ko

I M

Enter 4-diqit GEN . HJigitGE Check " Q if the organization is not required to attach Schedule B (Form 990,990 EZ. or 990-PF).

Revenue, Expenses, and Changes in Net Assets or Fund Balances (See instructions)
la lb le

93.946. 856.819

d Total (add lii a through 1c) (cash

'Ti

Program service revenue including government fees and contracts (from Part VII, line 93). Membership dues and assessments Interest on savings and temporary cash investments Dividends and interest from securities Gross rents 6a b Less: rental expenses 6b c Net rental income or (loss) (subtract line 6b from line 6a). 7 Other investment income (describe *" 8a Gross amount from sales of assets other than inventory b Less: cost or other basis and sales expenses c Gain or (loss) (attach schedule) .. .See. 1 .-.8. .S t m t . . . d Net gain or (loss) (combine line 8c, columns (A) and (B)) 9 Special events and activities (attach schedule) a Gross revenue (not including $ 6 1 . 093. reported on line la) b Less: direct expenses other than fundraising expenses (A) Securities 8a 8b 8c (B) Other

2 3 4 5 6a

1?*

s

950.765.

noneash

$

)

I
Id 6c | 8d|

950.765. 178.962. 2.154.

3.091 •3.091
~T.

-3.091.

of contributions 9a 9b

32.513. 59.546.1
S e e . .L.-.9. . S t m t I 9cl

c Net income or (Joss) from special events (subtract line 9b from line 9a) 10a Gross sales of inventory, less returns and allowances 10a b Less: cost of goods sold 10 b c Gross profit or (loss) from sates of inventory (attach schedule) (subtract line 10b from line 10a) 11 Other revenue (from Part VII, line 103) •. 12 Total revenue (add lines Id, 2, 3. 4. 5. 6c, 7. 8d. 9c, 10c. and 11) 13 Program services (from line 44, column (B)) 14 Management and general (from line 44, column ( Q ) 15 Fundraising {from line 44, column (D)) 16 Payments to affiliates (attach schedule) 17 Total expenses (add lines 16 and 44, column (A)) .. 18 Excess or (deficit) for the year (subtract line 17 from line 12) 19 Net assets or fund balances at beginning of year (from line 73, column (A)) 20 Other changes in net assets or fund balances (attach explanation) 21 Net assets or fund balances at end of year (combine lines 18, 19. and 20) .. BAA For Paperwork Reduction Act Notice, see the separate instructions.

-27.033.

10c 11 12 13 14 15 16 17 18 19 20 21
TEEA01O1 09/O5SO2

225. 1.101.982 1.192.846. 120,044. 109.797, 1,422.687. •320.705. 1.193.996. 873.291
Form 990 (2002)

Form990(2002) Save A L i f e F o u n d a t i o n Forrn990(2] 36-3869459 S t a t e m e n t of Functional E x p e n s e s All organizations must complete column (A). Columns (B), (C), and (D) are required for section 501(c)(3) and (4) organizations and section 4947(a)(1) nonexempt charitable trusts but optional for others.
Do not include amounts reported on line 6b, 8b, 9b. Wb. or 16 of Part I. 22 Grants and allocations (att sen) (cash $ non-cash $ 23 Specific assistance to individuals (att sen) 24 Benefits paid to or for members (alt sen) 25 Compensation of officers, directors, etc 26 Other salaries and wages 27 Pension plan contributions 28 Other employee benefits 29 Payroll taxes 30 Professional fundraising fees 31 Accounting fees 32 Legal fees 33 Supplies 34 Telephone 35 Postage and shipping 36 Occupancy 37 Equipment rental and maintenance 38 Printing and publications 39 Travel 40 Conferences, conventions, and meetings ... 41 Interest 42 Depreciation, depletion, etc (attach schedule) 43 Other expenses not covered above (itemize):
b

a Auto_ Expjn se J3Q.K. I e r y i c e _ Fees

c

$L ilFii J>2 ¥.C-ofi™?!11

d_Cornpjiter_ E x p e n s e s e Jee_pther^i(penses Stmt 44 Total functional expenses (add lines 22 ~43).~ Organizations completing columns (6) • (0), carry these totals to lines 13-15 Joint Costs. Check * Q ifyou are following SOP 98-2. Are any joint costs from a combined educational campaign and fundraising solicitation reported in (B) Program services? * Q Yes R ] No If "Yes." enter (i) the aggregate amounl of these joint costs $ ; (ii) the amount allocated to program services

$
to fundraising $

: (Hi) the amount allocated to management and general

$

; and (iv) the amount allocated

Statement of Program Service Accomplishments
What is the organization's primary exempt purpose? •■ . P r o m o t e J j _ f e_ 5 a y j ng^ _f i.r s t a i d All organizations must describe their exempt purpose achievements in"a"clea7and concise manner~SlaTe~trie nurnbeTof clienls served, publications issued, etc. Discuss achievements that are not measurable. (Section 501(c)(3) & (4) organizations and 4947(a)(1) nonexempt charitable trusts must also enter the amount of grants & allocations to others.)
a

J?il'j_^ r i>SC a J?£_"_EL 0 JP2Uo n ._ a i?d -teaching, o f _Ut e _ saving, f i r s t J l l J 2 J - U U ! 9 i s _ .school - C h i L d r e i T j S L 951 chi_ldre_n~taii£htj_~
(Grants and allocations $
> a a

Program Service Expenses (Requited lor 501(c)(3) and (4) organizations and raofo*-'""" *W(aXO trusts: but I7(ax optionalforothers.)

~

b

i ° C P i £ i J _ P r P B L J _ l f EPjnotLOD-^pd AejchJiJg J>J JJt* j a v J " S _ _ JiCS_t_aid_to_indi yidual_s_other "than. s c h p o l . - j i e ~chUdren" ~
(Grants and allocations $

±±1

344.020,

c_B I ue_ Arise I s _ r ogr am _-_P_ronotl on_ a nd_ te a_ch i n j _ of_ I if_e_ s a y i n g f i_r_s t P J i l _t o _t_he j > o l ice_1.n_ t h e . S t_a_te _of _ I U i noi s
(Grants and allocations %
d

^JL

11.382.

3L anch _De ve_l ograen t / E x g a n j io_n_ P rpg r am_ z. J x p_and _to_ sate U_i te_ _pf fi_ce _ins_ide and o u t s i d e the S t a t e " o f I l l i n o i s

±A
^_L

12.890.

(Grants and allocations $ e Other prog/am services (Grants and allocations $ f Total of Program Service Expenses (should equal line 44, column (B). program services)
BAA TEEA0102 01/22/03

824.554.

1.192.846.
Form 990 (2002)

i.

•:-;KA»'

.&/£Z*>Jst£&f*i*r. :

Form990(2002)

Save A Life Foundation

36-3869459

Page 3

B a l a n c e Sheets (See Instructions) Note: Where required, attached schedules and amounts within the description column should be for end-of-year amounts only, 45 Cash - non-interest-bearing 46 Savings and temporary cash investments 47 a Accounts receivable b Less: allowance for doubtful accounts 48a Pledges receivable b Less: allowance for doubtful accounts 49 Grants receivable 50 Receivables from officers, directors, trustees, and key employees (attach schedule) 51 a Other notes & loans receivable (attach sen) b Less: allowance for doubtful accounts 52 Inventories for sale or use 53 Prepaid expenses and deferred charges 54 Investments — securities (attach schedule) 55 a Investments — land, buildings, & equipment: basis b Less: accumulated depreciation (attach schedule) 56 Investments - other (attach schedule) 57a Land, buildings, and equipment: basis b Less: accumulated depreciation (attach schedule) L- S 7 . . S t m t 58 Other assets (describe ► S e e 59 Total assets (add lines 45 through 58) (must equal line 74) 60 Accounts payable and accrued expenses 61 Grants payable 62 Deferred revenue 63 Loans from officers, directors, trustees, and key employees (attach schedule) 64a Tax-exempt bond liabilities (attach schedule) b Mortgages and other notes payable (attach schedule) 65 Other liabilities (describe •■ See L i n e 6 5 S t m t 66 Total liabilities (add lines 60 through 65) Organizations that follow SFAS 117, check here through 69 and lines 73 and 74. 67 Unrestricted 68 Temporarily restricted 69 Permanently restricted | and complete lines 67 , 112,566. 1.081.430. L J and complete lines

67

Organizations that do not follow SFAS 117, check here 70 through 74.

68 69
70 71

227,529. 645.762.

70 Capital stock, trust principal, or current funds 71 Paid-in or capital surplus, or land, building, and equipment fund 72 Retained earnings, endowment, accumulated income, or other funds 73 Total net assets or fund balances (add lines 67 through 69 or lines 70 through 72; column (A) must equal line 19; column (B) must equal line 21) 74 Total liabilities and net assets/fund balances (add lines 66 and 73) 1.193,996. 1.271.793.

Form 990 is available for public inspection and. for some people, serves as the primary or sole source of information about a particular organization. How the public perceives an organization in such cases may be determined by the information presented on its return Therefore please make sure the return is complete and accurate and fully describes, in Part III, the organization's programs and accomplishments

1

72

873.291. 972,418.

BAA

TEEA0103

09AXU0Z

> ■*-- '

.M

. * • *. - ►

,Vi*'-.-*f**i3'''- -vu-.

t..:c.-2fe

Form990 (2002) Save A L i f e Foundation | Reconciliation of Revenue per Audited Financial Statements with Revenue per Return (See instructions.)
Total revenue, gains, and other support per audited financial statements > Amounts included on line a but not on line 12, Form 990:

36-3869459 Reconciliation of Expenses per Audited Financial Statements with Expenses per Return
Total expenses and losses per audited financial statements ' Amounts included on line a but not online 17. Form990: (1) Donated serv­ ices and use of facilities (2) Prior year adjust­ ments reported on line 20, Form 990 .. (3) Lasses reported on line 20, Form 990 . . . . (4) Olher (specify):

Page 4

(1) Net unrealized gains on investments (2) Donated serv­ ices and use of facilities

$

$

$_

(3) Recoveries of prior year grants $_ (4) Other (specify):

See_AUa_che_d $

See Attached

182.627

S

182.627

Add amounts on lines (1) through (4) Line a minus line b Amounts included on line 12. Form 990 but not on line a: 0 ) Investment expenses rot included on line 66, form 990 $_ (2) Other (specify):

Add amounts on lines (1) through (4) Line a minus line b Amounts included on line 17, Form 990 but not on line a: (1) Investment expenses not included on line 6b, Form 990 (2) Other (specify):

$_

$
Add amounts on lines f l ) and ( 2 ) . Total revenue per line 12, Form 990 (line c plus line d) (B) Title and average hours per week devoted to position

$
Add amounts on lines (1) and ( 2 ) . Total expenses per line 17, Form 990 (line c plus line d) (C) Compensation (if not paid, enter -0-) (0) Contributions to employee benefit plans and deferred compensation (E) Expense account and other allowances

(A) Name and address

Carol

Spizzirri Pres/Exec D i r 40 95.330. 2.153. 0.

Daniel Caravello Treasurer Martin A. Sandoval Secretary Carlos M. A z c o t i a Director Dr. Stanley. Zydlo
Director See List of Officers. Etc. Statement

0.

0.

0.

0.

0.

0.

0.

0.

0.

0.

0.

0.

o75 Did any officer, director, trustee, or key employee receive aggregate compensation of more than $100,000 from your organization and all related organizations, of which more than $10,000 was provided by the related organizations? If Yes.' attach schedule - see instructions.

0.

0.
[XJNo

► J_J Yes •

BAA
TEEA0104 01/22/03

Form 990 (2002)

Form930(2002) Save A L i f e Foundation Other Information (See instructions.)

36-3869459
76 77 78a 78 bl

Page5 Yes

76 Did the organization engage in any activity not previously reported to the IRS? If 'Yes.' attach a detailed description of each activity 77 Were any changes made in the organizing or governing documents but not reported to the IRS? If 'Yes,' attach a conformed copy of the changes. 78a Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return? . b If 'Yes.' has it filed a tax return onForm 990-T for this year? 79 Was there a liquidation, dissolution, termination, or substantial contraction during the year? If 'Yes,' attach a statement

79

80 a Is the organization related (other than by association with a statewide or nationwide organization) through common 80: membership, governing bodies, trustees, officers, etc, to any other exempt or nonexempt organization? b If 'Yes,' enter the name of the organization ► and check whether it is |_] exempt or | | nonexempt. 81 a Enter direct or indirect political expenditures. See line 81 instructions [ 81 a| 0. b Did the organization file Form 1120-POL for this year? 81b 82a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially less than fair rental value? 82s

b If 'Yes,' you may indicate the value of these items here. Do not include this amount as . . revenue in Part I or as an expense in Part II. (See instructions in Part III.) | B2b| 123, 0 8 1 . 83a Did the organization comply with the public inspection requirements for returns and exemption applications? 83a b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? 83b 84a Did the organization solicit any contributions or gifts that were not tax deductible? 84a b If 'Yes,' did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? dedirtible? 85 501(c)(4), (5), or (6) organizations, a Were substantially all dues nondeductibie by members? b Did the organization make only in-house lobbying expenditures of $2,000 or less? If "Yes" was answered to either 85a or 85b, do not complete 85c through S5h below unless the organization received a waiver for proxy tax owed for the prior year. c Dues, assessments, and simitar amounts from members d Section 162(e) lobbying and political expenditures e Aggregate nondeductibie amount of section 6033(e)(1)(A) dues notices f Taxable amount of lobbying and political expenditures (line 85d less 85e) g Does the organization elect to pay the section 6033(e) tax on the amount on line 85f? 85c 8Sd 84b 85a 85 b

X X

85e
85f 85g

h If section 6033(eX1XA) dues notices were sent, does the organization agree to add the amount on line 851 to its reasonable estimate of dues allocable to nondeductibie lobbying and political expenditures for the following tax year? 86 501(c)(7) organizations. Enter: a Initiation fees and capital contributions included on

line \2
b Gross receipts, included on line 12, for public use of club facilities 87 501(c)()2) organizations. Enter: a Gross income from members or shareholders . b Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.)

86a 86b 87a 87b

88 At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or partnership, or an entity disregarded as separate from the organization under Regulations sections 301.7701 -2 and 301.7701 -3? If "Yes,' complete Part IX 89a 501(c)(3) organizations. Enter: Amount of tax imposed on the organization during the year under: section4911 » ■ 0 . ; section 4912»* 0 . ; section4955' b 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year? If 'Yes,' attach a statement explaining each transaclion c Enter: Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958 d Enter: Amount of lax on line 89c, above, reimbursed by the organization. 90 a List the states with which a copy of this return is filed *■ JlHj'Sts b Number of employees employed in the pay period that includes March 12, 2002 (See instructions.) 91 The books are in care of *■ J i a r o J _ S f J 1 z z 1 _ r r i _ Telephone number •■ Loeatedat ► j>950_ L a w r e n c e _ S u _ U e J 0 0 , _ S c h i J . _ l e r _ f ar_k_IL 92 Section 4947(a)(1) nonexempt charitable trusts tiling Form 990 in lieu of Form 7041 - Check here and enter the amount of tax-exempt interest received or accrued during the tax year BAA
TEEAO10S 01/22/03

88

89b

Pgobj _(847)_928-9683 ZlP + 4 * _60176 ~. ~ . " 7. *\ 92 |

10
*-"Q

Form 990 (2002)

Form990(2002) Save A L i f e Foundation Analysis of Income-Producing Activities (See instructions.)
Note: Enter gross amounts unless otherwise indicated. 93 Program service revenue: Unrelated business income (B) (A) Amount Business code

36-3869459
Excluded by section 512, 513. or 514 (D) Exclusion code Amount

Page 6

(E) Related or exempt function income

a Program Fees bCourse Materials c Branch Fee d Membership Dues
( Medicare/Medicaid payments g Fees & contracts from government agencies ., 94 Membership dues and assessments . 95 Interest on savings & temporary cash invmnts 96 Dividends & interest from securities . 97 Net rental income or (loss) from real estate: a debt-financed property b not debt-financed property 98 Net rental income or (loss) from pers prop . . . 99 Other investment income 100 Gain or (loss) from sales of assets other than inventory 101 Net income or (loss) from special events
102 Gioss profit or (loss) from sales ol inventory . . .

31.693. 149.980. •2.916.
205.

14

2.154.

18

-3.091 •32.128.
225.

103

Other revenue: a

b Miscellaneous c d
e 104 Subtotal (add columns (BX (OX and (E)) 105 Total (add line 104. columns (B), (D), and (E)) Note: Line 105 plus line Id. Part I, should equal the amount on line 12, Part I.

•33.065.

379,187.

146.122.

Relationship of Activities to the Accomplishment of Exempt Purposes (See instructions.)
Une No. Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment
of the organization's exempt purposes (other than by providing funds for such purposes).

93a.93b. Promote and teach life saving first aid programs

93c.93d Promote and teach life saving first aid programs 103a To supplement funding required to perform and carry out the life saving first aid programs. Information Regarding Taxable Subsidiaries and Disregarded Entities (See instructions.)
(A) Name, address, and EIN of corporation, partnership, or disregarded entity (B) Percentage of ownership interest

N/A (E)
End-of-year assets

(C)
Nature of activities

(D) Total income

% % %

Information Regarding Transfers Associated with Personal Benefit Contracts (See instructions.)
a Old the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? b Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? Note: // Y e s 'to(b), file Form 8870 and Form 4720 (see instructions).

id Yes

I I Yes

No No

»6^!y'cffi|!/&.,&M^ Please Sign Here Paid Prearer's se Only
Signature ol officer Data

;l ol my knowledge and belief, it is

Type or print name and title Preporer's signature

Dale
•»•

Check if

sell.

G

Firm's name (or yours il sell-em ployed) address, and ZIP+ 4

Ahlbeck and Company 1665 Elk Blvd DES PLAINES

employed

n

Preparers SSN or PTIN (see General Instruction W)

P00237637

EIN

136-2991500
(847)
to/10/02

IL

60016

Phone no. TEEAOIOS

824-4000
Form 990 (2002)

BAA

SCHEDULE A
(Form 990 or 990-EZ)

Organization Exempt Under Section 501 (cK3)
(Except Private Foundation) and Section 501(e), 501(0,501(k), 501 (n), or Section 4947(a)(1) Nonexempt Charitable Trust Supplementary Information — (See separate instructions.) MUST be completed by the above organizations and attached to their Form 990 or 990-EZ.

OMB No. 15*5-0047

2002

Department of trie Treasury Internal Revenue Service Name of the organization

36-3869459 EeSHLM Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees
Save A L i f e Foundation
(See instructions. List each one. If there are none, enter 'None.') (a) Name and address of each employee paid more than $50,000 (b) Title and average hours per week devoted to position (c) Compensation (d) Contrifjubcns (e) Expense to employee benefit account and other plans and deferred allowances compensation

I

Employer identification number

None

Total number of other employees paid over $50,000

*

Compensation of the Five Highest Paid Independent Contractors for 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

Bennett

R.

Krause
Establish funding sources and contracts

2012 Apoleton Drive, Snringfield. IL 62707

51.154.

Total number of others receiving over $50,000 for professional services *• BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 and Form 990-EZ
TEEA0401
...*•.- .ii- . ! - . . > X ; ,

Schedule A (Form 990 or 990-EZ) 2002

01/22/03
.Jc-»-.._» !«...•

,'.&5aS^>Ii--

' .-s-iafiiL-: _ i ^

Schedule A (Form 990 or 990 -EZ) 2002

Save A L i f e

Foundation

36-3869459

Page 2

Statements About Activities (See instructions.)
1 During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? If 'Yes,' enter the total expenses paid or incurred in connection with the lobbying activities *" $ (Musi equal amounts on line 38, Part VI-A, or line i of Part Vl-B.) Organizations that made an election under section 501(h) by filing Form 5768 must complete Part VI-A. Other organizations checking 'Yes,' must complete Part Vl-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 substantial contributors, trustees, directors, officers, creators, key employees, or members of their families, or with any taxable organization with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary? (7/ the answer to any question is "Yes.' attach a detailed statement explaining the transactions.) a Sale, exchange, or leasing of property? b Lending of money or other extension of credit? c Furnishing of goods, services, or facilities?

2b

2c

See Part V, Form 990
d Payment of compensation (or payment or reimbursement of expenses if more than $1,000)? e Transfer of any part of its income or assets? Does the organization make grants for scholarships, fellowships, student loans, etc? (See Note below.). Do you have a section 403(b) annuity plan for your employees? Note: 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 receivo payments.

2d 2e

Reason for Non-Private Foundation Status (See instructions.)
The organization is not a private foundation because it is: (Please check only ONE applicable box.) A church, convention of churches, or association of churches. Section 170(b)(l)(A)(i). A school. Section 170(b)(1)(A)(ii). (Also complete Part V.) A hospital or a cooperative hospital service organization. Section )70(b)(1)(A)(iii). A Federal, state, or local government or governmental unit. Section 170(b)(1)(A)(v). A medical research organization operated in conjunction with a hospital. Section 170(b)(l)(A)(iii). Enter the hospital's name, city, and state * 10 n An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(l)(A)(iv). (Also complete the Support Schedule in Part IV-A.) 11a [Xj An organization that normally receives a substantial part of its support from a governmental unit or from the general oublic Section 170(b)0)(A)(vi). (Also complete the Support Schedule in Part IV-A.) 11 b [ ] A community trust. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV-A.) 12 Q An organization that normally receives: f l ) more than 33-1/3% of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc, functions - subject to certain exceptions, and (2) no more than 33-1/3% 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, J975. See section 509(a)(2). (Also complete the Support Schedule in Part IV-A.) L J An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in: 0 ) lines 5 through 12 above; or (2) section 501(c)(4), (5), or (6), if they meet the test of section 509(a)(2). (See section 509(a)(3).) Provide the following information about the supported organizations. (See instructions.) (a) Name(s) of supported organizations) (b) Line number from above

13

14 BAA

M An organization organized and operated to test for public safety. Section 509(a)(4). (See instructions.) TCEAOJ02 01/22/03 Schedule A (Form 990 or Form 990-EZ) 2002

Schedule A (Form 990 or 990-EZ) 2002

Save A L i f e Foundation

36-3869459

Page 3

( S u p p o r t S c h e d u l e (Complete only if you checked a box on line 10, 11, or 12.) Use cash method of accounting. Note: You may use the worksheet in the instructions for converting from the accrual to the cash method of accounting. Calendaryear (or fiscal year beginning In) 15 Gifts, grants, and contributions received. (Do not include unusual grants. See line 28.) .. 16 Membership fees received 001 201 2000 682.878 1 % Total

J&.

820,282.

621.043.

621.289.

2.745.492.

17 Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is related to ttte organization's charitable, etc. purpose 18 Cross income from interest, dividends, amounts received from payments on securities loans (section 512(a)(5)), rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organtzation after June 30.1975 19 Net income from unrelated business activities not included in line 18 . . . 20 Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf 21 The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of sen/ices or facilities generally furnished to the public without charge 22 Other income. Attach a schedule. Do not Include gain or (loss) from sale of capital assets 23 Total of lines 15 through 22 . 24 Line 23 minus line 17 25 Enter 1 % of line 23 26

197.535

52.664

41.158.

6.134

297.491

3,275.

8.725.

24,575.

676.

37.251

1,021.092. 823.557. 10,211

744.267 691,603. 7.443.

686.776 645.618. 6.868.

628.099.

3,080.234.

2.782,743.

Organizations described on lines 10 or 11: a Enter 2 % of amount in column (e), line 24 b Prepare a list lor your records to show the name of and amount contnbuted by each person (other than a governmental unit or publicly supported organization) whose total gifts for 1998 through 2001 exceeded the amount shown in line 26a. Do not file this list with your return. Enter the total of all these excess amounts c Total support for section 509(a)(1) test: Enter line 24. column (e) d Add: Amounts from column (e) for lines: 18 37.251. *"[Hc 19

22
e Public support (line 26c minus line 26d total)

26b

...

f Public support percentage (tine 26e (numerator) divided by line 26c (denominator)) 98.66 27 Organizations described on line 12: a For amounts included in lines 15,16, and 17 that were received from a 'disqualified person,' prepare a list for your records to show the name of, and total amounts received in each year from, each 'disqualified person.' Do not file this list with your return. Enter the sum of ro such amounts for each year: * *u"'ol (2001)
bF

2.745.492. %

(2000)

(1999)

(1998)

SL * '"eluded in line 17 that was received from each person (other than 'disqualified persons'), prepare a list for vour records to !£>£i ,. 5 °-f ■ 2 n d , a m o u r r t received for each year, that was more than the larger of 0 ) the amount on line 25 for the year or f » 55,000. (Include in the list organizations described in lines 5 through 1 1 , as well as individuals.) Do not file this list with your return After computing the difference between the amount received and the larger amount described in (1) or (2), enter the sum of these differences (the excess amounts) for each year: UMICIWIMSS

Se a mamn l ! nou h

and line 27b total e Public support (line 27c total minus line 27d total) f Total support for section 509(a)(2) test: Enter amount from line 23, column ( e ) . . . . *• g Public support percentage (line 27e (numerator) divided by line 271 (denominator)) h Investment income percentage (line 18, column (e) (numerator) divided by line 27f (denominator)) 28 Unusual Grants: For an organization described in line 1 0 . 1 1 . or 12 that received any unusual grants during 1998 through 2001 prepare a list for your records to show, for each year, the name of the contributor, the date and amount of the grant, and a brief description of the M nature of the grant. Do not file this list with your return. Do not include these grants in line 15. '
"TFFAD4M Oft/1 ?/D? c;,horf. .Ic A /Cn,m

(2001) (2000) c Add: Amounts from column (e) for lines: 17 dAdd: Line 27a total

(1999)
15 20

(1998)

BAA

Schedule A (Form OOn or onr\ rr-r\ 2002 990 990-EZ) m

U'iA

v—U*bfl)U_

ri^vWUW

Schedule A (Form 990 or 990-EZ) 2002 S a v e A L i f e

Foundation

36-3869459
N/A

Page 4

Private School Questionnaire (See instructions.)
(To be completed ONLY by schools that checked the box on line 6 in Part IV)

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

32 Does the organization maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative staff? b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student admissions, programs, and scholarships? d Copies of all material used by the organization or on its behalf to solicit contributions? If you answered "No" to any of the above, please explain. (If you need more space, attach a separate statement.)

32 a

32b 32c 32d

33 Does the organization discriminate by race in any way with respect to: a Students' rights or privileges? b Admissions policies? c Employment of faculty or administrative staff? d Scholarships or other financial assistance? e Educational policies? f Use of facilities? g Athletic programs? h Other extracurricular activities? If you answered "Yes* to any of the above, please explain. (If you need more space, attach a separate statement.)

33a
33b
33 c

33d

33e
33 f 33 q

33h

34 a Does the organization receive any financial aid or assistance from a governmental agency? . b Has the organization's right to such aid ever been revoked or suspended? If you answered 'Yes' to either 34a or b, please explain using an attached statement. 35 Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05 of Rev Proc 75-50, 1975-2 C.B. 587, covering racial nondiscrimination? If 'No.' attach an explanation.

BAA

TEEA04O4

0W24/03

Schedule A (Form 990 or 990-EZ) 2002

— 4 . . * * . • «*•••■«,,

' -

J*-i.i.;W*&'

fc-rfi f ' i - T ^ ^ *

I

'-

• ■"• •■"nnV"

Schedule A (Form 990 or 99Q-EZ) 2002

Save A L i f e

Foundation

36-3869459

PageS

Lobbying Expenditures by Electing Public Charities (See instructions.)
(To be completed ONLY by an eligible organization that filed Form 5768) Check a | 1 if the organization belongs to an affiliated group. Check — b | | if you checked 'a' and 'limited control" provisions apply . 00 To be completed Affiliated group totals for ALL electing (The term 'expenditures' means amounts paid or incurred.) organizations

Limits on Lobbying Expenditures

36 37 38 39 40 41

Total lobbying expenditures to influence public opinion (grassroots lobbying) Total lobbying expenditures to influence a legislative body (direct lobbying) Total lobbying expenditures (add lines 36 and 37) Other exempt purpose expenditures Total exempt purpose expenditures (add lines 38 and 39) Lobbying nontaxable amount. Enter the amount from the following table — If the amount on line 40 is Not over $500.000 Over $500,000 but not over Jl.000,000 Over $1,000,000 but rat over $1,500,000 Over $1,500,000 but not over $17,000,000 Over $17,000,000 The lobbying nontaxable amount is 2 0 % of the amount on line 4 0 $100,000 plus 15% of the excess over $500,000 $175,000 plus 10% of the excess over $1,000,000 $225,000 plus 5% of the excess over $1,500,000 $1,000.000

42 43 44

Grassroots nontaxable amount (enter 25% of line 4 1 ) Subtract line 4 2 from line 36. Enter -O- if line 4 2 is more than line 36 Subtract line 41 from line 38. Enter -O- if line 41 is more than line 38 Caution; If there is an amount on either line 43 or line 44, you must file Form 4720.

A -Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501 (h) election do not have to complete all of the five columns below. See the instructions for lines 45 through 50.) Lobbying Expenditures During 4 - Y e a r Averaging Period Calendar year (or fiscal year beginning in) »45 46 Lobbying nontaxable amount lobbying ceiling amount (150% ol line 45(e)) Total lobbying expenditures Grassroots non taxable amount Grassroots ceiling amount (150% of line 48(e)) Grassroots lobbying expenditures (a) 2002

47 48 49 50

Lobbying Activity by Nonelecting Public Charities
(For reporting only by organizations that did not complete Part VI-A) (See instructions.) During the year, did the organization attempt to influence national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of: a Volunteers b Paid staff or management (Include compensation in expenses reported on lines c through h.) c Media advertisements dMailings to members, legislators, or the public e Publications, or published or broadcast statements t Grants to other organizations for lobbying purposes g Direct contact with legislators, their staffs, government officials, or a legislative body h Rallies, demonstrations, seminars, convenlions, speeches, lectures, or any other means i Total lobbying expenditures (add lines c through h.) If 'Yes' to any of the above, also attach a statement giving a detailed description of the lobbying activities.

BAA
TCEA0405 0S/IZT02

Schedule A (Form 990 or 990-EZ) 2002

■—•x*d\.-J.-^ --:

"\^^.MtiL£C

Schedule A (Form 990 or 990-EZ) 2002

Save

A

Life

Foundation

36-3869459

Page 6

I Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations (See instructions)
51 Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section 501(c) v of the Code (other than section 501 (c)(3) organizations) or in section 5 2 7 , relating to political organizations? --iF„- '■ a Transfers from the reporting organization to a noncharitable exempt organization of: (l)Cash (ii)Olher assets b Other transactions: (i)Sales or exchanges of assets with a noncharitable exempt organization (ii)Purchases of assets from a noncharitable exempt organization (iii)Rental of facilities, equipment, or other assets (Iv)Reimbursement arrangements (v)Loans or loan guarantees (vi)Performance of services or membership or fundraising solicitations

Yes

Mo

SI'W
_ajQJi

Mi.
b(ii)
b(iii)
PQV)

_bj«a

b(vQ c Sharing of facilities, equipment, mailing lists, other assets, or paid employees , d If the answer to any of the above is 'Yes,' complete the following schedule. Column (b) should always 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 value in any Transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received:

(a)
Line no.


Amount involved

Name of noncharitable exempt organization blee

(d) Description of transfers, transactions, and sharing arrangements

5 2 a Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations described in section 501 (c) of the Code (other than section 501 (c)(3)) or in section 527? b If 'Yes,' complete the following schedule: (a) Name of organization (b) Type of organization

► [ 1 yes |x] ■

No

Description of relationship 10

BAA

TEEA0406

03/1Z/OZ

Schedule A (Form 990 or 990-EZ) 2002

Form'

-fecentber 2000)

8868

Application for Extension of Time to File an Exempt Organization Return
*~ File a separate application for each relurn.

OM&No. 1545-1709

•partmen! atHie Treasury iternal Revenue Service

• If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box * If you are filing for an Additional (not automatic) 3-Month Extension, complete only Part II (on page 2 of this form). Note: Do not complete Part II unless you have already been granted an automatic 3-month extension on a previously filed Form 8868. | A u t o m a t i c 3 - M o n t h E x t e n s i o n o f T i m e — Only submit original (no copies needed) Note: Form 990-T corporations requesting an automatic 6-month extension — check this box and complete Part I only

^xf

»- I I

All other corporations (including Form 990-C filers) must use Form 7004 lo request an extension of time to file income tax returns Partnerships H REMICs ana trusts must use Form 8736 to request an extension of time to file Form 1065, 1066. or 1041. ' Type or print File by the due date for filing your return. See instructions.
Name of Exempt Organization Employer identification number

Save A L i f e

Foundation

36-3869459

Number, street, and room or suite number. II a P.O.box. tee instructions

9950 Lawrence . #300
City, town or post oNice. For a foreign address, see instructions. slate

ZIP code

IL 60176 Check type of return to be filed (file a separate application for each return): —i Form 990 Form 990-T (corporation) Form 4720 Form 990-T (Section 401 (a) or 408(a) trust) Form 990BL Form 5227 Form 990EZ Form 990-T (bust other than above) Form 6069 Form 990-PF Form 1041-A Form 8870 • If the organization does not have an office or place of business in the United States, check this box • If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN) • If W s is for the whole group, check this box . * " £ ] . If it is for part of the group, check this box *- L J and attach a list with the names and EINs of all members the extension will cover. . 1 I request an automatic 3-month (6-month, for 990-T corporation) extension of time until AuK I S 20 0 3 lo file the exempt organization return for the organization named above. The extension is (or the organization's return for: *" 0 calendar year 20 0 2 or *" M tax year beginning ,20 . and ending . 20 . 2 If this tax year is for less than 12 months, check reason: Q Initial r e l u T r i ( j T i n a l return Q Change in accounting period

S c h i l l e r Park

f

3 a If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any nonrefundable credits. See instructions b If this application istorForm 990-PF or 990-T, enter any refundable credits and estimated tax payments made. Include any prior year overpayment allowed as a credit

$ J

c Balance Due. Subtract line 3b from line 3a. Include your payment with this form, or, if required, deposit with FTD coupon or, if required, by using EFTPS (Electronic Federal Tax Payment System). See instructions S Signature and Verification
Under penalties of perjury, t declare that I nave examined Ihis return, including accompanying schedules and statements, anil lo the best ofrayknowledoe and h#fc-r ;i i< i~.- _ * _ _ > . .. complete, and that I am authorized to prepare this form. ^ . K I C I . H S uve. correct, and

Signature

Dale

-

f/f-roi

BAA For Paperwork Reduction Act Notice, see instructions.

Form 8868 (12-2000)

Form 990

Line 8(A) and 8(B) Statement
Name Save A L i f e Foundation

Schedule of Gams and Losses from Sale of Assets Other than Inventory
*■ Attach to return

2002

Employer tdentificalion Number 36-3869459

Part I, Line 8, Column (A) Public Securities

Securities

Description P u b l i c l y Traded S e c u r i t i e s

Gross Sales Price Cost Selling. Expenses Basis

Basis

Nonpublic Securities Cost, other basis or FMV when donated (State which on top)

Description

Date Acquired and Method

Date Sold and to Whom

Gross Sales Price

Total Securities Gain or (Loss) from Sale of Securities Part 1, Line 8, Column (B) Date Acquired and Method

Other Assets
Date Sold and to Whom Gross Sates Price Cost, other basis or FMV when donated Cost Depreciation Basis Donation FMV Cost Depreciation Basts Donation FMV Cost Depreciation Basis Donation FMV Cost Depreciation Basis Donation FMV 12.255. -9.164. 3.091.

Description _0f.fi ce_Egu_ij3iDen t.

various
Donated/ Purchased

various scrapped

0.

Total Other Assets. Gain or (Loss) from Sale of Other Assets
TEEMC201.SCR 01/23/03

0.

3,091
■3.091

Save A Life Foundation

36-3869459

Form 990, Page I, Part I, Line 9 Special Events and Activities Statement List of Three Largest Events and Type and Number of Others Dinner Event Race Other Total Net Income (Loss) -25.814. -1.158. -61. -27.033.

Gross Receipts 87.360. 6.093. 1S3. 93.606.

Less Contributions 55.000. 6.093. 0. 61.093.

Gross Revenue 32.360. 0. 153. 32.513.

Less Direct Expenses 58.174. 1.158. 214. 59.546.

Form 990, Page 2, Part II. Line 43 Other Expenses Stmt (A) Total (B) Program services 77.370. (C) Management and oeneral 476. 667. 1.949. -11. 2.161. 543. 3.028. -5.812. 6. 239. 30.355. 812. 2.416. 36.829. (D) Fundraising

Other expenses not covered above (itemize): Consulting Fees Dues & Subscriptions Employee Bonus Independent Contractors Instructors Fees Insurance Licenses & Permits Marketing Miscellaneous Payroll Service Recruitment Cost of Goods Sold Training Supplies Website Toial

78.003. 917. 1.949. 191.090. 93.188. 10.728. 593. 60.560. -6.346. 1.156. 498. 30.383. 123.203. 4.311. 590,233.

157. 250. 71.612. 135. 50. 17.719. 24.

119.489. 93,188. 8.432. 39,813. -534. 1.126. 259. 28. 122.391. 1.895. 463.457.

89.947.

Form 990. Page 3. Part IV. Lines 57a & 57b Land, Buildings and Equipment Statement

(a) Cost/Other Basis O f f i c e Equipment Vehicles 92.085. 39.132. 131.217. Form 990, Page 3, Part IV, Line 58 Other Assets Statement

(b) Accumulated Depreciation 63.021. 3.913. 66.934.

(c) Book Value

29.064. 35.219. 64.283.

Line 58 - Other Assets: Credit Card Deposits Outstanding

Beginning of Year 11.185.

End of Year 0.

Save A Life Foundation

36-3869459 Continued

2

Form 990. Page 3, Part IV, Line 58 Other Assets Statement Beginning of Year

Line 58 • Other Assets:

End of Year

Total
Form 990. Page 3, Part IV. Line 65 Other Liabilities Statement

11.185.

0.

Line 65 - Other Liabilities: I n s t r u c t o r Deposits Total Form 990, Page 4, Part V List of Officers, Etc. Statement

Beginning of Year 340. 340.

End of Year 390. 390.

(A)
Name and address

(B) Title and average hours per week devoted to position

(C)
Compensation (if not paid, enter -0-)

(D) Contributions

to employee benefit plans and deferred compensation

(E) Expense account and other allowances

Or. Scott Betzelos Di rector
0.

0.

Deloris M. Burnam Director
0.

0.

0.

Michael Lavalle Director
0.

0.

0.

Robert Conrov Director
0.

0.

0.

Wayne Roberts Director
0. Note: The individuals above. except as noted, spend tine as needed in t h e i r capacity

0.

0.

0.

on the Board, They can be contacted c/o Save a Life
Foundation. 99S0Lawrence Ste300. Schiller Park. 1160176

Total

Save A Life Foundation

36-3869459

3

Supporting Statement of:

Form 990 p 2/Line 42 column (C) Description Depreciation Expense - Office Expense Depreciation Expense - Vehicle
Total

Amount 10.64S. 6.413. 17.059,

Supporting Statement of:

Form 990 p 3/Line 63. column (A) Description Due to Carol Spizzirri. President/Exec. Director Interest Rate - Variable
Total Amount 68,755.

68.755.

Supporting Statement of:

Form 990 p 3/Line 53, column (B) Description Due to Carol S p i z z i r r i . President/Exec. Director I n t e r e s t Rate - Variable Total Amount 72,227.

72,227.

Supporting Statement of: Form 990 p 4 / P a r t IV-A, Line b(4) Description Donated Materials. Services, and Facilities Special Events Expense
Total Amount

123,081. 59.546. 182.627.

Supporting Statement of: Form 990 p 4 / P a r t IV-B, Line b(4) Description Donated M a t e r i a l s .
L_,

Amount 123,081
->'-.\&iUij~.. >_._„i«*.

Services, and F a c i l i t i e s
JW"..
1

• . ii.

-*£25Ef

Save A Life Foundation

36-3869459 Continued

4

Supporting Statement of: Form 990 p 4 / P a r t IV-B, Line b(4) Description Special Events Expenses Total Amount 59.546.

182,627,

■i

■.

• « . * . - . -

SAVE A LIFE FOUNDATION, INC. AUDITED FINANCIAL STATEMENTS DECEMBER 31. 2002 AND DECEMBER 31, 2001

AHLBECK&COMPANY
CERTIFIED PUBLIC ACCOUNTANTS

SAVE

A

LIFE

FOUNDATION,

INC.

TABLE

OF

CONTENTS

December 31, 2002 and December 31, 2001

AUDITOR'S REPORT FINANCIAL STATEMENTS Comparative Statement of Financial Position December 31, 2002 and December 31, 2001 Statements of Activities For the Years Ended December 31, 2002 and December 31,2001 Statements of Functional Expenses For the Years Ended December 31, 2002 and December 31, 2001 Comparative Statement of Cash Flows For the Years Ended December 31,2002 and December 31,2001 NOTES TO FINANCIAL STATEMENTS 4

8

12

13

AHLBECK&COMPANY
CERTIFIED PUBLIC ACCOUNTANTS 1665 ELK BOULEVARD DES PLAINES. ILLINOIS 60016-4776 TELEPHONE: 847/824-4000 FACSIMILE: 847/824-4012 WEB: www.ahltKCkco.com

March 18, 2003 To the Board of Directors Save A Life Foundation, Inc. Schiller Park, Illinois INDEPENDENT AUDITOR'S REPORT

We have audited the accompanying statements of financial position of Save A Life Foundation, Inc. (an Illinois not-for-profit corporation) as of December 31, 2002 and December 31, 2001, and the related statements of activities, functional expenses, and cash flows for the years then ended. These financial statements are the responsibility of the organization's management. Our responsibility is to express an opinion on these financial statements based on our audits. We conducted our audits in accordance with U.S. generally accepted auditing standards. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion. In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of Save A Life Foundation, Inc. as of December 31, 2002 and December 31, 2001, and the results of their activities and their cash flows for the years then ended in conformity with U.S. generally accepted accounting principles.

I

SAVE

A

LIFE

FOUNDATION,

INC.

COMPARATIVE STATEMENT OF FINANCIAL POSITION December 31, 2002 and December 31,2001 2002 ASSETS Current Assets Cash and Cash Equivalents Inventory Trade Receivables Grants Receivable Credit Card Deposits Outstanding Prepaid Legal Fees Other Prepaid Expenses Total Current Assets Fixed Assets at Net Book Value Office Equipment Vehicles Total Net Fixed Assets Other Assets ses to Give Total Other Assets $ 477.154 77,028 6.771 317.968 6.813 2,401 888,135 $ 415,568 47,209 2,907 718,887 11,185 16,398 1.000 1,213,154 2001

29,064 35.219 64,283

24,801 13,838 38,639

20,000 20,000

20,000 20,000

TOTAL ASSETS

972,418

1,271,793

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

_. -^& '•< i.-.-..Xt<..:----J--.-.:Aii«.;^ri>.. ■■KMs.^.tLiil-i^^ ■ ■• ■ a • '- " ^ v * ^ ■ •■ T ' f n

i in'BJihMY ' • 1

SAVE

A LIFE

FOUNDATION,

INC.

COMPARATIVE STATEMENT OF FINANCIAL POSITION December 31,2002 and December 31, 2001 2002 LIABILITIES Current Liabilities Accounts Payable Instructor Deposits Total Current Liabilities Other Liabilities Due to Carol Spizzirri Total Other Liabilities AND NET ASSETS 26,510 390 26,900 $ 8,702 340 9,042 2001

72,227 72,227

68,755 68,755

TOTAL LIABILITIES Net Assets Temporarily Restricted Unrestricted Total Net Assets

99,127

77,797

645,762 227,529 873,291

1,081,430 112,566 1,193,996

TOTAL LIABILITIES & NET ASSETS

972,418

1,271,793

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 3 •s2tf£aa£L

SAVE

A

LIFE

FOUNDATION,

INC.

STATEMENT OF ACTIVITIES
For the Year Ended December 31, 2002 Unrestricted INCOME Public Support Contributions Private Grants Contributions In Kind Special Events Gross Income Total Public Support Government Contracts State of Illinois - IDPH State of Illinois - DCCA State of Illinois - Attorney General Federal - HHS/CDC Total Government Contracts Other Income Program Service Fees Miscellaneous Course Materials Branch Fee Membership Dues Total Other Income 1,353 31,500 123,081 93,606 249,540 1,353 31,500 123.081 93.606 249,540 Temporarily Restricted
Total

600.000 200,000

600,000 200.000 25,000 31.819

25,000 25,000

31,819

831,819

856,819

31,693 225 149.980 (2.916) 205 179,187

31,693 225 149,980 (2,916) 205 179,187

TOTAL INCOME (balances carried forward)

453,727

831,819

1,285,546

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS
4

SAVE

A LIFE

FOUNDATION,

INC.

STATEMENT OF ACTIVITIES For the Year Ended December 3J. 2002 TOTAL INCOME (balances brought forward) 453,727 Unrestricted EXPENSES Program Kids Program Corporate Program Blue Angels Expansion Program Branch Development Total Program Management and General Fundraising Total Functional Expenses Special Event Expenses TOTAL EXPENSES Release from Restrictions - IDPH Release from Restrictions - DCCA Release from Restrictions - HHS/CDC Excess Income Over Expenses Investment Income Interest Income Total Investment Income Excess Income Over Expenses Loss on Disposition of Assets Change in Net Assets Beginning Net Assets Ending Net Assets 344,020 11.382 12,890 586,255 347.747 1,302,294 133,677 109,797 1,545,768 59,546 1,605,314 684,298 1.140 582.049 115,900 (684.298) (1.140) (582,049) (435,668) (319,768) 344,020 11,382 12,890
586.255 347,747

831,819 Temporarily. Restricted

1,285,546 Total

1302,294 133.677 109,797 1,545,768 59,546 1,605,314

2,154 2,154 118,054 (3.091) 114,963 112,566 227,529 (435,668) 1.081,430 645,762

2.154 2,154 346,174 (3,091) (320,705) 1.193,996 873,291

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 5

SAVE

A

LIFE

FOUNDATION,

INC.

STATEMENT OF ACTIVITIES for the Year Ended December 31, 2001 Unrestricted INCOME Public Support Contributions Private Grants Contributions In Kind Special Events Gross Income Total Public Support Government Contracts State of Illinois -I DPH State of Illinois - DCCA Total Government Contracts Other Income Program Service Fees Miscellaneous Course Materials Fundraisers/Sales Total Other Income 1.475 22,660 79,602 117.346 221,083 20,000 $ 21.475 22,660 79,602 117,346 241,083 Temporarily Restricted Total

20,000

-

600.000 870,470 1,470,470

600,000 870,470 1,470,470

17.979 7,542 97,444 709 123,674

. -

17,979 7.542 97,444 709 123,674

TOTAL INCOME (balances carried forward)

344,757

1,490,470

1,835,227

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

6

SAVE A LIFE FOUNDATION, STATEMENT OF ACTIVITIES For the Year Ended December 31, 2001

INC.

TOTAL INCOME (balances brought forward)

344,757 Unrestricted

1,490,470 Temporarily Restricted

1,835,227 Total

EXPENSES Program Kids Program New Program Development Corporate Program Blue Angels Expansion Program Branch Development Total Program Management and General Fundraising Total Functional Expenses Special Event Expenses TOTAL EXPENSES Release from Restrictions - 1SBE Release from Restrictions - 1DPH Release from Restrictions - DCCA Excess Income Over Expenses Investment Income Interest Income Total Investment Income Change in Net Assets Beginning Net Assets Ending Net Assets 236,180 1,808 7,413 31,604 202.816
348.774

236.180
1,808

7,413 31,604 202,816
348,774

828,595 112,417 13.630 954,642 70,761 1,025,403 573,283 42,030 202,272 136,939 (573,283) (42,030) (202.272) 672,885

828,595 112,417 13,630 954,642 70,761 1,025,403

809,824

3.275 3,275 140,214
(27,648)

3,275 3,275 672,885 408,545 1,081,430 813,099 380,897 1,193,996

112,566

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 7

SAVE

A LIFE

FOUNDATION,

INC.

S T A T E M E N T O F F U N C T I O N A L EXPENSES For the Year Ended December 31, 2002 PROGRAM

Kid's Program

Corporate Program

Blue Angels

Expansion Program

Branch Development

Total

Salaries & Wages Employee Benefits Payroll Taxes Automobile Bank Service Fees Branch Development Computer Expenses Cost of Good Sold Depreciation Dues & Subscriptions Employee Bonus Equipment Rental Independent Contractors Instructor Fees Insurance Legal & Accounting Licenses & Permits Marketing & Promotional Meetings Miscellaneous Operating Interest Office Supplies Payroll Service Postage Printing 6r Reproduction Professional Fees Recruitment Rent Repairs & Maintenance Telephone Training Supplies Travel Web Site Total Program Expenses Administration Allocation Total Expenses

$

92.109 2.517 7,387 1,133 122,363 3.139

$

- $ 279,222 8,166 25,791 930 7.000

s

80,088

$

265
3,682

23

451,419 10,948 37,790 1.133 129,363 3.139

-

28

3,191 25.789 7.609 3.479 7,944 12,603

8.666

2,565 61,002

32.698 76.134 1,049

779
3,748 5,037 27,532 10,157

156 -

103 (534) 6.649

5,756 119.489 93,188 8.432 12,981 40,438 10,157 (534) 23,915 1,126 3,804 9.141 77,370

535 3,167

10,356

6,910

231
1,189 2.979 21,816

48
10.337

220
9.608 (722) 9,550 344,020 (25,333) 318,687

3.138

697
2,242 6.162 29,696

198 373 •
25,323

12
28,580

199
19,737

259
58,654

40
23,653 16,304 35,619 1,895 586,255

712 100,504

972
33,261 122,391 45.779 1.895 1,302,294 40,725 1,343,019

66
11,382 11,382

12,890 12,890

544 347,747 66,058 413,805

586,255

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 8

t

SAVE

A

LIFE

FOUNDATION,

INC.

STATEMENT OF FUNCTIONAL EXPENSES
For the Year Ended December 31, 2002 SUPPORT

Managemnt. & General Fundraising

Total

Organization Total

$

2,028 53 254 95 10 2,400 6,009 30.355 17.059 667 1,949 591 (ID 2,161 1,784 543 3,028 (5.812) 3.472 5,862 6 1,099 6.077 476 239 14,055 647 3,335 812 32,018 2.416 133,677 (40.725) 92,952

$

10,621 125 982 368 250 176 71.612 135 50 17,719 126 24 893 157 287 336 5,936 109,797 109,797

$

12,649 178 1.236 95 378 2,400 6,009 30,355 17.059 917 1.949 767 71,601 2.296 1,784 593 20.747 (5.812) 3.472 5,988 30 1,992 6.077 633 239 14,342 647 3,671 812 37.954 2,416 243,474 (40.725) 202,749

$

464,068 11,126 39,026 1,228 37B 131.763 9,148 30.383 17.059 917 1,949 6,523 191,090 93,188 10.728 14,765 593 61,185 10,157 (6,346) 3.472 29,903 1,156 5.796 15.218 78,003 498 72.996 1.619 36,932 123.203 83.733 4,311 1,545,768 1,545,768

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 9

<

SAVE

A LIFE

FOUNDATION.

INC.

STATEMENT OF FUNCTIONAL EXPENSES
For the Year Ended December 31, 2001 PROGRAM

Kid's Program

New Program Development

Corporate Program

Blue Angels

Expansion Program

Salaries & Wages Employee Benefits Payroll Taxes Automobile Bank Service Fees Branch Development Computer Expenses Conferences &r Meetings Cost of Good Sold Depreciation Dues & Subscriptions Equipment Rental Instructor Fees Insurance Legal & Accounting Licenses & Permits Marketing & Promotional Meetings Miscellaneous Operating Interest Office Supplies Postage Printing &r Reproduction Professional Fees Recruitment Reimbursed Program Fees Rent Repairs & Maintenance Research & Evaluation Telephone Training & Development Training Supplies Travel Web Site Total Program Expenses Administration Allocation Total Expenses

$

74.910 3,981 8,807 674 332 54 135 22 2,663 55.288 173 2.168 25 1,497 656 110 1,986 67 16,414 36,314 61 678 • 6,744 1,000 17,603 3,774 44 236,180 39.232 275,412

$

1.100 2 155 11 417 • . 123 . 1,808 713 2,521

$

1.500 774

$

83,978 1,789 7,247 107

23,100 11 955

1,264 4,251 9,263 238
2,427 8,483

3,132

945 ,167 17 ,022 .7,413 7,413

13 1,000 . 17,861 31,604 1.826 33,430

7.363 715 26.661 2,012 17,081 625 7,321 968 6,688 1,855 202,816 202,816

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 10
■i-Vi-iiftl' '•,-■' -i, iai.i&f"'tTif'^--i-«"» ■ . -..• i V w .
■X '--'^»ak'^'-> «-.vi-<fc!J> ,-tSagfi^.

-^ .H

<
SAVE A LIFE FOUNDATION, INC.

STATEMENT OF FUNCTIONAL EXPENSES
For the Year Ended December 31, 2001 SUPPORT s*-' "

Branch Development

Total

Managemnt. & General Fundraising

Total

Organization Total

$

102.678 4.739 6.374
422 44

!I

264,166 10,511 23,357 1.203
387

$

13,663
653 579 30

S

9.841
220

S

23,504
873

$

1,114
33 83 25 34 454 246 860 83 -

1,693
30

1.650
-

1.683
-

14,594
728 -

14,648 23,100
863 966 22

1,042 9.675 16,662
137

1.042 9.758 16.662
162

287.670 11,384 25,050 1,233 2,070 14,648 23,100 1,905 10,724 16.662
184

1,437 36.196 4,464 11.450
80

5.364 104,998 7.302 22,101
105

1.125
480

1.125
480

1.902 16.137 1.665
980 256

2.180
558 -

6.809 • 656
668 -

4,733
886 -

46,008 2,138 31.441
630

14,082 1,681 17.359 111.567 4.211 48.522 1.933 22.493 1.238 100.669 15.691 1,923 828,595 63.170 891,765

6.380 3,305 2,957 3,090 (8,783) 8,466
52

(8,485)
584 35

6,522
. -

1.936 16.591 1,665 1,226 1.116 6.463 3,305 (5,528) 3,674 (8.748) 14.988
52

6,489 105,478 9.238 38.692 1.770 8.035 1.772 7,131 3.305 8,554 5.355 8.611 126,555 4.263 81.440 4.030 24,430 1,238 99.426 10,020 4,180 954,642 954,642

32,918 2.097
220 -

32.918 2.097 1.937
-

8.305
221

1,717
264 -

63.215 5.229
24

(1.243) (5.935) 2.257 112,417 (73.156) 39,261

(1.243) (5.671) 2.257 126,047 (63,170) 62,877

348,774 21.399 370,173

13,630 9,986 23,616

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 11 ,v.viv«L-■'•--•-•->v^it'"ii-i>-.v-a'grfe-,'; tm*!&&,vrfoit -iv-r ■ ■ fr^^it,, . ..,:&&*■ ■ -W>. „%fe^%fe4- - as.4

SAVE

A LIFE

FOUNDATION,

INC.

COMPARATIVE STATEMENT OF CASH FLOWS
For the Years Ended December 31, 2002 and December 31, 2001
2002

2001

Cash Flows from Operating Activities: Change in net assets Adjustments to reconcile change in net assets to net cash provided by (used in) operating activities: Depreciation Loss (gain) on disposition of assets Donation of fixed assets Changes in current assets and liabilities: Decrease (increase) in accounts receivable Decrease (increase) in inventory Decrease (increase) in other current assets Decrease (increase) in other assets Increase (decrease) in accounts payable Increase (decrease) in other payables Net cash provided by (used in) operating activities Cash Flows from Investing Activities: Purchase of fixed assets Net cash provided by (used in) investing activities (27.794) (27,794) (675) (675) $ (320.705) $ 813.099

17.059 3.091 (18.000)

16.662

(3.864) (29.819) 420,288 17.808 3.522 89,380

1,080 4.980 (736,167) (19.838) 217 2,898 82,931

Net increase (decrease) in cash & cash equivalents Cash & cash equivalents at beginning of period Cash & cash equivalents at end of period Supplemental Disclosures: Interest paid

61,586 415,568 477,154

82,256 333.312 415,568

$

3,472

$

3,305

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

12

SAVE

A

LIFE

FOUNDATION.

INC.

NOTES TO FINANCIAL STATEMENTS For the Years Ended December 31, 2002 and December 31, 2001

NOTE 1 - SUMMARY OF SIGNIFICANT ACCOUNTING POUCIES Nature of Activities Save A Life Foundation, Inc. (SALF) works to train "Bystanders" as volunteers equipped with life ... supporting first aid skills to aid in an emergency the injured or ill. SALF received 46% of its total ; income in the year ended December 31, 2002 from the State of Illinois Department of Public Health. The remainder of SALFs income is from program fees, private contributions and fundraising projects, and federal appropriations through the U.S. Health and Human Services' Centers for Disease Control. Basis of Accounting The financial statements of SALF have been prepared on the accrual basis of accounting and accordingly reflect all significant receivables, payables, and other liabilities. The net assets of SALF are classified as follows: • Unrestricted, which represent the portion of expendable net assets that are available for operations. Temporarily Restricted, which represent grants which are for future periods. Upon termination of the restriction, a reclassification is made to unrestricted net assets.

Fixed Assets Fixed assets are carried at cost if purchased or fair value if contributed for current additions. Depreciation is computed on the straight-line method over 3-5 years for vehicles, computer equipment, furniture and office equipment. Maintenance, repairs and minor costs are expensed as incurred. When properties are retired or otherwise disposed of, the related cost and accumulated depreciation are removed from the respective accounts and any profit or loss on disposition is credited or charged to operations. Estimates The process of preparing financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions. These estimates and assumptions affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and reported amounts of income and expenses during the reporting period. Actual results could differ from those estimates. Cash and Cash Equivalents For purposes of the statement of cash flows, SALF considers all checking accounts, money market accounts, undeposited funds, and petty cash to be cash equivalents.

13

SAVE

A

LIFE

FOUNDATION,

INC.

NOTES TO FINANCIAL STATEMENTS For the Years Ended December 31, 2002 and December 31, 2001 Inventories Inventories are slated at cost using the weighted cost average method. Income Taxes SALF is exempt from income taxes under Section 501 (c)(3) of the Internal Revenue Code. In addition, SALF qualified for the charitable contribution deduction under Section 170(b)(l)(A)(vi) and has been classified as an organization other than a private foundation under Internal Revenue Code Section 509(a)(2). Functional Allocation of Expenses In the Statement of Functional Expenses, salaries and related expenses are first charged to the various programs and supporting services on the basis of actual expense. Expenses are then allocated based on various criteria, such as time spent in various areas. Receivables and Credit Policies Trade receivables are obligations due under normal trade terms requiring payment upon demand. There is no interest or fees charged on receivables. The amount of uncollectible trade receivables as of December 31, 2002 and 2001 is inestimable. ../.

NOTE 2 - DONATED MATERIALS AND SERVICES In-kind donations of materials and fixed assets are recorded at their estimated fair value at the date of donation. Such donations are reported as unrestricted support unless the donor has restricted the donated asset to a specific purpose. Conditional transfers of assets are recognized when the conditions upon which they depend are substantially met. During the years ended December 31, 2002 and 2001, SALF received $50,339 and $1,451 respectively, in donations of this type. Donations of services are recorded if they create or enhance a nonfinancial asset or are specialized skills that would be purchased if they were not donated. SALF received donations of this type in the years ended December 31, 2002 and 2001 of $37,000 and $37,000, respectively. SALF rents its office space at a lease amount substantially below market value. During the years ended December 31, 2002 and 2001, SALF received in-kind contributions of rent for $40,837 and $41,151, respectively.

NOTE 3 - POLICY ON CONTRIBUTIONS Contributions received are recorded as unrestricted, temporarily restricted, or permanently restricted support, depending on the existence and/or nature of any donor restrictions. Support that is restricted by the donor is reported as an increase in unrestricted net assets if the restriction expires in the reporting period in which the support is recognized. All other donor-restricted support is reported as an increase in temporarily or permanently restricted net assets, depending on the nature of the restriction. When a restriction expires (that is, when a stipulated time restriction ends or purpose restriction is accomplished), temporarily restricted net assets arc reclassified to unrestricted net assets and reported in the Statement of Activities as net assets released from restrictions. Federal 14

SAVE

A

LIFE

FOUNDATION,

INC.

NOTES TO FINANCIAL STATEMENTS
For the Years Ended December 31, 2002 and December 31, 2001 grant awards are not recorded until expended for the purpose of the grants since they are conditional promises to give.

NOTE 4 - CASH AND CASH EQUIVALENTS SALF maintains the majority of its cash at a single financial institution. These accounts are insured by the Federal Deposit Insurance Corporation up to 5100,000.

NOTE 5 - PROMISES TO GIVE SALF has received a promise to contribute to their school sponsorship program. Theses amounts are classified as temporarily restricted until received. The total amount of these promises is $20,000 at December 31, 2002 and $20,000 at December 31, 2001. The difference between the actual amount to be received and the present value of the promise is immaterial; therefore no adjustment has been made. Promises to give as of December 31, 2002 can be summarized as follows: Receivables in less than one year Receivables in one to five years $ 5,000 15,000

NOTE 6 - FIXED ASSETS At December 31, 2002 and 2001, the costs of such assets were as follows: December 31 1 2001 2002 92,085 86,340 $ 39.132 31,998 131,217 66,934 $ 64,283 $ 118.338 79,699 38,639 $ Increase (Decrease $ 5.745 7.134 12,879 (12.765) 25,644

Office Equipment Vehicles Less accumulated depreciation Net book value

$

Depreciation expense for years ending December 31, 2002 and 2001 was $17,059 and $16,662, respectively.

15

SAVE

A LIFE

FOUNDATION.

INC.

NOTES TO FINANCIAL STATEMENTS
For the Years Ended December 31, 2002 and December 31, 2001 NOTE 7 - DUE TO RELATED PARTY The organization's founder and current executive director, Carol Spizzirri, loaned SALF start up funding. As of December 31, 2002 and 2001 the amount of this loan is $72,227 and $68,755, respectively. Interest is accrued annually using the IRS AFR.

NOTE 8 - LEASE OBLIGATION AND RENTAL EXPENSE The estimated future minimum rental and operating lease obligation for the succeeding years under non-cancelable leases for office facilities in effect at December 31, 2002 are as follows:
2003 2004 $75,499 $37,750

Rental expense under the operating leases was $72,996 for the year ended December 31, 2002 and $81,440 for the year ended December 31, 2001.

NOTE 9 - SPECIAL EVENTS Special event income is shown at the gross amount in the Statement of Activities. Special event expense is also shown in the Statement of Activities. The following schedule details the gross income and expense components for each event:

December 31 2002

December 31.2001

Bgy.enme
Dinner Event Race for Life Other $ 87,360 6,093 153 93,606

Expenses
$58,174 1,158 214 $ 59,546

Usi
$29,186 4,935 (61) $ 34,060

Revenue
$115,325 2,021 $ 117,346

Expenses
$70,761 -_ $ 70,761

iki
$44,564 2,021 S 46,585

$

NOTE 10 - COMPENSATED ABSENCES SALF has a vesting vacation policy. The amount of existing vacation time remaining as of December 31, 2002 is immaterial.

16

i »
for OHIeBVjg Only.

PMT#

ILLINOIS CHARITABLE ORGANIZATION ANNUAL REPORT
Attorney General LISA M A D I G A N State of Illinois Charitable Trust Bureau, 100 West Randolph CO# 3rd Floor, Chicago, Illinois 60601
01026498

Form AG990-1L Revised 1/03

AMT

INIT

9
LEGAL NAME ^ a v e ^ ^e Foundation

Report for the Fiscal Period: .01 Beginning 0I 1 03 & Endingil
/ 31
MO DAY

/ 03

Check all items attached: U\ Copy of IRS Return Mskac/TK*! E l Audited Financial Statements cayawsto □ Copy of Form IFC cnerity ED $15.00 Annual Report Filing Fee Bwwoftinif □ $100.00 Late Report Filing Fee Date Organization was created: ^_

Federal ID # K 3 w w » Are contributions to the organization tax deductible? E
Y9S

D No

Year-end amounts
A)ASSETS B) LIABILITIES C)NET ASSETS

^m
A) $460309 B) J 364,284
C

DAY

YR

I 09 i 92

MAIL ADDRESS "

5 0w

' Lawrence #300

CITY, STATE Schiller Pa*, IL ZIP CODE .a,,,, 60176 I. SUMMARY OF ALL REVENUE ITEMS DURING THE YEAR: D) PUBLIC SUPPORT. CONTRIBUTIONS * PROGRAM SERVICE REV. (GROSS AMTS.J E) GOVERNMENT GRANTS & MEMBERSHIP DUES F) OTHER REVENUES G) TOTAL REVENUE, INCOME AND CONTRIBUTIONS RECEIVED (ADD D,E. & F) II. SUMMARY OF ALL EXPENDITURES DURING THE YEAR: H) OPERATING CHARITABLE PROGRAM EXPENSE 1) EDUCATION PROGRAM SERVICE EXPENSE J> TOTAL CHARITABLE PROGRAM SERVICE EXPENSE (ADD H &l) Ji) JOINT COSTS ALLOCATED TO PROGRAM SERVICES (INCLUDED IN J): K) GRANTS TO OTHER CHARITABLE ORGANIZATIONS L) TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD J & K) M) MANAGEMENT AND GENERAL EXPENSE N) FUNDRAISING EXPENSE O) TOTAL EXPENDITURES THIS PERIOD {ADD L, M, & N) $

) $ 96.025

PERCENTAGE 88.B8 10.27 0.85 % % % 100% 76.77 %

AMOUNT D>$ 324.331 E) S 37,488 F ) $ 3,113 G>$ 364,932

H) $ 861,501 l)$ J) $ 861,501

%
7S.77 %

%
76.77 8.25 14.98 % % % 100%

K)$ L>$ 861,501
M N

'

S

92,611

) $ 168,086

° ) $ 1,122,198

III. SUMMARY OF ALL PAID FUNDRAISER AND CONSULTANT ACTIVITIES:
(Attach Attorney General Report of Individual Fund raising Campaign- Form IFC. One for each PFR.) PHDFFSRIONAL FUNDRAISERS: P) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISERS 0) TOTAL FUNDRAISERS FEES AND EXPENSES R) NET RECEIVED BY THE CHARITY (P MINUS O R ) PJW1FFSSIONAL FUNDRAISING CONSULTANTS: S) TOTAL AMOUNT PAID TO PROFESSIONAL FUNDRAISING CONSULTANTS IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS T) NAME, TITLE: Carol Spizzim, CEO U) NAME, TITLE: Dane Neal, National ProgramCoordinalor V) NAME, TITLE: Linda Post, Accountant
V. C H A R I T A B L E P R O G R A M DESCRIPT\QU:CHARITABLE

100%

P)S 0

% %

0)5 0
R)$ 0

S)S o

f ^ * tl~^ ^ l p ^ ^ \ E 4 K 9 - * / ^ Jl-i ■ " ■ A T T O B N ^ °-TWIST CHAWlABLt' oftnA^VfV T)$ 71,250

U) $ 49,638 V) S 40.385 List on back side of instructions CODE

PROGRAM ti HIGHEST BY SEXPENIXBI CODE CATEGORIES

W) DESCRIPTION: Life Saving First Aid Training X) DESCRIPTION: Y) DESCRIPTION:

W}# o n X)# Y)#

v

v

•> IF THE ANSWER TO ANY OF THE FOLLOWING IS YES, ATTACH A DETAILED EXPLANATION: 1. 2. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION, FINE, PENALTY OR JUDGMENT? HAS THE ORGANIZATION OR A CURRENT DIRECTOR, TRUSTEE, OFFICER OR EMPLOYEE THEREOF, EVER BEEN CONVICTED BY ANY COURT OF ANY MIDSDEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY? - 1. YES NO

DB

2.

3.

DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES OWNS AN INTEREST; OR WAS IT A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES HAS A MATERIAL FINANCIAL INTEREST; OR DID ANY OFFICER, DIRECTOR OR TRUSTEE RECEIVE ANYTHING OF VALUE NOT REPORTED AS COMPENSATION? 3. HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER, DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES? IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER? (ATTACH FORM IFC ]

4

4.

5.

5. 6.

□H
□ EZ]

6.

7a. DID THE ORGANIZATION ALLOCATE THE COST OF ANY SOLICITATION, MAILING, ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES?

7

-

7b. IF "YES", ENTER (i) THE AGGREGATE AMOUNT OF THESE JOINT COSTS5 ;(ii) THE AMOUNT ALLOCATED TO PROGRAM SERVICES $ ; (i«) THE AMOUNT ALLOCATED TO MANAGEMENT AND GENERAL $ ; AND (iv) THE AMOUNT ALLOCATED TO FUNDRAISING % 8. DID THE ORGANIZATION EXPEND ITS RESTRICTED FUNDS FOR PURPOSES OTHER THAN RESTRICTED PURPOSES? 9. HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION OR TAX EXEMPTION SUSPENDED OR REVOKED BY ANY GOVERNMENTAL AGENCY? 9.

8.

ra
\/j

10. WAS THERE OR DO YOU HAVE ANY KNOWLEDGE OF ANY KICKBACK, BRIBE, OR ANY THEFT, DEFALCATION . . MISAPPROPRIATION, COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS? 10. [ _ ] 11. LIST THE NAME, ADDRESS AND THE ACCOUNT # OF THE FINANCIAL INSTITUTIONS WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST ACCOUNTS: Bank One, NA Illinois Market, P.O. Box 260180, Baton Rouge, LA 70826-0180, i

12. NAME AND TELEPHONE NUMBER OF CONTACT PERSON: Carol Sptaim {B47) gawas ALL ATTACHMENTS MUST ACCOMPANY THIS REPORT - SEE INSTRUCTIONS UNDER PENALTY OF PERJURY, I (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS ANNUAL REPORT AND THE ATTACHED DOCUMENTS, INCLUDING ALL THE SCHEDULES AND STATEMENTS AND THE FACTS THEREIN STATED ARE TRUE AND COMPLETE AND FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE STATE OF ILLINOIS RELY THEREUPON. I HEREBY FURTHER AUTHORIZE AND AGREE TO SUBMIT MYSELF AND THE REGISTRANT HEREBY TO THE JURISDICTION OF THE STATE OF ILLINOIS.

BE SURE TQ INCJ^JDE ALL FEES DUE: 1 .*) REPORTS ARE DUE~wiTHIN I f x MONTH5 OF YOUR FISCAL YEAR END, 2.) FOR FEES DUE SEE INSTRUCTIONS. 3.) REPORTS THAT ARE LATE OR INCOMPLETE ARE SUBJECT TO A $100.00 PENALTY.

" P K E S I D E N T OIATRUS 1fctt[PRIHT NAME)

I^Wfo GNATURE
SIGNATURE

TREASURER or TRUSTEE (PRINT NAME]

fr'ft"

A/-/T-6 e E H PREPARER (PRINT NAME}

SIGNAIUKe

DATE

June 30, 2004 Office of the Attorney General Charitable Trust Bureau Attn: Annual Report Section 100 West Randolph Street 3 rd Floor Chicago, Illinois 60601-3175 Re: Save A Life Foundation. Inc. EIN 36-3869459 Ladies and Gentlemen: We are writing to request an extension of time to file the Illinois Charitable Organization Annual Report Form AG990-IL for the year ended December 31, 2003. Due to additional time being needed to compile the necessary financial information and changes in staff, we will be unable to process the form by the due date of June 30, 2004. As a result, we are requesting an extension of 60 days to August 31, 2004. Please find enclosed the $ 15.00 annual filing fee. Thank you for your consideration. Please contact us should you require additional information.

Very truly yours,

Carol J. Spizzirri Executive Director

Fr 9 9 0 om
Department of llie Treasury Internal Revenue Service

Return of Organization Exempt from Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation) *■ The organization may have to use a copy of this return to satisfy state reporting requirements. , 2003, and ending
D C Please use IRS label or print or type. See specific instruc­ tions. Name of organ i zation

0MB No. 1545-0047

2003
Open to Public Inspection
Employer Menti5c*tJofi Number

A B

For the 2003 calendar year, or tax year beginning
Check if applicable: Address change Name change Initial return Final return Amended return Application pending

Save A Life Foundation
Number and street (or P.O. box il mail is not delivered to street addr) Room/suite E

36-3869459
Telephone number

9950

Lawrence
State

300
ZIP code + 4

City, town or country

Schiller

Park

IL

60176

• Section 501 (cX3) organizations and 4947(a)(1) ri on exempt charitable trusts must attach a completed Schedule A (Form 990 or 990-EZ). .ore ■—,
** | X ] 501(c) 3 (insert no.]

n

(847) 9 2 8 - 9 6 8 3 aSSS*"" [_]c**
Otbflr (specify)*

u

Accrual

H and I are not applJcaaJe to section 527 organizations H ( a ) Is this a fli-pup return for affiliates? , . . J H ( b ) If Yes," enter number of affiliates ** H (C) Are all affiliates included? \_\ Tes Q Ho | Ye* [ X j No

G Web site: *■ www. s a l f J K Organization type
(Check only o n e j

m
[ J 4947(a)(1) or \

m
I S27

(If 'No,' attach a list. See instructions.) H ( d ) Is this a separate return tile a by an organization covered by a croup ruling? I 1 yes D ( ] No.

Check here *■ [_| if the organization's gross receipts are normally not more than $25,000. The organization need not file a return with the IRS; but if the organization received a Form 990 Package in the mail, it should file a return without financial data. Some states require a complete return.

I M

L Gross receipts: Add lines 6b, 8b, 9b, and 10b to line 12 * 3 7 2 , 9 5 8 . iPartljl 5 " [ R e v e n u e , E x p e n s e s , a n d C h a n g e s i n N e t A s s e t s o r F u n d B a l a n c e s (See instructions) M 1 Contributions, gifts, grants, and similar amounts received; a Direct public support 1a 193,165. b Indirect public support lb nkkii. c Government contributions (grants) . 1c 37,488. 0.) Id "TrtiSSIcficMhJ 2 3 0 , 6 5 3 . noncasn $ 2 Program service revenue including government fees and contracts (from Part VII, line 93). 3 Membership dues and assessments 4 Interest on savings and temporary cash investments 5 Dividends and interest from securities 6a b c 7 Gross rents Less: rental expenses Net rental income or (loss) (subtract line 6b from line 6a). Other investment income (describe *• 6a 6b

Group Exemption Number . . . ** ___ Check *■ \_J if the organization is rot required to attach Schedule B (Form 990, 990-EZ, or 990-PF).

230.653 131,166. 795,

6c

(A) Securities (B) Other 8a Gross amount from sales of assets other Sa 5,250. than inventory 8b 7,926. b Less: cost or other basis and sales expenses . . . . 8c -2,676. c Gain or (loss) (attach schedule) .. .See. .Lr\8. . S t l T I t . . . 6 Net gain or (loss) (combine line 8c, columns (A) and (B)) 9 Special events and activities (attach schedule). If any amount is from gaming, chech here.. a Gross revenue (not including $ _^___ __0 . of contributions 1,504. reported on line la) 9a b Less: direct expenses other than fundraising, expenses 9b 100. c Net income or (loss) from special events (subtract line 9b from line 9a) ,5ee. .L.-.9. . S t m t 9c 10a Gross sales of invenlory, less returns and allowances 10a b Less: cost of goods sold 10b c Gross profit or (loss) from sales of inventory (attach schedule) (suhtract line 10b from line 10a) 10c 11 Other revenue (from Part VII, line 103) 11 12 Total revenue (add lines Id, 2, 3, 4, 5, 6c, 7, 8d, 9c, )0c, and 11) 12 13 Program services (from line 44. column (B)) 13 14 Management and general (from line 44, column (C)) 14 15 Fundraising (from line 44, column (D)) 16 Payments to affiliates (altach schedule)

-2,676.

1,404.

Ji.
16

3.590. 364,932. 861,501 92,611. 168,086. 1,122,198. -757,266. 873,291.
-20.000. 96,025. Form 990 (2003)

17 Total expenses (add lines 16 and 44, column (A)) .. 18 Excess or (deficit) for the year (subtract line 17 from line 12) 19 Net assets or fund balances at beginning of year (from line 73, column (A)) 20 Other changes in net assets or fund balances (attach explanation) 21 Net assets or fund balances at end of year (combine lines IS, 19. and 20) . BAA For Paperwork Reduction Act Malice, see the separate instructions.

17 _18_ 19 20^ 21
1EEA01O1 11/24)03

Form990(2003) Save A L i f e Foundation Part II J S t a t e m e n t Of F u n c t i o n a l E x p e n s e s
Do not include amounts reported on line 6b, 8b, 96. 10b, or 16 of Parti. 22 Grants and allocations (art self) (cash $ non-cash $ ) 23 Specific assistance to individuals (att sch) 24 Benefits paid to or for members (att sch) 25 Compensation of officers, directors, etc 26 Other salaries and wages 27 Pension plan contributions 28 Other employee benefits 29 Payroll taxes 30 Professional fimdraising fees 31 Accounting fees 32 Legal fees 33 Supplies , 34 Telephone 35 Postage and shipping 36 Occupancy 37 Equipment rental and maintenance 38 Printing and publications 39 Travel 40 Conferences, conventions, and meetings 41 Interest 42 Depreciation, depletion, etc (attach schedule) 43 Other expenses not covered above (itemize):

36-3869459

Page a

All organizations must complete column (A). Columns (B), (C), and (D) are required for section 501(c)(3) and (4) organizations and section4947(a)(1) nonexempt charitable trusts but optional forolhers. (A) Total (B) Program services (C) Management and general (D) Fundraising

22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43a 43b 43c 43 d 43e

•' 71.250. 323,341. 14,676. 30,945. 9,917. 4,069. 8,661. 30,375. 5,993. 76,366. 9.666. 24.260. 30,267. 51,780. 11,053. 26,618. 1,390. 398. -8,793. 2,799. 397,167. 70,538. 281,014. 13.246. 26.994. 6.535. 1.634. 7.145. 23,523. 2,614. 70,874. 9.305. 21,538. 26,133. 41.461. 5,702. 3,900. 658. 0. -8,793. 0. 257,480. 356. 9.924. 445. 1,352. 3,382. 2,435. 1.120. 4,317. 40. 2,913. 25. 349. 397. 38. 5,351. 22,718. 732. 236. 0. 2.799. 33.682. 356. 32,403. 985. 2,599. 0. 0. 396. 2,535. 3.339. 2,579. 336. 2,373. 3.737. 10,281. 0. 0. 0. 162. 0. 0. 106.005.

a Auto Expense b Bank Service Fees c Branch Development d Computer Expenses

e See Other Expenses Stmt 44 Total functional expenses (add lines 22 - 43). Organizations completing columns (B) - (D), carry these totals to lines 13- IS 44 861,501. 92,611. 1,122,198. 168.086. Joint Costs. Check . * [ _ ] if you are following SOP 98-2. Are any joint costs from a combined educational campaign and fundraising solicitation reported in(B) Program services? *■[___ ^ e s e ] " ° If 'Yes,' enter (I) the aggregate amount of these joint costs $ ; (ii) Ifie amount allocated to Program services ; Oil) the amount allocated to Management and general $ ; and (iv) the amount allocated to Fund raising] I

Part 11 Sj Statement of Program Service Accomplishments 1= :
What is Ihe organization's primary exempt purpose? *■ J * ! 0 ^ ! ^ J j.f_e_ s a v j rig__f i_r_S_t_a^i_d All organizations must describe their exempt purpose achievements in a clear and concise manner. State the number of clients served, publications issued, etc. Discuss achievements that are not measurable. (Section 501(c)(3) & (4) oiganizations and 4947(a)(1) nonexempt charitable trusts must also enter the amount of grants & allocations lo others.) Program Service Expenses
(Required tor 501(c)(3) and W Organizations and 4947(a)(1) trusls: Mil optional forolhers.)

a__>i d_'J_P.rpgCaJPi_"_ PCPJP21J*!1 _ a M JJriching_ of _l_i fe_ sa.yjng.__flr_s_t_ -aid.iP. J J I L n p i i _ s c r j o ( > l ^ i L d l i i l i S S j ? ^ c h U d m i . t a y s l l t J .
(Grants and allocations $

b Corj3_?£^t_e_P_r^)gr_ajTi_^ j . rqmot i_orj_a_nd_teachj n__ _of _l_ife. jay.ij.fi ~f i r5t_a_i_d_to_iridjyi_djjal_s_ot_h^r j:J_an_^ch_ool/_age _cnUdre_n
(Grants and allocations $
c

±A
iL_i

379.648.

^ f i U j ? s l ^ l < l JniJ-i'injS_iJ^yii^_£caJ?i.
(Grants and allocations $

13,336,

_0__1

30,760,

d Branch JJ_ev^lj)F_m_erit^^ inside and outside the State of Illinois
(Grants and allocations $ c. Other proqram services (Grants and allocations $ f Total ol Proqram Service Expenses (should equal line 44, column (B), Proqram services)

0. ) ) ».

437,757. 861.501.
Form 990 (2003)

BAA

TEEAD102

10/03*03

Form990 (2003)

Save A L i f e

Foundation

36-3869459

Page 3

Part IV | Balance Sheets (See instructions)
Note: Where required, attached schedules and amounts within the description column should be for snd-of-yesr amounts only. (A) Beginning of year 176,046. 301.108. 47a Accounts receivable b Less: allowance for doubtful accounts 48a Pledges receivable b Less; allowance for doubtful accounts 47a 47 b 43 a 48b 20,000. 317,968. 48c 49 50 51a 51b 77.028. 9,214.
,;-- ; ' i .

(B) End of year 45 46 .;, -5,556.

22,715. 6,771.

47 c

22,715.

100.000.

A

50 Receivables from officers, directors, trustees, and key

s s
E 1 S

b Less: allowance for doubtful accounts 52 Inventories for sale or use 53 Prepaid expenses and deferred charges 54 Investments - securities (attach schedule) 55a Investments - land, buildings, & equipment: basis . 55a b Less: accumulated depreciation

. ►□ Cost 0

FMV

51c 52 53 54

57.019. 4.634.

55b 56 Investments - other (attach schedule) 57a Land, buildings, and equipment: basis b Less: accumulated depreciation 57 b 58 Other assets (describe •" 59 Total assets (add lines 45 throuqh 58) (must equal line 74) 60 Accounts payable and accrued expenses 62 Deferred revenue 63 Loans from officers, directors, trustees, and key employees (attach sctiedu e) 64a Tax-exempt bond liabilities {attach schedule)
t

55 c 56 362,771. 91,274. ).. 972,418. 26,510. , 72.227. 64.283. 57 c 56 59 60 fil 62 63 64a 64 h G5 66 271.497. 460,309. 28.796.

57a

139.648. 194,416. 1,424. 364.284.

s
N T

65 Other liabilities (describe - See L i n e 66 Total liabilities (add lines 60 throuqh 65) Organizations thai follow SFAS117, check here *■ through 69 and lines 73 and 74. 68 Temporarily restricted

65 S t m t [Xj and complete lines 67

)..

390. 99,127.

227.529. 645,762. Q and complete lines

67 BR 69

-3,975. 100,000.

^
0 R

Organizations lhat do not follow SFAS 117, check here *■ 70 through 74.

k ar
70 71 72 873.291. 972.418. 73 74 96,025. 460.309.

D

G
71 Paid-in or capital surplus, or land, building, and equipmen 72 Retained earnings, endowment, accumulated income, or o her funds 73 Total net assets or fund balances (add lines 67 through 69 or lines 70 through 72; column (A) must equal line 19; column (B) must equal line 21) 74 Total liabilities and net assets/fund balances (add 1 nes6f 5 and 73)

t L A

Form 990 is available for public inspection and, for some people, serves as the primary or sole source of information about a particular organization. How the public perceives an organization in such cases may be determined by the information presented on its return. Therefore, please make sure the return is complete and accurate and fully describes, m Part III, the organization's programs and accomplishments.

BAA

TEEA01O3

10/01KB

Form990 [2003)

Save A L i f e

Foundation

36-3869459

Page 4

Part IV-A I Reconciliation of Revenue per Audited Financial Statements with Revenue per Return (See instructions.)
a Total revenue, gains, and other support per audited financial statements Amounts included o n line a but not on line 12, Form 990:

Part IV-B I Reconciliation of Expenses per Audited Financial Statements with Expenses per Return
a Total expenses and losses per audited financial statements * Amounts included on line a bul not on line 17, Form 990: (1) Donated serv­ ices and use of facilities

625.261.
b

1,382,527.

b

(1) Net unrealized gains on investments

$

$

(2) Donated serv­ ices and use of facilities . . . . $_
(3) Recoveries of prior year grants , .

(2) Prior /ear adjust­ ments reported on line 20, Form 990 . . . . $ (3) Losses reported on

#

%_

hie 20, Form 990 . . . . $

(4) Other (specify): See A t t a c h e d

(4) Other (specify): See A t t a c h e d

c d

I 260,329. Add amounts on lines {)) through (4) * Line a minus line b *■
Amounts included on line 12, Form 990 but not on line a:
(1) Investment expenses not included on line 6b, Form 990 $_

260,329.
364,932.

$ 260.329. Add amounts on lines (1) through (4) Line a minus line b Amounts included on line 17, Form 990 bul not on line a: O) Investment expenses not included on line Bb, Form 990 (2) Other (specify):

260,329. 1,122,198.

$_

(2) Other (specify): $ Add amounts on lines (1) and ( 2 ) , . . e

$ Add amounts on lines (1) and (2)

Total revenue per line 12, Form e Total expenses per line 17, Form 364,932. 990 (line c plus line d) 1,122,198. 990 (line c plus line d) P a r t V i N l l 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 insiructions. (B) Title and average hours (C) Compensalion (D) Contributions to (E) Expense per week devoted (if not paid, employee benefit account and other (A) Name and address to position enter -0-) plans and deferred allowances compensation £$ CP_L SpJ z z_i_rr i_ Chairman/Exec D i r 40 WaLter_Dudy_cz_ Vice Alan Thavisouk Secretary/Treasurer John Do_nleavy_ Di r e c t o r Mark Mitchell Di r e c t o r See List of Officers, Etc. Statement 0. 75 Did any officer, director, trustee, or key employee receive aggregate compensalion of more than $100,000 from your organization and all related organizations, of which more than $10,000 was provided by the related organizations? H 'Yes,' attach schedule — see instructions. 0. 0. 0. C h a i rman 0.

71,250.

1,701.

[]Yes

|x]No Form 990 (2003)

BAA
TEEA0104 10JOM13

Form990 (2003) Save A L i f e Foundation Part V I I Other Information (See instructions.)

36-3869459
Yes 76 77 78 a 78 b 79

Page 5 No

76 Did the organization engage in any activity not previously reported to the IRS? If 'Yes.' attach a detailed description of each activity 77 Were any changes made in the organizing or governing documents but not reported to the IRS? If 'Yes,' attach a conformed copy of the changes. 78a Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return? b If 'Yes,' has it filed a tax return on Form 99Q-T for (his year? 79 Was there a liquidation, dissolution, termination, or substantial contraction during the year? If 'Yes,' attach a statement

80a Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc, to any other exempt or nonexempt organization? , 80a b If Yes,' enter the name ol the organization * and check whether it is \_j exempt or \_J nonexempt. 81 a Enter direct and indirect political expenditures. See Iine81 instructions | 81 a| 0_ b Did the organization file Form 1120-POL for this year? 81b 82 a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially less than fair rental value? , 82a

■ffiffyf

i§||

x

m
X

b If 'Yes,' you may indicate the value of these items here. Do not include this amount as . . revenue in Part I or as an expense in Part II. (See instructions in Part III.) | 82b| 301,609 . 83a Did the organization comply with the public inspection requirements for returns and exemption applications? 83a b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? 83b 84a Did the organization solicit any contributions or gifts that were not tax deductible? 84a b It 'Yes,' did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible' 85 501(c)(4), (5). or (6) organizations, a Were substantially all dues nondeductible by members? b Did the organization make only in-house lobbying expenditures or $2,000 or less? If Tes' was answered to either 85a or 85b, do not complete 85c through 85h below unless the organization received a waiver for proxy lax owed for the prior year. c Dues, assessments, and similar amounts from members d Section 162(e) lobbying and political expenditures e Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices f Taxable amount of lobbying and political expenditures (line 85d less 85e) g Does the organization elect to pay the section 6033(e) tax on the amount on line 85f? B5c B5d 85 e 84b 85a 85b

X

851 85g
85 h

h If section 6033(eXIXA) dues notices were sent, does the organization agree to add Bie amount or line 85f to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year? 86 501(c)(7) organizations. Enter: a Initiation fees and capital contributions included on 86a line 12 b Gross receipts, included on line 12, for public use of club facilities 86b 87 501 (c)(l 2) organizations. Enter: a Gross income from members or shareholders . , . 87a bGross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) 87b

88 At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or partnership, or an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If 'Yes,' complete Part IX 89a 501(c)(3) organizations. Enter: Amount of tax imposed on the organization during the year under: section 4911 * 0 . ; section 4 9 1 2 " 0 . ; section 4955' b 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year? If 'Yes,' attach a statement explaining each transaction c Enter' Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958 d Enter: Amount of tax on line 89c, above, reimbursed by the organization 90 a List the states with which a copy of this return is filed •■ J I l _ i j i O L S ^ _ W i _ s c o n ^ j n , _ £ e n n _ s y _ l y i a n i _ a _ b Number of employees employed in the pay period that includes March 12, 2003 (See instructions.) 91 The books are in care of - _Car_ql_S|)i Z Z A f l l Telephone number Located at - . ? 9 5 0 _ L a w j e n V e J S u J t e _ 3 0 0 , _ S c h i _ U e r _ f ar_k_ll__ 92 Section 4947(a)(1) nonexempt charitable trusts filing Form 990 in lieu of Form 1041 - Check here and enter the amount of tax-exempt interest received or accrued during the tax year BAA
TEEA0105 12/Z3/03

88

0.
89b Q. 0^ f^bl ~ 13

*■ ►

_(847)_9_28-9683 Z T P V ^ *~J0~176_~ *"T"I H 92 | Form 990 (2003)

Form 990 (2003) Save A L i f e Foundation PaW VIII Analysis of Income-Producing Activities (See instructions.)
Unrelated business income Note: Enter gross amounts unless otherwise indicated. 93 Program service revenue: a P r o g r a m Fees b.Course Materials (A) Business code Amount

36-3869459
Excluded by section 512, 513, or 514 (C) (D) Exclusion coda Amount

Page 6

(E) Related or exempt function income

c
d~

36,016. 95,150.

e
f Medicare/Medicaid payments g Fees 1 contracts from government agencies . M Membership dues and assessments . 95 Interest on savings 8 temporary cash iwmnts 96 Dividends & interest from securities . 97 Hot rertal income or (loss) from real estate: a debt-financed property b not debt-financed property 98 Net rental income or (loss) from pers prop . , . 99 Other investment income 100 Gain or (loss) from sales of assels other than inventory 101 Net income or (loss) from special events 102 Gross profit or (loss) from sales of inventoiy . . . 103 Other revenue: a

14
.^rfSl

795
-lljj ! & ! . " ■

*&?mg

WE7¥A

k,^r..^«.

IS
■f*j*
1

-3,676. 1,404.

.S^t;'

b Mi scellaneous c d

sm&^mmb
-477

3,590.

.^___

e
104 Subtotal (add columns (B), (D), and (E)) .. 105 Total (add line 104, columns (B), (D), and (E» Note: Line 105 plus Una 1d, Part I, should equal the amount on line 12, Part I.

134,756. 134,279,

[PartVIII Relationship of Activities to the Accomplishment of Exempt Purposes (See instructions)
Line No. Explain how each activity for which income is reported in column (E) of Part Vil contributed importantly to the accomplishment of the organization's exempt purposes (other than by providing funds for such purposes).

93a,93b Promote and teach life saving first aid programs. 103a To supplement funding required to perform and carry out the life saving first aid programs. PartiWI Information Regarding Taxable Subsidiaries and Disregarded Entities (See instructions.)
(A) Name, address, and EIN of corporation, partnership, or disregarded entity (B) Percentage of ownership interest % % % (C> Nature of activities (D) Total income (E) End-of-year assels N/A

Part X I information Regarding Transfers Associa ed with Personal Benelit Contracts (See instructions.)
a Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? b Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?. Note: If Yes' to (b), fits Form 8370 andForm 4720 (see instructions).
UrNfei penalties qt periuiy.' Seclare |hat I have examined te jeliwn, imAjflino accompsnyino schedules and statements, and to the best o) my knowledge and belief, it is true, correct, and complete. Declaration of prepare' (other than officei) isbas&d on all infSrrnallon of which. preparerhasany knowledge.

Please Sign Here Paid Prearer's se Only

Signaljre of officer

Date

Type or print name and title Prepare r's signature Dale Check if selfemployer!

08/27/04

G

Firm's n m (or Ahlbeck & Company ae S A T fc- 16S5 Elk B l v d .
ffire-"1 Des Plaines

n

Prepare/'5 SSfJ or PTIN (see General Instruction W]

EIN

IL

60016

Phone no. -

(847)

824-4000

BAA

TEEA0106 to/03f03

Form 990 (2003)

SCHEDULE A (Form 990 or 990-EZ)

Organization Exempt Under Section 501(c)(3)
(Except Private Foundation) and Section 501(e), 501(f), 501(k), 501 (n), or Section 4947(aX1) Nonexempt Charitable Trust Supplementary Information — (See separate instructions.)

OMB No. I515-OM7

2003
Employer identification number

Department of the Treasury Internal Revenue Service Name of the organization

MUST be completed by the above organizations and attached to their Form 990 or 990-EZ.

Save A L i f e Part I

Foundation

36-3869459
(d) Contribution; to employee benefit plans ana deferred compensation

Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (See instructions. List each one. If there are none, enter 'None.') (a) Name and address of each employee paid more than $50,000 (b) Title and average hours per week devoted to position (c) Compensation (e) Expense account and other allowances

None

Total number of other employees paid over $50,000
;

None

l«S|*

lit
(c) Compensation

|,Partsl|S: j';:| Compensation of the Five Highest Paid Independent Contractors for 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

Bennett

R.

Krause Drive. Springfield, IL 62707
Establish funding sources and contracts

2012 A p p l e t o n

70.769.

Total number of others receiving over $50,000 for professional services *• None BAA For Paperwork Reduction Act Notice, see the Inslructiors for Form 990 and Form 990-EZ.
TEEJWMOl 08f28/03

Schedule A (Form 990 or 990-EZ) 2003

Schedule A (Form 990 or 990-EZ) 2003

Save

A Life

Foundation

36-3869459
Yes

Page 2 No

Part'HI
1

| Statements About Activities (See instructions.)

During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? If 'Yes,' enter the total expenses paid or incurred in connection with the lobbying activities *" $ (Must equal amounts on line 38, Part Vl-A, or line i of Part Vl-B.) Organizations that made an election under section 501(h) by filing Form 5768 must complete Part Vl-A, Other organizations checking 'Yes,' must complete Part Vl-B AMD 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 substantial contributors, trustees, directors, officers, creators, key employees, or members of their families, or with any taxable organization with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary? (if the answer to any question is 'Yes,' attach a detailed statement explaining the transactions.) a Sale, exchange, or leasing of property? b Lending of money or other extension of credit? c Furnishing of goods, services, or facilities? See P a r t V , d Payment of compensation (or payment or reimbursement of expenses if more than $1,000)? e Transfer of any part of its income or assets? Form 990 2d 2a 2b 2c

2e
3a 3b

3a Do you make grants for scholarships, fellowships, student loans, etc? (It 'Yes,' attach an explanation of how you determine that recipients qualify to receive payments.) b Do you have a section 403(b) annuity plan for your employees? 4 Did you maintain any separate account for participating donors where donors have the right to provide advice on the use or distribution of funds?

Pa!rt-lVgj.' Reason for Non-Private Foundation Status (See instructions.)
The organization is not a private foundation because it is: (Please check only ONE applicable box.) 5 _ A church, convention of churches, or association of churches. Section 170(b)(l)(A)(i). 6 _ A school. Section 170(b)(1 )(A)(ii). (Also complete Part V.) 7 _ A hospital or a cooperative hospital service organization. Section 170(b)0)(A)(iii). _ 8 A Federal, state, or local government or governmental unit. Section 170(bKl)(A)(v). 9 [ ] A medical research organization operated in conjunclion with a hospital. Section 170(b)(l)(A)(iii). Enter the hospital's name, city, and state " 10 Q An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(l )(A)(iv), (Also complete the Support Schedule in Part IV-A.) 11 a Pw An organization (hat normally receives a substantial part of its support from a governmental unit or from the general public. Section l70(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV-A.) 11 b Q A community trust. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV-A.) 12 0 An organization that normally receives: 0 ) more than 33-1/3% of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc, functions - subject to certain exceptions, and (2) no more than 33-1/3% 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. See section 509(a)®. (Also complete the Support Schedule in Part IV-A.) An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in'(1> lines 5 through 12 above; or (2) section 501 (c)(4), (5), or (6), if they meet the test of section 509(a)(2). (See section 509(a)(3).) Provide the following information about the supported organizations. (See instructions,) (a) Name(s) of supported organizalion(s) (b) Line number from above

13

n

14 BAA

|~| An organization organized and operated to test for public safety. Section 509(a)(4). (See instructions.)
TEEA0402 01II MM

Schedule A (Form 990 or Form 990-EZ) 2003

Schedule A (Form 990 or 99Q-EZ) 2003 Save A L i f e F o u n d a t i o n 36-3869459 P a r t I V - A 1 S u p p o r t S c h e d u l e (Complete only if you checked a box on line 10, 11, or 12.) Use cash method of accounting. Note: You may use the worksheet in the instructions tor converting from the accrual to the cash method of accounting. Calendar year (or fiscal year beginning in) 15 Gifts, grants, and contributions received. (Do not include unusual grants. See line 23.) .. 16 Membership fees received 17 Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is related to the organization's charitable, etc, purpose 18 Gross income from interest, dividends, amounts receivedfrompayments on securities loans (section 512(a)(5)), cents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organ­ ization after June 30,1975 19 Net income from unrelated business activities not included in line IS . . . 20 Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf 21 The value of services or facilities furnished to the organization by a governmental unil without charge. Do not include the value of services or facilities generally furnished to the public without charge 22 Other income. Attach a schedule. Do not include gain or (loss) from sale of capital assets 23 Total of lines 15 through 22 . . . . 744.267. 1.581.674. 1.021,092. 686.776. 24 Line 23 minus line 17 1.373.838. 823,557. 691.603. 645.618. 25 Enter 1% of line 23 7,443. 15.817. 10.211. 6.868. 26 Organizations described on lineslO o r H : a Enter 2% of amount in column (e), line 24 26a b Prepare a list (or your records to shew the name of and amount contributed by each person (other than a governmental unit or publicly supported organization) whose total gifts for 1 9 through 2002 exceeded the amount shown in line 26a. Do not File this list with your 9Q return. Enter the total of all these e«ess amounts 26b c Total support for section 509(a)(l) lest: Enter line 24, column (e) d Add: Amounts from column (e) for lines: 18 38. 729. 22 2002 £b) 2001 2000

Page 3

1999
621.043.

Total

1,371,684.

820,282

682,878.

3,495.887.

207.836

197,535

52,664.

41.158.

499.193.

2,154.

3,275.

8,725.

24,575.

38,729.

4,033,809. 3,534,616.

lllSlllPS 70,692.
3.534.616. 38.729.

26c 19 26 b 26d

e Public support (line 26c minus line 26d total) 3,495.887. 26e f Public support percentage (line 26e (numerator) divided by line 26c (denominator)). 98.90 % 26f 27 Organizations described on line 12: a For amounts included in lines 15,15, and 17 that were received from a 'disgualified person,' prepare a list for your records to show the name of, and total amounts received in each year from, each 'disqualified person.' Do not file Ihis list with your return. Enter the sum of such amounts for each year: (2001) (2000) (2002) (1999) bFor any amount included in line 17 that was received from each person (other than 'disqualified persons'), prepare a list for your records to show the name of. and amount received lor each year, that was more than the larger of (1) the amount on line 25 for the year or (2) $5,000. (Include in the list organizations described in lines 5 through 11, as well as individuals.) Do not file this list with your return. After computing the difference between the amount received and the larger amount described in (1) or <2), enter the sum of these differences (the excess amounts) for each year:

(2002)

(2001)
15 20

(2000)
16 21 and line 27b total

(1999)
27c 27 d

c Add: Amounts from column (e) for lines: 17

dAdd: Lire 27a total e Public support (line 27c total minus line 27d total)

27 e

f Total support for section 509(a)(2) test: Enter amount from line 23, column (e) 27f, g Public support percentage (line 27e (numerator) divided by line 27f (denominator)) h Investment Income percentage (line 18, column (e) (numerator) divided by line 27f (denominator)) 28

Ha

%

% Unusual Grants: For an organization described in line 10, 11, or 12 that received any unusual grants during 1999 through 2002, prepare a list for your records to show, for each year, the name ol the contributor, the date and amount of the grant, and a brief description of the nature or the grant. Do not file this list with your return. Do not include these grants in line 15.
TEEA04O3 08/29/03

27 h

BAA

Schedule A (Form 990 or 990-EZ) 2003

Schedule A (Form 990 or 990-EZ) 2003 Save A L i f e

Foundation

36-3869459

Page 4

PartV
29

Private S c h o o l Q u e s t i o n n a i r e (See instructions) (To be completed ONLY by schools that checked the box on line 6 in Part IV)

N/A
Yes No

Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, olher governing instrument, or in a resolution of its governing body? Does the organization include a statement of its racially nondiscriminatory policy toward students in all its brochures, catalogues, and other written communications with the public dealing with student admissions, programs, and scholarships?

29

30

30

31 Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during the period of solicitation for students, or during the registration period if it has no solicitation program, in a way that makes the policy known to all parts of the general community it serves? If 'Yes,' please describe; if 'No,' please explain, (If you need more space, attach a separate statement.)

32

Does the organization maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative staff? . b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student admissions, programs, and scholarships? ., d Copies of all material used by the organization or on its behalf to solicit contributions? If you answered 'No' to any of the above, please explain. (If you need more space, attach a separate statement.)

32a 32 b 32c 32d

33

Does the organization discriminate by race in any way with respect to: a Students' rights or privileges? b Admissions policies? c Employment of faculty or administrative staff? d Scholarships or other financial assistance? e Educational policies? f Use of facilities? g Athletic programs? h Other extracurricular activities? If you answered 'Yes' to any of the above, please explain. (If you need more space, attach a separate statement.) — , -33 a 33 b

33 c
33 d 33 e 33 f

ils
33h

'If

34a Does the organization receive any financial aid or assistance from a governmental agency? . b Has the organization's right to such aid ever been revoked or suspended? If you answered 'Yes' to either 34a or b, please explain using an attached statement. 35 Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05 of Rev Proc 75-50, 1975-2 C.B, 587, covering racial n o no iscri mi nation? If 'No,' attach an explanation.
TEEAMW 0&Z8TJ3

34a 34b

BAA

35 Schedule A (Form 990 or 990-EZ) 2003

Schedule A (Form 990 or 990-EZ) 2003

Save

A Life

Foundation

36-3869459

Page 5

RarEiVIrA I Lobbying Expenditures by Electing Public Charities (See instructions.)
(To be completed ONLY by an eligible organization that filed Form 5763) Check » a ■ if the organization belongs to an affiliated group. Check »• b I I if you checked 'a' and 'limited control' provisions apply. To be completed for ALL electing organizations

Limits on Lobbying Expenditures
(The term 'expenditures' means amounts paid or incurred.) 36 37 38 39 40 41 Total lobbying expenditures to influence public opinion (grassroots lobbying) — Total lobbying expenditures to influence a legislative body (direct lobbying) Total lobbying expenditures (add lines 36 and 37) Other exempt purpose expenditures Total exempt purpose expenditures (add lines 38 and 39) Lobbying nontaxable amount. Enter the amount from the following table — If the amount on line 40 is — The lobbying nontaxable amount is Not over $500,000 20% of the amount on line 40 ~ ~ Over 1500,000 but not over $1,000,000 $100,000 plus 15% of the excess over $500,000 Over $1,000,000 but rat over $1,500,000 $175,000 plus 10% of ttie excess over $1,000,000 Over $1,500,000 but rat over $17,000,000 $225,000 plus 5% of the excess over $1,500,000 Over $17,000,000 $1,000,000 _ 42 Grassroots nontaxable amount (enter 25% of line 41) 43 Subtract line 42 from line 36. Enter -0- if line 42 is more than line 36 44 Subtract line 41 from line 38. Enter -0- if line 41 is more than line 38 Caution: If there is an amount on either line 43 or line 44, you must file Form 4720.

A -Year A v e r a g i n g P e r i o d U n d e r S e c t i o n 5 0 1 ( h ) (Some organizations that made a section 501 (h) election do not have to complete all of the five columns below. See the instructions for lines 45 through 50.) Lobbying Expenditures During 4 -Year Averaging Period Calendar year (or fiscal year beginning in) " 45 Lobbying nontaxable amount (150% of line 45(e)) ..
i i . ' "

(a) 2003

(b) 2002

<c) 200)

(d) 2000

(e) Total

46 Lobbying ceiling amount
47 Total lobbying expenditures . 48 49 Grassroots nontaxable amount .. Grassroots ceiling arrwun (150% of line 48(e)) . . .

^■-¥*>

v

-

■ ■ - ■ > * & * . .

50 Grassroots lobbying expenditures

PartjVI-B | Lobbying Activity by Nonelecting Public Charities
(For reporting only by organizations that did not complete Part Vl-A) (See instructions.) During the year, did the organization attempt to influence national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of: a Volunteers bPaid staff or management (Include compensation in expenses reported on lines c through h.) c Media advertisements d Mailings to members, legislators, or the public e Publications, or published or broadcast statements f Grants to other organizations for lobbying purposes g Direct contact with legislators, their staffs, government officials, or a legislative body h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means i Total lobbying expenditures (add lines c through h.) It 'Yes' to any of the above, also attach a statement giving a detailed description of the lobbying activities. BAA
TEEAC405 0&I2BI03

Yes

No

Amount

MM'd

Schedule A (Form 990 or 990-EZ) 2003

Schedule A (Form 990 or 990-EZ) 2003 Save A L i f e F o u n d a t i o n 35-3869459 WV1I Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations (See instructions)

Page 6

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 lhan section 501 (c)(3) organizations) or in section 527, relating to political organizations? Yes No a Transfers from the reporting organization to a noncharitable exempt organization of: 51 a (i) X (I)Cash X (ii)Other assets a (ii) b Other transactions: X h(f) (i)Sales or exchanges of assets with a noncharitable exempt organization b(ii) X (ii)Purchases of assets Iron a noncharilable exempt organization b(iii) X (iii)Rental of facilities, equipment, or olher assets X (iv)Reimbursement arrangements b(iv) b(v) X (v)Loans or loan guarantees btvi) X (vi)Performance of services or membership or fundraising solicitations X c c Sharing of facilities, equipment, mailing lists, olher assets, or paid employees
d If the answer to any of the above is 'Yes,' complete the following schedule. Column (b) should always show fhe fair market value of the goods, other assets, or services given by the reporting organization. If the organizalion received less than fair market value in any transaction or sharina arranaement, show in column (d) fne value of the aoods, other assets, or services received: 0») (c) (a) (d) Amount involved Name of noncharitable exempt organization Line no. Description of transfers, transactions, and sharing arrangements

52a Is the organization direclly or indirectly affiliated with, or related to, one or more tax-exempt organizations b If 'Yes,' complete the followinq schedule; (a) Name of organization Type of organization

—.

._.

Description of relationship

SAA

TEEA0W6

09/05(03

Schedule A (Form 990 or 990-E2) 2003

Form

8868

(December 2000) Deparlmeri ol Me Treasury Internal Revenue Service

Application for Extension of Time to File an Exempt Organization Return

ONE No. 1545-1709

*~ File a separate application tor each return. • If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box — i ' If you are filing for an Additional (not automatic) 3-Month Extension, complete only part II (on page 2 of this form). Note: Do not complete Part II unless you have already been granted an automatic 3-month extension on a previously filed Form 8868. P a r t I'"'* | A u t o m a t i c 3 - M o n t h E x t e n s i o n Of T i m e - Only submit original (no copies needed) Note: Form 990-Tcorporations requesting an automatic 6-month extension - check this box and complete Part I only
K

u
LJ

All other corporations (including Form 990-C tilers) must use Form 7004 to request an extension of time to file income tax returns. Partnerships. FtEMtCs and trusts must use Form 8736 to request an extension of time to file Form 1065, J066. or 1041.
Name of Exempt Organization Employer Identlficetion number

Type or print File by the due date for filing your return. See instructions.

Save A L i f e

Foundation

36-3869459
state ZIP code

Number, street, and room or suite number. If a P.O.boi, see instructions

9950 Lawrence , #300
City, town or post office. For a foreign address, see inductions.

S c h i l l e r Park

IL

60176

Check type of return to be filed (file a separate application for each return): Form 990-T (corporation) X Form 990 Form 4720 Form 990-BL Form 990-T (Section 401 (a) or 408(a) trust) Form 5227 Form 990-E2 Form 990-T (trust other than above) Form 6069 Form 1041-A Form 990-PF Form 8870 • If Ihe organization does not have an office or place of business in the United States, check this box ► |_J • If Ihis is for a Group Return, enter the organization's four digit Group Exemption Number (GEN) . If this is for the whole group, check this box . *■ Q . If it is for part of the group, check this box.. *" Q and attach a list with the names and EINs of all members the extension will cover. ___ ___ 1 I request an automatic 3-month (6-month, for 990-T corporation) extension of time until Au.fi 16 20 0 4 , to file the exempt organization return for the organization named above. The extension is for the organization's return for: »• i(] calendar year 20 03 or *■ _] tax year beginning , 20 , and ending . 20 . 2 If this tax year is for less than 12 months, check reason: _ ] Initial return [_| Final return _ J Change in accounting period 3a If this application is for Form 990-BL, 990-PF, 990-T, 4720. or 6069, enter the tentative tax, less any nonrefundable credits. See instructions b If this application is for Form 990-PF or 990-T, enter arty refundable credits and estimated tax payments made. Include any prior year overpayment allowed as a credit c Balance Due. Subtract line 3b from line 3a. Include your payment with this form, or, if required, deposit with FTD coupon or. if required, by using EFTPS (Electronic Federal Tax Payment System). See instructions Signature and Verification $ % $

Under penalties ol perjury. I declare Ihat I have etamined this return, including accompanying schedules and statements, and to the best ot my knowledge and belief, it is true, correct, and complete, and trial I am authorized io prepare this iorm.

Signal

Title

*"

C/jf-

Date

r

/J/6V

BAA For Paperwork Reduction Act Notice, see instruction:..

Form 8868 (12-2000)

FIFZ0SQ1

01105/04

Form a868 ti2-2000)

Save A Life Foundation

36-3869459

Page 2

? If you are filing for an Additional (not automatic) 3-Month Extension, complete only Part II and check this box . lote: Only complete Part II if you have already been granted an automatic 3-month extension on a previously Form 3363. ? If you are filing for an Automatic 3-Month Extension, complete only Parti [on page 1).

Part II ;| Additional (not automatic) 3-Month Extension of Time ' Must File Original and One Copy.
Name of Exempt Organization Employer Identification number

Type or print
File twine extended due dale for Rung trie relum. sea Instructions.

Save A Life Foundation
Numtw street, and room of suits number. If a P.O. box. Bee instructions,

9950 Lawrence, #300
City, town or post office, stale, and ZIP cons. For 3 foreign addreu. I 6 s instructions

Schiller Park

IL

60176

B

Check type of return to be Tiled (file a separate application for each return): Form 990 Form 990-EZ _ Fonn 990-T (Section 401 (a) or 408(a) trust) Form 1041-A Form. 5227 [ ] Form 8870 Fonn 990-PF Form 990-T (trust other than above) Form 990-BL Form 4720 Form 6069 Slop: Do not complete Part II if you were not already granted an automatic 3-month extension on a pfaviously filed Form 8868. ? If (he organization does not have an office or place of business in the United States, check this box ,.G[] ? If Ihis Is lor a Group Return, enter the organizations four digit Group Exemption Number (GEN) . K this is for the whole group, check this box G [ _ ] . If M is part of the group, cheek this box G {_} and attach a list with the names and EINs of all members the extension is for. 4 I request an additional 3-month extension of time until _Nov_ | 5 .20 _04 . 5 For calendar year _2003_ , or other tax year beginning _ ,20 _ and ending _ ,20 . 6 If this lax year is for less than 12 months, check reason: L j ' " * a I return [ j Final relum [_j Change in accounting period 7 State In detail why you need the extension jyi^JlD^isjBquire^Jo^ajhjil^th

H

^accurately^corpplete lrie_return.
Sa Ifthis application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the lerrtaBve tax, less any nonrefundable credits. See instructions , ,., ,

$

b If this application is for Form 990-PF, 990-T, 4720, or 6069, enter any refundable credits and estimated tax payments made. Include any prior year overpayment allowed as a credit and any amount paid previously with FDmn8868 c Balance due. Subtract line Sb from line 8a. Include your payment with this form, or, if required, deposit with FTP coupon or, If required, by using EFTPS {Electronic Federal Tax Payment System). See instructions

$ $

Signature and Verification
Under penalties of perjury, I declare that I have examined this farm, includlngacerxnperiytng schedules and statements. and to trie best of mylmowlBdoeand belief, it Is true. cr —' "■«» and » » t I am authorized loprepare this form.

OA
Nonce to Migpllcant' To be Completed by the IRS

Date

f

/'T-/iay

B
D

We have approved this application. Please attach this form to the organization's return. We have not approved this application. However, we have granted a 10-day grace period from the later of the date shown below or the due date of the organization's return (including any prior extensions}. This grace period Is considered to be a valid extension of time for elections otherwise required to be made on a timely filed return. Please attach this form to the organization's return. We have not approved this application. After considering the reasons stated in item 7, we cannot grant your request for an extension of time to file. We are not granting a 10-day grace period. We cannot consider this application because it was filed after the due date of the return for which an extension was requested. Other: _ _ _
By:

B
D«elor

Data

Alternate Mailing Address' Enter the address if you want the copy of this application for an additional 3-month extension returned to an address different than the one entered above,
Name

I print

Typa or

Number and street {include suite, room, or apartment number) or a P.O. be* number

City or town, province or state, and country (including postal or ZIP code)

BAA

FIFZDS02 01AJ5iW

Form 88S8 (Rev 12-2000)

Form 990 Line 8(A) and 8(B) Statement Name Save A L i f e

Schedule of Gains and Losses from Sale of Assets Other than Inventory
*■ Attach to return

2003

Employer Identification Number Foundation

36-3869459 Securities

Part I, Line 8, Column (A)
Public Securities

Description P u b l i c l v Traded Securities

Gross Sales Price Cost Sellinq Expenses Basis

Basis

Nonpublic Securities Cost, other basis or FMV when donated (State which on top)

Description

Date Acquired and Method

Date Sold and to Whom

Gross Sales Price

Total Securities Gain or (Loss) from Sale of Securities Part 1, Line 8, Column (B) Date Acquired and Method

Other Assets
Date Sold and to Whom Gross Sales Price Cost, other basis or FMV when donated Cost Depreciation Basis Donation FMV Cost Depreciation Basis Donation FMV Cost Depreciation Basis Donation FMV Cost Depreciation Basis Donation FMV 8.343. -417. 7.926.

Description Vehicle

05/01/03

11/01/03 5,250.

Total Other Assets Gain or (Loss) from Sale of Other Assets
TEEW02015CR lO/SOTO

5,250.

7,926, -2^676,

Save A Life Foundation

36-3869459

1

Form 990, Page 1, Part I, Line 9 Special Events and Activities Statement List of Three Largest Events and Type and Number of Others Race Other Total Net Income (Loss) 608. 796. 1,404.

Gross Receipts 708. 796. 1.504.

Less Contributions 0. 0. 0.

Gross Revenue 708. 796. 1.504.

Less Direct Expenses 100. 0. 100.

Form 990, Page 2, Part II, Line 43 Other Expenses Stmt <A) Total <B> Program services 14.972. 0. 77.968. 63.749. 10.263. 818. -2.384. 0. 1,840. 108. 0. 77.583. 12.563. 0. 257.480. (C) Management and aerieral 0. 317. 0. 200. -945. -43. 402. 2,558. 608. 24. 14.628. 50. 883. 15,000. 33.682. (D) Fundraising

Other expenses not covered above (itemize): C o n s u l t i n g Fees Dues & S u b s c r i p t i o n s Independent Contractors I n s t r u c t o r s Fees Insurance Licenses & Permits Marketing Miscellaneous Payroll Service Recruitment Cost o f Goods S o l d Training Supplies Websi t e Program Development Total

14,972. 317. 168.025. 63,999. 9,472. 775. 13,464. 2,558. 2.679. 132. 14.628. 77,633. 13,513. 15,000. 397,167.

0. 0. 90,057. 50. 154. 0. 15,446. 0. 231. 0. 0. 0. 67. 0. 106,005.

Form 990, Page 3, Part IV. Lines 57a & 57b Land, Buildings and Equipment Statement

(a) Cost/Other Basis Land Building O f f i c e Equipment Vehicles Total 20,000. 181,912. 121,727. 39,132.

(b) Accumulated Depreciation 0. 4,548. 74,980. 11,746.

(c) Book Value

20.000. 177.3G4. 46.747. 27.386.

362,771.

91,274.

271.497.

Save A Life Foundation

36-3869459

Form 990, Page 3, Part IV, Line 65 Other Liabilities Statement Beginning of Year 390. Endol Year 490. 934.

Line 65 - Other Liabilities:

I n s t r u c t o r Deposits Real Estate Taxes Payable
Total

390

1,424.

Form 990, Page 4, Part V List of Officers, Etc. Statement

(A) Name and address

(B) Title and average hours per week devoted to position

(C) Compensation (if not paid, enter -0-)

(D) Contributions to employee benefit plans and deferred compensation

(E) Expense account and other allowances

Richard

Stipher Di r e c t o r 0. 0. 0.

Note: The individuals above, except as noted, spend time a5 needed in t h e i r capacity on the Board, They can be contacted c/o Save a L i f e Foundation, 9950 Lawrence Ste300. Schiller Park. IL6017S

Total

0.

0.

Save A Life Foundation

36-3869459

3

Supporting Statement of: Form 990 p 1/Line 20 Description Bad debt Total losses Amount -20,000. -20,000.

Supporting Statement of: Form 990 p 2 / L i n e 4-2 column (B) Description D e p r e c i a t i o n Expense Total - Program Expense Amount 3,900. 3,900.

Supporting Statement of: Form 990 p 2/Line 42 column (C) Description Depreciation Expense - Office Expense Depreciation Expense - Vehicle Total Amount 14,468. 8,250. 22,718.

Supporting Statement of: Form 990 p 3 / L i n e 63, column (A) Description Due t o Carol S p i z z i r r i , President/Exec. Di r e c t o r I n t e r e s t Rate - V a r i a b l e Total Amount 72.227.

72.227.

Supporting Statement of: Form 990 p 3/Line 63, column (B) Description Due t o Carol S p i z z i r r i , President/Exec. D i r e c t o r I n t e r e s t Rate - V a r i a b l e Amount 139.648.

Save A Life Foundation

36-3869459

4

Continued Supporting Statement of: Form 990 p 3 / L i n e 53, column <B> Description Amount

Total

139,648.

Supporting Statement of: Form 990 p 4 / P a r t IV-A, Line b(4) Amount 260,229. 100. 260,329.

Description In-Kind Contributions S p e c i a l Events Expenses Total

Supporting Statement of: Form 990 p 4 / P a r t I V - B , Line b(4) Amount 260,229. 100.

Description In-Kind Contributions Special Events Expenses
Total

260,329.

SAVE A LIFE FOUNDATION, INC. AUDITED FINANCIAL STATEMENTS DECEMBER 31, 2003 AND DECEMBER 31, 2002

AHLBECK&COMPANY
CERTIFIED PUBLIC ACCOUNTANTS

SAVE A LIFE TABLE OF

FOUNDATION,

INC.

C O N T E N T S

December 31, 2003 and December 31, 2002

AUDITOR'S REPORT FINANCIAL STATEMENTS Comparative Statement of Financial Position December 31, 2003 and December 31, 2002 Statements of Activities For the years Ended December 31, 2003 and December 31, 2002 Statements of Functional Expenses For the Years Ended December 31, 2003 and December 31, 2002 Comparative Statement of Cash Flows For the Years Ended December 31, 2003 and December 31, 2002 NOTES TO FINANCIAL STATEMENTS 8

12

13

AHLBECK&COMPANY
CERTIFIED PUBLIC ACCOUNTANTS 1665 ELK BOULEVARD DES FLAINES, ILLINOIS 60016-4776 TELEPHONE: B47/824-4000 FACSIMILE: 847/814-4012 WEB. www.ahlhcckco.coin

June 29,2004

To the Board of Directors Save A Life Foundation, Inc. Schiller Park, Illinois

I N D E P E N D E N T

A U D I T O R ' S

R E P O R T

We have audited the accompanying statements of financial position of SAVE A LIFE FOUNDATION, INC. Can Illinois not-for-profit corporation) as of December 3 1 , 2003 and December 3 1 , 2002, and the related statements of activities, functional expenses, and cash flows for the years then ended. These financial statements are the responsibility of the organization's management. Our responsibility is to express an opinion on these financial statements based on our audits.

We conducted our audits in accordance with U.S. generally accepted auditing standards. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstalement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion.

In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of SAVE A LIFE FOUNDATION, INC. as of December 3 1 , 2003 and December 3 1 , 2002, and the results of their change in net assets and their cash flows for the years then ended in conformity with U.S. generally accepted accounting principles.

1

SAVE

A LIFE

FOUNDATION,

INC.

COMPARATIVE STATEMENT OF FINANCIAL POSITION December 31, 2003 and December 31, 2002
2003 2002

ASSETS Current Assets Cash and Cash Equivalents Inventory Trade Receivables Grants Receivable Prepaid Legal Fees Other Prepaid Expenses Total Current Assets Fixed Assets at Net Book Value Land Building Office Equipment Vehicles Total Net Fixed Assets Other Assets Promises to Give Total Other Assets TOTAL ASSETS 460,309 $ (5,556) 67,019 22,715 100,000 2,905 1,729 188,812 $ 477,154 77,028 6,771 317,968 6,813 2,401 888,135

20,000 177,364 46,747 27,386 271,497

29,064 35,219 64,283

20,000 20,000 972,418

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 2

SAVE

A LIFE

FOUNDATION,

INC.

COMPARATIVE STATEMENT OF FINANCIAL POSITION
December 31, 2003 and December 31, 2002 2003 LIABILITIES Current Liabilities Accounts Payable Real Estate Taxes Payable Instructor Deposits Mortgage Payable Total Current Liabilities Other Liabilities Due to Carol Spizzirri Total Other Liabilities AND NET $ ASSETS 28,796 934 490 194,416 224,636 $ 26,510 390 26,900 2002

139,648 139,648

72,227 72,227

TOTAL LIABILITIES Net Assets Temporarily Restricted Unrestricted Total Net Assets

364,284

99,127

100,000 (3,975) 96,025

645,762 227,529 873,291

TOTAL LIABILITIES & NET ASSETS

460,309

972,418

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 3

SAVE

A LIFE

FOUNDATION,

INC.

STATEMENT OF ACTIVITIES
For the Year Ended December 31, 2003 Unrestricted INCOME Public Support Contributions Private Grants Contributions In Kind Special Events Gross Income Total Public Support Government Contracts State of Illinois - DCCA Rural Training HHS/CDC Total Government Contracts Other Income Program Service Fees Miscellaneous Course Materials Total Other Income 147,785 4,000 301,609 1,504 454,898 147,785 4,000 301,609 1,504 454,898 Temporarily Restricted Total

22,488 15,000 37,488

22,488 15,000 37,488

36,016 3,590 95,150 134,756 627,142

36,016 3,590 95,150 134,756

Total Income (balances carried forward)

627,142

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS
4

SAVE

A LIFE

FOUNDATION,

INC.

STATEMENT OF ACTIVITIES For the Year Ended December 31, 2003 Total Income (balances trought forward) 627,142 Unrestricted EXPENSES Program Kids Program Corporate Program Expansion Program Branch Development Springfield Building Rural Grant Total Program Management and General Fundraising Total Functional Expenses Special Event Expenses Total Expenses Release from Restrictions - IDPH Release from Restrictions - DCCA Release from Restrictions - HHS/CDC Excess Income Over Expenses Investment Income Interest Income Total Investment Income Excess Income Over Expenses Bad Debt Losses Loss on Disposition of Assets Change in Net Assets Beginning Net Assets Ending Net Assets 379,648 13,336 195,523 310,234 7,120 23,640 929,501 165,227 287,698 1,382,426 100 1382,526 307,793 100,000 117,968 (229,623) (307,793) (100,000) (117,968) (525,761) 379,648 13,336 195,523 310,234 7,120 23,640 929,501 165,227 287,698 1,382,426 100 1,382,526 Temporarily Restricted 627,142 Total

-

(755,384)

795 795 (228,828) (2,676) (231,504) 227,529 (3,975) (20,000) (545,762) 645,762 100,000

795 795 (754,589) (20,000) (2,676) (777,266) 873,291 96,025

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 5

SAVE

A

LIFE

FOUNDATION,

INC.

STATEMENT O F ACTIVITIES For the Year Ended December 31, 2002 Unrestricted INCOME Public Support Contributions Private Grants Contributions In Kind Special Events Gross Income Total Public Support Government Contracts Slate of Illinois - 1DPH State of Illinois - DCCA State of Illinois - Attorney General Federal - HHS/CDC Total Government Contracts Other Income Program Service Fees Miscellaneous Course Materials Branch Fee Membership Dues Total Other Income 1,353 31,500 123,081 93,606 249,540 1,353 31,500 123,081 93,606 249,540 Temporarily Restricted Total

25,000

600,000 200,000 31,819 831,819

600,000 200,000 25,000 31,819 856,819

25,000

31,693 225 149,980 (2,916) 205 179,187 -

31,693 225 149,980 (2,916) 205 179,187

TOTAL INCOME (balances carried forward)

453,727

831,819

1,285,546

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 6

SAVE

A

LIFE

FOUNDATION,

INC.

STATEMENT OF ACTIVITIES For the Year Ended December 31, 2002 TOTAL INCOME (balances brought forward) 453,727 Unrestricted EXPENSES Program Kids Program Corporate Program Blue Angels Expansion Program Branch Development Total Program Management and General Fundraising Total Functional Expenses Special Event Expenses TOTAL EXPENSES Release from Restrictions - 1SBE Release from Restrictions - 1DPH Release from Restrictions - HHS/CDC Excess Income Over Expenses Investment Income Interest Income Total Investment Income Excess Income Over Expenses Loss on Disposition of Assets Change in Net Assets Beginning Net Assets Ending Net Assets 344,020 11,382 12,890 586,255 347,747 1302,294 133,677 109,797 1,545,768 59,546 1,605,314 684,298 1,140 582,049 115,900 (684,298) (1,140) (582,049) (435,668) (319,768) 344,020 11,382 12,890 586,255 347,747 1,302,294 133,677 109,797 1,545,768 59.546 1,605,314 831,819 Temporarily Restricted 1,285,546 Total

2,154 2,154 118,054 (3,091) 114,963 112,566 227,529 (435,668) 1,081,430 645,762

2,154 2,154 (317,614) (3,091) (320,705) 1,193,996 873,291

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

7

SAVE

A LIFE

FOUNDATION,

INC.

STATEMENT OF FUNCTIONAL EXPENSES
For the Year Ended December 31, 2003 PROGRAM

Kid's Program

Corporate Program

Expansion Branch Springfield Program Development Building

Salaries & Wages Employee Benefits Payroll Taxes Other Payroll Expense Automobile Bank Service Fees Branch Development Computer Expenses Cost ol Good Sold Depreciation Dues &r Subscriptions Employee Bonus Equipment Rental Independent Contractors Instructor Fees Insurance Legal & Accounting Licenses &r Permits Marketing &r Promotional Meetings Miscellaneous Operating Interest Ol'tice Supplies Payroll Service Postage Printing & Reproduction Professional Fees Program Development Recruitment Rent Repairs & Maintenance Telephone Training Supplies Travel Utilities Web Site Total Program Expenses Administration Allocation Total Expenses

$ 184,830 6,048 15,419 584 3,900 3,301 32,223 46,138 2,439 2,180 40 6.020 12 4.256 1.010 651 35 84 17,365 6,059 42,874 3,992 188 379,648 67,486 447,134

$ . 9.269 69 3,946 5213,336 2,371 15,707

$

84,726 5.478 4,268 74 237 1.565 10,641 118 387 41,449 2,072 251 447 7,000 24 21,747 241 8,812 122 4,687 366 811 195,523 34,756 230,279

$

125,996 S 1,720 7.307 (9,030) ■

1,940 31,262 2,718 7,003 5,773 778 (8,860) 2,317 579 1,516 21,503 7,972 53,239 2.022 8,652 16.349 17,257 469 11,752 310,234 55,147 365,381

821 216 . 5,702 236 145 7,120 1,266 8,386

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

a

SAVE

A LIFE

FOUNDATION,

INC.

STATEMENT OF FUNCTIONAL EXPENSES
For the Year Ended December 31, 2003 SUPPORT Rural Gram Organization Total

Total

Managemnt. & General Fundraising

Total

$ _ 3,842 5,506 14,292 23,640 4,202 27,842

$

395,552 13,246 26,994 658 (8,793) 3,900 6,806 77,968 63,749 10,263 8,169 818 (2,384) 41,461 5,702 8,645 1,840 2.614 21,538 14,972 108 92.351 2,499 23,523 77,583 26,133 1,023 12,563 929,501 165,227

$

10,280 445 1,352 2,608 732 236 2,799 14,628 22,718 317 _ 200 (945) 12,174 (43) 58,662 38 (51) 5,351 1,120 608 40 8,349 15,000 24 2,913 25 4,317 50 397 883 165,227 (165,227)

$

32.759 985 2,599 162 336 90.057 50 154 22,093 117,146 396 231 3,339 8,473 2,579 2,535 3,737 67 287,698 287,698

$

43,039 1,430 3,951 2,608 732 398 2,799 14,628 22,718 317 336 90,057 250 (791) 12.174 (43) 80,755 117,184 (51) 5,351 1,516 839 3,379 16,822 15,000 24 5,492 25 6,852 50 4,134 950 452,925 (165.227) 287,698

$

438,591 14,676 30,945 2,608 1,390 398 (8,793) 2,799 14,628 26,618 317 7,142 168,025 63,999 9,472 20,343 775 78,371 158,645 (51) 11,053 10,161 2,679 5,993 38,360 14,972 15,000 132 97,843 2,524 30,375 77,633 30,267 1,023 13.513 1,382,426 1,382,426

1,094,728

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 9

SAVE

A

LIFE

FOUNDATION.

INC.

STATEMENT OF FUNCTIONAL EXPENSES
For the Year Ended December 31, 2002 PROGRAM

Kid's Program

Corporate Program

Blue Angels

Expansion Program

Branch Development

Total

Salaries & Wages Employee Benefits Payroll Taxes Automobile Bank Service Fees Branch Development Computer Expenses Cost ol Good Sold Depreciation Dues & Subscriptions Employee Bonus Equipment Rental Independent Contractors Instructor Fees Insurance Legal &r Accounting Licenses & Permits Marketing & Promotional ■ Meetings Miscellaneous Operating Interest Oltice Supplies Payroll Service Postage Printing & Reproduction Professional Fees Recruitment Rent Repairs & Maintenance Research & Evaluation Telephone Training & Development Training Supplies Travel Web Site Total Program Expenses Administration Allocation Total Expenses

'i

92,109 $ 2,517 7,387 1,133 122,363 3,139 3,191 25,789 3,479 7,944 12,803 6,910 231 1,189 2,979 21,816 48 10,337 220 9,608 (722) 9,550 344,020 35,313 379,333

5 7.609 535 3,167 66 11,382 1,168 12,550

930

279,222 8,166 25,791 7,000

80,088 265 3,682

451.419 10,948 37,790 1,133 129,363 3,139 28

23

8,666 156

2,565 61,002 779 3,748 5,037 27,532 10,157 10,356 697 2,242 6,162 29,696 12 28,580 40 23.653

32,698 76,134 1,049 103 (534) 6,649 198 373 25,323 199 19,737 712

5,756 119,489 93,188 8,432 12,981 40,438 10,157 (534) 23,915 1,126 3,804 9,141 77,370 259 58,654 972 33,261

3,138

16,304 35,619 1,895 586,255 60,178 646,433

100,504 544 347,747 35,695 383,442

122,391 45,779 1,895 1,302,294 133,677 1,435,971

12,890 1,323 14,213

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 10

SAVE

A

LIFE

FOUNDATION,

INC.

COMPARATIVE STATEMENT OF CASH FLOWS For the Years Ended December 31, 2003 and December 31, 2002 2003 Cash Flows from Operating Activities: Change in net assets Adjustments to reconcile change in net assets to net cash provided by (used in) operating activities: Depreciation Bad Debt Loss Loss (gain) on disposition of assets Donation of fixed assets Changes in current assets and liabilities: Decrease (increase) in accounts receivable Decrease (increase) in inventory Decrease (increase) in other current assets Increase (decrease) in accounts payable Increase (decrease) in other payables Net cash provided by (used in) operating activities Cash Flows from Investing Activities: Proceeds From sale of fixed assets Purchase of fixed assets Net cash provided by (used in) investing activities Cash Flows from Financing Activities: Issuance of short-term debt Repayment of short-term debt Net cash provided by (used in) financing activities 200,000 (5,584) 194,416 15,850 (210,979) (195,129) $ (777,266) $ (320,705) 2002

26,618 20,000 2,676 (41,380) (15,944) 10,009 222,549 2,286 68,455
(481,997)

17,059 3,091 (18,000) (3.864) (29,819) 420,288 17,808 3,522
89,380

(27,794) (27,794)

Net increase (decrease) in cash & cash equivalents Cash &r cash equivalents at beginning of period Cash & cash equivalents at end of period Supplemental Disclosures: Interest paid

(482,710) 477,154 (5,556)

61,586 415,568 477,154

$

11,053

$

3,472

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 12

SAVE

A LIFE

FOUNDATION,

INC.

NOTES TO FINANCIAL STATEMENTS For the Years Ended December 31, 2003 and December 31, 2002

NOTE 1 - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Nature of Activities Save A Life Foundation, Inc. (5ALF) works to train "Bystanders" as volunteers equipped with life supporting first aid skills to aid in an emergency the injured or ill. SALF received 72% of its total income in the year ended December 3 1 , 2003 from contributions in kind and special events gross income. The remainder of SALF's income is from program fees, private contributions, a training grant from the State of Illinois, and federal appropriations through the U.S. Health and Human Services' Centers for Disease Control. Basis of Accounting The financial statements of SALF have been prepared o n the accrual basis of accounting and accordingly reflect all significant receivables, payables, and other liabilities. The net assets of SALF are classified as follows: • Unrestricted, which represent the portion of expendable net assets that are available for operations. Temporarily Restricted, which represent grants which are for future periods. Upon termination of the restriction, a reclassification is made to unrestricted net assets.

Estimates The process of preparing financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions. These estimates and assumptions affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the Financial statements and reported amounts of income and expenses during the reporting period. Actual results could differ from those estimates. Cash and Cash Equivalents For purposes of the statement of cash flows, SALF considers all checking accounts, money market accounts, undeposited funds, and petty cash to be cash equivalents. Receivables and Credit Policies Trade receivables are obligations due under normal trade terms requiring payment upon demand. There is no interest or fees charged on receivables. The amount of uncollectible trade receivables as of December 3 1 , 2003 and 2002 is immaterial. Management has elected to record bad debts using the direct write-off method. Generally accepted accounting principles require that the allowance method be used to reflect bad debts. However, the effect of the use of the direct write-off method is not materially different from the results that would have been obtained had the allowance method been followed. Inventories Inventories are stated at cost using the weighted cost average method. 13

SAVE

A LIFE

FOUNDATION,

INC.

NOTES TO FINANCIAL STATEMENTS
For the Years Ended December 31, 2003 and December 31, 2002

Fixed Assets Fixed assets are carried at cost if purchased or fair value if contributed for current additions. Depreciation is computed on the straight-line method over 5-7 years for vehicles, computer equipment, furniture and office equipment. Maintenance, repairs and minor costs are expensed as incurred. When properties are retired or otherwise disposed of, the related cost and accumulated depreciation are removed from the respective accounts and any profit or loss on disposition is credited or charged to operations. Policy on Contributions Contributions received are recorded as unrestricted, temporarily restricted, or permanently restricted support, depending on the existence and/or nature of any donor restrictions. Support that is restricted by the donor is reported as an increase in unrestricted net assets if the restriction expires in the reporting period in which the support is recognized. All other donor-restricted support is reported as an increase in temporarily or permanently restricted net assets, depending on the nature of the restriction. When a restriction expires (that is, when a stipulated time restriction ends or purpose restriction is accomplished), temporarily restricted net assets are reclassified to unrestricted net assets and reported in the Statement of Activities as net assets released from restrictions. Federal grant awards are not recorded until expended for the purpose of the grants since they are conditional promises to give. Income Taxes SALF is exempt from income taxes under Section 501 CO (3) of the Internal Revenue Code. In addition, SALF qualified for the charitable contribution deduction under Section 170(b)(1)(A)(vi) and has been classified as an organization other than a private foundation under Internal Revenue Code Section 509(a)(2). Functional Allocation of Expenses In the Statement of Functional Expenses, salaries and related expenses are first charged to the various programs and supporting services o n the basis of actual expense. Expenses are then allocated based on various criteria, such as time spent in various areas.

NOTE 2 - DONATED MATERIALS AND SERVICES In-kind donations of materials and fixed assets are recorded as financial support at their estimated fair value at the date of donation. Such donations are reported as unrestricted support unless the donor has restricted the donated asset to a specific purpose. Conditional transfers of assets are recognized when the conditions upon which they depend are substantially met. During the years ended December 3 1 , 2003 and 2002, SALF received $41,380 and $50,339 respectively, in donations of this type. Donations of services are recorded if they create or enhance a nonfinancial asset or are specialized skills that would be purchased if they were not donated. SALF received donations of this type in the years ended December 3 1 , 2003 and 2002 of $237,729 and $37,000, respectively.

14

SAVE

A

LIFE

FOUNDATION,

INC.

NOTES T O FINANCIAL STATEMENTS For the Years Ended December 31, 2003 and December 31, 2002

Donations of use of facilities are recorded at their fair market value. Such donations are reported as unrestricted supports. During the years ended December 3 1 , 2003 and 2002, SALF received in-kind contributions of rent for $22,500 and $35,742, respectively.

NOTE 3 - CASH AND CASH EQUIVALENTS SALF maintains the majority of its cash at a single financial institution. These accounts are insured by the Federal Deposit Insurance Corporation up to $100,000. As of December 3 1 , 2003 and 2002, SALF's uninsured cash balances total $0 and $386,633.74, respectively.

NOTE 4 - PROMISES TO GIVE SALF has received a promise to contribute to their school sponsorship program. These amounts are classified as temporarily restricted until received. The total amount of these promises is $0 at December 3 1 , 2003 and $20,000 at December 3 1 , 2002. The difference between the actual amount to be received and the present value of the promise is immaterial; therefore no adjustment has been made.

NOTE 5 - FIXED ASSETS At December 3 1 , 2003 and 2002, the costs of such assets were as follows:

Land Building Office Equipment Vehicles Less accumulated depreciation Net book value

December 31, 2003 2002 $ 20,000 $ 181,912 121,727 92,085 39.132 39,132 362,771 131,217 91.274 $ 7.7^ 497 66,934

Increase (Decrease! $ 20,000 181,912 29,642 _ 29,642 24.340 $ 5.302

$

fit *^

2

Depreciation expense for years ending December 31, 2003 and 2002 was $26,618 and $17,059, respectively.

15

SAVE

A LIFE

FOUNDATION,

INC.

NOTES TO FINANCIAL STATEMENTS
For the Years Ended December 31, 2003 and December 31, 2002

NOTE 6 - MORTGAGE PAYABLE The mortgage payable at December 3 1 , 2003 and 2002 consists of the following: 2003 $194,416 2002 $0

Mortgage payable to Bank One due on April 28, 2004, secured by the 520 E. Capitol Ave., Springfield IL building, including interest at 4.25%. This was subsequently extended to July 28, 2004.

NOTE 7 - TEMPORARILY RESTRICTED NET ASSETS Temporarily restricted net assets at December 3 1 , 2003 and 2002 consists of the following: 2003 $ 100,000 2002 $200,000

Illinois Department of Commerce and Community Affairs-restricted for the purchase of a building in Springfield, IL Illinois Department of Public Health - restricted to use according to the grant agreement and also according to time release restrictions United States Department of Health and Human Services/ Center for Disease Control — restricted to use according to the grant agreement and also according to time release restrictions Promises to Give — restricted until received Total

0

307,794

0

117,968

Q 100,000

20,000 645,762

NOTE 8 - COMPENSATED ABSENCES SALF has a vesting vacation policy. The amount of existing vacation time remaining as of December 31, 2003 and 2002 is immaterial.

NOTE 9 - DUE TO RELATED PARTY The organization's founder and current executive director, Carol Spizzirri, loaned SALF start up funding. As of December 3 1 , 2003 and 2002 the amount of this loan is $112,578 and $72,227, respectively. Interest is accrued annually using the Internal Revenue Service Applicable Federal Rates. 16

SAVE

A LIFE

FOUNDATION,

INC.

NOTES TO FINANCIAL STATEMENTS
For the Years Ended December 31, 2003 and December 31, 2002

NOTE 10 - LEASE OBLIGATION AND RENTAL EXPENSE The estimated future minimum rental and operating lease obligation for the succeeding years under non-cancelable leases for office facilities in effect at December 3 1 , 2003 are as follows: Year Ending December 31, 2004 2005 2006 Rent $88,940 97,715 105,231

Rental expense under the operating leases was $97,843 for the year ended December 3 1 , 2003 and $72,996 for the year ended December 3 1 , 2002.

NOTE 11 - SPECIAL EVENTS Special event income is shown at the gross amount in the Statement of Activities. Special event expense is also shown in the Statement of Activities. The following schedule details the gross income and expense componems for each event: December 31. 2003 Revenue Dinner Event Race For Life Other $ • 708 796 $1-504 Expenses $ 100 _11QQ $ 608 796 $1.404 Net December 31. 2002 Revenue Expenses $87,360 6,093 153 $93,606 1,158 214 Net 4,935 (61) $58,174 $29,186

$59,546 $34,060

17

5AVE

A LIFE

FOUNDATION,

INC.

STATEMENT OF FUNCTIONAL EXPENSES For the Year Ended December 31, 2002 SUPPORT
Managemnt. & General Fund raising Organization Total

Total
$ 12,649 178 1,236 95 378 2,400 6,009 30,355 17,059 917 1,949 767 71,601 2,296 1,784 593 20,747 (5,812) 3,472 5,988 30 1,992 6,077 633 239 14342 647 3,671 812 37,954 2,416 243,474 (133,677) 109,797

$

2,028 S 53 254 95 10 2,400 6,009 30,355 17,059 667 1,949 591 (11) 2,261 1,784 543 3,028 (5,812) 3,472 5,862 6 1,099 6,077 476 239 14,055 647 3,335 812 32,018 2,416 133,677 (133,677) -

10,621 125 982 368 250 176 71,612 135 50 17,719 126 24 893 157 287 336 _ 5,936 109,797 109,797

$

464,068 11,126 39,026 1,228 378 131,763 9,148 30,383 17,059 917 1,949 6,523 191,090 93,188 10,728 14,765 593 61.185 10,157 (6,346) 3,472 29.903 1,156 5,796 15,218 78,003 498 72,996 1,619 36,932 123,203 83,733 4,311 1,545,768 1,545,768

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 11

Tgf>^

.^LlUJNOIS CHARITABLE ORGANIZATION ANNUAL REPORT
01026498

D ^ n T > IP /■j^ttorney General LISA M A D I G A N State of Illinois Charitable Trust Bureau, 100 West Randolph C O 3rd Floor, Chicago. Illinois 60601 # Report for the Fiscal Period: Beginning pi
& Ending Federal ID # 3 6 - 3 8 6 9 4 5 9 Are contributions to the organization tax deductible?
:

Form AG990-U Revised 1/0

/ oi
/ 30

/ ri4
/ 04
YR

Check all items attached: Q Copy of IRS Return M O I K ) ! C3: Audited Financial Statements chwiiy 3 $15.00 Annual Report Filing Fei flur-KiFuna Q j-] nn.OO Late Report Filing Fee
MO
DAY

06
MO

VR

Yes O No

LEGAL N M Save A L i f e A E
MAIL

Foundation

Date Organization was created: Year-end amounts
A)ASSETS A) $

02/09

/ 93

1.403.584

ADDRESS9950
01T S

H

- L a u r e n c e S u i t e 300

B) LIABILITIES C) N E T ASSETS

B) s
C)S

333.611
1,069^973
AMOUNT

zip cooE S c h i l l e r Park, IL 60176

I. SUMMARY OF ALL REVENUE ITEMS DURING THE YEAR:
D) PUBLIC SUPPORT, CONTRIBUTIONS 8 PROGRAM SERVICE R E V . ( G R O S S AMTS.) E) GOVERNMENT G R A N T S & MEMBERSHIP DUES F) OTHER R E V E N U E S G) TOTAL REVENUE. INCOME AND CONTRIBUTIONS RECEIVED { A D D D.E. & F l

PERCENTAGE

10.04 90-11 M5)
%

* *

D)$ E>$
F ) $

115,844 1.040.000 (1.689: ■154.155

100%

G)$

II. SUMMARY OF ALL EXPENDITURES DURING THE YEAR:
H) I) J) OPERATING CHARITABLE PROGRAM EXPENSE EDUCATION PROGRAM SERVICE EXPENSE TOTAL CHARITABLE PROGRAM SERVICE EXPENSE [ADD H & l> *

/ «&-1fi %
%
H)S

LiUi6A.
151,664

i)i
J)$

84.16

Jt> JOINT COSTS ALLOCATED TO PROGRAM SERVICES (INCLUDED IN J): K) GRANTS T O OTHER CHARITABLE ORGANIZATIONS L) T O T A L C H A R I T A B L E PROGRAM SERVICE EXPENDITURE ( A D D J & K ) M) MANAGEMENT A N D GENERAL EXPENSE N) FUNORAISING EXPENSE O) T O T A L E X P E N D I T U R E S T H I S P E R I O D ( A D D L , M , & N>

%

K)S L)S M)$ N)S

84.16 % 11-84
% 4.00 %
100%

151.664 21.328 7.215 180.207

o>$

III. SUMMARY OF ALL PAID FUNDRAISER AND CONSULTANT ACTIVITIES:
(Attach Attorney Gener3l Report ot Indiutduat FuniiraiRing Campaign- Form IFC. Onn for n a i * PFR. PROFESSIOHAL FUNDRAISERS: P) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISERS Q) TOTAL FUNDRAISERS FEES AND EXPENSES R) NET RECEIVED B Y T H E CHARITY [P MINUS Q=R) PROFESSIONAL FUNDRAISIN6 CONSULTANTS: S) TOTAL AMOUNT PAID T O PROFESSIONAL FUNORAISING CONSULTANTS S)$

100%

P)S Q)$

IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS DURING THE YEAR:
T) NAME. TITLE: U) NAME. TITLE: V) NAME. TITLE:

Carol S p i z z i r r J . CEO Dane Neal. N a t i o n a l Proeram C o o r d i n a t o r Donna Achs. Accountant
A i d Training

T>$

20.000 21.663 L.923
CODE

U)S
V)$

V. CHARITABLE PROGRAM DESCRIPTION:cWAnrrflai.e PROGRAM p MGHSST BV I BC«NBED) CODE CATEGORIES

Usl on back side of instructions

W)jjESCRIPTION: Life
X) DESCRIPTION: )-DESCRIPTION:

S a v i n g

F i r s t

W)»

Oil

^ECEIVEEl
ATTORNEY GENERAL^ CHARITABLE TRUST

X)#

Y)#

IF THE ANSWER TO A N Y OF THE FOLLOWING IS YES, ATTACH A DETAILED EXPLANATION: 1. 2. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION. FINE, PENALTY OR JUDGMENT? HAS THE ORGANIZATION OR A CURRENT DIRECTOR, TRUSTEE. OFFICER OR EMPLOYEE THEREOF. EVER BEEN CONVICTED BY ANY COURT OF AMY MIOSOEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY? t.

2.

3.

DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES OWNS AN INTEREST; OR WAS IT A PARTY TO ANY TRANSACTION IN WHICH ANY DF ITS OFFICERS. DIRECTORS OR TRUSTEES HAS A MATERIAL FINANCIAL INTEREST; OR DID ANY OFFICER, DIRECTOR OR TRUSTEE RECEIVE AMYTHING OF VALUE NOT REPORTED AS COMPENSATION? 3. HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER, DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES? , IS ANY PROPERTY OF THE ORGANIZATION HELD I N THE NAME OF OR COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER?( ATTACH FORM IFC )

X

4

4.

5.

_ _ 5. B.

6.

7a. DID THE ORGANIZATION ALLOCATE THE COST OF ANY SOLICITATION, MAILING, ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES? _ '-

7b. IF ' Y E S ' . ENTER {i> THE AGGREGATE AMOUNT OF THESE JOINT COSTS | ;(ii> THE AMOUNT ALLOCATED TO PROGRAM SERVICES $ ; (Hi) THE AMOUNT ALLOCATED TO MANAGEMENT AND GENERAL $ ; AND [iv) THE AMOUNT ALLOCATED TO FUNDRAISING S B. DID THE ORGANIZATION EXPEND ITS RESTRICTED FUNDS FOR PURPOSES OTHER THAN RESTRICTED PURPOSES? HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION OR TAX EXEMPTION S U S P E N D E D OR REVOKED BY A N Y GOVERNMENTAL A G E N C Y ? 9.

8-

9.

10. WAS THERE OR DO YOU HAVE ANY KNOWLEDGE O F ANY KICKBACK, BRIBE. OR ANY THEFT, DEFALCATION MISAPPROPRIATION. COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS? 10. 11. LIST THE NAME, ADDRESS AND THE ACCOUNT # OF THE FINANCIAL INSTITUTIONS WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST ACCOUNTS:

Bank One. NA I l l i n o i s M a r k e t . P . O . Box 2 6 0 1 8 0 . B a t o n R o u g e . LA 7 0 8 2 6 - 0 1 8 0 W a c h o v i a Bank N . A . , P.O. Box 5 0 0 1 5 , R o a n o k e , VA 2 4 0 4 0 - 7 3 5 0 12. NAME AND TELEPHONE NUMBER OF CONTACT PERSON: C a r o l SDizzlrri (W) 928-9683

ALL ATTACHMENTS MUST ACCOMPANY THIS REPORT • SEE INSTRUCTIONS UNDER PENALTY OF PERJURY, 1 [WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS ANNUAL REPORT AND THE ATTACHED DOCUMENTS. INCLUDING ALL THE SCHEDULES A N D STATEMENTS AND THE FACTS THEREIN STATED ARE TRUE AND COMPLETE AND FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE STATE OF ILLINOIS RELY THEREUPON. I HEREBY FURTHER AUTHORIZE AND AGREE TO SUBMIT MYSELF AND THE REGISTRANT HEREBY TO THE JURISDICTION OF THE STATE OF ILLINOIS.

BE SURE TO INCLUDE ALL FEE5 DUE: 1 .> REPORTS ARE DUE WITHIN SIX MONTHS OF YOUR FISCAL YEAR END. 2.) FOR FEES DUE SEE INSTRUCTIONS. %.) REPORTS THAT ARE LATE OR INCOMPLETE ARE SUBJECT TO A StOO.OO PENALTY.

PRESIDENT or TRUSTEE (PRINT HAUE)

'

"cwaniikH

w

DATE

£%Q6tA{ /?. fa/low*
TREASURER or TRUSTEE (PRINT MfcKE]

PREPARER (PRINT NAME,

j i o i v n i ut

CHANGE IK ACCOUNTING fEKlUD
Form

990

Return of Organization Exempt from Income Tax
Under section 501(c), 527, or 4947(aXl) of the Internal Revenue Code (except black lung benefit trust or private foundation)

OMB No. 1545-0047

J2003"2bo4
Open to Public Inspection , 2004
Employer d»ntific»tfon Number

Department of the Treasury Internal Revenue Sewice

The organization may ha-je to use a copy of this return to satisfy state reporting requirements, Jan 1 ^-r^eag; and ending Jun 30
D C Please use IRS label or print or type. Stu specific instruc­ tions. Name of organization

A

For the 2003 calendar year, or tax year beginning
Check if applicable: Address change Name change Initial return Final return Amended return Application pending

2004
Room/suite

Save A L i f e Foundation
Number and street {or P.O. b o i if mail is not delivered to street arJdr)

36-3869459
Tel* nh o n * number

9950 Lawrence
City, town or country State

300
ZIP code+ 4

(847)
Accountin niet&od": " * it&od: \ \

928-9683
| | Cash | X j Accrual

Schiller

Park

IL

60176

Other (specify)* -

■ Section 501 (cX3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A (Form990or990-EZ).

H anil are not applicable lo setfion 527 organizations. H ( a ) Is this a oroup return for affiliates? . , . | H ( b ) If 'Yes.' enter number of affiliates * " H (C) Are all affiliates included 1 [ J Yes Q No (If rNo,h attach a list. See instructions.} H ( d ) Is this a separate return filed by an organization covered by a rjioup ruling? I I yes | x | fjo | Yes | X j Ha

G J K

Website: *■ www. s a T f . o r g Organization type
(Check oniy o n e ) *

,-,
\*\ 501(c) 3 * [insert no.)

■—,
1_J W 7 f . a ) H ) or

■ > —
1 I 527

Check here ** \_J if the organization's gross receipts are normally not more than $25,000. The organization neerj not file a return with the IRS; but if the organization received a Form 990 Package in the mail, it should file a return without financial data. Some states require a complete return. Gross receipts: Add lines 6b, fib, 9b, and 10b to line 12 *■ 1 , 1 5 4 , 7 5 5 . 1 Contributions, gifts, grants, and similar amounts received; a Direct public support b Indirect public support c Government contributions (grants)
d

I

Group Exemption Number . . , **

M

L

Check " □ if the organization is not required to attach Schedule 6 (Form 990,990-EZ, or S90-PF).

PartUISlf Revenue, Expenses, and Changes in Net Assets or Fund Balances (See instructions)
la lb 1c

87,988.

1,040,000.
Id

2 3 4 5

0.) Program service revenue including government fees and contracts (from Part VII, line 93) Membership dues and assessments Interest on savings and temporary cash investments
UMr&g^TW S 1,127,988. noncash $

1,127,988, 27,856.
9.

Dividends and interest from securities 6a Gross rents b Less: rental expenses c Net rental income or (loss) (subtract line 6b from line 6a) 7 Other investment income (describe *"

6a 6b

6c

(A) Securities (B) Other 8a Gross amount from sales of assets other than inventory I I 8a b Less: cost or other basis and sales expenses 8b c G m or (loss) (attach schedule) a 8£ d Net gain or (loss) (combine line 8c, columns (A) and (B)) , 9 Special events and activities (attach schedule). If any amount is from gaming, check here . a Gross revenue (not including $ 2 , 6 3 8 . of contributions 600. reported on line la) 9a b Less: direct expenses other than f undraising expenses 9b 600. c Net income or (loss) from special events (subtract line 9b from line 9a) .See. . L - 9 . . S t i n t 10a Gross sales of inventory, less returns and allowances 10a b Less: cost of goods sold 10b c Gross profit or (loss) from sales of inventory (attach schedule) (subtract line 10b from line 10a) 11 Other revenue (from Part VII. line 103) 12 Total revenue (add lines I d , 2, 3,4, 5, 6c, 7, 3d, 9c, 10c, and 11) 13 program services (from line 44, column (B)) 14 Management and general (from line 44. column (C))

*a

8d

9c

0,

10c 11 12 13 14 15 17

15 16 17 18 19

Fundraising (from line 44, column (D)) Payments to affiliates (attach schedule) Total expenses (add lines 16 and 44, column (A)) . Excess or (deficit) for the year (subtract line 17 from line 12) Net assets or fund balances at beginning of year (from Itne 73, column (A))

-1,698. 1,154,155. 151,664, 21,328, 7,215. 180,207.
973,948.
96,025.

11
20_ 21
TEEA0101 11^4/03

.20 ■ Other changes in net assets or fund balances (attach explanation) 21 Net assets or fund balances at end of year (combine lines 18,19, and 20) . BAA For Paperwork Reduction Act Notice, see the separate instructions.

1,069,973.
Form 99043663)-

2004

2004 tiorm 99Q4a963r Save A L i f e

Foundation

36-3869459
(B) Program services

Page 2

Part II

I S t a t e m e n t of F u n c t i o n a l E x p e n s e s All organizations must complete column (A). Columns (B), (C), and [0) are required tor section 501(c)(3) and (4) organizations and section 4947(a)(1) nonexempt charitable trusts but optional for others.

Do not include amounts reported on line 6b, 8b, 9b, 10b, or 16 of Part 1. 22 Grants and allocations (att sen) (cash $ non-cash $ ) 23 Specific assistance to individuals (att sch) 24 Benefits paid to or for members (att sch) 25 Compensation of officers, directors, etc 26 Other salaries and wages 27 Pension plan contributions 28 Other employee benefits 29 Payroll taxes 30 Professional fundraising fees

Ill
22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43a 43b 43c 43d 43e

(A) Total

(C) Management and general
1 1

(D) Fundraising

, ' •* * ; - ^
J i va

-,,
i

20,000, 27,907. -414. 4,646.

20J300. 27,907. -414. 4,646.

o.
0. 0. 0.

0. 0. 0. 0.

33 34 35 36 37 38 39 40 41 42 43

Supplies Telephone Postage and shipping Occupancy Equipment rental and maintenance Printing and publications Travel Conferences, conventions, and meetings Interest Depreciation, depletion, etc (attach schedule) Other expenses not covered above (itemize);

5,850. -35. 5,109. 543. 54.347.

5,850. 2. 5,109. 524. 54,347.

0. -37. 0, 0. 0.

0. 0. 0. 19. 0.

.,

11,392. 9,945. 6,323, 16,958. 260. 119. 1,000. 1,217. 15,040.

5,446. 9,945, 3,315. 0, -264. 119. 1,000. 1,217. 12,915.

0. 0. 3.008. 16,958. 524. 0. 0. 0. 875.

5,946. 0. 0. 0. 0. 0. 0. 0. 1,250.

a Bank Service Fees fa Computer Expenses c C o n s u l t i n g Fees d Dues & S u b s c r i p t i o n s
e See Other Expenses Stmt 44 Total functional expenses (add lines Z2 - 43). Organizations completing columns (B) - (D), carry these totals to lines 13-15

44 180,207. 151,664. 21,328. 7,215. Joint Costs. Check . *■__ if you are following SOP 98-2. Are any joint costs from a combined educational campaign and fundraising solicitation reported in (B) Program services? *L_\ Yes [X] No If 'Yes,' enter (i) the aggregate amount o( these joint costs $ ; (ii) trie amount allocated to Program services $ ; (Mi) the amount allocated to Management and general $ ; and (iv) the amount allocated to Fundraising $

Part t l i i

Statement of Program Service Accomplishments
Program Service Expenses
(Required fix 501(c)(3) and (4) organizations and 4947(3)0) trusts; But optcrcal for others.)

What is the organization's primary exempt purpose? _P£0JTI0te_ J . i . f e _ s a y J ng_ _f i _ r s t _ a j d All organizations must describe their exempt purpose achievements in a clear and concise manner. Slate the number of clients served, publications issued etc. Discuss achievements that are not measurable. (Section 501(c)(3) & (4) organizations and 4947f,a)f,1) nonexempt charitable trusts must also enter the amount of grants & allocations to others.)

a_K^d_'_s_Programs - Promotion and teaching o f l i f e saving

first

(Grants and allocations S b Corp_0£at^_Pr_ogr_aj_-__Prqriotion_a__rd_teachi ng^ _of _ l j f e_ _say_ijig f i rst_^ijd_tp_T_n_djvnjjjjal_5__ot_her__tfja_n_ 5^h^oT^-^g^^hi_l^r_en_^l_14_t_ajjgh_t2
[Grants and allocations $

±±
0. )

11,638.

8,021.

c AAVi_ed Jlealth_Gr_ant_ j_Prpmo_t_ion_ o f 3_^_gency__re__ri "chi ldren_ t o j i f er_enc_e_ _(1_0_0_attendees)

ng_

(Grants and allocations $

d Jxp_ans ton_P.r_ogr_ajn_-_ Jxparjd Jo_sj_tel_U te_ 2f.fJ ce_ i n s i d e and o u t s i d e the State of I l l i n o i s
(Grants and allocations $ e Other program services (Grants and allocations $ Total of Program Service Expenses (should equal line 44, column (B), Program services) ■ BAA
TEEAOI02 I0;03;03

±2
0.

20,000,

112,005. 151.664.
Form 9 9 0 ^ 6 * 3 7 2004

2004 Form990-geoff

Save A

Life

Foundation

36-3869459

Page 3

H Balance Sheets (See instructions)
Note; Where required, attached schedules and amounts within the description column should be for end-of-year amounts only. 45 Cash - non-interest-bearing 46 Savings and temporary cash investments 47 a Accounts receivable b l e s s : allowance for'doubrful accounts 48a Pledges receivable b Less: allowance for doubtful accounts 49 Grants receivable 50 (A) Beginning of year -5,556. 0 45

(B)
End of year 3,399. 9.892

46

47 a
47 b 48a 48b

13,415
0.

22,715.

47 c

13,415.

48c

1 0 0 , 0 0 0 . 49
50 51c 52 53 54

1,057,000.

Receivables from officers, directors, trustees, and key employees (attach schedule) 51 a Othar tries $. loansreceivable(attach stti) , , , 51a b Less: allowance for doubtful accounts 51b 52 Inventories for sale or use 53 Prepaid expenses and deferred charges 54 Investments — securities (attach schedule) 55a Investments - land, buildings, & equipment: basis , 55a b Less: accumulated depreciation (attach schedule) 56 Investments — other (attach schedule) 57a Land, buildings, and equipment: basis 55 b 57 a

67,019.
4,634.

54,371 10,968.

► □ Costly FMV

1
55c

362,771. 108,232.
.)--

b Less: accumulated depreciation (attach schedule) LT5.7. 5till t . 57b 58 Other assets (describe ** 59 Total assets (add lines 45 through 5B) (must equal line 74) 60 Accounts payable and accrued expenses 61 Grants payable 62 Deferred revenue 63 Loans Iran officers, directors, trustees, and key employees (attach schedule) 64a Tax-exempt bond liabilities {attach schedule) b Mortgages and other note; payable (attach schedule)

271,497,

57c 58

254,539.

4 6 0 , 3 0 9 . 59 2 8 , 7 9 6 . 60
61

1,403,584.
37,377,

139,648 194,416. 1,424.
364,284

62 63
64a 64b 65

157.655. 137,155. 1,424. 333,611

65 Other liabilities (describe ► See L i n e 65 S t f f l t >.. 66 Total liabilities (add lines 60 through 65) Organizations that follow SFAS117, check here |Xj and complete lines 67 through 69 and lines 73 and 74. 67 Unrestricted 68 Temporarily restricted 69 Permanently restricted Organizations that do nol follow SFAS 117, check here \ \ and complete lines 70 through 74. 70 Capital stock, trust principal, or current funds 71 Paid-in or capital surplus, or land, building, and equipment fund 72 Retained earnings, endowment, accumulated income, or other funds 73 Total net assets or fund balances (add tines 67 through 69 or lines 70 through 72; column (A) must equal line 19; column (B) must equal line 21) 74 Total liabilities and net assetsffund balances (add lines 66 and 73)

66

-3.975

100,000

66

-69.570. 1,139,543.

69

70 71 72

96,025
460,309

73 74

1,069,973. 1,403,584.

Form 990 is available for public inspection and, for some people, serves as the primary or sole source of information about a particular organization. How the public perceives an organization in such. cases may be determined by the information presented on its return. Therefore, please make sure the return is complete and accurate and fully describes, in Part III, the organization's programs and accomplishments. BAA

TEEA0103

10/0l;03

2004 Form990-gaBr Save A Life Foundation

36-3869459
P a r H y - t t ; , I R e c o n c i l i a t i o n of E x p e n s e s p e r A u d i t e d Financial S t a t e m e n t s w i t h E x p e n s e s per R e t u r n a b Total expenses and losses per audited financial statements *• Amounts included on line a but not on line 17, Form 990: O ) Donated serv­ ices and use of facilities

Page 4

f j a r i l V - A } R e c o n c i l i a t i o n of R e v e n u e p e r A u d i t e d Financial S t a t e m e n t s w i t h R e v e n u e per R e t u r n ( S e e i n s t r u c t i o n s . ) a i Total raienue, gains, aid other support per audited financial statements Amounts included on line a but not on line 12, Form 990: (1) Net unrealized gains on investments (2) Donated serv­ ices and use of facilities (3) Recoveries of prior year grants (4) Other (specify): See A t t a c h e d

1,227,755

_25_3L807.

$

$__

72,500.

$_ $_

72,500.

(2) Prior year adjust­ ments reported on line 30, Form 990 . . . . $__ (3) Losses reported on line 20, Form 990 — $ (4> Other (specify); See A t t a c h e d 7^,600 $ 1,100. Add amounts on lines (1) through (4) Line a minus line b Amounts included on line 17, Form 990 but not on line a: O ) Investment expenses not included or line 5b, Form 390 (2) Other (specify):

1,100. $ Add amounts on lines (1) through (4) "• Line a minus line b *■
Amounts included on line 12, Form 990 but not on line a: CO Investment expenses not included on lire 6b, Form 990 $ (2) Other (specify): $ Add amounts on lines (1) and ( 2 ) . . .

73 600 180 Mf.

$_

$ Add amounts on lines (1) and (2)

Total revenue per line 12, Form Total expenses per line 17, Form 990 (line c plus lined) 990 (line c plus line ti) 1,154,155. 180,207 Part V I 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 instructions.) (C) Compensation <B) Title and average hours (D) Contributions to (E) Expense per week devoted (if nol paid, employee benefit account and other (A) Name and address to position enter -0-) plans and deferred allowances compensation _Carp_l_Sj)jzz_i_rrl Chai rman/Exec Rita Mullins Dir40 20,000.

1,334.

0.

Chai rwoman Peggy Trimble Vice Chairwoman Nadine Levick Secretary .Doug. Browne Treasurer
See List of Officej^Elc^ Statement _

0. 0.

0. 0. 0. 0.

0.

0.

0 75 Did any officer, director, trustee, or key employee receive aggregate compensation of more than $100,000 from yout organization and all related organizations, of which more than $10,000 was provided by the related organizations? H 'Yes,' attach schedule - see instructions. BAA
TEEA01M 10/02/03

0.

►Qre*

(*>o
Form 99CH2003) 2004

2004 Form 990 ffee3)- Save A L i f e Foundation Part-V);; Other Information (See instructions)
76

36-3869459
Yes 76 77 78a 7Bb 79

Page 5 No

Did the organization engage in any activity not previously reported to the IRS? If 'Yes,' attach a detailed description of each activity 77 Were any changes made in the organizing or governing documents but not reported to the IRS? If 'Yes,' attach a conlormed copy of the changes. 78a Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return? b If 'Yes,1 has it filed a tax return on Form 990-T for this year? 79 Was there a liquidation, dissolution, termination, or substantial contraction during the year? If 'Yes,' attach a statement

80a Is the organization related (other than by association with a statewide or nationwide organization) through common 80 a membership, governing bodies, trustees, officers, etc, to any other exempt or nonexempt organization? b If 'Yes,' enter the name of the organization *• and check whether it is \_] exempt or _j nonexempt. 81 a Enter direct and indirect political expenditures. See line 81 instructions | 81 a| CK b Did the organization file Form 1120-POL for this year? 81b 82 a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially less than fair rental value? blf 'Yes,' you may indicate the value of these items here. Do not include this amount as . . revenue in Parti or as an expense in Part II. (See instructions in Part III.) 82b| 83a Did the organization comply with the public inspection requirements for returns and exemption applications? b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? 84 a Did the organization solicit any contributions or gifts that were not tax deductible? 82a

73,000.
83 a 83 b 84a 84b 85a 85b

X

b l( 'Yes,' did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? 85 501(c)(4), (3J, or (6) organizations, a Were substantially all dues nondeductible by members? b Did the organization make only in-house lobbying expenditures of $2,000 or less? If 'Yes' was answered to either 85a or 85b, do not complete 85c through 85h below unless the organization received a waiver for proxy tax owed for the prior year. c Dues, assessments, and similar amounts from members d Section 162(e) lobbying and political expenditures e Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices I Taxable amount of lobbying and political expenditures (line 85d less 85e) g Does the organization elect to pay the section 6033(e) tax on the amount on line 85f? 85 c 85 d

85e
851 85q 85 h
S3idS"BK*J~;3

h If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount on line 851 to its reasonable estimate of dues allocable to nondeductible lobbying aid political expenditures for the following tax year? 86 501(c)(7) organizations. Enter; a Initiation tees and capital contributions included on a 86a line 12 86b b Gross receipts, included on line 12, for public use of club facilities 87a 87 501 (c)02) organizations. Enter; a Gross income from members or shareholders b Gross income from other sources. [Do not net amounts due or paid to other sources against amounts due or received from them.) 87b

88 At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or partnership, or an entity disregarded as separate from the organization under Regulations sections 301.7701 -2 and 301.7701 -3? If 'Yes,' complete Part IX 89a 501(c)(3) organizations. Enter: Amount of tax imposed on the organization during the year under: section49H *■ 0_^ ; section 4912"0 ^ ; section 4955 ► 0. b 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year? If 'Yes,' attach a statement explaining each transaction c Enter Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958 d Enter: Amount of tax on line 89c, above, reimbursed by the organization *■ *

88

89b 0. 0.

90 a List the states with which a copy of this return is filed " J I U j 1 O T _ S _ , _ W i _ s c o n _ s j n , _ Pe_n_nsy_\varvi_a b Number of employees employed in the pay period that includes March 12, 2003 (See instructions.) \90b\ 91 The boohs are in care of - ^ a r _ q l _ S p J zz_i_r_r i Telephone number ► _(84L7J_9_28^9_6_83 Located at *■ _?950_ L a w r e n_ce_ SuJ t e J 0 O , _ S c h i _ l l . e r _ f a r _ k _ I _ L 92 Section 4947(a)(1) nonexempt charitable trusts filing Form 990 In lieu of Form 1041 — Cneck here and enter the amount of tax-exempt interest received or accrued during the tax year BAA
TEEAO105 12<23rt)3

Z I P + 4 ■- i 0 1 _ 7 J > _ V J H 92 |

:

n

Form 990 ( 2 0 8 ^ —

2004

2004 Form990-{2SQ3)JSave A L i f e F o u n d a t i o n P a r t VUU A n a l y s i s of I n c o m e - P r o d u c i n g A c t i v i t i e s (See instructions. Note: Enter gross amounts unless otherwise indicated. 93 Program service revenue: a P r o g r a m Fees Unrelated business income (A) (B) Susinsss code Amount

36-3869459
Excluded by section 512, 513, or 514 Exclusion code C) D Amount

Page 6

(E) Related or exempt function income

b Course Materials c Branch Fee
d

23,160. 1,340.
3,356.

e
f Medteare/Medicaid payments g Fees 5 contracts from government agencies . . 94 Membership dues and assessments .. 95 Interest on savings & temporary cash invmnts . 96 Dividends & interest from securities ., 97 Net rental income or (loss) from real estate; a debt-financed property b not debt-Jmanced property 98 Netrentalincome or (loss) from pens prop 99 Other investment income 100 Gam or (loss) from sales of assets other lhan inventory 101 Net income or (loss) from special events 102 Gross profit or (loss) from sales ol inventory 103 Other revenue: a b Miscellaneous c d

14

W^mmmomM

-1.698.

e
104 Subtotal (arid columns (B), CD), and (E)) . . . mi 9. 105 Total (add line 104, columns (B), (D). and (E» Note: Line 105 plus line Id, Part I, should equal the amount on line 12, Part I. Part VIII: Relationship of Activities t o the A c c o m p l i s h m e n t o f Exempt P u r p o s e s (See instructions.) Line No.

26,158. 26,167,

Explain how each activity for which income is reported in column (E) ol Part VII contributed importantly to the accomplishment of the organization's exempt purposes (other than by providing funds for such purposes). to perform and c a r r y out the life

93a - 93cPromote and teach life saving first aid programs.
103a To s u p p l e m e n t f u n d i n g r e q u i r e d saving f i r s t aid programs.

Information Regarding Taxable Subsidiaries and D i s r e g a r d e d Entities (See instructions.) (A) (B) (D) Percentage of Name, address, and EfN u l w r p u i a l i u n Total Nature of activities ownership interest partnership, or disregarded entity income % %

MM (E) End-of-year assets

PartX-.| Information Regarding Transfers A s s o c i a t e d w i t h Personal Benefit C o n t r a c t s (See instructions. a Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? b Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? Note: If 'Yes' to 0), file Form 8870 andForm 4720 (see instructions).
Under penalties of penurv, I declare thai I have e«amined this return, including accompanying schedules and statements, and to the best of mv knowledge and belief. it is true, correct, ana complete. Declaration ot preparer (Other than officer) is based on all information ol which preparet has any knowledge.

Please Sign Here

Signature of officer

Date

Type or print name and title

Paid Pre­ pared Use Only
BAA

Pruparer's signature Firm's.name (or

Date

10/26/04
A h l b e c k & Company ► 1665 E l k B l v d . Des P l a i n e s

Check if selfemployed

r—| *" I

Preparer's SSN or PTIN (see General Instriidion W)

eXyedf ife5'3""

EIN

IL

60016

Phone no.

»

( 8 4 7 ) 1CI03J03

8 2 4 - 4 0 0 0

TEEA0106

Form 998-(£Be3} 2004

SCHEDULE A
(Form 990 or 990-EZ)

Organization Exempt Under Section 501 (cX3)
(Except Private Foundation) and Section 501(e), 501(f), 501 (k), 501(11), or Section 4947(a)(1) Nonexempt Charitable Trust
Supplementary Information — (See separate instructions.)

OMB No. 1545-OM7

2004

-2003Employer id entificirlior number

Department of the Treasury Internal Revenue Service Name of lhe organisation

*■ MUST be completed by the above organizations and attached to their Form 990 or 990-EZ.

Save A Life Foundation 36-3869459 Pattl Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees
(See instructions. List each one. If there are none, enter 'None.') (a) Name and address of each employee paid more than $50,000 (b) Title and average hours per week devoted to position (c) Compensation (d) Contributions to employee benefit plans and deferred compensation (e) Expense account and other allowances

None

Total number of other employees paid over $50,000

None

BMWl\

. Compensation of the Five Highest Paid Independent Contractors for Professional Services 1
(See instructions. List each one (whether individuals or firms). If there are none, enter 'None.') (b) Type of service (c) Compensation

(a) Name and address of each independent contractor paid more than $50,000

None

Total number of others receiving over None $50 000 for professional services *• BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 and Form 990-EZ.
TEEA0401 0&28/03

Schedule A (Form 990 or 990-EZ)-£e03—

2004

2004 Schedile A (Form 990 or 990-EZ)-aees-

Save A L i f e

Foundation

36-3869459
Yes

Page 2
No

R i f t . f l O t I Statements About Activities (See instructions.)
1 During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislalive mailer or referendum? If 'Yes,' enter the total expenses paid o" incurred in connection with the lobbying activities *■ $ (Must equal amounts on line 38, Part VI-A, or linei of PartVI-B.) Organizations that made an election under section 501 (h) by filing Form 5768 must complete Part Vl-A. Other oganizations checking 'Yes,' must complete Part 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 substantial contributors, trustees, directors, officers, creators, key employees, or members ol their families, or with any taxable organization with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary? (if the answer to any question is 'Yes,' attach a detailed statement explaining the transactions.) a Sale, exchange, or leasing of property? b Landing of money or other extension of credit? c Furnishing of goods, services, or facilities? See P a r t V , d Payment of compensation (or payment or reimbursement of expenses if more than $1,000)? e Transfer of any part of its income or assets? 3a Co you make grants for scholarships, fellowships, student loans, etc? (If 'Yes,' attach an explanation of how you determine that recipients qualify lo receive payments.) b Co you have a section 403(b) annuity plan for your employees? 4 Cid you maintain any separate account for participating donors where donors have the right to provide advice t f;'> r, ins use or distribution of t..r.As? Form 990

2a
2b

2c 2d

2e
3a 3b

IjfiHiiiyil^ll Reason for Non-Private Foundation Status (See instructions.)
The organization is not a private foundation because it is: (Please check only ONE applicable box.) 5 A church, convention of churches, or association of churches. Section 170(b)(l)(A)(i). 6 " A school. Section 170(b)(1)(A)(ii). (Also complete Part V.) 7 _ A hospital or a cooperative hospital service organization. Section 170(b)(l)(A)(iii). 8 A Federal, state, or local government or governmental unit. Section 170(b)(1)(A)(v). 9 _ A medical research organization operated in conjunction with a hospital. Section 170(b)(l)(A)(iii). Enter the hospital's name, city, and state *■ 10 n An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(1)(A)(iv). (Also complete the Support Schedule in Part IV-A.) 11a |X~| An organization that normally receives a substanHal part of its support from a governmental unit or from the general public, Section 170(b)(l)(A)(vi). (Also complete the Support Schedule in Part IV-A.) 11b Q A community trust. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV-A.) 12 0
An

organization that normally receives; (1) more than 33-1/3% of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc, functions - subject to certain exceptions, and (2) no more than 33-1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 3D, 1975. See section 509(a)(2). (Also complete the Support Schedule in Part IV-A.)

13

D An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in: (1) lines 5 through 12 above; or (2) section 501(c)(4), (5), or (6), if they meet the test of section 509(a)(2). (See section 509(a)(3).) Provide the following information about the supported organizations. (See instructions.) (a) Name(s) of supported organization(s) (b) Line number from above

14 BAA

| An organization organized and operated to test for public safety. Section 509(a)(4). (See instructions.) TEEAM02 C]/19/M Schedule A (Form 990 or Form 990-EZ)^Bej

2004 Schedule A (Form 990 or 990-EZ).g90r J

Save A L i f e

Foundation

36-3869459

Page 3

paftJVfrACl S u p p o r t S c h e d u l e (Complete only if you checked a box on line 10, 11, or 12.) Use cash method of 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) 15 Gifts, grants, and contributions received. (Do not include unusual grants. See line 28.) .. 16 Membership fees received -a?0S 2003

■ 2002 1 1.371,684.

-2600 2001
820,282.

-W99 2 0 0 0 682,878.

Total

448,621.

3.323,465.

17 Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is related to the organization's charitable, etc, purpose 18 Gross income from interest, dividends, amounts received from payments on securities loans (section 5l2(aX5)), rents, royalties, and unrelated business taxable income (less section 511 taxes) Irom businesses acquired by the organ­ ization after June 30.1975 19 Met income !rom unrelated business activities not included in line IS .. 20 Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf 21 The value of services or facilities furnished to the organization by a governmental unit without charge. Do not

120,316.

207,836

197,535,

52,664,

578.351

795

2.154.

3.275,

8,725.

14,949,

include the value of services or

facilities generally furnished to the public without charge 22 Other income. Attach a schedule. Do not include gain or (loss) from sale ol capital assets 23 24 25 26 Total of lines 15 through 22 569,732. 1,581,674. 1,021,092. 744,267. Line 23 minus line 17 823,557. 449,416. 1.373,838. 691,603. Enter 1%ot line 23 5.697. 15,817. 10.211. 7.443. Organizations described on lines 10 or 11: a Enter 2% of amount in column (e), line 24 26 a b Prepare a list for your records to snow the name of and amount contributed by each person (other than a governmental unit or publicly supported organization) whose total gifts for 1999 through 2 C exceeded the amount shown in line 26a. Do not file this list with your DZ return. Enter the total of all these excess amounts , c Total support for section 509(a)(1) test: Enter line 24, column (e) 26 c d Add; Amounts from column (e) for lines: 18 14, 949 . 19 22 26b 26 d 0.

3,916.765. 3,338,414.
iSi^sS^"'^"-*!^^ \ 66,768.

,338,414.
!slHr8As , S&

14,949.
3,323.465.

e Public support (line 26c minus line 26d total)

26 c

I Public support percentage (line 26e (numerator) divided by line 26c (denominator)) 26f 99.55 27 Organizations described on line 12: a For amounts included in lines 15, 16, and 17 that were received from a 'disqualified person,' prepare a list for your records to show the name of, and total amounts received in each year from, each 'disqualified person.' Do not file this list with your return. Enter the sum of such amounts for each year: (2001) (2000) (1999) (2002)

%

bFor any amount included in line 17 that was received from each person (other than 'disqualified persons'), prepare a list for your records to show the name of, and amount received for each year, that was more than the larger of 0 ) the amount on line 25 for the year or (2) $5,000. (Include in the list organizations described in lines 5 through 1), as well as individuals.) Do not file this list with your return After computing the difference between the amount received and the larger amount described in (1) or (2), enter the sum of these differences (the excess amounts) for each year; (2002) (2001) c Add: Amounts from column (e) for lines: 17 d Add: Line 27a total (2000) 15 20 and line 27b total 16

(1999) 21
27 c 27d

27 h 28 Unusual Grants: For an organization described inline 10, 11, or 12 that received any unusual grants during 1999 through 2002 prepare a list for your records to show, for each year, the name of the contributor, the date and amount of the grant, and a brief description of the nature of the grant. Do not tile this list with your return. Do not include these grants in line 15. BAA
TEEA0403 0Sf29rt)3

e Public support {line 27c total minus line 27d total) f Total support for section 509(a)(2) test: Enter amount from line 23, column (e) . . . *■[ 27 f g Public support percentage (line 27e (numerator) divided by line 27f (denominator)) h Investment income percentage (line 18, column (e) (numerator) divided by line 27f (denominator)) .,

27e 2Za

Schedule A (Form 990 or 990-EZ) 2063— 2004

2004 Schedule A (Form 990 or 990-EZ) 2993~ S a v e

A Life

Foundation

36-3869459 N/A
Yes

Page 4

PiBirfcVvSs:j Private School Questionnaire (See instructions.)
(To be completed ONLY by schools that checked the box on line 6 in Part IV) No

29

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

29
30

30

31

31

32 Does the organization maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative staff? . b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student admissions, programs, and scholarships? d Copies of all material used by the organization or on its behalf to solicit contributions? If you answered 'No' to any of the above, please explain. (If you need more space, attach a separate statement.)

32a 32b 32c 32d

33

Does the organization discriminate by race in any way with respect to: a Students' rights or privileges? b Admissions policies? c Employment of faculty or administrative staff? d Scholarships or other financial assistance? e Educational policies? f Use of facilities? g Athletic programs? h Other extracurricular activities? If you answered 'Yes' to any of the above, please explain. (If you need more space, attach a separate statement.) 33 a 33b 33c 33d 33e 33 f

Ma.
33 h

34a Does the organization receive any financial aid or assistance from a governmental agency? b Has the organization's right to such aid ever been revoked or suspended? If you answeted 'Yes' to either 34a or b, please explain using an attached statement35 Does the organization certify that it has compled with the applicable requirements of sections 4.01 through 4.05 of Rev Proc 75-50. 1975-2 C.B. 587, covering racial nondiscrimination? If 'No,' attach an explanation BAA
TEEA04O4 OS/28103

34a 34b

35 Schedule A (Form 990 or 990-EZ) 2 0 6 3 —

2004

2004 Schedule A (Form 990 or 990-EZ)^8ey

Save A L i f e Foundation Eja"rt"#feA%j Lobbying Expenditures by Electing Public Charities (See instructions.)
(To be completed ONLY by an eligible organization that filed Form 5768) |if the organization belongs to an affiliated group.

36-3869459

Page 5

Check

Check *■ b I I if you checked 'a' and 'limited control' provisions apply, (a) Affiliated group totals

Limits on Lobbying Expenditures
(The term 'expenditures' means amounts paid or incurred.) 36 Total lobbying expenditures to influence public opinion (grassroots lobbying) 37 Total lobbying expenditures to influence a legislative body (direct lobbying) 38 Total lobbying expenditures (add lines 36 and 37) 39 Other exempt purpose expenditures 40 Total exempt purpose expenditures (add lines 38 and 39) 41 Lobbying nontaxable amount. Enter the amount from the following table — If the amount on line 40 is The lobbying nontaxable amount is — Not over $500,000 20% of the amount on line 40 ' Over $500,000 tut not over $1,000,000 $100,000 plus 15% of the excess over $500,000 Over $1,000,000 but not over $1.500,000 $175,000 plus 10% of the excess over $1,000,000 Over $1,500,000 but not over $17,000,000 $225,000 plus 5% of the excess over $1,500,000 Over $17,000,000 $1,000,000 42 Grassroots nontaxable amount (enter 25% ot line 41) 43 Subtract line 42 from line 36. Enter -0- if line 42 is more than line 36 44 Subtract line 41 from line 38. Enter -0- if line 41 is more than line 38 Caution: If there is an amount on either line 43 or line 44, you must file Form 4720.

0»)
To be completed for ALL electing organizations

36
37 36

39
40

41

42 43 44
TEST

PiiiSHt-

4 - Y e a r A v e r a g i n g P e r i o d U n d e r S e c t i o n 501 (h) (Some organizations that made a section 501 (h) election do not have to complete all of the five columns below. See the instructions for lines 45 through 50.) Lobbying Expenditures During 4 -Year Averaging Period Calendar year (or fiscal year beginning in)» 45 46 Lobbying nontaxable amount Lobbying ceding amount (150% of line 45(e)) .. (a) 2003 (b) 2002 (c) 2001 (d) 2000 00 Total

47 Total lobbying expenditures . 48 Grassroots nontaxable amount .. 49 Grassroots ceiling amount (150% af line 48(e)) . . . 50 Grassroots lobbying expenditures
i.'-.-S cJIrTr'.'Cii

i P f l r t y t e B S l L o b b y i n q A c t i v i t y b y N o n e l e c t n g Public C h a r i t i e s -A) (For reporting only by organizations that did not complete Part VI-, (See instructions.) During the year, did the organization attempt to influence national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of: Yes No Y b Paid staff or management (Include compensation in expenses reported on lines c through h.) X X X X X X X Amount

,

<
i

g Direct contact with legislators, their staffs, government officials, or a legislative body h Rallies demonstrations, seminars, conventions, speeches, lectures, or any other means

>
If 'Yes' to aiy of Ihe above, also attach a statement giving a detailed description of the lobbying activities. BAA
TEEAM05 08/28/03

Schedule A (Form 990 or 990-EZ)-3eW—

2004

2004 Schedule A (Form 990 or 990-EZj 2S8T Save A L i f e Foundation

36-3869459

Page 6

?mm
51

Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations (See instructions)

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) organizations) or in section 527, relating to political organizations? a Transfers from the reporting organization to a noncharitable exempt organization of: Yes No (i)Cash X 51 a 0) a(ii) X (ii)Other assets b Other transactions: (i)Sales or exchanges of assets with a noncharitable exempt organization b(i) X X (il) Pur chases ot assets from a noncharitable exempt organization b(ii) (iii) Rental of facilities, equipment, or other assets - -. bC'ii) (iv) Reimbursement arrangements b(iv) b(v) (v)Loans or loan guarantees b(vi) (vi)Performance of services or membership or fundraising solicitations c Sharing of facilities, equipment, mailing lists, other assets, or paid employees — c d It the answer to any of the above is 'Yes,' complete the following schedule. Column (b) should always 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 value in any transaction or sharing arrangement, show in column [dj the value of the goods, other assets, or services received: X X X X X

Line no.

(b) Amount involved

Name of noncharitable exempt organization

Description of transfers, transactions, and sharing arrangements

52a Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations b 1 'Yes,' complete the tollowinq schedule: 1 (a) Name of organization (b> Type of organization (c) Description of relationship

BAA

TEEAO406

09/05/03

Schedule A (Form 990 or 990-EZ)-2Q6J-"

2004

Form

8868

{December 2000}
Department of the Treasury internal Revenue 5 e m t e

Application for Extension of Time to File an (Exempt Organization Return

0MB No. 1-45-170.

*• File a separate application tor each return. * If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box * If you are filing for an Additional (not automatic) 3-Month Extension, complete only Part II (on page 2 ol this form). Note: Do not complete Part II unless you have already been granted an automatic 3-month extension on a previously filed Form8868. PSft":lf_"^| A u t o m a t i c 3 - M o n t h E x t e n s i o n o f T i m e — Only submit original [no copies needed) Note: Form 990-7 corporations requesting an automatic 6-month extension — check this box and complete Part I only

w
* [_]

AH other corporations (including Form 990-C filers) must use Form 7004 to request an extension of time to file income tax returns. Partnerships, REMICs and trusts must use Form 8736 to request an extension of time to file Form 1065, f066, or 1041.
Name of Exempt Organizalion Empleyar {dmtificaiion number

Type or print Save A L i f e F o u n d a t i o n File by the due date for Murfflbei, sfceeV and room or suite nuntbef. If a P.O.ban, see _n__A_uctLon£ filing your return. See 9950 Lawrence , #300 instructions. City, town or post office. For a foreign address, see Instructions.

36-3869459
state

ZiPcoOe

Schiller

Park

IL

60176

Check type of return to be filed (file a separate application for each return): Form 990-T (corporation) X Form 990 Form 4720 Form 990-BL Form 990-T (Section 401(a) or 408(a) trust) Form 5227 Form 990-EZ Form 990-T (trust other than above) Form 6069 Form 1041-A Form 990-PF Form 8870 If the organization does not have an office or place of business in the United States, check this box *~ \ \ ► If this is for a Group Return, enter the organization's tour digit Group Exemption Number (GEN) . If this is for the whole group, check this bos . *• Q , If it is for part of the group, check this box .. *■ O and attach a list with the names and EINs of all members the extension wilt cover, 1 I request an automatic 3-month (6-month, for 990-T corporation) extension of time until F e b 15 , 20 0 5 , to file the exempt organization return for the organization named above. The extension is for the organization's return for: calendar year 20 or tax year beginning Jan 1 , 2 0 0 4 , and ending J u n 30 ,20 0 4 . 2 It this tax year is tor less than 12 months, check reason: Q Initial return [_J Final return | x ] Change in accounling period 3a If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any nonrefundable credits. See instructions b If this application is for Form 990-PF or 990-T, enter any refundable credits and estimated tax payments made. Include any prior year overpayment allowed as a credit c Balance Due. Subtract line 3b from line 3a. Include your payment with this form, or, if required, deposit with FTD coupon or, if required, by using EFTPS (Electronic Federal Tax Payment System). See instructions $ $

Signature and Verification
Under < ™ » n i « r^ net jury. I declare thai I have e « mined this return, including accompany mo schedules and statements, and to the best of my kjiowleilge and belief, it is true, correct, and completi "" ------

Signatu

Trtle

c#

Date

■ fo/zt/£f »
Form 8868 (12-2000)

BAA For Paperwork Reduction Act Notice, see instructions.

FIFZ0501

O1/05/04

Save A Life Foundation

36-3869459

1

Form 990, Page 1, Part I, Line 9 Special Events and Activities Statement List of Three Largest Events and Type and Number of Others Race Other Net Income (Loss) 0. 0.

Gross Receipts 2,588. 650.

Less Contributions 2,588. 50.

Gross Revenue 0. 600.

Less Direct Expenses 0. 600.

Total

3,238.

2,638.

600.

600.

(K

Form 990, Page 2, Part II, Line 43 Other Expenses Stmt (A) Total (B> Program services 7,721. 3,446. 20. 10. 1.909. 867. 670. -5,531. 1.803. 0. 2,000. (C) Management and qeneral 0. 607. 0. 0. 0. 0. 0. 0. 193. 75. 0.

Other expenses not covered above (itemize): I n s t r u c t o r s Fees Insurance Licenses & Permits Marketing Mi s c e l l a n e o u s Payroll Service Recruitment Cost o f Goods S o l d Website Bad Debt Expense P r o f e s s i o n a l Fees

Fundraising

7.721. 4,053. 20. 1,260. 1.909. 867. 670. -5,531. 1,996. 75. 2.000.

0. 0. 0. 1,250. 0. 0. 0. 0. 0. 0. 0.

Total

15,040.

12.915.

875.

1.250.

Form 990, Page 3, Part IV, Lines 57a & 57b Land, Buildings and Equipment Statement

(a) Cost/Other Basis 1 and Building O f f i c e Equipment Vehicles 20.000. 181,912. 121,727. 39.132.

(b) Accumulated Depreciation 0. 9.096. 83,477. 15.659.

(c) Book Value

20.000. 172,816. 38.250, 23.473.

Total

362,771,

108,232.

254,539.

Form 990, Page 3, Part IV, Line 65 Other Liabilities Statement Beginning of Year End of Year

Line 65 - Other Liabilities:

Save A Life Foundation

36-386S459 Continued

2

Form 990, Page 3, Part IV, Line 65 Other Liabilities Statement Beginning of Year

Line 6 5 - O t h e r Liabilities:

End of Year

Total

1,424.

1,424.

Form 990, Page 4, Part V List of Officers, Etc. Statement

(A) Name and address

(B) Title and average lours per week devoted to position

(C) Compensation (if not paid, enter -0-)

(D) Contributions to employee benefit plans and deferred compensation

(E) Expense account and other allowances

Mark

Mitchell Director 0. 0. 0.

Irv

Bock Director 0. 0, 0.

Steve

OrebauEh Director 0. 0. 0.

Joseph

Sabato Director 0. 0. 0.

Note: The individuals above, except as noted, spend time as needed in t h e i r capacity on the Board, They can be contacted c/o Save a L i f e Foundation, 9950 Lawrence 5te3Q0, Schiller Park, IL6017S

Total 0. 0. 0.

Save A Life Foundation

36-3869459

3

Supporting Statement of: Form 990 p 2 / L i n e 42 column (C) Description D e p r e c i a t i o n Expense - O f f i c e Expense D e p r e c i a t i o n Expense - V e h i c l e D e p r e c i a t i o n Eoxense - B u i l d i n g Total Amount 8,497. 3,913. 4,548. 16,958

Supporting Statement of: Form 990 p 3 / L i n e 63, column (A) Description Due t o Carol S p i z z i r r i , P r e s i d e n t / E x e c . Di r e c t o r I n t e r e s t Rate - V a r i a b l e Total Amount 139,648.

139,648.

Supporting Statement of: Form 990 p 3 / L i n e 64b, column (A) Description Mortgage Dated 4 / 2 8 / 0 3 , o r i g i n a l amount: $200,000 due d a t e : 4 / 2 8 / 0 4 , i n t e r e s t r a t e : 4.25% Total Amount 194,416.

194,416.

Supporting Statement of: Form 990 p 3 / L i n e 63, column (B) Description Due t o Carol S p i z z i r r i , P r e s i d e n t / E x e c . Di r e c t o r I n t e r e s t Rate - V a r i a b l e Total Amount 157.655.

157,655.

Save A Life Foundation Supporting Statement of:

36-3869459

1

Form 990 p 3 / L i n e 64b, column Description

(B) Amount 137.155.

Mortgage Dated 4 / 2 8 / 0 3 , o r i g i n a l amount: $200, 000 due d a t e : 7 / 2 8 / 0 4 , i n t e r e s t r a t e : 4,25% Total

137,155.

Supporting Statement of: Form 990 p 4 / P a r t IV-A, Line b ( 4 ) Amount 600. 500.

Description Special Events Expense Donated M a t e r i a l s Total

1.100.

Supporting Statement at: Form 990 p 4 / P a r t IV-B, Line b(4) Description Special Events Expenses Donated M a t e r i a l s Total Amount 600. 500.

1,100.

AHLBECK&COMPANY
SAVE A LIFE FOUNDATION, INC. AUDITED FINANCIAL STATEMENTS JUNE 30, 2004 AND DECEMBER 31, 2003
CERTIFIED PUBLIC ACCOUNTANTS

SAVE

A LIFE

FOUNDATION,

INC.

TABLE

OF

CONTENTS

June 30, 2004 and December 31, 2003

AUDITOR'S REPORT FINANCIAL STATEMENTS Comparative Statements of Financial Position June 30, 2004 and December 31, 2003 Statements of Activities For the Six Months Ended June 30, 2004 and the Year Ended December 31, 2003 Statements of Functional Expenses For the Six Months Ended June 30, 2004 and the Year Ended December 31, 2003 4

8

Comparative Statements of Cash Flows 12 For the Six Months Ended June 30, 2004 and the Year Ended December 31, 2003 NOTES TO FINANCIAL STATEMENTS 13

AHLBECK&COMPAKY
CERTIFIED PUBLIC ACCOUNTANTS 1665 ELK BOULEVARD DES PLAINES, ILLINOIS 60016-4776 TELEPHONE: 8+7/814-4000 FACSIMILE: 847/824-1012 WED: www.ahlbecfcco.com

October 5, 2004 To the Board of Directors Save A Life Foundation, Inc. Schiller Park, Illinois INDEPENDENT AUDITOR'S REPORT

We have audited the accompanying statements of financial position of SAVE A LIFE FOUNDATION, INC. (an Illinois not-for-profit corporation) as of June 30, 2004 and December 31, 2003, and the related statements of activities, functional expenses, and cash flows for the six months and year then ended. These financial statements are the responsibility of the organization's management. Our responsibility is to express an opinion on these financial statements based on our audits. We conducted our audits in accordance with U.S. generally accepted auditing standards. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion. In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of SAVE A LIFE FOUNDATION, INC. as of June 30, 2004 and December 31, 2003, and the results of its change in net assets and their cash flows for the six months and year then ended in conformity with U.S. generally accepted accounting principles.

c

1

SAVE

A LIFE

FOUNDATION,

INC.

COMPARATIVE STATEMENTS OF FINANCIAL POSITION June 30, 2004 and December 31, 2003
2004 2003

ASSETS Current Assets Cash and Cash Equivalents Inventory Trade Receivables Grants Receivable Prepaid Legal Fees Employee Advances Receivable Other Prepaid Expenses Total Current Assets Fixed Assets at Net Book Value Land Building Office Equipment Vehicles Total Net Fixed Assets TOTAL ASSETS $ 13,291 54,371 13,415 1,057,000 55 196 10,717 1,149,045 $ (5,556) 67,019 22,715 100,000 2,905 1,729 188,812

20,000 172,816 38,250 23,473 254,539 1,403,584

20,000 177,364 46,747 27,386 271,497 460,309

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 2

SAVE

A LIFE

FOUNDATION,

INC.

COMPARATIVE STATEMENTS OF FINANCIAL POSITION June 30, 2004 and December 31, 2003 2004 LIABILITIES Current Liabilities Accounts Payable Real Estate Taxes Payable Instructor Deposits Rent Payable Mortgage Payable Total Current Liabilities Other Liabilities Due to Carol Spizzirri Total Other Liabilities TOTAL LIABILITIES Net Assets Temporarily Restricted Unrestricted Total Net Assets TOTAL LIABILITIES & NET ASSETS AND NET $ ASSETS 6,487 934 490 30,890 137,155 175,956 $ 28,796 934 490 194,416
224,636

2003

157,655 157,655 333,611

139,648

139,648 364,284

1,139,543 (69,570) 1,069,973 1,403,584

100,000 (3,975) 96,025 460,309

THE ACCOMPANYING NOTES ARE AN INTBGRAL PART OT THESE STATEMENTS 3

SAVE A LIFE FOUNDATION,

INC.

STATEMENT OF ACTIVITIES
For the Six Months Ended June 30, 2004 Unrestricted INCOME Public Support Contributions Private Grants Contributions In Kind Special Events Gross Income Total Public Support Government Contracts State of Illinois - IDPH HHS/CDC Total Government Contracts Other Income Program Service Fees Miscellaneous Course Materials Branch Fee Total Other Income Total Income (balances carried forward) 850
73,000 3,238

Temporarily Restricted

Total

$ 84,500

850 84,500 73,000 3,238

77,088

84,500

161,588

20,000 20,000

1,020,000 1,020,000

20,000 1,020,000 1,040,000

i J , l U U

(1,698) 1,340 3,356 26,158 123,246

-

23,160 (1,698) 1,340 3,356
26,158

1,104,500

1,227,746

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS
4

SAVE A LIFE FOUNDATION,

INC.

STATEMENT OF ACTIVITIES
For the Six Months Ended June 30, 2004 Total Income (balances brought forward) 123,246 Unrestricted EXPENSES Program Kids Program Corporate Program Expansion Program Allied Health Grant Total Program Management and General Fundraising Total Functional Expenses Special Event Expenses Total Expenses Release from Restrictions - HHS/CDC Excess Income Over Expenses Investment Income Interest Income Total Investment Income Excess Income Over Expenses Change in Net Assets Beginning Net Assets Ending Net Assets (Deficit) 62,138 8,021 134,505 20,000 224,664 21,328 7,215 253,207 600 253,807 64,957 (65,604) (64,957) 1,039,543 62,138 8,021 134,505 20,000 224,664 21,328 7,215 253,207 600 253,807 973,939 1,104,500 Temporarily Restricted 1,227,746 Total

9 9 (65,595) (65,595) (3,975) (69,570)

-

9 9

1,039,543 100,000 1,139,543

973,948 973,948 96,025 1,069,973

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 5

SAVE A LIFE

FOUNDATION,

INC.

STATEMENT O F ACTIVITIES For the Year Ended December 31, 2003 Unrestricted INCOME Public Support Contributions Private Grants Contributions In Kind Special Events Gross Income Total Public Support Government Contracts State of Illinois - DCCA Rural Training HHS/CDC Total Government Contracts Other Income Program Service Fees Miscellaneous Course Materials Total Other Income TOTAL INCOME (balances carriedJorward) 147,785 4,000 301,609 1,504 454,898 147,785 4,000 301,609 1,504 454,898 Temporarily Restricted Total

22,488 15,000 37,488

22,488 15,000 37,488

36,016 3,590 95,150 134,756 627,142

36,016

3,590 95.150 134,756 627,142

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS
6

SAVE A LIFE FOUNDATION, STATEMENT OF ACTIVITIES For the Year Ended December 31, 2003

INC.

TOTAL INCOME (balances brought forward)

627,142 Unrestricted

Temporarily Restricted

627,142 Total

EXPENSES Program Kids Program Corporate Program Expansion Program Branch Development Springfield Building Rural Grant Total Program Management and General Fundraising Total Fnnctional Expenses Special Event Expenses TOTAL EXPENSES Release from Restrictions - IDPH Release from Restrictions - DCCA Release from Restrictions - HHSVCDC Excess Income Over Expenses Investment Income Interest Income Total Investment Income Excess Income Over Expenses Bad Debt Loss Loss on Disposition of Assets Change in Net Assets Beginning Net Assets Ending Net Assets (Deficit) 379,648 13,336 195,523 310,234 7,120
23,640

379,648 13,336 195,523 310,234 7,120 23,640 929,501 165,227 287,698 1,382,426 100 1,382,526 (307,793) (100,000) (117,968) (525,761) (755,384)

929,501 165,227 287,698 1,382,426 100 1,382,526 307,793 100,000 117,968 (229,623)

795 795 (228,828) (2,676) (231,504) 227,529 (3,975) (525,761) (20,000) (545,762) 645,762 100,000

795 795 (754,589) (20,000) (2,676) (777,266) 873,291 96,025

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS
7

SAVE

A

LIFE

FOUNDATION,

INC.

STATEMENT OF FUNCTIONAL EXPENSES For the Six Months Ended June 30, 2004 PROGRAM

Kid's Program

Corporate Program

Expansion Allied Program Health Grant

Total

Salaries & Wages Employee Benefits Payroll Taxes Other Payroll Expense Automobile Bad Debt Expense Bank Service Fees Computer Expenses Cost oi Good Sold Depreciation Dues & Subscriptions Instructor Fees Insurance Legal & Accounting Licenses & Permits Marketing & Promotional Meetings Operating Interest Office Supplies Payroll Service Postage Professional Fees Recruitment Rent Telephone Training Supplies Travel Utilities Web Site Total Program Expenses Administration Allocation Total Expenses

$

44,000 3,315 250 13,973 77 523 62,138 5,899 68,037

$

59,819 $ (814) 4,646 1,909 (264) 119 (5,531) 7,721 1,217 1,496 7,850 20 10 919 (661) 867 439 1,000 670 48,376 3,979 (285) 5,446 1,475 1,803 134,505 12,769 147,274

6,588 400 ; 1,950 ■

$

110,407 (414) 4,646 1,909 (264) 119 (5,531) 1,217 7,721 3,446 7,850 20 10 9,945 3,315 502 867 524 1,000 670 62,349 5,109 5,446 1,998 1,803 224,664 21,328 245,992

15

285

9,026 913 70 1,053 20,000 1,899 21,899

8,021 761 8,782

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS
8

SAVE

A LIFE

FOUNDATION,

INC.

STATEMENT OF FUNCTIONAL EXPENSES For (he Six Months Ended June 30, 2004 SUPPORT
Managemnt. & General Fundraising Organization Total

Total

$ 75 524 0 16,958 607 3,008 (37) , . ' 193 21,328 (21,328) -

$

_ 1,250 19 5,946 7,215 7,215

$ 75 524 16,958 607 1,250 3,008 (37) 19 5,946 193 28,543 (21,328) 7,215

$

110,407 (414) 4,646 1,909 75 260 119 (5,531) 16,958 1,217 7,721 4,053 7,850 20 1,260 9,945 6,323 465 867 543 1,000 670 62,349 5,109 11,392 1,998 1,996 253,207 253,207

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 9

SAVE

A LIFE

FOUNDATION,

INC.

STATEMENT OF FUNCTIONAL EXPENSES For the Year Ended December 31, 2003 PROGRAM
Kid's Program Corporate Expansion Program Branch Springfield Building

Program
$ 9,269 69 3,946 52 13,336 2,371 15,707

Development
$

Salaries & Wages Employee Benefits Payroll Taxes Other Payroll Expense Automobile Bank Service Fees Branch Development Computer Expenses Cost of Good Sold Depreciation Dues &r Subscriptions Equipment Rental Independent Contractors Instructor Fees Insurance Legal & Accounting Licenses & Permits Marketing 6t Promotional Meetings Miscellaneous Operating Interest Office Supplies Payroll Service Postage Printing & Reproduction Professional Fees Program Development Recruitment Rent Repairs St Maintenance Telephone Training Supplies Travel Utilities Web Site Total Program Expenses Administration Allocation Total Expenses

$

184,830 6,048 15,419 584 3,900 3,301 32,223 46,138 2,439 2,180 40 6,020 12 4,256 1,010 651 35 84 17,365 6,059 42,874 3,992 188 379,648 67,486 447,134

$

84,726 5,478 4,268 74 237 1,565 10,641 118 387 41,449 2,072 251 447 7,000 24 21,747 241 8,812 122 4,687 366 811 195,523 34,756 230,279

125,996 $ 1,720 7,307 (9,030) 1,940 31,262 2,718 7,003 5,773 778 (8,860) 2,317 579 1,516 21,503 7,972 53,239 2,022 8,652 16,349 17,257 469 11,752 310,234 55,147 365,381

821 216 5,702 236 145 7,120 1,266 8,386

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 10

SAVE

A LIFE

FOUNDATION,

INC.

STATEMENT OF FUNCTIONAL EXPENSES
For the Year Ended December 31, 2003 SUPPORT Rural Grant

Total

Managemnt. & General Fundraising

Total

Organization Total

$

3,842 5,506 14,292 • 23,640 4,202 27,842

5

395,552 13,246 26,994 658 (8,793) 3,900 6,806 77,968 63 749 10^263 8,169 818 (2,384) 41,461 5,702 8,645 1,840 2,614 21,538 14,972 108 92,351 2,499 23,523 77,583 26,133 1,023 12.563 929,501 165.227 188,867

$

10,280 $ 445 1,352 2,608 732 236 2,799 14,628 22.718 317 0 200 (945) 12,174 (43) 58,662 38 (51) 5,351 1,120 608 40 8,349 15,000 24 2,913 25 4,317 50 397 883 165,227 (165,227)

32,759 985 2,599 162 336 90,057 50 154 22,093 117,146 396 231 3,339 8,473 . 2,579 2,535 3,737 67 287,698 287,698

$

43,039 1,430 3,951 2,608 732 398 2,799 14,628 22.718 317 336 90,057 250 (790 12,174 (43) 80,755 117,184 (51) 5351 1,516 839 3,379 16,822 15,000 24 5,492 25 6,852 50 4,134 950 452,925 (165,227) 287,698

S

438,591 14,676 30,945 2,608 1,390 398 (8,793) 2.799 14,628 26,618 317 7,142 168,025 63,999 9,472 20,343 775 78,371 158,645 (51) 11,053 10,161 2,679 5,993 38^60 14,972 15,000 132 97,843 2,524 30,375 77,633 30,267 1,023 13,513 1,382,426 1,382,426

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 11

SAVE

A

LIFE

FOUNDATION,

INC.

COMPARATIVE STATEMENTS OF CASH FLOWS
For the Six Months Ended June 30, 2004 and the Year Ended December 31, 2003 2004 Cash Flows from Operating Activities: Change in net assets Adjustments to reconcile change in net assets to net cash provided by (used in) operating activities: Depreciation Bad debt loss Loss (gain) on disposition of assets Donation of fixed assets Changes in current assets and liabilities: Decrease (increase) in accounts receivable Decrease (increase) in inventory Decrease (increase) in grants receivable Decrease (increase) in other current assets Increase (decrease) in accounts payable Increase (decrease) in other payables Net cash provided by (used in) operating activities Cash Flows from Investing Activities: Proceeds from sale of fixed assets Purchase of fixed assets Net cash provided by (used in) investing activities Cash Flows from Financing Activities: Issuance of short-term debt Repayment of short-term debt Net cash provided by (used in) financing activities (57,261) (57,261)
200,000 (5,584)

2003

$

973,948

$ (777,266)

16,958 9,300 12,648 (957,000) (6334) (22,309) 48,897 76,108

26,618 20,000 2,676 (41,380) (13,944) 10,009 222,549 2,286 68,455 (481,997)

15,850 (210,979) (195,129)

194,416

Net increase (decrease) in cash & cash equivalents Cash & cash equivalents at beginning of period Cash & cash equivalents at end of period Supplemental Disclosures: Interest paid

18,847 (5,556) 13,291

(482,710) 477,154 (5,556)

$

6,323

$

11,053

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 12

SAVE

A LIFE

FOUNDATION,

INC.

NOTES T O FINANCIAL STATEMENTS For the Six Months Ended June 30, 2004 and the Year Ended December 31, 2003

NOTE 1 - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Nature of Activities Save A Life Foundation, Inc. (SALF) works to train "Bystanders" as volunteers equipped with life supporting first aid skills to aid in an emergency the injured or ill. SALF received 83% of its total income in the six months ended June 30, 20O4 from HHS/CDC. The remainder of SALPs income is from program fees, private contributions, a training grant from the State of Illinois, and other miscellaneous sources. Change in Accounting Period SALF has changed their year end for accounting purposes to June 30lh from December 31". As a result, the accompanying financial statements cover the six months ended June 30, 2004 and the year ended December 3 1 , 2003. This was done to provide for better matching of the operations to the accounting cycle. Basis of Accounting The financial statements of SALF have been prepared on the accrual basis of accounting and accordingly reflect all significant receivables, payables, and other liabilities. The net assets of SALF are classified as follows: • Unrestricted, which represent the portion of expendable net assets that are available for operations. Temporarily Restricted, which represent grants which are for future periods. Upon termination of the restriction, a reclassification is made to unrestricted net assets.

Estimates The process of preparing financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions. These estimates and assumptions affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and reported amounts of income and expenses during the reporting period. Actual results could differ from those estimates. Cash and Cash Equivalents For purposes of the statement of cash flows, SALF considers all checking accounts, money market accounts, undeposited funds, and petty cash to be cash equivalents. Receivables and Credit Policies Trade receivables are obligations due under normal trade terms requiring payment upon demand. There is no interest or fees charged on receivables. The amount of uncollectible trade receivables as of June 30, 2004 and December 3 1 , 2003 is immaterial. Management has elected to record bad debts using the direct write-off method. Generally accepted accounting principles require that the allowance method be used to reflect bad debts. However, the 13

SAVE

A LIFE

FOUNDATION,

INC.

NOTES TO FINANCIAL STATEMENTS For the Six Months Ended June 30, 2004 and the Year Ended December 31, 2003

effect of the use of the direct write-off method is not materially different from the results that would have been obtained had the allowance method been followed. Inventories Inventories are stated at cost using the weighted cost average method. Fixed Assets Fixed assets are carried at cost if purchased or fair value if contributed for current additions. Depreciation is computed on the straight-line method over 5-7 years for vehicles, computer equipment, furniture and office equipment. Maintenance, repairs and minor costs are expensed as incurred. When properties are retired or otherwise disposed of, the related cost and accumulated depreciation are removed from the respective accounts and any profit or loss on disposition is credited or charged to operations. Policy on Contributions Contributions received are recorded as unrestricted, temporarily restricted, or permanently restricted support, depending on the existence and/or nature of any donor restrictions. Support that is restricted by the donor is reported as an increase in unrestricted net assets if the restriction expires in the reporting period in which the support is recognized. All other donor-restricted support is reported as an increase in temporarily or permanently restricted net assets, depending on the nature of the restriction. When a restriction expires (that is, when a stipulated time restriction ends or purpose restriction is accomplished), temporarily restricted net assets are reclassified to unrestricted net assets and reported in the Statement of Activities as net assets released from restrictions. Federal grant awards are not recorded until expended for the purpose of the grants since they are conditional promises to give. Income Taxes SALF is exempt from income taxes under Section 5 0 1 (c)(3) of the Internal Revenue Code. In addition, SALF qualified for the charitable contribution deduction under Section 170(b)(l)(A)(vi) and has been classified as an organization other than a private foundation under Internal Revenue Code Section 509(a)(2), Functional Allocation of Expenses In the Statement of Functional Expenses, salaries and related expenses are first charged to the various programs and supporting services on the basis of actual expense. Expenses are then allocated based on various criteria, such as time spent in various areas.

NOTE 2 - DONATED MATERIALS AND SERVICES In-kind donations of materials and fixed assets are recorded as financial support at their estimated fair value at the date of donation. Such donations are reported as unrestricted support unless the donor has restricted the donated asset to a specific purpose. Conditional transfers of assets are recognized when the conditions upon which they depend are substantially met. During the six months endedjune 30, 2004 and the year ended December 3 1 , 2003, SALF received $500 and $41,380 respectively, in donations of this type. 14

SAVE

A LIFE

FOUNDATION,

INC.

NOTES TO FINANCIAL STATEMENTS For the Six Months Ended June 30, 2004 and the Year Ended December 31, 2003

Donations of services are recorded if they create or enhance a nonfinancia! asset or are specialized skills that would be purchased if they were not donated. SALF received donations of this type in the six months ended June 30, 2004 and the year ended December 31, 2003, of $62,500 and $237,729, respectively. Donations of use of facilities are recorded at their fair market value. Such donations are reported as unrestricted supports. During the six months ended June 30, 2004 and the year ended December 31, 2003, SALF received in-kind contributions of rent for $10,000 and $22,500, respectively.

NOTE 3 - FIXED ASSETS At June 30, 2004 and December 31, 2003, the costs of such assets were as follows: Increase June 30r 2004 $ 20,000 181,912 121,727 39.132 362,771 108-232 « peceinjber 31, 2fiQ2 $ 20,000 181,912 121,727 39.132 362,771 91.27.4 271.497 (Decrease"! $ _

Land Building Office Equipment Vehicles Lessaccumulated depreciation Net book value

16.958

Depreciation expense for the six months ended June 30, 2004 and the year ended December 31, 2003 was $16,958 and $26,618, respectively.

NOTE 4 - MORTGAGE PAYABLE The mortgage payable at June 30, 2004 and December 31, 2003 consists of the following: 2004 $137,155 2003 $194,416

Mortgage payable to Bank One originally due on April 28, 2004, secured by the 520 E. Capitol Ave., Springfield 1L building, including interest at 4.25%. This was subsequently extended to July 28, 2004.

15

SAVE

A LIFE

FOUNDATION,

INC.

NOTES TO FINANCIAL STATEMENTS For (he Six Months Ended June 30, 2004 and the Year Ended December 31, 2003

NOTE 5 - TEMPORARILY RESTRICTED NET ASSETS Temporarily restricted net assets a t j u n e 30, 2004 and December 31, 2003 consists of the following: 2004 $100,000 20J12 $100,000

Illinois Department of Commerce and Community Affairs - restricted for the purchase of a building in Springfield, IL United States Department of Health and Human Services/ Center for Disease Control — restricted to use according to the grant agreement and also according to time release restriction McDonald's Chicago Public Schools Project - to train 10,000 fourth graders; $50,000 total from Ronald McDonald's Charities, $24,500 from Chicago Public Schools Blue Cross Blue Shield - to train 10,000 kids in upcoming school year Total

955,043

0

74,500

0

lQ.QOQ

0

1.1^-W

100-000

NOTE 6 - COMPENSATED ABSENCES SALF has a vesting vacation policy. The amount of existing vacation time remaining as of June 30, 2004 and December 3 1 , 2003 is immaterial.

NOTE 7 - DUE TO RELATED PARTY The organization's founder and current executive director, Carol Spizzirri, loaned SALF start up and operations funding. As of June 30, 2004 and December 3 1 , 2003, the amount of this loan is $157,655 and $139,648, respectively. Interest is accrued annually using the Internal Revenue Service Applicable Federal Rates.

16

SAVE

A LIFE

FOUNDATION,

INC.

NOTES T O FINANCIAL STATEMENTS For the Six Months Ended June 30, 2004 and the Year Ended December 31, 2003

NOTE 8 - LEASE OBLIGATION AND RENTAL EXPENSE The estimated future minimum rental and operating lease obligation for the succeeding years under non-cancelable leases for office facilities in effect at June 30, 2004 are as follows: Year Ending June 30,
2005 2006 2007 2008

Rem
$92,704 102,726 107,737 110,242

Rental expense under the operating leases was $52,348 for the six months ended June 30, 2004 and $97,843 for the year ended December 31, 2003.

NOTE 9 - SPECIAL EVENTS Special event income is shown at the gross amount in the Statement of Activities. Special event expense is also shown in the Statement of Activities. The following schedule details the gross income and expense components for each event: lune 30. 2004 December 31. 2003 Revenue Expenses Net Revenue Expenses Net RaceforLife $ 2,588 $ - $ 2,588 $708 $100 $608 Other 6.5J2 £Q_Q 5J2 Z9_6_ Z26. = 3^3J . 60S 2.638 1.504 Iflfl

17

For O f f e » U « Only

PMT#

ILLINOIS CHARITABLE ORGANIZATION ANNUAL REPORT
Attorney General LISA M A D I G A N State of Illinois Charitable Trust Bureau, 100 West Randolph 11th Floor, Chicago, Illinois 60601 CO # 01026498 Report for the Fiscal Period: Beginning 07 & Ending <*
MO

Form AG990-IL Revised 3/05

AMT

INIT Federal ID#36-3869459

/ 01 I ™
DAY

/ o* / <*

H ■MMOnoka 21 «>«**•*• a S»*r^ 13 aw™**** □

Check all items attached: Copy of IRS Return Audited Financial Statements Copy of Form IFC $15.00 Annual Report Filing Fee $100.00 Late Report Filing Fee
MO DAY VR

Are contributions to the organization tax deductfole? NAME Save A Life Foundation MAIL ADDRESS 9950W. Lawrence, Suite 300
C

IZ1 Yes D No

Date Organization was created: 02

/ 09

/ 93

Year-end amounts
A)ASSETS B) LIABILITIES C) NET ASSETS PERCENTAGE

^ ^ ^ ^ ^ H
A ) $ 1643498 B)S 669348 <=)S 974150 AMOUNT D)$ S33339 E)S 1196000 • F ) $ 2801 G ) I 1732140 H)$ 1713050 D$ J) $ 1713050

'zVcODE Schiller Park, 1L 60176 I. SUMMARY OF ALL REVENUE ITEMS DURING THE YEAR: DJ PUBLIC SUPPORT. CONTRIBUTIONS & PROGRAM SERVICE REV. (GROSS AMTS.) £) GOVERNMENT GRANTS & MEMBERSHIP DUES F) OTHER REVENUES G) TOTAL REVENUE, INCOME AND CONTRIBUTIONS RECEIVED (ADD D,E, & F)

%

% %
100%

II. SUMMARY OF ALL EXPENDITURES DURING THE YEAR:
H) OPERATING CHARITABLE PROGRAM EXPENSE 1) EDUCATION PROGRAM SERVICE EXPENSE J> TOTAL CHARITABLE PROGRAM SERVICE EXPENSE {ADD Hal) J1) JOINT COSTS ALLOCATED TO PROGRAM SERVICES (INCLUDED IN J): K) GRANTS TO OTHER CHARITABLE ORGANIZATIONS L) TOTAL CHARITABLE PROGRAM SERVICE M) MANAGEMENT AND GENERAL EXPENSE N) FUNDRAISING EXPENSE J^N 9 rap

% % %
$

fW?f£(Pf\>P

£} ^_^ 2006^g^

% % % %
100%

K)$ L)$ 1713050 M)S 80431 N)S 34482 0 ) $ 1827963

O) TOTAL EXPENDITURES THIS PERIOD (ADD L M J C W E Y GENERAL

III. SUMMARY OF ALL PAID FUNDRAISER A N D ^ ^ t t T ^ T ^ T V l T I E S :
(Attach Attorney General Report of Individual Fund raising Campaign- Form IFC. One for each PFR.) PROFESSIONAL FUNDRAISERS: P) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISERS O) TOTAL FUNDRAISERS PEES AND EXPENSES R) NET RECEIVED BY THE CHARITY (P MINUS Q=R) PROFESSIONAL FUNDRAISIHQ CONSULTANTS: S) TOTAL AMOUNT PAID TO PROFESSIONAL FUNDRAISING CONSULTANTS IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS DURING THE YEAR: T) NAME, TITLE; Carol Spizzirri, President/Founder U) NAME, TITLE: Dane Neal, National Policy Director V) NAME, TITLE: Ciprina Spizzirri, National Communication Director V. CHARITABLE PROGRAM DB.SCmPVON.wmA^FsoGwawwMiYicxremEOJCOO€C*7RJO«6i 100% P)$ Q)$ R)$ S)$

% %

T ) $ 120000 U)S 54381 V) $ 35446 List on back side of inslrucJlDns CODE W)#0ll X)# Y}#

WJ DESCRIPTION: Life Saving First Aid Training X) DESCRIPTION: Y) DESCRIPTION:

IF THE ANSWER TO ANY OF THE FOLLOWING IS YES, ATTACH A DETAILED EXPLANATION: 1. 2. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION. FINE. PENALTY OR JUDGMENT? .

YES

NO

HAS THE ORGANIZATION OR A CURRENT DIRECTOR, TRUSTEE, OFFICER OR EMPLOYEE THEREOF, EVER BEEN CONVICTED BY ANY COURT OF ANY MIDSDEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY? .

2.

3.

DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES OWNS AN INTEREST; OR WAS IT A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES HAS A MATERIAL FINANCIAL INTEREST; OR DID ANY OFFICER, DIRECTOR OR TRUSTEE RECEIVE ANYTHING OF VALUE NOT REPORTED AS COMPENSATION? 3. HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER, DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES? IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER?* ATTACH FORM I F C ) . . .

4

4.

5.

6.

7a. DID THE ORGANIZATION ALLOCATE THE COST OF ANY SOLICITATION, MAILING, ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES?

7.

7b. IF "YES", ENTER (i) THE AGGREGATE AMOUNT OF THESE JOINT COSTS 5 ;(ll) THE AMOUNT ALLOCATED TO PROGRAM SERVICES $ ; <iii) THE AMOUNT ALLOCATED TO MANAGEMENT AND GENERAL £ ; AND (iv) THE AMOUNT ALLOCATED TO FUNDRAISING 1 8. DID THE ORGANIZATION EXPEND ITS RESTRICTED FUNDS FOR PURPOSES OTHER THAN RESTRICTED PURPOSES? -

-

8.

9.

HAS THE ORGANIZATION EVER SEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION OR TAX EXEMPTION SUSPENDED OR REVOKED BY ANY GOVERNMENTAL AGENCY?. 9,

10. WAS THERE OR DO YOU HAVE ANY KNOWLEDGE OF ANY KICKBACK, BRIBE, OR ANY THEFT, DEFALCATION MISAPPROPRIATION, COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS? 10. 11. LIST THE NAME AND ADDRESS OF THE FINANCIAL INSTITUTIONS WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST ACCOUNTS:

Bank One N.A.. P.O. Box 260180, Baton Rouge. LA 70826-0180 Wachovia Bank N.A. P.O. Box 50015, Roanokc, VA 24040-7350
12. NAME AND TELEPHONE NUMBER OF CONTACT PERSON: Carol Spizzirri (847) 928-9683 ALL ATTACHMENTS MUST ACCOMPANY THIS REPORT - SEE INSTRUCTIONS UNDER PENALTY OF PERJURY, I (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS ANNUAL REPORT AND THE ATTACHED DOCUMENTS, INCLUDING ALL THE SCHEDULES AND STATEMENTS AND THE FACTS THEREIN STATED ARE TRUE AND COMPLETE AND FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE STATE OF ILLINOIS RELY THEREUPON. I HEREBY FURTHER AUTHORIZE AND AGREE TO SUBMIT MYSELF AND THEREGISJRANT HEREBY TO THE JURISDICTION OF THE STATE OF ILLINOIS. (\~.A T <»-- — - . . : f> Unfa

(Wjs r ;«;c t : VFTVia ftu»Ji>eit
SIGNATURE

\LJ.ftiUlAU
BE SURE TO INCLUDE A U . FEH 1.) REPORTS ARE DUE WITHIN S MONTHS OF YOUR FISCAL Yl 2.) FOR FEES DUE SEE INSTRUC 3.) REPORTS THAT ARE LATE OR INCOMPLETE ARE SUBJECT TO A $100.00 PENALTY. IE) |

A? /syoj"
DATE

I KbASUKtK or i Kua r cc (PRINT NAME) Is" — -? Atj.ne „„ 'NT I

sirswAi

OIUNAIUKE

DATE

*
Form 990

Return of Organization Exempt from Income Tax
Under section 501(c), 527, or 4947(a)(1) ol the Internal Revenue Code (except black lung benefit trust or private foundation)

OMB No. 1545-0047

2004
Open to Public Inspection

Department of trie Treasury tntemal Revenue Service

* The organization may have to use a copy of this return to satisfy state reporting requirements. Jul 1 , 2004, and ending J u n 30
O C Plena u » IRS label orprfcit Name of organization

A
B

For the2004 calendar year, ortax year beginning
Check rf applicable: Address change Name change Initial return Final return Amended return Application pending

, 2005
Employer IriantillcitioriHurnper

Save A L i f e

Foundation
Room/suite E

36-3869459
Telephone number

"ST
ipacWc iititiuttfeM.

Number and streel (Or P.O. b o i * mail is not delivered to street 3ddr)

9950 L a w r e n c e
City, town or country

300
State ZIP cede + 4
f

(847)
meOio'

928-9683
Accrual

S c h i l l e r Park

IL

60176
H(a)

n p l n e r (specify) * *

> Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A (Form 990 or 990-EZ).

H a n d ! are not applicable to section 537 oganizatmns Is iWs a group return for affiliates? . . . Q V« | x ] No

G Web site: * www - s a l f . o r g
J K Organization
(Check only O n e V * " j ^ l S0Hc> 3 « Qnsert no.) D 49*7(a)<H or IJS27

H ( b ) If 'Yes,' enter number of affiliates *■ H ( c ) Are all affiliates included? tit T t o ; attach a l i d . See 'nstrucnons.) H ( d ) Is this a separate netum filed by an Organization covered by a group ruling? y „ [ x ] No Q Vn O No

Check here ** |_[ if the organization's gross receipts are normally not more than $25,000. The organization need not file a return with the IRS; but if the organization received a Form 990 Package in the mail, it should file a return without financial data. Some states require a complete return.

I M

L

Gross receipts: Add lines 6b, 8b, 9b, and 10b to line 12 * 1 , 7 3 2 , 1 4 0 . mmA Hevenue. txoenses, and uhanges in Net Assets or f und Balances (See instructions)
1 Contributions, gifts, grants, and similar amounts received:

Group Exemption Number ... *■ Check *■ Q if ttw organization is not required to attach Schedule B (Form 990, 990-EZ, or 990-PF).

d

2 4 5

la 125,822. lb 1c 1.196.000. T M M K V ; * * $ 1 , 3 1 7 , 3 2 2 . nonet, $ 4,500.).... Program service revenue including government fees and contracts (from Part */Il, line 93)
Interest on savings and temporary cash investments . Dwidends and interest from securities

Id 2 t 4 5

1.321.822. 310,971. 1,933.

6a 6b w
7 c Net rental income or (loss) (subtract line 6b from line t») Other investment income (describe +■ (A) Securities

E V E H U F

) (B) Other 8a

fir 7

8a Gross amount from sales of assets other

b Less: cost or other basis and sales expenses 8b c Gain or (loss) (attach schedule) ac d Net gain or (loss) (combine line 8c, columns (A) and ( 3)) 9 Special events and activities (attach schedule). If any amount is from gaming, chec * here a Gross revenue (not including $ 115,7'7. of contributions b Less: direct expenses other than fundraising expenses c Met income or (krss) from special events (Subtract line 9b from line 9a) 10a Gross sales o l inventory, less returns and allowances c Gross profit or (toss) from sales of inventory (attacN schedule) (siibtract line 10b from line 10a) . . Other revenue (from Part VII, line 103) Total revenue (add lines 1d, 2. 3 , 4 , 5 , 6c, 7, 8d, 9c, 10c, and U ) Program services (from line 44, column (B)) Management and general (from line 44. column (Q)

8d *[j~|

9a 9b 10*1 10b|

34,312. 34.312. See. L.-.9 Stmfc 62,234. 13,149.

9c

o
49,085. 868. 1,684,679. 1,699,901. 80,431. 170. 1.780,502. -95,823. 1.069,973. 974,150.
Form 9 9 0 (2004)

E X P E N

11 12 13 14

10c 11 12

n
14 IS 16 17 1R 19 ?0 21
TEEAQ101 01/07/05

& 16 Payments to affiliates (attach schedule) .
E S A 18

Excess or (deficit) for the year (subtract line 17 from 1ne 12) Net assets or fund balances at beginning of year (frorr line 73, column (A)) .. Other changes in net assets or fund balances (attach ;xplanation)

19 20

Net assets or fund balances at end of year (combine 1 nes 18, 19, and 20) . . . BAA For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.

s 21

Form990[2004)

Save A L i f e

Foundation

36-3869459

Page 2

| S t a t e m e n t of F u n c t i o n a l E x p e n s e s All organizations must complete column (A). Columns (8), (C), and (D) are required for section 501 (c)(3) and (4) organizations and section 4947(a)(1) noriexempt charitable trusts but optional for others. Do not include amounts reported on line 6b, 8b, 9b, I0b, or 16 of Part 1. 22 Grants and allocations (att sch) (cash $ non-cash $ ) Specific assistance to individuals (at) sch) Benefits paid to or for members (att sch) Compensation of officers, directors, etc Other salaries and wages Pension plan contributions (A) Total (B) Program services (C) Management and general (D) Fundraising

23 24 25 26 27

30 Professional fundraising fees 31 Accounting fees

33 Supplies 34 Telephone 35 Postage and shipping 37 Equipment rental and maintenance 38 Printing and publications

29,044. 264. 0. 29,308. 13,479. 0. 40 Conferences, conventions, and meetings 13,479. 0. 728. 6,210. 41 Interest 6,938. 0. 0. 42 Depreciation, depletion, etc (attach schedule) 42 30,301. 30,301. 0. 43 Other expenses not covered above (itemize); 2,281. 0. a Auto Expense 43a 2,281. 0. 264. -2. b Bank S e r v i c e Fees 43b 262. 0. 463,853. 0. c Branch Development 43c 463,853. 0. 30. d Computer Expenses 0. 0. 43d 30. 43e 630,861. e See Other Expenses Stmt 640,181. 9,201. 119. 44 Total functional expenses (add lines 22 - 43). Organizations completing columns (B) - (D), carrythete totaltta line* 13-15 44 1,780,502. 1,699,901. 80,431. 170. Joint Costs. Check . * 0 if you are following SOP 98-2. Are any joint costs from a combined educational campaign and fundraising solicitation reported in (B) Program services? * " £ j Yes [x] No If 'Yes,' enter (i) the aggregate amount of these joint costs $ : (jl) the amount allocated to Program services ; OH) the amount allocated to Management and general ; and (iv) the amount allocated $ to Fundraising $

22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41

120,000. 286,094. 9,332. 44,168.

114,000. 260,920. 8,565. 40,767.

6,000. 25,174. 767. 3,401.

0. 0. 0. 0.

3,000. 12,209. 10,847. 6,032. 101,425. 762.

3,000. 12,958. 10,817. 6,147. 101,425. 762.

0. -751. 6. -140. 0. 0.

0. 2. 24. 25. 0. 0.

I Statement of Program Service Accomplishments
What is the organization's primary exempt purpose? * See A t t a c h e d All organizations must describe their exempt purpose achievements in a clear and concise manner. State the number of clients served, publications issued, etc. Discuss achievements that are not measurable, (Section 501 (c)(3) & (4) organizations and 4947(aHI) nonexempt charitable trusts must also enter the amount of grants & allocations to others,) Program Service Expenses
(Required for 501(c)(3) and (41 organizations and lS*7(a>(1) trials; Dirt optional tor om««.)

*J^i4J.s_ Programs _"_ P]CP.EL°lii.0*l J*Qd. . f S ^ c h i l S . 2t. J-i£?_ SSyiHS. J i ^ s t . -?A*L1-2 J l i i i A S i ' L s c h o o l c h i l d r e n . ^ 2 _ 9 _ , 8 8 _ 9 _ c M J d r m J ^ u g h t J ,
b

(Grants and allocations $ _0^i ^2D^£i t ^_^ r 53^i?_^l , t^5t4PD_^d_t^aching i _of _life_ saving; _f Lr_st_ald_to_ individuals_other _than_ school_-age_ children_ ( 1 9 _taught_)_ .9
(Grants and allocations $ 0. )

679,505.

17,612.

c

J-5ES §4P _??v 2 il™_l. ExE?£^. S-S _ s a t e l _ l i t e _ o f f i c e _iiiside _ a n d _ p u t s i d e _the _State_of_ I l l _ i n q i s _ (10/2pl_tauc£ht2
(Grants and allocations $
r

n

n

0 ]

-°il

984,517.

d p t h e r _ G r a n t _ s _ - _ P o r n o t i q n _ a n d _ t e a c h i n g _o_f _ l i | e _savincj_ _f i r _ s t _ a i d _ t o _ variou_s_ r e ^ i £ . i e n t s _ _(8_555 _taught)_
(Grants and allocations $.

e Other program services

(Grants and allocations S

_°^L

18,267. 1,699,901. Form « 0 fpflfun

f Total of Program Service Expenses (should equal line 44, column (B), Program services) BAA TEE Mid? 01*7/05

Form 990 (2004)

Save A L i f e

Foundation

36-3869459

Page 3

Balance Sheets (See Instructions) Mote: Where required, attached schedules and amounts within the description column should be for end-of-year amounts only. 45 Cash - non-interest-bearing 46 Savings and temporary cash investments 47a Accounts receivable b Less: allowance for doubtful accounts 48a Pledges receivable b Less: allowance for doubtful accounts 49 Grants receivable | 48a [ 48b 22,254. (A) Beginning of year (B) End of year 3,758,

3 , 3 9 9 . 45 9,892.

810,218.

1 3 , 4 1 5 . 1 47c|

22,254.

48c

1 , 0 5 7 , 0 0 0 . 49
50 51c

496,000.

50 Receivables from officers, directors, trustees, and key

employees (attach schedule) 511 51 a Otter notes & loans receivable (attach sch) 51b b Less: allowance for doubtful accounts 52 Inventories for sale or use 53 Prepaid expenses and deferred charges 54 Investments-securities (attach schedule) , *"D ■ 55a Investments — land, buildings, & equipment: basis . 55a b Less: accumulated depreciation (attach schedule) 56 Investments - other (attach schedule) 57a Land, buildings, and equipment: basis 55b 57a

5 4 , 3 7 1 . 52 1 0 , 9 6 8 . 53
Cost

56,501, 5,539

D

FMV

54

55c

56
387,761.

b Less: accumulated depreciation 57b (attach schedule) L-5.7..Stmt. 138,533 58 Other assets (describe *■ 59 Total assets (add lines 45 through 58) (must equal line 74) 60 Accounts payable and accrued expenses 61 Grants payable 62 Deferred revenue — 63 Loans from officers, directors, trustees, and key employees (attach schedule) 64a Tax-exempt bond liabilities (attach schedule) b Mortgages and other notes payable (attach schedule) 65 Other liabilities (describe * See L i n e 65 S t m t 66 Total HabilWes (add lines 60 through 65) . Organizations thatfollowSFAS117, check here * |xj and complete lines 67 through 69 and lines 73 and 74. 67 Unrestricted 68 Temporarily restricted 69 Permanently restrtcted Organizations that do not follow SFAS 117, cheek here » Q and complete lines 70 through 74. 70 Capital stock, trust principal, or current funds 71 Paid-in or capital surplus, or land, building, and equipment fund 72 Retained earnings, endowment, accumulated income, or other funds ,.
_ ) ■

2 5 4 , 5 3 9 . 57 c 1,403,584,
37,377 58 59 60 61

249.226. 1,643,498.
505,204.

62 1 5 7 , 6 5 5 . 63 64a 1 3 7 . 1 5 5 . 64b 1 , 4 2 4 . 65 333,611.

163,654.

490. 669,348.

-69,570. 1 , 1 3 9 . 5 4 3 . 68 69

478,150. 496,000,

71

73 Total net assets or fund balances (add lines 67 through 69 or lines 70 through 72; column (A) must equal line 19; column (B) must equal line 21) 74 Total liabHJtJes and net assets/fund balances (add lines 66 and 73)

1,069,973. 1 , 4 0 3 , 5 8 4 . 74

974,150, 1,643,498.

Form 990 is available for public inspection and, for some people, serves as the primary or sole source of information about a particular organization. How the public perceives an organization in such cases may be determined by the information presented on its return. Therefore, please make sure the return is complete and accurate and fully describes, in Part III, the organization's programs and accomplishments. BAA

TEEA0103

01/07/05

Form 9M (2004)

Save A L i f e

Foundation

36-3869459

Page 4

I Reconciliation of Revenue per Audited Financial Statements with Revenue per Return (See instructions.)
a ) Total revenue, gains, and other suppert per audited financial statements Amounts included on line a but not on line 12, Form 990: C1) Net unrealized gains on investments (2) Donated serv­ ices and use of facilities .. (3) Recoveries of prior year grants a b

1 Reconciliation of Expenses per Audited Financial Statements with Expenses per Return
Total expenses and losses per audited financial statements., ' Amounts included on line a but not on line 17, Form 990: CO Donated serv­ ices and use of facilities . . . (2) Prior year adjust­ ments reported on line 20, Form 990 . . . . $ (3) Losses reported on line 20, Form 990 $

$

190,795.

(4) Other (specify): See A t t a c h e d

(4) Other (specify): See A t t a c h e d

61,746.
Add amounts on lines (1) through (4) Line a minus line b Amounts included on line 12, Form 990 but not on line a: 0 ) Investment e<penses not included on line St, form 990 $_ (2) Other (specify): Add amounts on lines (1) through (4) Line a minus line b Amounts included on line 17, Form 990 but not on line a: (1) Investment expenses not included on line 6b, Form 990 (2) Other (specify):

$

Add amounts on lines 0 ) and ( 2 ) . , Total revenue per line 12, Form 9901 (line c plus line d)

Add amounts on lines O) and (2)

1,684,679.

Total expenses per line 17, Form 990 (line c plus line d)

780,502.

ffffffflpnp List Of Officers, Directors. Trustees, and Kev Employees (List each one even if not compensated; see instructions.) (B) Title and average hours (C) Compensation (D) Contributions to (E) Expense per week devoted (If not paid, employee benefit account and other (A) Name and address to position enter -0-) allowances plans and deferred compensation Carol S p i z z i r r i Chairman/Exec D i r 4 0 Rita Mullins Vice Douglas Browne Treasurer Peggy Trimble Vice Mark Mitchell Director See List ot Office rSj_ Etc. Statement J 0. 75 Did any officer, director, trustee, or key emptoyee receive aggregate compensation of more than $100,000 from your organization and all related organizations, of which more than $10,000 was provided by the related organizations? If 'Yes,' attach schedule — see instructions. __ ____ 0. 0. 0. 0. 0. Chairwoman 0. 0. 0. 0. 0. 0. Chairwoman 0. 0. 0. 120,000. 1,839. 0.

Qves

|x]No
Form 990 (2004)

BAA
TEEA01C4 01/07/05

Form990 (2004)

Save A L i f e

Foundation

36-3869459

Page 5

[Other Information (See instructions.) 76 Did the organization engage in any activity not previously reported to the IRS? If 'Yes,' attach a detailed description of each activity 77 Were any changes made in the organizing or governing documents but not reported to the IRS? If Yes,' attach a conformed copy of the changes. 76a Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return? b If 'Yes,' has it filed a tax return on Form 990-T for this year?

76
77 78a 78b 79

i

79 Was there a liquidation, dissolution, termination, or substantial contraction during the
year? If 'Yes,' attach a statement

80 a Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc, to any other exempt or nonexempt organization? 80a b If 'Yes,' enter the name of the organization and check whether it is [__] exempt or |_| nonexempt. 81 a Enter direct and indirect political expenditures. See line 81 instructions I 81 a| 0_, b Did the organization file Form 1120-POL for this year? 82 a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially less than fair rental value? b If Yes,' you may indicate the value of these items here. Do not include this amount as , . revenue in Part I or as an expense in Part II. (See instructions in Part III.) | 82 bj 205, 080. 83a Did the organization comply with the public inspection requirements for returns and exemption applications? 83a b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? 83b B4a Did the organization solicit any contributions or gifts that were not tax deductible? 84a b If 'Yes,' did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? 85 501(c)(4), (5), or (6) organizations, a Were substantially all dues nondeductible by members? b Did the organization make only in-house lobbying expenditures of $2,000 or less? If 'Yes' was answered to either 85a or 85b, do not complete 85c through 85h below unless the organization received a waiver for proxy tax owed for the prior year. c Dues, assessments, and similar amounts from members if Section 162(e) lobbying and political expenditures « Aggregate nondeductible amount of section 6033(e)(1 )(A) dues notices I Taxable amount of lobbying and political expenditures (line 85d less 85e) g Does the organization elect to pay the section 6033(e) tax on the amount on line 85f? 85c 85cf 85e 651 85 g 85 h 84b 85a 85b

X

h If section 6033(eXIXA) dues notices were sent, does Vie organization agree to add the amount on line 85f to its reasonable estimate of dues allowable to nondeductible lobbying and political expenditures for the following tax year? 86 501(c)(7) organizations. Enter: a Initiation fees and capital contributions included on line 12 86a b Gross receipts, included on line 12, for public use of club facilities 86b 87 501 (c)02) organizations. Enter: a Gross income from members or shareholders 87a

b Gross income from other sources. (Do not net amounts due or paid to other sources 87b against amounts due or received from them.) 88 At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or partnership, or an entity disregarded as separate from the organization under Regulations sections 301.7701 -2 and 301.7701 -3? If 'Yes,' complete Part IX 88 89) 501(c)(3) organizations. Enter: Amount of tax imposed on the organization during the year under: section 4911 *■ 0 . ; section 4912*0 . ; section 4955 ' 0. b 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year? If 'Yes,' attach a statement explaining each transaction , 89b X

c Enter: Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958 0. d Enter: Amount of tax on line 89c, above, reimbursed by the organization *■ Q^ 90a List the states with which a copy of this return is filed »- _ I l l i n o i s _ , W i s c o n s i n , _ P e n n s y l v a n i a , _ . A r i z o n a , I n d i a n a b Number of employees employed in the pay period that includes March 12, 2004 (See instructions.) | 90 b| 1 91 The books are in care of *■ . C a r j D j _ S j ^ z z i r r i . Telephone number *■ _<8_17)_?_28-96_83

Located at *- 9 3 50_ Lawrenqe_ S u i t e _300 , _ S c h i l l e r . . P a r k , I L

ZIP + 4 * jiO17_6 ■
*"\\ *~| 92 1 Form 990 (2004)

92 Section 4947(a)(1) nonexempt charitable trusts filing Form 990 in lieu of Form 7041 — Check here and enter the amount of tax-exempt interest received or accrued during the tax year BAA
TEEA0105 01/07105

Form 9W (2004) Save A L i f e Foundation

36-3869459

Page 6

" f l f H R f l Analysis of Income-Producing Activities (See instructions.) Excluded by section 512, 513, or 514 Unrelated business income Note: Enter gross amounts unless (C) (A> (B) (DJ otherwise indicated. Exclusion code Bus) Ress code Amount Amount 93 Program service revenue: a P r o q r a m Fees b Course M a t e r i a l s c B r a n c h Fee d Conference/Seminar Income e f Medicare/Medicaid payments g Fees & contracts from government agencies . . . 94 Membership dues and assessments . 95 Interest on savings & temporary cash invrants . 14 1,933. 96 Dividends & interest from securities ,. 97 Netrentalincome or (loss) from real estate'. a debt-financed property b not debt-financed property 98 Net rental income or (loss) from pers prop . 99 Other investment income 100 Gain or (loss) from sales of assets other than inventory 101 Net income or (loss) from special events . . 102 Gross profit or floss) from sale* of inventory . 103 Other revenue: a

(E) Related or exempt function income 35,265. 259,353. 5,433. 10,920.

49,085 868.

b Miscellaneous c
d

e
104 Subtotal (add columns (B), (D), and (E)) 105 Total (add line 104, columns (B), (D), and (E)) Mole: Line 105 plus Una Id, Part I, should equal the amount on line 12f Part I. UrwNo.

1,933.

360,924, 362,857,

Relationship of Activities to the Accomplishment of Exempt Purposes (See instructions.)
Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment of the organization's exempt purposes (other than by providing funds for such purposes}.

103b M i s c e l l a n e o u s income t o c a r r y o u t t h e l i f e s a v i n g f i r s t a i d programs.

Information Regarding Taxable Subsidiaries and Disregarded Entities (See instructions.)
03)
Name, address, and EIN of corporation, partnership, or disregarded entity Percentage of ownership interest (C) Nature of activities Total income (E)

N/A
End-of-year assets

% Information Regarding Transfers Associated with Personal Benefit Contracts (See instructions.)
a Did the organization, during the year, receive any Funds, directly or indirectly, to pay premiums on a personal benefit contract? b Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? Mote: If Yes' to (b), file Form 8870 am/Form 4720 (see instructions).

0

Y« Yes

|x No [x No

Ureter penalties of periuiY. I declare that I have examined this lelum. including accompanying, schedules and statements and to the besl of my knowledge and belief, it is true, correct, and complete. Declaration of prepare! (other man officer) is basedon aH information 0TV*iicn preparer n a i any knowledge.

Please Sign Here Paid Preparer's Only
BAA

Signature of officer

Dale

Type ot prrit name and title. Preparer's signature Date Check if selfemployed i . - r - j i ' s SSN oi PTIN (See General Instruction W>

12/12/05
Ahlbeck & Company

i—| *" I I

yours if serfemployed), address, and ZIP**

Fim's n m [or a e

EIN

Des P l a i n e s

IL

60016-4721

more no. - ( 8 4 7 ) TEEAcioe 10/03/03

824-400Q Form 990 (2004)

SCHEDULE A
(Form 990 or 990-EZ)

Organization Exempt Under Section 501(c)(3)
(Except Private Foundation) and Section 501(e), 501(f), 50100, S01(n), or Section 4947(a)(1) Honexempt Charitable Trust Supplementary Information — (See separate Instructions.) MUST bo completed by the above organizations and attached to their Form 990 or 990-EZ.

OMSMo. 1545-OM7

2004
Employ** idwrlrllcatliui ninnlm

Department of the Treasury lnt«m»l Rewrite Service Name of ths ofjanizatiwi

Save A L i f e

Foundation

36-3869459

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

Dane N e a l
9950 Lawrence, Suite 300, S c h i l l e r Park, I L 60176 N a t i o n a l P o l i c v D i r e c t o r 4 0

54,381.

1,456.

0.

Total number of other employees paid over $50,000

*

None

IP^^
(b)Type of service (c) Compensation

Compensation of the Five Highest Paid Independent Contractors for 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

_Hogari_ & . H a r t s o n _L_. L ._P_. Columbia Square, 555 Thirteenth s t r e e t M , Washington p , c . 200404-1109 G o v e r n m e n t a l W Consulting 90,822

Total number ol others receiving over $50,000 for professional services None BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 and Form 990-EZ.
TEPAIWII mrtttiu

Schedule A (Form 990 or 990-EZ) 2004

MiM

Schedule A (Form 990 or 990-EZ) 2004

Save A L i f e

Foundation

36-3869459

Page 2

Statements About Activities (See instructions.)
1 During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? If Yes,' enter the total expenses paid or incurred in connection with the lobbying activities *~ $ (Must equal amounts on line 38, Part Vl-A, or line i of Part Vl-B.) Organizations that made an election under section 501(h) by filing Form 576S must complete Part VIA. Other organizations checking 'Yes' must complete Part Vl-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 thefollowingacts with any substantial contributors, trustees, directors, officers, creators, key employees, or members of their families, or with any taxable organization with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary? (If the answer to any question is 'Yes,' attach a detailed statement explaining the transactions.) a Sale, exchange, or leasing of property? b Lending of money or other extension of credit? c Furnishing of goods, services, or facilities? See P a r t V , d Payment of compensation (or payment or reimbursement of expenses if more Irian t1,000)? e Transfer of any part of its income or assets? 3a Do you make grants for scholarships, fellowships, student loans, etc? (If Yes,' attach an explanation of how you determine that recipients qualify to receive payments.) b Do you have a section 403(b) annuity plan for your employees? 4a Did you maintain any separate account for participating donors where donors have the right to provide advice on the use or distribution of funds? — b Do you provide credit counseling, debt management, credit repair, or debt negotiation services? F o r m 990 2b 2c

2d X 2e
3a 3b 4» 4b X X X

Reason for Non-Private Foundation Status (See instructions.)
The organization is not a private foundation because it is: (Please check only ONE applicable box.) 5 _ A church, convention of churches, or association of churches. Section 170(b)(l)(A)(i). 6 ~ A school. Section 170(b)(1)(A)(ii). (Also complete Part V.) 7 A hospital or a cooperative hospital service organization. Section 170(b)(l)(A)(iii). 8 A Federal, state, or local government or governmental unit. Section 170(b)(1 ){A)(v). 9 [ j A medical research organization operated in conjunction with a hospital. Section 1?Q(b)(1)(A)p). Enter the hospital's name, city, and state *■ 10 [ ] An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(1)(A)(iv). (Also complete the Support Schedule in Part IV-A.) 11a KJ An organization that normally receives a substantial part of its support from a governmental unit or from the general public. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV-A.) l i b Q A community trust. Section !70(b)(l)(A)(vi). (Also complete the Support Schedule in Part IV-A) 12 M An organization that normally receives: (1) more than 33-1/3% of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc, functions - subject to certain exceptions, and (2) no more than 33-1/3% 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. See section 509(a)(2), (Also complete the Support Schedule in Part IV-A.) 13 LJ * n organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in: (1) lines 5 through 12 above; or (2) section 501(c)(4), (5), or (6), if they meet the test of section 509(a)(2). (See section 509(a)(3).) Provide the following information about the supported organizations. (See instructions.) (a) Name(s) of supported organization^) (b) Line number from above

14 |~] An organization organized and operated to test for public safety. Section 509(a)(4). (See instructions.) Schedule A (Form 990 or Form 990-EZ) 2004 BAA TEEAM0Z 07/27/04

Schedule A (Form 990 or 990-E2) 2004 Save A L i f e F o u n d a t i o n 36-3869459 I K M S S H B S u p p o r t S c h e d u l e (Complete only if you checked a box on line 10,11, or 12.) Use cash method of accounting. Note: You may use the worksheet in the instructions for convertfna from the accrual to the cash method of account/no. Calendar year (or fiscal year 15 Gifts, grants, and contributions received, (Do not include unusual arants. See line 28.) ... 16 Membership fees received 17 Gross receipts from admissions, merchandise sold or seivices performed, or furnishing of facilities in any activity that is related to the organization's charitable, etc, purpose I B Gross income from interest, dividends, amounts received from payments on securities loans (section 512(aX5)), rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organ­ ization after June 3D, 1975 19 Net income from unrelated business activities not included in line IS 20 Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf 21 The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge , 22 Other income. Attach a schedule. Do not include gain or (loss) from sale of capital assets 23 Total of lines 15 throuqh 22 2% 448,621. 2002 1,371,684.

Page 3

A
820,282.

2000 682,878.

(6)

Total 3,323,465.

120,316.

207,836.

197,535.

52,664.

578,351.

795.

2,154.

3,275.

8,725.

14,949.

569,732. 1,581.674. 1,021,092. 744,267. 3,916,765. 449,416. 1.373,838. 823.557. 691,603. 3.338,414. 25 E n t e r ! * of line 23 5,697. 15,817. 10,211. 7,443. 26 Organizations described on lines 10 or 11: a Enter 2% of amount in column (e), line 24 b Prepare a list for your records to show the name of and amount contributed by each person (other than a governmental unit or publicly supported organization) whose total gifts for 2000 through 2003 exceeded the amount shown in line 26a. Do not file this list with your return. Enter the total of all these excess amounts c Total support for section 509(a)(1) test: Enter line 24, column (e) d Add: Amounts from column (e) for lines: 18 14, 949. 19 22 26b' 0. e Public support (line 26c minus line 26d total) f Public support percentage (line 26e (numerator) divided by line 26c (denominator)) 99.55 % 27 Organizations described on line 12: a For amounts included in lines 15, 16, and 17 that were received from a 'disqualified person,' prepare a list for your records to show the name of, and total amounts received in each year from, each disqualified person.' Do not file this list with your return. Enter the sum of such amounts for each year; (2003) (2002) (2001) (2000) bFor any amount included in line 17 that was received from each person (other than 'disqualified persons'), prepare a list for your records to show the name of, and amount received for each year, that was more than the larger or 0 ) the amount on line 25 for the year or (2) $5,000. (Include in the list organizations described in lines 5 through 11, as well as individuals.) Do not file this list with your ratura. After computing the difference between the amount received and the larger amount described in (1) or (2), enter the sum of these differences (the excess amounts) for each year: (2003) (2002) (2001) (2000). c Add: Amounts from column (e) for lines: 15 "" 16 ~ 17 20 21 27c d Add: Line 27a total and line 27b total. 27d e Public support (line 27c total minus line 27d total) 27e I Total support for section 509(a)(2) test: Enter amount from line 23, column (e) 2 T v " <>% 27f g Public support percentage (line 27e (numerator) divided by line Z7t (denominator)) 2?a % h Investment income percentage (line 18, column <e) (numerator) divided by line 27f (denominator)) 27h 28 Unusual Grants: For an organization described in line 10,11, or 12 that received any unusual grants during 2OQ0 through 2003 prepare a list for your records to show, for each year, the name of the contributor, the date and amount of the grant, and a brief description of the nature of the grant. Do not file this list with your return. Do not include these grants in line 15. BAA TE6A0403 cni23K» Schedule A (Form 990 or 990-EZ) 2004
lf

m

Schedule A (Form 990 or 990-EZ) 2004 Save A L i f e

Foundation

36-3869459 N/A

Page 4

Private School Questionnaire (See instructions.}
(To be completed ONLY by schools that checked the box on line 6 in Part IV) 29 Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, other governing instrument, or in a resolution of its governing body? 30 Does the organization include a statement of its racially nondiscnminatory policy toward students in all its brochures, catalogues, and other written communications with the public dealing with student admissions, programs, and scholarships? 31 Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during the period of solicitation for students, or during the registration period rf it has no solicitation program, in a way that makes the policy known to all parts of the general community it serves? If 'Yes,' please describe; if 'No,' please explain. (If you need more space, attach a separate statement.)

32 Does the organization maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative staff? b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student admissions, programs, and scholarships? d Copies of all material used by the organization or on its behalf to solicit contributions? If you answered 'No' to any of the above, please explain. Of you need more space, attach a separate statement.)

32a 32 b 32c 32d

33 Does the organization discriminate by race in any way with respect to: a Students' rights or privileges? b Admissions policies? c Employment of faculty or administrative staff? d Scholarships or other financial assistance? e Educational policies? f Use of facilities? g Athletic programs? h Other extracurricular activities? If you answered 'Yes' to any of the above, please explain. (If you need more space, attach a separate statement.) 33*

33b
33c 33d 33e 33 f 33a 33 h

34a Does the organization receive any financial aid or assistance from a governmental agency? b Has the organization's right to such aid ever been revoked or suspended? If ycu answered 'Yes' to either 34a or b, please explain using an attached statement. 35 Does the organization certify that it has complied with the applicable requirements of sections 4.0.1 through 4.05 of Rev Proc 75-50, 1975-2 C.B. 587, covering racial nondiscri mi nation? If 'No,' attach an explanation. TEEA0404 07/23/04 BAA

Schedule A (Form 990 or 990-EZ) 2004

Schedule A (Form 990 or 990-E2) 2004

Save A L i f e

Foundation

36-3869459
N/A
Affiliated group totals

Page 5

[ Lobbying Expenditures by Electing Public Charities (See instructions.)
(To be completed ONLY by an eligible organization that filed Form 5768) Check I if the organization belongs to an affiliated group, Check *• b \ I if you checked 'a' and 'limited control' provisions apply. To be completed for ALL electing organizations

Limits on Lobbying Expenditures
(The term 'expenditures' means amounts paid or incurred.)

(■>)

36 37
38 39 40 41

Total lobbying expenditures to influence public opinion (grassroots lobbying) Total lobbying expenditures to influence a legislative body (direct lobbying)

Total lobbying expenditures (add lines 36 and 37) Other exempt purpose expenditures , Total exempt purpose expenditures (add lines 38 and 39) Lobbying nontaxable amount. Enter the amount from the following table — l( the amount on line 40 Is The lobbying nontaxabie amount is Not over $500,000 20% of the amount on line 40 Over $500,000 but not over 11,000,000 (100,000 plus 15% of the excess over (500,000 Over $1,000,000 but not over $1,500,000 $175,000 plus 10% of the excess over $1,000,000 Over $1,500,000 but not orer $17,000,000 $225,000 plus 5% cfthe excess over $1,500,000 Over $17,000,000 $1,000,000 42 Grassroots nontaxabie amount (enter 25% of line 41) 43 Subtract line 42 from line 36. Enter -0- if line 42 is more than line 36 44 Subtract line 41 from line 38. Enter -0- if line 41 is more than line 38 Caution: if there is an amount on either line 43 or line 44, you must file Form 4720.

-

4 -Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501 (h) election do not have to complete all of the five columns below. See the instructions for lines 45 through 50.) Lobbying Expenditures During 4 -Year Averaging Period Calendar year (or fiscal year beginning In) *■ 45 46 Lobbying nontaxabie amount Lobbying ceiling amount (150% Jl line 45(e)) (b> 2003 (c) 2002 (d) 200)

2004

Total

| Lobbying Activity by Nonelecbng PuMic Charities
(For reporting only by organizations that did not complete Part Vl-A) (See instructions.) During the year, did the organization attempt to influence national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of: a Volunteers b Paid staff or management (Include compensation in expenses reported on lines c through h.) c d • f Media advertisements Mailings to members, legislators, or the public Publications, or published or broadcast statements Grants to other organizations for lobbying purposes

X X X

g Direct contact with legislators, their staffs, government officials, or a legislative body h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any olher means i Total lobbying expenditures (add lines c through h.) If 'Yes' to any of the above, also attach a statement giving a detailed description of the lobbying activities.

BAA
TEEA0405 07/23/04

Schedule A (Form 990 or 990-EZ) 2004

Schedule A (Form 990 or 99Q-EZ) 2004 Save A L i f e F o u n d a t i o n 36-3869459 | Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations (See instructions)

Page 6

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) organizations) or in section 527, relating to political organizations? a Transfers from the reporting organization to a noncharitable exempt organization of: Yes No 51afl) {l)Cash X (ii)Other assets X aOi) b Other transactions: (I)Sales or exchanges of assets with a noncharitable exempt organization bfi) X (ii)Purchases of assets from a noncharitable exempt organization X bOD (Ill)Rental of facilities, equipment, or other assets — b(Hl> X <iv)Reimbursement arrangements bflv) X (v)Loans or loan guarantees b(v) X pri)Performance of services or membership or fundraising solicitations b(vi> X c Sharing of facilities, equipment, mailing lists, other assets, or paid employees c X d If the answer to any of the above is Yes, complete the following, schedule. Column £b) should always show the fair market value of the goods, other assetSj or services given by trie reporting organization. If the organization receivea less than fair market value in any transaction or sharinq arrangement, show in column (d) the value of the qoods, other assets, or services received: 00 (b) Line no. Name of noncharitable exempt organization Description of transfers, transactions, arid sharing arrangements Amount involved

52a Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations b If 'Yes.' complete the following schedule: (a) Name of organization

_

,_.

O)
Type of organization

Description of relationship

BAA
TEEAM06 II/29/C4

Schedule A (Form 990 or 990-EZ) 2004

Save A Life Foundation

36-3869459

1

Form 990, Page 1, Part I, Line 9 Special Events and Activities Statement List of Three Largest Events and Type and Number of Others Summit Race f o r L i f e Cubs Game Total Net Income (Loss)

Gross Receipts 145,401. 308. 4,380. 150,089.

Less Contributions 111,257. 140. 4,380. 115,777.

Gross Revenue 34,144. 168.

Less Direct Expenses 34,144. 168.

34,312.

34,312,

Form 990, Page 2, Part Other Expenses Stmt

Line 43

Otrier expenses not covered above (itemize): Website Dues & S u b s c r i p t i o n s Independent Contractors I n s t r u c t o r s Fees Insurance Licenses & Permits Market i n g Miscellaneous Payroll Service Recruitment Traininq Supplies Bad D e b t E x p e n s e P r o f e s s i o n a l Fees Temporary S t a f f i n g Total

(A) Total

(B) Program services 106,466. -1,132. 119,807. 16,869. 3,482. 115. 13,279. 156. 2,579. -691. 322,188. 0. 41,455. 6,288. 630,861.

(C) Management and qeneral 0. 160. 0. 0. 1,057. 731. 1,435. -391. 0. 4,303. 6. -100. 2,000. 0. 9,201.

(D) Fundraising

106,466. -972. 119,807. 16,869. 4,539. 846. 14,833. -235. 2,579. 3,612. 322,194. -100. 43,455. 6,288. 640,181,

0. 0. 0. 0. 0. 0. 119. 0. 0. 0. 0. 0. 0. 0. 119,

Form 990, Page 3, Part IV, Lines 57a & 57b Land, Buildings and Equipment Statement

(a)
Cost/Other Basis Land Buildincr O f f i c e Equipment Vehicles Total 20,000. 181,912. 146,717. 39,132. 387.761

(b) Accumulated Depreciation 0. 18,191. 96.856. 23,486. 138,533.

(c) Book Value

20,000. 163,721. 49,861. 15,646. 249,228.

Save A Life Foundation

36-3869459

2

Form 990, Page 3, Part IV, Line 65 Other Liabilities Statement Beginning of Year 490. 934. 1,424. End of Year 490. 0. 490.

Line 65 - Other Liabilities:

I n s t r u c t o r Deposits Real E s t a t e Taxes Pavable
Total

Form 990, Page 4, Part V Ust of Officers, Etc. Statement

(A) Name and address

(B) Title and average hours per week devoted to position

(C) Compensation (if not paid, enter -0-)

<D> Contributions to employee benefit plans and deferred compensation

(E) Expense account and other allowances

I r v Bock Director 0. Emil J o n e s , Jr. Director 0. S t e v e n Oreba.ugh Director 0. Ernesto Pretto Director 0. Mote: The individuals above, axceut as noted, spend time as needed in t h e i r canacitv on the Board, Thev can be c o n t a c t e d c/o Save a L i r e Foundation, 9950 Lawrence
SCe3Q0. S c h i l l e r Park, IL S0176

0.

0.

0.

0.

0.

0.

0.

0.

Total 0. 0. 0.

Save A Life Foundation

36-3869459

3

Supporting Statement of: Form 990 p 2 / L i n e 42 column Description Building Vehicle O f f i c e Ecruipinent Total (C) Amount 9,096. 7,826. 13,379. 30,301.

Supporting Statement of: Form 990 p 3 / L i n e 6 3 , column Description Due t o C a r o l S p i z z i r r i , P r e s i d e n t / E x e c . D i r e c t o r I n t e r e s t Rate - V a r i a b l e Total IA) Amount 157,655.

157,655.

Supporting Statement of: Form 990 p 3 / L i n e 6 4 b , column (A) Description M o r t q a q e D a t e d 4 / 2 8 / 0 3 , o r i q i n a l amount: $200,000 d u e d a t e : 7 / 2 8 / 0 4 , i n t e r e s t r a t e : 4.25% Total Amount

137,155. 137,155.

Supporting Statement of: Form 990 p 3 / L i n e 6 3 , column Description Due t o C a r o l S p i z z i r r i , P r e s i d e n t / E x e c . I n t e r e s t Rate - V a r i a b l e Total Director 163,654. (B) Amount

163,654.

Save A Life Foundation

36-3869459

4

Supporting Statement of: Form 990 p 4 / P a r t IV-A, L i n e b ( 4 )

Description
S p e c i a l E v e n t s Expense Donated M a t e r i a l s C o s t of Goods S o l d Total

Amount
34,312. 14,285. 13,149. 61,746.

Supporting Statement of: Form 990 p 4 / P a r t IV-B, L i n e b(4> Description S p e c i a l Events Expense Donated M a t e r i a l s C o s t of Goods S o l d Total

Amount
34,312. 14,285. 13,149. 61,746.

Additional Information For Tax Return Save A Life Foundation 36-3869459

Form 990 p 2: Exempt purpose

___

Training and developing "Bystanders", including children as volunteers equipped witii Life Saving First Aid Skills to aid in an emergency,

AHLBEGK&COMPANY
SAVE A UFE FOUNDATION, INC. AUDITED FINANCIAL STATEMENTS JUNE 30, 2005 AND 2004
CERTLFIED
PUBLIC

ACCOUNTANTS

SAVE

A LIFE

FOUNDATION,

INC.

TABLE

OF

CONTENTS

June 30, 2005 and 2004 INDEPENDENT AUDITOR'S REPORT FINANCIAL STATEMENTS Comparative Statements of Financial Position June 30,2005 and 2004 Statements of Activities For the Year Ended June 30,2005 and the Six Months Ended June 30,2004 Statements of Functional Expenses For the Year Ended June 30, 2005 and the Six Months Ended June 30, 2004 Comparative Statements of Cash Flows For the Year Ended June 30, 2005 and the Six Months Ended June 30,2004 NOTES TO FINANCIAL STATEMENTS 2 1

4

8

12

13

AHLBECK& COMPANY
CERTIFIED PUBLIC ACCOUNTANTS 1665 ELK BOULEVARD DES PLA1NES, ILLINOIS 60016-4776 TELEPHONE 847/824-4000 FACSIMILE' 847/B24-4D12 WEB: www.ahlbtckco.com

August 31, 2005 To the Board of Directors Save A Life Foundation, Inc. Schiller Park, Illinois I N D E P E N D E N T AUDITOR'S REPORT

We have audited the accompanying statements of financial position of SAVE A LIFE FOUNDATION, INC. (an Illinois not-for-profit corporation) as of June 30, 2005 and 2004, and the related statements of activities, functional expenses, and cash flows for the year and the six months then ended. These financial statements are the responsibility of the organization's management. Our responsibility is to express an opinion on these financial statements based on our audits. We conducted our audits in accordance with U.S. generally accepted auditing standards. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion.

In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of SAVE A LIFE FOUNDATION, INC. as of June 30, 2005 and 2004, and the results of its change in net assets and its cash flows for the year and the six months then ended in conformity with U.S. generally accepted accounting principles.

1

SAVE

A LIFE

FOUNDATION.

INC.

COMPARATIVE STATEMENTS OF FINANCIAL POSITION June 30, 2005 and June 30, 2004
2005
ASSETS Current Assets Cash and Cash Equivalents Inventory Trade Receivables Grants Receivable Other Receivables Prepaid Expenses Total Current Assets Fixed Assets at Net Book Value Land Building Office Equipment Vehicles Total Net Fixed Assets TOTAL ASSETS $ 813,976 56,501 22,254 496,000 1,660 3,879 1,394,270 $ 13,291 54,371 13.415 1,057,000 196 10,772 1,149,045

2004

20,000 163,721 49,861 15,646 249,228 1,643,498

20,000 172,816 38,250 23,473 254,539 1,403,584

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

SAVE

A LIFE

FOUNDATION,

INC.

COMPARATIVE STATEMENTS OF FINANCIAL POSITION June 30, 2005 and June 30, 2004 2005 LIABILITIES Current Liabilities Accounts Payable Accrued Expenses Real Estate Taxes Payable Instructor Deposits Rent Payable Mortgage Payable Total Current Liabilities Other Liabilities
) Carol Spizzirri Total Other Liabilities TOTAL LIABILITIES 163,654 163,654 669,348 157,655 157,655 333,611

2004

AND

NET $

ASSETS
19,671 395,576
-

$

6,487
-

490 89,957
-

934 490 30,890 137,155

503,694

173,956

Net Assets Temporarily Restricted Unrestricted Total Net Assets TOTAL LIABILITIES & NET ASSETS

496,000 478,150 974,150 1,643,498

1,139,543 (69,570) 1,069,973 1,403,584

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

SAVE A LIFE

FOUNDATION.

INC.

STATEMENT OF ACTIVITIES
For the Year Ended June 30,2005 Unrestricted INCOME Public Support Contributions Contributions In Kind Special Events Gross Income Total Public Support Government Contracts State of Illinois - IDPH HHS/CDC Total Government Contracts Other Income Program Service Fees Course Materials Product Sales Conference/Seminar Income Branch Fee Miscellaneous Total Other Income Investment Income Interest Income Total Investment Income T o u l Income (balances carried forward) 5,545 209,580 150,089 365,214 5,545 209,580 150,089 365,214 Temporarily Restricted Total

-

700,000 496.000 1,196,000

700,000 496,000 1,196,000

35,265 259,353 62,234 10,920 5,433 868 374,073

. -

35,265 259,353 62,234 10,920 5,433 868 374,073

1,933 1,933 741,220

-

1,933 1,933 1,937,220

1,196,000

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

SAVE

A LIFE

FOUNDATION,

INC.

STATEMENT OF ACTIVITIES
For the Year Ended June 30, 2005 ^ Total Income (balances brought forward) EXPENSES Program Kids Program Corporate Program Expansion Program Other Grants Total Program Management and General Fundraising Total Functional Expenses Special Event Expenses Total Expenses Release from Release from Release from Release from Restrictions - HHS/CDC Restrictions - DCCA Building Purchase Restrictions - State of Illinois - IDPH Restrictions - Private Grants 813,454 17,621 1,050,403 18,267 1,899,745 98,816 170 1,998,731 34,312 2,033,043 955,043 100,000 700,000 84,500 547,720 (69,570) 478,150 (955,043) (100,000) (700,000) (84,500) (643,543) 1,139,543 496,000 (93,823) 1,069,973 974,150 813,454 17,621 1,050,403 18,267 1,899,743 98,816 170 1,998,731 34,312 2,033,043 Unrestricted 741,220 Temporarily Restricted 1,196,000 Total 1,937,220

Change in Net Assets Beginning Net Assets Ending Net Assets (Deficit)

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

SAVE

A LIFE

FOUNDATION,

INC.

STATEMENT OF ACTIVITIES For the Six Months Ended June 30, 2004 Unrestricted INCOME Public Support Contributions Private Grants Contributions In Kind Special Events Gross Income Total Public Support Government Contracts State of Illinois - DCCA Rural Training HHS/CDC Total Government Contracts Other Income Program Service Fees Miscellaneous Course Materials Branch Fee Total Other Income Investment Income Interest Income Total Investment Income
TOTAL INCOME (balances carried forward)

Temporarily Restricted

Total

850 73,000 3,238 77,088

$ 84,500

850 84,500 73,000 3,238 161,388

84,500

20,000
-

-

1,020,000 1,020,000

20,000 1,020,000 1,040,000

20,000

23,160 (1,698) 1,340 3,356 26,138

. -

23,160 (1,698) 1,340 3,356 26,158

9 9 123,255

-

9 9 1,227,735

1,104,500

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

SAVE A LIFE FOUNDATION,

INC.

STATEMENT OF ACTIVITIES
For the Six Months Endedjune 30, 2004 Unrestricted TOTAL INCOME (balances brought jorward) EXPENSES Program Kids Program Corporate Program Expansion Program Allied Health Gram Total Program Management and General Fundraising Total Functional Expenses Special Event Expenses TOTAL EXPENSES Release from Restrictions - HHS/CDC Change in Net Assets Beginning Net Assets Ending Net Assets (Deficit) 62,138 8,021 134,505 20,000 224,664 21,328 7,215 253,207 600 253,807 64,957 (65,595) (3,975) (69,570)
-

Temporarily Restricted 1,104,500

Total 1,227,755 ____

123,255

-

62,138 8,021 134,505 20,000 224,664 21,328 7,215 253,207 600 233,807
-

(64,957) 1,039,543 100,000 1,139,543

973,948 96,025 1,069,973

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

SAVE

A LIFE

FOUNDATION,

INC.

STATEMENT OF FUNCTIONAL EXPENSES
For the Year Ended June 30,2005 PROGRAM
Kid's Program Corporate Program Expansion Program Other Grants

Total

Salaries & Wages Employee Benefits Payroll Taxes Other Payroll Expense Automobile Bad Debt Expense Bank Service Fees Branch Development Computer Expenses Cost of Good Sold Depreciation Dues & Subscriptions Independent Contractors Instructor Fees Insurance Legal & Accounting Licenses & Permits Marketing & Promotional Meetings Miscellaneous Operating Interest Office Supplies Payroll Service Postage Professional Fees Recruitment Rent Repairs & Maintenance Telephone Temporary Staffing Training Supplies Travel Utilities W e b Site Total Program Expenses Administration Allocation Total Expenses

$ 222,456 $ 2,602 11,389 204,957 45 2,815 1,128 35,562 130 1,440 5,463 728 8,490 141 347 (1) 26,762 1,634 1,323 207,568 1,272 2,808 74,397 813,454 42,312 855,766

3,355 $ 84 374 9 13,754 51 (20) 16 17,621 917 18,538

311,512 S 7,549 27,943 (1,909) 2,281 264 258,896 110 (1,132) 119,807 300 2,354 8,893 (15) 11,199 13.479 12,182 2,438 3,155 (670) 83,009 762 9,183 4,668 113,553 27,987 537 32,069 1,050,403 54,637 1,105,040

9,506 239 1,061 30 640 1,171 2,594 297 1,051 1,679 18,267 950 19417

$

546,829 10,474 40,767 (1,909) 2,281 264 463,853 30 164 (1,132) 119,807 16,869 3,482 44,455 115 13,279 13,479 5,463 728 21,843 2,579 6,147 (691) 109,771 762 10,817 6,288 322,188 30,938 3,345 106,466 1,899,745 98,816 1,998,561

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS
a

SAVE

A LIFE

FOUNDATION,

INC.

STATEMENT OF FUNCTIONAL EXPENSES For the Year Ended June 30, 2005 SUPPORT
Managemnt. & General Fundraising $ 31,174 $ 767 3,401 (100) (2) 18,385 30,301 160 1,057 731 1,435 (390) 6,210 (751) (140) 2,000 4,303 6 6 264 98,816 (98,816) 119 2 25 24 170 170 $ Organization Total $ 578,003 11,241 44,168 (1,909) 2,281 (100) 262 463,853 30 18,549 30,301 (972) 119,807 16,869 4,539 44,455 846 14,833 13,479 5,073 6,938 21,094 2,579 6,032 2,000 3,612 109,771 762 10,847 6,288 322,194 31,202 3,345 106,466 1,998,731 1,998,731

Total 31,174 767 3,401 (100) (2) 18,385 30,301 160 1,057 731 1,554 (390) 6,210 (749) (115) 2,000 4,303 30 6 264 98,987 (98.816) 171

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

SAVE

A LIFE

FOUNDATION,

INC.

STATEMENT OF FUNCTIONAL EXPENSES For the Six Months Ended June 30, 2004 PROGRAM

Kid's Program

Corporate Program

Expansion Program

Allied Health Grant

Total

Salaries & Wages Employee Benefits Payroll Taxes Other Payroll Expense Automobile Bad Debt Expense Bank Service Fees Branch Development Computer Expenses Cost of Good Sold Depreciation Dues & Subscriptions Equipment Rental Independent Contractors Instructor Fees Insurance Legal & Accounting Licenses & Permits Marketing & Promotional Meetings Miscellaneous Operating Interest Office Supplies Payroll Service Postage Printing St Reproduction Professional Fees Program Development Recruitment Rent Repairs & Maintenance Telephone Training Supplies Travel Utilities Web Site Total Program Expenses Administration Allocation Total Expenses

$

44,000

$

59,819 $ (814) 4,646 1,909

6,588 400 -

$

110,407 (414) 4,646 1,909

(264) 119 (5,531) 1,217

(264) 119 (5,531) 1,217

7,721

1,496 7,850 20 10 919 (661) 867 439 1,000 670 48,376 3,979 (285) 5,446 1,475 1,803 134,505 12,769 147,274

1,950 9,026 _ 913 70 _ 1,053 20,000 1,899 21,899

7,721 3,446 7,850 20 10 9,945 3,315 502 867 524 1,000 670 62,349 5,109 5,446 1,998 1,803 224,664 21,328 245,992

3,315 250 15

13,973 77 285 523 62,136 5,899 68,037 8,021 761 8,782

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

SAVE

A LIFE

FOUNDATION,

INC.

STATEMENT OF FUNCTIONAL EXPENSES For the Six Months Ended June 30, 2004 SUPPORT
Managemnt. & General Fundraising Organization Total

Total

$

$

-

$ -

$

110,407 (414) 4,646 1,909 75 260 119 (5,531) 16,958 1,217

75 524

-

75 524

16,958 -

16,958

607

607

1,250

1,250

7,721 4,053 7,850 20 1,260 9,945 6323 465 867 543 1,000 670 62,349 5,109 11392 1,998 1,996 253,207 253,207

3,008 (37) 19 5,946 193 21,328 (21,328) 7,215 7,215 -

3,008 (37) 19 -

5,946 193 28,343 (21,328) 7,215

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 11

SAVE

A LIFE

FOUNDATION,

INC.

COMPARATIVE STATEMENTS OF CASH FLOWS For the Year Ended June 30, 2005 and the Six Months Ended June 30, 2004 2005 Cash Flows from Operating Activities: Change in net assets Adjustments to reconcile change in net assets to net cash provided by (used in) operating activities: Non-cash in kind donations - fixed assets Depreciation Changes in current assets and liabilities: Decrease (increase) in accounts receivable Decrease (increase) in inventory Decrease (increase) in grants receivable Decrease (increase) in other current assets Increase (decrease) in accounts payable Increase (decrease) in other payables Net cash provided by (used in) operating activities Cash Flows front Investing Activities: Purchase of fixed assets Net cash provided by (used in) investing activities Cash Flows from Financing Activities: Issuance of short-term debt Repayment of short-term debt Net cash provided by (used in) financing activities 6,210 (137,366) (131,156) (20,490) (20,490) $ (95,823) $ 973,948 2004

(4,500) 30,301

16,958

(8,839) (2,130) 561,000 5,429 13,184 453,709

9,300 12,648 (957,000) (6,334) (22,309) 48,897

952,331

76,108

(57,261) (37,261)

Net increase (decrease) in cash & cash equivalents Cash & cash equivalents at beginning of period Cash fix cash equivalents at end of period Supplemental Disclosures: Interest paid

800,685 13,291 813,976

18,847 (5,556) 13,291

$

6,938

$

6,323

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS
n

SAVE A LIFE FOUNDATION. INC. N O T E S T O FINANCIAL STATEMENTS For the Year Ended June 30, 2005 and the Six Months Ended June 30,2004

NOTE 1 - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Nature of Activities Save A Life Foundation, Inc. (SALF) works to train and develop "Bystanders", including children, as volunteers equipped with life supporting first aid skills to aid in an emergency the injured or ill. SALF received 36% of its total income in the year ended June 30, 2005 from the State of Illinois Department of Public Health (IDPH) and 26% from the U.S. Department of Health and Human Services/Centers for Disease Control. The remainder of SALF's income is from program fees, private contributions, and other miscellaneous sources. Change in Accounting Period SALF has changed their year end for accounting purposes to June 30,h from December 31". As a result, the accompanying financial statements cover the year ended June 30, 2005 and the six months ended June 30, 2004. This was done to provide for belter matching of the accounting cycle to the operations. Basis of Accounting The financial statements of SALF have been prepared on the accrual basis of accounting and accordingly reflect all significant receivables, payables, and other liabilities. The net assets of SALF are classified as follows: • Unrestricted, which represent the portion of expendable net assets that are available for operations. Temporarily Restricted, which represent grants which are for future periods. Upon termination of the restriction, a reclassification is made to unrestricted net assets.

Estimates The process of preparing financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions. These estimates and assumptions affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and reported amounts of income and expenses during the reporting period. Actual results could differ from those estimates. Cash and Cash Equivalents For purposes of the statement of cash flows, SALF considers all checking accounts, money market accounts, and petty cash to be cash equivalents. Receivables and Credit Policies Trade receivables are obligations due under normal trade terms requiring payment upon demand. There is no interest or fees charged on receivables. The amount of uncollectible trade receivables as of June 30, 2005 and 2004 is immaterial.

13

SAVE A L I F E

FOUNDATION,

INC.

NOTES TO FINANCIAL STATEMENTS
For the Year Ended June 30, 2005 and the Six Months Ended June 30, 2004 Management has elected to record bad debts using the direct write-off method. Generally accepted accounting principles require that the allowance method be used to reflect bad debts. However, the effect of the use of the direct write-off method is not materially different from the results that would have been obtained had the allowance method been followed. Inventories Inventories are stated at cost using the weighted cost average method. Fixed Assets Fixed assets are carried at cost if purchased or fair value if contributed for current additions. Depreciation is computed on the straight-line method over 5-7 years for vehicles, computer equipment, furniture and office equipment and over 20 years for buildings. Maintenance, repairs and minor costs are expensed as incurred. When properties are retired or otherwise disposed of, the related cost and accumulated depreciation are removed from the respective accounts and any profit or loss on disposition is credited or charged to operations. Policy on Contributions Contributions received are recorded as unrestricted, temporarily restricted, or permanently restricted support, depending on the existence and/or nature of any donor restrictions. Support that is restricted by the donor is reported as an increase in unrestricted net assets if the restriction expires in the reporting period in which the support is recognized. All other donor-restricted support is reported as an increase in temporarily or permanently restricted net assets, depending on the nature of the restriction. When a restriction expires (that is, when a stipulated time restriction ends or purpose restriction is accomplished), temporarily restricted net assets are reclassified to unrestricted net assets and reported in the Statement of Activities as net assets released from restrictions. Income Taxes SALF is exempt from income taxes under Section 501 (c)(3) of the Internal Revenue Code. In addition, SALF qualified for the charitable contribution deduction under Section 170(b)(l)(A)(vi) and has been classified as an organization other than a private foundation under Internal Revenue Code Section 509(a)(2). Functional Allocation of Expenses In the Statement of Functional Expenses, salaries and related expenses are first charged to the various programs and supporting services on the basis of actual expense. Expenses are then allocated based on various criteria, such as time spent in various areas.

NOTE 2 - DONATED MATERIALS AND SERVICES In-kind donations of materials and fixed assets are recorded as financial support at their estimated fair value at the date of donation. Such donations are reported as unrestricted support unless the donor has restricted the donated asset to a specific purpose. Conditional transfers of assets are recognized when the conditions upon which they depend are substantially met. During the year ended June 30, 2005 and the six months ended June 30, 2004, SALF received $25,980 and $500 respectively, in donations of this type. 14

SAVE A L I F E

FOUNDATION,

INC.

NOTES TO FINANCIAL STATEMENTS For the Year Ended June 30, 2005 and the Six Months Ended June 30, 2004 Donations of services are recorded if they create or enhance a nonfinancial asset or are specialized skills that would be purchased if they were not donated. SALF received donations of this type in the year ended June 30, 2005 and the six months ended June 30, 2004, of $171,909 and $62,500, respectively. Donations of use of facilities are recorded at their fair market value. Such donations are reported as unrestricted supports. During the year ended June 30, 2005 and the six months ended June 30, 2004, SALF received in-kind contributions of rent for $11,691 and $10,000, respectively.

NOTE 3 - CASH & CASH EQUIV1LANTS SALF maintains the majority of its cash at a single financial institution located in Schiller Park, Illinois. This account is insured by the Federal Deposit Insurance Corporation up to $100,000. As of June 30, 2005 and 2004, SALF's uninsured cash balances total $736,130 and $0, respectively.

NOTE 4 - FIXED ASSETS At June 30, 2005 and 2004, the costs of such assets were as follows: June 30, 2QQ5 2Sm $ 20,000 $ 20,000 181,912 181,912 146,717 121,727 39,132 39,132 387,761 138,533 249,228 362,771 108,232 254,539 Increase meoeasej $ 24,990 24,990 30,301 (5,311)

Land Building Office Equipment Vehicles Less accumulated depreciation Net book value

Depreciation expense for the year ended June 30, 2005 and the six months ended June 30, 2004 is $30,301 and $16,958, respectively.

NOTE 5 - MORTGAGE PAYABLE The mortgage payable at J u n e 30, 2 0 0 5 a n d 2004 consisted of the following: 200_5_ $0 2004 $137,155

Mortgage payable to Bank O n e originally d u e o n April 28, 2004, secured by the 520 E. Capitol Ave., Springfield 1L building, including interest at 4,25%. This was subsequently extended to July 28, 2004. 15

SAVE A L I F E

FOUNDATION,

INC.

N O T E S T O FINANCIAL STATEMENTS For the Year Ended June 30, 2005 and the Six Months Ended June 30, 2004 NOTE 6 - TEMPORARILY RESTRICTED NET ASSETS Temporarily restricted net assets at June 30, 2005 and 2004 consist of the following: 2QQ5. $ 2004 $100,000

Illinois Department of Commerce and Community Affairs - restricted for the purchase of a building in Sprmgfield, IL United States Department of Health and Human Services/ Center for Disease Control - restricted to use according to the grant agreement and also according to time release restriction McDonald's Chicago Public Schools Project - to train 10,000 fourth graders; $50,000 total from Ronald McDonald's Charities, $24,500 from Chicago Public Schools Blue Cross Blue Shield - to train 10,000 children in upcoming school year Total

496,000

955,043

-

74,500

-__

10.000

496.000

1.119.543

NOTE 7 - COMPENSATED ABSENCES SALF has a vesting vacation policy. The amount of existing vacation time remaining as of June 30, 2005 and June 30, 2004 is immaterial.

NOTE 8 - DUE TO RELATED PARTY The organization's founder and current executive director, Carol Spizzirri, loaned SALF start up and operations funding. As of June 30, 2005 and 2004, the amount of this loan is $163,654 and $157,655, respectively. Interest is accrued annually using the Internal Revenue Service Applicable Federal Rates.

16

SAVE A LIFE FOUNDATION. INC. NOTES T O FINANCIAL STATEMENTS For the Year Ended June 30, 2005 and the Six Months Ended June 30, 2004 NOTE 9 - LEASE OBLIGATION AND RENTAL EXPENSE The estimated future minimum rental and operating lease obligation for the succeeding years under non-cancelable leases for office facilities in effect a: June 30, 2005 are as follows: Year Ending June 30, 2006 2007 2008

Rent
102,726 107,737 110,242

Rental expense under the operating leases was 5109,771 for the year ended June 30, 2005 and $62,349 for the six months ended June 30, 2004.

NOTE 10 - SPECIAL EVENTS Special event income is shown at the gross amount in the Statement of Activities. Special event expense is also shown in the Statement of Activities. The following schedule details the gross income and expense components for each event: Six Months Ended Tun* 30. 2004 Year Ended Tune 30, 2005 Revenue Expenses Nei £SY£HH£ Expenses H& Summit Race for Life Cubs Game Other $145,401 $34,144 308 168 4,380 l^p.pfTO $111,237 140 4,380 $ - $ 2,588 - $ 2,588

17

»

T

«

*

FnOffic lUaaOife

PMT#

ILLINOIS CHARITABLE ORGANIZATION ANNUAL REPORT
Attorney General LISA M A D I G A N State of Illinois Charitable Trust Bureau, 100 West Randolph 11th Floor, Chicago, Illinois 60601 CO # 01026498 Report for the Fiscal Period: Beginning 07
& Endino <*
MO

Form AG990-IL Revised 3/05

AMT

JT\5
TJc<_
36 3869459

IHIT

,01
/ 3Q
DAY

/

05

/ 06
YR

CAecft aff Hams attached: Zl Copy of IRS Return MMHCfwta 21 Audited Financial Statements £*•«»* a Copy of Farm IFC SJ^T" H S15.00 Annual Report Filing Fee em*,*.** □ $100.00 Late Report Filing Fee
MO DAY YR

Federal I D S ' Are contributions to the organization tax deductible? LEGAL Save a Life Foundation NAME MAIL 9950 W. Lawrence, Suite 300 ADDRESS

g) Y»* O No

Date Organization was created: 02 Year-end amounts A) ASSETS B) LIABILITIES C) NET ASSETS PERCENTAGE % A) 5 1,161,576 B>$ 357,975 C>$ 803,601

/ 09 / 93

C,

i^

Sd,akrPrt ILai76

-

I. SUMMARY OF A L L REVENUE ITEMS DURING THE YEAR:

AMOUNT D)I 189,738 E) $ 700,000

D) PUBLIC SUPPORT, CONTRIBUTIONS & PROGRAM SERVICE REV. (GROSS AMTS.) 21.30 E) GOVERNMENT GRANTS S MEMBERSHIP DUES F) OTHER REVENUES G) TOTAL REVENUE. INCOME AND CONTRIBUTIONS RECEIVED (ADD D,E, & F) II. SUMMARY OF A L L EXPENDITURES DURING THE YEAR: H) OPERATING CHARITABLE PROGRAM EXPENSE I) EDUCATION PROGRAM SERVICE EXPENSE J) TOTAL CHARITABLE PROGRAM SERVICE EXPEH3E (ADD H & 1} J1> JOINT COSTS ALLOCATED TO PROGRAM SERVICES {INCLUDED IN J): K) GRANTS TO OTHER CHARITABLE ORGANIZATIONS L) TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD J ft K)
1

78.59 .11 % 100% 94.75 % % 94.75 %

F ) » 956 G) J 890,694 H) S 1,005,527 »> J)S 1,005,527

% % 5.25 % % 100%

K)S L)S M) S 55,716 N)$ 0 CO* 1,061,243

M) MANAGEMENT AND GENERAL EXPENSE H) FUNDRAISING EXPENSE O) TOTAL EXPENDITURES THIS PERIOD (ADD L, M, ft N)

III. SUMMARY OF A L L PAID FUNDRAISER AND CONSULTANT ACTIVITIES: (Attach Attorney General Report of Individual F undralsing Campaign- Form IFC. One for each PFR. PROFESSIONAL FUNDRAISERS: P) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISERS O) TOTAL FUNDRAISERS FEES AND EXPENSES R) NET RECEIVED BY THE CHARITY (P MINUS Q-R) PROFESSIONAL FUNDRAISING CONSULTANTS: S) TOTAL AMOUNT PAID TO PROFESSIONAL FUNDRAISING CONSULTANTS IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS DURING THE YEAR: T) NAME, TITLE: Carol Spizzini, President/Founder U) NAME, TITLE Dane Neal, National Policy Director V) NAME, TITLE: Robert Barnes, Director V. CHARITABLE PROGRAM

100% %

P)*
Q)$

R)l S)S

T)$ 130,000 LJ> * 63,500

V) $ 55,000 List on beck side of instructions DESCKPJlOH:cHMiTMUPiwaiumpHKM^BYtexpaio^MMtJih^c^ CODE W)#011 Xl>#> Y)#

W) DESCRIPTION: Life Saving First Aid Training X) DESCRIPTION Y) DESCRIPTION


IF THE ANSWER TO ANY OF THE FOLLOWING IS YES, ATTACH A DETAILED EXPLANATION: 1. 2. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION. FINE, PENALTY OR JUDGMENT? _ _ HAS THE ORGANIZATION OR A CURRENT DIRECTOR. TRUSTEE, OFFICER OR EMPLOYEE THEREOF, EVER BEEN CONVICTED BY ANY COURT OF ANY MIDSDEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY? 1.

WT
YES NO

*

2.

3.

DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES OWNS AN INTEREST; OR WAS IT A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES HAS A MATERIAL FINANCIAL INTEREST; OR DID ANY OFFICER. DIRECTOR OR TRUSTEE RECEIVE ANYTHING OF VALUE NOT REPORTED AS COMPENSATION? 3. HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER, DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES? IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION?

4

4.

5.

5.

6.

DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER? (ATTACH FORM IFC)_ _ _ 6.

7a. DID THE ORGANIZATION ALLOCATE THE COST OF ANY SOLICITATION, MAILING, ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES?

7

-

7b. IF "YES", ENTER (i) THE AGGREGATE AMOUNT OF THESE JOINT COSTS $ ;(ii)THE AMOUNT ALLOCATED TO PROGRAM SERVICES $ ; (ill) THE AMOUNT ALLOCATED TO MANAGEMENT AND GENERAL £ ; AND (iv) THE AMOUNT ALLOCATED TO FUNDRAISING £ 8. DID THE ORGANIZATION EXPEND ITS RESTRICTED FUNDS FOR PURPOSES OTHER THAN RESTRICTED PURPOSES? _ __ HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION OR TAX EXEMPTION SUSPENDED OR REVOKED BY ANY GOVERNMENTAL AGENCY? 9.

8.

9.

10. WAS THERE OR DO YOU HAVE ANY KNOWLEDGE OF ANY KICKBACK, BRIBE, OR ANY THEFT, DEFALCATION MISAPPROPRIATION, COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS? 10. 11. LIST THE NAME AND ADDRESS OF THE FINANCIAL INSTITUTIONS WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST ACCOUNTS:

Bank One N.A., P.O. Box 260180, Baton Rouge, LA 70826-0180 TCF National Bank, 500 W. Joliet Rd., Willowbrook, H. 60527
12. NAME AND TELEPHONE NUMBER OF CONTACT PERSON:
Caro1

Spizzirri (847) 928-9683

ALL ATTACHMENTS MUST ACCOMPANY THIS REPORT • SEE INSTRUCTIONS UNDER PENALTY OF PERJURY, I (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS ANNUAL REPORT AND THE ATTACHED DOCUMENTS, INCLUDING ALL THE SCHEDULES AND STATEMENTS AND THE FACTS THEREIN STATED ARE TRUE AND COMPLETE AND FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE STATE OF ILLINOIS RELY THEREUPON. I HEREBY FURTHER AUTHORIZE AND AGREE TO SUBMIT MYSELF AND THE REGISTRANT HEREBY TO THE JURISDICTION OF THE STATE OF ILLINOIS.

BE.3MRE.TJl W & H K A k k F J i B L Q ! ^ 1.) REPORTS ARE DUE WITHIN SIX MONTHS OF YOUR FISCAL YEAR END. 2.) FOR FEES DUE SEE INSTRUCTIONS. 3.) REPORTS THAT ARE LATE OR INCOMPLETE ARE SUBJECT TO A $100.00 PENALTY.

PRESIDENT or TRUSTEE (PRINT NAME) uplifts TREASURER or TRUSTEE (PRINT NAME)

it/Ajto*

4

c f t < -1**-**
SIGNATURE DATE

PREPARER {PRINT NAME)

Form

990

Return off Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of. the Internal Revenue Code (except Mack lung benett bust or private foundation)

□MB Ho. 1545-0047

2005
Open to Public Inspection

Department of the Treasury Internal Revenue Service

The organization may have to use a copy of this return to satisfy state reporting requirements.

A For the 2005 olendaryear.ortaxvearBeglnnlng C Name ol afganiwtion B ChKk if applicable:
Address chanoe Name change Initial return Final return Amended return Application pending Pleas* UM HIS label at print o*W. Sea •padfc imbue Hem.

Jul

1

, 2005, and ending

J u n 30

2006
36-3869459

D emoto»wld*n«rl«e«iMun**f

Save A L i f e

Foundation
Room/suite

Nunbaf and street (M F-O. bo* it mail it not delivered to street addr)

E TeleetHMem

9950 Lawrence
City, toon or country

300
State ZIP code* 4

(847)

928-9683

S c h i l l e r Park

IL

60176

|~1 o r (wwcifr)1*

m

Accrual

• Section S01(cX3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A (Form99Bor990-EZ).

H tnd\ me nol applicable to section 527 otgamzatkirriH ( a ) is this a grout return tar affiliates? . . . Q Ye* H ( b ) lfTe«/enternurntnrofaffiliWu*' H (C) Are all affiliates included? ' - LJ (If No,' attach a ksL See iistrudjansj H ( d ) Is Hihs a separate return filed by an oroaniation covered by a gnxip ruling? |
V n

0

He

S

WebsHe:^www.salf.org
Organization 3 * fruertno.) «W(a)P) »r 527 (check only one; 501M Check here *■ Q if the organization's gross receipts are normally not more than $25,000. The organization need not file a return with the IRS; but it the organization chooses to file a return, be sure to file a complete return. Some slates require a complete return.

0

K

3^

J*L

n

in

|yw

[ x | Mb

I

L

Gross receipts: Add lines 6b. Sb. 9b. and 10b to line 12

902_j_426. Revenue, Expenses, and Changes in Net Assets or Fund Balances (See instructions)

Group Exemption Number empti Check * * O i f the organization is not required to attach Schedule S (Form 990,990-EZ, or 99C-PF).

Contributions, gifts, grants, and similar amounts received: la 94,403. lb 1c 700,000. c Government contributions (grants) d TrtKftlePw* S 7 9 4 . 4 0 3 . *™asr, $ ) Z Program service revenue including government fees and contracts (from Part Vlt, line 93) 3 Membership dues and assessments 4 Interest on savings and temporary cash investments 5 Dividends and interest from securities 6a Gross rents 6a b Less: rental expenses 6b c Net rental income or floss) (subtract line 6b from line 6a) 6c 7 Other investment income (describe *" (A) Securities (B) Other 8a Gross amount from sales of assets other 8a 5,800. than inventory b Less: cost or other basis and sales expenses 11,732.1 8b c Gain or (loss) (attach schedule) .. S e e , -L-.8. .Stint. ■. 8c -5,932.1 d Net gain or (loss) (combine line 8c, columns (A) and (B)) 8d
a Direct public support b Indirect public support

794,403. 95,335.
4,882,

-5,932.

Special events and activities (attach schedule). If any amount is from gaming, check here Gross revenue (not including $ of contributions reported on line 1a) 9a Less: direct expenses other than tundraising expenses 9b c Net income or Ooss) from special events (subtract line 9B from line 9a) 10a Gross sales of inventory, less returns and allowances
...

*Q

9c 101 10b 10c 11 12 13 14 15 16 17 18
20_ 21 803,601, TEEAOIOI 02103m Form 990 (2005)

Less: cost of goods sold c Gross profit or (loss) tram sales of irwentory (attach schedule) (subtract line 10b from line 10a) 11 Other revenue (from Part VII, line 103)

b

12 13 14 19 16 17 18 19 20 21

Total revenue (add lines I d . 2 . 3 , 4 , 5 , 6c, 7. 8d, 9c, 10c, and 11) Program services (from line 44, column 03)) Management and general (from line 44, column (O) Fund raising (from line 44, column (D» Payments to affiliates (attach schedule) Total expenses (add lines 16 and 44, column (A)) ., Excessor (deficit) fortheyear (subtract line 17fromline 12) Net assets or fund balances at beginning of year (from line 73, column (A)) Other changes in net assets or fund balances (attach explanation) Net assets or fund balances at end of year (combine tines IB, 19, and 20) .

2,006, 890,694, 1,005,527. 55,716.

1,061,243. -170,549.
974.15Q.

BAA For Privacy Act and Paperwork Reduction Act Notice, see the separate Instructions.

Form 990(2005)

Save ft L i t e F o u n d a t i o n

36-3B69459

Page 2

S t a t e m e n t Of F u n c t i o n a l E x p e n s e s All organizations must complete column (A). Columns (B), (C), and (D> are required for section 501 (c)(3) and £4) organizations and section 4947(a)(1) nonexempt charitable trusts but optional for others. Do not include amounts reported on line 6t>,8b,9b, 10b, or 16 of Part I.

22 Grants and allocations (art sen)
(cash non-cash $ $ 412,273.

AO

23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43

If this amount includes —. foreign grants, check here .. *■ |_| Specific assistance to individuals (alt sell) Benefits paidtoor for members (att sen) Compensation of officers, directors, etc Other salaries and wages Pension plan contributions Other employee benefits Payroll laxes Professional fundraising fees Accounting fees Legal fees Supplies Telephone Postage and shipping Occupancy Equipment renlal and maintenance — Printing and publications Travel Conferences, conventions, and meetings Interest Depreciation, depletion, etc (attach schedule) Otter expenses not cowered above (itemize):

313,141
27 28 29 30 31 32 33 34 35 37 38

28,155

9,033
46,426

7,.529 41,166.

1,504. 5,260.

JL
0.

10,707 13,170
3,883

9.990 12,897.
3^865

717.
273.

JL JL

19,846 6,160 49,419
8,653

15,234. 6,069 49,142
8,583

18. 4,612. 91
277. 70

i

o. JL JL JL
0,

39
40

41

8,181
33,602

6,320 33,602 6,119 1,084 68,110 701 115
36,829

1,861

a _Auto_ E x p e n s e

c _Cgmjm t er_ E x p e n s e s _ d Website «_Dues_ & _ S u b s c r i £ t i o n s f ^Independent^ . C o n t r a c t o r s_ _
g Jw_pther^xpensejs Stmt 44 Total functional exptntes. Add lines 22 through 43. (Organizations completing columns (B) • (0), carry tfese^tolabtolines 13-15).

43a 43b 43c 43d 43* 431
43g.

6,165
1,084

68,110 701 115
36,829

46. 0. 0. 0. 0

296,018 1,061,243.1

289,686 1.005,527

6,332 55,716

JL JL JL JL JL o.

44

Joint Costs. Check . * Q if you are following SOP 98-2, w Are any joint costs from a combined educational campaign and fundraising solicitation reported in (B) Program services? \_j Yes [x] No If 'Yes,' enter (i) the aggregate amount of these joint costs $ ;(ii)the amount allocated to Program services S ; (I'D the amount allocated to Management and general $ ; and (Iv) the amount allocated to Fundraising $ Form 990 (2005) BAA

TEEM102

ll«l«M

'

'

I

Form 990 (2005) Save ft. L i f e Foundation Statement of Program Service Accomplishments

36-3BiM19

_PageJ

Form 990 is available for public inspection and. for some people, serves as the primary or sote source of information about a particular organization. How the public perceives an organization in such cases may be determined by the information presented on its return. Therefore, please make sure the return is complete and accurate and fully describes, in Part III, the organization's programs and accomplishments. Program Service Expenus What is the organization's primary exempt purpose? » J3ee J i t t a c h e d _ iund tor 501<c)(3) and All organizations must describe their exempt purpose achievements in a clear and concise manner. State the number of ipanizatons and clients served, publications issued, etc. Discuss achievements that are not measurable. (Section 501 (c)(3) and (4) organ'<a)tlf trusts; but izations and 4947(a)(1) nonexempi charitable trusts must also enter the amount of grants and allocations to others.) optional for other* ■)

■ _National_ Prc^rams_- _which_de_liye_r_ lifjf_suppgrting_ J i r s t _ a i d _ t r a i n i n g _ _to _kf 12_ _students_ _in _PAt _WI.[_ J r N_ a J^_FI^_uti_lizing -?.?ij2^?!l _comp_ensated _ i n s t r u c t p r s _(_26 ,_114 _ t a u g h t l
(Grants and allocations $ 0 . ) If this amount includes foreign grants, check here *~ \]

401,055.

bj!tar^_Programs_-^_ w h ^ h _ d e l i v e r ^ l i f e _supp.qrting_ f i r s t _aid . t r a i n i n g . _to _krl2. . s t u d e n t s . _in J^L J i t i l i _ z i n g -Stipend .compensated i n s t r u c t o r s _

J1 l6_i 2 £6_ taught)
(Grants and allocations

11 _ _ I _ I
0 . ) If this amount includes foreign grants, check here *" \]

$

604,472

c^ranch_Programs _-_ which . d e l i v e r _ l i f e _supjrorting_first_ aid. g r a i n i n g . _ _to _K^ 12_ _students. ,thjrpugh_ Jn-JCind .time. d o n a t i o n s _ f r o m . v o l u n t e e r . i n s t r u c t o r s _(4 i_l_5^_taugh_tj
(Grants and allocations $

0 . ) If this amount includes foreign grants, check here *~ \[

(Grants and allocations $ ) If this amount includes foreign grants, check here * * T l • Other program services (Grants and allocations ) If this amount includes foreign grants, check here *• |~1 f Total ol Program Service Expenses (should equal line 44. column (B). Program services;) BAA

1,005,527.
Form 990 (2005)

TEEA0103

10/1*05

Form 990 (2005)

Save A L i f e

Foundation

36-3869459

PagB4

Balance Sheets (See instructions) Note: Where required, attached schedules and amounts within the description column should be for and-of-yaar amounts only. 45 Cash — non-interest-bearing 46 Savings and temporary cash investments 47a Accounts receivable b Less: allowance for doubtful accounts 48a Pledges receivable b Less: allowance for doubtful accounts 49 Grants receivable 50 Receivables from officers, directors, trustees, and key employees (attach schedule) 51 a Ottor notes & loans receivable (attach sch) I 51a b Less: allowance for doubtful accounts | 51b 52 Inventories for sate or use 53 Prepaid expenses and deferred charges 54 Investments - securities (attach schedule) , * [ ] Cost 0 55a Investments - land, buildings, & equipment: basis . 55a b Less: accumulated depreciation (attach schedule) 56 Investments - other (attach schedule), 57a Land, buildings, and equipment: basis. 55b 57a 395,964, 249,228. 1,643,498, 505,204. 57c 58 59 60 61 62 63
64a

Beginning of year 3,758, 810,218.

End of year iSPy 1,007. 591,786,

5,495, 22,254. 5,495.

4Bc 4 9 6 , 0 0 0 . 49 50 51c 52 53 54

256,000.

56,501. 5,539. FMV

56,400, 11,304,

55c 56

bLess: accumulated depreciation (attach schedule) L-5.7. . S t m t . 57b 156,380 58 Other assets (describe *• 59 Total assets (must equal line 74). Add lines 45 through 58 60 Accounts payable and accrued expenses 61 Grants payable 62 Deferred revenue 63 Loans from officers, directors, trustees, and key employees (attach schedule) 64a Tax-exempt bond liabilities (attach schedule) b Mortgages and other notes payable (attach schedule) 65 Other liabilities (describe »• I n s t r u c t o r D e p o s i t s 66 Total HaMWes. Add lines 60 through 65 Organiza1lonsthatfollowSFAS117,crwchh«n *- |xjand complete lines 67 through 69 and lines 73 and 74. 67 Unrestricted 68 Temporarily restricted 69 Permanently restricted [~~| and complete lines Organizations that do not lollow SFAS117, check here 70 through 74. 70 Capital stock, trust principal, or current funds 71 Paid-in or capital surplus, or land, building, and equipment fund 72 Retained earnings, endowment, accumulated income, or other funds ..
. )

239,584, 1,161,576. 187,342.

163,654.

170,183.

490. 669,348,

64b 65

450. 357,975,

478,150, 496,000.

68

532,601. 271,000.

71 72 974,150. 1,643,498. 803,601. 1,161,576. Form 990 (2005)

73 Total net assets or fund balances (add lines 67 through 69 or lines 70 through 72; column (A) must equal line 19; column (B) must equal line 21) 74 Total liabilities and net assets/fund balances. Add lines 66 and 73 BAA

TEEA0104

1*17(135

Form 990 i

Save A L i f e

Foundation

36-3869459

Page5

| Reconciliation of Revenue per Audited Financial Statements with Revenue per Return (See instructions.)
Total revenue, gains, and other support pet audited financial statements Amounts included on line ■ but not on Part I, line 12: 1 Net unrealized gains on investments 2Donated services and use of facilities 3Recoveries of prior year grants

1,877,081.
b1 b2 b3 b4

973f687.

40ther (specify): . D o n a t e d _SyEE?-_ies 12,700.
|h | c dl d2 Add lines dl and d2 Total revenue (Part I, line 12). Add lines c and d Add lines bl through M c Subtract line b from line ■ Amounts included on Part I, line 12, but not on lines: d 11nvestment expenses not included on Part I, line 6b 20ther (specify):

986,387, 890,694.

890,694,

Reconciliation of Expenses per AudHed Financial Statements with Expenses per Return
Total expenses and losses per audited financial statements Amounts included on line a but not on Part I, line 17: 1 Donated services and use of facilities 2Prior year adjustments reported on Part I, line 20 3Losses reported on Part I, line 20

2,047,630.
bl b2 b3 b4

973,687.

40ther (specify): . D o n a t e d J i u g g l i e s 12,700. 986,387. 1,061,243,
dl d2 Add lines dl and d2 Total expenses (Part I, line 17). Add lines c and d or key employee at any time during the year even if they were not compensated.) (See the instructions.) (B) Title and average hours (C) Compensation (D) Contributions to per week devoted (If not paid, employee benefit (A) Name and address enter-0-) plans and deferred to position compensation plans Sjaizzirri Chairman/Exec D i r 4 0 Rita Mullins Vice Douglas Browne Treasurer Peggy Trimble Vice Mark Mitchell Director See List of OfficerSj.Etc. Statement 0. 0. 0. Chairwoman 0. 0. 0. 0. 0. 0. Chairwoman 0. 0. 0. 130,000. Add lines b1 through M Subtract line b from line a Amounts included on Part I, line 17, but not on line a: 11nvestment expenses not included on Part I, line 6b .. 20ther (specify):

1,061,243.

Current Officers, Directors, Trustees, and Key Employees (List each person who was an officer, director, trustee,
(E) Expense account and other allowances

Carol

1,900.

0.

BAA

TEEA0105

KV17/M

Form 990 (2005)

Form 990 <

Save A L i f e Foundation I Current Officers, Directors. Trustees, and Key Employees (continued)

36-3869459

Page 6

75a Enter thetotalnumber of officers, directors, and trustees permitted to vote on organization business as board meetings b Are any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part ll-A or ll-B, related to each other through family or business relationships? II Yes,' attach a statement that identifies the individuals and explains the relationship^) c Do any officers, directors, trustees, or key employees listed in form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part ll-A or ll-B, receive compensation from any other organizations, whether tax exempt or taxable, that are related to this organization through common supervision or common control? Note. Related organizations include section 509(a)(3) supporting organizations. If Yes,' attach a statement that identifies the individuals, explains the relationship between this organization and the other organization^), and describes the compensation arrangements, including amounts paid to each individual by each related organization d Doeslhe organization have a written conflict of interest policy?

Former Officers, Directors, Trustees, and Key Employees That Received Compensation or Other
Benefits (If any former officer, director, trustee, or Key employee received compensation or other benefits (described below) during the year, list that person below and enter the amount of compensation or other benefits in the appropriate column. See the instructions.) (E) Expense (B) Loans and (D) Contributions to (C) Compensation account and other Advances employee benefit (A) Name and address allowances plans and deferred compensation plans

None

P u t V j y Other Information (See the instructions") 76 Did the organization engage in any activity not previously reported to the IRS? If 'Yes,' attach a detailed description of each activity 77 Were any changes made in the organizing or governing documents out not reported to the IRS? If Yes,' attach a conformed copy of the changes. 78a Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return? b If "Yes,' has it filed a tax return on Form 990-T for this year? 79 Was there a liquidation, dissolution, termination, or substantial contraction during the year? If 'Yes,' attach a statement

Yes No
T

76
77 78a 78b

ifi. & X

79

80a Is the organization related (other than by association with a statewide or nationwide organization) through common 80a membership, governing bodies, trustees, officers, etc, to any other exempt or nonexempt organization? b If "Yes,' enter the name of the organization and check whether it is (_| exempt or \_j nonexempt. 81 a Enter direct and indirect political expenditures. (See line 81 instructions.) I 81 a| 81b b Did the organization file Form 1120-POL for this year? Form 990 (2005) BAA
■*-■■ - " *

TEEAG1D6

11/03/05

Form990 (2005) Save A L i f e F o u n d a t i o n I Other Information (continued)

36-3869459

Page 7 Yes Ho 82)

82 a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially less than fair rental value? ,

b If 'Yes,' you may indicate the value of these items here. Do not include this amount as revenue in Part I or as an expense in Part II. (See instructions in Part III.) 82b 986,387. 83a 83a Did trie organization comply with the public inspection requirements for returns and exemption applications? b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? 83b X 84a Did the organization solicit any contributions or gifts that were not tax deductible? 84a b If Yes,' did the organization include with every solicitation an express statement that such contributions or gifts were not nnl tax dedutfihle? deductible? . . . . . . B5 50>(c)(4), (5), or (6) organizations, a Were substantially all dues nondeductible by members? b Did the organization make only in-house lobbying expenditures of $2,000 or less? If 'Yes' was answered to either 85a or 85b, do not complete 85c through 85h below unless the organization received a waiver for proxy tax owed for the prior year, c Dues, assessments, and similar amounts from members d Section 162(e) lobbying and political expenditures • Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices f Taxable amount of lobbying and political expenditures (line 85d less 85e) g Does the organization elect to pay the section 6033(e) tax on the amount on line 851? 85c 85d 85* 85f 84b 85a 85b

85g
85 h

h If section 6033(eXlXA) dues notices were sent, does the organization agree to add the amount on line S5f to its reasonable estimate of dues allouble to nondeductible lobbying and political expenditures fur the following tax year? 86 501(c)(7) organizations. Enter: a Initiation fees and capital contributions included on line 12 86a b Gross receipts, included on line 12, for public use of club facilities 86b 87 501(c)(l2) organizations. Enter: a Gross income from members or shareholders 87) 87b 88 At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or partnership, or an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701 -3? If 'Yes.' complete Part IX 89a 501(c)(3) organizations. Enter: Amount of tax imposed on the organization during the year under: section 4911 * 0 . ; section 4912 » ■ 0 . ; section 4955 » ■ 0 b 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year? If 'Yes,' attach a statement explaining each transaction b Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.)

88

89b

c Enter: Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912,4955, and 4958 .. ... 0. d Enter: Amount of tax on line 89c, above, reimbursed by the organization 90 a List the states with which a copy of this return is filed *■ J : i y ^ 2 4 s J _ y ^ i ^ c c 2 n j i n J _ P e ^ s y l v a j ^ a ^ 3 r ^ z p n a J , I n d i a n a . b Number of employees employed in the pay period that includes March 12, 2005 (See instructions.) fgObl 9 91 a The books are in care of - _ C a r q l _ S o _ i z z i r r i Telephone number ► J847J_92_8-96_83

Locatedat*- 9950 L a w r e n c e S u i t e 3 0 o / s c h i l l e r P a r k IlT

zTp + 4 * 60176
Yes 91b No

b At any time during the calendar year, did the organization have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)? If 'Yes,' enter the name of the foreign country •* See the instructions for exceptions and filing requirements for FormTD F 90-22.1, Report of Foreign Sank and Financial Statements c At any time during the calendar year, did the organization maintain an office outside of the United States? If Yes,' enter the name of the foreign country *■ 92 Section 4947(a)(1) nonexempt charitable trusts filing Form 990 in lieu of Form 1041 - Check here and enter the amount of tax-exempt interest received or accrued during the tax year H 92 I BAA

91c * Form 990 (2005) Q

TEEAM07

QMS/OS

Form 990

i) Save A L i f e F o u n d a t i o n Analysis of Income-Producing Activities (See the instructions.)
Unrelated business income Business code Amount

36-3869459

Page 8

Note: Enter gross amounts unless otherwise indicated.

Excluded by section 512, 513, or 514 <C> Amount Exclusion code

<E> Related or exempt function income 23,780,

93 Program service revenue: ■ program Fees bCourse Materials c Branch F e e d e
f Medicare/Medicaid payments g Fees & contracts from government agencies . 94 Membership dues and assessments 93 Interest on savings & temporary cash irwmnti 96 Dividends & interest from securities . 97 Netrentalincome or (loss) from real estate: a debt-financed property , b not debt-financed property 9S Net rental income or (loss) from pers prop . 99 Other investment income 100 Gain or (loss) from sales of assets other than inventory 101 Net income or (loss) from special events . . 102 dross profit orfloss)fromsates of inventory . 103 Other revenue: a

67,133.
4,422

14

4,882.

18

-5,932.

b Miscellaneous c
d

2,006,

B » 104 Subtotal (add columns (B), (D), and (E)) . 105 Total (add line 104, columns (B), (D), and (E)) Note: Line 105 plus line Id, Parti, should equal the amount on line 12, Parti.

31

-1,050.

97,341. 96,291.

Relationship of Activities to the Accomplishment of Exempt Purposes (See the instructions.)
Line No. Explain how each activity for which income is reported in column (E) of Part Vlt contributed importantly to the accomplishment of the organization's exempt purposes (other than by providing funds for such purposes).

93a-c Provide life saving first aid skills to volunteers to aid in an emergency. 103b Miscellaneous income to carry out the life saving first aid programs. Information Regarding Taxable Subsidiaries and Disregarded Entitles (See the instructions)
(A) Name, address, and EIN of corporation, partnership, or disregarded entity <B) Percentage of ownership interest <0) Nature of activities Total income End-of-year assets

N/A

%

P i t X I Information Regarding Transfers Associated with Personal Benefit Contracts (See the instructions.)
a Did the organization, rturing the year, receive any funds, directly or indirectly,top^P'eniiunis on a personal benefit contract? b Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? Note: ft 'Yes' to (b\ file Form 8870 and Form 4720 (see instructions}.

B
Preparer's SSN « PTIN (See Geifnal Instruction W)

Under penalties of pefiory, I declare that I have eiamined Ins return, including accompariyina schedules and statements, and to the best ot my Knowledge and belief, rt s true, coirect *nJt6nipW. Declaralion ^

Please Sign Here Paid Preparer's Use Only
BAA

Signature of officer Type oi cainl name and tiHa. Preparer's denature
D*M

Data

11/01/06
"~ _,

Chock if selfemployed

n

F»m"* name (or A h l b e c k & C o m p a n y yours if sell. _ . _ „, , _, employed), ft» 1 6 6 5 E l k B l v d
address, and

EIN

ZP + 4

Des P l a i n e s

IL

60016

Phone no. ► ( 8 4 7 ) TEEAOiOS iCviarOS

824-4000 Form 990 (2005)

SCHEDULE A (Form 990 or 990-EZ)

Organization Exempt Under Section 501(c)(3)
(Except Private Foundation) and Section 501(e). 501(f). 501(h), 501(0), or 4M7(»XD Nonexempt Charitable Trust Supplementary Information — (See separate instructions.) *■ MUST be completed by the above organteations and attached to their Form 990 or 990-EZ.

OMB No. 1545-004?

2005

Department of the Treasury IrteinM RCVMMM S t n t e fttrna at n t aganizalion

Employer WmWterton w n h r

Save A L i f e

Foundation

36-3869459

(See instructions. List each one. If there are none, enter 'None.1) (a) Name and address of each (b) Title and average employee paid more hours per week than $50,000 devoted to position

[Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees
(c) Compensation (d) Contributions to amployet benefit plans and dstarred compensation 1,800, (e) Expense account and other allowances

,Dane_ N e a l
9950 Lawrenc*. Suite 3Q0, Schiller Park, IL 60176 National Policy Director 4 0

63,500.

Total number of other employees paid over $50,000

None

Compensation of the Five Highest Paid Independent Contractors for 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 Consulting

<c) Compensation

J*59.an_% .Ha^^son _L_. L . J \ Columbia Square, 555 Thirteenth Street ww, Washington P.c. 200404-1109 G o v e r n m e n t a l

68,671,
51,663

_Nawajra_Pinancia.^. Adisors_ Jnc_._ 7420 W. College Drive, Ste. 2E*. Palos Heights, TL 60463 Accounting Service

Total number of others receiving over $50,000 for professional services

None

■ P i r t i P ' w j Compensation of the Five Highest Paid Independent Contractors for Other Services
(List each contractor who performed services other than professional services, whether individuals or firms. If there are none, enter 'None.' See instructions,) (a) Name and address of each independent contractor paid mote than $50,000 None (b) Type of service (c) Compensation

"",

.

,

S

Total number of other contractors receiving

None BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 and Form 990-EZ.
TEEA0401 08/W05

Schedule A (Form 990 or 990-EZ) 2005

Schedule A (Form 990 or 990-EZ) 2005

Save A L i f e

Foundation

36-3869459

Page 2

Statements About Activities (See instructions.)
1 During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? If "Yes," enter the total expenses paid or incurred in connection with the lobbying activities +• $ <^uste<M amounts on line 38, Part Vl-A,w l" 1 * lot Part Vt-B.) Organizations that made an election under section 501 (h) by filing Form 5768 must complete Part VIA. Other organizations checking 'Yes' must complete Part 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 ol the following acts with any substantial contributors, trustees, directors, officers, creators, key employees, or members of their families, or with any taxable organization with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary? (If the answer to any question is 'Yes,'attach a detailed statement explaining the transactions.) a Sale, exchange, or leasing of property? b Lending of money or other extension of credit? c Furnishing of goods, services, or facilities? See P a r t V , d Payment of compensation (or payment or reimbursement of expenses if more than $1,000)? • Transfer of any part of its income or assets? 3a Do you make grants for scholarships, fellowships, student loans, etc? (If 'Yes,' attach an explanation of how you determine that recipients qualify to receive payments.; b Do you have a section 403(b) annuity plan for your employees? c During the year, did the organization receive a contribution of qualified real property interest under section 170(h)? 4a Did you maintain any separate account for participating donors where donors have the right to provide advice on trie use or distribution of funds? b Do you provide credit counseling, debt management, credit repair, or debt negotiation services? , Form 990 2d

2a
2b

2c

2e 3a
3b 3c 4a 4b

X

X

Reason for Non-Private Foundation Status (See instructions.)
The organization is not a private foundation because it is: (Please check only ONE applicable box.) 5 A church, convention of churches, or association of churches. Section 170(b) (l)(A)(i). 6 " A school. Section 170(b)(1>(A)(ji). (Also complete Part V.) 7 _ A hospital or a cooperative hospital service organization. Section 170(b)(1)(A)(iii). 8 _ A Federal, state, or local government or governmental unit Section 170(b)0 )(A)(v). 9 _ A medical research organization operated in conjunction with a hospital. Section 170(b)0)(A)(iii)- Enter the hospital's name, city, and state ► 10 n An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(l)(A)(iv>. (Also complete the Support Schedule in Part IV-A.) 11 a Ec] An organization that normally receives a substantial part of its support from a governmental unit or from the general public. Section 170(b)(1) (A) (vi). (Also complete the Support Schedule in Part IV-A.) 11 b Q A community trust. Section 170(b)(l)(A)fyi). (Also complete the Support Schedule in Part IV-A.) 12 ["I An organization that normally receives: (1) m o m l h * n 33-1/3% of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc, functions - subject to certain exceptions, and (2) no more than 33-1/3% 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. See section 509(a)(2). (Also complete the Support Schedule in Part IV-A.) \_J An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in: (1) lines 5 through 12 above; or (2) section 501(c)(4), (5), or (6), if they meet the test of section 509(a)(2), Check me box that describes the type ofsupporting organization: ► p j T y p e 1 [~]Type2 | | Type 3 Provide the following information about the supported organizations. (See instructions.) (a) Name(s) of supported organization^) (b) Line number from above

13

Schedule A (Form 990 or 990-EZ) 2005

Save A L i f e

Foundation

36-3869459

Page 3

S u p p o r t S c h e d u l e (Complete only if you checked a box on line 10, 11, or 12.) Use cash method of accounting. Note: You may use the worksheet in the instructions tor converting from the accrual to the cash method of accounting. Caltndar y a w (or fiscal year beginning in) 15 Gifts, grants, and contributions received. (Do not include unusual grants. See line 28.) . 16 Membership fees received

&
1,882,822.

2003

A
1,371,684.
820,282.

Total

446,621.

4,523,409,

17 Gross receipts from admissions,
merchandise sold or services performed, or furnishing of facilities in any activity that isrelatedto the organization's charitable, etc, purpose 18 Gross income from interest, dividends, amounts received from payments on securities loans (section 512(a)(5)), rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organ­ ization after June 30,1975

399,546,

120,316.

207.836.

197,535.

925,233

1,933.

795.

2,154.

3,275.

8,157

19

Net income from unrelated business activities not included in line 18 ., -

20 Tax revenues levied for the

organization's benefit and either paid to ft or expended on its behalf 21 The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge 22 Other income. Attach a schedule. Do not include gain or (loss) from sale of capital assets 23 Total of lines 15 through 22 .

2,284,301
1,864,755,

24 Line 23 minus tine 17

25 Enter 1 % of line 23 22,843. 15,817. 10,211. _j 26 Organizations described on lints 10 or 1 1 : * Enter 2% of amount in column (e), line 24 26a 90,631. b Prepare a list for your records to snow the name of and amount contributed by each person (other than a governmental unit or publidy supported organization) whose total gifts for 2001 through 2004 exceeded trie amount slum in line 26a. Do not file this list with your return. Enter the total of all these excess amounts 26b c Total support for section 509(a)(1) test: Enter line 24, column (e) 4,531,566. 26c d Add: Amounts from column (e) for lines: 8,157. 19 18 26b 22 0. 26d 6,157. e Public support (line 26c minus line 26d total) 4,523,409, 26e f Public support percentage (line 26« (numerator) divided by lint 26c (denominator!) 26 f 99.82 % 27 Organizations described on line 12: a For amounts included in lines 15.16, and 17 that were received from a disqualified person,' prepare a list for your records to show tne its name of, and total amounts received in each year from, each 'disqualified person." Donotfilethia list with your raturn. Enter the sum of such amounts for each year: (2002) (2001) (2004) (2003) bFor any amount included in line 17 that was received from each person (other than 'disqualified persons'), prepare a list tor your records to show the name of, and amount received for each year, that was more than the larger of (1) the amount on line 25 for the year or (2) $5,000, (Include in the list organizations described in lines 5 through 11 b, as well as individuals.) Do not file this list with your return. After computing the difference between the amount received and the larger amount described in (1) or (2), enter the sum of these differences (the excess amounts) for each year: (2002) (2001) (2004) (2003) _ 16 c Add: Amounts from column (e) for lines: 15 17 d Add: Line 27a total 20 and line 27b total 21

569,732. 449,416. 5,697.

1,581,674.
1,373,838.

1,021,092.
823,557.

5,456.799. 4,531,566.

aa

p§lljpi

e Public support (line 27c total minus line 27d total) f Total support for section 509(a)(2) test: Enter amount from line 23, column (e) .. g PuMic support percentage (line 27« (numerator) divided by Hne27f (denominator)) 28

27c 27d 27f 271 27j
27 h

h Investment Income percentage (line IB, column (*) (numerator) divided by lint 271 (denominator))

%

Unusual Grants: For an organization described inline 10, 11, or 12 that received any unusual grants during 2001 through 2004, prepare a list for your records to show, for each year, the name of the contributor, the date and amount of the grant, and a brief description of the nature of the grant. Do not Be this list with your return. Do not include these grants in line 15. TEEAM03 92/03/06 Schedule A (Form 990 or 990-EZ) 2005 BAA

Schedule A (Form 990 or 990-EZ) 2005 Save A L i f e

Foundation

36-3869459 N/A

pa

I Private School Questionnaire (See instructions.)
<To be completed OHLY by schools that checked the box on In* 6 in Part IV) 29 Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, other governing instrument, or in a resolution of its governing body? 30 Does the organization include a statement of its racially nondiscriminatory policy toward students in all its brochures, catalogues, and other written communications with the public dealing with student admissions, programs, and scholarships? 31 Has the organization publicized Hs racially nondiscriminatory policy through newspaper or broadcast media during the period of solicitation tor students, or during the registration period if it has no solicitation program, in a way that makes the policy known to all parts of the general community it serves? , If 'Yes,' please describe; if 'No,' please explain. Of you need more space, attach a separate statement.)

aM

29

32 Does the organization maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative staff? b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student admissions, programs, and scholarships? d Copies of all material used by the organization or on its behalf to solicit contributions? If you answered 'No' to any of the above, please explain. (If you need more space, attach a separate statement.)

32a 32b 32c 32d

33 Does the organization discriminate by race in any way with respect to: a Students' rights or privileges? b Admissions policies? c Employment of faculty or administrative staff? d Scholarships or other financial assistance? • Educational policies? f Use of facilities? g Athletic programs? h Other extracurricular activities? If you answered Yes' to any of the above, please explain. (If you need more space, attach a separate statement.) , 33a 33b 33c 33d 33* 33f

33ft
33 h

34a Does the organization receive any financial aid or assistance from a governmental agency? b Has the organization's right to such aid ever been revoked or suspended? If you answered 'Yes' to either 34a or b, please explain using an attached statement. 35 Does the organization certify mat it has complied with the applicable requirements of sections 4.01 through 4.05 of Rev Proc 75-50, 1975-2 C.B. 587, covering racial nondiscrimination? If 'No,' attach an explanation , BAA
TEEAMW 0*0*05

34a
34b
* / * ■

35 Schedule A (Foim 990 or 990-EZ) 2005

Schedule A (Form 990 or 990-EZ) 2005

Save A L i f e

Foundation

36-3869459
H/A
Affiliated group totals

Page 5

[Lobbying Expenditures by Electing Public Charities (See instructions.)
(To be completed ONLY by an eligible organization that filed Form 5768) Check I if the organization belongs to an affiliated group. Check ► h f l i t von checked 'a' and limited control' provisions apply. (b) To be completed for ALL electing organizations

Limits on Lobbying Expenditures
(The term 'expenditures' means amounts paid or incurred.) 36 37 38 39 40 41 Total lobbying expenditures to influence public opinion (grassroots lobbying) Total lobbying expenditures to influence a legislative body (direct lobbying) Total lobbying expenditures (add lines 36 and 37) Other exempt purpose expenditures — Total exempt purpose expenditures (add lines 3B and 39) Lobbying nontaxable amount Enter the amount from the following table If the amount on line 40 is — The lobbying nontaxable amount Is — Not over $500,000 20% of the amount on line 40 -

Over 1500,000 but not over (1,000,000 $100,000 plus 15% of tta excess over $500,000 Over $1,000,000 but not ovar (1,500,000 $175^)00 plus 10% of the excess over $1^00,000 Over $1,500,000 but not over $17,000,000 $225/100 plus 5% of the excess over $1,500,000 Over $17,000,000 $1,000,000 _ 42 Grassroots nontaxable amount (enter 2 5 * of line 41) 43 Subtract line 42 from line 36. Enter -0- if line 42 is more than line 36 44 Subtract line 41 from line 38. Enter -0- if line 41 is more than line 38 Caution: If thera is an amount on either line 43 or line 44, you must fife Form 4720.

4 -Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501 (h) election do not have to complete all of the five columns below. See the instructions for lines 45 through 50.) Lobbying Expenditures During 4 -Year Averaging Period Calendar year for fiscal year beginning In) • 45 46 Lobbying nontaxable amount Lobbying ceiling amount (150% of Una 45(e)) expenditures 48 49 Grassroots nontaxable amount Grassroots ceiling amount (150% 0lHne48<a» expenditures (t) Total

2005

47 Total lobbying

50 Grassroots lobbying

Lobbying Activity by Nonelecting Public Charities
(For reporting only by organizations that did not complete Part Vl-A) (See instructions.) During the year, did the organization attempt to influence national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of: a Volunteers b Paid staff or management (Include compensation in expenses reported on lines c through h.) c Media advertisements d Mailings to members, legislators, or the public « Publications, or published or broadcast statements I Grants to other organizations for lobbying purposes g Direct contact with legislators, their staffs, government officials, or a legislative body h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means I Total lobbying expenditures (add lines c through h.) If "Yes* to any of the above, also attach a statement giving a detailed description of the lobbying activities

BAA
TEEA0405 0BWQ5

Schedule A (Form 990 or 990-EZ) 2005

Schedule A (Form 990 or 990-EZ) 2005

S a v e A Lite

Foundation

36-3869459

Page 6

Information Regarding Transfers To and Transactions and Relationships With Noncharitabfe Exempt Organizations (See instructions) 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) organizations} or in section 527, relating to political organizations? a Transfers from the reporting organization to a noncharitable exempt organization of: (l)Cash <ii)Other assets Yes 51a© a (11) No X X X X X X X X X

b Other transactions: b<rj 0)Sales or exchanges of assets with a noncharitable exempt organization (U)Purcnases of assets from a noncharitable exempt organization bOD (NQRental of facilities, equipment, or other assets bflH) (^Reimbursement arrangements b(iv> (v) Loans or loan guarantees b(v) (vl) Performance of services or membership or fundraising solicitations b(vi) c Sharing of facilities, equipment, mailing lists, other assets, or paid employees c d If the answer to any of the above is 'Yes, complete the following schedule. Column (b) should always 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 value in any transaction or shanna arrangement, show in column (d) the value of the aoods. other assets, or services received: Line no. (b) Amount involved (c) Name of noncharitable exempt organization

«9
Description of transfers, transactions, and sharing arrangements

52• Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations ,—, __ described in section 501(c) of the Code (other than section 501 (c)(3)) or in section 527? ** | _ | Yes |x] No b If 'Yes.' complete the following schedule: 0>) (») (cl Name of organization Type of organization Description of relationship

BAA
TEEAOWS 08/06705

Schedule A (Form 990 or 990-EZ) 2005

Form 990 Line 8(A) and 8(B) Stat«ni«frt Name

Schedule of Gains and Losses from Sale of Assets Other than Inventory
•■ Attach to return

2005

Save A L i f e F o u n d a t i o n Part I, Line 8, Column (A)
Public Securities Gross Sales Price Cost Selling Expenses Basis

Employer Identification Number 36-3869459

Securities

Description P u b l i c l y Traded Securities

Basis

Nonpublic Securities Cost, other basis or FMV when donated (State which on top)

Description

Date Acquired and Method

Date Sold and to Whom

Gross Sales Price

Total Securities Gain or (Loss) from Sale of Securities Parti, Line 8, Column (B) Date Acquired and Method

Other Assets
Date Sold and to Whom Gross Sales Price Cost, other basis or FMV when donated Cost Depreciation Basts Donation FMV Cost Depreciation Basis Donation FMV Cost Depreciation Basis Donation FMV Cost Deoreciation Basis Donation FMV 11,732. 11,732.

Description
Vehicles acA E q u i n a n t

various sold

various 5,800.

Total Other Assets Gain or (Loss) from Sale of Other Assets
TEEW0201.SCR 10O7TO

5,800.

11,732. -5,932.

Save A Life Foundation

36-3869459

1

Additional Information Form 990 p 3; Exempt purpose

Training and developing "Bystanders*, including children as volunteers equipped with life saving first aid skills to aid in an emergency.

Save A Life Foundation

36-3869459

1

Form 990, Page 2, Part II, Line43 Other Expenses Stmt (A) Total (B) Program services 13,044. 5,301. 2,900. 14,782. 0. 2,781. 2,257. 30,412. 64,966. 20,225. 87,677. 741. 44,600. (C) Management and qeneral 0. 620. 91. 0. 770. 20. 0. 0. 4,028. 803. 0. 0. 0. (D) Fundraising

Other expenses not covered above (itemize): I n s t r u c t o r s Fees Insurance Licenses & Permits Marketina Miscellaneous Payroll Service Recruitment Training Supplies P r o f e s s i o n a l Fees Temporary S t a f f i n q Consultinq Training & Development Proqram Mini G r a n t s

13,044. 5,921. 2,991. 14,782. 770. 2,801. 2.257. 30,412. 68,994. 21,028. 87.677. 741. 44,600.

0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0.

Total
Form 990, Page 5, Part V-A List of Officers, Etc Statement (A) Name and address

296,018.

289,686.

6,332.

0.

(B) Title and average hours per week devoted to position

(C) Compensation Of not paid, enter -0-)

(D) Contributions to employee benefit plans and deferred compensation

(E) Expense account and other allowances

I r v Bock Director 0. Emil J o n e s , Jr. Director 0. S t e v e n Orebauqh Director 0. Ernesto Pretto Director 0. Note: The individuals above, except as noted, spend time as needed in t h e i r capacity on the Board, Thev can be c o n t a c t e d c/o Save a Life Foundation, 9950 Lawrence
See 300, S c h i l l e c P a t k , IL 60176

0.

0.

0.

0.

0.

0.

0.

0.

Save A Life Foundalion

36-3859459

2

Form 990, Page 4. Part IV, Lines 57a & 57b Land, Buildings and Equipment Statement

(a) Cost/Other Basis Land Buildina O f f i c e Equipment Vehicles Total 20,000. 181,912. 162,862. 31,190. 395,964.

(b) Accumulated Depreciation 0. 27,286. 125,975. 3,119. 156,380.

(c) Book Value

20,000. 154,626. 36,887. 28,071. 239,584.

Save A Life Foundation

36-3869459

3

Supporting Statement of:

Form 990 p 2 / L i n e 25 column (B) Description Proaram S e r v i c e S a l a r i e s : Carol S p i z z i r r i
Total

Amount 123,500. 123,500.

Supporting Statement of:

Form 990 p 2 / L i n e 25 column <C) Description Management and General S a l a r i e s : Carol S p i z z i r r i Total Amount 6,500. 6,500,

Supporting Statement of:

Form 990 p 2/Line 42 column (B) Description Building Eauipment Vehicles Total Amount 9,096. 22,624. 1,882. 33,602.

Supporting Statement ol: Form 990 p 4/Line 63, column (A) Description Due t o Carol S p i z z i r r i , P r e s i d e n t / E x e c . D i r e c t o r I n t e r e s t Rate - V a r i a b l e Total Amount 163,654. 163,654.

Save A Life Foundation

36-3869459

4

Supporting Statement of:

Form 990 p 4 / L i n e 63, column (B) Description Due t o Carol S p i z z i r r i , P r e s i d e n t / E x e c . D i r e c t o r I n t e r e s t Rate-Variable Total Amount 170.163. 170.183.

Supporting Statement of:

Form 990 p 5 / P a r t V-A. Column (D>-1 Description Carol S p i z z i r r i b e n e f i t s : Medical i n s u r a n c e
Total

Amount
1.900.

1.900.

AHLBECK&COMPANY
SAVE A LIFE FOUNDATION, INC. AUDITED FINANCIAL STATEMENTS JUNE 30, 2006 AND JUNE 30,2005
CERTIF1FD PUBLIC ACCOUNTANTS

SAVE

A LIFE

FOUNDATION,

INC.

TABLE

OF

CONTENTS

June 30, 2006 andjune 30,2005 INDEPENDENT AUDITOR'S REPORT FINANCIAL STATEMENTS Comparative Statements of Financial Position June 30, 2006 andjune 30, 2005 Statements of Activities For (he Years Ended June 30, 2006 andjune 30, 2005 Statements of Functional Expenses For the Years Ended June 30, 2006 andjune 30, 2005

Comparative Statements of Cash Flows For the Years Ended June 30, 2006 andjune 30, 2005 NOTES TO FINANCIAL STATEMENTS

11

12

AHLBECK Sr COMPANY
CERTIFIED PUBLIC ACCOUNTANTS 1665 ELK BOULEVARD DE5 PLAINES, ILLINOIS 60016-1776 TELEPHONE: 847/824-4000 FACSIMILE: 847/B24-40O WEB: www.ahlbcckco.com

August 11,2006 To the Board of Directors Save A Life Foundation, Inc. Schiller Park, Illinois I N D E P E N D E N T AUDITOR'S REPORT

We have audited the accompanying statements of financial position of SAVE A LIFE FOUNDATION, INC. (an Illinois not-for-profit corporation) as of June 30, 2006 and 2005, and the related statements of activities, functional expenses, and cash flows for the year then ended. These financial statements are the responsibility of the organization's management. Our responsibility is to express an opinion on these financial statements based on our audits. We conducted our audits in accordance with U.S. generally accepted auditing standards. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion.

In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of SAVE A LIFE FOUNDATION, INC. as of June 30, 2006 and 2005, and the results of its change in net assets and its cash Hows tor the years then ended in conformity with U.S. generally accepted accounting principles.

1

SAVE

A LIFE

FOUNDATION,

INC.

COMPARATIVE STATEMENTS OF FINANCIAL POSITION June 30, 2006 and June 30, 2005
2006 ASSETS Current Assets Cash and Cash Equivalents Inventory Trade Receivables Grants Receivable Other Receivables Prepaid Expenses Total Current Assets Fixed Assets at Net Book Value Land Building Office Equipment Program Equipment Vehicles Total Net Fixed Assets TOTAL ASSETS $ 592,793 56,400 5,495 256,000
-

2005

$

11,304 921,992

813,976 56,501 22,254 496,000 1,660 3,879 1,394,270

20,000 154,626 32,561 4,326 28,071 239,584 1,161,576

20,000 163,721 49,861
-

15,646 249,228 1,643,498

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 2

SAVE

A

LIFE

FOUNDATION,

INC.

COMPARATIVE STATEMENTS OF FINANCIAL POSITION June 30, 2006 and June 30, 2005
2006 LIABILITIES Current Liabilities Accounts Payable Accrued Expenses Credit Card Payable Instructor Deposits Rent Payable Mini-Grants Payable Total Current Liabilities Other liabilities ) Carol Spizzirri Total Other Liabilities TOTAL LIABILITIES Net Assets Temporarily Restricted Unrestricted Total Net Assets TOTAL LIABILITIES AND NET ASSETS AND NET $ ASSETS 43,198 13,520 450 130,624 187,792 $ 19,671 395,576 490 89,957 503,694 2005

170,183 170,183 357,973

163,654 163,654 669,348

271,000 532,601 803,601 1,161,576

496,000 478,150 974,150 1,643,498

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS

3

SAVE

A LIFE

FOUNDATION,

INC.

STATEMENT OF ACTIVITIES
For the Year Ended June 30,2006 Unrestricted INCOME Public Support Contributions Private Grants Contributions In Kind Total Public Support Government Contracts State of Illinois-IDPH Total Government Contracts Other Income Course Materials Training Program Fees Branch Revenue Sharing Miscellaneous Loss on Asset Disposal Total Other Income Investment Income Interest Income Total Investment Income Total Income (balances carried forward) 655 64,500 1,000,635 1,063,790 655 79,500 1,000,635 1,080,790 Temporarily Restricted Total

15,000 13,000

700,000 700,000

700,000 700,000

67,133 23,780 4,422 2,006 (5,932) 91,409

67,133 23,780 4,422 2,006 (5,932) 91,409

4,882 4,882 1,162,081

-

4,882 4,882

713,000

1,877,081

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 4

SAVE A LIFE

FOUNDATION,

INC.

STATEMENT O F ACTIVITIES For the Year Ended June 30, 2006 Unrestricted Total Income (balances brought forward) EXPENSES Program National State Branch Programs Total Program Management and General Total Expenses Release from Release from Release from Release from Restrictions - HHS/CDC Restrictions - DCCA Building Purchase Restrictions - State of Illinois - IDPH Restrictions - Private Grants 401,055 691380 899,479 1,991,914 55,716 2,047,630 240,000 700,000 54,451 478,150 332,601 (240,000) (700,000) (225,000) 496,000 271,000 401,055 691,380 899,479 1,991,914 55,716 2,047,630 1,162,081 Temporarily Restricted 713,000 Total 1,877,081

Change in Net Assets Beginning Net Assets Ending Net Assets (Deficit)

(170,349) 974,150 803,601

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 5

SAVE A LIFE FOUNDATION,

INC.

STATEMENT OF ACTIVITIES
For the Year Ended June 30,2005 Unrestricted INCOME Public Support Contributions Contributions In Kind Special Events Gross Income Total Public Support Government Contracts State of Illinois - 1DPH HHS/CDC Total Government Contracts Other Income Program Service Fees Course Materials Product Sales Conference/Seminar Income Branch Fee Miscellaneous Total Other Income Investment Income Interest Income Total Investment Income 5,545 209,580 150,089 365,214 S 5,545 209,580 150,089 363,214 Temporarily Restricted Total

700,000 496,000 1,196,000

700,000 496,000 1,196,000

35,265 259,353 62,234 10,920 5,433 868 374,073

35,265 259,353 62,234 10,920 5,433 868 374,073

1,933 1,933

-

1,933 1,933 1,937,220

TOTAL INCOME Qwlances carried forward)

741,220

1,196,000

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 6

SAVE A LIFE FOUNDATION, STATEMENT OF ACTIVITIES For the Year Ended June 30,2005

INC.

Unrestricted TOTAL INCOME (balances brought Jorward) EXPENSES Program Kids Program Corporate Program Expansion Program Allied Health Grant Total Program Management and General Fundraising Total Functional Expenses Special Event Expenses TOTAL EXPENSES Release Release Release Release from from from from Restrictions Restrictions Restrictions Restrictions - HHS/CDC - DCAA Building Purchase - State of Illinois - IDPH - Private Grants 813,454 17,621 1,050,403 18,267 1,899,743 98,816 170 1,998,731 34,312 2,033,043 955,043 100,000 700,000 84,500 347,720 (69,570) 478,130 741,220

Temporarily Restricted 1,196,000

Total 1,937,220

813,454 17,621 1,050,403 18,267 1,899,743 98,816 170 1,998,731 34,312 2,033,043 (955,043) (100,000) (700,000) (84,500) (643,343) 1,139,543 496,000 (93,823) 1,069,973 974,130

Change in Net Assets Beginning Net Assets Ending Net Assets (Deficit)

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS
7

SAVE

A LIFE

FOUNDATION,

INC.

STATEMENT OF FUNCTIONAL EXPENSES For the Year Ended June 30,2006
PROGRAM Branch Programs $ 160,325 130,000 287,917 8,641 12,700 298348 1,548 ~ 899,479 25,159 924,638 $ SUPPORT Management and General $ 34,655 1,504 5,260 46 • 620 4,028 91 70 770 1,861 717 20 18 4,612 91 273 803 277 55,716 (55,716) Organization Total $ 603,466 9,033 46.426 6,164 1,084 68,110 87,677 33,602 115 204,030 300,961 5.921 77.635 2,991 14,782 8,653 770 8.181 23,407 2,801 3,883 44,600 2,257 363,685 6.160 13.170 21.028 741 30,412 50,967 4.216 701 2,047,630 2,047,630

National Salaries and Wages Employee Benefits Payroll Taxes Automobile Bank Service Fees Computer Expenses Consulting Depreciation Dues and Subscriptions Independent Contractors Instructor Fees Insurance Legal and Accounting Licenses and Permits Marketing and Promotional Meetings Miscellaneous Operating Interest Office Supplies Payroll Service Postage Program Mini-Grants Recruitment Rent Repairs and Maintenance Telephone Temporary Staffing Training and Development Training Supplies Travel Utilities Web Site Total Program Expenses Administration Allocation Total Expenses $ 187,174 3,510 12,132 0 375 45,300 43,677 3,385 8,775 228 9,469 2,300 5,935 3,332 2,210 3,100 800 1,600 14,200 12,966 603 5,810 4,025 294 10,012 17,815 1,513 514 401,055 11,218 412,273

State $ 221,312 4,019 29,035 6,118 709 22,810 44,000 30,217 115 65,255 13,044 5,073 55,497 600 8,847 5,250 4,110 6,890 1,981 2,265 30,400 2,257 47,759 5,466 7,087 16,200 447 20,400 31,327 2,703 187 691,380 19,339 710,719

Total 568,811 7,529 41,166 6,119 1,084 68,110 87,677 33,602 U5 204,030 300,961 5,301 73,607 2,900 14,782 8.582 6,320 22,690 2,781 3,865 44,600 2,257 359,073 6,069 12,897 20,225 741 30,412 50,690 4,216 701 1,991,914 55,716 2,047,630

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 8

SAVE A LIFE FOUNDATION,

INC.

STATEMENT OF FUNCTIONAL EXPENSES
For the Year Ended June 30, 2005 PROGRAM Kid's Program Corporate Program Expansion Allied Program Health Grant 9,506 239 1,061 30 640 1,171 2,594 297 1,050 1,679 18,267 950 19,217 $

Total 546,829 10,474 40,767 (1,909) 2,281 264 463,853 30 164 (1,132) 119,807 16,869 3,482 44,455 115 13,279 13,479 5,463 728 21,843 2,579 6,147 (691) 109,771 762 10,817 6,288 322,182 30,938 3,345 106,466 1,899,745 98,816 1,998,561

Salaries and Wages !i 222,456 $ Employee Benefits 2,602 Payroll Taxes 11.389 Other Payroll Expense Automobile Bad Debt Expense Bank Service Fees Branch Development 204,957 Computer Expenses Cost of Good Sold 45 Depreciation Dues and Subscriptions Equipment Rental Independent Contractors Instructor Fees 2,815 Insurance 1,128 Legal and Accounting 35,562 Licenses and Permits 130 Marketing and Promotional 1,440 Meetings Miscellaneous 5,463 Operating Interest 728 Office Supplies 8,490 Payroll Service 141 Postage 347 Printing and Reproduction Professional Fees Program Development Recruitment (1) Rent 26,762 Repairs and Maintenance Telephone 1,634 Temporary Staffing 1,323 Training Supplies 207,566 Travel 1,272 Utilities 2,808 Web Site 74,397 Total Program Expenses Administration Allocation Total Expenses 813,454 42.312 855,766

3.355 $ 311.512 $ 84 7,549 374 27,943 (1.909) 2,281 264 258,896 9 110 (1,132) 119,807 13,754 300 2,354 8,893 (15) 11,199 13,479 12,182 2,438 51 3,155 . (20) (670) 83,009 762 9,183 4,668 14 113,552 27,987 537 32,069 17,621 917 18,538 1,050,403 54.637 1,105,040

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 9

SAVE

A LIFE

FOUNDATION,

INC.

STATEMENT OF FUNCTIONAL EXPENSES
For the Year Ended June 30, 2005 SUPPORT

Management and General Fundrateing

Total

Organization Total

Salaries and Wages $ Employee Benefits Payroll Taxes Other Payroll Expense Automobile Bad Debt Expense Bank Service Fees Branch Development Computer Expenses Cost of Good Sold Depreciation Dues and Subscriptions Equipment Rental Independent Contractors Instructor Fees Insurance Legal and Accounting Licenses and Permits Marketing and Promotiona Meetings Miscellaneous Operating Interest Office Supplies Payroll Service Postage Printing and Reproduction Professional Fees Program Development Recruitment Rent Repairs and Maintenance Telephone Temporary Staffing Training Supplies Travel Utilities Web Site Total Program Expenses Administration Allocation Total Expenses

31,174 $ 767 3,401 (100) (2) 18,385 30,301 160 1,057 731 1,435 (390) 6,210 (751) (140) 2,000 4,303 6 5 264 98^16 (98,816)

(i 119 2 25 24 170

31,174 767 3,401 (100) (2) 18,385 30,301 160 1,057 731 1,554 (390) 6,210 (749) (115) 2,000 4,303 30 6 264 98,987 (98,816)

$

578,003 11,241 44,168 (1,909) 2,281 (100) 262 463,853 30 18,549 30301 (972) 119,807 16,869 4,539 44,455 846 14,833 13,479 5,073 6,938 21,094 2,579 6,032 2,000 3,612 109,771 762 10,847 6,288 322,188 31,202 3,345 106,466 1,998,731

170

171

1,998,731

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 10

SAVE A LIFE FOUNDATION, COMPARATIVE STATEMENTS OF CASH FLOWS

INC.

For the Years Ended June 30,2006 andjune 30,2005 2006 Cash Flows from Operating Activities: Change in net assets Adjustments to reconcile change in net assets to net cash provided by (used in) operating activities: Non-cash in kind donations - fixed assets Depreciation Loss on disposal of fixed assets Changes in current assets and liabilities: Decrease (increase) in accounts receivable Decrease (increase) in inventory Decrease (increase) in grants receivable Decrease (increase) in other current assets Increase (decrease) in accounts payable Increase (decrease) in other payables Net cash provided by (used in) operating activities Cash Flows from Investing Activities: Purchase of fixed assets Disposal of fixed assets Net cash provided by (used in) investing activities Cash Flows from Financing Activities: Issuance of short-term debt Repayment of short-term debt Net cash provided by (used in) financing activities 6,210 (137,366) (131,156) (35,690) 5,800 (29,890) (20,490) (20,490) $ (170,549) $ (95,823) 2005

33,602 5,932

(4,500) 30,301 -

16,759

101
240,000 (5,765) 23,527 (341,429)

(8,639) (2,130) 561,000 5,429 13,184 453,709

(197,822)

952,331

6,529 6,529

Net Increase (Decrease) in Cash and Cash Equivalents Cash and Cash Equivalents at Beginning of Period Cash and Cash Equivalents at End of Period Supplemental Disclosures: Interest paid

(221,183) 813,976 592,793

800,683 13,291 813,976

728

THE ACCOMPANYING NOTES ARE AN INTEGRAL PART OF THESE STATEMENTS 11

SAVE A LIFE FOUNDATION, INC. N O T E S T O FINANCIAL STATEMENTS For the Years Ended June 30,2006 and June 30,2005

NOTE 1 - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Nature of Activities Save A Life Foundation, Inc. (SALF) works to train and develop "Bystanders", including children, as volunteers equipped with life supporting first aid skills to aid the injured or ill in an emergency. SALF received 49% of its total income in the year ended June 30, 2006 from the State of Illinois Department of Public Health (IDPH). The remainder of SALF's income is from program fees, private contributions, and other miscellaneous sources. Basis of Accounting The financial statements of SALF have been prepared on the accrual basis of accounting and accordingly reflect all significant receivables, payables, and other liabilities. The net assets of SALF are classified as follows: • Unrestricted, which represent the portion of expendable net assets that are available for operations. Temporarily Restricted, which represent grants which are for future periods. Upon termination of the restriction, a reclassification is made to unrestricted net assets.

Estimates The process of preparing financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions. These estimates and assumptions affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of die financial statements and reported amounts of income and expenses during the reporting period. Actual results could differ from those estimates. Cash and Cash Equivalents For purposes of the statement of cash flows, SALF considers all checking accounts and petty cash to be cash equivalents. Receivables and Credit Policies Trade receivables are obligations due under normal trade terms requiring payment upon demand. There is no interest or fees charged on receivables. The amount of uncollectible trade receivables as of June 30, 2006 and 2005 is immaterial. Management has elected to record bad debts using the direct write-off method. Generally accepted accounting principles require that the allowance method be used to reflect bad debts. However, the effect of the use of the direct write-off method is not materially different from the results that would have been obtained had the allowance method been followed. Inventories Inventories are stated at cost using the average cost method.

12

SAVE A L I F E

FOUNDATION,

INC.

N O T E S T O FINANCIAL STATEMENTS For the Years Ended June 30, 2006 and June 30, 2005 Fixed Assets Fixed assets are carried at cost if purchased or fair value if contributed for current additions. Depreciation is computed on the straight-line method over 5-7 years for vehicles, computer equipment, furniture and office equipment and over 20 years for buildings. Maintenance, repairs and minor costs are expensed as incurred. When properties are retired or otherwise disposed of, the related cost and accumulated depreciation are removed from the respective accounts and any profit or loss on disposition is credited or charged to operations. Policy on Contributions Contributions received are recorded as unrestricted, temporarily restricted, or permanently restricted support, depending on the existence and/or nature of any donor restrictions. Support that is restricted by the donor is reported as an increase in unrestricted net assets if the restriction expires in the reporting period in which the support is recognized. All other donor-restricted support is reported as an increase in temporarily or permanently restricted net assets, depending on the nature of the restriction. When a restriction expires (that is, when a stipulated time restriction ends or purpose restriction is accomplished), temporarily restricted net assets are reclassified to unrestricted net assets and reported in the Statement of Activities as net assets released from restrictions. Income Taxes SALF is exempt from income taxes under Section 501 (c)(3) of the Internal Revenue Code. In addition, SALF qualified for the charitable contribution deduction under Section 170(b)(l)(A)(vi) and has been classified as an organization other than a private foundation under Internal Revenue Code Section 509(a)(2). Functional Allocation of Expenses In the statement of functional expenses, salaries and related expenses are first charged to the various programs and supporting services on the basis of actual expense. Expenses are then allocated based on various criteria, such as time spent in various areas. ^classifications Certain items in the financial statements for the year ended June 30, 2005 have been reclassified for presentation purposes.

NOTE 2 - ACCOUNTING REORGANIZATION

During the year ended June 30, 2006, SALF reorganized the accounting reporting of programs. This was done in an effort to more accurately present programs and their related costs.

13

SAVE A LIFE FOUNDATION, INC.

NOTES TO FINANCIAL STATEMENTS
For the years Ended June 30,2006 and]unc 30,2005

NOTE 3 - DONATED MATERIALS AND SERVICES Donations of services are recorded if they create or enhance a nonfinancial asset or are specialized skills that would be purchased if they were not donated. SALF received donations of this type in the year ended June 30, 2006 and 2005, of $25,842 and $0, respectively. Donations of use of facilities are recorded at their fair market value. Such donations are reported as unrestricted supports. During the year ended June 30,2006 and 2005, SALF received rent forgiveness for $75,314 and $0, respectively due to a change in building management. SALF has branches located in a number of states created through relationships with other entities, such as hospitals. Each branch receives in-kind support for facilities, services and other expenses through these relationships. During the year ended June 30, 2006 and 2005, SALF received donations of this type for $899,479 and $209,580, respectively.

NOTE 4 - CASH & CASH EQUIVALENTS SALF maintains the majority of its cash at a single financial institution located in Schiller Park, Illinois. This account is insured by the Federal Deposit Insurance Corporation up to $100,000. As of June 30, 2006 and 2005, SALF's uninsured cash balances total $476,833 and $736,130, respectively.

NOTE 5 - FIXED ASSETS At June 30, 2006 and 2005, die costs of such assets were as follows: June 30, 2006 2005 $ 20,000 $ 20,000 181,912 181,912 158,363 146,717 4,500 31,190 39,132 395,965 156,381 239,584 387,761 138,533 249,228 Increase (Decrease)
$ -

Land Building Office Equipment Program Equipment Vehicles Less accumulated depreciation Net book value

11,646 4,500 (7,942) 8,204 17,848 (9,644)

Depreciation expense for the year ended June 30, 2006 and 2005 is $33,602 and $30,301, respectively.

14

SAVE A L I F E

FOUNDATION.

INC.

NOTES T O FINANCIAL STATEMENTS For the Years Ended June 30,2006 and June 30,2005 NOTE 6 - TEMPORARILY RESTRICTED NET ASSETS Temporarily restricted net assets at June 30, 2006 and 2005 consist of the following: 2006 $256,000 2005 $496,000

United States Department of Health and Human Services/ Center for Disease Control - restricted to use according to the grant agreement and also according to time release restriction VELCO Total

15000 271000 496,000

;

NOTE 7 - COMPENSATED ABSENCES SALF has a vesting vacation policy. The amount of existing vacation time remaining as of June 30, 2006 and June 30, 2005 is immaterial.

NOTE 8 - DUE TO RELATED PARTY The organization's founder and current executive director, Carol Spizzirri, loaned SALF start up and operations funding. As of June 30, 2006 and 2005, the amount of this loan is $170,183 and $163,654, respectively. Interest is accrued annually using the Internal Revenue Service Applicable Federal Rates.

NOTE 9 - LEASE OBLIGATION AND RENTAL EXPENSE The estimated future minimum rental and operating lease obligation for the succeeding years under non-cancelable leases for office facilities in effect at June 30, 2006 are as follows: Year Endingjune 30,
2007 2008 $

Rent
107,737 110,242

Rental expense under the operating leases was $363,685 for the year ended June 30, 2006 and $ 109,771 for the year ended June 30, 2005.

15

SAVE

A LIFE

FOUNDATION,

INC.

NOTES TO FINANCIAL STATEMENTS
For the Years Ended June 30, 2006 and June 30, 2005 NOTE 10 - SPECIAL EVENTS Special event income is shown at the gross amount in the Statement of Activities. Special event expense is also shown in the Statement of Activities. The following schedule details the gross income and expense components for each event: Year Ended lune 3D. 2006 Year Ended lune 30. 2005 Summit Race for Life CuhsGame Revenue Expenses £& $ -$ - $ . . . : :

-

B£2£0J1£ $145,401 308 4.380 150089

Expenses $34,144 168 34.312

Hfit $111,257 140 4.380 115.777

16

For Office Use Only

Illinois Charitable Organization Annual Report
Attorney General Lisa Madigan State of Illinois Charitable Trust Bureau, 100 West Randolph 11th Floor, Chicago, Illinois 60601
Report for the Fiscal Period: Beginning 7 / 0 1 / 0 6 & Ending 6/30/07
MO DAY YR Make Checks Payable to the Illinois

Form AG990-IL Revised 3/05 iD:30ii

CO#

01026498

Check all items attached: Copy of IRS Return
Audited Financial Statements Copy of Form IFC 515.00 Annual Report Filing Fee $100.00 Late Report Filing Fee

Charity

Bureau Fund

Federal ID # 3 6 - 3 8 6 9 4 5 9
Are contributions to the organization tax deductible? |X| Yes LEGAL | | No Date Organization was created: Year-end amounts A ASSETS LIABILITIES NET ASSETS

MO

DAY

YR

NAME SAVE A LIFE FOUNDATION
9950 LAWRENCE #300

PTT^FlVFTtl

HHBHi
A$ B$ C$ 449,823. 191,214. 258,608. AMOUNT D$ E$ F$ G$ H$ 1$ J$ K$ L$ M$ N$ 0$ 1,470,538. 1,330,239. 140,299. 1,330,239. 211,116. 700,000. 14,429. 925,545. 1,330,239.

2/09/1993

ADDRESS CITY, STATE

ZIP CODE SCHILLER PARK, I L 60176

' }

J(

MAY 1 « 2008
Attorney General ^

j

B C

x

1 SUMMARY OF ALL REVENUE ITEMS DURING THE Vii&H:* ^
D PUBLIC SUPPORT, CONTRIBUTIONS AND PROGRAM SERVICE REVENUE (GROSS AMOUNTS) E GOVERNMENT GRANTS AND MEMBERSHIP DUES F OTHER REVENUES See. . S t a t e m e n t . . 1

PERCENTAGE 22.81%

75.63% 1.56% 100%

G TOTAL REVENUE, INCOME AND CONTRIBUTIONS RECEIVED (ADD Dr Er AND F) II SUMMARY OF A L L EXPENDITURES DURING THE YEAR: H OPERATING CHARITABLE PROGRAM EXPENSE 1 EDUCATION PROGRAM SERVICE EXPENSE J TOTAL CHARITABLE PROGRAM SERVICE EXPENSE (ADD H AND J). J1 JOINT COSTS ALLOCATED TO PROGRAM SERVICES (INCLUDED IN J) K GRANTS TO OTHER CHARITABLE ORGANIZATIONS L TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD J AND K) N FUNDRAISING EXPENSE O TOTAL EXPENDITURES THIS PERIOD (ADD L, M, AND N) $

90.46%
o, "5

90.46%

*6
90.46% 9.54 %
%

Ill SUMMARY OF ALL PAID FUNDRAISER AND CONSULTANT ACTIVITIES:
(Attach Attorney General Report of Individual Fundraising Campaign - Form IFC. One for each PFR.) PROFESSIONAL FUNDRAISERS: P TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISERS Q TOTAL FUNDRAISERS FEES AND EXPENSES R NET RECEIVED BY THE CHARITY (P MINUS Q=R) PROFESSIONAL FUNDRAISING CONSULTANTS: S TOTAL AMOUNT PAID TO PROFESSIONAL FUNDRAISING CONSULTANTS

BRHH
100%
0,

100%

P$ Q$ R$ S$ T$ U$ V$ 130,000. 63,520. 50,000.

%

IV COMPENSATION TO THE (3) HIGHEST PAID PERSONS DURING THE Y E /KR: T NAME. TITLE: CAROL S P I Z Z I R R I , PRESIDENT/FOUND U NAME, TITLE: DANE NEAL, DIRECTOR V NAME, TITLE: VINCENT DAVIS, DIRECTOR V
W X Y

CHARITABLE PROGRAM DESCRIPTION: CHARITABLE PROGRAM (3 HIGHEST BY $ EXPENDED) CODE CA TEGORIES
DESCRIPTION: DESCRIPTION: DESCRIPTION: LIFE SAVING F I R S T A I D TRAINING

See instructions for list CODE W# X# Y# 011

■^H

^ ^ ^ ^ ^ ^ ^ _

1

SAVE A LIFE FOUNDATION
IF THE ANSWER TO ANY OF THE FOLLOWING IS YES, ATTACH A DETAILED EXPLANATION: 1 2

36-3869459

Page 2

YES NO
1

WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION, FINE, PENALTY OR JUDGMENT? HAS THE ORGANIZATION OR A CURRENT DIRECTOR, TRUSTEE, OFFICER OR EMPLOYEE THEREOF, EVER BEEN CONVICTED BY ANY COURT OF ANY MISDEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY?. DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES OWNS AN INTEREST; OR WAS IT A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES HAS A MATERIAL FINANCIAL INTEREST; OR DID ANY OFFICER, DIRECTOR OR TRUSTEE RECEIVE ANYTHING OF VALUE NOT REPORTED AS COMPENSATION? HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER, DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES? IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER? (ATTACH FORM IFC )

X X

2

3

3 4 5 6 7

X

4 5 6

1?
X X X

7a DID THE ORGANIZATION ALLOCATE THE COST OF ANY SOLICITATION, MAILING, ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES? 7 b IF 'YES', ENTER (i) THE AGGREGATE AMOUNT OF THESE JOINT COSTS $ AMOUNT ALLOCATED TO PROGRAM SERVICES $ MANAGEMENT AND GENERAL $ 8 9 ; AND (iv) THE AMOUNT ALLOCATED TO ; (ii) THE ; (ii) THE AMOUNT ALLOCATED TO

FUNDRAISING $ _ __ DID THE ORGANIZATION EXPEND ITS RESTRICTED FUNDS FOR PURPOSES OTHER THAN RESTRICTED PURPOSES? HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION OR TAX EXEMPTION SUSPENDED OR REVOKED BY ANY GOVERNMENTAL AGENCY?

8 9 10

X X X

10 WAS THERE OR DO YOU HAVE ANY KNOWLEDGE OF ANY KICKBACK, BRIBE, OR ANY THEFT, DEFALCATION MISAPPROPRIATION, COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS? 11

LIST THE NAME AND ADDRESS OF THE FINANCIAL INSTITUTIONS WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST ACCOUNTS:

See Statement 2

ALL ATTACHMENTS MUST ACCOMPANY THIS REPORT - SEE INSTRUCTIONS UNDER PENALTY OF PERJURY, I (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS ANNUAL REPORT AND THE ATTACHED DOCUMENTS, INCLUDING ALL THE SCHEDULES AND STATEMENTS AND THE FACTS THEREIN STATED ARE TRUE AND COMPLETE AND FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE STATE OF ILLINOIS RELY THEREUPON. I HEREBY- FURTHER AUTHORIZE AND AGREE TO SUBMIT MYSELF AND THE REGISTRANT HEREBY TO THE JURISDICTION OF THE STATE

BE SURE TO INCLUDE ALL FEES DUE: 1 2 REPORTS ARE DUE WITHIN SIX MONTHS OF YOUR FISCAL YEAR END. FOR FEES DUE SEE INSTRUCTIONS. REPORTS THAT ARE LATE OR INCOMPLETE ARE SUBJECT TO A $100.00 PENALTY.

OMB No. 1545-0047

Form

990

Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(aX1) of the Internal Revenue Code (except black lung benefit trust or private foundation) »- The organization may have to use a copy of this return to satisfy state reporting requirements.
7/01 , 2006, and ending 6/30
D Please use IRS label or print or type. See specific instruc­ tions.

2006
Open to Public Inspection 2007
Employer Identification Number

Department of the Treasury Internal Revenue Service

For the 2006 calenda^year, or tax year beginning
Check if applicable: Address change Name change Initial return Final return Amended return Application pending

SAVE A LIFE FOUNDATION 9950 LAWRENCE #300 SCHILLER PARK, IL 60176

36-3869459
E Telephone number

(847)
method:

928-9683
Cash

| j Other (specify)

T T ~m
j Yes [_jYes

Accrual

Section 501 (cX3) organizations and 4947faX"D nonexempt charitable trusts must attach a completed Schedule A (Form990or990-EZ).

H andl are not applicable to section 527 organizations. H ( a ) ts this a group return for affiliates?. . . . | H ( b ) If 'Yes,' enter number of affiliates H ( C ) Are all affiliates included?. (If 'No,' attach a list. See instructions.) \_J No | X [ No

G Web site: * www. s a l f . o r q

K

L

Organization type 4947(a)(1) or 527 501(c) (insert no.) H (check only one). Check here ■* [_] if the organization is not a 509(a)(3) supporting organization and its gross receipts are normally not more than $25,000. A return is not required, but if the I organization chooses to file a return, be sure to file a complete return. M Gross receipts: Add lines 6b, 8b, 9b, and 10b to line 1 2 . . * 9 2 5 , 5 4 5 .

m

D

D

( d ) Is this a separate return filed by an organization covered by a group ruling? I

Iyes

[}(] N

o

Group Exemption Number... *" Check »• | | if the organization is not required to attach Schedule B (Form 990,990-EZ, or 990-PF).

Bart I
a b c d

I Revenue, Expenses, and Changes in Net Assets or Fund Balances (See the instructions.)
Contributions, gifts, grants, and similar amounts received: Contributions to donor advised funds Direct public support (not included on line l a ) Indirect public support (not included on line l a ) Government contributions (grants) (not included on line l a )
la through Id)%ash $ 7 3 1 , 9 4 5 . - noncash $

la lb 1c Id

31,945
700,000

)

1e

2 Program service revenue including government fees and contracts (from Part VII, line 93). 3 Membership dues and assessments 4 Interest on savings and temporary cash investments 5 Dividends and interest from securities
6a Gross rents b Less: rental expenses c Net rental income or (loss). Subtract line 6b from line 6a. 7 Other investment income (describe ** 6a 6b

731,945 179,171 13,684

(A) Securities (B) Other 8a Gross amount from sales of assets other 8a than inventory 8b b Less: cost or other basis and sales expenses 8c c Gain or (loss) (attach schedule) d Net gain or (loss). Combine line 8c, columns (A) and (B) Special events and activities (attach schedule), ff any amount is from gaming, check here Gross revenue (not including $ of contributions 9a reported on line l b ) 9b Less: direct expenses other than fundraising expenses c Net income or (loss) from special events. Subtract line 9b from line 9 a — 10a 10a Gross sales of inventory, less returns and allowances 10b b Less: cost of goods sold c Gross profit or (loss) from sales of inventory (attach schedule). Subtract line 10b from line 10a. 11 Other revenue (from Part VII, line 103) 12 Total revenue. Add lines 1e, 2, 3, 4, 5, 6c, 7, 8d, 9c, 10c, and 11 13 Program services (from line 44, column (B)) 14 15 16 17 18 19 20 21 Management and general (from line 44, column (C)). Fundraising (from line 44, column (D)) Payments to affiliates (attach schedule) Total expenses. Add lines 16 and 44, column (A) Excess or (deficit) for the year. Subtract line 17 from line 12 Net assets or fund balances at beginning of year (from line 73, column (A)). Other changes in net assets or fund balances (attach explanation) Net assets or fund balances at end of year. Combine lines 18, 19, and 2 0 . . .

■□

10c 11 12 13 14 15 16 17 18 19 20 21

745 925,545 1,330,239 140,299

1,470,538

-544,993 803,601 258,608
Form 990 (2006)

BAA For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.

Form 990 (2006)

SAVE A LIFE FOUNDATION

36-3869459

Page 2

R a M l l l i S t a t e m e n t of Functional E>Cpenses All organizations must complete column (A). Columns (B), (C), a nd (D) are required for section 501(c)(3) and (4) organizations and section 4947(a)(1) nonexempt charitable trusts but opl ional for others. (B) Program (C) Management Do not include amounts reported on line (A) Total (D) Fundraising and general 6b, 8b, 9b, 10b, or 16 of Parti. services


22 a

22 a Grants paid from donor advised funds (attach sch) (cash $ non-cash $ ) If this amount includes ,—. foreign grants, check here.. *" | |
2 2 b Other grants and allocations (att sch)

(cash non-cash

$ $

)
22 b

If this amount includes .—. foreign grants, check here - • *" | | 23 24 Specific assistance to individuals (attach schedule) Benefits paid to or for members (attach schedule)

23 24

25a Compensation of current officers, directors, key employees, etc listed in Part V-A (attach sch). b Compensation of former officers, directors, key employees, etc listed in Part V-B (attach sch). c Compensation and other distributions, not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(cX3XB) (attach schedule) 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 Salaries and wages of employees not included on lines 25a, b, and c Pension plan contributions not included on lines 25a, b, and c Employee benefits not included on lines 25a - 27. Payroll taxes Professional fundraising fees Accounting fees Legal fees Supplies Telephone Postage and shipping Occupancy Equipment rental and maintenance Printing and publications Travel Conferences, conventions, and meetings Interest Depreciation, depletion, etc (attach schedule) Other expenses not covered above (itemize): a See S t a t e m e n t 1 b c d e f 9 44 Total functional expenses. Add lines 22a through 43g. (Organizations completing columns (B) - (0), carry these totals to lines 13-15)

25 a

130,000.

123,500.

25 b

0.

0.

I

|

6,500.

0.

0.

0.

25 c 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42
43 a

0. 299,753.

0. 271,873.

0. 27,880.

0.

8,426. 40,040.

7,752. 36,837.

674. 3,203.

56,462. 15,076. 10,226. 102,756. 6,698. 53,187. 8,523.

56,462. 13,267. 9,919. 102,756. 5,827. 52,083. 8,523.

1,809. 307. 871. 1,104.

739,391.

641,440.

97,951.

43 b 43 c 43 d 43 e 43 f 43 g

44 1,470,538. 1,330,239. 0. 140,299.1 Joint Costs. Check. * Q if you are following SOP 98-2. Are any joint costs from a combined educational campaign and fundraising solicitation reported in (B) Program services? ^ M Yes [XJ No If 'Yes,' enter (i) the 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 $ BAA Form 990 (2005)

Form 990 (2006)

SAVE A LIFE FOUNDATION

36-3869459

Page 3

BSTjtllHBI S t a t e m e n t of P r o g r a m Service A c c o m p l i s h m e n t s Form 990 is available for public inspection and, for some people, serves as the primary or sole source of information about a particular organization. How the public perceives an organization in such cases may be determined by the information presented on its return. Therefore, please make sure the return is complete and accurate and fully describes, in Part III, the organization's programs and accomplishments. Program Service Expenses What is the organization's primary exempt purpose? ** See_ S t a t e m e n t _2 All organizations must describe their exempt purpose achievements in a clear and concise manner. State the number of (Required for 501(c)(3) and (4) organizations and clients served, publications issued, etc. Discuss achievements that are not measurable. (Section 501(c)(3) and (4) organ­ 4947(a)(1) trusts; but izations and 4947(a)(1) nonexempt charitable trusts must also enter the amount or grants ana allocations to others.) optional for others.)

a JJATIONAL. PROGRAMS, - JfflICH_ DELIVER_ LIFE .SUPPORTING, FIRST _AID JRAI_NING_

J P A " ! I _STUDENTS_ IN _PA,_ JW ~ JN_AHD JO*I J U I & l l I C L0CJ^~EMERCENCY
MEDICAL SERVICE PROVIDERS AS INSTRUCTORS.

(Grants and allocations

$

) If this amount includes foreign grants, check here

b_STATE_ PROGRAMS_-_ JifflrcH J3ELIVER_IJFE _SUPP_ORTING_FIRST_ AID. TRAINING, T0_ i G 12_ STUDENTS^UTILIZING _LpCAL_EMERCENCY _MEDICAL _SERVICE _PRQVipERS__AS. INSTRUCTORS.

n

302,613

(Grants and allocations

$

) If this amount includes foreign grants, check here.. * \ \

218,280

c_BRANCH_P_ROGRAMS _-_WHICH .DELIVER .LIFE. SUPPORTING J1RSJ_AIJ)_TRAINI_NG_TP. K-1Z. STUDENTS.UTILIZING .LOCAL.EMERCENCY .MEDICAL .SERVICE .PROVIDERS.AS_ _ INSTRUCTORS.

(Grants and allocations,, $

) If this amount includes foreign grants, check here .. »• | |

809,346

(Grants and all_ocations__ $ e Other program services.

) If this amount includes foreign grants, check here.. ^ | [

) If this amount includes foreign grants, check here .. ► | | * (Grants and allocations, f Total of Program Service Expenses (should equal line 44, column (B), Program services) BAA

1,330,239
Form 990 (2006)

Form 990 (2006)
ffiuifliyjl Note: 45 46

SAVE A LIFE FOUNDATION
the instructions.)

36-3869459
(A) Beginning of year

Page 4

B a l a n c e S h e e t s (See

Where required, attached schedules and amounts within the description column should be for end-of-year amounts only. Cash - non-interest-bearing Savings and temporary cash investments 47 a 47 b 48a 48b

End of year 45

1,007 591,786 3,250 5,495.

46

52,909 130,655

47a Accounts receivable b Less: allowance for doubtful accounts 48a Pledges receivable b Less: allowance for doubtful accounts. 49 Grants receivable

47 c

3,250.

48c

2 5 6 , 0 0 0 . 49
50 a 50 b

4,899 2,750

50 a Receivables from current and former officers, directors, trustees, and key employees (attach schedule) b Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) (attach schedule) 51 a Other notes and loans receivable (attach schedule) b Less: allowance for doubtful accounts 52 Inventories for sale or use 53 Prepaid expenses and deferred charges 54a Investments - publicly-traded securities b Investments - other securities (attach sch) 55a Investments - land, buildings, & equipment: basis.. b Less: accumulated depreciation (attach schedule) 56 Investments - other (attach schedule) 57a Land, buildings, and equipment: basis b Less: accumulated depreciation (attach schedule) S t a t e m e n t . 3 ... 58 Other assets, including program-related investments 59 60 61 62 63 51a 51b

56,400 11,304
Cost Cost 55 a 55 b 57 a 57 b FMV FMV

51c 52 53 54a 54b

41,767

I
239,584 1,161,576 187,342

55 c

56

399,685 186,092
57 c 58

213,593

(describe * Total assets (must equal line 74). Add lines 45 through 58 Accounts payable and accrued expenses. Grants payable Deferred revenue

59 60
61

449,823 9,540

62

Loans from officers, directors, trustees, and key employees (attach schedule) See.. S.tm . 4.. 64a Tax-exempt bond liabilities (attach schedule) b Mortgages and other notes payable (attach schedule) 65 Other liabilities (describe +... _See _ S t a t e m e n t _ 5 ) 66 Total liabilities. Add lines 60 through 65 [Xjand complete lines 67 Organizations that follow SFAS 117, check here through 69 and lines 73 and 74. 67 Unrestricted 68 Temporarily restricted 69 Permanently restricted j ~ | and complete lines Organizations that do not follow SFAS 117, check here 70 through 74. 70 Capital stock, trust principal, or current funds 71 Paid-in or capital surplus, or land, building, and equipment fund 72 Retained earnings, endowment, accumulated income, or other funds 73 74 BAA Total net assets or fund balances. Add lines 67 through 69 or lines 70 through 72. (Column (A) must equal line 19 and column (B) must equal line 21). Total liabilities and net assets/fund balances. Add lines 66 and 73

170,183

63 64a 64b

178,974

450 357,975

65 66

2,701 191,215

532,601 271,000

67
68

258,608

69

70 71 72

803,601 1,161,576

73 74

258,608 449,823
Form 990 (2006)

Form 990 (2006)

SAVE A LIFE FOUNDATION

36-3869459
the

Page 5

Baft-ilVgAX R e c o n c i l i a t i o n o f R e v e n u e p e r A u d i t e d F i n a n c i a l S t a t e m e n t s w i t h R e v e n u e p e r R e t u r n (See instructions.) a b Total revenue, gains, and other support per audited financial statements. Amounts included on line a but not on Part I, line 12: 1 Net unrealized gains on investments 2Donated services and use of facilities 3Recoveries of prior year grants 4Other (specify): b4 Add lines b l through M. Subtract line b from line a Amounts included on Part I, line 12, but not on line a: 11nvestment expenses not included on Part I, line 6b .. 2Other (specify): d2 Add lines dl and d2. Total revenue (Part I line 12). Add lines c and d . B I M i y i B l R e c o n c i l i a t i o n of E x p e n s e s per A u d i t e d F i n a n c i a l S t a t e m e n t s w i t h E x p e n s e s per R e t u r n Total expenses and losses per audited financial statements. Amounts included on line a but not on Part I, line 17: 1 Donated services and use of facilities 2Prior year adjustments reported on Part I, line 20 3Losses reported on Part I, line 20. 40ther (specify): Add lines b l through b4 Subtract line b from line a Amounts included on Part I, line 17, but not on line a: 11nvestment expenses not included on Part I, line 6b .. 20ther (specify): _ Add lines d l and d 2 . Total expenses (Part dl d2 line 17). Add lines c and d __ . _ b4 dl b1 b2 b3

1,256,155

330,610.

330,610 925,545

925,545

1,801,148
bl b2 b3

330,610.

330,610 1,470,538

1,470,538 (C) Compensation (if not paid, enter -0*) 130,000.

B a i i t l V I A ^ ! C u r r e n t 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 person who was an officer, director, trustee, or key employee at any time during the year even if they were not compensated.) (See the instructions.)

(A) Name and address CAROL SPIZZIRRI 9950 LAWRENCE #300 SCHILLER PARK, IL 60176 RITA MULLINS 9950 LAWRENCE #300 SCHILLER PARK, IL 60176 DOUGLAS BROWNE 9950 LAWRENCE #300 SCHILLER PARK, IL 60176 JOHN DONLEAVY 9950 LAWRENCE #300 SCHILLER PARK, IL 60176 ANDY KNAPP 9950 LAWRENCE #300 SCHILLER PARK, IL 60176

(B) Title and average hours per week devoted to position P r e s i d e n t & CEO 40 Secretary 0 Treasurer 0 Director 0 Director 0

(D) Contributions to employee benefit plans and deferred compensation plans 0.

(E) Expense account and other allowances 838.

0.

0.

0.

0.

0.

0.

0.

0.

0.

j

0.

0.

0.

BAA

Form 990 (2006)

Form 990 (2006) SAVE A LIFE FOUNDATION

36-3869459

Page 6

RaMViffi Current Officers, Directors, Trustees, and Key Employees (continued) 75 a Enter the total number of officers, directors, and trustees permitted to vote on organization business as board meetings. b Are any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part 11-A or II -B, related to each other through family or business relationships? If 'Yes,' attach a statement that identifies the individuals and explains the relationship(s) c Do any officers, directors, trustees, or key employees listed in form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or ll-B, receive compensation from any other organizations, whether tax exempt or taxable, that are related to the organization? See the instructions for the definition of'related organization" If 'Yes,' attach a statement that includes the information described in the instructions. d Does the organization have a written conflict of interest policy?

RalMB! Former Officers, Directors, Trustees, and Key Employees That Received Compensation or Other

Benefits (If any former officer, director, trustee, or key employee received compensation or other benefits (described below) during the year, list that person below and enter the amount of compensation or other benefits in the appropriate column. See the instructions.) (C) Compensation (D) Contributions to (E) Expense (B) Loans and (if not paid, employee benefit account and other (A) Name and address Advances enter -0-) plans and deferred allowances compensation plans

None

BartlVII Other Information (See the

instructions.)

Yes

No

76 Did the organization make a change in its activities or methods of conducting activities? If 'Yes,' attach a detailed statement of each change 77 Were any changes made in the organizing or governing documents but not reported to the IRS? If 'Yes,' attach a conformed copy of the changes. 78a Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return? .. b If 'Yes,' has it filed a tax return on Form 990-T for this year? 79 Was there a liquidation, dissolution, termination, or substantial contraction during the year? If 'Yes,' attach a statement

76
77 78 a 78 b 79

N,

80a Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc, to any other exempt or nonexempt organization? 80 a b If 'Yes,' enter the name of the organization *• N/A and check whether it is [ J exempt or [_j nonexempt. 81 a Enter direct and indirect political expenditures. (See line 81 instructions.) [ 81 a] 0. b Did the organization file Form 1120-POL for this year? 81b Form 990 (2006) BAA

Form 990 (2006)

SAVE A LIFE FOUNDATION
(continued)

36-3869459

Page 7 Yes 82 a No

Other Information

82 a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially less than fair rental value? b l f 'Yes,' you may indicate the value of these items here. Do not include this amount as 82 b 330,610. revenue in Part I or as an expense in Part II. (See instructions in Part III.) 83a Did the organization comply with the public inspection requirements for returns and exemption applications?. b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? 84a Did the organization solicit any contributions or gifts that were not tax deductible? b If 'Yes,' did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? 85 501(c)(4), (5), or (6) organizations, a Were substantially all dues nondeductible by members? b Did the organization make only in-house lobbying expenditures of $2,000 or less? If 'Yes* was answered to either 85a or 85b, do not complete 85c through 85h below unless the organization received a waiver for proxy tax owed for the prior year. c Dues, assessments, and similar amounts from members d Section 162(e) lobbying and political expenditures e Aggregate nondeductible amount of section 6033(e)(1 )(A) dues notices f Taxable amount of lobbying and political expenditures (line 85d less 85e) g Does the organization elect to pay the section 6033(e) tax on the amount on line 85f? h If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount on line 85f to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year?. 86 501(c)(7) organizations. Enter: a Initiation fees and capital contributions included on 86 a 86 b line 12 b Gross receipts, included on line 12, for public use of club facilities 87 501(c)(l2) organizations. Enter: a Gross income from members or shareholders b Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.)

83 a 83 b 84a

X X

84b
85 a 85 b

I'A

N.' N A

85 c
85 d

85 e
85 f

N/A N/A N/A N/A
85 q 85 h

N/A N/A

87 a
87 b

N/A N/A N/A N/A
88a X

88 a At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or partnership, or an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If 'Yes,' complete Part IX b At any time during the year, did the organization, directly or indirectly, own a controlled entity within the meaning of section 512(b)(13)? If 'Yes,' complete Part XI 89a 501(c)(3) organizations. Enter: Amount of tax imposed on the organization during the year under: section 4911 * 0. ; section 4912 » 0 . ; section 4955 ** b 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year? If 'Yes,' attach a statement explaining each transaction c Enter: Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958. d Enter: Amount of tax on line 89c, above, reimbursed by the organization i All organizations. Did the organization acquire a direct or indirect interest in any applicable insurance contract? g For supporting organizations and sponsoring organizations maintaining donor advised funds. Did the supporting organization, or a fund maintained by a sponsoring organization, have excess business holdings at any time during the year? 90a List the states with which a copy of this return is filed *• I L , WT, P A , A Z , V T b Number of employees employed in the pay period that includes March 12, 2006 (See instructions.) 91 a The books are in care of * i ^ A R Q L _ S P I Z Z I R R I Telephone number 0.

► 88b 0.

89 b

X

0.
89 e 89 f X X

e All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction?..

89 g

X

90b

Jj? i l ) _ 928-9683.
ZIP~+4 > 60176
Yes 91b No X

Located a t - 9 9 5 0 LAWRENCE SUITE 300% SCHILLER PARK I L

b At any time during the calendar year, did the organization have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)? If 'Yes,' enter the name of the foreign country .. * See the instructions for exceptions and filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts. BAA

Form 990 (2006)

36-3869459 Page 8 i E a r t i y i Other Information (continued) Yes No c At any time during the calendar year, did the organization maintain an office outside of the United States? X 91c If 'Yes,' enter the name of the foreign country .. *" _ 92 Section 4947(a)(1) nonexempt charitable trusts filing Form 990 in lieu of Form 1041 - Check here. N / A . . . *■ \ \ and enter the amount of tax-exempt interest received or accrued during the tax year...._._._.__._._.__._.... ..._. ■__ _ * 92 [ . . _ *! N/A BafflTO Analysis of Income-Producing Activities (See the instructions.) Unrelated business income Excluded by section 512, 513, or 514 Note: Enter gross amounts unless (A) (B) Related or exempt (D) otherwise indicated. Exclusion code function income Business code Amount Amount 93 Program service revenue: a COURSE M A T E R I A L S 165,155

Form 990 (20Q6) SAVE A LIFE FOUNDATION

b PROGRAM FEES
c d

14,016

e
f Medicare/Medicaid payments g Fees & contracts from government agencies.. 94 Membership dues and assessments. 95 Interest on savings & temporary cash invmnts 96 Dividends & interest from securities. 97 Net rental income or (loss) from real estate: a debt-financed property b not debt-financed property 98 Net rental income or (loss) from pers prop... 99 Other investment income 100 Gain or (loss) from sales of assets other than inventory. 101 Net income or (loss) from special events... 102 Gross profit or (loss) from sales of inventory . . 103 Other revenue: a

14

13,684.

b MISCELLANEOUS
c d e

745

104 Subtotal (add columns (B), (D), and (E))... 13,684. 179,916 105 Total (add line 104, columns (B), (D), and (E)> 193,600 Note: Line 1'05 plus line le, Part I, should equal the amount on line 12, Part I. Relationship of Activities t o the A c c o m p l i s h m e n t of Exempt Purposes (See the instructions.) Line No. Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment of the organization's exempt purposes (other than by providing funds for such purposes).

93A-C 103-B

PROVIDE LIFE SAVING FIRST AID SKILLS TO VOLUNTEERS TO AID IN AN EMERGENCY. MISCELLANEOUS INCOME TO CARRY OUT THE LIFE SAVING FIRST AID PROGRAMS.

fjattjIXf Information Regarding Taxable Subsidiaries a n d Disregarded Entities (See the (A) (B) (D) (C) Name, address, and EIN of corporation, partnership, or disregarded entity Percentage of ownership interest Nature of activities Total income

instructions.)

(E)
End-of-year assets

N/A

RaljtfXi Information Regarding Transfers Associated with Personal Benefit Contracts (See the a Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? b Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? Note: If 'Yes' to (b), file Form 8370 and Form 4720 (see instructions). BAA

instructions^ Yes No Yes No

Form 990 (2006)

Form 990 (2006) SAVE A LIFE FOUNDATION 36-3869459 IRarftXH Information Regarding Transfers To and From Controlled Entities. Complete only if the organization is a controlling organization as defined in section 512(b)(13).
106 Did the reporting organization make any transfers to a controlled entity as defined in section 512(b)(13) of the Code? If 'Yes,' complete the schedule below for each controlled entity (A) Name, address, of each controlled entity (B) Employer Identification Number

Page 9

Yes

No X

R
Description of transfer

(D) Amount of transfer

a

b

c

Totals

■■■■■ ■ ■ ■
Yes No

107

Did the reporting organization receive any transfers from a controlled entity as defined in section 512(b)(13) of the Code? If (A) Name, address, of each controlled entity (B) Employer Identification Number (C) Description of transfer

X

(D) Amount of transfer

a

b

c

Totals

■■■■■■■^^1

Yes

No

108

Did the organization have a binding written contract in effect on August 17, 2006, covering the interest, rents, royalties, and

X

Please Sign Here

Paid Pre­ pare r's Use Only BAA

SCHEDULE A (Form 990 or 990-EZ)

Organization Exempt Under Section 501(c)(3)
(Except Private Foundation) and Section 501(e), 501(0,501 (k), 501 (n), or 4947(aXl) Nonexempt Charitable Trust Supplementary Information — (See separate instructions.) MUST be completed by the above organizations and attached to their Form 990 or 990-EZ.

OMBNo. 1545-0047

2006

Department of the Treasury Internal Revenue Service Name of the organization

Employer identification number

SAVE A LIFE FOUNDATION

36-3869459

l l l a l ^ i l P l l f f l C o m p e n s a t i o n of t h e Five Highest Paid E m p l o y e e s O t h e r T h a n O f f i c e r s , D i r e c t o r s , a n d T r u s t e e s (See instructions. List each one. If there are none, enter N o n e . ' ) (d) Contributions (a) Name and address of each (b) Title and average (e) Expense (c) Compensation to employee benefit account and other employee paid more hours per week plans and deferred devoted to position than $50,000 allowances compensation

See Statement 6 113,520.
0.

1,308

Total number of other employees paid

_oy_e_r $50,000

J£I»MlliSjil Compensation of the Five Highest Paid Independent Contractors for Professional Services (See instructions. List_each one (whether individuals or firms). If there are none, erjter 'None.')
(a) Name and address of each independent contractor paid more than $50,000 (b) Type of service (c) Compensation

See Statement 7 77,039.

Total number of others receiving over $50,000 for professional services

$

&

-

<

*

'BaeflllMBill Compensation of the Five Highest Paid Independent Contractors for Other Services (List each contractor who performed services other than professional services, whether individuals or firms. If there are none, enter 'None.' See instructions.)
(a) Name and address of each independent contractor paid more than $50,000 None (b) Type of service (c) Compensation

Total number of other contractors receiving 0 over $50,000 for other services *" BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 and Form 990-EZ.

3BHKSHS9HH
Schedule A (Form 990 or 990-EZ) 2006

Schedule A (Form 990 or 990-EZ) 2006

SAVE A LIFE FOUNDATION

36-3869459
Yes

Page 2 No

K a K l i l l M i S t a t e m e n t s A b o u t A c t i v i t i e s (See instructions.) 1 During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? If 'Yes,' enter the total expenses paid or incurred in connection with the lobbying activities. N/A $ (Must equal amounts on line 38, Part Vl-A, or line i of Part Vl-B.). Organizations that made an election under section 501(h) by filing Form 5768 must complete Part Vl-A. Other organizations checking 'Yes' must complete Part Vl-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 substantial contributors, trustees, directors, officers, creators, key employees, or members of their families, or with any taxable organization with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary? (If the answer to any question is 'Yes,' attach a detailed statement explaining the transactions.)

a Sale, exchange, or leasing of property? b Lending of money or other extension of credit?. c Furnishing of goods, services, or facilities? See Form 9 9 0 , d Payment of compensation (or payment or reimbursement of expenses if more than $1,000)? e Transfer of any part of its income or assets? 3a Did the organization make grants for scholarships, fellowships, student loans, etc? (If 'Yes,' attach an explanation of how the organization determines that recipients qualify to receive payments.) b Did the organization have a section 403(b) annuity plan for its employees? c Did the organization receive or hold an easement for conservation purposes, including easements to preserve open space, the environment, historic land areas or historic structures? If 'Yes,' attach a detailed statement dDid the organization provide credit counseling, debt management, credit repair, or debt negotiation services? 4a Did the organization maintain any donor advised funds? If 'Yes,' complete lines 4b through 4g. If 'No,' complete lines 4f and 4g b Did the organization make any taxable distributions under section 4966? c Part V

2a 2b 2c 2d X 2e 3a 3b

X X

X X

3c 3d 4a 4b 4c N.

X

X

N ^A N/A

Did the organization make a distribution to a donor, donor advisor, or related person? d Enter the total number of donor advised funds owned at the end of the tax year

N/A
e Enter the aggregate value of assets held in all donor advised funds owned at the end of the tax year. f Enter the total number of separate funds or accounts owned at the end of the tax year (excluding donor advised funds included on line 4d) where donors have the right to provide advice on the distribution o( investment of amounts in such funds or accounts g Enter the aggregate value of assets held in all funds or accounts included on line 4f at the end of the tax year..

0.

BAA

Schedule A (Form 990 or Form 990-EZ) 2006

Schedule A (Form 990 or 99Q-EZ) 2006

SAVE A LIFE FOUNDATION

36-3869459

Page 3

j j J l j j j ^ H Reason for Non-Private Foundation Status (See instructions.)
I certify that the organization is not a private foundation because it is: (Please check only ONE applicable box.) 5 6 7 8 9 M A church, convention of churches, or association of churches. Section 170(b)(l)(A)(i). \~\ A school. Section 170(b)(1)(A)(ii). (Also complete Part V.) Q A hospital or a cooperative hospital service organization. Section 170(b)(l)(A)(iii). Q A federal, state, or local government or governmental unit. Section 170(b)(1)(A)(v). Q A medical research organization operated in conjunction with a hospital. Section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state *• _, P I An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(1)(A)(iv). (Also complete the Support Schedule in Part IV-A.)

10

11a [Xl An organization that normally receives a substantial part of its support from a governmental unit or from the general public. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV-A.) l i b ["I A community trust. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV-A.) 12 l_] An organization that normally receives: (1) more than 33-1/3% of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc, functions - subject to certain exceptions, and (2) no more than 33-1/3% 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. See section 509(a)(2). (Also complete the Support Schedule in Part IV-A.) An organization that is not controlled by any disqualified persons (other than foundation managers) and otherwise meets the requirements of section 509(a)(3). Check the box that describes the type of supporting organization: *

«□

pType

F1Typ*

j [Type lll-Functionally Integrated n T y p e III-Other Provide the following information about the supported organizations. (See instructions.)
(b) (c) (d) Type of Is the supported Employer identification organization (described organization listed in number (EIN) in lines 5 through 12 the supporting above or JRC section) organization's governing documents? Yes No (e) t Amount of support

(a) Name(s) of supported organization(s)

Total

0.

14 BAA

| | An organization organized and operated to test for public safety. Section 509(a)(4) (See instructions.) Schedule A (Form 990 or 990-EZ) 2006

Schedule A (Form 990 or 990-EZ) 2006

SAVE A LIFE FOUNDATION

36-3869459

Page 4

r?arttlV^ A: [ S u p p o r t S c h e d u l e (Complete only if you checked a box on line 10, 11, or 12.) Use cash method of 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) 15 Gifts, grants, and contributions received. (Do not include unusual grants. See line 28-)... (a) 2005 (b) 2004 (c) 2003 (d) 2002 (e) Total 4,737,530 0

1,034,403

1,882,822

448,621

1,371,684

16 Membership fees received 17 Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is related to the organization's charitable, etc, purpose 18 Gross income from interest, dividends, amounts received from payments on securities loans (section 512(a)(5)), rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organ­ ization after June 30,1975 19 Net income from unrelated business activities not included in line 18 Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf. 21 The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge 22 Other income. Attach a schedule. Do not include gain or (loss) from sale of capital assets S e e . S t i n t . . 8. 23 Total of lines 15 through 2 2 . . . . 20

112,094

399,546

120,316

207,836

839,792

4,882

1,933

795

2,154

9,764

24 Line 23 minus line 17. 5,697. 22,843. 25 Enter 1% of line 23. 26 Organizations described on lines 10 or 1 1 : a Enter 2% of amount in column (e), line 24. b Prepare a list for your records to show the name of and amount contributed by each person (other than a governmental unit or publicly supported organization) whose total gifts for 2002 through 2005 exceeded the amount shown in line 26a. Do not file this list with your return. Enter the total of all these excess amounts c Total support for section 509(a)(1) test: Enter line 24, column (e) d Add: Amounts from column (e) for lines: 18 9, 764 . 22 2,006. 19

2,006 1,153,385. 1,041,291. 11,534.

2,284,301. 1,884,755.

569,732. 449,416.

1,581,674. 1,373,838. 15,817. 26 a 26 b 26 c 26 d

2,006 5,589,092 4,749,300 94,986

4,749,300 11,770

26b

e Public support (line 26c minus line 26d total) 4,737,530 26 e f Public support percentage (line 26e (numerator) divided by line 26c (denominator)) 99.75 % 26 f 27 Organizations described on line 12: JJ/A a For amounts included in lines 15, 16, and 17 that were received from a "disqualified person," prepare a list for your records to show the name of, and total amounts received in each year from, each 'disqualified person.' Do not file this list with your return. Enter the sum of such amounts for each year: (2005) (2004) (2003) (2002) bFor any amount included in line 17 that was received from each person (other than 'disqualified persons'), prepare a list for your records to show the name of, and amount received for each year, that was more than the larger of (1) the amount on line 25 for the year or (2) $5,000. (Include in the list organizations described in lines 5 through l i b , as well as individuals.) Do not file this list with your return. After computing the difference between the amount received and the larger amount described in (1)or (2), enter the sum of these differences (the excess amounts) for each year: (2005) (2004) _ (2003) (2002) 15 c Add: Amounts from column (e) for lines: 16 20 21 17 27 c and line 27b total. d Add: Line 27a total e Public support (line 27c total minus line 27d total) f Total support for section 509(a)(2) test: Enter amount from line 23, column ( e ) . . . »~| 27f g Public support percentage (line 27e (numerator) divided by line 27f (denominator)) h Investment income percentage (line 18, column (e) (numerator) divided by line 27f (denominator)) 28 27 d

27 e

27 h

Unusual Grants: For an organization described in line 10, 11, or 12 that received any unusual grants during 2002 through 2005, prepare a list for your records to show, for each year, the name of the contributor, the date and amount of the grant, and a brief description of the nature of the grant. Do not file this list with your return. Do not include these grants in line 15.

BAA

Schedule A (Form 990 or 990-EZ) 2006

Schedule A (Form 990 or 990-EZ) 2006 SAVE A L I F E FOUNDATION

36-3869459 N/A

Page 5

R»Vj
29

Private School Questionnaire (See instructions.) (To be completed ONLY by schools that checked the box on line 6 in Part IV)

Yes Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, other governing instrument, or in a resolution of its governing body? 29

No

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

30

31

32

Does the organization maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative staff? b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student admissions, programs, and scholarships? d Copies of all material used by the organization or on its behalf to solicit contributions? If you answered 'No' to any of the above, please explain. (If you need more space, attach a separate statement.)

32 a

32 b
32 c

111
33 Does the organization discriminate by race in any way with respect to: a Students' rights or privileges? b Admissions policies?. c Employment of faculty or administrative staff? d Scholarships or other financial assistance? e Educational policies? f Use of facilities? g Athletic programs?. h Other extracurricular activities? If you answered 'Yes' to any of the above, please explain. (If you need more space, attach a separate statement.) 33 a

ma
33 b
33 c 33 d

33e
33 f

J3fl
33 h

mm
34a Does the organization receive any financial aid or assistance from a governmental agency?. b Has the organization's right to such aid ever been revoked or suspended?. If you answered 'Yes' to either 34a or b, please explain using an attached statement. 35 Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05 of Rev Proc 75-50, 1975-2 C.B. 587, covering racial nondiscrimination? If 'No,' attach an explanation. BAA 34a

34b

35 Schedule A (Form 990 or 990-EZ) 2006

Schedule A (Form 990 or 990-EZ) 2006

SAVE A LIFE FOUNDATION

36-3869459 N/A

Page6

.BaTsflKlfAl L o b b y i n g E x p e n d i t u r e s b y E l e c t i n g P u b l i c C h a r i t i e s (See instructions.) (To be completed ONLY by an eligible organization that filed Form 5768) Check •" a f l i f the organization belongs to art affiliated group. Check * b

Limits o n Lobbying Expenditures (The term "expenditures' means amounts paid or incurred.) 36 Total lobbying expenditures to influence public opinion (grassroots lobbying) 37 Total lobbying expenditures to influence a legislative body (direct lobbying) 38 Total lobbying expenditures (add lines 36 and 37) 39 Other exempt purpose expenditures 41 Lobbying nontaxable amount. Enter the amount from the following table If the amount on line 40 is Not over $500 000 Over $500,000 but not over $1,000,000 Over $1,000,000 but not over $1,500,000 Over $1 500,000 but not over $17 000,000

if you checked 'a' and 'limited control' provisions apply. (a) (b) Affiliated group To be completed totals for all electing organizations 36 37 38 39 40

The lobbying nontaxable amount is 20% of the amount on line 40 1 $100,000 plus 15% of the excess over $500,000 $175,000 plus 10% of the excess over $1,000,000 $225,000 plus 5% of the excess over $1,500,000

Over $17,000,000. $1,000,000 42 Grassroots nontaxable amount (enter 25% of line 41) 43 Subtract line 42 from line 36. Enter -0- if line 42 is more than line 36 44 Subtract line 41 from line 38. Enter -0- if line 41 is more than line 38 Caution: If there is an amount on either line 43 or line 44, you must file Form 4720.

■■ ■
41 42 43 44

II

■ ■

4 -Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501 (h) election do not have to complete all of the five columns below. See the instructions for lines 45 through 50.) Lobbying Expenditures During 4 -Year Averaging Period Calendar year (or fiscal year beginning in) ■ 45 46 Lobbying nontaxable amount Lobbying ceiling amount (150% of line 45(e))... (a) 2006

(b) 2005

(c) 2004

2003

(e) Total

47 Total lobbying expenditures.. 48 Grassroots nontaxable amount.

49 Gra ss roots cei I i ng amount (150% of line 48(e)) 50 Grassroots lobbying expenditures. BatflWl'BJl L o b b y i n g Activity by N o n e l e c t i n q P u b l i c C h a r i t i e s (For reporting only by organizations that aid not complete Part VI-A) (See instructions.) During the year, did the organization attempt to influence national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of: a Volunteers b Paid staff or management (Include compensation in expenses reported on lines c through h.) c Media advertisements. d Mailings to members, legislators, or the public e Publications, or published or broadcast statements f Grants to other organizations for lobbying purposes. g Direct contact with legislators, their staffs, government officials, or a legislative body. h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means r Total lobbying expenditures (add lines c through h.) If 'Yes' to any of the above, also attach a_staternent_giving a detailed description of the lobbying activities. _ BAA Schedule A (Form 990 or 990-EZ) 2006 Yes

N/A No
Amount

Schedule A (Form 990 or 990-EZ) 2006

SAVE A LIFE FOUNDATION

36-3869459

Page 7

RaTjtlVHl information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations (See instructions) _____ _________
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) organizations) or in section 527, relating to political organizations? a Transfers from the reporting organization to a noncharitable exempt organization of: Yes No 51 a (i) X (i)Cash (ii)Other assets b Other transactions: (i)Sales or exchanges of assets with a noncharitable exempt organization (ii)Purchases of assets from a noncharitable exempt organization (iii)Rental of facilities, equipment, or other assets (iv)Reimbursement arrangements (v)Loans or loan guarantees (vi)Performance of services or membership or fundraising solicitations afli) b(i) b(ii) b(iii) b(iv) b(v) b(vi)

X X X X X X X
X

c Sharing of facilities, equipment, mailing lists, other assets, or paid employees c d If the answer to any of the above is 'Yes,' complete the following schedule. Column (b) should always show the fair market value of the goods, other assets, or services given by the reporting organization. If the organization receivea less than fair market value in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received: (a) Line no. Amount involved (c) Name of noncharitable exempt organization

Description of transfers, transactions, and sharing arrangements

N/^

52a Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations described in section 501 (c) of the Code (other than section 501 (c)(3)) or in section 527? b If 'Yes,' complete the following schedule: (a) Name of organization N/A (b) Type of organization

.__ . . ■* | | Yes jXj No

(c) Description of relationship

BAA

Schedule A (Form 990 or 990-EZ) 2006

2006
Client 18015
5/14/08

Illinois Statements
SAVE A LIFE FOUNDATION

Page 1
36-3869459,
02:53PM

Statement 1 Form AG990-IL, Page 1, Line F Other Revenues INTEREST INCOME INSTRUCTOR DUES $ Total $ 13, 684 . 745. 14,429.

Statement 2 Form AG990-IL, Page 2, Question 11 Name and Account Number of Institutions Holding Three Largest Accounts JP M R A CHASE BANK, N.A. OGN

2006
Client 18015 5/14/08 Statement 1 Form 990, Part II, Line 43 Other Expenses

Federal Statements
SAVE A LIFE FOUNDATION

Pagel
36-3869459 02:53PM

(A)
AUTO EXPENSE BAD DEBTS BANK SERVICE FEES COMPUTER EXPENSES CONSULTING DEPRECIATION DUES A N D SUBSCRIPTIONS INDEPENDENT CONTRACTORS INSTRUCTOR FEES INSURANCE LEGAL AND ACCOUNTING LICENSES AND PERMITS MARKETING A N D PROMOTIONAL MEETINGS MISCELLANEOUS OFFICE SUPPLIES PAYROLL SERVICE PROGRAM MINI-GRANTS TEMPORARY STAFFING TRAINING AND DEVELOPMENT UTILITIES WEBSITE

Total $

Total 3,104. 1,850. 2,806. 56,148. 183,778. 33,211. 1,827. 20,040. 3,216. 10,227. 92,842. 10,409. 157,101. 6,648. 405. 15,149. 3,093. 92,141. 37,548. 388. 5,522. 1,938. 739,391. $

(B) Program Services 2,948.

(C) Management & General 156. 1,850. 2,806. 8,422. 27,566. 182. 8,386. 10,916. 520.

(D)
Fundra^sing

47,726. 156,212. 33,211. 1,645. 20,040. 3,216. 1,841. 81,926. 9,889. 157,101. 6,648. 385. 14,846. 2,691. 92,141. 1,126. 388. 5,522. 1,938. 641,440. $

20.
303. 402. 36,422.

97,951. $

0.

Statement 2 Form 990 , Part I I I Organization's Primary Exempt Purpose TRAINING AND DEVELOPING "BYSTANDERS", INCLUDING CHILDREN, A S VOLUNTEERS EQUIPPED WITH LIFE SAVING FIRST AID SKILLS TO AID IN AN EMERGENCY.

Statement 3 Form 990, Part IV, Line 57 Land, Buildings, and Equipment Cateaory Machinery and Equipment Buildings Land Miscellaneous

$

Total $

Basis 166,583. $ 181,912. 20,000. 31,190. 399,685. $

Accum. DeDrec. 140,353. $ 36,382. 9,357. 186,092. $

Book Value 26,230. 145,530. 20,000. 21,833. 213,593.

2006
Client 18015 5/14/08

Federal Statements
SAVE A LIFE FOUNDATION

Page 2
36-3869459 02:53PM

Statement 4 Form 990, Part IV, Line 63 Loans from Officers, Directors, Trustees, and Key Employees Balance Due
Lender's Name: Lender's Title: Repayment Terms: Interest Rate: Purpose of Loan: Original Amount: Balance Due: CAROL SPIZZIRRI PRESIDENT DUE ON DEMAND 5.00% OPERATIONS 61,496. Total $ 178, 974 . 178,974.

Statement 5 Form 990, Part IV, Line 65

Other Liabilities INSTRUCTOR DEPOSITS Rounding $ Total $ 2,700. 1^ 2,701.

Statement 6 Schedule A, Part I Compensation of Five Highest Paid Employees Name and Address DANE NEAL 9950 LAWRENCE, SUITE 300 SCHILLER PARK, IL 60176 VINCENT DAVIS 9950 LAWRENCE, SUITE 300 SCHILLER PARK, IL 60176 _ T i t l e & Average Hours Worked NATL POLICY DIR 40 DIR -STATE/MILI 40 Total $ Compensation 63,520. Contribut. EBP & DC 0. Expense Account 584.

50,000.

0.

724.

113,520. $

0. $

1,308.

Statement 7 Schedule A, Part ll-A Compensation of Five Highest Paid Professional Service Contractors __ Name and Address __ Type of 5 e r v i c e CONSULTING . Compensation 77,039.

H G N & HARTSON LLP OA COLUMBIA SQUARE, 555 THIRTEENTH ST WASHINGTON, DC 20004

Total $

77,039.

2006
Client 18015
5/14/08

Federal Statements
SAVE A LIFE FOUNDATION
" . -

Page 3,
36-3869459
02:53PM

Statement 8 Schedule A, Part IV-A, Line 22 Other Income

j I

Description Miscellaneous

(a) 2005 fb) 2004 fc) 2003 (d) 2002 fe) T o t a l $ 2,006. $ 0^ $ 0^ $ g^_ $ 2,006. Total $ 2,006. $ (K $ 0^ $ 0^ $ 2,006. I

SAVE A LIFE FOUNDATION, INC. FINANCIAL STATEMENTS Years Ended June 30, 2007 and 2006

Mayer Hoffman McCann RC.
An Independent CPA Firm One South Wacker Drive, Suite 1800 Chicago, Illinois 60606 312-602-6800 ph 312-602-6950 fx www.mhm-pc.com

INDEPENDENT AUDITORS' REPORT

To the Board of Directors SAVE A LIFE FOUNDATION, INC. We have audited the accompanying statement of financial position of Save A Life Foundation, Inc. (an Illinois not-for-profit corporation) as of June 30, 2007, and the related statements of activities and changes in net assets, functional expenses and cash flows for the year then ended. These financial statements are the responsibility of the organization's management. Our responsibility is to express an opinion on these financial statements based on our audit. The financial statements of Save A Life Foundation, Inc. as of June 30, 2006, were audited by other auditors whose report dated August 11, 2006, expressed an unqualified opinion on those statements. We conducted our audit in accordance with U.S. generally accepted auditing standards. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audit provides a reasonable basis for our opinion. In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of Save A Life Foundation, Inc. as of June 30, 2007, and the changes in its net assets and its cash flows for the year then ended in conformity with U.S. generally accepted accounting principles.

Chicago, Illinois May 14, 2008

-1 -

SAVE A LIFE FOUNDATION, INC. STATEMENTS OF FINANCIAL POSITION June 30,2007 and 2006 2007
ASSETS

2006

CURRENT ASSETS Cash Inventory Trade receivables Grants receivable Other receivables Prepaid expenses TOTAL CURRENT ASSETS PROPERTY AND EQUIPMENT, at cost. net of accumulated depreciation TOTAL ASSETS

$

183.563 41,767 3.250 7,649

$

592,793 56,400 5,495 256,000 11,304

236,229 213.593 $ 449,822 $

921,992 239,584 1,161,576

LIABILITIES
CURRENT LIABILITIES Accounts payable Accrued expenses Credit card payable Instructor deposits Mini-grants payable TOTAL CURRENT LIABILITIES $ 7,013 1,788 739 2.700 12.240 $ 43,198 13,520 450 130,624 187.792

LONG-TERM LIABILITIES Due to Carol Spizzirri TOTAL LIABILITIES NET NET ASSETS Temporarily restricted Unrestricted TOTAL NET ASSETS TOTAL LIABILITIES AND NET ASSETS ASSETS

178.974 191,214

170,183 357,975

258,608 258,608 $ 449,822 $

271,000 532,601 803,601 1,161,576

See Notes to Financial Statements -2-

SAVE A LIFE FOUNDATION, INC. STATEMENTS OF ACTIVITIES AND CHANGES IN NET ASSETS Year Ended June 30,2007 Temporarily Restricted

Unrestricted REVENUE AND OTHER SUPPORT Contributions Private grants Contributions in kind Grants and contributions from government agencies . Course materials Training program fees Miscellaneous Net assets released from restrictions: Satisfaction of program restrictions TOTAL REVENUE AND OTHER SUPPORT EXPENSES National State Branch programs Management and general TOTAL EXPENSES DEFICIENCY OF REVENUE AND OTHER SUPPORT OVER EXPENSES FROM OPERATIONS NONOPERATING REVENUE Interest income CHANGE IN NET ASSETS NET ASSETS, BEGINNING OF YEAR NET ASSETS, END OF YEAR $

Total

$

1,445 334,110 -• 165,155 14,016 745 998,000 1,513,471

$ 27,000 700,000 (998,000) (271,000)

$

1,445 27,000 334,110 700,000 165,155 14,016 745 1,242,471 .

318,932 218,280 1,123,637 140,299 1,801,148

-

318,932 218,280 1,123,637 140,299 1,801,148

(287,677)

(271,000)

(558,677)

13,684 (273,993) 532,601 258,608 $

(271,000) 271,000 $

13,684 (544,993) 803,601 258,608

See Notes to Financial Statements -3-

SAVE A LIFE FOUNDATION, INC. STATEMENTS OF ACTIVITIES AND CHANGES IN NET ASSETS - Continued Year Ended June 30, 2006 Temporarily Restricted

Unrestricted REVENUE AND OTHER SUPPORT Contributions Private grants Contributions in kind Grants and contributions from government agencies Course materials Training program fees Branch revenue sharing Miscellaneous Loss on assets disposal Net assets released from restrictions: Satisfaction of program restrictions TOTAL REVENUE AND OTHER SUPPORT EXPENSES National State Branch programs Management and general TOTAL EXPENSES EXCESS (DEFICIENCY) OF REVENUE AND OTHER SUPPORT OVER EXPENSES FROM OPERATIONS NONOPERATING REVENUE Interest income CHANGE IN NET ASSETS NET ASSETS, BEGINNING OF YEAR NET ASSETS, END OF YEAR $

Total

$

655 $ 64,500 1,000,635.
-

$

15,000
-

655 79,500 1,000,635 700,000 67,133 23,780 4,422 2,006 (5,932)
-

700,000
. . -

67,133 23,780 4,422 2,006 (5,932) 940,000 2,097,199

(940,000) (225,000)

1,872,199

401,055 691,380 899,479 55,716 2,047,630

- ■

. -. .

401,055 691,380 899,479 55,716 2,047,630

49,569

(225.000)

(175,431)

4,882 54,451 478,150 532,601 $

-

4,882 (170,549) 974.150 $ 803,601

(225,000) 496,000 271,000

See Notes to Financial Statements -4-

SAVE A LIFE FOUNDATION, INC. STATEMENTS OF FUNCTIONAL EXPENSES Year Ended June 30, 2007
Program Branch Programs Support Management and General Organization Total

National

State

Total

Salaries $ Employee benefits Payroll taxes TOTAL SALARIES AND RELATED COMPENSATION Automobile Bad debts Bank service fees Computer expenses Consulting Depreciation Dues and subscriptions Independent contractors Instructor fees Insurance Legal and accounting Licenses and permits Marketing and promotional Meetings Miscellaneous Operating interest Office supplies Payioll service Postage Program mini-grants Reni: Repairs and maintenance Telephone Temporary staffing Training and development Training supplies Travel Utilities Website TOTAL PROGRAM EXPENSES Administration allocation TOTAL EXPENSES $

64,463 1,264 6.006 71,733 310

$

21,488 421 2,002 23,911 931

$

309,422 6,067 28,829 344.318 1,707

$

395.373 7.752 36,837 439,962 2,948

$

34,380 674 3,203 38,257 156 1,850 2,806 8.422 27,566

$

429,753 8,426 40,040 478,219 3,104 1,850 2,806 56,148 183,778 33,2111,827 137,083 3,216 10,227 109,161 10,409 157,101 6,648 405 8,523 15,149 3.093 10,226 92.141 298.004 6,698 15,076 37,548 388 56,462 55,187 5.522 1.938 1.801,148

* 36.756 3,346 1,608

9,189 29,865 37

' 47,726 110,267

137,083 3,216

84,054 9,160 17,281 2.194 8 1,278 2,121 278 716 21,192 29,800 670 4,372


1,841 14,191 729

139,820 4.454 369 6,819 11.816 2,320 8,794

8 426 909 93 409 70,949 8,940 268 1.809


259,264 4,889 7,086 1,126 388
■ -


22,585 7,726

33,877 14,900 4,804 194 218.280 18,439 $ 236,719 $

1,744 318,932 26,942 345.874

31,457 718

1,123,637 94,918 1,218.555 $

47,726 156,212 33.211 1,645 137,083 3.216 1,841 98,245 9,889 157,101 6,648 385 8,523 14,846 2.691 9,919 92,141 298.004 5,827 13,267 1,126 388 56,462 54,083 5,522 1,938 1,660,849 140,299 1,801,148 S

182

8,386 10,916 520

20

303 402 307

871 1,809 36.422


1,104

140.299 (140,299) $

.
1,801,148

See Notes to Financial Statements -5-

SAVE A LIFE FOUNDATION, INC. STATEMENTS OF FUNCTIONAL EXPENSES - Continued Year Ended June 30, 2006
Program Branch Proqrams Support Management and General Organization Total

National

State

Total

Salaries !I Employee benefits Payroll taxes TOTAL SALARIES AND RELATED COMPENSATION Automobile Bank service fees Computer expenses Consulting DeDreciation Dues and subscriptions Independent contractors Instructor fees Insurance Legal and accounting Licenses and permits Marketing and promotional Meetings Miscellaneous Operating interest Office supplies Payroll service Postage Program mini-grants Recruitment Rent Repairs and maintenance Telephone Temporary staffing Training and development Training supplies Travel Utilities Website TOTAL PROGRAM EXPENSES Administration allocation TOTAL EXPENSES $

187,174 3,510 12,133 202,817

$

221.312 4,019 29,035 254,366 . 6.118 709 22,810 44,000 30.217 115 65,255 13.044 5.073 55,497 600 8,847 5.250

$

160,325

$

160,325

568,811 7,529 41,168 617,508 6,118 1,084 68,110 87,677 33,602 115 204,030 300,961 5,301 73.607 2.900 14.782 8,582

34,655 1,504 5,260 41,419 46

$

603,466 9,033 46,428 658,927
6,164 1,084 68,110 87,677

.
375 45,300 43,677 3.385

8,775

_ • 130,000 287,917

33,602
115 204,030


228 9,469 2,300 5,935 3,332

300,961
5,921 4,028 91

8,641

77,635
2,991 14,782 8,652 770 8,181 23,407

2,210 3,100 800 1,600 14,200

4,110 6,890 1.981 2,265 30.400 2,257 47,759 5.466 7,087 16.200 447 20,400 31,327 2.703 187 691.380 19,339 $ 710.719 $

12,700

.
6,320 22,690 2,781 3.865 44,600 2,257 359,073 6,069 12,897 20,225 741 30,412 50,690 4,216 701 1,991,914 55,716 $ 2,047,630 $

12,966 603 5,810 4,025 294 10,012 17.815 1,513 514 401.055 11,218 412.273

• 298,348

770 ,861 717 20 18

2.801
3.883 44,600 2.257

*
1,548

4,612 91