Save-A-Life Foundation annual reports to IL Atty Gen'l w/IRS 990s+audits, 1/1/94-6/30/08 (download!)

CO # 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

Form AG990-IL Revised 3/95

REPORT FOR THE FISCAL PERIOD BEGINNING: 0 I \q\l\ [± V MO DAY YR MO DAY YR

ARE CONTRIBUTIONS TO ORGANIZATION TAX DEDUCTIBLE? 0 Yes D No

LEGAL SAVE A LIFE FOUNDATION NAME 17479 W. DARTMOOR DRIVE ^ T T - r ^ n r ^ r ^ r ™ ^ MAILGRAYSLAKE, ILLINOIS eOOSO-**^*^1^1 V l i J j

ADDRESS CITY, STATE JUL 2 5 1995

ZIP CODE CHARITABLE TRUST AUOfrNCY

AND ENDING:

FEDERAL ID NUMBER:

DATE ORGANIZATION WAS CREATED: A) ASSETS

B) LIABILITIES C) ENDING FUND C) BALANCE

GENERAL

3N

A) S

MO DAY

/V. 337

YR 13

B) S i%, °II I

C) S (H r?v) 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)

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) 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 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)

IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS-DURING THE YEAR:

R) NAME. TITLE: fjffi,

PERCENTAGE

J24.

100%

AMOUNT

fLf ? 3,Yof JLf -?..?7r F) S W 3 f

211 77,7//

R) S

% H) S

f^% ") s %i m-% J) S

i

«?/-% K) S %> /?2-/ f % L) S \% /32

% M) S

100 % N) S ??3^y

100 % 0) s /JlA ■ % P) S

% 0) s

S) NAME. TITLE S) S

T) NAME. TITLE T) $

V. CHARITABLE PROGRAM DESCRIPTION:

CHARITABLE PROGRAM (3 HIGHEST BY $ EXPENDED) CODE CATEGORIES (List on back side of instructions)

U) DESCRIPTION: ?U4U<L £bU*A-n0J 3V MA/L, ML CODE

U) # Ot.O V) DESCRIPTION; QUf/L fhj<?Af,*J/ry- WiArC/UALS fb/L im ?<*4^c V) # O/ 2-W) DESCRIPTION W)0

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.

2. 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 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? 4.

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

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

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

8. HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION SUSPENDED OR REVOKED? 8.

9. DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER? 9.

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

YES

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 £ - 5 V T , - 7 3 S 3

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.

UBSCRIBED AND SWORN 0 BEFORE ME.THIS AY OF .19

?M4i.~* STtzzifi-H\ PRESIDENT or TRUSTEE (PRINTNAME>

TREASURER or TRUSTEECPRINTNAME)

„ -.

SIGNATURE

TE

DATE

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

SIGNATURE OF PREPARER (PRWT 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 Re: 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

Form 990-EZ

Depertmenl si lti< Treasury Internal Re«eage Str>icc

snort i-orm 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

► For organizations with gross receipts less than $100,000 and total assets less than $250,000 at the end of the year.

The organization may have to use a copy of this return to satisfy state reporting requirements.

OMB No. 1S45-I ISO

1994

A For the 1994 calendar year. OR fiscal year beginning B Ctiect il

This Form is Open to Public

Inspection

i—}T"9' I 'address r y i l n i l i i l !■■" irelura □Final

return I lAiaendctf

Hum (required >lso lor Sine reporting!

Pleese ote IRS libel or prim or type. See Specific IntKuc-lions.

C Name of organization

jSAVE A L I F E F O U N D A T I O N / I N C

1994. and ending

Number and street (or P.O. box if mail is not delivered to street address) 174 79 W. DARTMOOR DRIVE

Room/suite

City, town or post office, state, and ZIP code SRAYSLAKE, IL 60030

19 D Employer identification number

36-3869459 E State registration number

0 1 0 2 6 4 9 8 Check ► I | if exemption application is pending

H Enter four-digit group exemption number (GEN) G Accounting method: |_XJ Cash I 1 Accrual | | Other (specify) ►

I Type of organization - ► [ X ) Exempt under Section 501(c) ( 3 j <4 (insert number) OR ► □ Section 4947(a)(1) nonexempt charitable trust 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.

K H I Statement of Revenue, Expenses, and Changes in Net Assets or Fund Balances

9 7 7 1 1 .

I

1 Contributions, gifts, grams, and similar amounts received 2 Program service revenue including government fees and contracts 3 Membership dues and assessments 4 Investment income 5a Gross amount from sale of assets other than inventory b Less: cost or other basis and sales expenses c Gain or (loss) from sale of assets other than inventory (line 5a less line 5b)

6 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 Other revenue (describe ► 9 Total revenue (add lines 1. 2. 3. 4. 5c. 6c, 7c, and 8)

Stmt 3

5a 5b

6a 6b

5c

93405

2875

7a 7b

14 31 1431

6c

7c

I

41

z

10 11 12 13 14 15 16 17

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 Other expenses (describe ►

See Statement 4

10 96280

i i 12 13 14

Total expenses (add lines 10 through 16) See Statement 1 j

18 19

20 21

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)

Balance Sheets

15 16 17 18

8163 13770 46714 29246 97893 -1613

19 20 21

-12961 -14574

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

22 23 24 25 26 27 w

Cash, savings, and investments Land and buildings Other assets (describe ► Total assets Total liabilities (describe ► DUE TO CAROL S P I Z Z I R I

See Statement 2

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.

(A) Beginning of year

- 7 1

3931 3860

16821 - 1 2 9 6 1

22 23 24 25 26 27

(Bl End of year 8 3 0 .

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? S e e S t a t e m e n t 6

3 6 - 3 8 6 9 4 5 9 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.

TO PROMOTE EDUCATION & CONTINUING EDUCATION IN CPR & FIRST 28 AID NATIONALLY. TO PROMOTE, CONSISTENCY, UNIFORMITY & SAFETY IN THE APPLICATION OF FIRST AID & (Grants $

29 CPR. TO ASSURE THAT THE BEST PROCEDURES AND HIGHEST QUALITY MATLS ARE USED & ACCESSIBLE. TO PROMOTE GOOD SAMARITAN LAWS. " (Grants $

30

(Grants $

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

28a

29a

31 Other program services (attach schedule) (Grants S 32 32 Total program service expenses (add lines 28a through 31a)

■i fT i i r i List of Officers. Directors, Trustees, and Key Employees (list each one even if not compensated.)

30a

9 9 3 2 4

31a 9 9 3 2 4

(Al Name and address See Statement 5

(B) Title and average hours per week devoted to

position

(Cl Compensation (if not paid, enter

-0-I

(D) Contiibulioiii 10 employee beoelit plans & detente

compensation

k-SMm^ nther Information

(El Expense account and

other allowances

33 Did the organization engage in any activity not previously reported to the IRS? If "Yes," attach a detailed description of each activity

34 Were any changes made to the organizing or governing documents but not reported to the IRS? H ■»•»,- aiiaco a coniotmed copyol tat changes. 35 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. 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) 37a Enter amount of political expenditures, direct or indirect, as described in the instructions. p> | 37a | 0 1

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, OR were any such loans made in a prior

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 | 38b | 2 8 9 1 1 1

39 Section 501(c)(7) organizations "

Yes No

N7A

39a N / A

40 41

42

Enter: a Initiation fees and capital contributions included on line 9 b Gross receipts, included on line 9. for public use of club facilities I 395 I N 7 A 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) List the states with which a copy of this return is filed. ► I L L I N O I S 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.

N / A

GRAYSLAKE, I L Telephone no. ► 7 0 8 - 5 4 9 - 7 3 5 3 ZIP code ► 6 0 0 3 0

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

Please Sign Here

Paid Pieparer's Use Only

4J3431 .'2-12-94

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 I L r Signature of officer n-._ ^ Date Preparer's signature

Firm's name (or

Title Date

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

Check if self -employed ►[Z^l

Preparer's SSN

E.I. No. ►

ZIP codeaV

http://prov.de

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 4947UII I I

Nonexempt Charitable Trust Supplementary Informat ion

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

SAVE A LIFE FOUNDATION INC.

0MB he. IS4S-004?

1994 Employer identification number 3 6 - 3 8 6 9 4 5 9

C S B T Compensation of the Five Highest Paid Employees Other Than Off icers, 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

None

(bl Title and average hours per week devoted to

position (cl Compensation

14) Cootribulions lo employee beotlii plant & 4elened

toinpemiiion

(el Expense account and other

allowances

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

L £ ] | l i l Compensation of the Five Highest Paid Independent Contractors for 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

None (blType of service I d Compensation

Total number of others receiving over

$50.000 for professional services

Statement About Act iv i t ies

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. ► $ 2 7 1 2 .

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 Does the organisation make grants for scholarships, fellowships, student loans, etc.?

4 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.

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

SAVE A LIFE FOUNDATION, INC Schedule A (Form 990) 1994 | j g | j ^^ | Rpggnn for Non-Private Foundation Status (See instructions for definitions I

36-3869459 Page2

The organization is not a private foundation because it is (please check only ONE applicable box): S 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.) 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).)

6 7 8 9

□ □ □ □ 10 □ 11a □ 11b 12

□ DO

13 □

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.)

S u p p o r t S c h e d u l e (Complete only if you checked boxes on lines 10, 11, or 12 above.) Use cash method of accounting. Calendar year (or fiscal year beginning inl ► (al 1993 (b) 1992 (cl 1991 (d) 1990 (el Total 15 Cilti, gums, and conuibuiiont received.

(Do not include unusual grams. See line 28) 7 1 9 9 . 7 1 9 9 .

16 Membership fees received

17 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

18 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

19 Net income from unrelated business

activities not included in line 18 Z0 Ta« revenges levied lor Ihe organization's

stnelit and either paid lo il or eipended oo ill bthalf

2 1 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

2 2 Other income. Attach a schedule. Oo nol include gain oi (loss) hom tale ol capital astelt

23 Total of lines 15 through 22 7 1 9 9 . 0 . 0 . 0 . 7 1 9 9 . 24 Line 23 minus line 17 . 7 1 9 9 . 7 1 9 9 . 25 Enter 1 % of line 23 7 2 . 26 Organizations described in lines 10 or 11:

a Enter 2% of amount in column (e). line 24 N/A b Attach a list (which is not open to pub

governmental unit or publicly supporte in line 26a. Enter the sum of all these

ic inspection) showing t d organization) whose tt excess amounts here

le name of and amount tal gifts for 1990throu

:ontributed by each pers

gh 1993 exceeded thee on (other than a

mount shown

► N/A 423111 12-12-94

9 3 5 0 7 1 3 758985 SAVE50 (Support Schedule continued on page 3)

4 060 SAVE A LIFE FOUNDATION, INC 18616924

3 6 - 3 8 6 9 4 5 9 pa9e 3 Schedule A (form 9901 1964 SAVE A LIFE FOUNDATION, INC.

l e f f l l l l 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.)

27 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 """" ' ' • "nd *m0Unt inC 'uded in Nne 17 , 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 descnbed in (1) or 12). enter the sum of all these differences (the excess amounts) lor each year- 3

, 1 9 9 3 ) < L L H992I ( K 0 9 9 , ) 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.) N o n e

B S D Private School Questionnaire (To be completed ONLY by schools that checked the box on line 6 in Part IV) N/A

29 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.)

30

31

29

30

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

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? a 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.)

32c

32d

33a 33b 33c

33d 33e 331

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

3 5 WB «7^f" C e f , i , y ^ " h M C ° m P " e d W U h ,hB 8PP"eab,e r e " " f e m e n , s • ' "<«'<"« 4.01 through 4.05 ol Rev. Pr.c. 75-50 . 1 8 7 W " • 587, covering racial nondiscrim.nation? If "No," attach an explanation. (See instructions for Part V.)

33a 33h

34a 34b

35

Yes No

«23I21 12-12-94


Seneduie AlForm 990) 1994 SAVE A L I F E FOUNDATION, INC. ' f i E T W J P ^ I O h h y i n r f F w p a n H i f r 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)

Check here ► al I If the organization belongs to an affiliated group. Check here ► b [ | If you checked a and "limited control" provisions apply.

Limits on Lobbying Expenses (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 (see Part Vl-A instructions) 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 -NolovorS 500.000 20% ol ihe jmouni on lint 40

Ortf $600,000 bul noi Dvtr SI.OOO.000 $100,000 plus 15% ol Ihc t iccsi o>» $500,000

0«ei S 1.000.000 bm col over SI.500.DO0 SI75.000 plus 10% ol Ihe m t i i o.ti $1,000,000

OiorS1.SOO.000 bul not o««f S17.000.0U0 $225,000 plus Sk ol lot i ictst o«oi S 1.500.000 Over $17.000.000 S 1,000.000

42 Grassroots nontaxable amount (enter 25% 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. En te 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.

3 6 - 3 8 6 9 4 5 9 p8qe4

N/A

36 37

(al Affiliated group totals

N~7A

38 39 40

] 41

lb) To be completed for ALL

electing organizations

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.)

Calendar year (or fiscal year beginning in)

45 Lobbying nontaxable amount

46 Lobbying ceiling amount

(150% of line 45(e))

47 Total lobbying

expenditures

Lobbying Expenditures During 4-Year Averaging Period

(a) 1S94

lb) 1993

48 Grassroots nontaxable amount

49 Grassroots ceiling amount

1150% of line 48(e))

50 Grassroots lobbying

expenditures Part Vl-B

(c) 1992

N/A Id)

1991 (el

Total

_0_

0

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

0 .

0 .

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) t 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 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.

Yes No Amount

2 6 3 .

2449

2 7 1 2 . See Statement 7

423131 12-12-94


http://OiorS1.SOO.000

36 -3869459 paaes Schedule A (Form 990) 1994 SAVE A L I F E F O U N D A T I O N , I N C l i f l iWH Information Regarding Transfers To and Transactions and Relationships With Noncharitable

Exempt Organizations i i

Slali) alii)

blil

Yes

blii)

(al Line no.

Did the reporting organization directly or indirectly engage many of the following with any other organization described in section 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 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

Ic) Name of noncharitable exempt organization

bliiil b(iv) b(vl bfvil

No

X

(bl Amount involved (d)

Description of transfers, transactions, and sharing arrangements

□ v es

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?

b '< "Yes," complete the following schedule. N / A

~W ~ 1 (bl Nime "' organization Type of organization

[X]Nc

(cl Description of relationship

423141 12-12-94

J350713 758985 SAVE50 060 SAVE A LIFE FOUNDATION, INC 18616924

SAVt A Lift* FOUNDATION, INC. 36-3869459

Form 990-EZ Other Expenses Statement

Description CONFERENCE MEALS AND ENTERTAINMENT OFFICE SUPPLIES & EXPENSE MERCHANDISE PRODUCTS TRAVEL MISCELLANEOUS Total to Form 990-EZ, line 16

Amount 2011. 2465. 4502. 9569. 7861. 2838. 29246

Form 990-EZ Other Assets Statement

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

Beg. of Year 3931

End of Year 13507

3931. 13507

9350713 758985 SAVE50 8 Statement(s) 1, 2 060 SAVE A LIFE FOUNDATION, INC. 18616924

SAVt; A LIFE FOUNDATION, INC. 36-3869459

Form 990-EZ Occupancy, Rent, Utilities and Maintenance

Description Depreciation/Amortization Other Expenses Total to Form 990-EZ, line 14

Statement

Amount 2731. 11039. 13770.

Form 990-EZ Part IV - List of Officers, Directors, Trustees and Key Employees Statement

Name and Address Title 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

Average Hours

per Week 100

Employee Compen- Ben Plan Expense sation Contrib Acct

0.

0.

0.

0.

0.

0.

>orm 990-EZ Statement of Organization's Primary Exempt Purpose Statement 6 Part III

.'xplanation

•ROMOTE EDUCATION & CONTINUING EDUCATION IN CPR & FIRST AID NATIONALLY,

chedule A Statement of Lobbying Activities - Part VI-B Statement

£££» iS ™"EAIDGSACPRN "W,n»«'« T H A T P ° " ^ - FIREFIGHTERS AND BE

J350713 758985 SAVE50 « „ 10 Statement(s) 4, 5. 6, 7 060 SAVE A LIFE FOUNDATION, INC. 18616924

Form 4562 Ocpa'lmeni ol the Treasury Internal Revenue Service ISSI Nanelt) snona on return

Depreciation and Amortization (Including Information on Listed Property) 990 -EZ

► Attach this form to your return.

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

Form 990-EZ Page 1

0MB No. 1615-0172

1994 Attachment Sequence No. 67

Identifying number

36-3869459

$17.500

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 Total cost ol section 179 property placed in service during the tax year 3 Threshold cost of section 179 property before reduction in limitation 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

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 ►

(c) fleeced coil

$200,000

13

10 11 12

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

14 a 3-year property

b 5-year property

Section A • General Depreciation System (GPS)

le] Convention II) Method (gl Depreciation deduction

c 7-year property

d 10-year property

e 15-year property

f 20-year property

g Residential rental property

h iMonresidential real property

12307 7 Y r s .

27.5 yrs. 27.5 yrs.

HY FOOD!

MM

15 a Class life b 12-year

c 40-year

Section B - Alternative Depreciation System (ADS)

MM MM MM

S/L S/L S/L

1759

S/L

m i H U Other Depreciation (Do Not Include Listed Property)

12 yrs. 40 yrs. MM

S/L S/L S/L

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 lifoif IJ s..n,mjry ~ —~

16 17 18

548

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 I the basis attributable to section 263A costs 21

19

20

S430 For Paperwork Reduction Act Notice, see page 1 of the separate instructions. BZvl -U-94 1 1 9350713 758985 SAVE50 060 SAVE A LIFE FOUNDATION, INC

2307 .

Form 4562 (1994)

18616924

r-ormiaiu t m o

' i m X i *Vc£uoVXmTm™?n"- C , ' U i n ° ' h e ' V e h i C ' " - C r i ""» T e l e p h < " '" - C e " a i " C ° " " " " « " - ■■« P"»P"ty Used for EntertainmJt,

£.% aft'factSBrsr^Scri asaj8^ ra ,e or deduc,in9 iease expense- com',ie,e °ni> *»• " » • « * — « • - ■ — ^ u . (

Page 2

Section A - Depreciation and Other Information (Caution: See instructions for l.mitauons for automobiles.) : r • — - —■■■» w..n«»iun iv.«uuun; aee instructions lor limit 22a Do you have evidence to support the business/investment use claimed? I I Yes I I No

(al Type of property

(list vehicles first)

(bl Date placed in service

Business/ investment

use percentage

(dl Cost or

other basis 23 Property used more than 50% in a qualified business use:

le) Basis for depreciation (business/

investment use only)

22b II "Yes." is the evidence written? L I Yes I I No

Ifl Recovery

period

<gl Method /

Convention

(hi Depreciation

deduction

(it Elected

section 179 cost

%

24 Properly used 60% or less in a qualified business use:

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

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

25 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

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?

(al Vehicle

lb) Vehicle

(cl Vehicle

(dl Vehicle

(e) Vehicle

Yes No Yes No Yes No Yes No Yes

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.

(fl Vehicle

No Yes No

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 ° U f a " S W e f ' " 3 4 ' " • 3 6 ' 3 7 ' or 3B is " Y e s / ' you n e e d no1 c o n""e l e S e c , i o n B <°r "« "v«ed vehicles I r f T i M l Am0rii„tion ~ '

Yes No

(•I Otscription ol cons (bl Date

imoilililion

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

40 Amortisation of costs that began before 1994

(c) Araoiti/tbl* atnounl

Id) Cote stcli'on

(el Amortiittign ptiiod or

piictnl»9«

41 Total. Enter here and on "Other Deductions" or "Other Expenses" line of your return

5350713 758985 SAVE50

40 41

III Atnadizttion lor (hit yen

424 424

I2J2 21-94 12

060 SAVE A LIFE FOUNDATION, INC 18616924

r^. CO # 01-026,498

CHARITABLE ORGANIZATION SUPPLEMENT Attorney General JIM RYAN State of Illinois

Form AG990-1L Revised 3/95

Charitable Trust and Solicitations Bureau, 100 West Randolph Street, 12th Floor, Chicago, Illinois 60601

MO DAY YR REPORT FOR THE FISCAL PERIOD BEGINNING: \o\ f\ \o\t G

MO DAY YR

ARE CONTRIBUTIONS TO ORGANIZATION TAX DEDUCTIBLE? j 3 Yes D No AND ENDING:

FEDERAL ID NUMBER:

TEE] H T 9 5

LEGAL NAME MAIL

ADDRESS CITY, STATE ZIP CODE

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

JL 3 6 - 3 8 6 9 4 5 9

DATE ORGANIZATION WAS CREATED:

MO DAY YR OS £3 9 ? 3

A) ASSETS

B) LIABILITIES C) ENDING FUND C) BALANCE

A) s y ? yra B) S 30, /y?

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

I. SUMMARY OF REVENUE ITEMS DURING THE YEAR: D) PUBUC SUPPORT, CONTRIBUTIONS & PROGRAM SERV. REV. (GROSS AMTS.)


F) OTHER REVENUES

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

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







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


Q) NET RECEIVED BY THE CHARITY (O MINUS P=Q)

PERCENTAGE

n.-> Ai_

100%

AMOUNT

D> S t/0. ~7& / E) $ / , V/O F) $

G>S / / J , / 7 /

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

% H) $

% '> s &&,3&/ % J) $

% K ) « 60.3&Z % L) $ /// / ? 7

% M) $ _?-?, 3 /<f 100 % N>$ /Pl.ffi,

100 % O) $ At 14 % P) $

% Q) S

S) NAME, TITLE S) $

T) NAME. TITLE T) $

V. CHARITABLE PROGRAM DESCRIPTION: CHARITABLE PROGRAM (3 HIGHEST BY S EXPENDED) CODE CATEGORIES (Ust on back side of instructions): CODE

U) DESCRIPTION: PtfMft S/tpCJTJTO/J &/M4JL U) tf £>/& V) DESCRIPTION. ^Z/ZfA f0„fA TZ0AJ4L AMTf/W/S roSrSf /?*,S17£ V) # O /? W) DESCRIPTION: W) D

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.

2. 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? «

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.

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 COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? 5

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

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

8. HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION SUSPENDED OR REVOKED? 0

DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER? 9.

10. DO YOU HAVE ANY KNOWLEDGE OF ANY THEFT. DEFALCATION. MISAPPROPRIATION COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS? 1 0

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

6fi4*0 A/JIITÂI 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/ |DATB"

i m s i n n 1 r \JUI-IUI

TREASURER or TRUSTEE<PBWT NAME) SIGNATURE

•ION REQUIRED UNDER TRUST ACT ONLY)*

y

SIGNn,, ST&WCV fte/f

tncri(PftlNT NAME) SIGNATURE

DATE

fit/* DATE

Form 990 Department ol the Treasury Internal Revenue Service

Return of Organization Exempt From Income Tax 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 g Chock it

OS""90 oddresft □ □Final n

Initial return

J return □Amended return

(rtawedttse bSsc rtfioftno

6 Type of organization

Please use IRS label or print or type-See Specific Instruc' lions.


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

,1995. and ending

OMB Mo 1S4S-0CM7

1995 This Form Is Open to Public Inspection

Number and street (or P.O. box if mail is not delivered to street address) 17479 W. DARTMOOR DR.

Room/suite

City, town, or post office, state, and ZIP code IGRAYSLAKE, I L 60030

,19 D Employer identification number


01026498

G O Exempt under 501(c) ( 3 )A (insert number) OR ►! 1 section 4947(a)(1) nonexempt chartitable trust

F Check ► C D if exemption application is pending

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

(b) If *Yes.' enter the number of affiliates for which this return is filed: ►

f C) tt Uira a separate return Hied by an omanteallon covered by a croup ruling? □ Yes I S NO 1

If either box in H is checked *Yes,* enter four-digit group exemption number (GEN) ► Accounting method: I X I Cash I 1 Accrual

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. ranir

a b c d

2 3 4 5 6 a

b c

7 8 a

b c d

la

Statement of Revenue, Expenses, and Changes in Net Assets Contributions, gifts, grants, and similar amounts received: Direct public support Indirect public support Government contributions (grants) Total (add lines 1 a through 1 c) (attach schedule of contributors) S T M T 1 (cash$ 4 2 , 9 1 1 . noncashS 6 7 , 8 5 0

1b 1c

1 1 0 , 7 6 1

STMT 2 )

6a 6b

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 or other basis and sales expenses Gain or (loss) (attach schedule)

1d

(A) Securities 8a 8b 8c

(B) Other

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)

of contributions

6c

8d

b c

10 a b c

11 12

9b

10a

Less: direct expenses other than fundraising expenses Net income or (loss) from special events (subtract line 9b from line 9a) Gross sales of inventory, less returns and allowances Less: cost ol goods sold Gross profit or (loss) from sales of inventor/ (attach schedule) (subtract line 10b from line 10a) S T M T .3 Other revenue (from Part VII. line 103) Total revenue (add lines 1d. 2.3.4.5.6c. 7.8d. 9c. 10c. and ID

14 10b 14

8 c &

to

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 (AH

9c

10c 11 12 13

18 19 20 21

LHA S23O01 01-03-96

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) S E E S T A T E M E N T 4 Net assets at end of year (combine lines 16.19. and 20)

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

14 15 16 17 18 19 20 21

1 1 0 , 7 6 1 ,

1 , 4 1 0 .

1 1 2 , 1 7 1 6 2 , 4 4 5 1 4 , 7 1 1 3 3 , 3 1 8

1 1 0 , 4 7 4 1 , 6 9 7

< 1 4 , 5 7 4 <7^_24 3

< 2 0 , 1 2 0 Form 990 (1995)

Form 990 (1995) SAVE A LIFE FOUNDATION, INC. 3 6 - 3 9 6 0 4 ^ 9 Page2 ■ t i » » l l l S t a t e m e n t o f AH organizations must complete column (A). Columns (B). (C). and (0) are required for section 501(c)(3) and I K I U I I Funct ional E x p e n s e s (4) organizations and section 4947(a)(1) nonexempt charitable trusts but optional for others.

Do not include amounts reported on line 6b. 8b, 9b. 10b. or 16 of Part I. (A) Total (B) Program

services (C) Management

and general (D) Fundraising 22 Grants and allocations (attach schedule)

cash S noneash $ 22

0 .

/ ' ' ' 23 Specific assistance to individuals (attach schedule) 23

0 . 24 Benefits paid to or for membe rs (attach schodult) 24

0 . 2 5 Compensation of office's, directors. etc. 25 0. 0 . 0 . 0 . 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 ^■^S." \ .W Vi V f Wft W * * f «■ \ % * s •.

31 Accounting fees 31 ^■^S." \ .W Vi V f Wft W * * f «■ \ % * s •.

32 Legalfees 32 150 . 150 . 33 Supplies 33 1 ,618 . 1 , 6 1 8 . 34 Telephone 34 3 , 7 8 8 . 3 , 7 8 8 . 35 Postage and shipping 35 778 . 7 7 8 . 36 Occupancy 36 1 , 2 0 0 . 1 , 2 0 0 . 37 Equipment rental and maintenance 37 3 , 6 5 0 . 3 , 6 5 0 . 38 Printing and publications 38 9 , 2 9 3 . 9 , 2 9 3 . 39 Travel 39 8 , 0 0 5 . 8 , 0 0 5 . 40 Conferences, conventions, and meetings 40 1 ,773 . 1 , 7 7 3 . 41 Interest 41 42 Depreciation, depletion, etc. (attach schedule) 42 3 , 9 3 5 . 3 , 9 3 5 . 43 Cither expenses (itemize):

a 43a b 13b c 43c d 13d e S E E S T A T E M E N T 5 t I3e 7 6 , 2 8 4 . 3 3 , 2 5 5 . 9 , 7 1 1 . 3 3 , 3 1 8 .

44 Total functional expenses (add lines 22 through 43) Organizations completing columns (B>(D), cony these totals to lines 13-15 44 1 1 0 , 4 7 4 . 6 2 , 4 4 5 . 1 4 , 7 1 1 . 3 3 , 3 1 8 .

Reporting of Joint Costs. - Did you report in column (B) (Program services) any joint costs from a combined educational campaign and fundraising solicitation? ► I I yes QT | 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 rrv) the amount allocated lo Fundraising $ . frv) the 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 $

(Grants and allocations S

62 ,445


(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 6 2 , 4 4 5

1?-»7.9S

Form 990(1995) SAVE A LIFE FOUNDATION, INC. 3 6 - 3 8 6 9 4 5 9 Paoea Balance Sheets

Note: Wiiere required, attached schedules and amounts within the description column should be for end-of-year amounts only.


(B) End of year

45 Cash - non-interest-bearing 830 * 45 1 ,096 . 46 Savings and temporary cash investments 46

47 a Accounts receivable 47a I b Less: allowance for doubtful accounts 47b

I 48 a Pledges receivable 48a i

b Less: allowance for doubtful accounts 48b i

49 Grants receivable 49 SO Receivables due fiom officers, directors, trustees, and key employees (attach

schedule) 50 J3 « 51 a Other notes and loans receivable 51a 111; 51c 1 b Less: allowance for doubtful accounts Sib

111; 51c

52 Inventories for sale or use 53 Prepaid expenses and deferred charges 53 54 Investments - securities (attach schedule) 54 55 a Investments - land, buildings, and

equipment: basis 55a " * : > : v : : '

b Less: accumulated depreciation (attach schedule) 55b

" * : > : v : : '

56 Investments - other (attach schedule) 56 57 a Land, buildings, and equipment: basis . 57a 1 7 , 4 0 6 .

1 3 , 5 0 7 . ii! 57e

b Less: accumulated depreciation S T A T E M E N T 8 57b 1 7 , 0 9 1 . 1 3 , 5 0 7 . ii! 57e

1 0 , 3 1 5 . 58 Other assets (describe ► D E S I G N A T E D C A S H 1 8 , 4 7 7 .

59 Total assets (add lines 45 through 58) (must equal line 74) .. 1 4 , 3 3 7 . 59 1 9 , 8 8 8 . 60 Accounts payable and accrued expenses 60 61 Grants payable 61

8 62 Deferred revenue jg*

63 Loans from officers, directors, trustees, and key employees 2 8 , 9 1 1 . 63 4 0 , 0 0 8 . JS 64 a Tax-exempt bond liabilities 64 a

b Mortgages and other notes payable 64b 65 Other liabilities (describe ► )

66 Total liabilities (add lines 60 throuoh 65)

65 65 Other liabilities (describe ► )

66 Total liabilities (add lines 60 throuoh 65) 2 8 , 9 1 1 . 66 4 0 , 0 0 8 .

0

Organizations that follow SFAS 117, check here ► L K J and complete lines 67 through 69 and lines 73 and 74

67 Unrestricted < 1 4 , 5 7 4 . : ■ "67 < 2 0 , 1 2 0 . >

c a 68 Temporarily restricted 0 . 0 . & 69 Permanently restricted 0 . 64 0 . ■v c a L. 0

Organizations that do not follow SFAS 117, check here ► I I and complete lines 70 through 74

70 Capital stock, trust principal, or current funds 70 • in

71 Paid-in or capital surplus, or land, bldg., and equipment fund 71 < 72 Retained earnings, accumulated income, endowment, or other funds 72 o

Z 73 Tnlal net assets or fund balancess (add lines 67 through 69 OR column (A) must equal line 19 and column (B) must equal line 2

lines) 1) ...

r0 through 72; < 1 4 , 5 7 4 . > w < 2 0 , 1 2 0 . >

_L r4 Total liabilities and net assets/fund balances (add lines 66 and 73) r 14 ,337 .1 74 1 9 , 8 8 8 .

S23021 12-27-95

Form 990 (1995) Part IV-A

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

Part IV-B 36-3869459

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

b 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):

"NTA"

Add amounts on lines (1) through (4)

Line a minus line b Amounts included on line 12, Form 990 but not on line a:

Reconciliation of Expenses per Audited Financial Statements With Expenses per Return

Page 4

(1) Investment expenses not included on line 6b, Form 990


a Total expenses and losses per audited financial statements

b Amounts included on line a but not on line 17. Form 990:


(2) Prior year adjustments reported on line 20, Form 990

(3) Losses reported on line 20. Form 990


"N7A~

L

Add amounts on lines (1) and (2) . Total revenue per line 12. Form 990 (line c plus line d)

X

e d

(1)

(2)

Add amounts on lines (1) through (4) 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):

> ►

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

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

(A) Name and address (B) Title and average hours

per week devoted to position

(C) Compensation (If not paid, enter

(D)ContnDutiom to employee benefit plant 1 deferred

(E) Expense account and

other allowances CAROL S P I Z Z I R R I PRESIDENT

100 0 . 0 . 1 7 4 7 9 W. DARTMOOR DR, GRAYSLAKE, I L PRESIDENT 100 0 . 0 . 8 , 0 0 0 .

STEPHEN J . COLE TREASURER O. 0 . 1 7 3 7 7 W. DARTMOOR DR, GRAYSLAKE, I L

TREASURER O. 0 . 0 .

SANDY ENGBER SECRETARY 0 . 0 . 1 7 5 9 3 W. DARTMOOR DR, GRAYSLAKE, I L

SECRETARY 0 . 0 . 0 .

LEE JUNGKANS VICE PRES. O. 0 . 8 3 2 0 W. BLUE MOUND AVE, WAUWATOSA, WI

VICE PRES. O. 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).

CD Yes QG No

623031 12-27-95

Form990(1995) SAVE A LIFE FOUNDATION, INC. f i f t jyi l Other Information 76 Did the organization engage in any activity not previously reported to the IRS? II •Yes.* attach a detailed description of each activity 77 Were any changes made in the organizing or governing documents, but not reported to IRS?

36 -3869459 Pages

II "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?

b If "Yes," has it filed a tax return on Form 990T, Exempt Organization Business Income Tax Return, for this year? .N/A. 79 Was there a liquidation, dissolution, termination, or substantial contraction during the year?

it'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 otherexempt or nonexempt organization? b If "Yes," enter the name of the organization ►

Y e s N o 76 77

78a 78li 79

81 a and check whether it is L3 exempt OR □ nonexempt.

Enter the amount of political expenditures, direct or indirect, as described in the instructions for line 81 | g j 3 |

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

80a

81b

1 3 , 0 0 0 .

65

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 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 Section 162(e) lobbying and political expenditures Aggregate nondeductible amount of section 6033(e)(1 )(A) dues notices Taxable amount of lobbying and political expenditures (line 85d less B5e)

g Does the organization elect to pay the section 6033(e) tax on the amount in 851? .7ZZZZZI N/A h 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:

82a X

83a 83b 84a

%.-.

84b 65a 85b

85c 65d 85e 851

N/A N/A

W A N/A

86 a b

87 a b

89 90 91

92

66a 86b 87a

87b

Initiation fees and capital contributions included on line 12 Gross receipts, included on line 12. for public use of club facilities Section 501 (c)(12) organizations. - Enter: Gross income from members or shareholders Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) 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 The books are in care of ►CAROL SPIZZIRRI Located at ► J / 7 4 7 9 W. DARTMOOR DR. , GRAYSLAKE, IL

N/A "N7A" W A "

85o

85h

N/A

86

Telephone no. ► 8 4 7 - 5 4 9 - 7 3 5 3 ZIP Code ^60030

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 ► □

823041 M-27-9S

Form990(1995) SAVE A L I F E FOUNDATION, INC. 36- - 3 8 6 9 4 5 9 Page6 |*£ i|2{J| Analysis of Income-Producing Activities Enter gross amounts unless otherwise indicated.

93 Program service revenue:

Unrelated business income Excluded by section 512. 513, or SI 4 rci Enter gross amounts unless otherwise indicated.

93 Program service revenue: Business

code

(B) Amount

(C) Exclusion code

(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 1 , 4 1 0 . 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 b c d e

104 Subtotal (add columns (B).(D). and (E)) ■M§MM 0 . 0 . 1 ,410 . 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.)

1 , 4 1 0 .

Line No.

r

Relationship of Activities to the Accomplishment of Exempt Purposes 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

I n fo rmat ion R e g a r d n g T a x a b l e Subsid iar ies (Complete this Part If the "res' box on BB Is checked.)

Name, address, and employer identification number of corporation or partnership

~N7A"

Percentage of ownership interest Nature of business activities Total income End-of-year

assets

%

Please Sign Here

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.

Signature of officer Date Title Check if self- . . employed ► I I Paid

Preparer*; Use Only

Preparer's ^ signature r

Date Preparer's social security no.

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

E.I. NO. ►

and address LINCOLNWOOD, ILLINOIS ZIPcode ► 6 0 6 4 6 623161 1227 95


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 In format ion

► Must be completed by the above organization! and attached to their Form 990 (or Form 99QE2)

CMBNo 1S45-0O47

1995 Name of the organization _ „ SAVE A LIFE FOUNDATION, INC. J 6 : 3afiQdSQ | M U Compensation of the Five Highest Paid Employees Other Than Offtcers, Directors, and Trustees

(See instructions.) (List each one. If there are none, enter •Wone • irusiees

Employer identification number 36 j 3 8 6 9 4 5 9

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

(b) Title and average hours per week devoted to

position (c) Compensation i re

hss | COI

. joni/ibuttons to emptoyoo barteM

componmion

(e)Expense account and other

allowances

Total number of other employees paid over $50,000

l i M U l 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

NONE

(b) Type of service (c) Compensation

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).

-;r

623101 12-19-99

Schedule A (Form 990) 1995

Schedule A (Form 990) 1995 SAVE A L I F E F O U N D A T I O N , I N C .

Statement About Activities 36-386 ,9459 Page 2

Yes No During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative 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?

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.) I r T i i r l Reason for Non-Private Foundation Status (See instructions for definitions i

ft 3r

The organization is not a private foundation because it is (please check only ONE applicable box):

2a X

2b X

2c X

2d X

2e X

3 X

5 6 7 6 9

10

11a

11b 12

D a □ □ □

□ □ EH

13

A church, convention of churches, or association of churches. Section I70(b)(1 )(A)(i). A school. Section 170(b)(1 )(A)(ii). (Also complete Part V, page 4.) A hospital or a cooperative hospital service organization. Section 170(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)(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)fA)(iv) (Also complete the Support Schedule In Part IV-A.) 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.) A community trust. Section i70(b)(l)(A)(vi). (Also complete the Support Schedule In Part IV-A) 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.)

□ 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 (2) section 501fc)f4,. a\. nr ,6V if they meet the test of section 509ra)/2,. « M m m - 509(a)(3))

lOWinO information annul trip simnnrlort n«,»nh,ii...... / e „ . ! . . . _ . - . : ' . . ~ ?l°n*i- l J " >emuii 3U»(a||j).) _ . ; — ; ■ - ■-. . - . .^. . . .w„ ». iv,,. ii t.iBy nisei UIB IB Provide the following information about the supported organizations. (See instructions on paoe 4.1

(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 on page 4.)

623111 12-1996

Schedule A (Form 990) 1995 SAVE A L I F E F O U N D A T I O N , I N C . 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 tor converting from the accrual to the cash method of accounting.

36-3869459 Pages

Calendar year (or fiscal year beginning In) "J 5 Oitta. grants, and contributions received.

(Do not include unusual grants. S n tint 88.)


17 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

(a) 1994

9 3 , 4 0 5 . 2 , 8 7 5 .

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 organization after June 30,1975

(b) 1993

7 , 1 9 9 .

(c) 1992 (d) 1991

19 Net income from unrelated business activities not included in fine 18

2 0 Ta> revenues levied lor the organization's benefit and diner paid to it or upended 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

(e) Total

1 0 0 , 6 0 4 . 2 , 8 7 5 .

2 2 Outer Income. Attach a schedule. Oe not include gain or floss) from sole of capital assets

23 Total of lines 15 through 22 24 Line 23 minus line 17 25 Enter 1 % of line 23

9 6 , 2 8 0 . 9 6 , 2 8 0

9 6 3 .

7 , 1 9 9 . 7 , 1 9 9 .

0 .

7 2 . 26

0 .

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

26a

1 0 3 , 4 7 9 . 1 0 3 , 4 7 9

27

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

19 J_ 26b X

>

.►

> > ►

26b

26c

26d 26e 261

N/A ' ' ■ ? ' N

>'-

N/A

N/A • M V V A S W

N/A ~N7A" N/A

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) 0 . . . (1991) 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 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) 0 . , . (1992) Q.... (1991) 0 . . .

Add: Amounts from column (e) for lines: 15 |_ 17 | 20 $_

Add:Line27atotal $ 0 .

1 0 0 , 6 0 4 . 16 L 21 $

2 , 8 7 5 .

and tine 27b total $_ 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) 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)!

27! I S

_ ► _ ►

► 1 0 3 , 4 7 9 .

27c

►

27d 27e

27g_ 27h

1 0 3 , 4 7 9 . 0 .

1 0 3 , 4 7 9 .

100% .0000%

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.)

■ NONE (23121 01-06-96

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)

3 6 - 3 8 6 9 4 5 9 Page 4

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

31

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.)

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!)

33 a b c d e f

9 h

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!)

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

N/A

Yes No 29

30

31

'">?

32a

32b

32c 32d

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

34a 34b

35

8*3131 12-19 95

Schedule A (Form 990) 1995 SAVE A LIFE FOUNDATION/ INC. Part Vl-A Lobbying Expenditures by Electing Public Charities

(To be completed ONLY by an eligible organization that filed Form 5768)

36-3869459 P T <

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.

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

N/A

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 20*4 of tno tmount on lino 40

OverJ500.00OtiuInotowS1.O0O.000 $100,000 p l j i 15K ol Out oxosu ovw $500,000

Cw$1,000,00Obutrtotovw$1,S00,000 (175,000 pint I OK or tho w c « u ovw $1,000,000

O»«$1.506,000butnotoverS17,000,00O $22S.Oobphi§ 5M or the oxcau ovw $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

36 37 38 39 40

(a) Affiliated group totals

WA"

To be completed for ALL electing organizations

41

Caution: if there is an amount on either line 43 or line 44. file Form 4720.

42 43

m ^ ^ 5

-$,-

'-$

44

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


Calendar year (or fiscal year beginning In)


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

47 Total lobbying expenditures .

48

(a) 1995 1994


1 N/A

Grassroots nontaxable amount

(c) 1993

A T

(d) 1992

(e) Total

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

50 Grassroots lobbying expenditures

Part Vl-B

«v,1

o.

0 .

0 .

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

0 .

0 .

0 .

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)

N/A

Yes No

If 'Yes' to any of the above, also attach a statement giving a detailed description of the■ Vobbyino activities!

Amount

0 .

(23141 12-19-SS

http://OverJ500.00OtiuInotowS1.O0O.000

Sc uleA(Form990)i995 SAVE A LIFE FOUNDATION, INC. 3 6 - 3 8 6 9 4 5 9 IJEHSUI Information Regarding Transfers To and Transactions and Relationships With Noncharitable

Exempt Organizations 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, 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

(a) Line no

(Iv) Reimbursement arrangements T 7 ~ r (v) Loans or loan guarantees

(vi) Performance of services or membership or fundraising solicitations 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

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

b(i) X mil) X b(lii) X b(h>) X b(v) X b(vi) X

c X

(b) Amount involved

(c) 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? \—] Y

b If 'Yes.' complete the following schedule. N/A — 6 S LXlNo (a)

Name of organization (b)

Type of organization Description of relationship

823151 12-19-95

Depreciation and Amortization Detail

Asset Number

FORM 990 PAGE 2 990 Description of property

Dale placed

in service Method/ Life IRC sec. or rate

Line No. Cost or

other basis ORGANIZATION COSTS

Basis reduction Accumulated

depreciation/amortization

JJWiiP 60M 41 OFFICE EQUIPMENT 2 , 1 2 0 . 5 3 0 .

12,31,93|200DB|7.00 117 OFFICE EQUIPMENT i|06,30,94|2QODB|7.00 TT

2 , 2 3 6 . 86777

OFFICE EQUIPMENT ii106,30,95|200DB|7.00 |l5CT

12,307. 1,759 ** 743 TOTAL 990" PAGE 2 DEPRECIATION & AMORTIZATION

J L J L J L

17,406. 3,156.

«• Current year section 179 (D) - Asset disposed

Current year deduction

4 2 4 .

391.

3 ,014

106.

3 , 9 3 5 .

SAVE A LIFE FOUNDATION, INC. 36-3869459

FORM 990 INCOME AND COST OF GOODS SOLD STATEMENT 3 INCLUDED ON PART I, LINE 10

INCOME 1. GROSS RECEIPTS 14 2. RETURNS AND ALLOWANCES 3. LINE 1 LESS LINE 2 4. COST OF GOODS SOLD (LINE 15) 14 5. GROSS PROFIT (LINE 3 LESS LINE 4) COST OF GOODS SOLD

14

8. INVENTORY AT BEGINNING OF YEAR 9. MERCHANDISE PURCHASED 14 10. COST OF LABOR 11. MATERIALS AND SUPPLIES 12. OTHER COSTS 13. ADD LINES 8 THROUGH 12 14 14. INVENTORY AT END OF YEAR 15. COST OF GOODS SOLD (LINE 13 LESS LINE 14). . 14

STATEMENT(S) 3


FORM 990 OTHER CHANGES IN NET ASSETS OR FUND BALANCES STATEMENT 4

DESCRIPTION 1994 FINANCIAL STATEMENTS RESTATED FOR ADDITIONAL TRAVEL EXPENSES TOTAL TO FORM 990, PART I, LINE 20

AMOUNT

<7,243.> <7,243.>

FORM 990

rOTAL TO FM 990, LN 43

OTHER EXPENSES STATEMENT

DESCRIPTION (A)

TOTAL (B)

PROGRAM SERVICES

(C) MANAGEMENT AND GENERAL

(D) FUNDRAISING

BANK CHARGES 318. 318 DUES & SUBSCRIPTIONS 461. 461. 8,000. 382. 155. 84.

MANAGEMENT FEE NEWSLETTER OFFICE EXPENSE OTHER TAXES MISCELLANEOUS

8,000. 343. 382. 155. 84.

343. 461.

8,000. 382. 155. 84. PROMOTION

RAFFLE PRIZES & 20,172. 20,172.

461. 8,000. 382. 155. 84.

AWARDS VIDEOS FOOD INSURANCE

21,300. 12,740. 12,018.

311. 12,740.

311.

21,300. 12,018.

76,284. 33,255 9,711. 33,318,

ORM 990 STATEMENT OF ORGANIZATION'S PRIMARY EXEMPT PURPOSE PART III

STATEMENT

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

STATEMENT(S) 4, 5, 6

SAVE A LIFE FOUNDATION, INC. 36-3869459 FORM 990 STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS

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 7

GRANTS TO FORM 990, PART III, LINE A

EXPENSES 62,445

FORM 990 DEPRECIATION OF ASSETS NOT HELD FOR INVESTMENT STATEMENT 8

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

COST OR OTHER BASIS ACCUMULATED

DEPRECIATION

17,406 7,091

BOOK VALUE 2 , 1 2 0 . 9 5 4 . 1 ,166 . 2 , 2 3 6 . 1 , 2 5 8 . 9 7 8 .

1 2 , 3 0 7 . 4 , 7 7 3 . 7 , 5 3 4 . 7 4 3 . 1 0 6 . 637 .

10,315.

STATEMENT(S) 7, 8

foim 4562 Department of the Treasury Internal Revenue Service (99)

Depreciation and Amortization (Including Information on Listed Property)

►• Attach this farm to your return. 990 Namefc) shown on return

Business or activity to which this torn reuiu

OMB No 1545-017J

1995

FORM 990 PAGE 2

Attachment Sequence No 67

Identifying number

36-3869459

(a) Description or property (b)Co»l

_. 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 ► !""»"

1

SAVE A LIFE FOUNDATION, INC. l ™ 1 E"*I"TTn ?.""" Certa'n Tan9""e Pfoperty (secl"'n 179) (Note:"vfl"have antf ,Lis,ed PMm c ° " » - v * * ^ = ~ , > 1 Maximum dollar limitation (If an enterprise 2one business, see instructions.) ' ^~ w w r 3 f I J i 2 Total cost of section 179 property placed in service durinp. the tax year 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 -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

17 ,500 ,

(c) Elected cost

$200.000

: v ^ ?<f-\

10 11 12

o„ 0 , ! f ; l 0 l 0 i , U S e P a 1 " or P a r t ' " b e l 0 w . ! ° f ,is.,ed proper ty ( » « ' « ™ l * « . « t a i n other vehicles, cellular telephones, certain computers or property used for entertainment, recreation, or amusement). Instead, use Part V for listed property. . « " • 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 ' ^ -.s

b 5-year property •* * f f \f v.

c 7-year property -> 'V *,, ', 743 . 7 YRS. HY 200DB 106. d 10-year property e 15-year property s> \ f 20-year property ' ' ' V

g Residential rental property / 27.5 yrs. MM S/l g Residential rental property 1 27.5 yrs. MM S/L

h Nonresidential real property [ 1 MM S/L h Nonresidential real property [ 1 . MM S/L I

16 a Class life Section C -Alternative Peprecialion System (ADS) (See instructions)

b 12-year c 40-year

l i f l j l l i l Other Depreciation (Do Wot Include Listed Properly)

12 yrs. 40 yrs. MM

S/L S/L S/L

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 ^ ^ ^ ^

17 3 , 4 0 5 . 18 19

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 f

the basis attributable to section 263A costs | LHA

20

21

For Paperwork Reduction Act Notice, see page 1 ol the separate Instructions. 22

3,511.

Form 4562 (1995)

Form 4562 (1995) Page

Entertainment, Recreation, or Amusement -^flf^Xl^SWg™ mi,ea0e ' a , e " d 8 d U C , i n ° l e a s e expense' c o m » l e , 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 have evidence to support the business/investment use claimed? I I Yat I I Hn

(a) Type of property


(b) Date placed in service

it) Business/

investment use percentage

24 Property used more than 50% in a qualified business use:

(d) Cost or

other basis

(e) Basis, for depreciation .(business/ investment use only)

23b If "Yes: is the evidence written? | | y P t | [ 0)

Recovery period

(9) Method/

Convention

(h) Depreciation deduction

No (•)

Elected section 179

cost

% % %

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

%

S/L-sn.< S/L-S/L-

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 1

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.

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

(a) Vehicle

(b) Vehicle

(c) Vehicle



34 is another vehicle available for personal use? ..

Yes No Yes No

(d) Vehicle

( B ) Vehicle

Yes No

(') Vehicle

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.) Do you treat all use of vehicles by employees as personal use? 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? Do you meet the requirements concerning qualified automobile demonstration use?

rJs&t^ZninZn > 0 3 5 ' 3 6 ' 3 7 ' 3 8 ' " " " " " nWi>"0tCOm°MBg^'"Mtt"«"^''^''''*''

37 38

39

Yes No

(a) Description of costs

(b) fOileiinortaion

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

Amortization of costs that began before 1995

<0 Amoftfnbt*

amount

(d) Coda

soction

(e) Amoffottoei

M Amortluliafl (of mil y«w

FornTAG990-iL CHARITABLE ORGANIZATION SUPPLEMENT CO # 0 1 - 0 2 6 , 4 9 8 . Revised 3/95 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 THE FISCAL PERIOD BEGINNING: 0 1 / 0 1 / 9 6 AND ENDING: 1 2 / 3 1 / 9 6 ARE CONTRIBUTIONS TO ORGANIZATIONS TAX DEDUCTIBLE? D O Yes □ No FEDERAL 10 NUMBER: I 3 6 - 3 8 6 9 4 5 9

LEGAL NAME SAVE A L I F E FOUNDATION, I N C . MAIL

ADDRESS 1 7 4 7 9 W. DARTMOOR DR. CITY. STATE GRAYSLAKE, I L

ZIPCOOE 6 0 0 3 0

DATE ORGANIZATION WAS CREATEO: A)ASSETS

B) LIABILITIES

C) ENDING FUND BALANCE

MO DAY YR 0 2 / 0 9 / 9 3

A) S 2 3 , 4 0 6 .

B) S 5 8 , 8 7 0 .

C) $ < 3 5 , 4 6 4 . >

I. SUMARY OF REVENUE ITEMS DURING THE YEAR: D) PUBLIC SUPPORT. CONTRIBUTIONS PROGRAM SERV. REV. (GROSS AMTS.)


F) OTHER REVENUES

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

FILE COPY PERCENTAGE

9 6 . 0 9 4 %

3 . 9 0 6 %

100%

AMOUNT D)$ 3 7 , 5 6 6 .

E) $ 1 , 5 2 7 .

F) $

G)$ 3 9 , 0 9 3 .

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

" "* '" • ''





M) FUNORAISING EXPENSE

N) TOTAL EXPENDITURES THIS PERIOD (ADO K, L. & M)

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


0) NET RECEIVED BY THE CHARITY (0 MINUS P=0)

IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS DURING THE YEAR:

R) NAME. TITLE: N O N E

S) NAME. TITLE:

T) NAME. TITLE: V. CHARITABLE PROGRAM DESCRIPTION:

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

PUBLIC EDUCATION BY MAIL

6 2 . 3 4 4 %

H)$

i) $ 3 3 , 9 3 8 .

JLL

62.344%

33.936%

3.720%

100%

K)$ 3 3 , 9 3 8 .

iLL 1 8 , 4 7 4 .

MJJL 2 , 0 2 5 .

NIX 5 4 , 4 3 7 .

100 % 0)$

%

£!L

QLt

BLL

U S

I I I

V) DESCRIPTION:

W) DESCRIPTION: OTHER EDUCATIONAL MATERIALS FOR THE PUBLIC

CODE U)#

010 V) I

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

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

8. HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAO ITS REGISTRATION SUSPENDED OR REVOKED? 8.

9. DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER? 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

YES NO

X

X

X

X

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

SUBSCRIBED AND SWORN TO BEFORE ME. THIS DAY OF

CAROL SPIZZIRRI PRESIDENT or TRUSTEE (PR.NT NA....

.19 TREASURER or TRUSTEE (PRINT NAME)

i • It DATE

SIGNATURE DATE

(NOTARY PUBLIC) •"(NOTARIZATION RE

STEPHEN J . COLE SIGNATURE OF PREPARER PRINT NAME

2 30805 SAVE50 070 SAVE A LIFE FOUNDATION, INC. SAVE50 1

Form 990 Department ol Ihe Treasury Internal Revenue Service

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.

3MB No 1S4S-0047

1996 This Form Is Open to Public Inspection

A For the 1996 calendar year, OR tax year period beginning , 1996. and ending .19 D Chech If:

□Change °L address

□Initial return

□ Final return

□ A m e n d e d return

[teoHtdiso

icpo «>

Please use IRS label or print or type. See Specific Instructions.

C Name of organ iiation

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

17479 W. DARTMOOR DR. Room/suite

City, town, or post office, state, and ZIP code SRAYSLAKE, I L 60030

O Employer identification number


01-026,498 F Check if exemption

application is pending G Type of organization - ► Q D Exempt under 501(c) ( 3 )<4 (insert number) OR ► □ section 4947(a)(l) nonexempt chartitable trust Note: Section S01 (c)(3) exempt ornanlzatlons and 4947(a)(1) nonexemptcharitable trusts MUST attach a completed Schedule A (Form 090). H(a) is this a group return filed for affiliates? C U Yes Q O No

(b) If "Yes.* enter the number of affiliates for which this return is filed: ►

( t ) Is Iha a separate return Bled ay in organiiilion covered by a group ruling? □ Yes [EH No

I If either box in H Is checked "Yes,* enter four-digit group exemption number (GEN) ► _

J Accounting method: I X I Cash I I Accrual □ Other (specify) ►

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 o 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. No o H I U Revenue, Expenses, and Changes in Net Assets or Fund Balances 1 Contributions, gifts, grants, and similar amounts received:

a Direct public support 1a 3 7 , 5 6 6 .

: ■ ■■

id

b Indirect public support 1b

: ■ ■■

id

c Government contributions (grants! 1c : ■ ■■

id d 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 . ) : ■ ■■

id 3 7 , 5 6 6 . 2 Program service revenue Including government fees and contracts (from Part VII, line 93) 3 Membership dues and assessments 2 Program service revenue Including government fees and contracts (from Part VII, line 93) 3 Membership dues and assessments 3 1 , 5 2 7 . 4 Interest on savings and temporary cash investments 5 Dividends and interest from secu rities

4 4 Interest on savings and temporary cash investments 5 Dividends and interest from secu rities 5 6 a Gross rents 6a

; ■ ■ ' .

b Less: rental expenses 6b

; ■ ■ ' .

c Net rental income or (loss) (subtract line 6b Irom line ( 7 Other investment income (describe ►

ia)

; ■ ■ ' .

a c c Net rental income or (loss) (subtract line 6b Irom line (

7 Other investment income (describe ► ) 7 0 > 8 a Gross amount from sale of assets other

than inventory (A) Securities (B) Other

--'«•■ r'.'

':'■ ■-. ~

a 8 a Gross amount from sale of assets other

than inventory 8a --'«•■ r'.'

':'■ ■-. ~ b Less: cost or other basis and sales expenses c Gain or (loss) (attach schedule)

8b

--'«•■ r'.'

':'■ ■-. ~ b Less: cost or other basis and sales expenses c Gain or (loss) (attach schedule) 8c

--'«•■ r'.'

':'■ ■-. ~

d Net gain or (loss) (combine line 8c, columns (A) and (I 9 Special events and activities (attach schedule):

a Gross revenue (not including $

))

--'«•■ r'.'

':'■ ■-. ~

d Net gain or (loss) (combine line 8c, columns (A) and (I 9 Special events and activities (attach schedule):

a Gross revenue (not including $ of contributions :<:': :'■•■■'.

9c

reported on line la) . . . . 9a :<:': :'■•■■'.

9c b Less: direct expenses other than fundraising expenses c Net income or (loss) from special events (subtract line

10 a Gross sales of inventory, less returns and allowances rj Less: cost of aoods sold

9b

:<:': :'■•■■'.



3b from line 9a) . .

:<:': :'■•■■'.



10a * • * . : ' ■ •

10c

b Less: direct expenses other than fundraising expenses c Net income or (loss) from special events (subtract line

10 a Gross sales of inventory, less returns and allowances rj Less: cost of aoods sold 10b

* • * . : ' ■ •

10c c Gross profit or (loss) from sales of inventory (attach schedule) (subtract line 10b from line 1 11 Other revenue (from Part VII, line 103)

Oa)

* • * . : ' ■ •

10c c Gross profit or (loss) from sales of inventory (attach schedule) (subtract line 10b from line 1 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) 3 9 , 0 9 3 . 13 Program services (from line 44, column (B)) 3 3 , 9 3 8 .

in 14 Management and general (from line 44, column (C)) 15 Fundraising (from line 44, column (0)) .

1 8 , 4 7 4 . c

14 Management and general (from line 44, column (C)) 15 Fundraising (from line 44, column (0)) . 2 , 0 2 5 .

K Ul 16 Payments to affiliates (attach schedule) 17 Total expenses (add lines 16 and 44. column (A)) 5 4 , 4 3 7 . 1B Excess or (deficit) for the year (subtract line 17 from line 19 Net assets at beginning of yea r (from line 73, column (A 20 . Other changes in net assets (attach explanation)

12) < 1 5 , 3 4 4 . >

«f 1B Excess or (deficit) for the year (subtract line 17 from line 19 Net assets at beginning of yea r (from line 73, column (A 20 . Other changes in net assets (attach explanation)

I) < 2 0 , 1 2 0 . >

H 1B Excess or (deficit) for the year (subtract line 17 from line 19 Net assets at beginning of yea r (from line 73, column (A 20 . Other changes in net assets (attach explanation) 20 0 . 21 Net assets or fund balances at end of year (combine lines IB, 19. and 20) -21 . < 3 5 , 4 6 4 . >

LHA For Paperwork Reduction Act Notice, see page 1 ol the separate Instructions. B230O1 2 12-1396 OORflS S A V E 5 0 0 7 0 SAVE A LIFE FOUNDATION, I N C .

Form 990 (1996)

SAVE50 1

form 990 099*)

TEEfflW Statement of Functional Expenses

SAVE A LIFE FOUNDATION. INC. 36-3869459 Page2

Oo not include amounts reported on line 6b. Bb, 9b, 10b. or 16 of Part I.

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.

22

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

Grants and allocations (attach schedule) caah $ noncash $

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 tundraising 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):

22 23

(A) Total

24 25 26 27 28 29

0 .

(B) Program services

30 31 32 33 34 35

(C) Management and general (0 ) Fundraising

1 , 1 5 0

3 , 6 1 9 .

36 37 38 39 40 41

1 , 9 5 4 1 , 2 0 0 .

2 , 1 7 1 1 , 9 5 4

4 , 6 2 0 1 0 , 5 4 9 .

4 , 6 2 0

1 , 1 5 0

1 , 4 4 8 .

1 , 2 0 0

3,372

42

43a 43b

B SEE STATEMENT 2 44 Total functional axpenae* (taa line. 22 through 43)

Organization. completing columns (B)-(D), cany the**

43c

5 , 2 7 7 .

6 , 3 2 9 . 3,372

4 , 8 5 3

4 , 2 2 0

424

43d 43el 2 2 , 6 9 6 .

total* lo line. 13-18 44 I 5 4 , 4 3 7 .

1 0 , 6 3 9 .

3 3 , 9 3 8 .

1 0 , 0 3 2

1 8 , 4 7 4 . 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 $

[the amount allocated lo Management and general $

2 , 0 2 5 .

2 , 0 2 5 .

► □ Yes 1X1 No ; (ii) the amount allocated to Program services $

Statement of Program Service Accomplishments and (iv) the amount allocated to Fundraising $

What is the organization's primary exempt purpose? ► S E E S T A T E M E N T 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.)

a SEE STATEMENT 4 '


(Required lor 501(4(3) and |4) org... and 4947(e)(1)

Iru.ta; but optional for other.)

(Grants and allocations $ 3 3 , 9 3 8 .



i Other program services (attach schedule) Total ol Program Service Expenses (should equal line 14. column (8). Program services)

(Grants and allocations S (Grants and allocations $ 1L

101 13-96

nprm

3 3 , 9 3 8 ,

savKsn 0 7 0 SAVE A LIFE FOUNDATION, INC. SAVE50 1

http://mu.iao.o1B

Form990(1996) SAVE A L I F E FOUNDATION, I N C . 3 6 - 3 8 6 9 4 5 9 Page3 Balance Sheets

Note: Where required, attached schedules and amounts within the description column should be for end-of-year amounts only.


(B) End of year

45 Cash - non-interest-bearing 1 , 0 9 6 • 45 7 , 1 6 7 . 46 Savings and temporary cash investments 46

47 a Accounts receivable 47a 47e b Less: allowance tor doubtful accounts

48 a Pledges receivable b Less: allowance for doubtful accounts

47b 47e b Less: allowance tor doubtful accounts


48a 48c

b Less: allowance tor doubtful accounts

48 a Pledges receivable b Less: allowance for doubtful accounts 48b 48c

49 Grants receivable 49 SO Receivables from officers, directors, trustees, and key employees (attach

schedule) SO Z 51 a Other notes and loans receivable 51a

sic a b Less: allowance for doubtful accounts 51b sic 52 Inventories for sale or use 52 53 Prepaid expenses and deferred charges 54 Investments - securities (attach schedule)

53 53 Prepaid expenses and deferred charges 54 Investments - securities (attach schedule) 54 55 a Investments - land, buildings, and

equipment: basis SSa

55c b Less: accumulated depreciation (attach

schedule) 55b 55c 56 Investments - other .. 56 57 a Land, buildings, and equipment: basis

b Less: accumulated depreciation S T M T 5 57a 2 8 , 6 0 6 .

1 0 , 3 1 5 . 57c 57 a Land, buildings, and equipment: basis

b Less: accumulated depreciation S T M T 5 57b 1 2 , 3 6 7 . 1 0 , 3 1 5 . 57c 1 6 , 2 3 9 . 58 Other assets (describe ► D E S I G N A T E D CJ \SH ) 8 , 4 7 7 . 58 0 .

59 Total assets (add lines 45 through 58) (must equal line 74) . . 1 9 , 8 8 8 . 59 2 3 , 4 0 6 . 60 Accounts payable and accrued expenses 60 61 Grants payable 61

8 62 Deferred revenue 62 •* 63 Loans from officers, directors, trustees, and key employees

64 a Tax-exempt bond liabilities

4 0 , 0 0 8 . 63 5 8 , 8 7 0 . .3

63 Loans from officers, directors, trustees, and key employees 64 a Tax-exempt bond liabilities 64a

b Mortgages and other notes payable 64b 65 Other liabilities (describe ► )

65 Total liabilities (add lines 60 throuah 65)

65 65 Other liabilities (describe ► )

65 Total liabilities (add lines 60 throuah 65) 4 0 , 0 0 8 . fiB 5 8 , 8 7 0 .

v> ti u

Organlzatloni thai follow SFAS 117, check here ► I X I and com 69 and lines 73 and 74

67 Unrestricted 66 Temporarily restricted

plete lines 67 through

< 2 0 , 1 2 0 . = ►67 < 3 5 , 4 6 4 . > c a

Organlzatloni thai follow SFAS 117, check here ► I X I and com 69 and lines 73 and 74

67 Unrestricted 66 Temporarily restricted

plete lines 67 through

0 . 66 0 . 3 69 Permanently restricted 0 . 69 0 . •o c 3 u. •> 0

Organliallons that do not lollow SFAS 117, check here ► I I and complete lines 70 through 74

70 Capital stock, trust principal, or current funds 70

1 71 Paid-in or capital surplus, or land, building, and equipment fund 72 Retained earnings, endowment, accumulated Income, or other ft JZ Total net assets or fund balances (add lines 67 through 69 OR

column (A) must equal line 19 and column (B) must equal line 2

mds .... ines 70 through 72;

D

71 <

71 Paid-in or capital surplus, or land, building, and equipment fund 72 Retained earnings, endowment, accumulated Income, or other ft JZ Total net assets or fund balances (add lines 67 through 69 OR



D

72 « z

71 Paid-in or capital surplus, or land, building, and equipment fund 72 Retained earnings, endowment, accumulated Income, or other ft JZ Total net assets or fund balances (add lines 67 through 69 OR



D < 2 0 , 1 2 0 . > 73 < 3 5 , 4 6 4 . > ' '4 Total liabilities and net assets / lund balances (add tin es66< ind 73) 1 9 , 8 8 8 . 1 74 2 3 , 4 0 6 .

13021 J-13-86

m o m ; c a v e r n 0 7 0 SftVE a T.TFF. FOUNDATION. TNC. S A V E 5 0 1

Form 990 (1996) Part IV-A

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

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


(1) Net unrealized gains on investments $ Donated services and use ol facilities $ Recoveries of prior yeargrants $ Other (specify):

(2)

0)

(«)

~N7A~

3 6 - 3 8 6 9 4 5 9 Page 4 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 F inanc ia l S t a t e m e n t s W i t h E x p e n s e s p e r R e t u r n

e d

(l)

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

Investment expenses not included on line 6b. Form 990 $.

|2) Other (specify):



(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 ..$


"N7A

c d

(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:

Investment expenses not included on line 6b, Form 990 ..$_


Add amounts on lines (1) and (2) I e Total revenue per line 12. Form 990

(line c plus line d) ^ I e

m-*nmm List of Officers, Directors, Trustees, and Key Employees (List each one even if not compensated)

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

(A) Name and address

CAROL SPIZZIRRI

174 79 W. DARTMOOR PR, GRAYSLAKE, IL


position PRESIDENT

(C) Compensation (II not paid, enter

(D)Contributiont to employes benefit pltnt&defMTSd

>benefit JelefToc

eornaeneatton

100 STEPHEN J . COLE TREASURER

17377 W. DARTMOOR PR, GRAYSLAKE, IL SANDY ENGBER

17593 W. DARTMOOR PR, GRAYSLAKE, IL LEE JUNGKANS ~"

SECRETARY

0 .

O.

VICE PRES.

3320 W. BLUE MOUNP AVE, WAUWATOSA, WI

0 .


other allowances

7,864

0 .

0 .

0 .

0 .

0 .

0 .

0 .

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 QT] No

Form 990(1996} SAVE A L I F E FOUNDATION, INC 3 6 - 3 8 6 9 4 5 9 Page 5 Other Information Yes No

76 77

7Ba b

79

80 a

81 a

Oid the organization engage in any activity not previously reported to the IRS? It "Yes," attach a detailed description of each activity Were any changes made in the organizing or governing documents but not reported to IfiS? If "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 990-T for this year? N/A Was there a liquidation, dissolution, termination, or substantial contraction during the year? If "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 other exempt or nonexempt organization? 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 instructions for line 81 I 61 a I 0 <

b Did the organization file Form 1120-POL for this year? 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? 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 , O O P 83 a

b 84 a

b

85

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? If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? N / A 501(c)(4), (5), or (6) organizations, -a Were substantially all dues nondeductible by members? N / A . .

b Did the organization make only in-house lobbying expenditures of $2,000 or less? N / A 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.

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 in 851? NTA" 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 _ 501(c)(7) organizations. - Enter:

85c 85d B5e 851

N / A N/A N/A

"NTA"

86a 86b 87a

87b

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. (Oo not net amounts due or paid to other sources

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?

If "Yes," complete Part IX 89 a 501(c)(3) organizations. - Enter: Amount of tax paid during the year under:

section4911 ► 0^ ;sec t i on 4912 ► 0^ ;sec t i on 4955 ► 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 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

N/A "NTA" NTA N/A

0.

76 77

78a 78b 79

80a

81b

82a

83a 83b 84a

84b 85a B5b

85q

B5h

88

89b

► 0_ 0,

II The books are in care of ► CAROL S P I Z Z I R R I

Located at ► 174 79 W. DARTMOOR D R . , GRAYSLAKE, I L

Telephoneoo> 8 4 7 - 5 4 9 - 7 3 5 3

Zip +4 ► 6 0 0 3 0

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

'orm 990 (1996) SAVE A LIFE FOUNDATION, INC 3 6 - 3 8 6 9 4 5 9 Page 6

lyijeVill Analysis of Income-Producing Activities Enter gross amounts unless otherwise indicated

93 Program service revenue:

(a)

(b) (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



a b c d _ _ _ e

Unrelated business income

o ' * ' Business code

IB) Amount

Excluded by section SI?, 513. Q' 514

(C) Exclusion code

(0) Amount

104 Subtotal (add columns (fl).(D), and (E)) 105 TOTAL (add line 104. columns (B), (0). and (E))

O.

(E) Related or exempt function income

1 , 5 2 7 .

1 , 5 2 7 . 1 , 5 2 7 .

Hole: (Line 105 plus line 1d. Part I. should equal the amount on line 12. Part I.) pjSBMIII Relationship of Activities to the Accomplishment of Exempt Purposes Line No

T 94 MEMBERSHIP DUES - CORPORATE AND INDIVIDUALS

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),

I J J H I K I Information Regard ng Taxable Subsidiaries (Complete this Part HlneTes" box on 86 Is checked.) Name, address, and employer identification

number of corporation or partnership Percentage of

ownership interest

N/A % %

Nature of business activities

Please Sign Here

Paid Preparer's Use Only

673161 1M3-96 / i n an i

ja

Total income End-of-year assets

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

Signature of officer Date


Date W Type or print name and title

Check if self-employed

MARTIN, & it self-employed) ^ 7 3 0 1 N . LINCOLN

LINCOLNWOOD, IL

Firm's name (or yours C O L E ,

►i CO. , AVE. ,

LTD. 140

and address

► o Preparer's SSN

EIN

ZIP+ 4 60646 c A\7c«;n

8 070 RRVK A T.TFF. FOUNDATION, INC. SAVE50 1

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 Supplementary Information

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

Name of the organization SAVE A LIFE FOUNDATION, INC.

OMBNo 1S45-C047

1996 Employer identification number 36 3869459

Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees

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


position ,c, Compensation

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

(e) Expense account and other

allowances

N O N E _ _

Total number of other employees paid 0

Compensation of the Five Highest Paid Independent Contractors for Professional Services (See instruct ions. ) (List each one (whether Individuals orfirms.) (If there are none, ente "None.'))


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

c nwir«;n


nm .QM/P ft T.TFF. FOUNDATION. I N C . SAVE50 1

.Schedule A (Form 990) 1996 SAVE A LIFE FOUNDATION, INC. 3 6 - 3 8 6 9 4 5 9 PageZ

Statement About Activities Yes No

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. ► $

2

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. 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:



c Furnishing of goods, services, or facilities? .

2a

2b

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.) fjEiMEM Reason for Non-Private Foundation Status (See instructions.)

2c

2d

2e

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) A school. Section I70(b)(l )(A)(ii). (Also complete Part V, page 4.) A hospital or a cooperative hospital service organization. Section l70(b)(l)(A)(iii). A Federal, state, or local government or governmental unit. Section I70(b)(l )(A)(v). A medical research organization operated in conjunction with a hospital. Section 170(b)(1)(A)(iii). Enter the hospllal's name, city, and slate ► 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 170(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.)

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)

5 □ 6 □ 7 □ 8 □ 9 □

10 □ 11a □ 11b □ 12 (3

13 □

(a) Namefs) of supported organizational (b) Line number

from above

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 10

0 7 0 RAVE A T.TFK FOUNDATION. TNC SAVE50 1

Schedule A (Form 990) 1996 SAVE A LIFE 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 method of account ing. Note: You may use the worksheet in the instructions for converting from the accrual to the cash method of accounting

Calendar year (or fiscal year beginning In) (a) 1995 (b) 1994 (c) 1993 (d) 1992 (e) Total 1Q Gifts, grants, and contributions received.

(Do nol include unusual grants See line 28) 110,761 93,405. 7,199 211,365

16 Membership fees received 1,410 2,875 4 ,285 17 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

18 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

19 Net income from unrelated business activities not included in line 18

20 Tax revenues levied lot trie 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. Oo not include the value of services or facilities generally furnished to the public without charge

22 Other Income. Attach a schedule Oo not Include gain or (loss) from sale ol capital assets

23 Total of lines 15 through 22 1 1 2 , 1 7 1 9 6 , 2 8 0 . 7^199. 2 1 5 , 6 5 0 , 24 Line 23 minus fine 17 1 1 2 , 1 7 1 . 9 6 , 2 8 0 . ^ 1 9 9 . 2 1 5 , 6 5 0 . 25 Enter 1 % of line 23 1 , 1 2 2 . 9 6 3 . 7 2 .

"N7A" 26 Organizations described in lines 10 or 11:a Enter 2% of amount in column (e), line 24 ► 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 1992 through 1995 exceeded the amount shown in line 26a. Enter the sum of all these excess amounts ►

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

22 J Public support (line 26c minus line 26d total)

19 . 26b

I Public support percentage (line 26e (numerator) divided by line 26c (denominator))

26a

26b N/A

26c N/A

26d 26e 261

N/A "NTA" ~N7A"

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: IS $ 17 $ 20 $

Add: Line 27a total $ 0 .

2 1 1 , 3 6 5 . 16$ 21 $

and line 27b total $

4 , 2 8 5 .

o . ► ►

2 1 5 , 6 5 0 .

27c 2 1 5 , 6 5 0 . d

Add: Amounts from column (e) for lines: IS $ 17 $ 20 $

Add: Line 27a total $ 0 .

2 1 1 , 3 6 5 . 16$ 21 $

and line 27b total $

4 , 2 8 5 .

o . ► ►

2 1 5 , 6 5 0 .

27d 0 . e Public support (line 27c, total minus line 27d total)

Total support for section 509(a)(2) test: Enter amount on Public support percentage (line 27e (numerator] Investment income percentane (lino 18 column

line 23. column (e) ► 1 271 f S

4 , 2 8 5 .

o . ► ►

2 1 5 , 6 5 0 . 27e 2 1 5 , 6 5 0 .

1 Public support (line 27c, total minus line 27d total) Total support for section 509(a)(2) test: Enter amount on Public support percentage (line 27e (numerator] Investment income percentane (lino 18 column

line 23. column (e) ► 1 271 f S

4 , 2 8 5 .

o . ► ►

2 1 5 , 6 5 0 . 27fl g

Public support (line 27c, total minus line 27d total) Total support for section 509(a)(2) test: Enter amount on Public support percentage (line 27e (numerator] Investment income percentane (lino 18 column

divided by line 27f, (denominator)) ► e) (numerator) divided by line 271 (denominator)) ►

27fl 100% h

Public support (line 27c, total minus line 27d total) Total support for section 509(a)(2) test: Enter amount on Public support percentage (line 27e (numerator] Investment income percentane (lino 18 column

divided by line 27f, (denominator)) ► e) (numerator) divided by line 271 (denominator)) ► 27h .0000%

•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

0 7 0 SAVE A T.TFR FOUNDATTON. I N C . SAVE50 1

Schedule A (Form 990) 1996 T T 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)

3 6 - 3 8 6 9 4 5 9 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.)

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.)

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?

g Athletic programs? h Other extracurricular activities?


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?

If you answered "Yes" to either 34a or b, please explain using an attached statement. 15 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

N/A

29

30

Yes

31

32a

32b

32c 32d

33a 33b 33c 33d 33e 331 33o 33h

34a 34b

36

No

1131 »fr96 ">nn«; savR^n

12 0 7 0 SAVR A T.TFR FOUNDATION. INC. SAVE50 1

Schedule A (Form 990) 1996 Part Vl-A

SAVE A LIFE FOUNDATION, INC. 36-3869459 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)

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 20M ot the amounl on lino 40

Over $500,000 bul not over 11.000,000 $100.000 pus 15« ol lite excess over $500,000

Over SI ,000,000 but not over Si .£00.000 S17S.000 plus 10H ol the excess over S1,000,000

Over SI.SOO.OOO out not over $17,000.030 $225,000 plus 9 W ol the excess over S1.9O0.O0O

OverS17,000,000 $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 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.

N/A

36 37 38 39 40

41

42 43 44

U) Affiliated group totals

N/A

(b) To be completed for ALL

electing organizations

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 N/A Calendar year (or fiscal year beg Inning in) ►

(a) 1996

(b) 1995

(c) 1994

«0 1993

(e) Total

45 Lobbying nontaxable amount 0 .

46 Lobbying ceiling amount (150% of line 45(e)) 0 .

47 Total lobbying expenditures 0 .

46 Grassroots nontaxable amount 0 .


- > \ • - 0 . SD Grassroots lobbying

expenditures 0 . Part Vi-B Lobbying Activity by Nonelecting Public Charities

(For reporting only by organizations that did not complete Part Vl-A) N/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 Ihrough 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, theirstaffs, 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' lo any of the above, also attach a statement giving a detailed description of the lobbying activities.

Yes No Amount

623141 12 16 36

f l A n o n e CnVFRO 13 070 SAVE A LIFE FOUNDATION, INC. SAVE50 1

Schedule A (form 990} 1996 SAVE A L I F E FOUNDATION, I N C . 36-3869459 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: (i) Sales of assets to a noncharitable exempt organization

(if) Purchases of assets from a noncharitable exempt organization (Hi) Rental of facilities or equipment (Iv) Reimbursement arrangements (») Loans or loan guarantees (vl) Performance of services or membership or fundraising solicitations

e Sharing of facilities, equipment, mailing lists, other assets, or paid employees 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 received-

Page 6

Yes No Sia(l) X a(ii) X

b(l) X b(ll) X b(lll) X b(lv) X b(v) X b(vl) X

c X

(a) Line no

(b) Amount involved

(e) Name of noncharitable exempt organization

N / A (d)


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 [K]No

(a) Name of organization

(b) Type of organization Description of relationship

S23191 12-16-96 inRrm RAVRSn 0 7 0

14 SAVR A T.TFK FOUNDATION. I N C . SAVE50 1


ORM 990 OTHER EXPENSES STATEMENT

ASCRIPTION

SANK CHARGES )UES & SUBSCRIPTIONS )UTSIDE SERVICES INSURANCE )FFICE EXPENSE )THER TAXES IAFFLE PRIZES & VWARDS iRT WORK AND SUPPLIES

?OTAL TO FM 9 9 0 , LN 4 3

(A) (B) (C) (D) PROGRAM MANAGEMENT

TOTAL SERVICES AND GENERAL FUNDRAISING 69. 69. 11. 11.

12,648. 7,589. 5,059. 1,850. 1,850. 3,035. 3,035.

8. 8. 2,025. 2,025. 3,050. 3,050.

2 2 , 6 9 6 . 1 0 , 6 3 9 1 0 , 0 3 2 2 , 0 2 5 .

'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.

16 STATEMENT(S) 2 , 3 fiinnfln"; KAVP.SO 070 SAVE A LIFE FOUNDATION, INC. SAVE50_1


ORM 990 STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS 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 EXPENSES 0 FORM 990, PART III, LINE A 33,938.

DRM 990 DEPRECIATION OF ASSETS NOT HELD FOR INVESTMENT STATEMENT 5

COST OR ACCUMULATED 2SCRIPTION OTHER BASIS DEPRECIATION BOOK VALUE

W3ANIZATION COSTS 2 , 1 2 0 . 1 , 3 7 8 . 7 4 2 . ?FICE EQUIPMENT 2 , 2 3 6 . 1 , 5 3 7 . 6 9 9 . iTICE EQUIPMENT 1 2 , 3 0 7 . 6 , 9 2 5 . 5 , 3 8 2 . •TICE EQUIPMENT 7 4 3 . 2 8 8 . 4 5 5 . )PIER 8 , 0 0 0 . 1 , 6 0 0 . 6 , 4 0 0 . )MPUTER 1 , 5 0 0 . 3 0 0 . 1 , 2 0 0 . IINTER 5 0 0 . 1 0 0 . 4 0 0 . )MPUTER 1 , 2 0 0 . 2 4 0 . 9 6 0 .

)TAL TO FORM 9 9 0 , PART IV, LN 57 2 8 , 6 0 6 . 1 2 , 3 6 8 . 1 6 , 2 3 8 .

17 STATEMENT(S) 4, 5 " » ' " " : n A-7CI C7\T7E> A T T u p ETtMKinBTTflM TVJC fi&VFSn 1

Depreciation and Amortization Detail pQRM 990 PAGE 2 990

Description of property

Number Date placed

in service Method/ IRC sec.

Life or rate

Line No.

Cost or other basis

Basis reduction

Accumulated depreciation/amortization


: ORGANIZATION COSTS S 12,31,93 60M 4 1 2 , 1 2 0 . 1 9 5 4 . 4 2 4 .

iDFFICE EOUIPMENT :l l j l2 ,31,93 2 0 0 D B 7 . 0 0 1 7 2 , 2 3 6 . 1 , 2 5 B . 2 7 9 .

O F F I C E EQUIPMENT 0 6 . 3 0 . 9 4 2 0 0 D B I 7 . 0 0 17 1 2 , 3 0 7 . 4 , 7 7 3 . 2 , 1 5 2 .

A 3FFICE EQUIPMENT 06,30,95 2 0 0 D B I 7 . 0 0 1 7 7 4 3 . 1 0 6 . 1 8 2 .

c COPIER 0 1 | 1 5 | 9 6 2 0 0 D B 5 . 0 0 1 5 B 8 , 0 0 0 . 1 , 6 0 0 .

6 COMPUTER | 0 2 | 1 5 | 9 6 2 0 0 D B 5 . 0 0 15B 1 , 5 0 0 . | 3 0 0 .

7 PRINTER ^ | 0 2 , 1 5 , 9 6 2 0 0 D B 5 . 0 0 15B 5 0 0 . 1 0 0 .

t COMPUTER p 4 , 1 5 | 9 6 2 0 0 D B 5 . 0 0 1 5 B 1 , 2 0 0 . 2 4 0 .

* * TOTAL 9 9 0 PAGE 2 DEPRECIATION & AMORTIZATION 1 1 1 ' 2 8 , 6 0 6 . 7 , 0 9 1 . 5 , 2 7 7 .

, , 1

■:.11 , ,

i i

■m . ,

m\ , , i ,:.VV | |

■m . .

i i

iM , ,

ill , ,

%'i i i

N . . m , , 1 M , , 1 1

m . . m . . 1 1

m . . - 1 i . l

16261 1-22-88 ^nnRnR KAVRSO

# - Current year section 179 (0) ■ Asset disposed 18 070 SAVE A LIFE FOUNDATION, INC. SAVE50 1

fotm 4562 Department ol he Treasury Internal Revenue Sen/tec

Depreciation and Amortization (Including Information on Listed Property) 990

► Attach this form to your return. Nameis) shown on return

SAVE A LIFE FOUNDATION, INC.

OMB No 1545-017?

1996 Attachment Sequence No. 6 7

Business or activity lo which this form relates

FORM 9 9 0 PAGE 2

Identifying number

36-3869459 Part V belore you complete Part I. Election To Expense Certain Tangible Property (Section 179) (Note: If you have any listed property .'complete

1 Maximum dollar limitation. If an enterprise zone business, see instructions 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-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

17 ,500

$200,000

la) Description of properly (e) Cost (Dullness only)

7 Listed property. Enter amount from line 27 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 1995

(e| Elected cost

11 Business income limitation. Enter the smaller of business income (not less than zero) or line S 12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 13 Carryover of disallowed deduction to 1997. Add lines 9 and 10, less line 12

10 11 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

15 a 3-year property b 5-year property 1 1 , 2 0 0 . 5 YRS. HY 200DB 2 , 2 4 0 . c 7-year property d 10-year property e 15-year property f 20-year property g 25-year property 25 yrs. S/L

h Residential rental property / 27.5 yrs. MM S/L h Residential rental property / 27.5 yrs. MM S/L / MM S/L / MM S/L

Section C • Alternative Depreciation System (ADS) (See instructions.) 16 a Class life S/L

b 12-year 12 yrs. S/L c 40-year / 40 yrs. MM S/L

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

17 18 19

2 , 6 1 3

20 Listed property. Enter amount from line 26 20 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 21 4 , 8 5 3 . 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.

'» 19 ' n o o n * R B V P S n 0 7 0 RAVK A T.TFE FOUNDATION. INC

Form 4562 (1996)

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.) 23a Do you have evidence to support the business/investment use claimed? I "1 Yes I I No




(c) Business/


(d) Cost or

other basis

<e) Basil (or depreciation (buitness/mveslmcnt

use only)

23blf 'Yes.' is the evidence written? I I Yes P H No (0

Recovery period

(9) Method/

Convention


(i) Elected

section 179 cost

24 Property used more than 50% in a qualified business use %

J L % %

25 Property used 50% or less in a aualified business use: % S/L- ^SM:0-:M-% S/L- ^^M&ti&M % S/L- îilmM'mi} % S/L- M^SmM^

26 Add amounts in column (h). Enter the total here and on line 20. page 1 26 &£££&■ ^:->. 27 Add amounts in column (i). Enter the total here and on line 7, page 1 27

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. 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.

28 Total business/investment miles driven during the (a)

Vehicle (b)

Vehicle (c)

Vehicle (d)

Vehicle (e)

Vehicle (f)

Vehicle

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 No Yes No Yes No Yes No Yes No Yes No



34 Is another vehicle available for personal

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.


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.

Yes No

Amortization

a 1-96

(a) Description ol costs

(b) Oifctmoruiecn

beomj

(c) Amort n« bio

amount

(d) Codo

section

(e) Arwttltion

peitcd Of pcrcenBgt

(f) Amortization for this year

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

41 Amortization of costs that began before 1996 41 4 2 4 . 42 Total. Enter here and on "Other Deductions' or "Other Expenses" line of your return 42 4 2 4 .

C M r r c n m n 20

KBVF n I.TFR FntJNDATTON. INC. S A V E 5 0 1

CO* 0 1 - 0 2 6 , 4 9 8 Fotm AG990-IL CHARITABLE ORGANIZATION SUPPLEMENT Revised 3/9S Attorney General JIM RYAN State of Illinois

Charitable Trust and Solicitations Bureau, 100 West Randolph Street, 11th Floor, Chicago, Illinois 60601-3175 M0 0AY YR M0 DAY YR

REPORT FOR THE FISCAL PERIOD BEGINNING: 0 1 / 0 1 / 9 7 AND ENDING: 1 2 / 3 1 / 9 7 ARE CONTRIBUTIONS TO ORGANIZATIONS TAX DEDUCTIBLE? Q D Yes □ No FEDERAL ID NUMBER: # 3 6 ^ 3 8 6 9 4 5 9

LEGAL NAME SAVE A LIFE FOUNDATION, INC. MAIL

ADDRESS 4 8 2 5 N. SCOTT STREET, NO. 74A CITY,STATE SCHILLER PARK, IL m,,;

ZIPCOOE 60176 RECEIVI-rY 1 , ' - v ^ t - i V COVWDING FUND

J BALANCE

DATE ORGANIZATION WAS CREATED:

A) ASSETS

I LIABILITIES

3CP 1 8 1998

MO DAY YR 02/09/93

A) $ 31,060.

B) $ 60 ,070 .

C) $ <29 ,010 . ;

I. SUMARY OF REVENUE ITEMS DURING THE YEAR: D) PUBLIC SUPPORT. CONTRIBUTIONS PROGRAM SERV. REV. ( G R O S S ^ M T & R N E Y G E N E R A L

CHARITABLE TRUST E) GOVERNMENT GRANTS & MEMBERSHIP DUES

F) OTHER REVENUES

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

II- SUMMARY OF EXPENDITURES DURING THE YEAR:




K) TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD H. I & J)


M) FUNORAISING EXPENSE


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)

PERCENTAGE 99.460%

AMOUNT D)$ 101 ,330

0.540%

100 %

E) $ 5 5 0 .

F) $

G)$ 1 0 1 , 8 8 0 .

68.107% HLL 6 4 , 9 9 2 .

i) $

J) $

68.107.; %

24.332%

7.561%

K)$ 6 4 , 9 9 2

US 2 3 , 2 1 9

M)$ 7 , 2 1 5 .

100% Iws 9 5 , 4 2 6 .

100 %

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

0)S

P)S

QLL

IRIS

S) NAME. TITLE.

T) NAME. TITLE:

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

S) $

ILL

CODE

V) DESCRIPTION:

W) DESCRIPTION:

U) f

V) t

W)#


1. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION. FINE. PENALTY OR JUDGMENT'

2. 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?

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 REPORTEO AS COMPENSATION?

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

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

6. DID THE ORGANIZATION ALLOCATE THE COST OF ANY MAILING, ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNORAISING EXPENSES?

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

8. HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION SUSPENDED OR REVOKED?

9. DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER?

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:

GRAND NATIONAL BANK, GURNEE, IL

. 12. NAME AND TELEPHONE NUMBER OF CONTACT PERSON: CAROL S P I Z Z I R R I 8 4 7 - 9 2 8 - 9 6 8 3

YES

5.

7.

8.

9.

10.1

NO

X

X

X

X

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 \ - uli. 2\1-"X SUBSCRIBED AND SWORN TO BEFORE ME. THIS DAY OF

,-..... SIGNATURE DATE

.19 TREASURER or TRUSTEE (PRINT NAME) SIGNATURE DATE

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

STEPHEN J . COL] SIGNATURE OF PREPARER (PWN . _ ^ , „ . . ^ DATE

97


Form 990 Department ol Iht Treasury Internal Revenue Service

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

A For the 1997 calendar year. OR tax year period beginning p Check if

OMBNo. 1S45-0M7

1997 This Form is Open to Public Inspection

admosi

□Initial return

□ F i n a l return

□ A "I Amended Jretum

uirednso lot State reportna)

G Type of organization

1997, and ending

Please use IRS label ar print or type See Specific Instructions.


[SAVE A L I F E F O U N D A T I O N , I N C . Number and street (or P.O. box if mail is not delivered to street address)

4825 N. SCOTT STREET Room/suite 74A

City, town, or post office, state, and ZIP+4 S C H I L L E R P A R K , I L 6 0 1 7 6

19 0 Employer identification number


0 1 - 0 2 6 , 4 9 8

l_XJ Exempt under 501(c) ( 3 H (insert number) OR ► ! 1 section 4947(a)(1) nonexempt chartitable trust

F Check ► C D if exemption application is pending

Note: Section 501(c)(3) exempt organizations and 4947(a)(1) nonexempt charitable trusts M U S T attach a completed Schedule A (Form 990) H(a) Is this a group return filed for affiliates? C Z l Yes I X I No

(b) If "Yes.* enter the number of affiliates for which this returnisWed: ►

(C) Is this o separate, return filed by an organisation covered by a group ruling? □ Yes [ g No

If either box in H is checked "Yes,* enter four-digit group exemption number (GEN) ► Accounting method: I X I Cash I I Accrual □ 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

a b c d

2 3 4 5 6 a

b

c

7

8 a

b

c

d

Revenue, Expenses, and Changes in Net Assets or Fund Balances Contributions, gifts, grants, and similar amounts received: Direct public support l a Indirect public support l b Government contributions (grants) 1c Total (add lines 1a through 1c) (attach schedule of contributors) S T M T 1 (cash$ 2 7 , 8 3 5 . noncash$ 7 3 , 4 9 5 . )

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

1 0 1 , 3 3 0 .

STMT 2

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 or other basis and sales expenses Gain or (loss) (attach schedule)

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)

6a 6b

id

(A) Securities

8a 8b 8c

(B) Otter

6c

of contributions

b c

10 a b c

11 ■12

9a 9b

10a 3 , 3 3 9 .

Less: direct expenses other than fundraising expenses

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

Gross profit or (loss) from sales of inventory (attach schedule) (subtract line 10b from line 10a) S T M T 3 Other revenue (from Part VII. line 103) Total revenue (add lines 1d,2.3.4.5.6c.7.8d.9c, 10c, and 11)

Bd

10b 3 , 3 3 9 .

9c

10c 11 12

1 0 1 , 3 3 0

550 .

1 0 1 , 8 8 0 .

1 13 Program services (from line 44. column |B)) 14 Management and general (from line 44, column (C)) 15 Fundraising (from line 44, column (D)) 16 Payments to affiliates (attach schedule) 17 Total expenses (add lines 16 and 44. column (A)) .

13 14 15 16 17

6 4 , 9 9 2 2 3 , 2 1 9

7 , 2 1 5

9 5 , 4 2 6 2

18 Excess o r (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) .

18 19 20 21

6 , 4 5 4 . < 3 5 , 4 6 4 . >

< 2 9 , 0 1 0 . > LHA For Paperwork Reduction Act Notice, see page 1 ol the separate instructions. 723001 2

230 902 75 8985 SAVE50 050 SAVE A LIFE FOUNDATION, INC. Form 990 (1997)

SAVE50 1

furm 990(199?) SAVE A LIFE FOUNDATION. INC 36-3869459 Paoe2 | j w | | | S t a t e m e n t o f AH organizations must complete column (A). Columns (B), (C). and (0) are required for section 501(c)(3) and UMiiMMlM F u n c t i o n a l E x p e n s e s (4) organizations and section 4947(a)[1) nonexempt charitable trusts but optional for others.

Do not include amounts reported on line 6b. 8b, 9b, 10b, or 16 of Parti. (A) Total (B) Program

services (C) Management

and qeneral (0) Fundraising 22 Grants and allocations (attach schedule)

cash S noncash S 22

0 .

23 Specific assistance to individuals (attach schedule) 23

0 . 24 Benefits paid to or for members (attach schedule) 24

0 . 25 Compensation of officers, directors, etc. 25 0 . 0 . 0 . 0 . 26 Other salaries and wages 26 27 Pension plan contributions 27 28 Other employee benefits 28 29 Payroll taxes 29 30 Professional (und/aising fees 30 31 Accounting fees 31 32 Legalfees 32 33 Supplies 33 34 Telephone . 34 4 , 2 2 2 . 2 , 5 3 3 . 1 , 6 8 9 . 35 Postage and shipping 35 2 , 0 3 4 . 2 , 0 3 4 . 36 Occupancy 36 1 ,200 . 1 , 2 0 0 . 37 Equipment rental and maintenance 37 1 8 , 0 8 0 . 1 0 , 8 4 8 . 7 , 2 3 2 . 38 Printing and publications 38 3 , 8 9 3 . 3 , 8 9 3 . 39 Travel . 39 2 , 6 2 2 . 1 , 5 7 3 . 1 , 0 4 9 . 40 Conferences, conventions, and meetings 40 1 7 , 1 8 4 . 1 7 , 1 8 4 . 41 Interest 41 42 Depreciation, depletion, etc. (attach schedule) 42 9 , 3 0 8 . 8 , 8 8 4 . 4 2 4 . 43 Other expenses (itemize):

a 43a b 43b e 43e 0 13d e SEE STATEMENT 4 !3e 3 6 , 8 8 3 . 1 8 , 0 4 3 . 1 1 , 6 2 5 . 7 , 2 1 5 .

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

44 1 9 5 , 4 2 6 . 6 4 , 9 9 2 . 2 3 , 2 1 9 . 7 , 2 1 5 . Reporting of Joint Costs. - Did you report in column (B) (Program services) any joint costs from a combined educational campaign and _____ tundraising solicitation? ► I I Yes I X I 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 $ .

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.)


(Required for 501(c)(3) and (4) orgs, and4947(oXn

trusts; but optional far others.)

a SEE STATEMENT 6

(Grants and allocations $ 6 4 , 9 9 2 .



(Grants and allocations $ e Other program services (attach schedule) (Grants and allocations $ f Total of Program Service Expenses (should equal line 44. column (8). Program services) 64,992

723011 12-09-97

30902 758985 SAVE50 050 SAVE A LIFE FOUNDATION, INC, SAVE50 1

Form990(1997) S A V E A L I F E F O U N D A T I O N , I N C . 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.


(B) End of year

45 Cash - non-interest-bearing 7,167 • 45 6 , 7 1 9 . 46 Savings and temporary cash investments 46

47 a Accounts receivable

b Less: allowance for doubtful accounts 47a

47c

47 a Accounts receivable

b Less: allowance for doubtful accounts 47b 47c

48 a Pledges receivable 48a

48c b Less: allowance for doubtful accounts 48b 48c 49 Grants receivable 44 SO Receivables from officers, directors, trustees, and key employees (attach

schedule) 50 a SI a Other notes and loans receivable 51 a

51C * b Less: allowance for doubtful accounts 51b 51C 52 Inventories for sale or use 5? S3 Prepaid expenses and deferred charges 53 54 Investments - securities (attach schedule) 54 SS a Investments • land, buildings, and

equipment: basis b Less: accumulated depreciation (attach

schedule)

55a

55c

SS a Investments • land, buildings, and equipment: basis

b Less: accumulated depreciation (attach schedule) 55b 55c

56 Investments - other 56 57 a Land, buildings, and equipment: basis 1

b Less: accumulated depreciation S T M T 7 [ 58 Other assets (describe ►

57a I 4 6 , 0 1 6 . 1 6 , 2 3 9 . 57c

57 a Land, buildings, and equipment: basis 1 b Less: accumulated depreciation S T M T 7 [

58 Other assets (describe ► 57b 1 2 1 , 6 7 5 . 1 6 , 2 3 9 . 57c 2 4 , 3 4 1 .

57 a Land, buildings, and equipment: basis 1 b Less: accumulated depreciation S T M T 7 [

58 Other assets (describe ► » 58

59 Total assets (add lines 45 through 58) (must equal line 74) 2 3 , 4 0 6 . 59 3 1 , 0 6 0 . 60 Accounts payable and accrued expenses 6ft 61 Grants payable 61

s 62 Deferred revenue 6? IS 63 Loans from officers, directors, trustees, and key employees

64 a Tax-exempt bond liabilities 5 8 , 8 7 0 . 63 6 0 , 0 7 0 .

a 3

63 Loans from officers, directors, trustees, and key employees 64 a Tax-exempt bond liabilities 64a

b Mortgages and other notes payable 641) 65 Other liabilities (describe ► j 65

66 Total liabilities (add lines 60 throuoh 65) . . 5 8 , 8 7 0 . 66 6 0 , 0 7 0 .

8 c

Organizations that follow SFAS117, check here ► L X J and complete lines 67 through 69 and lines 73 and 74

67 Unrestricted

68 Temporarily restricted < 3 5 , 4 6 4 . : "67 < 2 9 , 0 1 0 . >

§

Organizations that follow SFAS117, check here ► L X J and complete lines 67 through 69 and lines 73 and 74

67 Unrestricted

68 Temporarily restricted 66 o ■o

>9 Permanently restricted


'0 Capital stock, trust principal, or current funds

69 § u. 0 o

>9 Permanently restricted


'0 Capital stock, trust principal, or current funds 70 s ■ 4 ■

M Paid-in or capital surplus, or land, building, and equipment fund '2 Retained earnings, endowment, accumulated income, or other fu

71 s ■ 4 ■

M Paid-in or capital surplus, or land, building, and equipment fund '2 Retained earnings, endowment, accumulated income, or other fu nds 72

z ' r3 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) < 3 5 , 4 6 4 . > 73 < 2 9 , 0 1 0 . >

7 4 Total liabilities and net assets / fund balances (add lin »66a nd73) 2 3 , 4 0 6 . 74 3 1 , 0 6 0 . 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


Form 990(1997) Part IV-A

SAVE A LIFE FOUNDATION, INC. Part IV-B Reconciliation of Revenue per Audited

Financial Statements with Revenue per Return

36-3869459


$_


(1) Net unrealized gains on investments

(2) Donated services and use of facilities

(3) Recoveries of prior yeargrants

(4) Other (specify): $

"N7A~

Add amounts on lines (1) through (4) c Line a minusline 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): $

► ►

Reconciliation of Expenses per Audited Financial Statements With Expenses per Return




(2) Prior year adjustments reported on line 20. Form 990 $

(3) Losses reported on line 20. Form 990 ...$


NTA

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 $


Add amounts on lines (1) and (2) I e Total revenue per line 12. Form 990

(line c plus line d) I

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

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


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


position PRESIDENT 100 TREASURER

SANDY ENGBER SECRETARY 17593 W. DARTMOOR PR, GRAYSLAKE, IL LEE JUNGKANS 8320 W. BLUE MOUND AVE, WAUWATOSA, WI

C) Compensation If not paid, enter

(D)ContnDuticns to emsioyee benef pran* 1 aafefln compensation

0 .


other allowances

VICE PRES.

0 .

0 .

0 .

0 .

0 .

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 FOUNDATION, INC i j f f lWi l Other Information

3 6 - 3 8 6 9 4 5 9 Page5 Yes No

76 77

78 a b

79

66 a

Did the organization engage in any activity not previously reported to the IRS? If 'Yes.' attach a detailed description ot 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. 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 990-T for this year? N/A Was there a liquidation, dissolution, termination, or substantial contraction during the year? If'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 other exempt or nonexempt organization? 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 b Did the organization file Form 1120-POL for this year?

81 a

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) | 82b I 6 , 0 0 0

85

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 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 501(c)(4), (5), or (6) organizations.-a Were substantially all dues nondeductible by members? N/A Did the organization make only in-house lobbying expenditures of $2,000 or less? N/A 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 Section 162(e) lobbying and political expenditures Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices Taxable amount of lobbying and political expenditures (line 85d less 85e) Does the organization elect to pay the section 6033(e) tax on the amount in 85f? N/A 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

501(c)(7) organizations. - Enter:

65c 85d 85e 851

N/A N/A N/A N/A

87

88

89 a

86a 86b 87a

87b

go i

Initiation fees and capital contributions included on line 12 Gross receipts, included on line 12. for public use of club facilities 501(c)(12) organizations. - Enter: a Gross income from members or shareholders Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) 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 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 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 List the states with which a copy ot this return is filed ► I L L I N O I S

N/A N/A N/A

N/A

► ►

76 77

78a 76b 79

80a

81b

82a

83a 83b

84b 85a 85b

85JL

851)

86

89b

b Number of employees employed in the pay period that includes March 12,1997 | 9Qp |

0 .

81 The books are in care of ►CAROL S P I Z Z I R R I Telephone no. ► 8 4 7 - 9 2 8 - 9 6 8 3

Locatedat^ 4825 N. SCOTT STREET, STE 74A, SCHILLER PARK, IL Z I P + 4 ► 6 0 1 7 6

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 92 N/A

► □

723041

2309902 7 5 8 9 8 5 SAVE50 050 SAVE A LIFE FOUNDATION, INC SAVE50 1

SAVE A LIFE FOUNDATION, INC. Form 990 (1997) ■asflimi Analysisof Income-Producing Activities

3 6 - 3 8 6 9 4 5 9 Pages

Enter gross amounts unless otherwise indicated.

93 Program service revenue: (a) (b) (c) (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



101 Net income or (loss) from special events 102 Gross profit or (loss) from sales ol inventory 103 Other revenue:

a b _ _ _ _ _ c d e


Business code

(B) Amount

Excluded by section 5:2, 513, or 514 (C)

Exclusion code

ID) Amount


5 5 0 .

L 1 _ _ 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.)

■sfcTiMiia Relationship of Activities to the Accomplishment of Exempt Purposes

0 . 5 5 0 . 5 5 0 .

Line No. T

94

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 "

■ifsnawj Information Regarding Taxable Subsidiaries (Complete this Part II the "Yes" box on 88 Is checked.) Name, address, and employer identification

number of corporation or partnership N7A

Please Sign Here

Paid Preparer's Ute Only

Percentage of ownership interest

%

%

Nature of business activities Total income End-of-year assets

k I _> V Signature of officer Date V

Preparer's _ t signature V

723161 1J05-97

230902

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 . L I N C O L N A V E . , 1 4 0 and address VLINCOLNWOOD, I L

Type or print name and title Check if Date sett- . , employed ► _ _ J

Preparer's SSN

EIN

758985 SAVE50 8 ZIP+ 4 ► 60646

050 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 Supplementary Information

►Must be completed by the above organizations and attached to their Form 990 (or Form 990EZ). Name of the organization


OMB No 1545 0047

1997 Employer identification number 36 3869459

IjfjUU 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") (a) Name and address of each employee paid

more than $50,000 (b) Title and average hours


(c) Compensation (d) Conlrioutions 10

employee benefit plans & tietafred compensation


allowances

NONE

Total number of other employees paid over$50.000

■JEHU! Compensation of the Five Highest Paid Independent Contractors for 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.*!)


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

230902 758985 SAVE50 050 SAVE A LIFE FOUNDATION, INC


SAVE50 1

Schedule A (Form 990) 1997 SAVE A L I F E FOUNDATION, INC

Statement About Activities 3 6 - 3 8 6 9 4 5 9 Page2

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:


Yes No

2a




2b

2c

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 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)

2d

Ze

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).

A school. Section 170(b)(1 )(A)(ii). (Also complete Part V. page 4.) A hospital or a cooperative hospital service organization. Section 170(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)(1)(A)(iii). Enter the hospital's name, city and state ►

6 7 6 9

□ □

10

11a

11b 12

□ □ □

13 □

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)

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 7 5 8 9 8 5 SAVE50 10

050 SAVE A LIFE FOUNDATION, INC, SAVE50 1

Schedule A (Form 990) 1997 SAVE A L I F E FOUNDATION, I N C . Part IV-A 3 6 - 3 8 6 9 4 5 9 Page3

Calendar year (or liscal year beginning In)

w-?p 0v.S c h e d u l e .JC o mP l? , e .o n ly. . i f v o u 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

15 Gifts, (pants, ana conlneutions received (Do not include unusual grants See imeZB)

(a) 1996

16 Membership tees received

17 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

3 7 , 5 6 6 . 1 , 5 2 7 .

(b) 1995

1 1 0 , 7 6 1 . 1 , 4 1 0 .

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 organization after June 30.1975

Jc) 1994

9 3 , 4 0 5 . 2 , 8 7 5 .

(d) 1993 (e) Total

7 , 1 9 9 . 2 4 8 , 9 3 1 . 5 , 8 1 2 .

19 Net income from un related business activities not included in line 18

20 T a* revenues levied lor tne organization's Benefit end either paid to it or expended on its behalf ..


2 2 Otner income Attach a schedule Oo not include gain or (loss) from safe of capital assets

23 Total of lines 15 through 22 24 Line 23 minus line 17 25 Enter 1% of line 23

3 9 , 0 9 3 . 3 9 , 0 9 3 .

3 9 1 .

1 1 2 , 1 7 1 . 1 1 2 , 1 7 1 .

1 , 1 2 2 .

9 6 , 2 8 0 . 9 6 , 2 8 0 .

9 6 3 .

7 , 1 9 9 7 , 1 9 9 .

26 Organizations described in lines 10 or 11: a Enter 2% ol amount in column (e). line 24 " ► 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>

72

254 ,743 2 5 4 , 7 4 3 ,

26a

26b

"NTA"

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

22 19 . 26b

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

27 Organizations described on line 12:

► > ►

26c

26d 26e 261

N/A

N/A

N/A "N7A~ N/A

0 .

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 . (,g94, 0 . ( 1 9 9 3 ) 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) 0 . ,,9941 0 . (,993, (1994)

Add: Amounts from column (e) for lines: ,5 17 20 '_

Add: Line 27a total 0 .

2 4 8 , 9 3 1 . 16 21

5 , 8 1 2

and line 27b total 0 . 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 Public support percentage (line 27e (numerator) divided by line 27f, (denominator))

L

_ ► __ ►

► 2 5 4 , 7 4 3 .

►

27c 27d 27e

17A 27h

0 .

2 5 4 , 7 4 3 . 0 .

2 5 4 , 7 4 3 .

100% .0000% — H Investment income percentage (line 18 column le) (numerator) divided bv line 27f (denominator

2 8 i/!J.Y?Val G ? n t , s ; For 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 ffie^S ^ — HONE 12-05-97 3 0 9 0 2 758985 SAVE50 11


Schedule A (Form 990) 1997 SAVE A LIFE FOUNDATION, INC. 3 6 - 3 8 6 9 4 5 9 Page4 Private School Questionnaire (To be completed ONLY by schools that checked the box on line 6 in Part IV) N/A

29

30

31

32

33

34 a b

35

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.)

29

30

31

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.)

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.)

32a

32b

32c 32d

33a 33b 33c 33d

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

33e 33f 33q 33h

34a 34b

35

Yes No

723131 12-04-97

1230902 7 5 8 9 8 5 SAVE50 12


Schedule A (Form 990) 1997 S A V E A L I F E F O U N D A T I O N , I N C . Part Vl-A

36-3869459 Lobbying Expenditures by Electing Public Charities (To be completed ONLY by an eligible organization that filed Form 5768)

Page5

N/A Check here ► a If the organization belongs to an affiliated group Check here ► b It you checked *a" above and 'limited control' provisions apply

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

(a) Affiliated group totals

(b) To be completed for ALL electing organizations

36 Total lobbying expenditures to influence public opinion (grassroots lobbying) 36 N/A

37 Total lobbying expenditures to influence a legislative body (direct lobbying) 37 38 Total lobbying expenditures (add lines 36 and 37) 38 39 Other exempt purpose expenditures 39 40 Total exempt purpose expenditures (add lines 38 and 39) 40 41 Lobbying nontaxable amount. Enter the amount trom the following table -

It the amount on line 40 is - The lobbying nontaxable amount is • Not over $500,000 .. . . . . . 20H of the amount on line 40 "\

41 Over $500,000 out not over $1,000,000 J 100.000 plus 15H oltneexcen over $500,000 I

41 Over $1,000,000 Djl rot over $1.600.000 S17S.000 plus 10% ol mo excess over $1,000,000 > 41 Over $1.500,000 bul not over $17.000.000 $225,000 plus 5% ol the excess over $1,500,000

Over $17,000,000 . $1,000,000 J

42 42 Grassroots nontaxable amount (enter 25% of line 41) 42 43 Subtract line 42 from line 36. Enter -0- if line 42 is more than line 36 43 44 Subtract line 41 from line 38. Enter -0- if line 41 is more than line 38 44

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


Lobbying Expenditures During 4-Year Averaging Period N/A Calendar year (or fiscal year beginning in) ►

(a) 1997

(b) 1996

(c) 1995

W 1994

(6) Total





49 Grassroots ceiling amount (150% of line 48(e)) 0 .

50 Grassroots lobbying expenditures 0 .

Part VI-B Lobbying Activity by Nonelecting Public Charities (For reporting only by organizations that did not complete Part Vl-A) N/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: Yes No Amount

a Volunteers \--im^**£m-. 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) :""::; 0 .

If "Yes" to any of the above, also attach a statement giving a detailed description of the lobbying activities.

723141 12-05-97

230902 758985 SAVE50 050 13

SAVE A LIFE FOUNDATION, INC SAVE50 1

Schedule A (form 990) 1997 SAVE A L I F E FOUNDATION, I N C . P j f n W l l l In format ion Renarrf inn Trancforc T » a n r i T r a n « 3 M i » n . »„,< D . v t ^ t i ^ o t . i p , y ^ p N o n c h a r i t a b l e

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) 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:

(i) Cash (ii) Other assets

b Other transactions: (i) Sales ot assets to a noncharitable exempt organization (ii) Purchases of assets from a noncharitable exempt organization (ill) Rental ol facilities or equipment (iv) Reimbursement arrangements (v) Loans or loan guarantees (vl) Performance of services or membership or fundraising solicitations

c Sharing of facilities, equipment, mailing lists, other assets, or paid employees 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.

Yes No 51a(i) X a('i) X

b(D X b(N) X b(lil) X b(iv) X b(v) X b(vi) X

« X

(a) Line no

(b) Amount involved

(c) Name of noncharitable exempt organization

N / A


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 QQ No

b It "Yes." complete the following schedule. N / A (a)

Name ot organization (b)

Type ot organization (c)

Description of relationship

_..

12-05-97

J3O902 758985 SAVE50 14 050 SAVE A LIFE FOUNDATION, INC SAVE50 1


'ORM 990 INCOME AND COST OF GOODS SOLD STATEMENT 3 INCLUDED ON PART I, LINE 10

NCOME . GROSS RECEIPTS 3,339 . RETURNS AND ALLOWANCES . LINE 1 LESS LINE 2 3,339 . COST OF GOODS SOLD (LINE 15) 3,339 . GROSS PROFIT (LINE 3 LESS LINE 4) OST OF GOODS SOLD . INVENTORY AT BEGINNING OF YEAR . MERCHANDISE PURCHASED 3,339 0. COST OF LABOR 1. MATERIALS AND SUPPLIES 2. OTHER COSTS 3. ADD LINES 8 THROUGH 12 3,339 4. INVENTORY AT END OF YEAR 5. COST OF GOODS SOLD (LINE 13 LESS LINE 14). . 3,339

17 STATEMENT(S) 3 230902 758985 SAVE50 050 SAVE A LIFE FOUNDATION, INC. SAVE50_1

SAVE A LIFE FOUNDATION, INC. 3 6 - 3 8 6 9 4 5 9

'ORM 990

ASCRIPTION

IANK CHARGES IUES & SUBSCRIPTIONS 'UTSIDE SERVICES NSURANCE FFICE EXPENSE THER TAXES AFFLE PRIZES & WARDS RT WORK AND UPPLIES ROMOTION EMINARS ISCELLANEOUS

DTAL TO FM 9 9 0 , LN 4 3

(A)

TOTAL

OTHER EXPENSES

(B) PROGRAM SERVICES

0 . 7 4 4 .

1 9 , 3 7 1 . 8 2 5 .

2 , 2 1 0 . 8 .

5 , 6 4 5 .

6 , 1 0 0 . 1 , 5 7 0 .

3 2 0 . 9 0 .

3 6 , 8 8 3 .

1 1 , 6 2 3

6 , 1 0 0

320 ,

1 8 , 0 4 3

(C) MANAGEMENT AND GENERAL

744 7 ,748 ,

825, 2 , 2 1 0 .

8.

90

1 1 , 6 2 5

)RM 990 STATEMENT OF ORGANIZATION'S PRIMARY EXEMPT PURPOSE PART I I I

STATEMENT

(D)

FUNDRAISING

5 , 6 4 5

1 , 5 7 0 .

7 , 2 1 5

STATEMENT

CPLANATION

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

30902 7 5 8 9 8 5 SAVE50 18 STATEMENT(S) 4 , 5



"ORM 990 STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS

JESCRIPTION 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.

STATEMENT

GRANTS D FORM 990, PART III, LINE A

EXPENSES 64,992.

DRM 990 DEPRECIATION OF ASSETS NOT HELD FOR INVESTMENT 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

' OR ACCUMULATED BASIS DEPRECIATION BOOK VALUE 2,120. 1,802. 318. 2,236. 1,737. 499. 12,307. 8,462. 3,845.

743. 418. 325. 8,000. 4,160. 3,840. 1,500. 780. 720. 500. 260. 240.

1,200. 624. 576. 8,000. 1,600. 6,400. 2,000. 400. 1,600.

850. 121. 729. 1,200. 240. 960. 2,698. 540. 2,158.

275. 55. 220. 1,937. 387. 1,550. 450. 90. 360.

46,016 21,676. 24,340.

30902 758985 SAVE50 19 STATEMENT(S) 6, 7 050 SAVE A LIFE FOUNDATION, INC. SAVE50 1

Depreciation and Amortization Detail p Q R M gQQ p A G E 2

Asset Number

1 ORGANIZATION COSTS

Description of property

Date placed

in service Method/ IRC sec.

Life or rate

Line No

Cost or other basis

Basis reduction

Accumulated depreciation/amortization

12,31,93 60M 41 OFFICE EQUIPMENT

2 , 1 2 0 . 1 , 3 7 8 .

12,31|93g00DB|7.00 [17 3OFFICE EQUIPMENT

2 , 2 3 6 . 1 ,537

06,30,94g00DBI7.00 |17 4 OFFICE EQUIPMENT

1 2 , 3 0 7 . 6 , 9 2 5 .

5 COPIER 06,30|95T200DB|7.00 |17 7 4 3 . 288

01il5|96|200DB[5.00 |17 6JCOMPUTER

02|15,96|20ODB|5.06~liT

8 , 0 0 0 . 1 , 6 0 0 .

7 PRINTER 1 , 5 0 0 . 300J

!02|15|96r200DB|5.00 |17 8POMPUTER

P4,15,96[200DB|5.00]lT

500 1 0 0 .

9 COPIER 1 , 2 0 0 . 240

01il5,97|200DB|5.00 I15B 10 COMPUTER

8,000 02|05,97|200DB[5.00 |15B

11 OFFICE EQUIPMENT 2 , 0 0 0 .

02,15,97I200DB7.00 |15C 12ICOMPUTER

]04,17,97|200DB|5.00 |15B

850

13COMPUTER 1,200.

J05|18|97|200DB|5.00 |15B 14|COMPUTER MONITER

06|07,97|200DB15.00 U5B|

2 , 6 9 8 ,

2 7 5 . 15ICOMPUTER

P8|01,97|200DB|5.00 |15B| 16PRINTER

1 , 9 3 7 .

11|10,97|200DB|5.00 |15"lf 4 5 0 . * TOTAL 990 PAGE 2 DEPRECIATION & AMORTIZATION

J L 4 6 , 0 1 6 . 1 2 , 3 6 8 .

J L

J L

eei 07-97 230902 758985 SAVE50

« • Current year section 179 (D) - Asset disposed

050 SAVE A LIFE FOUNDATION, INC

990


424 200

1,537

130 2,560

480, 160,

384 1,600,

400. 121.

240 540.

55. 387.

90. 9,308.

SAVE50 1

4562 Department of trie Treasury Internal Revenue Service

Depreciation and Amortization (Including Information on Listed Property)

► Attach this form to your return. 990

Namefs) shown on return Business or activity to which this form relates

OMBMo 1545-0172

FORM 990 PAGE 2 SAVE A LIFE FOUNDATION, INC. l l S m Election To Expense Certain Tangible Property (Section 179) (Note: 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 4 Reduction in limitation. Subtract line 3 from line 2. If 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

1997 Attachment Sequence No 6 7

Identifying number

36-3869459 If you have any 'listed property .'complete Part V before you complete Part I.)

1 8 , 0 0 0 ,

(a) Description of property (C) Cost (Business use onry)

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 Tentative deduction. Enter the smaller of line 5 or line B

10 Carryover of disallowed deduction from 1996 11 Business income limitation. Enter the smaller of business 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 1998. Add lines 9 and 10. less line 12

(c) Elected cost

$200,000

13

10 11 12

j 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 Section A - General Asset Account Election

(Do Not Include Listed Property.)

1 4 "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

15 a 3-year property b 5-year property c 7-year property d 10-year property

(b) Month and year placed

in service

e 15-year property f 20-year property

(e) Basis for depreciation (Business/investment use

only - see instructions) (d) Recovery

period

1 6 , 5 6 0 . 8 5 0 .

g 25-year property

h Residential rental property

Non residential real property

5 YRS, 7 YRS.

(e) Convention

HY HY

25 yrs. 27.S yrs. 27.5 yrs.

(0 Method

200DB 200DB

(0) Depreciation deduction

3 , 3 1 2 . 1 2 1 .

MM MM MM MM

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

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

b 12-year c 40-year

12 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

40 yrs. MM

S/L S/L S/L

17 18 19

5 , 4 5 1

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.

20

21 8,884.

30902 758985 SAVE50 21 050 SAVE A LIFE FOUNDATION, INC

Form 4562 (1997)

SAVE50 1

Form 4562 (1997) | j g | | ! | |Js ted Property _• Automobiles, Certain Other Vehicles, Cellular telephones, Certain Computers, and Property Used for

Page 2

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 limits for passanger automobiles.) 23a Do you have evidence to support the business/investment use claimed? C D Yes U3 No




__

(c) Business/


(d) Cost or

other basis

to Basis lor depredation (business/investment

use only)

23blf 'Yes.' is the evidence written? \_3 Yes E H No (0

Recovery period

(9) Method/

Convention


24 Property used more than 50% in a qualified business use

(i) Elected

section 179 cost

96 _%. % 96

25 Property used 5096 or less in a Qualified business use: % S/L- -•-. -:: : 96 S/L- - . : - ■ - : . - : r - -.-:: .

96 S/L- ■ ' . : ' . . . - . ■ ■ - ■ ■ ' : ' ; ; . . : ' ■ ' :

96 S/L-26 Add amounts in column (h). Enter the total here and on line 20, page 1 26 ;:\&iM-K:w:. •":".' 27 Add amounts in column (i). Enter the total here and on line 7, page 1 27

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.


Vehicle (b)

Vehicle (c)

Vehicle (d)

Vehicle (e)

Vehicle m

Vehicle 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 No Yes No Yes No Yes No Yes No Yes No



34 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 for vehicles used by employees who are not more than 596 owners or related persons.


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.

Yes

Amortization

No

1-98

(a) Description ol costs

(b) DtfctfflOftafion

btQins

(c) Amertizools

amount

id) Code

secbon

(e) Amgrtaton

period Of peonage

(0 Amortization tor tni» yew

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

41 Amortization of costs that began before 1997 41 4 2 4 . 42 Total. Enter here and on 'Other Deductions' or 'Other Expenses* line of your return 42 4 2 4 .

230902 758985 SAVE50 22



REPORT FOR THE FISCAL PERIOD BEGINNING

CO » 0 1 - 0 2 6 4 9 8 y CHARITABLE ORGANIZATION SUPPLEMENT

Attorney General JIM RYAN State ol Illinois Charitable Trust and Solicitations Bureau, 100 West Randolph Street, 12th Roor, Chicago. Illinois 60601

MO DAY YR MO DAY YR I 1 2 / 3 1 / 9 8 0 1 / 0 1 / 9 8

ARE CONTRIBUTIONS TO ORGANIZATION TAX DEDUCTIBLE? g Yes [J No AND ENDING:

LEGAL NAME S a v e a L i f e F o u n d a t i o n MAIL

ADDRESS 4 8 2 5 N. S c o t t S t r e e t #74A

CITY,STATE S c h i l l e r P a r k , IL ZIP CODE 6 0 1 7 6

FEDERAL ID NUMBER: # 3 6 - 3 8 6 9 4 5 9 DATE ORGANIZATION WAS CREATED:

A) ASSETS

B) LIABILITIES C) ENDING FUND

BALANCE

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)

II. SUMMARY OF EXPENDITURES DURING THE YEAR:

RECEXVfiO H) OPERATING CHARITABLE PROGRAM EXPENSE

APR 2 6 1399 I) EDUCATION PROGRAM SERVICE EXPENSE

CHARITABLE i RUST, J) GRANTS TO OTHER CHARITABLE ORGANIZATIONS ATTORNEY. GENERAL

K) TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD H, I, & J)




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)

PERCENTAGE 3.3984%

95.7795°/. 8221%

100 %

83.1506%

D) $ E) $ F) S G)S

83.1506%

15.6729%

H) s

I) s

J) $

K) S

1.17 65%

100 %

100 % % %


R) NAME.TITLE: CAROL S P I Z Z I R I - P R E S I D E N T

L) $

M)$

N) $

Q ) $ P) $ Q ) $

S) NAME, TITLE: STACY FON - SECRETARY T) NAME. TITLE: LINDA P I W I N S K I PROGRAM SCHED. COORDINATOR

V. CHARITABLE PROGRAM DESCRIPTION:

CHARITABLE PROGRAM (3 HIGHEST BY $ EXPENDED) CODE CATEGORIES (Ust on back side of inst.):

U) DESCRIPTION V) DECSRIPTION W) DESCRIPTION

L I F E SAVING FIRST AID TRAINING

R) $ S) $

)N MO DAY YR 0 2 / 0 9 / 9 3

A)$ 5 2 5 . 5 5 0 .

B)$ 8 7 , 8 3 0 .

C)S 4 3 7 . 7 2 0 .

AMOUNT 2 1 , 2 8 9

600 ,000 5 , 1 5 0 .

626 ,439

1 3 2 , 7 9 9

1 3 2 , 7 9 9 .

2 5 , 0 3 1

1 ,879 .

1 5 9 , 7 0 9

35 ,000 5 ,376

CODE u) * 011 V) » W)ff

IL9901 NTF4935 &ycc$/y -fy

Save a Life Foundation IL A.G990-IL (Revised 3/95)

36-3869459 Page 2


1 . WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION, FINE. PENALTY OR JUDGEMENT? 1.

2. 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? 4.


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

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

8. HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION

SUSPENDED OR REVOKED? 8

9. DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER? g.

10. DO YOU HAVE ANY KNOWLEDGE OF ANY THEFT, DEFALCATION, MISAPPROPRIATION. COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS? 1 0

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

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 S P I Z Z I R R I 8 4 7 - 9 2 8 - 9 6 8 3

YES NO

X

X

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 SPIZZIRRI PRESIDENT or TRUSTEE (PRINT NA»* M

UBSCRIBED AND SWORN 0 BEFORE ME. THIS AY OF

\ T --VTE m

T T C l I

.19

(NOTARY PUBLIC)

ILSS02

TREASURER or TRUSTEE (PRINT NAME)

•••(NOTARIZATION

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

SIGNATURE DATE

99 SIGNATURE DAl t

Form 990

Dapartrean t ollha Treasury Internal Ravanvi Sarviea

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 A Fof the 1998 calendar year. OR tax year period beginning . i 8 Sg. and endin

OMB No. 1545-0047

1998

B Check ft Chang* of addraaa Initial return Final return Amandad nturn (required aba for (tat* reporting)

Q Type of organization

Please use IRS label or print or

type. See

Specific Instate

tlons.

This Form Is Open to Public

Inspection

C Name of organization, number and street, city. town, state, and ZIP code Save a L i f e F o u n d a t i o n

4825 N. Scott Street #74A Schiller Park, IL 60176

19 Employer Identification number

36-3869459 Telephone number ( 8 4 7 ) 9 2 8 - 9 6 8 3 Check ► [J if exemption application

Xj Exempt under section 501 (c){ 3 ) is pending

M f l l - . „^ .„ . „ , , „ , , . , M (insert number) OR ► |J section 4947(a)(1) nonexempt charitable trust 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 ^ ft N o I, Mmm^^HwJL^^^^^

group exemption no. (GEN>P» J Accounting method: [ ] Cash |Xj Accrual

r i o u w (specify) ►

(b) If "Yes,* enter number of affiliates for which return is filed: ► (C) l«thitaitparat»returnfil.d by an organisation cavarad by a group ruling? . . |~ Yes M No

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 IRS-but 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 ^ Revenue, Expenses, and Changes In Net Assets or Fund Balances (See Specific instructions onTaiTJIT

•venue

a b c d

2 3 4 5 6a b c

7 8a

b c d

9 a

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) (ens 621 .28 9 . noncaah $

1a 2 1 . 2 8 9 . l b 1c l b 1c 6 0 0 . 0 0 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 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)

b c

10a b c

11 12

wises

i«ts

13 14 15 16 17 18 19 20 21

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

Net gain or (loss) (combine line 8c. columns (A) and (B)) g j Special events and activities (attach schedule) Gross revenue (not including $ of contributions reported on line 1a) I 9 a I 6 1 3 4 Less: direct expenses other than fundralsing expenses I 9 b | 1 6 6 0 ~ . Net income or (loss) from special events (subtract line 9b from line 9a) HgS" Gross sales of inventory, less returns and allowances Less: cost of goods sold 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, s. 6c. 7, 8d. 9c. 10c. and 11)

99012 NTF 10758 GLD 4224 Form 9 9 0 (1998)

ii.n 990 (1!»98) *

Save a Life Foundation Statement of Functional Expenses

3 6 - 3 8 6 9 4 5 9

Do not include amounts reported on line 6b, 8b, 9b, 10b, or 16 of Part I

2 Grants and allocations (attach schedule) . . . nen-

<cach S cat h $ )

) Specific assistance to individuals (attach »chi. I Benefits paid to or for members lattachich.) . 5 Compensation of officers, directors, etc . . . . » Other salaries and wages ' Pension plan contributions I Other employee benefits I Payroll taxes I 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 S t m t A 1 1

b c d B

All o ,gani , . t , .n . ra„,t compl. t . colu«.n(A). CotomwCBUCJ. » d | 0 ) » . , . , „ „ . „ , „ , , .c l ,„n S01<eX3>and(4Jo, , . 0 ,M„ 0„, „ d

.action 494yUX1H. . B . »n .p l charitaDIa t ru . t i but optional lor othori . (S.a Spoc.lic InHroctioni or. paga U.)

Page 2

Total functional expenses (add tints 22 through £)OrauilzaUons completing columns

JMLE— " , carry these totals to lines 13-15

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 to Management and general $

; (II) ami allocated to Prog, services . . S .► Q Yes g No

■M. W W H » « , u, w a n a B B mem ano genera 3 ; and (rv) ami allocated to FundrafeHno S Statement of Program Service Accomplishments (SeeSpecific instructions on page 20)

t is the organization's primary exempt purpose? ► P r o m o t e L i f e S a v i n g F i r s t ~ A i d

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.)

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


(FUqgiradfor S01(cX3) and (4) org*., and «»4r(aXl)

truats; but optional lorothart . )



1 3 2 , 7 9 9

(Grantt and allocations $ (Grants and allocations $ ther program services (attach schedule)

otal of Program Service Expenses (should equal line 44. column (B), Program services) " ~~t 8 99012 NTF M7SB GLO 4224 ' 1 3 2 , 7 9 9 .

Form990(1998) Save a L i f e F o u n d a t i o n

Balance Sheets (See Specific Instructions on page 20.) 3 6 - 3 8 6 9 4 5 9 Page 3

Note: Where required, attached schedules and amounts within the description column should be for end-ot-year amounts only.

Is sets

st ssets Fund

■lances

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) 51a Other notes and loans receivable (attach

schedule) 151 a b Less: allowance for doubtful accounts 151b

5 2 Inventories for sale or use 53 Prepaid expenses and deferred charges 54 Investments — securities (attach schedule) 55a Investments — land, buildings, and

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) Oth«r ^ •stati (dcscriba ■*'

56

59 Total assets (add lines 45 through SB) (must equal line 74) 60 61 62 63

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 ► Stmt Attchd

66 Total liabilities (add lines 60 through 65) OrganizaUons 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

lines 70 through 74. Capital stock, trust principal, or current funds Paid-in or capital surplus, or land, building, and equipment fund Retained earnings, endowment, accumulated Income, or other funds 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)

70 71 72 73

oroaSton » Z ' S t S j ^ ^ T ^ " £ « ' 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" Z £ L . ^ .K P"bfc.Perce iv*5 a n organization in such cases may be determined by the information presented on te retumTh«refore

c* a V s S t r N ^ , ^ . 0 ^ 8L r ^ l a s C C U r a , 8 " " , " * d e S C f i D e 8 ' h ^ "'• " " «*«"** P^^^TJ^Sem '

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


(1) Net unrealized gains on investments . . $

(2) Donated services & use of facilities. $ 4 2 , 5 0 0 .

(3) Recoveries of prior year grants $


36 -3869459 Page 4

M a t e r i a l s $ 3 0 , 9 4 5 . 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 $


Add amounts on lines (1) and (2) . . e Total revenue per line 12, Form 990

(Bne e plus line d) ►

Reconciliation of Expenses per Audited Financial Statements with Expenses per Return

a Total expenses and losses per audited financial statements »>


(1) Donated services & use of facilities.. % 4 2 , 5 0 0 .

(2) Prior year adjustments reported on line 20, Form 990 . $

(3) Losses reported on line 20, Form 990 . $


Materials 3 0 , 9 4 5 Add amounts on lines (1) through ( 4 ) . . >

C Line a minus line b p» d Amounts included on line 17,

Form 990 but not o n line a: (1) Investment expenses

not included on line 6b, Form 990 . $


Add amounts on lines (1) and (2) ► Total expenses per line 17, Form 990 (line c plus line d) > 1 5 9 , 7 0 9 .

List of Officers, Directors, Trustees, and Key Employees (List each one even rf not compensated; see Specific Instructions on page 22.) . r •.

(Ol Contributions to >mplo (A) Name and address

See At tached

(B) Title and average hours per week

devoted to position (C) Compensation

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

75

.JO benefit plans referred comp

0 .

(E) Expense account and other

allowances

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? ► H Yes H No If "Yes," attach schedule — see Specific Instructions on page 22.

CAA 8 99034 NTF i s re i GLD 4225

Form990(1998) Save a L i f e F o u n d a t i o n m 3 6 - 3 8 6 9 4 5 9 Other Information (See Specific Instructions on page 23.)

76 Did organization engage in any activity not previously reported to IRS? If "Yes." attach 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? .

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 ês," 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

Page 5 Yes

81a Enter the amount of political expenditures, direct or indirect, as described In the instructions for line 81

b Did the organization file Form 1120-POL for this year? |81a|

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.) | 8 2 b | ? 3 4 4

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 W -Yes.' did the organization include won every solicitation an express statement that such'contributions or gifts were not'

tax deductible? 85 501(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.

C Dues, assessments, and similar amounts from members d Section 162(e) lobbying and political expenditures B Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices f Taxable amount of lobbying and political expenditures (One B5d less 85e) g Does the organization elect to pay the section 6033(e) tax on the amount in 8Sf? . 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? 501(c)(7) organizations. - Enter a Initiation fees and capital contributions included on line 12 __

. _ , . , 86a 0 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.)

82a X

E30I 83b X

85aN/j E232IE

85c 85d 85e 85f

86

88

86b

87a

87b At any time duringthe year, did the organization 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 section 4911> ; section 4912 ►

year under ; 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.

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 March 91 The books are in care of ► C A R O L S P I Z Z I R R I

Located at ► 4 8 2 5 92

89b

>

112,1998 (See instructions.) I gg^j 0

N SCOTT STREET, SCHILLER PARK T e l e p h o n e n o > 8 4 7 - 9 2 8 - 9 6 8 3 ZIP * 4 * 6 0 1 7 6

CAA

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 '■■■■!.► I 92 I *n

8 99056 NTF 18782 GLD2877

Form 990 (1998) Save a Life Foundation Analysis of Income-Producing Activities (See specific instructions on page 27)

36-3869459 Page 6

Enter gross amounts unless otherwise indicated. 93 Program service revenue:

a b c d e f Modicaie/Madicaidpaymants

g Faa i and contracts from govt. agsncias ,

94 Mambaiship d u a l and asaastrasnts . . . 9 5 '"torna! on savings and temporary cash

investments.

Unrelated business income w

9 6 Oividendsandintarestfrom security*. . .

9 7 Nat rantal incoma Of (lo«») Irom laal astata:

S debt-financed property

D n o t dabt-financad proparty

Business code

(B) Amount

Excluded by section 512,513. or 514 (C)

Exclusion code (D)

Amount


9 8 Net rental income or(lo«s)t»orn personal proparty

99 Othar invactmant incoma 1 0 0 Gain or(lo«») flora sates of assets othar

than inventory

1 0 1 Net income or|loss)fromspecialevents. .

1 0 2 Gross profit/(lgss) from salas of invantory

103 Other revenue: a b c d e

1 0 4 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 Id , Part I. should equal the amount on line 12, Part I.)

Line No.

95 101

Relationship of Activities to the Accomplishment of Exempt Purposes (See specific instructions on pg.2BT 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). INCIDENTAL ITEMS FROM PROGRAM OPERATIONS INCIDENTAL ITEMS FROM PROGRAM OPERATIONS

Name, address, and employer identification number of corporation or partnership

Please Sign Here

Patd Prepare r*s Use Only

age ownership

interest

%

Information Regarding Taxable Subsld aries (Complete this Part if "Yes" box on line 68 Is checked.) i rnss anr l e m n l n u a r Mantrf?r>gKnn P e r c e n t a g e Of • . _ . , _ . . I _ . Nature of

business activities Total

income End-of-year

b r & ' f t T t w V c n , ™ ^ ? . . ! « ™ i ! t , . h " n i ^ V * n ' i ' , , d , h i * ? X " ' tofMba "companying schadula. and statements. and to tha ba i t of my knowledge and nJL.:,'}," VZ.'^?"'.m.Ct'-"?.e"re.•'.,,,•• D • c l * • » , " • " •« praparar (othar than offiear) it bassd on all information of which praparar has any knowladga. (S.a Ganaral Instruction U, on paga 12.)

► Signature of officer Date Preparer's k signature f Firm's name (or yoursi A h l b e c k & C o m p a n y if self-employed) m 1665 Elk Boulevard a n d arfrfmfie r r-> i - i i _ - ■» ■»

► Type or print narra r~' ,M~ Date 04/22/99

CAA 8 9 9 0 5 6 N T F I O T M G L 0 2 B 7 7 Software by Tai and Accounting Soltwara Corp.

Des P l a i n e s , IL

Chock if saH em ■ m - r-ployad ► |

EIN ► 36-2991500 ZIP+ 4*

60016


Dapvtmant of tha Traasury tntntnal Ravanua Service

Name of the organization Save a L i fe Foundation

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 Supplementary Information

See separate Instructions. ► Must be completed by the above organtartlons and attached to their Form 990 or 990-EZ.

OMB No. 1545-0047

1998

Employer identification number 36-3869459

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 ■■«««•»»

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

NONE

(b) Title and average hours per week devoted to position (c) Compensation ■npl banafll plant*

dafarrad cempanaation

(e) Expense account and

other allowances

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


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 GLO 3274 Schedule A (Form 990) 1998

Supplemental Schedules -1998 Company: Save a Life Foundation Page: 1

EIN: 36-3869459

Form 990 - Exempt Organization Tax Return Line 9a - Special Fundraising Events and Activities Description of Event Gross Rec Contrib. Exp.

Various Fundraisers TOTAL

6,134 6,134

0. 0.

1,660. 1,660.

Form 990 - Exempt Organization Tax Return Line 42 - Depreciation, Depletion, Etc. Description (A) Total (B)Program (C) Mgmt. & (D)Fund-

Services General raising

Depreciation Amortization TOTAL

12,209. 318.

12,527

0. 0.

12,209. 318. 0.

0. 12,527

Form 990 - Exempt Organization Tax Return Line 43 - Other Expenses Description

TOTAL

(A) Total (B)Program (C) Mgmt. & Services General

42,738 32,256. 10,482

(D)Fund-raising

Auto expense 561. 561. 0. 0. 0. 0. 0. 0. 0. 0. n

Computer expenses 20,187. 13,547. 6,640. 0. 0. 0. 0. 0. 0. 0. n

Consulting fees 7,215. 7,215. 0. 0. 0. 0. 0. 0. 0. 0. n

Instructor fees 3,200. 3,200. 0.

0. 0. 0. 0. 0. 0. 0. n

Insurance Licenses & permits

2,390. 90.

0. 0.

2,390. 90

0. 0. 0. 0. 0. 0. 0. n

Marketing 6,135. 6,135. 0.

0. 0. 0. 0. 0. 0. 0. n Recruitment 1,598. 1,598. 0.

0. 0. 0. 0. 0. 0. 0. n

Miscelleanous 660. 0. 660. 0. 0. o

Awards 340. 0. 340. 0. 0. o Bank charges 39. 0. 39.

0. 0. o Dues & subscriptions 323. 0. 323. 0.

Continued on Page 2

Form 990 (1998) PartV

Save a Life Foundation 36-3869459

List of Officers, Trustees, and Directors

Contributions to Expense account Title & Average Hours employee benefit and other

Name and Address per Week Compensation plans allowances

Judge Sam Amirante Director 0 0 4825 N. Scott Street Schiller Park, IL 60176

Mr. Rick Bronstein Director 0 0 4825 N. Scott Street Schiller Park, IL60176

Ms. Carol Spizzirri Executive Director $ 35,000 0 4825 N. Scott Street 40 HRS Schiller Park, IL 60176

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 F o u n d a t i o n Statements About Activities

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) by ffling 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 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:



C Furnishing of goods, services, or facilities?

See P a r t V F o r m 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? 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 on page 2.)

2a X

2b X

2c X

2d X

2e X

3 X 4a 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)

11a 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)

11 b [ I A community trust Section l70(b)(l)(A)(vi). (Also complete the Support Schedule in Part IV-A.) 1 2 ( 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)

1 3 [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

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

Schedule A (Form 990) 1998 Save a L i f e F o u n d a t i o n 36-3869459 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>

15 Gif t* , pants, and contributions racoivad. (Do not inctudt unusual grants. Sao lino 2s.)

1 6 Mornbsrship tsaa racoivad . .

1 7 Gross rscsipts from admissions, nstrchsndisa sold or sarvicas parfornad, or furnishing of iacilitisi in any activity that is not a businns unrtlatad to tha organisation's charitabla, a t e , purposs

1 8 Gross hcoroa from intarast, dividosds, amounts rscoivod frora

fiaymasts 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

(a) 1997

1 0 1 , 3 3 0 . 550

'f g Nat In coma from unrslatad businais activitias not includsd in Una IB

2 0 Tax ravsnuss laviad tor tha organization's bonsfitand ailhar paid to it or axpandod on its bahalf

2 1 Tha vatua of sarvicas or facilitias furnished to lha organization by a QovarnraantaJunit without charga. Do aotinchida tha vahia of sarvicas or facilitias ganaralty lurnishsd to tho public without charga

(b) 1996

3 7 , 5 6 6 1 , 5 2 7 .

22 Othar iftcoras. Attach a schadula. Oo not inctuda gain or (loss) from sala of capital assata

2 3 Totalof Imal 1J through 22.

2 4 Lino 23 minus Ima 17 .

2 5 Entar 1% of tins 23

1 0 1 , 8 8 0 .

(C) 1995

1 1 0 , 7 6 1 1 ,410

(d) 1994

9 3 , 4 0 5 . 2,875

101 ,880 1 ,019.

3 9 , 0 9 3 3 9 , 0 9 3

(e) Total

3 4 3 , 0 6 2 6 , 3 6 2 .

1 1 2 , 1 7 1

39TJ 1 1 2 , 1 7 1

1 ,122

96,280 9 6 , 2 8 0 .

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 ►

C Total support for section 509(a)(1) test: Enter line 24, column (e) b> d Add: Amounts from column (e) for lines: 18 19

22

963

3 4 9 , 4 2 4 3 4 9 . 4 2 4

26b 3 ,012 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:

(1997) (1996) (1995) (1994)

C Add: Amounts from column (e) for lines: 17

d Add: Une 27a total

15 20

16 21

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 on line 23, col. (e) ► | 27f |

27c 27d 27e

g Public support percentage (line 27e (numerator) divided by line 27f (denominator)) *> h Investment Income percentage (line IB, column (e) (numerator) divided by line 27f (denominator)) ►

27g 27h

% %

28 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 ~ " — ' CAA

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


30 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?

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; H "No," please explain. (If you need more space, attach a separate statement)

29

30

31

No

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?

32a

32c

If you answered "No" to any of the above, ptease explain. (If you need more space, attach a separate statement)

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?


33b 33c 33d 33e 33f

3& 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

35 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

CAA B 990A34 N T F 1B4B0 GLD 3275

Life Foundation Schedule A (Form 990) 1998 S a v e a re*" Lobbying Expenditures by Electing Public Charities (See instructions on page e.)

36-3869459 Page 5

(To be completed O N L Y by an eligible organization that filed Form 5768)

Check here ► a Check here ► b

if the organization belongs to an affiliated group. if you checked ' a * above and "limited control" provisions apply.

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 tobbying). 38 Total lobbying expenditures (add lines 38 and 37) 39 Other exempt purpose expenditures 40 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 Piu. i s * of ih. .« .<• 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 _

42 Grassroots nontaxable amount (enter 25% of tine 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

® Affiliated group

totals

{5} To be completed for ALL electing

organizations

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.)


Calendar year (or fiscal year beginning In) ►

45 Lobbying nontaxable amount.

46 Lobbying a amount [150% of line 45(e))

47 Total lobbying expenditures

48 Grassroots nontaxable amount



Lobbying Activity by Nonelectjng Public Charities (For reporting only by organizations that did not complete Part Vl-A) (See instructions on page 8.)

a b c d e f g h i

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

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. CAA 8 990A56 NTF 18491 GLO 3276

Schedule A (Form 990) 199s Save a L i f e F o u n d a t i o n 36-3869459 Page 6 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?

a Transfers from the reporting organization to a noncharitable exempt organization of: (I) Cash (II) Other assets

b Other transactions: (I) Sales of assets to a noncharitable exempt organization (II) Purchases of assets from a noncharitable exempt organization (III) Rental of facilities or equipment (Iw) Reimbursement arrangements (v) Loans or loan guarantees (vl) Performance of services or membership or fundraising solicitations

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:

Yea No S1a(i) X

a(ii) X

b<i) X b(li) X bfll) X b(lv) X b(v) X b(vi) X

c X

(a) Line no.

f » Amount involved


(d) Description of transfers, transactions, & 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? ► [ ] Yes

b If "Yes." complete the following schedule: (XjNo


0>) Type of organization

(c) Description of relationship

Form 990 (1998) Part IV Line 57

Save a Life Foundation

Land, Buildings, and Equipment

36-2171716

Asset

Office Equipment Vehicle

Basis

43,896 31,998

Accum Depr

19,873 0

Book Value

24,023 31,998

Total 75,894 19,873 56,021

Supplemental Schedules -1998 Company: Save a Life Foundation

Page: 2 EIN: 36-3869459

Form 990 Line 64b Descript

- Part IV - Balance Sheets - Mortgages and Other Notes Payable Lon Amount

Vehicle ] Date of 1 Maturity Original

Loan Loan: 09/07/98 Date: 09/07/02 Amount: 21,668

- Part IV - Balance - Other Liabilities Lon

Sheets

19,907.

TOTAL



Sheets

19,907.

Form 990 Line 65 -Descript.



Sheets

Amount

Payroll Liabilities Interest Due to State of IL

-747. 5,675.

TOTAL 4 , 9 2 8 .

Supplemental Schedules -1998 Company: Save a Life Foundation

Page: 3 EIN: 36-3869459

Form 990 - Schedule A - Part IV - Line 26b People Whose Gifts Exceeded Amount on Line 26a

Name Amount 2% of 24e Difference

Schedule D Foundation 10,000. 6,988. 3,012. TOTAL 10,000. 3,012.

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

AHLBECK&COMPANY CERTIFIED PUBLIC ACCOUNTANTS

AHLBECK&COMPANY

Exhibit


TABLE OF CONTENTS

DECEMBER 31, 1998

Auditor's Report

Financial Statements

Comparative Statement of Financial Position A December 31, 1998 and December 31, 1997

Statements of Activities B for the years ended December 31, 1998 and December 31, 1997

Comparative Statement of Functional Expenses C for the years ended December 31, 1998 and December 31, 1997

Statements of Cash Flows D for the years ended December 31, 1998 and December 31, 1997

Notes to Financial Statements

AHLBECK&COMPANY

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

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 EXHIBIT A

1998 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

14,974 28.838 43,812

2,120 (2.120)

0 525.SSO

6.719 6.719

24,023 0

24,023

2,120 (1.802)

318 31.060

L I A B I L I T I E S A N D N E T A S S E T 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

1,474 (747)

5,675 4.743

$ 0 0 0 0

11.145

$

0

19,907 4.742

0 0

15,164

61.521

TOTAL LIABILITIES AND NET ASSETS

61.521 87.830

60.070 60.070

137,720 300.000 437.720

(29,010) 0

(29.010)

525.550 $ 31.060

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

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

Temporarily Unrestricted Restricted. X&al

$ $ _ $ 1 , 8 1 3 - 1 , 8 1 3

1 4 , 5 0 0 - 1 4 , 5 0 0 3 , 0 8 1 - 3 , 0 8 1 4 , 2 0 2 - 4 , 2 0 2

5 5 0 - 5 5 0 7 9 , 4 9 5 - 7 9 , 4 9 5

7 , 5 7 9 - 7 , 5 7 9

1 1 1 , 2 1 9 - 1 1 1 , 2 1 9

6 8 , 3 3 1 6 8 , 3 3 1 7 , 2 1 5 - 7 , 2 1 5

2 9 , 2 1 9 - 2 9 , 2 1 9 1 0 4 , 7 6 5 - 1 0 4 , 7 6 5

6 , 4 5 4 - 6 , 4 5 4

INVESTMENT INCOME Interest Income

TOTAL INVESTMENT INCOME

CHANGE IN NET ASSETS BEGINNING NET ASSETS ENDING NET ASSETS

6,454 (35,464) (29,010)

6,4 54 (35,464)

$ (29,010)


- 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

I In

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

1997 Unaudited Totals

support Org anization U

1997 IL Pilot Management and Org anization U naudited Program Fundraising General Total Total Totals $ 58,169 $ 1,250 $ 625 $ 1,875 $ 60,044 $ 262 - - - 262 _

1,709 - - - 1,709 . 1,191 - - - 1,191 .

- - 318 318 318 424 561 - - - 561 18,080

~ - 340 340 340 5,645 ~ - 39 39 39 _

13,547 - 6,640 6,640 20.1B7 . 1,455 - 745 745 2,200 20,843 7,215 - 33,750 33,750 40,965 25,371

~ - 12,209 12,209 12,209 8,884 ~ - 323 323 323 744

3,200 - - - 3,200 . ~ - 2,390 2,390 2,390 825 - - 154 154 154 .

10,000 - - - 10,000 . - - 90 90 90 8

6,135 3,000 - 3,000 9,135 8,520 - - - - 90

4,630 15 2B.0SB 28,073 32,703 2,210 - - 660 660 660 .

941 54 27 81 1,022 2,034 7,412 - - - 7,412 3,043 1,598 - - - 1,598 . 275 6 8,783 8.7B9 9,065 1,200 170 20 10 30 200 _

6.2S6 199 100 299 6,555 4,222 2,362 - - - 2,362 _ 5,713 334 215 549 6,263 2,622

$ 132,799 $ 4,879 $ 95,476 $ 100,355 $ 233,154 $ 104,765

$ 68,331 $ 7,215 $ 29,219 $ 36,434 $ 104,765


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 $ 466,730

Adjustments to reconcile change in net assets to

net cash provided by (used in) operating activities:

Depreciation and amortization $ 12,527

Changes in assets and liabilities: Increase (decrease) in accounts payable 1,474 Increase (decrease) in other payables 6. 379 Total adjustments 20.380

Net cash provided by (used in) operating activities 487,110

Cash Flows from Investing Activities:

Purchase of fixed assets (31.998) Net cash provided by (used in) investing activities (31,998)

Cash Flows from Financing Activities:

Proceeds on issuance of debt 21,668 Repayments on debt (1, 761)

Net cash provided by (used in) financing activities 19.907

Net increase (decrease) in cash and cash equivalents 475,019

Cash and cash equivalents at beginning of period 6-719

Cash and cash equivalents at end of period S 481.738

Supplemental Disclosures: Interest paid S 154


- 6 -


STATEMENT OF CASH FLOWS - UNAUDITED FOR THE YEAR ENDED DECEMBER 31, 1997


Change in Net Assets

Adjustments to reconcile change in net assets to net cash provided by (used in) operating activities: Depreciation and amortization 9 , 3 0 8

6 , 4 5 4

1 . 2 0 0

Changes in assets and liabilities:

Increase (decrease) in other payables Total adjustments

Net cash provided by (used in) operating activities


Purchase of fixed assets (17.410) Net cash provided by (used in) investing activities

— Cash Flows from Financing Activities:

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

10.508

16,962

(17,410)

(448)

7.167

S 6.719


- 7 -


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 -



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 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 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 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

- 9 -



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 / Increase 1998 1997 (Decrease)

$ 43,896 $ 43,896 $ -31,998 75,894

- 31,998 31,998 75,894 43,896 31.998 32,082 19,873 12,209

$ 43,812 $ 24,023 $ 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 -



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:

Year 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:

V a r i o u s Mdse Other

n ^ m h e r - 3 1 . 1998 Revenue Expenses ^ $ 6 .134 $ 1 ,660 $ 4 , 4 7 4

$ 6 ,134 $ 1 ,660 $ 4 , 4 7 4 $ 4 , 2 0 2 $_

P T T 1 ™ ^ 31- 1 9 9 7

Revenue Expenses Hfifc $ 3 , 3 3 9 $ " $ 3 , 3 3 9

863 -_ 863 $ 4 , 2 0 2

MOTB 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.

- 11 -

aâsgss-,^*

*

tfr <b ILLINOIS CHARITABLE ORGANIZATION ANNUAL REPORT

Attorney General JIM RYAN State of Illinois Charitable Trust Bureau, 100 West Randolph

Revised 4/99

Federal ID # 36-3869459 Are contributions to the organization tax deductible?

3rd Floor, Chicago, Illinois 60601

Report for the Fiscal Period:

Beginning 01 / 01 / 99

& Fnriing 1 2 / 3 1 / 99

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"JBte H $15.00 AnnuaMteport Filing Fee

MO

| Yet D No

LEGAL NAME MAIL

ADDRESS CITY. STATE

ZIP CODE

Save a Life Foundation m 2 3 Z000

4825 N. Scott Street #74AATrORWPyoet Schiller Park, IL C^R,^BLETRlfT

L

BuntuFwd n $100.00 Late Report Filing Fee DAY ~YR MO DAY VH

Date Organization was created: 02 / ng / Q

60176

Year-end amounts

A) ASSETS

B) LIABILITIES C) NET ASSETS

A)S 617 ,345 B)S 69 ,641 C)$ 547, ,704

"I. SUMMARY OF ALL REVENUE ITEMS DURING THE YEAR: D) PUBLIC SUPPORT. CONTRIBUTIONS & PROGRAM SERVICE REV. {GROSS AMTS.)


F) OTHER REVENUES

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

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): 5

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, ft N)

IN. SUMMARY OF ALL PAID FUNDRAISER AND CONSULTANT ACTIVITIES (Attach Attorney General Report of Individual Fundraising. Campaign- Form IFC. One tor each PFR.J PROfEWICfjAL FVHPRAJSERS; P) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISERS

%

90.1 *

3.3 6 . 6 *

100%

K)S

«-)* 498,438 M>$ 17,958 N>* 36,568

°>* 552,964

100%

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


T) NAME. TITLE: Carol S o i z z i r r i . P r e s i d e n t

%

P ) $

Q ) $

R ) 5

S ) $

U) NAME. TITLE: Robert Myer, School Scheduler V) NAME.TITLE: F ranc i s F u l l e r , Computer Technic ian

I. CHARITABLE P R O G R A M DESCRIPTION:c«Aflmifli£«?oe»i«r»M«HE5rBriBtPEwoEojcooECA7EGo«Es

W) DESCRIPTION: Li fe Saving F i r s t Aid T r a i n i n g . X) DESCRIPTION:

vt nFRr.RiPTiON-

T)* 83.359 U)$ 20,719 V ) S 19,569

PERCENTAGE ~~ AMOUNT

5 . 7 * O)* 37,874

9 0 . 5 * E > * 600.000

3 . 8 * P>* 25.074 100% G)$ 662.948

90 .1 * H>$ 498.438 % OS

9 0 . 1 * J)» 498,438

List on back side of instructions CODE

Wj# o i l X ) #

Y ) *

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? \.

2 . 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.

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 COMMINGLED WITH THE

PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? 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 -

'ES

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? B.

9. HAS THE ORGANIZATION EVER BEEN 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, ADDRESS AND THE ACCOUNT # OF THE FINANCIAL INSTITUTION0 * *«•=»* THE ORGANIZATION MAINTAINS ITS THREE LARGEST ACCOUNTS:

Northern Trust Bank, 50 LaSalle S t . , Chicago, IL 60675

LaSalle Bank. 135 S. LaSalle S t . , Chicago, IL 60603

12. NAME AND TELEPHONE NUMBER OF CONTACT PERSON: C a r t k S p i z z i r r i 8 4 7 - 9 2 8 - 9 b « J

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 TO 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 Sp izz irr i PRESIDENT or TRUSTEE {PRINT NAME)

TREASURER or TRUSTEE [PRINT ■

P i ft* T. AHiBge*-PREPARER (PRINT NANit)

SlUNAIUKb . WilUAMVI CO-

SIGNATURE

aE

DATE

Form 990

Department of the Treasury Internal Revenue Service

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

Note: The organization may have to use a copy of this return to satisfy state reporting requirements

OMBNo. 1545-0O47

1999

A B

For the 1999 calendar year, Or tax year period beginning

This Form is Open to Public Inspection

Check if: Change of address

Initial return

Final return

Amended return (required also for state reporting)

Please use IRS label or print or type.

See specific Instructions.


Save A Li fe Foundation

,1999. and ending

Number & street (or P.O. box if mail is not delivered to street addr) Room/suite

4825 N. S c o t t S t r e e t 74A

G Type of organization '

City, Town or Country

Schi l le r Park jXj Exempt under section 501(c)

State

I L ZIP + 4

G0176

Employer Identification Number

3 6 - 3 8 6 9 4 5 9 Telephone number

(847) 928-9683 Check.. *" L j jf exemption application is pending

_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? (_J Yes |x ] No

(b ) If Yes," enter the number of affiliates for which this return is filed '

(c) Is this a separate return filed by an organization covered by a group ruling?

L J if the organization's gross receipts are normally not more than $25,000. The organization need not file a return with the !Yes No

I If either box in H is checked 'Yes,' enter four-digit group exemption number (GEN) *"

J Accounting method: [ J c a s h | x j Accruaf | | Other (specify)

K Check here .

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. ^Xyl>F£-™, 99Q-EZmavbe 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) 1 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 21.043. l b 1c 600.000.

0 ) L T 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 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

I d 621 .043 . 16.831

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)

(A) Securities

8a 8b 8c

(B) Other

6c

24.575.

8d

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 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) Total revenue (add lines Id, 2, 3, 4, 5, 6c. 7, 8d, 9c, 10c, and 11)

9a

9b 2 5 , 6 3 7 25.578

.See..Lr3. Stint. 10a 10b

12 13 14 15 16 17

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)) . . .

9c

10c 11 12

18 19 20 21

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)

13

5 9 .

4 4 0 . 662.948.

14 15 16 17 18 19 20

Net assets or fund balances at end of year (combine lines 18, 19, and 20) | 21

498,438. 17.958 36,568

552.964. 109.984 437,720.

BAA For Paperwork Reduction Act Notice, see separate instructions. 5 4 7 , 7 0 4

TEEA0101 08/10/99 Form 990 (1999)

S 5 - 1 9 - S S s a

£orm 990 (] 999) G4 AHLBECK

B4?e244012 AND COMPANY

WtF I 1 ■ * l i f e Foundarion lEle-fJ Statement of Functional F*«

required far secf.cn m f f x % * E H ?

ID=847B244Q12 P . S2

ir^lf!!!^^^^^^ 22 * * * S W f l X ? t a ^ss^^s^ffiasaSftaSa,,,

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

Crjr,ts and aJlocatons (»tt»ch seheduJej teasr. $ non-cash $ "

Speak asi«t«« toindwduah(JlSrtBh)

Compenaton of offers, directors, etc Otfiw salaries

37 38 39 40 41 42

and wages rZ: pe™on plan contributions Other employee benefits Payroll taxes Professional fundraising few Accounting feos Utoal fees Supplies Telephone Postage and shipping Occupancy

Shipment rental and maintenance Printing and publications . . . . Travel CcnfelBnws. eowMtions. M d «,„,„„« Interest . . .

44

Deprecate fcp,,,^ { K ( iRj f ih ^ . 43 Ot iwr .«p m ! „ ( i t e m i a L

b-A!Jto_£xpenSe_

d-B3Q.'L Charges « See Other F>p. .nLrs tmt~

ttrnrthw S*S^p'S8l,»f?l'"n'li(B)

w » « aggiegata amount : of these joint costs I <•«!) the amount allocated to (ti) the arrount a l l o c a t e d ' t a t S * * * ^ N " aiiovaieo to program services

J and (iv) the amount allocated

0 .Otter Program saiv la»« ■ (Grants and allocations" <

TEEA0IB2 12H9/9S

Form 990 (1999;

http://secf.cn

F^rm990,'1999) Save A L i f e F o u n d a t i n n

a>ait lV 1 Balance Sheets (See instructions) 3 6 - 3 8 6 9 4 5 9 .Page 3

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 I 47 b Less: allowance for doubtful accounts


49 Grants receivable

5 0 ? a f f i S E , ? Z 3 °" ICerS ' d ' r e c , o r s < t r u s t e e s - a n " key employees (attach schedule) 51 a Other notes & loans receivable (attach schedule) .. I 51 a

b Less: allowance for doubtful accounts ( 5 1 ^ 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 I 57

b Less: accumulated depreciation (attach schedule) L -57.

58 59

Strut Other assets (describe - D e p o s i t s 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)

a

f

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. Capital stock, trust principal, or current funds Paid-in or capital surplus, or land, building, and equipment fund Retained earnings, endowment, accumulated income, or other funds

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) ... Total liabilities and net assets/fund balances (add lines 66 and 73)

70 71 72

73

74

° p i z ^ ^ * T e " " * " * « " about a particular" P-ease make sure the return is complete and9accurate A l S j / K E K M R W & & 3 £ S ^ ^ BAA

TEEA0103 08/04/99

«.j i ZJ -«* U IO. ISO H t t LB tCK AND COMPANY

fx,namc.xs) Save A u f e foundat ion I f ia r tJE^ I Reconciliation of Revenue per Audited

Financial Statements with Revenue per Return (Sae instructions.)

a Toisi revenue, gams, ana oth« support M audited financa statement'

b Amounts included on linE a but not on line 12. rorm 990.

(1) Net unrealized osine on investments . . $

(2) >.nated serv-Kit and use at facilities $

(3) fttttttetuii of pricr )W grants $

(4) Ctnar (specify): Jup_pljes

" s

1D = 84?824-4Q12

36-3869459 i Reconciliation of Expenses per Audited

Financial Statements with Expenses per Return

P . S 3

Pane 4


b Amounts included on line a but not online i7, Form 990:

0 ) Donated services and use of facilities . $ 8 . 7 5 0 .

( 9 Prieryear adjust menb reported on In* 20, Form 990 .. $

566^214.

Add amounts on lines f l ) throuoh (4)

(3) Losses reported on line 20. Form 930 . . $

(4) Other (specify): $y BPJ i £s

S 4 . 4 0 0

c -irik- a minus line b . . .

d 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):

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:

(1) Investment expenses not included on line 6b, Form 990 . . . $_

(?) Other (specify):

13.150. 5S2.964.

Ai'd amounts on lines (1) and (2)

* !««•'revenue per line 12, Form •-;?" pine c plus Imed',

J


_ c3L°J_Spizz i r r

Add amounts on lines f l ) and (2) . . . ►■

SE? *AR I c Totelexpensespet line 17. Form b b ^ , 3 4 8 , | 990 (line c plus line d) *■

fcfcyw»dList of Queers! P,rector*rTrustees, a n d k e w E L I , ^ ^ ^ T ™ V ^ * ' [ 552. 96A. * " * - c a ' « n g ™ Y ^mptoyees (L,st each one even rf not compensated: see instruction^

{ B > 1 2 5 S 2 i k S S K - h 0 W 8 l (C>i°-mPe-Q?5 t i0" I <*» contributions to per week devoted to position

-DI^_siarLly.dlo Carlos Costes

Sam _L_. Amirante

fres/Exec Dir 40*.

(if not paid, enter -D-)

LL

83.359 Director

Director

r>c9_tt_ Anders on |Director

PeLqrj s jr _Bu_rnam7_

?fL _s?qt_t_ Bet zel_os_I"_

Director

20.832.

employee benefit plans and deferred

compensation

3 7 2 ,

(E> Expense account and other

allowances

D i r e c t o r

Job _Con rpy [D i rec to r 1.666.

|D1rector

*s LUX Of Officers. Etc. Statement

' 5 fromavo^,o^•n?«tv!^r, W 6 ' FJSP erT,P.l°yee receive aggregate compensation of more tnan $100 000 K*duZSZSSSS? d a"/e.,8te<, 0r9Bn.'at!0nS'. ° f wh,Ch T" man $ , ° ' 0 0 0 Was P ^ e d by tAV' It Ves,1 attach schedule - see instructions. • * Q Y « S 0No

form990/1999) Save A L i f e Foundat ion

9>»rtVtW}Owier informat ion rSee spec.fic instructs.) 3 6 - 3 8 6 9 4 5 9

7 6 o ^ S r °nen9a9e '" a n y aC"V,,y n ° ' W t e d to me IRS? „ -Yes/ attach a de,a„ed descr.pt.on " 77 r^r^^^ 7 9 Statement "q U , d a , , 0 n- d ,SS0 ,u , l 0n ' te™*''™. ° ' substantial contraction dunng the year? If 'Yes/attach

"•ssajagTK s s r ^^"™'--". equipment, or facilities at no charge or at

83a Did the organization comply with the public inspection requirements for returns and exemption applications?

b Did the organization comp.y with the d.sclosure requirements relating to quid pro quo contributions? 84a Did the organization solic, any contributions or gifts that were not tax deductible? C ° n t r , b U , ' 0 n S ?

b M&'&StfTT6?.inClUde W,th 6 V e r y S ° , i C , t a , I O n 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' . iV ° r 9 a n , 2 a t , o n m a k e on,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 86 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

^ S i n a ^ 88 S L i ^ 89a 501(c)(3) organizations. Enter: Amount of tax

.= 0 Section 4911 imposed on the organization during the year under 0 . ; Section 4912- n ;Sect,on4955

" S^L%?iîSSSSBS.'S S£SSSWSS^X S e C " 0 n 4 9 5 f i e x c e s s * " • « transaction" explaining each transaction SS I f " ™ 1 tranSMt»n from a prior year? If 'Yes.1 attach a statement

° I K i £ S g % £ S S 0 " . t , , . ° T T 0 n m a n a 9 e r S ° r d 'S q U a , , f , e d P^sons durmg the year under

J f T l A m ° U m ° f taX ° 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 b T H U T r „ * e m P ' ° y e e S e m P ' ° y e d l n U l e P a y P e r i 0 d , h a t ™lud-es~Ma7ch ^ l i ^ s e e ™t7uction"sf T*nZ\ 91 The books are in care of ► C a r o l S o i z z i r r i i , r u c r , o n s ; I 90b| 2

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 " " ~ T e ' e p h o n e n u m b % * -<H7)_928_-96_8_3_ _ _

_ . and enter the amount of t a x - e x e m p t , ^ , ^ i v e d or accrued ^ e . J % , , ; , , . ; . j 9 2 | ^

TEEAOIOS ,2120m Form 990 (1999)

g r n j g n w g ) Save A Li to P n , H a t i o n ' t a t M l l A„alvs,s of Incom-P^l. .^ A c t | V | f t e s ^ . ^ ^

Enter gross amounts unless otherwise indicated.

93 Program service revenue: « Program Feps b " —

36-3869459

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 ... Other investment income Gam or (loss) from sales of assets other than inventory Net income or (loss) from special events Gross profit or (loss) from sales ol inventory Other revenue: a

99 700 101 102 103

I — » , B^mtm, I...bl, Sn^rto, and U.™^.. — . . r ^ g — Name address, and EIN of corporation, Percentaoeof . ( C ) I <°> '

partnership, or disregarded entity | ownershiD?ntereS|j Nature of activities | Total %\ income

XI

<E) End-of-year

assets

N/A

iere ' •--

'aid >re-tarer's Ise >nly AA

Typo or Prml Name and Title

IFinn's Name (or yours it sell-employed) and Address

Ahlbeck & Company 1 6 6 5 E l k finijlpv/arrl

DesPlaines TEEAOI06 12/27/99

36-29915QO 60016-4798

Form 990(1999)

Schedule A (Form 990)

Department of the Treatury Internal Rovenue Service

Organization Exempt Under 1 9 9 9 Section 501(c)(3) IRS use only - Do not w „ i , c , s t a p l „ [ n ^ ^ ^

OMB Na 1M5 0047

.." M U 5 t b C 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. Name of the Organisation

Save A Life Foundation Employer Identification Number

(a) Name and address of each employee paid more

than $50,000

None

(b) Title and average hours per week

devoted to position (e) Compensation (d) Contributions

to employee benefit plans & deferred compensation


allowances

are none, enter 'None.') Services

Total number of other employees paid i >■- ^ - , v,*, , .*„-, ,-**, *,<,, .»>. „* ■ ***,!. >^ ? over$50.000 „ y w J ., i-^^^^^^%^&^^^x^<^î 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 Professional


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. Schedule A (Form 990) 1999

TEEA040I 08/04/99

Schedule A (Form 990) 1999 Save A Life Foundation iPaftWlil;} Statements About Activities

36-3869459

1 F^tS^S!^^ or loca, legis.ation. i n c | u d l n g a n y a „ e m p t

If 'Yes,' enter the total expenses paid or incurred in connection with the lobbying activities $

o f e ^ Form 5768 must complete Part V.-A. Other lobbying activities. complete Part V IB and attach a statement giving a detailed description of the

2 S l ^ o ^ of the following acts with any of „s *.th which any such person ,s . l * ^ r & £ . ^


Dage2

Yes No

1§

2a b Lending of money or other extension of credit?


d Payment of compensation (or payment or reimbursement of expenses if more than $1,000)? S e e . P.t V , Fftl 9 9 0

2b

2c

x

2d X

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. 2e

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? ' . . . . ' .

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):

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).

4a i « « ^ ^ ,

5 6 7 8 9 u A^medical research organization operated ,n conjunction with a hospital. Section 170(b)(l)(A)(„l). Enterthe hospital

s name, city,

1 0 D 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 , ! ieôn F T V M I ^ 0 *

1 1 8 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)

13

from gross investment ™°me ™ 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 * '

D ^ c f f i ^ S R S a ^ o T S ,?fU,n? , ,0n T W ? ? n d * W * organizations section 509(a)(3).) a ' w s e c i , o n 3 U I 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 Foundat ion P a t t W *

36-3869459 Suppor t S c h e d u l e (Complete only il you checked a 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

Page 3

Calendar year (or fiscal year beginning in) 15 Gifts, grants, and contributions

received. (Do not include unusual grants. See line 28.) . .

1998


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 .

621.289.

1997

101.330. 550.

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 organization alter June 30,1975


6,134.

1 &

37.566 1.527

$ 5

110,761 1.410.

Je) Total

870.946. 3,487.

676

20 Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf


6.134.

22 Other income. Attach a schedule. Do not include gam 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 Organizations described on lines 10 or 11:

676.

628.099. 621,965. 6.281

101.880. 101,880.

39.093

1.019. 39.093

391 112.171 112.171

a Enter 2% of amount in column (e), line 24 1.122.

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

26a

676. 22

19 26b

26 b

881.243. 875.109.

nm&£ 17.502.

26c

26 d 26e 26 f

875.109.

676. 874,433. 99.92 %

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


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 ) (1997) (1996) (1995)

b^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 and the larger amount described in (1)or (2). enter the sum of these differences (the excess amounts)Tfor each year r e c e , v e a

('998) (1997) (1996) c Add: Amounts from column (e) for lines: 15

(1995)

17 20 dAdd: Line 27a total and line 27b total

16 21

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

27c 27d 27e

27f l

§AA~

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 list fwhich is not open to public inspection) for each year showing the name of the contributor, the date and amount of ttie brief description of the nature of the qrant. Do not include these orants in line 15 rSee inctn irhnnc ^

%

grant. Do not include these grants in line 15. (See instructions.) TEEAM03 12/20/99

1998, attach a the grant, and a


• Schedule A (Form 990) 1999 Save A L i fe Foundation Ipaft V I Private School Questionnaire (See instructions.

36-3869459 Page 4

' (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 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.)

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.)




c Employment of faculty or administrative staff?




gAthletic programs?


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

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 Proc75-50, 1975-2 C.B. 587, covering racial nondisenmination? If 'No,' attach an explanation

3AA

N/A

29

30

31

Yes

32a

32b

32c 32d

J X *

33a

33b

33c

33d

33e

33f

33fl

33h

34a

34b

35

M

&

M

TEE AM W 1200/99 Schedule A (Form 990) 1999

ScheduleA(Form990) 1999 Save A Li fe Foundat ion 36-3869459 Page5

(To be completed Only by an eligible organization that filed Form 5768) Check here ►• a "T i f the Check here »■ b ~ if you

organization belongs to an affiliated group. checked 'a' above and 'limited control' provisions apply.

N/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 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 but not over $1,000,000 $100,000 plus 15% of the excess orer $500,000

Over $1,000,000 but no! over $1,500,000 $175,000plus 10% ot the excess over $1,000,000

Over $1,500,000 but nol over $17,000,000 $225,000 plus 5% of the excess over $1,500,000

Over $17,000,000 $1,000,000 ' . . ' . _


Caution: If there is an amount on either line 43 or line 44. you must file Form 4720

,c .. „_ 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.)

Calendar year (or fiscal year beginning in) ►


Lobbying Expenditures During 4 -Year Averaging Period

(■) 1999

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


(b) 1998

(c) 1997

4&x

48 Grassroots non-taxable a m o u n t .

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


(d) 1996

0^ Mm. m, ^ . * » w ' i ^

<£&&Vfc^ ■W?** yOt"

(e) Total

■ ' * > < 1 ^ * « *

fcipJSBIf Lobbying Activity by Nonelecting Public Charities (For reporting only by organizations that did not complete Part VIA) (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)

Yes No Amount :.?mm

3AA II 'Yes' to any of the above, also attach a statement giving a detailed description of the lobbying activitu

TEE AMOS 12/20/99 Schedule A (Form 990) 1999

Schedule A (Form 990) 1999 gPartVH

Save A L i fe Foundation 36-3869459 iT»rpfo°g,Rni?ff.'^^^

Paoe6

5' KVor,srss«^^^^ a Transfers from the reporting organization to a nonchantable exempt organization of- rz~

(i)Cash ' - I Yes

■(M) 51 a (i)

b(i) ban b(iii)

(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 (vi)Performance of services or membership or fundraismg solicitations

c Sharing of facilities, equipment, mailing lists, other assets, or paid employees d L % % » ^ §TTe S S S 1 ^ M ^ d a l ^ f s h ™ * • '*r market value of

_jnylan5act,0n or sharing arrangement. o V in* 'cXA^T^% V ^ a S ^ X ^ ^ ^ J ^ J ! ^ ! P ^ value ?n°f

<b) I (c)

b(iv) b(v) b(vi)

No

_X_ X

(») Line no. amouMmvoLed Nam. .1 n .nch m l M , l . e>C T p l ^ m , , fc^M „ „ „ , , „ , „ „ & , , M s M r , „ , „ „ , „ „ „

i If 'Yes.' complete the followina schedule- l_ | res |xj NO b If 'Yes,' complete the following schedule:

<"> Name of organization Type of organization (c)


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

IL Dept, of Commerce & Communi ty Af fat rs 620 East Adams S t r e e t

IL Springfield 62701

Description

Cash

IL State Board of Education 100 N. First St. Springfield IL Abbott Laboratories Dept 379-Ap Bide 14C Abbott Park IL

Abbott Laboratories Dept 379-AP Bide 14C Abbott Park IL

62777

Cash

60064

Cash

Cash

60064

Date Received

v a r i o u s

v a r i o u s

04/05/99

12/09/99

Amount Received

3 0 0 . 0 0 0 .

3 0 0 . 0 0 0 .

4 , 0 0 0 .

4 . 0 0 0 .

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 Gross

Receipts Less

Contributions Gross

Revenue Less Direct Expenses

Net Income (Loss)

D i n n e r Event 3 4 . 5 2 5 . 9 , 0 3 8 . 2 5 . 4 8 7 . 2 5 . 4 8 7 . 0 . Various Merchandise 1 5 0 . 150 . 9 1 . 5 9 .

Total 34.675. 9,038. 25.637. 25 .578. 59.

Form 990. Page 2, Part II, Line 43 Other Expenses Stmt

Other expenses (itemize)

(A) Total


(C) Management and qeneral

(D) Fundraising

Computer Expenses 2 2 . 5 4 2 . 2 1 . 5 9 2 . 3 8 8 . 5 6 2 . C o n s u l t i n g Fees 3 6 . 7 6 5 . 3 3 . 6 1 5 . 3 . 1 5 0 . 0 . C o n t r a c t Labor 1 . 6 9 7 . 1 . 5 6 4 . 2 5 . 1 0 8 . Dues & S u b s c r i p t i o n s 8 0 0 . 4 1 9 . 3 8 1 . 0 . Equ ipment R e n t a l 1 . 7 4 0 . 1 . 5 8 4 . 5 2 . 1 0 4 . I n s t r u c t o r s Fees 6 4 . 0 1 5 . 6 4 . 0 1 5 . 0 . 0 . I n s u r a n c e 7 . 0 7 2 . 6 . 4 3 5 . 2 1 2 . 4 2 5 . L i c e n s e s 8r P e r m i t s 1 . 0 6 3 . 1.044 . 1 7 . 2 . M a r k e t i n g 9 . 5 3 4 . 8 . 8 4 9 . 4 5 . 6 4 0 . Memorial Fund Expenses 3 7 0 . 0 . 3 7 0 . 0 . M i s c e l l a n e o u s 1 , 1 5 7 . 4 4 3 . 7 1 3 . 1 . R e c r u i t m e n t 2 . 3 2 1 . 2 . 1 9 3 . 3 9 . 8 9 . R e s e a r c h / E v a l u a t i o n 1 . 1 2 3 . 1 . 0 4 2 . 3 0 . 5 1 .

Total 1 5 0 , 1 9 9 . 1 4 2 . 7 9 5 . 5 , 4 2 2 . 1 . 9 8 2 .

Form 990. Page 3, Part IV, Lines 57a & 57b Land, Buildings and Equipment Statement

(a) Cost/Other

Basis

(b) Accumulated Depreciation

(c) Book Value

O f f i c e Equ ipment 7 5 . 0 2 5 . 3 8 . 0 2 0 . 3 7 . 0 0 5 . V e h i c l e s 3 1 . 9 9 8 . 8 . 1 6 0 . 2 3 . 8 3 8 .

Total 107.023. 46. 180. 60 .843 .

Form 990, Page 3, Part IV, Line 65 Other Liabilities Statement

Line 65 - Other Liabilities: Beginning

of Year End of Year

P a y r o l l L i a b i l i t i e s - 7 4 7 . 0 . I n t e r e s t due t o S t a t e o f I L 5 . 6 7 5 . 0 .

Save A Life Foundation 36-3869459 2

Form 990, Page 3, Part IV, Line 65 Continued Other Liabilities Statement


of Year End of

Year

4 . 9 2 8 . 0 .

Form 990, Page 4, Part V List of Officers, Etc. Statement


(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 the i r capacity on the Board, They can be contacted c/o Save a L i f e foundation, 4825 N. Scott St. U74A. Schil ler Park. IL 60176

Total


Supporting Statement of:

Form 990 p 2 /L i ne 42(B)

Description

O f f i c e Equipment-Program Deprec ia t i on Vehic les-Program Dep rec ia t i on

Total

Amount

8.316 4 .570 .

1 2 . 8 8 6 ,


Form 990 p 2 /L ine 42(C)

Description

O f f i c e Eouipment-Mgmt & Genrl Dep rec ia t i on Vehicles-Mgmt & Genrl Dep rec ia t i on

Total

Amount

260. 143.

403.


Form 990 p 2 /L i ne 42(D)

Description

O f f i c e Equipment -Fundra is ing Dep rec i a t i on V e h i c l e s - F u n d r a i s i n g Dep rec ia t i on

Total

Amount

521 287,

808.


Form 990 p 3 /L ine 63. column (B)

Description

Due to Carol S p i z z i r r i

Amount

65.475.

Total 65,475

SAVE A LIFE FOUNDATION, INC. AUDITED FINANCIAL STATEMENTS DECEMBER 31, 1999



TABLE OF CONTENTS

DECEMBER 31, 1999

Auditor's Report


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


AHLBECK&COMPANY

CERTIFIED 1665 ELK BOULEVARD TELEPHONE: 847/824-1000 PUBLIC DES PLA1NES. ILLINOIS FACSIMILE 847/824-40U ACCOUNTANTS 60016-4798 WEB: wwwahlbcckco com

February 16, 2000

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


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

EXHIBIT A

1999 1998

A S S E T S

CURRENT ASSETS Cash and Cash Equivalents Prepaid Legal Fees Inventory Accounts Receivable Deposits Prepaid Expenses


FIXED ASSETS AT BOOK VALUE Office Equipment Vehicle

Net Fixed Assets TOTAL ASSETS

509, ,770 17, ,500 26, ,593 1. ,750

162 727

556, 502

37, 006 23. 838 60, 843

617, 345

481 ,738 0 0 0 0 0

481 ,738

14, ,974 28. 838 43. 812

S2S. 550


CURRENT LIABILITIES Accounts Payable Payroll Liabilities Interest Due To State Of II Current Portion Loan Payable


LONG TERM LIABILITIES Vehicle Loan Less: Current Portion

Total Long Term Liabilities OTHER LIABILITIES

Due To Carol Spizzirri Total Other Liabilities

TOTAL LIABILITIES

4,167 * ? 1,474 0 (747) 0 5,675 0 4.743

4,167 11,145

0 19,907 0 4.742

65.475 65.475 69.642

15,164

61.521 61.521 87,830


TOTAL NET ASSETS


247, 300.

,704 ,000

547. 704

617, 345

137,720 300.000 437.720

525.550


- 2 -

SAVE A LIFE FOUNDATION, INC. STATEMENT OF ACTIVITIES

For the Year Ended December 31, 1999

EXHIBTT R

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




Temporarily Unrestricted Restricted l££al $ 1,825 $ . $ 1,825

16,831 - 16,831 300,000 300 ,000 600,000 9,500 - 9,500

59 - 59 680 - 680

13,150 - 13,150 9,038 - 9,038 440 - 440

351,523 300, 000 651,523

466 43

,901 ,503

510 37 18,

,404 ,357 ,353

566, 300,

,114 000

85, 409

24, 575 24. 575

109,984 137,720

(300,000)

466 43

,901 ,503

510 37 18,

,404 ,357 ,353

566, ,114

85, 409

24, 575 24, 575

247,704

300,000

$ 300,000

109,984 437,720

$ 547,704


- 3 -



EXHIBIT R

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




Tempo ra irily Unrestricted Restricted Total $ 1,200 $ . $ 1,200

300,000 300, ,000 600,000 19,500 - 19,500

16S - 165 4,474 - 4,474

140 - 140 73,445 - 73,445

284 - 284 399,208 300, 000 699,208

132,799 132,799 4,879 - 4,879

95,476 - 95,476 233,154 - 233,154

166,054 300, 000 466,054

676 676

166,730 (29,010)

137,720

300,000

$ 300,000

676 676

466,730 (29,010)

$ 437,720


- 4 -

SAVE A LIFE jMDATION, INC. STATEMENT OF FUNCTIONAL EXPENSES

For the Year ended December 31, 1999

Program

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

Kid's Program

$ 175,772 1,955

15,243 18,508

Other Training Programs

5 13,872 116

1.431 783

Total Program

$ 189,643 2,071

16,674 19.292

Fundraising $ 21,682

116 1.832 781

Support Management and

General S 6,525

915 531

1.271

Total $ 28.207

1.031 2.363 2.051

Organization Total

S 217,850 3.101 19,037 21,343

2,749 199

160 2,909 199

192 535

96 288 3,197 351

21,063 411

33,615 1,522

12,213 419

1.497 51,103

20 529 68

42 673

87 12,912

371 21,592

479 33,615 1.564

12,886 419

1.584 64,015

24 562 445

107 608

104

12 387 450

3,150 25

404 381 52

535 37

950 895

3.150 133

1,211 381 157

734 40B

22,542 1,374

36,765 1,697

14.097 800

1.740 6,082 3,677

354 211

6,435 3,888

424 211

212 127

636 338

64,015 7,072 4,226

1,042 8,730

522

2 118

1,044 8.849

522

2 641 15

16 45 319

19 686 334

1.063 9,534

856 406

12.659 40 901

446 13.560 BB3

370 713 342

370 713

1,226

370 1.159

14,785 5,440

30,529 2.153

21,668 1,081

991 13,299 5,115

296 2,557

39 1.194

63 51

710 2,687

5,736 33,086 2,193

22,862 1,144 1,042

14,009 7,802

378 4,601

89 1,441

75 51

B51

186 170 39

708 38 31

426

564 4,771

128 2,150

113 82

1,277

6.300 37,857 2,321

25.012 1.257 1.123

15,286 16,889 3,587 20,476 504 413 917

7,802 466,901 43,503 510,104 37,357 16,353 5S.710 $ 566,114

Management and General Allocation 15,126

Total Expenses S 482,027 528 1S.6S4

$ 44.031 $ 526,058

1,935

$ 39.292

(17,589) (15,654)

?64 $ 40.056 566.114

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

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

IL Pilot Program Fundraising

Management and General Total

Organization Total

$ 58,169 $ 1,250 $ 625 $ 1,875 $ 60,044 262 - - . 262 1,709 - - . 1, 709 1,191 - - - 1,191 ~ 318 318 318 561 - - - 561 "" 340 340 340 - 39 39 39 13,547 - 6,640 6,640 20,187 1,455 - 745 745 2,200 7,215 - 33.750 33,750 40.965 ~ 12,209 12,209 12,209 ~ 323 323 323 3,200 ~ - - 3,200 ~ 2,390 2,390 2,390 - 154 154 154 10,000 - - - 10,000 - 90 90 90 6,135 3,000 - 3,000 9,135

4,630 IS 28,058 28,073 32,703 - 660 660 660 941 54 27 81 1,022

7,412 - - . 7.412 1,598 - - . 1.598 275 6 8,783 8,789 9,065 170 20 10 30 200 6,256 199 100 299 6,555 2,362 - - - 2,362 5,713 334 215 54 9 6,263

$ 132,799 $ 4.B79 $ 95,476 $ 100,355 $ 233,154


EXHIBIT D SAVE A LIFE FOUNDATION, INC. STATEMENT OF CASH FLOWS

FOR THE YEAR ENDED DECEMBER 31, 1999


Change in Net Assets S 109,984

Adjustments to reconcile change in net assets to net cash provided by (used in) operating activities: Depreciation and amortization $ 14,097


Decrease (increase) in accounts receivable (1,750) Decrease (increase) in inventory (26,593) Decrease (increase) in other current assets (18,389) Increase (decrease) in other payables l.719 Total adjustments (30.916)



Purchase of fixed assets (31.129)

Net cash provided by (used in) investing activities (31,129)


Payments on loan (19,907)

Net cash provided by (used in) financing activities (19,907)


Cash and cash equivalents at beginning of period 481.738

Cash and cash equivalents at end of period S 509.770 Supplemental Disclosures: Interest paid S 4.226


- 7 -


FOR THE YEAR ENDED DECEMBER 31, 1998 Cash Flows from Operating Activities:

Change in Net Assets $ 4 6 6 7 3 Q

Adjustments to reconcile change in net assets to net cash provided by (used in) operating activities:


Changes in assets and liabilities: Increase (decrease) in accounts payable 1,474 Increase (decrease) in other payables s, 379 Total adjustments 2Q,380

Net cash provided by (used in) operating activities 487,110 Cash Flows from Investing Activities:

Purchase of fixed assets (31.998) Net cash provided by (used in) investing activities (31,998)


Proceeds on issuance of debt 21,668 Repayments on debt (i, 7gp

Net cash provided by (used in) financing activities 19.907


Cash and cash equivalents at beginning of period 6. 719

Cash and cash equivalents at end of period $ 481.73B

Supplemental Disclosures: Interest paid $ 154


- 8 -

SAVE A LIFE FOUNDATION, INC. t


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




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



Estimates


- 9 -



DECEMBER 31, 1999


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).



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 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

- 10 -



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 UD to $100,000.

NOTE 5 - Fixed Assets At December 31, 1999 and 1998, the costs of such assets were as follows:




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. fignt. 2000 $ 12,792 2001 996

Decemt l e r 3 1 , Increase 1 9 9 9 1 9 9 8 (Decrease)

$ 7 5 , 0 2 5 $ 4 3 . B 9 6 $ 3 1 , 1 2 9 3 1 , 9 9 8 3 1 , 9 9 8

7 5 , 8 9 4

-

1 0 7 , 0 2 3

3 1 , 9 9 8

7 5 , 8 9 4 3 1 , 1 2 9 4 6 , 1 8 0

$

3 2 , 0 8 2 4 3 , 8 1 2 $

1 4 , 0 9 8 $ 6 0 , 8 4 3 $

3 2 , 0 8 2 4 3 , 8 1 2 $ 1 7 , 0 3 1

- 11 -



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 December 31. iggR Revere Expenses UsL Revenue Expenses Net

Dinner Event $34,525 $25,487 $ 9,038 $ - $ - $ Various Merchan 150 9£ 59 6,134 1,660 4,474

$34,675 $25,578 $ 9,097 $ 6,134 $ 1,660 $ 4,474

- 12 -

fr» <yflc» Uf l Only

PMT#

(iKM ^ AMT

INIT

dj>£ ^ ^

ILLINOIS CHARITABLE ORGANIZATION ANNUAL REPORT Attorney General JIM RYAN State of Illinois

Charitable Trust Bureau, 100 West Randolph m M ( , , n ( . CO U 01026498


Federal ID # 363869459



Beginning oi / oi / oo 12

& Ending 12. 31 . 2000 7 /

MO DAY

Are contributions to the organization tax deductible? B Yes Q No

Cheek all items attached: B Copy of IRS Return

M»k» anon E) Audited Financial Statements pjyibteio □ Copy of Form IFC S M X ° " H $15.00 Annual Report Filing Fee BtmtuFviut □ $100.00 Late Report Filing Fee

MO DAY YR

Date Organization was created: 0 2 / 09 / 9 3

LEGAL NAME MAIL

ADDRESS CITY. STATE

ZIP CODE

SAVE A LIFE FOUNDATION 402SNOCOTTCTIUIETff71A fffp UJ-itUUA£AJ££ AJ&0 SCHILLER PARK.IL 60176

I. 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)

II. SUMMARY OF ALL EXPENDITURES DURING THE YEAR:

H) OPERATING CHARITABLE PROGRAM EXPENSE RECEIVED

I) EDUCATION PROGRAM SERVICE EXPENSE M « y 9 2 2 0 0 1

J) TOTAL CHARITABLE PROGRAM SERVICE EXPENSE (ADD H & I) „ , , . . . . ATTORNEY GENERAL

Ji) JOINT COSTS ALLOCATED TO PROGRAM SERVICES ^ M f f i F A S t Q M R U S T


L> TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD J & K)



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


R) NET RECEIVED BY THE CHARITY (P MINUS Q=R) PROFESSIONAL FUNDRAISING CONSULTANTS: S) TOf AL AMOUNT PAID TO PROFESSIONAL FUNDRAISING CONSULTANTS


T) NAME.TITLE: C a r o l S p 1 , , g - i r r i . P r e s i d e n t

Year-end amounts

A)ASSETS

B) LIABILITIES

C) NET ASSETS

PERCENTAGE

A)$ 455,579 B)$ 74,681 C)$ 380,898

10 %

89 %

100%

AMOUNT

0 } $ 72,064 E)$ 650,000 F ) $ 9.512 G)S 731,576

80 *

%

H) 711,626 l ) $

711,626

%

80 %

16

100%

K)$

L>* 711,626 M ) $ 143,155 N)$ 43,601 ° ) $ 898,382

100%

%

%

P)$

Q ) $

R)$

S)S

T>* 104.900.00 U) NAME.TITLE: F r a n c l B F u l l e r . C o m p u t e r T e c h n i c i a n U ) $ 34,985.60

V) NAME.TITLE: M a r r v A n H r a n r g . M a r k e t i n g f. P u b l i c R e l a t i o n s V ) $ 2 6 . 7 0 1 . 8 6

V. CHARITABLE P R O G R A M DESCRIPT\ON:cHAmrABL£pitoGMu(i HIGHEST BY IEXPEHDEOI CODE CATEGORIES

W) DESCRIPTION: L i f e S a v i n g F i r s t A id T r a i n i n g


W)# o i l X) DESCRIPTION: X)#

Y) DESCRIPTION: Y)#

IF

1.

2.

6.

7a.

7b.

8.

10.

11.

THE ANSWER TO ANY OF THE FOLLOWING IS YES, ATTACH A DETAILED EXPLANATION:

WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION. FINE. PENALTY OR JUDGMENT? I.

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.

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? 4.

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

DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER?{ ATTACH FORM IFC ). 6.

DID THE ORGANIZATION ALLOCATE THE COST OF ANY SOLICITATION, MAILING. ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES? 7-

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 S 1 _ : AND (iv) THE AMOUNT ALLOCATED TO FUNDRAISING £

DID THE ORGANIZATION EXPEND ITS RESTRICTED FUNDJ5 FOR PURPOSES OTHER THAN RESTRICTED PURPOSES? .' .' ; . . .-•.'. 8.

HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION OR TAX EXEMPTION SUSPENDED OR REVOKED BY ANY GOVERNMENTAL AGENCY? 9.

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

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: Caro l S p i z z i r r i 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.

Carol S p i z z i r r i Q\ 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.

PRESIDENT or TRUSTEE {PRINT NA-

£CL<>7TA' ffVG&#tJ TREASURER or TRUSTEE <PRINT NAum—^

PREPARER (PRINTNAME)" "

- - v — v ^ - e t X E ^ L ^ w . . SIGNATURE

SIGNATURE

DATE S^V

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

*■ The organization may have to use a copy of this return to satisfy state reporting requirements.

OMB No. 1545-0047 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


2000 Department of tho Tmaay Internal Revtnu* Servie*

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

*■ The organization may have to use a copy of this return to satisfy state reporting requirements. Open to Public

inspection

A B

For the 2000 calendar year, or tax year period beginning Chock If apptablo:

Chang* of tddnxa Chang* of m m Initial ratam Finis refcjni AnMftPBa nriurn

IRS label OIBjiBt w w e .

Sc* •pcdSe taftivc* float.

,2000, and ending .20 C Name of orjanitatwn

Save A L i fe Foundation Number aVatroat (or P.O. boxrt rr^ b net dcoVand to stnKt addr) Room/suite

9950 Lawrence 300 City, Town or Country

Schi l ler Park State

IL ZIP sod*

60176

G Otgaruiatfan typ* <eh*cfc only an*) * ® SM_ 3 * (insert no.) 4W7&00) • Section SOIfcffl organizations and 4947(aX1)nonexempt charitable trusts must attach a completed Schedule A (form 990 or$90-E2X

) Cash |XJ Accrual U Other (spBcirvV J Accounting method: 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.

Employer IdcaMcatai Nambof

36-3869459 H> Tc|cpfcoti& ottmpny

(847) 928 F Check. n 9683

if appfiaSon pending

Note: H and I are not applicable to section 527 orgs. H ( 8 ) lathtaaorauproojm foraffirao»? \^}r<a ( * ] No H (b) If •yn,' *n«H number of afrKabaa*-H (c) Are all affiliates included? Q Y * * Q NO

(If *no,' attach a list See instructiens) H (d) hi Ms a separata return Nod by on

orgartobon eovtred by a group ruling? j~~ly** (XJ No

I Enter 4-oVtt group oxempbon no. (GEN) " 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 3 2 . 8 7 8 .

I d

lb

I d 1c 6 5 0 . 0 0 0 .

I d d l ! M ( » t a * » n o n e * ! >• nd contracts (from Part

I d 6 8 2 . 8 7 8 . 2 Program service revenue including government fees a

>• nd contracts (from Part VII, It 2 3 9 . 1 8 6 . VII, It

3 4 Interest on savings and temporary cash investments. 4 8 . 7 2 5 . 4 Interest on savings and temporary cash investments.

5 Gal

6c 6b|

6c c Net rental income or (loss) (subtract line 6b from line ( 5a) 6c c Net rental income or (loss) (subtract line 6b from line ( ) 7

8a Gross amount from sales of assets other than inventory

(A) Securities (B) Other

8d

R 8a Gross amount from sales of assets other

than inventory 8a

8d

V b Less: cost or other basis and sates expenses c Cain or (loss) (attach schedule)

8b

8d

E N

b Less: cost or other basis and sates expenses c Cain or (loss) (attach schedule) 8c

8d U E d Net gain or (loss) (combine line 8c, columns (A) and 0

9 Special events and activities (attach schedule) a Gross revenue (not including... $ 6 .5

3)) 8d d Net gain or (loss) (combine line 8c, columns (A) and 0 9 Special events and activities (attach schedule)

a Gross revenue (not including... $ 6 .5 >40. 9a 1 5 . 5 7 9 .


10a Gross sales of inventory, less returns and allowances

9b 1 4 . 9 2 8 . 9c


10a Gross sales of inventory, less returns and allowances S e e . u a . S t m t . . . 9c 6 5 1 .


10a Gross sales of inventory, less returns and allowances 10a

10c


10a Gross sales of inventory, less returns and allowances 10b

10c c Gross profit or (loss) from sates of inventory (attach schedule) (subtract line 10b from line 10a).. 10c c Gross profit or (loss) from sates of inventory (attach schedule) (subtract line 10b from line 10a).. 11 136.

12 Total revenue (add lines 1d, 2 ,3,4, 5, 6c, 7, Bd, 9c, 10c, and 11) 12 7 3 1 . 5 7 6 . 13 Program services (from line 44, column (B)) 13 7 1 1 . 6 2 6 .

X 14 Management and general (from line 44, column (C)) . 15 Fundraising (from line 44, column (D))

14 143 .155 . E

14 Management and general (from line 44, column (C)) . 15 Fundraising (from line 44, column (D)) 15 4 3 . 6 0 1 . N

S 16 s 17 8 9 8 . 3 8 2 .

18 Excess or (deficit) for the year (subtract line 17 from li 19 Net assets or fund balances at beginning of year (from 20 Other changes In net assets or fund balances (attach < 21 Net assets or fund balances at end of year (combine li

18 - 1 6 6 . 8 0 6 . si


line 73, column (A)) , 19 547 .704 . M


line 73, column (A)) , 20

s

18 Excess or (deficit) for the year (subtract line 17 from li 19 Net assets or fund balances at beginning of year (from 20 Other changes In net assets or fund balances (attach < 21 Net assets or fund balances at end of year (combine li 21 3 8 0 . 8 9 8 .

BAA For Paperwork Reduction Act Notice, see separate Instructions. TEEA0101 12/2000 Form 990 (2000)

Form990coco) Save A Li fe Foundation "" Statement of Functional Expenses

36-3869459 . . . _ . „ , , , , .v 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.

Page 2

Do not include amounts reported on line 6b. 8b. 9b. 10b. or 16 of Part I.

22 Grants and allocations {attach schedule) (cash $

$ non-cash 23 24 25 26 27 28 29 30 31 32 33 34 35

37 33 39 40 41 42 43

44

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 Travel Conferences, conventions, and meetings Interest Depreciation, depletion, etc (attach schedule) Other expenses (itemize):

»._ _i _ ______ b Jl __ c____€ ZZZ ZZ~Z c Jl ___ I _*_ _&____• I _ d Corojjyter] Expenses ~ _ oJeeJWier Expenses Stmt ~ ~

To___t_ul •»]»__ (a_"lin__" tarry a t _ man _ 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? ►-[""] Yes (x l No

If Yes,' enter (i) ttw aggregate amount of these joint costs $ ; (II) the amount allocated to program services

5 ; (i») the amount allocated to management and general $ ; and (hf) the amount allocated to fundraising $

[Statement of Program Service Accomplishments What is the organization's primary exempt purpose? * J'XOmpte J j f e S a v i n g _ f 1 r s t a i d *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 *

• Kid's i^Ls_tnP£L^mi_t.ft0Jnpt1j)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}_ _ ~ ~ Z ~ _ _

(Grants and allocations $ b__ _______.CPJ7___z__T____on_ and_ teaching_of_ . l i te saving J:iLS_t_a1jl_tp_jndJviduatr othej"fhan~s"chool-age chUdren__~ JIG7G_clJents_served)_ ~ """"

(Grants and allocations $ 0. ) c 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 . ) di£_!ch_Q_5velj)pmenjt^ -_Expand_ to satellite.office Jnside_a_nd outside the State of Illinbis ~ "

(Grants and allocations $ e Other program services.. .See. a t t a c h e d (Grants and allocations $ _L_

BAA f Total of Program Service Expense. (should equal line 44, column (B). program services)

_____

Program Semite Eipesm ftqulrad toe SOI<O0> mil

tiginlailemaj-I7SM1) tnnh; but

alfefoCmv)

521.220.

4 1 . 8 0 8 .

11 .653 .

134 .644 . 2.301.

TEEM1Q2 090000 711.626.

Form 990 (2000)

Form930(2000) Save A Li fe Foundation 36-3869459 Page 3

Balance Sheets (See instructions)



,- CB) End of year 45 Cash - non-interest-bearing 46 Savings and temporary cash investments

8.925 45 500.845 46

47a Accounts receivable bless: allowance for doubtful accounts

48a Pledges receivable bless: allowance for doubtful accounts


47a 47b

48a 48b

3 .987 1.750 47c

48c 49

50 Receivables from officers, directors, trustees, and key employees (attach schedule)

51 a Other notes & loans receivable (attach schedule) .. |_51 a 50

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.

51c 26.593 52 18.227 53

54

bLess: accumulated depreciation (attach schedule)

55a

55b 55c 56 Investments — other (attach schedule) 57 a Land, buildings, and equipment: basis .

56

b Less: accumulated depreciation (attach schedule) L.-.57. .Stm.t.

58 Other assets (describe ► Deposi ts

57a

57b

117.663

63.038 60.843 57c . ) • 162 58

S3 Total assets (add lines 45 through 58) (must equal line 74), 617.345 59

500. 332.812.

3.987.

52.188. 11.305.

54.625. 162.

455.579. 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 Line 65 Stffit ) .

4.166. 61 62

65.475. 63 64a 64b 65

66 Total liabilities (add lines 60 through 65) 69,641 66

8.648.

65.450.

583. 74,681

|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 70 through 74. Capital stock, trust principal, or current funds Paid-in or capital surplus, or land, building, and equipment fund Retained earnings, endowment, accumulated income, or other funds .

49.294. 67 498.410.

• 2 7 . 6 4 8 . 68 4 0 8 . 5 4 6 .

f~l and complete lines 69

70 77 72

71 72

73

74

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 liability i and net assets/fund balances (add lines 66 and 73).

547 .704 . 73 3 8 0 . 8 9 8 . 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 fe Foundation 36-3869459 Page 4 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:


(SS) Donated services and use of facilities $

(3) Recoveries of prior yeargrants >_

(4) Other (specify): Oonatcd flatcrlstt

5 4 . 6 7 5

c

d

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 $


Add amounts on lines (1) and (2)

Total revenue per line 12, Form 990 (line c plus line d)

I List of Officers. Directors,

786.251 ? j * A * *

P f*tH:

Uifrj>.i.iifiiiAjfSjtt..tiM3t.t

54.675 731.576

731.576,

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 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): Donated Ftatcriats

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 $


Add amounts on lines (1) and (2) .

Total expenses per line 17, Form 990 (line c plus line d)

rustees. a n d K e y Emp oyeos (List each one even it not compensated; see instructions.



(C) Compensation (if not paid, enter-0-)

(D) Contributions to employee benefit

plans and deferred compensation


allowances

JF2 L°)_ In11 z trx i Pres/Exec 01r 40 104,900 568.

S>L i. J i§n. J?y_dloI. _Jr j Director

Carlos A. Azcoltia 0.

Director Sam L. Amirante

Director J), JL JL JL JO.

_p_.

0.

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.

* Q Y « 0No

BAA 1EEAD1H 09/21/00 Form 990 (2000)

Form990(2000) Save A L i f e Founda t i on 36-3869459 Page 5 Other Information (See specific instructions.) N/A Yes 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 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?


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?

54.675.

b If "res/ did the organization include with every solicitation an express statement that such contributions or gifts were mt 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

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 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.)

86a 86b 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 in any Section 4958 excess benefit transaction did

ny: 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

76 77

78a 78b

79

80a

81b

82a

83a 83b 84a

84b 85a 8Sb

85fl

89b

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) Ôb l 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 928-9683

located at ► 9950_ Laxren«" fu l te3Mi_ schHJer i ?aMTrr J i _ 2Pode »•""60176" 92 Section 4947(a)(1) nonexempt charitable trusts tiling Form 990 in lieu of Form 1041 - Check here *"T3

and enter the amount of tax-exempt interest received or accrued during the tax year H 92 I BAA Form 990 (2000)

TEEA010S 12/20*0

Form990(2000) Save A l i f e Foundation 36-3869459 Page 6 Analysis of Income-Producing Activities (See instructions.)

Enter gross amounts unless otherwise Indicated.

93 Program service revenue: 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:


98 Net rental income or (loss) (iwnpers prop . . . 99 Other investment income

Gain or (loss) from sales of assets other than inventory Net income or (loss) from special events Gross profit or (loss) from sates of inventory...

Other revenue: a

100

101 102 103

bMiscellaneous c d e


0 W „ . Business code

<B) Amount Exclusion code

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.

Excluded by section 512, 513. or 514

14

Amount

8 . 7 2 5 .

8 . 7 2 5 ,


3 8 . 3 8 6 . 800 .

651

39.973. 4 8 . 6 9 8 .

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.) N/A <A)

Name, address, and EIN of corporation, partnership, or disregarded entity

(B) Percentage of

ownership interest

<C)

Nature of activities

<D) Total

income End-of-year

assets % %

% [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? M Yos l |Nt>

b Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? [ J Yes [ H No Note: It yes'*" "=—~ ' .7sn. / C A0.a

Please Sign Here

Paid Pre-

Jnttnirfions).

Prep at Sfenrt

Garer's Ah 1 beck & Company se ^^J^PS »> 1665 Elk Boulevard

Only iddrttt, ii Des Plaines

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 fUyVf t , fees fcttrtOwA Typa or Print Nan4*n i *~ ' ' [

36-2991500 60016 |phon.n. - (847) 824-4000

BAA TEEA010G 12/21/00 Form 990 (2000)

2000 Department ol the Treasury Intern) Revenue Service

Schedule A Organization Exempt Under Cform990 orKKMZ) 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.)

*■ Must be completed by the above organizations and attached to their Form 990 or 990-EZ.

WS w e only — Dp not write or staple in Ihrt tpeco.

[ OMB No. 1M5-0M7

Nam* of the Oiyamnban

Save A Li fe Foundation IEmployer Identification Number

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.*)


than $50,000


devoted to position

(c) Compensation (d) Contributions to employe* benefit plans s deferred compensation


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)

(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 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 F o u n d a t i o n 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 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:


b Lending of money or other extension of credit? ,


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 6 7 8 9

A church, convention of churches, or association of churches. Section 170(b)(l)(A)(i). A school. Section l70(b)(1)(A)(ii). (Also complete Part V, page 5.) A hospital or a cooperative hospital service organization. Section 170(b)(l)(A)(iii). A federal, state, or local government or governmental unit Section 170(b)0)(A)(v). 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.)

11 a 0 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 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.)

13 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).)


(a) Name(s) of supported organization(s)

14 f l An organization organized and operated to test for public safety. Section 509(a)(4). (See instructions.)

BAA

(b) Line number from above

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 F o u n d a t i o n 36-3869459 Page 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.

Calendar year (or fiscal year beginning In) *■ A 1998 A A > >

Total 15 Gifts, grants, and contributions

received. (Do not include unusual grants. See line 28.) . . . 6 2 1 . 0 4 3 . 6 2 1 . 2 8 9 . 1 0 1 . 3 3 0 . 3 7 . 5 6 6 . 1 . 3 8 1 . 2 2 8 .

5 5 0 . 1 . 5 2 7 . 2 . 0 7 7 . 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 . . 4 1 . 1 5 8 . 6 . 1 3 4 . 4 7 . 2 9 2 .

18 Gross income from interest, dividends, amounts received from payments on securities loans (Section SlttaXS)), rents, royalties, and unrelated business taxable income (less Section 511 taxes) from businesses acquired by the organization after June 30, 1975 2 4 . 5 7 S . 676 . 2 5 . 2 5 1 .

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 6 8 6 . 7 7 6 . 6 2 8 . 0 9 9 . 1 0 1 . 8 8 0 . 3 9 . 0 9 3 . 1.455 . 8 4 8 . , 5 5 6 . 6 4 5 . 6 1 8 . 6 2 1 . 9 6 5 . 1 0 1 . 8 8 0 . 3 9 . 0 9 3 . l j 4 0 8 . 8 4 8 . , 5 5 6 .

6 . 8 6 8 . 6 . 2 8 1 . 1 . 019 . ■ 191. 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 an

► 26a 2 8 . 1 7 1 . 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 an d amount contributed by each

96 through

•> 1999 exceeded the amount shown in line 26a. Enter the sum of all these excess amounts

by each 96 through

•> 26b

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

22

by each 96 through

•> 26c cJL40JL!5G-c Total support for Section 509(a)(1) test Enter line 24, < d Add: Amounts from column (e) for lines: 18

22 2 5 . 2 5 1 . 19

26b 26d 2 5 . 2 5 1 . e Public support (line 26c minus lin ( Public support percentage (line 2

26e 1.383 305 e Public support (line 26c minus lin ( Public support percentage (line 2 » ■ 26f 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

d Add: Line 27a total 20 21

and line 27b total o Public support Cine 27c total minus line 27d total) ( 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)) h Investment income percentage (line 18, column (e) (numerator) divided by line 27f (denominator)).

27c 27d 27e

27fl 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.)

BAA TEEA0403 12/10JO0 Schedule A (Form 990 or 990-EZ) 2000

Schedule A (Form 990 or 990-EZ) 2000 Save A L i f e Foundation 36-3869459 I Private School Questionnaire Gee instructions.)

I Only by schools that checked the box on line 6 In Part IV)

Page 4

(To be completed I

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)


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.)





d Scholarships or olher financial assistance?



B Athletic programs?


If you answered 'Yes' to any of the above, please explain, (if you need more space, attach a separate statement}



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.

N/A Yes

31

32a

32b

32c 32d

No

TEEAMM l2niX» Schedule A (Komi 990 or 990-EZ) 2000

33b

33c

33d

33e

33f

33g

34a

34b

35

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)

36-3869459 Page 5

Check here »■ Check here •>

if the organization belongs to an affiliated group. if you checked 'a' above and 'limited control' provisions apply,


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 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 there te an 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.


Calendar year for fiscal year beginning In) *-



48 Grassroots non-taxable amount.

49 Grassroots ceiling amount (150% of ling 46(e))....



(a) 2000

(b) 1999

(c) 1998

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

«0 1997 Total

(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)

Yes No

^ * ■»*!« * f e t V 5

Amount

If 'Yes' to any of the above, also attach a statement giving a detailed description of the lobbying activities. B A A 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 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) 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: (QCash (IQOther assets

b Other transactions: (l)Sales or exchanges of assets with a noncharitable exempt organization

(Ii)Purchases of assets from a noncharitable exempt organization (ill)Rental of facilities, equipment, or other assets (tv)Reimbursement arrangements (v)Loans or loan guarantees

(vQPerformance of services or membership or fundraising solicitations c Sharing of facilities, equipment, mailing lists, other assets, or paid employees d If the answer to <

the any

5i«m _?J!ft

_bJD_ _M& _bj& b(h0 b&

_bjw&

Yes

(a) Line no.

fair market value of ilr market value in

received:

No

Jt Amount involved >lee Name of noncharitable exempt organization <«D 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 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)

Name of organization (b)

Type of organization (c)


BAA 1EEA04C8 OUZOflO Schedule A (Form 990 or 990-E2) 2000


Form 990, Page 1. Part I, Line 9 Spedai Events and Activities Statement



Receipts Less

Contributions Gross


Net Income (Loss)

Dinner Event 20.800. 6.540. 14.260. 14.260. 0 . Various Merchandise 1.319. 1.319. 668. 6 5 1 .

Total 22.119. 6.540. 15.579. 14.928. 651.

Form 990, Page 2, Part il. Line 43 Other Expenses Stmt

Other expenses (itemize)

(A) Total


(C) Management and general

<D) Fundraising

Consulting Fees 38.391. 37.891. 500. 0 . Dues & Subscriptions 577. 187. 285. 105. Education 1.606. 1.156. 450. 0 . Equipment Rental 4.719. 4.323. 396. 0 . Instructors Fees 112.152. 112.152. 0. O. Insurance 5.500. 0. 5.325. 175. Licenses & Permits 680. 570. 110. 0 . Marketing 7.648. 7.648. 0. 0 . Miscellaneous 676. 204. 94. 378. Professional Fees-Other 390. 240. 150. 0 . Program Coordinator 1.666 . 1 .666 . 0 . O. Promotional 5.507. 5.278. 229. 0 . Recruitment 527. 218. 309. 0 . Reinbursed Program Fees 70. 70. 0 . 0 . Research/Evaluation 493. 493. 0 . 0 . Temporary Help 32.141. 32.141. 0. 0 .

Total 212.743. 204.237. 7.848. 658.

Form 990, Page 3, Part IV, Lines 57a & 57b Land, Buildings and Equipment Statement

(a) Cost/Other

Basis


(c) Book Value

Office Equipment 85.665. 49.878. 35.787. Vehicles 31.998. 13.160. 18.838.

Total 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



Line 65-Other Liabilities: Beginning

of Year End of Year

Instructor Deposits 0. 190. Due to Horelli Fund 393.

Total (L 5 8 3 .



<B) Title and


to position

(C) Compensation

Of not paid, enter-0-)

0>) Contributions to employee benefit plans and deferred compensation

(E) Expense account


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 fe Foundation. 9950 Lawrence Ste300. SchiUer Park. IL 60176

Total



Form 990 p 2 /L ine 42 column (C)

Description Amount

Office Equipment - Mgmt & Genl Depreciation 11.858. Vehicles - Mgmt & Genl Depreciation 5.000.

Total 16.858.


Form 990 p 3/L ine 63, column (A)

Description Amount

Due to Carol Sp izz i r r i 65.475.

Total 65.475.

SAVB A I.IFB FOUNDATION, INC. ^ — — — — — _ _ _ _ « « AODITBD FINANCIAL STATBMBNTS A HI RFf If firf* ftMPAMY DBCBHBBR 3 1 , 2000 AMD DBCBHBBR 3 1 , 1999 #%ni»DBVI*.<i£VWI'ir'Jlf«¥

CERTIFIED PUBLIC ACCOUNTANTS


TABLE OF CONTENTS

DECEMBER 31, 2000 AND DECEMBER 31, 1999

Auditor's Report



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

Exhibit


AHLBECK&COMPANY

CERTIFIED 166J ELK BOULEVARD TELEPHONE: 8<7/824-40O0 P U B U C DES PLAINES. ILLINOIS FACSIMILE: 847/824-4012 ACCOUNTANTS 60016-4798 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

EXHIBIT A

2000 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 NET BOOK VALDB Office Equipment Vehicle

Net Fixed Assets TOTAL ASSETS

333,312 $ 509,770 9,420 17,500

52,188 26,593 3,987 1,750

162 162 1.885 72.7

400.954 556.502

35,788 37,006 18.838 23.838 54.625 60.843

, 455.579 S 617.345

L I A B I L I T I E S A N D N B T A S S E T 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


TOTAL NET ASSETS

8,485 4,167-


9 190 155 393

9.232

0 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

49,294 498.410 547.704

455.579 $ 617l?45.


- 2


For the Year Ended December 3 1 , 2000

EXHIBIT fl

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

Temporarily unrestricted. Restricted T o t a l

$ 1 9 , 8 3 9 $ - $ 1 9 , 8 3 9 - 650,000 6 5 0 , 0 0 0

6 , 5 0 0 - 6 , 5 0 0 8 0 0 - 8 0 0 4 4 9 - 4 4 9

6 , 7 4 2 - 6 , 7 4 2 3 8 , 3 8 6 - 3 8 , 3 8 6 5 4 , 6 7 5 - 5 4 , 6 7 5

1 3 6 - 136

1 2 7 , 5 2 6 650 ,000 7 7 7 , 5 2 6

5 3 2 , 9 0 0 5 3 2 , 9 0 0 2 , 3 0 1 - 2 , 3 0 1

4 4 , 3 6 9 - 4 4 , 3 6 9 1 1 , 8 0 7 - 1 1 , 8 0 7 1 7 , 4 1 0 - 1 7 , 4 1 0

1 5 5 , 7 5 0 - 1 5 5 , 7 5 0 7 6 4 , 5 3 8 - 7 6 4 , 5 3 8

4 5 , 1 3 1 - 4 5 , 1 3 1 143 ,388 - 1 4 3 , 3 8 8 9 5 3 , 0 5 7 - 9 5 3 , 0 5 7

4 9 8 , 4 0 9 (498 ,409) -2 3 4 , 6 2 5 (234,625) -

6 , 8 3 0 (6 ,830) -

EXCESS INC0MB OVER EXPENSES FROM ACTIVITIES (85 ,667) (89 ,864) (175 ,531)

INVESTMENT INCOME I n t e r e s t Income

TOTAL INVESTMENT INCOMB 8 , 7 2 5 8,725

8,72S 8,725

CHANGE IN NET ASSBTS BEGINNING NET ASSETS ENDING NET ASSBTS

(76,942) 49,294

(27,648)

(89,864) 498,410

$ 408,546

(166,806) 547,704

$ 380,898


- 3 -

SAVE A LIFB FOUNDATION, INC. STATEMENT OF ACTIVITIES


EXHIBIT B

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

Temporarily Unrestricted Restricted Total

$ 1,825 $ - $ 1,825 16,831 - 16,831

- 600, 000 600,000 9,500 • - 9.500

59 - 59 680 - 680

13,150 - 13,150 9,038 - 9,038 440 - 440

51,523 600,000 6S1.523

466,901 43,503

466,901 43,503

510,404 37.357 18,353

-510,404 37,357 18,353

566,114 101,590 300,000

(101, (300,

198,

590) 000) ,.

410

566,114

(113,001)

(101, (300,

198,

590) 000) ,.

410 85,409


TOTAL INVESTMENT INCOME 24,575 24,575

24,575 24,575


(88,426) 137,720 49,294

198,410 300,000

$ 498,410

109,984 437,720

$ 547,704


- 4 -

8AV8 X UPS v^^CATIOM, IRC. BTxtaan or r o s c n o H U Q P H S S I S

Por the Tear ended Decesteer 11, 3000

.ITBTT C ,

Piugiaa

I i n

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 feae-other Printing a Reproduction Reiefeursed Prograa Pee* Recruitment Rant Repair* Research/Evaluation Telephone Temporary Help Training suppllo* Travel

Total Functional expenses

Kid's Prograa

S 1 5 7 , l i t

i 2 . * i »

1.417

1.521 I t ,231 a ,1 (1

2 ( .025

I I 4 .121 1 .151

13 . M O

1 . M l 2 * . •20

529 7 , • •« 1 ,«*»

204 13 112

■ 4 5 2 7 1 ( 1 1 ((<

2 4 0 1 * . JI7

• 241

5 , 4 ( ( 1 , («»

4 1 1 21. I I I 12, 1 4 1

4 , 201

*, 211

New Prograa Development f 1.575

(314) 101

I f taa

Corporato Pxogrens

I 7 .5(2

COS

10 4,145

»»

15.313

117

50

Slue Angela Expansion Prograa Prograoi

I 8,155 | 15.715

Branch Total Dsvelopaent Prograa

I ) « , * ! • 1227.744

Support

•71 1.212 2,174

12,125 5,117

5,100

241 150

5(7 1,035

1215) 10

( 7

12.440 70

(10)

(211 * ♦

42t

750 (14)

512,100 2,101 44,170

275 1,75*

155,750

I I , I f* 1,5*1

1,552 11,125 41,145 1,171 17,151

117 4,121 1.155

113,153

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

Management and Pundralslng oeneral I 12,2*2 5 12,121

• ,»•! 2.(2* 2,705 101 10,221

1.547 10 755

214

105

175 410 71)

17*

500

7.477

(7

5 . •SI 417 5 0 0

1 ( .151 2 5 5 1*( 4 5 0

• 5 .125

S40 11 .411

1 1 0

147 14

1 ,1 (4 373

a •

ISO (721

• 1 0 *

10 5 ) 1 ia«

4,55*

45,111 141,115

Total Organisation Support Total

t ( 4 , 5 (1 I 2*2,307 l , * ) 4 l ,**4 5.1)4 21,703

10.J3J 11.121 1,547 1,547

715 2.111 • 12.125

5.151 51,001 5 7 1 1,542 500 11,1*1

K . t S I 1( , I55 1*0 577 I K 4,71* 450 1,(01

• 112,152 5.500 5,500 1,030 1.954

14,200 4*.712 110 ( 1 0

• 7,(41 147 1,*05 4 7 ] ( 7 7

1.1(4 17.34* 172 1.124 503 1,5*3

• !,((( ISO 1*0

7,405 5*,**7 - 70

1 0 1 527

10,500 15,412 1 2 ( 1.715

• 4 1 ) 4,5(5 31.4(1

• 12.141 - 4,450 s 10,0*3

111,51* »S1,057

Management sod Oeneral Allocation

Total expenses

15.777 1,»7( 1.551 17,277 115,»*( 1 ( . ( 5 * (112.(44) ( 1 1 5 . t i l )

I (11.577 t 4,277 t 47,»23 5 11,107 8 24,114 1171,027 I II0 .S24 I «1.7l> I 10.744 I 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 Support Other Training Total Management and Orgnniaatti

Program Programs Program Pundraising General Total Total Salarlea & Wages $ 175,773 $ 13.872 $ 189,(43 $ 31,683 S 6.S2S 9 3B.207 9 317,BSO Employee Benefits 1,955 lit 2,071 116 913 1,031 3.101 Payroll Taxes 15,343 1,431 16,474 1,833 531 3,363 19.037 Accounting Fee* ie,soe 783 19,292 781 1,371 3,051 31,343 Amortization • . . . m Automobile Expense 3,749 160 2,909 193 96 386 3,197 Awards a Recognitions 199 - 199 535 . 535 734 Bank charges 351 20 171 34 12 37 408 Computer Expenses 21,063 529 31,592 563 387 950 33,542 conferences 411 68 479 44S 4S0 895 1,374 Consulting Fees 33,615 - 33,(15 • 3,150 3,150 36,765 Contract Labor 1,522 42 1,564 107 25 133 1.697 Depreciation Expense 12,313 673 12,886 808 404 1,211 14.097 Dues * Subscriptions 419 - 419 . 381 381 600 Equipment Rental 1,497 87 1,584 104 52 157 1,740 Instructor Fees 51,103 12,912 64,015 . - .» 64,015 Insurance 6,062 3S4 6,435 424 212 636 7,073 Interest Expense 3,677 211 3.118 211 127 336 4,236 Legal Fees - - - . - » . Licenses fc Permits 1,043 2 1,044 2 16 19 1.063 Marketing B.730 118 8,849 641 45 686 9,534 Meetings 522 - 522 15 319 334 856 Meoorial Fund Expenses - - - • 370 370 370 Miscellaneous 406 40 446 • 713 713 1.159 Of rice Supplies 12,659 901 13,560 883 342 1,226 14,785 Penalties - - - - - . -Postage a Delivery 5,440 296 5,736 376 106 56« 6,300 Printing k Reproduction 30,529 2,557 33,086 4,601 170 4.771 37,857 Recruitment 2,153 39 2,193 69 39 128 3,331 Rent 21,668 1,194 22,(62 1,441 708 2,150 35,012 Repairs 1,081 63 1,144 75 38 113 1.357 Research/Evaluat ion 991 51 1,043 51 31 83 1,123 Telephone 13,399 710 14,009 651 436 1,377 15,386 Training Supplies 5,115 3,687 7,102 - - . 7,803 Travel 16.889 3.587 30,476 504 413 917 31.393

Total Functional Expenses 466,901 43.503 510,404 37,357 16,353 55,710 $ 566,114

Management and General Allocation 15,126 538 IS,654 1.935 (17,589) (15,654)

Total Expenses $ 493,037 S 44,031 8 536,058 $ 39,393 $ 764 $ 40,056 $ 566,114



STATEMENT OF CASH FLOWS FOR THE YEAR ENDED DBCEMBER 31, 2000


change in Net Assets $ (166,806)

Adjustments to reconcile change in net assets to

net cash provided by (used in) operating activities:

Depreciation $ 16,8SB

Changes in assets and liabilities: Decrease (increase) in accounts receivable (2,237) Decrease (increase) in inventory (25,595) Decrease (increase) in other current assets 6,922 Increase (decrease) in accounts payable 4,318 Increase (decrease) in other payables 747 Total adjustments 1.013

Net cash provided by (used in) operating activities (165,793)

Cash FJ,OWB from Investing Activities:




Repayments on debt (25)

Net cash provided by (used in) financing activities (25)

Net increase (decrease) in cash and cash equivalents (176,458)


Cash and cash equivalents at end of period Supplemental Disclosures: Interest paid


- 7


FOR THB YEAR ENDED DBCEMBRR 31, 1999


Change in Net Assets $ 109,984




Decrease (increase) in accounts receivable (1,7SO) Decrease (increase) in inventory (26,593) Decrease (increase) in other current assets (18,389) Increase (decrease) in other payables 1,719 Total adjustments (30.9161






Payments on loan (19.907)

Net cash provided by (used in) financing activities (19.907)



Cash and cash equivalents at end of period S S09.77O

Supplemental Disclosures; Interest paid $ 4r226

THB ACCOMPANYING NOTES ARE AN INTBGRAI. PART OF THESB STATEMENTS

- 8 -

SAVE A LIFE FOUNDATION, INC. NOTES TO FINANCIAL STATEMENTS


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




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



Estimates


- 9 -





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) .



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 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

- 10 -




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:




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:

Decetnb 2000

85,665 31 ,998

er 31 , 1999

Increase (Decrease)

$

Decetnb 2000

85,665 31 ,998

$ 7 5 , 0 2 5 3 1 , 9 9 8

$ 10 ,640

117 ,663 63,037

54 ,626

107 ,023 46.180

10 ,640 16,657

$

117 ,663 63,037

54 ,626 $ 60 ,B43 $ (6 ,217)

Efint 2001 40 ,046 2002 39 ,020 2003 19 ,510

- 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 December 31. 1999 ReveflWe Expenses H@£ Revenue Expenses gg£

Dinner Event $ 1.4,260 $ 7,720 $ 6,540 $ 34,525 $ 25,487 $ 9,038 Various Merchandise B70 668 202 150 91 59

$ 15,3(30 $ 8,388 $ 6,742 $ 34,675 $ 25,578 $ 9,097

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 AMT

INIT

4 |5.J>°

M

ILLINOIS CHARITABLE ORGANIZATION ANNUAL REPORT Attorney General J I M R Y A N State of Illinois

Charitable Trust Bureau 100 West Randolph 3rd Floor Chicago Illinois 60601 CO# oi026498

Form AG990 IL Revised 6/01

Report for the Fiscal Period Beginning oi / 0 i / o i

Federal ID# 3 6 - 3 8 6 9 4 5 9 & Ending 1 2 / 3 1 / 01

MO DAY vn

Are contributions to the organization tax deductible? E Yes D No

Cheek all items attached r£ Copy of IRS Return

M * a> k Ly Audited Financial Statements J / W

w ' 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 YR

Pate Organization was created 0 2 / 0 9 / 9 3

Lf?.~ Save A Life Foundation NAME MAIL

A0DRESS 9950 Lawrence - Suite 300

CITY STATE „ . . , , , „ , - , , . « , - * ZIP CODE Schi l ler Park, IL 60176

RECEIVED MAf J 7 2002

ATTORNEY GENERAL CHARITABLE TRUST

I SUMMARY OF ALL REVENUE ITEMS DURING THE YEAR 0) PUBLIC SUPPORT CONTRIBUTIONS & PROGRAM SERVICE REV (GROSS AMTS )


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) $


L) TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD J ft K)


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



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 Sp izz i rr 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 S a v i n g F i r s t A i d T r a i n i n g X) DESCRIPTION

Y) DESCRIPTION

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? I

2 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

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 COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? 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 £ (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 - Su i t e 125, 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 Parnl S p - f g ^ r r i 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 '•'"««!.

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

te.£iRttj flGNATURE

/ft/M TMTF

TREASURER or THUS I t t (PRIHT NJ ?h*k bSL

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) ► The organization may have to use a copy of this return to satisfy state reporting requirements.

0MB No. IMS4M7 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)

► The organization may have to use a copy of this return to satisfy state reporting requirements.

2001 OaetttmCTt ol tm T n o u y Internal Rcmnu* Sarvio

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) ► The organization may have to use a copy of this return to satisfy state reporting requirements.

Open to Public Inspection

A B

For the 2001 calendar year, or tax year beginning Chock a •pslkabh:

Mint* <tung» Nnmdunga Maintain Final rekjm Afttonoao rakMH Aopucobon poncinQ

R S h M or pilot

S M tsedflc toofruc-B o n .

v N m of GfBsiuxotion

Save A Life Foundation

, 2001. and ending

Numbtr »ti»ot<orP.O. box if m i l b not oabVond'to sbwt addr) Roomfcuito

9950 Lawrence 300 Oty, Town or Country

Schiller Park State 2Peod» + 4

I L 6 0 1 7 6 e Section 501(c)(3) organizations and 4947<a)(l) rtonexempt

charitable trusts must attach a completed Schedule A (Form 990 or 990-E2).

G Website: * - w w w . s a l f . o r g

Organization type (check only one). m. 501(0 3 " Cwrtno.) D 4*7(1)0) a-O S27

K 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.

L Gross receipts: Add lines 6b, to. 9b. and 10b to line 12 * 1 . 7 5 8 . 8 9 9 .

D fa»to»»rlointtfl<JBoo rfcbtr

36-3869459 E TdtphoM

(847) 928-9683

r"|ch»(ip«crM>-E Accnnl

H onrfl an nefappfciMo to Sacftbn 337 onjanHaobRi. H ( a ) btibjagroupratnnhrolfiiiteT . . . Q v t * 0 No H ( b ) lfVn,'«0»rnuinWof*ffifatM^-H(C) AmaSsfl9rt»MudMl7 0 Y c * Q " °

01 "no; itteeh • B»t S M ■mtrudiona i

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).

Revenue, Exponsos. and Changes In Net Assets or Fund Balances (see instructions)

l a l b 1c

)

1 Contributions, gifts, grants, and similar amounts received: a Oirect public support b Indirect public support c Government contributions (grants)

*M&fr+*$ »—* t 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 6a

88.699

1.470.470

b Less: rental expenses I 6b c Net rental income or (loss) (subtract line 6b from line 6a)

7 Other investment income (describe ■*

Be Gross amount from sates of assets other lhan inventory

b Less: cost or other basis and sales expenses c Gain or (toss) (attach schedule)


(B) Other

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

b Less: direct expenses other than fundralsing expenses I 9b 7 3 . 4 9 1 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)

I d

6c

9c

10c 11 12

1.559.169. 115.423.

3.275.

2 . 7 3 0 .

7 .541 1.688.138.

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))

13 7 4 9 . 4 9 4 . 14 15_ 16_ 17

1 1 1 . 9 1 7 . 13.630.

875 .040 . 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) .

18_

19. 20_ 21

813.098. 380 .898 .

1.193.996, BAA For Paperwork Reduction Act Notice, see the separate instructions. TEEA010I 01/I67DZ Form 990 (2001)

http://www.salf.org

Save A Life Foundation 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.

Do net include amounts reported on line 6b, 8b. 9b, 10b, or 16 of Part I.

(C) Management and general (D) Fundraising

22 Grants and alkwbons (att sch) (cash $ non-cash $ .)

23 Specific assistatoj to litdMduals (att sdi) . . 24 Benefits paid b erf or numbers (att sch) . . . 25 Compensation rf 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 Depredation, dtphtion, ate (attach schedule). 43 Other expenses not covered above (itani»):

■Auto. Expense

94.309, 26 1S6.361

93,366 133.800.

27 28 11.384 29 25 .050 .

1Q.S11 23 .357

30 31 22.593 6.621 32 16.100. 15.481 33 8^054 14.082 34 24.430. 35 5.355

22.493

40.289 1.681

37 10.519. 7 .371 7.297

38 8^611 10 .020,

17.359 15.691

40 3.677 41 3.305

1.519

42 16.662

43a 1.233 1.203 bJaQX. Jeryj ce_ Fee_s_. c J ra nc h _Dey elopraent _ djCornpjiter_ JxjTens es_.

43b 2.070. 387. 43c 14.648. 43d 22 .572 .

14 .648 . 22.572

44 total fuMtJaul nptaiaT (aid linef22 • 431 ' Orgaahjtton centMlng column (B) • (o), tarry t h w b o b to line* 13-15

43e 377.798 340.055

44 875.040. 749.494.

472 13.191 9.370.

653 220. 579 1 .114 .

15.972 165 454.

2.457 8.485. 220.

3.090 1 . 7 1 7 .

584. 32 .918

3.222 ■8.783 35. •5.935 264. 1.298 860. 3 .305

16.662

30, 1.650 33.

30.751 6 . 9 9 2 .

111.917 13 .630 . 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 senrices? * f | Yea [KJ No If "Yes/ enter © the aggregate amount of these joint costs $ ; (ii) Ihe amount allocated to program services

to fundraising S ; (Hi) the amount allocated to management and general ; and flv) the amount allocated

[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) organ-izations & 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' *9«7(oV option*! tor often.)

organizations tnd iSf7(«X)) truiti; but — fid for r •

■Kid '.?_ PCPBiaras_-_ Prompt ton_a_nd_ teach 1ng_qf_ l i f e .saying f i rst J i l 3 i l 0 i I»ipJ£Isch<rol~chJ Idren1(66~1J6_chiTdren Jtaught^

(Grants and allocations $ ^ J . 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

236.180.

(Brants and allocations S ±A c_Biye.Angels .Program_-_Pxogiot_1 onjand_teach_1 ng_pf _lj.fi_savinj_fijrst J i l 3-9-%&§_R°3 ICA. I i IE?. 3£3*?_°.f. I UJD_,l?

7.413.

(Grants and allocations S ^ J . d Jra/u:h_Dj!velj>£mejit/r^xpansjon program j_Expand, to _sateU_te_ of fj ce _

inf id i andoutsfde the~State of I l l inois

31.604.

(Grants and allocations S JL_L 4 7 2 . 4 8 9 . e Other prooram services.. .See. a t t a c h e d (Grants and allocations $ i_L 1■808. f Total of Program Service Ekpenses (should equal line 44, column (B). program services) 749 .494 .

BAA lEEAOtoe oinnnz Form 930 (2001)

http://_lj.fi

Form990(2001) Save A L i fe Foundation 36-3869459 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



47a 47b

48a 48b

2 . 9 0 7 .

2 0 . 0 0 0 .


51 oOttwr notes & loans receivable (attach »lt) b Less: allowance for doubtful accounts

52 Inventories for sale or use 53 Prepaid expenses and deferred charges.

51a

Beginning of year

51b

54 Investments - securities (attach schedule) * Q Cost[[] FMV 55a Investments - land, buildings, & equipment: basis


55a

55b 56 Investments - other (attach schedule) 57a Land, buildings, and equipment: basis .

b Less: accumulated depreciation (attach schedule) L.-.57.. Stmt.

57a

57b

118 .338

58 Olher assets (describe •> See l i n e 58 Stmt 59 Total assets (add lines 45 through 58) (must equal line 74)

7 9 . 6 9 9 . . ) •

500 3 3 2 . 8 1 2

3.987

52.188

45 46

47c

48c 49

50

51c 52

11.305

5 4 . 6 2 5 162

4 5 5 . 5 7 9

53 54

55c 56

57c 58 59

Page 3

_ (B) End of year

115 .104 . 300 .464 .

2 . 9 0 7 .

20.000. 718.887.

47.209. 17.398.

3 8 . 6 3 9 . 11 .185 .

1.271.793. 8.702. 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 » See L i n e 65 Stmt 66 Total liabilities (add lines 60 through 65)

[Xjand complete lines 67 Organizations that follow SFAS117, check here through 69 and lines 73 and 74.

67 Unrestricted 68 Temporariry restricted 69 Permanently restricted

Organizations that do not follow SFAS 117, check here 70 through 74. Capital stock, trust principal, or current funds Paid-in or capital surplus, or land, building, and equipment fund Retained earnings, endowment, accumulated income, or other funds.

8 . 6 4 8 60 61 62

6 5 . 4 5 0 63 64* 64b

583. 65 74.681 66

■27.648 4 0 8 . 5 4 6 68

Q and complete lines 69

70 71 72 73

70 71 72

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). 3 8 0 . 8 9 8 4 5 5 . 5 7 9 . 74

68 .755 .

340. 77,797.

112 .566 . 1 . 0 8 1 . 4 3 0 .

1 .193 .996 . 1 . 2 7 1 . 7 9 3 .

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 36-3869459 Page 4

I Reconciliation of Revenue per Audited Financial Statements with Revenue per Return (See instructions.)

Reconciliation of Expenses per Audited Financial Statements with Expenses per Return

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 services and use of facilities . . .

■ Total expenses and losses per audited financial statements •


(1) Donated services and use of facilities S

(2) Prior year adjustments reported on lint 20, Form 990.

1 . 0 2 5 . 4 0 3 .

(3) Recoveries of prior year grants S ,

(4) Other (specify): See Attached

(3) Losses reported on lino 20, Form 990..

(4) Other (specify): See A t t a c h e d

$.

$

150.364, 150.363 Add amounts on lines O ) through (4) Line a minus line b

Add amounts on lines (1) through (4). Line a minus line b


0 ) Investment expenses not included on line 60, Form 990 $_


Amounts Included on line 17, Form 990 but not on line a:

0 ) Investment osxnses net included en line 6b, Form 930 $



a Total revenue per line 12, Form 990 (line c plus line d)

Add amounts on lines f l ) and (2) • • -

e Total expenses per line 17, Form 990 (line c plus line d) «-

Wm List of Officers, Directors. Trustees, and Key Employees gist each one even If not compensated; see instructions.)


per week devoted to posib'on

(C) Compensation (If not paid,

entofO-)




allowances

jCa r_oJ_ Sp_i 2 zi_rf i. Pres/Exec Dir 40 94.309 2.290 _0,

0, Sam Amirante

Vice President Daniel Caravello

Treasurer _0.

JL JL JL JL JL 0.

Martin A. Sandoval Secretary

Carlos M. Azcotia Director

.Pi ■- _s£«LnJey. Jl* \P_ Director

Dr. Scott Betzelos Director

Deloris M. Burnam Director

Michael Lavalle D i r e c t o r

See List of Officers. Etc. Statement 0, 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. DY«* BNo

BAA TEEA0104 10/18X11 Form 990 (2001)

Form 990 i Save A Life Foundation I O ther I n f o r m a t i o n (See specific instructions.)

76 Oid Ihe organization engage in any activity not previously reported to the IRS? If 'Yes,' attach a detailed description of each activity


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 vaar? If 'Yn« ' attach a statement 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?

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?


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 I I . (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?


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 8Sf ta its reasonable estimate of

dues aliocablo 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 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


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 " !?. «► 0 .

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 90b | " 91 The books are in care of * j : a r o _ l _ S p J z z i j * r i Telephone number •> _ ( 8 4 7 ) 9 2 8 - 9 6 8 3 _

Located at ^ i95Q_ LaênM_Strite J00 Jk:hUJer__Park IL_ ZIP+4 ►60176 92 Section4947(a)(1) nonexemptcharitable frusfs King Form~99oWileVof Form 1041 - Check here".7.7 . 7 7 7 7.7 *•"[]

and enter the amount of tax-exempt interest received or accrued during the tax year H 92 | BAA Form 990 (2001)

TEEAOIOS 01/01/02

Form 990 goot) Save A Li fe Foundation Analysis of Income-Producing Activities (See instructions.)

36-3859459 Page 6

Note: Enter gross amounts unless otherwise indicated.

93 Program service revenue: » Program Fees b Course Materials c 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:


98 Met rental income or (loss) from pers prep . . . 99 Other investment income


101 Net innme or (loss) from special events 1 0 2 GrottpreGtofOott) from t»ta» of imantocy...

103 Other revenue: a bMiscellaneous c d


Business code Amount fe,«JS««| Excluded by section 5 ) 2 , 5 1 3 , or 514

104 Subtotal (add columns (6), <D), and (£)). 105 Total (add line 104, columns (B), (D), and (E)>.

Note:[Une JOS plus line Id. Part I. should equal the amount on line IZ Part I.

14

Amount

3.275

2 . 7 3 0 .


1 7 . 9 7 9 . 9 7 . 4 4 4 .

7 . 5 4 1 .

6.005 122.964. 128.969.

Una No.

93a.93b 103a

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). Promote and teach l i f e saving f i r s t aid programs. To supplement funding required to perform and carry out the l i f e saving f i r s t aid programs.

Information Regarding Taxable Subsidiaries and Disregarded Entities (See instructions.) (A)


(B) Percentage of

ownership interest %

% %

Nature of activities (D)

Total 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 w

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).

No No

Please Sign Here

Paid Pre-

Earer's se

Only

Undar USMA'feL^^ knoarlado* and baGaf, i t »

Signibtra of Offico Data

Typa or Print Nam* and Titta

Praparw'a Signature

Firm'i turn* (or younif

I and k w i . H . and Z I P * *

Ahlbeck & Company 1665 Elk Blvd.

Data

Pes Plaines IL 600164721 BAA

Ctwckif aalf- £1 P00237637

EIN ► 136-2991500 Phonano - ( 8 4 7 ) 8 2 4 - 4 0 0 0

TEEA010S 0)101/02 Form 990 (2001)

Schedule A (Form 990 or 990-EZ)

Dopwtimfitof to Treasury Internal Ravaflw Sanica

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 Maim <K th* Oigtnizalien

Save A Life Foundation Entpteyw Idtntifieitien Monbw

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.')


than $50,000


devoted to position

(c) Compensation (d) Contribution! to employe* benefit pteu * deferred compensation


allowances

Laura F i l i p j j e U i

NM. Protect Coordinator. 4 0 58.000. 0 . 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.")


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 F o u n d a t i o n 36-3869459 | Statements About Activities (See instructions.) Yes No

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.) 1

Organizations that made an election under section 501 (h) by filing Form 5768 must complete Part VIA. Other - ■ ■ * - - " " " ■ ■ - j c n 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.)


b Lending of money or other extension of credit? 2b

c Furnishing of goods, services, or facilities? 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? _ 2 e

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.

2c

2d 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 [ 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 ^ 10 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.)

13 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).)


(e)Name(s) of supported organizationfs) (b) Line number from above

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

BAA 1EEA0402 01/2102 Schedule A (Form 990 or Form 990-EZ) 2001

schedule A (Form 990 or 990-EZ) 2001 Save A L i f e Foundat ion 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 •ft lft A to)

Total 15 Gifts, grants, and contributions

received. (Do not include unusual grants. See line 28.) . . . 6 8 2 . 8 7 8 . 6 2 1 . 0 4 3 . 6 2 1 . 2 8 9 . 1 0 1 . 3 3 0 . 2 . 0 2 6 . 5 4 0 .

16 Membership fees received 5 5 0 . 5 5 0 .

17 Crow receipts from admissions, merchandise sold or services performed, or furnishing of facilities m any activity that is related to the organization's

5 2 . 6 6 4 . 4 1 . 1 5 8 . 6 . 1 3 4 . 9 9 . 9 5 6 . 18 Grass income from interest, dividends,

amounts received from payments on securities loans (Section S12UX5)). rents, royalties, and unrelated business taxable income (lets Section 511 tans) from businesses acquired by the orpan-

8 . 7 2 5 . 2 4 . 5 7 5 . 676 . 3 3 . 9 7 6 .

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

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 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 7 4 4 . 2 6 7 . 686 .776 . 6 2 8 . 0 9 9 . 1 0 1 . 8 8 0 . 2 . 1 6 1 . 0 2 2 . 24 Line 23 minus line 17 6 9 1 . 6 0 3 . 6 4 5 . 6 1 8 . 6 2 1 . 9 6 5 . 1 0 1 . 8 8 0 . 2 j j ) 6 l J D 6 6 .

7 . 4 4 3 . 6 . 8 6 8 . 6 . 2 8 1 . 1 . 0 1 9 . 26 Organisations described on lines 10 or 1 1 : a Enter 2% of amount in cc

b Prepare a list for your records to show the name of and amount contributed by each person (other ilumn (e), line 24 .. . *• 26a 4 1 . 2 2 1 . 26 Organisations described on lines 10 or 1 1 : a Enter 2% of amount in cc

b Prepare a list for your records to show the name of and amount contributed by each person (other than a governmental unit c ir publicly wtthvoar

retain. Enter the total of all these excess a c Total support for Section 509(a) (1

ir publicly wtthvoar

26b retain. Enter the total of all these excess a c Total support for Section 509(a) (1 ) test: Enter line 24, ( >» 26c 2 . 0 6 1 , 0 6 6 . d Add: Amounts from column (e) for lines: 18 3 3 , 9 7 6 . 19

»» ►»

1 , 0 6 6 .

22 26b »» ►»

26d r ^ 3 3 . 9 7 6 . e Public support (line 26c minus lini f Public support percentage (fine 2i

; 26d total) »» ►» 26e 2 . 0 2 7 . 0 9 0 . e Public support (line 26c minus lini

f Public support percentage (fine 2i So (numerator) divided by line 26c (denominator)) »> 26f 9 8 . 3 5 % 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).

c Add: Amounts from column (e) for lines: 17

d Add: Line 27a total

(1998) (1997). 15 20

16 21

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 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)).

27c 27d 27e

ZTfl 27h

%

28 Unusual Grants: For an organization described in line 10, 11 , 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 th your ratum. Do not include these grants in llna 15.

BAA TEEAM03 12/31/01 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


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.)




dCopies of all material used by the organization or on its behalf to solicit contributions?







• Educational policies?




If you answered 'Yes' to any of the above, please explain. (If you need more space, attach a separate 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.

29

30

Yes No

32a

32b

32c 32d

33a

33b

33c

33d

33e

33f

33a

33h

34a

34b

35 TEEAO40* OS/ZSAI Schedule A (Form 990 or 990-EZ) 2001

scheduiBA(Form990or990EZ)200i Save A l i f e Foundation 36-3869459 ]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. Check *■ b | | if you checked V and'limited control'provisions apply,

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

O) To be completed

for all electing organizations

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 -

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 but rot over $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.


Lobbying Expenditures Owing 4 -Year Averaging Period

Calender year (or fiscal year beginning In) *

(a) 2001 2000 1999

<«0 1998

(•) Total




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

X b Paid staff or management (include compensation in expenses reported on lines c through h.) X

X 0 . X 0 . X 0 . X 0 . X 0 . X 0 .

0 . If 'Yes' to any of the above, also attach a statement giving a detailed description of Ihe lobbying activities.

BAA Schedule A (Form 990 or 990EZ) 2001

TEEA0405 12/31/01

Schaduie A (Form 990 or 990-E2) 2001 Save A L i fe foundation 36-3869459 Page I I Information Regarding Transfers To and Transactions and Relationships With NoncharitaUe 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: (DCash


(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

Yes No 51a(l) X

■ 01) X

b(l> X bflf) X b(HD X bflv) X b(v) X b<V0 X c X

show the fair market value of ess than fair market value in services received:

Line no. ntin Amount involved A 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 ._. __ described in section 501(c) of the Code (other than section 501 (c)(3)) or in section 527? *■■[_] Yes |Xj No

b If *Yes,' complete the following schedule: (a)

Name of organization 0>)


BAA TEEA0M6 09/2SAH Schedule A (Form 990 or 990EZ) 2001


Form 990, Page 1. Part I, Line 9 Special Events and Activities Statement



Receipts Less

Contributions Gross


Net Income (Loss)

Dinner Event 115.325. 44.564. 70 .761 . 70 .761 . 0 . Other 2.730. 2 .730. 2 .730 .

Total 118.055. 44.564. 73 .491. 70.761. 2 .730 .

Form 990, Page 2. Part II, Line 43 Other Expenses Stint

Other expenses not covered above (itemize):

(A) Total

<B) Program services


(P) Fundraising

Consul t ine Fees 126.555. 111.567. 8 .466. 6 .522. Dues & Subscriptions 184. 22 . 137. 25. Instructors Fees 105.478. 104.998. 480. 0 . Insurance 9.238. 7 .302. 1.902. 34. Licenses & Permits 1.770. 105. 1.665. 0 . Marketinn 8.035. 6 .809. 980. 246. Miscellaneous 6.707. 245. 6 .380. 82. Recruitment 4.263. 4 . 2 1 1 . 52. O. Cost of Goods Sold 10.724. 966. 9 .675. 83. Training & Development 1.238. 1.238. 0 . 0 . Training Supplies 99.426. 100.669. - 1 .243 . 0. Website 4.180. 1.923. 2 .257. 0 .

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

0») Accumulated Depreciation

(c) Book Value

Office Equipment 86.340. 61.539. 24 .801 . Vehicles 31.998. 18.160. 13.838.

Total 118.338. 79.699. 38.639.

Form 990, Page 3, Part IV. Line 58 Other Assets Statement

Line SB • Other Assets: Beginning

of Year End of Year

Deposits 162. 0. Credit Card Deposits Outstanding 0. 11.185.


Form 990, Page 3, Part IV, Line 58 Other Assets Statement

Continued

Line 58 - Other Assets: Beginning

of Year End of Year

Total 162 . 1 1 . 1 8 5 .



of Year End of Year

I n s t r u c t o r Deposi ts 190 . 3 4 0 . Due to M o r e l l t Fund 393 . 0 .

Total 5 8 3 . 3 4 0 .


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


Robert Conrov D i r e c t o r 0 . 0 . D i r e c t o r 0 . 0 . 0 .

Wayne Roberts D i r e c t o r 0 . 0 . D i r e c t o r 0 . 0 . 0 .

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 fe Foundation, 9950 Lawrence Ste 300, Schiller Park, I I 60176

Total 0. 0. 0.



Form 990 p 2/line 42 column (C)

Description Amount

Depreciation Expense - Office Equipment 11.662. Depreciation Expense - Vehicle 5.000.

Total 16.662.


Form 990 p 2/0ther Program Service Exp

Description Amount

New Program Development - Research and development 1.808. for new wavs to serve the community.

Total 3.808.


Form 990 p 3/Line 63, column (B)

Description Amount

Due to Carol Splzzlrrl, President/Exec. Director 68.755. Interest Rate - Variable

Total 68.755.


Form 990 p 4/Part IV-A, Line b(4)

Description Amount

Donated Materials, Services, and Facilities 79.602. Special Events Expense 70.762.

Total 150.364.

Save A Life Foundation 36*3869459 4


Form 990 p 4 /Part IV-B, Line b(4)

Description Amount Donated Materials, Services, and Facilities 79.602. Special Events Expenses 70.761.

Total 150.363.


AUDITED FINANCIAL STATEMENTS

DECEMBER 31.2001 AND DECEMBER 31, 2000



TABLE OF C O N T E N T S 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

4

Statements of Functional Expenses For the Years Ended December 31.2001 and December 31.2000

8

Comparative Statement of Cash Flows For the Years Ended December 31,2001 and December 31, 2000

12

NOTES TO FINANCIAL STATEMENTS 13

AHLBECK&COMPANY

CERTIFIED 1663 ELK BOULEVARD TELEPHONE: 847/B24-4000 PUBLIC DES PLAINES. ILLINOIS FACSIMILE: 647/824-4011 ACCOUNTANTS 60016-4798 WEB: www.ihlbeckco.com

February 20,2002


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 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-âr-

1

http://www.ihlbeckco.com


COMPARATIVE STATEMENT OF FINANCIAL POSITION

December 31,2001 and December 31,2000

2001

Total Current Assets 1,213,154

2000

A S S E T S

Current Assets Cash and Cash Equivalents $ 415,568 $ 333,312 Inventory 47.209 52,189 Trade Receivables 2,907 3,987 Grants Receivable 718,887 . Credit Card Deposits Outstanding 11,185 • Prepaid Legal Fees 16,398 9,420 Other Prepaid Expenses 1,000 1.884

400,792

Fixed Assets at Net Book Value Office Equipment Vehicles

Total Net Fixed Assets

24,801 13.838

38,639

35.788 18.838

54,626

Other Assets Promises to Give Deposits

20.000 its - 162

Total Other Assets 20,000 162

TOTAL ASSETS 1,271,793 455,580


2

S A V E A L I F E F O U N D A T I O N . INC.


December 31,2001 and December 31, 2000

2001 2000

L I A B I L I T I E S AND NET A S S E T S

Current Liabilities Accounts Payable $ 8,702 $ 8,485 Sales Tax Payable - 9 Instructor Deposits 340 190 Health Insurance Withheld - 155 Due to Morelli Fund . 393

Total Current Liabilities 9,042 9,232

Other Liabilities Due to Carol Spizzirri 68,755 65,450

Total Other Liabilities 68,755 65,430

TOTAL LIABILITIES 77,797 74,682

Net Assets Temporarily Restricted 1,081,430 408,546 Unrestricted 112,566 (27,648)

Total Net Assets 1,193,996 380,898

TOTAL LIABILITIES & NET ASSETS 1,271,793 455,580


3


STATEMENT OF ACTIVITIES

For the Year Ended December 31,2001

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

Temporarily Unrestricted Restricted

221,083

Total

123,674

1,475 20,000 $ 21,475 22,660 - 22,660 79,602 - 79,602 117,346 - 117.346

20,000 241,083

- 600,000 600,000 - 870,470 870,470 - 1,470,470 1,470,470

17,979 — 17,979 7,542 - 7,542

97,444 - 97,444 709 - 709

123,674

TOTAL INCOME (balances carried forward) 344,757 1,490,470 1,835,227


4



For the Year Ended December 31,2001

TOTAL INCOME (balances brought forward) 344,757 1,490,470 1,835,227


EXPENSES

Program Kids Program 236,180 - 236,180 New Program Development 1,808 - 1,808 Corporate Program 7,413 - 7,413 Blue Angels 31,604 - 31,604 Expansion Program 202,816 - 202,816 Branch Development 348,774 - 348,774

Total Program 828,595 828,595 Management and General 112,417 112,417 Fundraising 13,630 13,630

Total Functional Expenses 954,642 954,642 Special Event Expenses 70,761 70,761

TOTAL EXPENSES 1,025,403 - 1,025,403

Release from Restrictions - HHS/CDC 202,272 (202,272) Release from Restrictions - 1DPH 573,283 (573,283) Release from Restrictions - DCCA 42,030 (42,030)

Excess Income Over Expenses 136,939 672,885 809,824

Investment Income Interest Income 3,275 - 3,275

Total Investment Income 3,275 - 3,275

Change in Net Assets 140,214 672,885 813,099 Beginning Net Assets (27,648) 408,545 380,897 Ending Net Assets 112,566 1,081,430 1,193,996


5



For the Year Ended December 31, 2000 Temporarily

Unrestricted Restricted Total

INCOME


19,839 $ 6,500

54,675 15,130

19,839 6,500

54,675 15,130

Total Public Support 96,144 96,144

Government Contracts State of Illinois - 1DPH State of Illinois - DCCA

600,000 50.000

600,000 50.000

Total Government Contracts 650,000 650,000

Other Income Program Service Fees Miscellaneous Conferences Fundraisers/Sales

38,386 136 800 449

38.386 136 800 449

Total Other Income 39,771 39,771

TOTAL INCOME (balances carried forward) 135,915 650,000 785,915


6

SAVE A LIFE FOUNDATION. INC.



TOTAL INCOME (balances brought forward) 133,915 650,000 785,915

Unrestricted Temporarily

Restricted Total

EXPENSES

Program Kids Program New Program Development Corporate Program Blue Angels Expansion Program Branch Development

Release from Restrictions - ISBE Release from Restrictions - IDPH Release from Restrictions - DCCA

532,899 2,302

44,370 11,807 17,409

155,750

498,409 (498,409) 234,625 (234,625)

6.830 (6,830)

532,899 2,302

44,370 11,807 17,409

155.750

Total Program 764,538 764,538 Management and General 143,389 143,389 Fundraising 45.131 45,131

Total Functional Expenses 953,058 933,058 Special Event Expenses 8,388 8,388

TOTAL EXPENSES 961,446 961,446

Excess Income Over Expenses (83,667) (89,864) (175,531)

Investment Income Interest Income 8,725 8,725


Change in Net Assets (76,942) (89,864) (166,806) Beginning Net Assets 49,294 498,410 547,704 Ending Net Assets (27,648) 4 0 8 X 6 380,898


7

S A V E A L I F E F O U N D A T I O N , I N C .

STATEMENT OF FUNCTIONAL EXPENSES For the Year Ended December 31, 2001

PROGRAM

Kid's New Program Corporate Expansion Program Development Program Bine Angels Program

Salaries & Wages $ 74,910 $ 1.100 Employee Benefits 3,981 2 Payroll Taxes 8,807 155 Automobile 674 . Bank Service Fees 332 11 Branch Development 54 -Computer Expenses - -Conferences & Meetings 135 -Cost of Good Sold - -Depreciation - -Dues & Subscriptions 22 -Equipment Rental 2.663 -Instructor Fees 55,288 -Insurance 173 . Legal & Accounting 2,168 -Licenses & Permits 25 . Marketing & Promotional 1,497 -Meetings 656 -Miscellaneous 110 -Operating Interest - • Office Supplies 1,986 -Postage 67 -Printing & Reproduction 16,414 -Professional Fees 36,314 417 Recruitment 61 . Reimbursed Program Fees - -Rent - -Repairs & Maintenance 678 • Research & Evaluation - . Telephone 6,744 123 Training & Development 1.000 • Training Supplies 17.603 -Travel 3,774 -Web Site 44 . Total Program Expenses Administration Allocation Total Expenses

11

4,251

1.500 $ 83.978 1.789

774 7,247 107

955

9,263 238

23,100

1.264

2,427 8.483

3,132

- - 7.363 - 13 715

945 • -1,167 1,000 26,661

- - 2,012

- ■ 17,081 - - 625

. . 7,321 17 - -

1,022 17.861 968 - - 6,688 - - • 1,855

236,180 1,808 7,413 31,604 202,816 39,232 713 - 1.826 -

275,412 2,521 7,413 33,430 202,816


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STATEMENT OF FUNCTIONAL EXPENSES For the Year Ended December 31,2000

PROGRAM

Kid's New Program Corporate Expansion Program Development Program Blue Angels Program

Salaries & Wages $ 157,328 $ 1.575 S 7,562 $ 8,855 $ 15,735 Employee Benefits - - - - -Payroll Taxes 12,920 (283) 604 873 1,281 Automobile - . . m _ Bank Service Fees 1.523 30 _ _ _ Branch Development - - - - . Computer Expenses 12.109 - - . . Conferences & Meetings 8,861 - 10 - . Depreciation - - - - . Dues & Subscriptions 88 - 99 - . Equipment Rental 4.323 - - . . Instructor Fees 92.940 - 19.212 . . Insurance - - - - _ Legal & Accounting 30,117 888 - . 150 Licenses fir Permits 520 - 50 . • Marketing & Promotional 16,336 - - . _ Meetings 1,659 9 - - . Miscellaneous 205 - - - . Operating Interest 1,991 16 117 . 243 Office Supplies 13,382 - - - . Postage 7,661 - - 429 . Printing & Reproduction 38,387 - 12,440 750 . Professional Fees 60.071 - 4.165 900 _ Recruitment 248 - (30) , _ Reimbursed Program Fees - - 70 . , Rent 5.466 67 - - . Repairs & Maintenance 1,669 - - . . Research & Evaluation 493 . . . _ Telephone 23,894 - - . . Training fir Development 1.156 - • - . Training Supplies 4,203 - (28) . . Travel 8.231 - 99 _ . Web Site 27,119 - - - -

Total Program Expenses 532,900 2,302 44,370 11,807 17,409 Administration Allocation 85,777 1,976 3,552 - 7,404 Total Expenses 618,677 4,278 47,922 11,807 24,813


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COMPARATIVE STATEMENT OF CASH FLOWS

For the Years Ended December 31.2001 and December 31.2000

2001 2000


Change in net assets $ 813.099 $ (166.806)


Depreciation 16,662 16.858

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


1,080 (2,237) 4,980 (25.595)

(736,167) 6,922 (19,838) -

217 4.318 2,898 747

82,931 (165,793)


Purchase of fixed assets Net cash provided by (used in) investing activities

(675)

(675)

(10.640)

(10,640)


Repayment of debt Net cash provided by (used in) investing activities

Net increase (decrease) in cash & cash equivalents 82,256

(25)

(25)

(176,458)

Cash & cash equivalents at beginning of period Cash & cash equivalents at end of period

333,312 415,568

509,770 333,312

Supplemental Disclosures: Interest paid 3,305 $ 3.954


12

SAVE A LIFE F O U N D A T I O N . INC.


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.


• 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.


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



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 F O U N D A T I O N , INC.


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 $ 5,000 Receivables in one to five years 15,000

NOTE 6 - FIXED ASSETS

At December 31,2001 and 2000, the costs of such assets were as follows:


$

S

December 31 2001

86.340 $ 31.998

118,338 79.699 38,639 $

2QQQ 85,665 31,998

117,663 63.037 54.626

Increase (Decrease*

$ 675


$

S

December 31 2001

86.340 $ 31.998

118,338 79.699 38,639 $

2QQQ 85,665 31,998

117,663 63.037 54.626

675 16.662

$ (15.987)

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 F O U N D A T I O N , I N C


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


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

December 11 7000 R£Y£nU£ Expenses Njtf $ 14,260 $ 7.720 $ 6,540

870 668 202 2.021 2,021

$ 117,346 $ 70,761 $ 46,585 $ 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

Form AG990-Revised I.

ILLINOIS CHARITABLE ORGANIZATION ANNUAL REPORT Attorney General LISA 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 attached Report for the. Fiscal Period:. , . E copy of IRS Return Beginning oi / oi /2002

2002 Federal ID # 363869459 & Ending. 12 , 31 /

Make Cheeks 83 Audited Financial Statements

ctarfv L-1 $15.00 Annual Report Filing Fi BurnuFu** a S100.00 Late Report Filing Fe.

Are contributions to the organization tax deductible? C3 Yes Q No

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

I. SUMMARY OF ALL REVENUE ITEMS DURING THE YEAR: D) PUBLIC SUPPORT. CONTRIBUTIONS & PROGRAM SERVICE REV. (GROSS AMTS.)


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



J1) JOINT COSTS ALLOCATED TO PROGRAM SERVICES (INCLUDED IN J): $


L) TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD J & K)


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


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 Snizzirri . President-

U) NAME. TITLE: Linda Post . Finance Director

A) ASSETS

B) LIABILITIES

C) NET ASSETS

PERCENTAGE

A ) $

B ) $

C ) S

24.77 % 77.76 %

(2.53) % 100%

D ) S

E ) $

F ) $

G ) $

V) NAME. TITLE: D a n e N e a l . D i r e ( l t o r o f M e d l a R e i a t : j n n g

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

W) DESCRIPTION: L 1 £ e Savine First Aid Training X) DESCRIPTION:

Y) DESCRIPTION:

T ) S

U ) $

V ) $

972 ,4U

99,127 873,291

AMOUNT

272.QOP 856.81? (27,745

1,101.982

1.19?..rH6

95.33C 41,215 39.61J


W)#

X ) # -OJJ

Y ) #


1. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION, FINE. PENALTY OR JUDGMENT?

2. 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?

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?

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

5. 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 )

7a. DID THE ORGANIZATION ALLOCATE THE COST OF ANY SOLICITATION, MAILING, ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES?

:(ii) THE AMOUNT 7b. IF-"YES". ENTER (i) THE AGGREGATE AMOUNT OF THESE JOINT COSTS $ 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? 8.

9. HAS THE ORGANIZATION EVER BEEN 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? 1 0

11. 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. Bensenvi l le . 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 (847) 928-9683

ALL ATTACHMENTS MUST ACCOMPANY THIS REPORT • SEE INSTRUCTIONS

NO

X i

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.

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.

"TRFASUREFTBrPROSTEElPRIFirNSfl'

SIGNATURE ( DATf /■

M M / ) ^ B-ktiuat foiiA SIGNATURE 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)


CM8 No. 15454047

2002 Open to Public

Inspection A B

For the 2002 calendar year, or tax year beginning 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 instructions.

, 2002, and ending C Name of organization

Save A Li fe Foundation Number street (or P.O. box H mail is not delivered to street aOdr) Room/suite

9950 Lawrence 300 City, town or country

Schiller Park State ZIP code* 4

IL 60176 • Section 501(c)(3) organizations and 4947(a)(1) nonexempt

charitable trusts must attach a completed Schedule A (Form 990 or 990-EZ).

G Website:^ WWW.salf.org Organization type (check only one) . • * ~ | X ] 501(c) 3 ■* (insert no.) | _ | <947fa)t;n or M S27

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 .

0 Employer Identification Number

36-3869459 E Telephone number

(847) 928-9683 F aso?n9 Qc^r

l l Other (specify)*- 0 Accrual

H andl ate net aopncaMe to section 527 orotnoations

H ( a ) Is this a grotp return for affiliates? . . . | _J Yes i X j No

H ( b ) If "res." enter numser of affiliates *"

H ( c ) Are all aff.liates included? Q Yes Q No (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(] K o

I Enter 4-diqit GEN . M

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

a Direct public support b Indirect public support c Government contributions (grants) d Total (add lii 'Ti

l a l b l e

a through 1c) (cash 1?* s 9 5 0 . 7 6 5 . noneash $

9 3 . 9 4 6 .

856.819 I )

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

2 3 4 5 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

I d 950 .765 . 178 .962 .

2 . 1 5 4 .


6c

(B) Other

3.091 •3.091


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)) ~ T . | 8d|

9 Special events and activities (attach schedule) a Gross revenue (not including $ 6 1 . 0 9 3 . of contributions

reported on line la)

- 3 . 0 9 1 .

9 b b Less: direct expenses other than fundraising expenses c Net income or (Joss) from special events (subtract line 9b from line 9a) See . .L.-.9. .Stmt I 9cl

9a 3 2 . 5 1 3 . 59.546.1

10a Gross sales of inventory, less returns and allowances b Less: cost of goods sold 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)

10a 10 b

-27.033.

13 14 15 16 17

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 (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.

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

225. 1 .101 .982 1 . 1 9 2 . 8 4 6 .

120 ,044 . 109.797,

1 , 4 2 2 . 6 8 7 . •320 .705 .

1 . 1 9 3 . 9 9 6 .

873.291 TEEA01O1 09/O5SO2 Form 990 (2002)

http://WWW.salf.org

Form990(2002) Save A L i f e Founda t ion Forrn990(2] 36-3869459 Statement of Functional Expenses 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):

a Auto_ Expjn se b J3Q.K. Ie ry ice_ Fees c $L ilFii J>2 ¥.C-ofi™?!11 d_Cornpjiter_ E x p e n s e s e Jee_ptherî(penses Stmt

44 Total functional expenses (add lines 22 ~43).~ Organizations completing columns (6) • (0), carry these totals to lines 13-15

* Q ifyou are following SOP 98-2. Joint Costs. Check 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 $ : (Hi) 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? •■ . 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) organ-izations and 4947(a)(1) nonexempt charitable trusts must also enter the amount of grants & allocations to others.)

aJ?il'j_^ri>SCaJ?£_"_EL0JP2Uon._ai?d - teaching, o f _Ute_ saving, f i r s t J l l J 2 J-UU!9 i s_ .school -ChiLdre iT jSL 951 chi_ldre_n~taii£htj_~ ~

Program Service Expenses (Requited lor 501(c)(3) and

raofo*-'""" I7(ax

(4) organizations and *W(aXO trusts: but optional for others.)

(Grants and allocations $ ±±1 b i °CPi>£ a i J_PrPBL aJ_l f EPjnotLOD-^pd AejchJiJg J>J JJt* j a v J "S_ _ JiCS_t_aid_to_indi yidual_s_other "than. schpol . - j ie ~chUdren" ~

(Grants and allocations $ ^ J L c_B I ue_ Arise Is _P 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 J i l _t o _t_he j>o l ice_1.n_ the . S t_a_te _of _I U i noi s

(Grants and allocations % ±A d 3L anch _De ve_l ograen t /Exganj io_n_ P rpg r am_ z. J x p_and _to_ sate U_i te_ _pf fi_ce _ins_ide and outs ide the Sta te"o f I l l i n o i s

(Grants and allocations $ e Other prog/am services (Grants and allocations $

^ _ L

f Total of Program Service Expenses (should equal line 44, column (B). program services) B A A TEEA0102 01/22/03

344.020,

11.382.

12 .890.

824 .554 .

1 .192 .846 .

i. • : - ; K A » ' .&/£Z*>Jst£&f*i*r. :

Form 990 (2002)

Form990(2002) Save A Life Foundation 36-3869459 Page 3

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 Less: allowance for doubtful accounts




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


56 Investments - other (attach schedule) 57a Land, buildings, and equipment: basis

b Less: accumulated depreciation (attach schedule) L- S7. .S tmt

58 Other assets (describe ► See 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 tmt 66 Total liabilities (add lines 60 through 65)

| and complete lines 67

LJ and complete lines

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 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 1 2 , 5 6 6 . 1 . 0 8 1 . 4 3 0 .

67 68 69

70 71

1 . 1 9 3 , 9 9 6 . 1 . 2 7 1 . 7 9 3 .

72

1

227,529. 645.762.

873.291. 972,418.

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 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.)

36-3869459 Page 4 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:


Total expenses and losses per audited financial statements '

Amounts included on line a but not online 17. Form990:


(2) Donated services and use of facilities $_

(3) Recoveries of prior year grants $_

(4) Other (specify): See_AUa_che_d

$

(2) Prior year adjustments reported on line 20, Form 990 ..

(3) Lasses reported on line 20, Form 990 . . . .

(4) Olher (specify): See Attached

182.627 Add amounts on lines (1) through (4) Line a minus line b

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 $_



(1) Investment expenses not included on line 6b, Form 990 $_


$ $ Add amounts on lines f l ) and (2) .


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



allowances

Carol S p i z z i r r i

Pres/Exec Di r 40 95.330. 2.153. Pres/Exec Di r 40 95.330. 2.153. Pres/Exec Di r 40 95.330. 2.153. 0. Daniel Caravel lo

Treasurer 0. 0. Treasurer 0. 0. Treasurer 0. 0. 0. Mart in A. Sandoval

Secretary 0. 0. Secretary 0. 0. Secretary 0. 0. 0. Carlos M. Azcot ia

D i rec to r 0. 0. D i rec to r 0. 0. D i rec to r 0. 0. 0. Dr. Stanley. Zydlo

D i r e c t o r 0. 0. D i r e c t o r 0. 0. 0.

o- 0. See List of Officers. Etc. Statement

o- 0. 0.

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? ►• J_J Yes [XJNo If Yes.' attach schedule - see instructions.

BAA Form 990 (2002)

TEEA0104 01/22/03

Form930(2002) Save A L i f e Foundation 36-3869459 Page5 Other Information (See instructions.) Yes

76 Did the organization engage in any activity not previously reported to the IRS? If 'Yes.' attach a detailed description of each activity


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?

76 77

78a 78 bl



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?

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 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| 1 2 3 , 0 8 1 .

79

80:

81b



82s

83a X

b If 'Yes,' did the organization include with every solicitation an express statement that such contributions or gifts were not tax dedirtible? not tax deductible?

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.

85c 8Sd 85e 85f

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?

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

83b X 84a

84b 85a 85 b

85g

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 .


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

88

89b 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 *■ J l H j ' S t s b Number of employees employed in the pay period that includes March 12, 2002 (See instructions.) Pgobj

91 The books are in care of *■ JiaroJ_SfJ1zz1_rr i_ Telephone number •■ _ ( 8 4 7 ) _ 9 2 8 - 9 6 8 3 10

Loeatedat ► j>950_ Lawrence_Su_Ue J00 ,_Sch iJ ._ le r_ f ar_k_IL ZlP + 4 * _60176 92 Section 4947(a)(1) nonexempt charitable trusts tiling Form 990 in lieu of Form 7041 - Check here ~. ~ ." 7. * - "Q

and enter the amount of tax-exempt interest received or accrued during the tax year *\ 92 | BAA

TEEAO10S 01/22/03 Form 990 (2002)

Form990(2002) Save A L i f e Foundation 36-3869459 Analysis of Income-Producing Activities (See instructions.)

Page 6


93 Program service revenue: 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:


98 Net rental income or (loss) from pers prop . . . 99 Other investment income


101 Net income or (loss) from special events 1 0 2 Gioss profit or (loss) from sales ol inventory . . .

103 Other revenue: a b Miscel laneous c d e

Unrelated business income (A)

Business code (B)

Amount

Excluded by section 512, 513. or 514

Exclusion code

14

(D) Amount

2.154.

(E) Related or exempt

function income

31.693. 149.980.

•2.916. 205.

18 -3.091 •32.128.

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 .

225.

379 ,187 . 146.122.

Une No.

93a.93b. 93c.93d

103a

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).

Promote and teach life saving first aid programs Promote and teach life saving first aid programs 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 % %

%

(C)


(D) Total

income

N/A (E)

End-of-year assets

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? I I Yes

id b Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? Note: // Yes ' to (b), file Form 8870 and Form 4720 (see instructions).

Yes No No

Please Sign Here

Paid Pre-

Garer's se

Only

»6^ !y ' c f f i | ! /& . , &M^ ;l ol my knowledge and belief, it is

Signature ol officer Data

Type or print name and title

Preporer's signature •»•

Dale

Firm's name (or yours il sell-em ployed) address, and ZIP+ 4

Ahlbeck and Company 1665 Elk Blvd DES PLAINES IL 60016

Check if sell. employed n Preparers SSN or PTIN (see

General Instruction W)

P00237637

EIN 136-2991500 Phone no. (847) 824-4000

BAA TEEAOIOS to/10/02 Form 990 (2002)

SCHEDULE A (Form 990 or 990-EZ)

Department of trie Treasury Internal Revenue Service

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 Name of the organization

Save A L i f e Foundation I Employer identification number

36-3869459 EeSHLM Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees

(See instructions. List each one. If there are none, enter 'None.')


than $50,000


devoted to position

(c) Compensation (d) Contrifjubcns to employee benefit plans and deferred

compensation


allowances

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.')


B e n n e t t R. K r a u s e

Establish funding sources and contracts 2012 Apoleton Drive, Snringfield. IL 62707 Establish funding sources and contracts 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 01/22/03


. . . * • . - . i i - . ! - . . > X ; , .Jc-»-.._» !«...• ,'.&5aS^>Ii-- ' .-s-iafiiL-: _ i ^

Schedule A (Form 990 or 990 -EZ) 2002 Save A L i f e F o u n d a t i o n 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.)



c Furnishing of goods, services, or facilities? See Part V, Form 990



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?

2b

2c

2d

2e

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.

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.)

13 LJ 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).)


(a) Name(s) of supported organizations) (b) Line number from above

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

BAA 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 ( 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.

Page 3

Calendaryear (or fiscal year beginning In)

15 Gifts, grants, and contributions received. (Do not include unusual grants. See line 28.) ..


17

18

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

201 001

820,282.

2000

6 8 2 . 8 7 8

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 organ-tzation after June 30.1975

19 Net income from unrelated business activities not included in line 18 . . .


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

197.535

3,275.

1 %

621.043. 621.289.

J&. Total

52.664

8.725.

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

1,021.092. 823.557. 10,211

41.158.

24,575.

6.134

676.

2.745.492.

744.267 691,603. 7.443.

686.776

297.491

37.251

645.618. 6.868.

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

628.099. 3 , 0 8 0 . 2 3 4 . 2.782,743.

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) * " [ H c d Add: Amounts from column (e) for lines: 18 3 7 . 2 5 1 . 19

22 26b ... e Public support (line 26c minus line 26d total) f Public support percentage (tine 26e (numerator) divided by line 26c (denominator))


2.745.492. 98.66 %

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: * ro * u " ' o l

(2001) (2000) (1999) (1998) bFSL * S ! a m o u n l '"eluded in line 17 that was received from each person (other than 'disqualified persons'), prepare a list for vour records to

! £ > £ i h e , . n a m 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 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: UMICIWIMSS (2001) (2000)


dAdd: Line 27a total

(1999) (1998) 15 20

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 nature of the grant. Do not file this list with your return. Do not include these grants in line 15. M '

B A A "TFFAD4M Oft/1 ?/D? c;,horf. .Ic A /Cn,m OOn onr\ rr-r\ m Schedule A (Form 990 or 990-EZ) 2002

U ' i A v—U*bfl)U_ ri^vWUW

Schedule A (Form 990 or 990-EZ) 2002 Save A L i f e F o u n d a t i o n 36-3869459 Private School Questionnaire (See instructions.) (To be completed ONLY by schools that checked the box on line 6 in Part IV)

Page 4

N/A


Yes

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.)





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










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? .


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 F o u n d a t i o n 36-3869459 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

PageS


. 00 Affiliated group

totals To be completed for ALL electing organizations


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 over Jl.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 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 -O- if line 42 is more than line 36 44 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.


Calendar year (or fiscal year beginning in) »-



(a) 2002

46 lobbying ceiling amount (150% ol line 45(e))


48 Grassroots non taxable amount



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 Schedule A (Form 990 or 990-EZ) 2002

TCEA0405 0S/IZT02

■—•x*d\.-J.-^ --: "\^^.MtiL£C

Schedule A (Form 990 or 990-EZ) 2002 S a v e A L i f e F o u n d a t i o n 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) of the Code (other than section 501 (c)(3) organizations) or in section 527, relating to political organizations? v--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

c Sharing of facilities, equipment, mailing lists, other assets, or paid employees ,

SI'W _ajQJi

Mi. b(ii) b(iii) PQV)

_bj«a

Yes

b(vQ

Mo

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.

0» Amount involved blee Name of noncharitable exempt organization

(d) 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? ►■ [ 1 yes |x] No

b If 'Yes,' complete the following schedule:


(b) Type of organization 10 Description of relationship

BAA TEEA0406 03/1Z/OZ Schedule A (Form 990 or 990-EZ) 2002

8868 Form' -fecentber 2000)

•partmen! atHie Treasury iternal Revenue Service

Application for Extension of Time to File an Exempt Organization Return

*~ File a separate application for each relurn.

OM&No. 1545-1709

• 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.

^ x f

| A u t o m a t i c 3-Month Ex tens ion of T ime — 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 »- 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 REMICs ana trusts must use Form 8736 to request an extension of time to file Form 1065, 1066. or 1041. H '

Type or print File by the due date for filing your return. See instructions.

Name of Exempt Organization

Save A L i f e Foundat ion Number, street, and room or suite number. II a P.O.box. tee instructions

9950 Lawrence . #300

Employer identification number

36-3869459

City, town or post oNice. For a foreign address, see instructions.

S c h i l l e r Park slate

I L Check type of return to be filed (file a separate application for each return):

ZIP code

60176

f Form 990 Form 990-T (corporation) — i

Form 4720 Form 990BL Form 990-T (Section 401 (a) or 408(a) trust) 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)

check this box . * " £ ] . If it is for part of the group, check this box the extension will cover.

. 1 I request an automatic 3-month (6-month, for 990-T corporation) extension of time until AuK I S

• If Ws is for the whole group, *- L J and attach a list with the names and EINs of all members

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 .

Q Initial r e l u T r i ( j T i n a l return Q Change in accounting period 2 If this tax year is for less than 12 months, check reason:

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 is tor Form 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 of ray knowledoe 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 BAA For Paperwork Reduction Act Notice, see instructions.

- f/f-roi Form 8868 (12-2000)

Form 990 Line 8(A) and 8(B)

Statement

Schedule of Gams and Losses from Sale of Assets Other than Inventory

*■ Attach to return

2002

Name Save A L i fe Foundation

Employer tdentificalion Number 36-3869459

Part I, Line 8, Column (A) Securities

Public Securities

Description Gross

Sales Price Basis

Publ ic ly Traded Secur i t ies Cost Selling. Expenses Basis

Nonpublic Securities

Description Date Acquired and Method

Date Sold and to Whom

Gross Sales Price

Cost, other basis or FMV when donated (State which on top)

Total Securities

Gain or (Loss) from Sale of Securities

Total Other Assets. 0.

Gain or (Loss) from Sale of Other Assets

Part 1, Line 8, Column (B) Other Assets



Gross Sates Price

Cost, other basis or FMV when donated

_0f.fi ce_Egu_ij3iDen t.

various various 0 .

Cost 12.255.

various various 0 .

Depreciation - 9 . 1 6 4 . various various

0 . Basis 3 . 0 9 1 .

Donated/ Purchased scrapped 0 . Donation FMV Cost Depreciation Basts Donation FMV Cost Depreciation Basis Donation FMV Cost Depreciation Basis Donation FMV

3,091

■3.091

TEEMC201.SCR 01/23/03

http://_0f.fi


Form 990, Page I, Part I, Line 9 Special Events and Activities Statement



Receipts Less

Contributions Gross


Net Income (Loss)

Dinner Event 87.360. 55.000. 32.360. 58.174. -25.814. Race 6.093. 6.093. 0. 1.158. -1 .158 . Other 1S3. 0. 153. 214. - 6 1 .

Total 93.606. 61.093. 32.513. 59.546. -27.033.

Form 990, Page 2, Part II. Line 43 Other Expenses Stmt


(A) Total


(C) Management and oeneral

(D) Fundraising

Consulting Fees 78.003. 77.370. 476. 157. Dues & Subscriptions 917. 667. 250. Employee Bonus 1.949. 1.949. Independent Contractors 191.090. 119.489. - 1 1 . 71.612. Instructors Fees 93.188. 93,188. Insurance 10.728. 8 .432 . 2 . 1 6 1 . 135. Licenses & Permits 593. 543. 50. Marketing 60.560. 39,813. 3.028. 17.719. Miscellaneous -6 .346. -534. -5 .812. Payroll Service 1.156. 1.126. 6. 24. Recruitment 498. 259. 239. Cost of Goods Sold 30.383. 28. 30.355. Training Supplies 123.203. 122.391. 812. Website 4 . 3 1 1 . 1.895. 2.416.

Toial 590,233. 463.457. 36.829. 89.947.

Form 990. Page 3. Part IV. Lines 57a & 57b Land, Buildings and Equipment Statement

(a) Cost/Other

Basis


(c) Book Value

Off ice Equipment 92.085. 63 .021. 29.064. Vehicles 39.132. 3.913. 35.219.

1 3 1 . 2 1 7 . 6 6 . 9 3 4 . 6 4 . 2 8 3 .

Form 990, Page 3, Part IV, Line 58 Other Assets Statement

Line 58 - Other Assets: Beginning

of Year End of Year

Credit Card Deposits Outstanding 11.185. 0.


Form 990. Page 3, Part IV, Line 58 Continued Other Assets Statement

Line 58 • Other Assets: Beginning

of Year End of Year

Total 11.185. 0.

Form 990. Page 3, Part IV. Line 65 Other Liabilities Statement


of Year End of Year

Instructor Deposits 340. 390.

Total 340. 390.



(B) Title and


to position

(C) Compensation



compensation

(E) Expense account


Or. Scott Betzelos Di rector

0 . 0. Di rector

0 . 0. 0 . 0. 0. Deloris M. Burnam

Director 0 . 0.

Director 0 . 0. 0 . 0. 0.

Michael Lavalle Director

0 . 0. Director

0 . 0. 0 . 0. 0. Robert Conrov

Director 0 . 0.

Director 0 . 0. 0 . 0. 0.

Wayne Roberts Director

0 . 0. Director

0 . 0. 0 . 0. 0. Note: The individuals above. except as noted, spend t ine as needed in thei r capacity on the Board, They can be contacted c/o Save a Life Foundation. 99S0Lawrence Ste300. Schiller Park. 1160176

Total



Total

Form 990 p 2/Line 42 column (C)

Description Amount

Depreciation Expense - Office Expense 10.64S. Depreciation Expense - Vehicle 6.413.

17.059,


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.



Description

Due to Carol S p i z z i r r i . President/Exec. Director Interest Rate - Variable

Total

Amount

72,227.

72,227.


Form 990 p 4/Part IV-A, Line b(4)

Description

Donated Materials. Services, and Facilities Special Events Expense

Total

Amount

123,081. 59.546.

182.627.


Form 990 p 4 /Part IV-B, Line b(4)

Description

Donated Mater ia ls . Services, and F a c i l i t i e s

Amount

123,081 L_, J W " . . 1 • . i i . ->'-.\&iUij~.. > _ . _ „ i « * . -*£25Ef


Continued Supporting Statement of:

Form 990 p 4 /Par t IV-B, Line b(4)

Description Amount

Special Events Expenses 59.546.

Total 182,627,

■i ■ . • « . * . - . -


AUDITED FINANCIAL STATEMENTS

DECEMBER 31. 2002 AND DECEMBER 31, 2001



T A B L E OF C O N T E N T S December 31, 2002 and December 31, 2001

AUDITOR'S REPORT



Statements of Activities For the Years Ended December 31, 2002 and December 31,2001

4

Statements of Functional Expenses For the Years Ended December 31, 2002 and December 31, 2001

8

Comparative Statement of Cash Flows For the Years Ended December 31,2002 and December 31,2001

12


AHLBECK&COMPANY

CERTIFIED 1665 ELK BOULEVARD TELEPHONE: 847/824-4000 PUBLIC DES PLAINES. ILLINOIS FACSIMILE: 847/824-4012 ACCOUNTANTS 60016-4776 WEB: www.ahltKCkco.com

March 18, 2003



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

http://www.ahltKCkco.com



December 31, 2002 and December 31,2001

2002 2001

A S S E T S

Current Assets Cash and Cash Equivalents $ 477.154 $ 415,568 Inventory 77,028 47,209 Trade Receivables 6.771 2,907 Grants Receivable 317.968 718,887 Credit Card Deposits Outstanding - 11,185 Prepaid Legal Fees 6.813 16,398 Other Prepaid Expenses 2,401 1.000

Total Current Assets 888,135 1,213,154

Fixed Assets at Net Book Value Office Equipment 29,064 24,801 Vehicles 35.219 13,838

Total Net Fixed Assets 64,283 38,639

Other Assets ses to Give 20,000 20,000

Total Other Assets 20,000 20,000

TOTAL ASSETS 972,418 1,271,793


_. -^& '•< i.-.-..Xt<..:----J--.-.:Aii«.;^ri>.. ■■KMs.^.tLiil-i^^ ■■'■••■■Tfan • '- " ^ v * ^ - i in'BJihMY ' • 1

S A V E A LIFE F O U N D A T I O N , INC.


December 31,2002 and December 31, 2001

2002 2001


Current Liabilities Accounts Payable 26,510 $ 8,702 Instructor Deposits 390 340


Other Liabilities Due to Carol Spizzirri 72,227 68,755



Net Assets Temporarily Restricted 645,762 1,081,430 Unrestricted 227,529 112,566

Total Net Assets 873,291 1,193,996

TOTAL LIABILITIES & NET ASSETS 972,418 1,271,793


3

•s2tf£aa£L





INCOME


1,353 31,500

123,081 93,606

1,353 31,500

123.081 93.606


Government Contracts State of Illinois - IDPH State of Illinois - DCCA State of Illinois - Attorney General Federal - HHS/CDC


Other Income Program Service Fees Miscellaneous Course Materials Branch Fee Membership Dues

25,000

25,000

31,693 225

149.980 (2.916)

205

600.000 600,000 200,000 200.000

- 25,000 31,819 31.819

831,819 856,819

31,693 225

149,980 (2,916)

205


TOTAL INCOME (balances carried forward) 453,727 831,819 1,285,546


4

SAVE A L I F E F O U N D A T I O N , I N C .


For the Year Ended December 3J. 2002

TOTAL INCOME (balances brought forward) 453,727 831,819 1,285,546

Unrestricted Temporarily.

Restricted Total

EXPENSES

Program Kids Program Corporate Program Blue Angels Expansion Program Branch Development

Release from Restrictions - IDPH Release from Restrictions - DCCA Release from Restrictions - HHS/CDC

344,020 11.382 12,890

586,255 347.747

684,298 (684.298) 1.140 (1.140)

582.049 (582,049)

344,020 11,382 12,890

586.255 347,747

Total Program 1,302,294 1302,294 Management and General 133,677 133.677 Fundraising 109,797 109,797

Total Functional Expenses 1,545,768 1,545,768 Special Event Expenses 59,546 59,546

TOTAL EXPENSES 1,605,314 1,605,314

Excess Income Over Expenses 115,900 (435,668) (319,768)

Investment Income Interest Income 2,154 2.154


Excess Income Over Expenses 118,054 - 346,174 Loss on Disposition of Assets (3.091) - (3,091) Change in Net Assets 114,963 (435,668) (320,705) Beginning Net Assets 112,566 1.081,430 1.193,996 Ending Net Assets 227,529 645,762 873,291


5



for the Year Ended December 31, 2001 Temporarily


INCOME


1.475 22,660 79,602

117.346

20,000 $ 21.475 22,660 79,602

117,346

Total Public Support 221,083 20,000 241,083

Government Contracts State of Illinois -I DPH State of Illinois - DCCA

- 600.000 600,000 - 870,470 870,470

- 1,470,470 1,470,470

17.979 — 17,979 7,542 - 7.542

97,444 - 97,444 709 . 709


Other Income Program Service Fees Miscellaneous Course Materials Fundraisers/Sales

Total Other Income 123,674 - 123,674

TOTAL INCOME (balances carried forward) 344,757 1,490,470 1,835,227


6




TOTAL INCOME (balances brought forward) 344,757 1,490,470 1,835,227

Unrestricted Temporarily

Restricted Total

EXPENSES

Program Kids Program New Program Development Corporate Program Blue Angels Expansion Program Branch Development

236,180 1,808 7,413

31,604 202.816 348.774

236.180 1,808 7,413

31,604 202,816 348,774

Total Program

Management and General

Fundraising


828,595

112,417

13.630

954,642

828,595

112,417

13,630

954,642 Special Event Expenses

TOTAL EXPENSES

Release from Restrictions - 1SBE Release from Restrictions - 1DPH Release from Restrictions - DCCA

70,761

1,025,403

573,283 (573,283) 42,030 (42,030)

202,272 (202.272)

70,761

1,025,403

Excess Income Over Expenses

Investment Income Interest Income

Total Investment Income

136,939 672,885

3.275

3,275

809,824

3,275

3,275

Change in Net Assets

Beginning Net Assets Ending Net Assets

140,214 (27,648)

112,566

672,885 408,545

813,099 380,897

1,081,430 1,193,996


7


STATEMENT OF F U N C T I O N A L EXPENSES


PROGRAM

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

Kid's Corporate Expansion Branch Program Program Blue Angels Program Development Total

$ 92.109 $ 2.517 7,387 1,133

122,363 3.139

3,191 25.789

3.479 7,944

12,603

344,020 (25,333)

- $ 279,222 s 80,088 $ 451,419 - 8,166 265 10,948

930 25,791 3,682 37,790 - - - 1.133

- 7.000 - 129,363 - - - 3.139 - - 23 28

7.609

6,910 -231 -

1,189 -2.979 -

21,816 535 48 -

10.337 -220 -

9.608 -(722) 3,167 9,550 66

- 2,565 - 5,756 - 61,002 32.698 119.489

8.666 779 76.134 93,188 156 3,748 1,049 8.432 - 5,037 - 12,981

- 27,532 103 40,438 - 10,157 - 10,157 - - (534) (534) - 10,356 6.649 23,915 - 697 198 1,126 - 2,242 373 3,804 - 6.162 • 9.141 - 29,696 25,323 77,370 - 12 199 259 - 28,580 19,737 58,654 - 40 712 972 - 23,653 - 33,261

3.138 16,304 100,504 122,391 - 35,619 544 45.779 - 1,895 - 1.895

11,382 12,890 586,255 347,747 66,058

1,302,294

40,725 318,687 11,382 12,890 586,255 413,805 1,343,019


8

t



SUPPORT

Managemnt. Organization & General Fundraising Total Total

$ 2,028 $ 10,621 $ 12,649 $ 464,068 53 125 178 11,126

254 982 1.236 39,026 95 - 95 1,228 10 368 378 37B

2,400 - 2,400 131.763 6,009 - 6,009 9,148

30.355 - 30,355 30.383 17.059 - 17.059 17.059

667 250 917 917 1,949 - 1.949 1,949

591 176 767 6,523 ( ID 71.612 71,601 191,090

- - - 93,188 2,161 135 2.296 10.728 1,784 - 1,784 14,765

543 50 593 593 3,028 17,719 20.747 61,185

- - - 10,157 (5.812) - (5.812) (6,346) 3.472 - 3.472 3.472 5,862 126 5,988 29,903

6 24 30 1,156 1,099 893 1,992 5.796 6.077 - 6.077 15.218

476 157 633 78,003 239 - 239 498

14,055 287 14,342 72.996 647 - 647 1.619

3,335 336 3,671 36,932 812 - 812 123.203

32,018 5,936 37.954 83.733 2.416 - 2,416 4,311

133,677 109,797 243,474 1,545,768 (40.725) - (40.725) -92,952 109,797 202,749 1,545,768


9

<



PROGRAM

Kid's New Program Corporate Expansion Program Development Program Blue Angels Program

Salaries & Wages $ 74.910 $ 1.100 $ Employee Benefits 3,981 2 Payroll Taxes 8,807 155 Automobile 674 -Bank Service Fees 332 11 Branch Development 54 -Computer Expenses - -Conferences &r Meetings 135 -Cost of Good Sold - -Depreciation - -Dues & Subscriptions 22 -Equipment Rental 2,663 -Instructor Fees 55.288 -Insurance 173 -Legal & Accounting 2.168 -Licenses & Permits 25 -Marketing & Promotional 1,497 -Meetings 656 -Miscellaneous 110 -Operating Interest - -Office Supplies 1,986 -Postage 67 -Printing &r Reproduction 16,414 -Professional Fees 36,314 417 Recruitment 61 -Reimbursed Program Fees - -Rent - -Repairs & Maintenance 678 • Research & Evaluation • . Telephone 6,744 123 Training & Development 1,000 -Training Supplies 17,603 -Travel 3,774 -Web Site 44 .



Total Expenses

11

4,251

1.500 $ 83,978 1,789

774 7,247 107

955

9,263 238

23,100

1,264

2,427 8,483

3,132

- - 7.363 - 13 715

945 - -,167 1,000 26.661

- - 2,012

- - 17,081 - - 625

- . 7,321 17 - -

,022 17,861 968 .- - 6,688 - - 1,855

236,180 1,808 7,413 31,604 202,816 39.232 713 - 1.826 -

275,412 2,521 7,413 33,430 202,816


10

- .H ■i-Vi-iiftl' '•,-■' -i, iai.i&f"'tTif'^--i-«"» ■ . -..• i V w . ■X '--'^»ak'^'-> «-.vi-<fc!J> ,-tSagfi^.

<


STATEMENT OF FUNCTIONAL EXPENSES For the Year Ended December 31, 2001 s*-' "

SUPPORT

Branch Managemnt. Organization Development Total & General Fundraising Total Total

$ 102.678 ! I 264,166 $ 13,663 S 9.841 S 23,504 $ 287.670 4.739 10,511 653 220 873 11,384 6.374 23,357 579 1,114 1,693 25,050

422 1.203 30 - 30 1,233 44 387 1.650 33 1.683 2,070

14,594 14,648 - - - 14,648 - 23,100 - - - 23,100

728 863 1,042 - 1.042 1,905 - 966 9.675 83 9.758 10,724 - - 16,662 - 16.662 16.662 - 22 137 25 162 184

1,437 5.364 1.125 - 1.125 6,489 36.196 104,998 480 - 480 105,478

4,464 7.302 1.902 34 1.936 9.238 11.450 22,101 16.137 454 16.591 38.692

80 105 1.665 - 1,665 1.770 2.180 6.809 980 246 1,226 8.035

- • 656 256 860 1.116 1.772 558 668 6.380 83 6.463 7,131

- - 3,305 - 3,305 3.305 4,733 14,082 2,957 (8,485) (5,528) 8,554

886 1,681 3,090 584 3,674 5.355 - 17.359 (8,783) 35 (8.748) 8.611

46,008 111.567 8,466 6,522 14.988 126,555 2,138 4.211 52 - 52 4.263

31.441 48.522 32,918 . 32.918 81.440 630 1.933 2.097 - 2.097 4.030

8.305 22.493 220 1,717 1.937 24,430 221 1.238 - - - 1,238

63.215 100.669 (1.243) - (1.243) 99.426 5.229 15.691 (5.935) 264 (5.671) 10,020

24 1,923 2.257 - 2.257 4,180 348,774 828,595

63.170 112,417 13,630 126,047 954,642

21.399 828,595

63.170 (73.156)

39,261

9,986

23,616

(63,170)

62,877

954,642

370,173 891,765

(73.156)

39,261

9,986

23,616

(63,170)

62,877 954,642


11

,v.viv«L-■'•--•-•->vît'"ii-i>-.v-a'grfe-,'; tm*!&&,vrfoit -iv-r ■■ fr^ît,, . ..,:&&*■ ■ -W>. „%fe^%fe4- - as.4

S A V E A LIFE F O U N D A T I O N , INC.

COMPARATIVE STATEMENT OF CASH FLOWS For the Years Ended December 31, 2002 and December 31, 2001

2002 2001


Change in net assets


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

$ (320.705) $ 813.099

17.059 3.091

(18.000)

16.662

(3.864) (29.819) 420,288

1,080 4.980

(736,167) (19.838)

17.808 3.522

217 2,898



89,380 82,931

Purchase of fixed assets (27.794) (675) Net cash provided by (used in) investing activities (27,794) (675)

Net increase (decrease) in cash & cash equivalents 61,586 82,256

Cash & cash equivalents at beginning of period 415,568 333.312

Cash & cash equivalents at end of period 477,154 415,568

Supplemental Disclosures: Interest paid $ 3,472 $ 3,305


12

S A V E A L I F E F O U N D A T I O N . I N C .


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.








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 L I F E F O U N D A T I O N , INC.


For the Years Ended December 31, 2002 and December 31, 2001 ../.

Inventories Inventories are slated at cost using the weighted cost average method.



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




grant awards are not recorded until expended for the purpose of the grants since they are conditional promises to give.


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.


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 $ 5,000 Receivables in one to five years 15,000


At December 31, 2002 and 2001, the costs of such assets were as follows:

December 31 1 Increase 2002 2001 (Decrease

Office Equipment $ 92,085 $ 86,340 $ 5.745 Vehicles 39.132 31,998 7.134

131,217 118.338 12,879 Less accumulated depreciation

$ 66,934 64,283 $

79,699 38,639

(12.765) Net book value $

66,934 64,283 $

79,699 38,639 $ 25,644

Depreciation expense for years ending December 31, 2002 and 2001 was $17,059 and $16,662, respectively.

15





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.


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 $75,499 2004 $37,750




December 31 2002 December 31.2001 Bgy.enme Expenses Usi Revenue Expenses iki

Dinner Event $ 87,360 $58,174 $29,186 $115,325 $70,761 $44,564 Race for Life 6,093 1,158 4,935 Other 153 214 (61) 2,021 -_ 2,021

$ 93,606 $ 59,546 $ 34,060 $ 117,346 $ 70,761 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 » fo r OHIeBVjg Only.

PMT#

AMT

INIT 9

ILLINOIS CHARITABLE ORGANIZATION ANNUAL REPORT Attorney General LISA MADIGAN State of Illinois

Charitable Trust Bureau, 100 West Randolph

Form AG990-1L Revised 1/03



CO# 01026498

Beginning 0I .01 1 03

Federal ID # K3ww» & Endingil / 31 / 03

Check all items attached: U\ Copy of IRS Return

Mskac/TK*! El Audited Financial Statements cayawsto □ Copy of Form IFC cnerity ED $15.00 Annual Report Filing Fee Bwwoftinif □ $100.00 Late Report Filing Fee

MO DAY

Are contributions to the organization tax deductible? E Y 9 S D No Date Organization was created: ^_ DAY YR

I 09 i 92

LEGAL NAME âve ^ e Foundation

MAIL ADDRESS " 5 0 w ' Lawrence #300

CITY, STATE Schiller Pa*, IL ZIP CODE .a, , , ,

60176


D) PUBLIC SUPPORT. CONTRIBUTIONS * PROGRAM SERVICE REV. (GROSS AMTS.J


F) OTHER REVENUES

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



1) EDUCATION PROGRAM SERVICE EXPENSE

J> TOTAL CHARITABLE PROGRAM SERVICE EXPENSE (ADD H &l)

Ji) JOINT COSTS ALLOCATED TO PROGRAM SERVICES (INCLUDED IN J): $





O) TOTAL EXPENDITURES THIS PERIOD {ADD L, M, & N)

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:


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

Year-end amounts

A)ASSETS

B) LIABILITIES

C)NET ASSETS

PERCENTAGE

88.B8 %

10.27 %

0.85 %

100%

76.77 %

% 7S.77 %

% 76.77 %

8.25 %

14.98 %

100%

100%

% %

f * t l~^ IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS ^ l p ^ ^ \ E 4 K 9 - * /

T) NAME, TITLE: Carol Spizzim, CEO ^ o f t nA^V fV

U) NAME, TITLE: Dane Neal, National ProgramCoordinalor J l - i ■"■

V) NAME, TITLE: Linda Post, Accountant A T T O B N ^ ° - T W I S T C H A W l A B L t '

V. CHARITABLE PROGRAM DESCRIPT\QU:CHARITABLE PROGRAM ti HIGHEST BY SEXPENIXBI CODE CATEGORIES

W) DESCRIPTION: Life Saving First Aid Training

X) DESCRIPTION:

Y) DESCRIPTION:

^m A) $460309

B) J 364,284

C ) $ 96.025

AMOUNT

D>$ 324.331

E) S 37,488

F ) $ 3,113

G>$ 364,932

H) $ 861,501

l ) $

J) $ 861,501

K)$

L>$ 861,501

M ' S 92,611 N ) $ 168,086

° ) $ 1,122,198

P)S 0

0)5 0

R ) $ 0

S ) S o

T ) $ 71,250

U) $ 49,638

V) S 40.385


W}# on

X ) #

Y ) #

v v •>


1. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION, FINE, PENALTY OR JUDGMENT? - 1.

2. 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.

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.


YES NO

DB

6. DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER? (ATTACH FORM IFC ] 6.

□ H □ EZ]

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? 8.

9. HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION OR TAX EXEMPTION SUSPENDED OR REVOKED BY ANY GOVERNMENTAL AGENCY? 9. ra

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. [ _ ] \/j

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


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


" P K E S I D E N T OIATRUS 1 fctt [PRIHT NAME) GNATURE

TREASURER or TRUSTEE (PRINT NAME]

fr'ft" A/-/T-6 e EH

PREPARER (PRINT NAME}

SIGNATURE

SIGNAIUKe

I^Wfo

DATE

June 30, 2004

Office of the Attorney General Charitable Trust Bureau Attn: Annual Report Section 100 West Randolph Street 3rd 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

Form 9 9 0

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



0MB No. 1545-0047

2003 Open to Public

Inspection

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


See specific instructions.

, 2003, and ending C Name of organ i zation

Save A Li fe Foundation Number and street (or P.O. box il mail is not delivered to street addr) Room/suite

9 9 5 0 L a w r e n c e 3 0 0 City, town or country

S c h i l l e r P a r k

State

IL ZIP code + 4

6 0 1 7 6 • Section 501 (cX3) organizations and 4947(a)(1) ri on exempt

charitable trusts must attach a completed Schedule A (Form 990 or 990-EZ).

G Web site: *■ www. s a l f . o r e

J Organization type ■—, m m (Check o n l y o n e j ** | X ] 501(c) 3 - (insert no.] [ J 4947(a)(1) or \ I S27

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 * 3 7 2 , 9 5 8 .

D Employer Menti5c*tJofi Number


(847) 928-9683 [_]c** aSSS*"" n u Accrual

Otbflr (specify)*

H and I are not applJcaaJe to section 527 organizations

H ( a ) Is this a fli-pup return for affiliates? , . . J | Ye* [ X j No

H ( b ) If Yes," enter number of affiliates **

H (C) Are all affiliates included? \_\ Tes Q Ho

(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 y e s D( ] No.

I Group Exemption Number . . . ** ___ M Check *■ \_J if the organization is rot required

to attach Schedule B (Form 990, 990-EZ, or 990-PF).

iPartljl5 "M [ 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 in Ne t A s s e t s o r F u n d B a l a n c e s (See instructions) 1 Contributions, gifts, grants, and similar amounts received;

a Direct public support b Indirect public support c Government contributions (grants) . " T r t i S S I c f i c M h J 2 3 0 , 6 5 3 . noncasn $

1a l b 1c

1 9 3 , 1 6 5 .

3 7 , 4 8 8 . 0 . )



b Less: rental expenses c Net rental income or (loss) (subtract line 6b from line 6a).

7 Other investment income (describe *•

6a 6b

(A) Securities

Sa 8b 8c


b Less: cost or other basis and sales expenses . . . . c Gain or (loss) (attach schedule) .. .See. .Lr\8. .S t lT 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

reported on line la)

(B) Other

5 , 2 5 0 . 7 , 9 2 6 .

- 2 , 6 7 6 .

9a 9b

1 ,504. 100.

10a

b Less: direct expenses other than fundraising, expenses c Net income or (loss) from special events (subtract line 9b from line 9a) ,5ee. .L.-.9. . S t m t

10a Gross sales of invenlory, less returns and allowances b Less: cost of goods sold c Gross profit or (loss) from sales of inventory (attach schedule) (suhtract 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, )0c, and 11)

10b

nkkii.

I d

6c

9c

10c 11 12

230.653 131 ,166 .

795,

- 2 , 6 7 6 .

1,404.

3 .590 . 3 6 4 , 9 3 2 .

13 14 15 16 17

Program services (from line 44. column (B)) Management and general (from line 44, column (C)) Fundraising (from line 44, column (D)) Payments to affiliates (altach schedule) Total expenses (add lines 16 and 44, column (A)) ..

13 861,501 14

Ji. 16 17

9 2 , 6 1 1 . 168 ,086 .

1 , 122 ,198 . 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) .

_18_ 19 20^ 21

- 7 5 7 , 2 6 6 . 8 7 3 , 2 9 1 . - 2 0 . 0 0 0 .

9 6 , 0 2 5 . BAA For Paperwork Reduction Act Malice, see the separate instructions. 1EEA01O1 11/24)03 Form 990 (2003)

Form990(2003) Save A L i f e Foundation 36-3869459 Page a Part II J Statement Of Functional Expenses 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.

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):

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

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

44

(A) Total

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.

1,122,198.


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.

861,501.


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.

92 ,611 .

(D) Fundraising

•'

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.

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

; and (iv) the amount allocated ; Oil) the amount allocated to Management and general $ to Fund raising] I Part 111:= Sj Statement of Program Service Accomplishments 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) oigan-izations 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. JJILnpi i_scr jo(>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. i j . f i ~f i r5t_a_i_d_to_iridjyi_djjal_s_ot_h^r j:J_an_^ch_ool/_age _cnUdre_n

±A 3 7 9 . 6 4 8 .

(Grants and allocations $ c^f iUj?sl^ l< l JniJ-i'injS_iJ^yii^_£caJ?i.

iL_i 13,336,

(Grants and allocations $ d Branch JJ_ev lj)F_m_erit ^ inside and outside the State of Illinois

_0__1 30,760,

(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. BAA TEEAD102 10/03*03 Form 990 (2003)

http://sa.yjng.__fl

http://jay.ij.fi

Form990 (2003) Save A L i f e F o u n d a t i o n 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 s s E 1 S

t s

N

T

^

0 R

G D

t L A


48a Pledges receivable b Less; allowance for doubtful accounts

47a 47 b

43 a 48b

2 2 , 7 1 5 .

50 Receivables from officers, directors, trustees, and key

b Less: allowance for doubtful accounts 51a 51b

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

55a

55b

. ►□ Cost 0 FMV


b Less: accumulated depreciation

58 Other assets (describe •"

57a

57 b

3 6 2 , 7 7 1 .

9 1 , 2 7 4 . ) . .

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 64a Tax-exempt bond liabilities {attach schedule)

e)

65 Other liabilities (describe - See L i n e 65 S t m t ) . . 66 Total liabilities (add lines 60 throuqh 65)

Organizations thai follow SFAS117, check here *■ [Xj and complete lines 67 through 69 and lines 73 and 74.

68 Temporarily restricted

Organizations lhat do not follow SFAS 117, check here *■ Q and complete lines 70 through 74.

71 Paid-in or capital surplus, or land, building, and equipmen 72 Retained earnings, endowment, accumulated income, or o her funds


74 Total liabilities and net assets/fund balances (add 1 nes6f 5 and 73)


1 7 6 , 0 4 6 . 3 0 1 . 1 0 8 .

6 , 7 7 1 .

2 0 , 0 0 0 . 3 1 7 , 9 6 8 .

7 7 . 0 2 8 . 9 , 2 1 4 .

6 4 . 2 8 3 .

9 7 2 , 4 1 8 . 2 6 , 5 1 0 .

7 2 . 2 2 7 .

3 9 0 . 9 9 , 1 2 7 .

2 2 7 . 5 2 9 . 6 4 5 , 7 6 2 .

8 7 3 . 2 9 1 . 9 7 2 . 4 1 8 .

45 46

. ; ,

47 c

48c 49

50 ,;-- ; ' i .

51c 52 53 54

55 c 56

57 c 56 59 60 fil 62 63 64a 64 h G5 66

67 BR 69

k a r

70 71 72

73 74

(B) End of year

- 5 , 5 5 6 .

2 2 , 7 1 5 .

1 0 0 . 0 0 0 .

5 7 . 0 1 9 . 4 . 6 3 4 .

2 7 1 . 4 9 7 .

4 6 0 , 3 0 9 . 2 8 . 7 9 6 .

1 3 9 . 6 4 8 .

1 9 4 , 4 1 6 . 1 , 4 2 4 .

3 6 4 . 2 8 4 .

- 3 , 9 7 5 . 1 0 0 , 0 0 0 .

9 6 , 0 2 5 . 4 6 0 . 3 0 9 .

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 F o u n d a t i o n 3 6 - 3 8 6 9 4 5 9 Page 4

Part IV-A I Reconciliation of Revenue per Audited Financial Statements with Revenue per Return (See instructions.)

Part IV-B I Reconciliation of Expenses per Audited Financial Statements with Expenses per Return




(2) Donated services and use of facilities . . . .

(3) Recoveries of prior year grants , .


$_

%_

I 2 6 0 , 3 2 9 . Add amounts on lines {)) 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 $_


$ Add amounts on lines (1) and (2 ) , . .

e Total revenue per line 12, Form 990 (line c plus line d)

625.261. a Total expenses and losses per audited

financial statements *

b Amounts included on line a bul not on line 17, Form 990:


(2) Prior /ear adjustments reported on line 20, Form 990 . . . . $

(3) Losses reported on hie 20, Form 990 . . . . $


$ 260.329. 260,329. 3 6 4 , 9 3 2 .

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 $_


$

3 6 4 , 9 3 2 .


e Total expenses per line 17, Form 990 (line c plus line d)

1,382,527.

#

260,329. 1,122,198.

1,122,198. Par tViN l l List of Off icers, Directors. T rus tees , and Key Employees (List each one even if not compensated; see insiructions.



(C) Compensalion (if not paid, enter -0-)




allowances

£$ CP_L SpJ z z_i_rr i_

C h a i r m a n / E x e c D i r 4 0 71,250. 1,701. WaLter_Dudy_cz_

V i c e C h a i rman 0 . A l a n T h a v i s o u k

Secre tary /Treasurer J o h n Do_nleavy_

D i r e c t o r 0 . Ma rk M i t c h e l l

D i r e c t o r 0 .

See List of Officers, Etc. Statement 0 . 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.

[ ] Y e s |x]No

BAA

TEEA0104 10JOM13

Form 990 (2003)

Form990 (2003) Save A L i f e Foundation 36-3869459 Page 5 Part V I I Other Information (See instructions.) Yes No

76 Did the organization engage in any activity not previously reported to the IRS? If 'Yes.' attach a detailed description of each activity


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?


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? ,

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?

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| 3 0 1 , 6 0 9 .



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.

B5c B5d 85 e

851

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(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?


b Gross receipts, included on line 12, for public use of club facilities 87 501 (c)(l 2) organizations. Enter: a Gross income from members or shareholders . , .

bGross 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: 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

76 77

78 a 78 b

79

80a

81b

82a

83a X 83b 84a

84b 85a 85b

85g

85 h

88

89b

■ffiffyf

m

X

i § | | x

c Enter' Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958 *■ Q.

d Enter: Amount of tax on line 89c, above, reimbursed by the organization ► 0 ^ 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.) f ^ b l ~ 13 91 The books are in care of - _Car_ql_S|) i Z Z A f l l Telephone number - _ ( 8 4 7 ) _ 9 _ 2 8 - 9 6 8 3

Located at - .?950_ 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__ Z T P V ^ *~J0~176_~ 92 Section 4947(a)(1) nonexempt charitable trusts filing Form 990 in lieu of Form 1041 - Check here * "T" I

and enter the amount of tax-exempt interest received or accrued during the tax year H 92 | BAA

TEEA0105 12/Z3/03 Form 990 (2003)

Form 990 (2003) Save A L i f e Foundation 36-3869459 Page 6 PaW VIII Analysis of Income-Producing Activities (See instructions.)


93 Program service revenue: a P r o g r a m Fees b . C o u r s e c d~ e

Mate r ia l s

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:


98 Net rental income or (loss) from pers prop . , . 99 Other investment income

100 Gain or (loss) from sales of assels other than inventory Net income or (loss) from special events Gross profit or (loss) from sales of inventoiy . . .

Other revenue: a

101 102 103

b Mi scel laneous c . ^ _ _ _ d e

104 Subtotal (add columns (B), (D), and (E)) . . 105 Total (add line 104, columns (B), (D), and (E»


Business code

. ^ r f S l

Amount

*&?mg

Excluded by section 512, 513, or 514 (C)

Exclusion coda

14

WE7¥A

IS

■f* j* 1 .S^t;'

(D) Amount

795

-lljj !&! . "■

-3,676. 1,404.

sm&^mmb

- 4 7 7


36,016. 95,150.

k , ^ r . . ^ « .

3 , 5 9 0 .

134,756. 134,279,

Note: Line 105 plus Una 1d, Part I, should equal the amount on line 12, Part I. [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.) N/A (A)


(B)


(C>


(D)

Total income

(E)

End-of-year assels

%

% %

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).

Please Sign Here

UrNfei penalties qt periuiy.' Seclare |hat I have examined te jeliwn, imAjflino accompsnyino schedules and statements, and to the best o) true, correct, and complete. Declaration of prepare' (other than officei) isbas&d on all infSrrnallon of which. preparerhasany knowledge.

my knowledge and belief, it is

Signaljre of officer Date


Paid Pre-

Garer's se

Only

Prepare r's signature

Dale

0 8 / 2 7 / 0 4 Check if self-employer! n Prepare/'5 SSfJ or PTIN (see

General Instruction W]

Firm's name (or Ahlbeck & Company S A T fc- 16S5 Elk B l vd . ffire-"1 Des P l a i n e s

EIN

IL 60016 Phone no. - ( 8 4 7 ) 8 2 4 - 4 0 0 0

BAA TEEA0106 to/03f03 Form 990 (2003)




(Except Private Foundation) and Section 501(e), 501(f), 501(k), 501 (n), or Section 4947(aX1) Nonexempt Charitable Trust


OMB No. I515-OM7


Save A L i f e Foundation Employer identification number

36-3869459 Part I Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees



than $50,000


devoted to position

(c) Compensation (d) Contribution; to employee benefit plans ana deferred

compensation


allowances

None

Total number of other employees paid over $50,000 None l « S | * lit |,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.')


Benne t t R. Krause

2012 A p p l e t o n D r i v e . S p r i n g f i e l d , I L 62707

Total number of others receiving over $50,000 for professional services *• None

(b)Type of service

Establish funding sources and contracts

(c) Compensation

7 0 . 7 6 9 .

BAA For Paperwork Reduction Act Notice, see the Inslructiors for Form 990 and Form 990-EZ. Schedule A (Form 990 or 990-EZ) 2003

TEEJWMOl 08f28/03

Schedule A (Form 990 or 990-EZ) 2003 Save A L i f e F o u n d a t i o n 36-3869459 Page 2

Part'HI | Statements About Activities (See instructions.) Yes No

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 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.)



c Furnishing of goods, services, or facilities? See P a r t V , Fo rm 9 9 0



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?

2a

2b

2c

2d

2e

3a 3b

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),


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.)

13 n 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

14 |~| An organization organized and operated to test for public safety. Section 509(a)(4). (See instructions.)

BAA 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 3 6 - 3 8 6 9 4 5 9 P a r t IV-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.

Page 3

Calendar year (or fiscal year beginning in) 2002

£b) 2001 2000 1999 Total

15 Gifts, grants, and contributions received. (Do not include unusual grants. See line 23.) .. 1 ,371 ,684 . 820 ,282 6 8 2 , 8 7 8 . 6 2 1 . 0 4 3 . 3 , 4 9 5 . 8 8 7 .


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 207.836 197,535 5 2 , 6 6 4 . 4 1 . 1 5 8 . 4 9 9 . 1 9 3 .

18 Gross income from interest, dividends, amounts received from payments on securities loans (section 512(a)(5)), cents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organization after June 30,1975 2 , 1 5 4 . 3 , 2 7 5 . 8 , 7 2 5 . 2 4 , 5 7 5 . 3 8 , 7 2 9 .

19 Net income from unrelated business activities not included in line IS . . .


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 . . . . 1 . 5 8 1 . 6 7 4 . 1 . 0 2 1 , 0 9 2 . 7 4 4 . 2 6 7 . 6 8 6 . 7 7 6 . 4 , 0 3 3 , 8 0 9 . 24 Line 23 minus line 17 1 . 3 7 3 . 8 3 8 . 8 2 3 , 5 5 7 . 6 9 1 . 6 0 3 . 6 4 5 . 6 1 8 . 3 , 5 3 4 , 6 1 6 . 25 Enter 1% of line 23 1 5 . 8 1 7 . 1 0 . 2 1 1 . 7 , 4 4 3 . 6 . 8 6 8 . lllSlllPS 26 Organizations described on lineslO o r H : a Enter 2% of amount in column (e), line 24

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 199Q through 2002 exceeded the amount shown in line 26a. Do not File this list with your return. Enter the total of all these e«ess amounts

c Total support for section 509(a)(l) lest: Enter line 24, column (e) d Add: Amounts from column (e) for lines: 18 3 8 . 7 2 9 .

22 19 26 b

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

26a

26b

7 0 , 6 9 2 .

26c 3 . 5 3 4 . 6 1 6 .

26d 3 8 . 7 2 9 . 26e 3 , 4 9 5 . 8 8 7 . 26f 98 .90 %

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) (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 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) (2000) (1999) c Add: Amounts from column (e) for lines: 15 16

17 20 21 dAdd: Lire 27a total and line 27b total

27f , 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 27f (denominator)) h Investment Income percentage (line 18, column (e) (numerator) divided by line 27f (denominator))

27c 27 d

27 e

Ha 27 h

% %

28 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.

BAA TEEA04O3 08/29/03 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 Private School Quest ionnaire (See instructions) (To be completed ONLY by schools that checked the box on line 6 in Part IV) N/A

29 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?

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.)

32 Does the organization maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative staff? .


c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student admissions, programs, and scholarships? .,





b Admissions policies? - -




f Use of facilities? — ,




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


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.

29

30

32a

32 b

32c 32d

33 a

33 b

33 c

33 d

33 e

33 f

i l s

33h

34a

34b

35

Yes No

'If

BAA TEEAMW 0&Z8TJ3 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 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.

46


To be completed for ALL electing organizations

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 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 _


Caution: If there is an amount on either line 43 or line 44, you must file Form 4720.

A -Year Averaging Period Under Sect ion 501(h) (Some organizations that made a section 501 (h) election do not have to complete all of the five columns below.


Calendar year (or fiscal year beginning in) "



(a) 2003

(b) 2002

<c) 200)

(d) 2000

(e) Total

Lobbying ceiling amount (150% of line 45(e)) .. i i . ' "

^ ■ - ¥ * > v -47 Total lobbying

expenditures .

48 Grassroots non-taxable amount ..

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

■ ■ - ■ > * & * . .


PartjVI-B | Lobbying Activity by Nonelecting Public Charities (For reporting only by organizations that did not complete Part Vl-A) (See instructions.)


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 Schedule A (Form 990 or 990-EZ) 2003

Yes No Amount

MM'd

TEEAC405 0&I2BI03

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 Page 6 W V 1 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) of the Code (other lhan 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: (i)Sales or exchanges of assets with a noncharitable exempt organization (ii)Purchases of assets Iron a noncharilable exempt organization (iii)Rental of facilities, equipment, or olher assets (iv)Reimbursement arrangements (v)Loans or loan guarantees (vi)Performance of services or membership or fundraising solicitations

c Sharing of facilities, equipment, mailing lists, olher assets, or paid employees

51 a (i) a (ii)

h(f) b(ii) b(iii) b(iv) b(v) btvi) c

Yes No X X

X X X X X X X

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:

(a) Line no.

0») Amount involved


(d) 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

8868 Form (December 2000)

Deparlmeri ol Me Treasury Internal Revenue Service

Application for Extension of Time to File an Exempt Organization Return

*~ File a separate application tor each return.

ONE No. 1545-1709

• 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.

u Par t I'"'* | A u t o m a t i c 3 -Mon th 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 L J

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.



Save A L i f e Foundation

Employer Identlficetion number

36-3869459 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.

Schi l ler Park state

IL ZIP code

60176 Check type of return to be filed (file a separate application for each return): X Form 990

Form 990-BL Form 990-E2 Form 990-PF

Form 990-T (corporation) Form 990-T (Section 401 (a) or 408(a) trust) Form 990-T (trust other than above) Form 1041-A

Form 4720 Form 5227 Form 6069 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 04 , 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 BAA For Paperwork Reduction Act Notice, see instruction:..

Title * " C/jf- Date r / J / 6 V

Form 8868 (12-2000)

FIFZ0SQ1 01105/04

http://Au.fi

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.

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. I6s instructions

Schiller Park IL 60176

Employer Identification number

Check type of return to be Tiled (file a separate application for each return):

BForm 990 Form 990-BL

Form 990-EZ Fonn 990-PF

_ Fonn 990-T (Section 401 (a) or 408(a) trust) Form 990-T (trust other than above)

Form 1041-A Form 4720 H Form. 5227

Form 6069 [ ] Form 8870

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 j y i ^ J l D ^ i s j B q u i r e ^ J o ^ a j h j i l ^ t h

âccurately^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.

O A Date

B D

B

Nonce to Migpllcant' To be Completed by the IRS 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: _ _ _

f / ' T - / i a y

By:

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,

Typa or I print

Name

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)


Statement

Schedule of Gains and Losses from Sale of Assets Other than Inventory

*■ Attach to return

2003

Name Save A L i f e Foundat ion

Employer Identification Number 36-3869459


Public Securities

Description

P u b l i c l v Traded S e c u r i t i e s

Gross Sales Price Basis

Cost Sellinq Expenses Basis




Gross Sales Price


Total Securities


Part 1, Line 8, Column (B)

Description

Veh ic le

Date Acquired and Method

05/01/03

Other Assets


11/01/03

Gross Sales Price

5 ,250.


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.

Total Other Assets 5,250. 7,926,

Gain or (Loss) from Sale of Other Assets -2^676,

TEEW02015CR lO/SOTO




Number of Others

Race Other

Gross Receipts

708 . 796 .

Less Contributions

0. 0.

Gross Revenue

708. 796 .

Less Direct Expenses

100 . 0 .

Net Income (Loss)

608 . 796 .

Total 1 . 504 . 0. 1 .504 . 100 . 1 ,404 .

Form 990, Page 2, Part II, Line 43 Other Expenses Stmt


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 I n s u r a n c e L i censes & P e r m i t s M a r k e t i n g M i s c e l l a n e o u s P a y r o l l S e r v i c e R e c r u i t m e n t Cost o f Goods So ld T r a i n i n g S u p p l i e s Websi t e Program Development

<A) Total

1 4 , 9 7 2 . 3 1 7 .

1 6 8 . 0 2 5 . 6 3 , 9 9 9 .

9 , 4 7 2 . 775 .

1 3 , 4 6 4 . 2 , 5 5 8 . 2 . 6 7 9 .

132 . 1 4 . 6 2 8 . 7 7 , 6 3 3 . 1 3 , 5 1 3 . 1 5 , 0 0 0 .

<B> Program services

1 4 . 9 7 2 . 0 .

7 7 . 9 6 8 . 6 3 . 7 4 9 . 1 0 . 2 6 3 .

818 . - 2 . 3 8 4 .

0 . 1 , 8 4 0 .

108. 0 .

7 7 . 5 8 3 . 1 2 . 5 6 3 .

0 .

(C) Management and aerieral

0 . 317 .

0 . 200 .

- 9 4 5 . - 4 3 . 4 0 2 .

2 , 5 5 8 . 608 .

2 4 . 1 4 . 6 2 8 .

5 0 . 883 .

1 5 , 0 0 0 .

(D) Fundraising

0 . 0 .

9 0 , 0 5 7 . 5 0 .

154 . 0 .

1 5 , 4 4 6 . 0 .

2 3 1 . 0 . 0 . 0 .

6 7 . 0 .

Total 3 9 7 , 1 6 7 . 2 5 7 . 4 8 0 . 3 3 . 6 8 2 . 1 0 6 , 0 0 5 .

Form 990, Page 3, Part IV. Lines 57a & 57b Land, Buildings and Equipment Statement

Land B u i l d i n g O f f i c e Equipment V e h i c l e s

(a) Cost/Other

Basis

2 0 , 0 0 0 . 1 8 1 , 9 1 2 . 1 2 1 , 7 2 7 . 3 9 , 1 3 2 .


0. 4 , 5 4 8 .

7 4 , 9 8 0 . 1 1 , 7 4 6 .

(c) Book Value

2 0 . 0 0 0 . 177.3G4. 4 6 . 7 4 7 . 2 7 . 3 8 6 .

Total 362,771 . 91,274. 271.497.



Line 65 - Other Liabilities:

I n s t r u c t o r Deposits Real Estate Taxes Payable

Beginning of Year

390 .

Endol Year

4 9 0 . 9 3 4 .

Total 390 1,424.



R i cha rd S t i p h e r

Note: The individuals above, except as noted, spend time a5 needed in the 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

(B) Title and


to position

Di r e c t o r

(C) Compensation


0 .

(D) Contributions to employee benefit plans and deferred compensation

0 .

(E) Expense account


0 .

Total 0. 0.



Form 990 p 1/Line 20

Description

Bad debt losses

Total


Form 990 p 2 /L ine 4-2 column (B)

Description

Deprec ia t ion Expense - Program Expense

Amount

3,900.

Total 3,900.


Form 990 p 2/Line 42 column (C)

Description

Depreciation Expense - Office Expense Depreciation Expense - Vehicle

Total


Form 990 p 3 /L ine 63, column (A)

Description

Due to Carol S p i z z i r r i , President/Exec. Di rec tor I n t e r e s t Rate - Va r iab le

Amount

72.227.

Total 72.227.



Description

Due to Carol S p i z z i r r i , President/Exec. D i rec to r I n t e r e s t Rate - Va r iab le

Amount

139.648.

Amount

-20,000.

-20,000.

Amount

14,468. 8,250.

22,718.



Form 990 p 3/L ine 53, column <B>

Description

Total

Continued

Amount

139,648.


Form 990 p 4 /Par t IV-A, Line b(4)

Description

In -K ind Con t r i bu t i ons Specia l Events Expenses

Amount

260,229. 100.

Total 260,329.



Description

In -K ind Con t r i bu t i ons Special Events Expenses

Amount

260,229. 100.

Total 260,329.

SAVE A LIFE FOUNDATION, INC. AUDITED FINANCIAL STATEMENTS DECEMBER 31, 2003 AND DECEMBER 31, 2002

AHLBECK&COMPANY

CERTIFIED PUBLIC ACCOUNTANTS


T A B L E O F C O N T E N T S

December 31, 2003 and December 31, 2002

AUDITOR'S REPORT



Statements of Activities For the years Ended December 31, 2003 and December 31, 2002

Statements of Functional Expenses 8 For the Years Ended December 31, 2003 and December 31, 2002

Comparative Statement of Cash Flows 12 For the Years Ended December 31, 2003 and December 31, 2002


AHLBECK&COMPANY

CERTIFIED 1665 ELK BOULEVARD TELEPHONE: B47/824-4000 PUBLIC DES FLAINES, ILLINOIS FACSIMILE: 847/814-4012 ACCOUNTANTS 60016-4776 WEB. www.ahlhcckco.coin

June 29,2004

To the Board of Directors

Save A Life Foundation, Inc.

Schiller Park, Illinois


We have audited the accompanying statements of financial position of SAVE A LIFE

FOUNDATION, INC. Can Illinois not-for-profit corporation) as of December 31 , 2003 and

December 31 , 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 31 ,

2003 and December 31 , 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

http://www.ahlhcckco.coin


COMPARATIVE STATEMENT OF FINANCIAL POSITION December 31, 2003 and December 31, 2002

2003 2002

A S S E T S

Current Assets Cash and Cash Equivalents Inventory Trade Receivables Grants Receivable Prepaid Legal Fees Other Prepaid Expenses


Fixed Assets at Net Book Value Land Building Office Equipment Vehicles


Other Assets Promises to Give

Total Other Assets

TOTAL ASSETS

$ (5,556) 67,019 22,715

100,000 2,905 1,729

188,812

20,000 177,364 46,747 27,386

271,497

-

460,309

$ 477,154 77,028 6,771

317,968 6,813 2,401

888,135

29,064 35,219

64,283

20,000

20,000

972,418


2


COMPARATIVE STATEMENT OF FINANCIAL POSITION December 31, 2003 and December 31, 2002

2003 2002


Current Liabilities Accounts Payable Real Estate Taxes Payable Instructor Deposits Mortgage Payable


Other Liabilities Due to Carol Spizzirri



Net Assets Temporarily Restricted 100,000 645,762 Unrestricted (3,975) 227,529

Total Net Assets 96,025 873,291

TOTAL LIABILITIES & NET ASSETS 460,309 972,418

$ 28,796 $ 26,510 934 490 390

194,416 224,636

139,648

26,900

72,227


3





INCOME


147,785 4,000

301,609 1,504

147,785 4,000

301,609 1,504

Total Public Support 454 ,898

Government Contracts State of Illinois - DCCA Rural Training 22,488 HHS/CDC 15,000

454,898

22,488 15,000


Other Income Program Service Fees Miscellaneous Course Materials

37 ,488

36,016 3,590

95,150

37,488

36,016 3,590

95,150


Total Income (balances carried forward) 627,142 627,142


4


S T A T E M E N T O F A C T I V I T I E S


Total Income (balances trought forward) 627 ,142

Unrestricted

-

Temporarily Restricted

627,142

Total

EXPENSES

Program Kids Program Corporate Program Expansion Program Branch Development Springfield Building Rural Grant

379,648 13,336

195,523 310,234

7,120 23,640

379,648 13,336

195,523 310,234

7,120 23,640

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 Bad Debt Losses

Loss on Disposition of Assets Change in Net Assets Beginning Net Assets Ending Net Assets

929 ,501 165,227

287,698

1,382,426 100

1 3 8 2 , 5 2 6

307,793 100,000 117,968

(229 ,623)

795

795

(228,828) -

(2,676) (231,504)

227,529 (3 ,975)

--

--

-

(307,793) (100,000) (117,968)

(525,761)

-

-(20,000)

-(545,762)

645,762 100,000

929,501

165,227

287,698

1,382,426

100

1,382,526

-

(755,384)

795

795

(754,589) (20,000)

(2,676) (777,266)

873,291 96,025


5


S T A T E M E N T O F ACTIVITIES



INCOME


1,353 31,500

123,081 93,606

1,353 31,500

123,081 93,606


Government Contracts Slate of Illinois - 1DPH State of Illinois - DCCA State of Illinois - Attorney General Federal - HHS/CDC

249 ,540

25,000

249,540

600,000 200,000

-31,819

600,000 200,000

25,000 31,819


Other Income Program Service Fees Miscellaneous Course Materials Branch Fee Membership Dues

25 ,000

31,693 225

149,980 (2,916)

205

831,819 856,819

31,693 225

149,980 (2,916)

205

Total Other Income

TOTAL INCOME (balances carried forward)

179,187

453,727

-

831,819

179,187

1,285,546


6


S T A T E M E N T O F A C T I V I T I E S


TOTAL INCOME (balances brought forward) 453 ,727

Unrestricted

831,819

Temporarily Restricted

1,285,546

Total

EXPENSES

Program Kids Program Corporate Program Blue Angels Expansion Program Branch Development

Release from Restrictions - 1SBE Release from Restrictions - 1DPH Release from Restrictions - HHS/CDC

344,020 11,382 12,890

586,255 347,747

684,298 1,140

582,049

(684,298) (1,140)

(582,049)

344,020 11,382 12,890

586,255 347,747

Total Program


Fundraising


TOTAL EXPENSES

1 3 0 2 , 2 9 4 133,677

109,797

1,545,768 59,546

1,605,314

1,302,294

133,677

109,797

1,545,768 59.546

1,605,314





Loss on Disposition of Assets Change in Net Assets Beginning Net Assets

Ending Net Assets

115 ,900

2,154

2,154

118,054

(3,091) 114,963

112,566

227,529

(435,668)

-

-

-(435,668) 1,081,430

645,762

(319,768)

2,154

2,154

(317,614)

(3,091) (320,705) 1,193,996

873,291


7



PROGRAM

Kid's Corporate Expansion Branch Springfield Program Program 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 52-

--

13,336

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


a



SUPPORT

Rural Gram

$ ----------

_ 3,842 5,506

-----------------

14,292 ---

23,640 4,202

27,842

Total

$ 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

1,094,728

Managemnt. & General

$ 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)

Fundraising

$ 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

Total

$ 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

Organization Total

$ 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


9

S A V E A L I F E F O U N D A T I O N . I N C .


PROGRAM

Kid's Corporate Expansion Branch Program Program Blue Angels Program 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

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 -

-------5 -----

7.609 -----------

535 ------

3,167 66

-

930



Total Expenses

8,666 156

3,138

279,222 8,166

25,791

7,000

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

16,304 35,619

1,895

80,088 265

3,682

23

32,698 76,134

1,049

103

(534)

6,649 198 373

25,323 199

19,737 712

100,504 544

451.419 10,948 37,790

1,133

129,363 3,139

28

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

122,391 45,779

1,895 344,020

35,313

379,333

11,382

1,168

12,550

12,890 1,323

14,213

586,255 60,178

646,433

347,747 35,695

383,442

1,302,294 133,677

1,435,971


10


C O M P A R A T I V E S T A T E M E N T O F C A S H F L O W S


2003 2002




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

$ (777,266) $ (320,705)

26,618 20,000

2,676 (41,380)

(15,944) 10,009

222,549 2,286

68,455

17,059 -

3,091 (18,000)

(3.864) (29,819) 420,288

17,808 3,522



Proceeds From sale of fixed assets Purchase of fixed assets

(481,997)

15,850 (210,979)

89,380

(27,794) Net cash provided by (used in) investing activities


Issuance of short-term debt Repayment of short-term debt

(195,129) (27,794)

200,000 (5,584)

Net cash provided by (used in) financing activities 194,416

Net increase (decrease) in cash & cash equivalents (482,710) 61,586

Cash &r cash equivalents at beginning of period 477,154 415,568

Cash & cash equivalents at end of period (5,556) 477,154



12


N O T E S T O F I N A N C I A L S T A T E M E N T S


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 31 , 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.





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.


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






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).



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 31 , 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 31 , 2003 and 2002 of $237,729 and $37,000, respectively.

14




Donations of use of facilities are recorded at their fair market value. Such donations are reported as unrestricted supports. During the years ended December 31 , 2003 and 2002, SALF received in-kind contributions of rent for $22,500 and $35,742, respectively.


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 31 , 2003 and 2002, SALF's uninsured cash balances total $0 and $386,633.74, respectively.


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.


At December 31 , 2003 and 2002, the costs of such assets were as follows:

Land Building Office Equipment Vehicles


Depreciation expense for years ending December 31, 2003 and 2002 was $26,618 and $17,059, respectively.

December 31, 2003

$ 20,000 181,912 121,727 39.132

362,771

91.274 $ 7.7 497

2002 $

-92,085 39,132 131,217

66,934

$ fit2*^

Increase (Decrease! $ 20,000

181,912 29,642

_ 29,642

24.340 $ 5.302

15




NOTE 6 - MORTGAGE PAYABLE

The mortgage payable at December 31 , 2003 and 2002 consists of the following:

2003 2002 Mortgage payable to Bank One due on April 28, 2004, $194,416 $0 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 2002 Illinois Department of Commerce and Community $ 100,000 $200,000 Affairs-restricted for the purchase of a building in Springfield, IL

Illinois Department of Public Health - restricted to use 0 307,794 according to the grant agreement and also according to time release restrictions

United States Department of Health and Human Services/ 0 117,968 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 Q 20,000

Total 100,000 645,762


SALF has a vesting vacation policy. The amount of existing vacation time remaining as of December 31 , 2003 and 2002 is immaterial.


The organization's founder and current executive director, Carol Spizzirri, loaned SALF start up funding. As of December 31 , 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





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, Rent 2004 $88,940 2005 97,715 2006 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 31 , 2002.


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 Expenses Net

Dinner Event $ - $ - $ Race For Life • 708 100 608 Other 796 - 796

$1-504 _ 1 1 Q Q $1.404

December 31. 2002 Revenue

$87,360 6,093

153 $93,606

Expenses $58,174

1,158 214

$59,546

Net $29,186

4,935 (61)

$34,060

17

5AVE A LIFE F O U N D A T I O N , INC.


SUPPORT


$ 2,028 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)

-

Fund raising

S 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

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

Organization Total

$ 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


11

T g f > ^ .^LlUJNOIS CHARITABLE ORGANIZATION ANNUAL REPORT D ^ n T > IP /■j^t torney General LISA M A D I G A N State of Illinois

Charitable Trust Bureau, 100 West Randolph

Form AG990-U Revised 1/0

3rd Floor, Chicago. Illinois 60601 Report for the Fiscal Period: Beginning pi / oi / ri4

C O # 01026498

& End ing 06 / 30 / 04 Federal ID # 36-3869459 Are contributions to the organization tax deductible?

MO

: Yes O No 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 V R

Date Organization was created: 0 2 / 0 9 / 93

LEGAL NAME Save A L i f e F o u n d a t i o n MAIL

A D D R E S S 9 9 5 0 H - Lau rence S u i t e 300

01TzipScooE S c h i l l e r Park, IL 60176

«&-1fi

I. SUMMARY OF ALL REVENUE ITEMS DURING THE YEAR: D) PUBLIC SUPPORT, CONTRIBUTIONS 8 PROGRAM SERVICE REV. (GROSS AMTS.)


F) OTHER REVENUES

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

II. SUMMARY OF ALL EXPENDITURES DURING THE YEAR: /

H) OPERATING CHARITABLE PROGRAM EXPENSE *


J) TOTAL CHARITABLE PROGRAM SERVICE EXPENSE [ADD H & l>

Jt> JOINT COSTS ALLOCATED TO PROGRAM SERVICES (INCLUDED IN J):




N) FUNORAISING EXPENSE

O) TOTAL EXPENDITURES THIS PERIOD (ADD L, M , & N>

III. SUMMARY OF ALL PAID FUNDRAISER AND CONSULTANT ACTIVITIES: (Attach Attorney Gener3l Report ot Indiutduat FuniiraiRing Campaign- Form IFC. Onn for na i * PFR. PROFESSIOHAL FUNDRAISERS: P) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISERS


R) NET RECEIVED BY THE CHARITY [P MINUS Q=R) PROFESSIONAL FUNDRAISIN6 CONSULTANTS: S) TOTAL AMOUNT PAID TO PROFESSIONAL FUNORAISING CONSULTANTS


Year-end amounts

A ) A S S E T S

B) LIABILITIES

C) NET ASSETS

PERCENTAGE

A) $ 1 .403 .584

B) s 333.611 C ) S 1,069^973

10 .04 *

90 -11 *

M 5 ) %

100%

%

84.16 %

AMOUNT

D ) $ 115,844 E > $ 1.040.000 F ) $ (1.689: G ) $ ■154.155

H ) S LiUi6A. i ) i

%

84.16 %

11-84 %

4 . 0 0 % 100%

J ) $

K ) S

151,664

L ) S 151.664 M ) $ 21.328 N ) S 7.215 o>$ 180.207

100% P ) S

Q ) $

T) NAME. TITLE:

U) NAME. TITLE:

V) NAME. TITLE:

Carol S p i z z i r r J . CEO Dane Neal . Nat iona l Proeram Coordinator Donna Achs. Accountant

T>$

U)S V ) $

20.000 21.663

L.923

S ) $

V. CHARITABLE PROGRAM DESCRIPTION:cWAnrrflai.e PROGRAM p MGHSST BV I BC«NBED) CODE CATEGORIES

W)jjESCRIPTION:Life S a v i n g F i r s t A i d T r a i n i n g

Usl on back side of instructions CODE

W ) » O i l X) DESCRIPTION:

)-DESCRIPTION: ÊCEIVEEl X)#

Y)#

ATTORNEY GENERAL^ CHARITABLE TRUST


1. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION. FINE, PENALTY OR JUDGMENT? t.

2. 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? 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.

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 COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? - _ _ 5.

6. DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER?( ATTACH FORM IFC ) B.

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 $ ; AND [iv) THE AMOUNT ALLOCATED TO FUNDRAISING S

B. DID THE ORGANIZATION EXPEND ITS RESTRICTED FUNDS FOR PURPOSES OTHER THAN RESTRICTED PURPOSES? 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:

Bank One. NA I l l i n o i s M a r k e t . P . O . Box 260180 . Baton Rouge. LA 70826-0180

X

12.

Wachov ia Bank N . A . , P.O. Box

NAME AND TELEPHONE NUMBER OF CONTACT PERSON:

50015 ,

C a r o l

Roanoke,

S D i z z l r r i

VA 24040-7350

(W) 928-9683


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 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 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) '

£%Q6tA{ /?. fa/low* TREASURER or TRUSTEE (PRINT MfcKE]

PREPARER (PRINT NAME,

" c w a n i i k H w DATE

j i o i v n i ut

Form 990

Department of the Treasury Internal Revenue Sewice

CHANGE IK ACCOUNTING fEKlUD 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)

The organization may ha-je to use a copy of this return to satisfy state reporting requirements,

OMB No. 1545-0047

J2003"2bo4 Open to Public

Inspection

A For the 2003 calendar year, or tax year beginning J a n 1 Check if applicable:

Address change

Name change

Initial return

Final return

Amended return

Application pending


Stu specific instructions.


Save A L i fe Foundation

^-rêag; and ending J u n 30 2004

Number and street {or P.O. bo i if mail is not delivered to street arJdr) Room/suite


S c h i l l e r Park State ZIP code+ 4

IL 60176 ■ Section 501 (cX3) organizations and 4947(a)(1) nonexempt

charitable trusts must attach a completed Schedule A (Form990or990-EZ).

G Website: *■ www. s a T f . o r g

J Organization type , - , ■—, ■—> (Check o n i y o n e ) * \*\ 501(c) 3 * [insert no.) 1_J W7f .a )H) or 1 I 527

K 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.

L Gross receipts: Add lines 6b, fib, 9b, and 10b to line 12 *■ 1 , 1 5 4 , 7 5 5 .

, 2 0 0 4 D Employer d»ntific»tfon Number

36-3869459 Tel* nh on * number

(847) 928-9683 Accountin

it&od: niet&od": " * | | Cash |X j Accrual

\ \ Other (specify)*-

H anil are not applicable lo setfion 527 organizations.

H (a) Is this a oroup return for affiliates? . , . | | Yes |X j Ha

H (b ) If 'Yes.' enter number of affiliates * "

H (C) Are all affiliates included1 [ 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 y e s | x | fjo

I Group Exemption Number . . , ** M 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) 1 Contributions, gifts, grants, and similar amounts received;

a Direct public support b Indirect public support c Government contributions (grants) d U M r & g ^ T W S 1 , 1 2 7 , 9 8 8 . noncash $

l a l b 1c

8 7 , 9 8 8 .

1 , 0 4 0 , 0 0 0 . 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 securities


b Less: rental expenses c Net rental income or (loss) (subtract line 6b from line 6a)

7 Other investment income (describe *"

6a 6b

(A) Securities 8a Gross amount from sales of assets other than inventory I I 8a

b Less: cost or other basis and sales expenses 8b c Gam or (loss) (attach schedule) 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 , 638 . of contributions

reported on line la) 9a

(B) Other

*a 9b

6 0 0 . 6 0 0 . b Less: direct expenses other than f undraising expenses

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

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 Id , 2, 3,4, 5, 6c, 7, 3d, 9c, 10c, and 11)

10a 10b

I d

6c

8d

9c

10c 11 12

1 ,127 ,988 , 2 7 , 8 5 6 .

9 .

0 ,

- 1 , 6 9 8 . 1 ,154 ,155 .

13 program services (from line 44, column (B)) 14 Management and general (from line 44. column (C)) 15 Fundraising (from line 44, column (D)) 16 Payments to affiliates (attach schedule) 17 Total expenses (add lines 16 and 44, column (A)) .

13 151 ,664 , 14 2 1 , 3 2 8 , 15 7 , 2 1 5 .

17 180 ,207 . 18 Excess or (deficit) for the year (subtract line 17 from line 12) 19 Net assets or fund balances at beginning of year (from Itne 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) .

11 20_ 21

9 7 3 , 9 4 8 . 9 6 , 0 2 5 .

1 , 0 6 9 , 9 7 3 . BAA For Paperwork Reduction Act Notice, see the separate instructions. TEEA0101 11^4/03 Form 99043663)-

2004

2004 tiorm 99Q4a963r Save A L i f e Foundation 36-3869459 Page 2 Part II I Statement of Functional Expenses 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

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);

a Bank Service Fees fa Computer Expenses c Consul t ing Fees d Dues & Subscr ipt ions 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

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

44

(A) Total

2 0 , 0 0 0 , 2 7 , 9 0 7 .

- 4 1 4 . 4 , 6 4 6 .

5 , 8 5 0 . - 3 5 .

5 , 1 0 9 . 5 4 3 .

5 4 . 3 4 7 .

1 1 , 3 9 2 . 9 , 9 4 5 . 6 , 3 2 3 ,

1 6 , 9 5 8 .

2 6 0 . 1 1 9 .

1 , 0 0 0 . 1 , 2 1 7 .

1 5 , 0 4 0 .

1 8 0 , 2 0 7 .


2 0 J 3 0 0 . 2 7 , 9 0 7 .

- 4 1 4 . 4 , 6 4 6 .

5 , 8 5 0 . 2 .

5 , 1 0 9 . 5 2 4 .

5 4 , 3 4 7 .

5 , 4 4 6 . 9 , 9 4 5 , 3 , 3 1 5 .

0 ,

- 2 6 4 . 1 1 9 .

1 , 0 0 0 . 1 , 2 1 7 .

1 2 , 9 1 5 .

1 5 1 , 6 6 4 .


11 , ' •*

o. 0 .

0 . 0 .

0 . - 3 7 .

0 , 0 . 0 .

0 . 0 .

3 . 0 0 8 . 1 6 , 9 5 8 .

5 2 4 . 0 . 0 . 0 .

8 7 5 .

2 1 , 3 2 8 .

(D) Fundraising

* ; - ^ - , , J i

i - va

0 . 0 .

0 . 0 .

0 . 0 . 0 .

1 9 . 0 .

5 , 9 4 6 . 0 . 0 . 0 .

0 . 0 . 0 . 0 .

1 , 2 5 0 .

7 , 2 1 5 . 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 What is the organization's primary exempt purpose? - _P£0JTI0te_ J . i . fe_ s a y J ng_ _f i_ rs 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) organ-izations and 4947f,a)f,1) nonexempt charitable trusts must also enter the amount of grants & allocations to others.)

Program Service Expenses (Required fix 501(c)(3) and

(4) organizations and 4947(3)0) trusts; But optcrcal for others.)

a_K^d_'_s_Programs - Promotion and teaching o f l i f e saving f i r s t

(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_îjd_tp_T_n_djvnjjjjal_5__ot_her__tfja_n_ 5^hôT^-^g^^hi_l^r_en_^l_14_t_ajjgh_t2

11,638.

[Grants and allocations $ 0 . ) c AAVi_ed Jlealth_Gr_ant_ j_Prpmo_t_ion_ o f 3_^_gency__re__ri ng_ "chi ldren_ to j i f er_enc_e_ _(1_0_0_attendees)

8,021.

(Grants and allocations $ d Jxp_ans ton_P.r_ogr_ajn_-_ Jxparjd Jo_sj_tel_U te_ 2f.fJ ce_

ins ide and outs ide the State of I l l i n o i s ±2 2 0 , 0 0 0 ,

(Grants and allocations $ 0 . 112,005. e Other program services (Grants and allocations $

Total of Program Service Expenses (should equal line 44, column (B), Program services) ■ 151.664. BAA TEEAOI02 I0;03;03 Form 990^6*37

2 0 0 4

2 0 0 4 Form990-geoff Save A L i f e F o u n d a t i o n 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.


(B) End of year

45 Cash - non-interest-bearing 46 Savings and temporary cash investments

- 5 , 5 5 6 . 45 0 46

47 a Accounts receivable b less: allowance for'doubrful accounts



47 a 47 b

48a 48b

13,415 0 . 2 2 , 7 1 5 . 47 c

48c 100 ,000 . 49

50 Receivables from officers, directors, trustees, and key employees (attach schedule) 50

51 a Othar tries $. loans receivable (attach stti) , , , b Less: allowance for doubtful accounts

52 Inventories for sale or use 53 Prepaid expenses and deferred charges

51a 51b 51c

67 ,019 . 52

54 Investments — securities (attach schedule) ► □ Costly FMV 4 , 6 3 4 . 53

54 55a Investments - land, buildings, & equipment: basis ,


56 Investments — other (attach schedule) 57a Land, buildings, and equipment: basis

55a

55 b

1 55c

b Less: accumulated depreciation (attach schedule) L T 5 . 7 . 5 t i l l t .

58 Other assets (describe **

57 a

57b

3 6 2 , 7 7 1 .

1 0 8 , 2 3 2 . 271 ,497 , . ) - -

59 Total assets (add lines 45 through 5B) (must equal line 74) 4 6 0 , 3 0 9 .

57c 58

59

3 , 3 9 9 . 9 . 8 9 2

13 ,415 .

1 ,057 ,000 .

54 ,371 1 0 , 9 6 8 .

2 5 4 , 5 3 9 .

1 ,403 ,584 . 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) 65 Other liabilities (describe ► See L i n e 65 S t f f l t

28 ,796 . 60 61 62

139,648 63 64a

194 ,416 . 64b

>.. 1,424. 65 66 Total liabilities (add lines 60 through 65)

|Xj and complete lines 67 3 6 4 , 2 8 4 66

3 7 , 3 7 7 ,

157 .655 .

137 ,155 . 1 ,424.

333 ,611 Organizations that follow SFAS117, check here

through 69 and lines 73 and 74. 67 Unrestricted 68 Temporarily restricted 69 Permanently restricted

Organizations that do nol 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

- 3 . 9 7 5 100,000 66

69 \ \ and complete lines

70 71 72

73

74

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) Total liabilities and net assetsffund balances (add lines 66 and 73)

96 ,025 73 4 6 0 , 3 0 9 74

- 6 9 . 5 7 0 . 1 , 1 3 9 , 5 4 3 .

1 , 0 6 9 , 9 7 3 . 1 , 4 0 3 , 5 8 4 .

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

2 0 0 4

F o r m 9 9 0 - g a B r Save A L i f e F o u n d a t i o n 36-3869459 Page 4 f j a r i l V - A } Reconci l iat ion of Revenue per Aud i ted

Financial S ta tements with Revenue per Return (See ins t ruct ions. )

P a r H y - t t ; , I Reconci l iat ion of Expenses per Audi ted Financial S ta tements wi th Expenses per Return

a Total raienue, gains, aid other support per audited financial statements

i Amounts included on line a but not on line 12, Form 990:


(2) Donated services and use of facilities $ _

(3) Recoveries of prior year grants $ _


7 2 , 5 0 0 .

$ 1,100. Add amounts on lines (1) through (4) "• Line a minus line b *■


CO Investment expenses not included on lire 6b, Form 990 $


$ Add amounts on lines (1) and (2 ) . . .

Total revenue per line 12, Form 990 (line c plus lined)

1 ,227 ,755

7 2 , 5 0 0 .

a Total expenses and losses per audited financial statements *•


O) Donated services and use of facilities $__

(2) Prior year adjustments 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

$ 1 ,100 . 7 ^ , 6 0 0 Add amounts on lines (1) through (4)

Line a minus line b


O) Investment expenses not included or line 5b, Form 390 $_


$

_25_3 L 807.

73 600 180 Mf.

1 , 1 5 4 , 1 5 5 .


Total expenses per line 17, Form 990 (line c plus line ti) 180,207

Part V I List of Off icers, Directors, Trustees, a n d Key E m p l o y e e s (List each one even if not compensated; see instructions.)

(A) Name and address <B) Title and average hours


(C) Compensation (if nol paid, enter -0-)




allowances

_ C a r p _ l _ S j ) j z z _ i _ r r l

Cha i rman /Exec D i r 4 0 2 0 , 0 0 0 . 1,334. 0 . R i t a M u l l i n s

Chai rwoman 0. 0. 0. Peggy Trimble

Vice Chairwoman 0. 0. Nadine Levick

Secretary 0. 0. .Doug. Browne

Treasurer 0.

See List of OfficejÊlc^ Statement _ 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.

►Qre* ( *>o

BAA

TEEA01M 10/02/03

Form 99CH2003) 2 0 0 4

2004 Form 990 ffee3)- Save A L i f e Foundation 36-3869459 Page 5

Part-V);; Other Information (See instructions) Yes 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 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?



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?


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| 73,000.


84 a Did the organization solicit any contributions or gifts that were not tax deductible?

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?


85 c 85 d

85e 851

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?

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 line 12

b Gross receipts, included on line 12, for public use of club facilities 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.)

86a 86b 87a

87b

0 .

76 77

78a 7Bb

79

80 a

81b

82a

83 a 83 b 84a

84b 85a 85b

85q

85 h

88

89b

X

S3idS"BK*J~;3

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 ►


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 IU j 1 OT_S_,_Wi_scon_s jn ,_ 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_ Lawr e n_ce_ SuJ t e J0O,_Sch i_ l l . e r_ fa r_k_I_L Z I P + 4 ■- i 0 1 _ 7 J > _ V J 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 H 92 |

0 . 0 .

:n BAA

TEEAO105 12<23rt)3 Form 990 ( 2 0 8 ^ —

2004

2004

Form990-{2SQ3)JSave A L i f e Founda t i on 36-3869459 Page 6 Part VUU Analysis of Income-Producing Act iv i t ies (See instructions.


93 Program service revenue: a Program Fees b Course Materials c Branch d e

Fee

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 Net rental income or (loss) from pens prop 99 Other investment income

100 Gam or (loss) from sales of assets other lhan inventory Net income or (loss) from special events Gross profit or (loss) from sales ol inventory

Other revenue: a

101 102 103

b M i s c e l l a n e o u s c d e


Susinsss code (B)

Amount

W^mmmomM

104 Subtotal (arid columns (B), CD), 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.

Excluded by section 512, 513, or 514

Exclusion code

14

mi

CD) Amount

9.


23,160. 1,340. 3 , 3 5 6 .

-1 .698.

26,158. 26,167,

Part VIII: Relationship of Activit ies t o the Accompl ishment of Exempt Purposes (See instructions.) Line No. 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).

93a - 93c Promote and teach life saving first aid programs. 103a To supplement f u n d i n g r e q u i r e d t o p e r f o r m and 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 p rog rams .

Information Regarding Taxable Subsidiaries and Disregarded Entities (See instructions.) MM (A)

Name, address, and EfN u l wrpu ia l iun partnership, or disregarded entity

(B) Percentage of

ownership interest Nature of activities

(D) Total

income

(E) End-of-year

assets

% %

PartX-.| Information Regarding Transfers Associated w i th 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? Note: If 'Yes' to 0), file Form 8870 andForm 4720 (see instructions).

Please Sign Here

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.



Paid Prepared Use Only

Pruparer's signature

Firm's.name (or Ah lbeck & Company eXyedf ► 1665 E lk B l v d . i f e 5 ' 3 " " Des P l a i n e s

Date

10/26/04

IL 60016

Check if self- r—| employed *" I

Preparer's SSN or PTIN (see General Instriidion W)

EIN

Phone no. » ( 8 4 7 ) 8 2 4 - 4 0 0 0

BAA TEEA0106 1CI03J03 Form 998-(£Be3} 2004



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.)

*■ MUST be completed by the above organizations and attached to their Form 990 or 990-EZ.

OMB No. 1545-OM7

2004

-2003-Name of lhe organisation

Save A Li fe Foundation Employer id entificirlior number

36-3869459 Pattl Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees



than $50,000


devoted to position

(c) Compensation (d) Contributions to employee benefit plans and deferred

compensation


allowances

None


BMWl\ .1 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.')


None

Total number of 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.

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 F o u n d a t i o n 36-3869459 Page 2

R i f t . f l O t I Statements About Activities (See instructions.) Yes No

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 l inei 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.)


b Landing of money or other extension of credit?

c Furnishing of goods, services, or facilities? See P a r t V , Form 9 9 0



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

r, ins use or distribution of t t..r.Af;'> s?

2a

2b

2c

2d

2e

3a 3b

Ijf iHii iyi l^l l 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).


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 A n 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).)


(a) Name(s) of supported organization(s) (b) Line number from above

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

BAA TEEAM02 C]/19/M Schedule A (Form 990 or Form 990-EZ)^Bej

2 0 0 4 Schedule A (Form 990 or 990-EZ).g90rJ Save A L i f e F o u n d a t i o n 36-3869459 Page 3 paftJVfrACl Support Schedu le (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) -a?0S 2 0 0 3 ■1 2002 -2600 2001 -W99 2 0 0 0 Total 15 Gifts, grants, and contributions

received. (Do not include unusual grants. See line 28.) .. 4 4 8 , 6 2 1 . 1 . 3 7 1 , 6 8 4 . 8 2 0 , 2 8 2 . 6 8 2 , 8 7 8 . 3 . 3 2 3 , 4 6 5 .


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 120 ,316 . 2 0 7 , 8 3 6 197,535 , 5 2 , 6 6 4 , 578.351

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 organization after June 30.1975 795 2 . 1 5 4 . 3 . 2 7 5 , 8 ,725 . 14,949,

19 Met income !rom unrelated business activities not included in line IS . .



22 Other income. Attach a schedule. Do not include gain or (loss) from sale ol capital assets

23 Total of lines 15 through 22 5 6 9 , 7 3 2 . 1 , 5 8 1 , 6 7 4 . 1 ,021 ,092 . 7 4 4 , 2 6 7 . 3 , 9 1 6 . 7 6 5 . 24 Line 23 minus line 17 4 4 9 , 4 1 6 . 1 . 3 7 3 , 8 3 8 . 25 Enter 1%ot line 23 5 . 6 9 7 . 1 5 , 8 1 7 .

8 2 3 , 5 5 7 . 6 9 1 , 6 0 3 . 1 0 . 2 1 1 . 7 . 4 4 3 .

3 , 3 3 8 , 4 1 4 . iSi^sS^"'^"-*!^^ \

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 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 2DCZ 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 1 4 , 9 4 9 .

22 19 26b 0.

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

26 a 6 6 , 7 6 8 .

26 c , 3 3 8 , 4 1 4 . !slHr8As ,S&

26 d 14 ,949 . 26 c 3 , 3 2 3 . 4 6 5 . 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) (2000)

c Add: Amounts from column (e) for lines: 15 17 20

d Add: Line 27a total e Public support {line 27c total minus line 27d total)

(1999)

and line 27b total

16 21

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 27f (denominator))

27 f

h Investment income percentage (line 18, column (e) (numerator) divided by line 27f (denominator)) .,

27 c 27d 27e

2Za 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 Schedule A (Form 990 or 990-EZ) 2063— 2004

2 0 0 4 Schedule A (Form 990 or 990-EZ) 2993~ Save A L i f e F o u n d a t i o n 36-3869459 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) N/A

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?


31

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? .













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?




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 statement-

35 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

29

30

31

32a

32b

32c 32d

Yes No

33 a

33b

33c

33d

33e

33 f

Ma. 33 h

34a

34b

35 BAA TEEA04O4 OS/28103 Schedule A (Form 990 or 990-EZ) 2063—

2004

2 0 0 4 Schedule A (Form 990 or 990-EZ)^8ey Save A L i fe Foundation 36-3869459 Page 5

Eja"rt"#feA%j Lobbying Expenditures by Electing Public Charities (See instructions.) (To be completed ONLY by an eligible organization that filed Form 5768)

Check |if the organization belongs to an affiliated group. Check *■ b I I if you checked 'a' and 'limited control' provisions apply,


(a) Affiliated group

totals

0») To be completed for ALL electing organizations


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


36 37 36

39 40

41

42 43 44

TEST Pi i iSHt-4 -Year Averaging Per iod Under Sect ion 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.)


Calendar year (or fiscal year beginning in)»

(a) 2003

(b) 2002

(c) 2001

(d) 2000

00 Total


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


48 Grassroots non-taxable amount ..

49 Grassroots ceiling amount (150% af line 48(e)) . . . i.'-.-S cJIrTr'.'Cii


iPf lr tyteBSlLobbyinq Act iv i ty by Nonelect ng Public Char i t ies (For reporting only by organizations that did not complete Part VI-, -A) (See instructions.)


b Paid staff or management (Include compensation in expenses reported on lines c through h.)

g Direct contact with legislators, their staffs, government officials, or a legislative body h Rallies demonstrations, seminars, conventions, speeches, lectures, or any other means

Yes No

Y X X X X X X X

>

Amount

, < i

If 'Yes' to aiy of Ihe above, also attach a statement giving a detailed description of the lobbying activities. BAA Schedule A (Form 990 or 990-EZ)-3eW—

2004 TEEAM05 08/28/03

2 0 0 4

Schedule A (Form 990 or 990-EZj 2S8T S a v e A L i f e F o u n d a t i o n 36-3869459 Page 6

?mm 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: (i)Cash (ii)Other assets

b Other transactions: (i)Sales or exchanges of assets with a noncharitable exempt organization

(il) Pur chases ot 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 c Sharing of facilities, equipment, mailing lists, other assets, or paid employees —

51 a 0) a(i i )

b(i) b(i i) bC'ii) b(iv) b(v) b(vi) c

Yes No X X

X X X X X X X

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:

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 11 'Yes,' complete the tollowinq schedule: (a)

Name of organization (b>

Type of organization (c)


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

*• File a separate application tor each return.

0MB No. 1-45-170.

w * 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 * [_]

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

Save A L i f e F o u n d a t i o n

Empleyar {dmtificaiion number

36-3869459 Murfflbei, sfceeV and room or suite nuntbef. If a P.O.ban, see _n__A_uctLon£

9950 Lawrence , #300 City, town or post office. For a foreign address, see Instructions.

S c h i l l e r Park

state

IL ZiPcoOe

60176 Check type of return to be filed (file a separate application for each return): X Form 990

Form 990-BL Form 990-EZ Form 990-PF

Form 990-T (corporation) Form 990-T (Section 401(a) or 408(a) trust) Form 990-T (trust other than above) Form 1041-A

Form 4720 Form 5227 Form 6069 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 Feb 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 J a n 1 ,20 04 , 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 <™»ni« 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

BAA For Paperwork Reduction Act Notice, see instructions. Trtle c# Date ■» fo/zt/£f

Form 8868 (12-2000)

FIFZ0501 O1/05/04




Number of Others

Race Other

Gross Receipts

2 , 5 8 8 . 650 .

Less Contributions

2 , 5 8 8 . 50 .

Gross Revenue

0 . 600 .

Less Direct Expenses

0 . 600 .

Net Income (Loss)

0 . 0 .

Total 3 , 2 3 8 . 2 , 6 3 8 . 600 . 600. (K

Form 990, Page 2, Part II, Line 43 Other Expenses Stmt


I n s t r u c t o r s Fees I n s u r a n c e L i c e n s e s & P e r m i t s M a r k e t i n g Mi s c e l l a n e o u s P a y r o l l S e r v i c e R e c r u i t m e n t Cost o f Goods S o l d Webs i t e Bad Debt Expense P r o f e s s i o n a l Fees

(A) Total

7 . 7 2 1 . 4 , 0 5 3 .

2 0 . 1 ,260. 1 .909.

867. 670 .

- 5 , 5 3 1 . 1 ,996.

7 5 . 2 . 0 0 0 .

(B> Program services

7 , 7 2 1 . 3 , 4 4 6 .

2 0 . 10 .

1 . 9 0 9 . 8 6 7 . 6 7 0 .

- 5 , 5 3 1 . 1 . 8 0 3 .

0 . 2 , 0 0 0 .


0 . 607.

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

193. 75 .

0 .

Fundraising

0 . 0 . 0 .

1 ,250 . 0 . 0 . 0 . 0 . 0 . 0 . 0 .

Total 1 5 , 0 4 0 . 1 2 . 9 1 5 . 875 . 1 .250 .


1 and B u i l d i n g O f f i c e Equipment V e h i c l e s

(a) Cost/Other

Basis

2 0 . 0 0 0 . 1 8 1 , 9 1 2 . 1 2 1 , 7 2 7 .

3 9 . 1 3 2 .


0 . 9 . 0 9 6 .

8 3 , 4 7 7 . 1 5 . 6 5 9 .

(c) Book Value

2 0 . 0 0 0 . 1 7 2 , 8 1 6 .

3 8 . 2 5 0 , 2 3 . 4 7 3 .

Total 3 6 2 , 7 7 1 , 1 0 8 , 2 3 2 . 2 5 4 , 5 3 9 .


Line 65 - Other Liabil i t ies: Beginning

of Year End of

Year

Save A Life Foundation 36-386S459 2

Form 990, Page 3, Part IV, Line 65 Continued Other Liabilities Statement

Line 65-Other Liabilities: Beginning

of Year End of

Year

Total 1 ,424. 1 ,424.



Mark M i t c h e l l

I r v Bock

Steve OrebauEh

Joseph Saba to

Note: The individuals above, except as noted, spend time as needed in the 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

(B) Title and

average lours per week devoted

to position

D i r e c t o r

D i r e c t o r

D i r e c t o r

D i r e c t o r

(C) Compensation


0 .

0 .

0 .

0 .


compensation

0.

0,

0 .

0 .

(E) Expense account


0.

0 .

0 .

0 .

Total 0 . 0. 0 .



Form 990 p 2 /L ine 42 column (C)

Description

Deprec ia t ion Expense - O f f i c e Expense Deprec ia t ion Expense - Veh ic le Deprec ia t ion Eoxense - B u i l d i n g

Amount

8,497. 3,913. 4,548.

Total 16,958


Form 990 p 3/L ine 63, column (A)

Description

Due to Carol S p i z z i r r i , Pres ident /Exec. Di rector I n t e r e s t Rate - V a r i a b l e

Amount

139,648.

Total 139 ,648 .


Form 990 p 3/L ine 64b, column (A)

Description

Mortgage Dated 4 /28 /03 , o r i g i n a l amount: $200,000 due date: 4 /28 /04 , i n t e r e s t r a t e : 4.25%

Amount

194,416.

Total 194 ,416 .


Form 990 p 3 /L ine 63, column (B)

Description

Due to Carol S p i z z i r r i , Pres ident /Exec. Di rec tor I n t e r e s t Rate - Va r i ab le

Amount

157.655.

Total 157 ,655 .



Form 990 p 3 /L ine 64b, column (B)

Description

Mortgage Dated 4/28/03, o r i g i n a l amount: $200, 000 due da te : 7 /28/04, i n t e r e s t r a t e : 4,25%

Amount

137.155.

Total 137,155.


Form 990 p 4 /Par t IV-A, Line b(4)

Description

Special Events Expense Donated M a t e r i a l s

Amount

600. 500.

Total 1.100.

Supporting Statement at:


Description

Special Events Expenses Donated M a t e r i a l s

Amount

600. 500.

Total 1,100.

SAVE A LIFE FOUNDATION, INC. AUDITED FINANCIAL STATEMENTS JUNE 30, 2004 AND DECEMBER 31, 2003




June 30, 2004 and December 31, 2003

AUDITOR'S REPORT


Comparative Statements of Financial Position June 30, 2004 and December 31, 2003

Statements of Activities 4 For the Six Months Ended June 30, 2004 and the Year Ended December 31, 2003

Statements of Functional Expenses 8 For the Six Months Ended June 30, 2004 and the Year Ended December 31, 2003

Comparative Statements of Cash Flows 12 For the Six Months Ended June 30, 2004 and the Year Ended December 31, 2003


AHLBECK&COMPAKY

CERTIFIED 1665 ELK BOULEVARD TELEPHONE: 8+7/814-4000 PUBLIC DES PLAINES, ILLINOIS FACSIMILE: 847/824-1012 ACCOUNTANTS 60016-4776 WED: www.ahlbecfcco.com

October 5, 2004



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.


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

http://www.ahlbecfcco.com


COMPARATIVE STATEMENTS OF FINANCIAL POSITION June 30, 2004 and December 31, 2003

2004 2003

A S S E T S

Current Assets Cash and Cash Equivalents Inventory Trade Receivables Grants Receivable Prepaid Legal Fees Employee Advances Receivable Other Prepaid Expenses




TOTAL ASSETS

$ 13,291 54,371 13,415

1,057,000 55

196 10,717

1,149,045

20,000 172,816 38,250 23,473

254,539

1,403,584

$ (5,556) 67,019 22,715

100,000 2,905

-1,729

188,812

20,000 177,364 46,747 27,386

271,497

460,309


2


COMPARATIVE STATEMENTS OF FINANCIAL POSITION

June 30, 2004 and December 31, 2003

2004 2003


Current Liabilities Accounts Payable Real Estate Taxes Payable Instructor Deposits Rent Payable Mortgage Payable


Other Liabilities Due to Carol Spizzirri



Net Assets Temporarily Restricted 1,139,543 100,000 Unrestricted (69,570) (3,975)

Total Net Assets 1,069,973 96,025

TOTAL LIABILITIES & NET ASSETS 1,403,584 460,309

$ 6,487 934 490

30,890 137,155

175,956

157,655

$ 28,796 934 490

194,416

224,636

139,648

THE ACCOMPANYING NOTES ARE AN INTBGRAL PART OT THESE STATEMENTS

3



For the Six Months Ended June 30, 2004 Temporarily


INCOME


850 $ 84,500

73,000 3,238

850 84,500 73,000

3,238


Government Contracts State of Illinois - IDPH HHS/CDC

77,088 84,500 161,588

20,000 -

20,000

i J , l U U

(1,698) 1,340 3,356

-1,020,000

1,020,000

---

20,000 1,020,000

1,040,000

23,160 (1,698) 1,340 3,356


Other Income Program Service Fees Miscellaneous Course Materials Branch Fee


Total Income (balances carried forward) 123,246 1,104,500 1,227,746


4



For the Six Months Ended June 30, 2004

Total Income (balances brought forward) 123,246

Unrestricted

1,104,500 Temporarily Restricted

1,227,746

Total

EXPENSES

Program Kids Program 62,138 - 62,138 Corporate Program 8,021 - 8,021 Expansion Program 134,505 - 134,505 Allied Health Grant 20,000 - 20,000

Total Program Management and General Fundraising


Special Event Expenses

Total Expenses

Release from Restrictions - HHS/CDC


224,664 21,328

7,215

253,207

600

253,807

64,957

(65,604)

--

-

-

-

(64,957)

1,039,543

224,664 21,328

7,215

253,207

600

253,807

-

973,939

Investment Income Interest Income 9 - 9 Total Investment Income 9 9

Excess Income Over Expenses Change in Net Assets Beginning Net Assets Ending Net Assets (Deficit)

(65,595) (65,595)

(3,975) (69,570)

-1,039,543

100,000 1,139,543

973,948 973,948

96,025 1,069,973


5





INCOME


147,785 4,000

301,609 1,504

147,785 4,000

301,609 1,504

Total Public Support 454,898

Government Contracts State of Illinois - DCCA Rural Training 22,488 HHS/CDC 15,000

454,898

22,488 15,000

Total Government Contracts 37,488 37,488

Other Income Program Service Fees Miscellaneous Course Materials

36,016 3,590

95,150

36,016 3,590

95.150


TOTAL INCOME (balances carriedJorward) 627,142 627,142


6




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

Release from Restrictions - IDPH Release from Restrictions - DCCA Release from Restrictions - HHSVCDC

379,648 13,336

195,523 310,234

7,120 23,640

307,793 100,000 117,968

(307,793) (100,000) (117,968)

379,648 13,336

195,523 310,234

7,120 23,640

Total Program Management and General Fundraising

Total Fnnctional Expenses Special Event Expenses

TOTAL EXPENSES

929,501 165,227 287,698

1,382,426 100

1,382,526

929,501 165,227 287,698

1,382,426 100

1,382,526




Excess Income Over Expenses Bad Debt Loss Loss on Disposition of Assets Change in Net Assets Beginning Net Assets

Ending Net Assets (Deficit)

(229,623)

795

795

(228,828) -

(2,676) (231,504)

227,529

(3,975)

(525,761)

-

(525,761) (20,000)

-(545,762)

645,762

100,000

(755,384)

795

795

(754,589) (20,000)

(2,676) (777,266)

873,291

96,025


7

S A V E A L I F E F O U N D A T I O N , INC .

STATEMENT OF FUNCTIONAL EXPENSES


PROGRAM

Kid's Corporate Expansion Allied Program Program 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

$ 44,000 $ ----------------

3,315 250

----

13,973 77

--

523 -

Total Program Expenses Administration Allocation Total Expenses

7,721

15

285

59,819 $ (814)

4,646 1,909

(264) 119

(5,531)

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

6,588 $ 110,407 400

-

; -

--

--

1,950 --■

9,026 -

913 -

70 ---

1,053 ----

(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

62,138 5,899

68,037

8,021 761

8,782

134,505 12,769

147,274

20,000 1,899

21,899

224,664 21,328

245,992


8


STATEMENT OF FUNCTIONAL EXPENSES For (he Six Months Ended June 30, 2004

SUPPORT


$ ---

75 524

-0

16,958 --

607 ----

3,008 (37)

, --. -'

--

193

21,328 (21,328)

-

Fundraising

$ - $ ---

_ ---------

1,250 ----

19 ----

5,946 --

7,215 -

7,215

Total

---

75 524

--

16,958 --

607 --

1,250 -

3,008 (37)

-19

----

5,946 -

193

28,543 (21,328)

7,215

Organization Total

$ 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


9



PROGRAM

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

Kid's Program

$ 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

Corporate Program

$ ------------

9,269 ---

69 -------------

3,946 52

--

13,336 2,371

15,707

Expansion Program

$ 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

Branch Development

$ 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

Springfield Building

$ -------------

821 216

----

5,702 --------

236 --

145 --

7,120 1,266

8,386


10



Rural Grant

$ - 5 -----------

3,842 5,506

-----------------

14,292 --•

23,640 4,202

27,842

Total

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

SUPPORT


$ 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)

Fundraising

$ 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

Total

$ 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

Organization Total

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


11


COMPARATIVE STATEMENTS OF CASH FLOWS For the Six Months Ended June 30, 2004 and the Year Ended December 31, 2003

2004 2003




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

$ 973,948 $ (777,266)

16,958 ---

9,300 12,648

(957,000) (6334)

(22,309) 48,897

26,618 20,000

2,676 (41,380)

(13,944) 10,009

-222,549

2,286 68,455



Proceeds from sale of fixed assets Purchase of fixed assets

76,108 (481,997)

15,850 (210,979)

Net cash provided by (used in) investing activities


Issuance of short-term debt Repayment of short-term debt (57,261)

(195,129)

200,000 (5,584)

Net cash provided by (used in) financing activities (57,261) 194,416

Net increase (decrease) in cash & cash equivalents 18,847 (482,710)

Cash & cash equivalents at beginning of period (5,556) 477,154

Cash & cash equivalents at end of period 13,291 (5,556)



12

S A V E A L I F E F O U N D A T I O N , INC.


For the Six Months Ended June 30, 2004 and the Year Ended December 31, 2003


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 31 , 2003. This was done to provide for better matching of the operations to the accounting cycle.







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 31 , 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




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.




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 (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),



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 31 , 2003, SALF received $500 and $41,380 respectively, in donations of this type.

14

S A V E A L I F E F O U N D A T I O N , INC.



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.


At June 30, 2004 and December 31, 2003, the costs of such assets were as follows:

Increase

Land Building Office Equipment Vehicles

Lessaccumulated depreciation Net book value

June 30r 2004

$ 20,000 181,912 121,727 39.132

peceinjber 31, 2fiQ2

$ 20,000 181,912 121,727 39.132

(Decrease"! $

--_

362,771

108-232

362,771

91.27.4 « 271.497

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.


The mortgage payable at June 30, 2004 and December 31, 2003 consists of the following:

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.

2004 2003 $137,155 $194,416

15



For (he Six Months Ended June 30, 2004 and the Year Ended December 31, 2003


Temporarily restricted net assets a t june 30, 2004 and December 31, 2003 consists of the following:

2004 20J12 Illinois Department of Commerce and Community $100,000 $100,000 Affairs - restricted for the purchase of a building in Springfield, IL

United States Department of Health and Human Services/ 955,043 0 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 74,500 0 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 lQ.QOQ 0 school year

Total 1 . 1 ^ - W 100-000


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.


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





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, Rem 2005 $92,704 2006 102,726 2007 107,737 2008 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.



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#

AMT

INIT


Charitable Trust Bureau, 100 West Randolph 11th Floor, Chicago, Illinois 60601 CO # 01026498


Report for the Fiscal Period: Beginning 07 / 01 / o*

Federal ID#36-3869459 & Ending <* I ™ / <*

MO DAY

Are contributions to the organization tax deductfole? IZ1 Yes D No

Check all items attached: H Copy of IRS Return

■MMOnoka 21 Audited Financial Statements «>«**•*• a Copy of Form IFC S » * r ^ 13 $15.00 Annual Report Filing Fee aw™**** □ $100.00 Late Report Filing Fee

MO DAY VR

Date Organization was created: 02 / 09 / 93

NAME Save A Life Foundation

MAIL ADDRESS 9950W. Lawrence, Suite 300

C 'zVcODE Schiller Park, 1L 60176


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)

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)



L) TOTAL CHARITABLE PROGRAM SERVICE rapfW?f£(Pf\>P £ }

M) MANAGEMENT AND GENERAL EXPENSE ^ _ ^

N) FUNDRAISING EXPENSE J ^ N 9 - 2 0 0 6 ^ g ^

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:


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 YE

T) NAME, TITLE; Carol Spizzirri, President/Founder

Year-end amounts

A)ASSETS


PERCENTAGE

% % %

100%

% %

%

% % % %

100%

100%

% %

AR:

U) NAME, TITLE: Dane Neal, National Policy Director

V) NAME, TITLE: Ciprina Spizzirri, National Communication Director

V. CHARITABLE PROGRAM DB.SCmPVON.wmA^FsoGwawwMiYicxrem

WJ DESCRIPTION: Life Saving First Aid Training

EOJCOO€C*7RJO«6i

X) DESCRIPTION:

Y) DESCRIPTION:

^ ^ H A)$ 1643498

B)S 669348

<=)S 974150

AMOUNT

D)$ S33339

E)S 1196000 •

F)$ 2801

G ) I 1732140

H)$ 1713050

D$

J) $ 1713050

K)$

L)$ 1713050

M)S 80431

N)S 34482

0 )$ 1827963

P)$

Q)$

R)$

S)$

T)$ 120000

U)S 54381

V) $ 35446 List on back side of inslrucJlDns

CODE W ) # 0 l l

X)#

Y}#


1. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION. FINE. PENALTY OR JUDGMENT? .

2. 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?

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

3.

4.

5. 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 I F C ) . . .

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

YES NO

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


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

\LJ.ftiUlAU

(Wjs r;«;c t: VFT-Via ftu»Ji>eit

A? /syoj" 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


IE) | SIGNATURE DATE

I KbASUKtK or i Kua r cc (PRINT NAME) sirswAi

Is" — - -? Atj.ne „ „

'NT I OIUNAIUKE DATE

*

Form 990

Department of trie Treasury tntemal Revenue Service

Return of Organization Exempt from Income Tax Under section 501(c), 527, or 4947(a)(1) ol the Internal Revenue Code


* The organization may have to use a copy of this return to satisfy state reporting requirements.

OMB No. 1545-0047

2004 Open to Public

Inspection

A For the2004 calendar year, ortax year beginning J u l 1 B Check rf applicable:

Address change

Name change

Initial return

Final return

Amended return

Application pending

Plena u » IRS label orprfcit

"ST ipacWc i i t i t i u t -t feM.

, 2004, and ending J u n 30 C Name of organization

Save A L i f e F o u n d a t i o n Number and streel (Or P.O. bo i * mail is not delivered to street 3ddr) Room/suite


S c h i l l e r Park State ZIP cede + 4

IL 60176 > Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A (Form 990 or 990-EZ).

G Web site: * www - s a l f . o r g

J Organization ( C h e c k o n l y O n e V * " j ^ l S0Hc> 3 « Qnsert no.) D 49*7(a)<H or IJS27

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 , 7 3 2 , 1 4 0 .

, 2005 O Employer IriantillcitioriHurnper


(847) 928-9683

n p l n e r (specify) * *

f meOio' Accrual

H a n d ! are not applicable to section 537 oganizatmns

H ( a ) Is iWs a group return for affiliates? . . . Q V « | x ] No

H ( b ) If 'Yes,' enter number of affiliates *■

H ( c ) Are all affiliates included? Q V n O No tit Tto; attach a l id . See 'nstrucnons.)

H ( d ) Is this a separate netum filed by an

Organization covered by a group ruling? y „ [ x ] No

I Group Exemption Number ... *■ M Check *■ Q if ttw organization is not required

to attach Schedule B (Form 990, 990-EZ, or 990-PF).

w E V E H U F

E X P E N & E S

A

s

mmA Hevenue. txoenses, and uhanges in Net Assets or f und Balances (See instructions) 1 Contributions, gifts, grants, and similar amounts received:

d T M M K V ; * * $ 1 , 3 1 7 , 3 2 2 . nonet, $ 4 , 5 0 0

2 Program service revenue including government fees and contracts (from Part *

4 Interest on savings and temporary cash investments . 5 Dwidends and interest from securities

c Net rental income or (loss) (subtract line 6b from line t 7 Other investment income (describe +■

8a Gross amount from sales of assets other

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 (

9 Special events and activities (attach schedule). If any a Gross revenue (not including $ 1 1 5 , 7 '

b Less: direct expenses other than fundraising expenses c Met income or (krss) from special events (Subtract line

10a Gross sales ol inventory, less returns and allowances

»)

(A) Securities

3)) amount is from gaming, 7 . of contributions

9b from line 9a)

c Gross profit or (toss) from sales of inventory (attacN schedule) (siibtr 11 Other revenue (from Part VII, line 103)

act line 10b from line 10a) . .

l a l b 1c

1 2 5 , 8 2 2 .

1 . 1 9 6 . 0 0 0 . . ) . . . . / I l , line 93)

6a 6b

)

8a 8b ac

(B) Other

chec

9a 9b

* here *[j~|

34,312. 34.312.

See. L.-.9 Stmfc 10*1 6 2 , 2 3 4 . 10b| 1 3 , 1 4 9 .

12 Total revenue (add lines 1d, 2. 3 ,4 ,5 , 6c, 7, 8d, 9c, 10c, and U ) 13 Program services (from line 44, column (B)) 14 Management and general (from line 44. column (Q)

16 Payments to affiliates (attach schedule) .

18 Excess or (deficit) for the year (subtract line 17 from 1 19 Net assets or fund balances at beginning of year (frorr 20 Other changes in net assets or fund balances (attach 21 Net assets or fund balances at end of year (combine 1

ne 12) line 73, column (A)) ..

;xplanation) nes 18, 19, and 20) . . .

I d 2 t 4 5

fir 7

8d

9c

10c 11 12 n 14 IS 16 17 1R 19 ?0 21

1 . 3 2 1 . 8 2 2 . 3 1 0 , 9 7 1 .

1 , 9 3 3 .

o

4 9 , 0 8 5 . 8 6 8 .

1 , 6 8 4 , 6 7 9 . 1 , 6 9 9 , 9 0 1 .

8 0 , 4 3 1 . 1 7 0 .

1 . 7 8 0 , 5 0 2 . - 9 5 , 8 2 3 .

1 . 0 6 9 , 9 7 3 .

9 7 4 , 1 5 0 . BAA For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. TEEAQ101 01/07/05 F o r m 9 9 0 ( 2 0 0 4 )

Form990[2004) Save A L i f e F o u n d a t i o n 36-3869459 Page 2 | S ta tement of Functional 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 $ )

23 Specific assistance to individuals (at) 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

30 Professional fundraising fees 31 Accounting fees

33 Supplies 34 Telephone 35 Postage and shipping

37 Equipment rental and maintenance 38 Printing and publications

40 Conferences, conventions, and meetings 41 Interest 42 Depreciation, depletion, etc (attach schedule) 43 Other expenses not covered above (itemize);

a A u t o E x p e n s e b Bank S e r v i c e F e e s c B r a n c h D e v e l o p m e n t d C o m p u t e r E x p e n s e s e See Other Expenses Stmt

44 Total functional expenses (add lines 22 - 43). Organizations completing columns (B) - (D), carrythete totaltta line* 13-15

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

44

(A) Total

1 2 0 , 0 0 0 . 2 8 6 , 0 9 4 .

9 , 3 3 2 . 4 4 , 1 6 8 .

3 , 0 0 0 . 1 2 , 2 0 9 . 1 0 , 8 4 7 .

6 , 0 3 2 . 1 0 1 , 4 2 5 .

7 6 2 .

2 9 , 3 0 8 . 1 3 , 4 7 9 .

6 , 9 3 8 . 3 0 , 3 0 1 .

2 , 2 8 1 . 2 6 2 .

4 6 3 , 8 5 3 . 3 0 .

6 4 0 , 1 8 1 .

1 , 7 8 0 , 5 0 2 .


1 1 4 , 0 0 0 . 2 6 0 , 9 2 0 .

8 , 5 6 5 . 4 0 , 7 6 7 .

3 , 0 0 0 . 1 2 , 9 5 8 . 1 0 , 8 1 7 .

6 , 1 4 7 . 1 0 1 , 4 2 5 .

7 6 2 .

2 9 , 0 4 4 . 1 3 , 4 7 9 .

7 2 8 . 0 .

2 , 2 8 1 . 2 6 4 .

4 6 3 , 8 5 3 . 3 0 .

6 3 0 , 8 6 1 .

1 , 6 9 9 , 9 0 1 .


6 , 0 0 0 . 2 5 , 1 7 4 .

7 6 7 . 3 , 4 0 1 .

0 . - 7 5 1 .

6 . - 1 4 0 .

0 . 0 .

2 6 4 . 0 .

6 , 2 1 0 . 3 0 , 3 0 1 .

0 . - 2 .

0 . 0 .

9 , 2 0 1 .

8 0 , 4 3 1 .

(D) Fundraising

0 . 0 .

0 . 0 .

0 . 2 .

2 4 . 2 5 .

0 . 0 .

0 . 0 . 0 . 0 .

0 . 0 . 0 . 0 .

1 1 9 .

1 7 0 . 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 $ I Statement of Program Service Accomplishments

See A t t a c h e d What is the organization's primary exempt purpose? * 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) organ-izations 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««.)

*Jî4J.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 chi ldren.^2_9_, 88_9_cMJdrm J ^ u g h t J ,

(Grants and allocations $ _0 i b^2D^£it^_^r53î?_^l,t^5t4PD_^d_tâchingi_of _life_ saving; _f Lr_st_ald_to_ individuals_other _than_ school_-age_ children_ (.199 _taught_)_

(Grants and allocations $ 0 . )

6 7 9 , 5 0 5 .

c J-5ESn§4Pn_??v02 ]il™_l. ExE?£^. S-S _ sa t e l_ l i t e_ o f f i c e _i i is ide _ 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

1 7 , 6 1 2 .

(Grants and allocations $ - ° i l dpther_Grant_s_ - _P r orno t iqn_and_ teach ing _o_f _ l i | e _savincj_

_f i r_s t_a id_ to_ variou_s_ r e ^ i £ . i e n t s _ _(8_555 _taught)_

9 8 4 , 5 1 7 .

(Grants and allocations $. _° L 1 8 , 2 6 7 . e Other program services (Grants and allocations S f Total of Program Service Expenses (should equal line 44, column (B), Program services)

BAA TEE Mid? 01*7/05 1 , 6 9 9 , 9 0 1 . Form « 0 fpflfun

Form 990 (2004) Save A L i f e F o u n d a t i o n 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.


(B) End of year



3 , 3 9 9 . 45 9 , 8 9 2 .

48a Pledges receivable | 48a

49 50

b Less: allowance for doubtful accounts [ 48b Grants receivable

2 2 , 2 5 4 . 13,415 .1 47c|

1 , 0 5 7 , 0 0 0 . 49 Receivables from officers, directors, trustees, and key employees (attach schedule)

48c

50 511 51b

51 a Otter notes & loans receivable (attach sch) b Less: allowance for doubtful accounts

52 Inventories for sale or use 53 Prepaid expenses and deferred charges 54 Investments-securities (attach schedule) ,■ * "D C o s t D F M V

55a Investments — land, buildings, & equipment: basis . 55a b Less: accumulated depreciation

(attach schedule) 56 Investments - other (attach schedule) 57a Land, buildings, and equipment: basis

5 4 , 3 7 1 . 52 1 0 , 9 6 8 . 53

51c

55b

54

55c

b Less: accumulated depreciation (attach schedule) L-5.7. .Stmt.

58 Other assets (describe *■

57a

57b

3 8 7 , 7 6 1 .

1 3 8 , 5 3 3 2 5 4 , 5 3 9 . _ ) ■

59 Total assets (add lines 45 through 58) (must equal line 74) 1 , 4 0 3 , 5 8 4 ,

56

57 c 58 59

3 , 7 5 8 , 8 1 0 , 2 1 8 .

2 2 , 2 5 4 .

4 9 6 , 0 0 0 .

5 6 , 5 0 1 , 5 ,539

2 4 9 . 2 2 6 .

1 , 6 4 3 , 4 9 8 . 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) .

37 ,377 60 61 62

1 5 7 , 6 5 5 . 63

64a 1 3 7 . 1 5 5 . 64b

1,424. 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 restrtcted

Organizations that do not follow SFAS 117, cheek 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 ,.

3 3 3 , 6 1 1 .

- 6 9 , 5 7 0 . 1 , 1 3 9 . 5 4 3 . 68

69 Q and complete lines

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) 1 , 0 6 9 , 9 7 3 .

74 Total liabHJtJes and net assets/fund balances (add lines 66 and 73) 1 , 4 0 3 , 5 8 4 .

71

74

5 0 5 , 2 0 4 .

1 6 3 , 6 5 4 .

490 . 6 6 9 , 3 4 8 .

4 7 8 , 1 5 0 . 4 9 6 , 0 0 0 ,

9 7 4 , 1 5 0 , 1 , 6 4 3 , 4 9 8 .

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 F o u n d a t i o n 36-3869459 I Reconciliation of Revenue per Audited Financial Statements with Revenue per Return (See instructions.)

Page 4

1 Reconciliation of Expenses per Audited Financial Statements with Expenses per Return

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 services and use of facilities . .

(3) Recoveries of prior year grants

(4) Other (specify): See At tached

1 9 0 , 7 9 5 .

6 1 , 7 4 6 . Add amounts on lines (1) through (4) Line a minus line b


0 ) Investment e<penses not included on line St, form 990 $_


Add amounts on lines 0 ) and (2) . ,


a Total expenses and losses per audited financial statements., '


CO Donated services and use of facilities . . .

(2) Prior year adjustments reported on line 20, Form 990 . . . . $

(3) Losses reported on line 20, Form 990 $


Add amounts on lines (1) through (4) Line a minus line b


1 , 6 8 4 , 6 7 9 .

(1) Investment expenses not included on line 6b, Form 990 $


Add amounts on lines O) and (2)

Total expenses per line 17, Form 990 (line c plus line d) 7 8 0 , 5 0 2 .

ffffffflpnp List Of Officers, Directors. Trustees, and Kev Employees (List each one even if not compensated; see instructions.)


C a r o l S p i z z i r r i

R i t a M u l l i n s

D o u g l a s Browne

Peggy T r i m b l e


See List ot Office rSj_ Etc. Statement J

(B) Title and average hours per week devoted

to position

Chairman/Exec D i r 4 0

V i c e Chai rwoman

T r e a s u r e r

V i c e Chairwoman

D i r e c t o r

(C) Compensation (If not paid, enter -0-)

1 2 0 , 0 0 0 .

0 .

0 .

0 .

0 .

0 .



1 , 8 3 9 .

0 .

0 .

0 .

0 .

0 .


allowances

0 .

0 .

0 .

0 .

0 .

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. _ _ ____

Q v e s |x]No

BAA

TEEA01C4 01/07/05

Form 990 (2004)

Form990 (2004) Save A L i f e F o u n d a t i o n 36-3869459 Page 5 [Other Information (See instructions.)

76

77

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 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?



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?


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 , 0 8 0 .


B4a Did the organization solicit any contributions or gifts that 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?


c Dues, assessments, and similar amounts from members 85c 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?

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?


85cf 85e 651


87 501 (c)02) organizations. Enter: a Gross income from members or shareholders


86a 86b 87a


or an entity disregarded as separate from the organization under Regulations sections 301.7701 -2 and 301.7701 -3? If 'Yes,' complete Part IX

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 ,

76 77

78a 78b

i 79

80a

83a X 83b 84a

84b 85a 85b

85 g

85 h

88

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 ,_Sch i l l e r . .Pa rk , IL ZIP + 4 *■ jiO17_6 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 *~| 92 1 BAA

TEEA0105 01/07105 Form 990 (2004)

Form 9W (2004) Save A Life Foundation 36-3869459 Page 6 " f l f H R f l Analysis of Income-Producing Activities (See instructions.)


93 Program service revenue: a P r o q r a m Fees b C o u r s e 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 . 96 Dividends & interest from securities ,.

Unrelated business income (A>

Bus) Ress code (B)

Amount

Excluded by section 512, 513, or 514 (C)

Exclusion code

14

(DJ Amount

1 , 9 3 3 .


3 5 , 2 6 5 . 2 5 9 , 3 5 3 .

5 , 4 3 3 . 1 0 , 9 2 0 .

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 . Other investment income Gain or (loss) from sales of assets other than inventory Net income or (loss) from special events . . Gross profit or floss) from sale* of inventory .

Other revenue: a

99 100

101 102 103

b Misce l laneous c d e

104 105

Mole: Line 105 plus Una Id, Part I, should equal the amount on line 12f Part I.

Subtotal (add columns (B), (D), and (E)) Total (add line 104, columns (B), (D), and (E))

1,933.

49,085

868.

360,924, 362,857,

Relationship of Activities to the Accomplishment of Exempt Purposes (See instructions.) UrwNo. 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 Misce l laneous income t o c a r r y out t h e l i f e sav ing f i r s t a i d programs.

Information Regarding Taxable Subsidiaries and Disregarded Entities (See instructions.) N/A


03) Percentage of

ownership interest

(C)

Nature of activities Total income

(E) End-of-year

assets

% Information Regarding Transfers Associated with Personal Benefit Contracts (See instructions.)

0Y « |x Yes [x

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).

No No

Please Sign Here

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 na i any knowledge.

Signature of officer Dale

Type ot prrit name and title.

Paid Pre-parer's

Only

Preparer's signature

Date

12/12/05 Check if self- i—| employed *" I I

i . - r - j i ' s SSN oi PTIN (See General Instruction W>

Fim's name [or A h l b e c k & Company yours if serf- — employed), address, and Z I P * *

EIN

Des P la ines IL 60016-4721 more no. - (847) 824-400Q BAA TEEAcioe 10/03/03 Form 990 (2004)


Department of the Treasury lnt«m»l Rewrite Service


(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 Name of ths ofjanizatiwi

Save A L i f e F o u n d a t i o n Employ** idwrlrllcatliui ninnlm

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.')


than $50,000

Dane N e a l

9950 Lawrence, Suite 300, Sch i l l e r Park, IL 60176

Total number of other employees paid over $50,000 *


devoted to position

Nat iona l Po l icv D i r e c t o r 40

None

(c) Compensation

5 4 , 3 8 1 .

(d) Contributions ID employee benefit plans ana deferred

compensation

1 , 4 5 6 .


allowances

0 .

IP^^ 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

_Hogari_ & . H a r t s o n _L_. L ._P_.

Columbia Square, 555 Thirteenth s t reet MW, Washington p , c . 200404-1109 Governmen ta l C o n s u l t i n g 90 ,822

Total number ol others receiving over $50,000 for professional services None MiM BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 and Form 990-EZ. Schedule A (Form 990 or 990-EZ) 2004

TEPAIWII mrtttiu


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 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.)



c Furnishing of goods, services, or facilities? See P a r t V, Form 990

d Payment of compensation (or payment or reimbursement of expenses if more Irian t1,000)?


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?

2b

2c

2d

2e

3a 3b

4» 4b

X

X X

X


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).


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).)



14 |~] An organization organized and operated to test for public safety. Section 509(a)(4). (See instructions.) BAA TEEAM0Z 07/27/04 Schedule A (Form 990 or Form 990-EZ) 2004

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 Page 3 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.) . . .


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

IB 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 organization after June 3D, 1975

19 Net income from unrelated business activities not included in line IS


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 ,


23 Total of lines 15 throuqh 22

25 E n t e r ! * of line 23

2 %

4 4 8 , 6 2 1 .

1 2 0 , 3 1 6 .

795 .

5 6 9 , 7 3 2 . 4 4 9 , 4 1 6 .

5 , 6 9 7 .

2002

1 , 3 7 1 , 6 8 4 .

2 0 7 , 8 3 6 .

2 , 1 5 4 .

1 , 5 8 1 . 6 7 4 . 1 . 3 7 3 , 8 3 8 .

1 5 , 8 1 7 .

A 8 2 0 , 2 8 2 .

1 9 7 , 5 3 5 .

3 , 2 7 5 .

1 , 0 2 1 , 0 9 2 . 8 2 3 . 5 5 7 .

1 0 , 2 1 1 .

2000

6 8 2 , 8 7 8 .

5 2 , 6 6 4 .

8 , 7 2 5 .

7 4 4 , 2 6 7 . 6 9 1 , 6 0 3 .

7 , 4 4 3 .

(6) Total

3 , 3 2 3 , 4 6 5 .

5 7 8 , 3 5 1 .

1 4 , 9 4 9 .

3 , 9 1 6 , 7 6 5 . 3 . 3 3 8 , 4 1 4 .

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 1 4 , 949 .

22 19 26b' 0 .

e Public support (line 26c minus line 26d total) f Public support percentage (line 26e (numerator) divided by line 26c (denominator)) 9 9 . 5 5 %

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;

(2002) (2001) (2000) (2003) 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)


15 20

(2001) (2000). "" 16 ~

21 and line 27b total. d Add: Line 27a total

e Public support (line 27c total minus line 27d total) I 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 Z7t (denominator)) h Investment income percentage (line 18, column <e) (numerator) divided by line 27f (denominator))

27f

27c 27d 27e

2?a 27h

2 T l f v " <>% m %

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

Schedule A (Form 990 or 990-EZ) 2004 Save A L i f e F o u n d a t i o n 36-3869459 Private School Questionnaire (See instructions.} (To be completed ONLY by schools that checked the box on line 6 in Part IV)

Page 4

N/A


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.)





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*

33b

33c

33d

33e

33 f

33a

33 h


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.

BAA TEEA0404 07/23/04 Schedule A (Form 990 or 990-EZ) 2004

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 Page 5

[ Lobbying Expenditures by Electing Public Charities (See instructions.) (To be completed ONLY by an eligible organization that filed Form 5768) N/A

Check I if the organization belongs to an affiliated group, Check *• b \ I if you checked 'a' and 'limited control' provisions apply.


Affiliated group totals

(■>) To be completed for ALL electing organizations

36 37 38 39 40 41

42 43 44

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 -Grassroots nontaxabie amount (enter 25% of line 41) Subtract line 42 from line 36. Enter -0- if line 42 is more than line 36 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.



Calendar year (or fiscal year beginning In) *■

45 Lobbying nontaxabie amount


2004 (b>

2003 (c)

2002 (d)

200) Total

46 Lobbying ceiling amount (150% Jl line 45(e))

| Lobbying Activity by Nonelecbng PuMic Charities (For reporting only by organizations that did not complete Part Vl-A) (See instructions.)


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 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 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.

X

X X

BAA Schedule A (Form 990 or 990-EZ) 2004

TEEA0405 07/23/04

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 Page 6 | 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: {l)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 (Ill)Rental of facilities, equipment, or other assets — <iv)Reimbursement arrangements (v)Loans or loan guarantees pri)Performance of services or membership or fundraising solicitations


51afl) aOi)

bfi) bOD b(Hl> bflv) b(v) b(vi> c

Yes No X X

X X X X X X 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:

Line no. (b)

Amount involved Name of noncharitable exempt organization 00

Description of transfers, transactions, arid sharing arrangements

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)



TEEAM06 II/29/C4





Receipts Less

Contributions Gross


Net Income (Loss)

Summit 1 4 5 , 4 0 1 . 1 1 1 , 2 5 7 . 3 4 , 1 4 4 . 3 4 , 1 4 4 . Race f o r L i f e 308. 140. 168. 168 . Cubs Game 4,380. 4,380.

Total 1 5 0 , 0 8 9 . 1 1 5 , 7 7 7 . 3 4 , 3 1 2 . 3 4 , 3 1 2 ,

Form 990, Page 2, Part Other Expenses Stmt

Line 43

Otrier expenses not covered above (itemize):

W e b s i t e 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 F e e s I n s u r a n c e L i c e n s e s & P e r m i t s Marke t i n g M i s c e l l a n e o u s P a y r o l l S e r v i c e R e c r u i t m e n t T r a i n i n q S u p p l i e s Bad Debt Expense P r o f e s s i o n a l F e e s Tempora ry S t a f f i n g

(A) Total

1 0 6 , 4 6 6 . - 9 7 2 .

1 1 9 , 8 0 7 . 1 6 , 8 6 9 .

4 , 5 3 9 . 8 4 6 .

1 4 , 8 3 3 . - 2 3 5 .

2 , 5 7 9 . 3 , 6 1 2 .

3 2 2 , 1 9 4 . - 1 0 0 .

4 3 , 4 5 5 . 6 , 2 8 8 .


1 0 6 , 4 6 6 . - 1 , 1 3 2 .

1 1 9 , 8 0 7 . 1 6 , 8 6 9 .

3 , 4 8 2 . 1 1 5 .

1 3 , 2 7 9 . 1 5 6 .

2 , 5 7 9 . - 6 9 1 .

3 2 2 , 1 8 8 . 0 .

4 1 , 4 5 5 . 6 , 2 8 8 .


0 . 160 .

0 . 0 .

1 , 0 5 7 . 7 3 1 .

1 , 4 3 5 . - 3 9 1 .

0. 4 , 3 0 3 .

6 . - 1 0 0 .

2 , 0 0 0 . 0 .

(D) Fundraising

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

119 . 0 . 0. 0. 0. 0 . 0 . 0 .

Total 6 4 0 , 1 8 1 , 6 3 0 , 8 6 1 . 9 , 2 0 1 . 119,


Land Bui ld incr O f f i c e Equipment V e h i c l e s

(a) Cost/Other

Basis

2 0 , 0 0 0 . 1 8 1 , 9 1 2 . 1 4 6 , 7 1 7 .

3 9 , 1 3 2 .


0 . 1 8 , 1 9 1 . 9 6 . 8 5 6 . 2 3 , 4 8 6 .

(c) Book Value

2 0 , 0 0 0 . 1 6 3 , 7 2 1 .

4 9 , 8 6 1 . 1 5 , 6 4 6 .

Total 3 8 7 . 7 6 1 1 3 8 , 5 3 3 . 2 4 9 , 2 2 8 .



Line 65 - Other Liabilities:

I n s t r u c t o r Deposi ts Real Es t a t e Taxes Pavable

Beginning of Year

490 . 934.

End of Year

4 9 0 . 0 .

Total 1,424. 490.

Form 990, Page 4, Part V Ust of Officers, Etc. Statement


I r v Bock

Emil J o n e s , J r .

S t e v e n Oreba.ugh

E r n e s t o P r e t t o

Mote: The individuals above, axceut as noted, spend time as needed in the i r canacitv on the Board, Thev can be contacted c/o Save a L i re Foundation, 9950 Lawrence SCe3Q0. S c h i l l e r Park, IL S0176

(B) Title and


to position

D i r e c t o r

D i r e c t o r

D i r e c t o r

D i r e c t o r

(C) Compensation


0 .

0 .

0 .

0 .

<D> Contributions to employee benefit plans and deferred

compensation

0 .

0 .

0 .

0 .

(E) Expense account


0 .

0 .

0 .

0 .

Total 0 . 0 . 0 .



Form 990 p 2 / L i n e 42 column (C)

Description

B u i l d i n g V e h i c l e O f f i c e Ecruipinent

Amount

9 , 0 9 6 . 7 , 8 2 6 .

1 3 , 3 7 9 .

Total 3 0 , 3 0 1 .


Form 990 p 3 / L i n e 6 3 , column IA)

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 R a t e - V a r i a b l e

Amount

1 5 7 , 6 5 5 .

Total 1 5 7 , 6 5 5 .


Form 990 p 3 / L i n e 64b, 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 due d a t e : 7 / 2 8 / 0 4 , i n t e r e s t r a t e : 4.25%

Amount

1 3 7 , 1 5 5 .

Total 1 3 7 , 1 5 5 .


Form 990 p 3 / L i n e 6 3 , column (B)

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 R a t e - V a r i a b l e

Amount

1 6 3 , 6 5 4 .

Total 163,654.



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 Dona ted M a t e r i a l s C o s t of Goods S o l d

Amount

3 4 , 3 1 2 . 1 4 , 2 8 5 . 1 3 , 1 4 9 .

Total 6 1 , 7 4 6 .


Form 990 p 4 / P a r t IV-B, L i n e b(4>

Description

S p e c i a l E v e n t s Expense Dona ted M a t e r i a l s C o s t of Goods S o l d

Amount

3 4 , 3 1 2 . 1 4 , 2 8 5 . 1 3 , 1 4 9 .

Total 6 1 , 7 4 6 .

Additional Information For Tax Return


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 CERTLFIED

PUBLIC

JUNE 30, 2005 AND 2004 ACCOUNTANTS



June 30, 2005 and 2004

INDEPENDENT AUDITOR'S REPORT 1


Comparative Statements of Financial Position 2 June 30,2005 and 2004

Statements of Activities 4 For the Year Ended June 30,2005 and the Six Months Ended June 30,2004

Statements of Functional Expenses 8 For the Year Ended June 30, 2005 and the Six Months Ended June 30, 2004

Comparative Statements of Cash Flows 12 For the Year Ended June 30, 2005 and the Six Months Ended June 30,2004


AHLBECK& COMPANY

CERTIFIED 1665 ELK BOULEVARD TELEPHONE 847/824-4000 PUBLIC DES PLA1NES, ILLINOIS FACSIMILE' 847/B24-4D12 ACCOUNTANTS 60016-4776 WEB: www.ahlbtckco.com

August 31, 2005



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.



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

http://www.ahlbtckco.com

SAVE A L I F E F O U N D A T I O N . INC.

COMPARATIVE STATEMENTS OF FINANCIAL POSITION June 30, 2005 and June 30, 2004

2005 2004 A S S E T S

Current Assets Cash and Cash Equivalents Inventory Trade Receivables Grants Receivable Other Receivables Prepaid Expenses




TOTAL ASSETS

$ 813,976 56,501 22,254

496,000 1,660 3,879

1,394,270

20,000 163,721 49,861 15,646

249,228

1,643,498

$ 13,291 54,371 13.415

1,057,000 196

10,772

1,149,045

20,000 172,816 38,250 23,473

254,539

1,403,584



COMPARATIVE STATEMENTS OF FINANCIAL POSITION

June 30, 2005 and June 30, 2004

2005 2004

L I A B I L I T I E S A N D NET A S S E T S

Current Liabilities Accounts Payable $ Accrued Expenses Real Estate Taxes Payable Instructor Deposits Rent Payable Mortgage Payable


Other Liabilities

19,671 395,576

-490

89,957 -

$ 6,487 -

934 490

30,890 137,155

) Carol Spizzirri

Total Other Liabilities

TOTAL LIABILITIES

163,654

163,654

669,348

157,655

157,655

333,611

Net Assets Temporarily Restricted 496,000 1,139,543 Unrestricted 478,150 (69,570)

Total Net Assets 974,150 1,069,973

TOTAL LIABILITIES & NET ASSETS 1,643,498 1,403,584




For the Year Ended June 30,2005 Temporarily


INCOME

Public Support Contributions Contributions In Kind Special Events Gross Income

5,545 209,580 150,089

5,545 209,580 150,089


Government Contracts State of Illinois - IDPH HHS/CDC

365,214 365,214

--

-

35,265 259,353 62,234 10,920 5,433

868

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


Other Income Program Service Fees Course Materials Product Sales Conference/Seminar Income Branch Fee Miscellaneous




Toul Income (balances carried forward)

1,933

1,933

741,220

-

-

1,196,000

1,933

1,933

1,937,220




For the Year Ended June 30, 2005 Temporarily

^ Unrestricted Restricted Total

Total Income (balances brought forward) 741,220 1,196,000 1,937,220

EXPENSES

Program Kids Program 813,454 - 813,454 Corporate Program 17,621 - 17,621 Expansion Program 1,050,403 - 1,050,403 Other Grants 18,267 - 18,267


Fundraising


Special Event Expenses

Total Expenses

1,899,745

98,816

170

1,998,731

34,312

2,033,043

1,899,743 98,816

170

1,998,731

34,312

2,033,043

Release from Restrictions - HHS/CDC 955,043 (955,043) Release from Restrictions - DCCA Building Purchase 100,000 (100,000) Release from Restrictions - State of Illinois - IDPH 700,000 (700,000) Release from Restrictions - Private Grants 84,500 (84,500)

Change in Net Assets Beginning Net Assets Ending Net Assets (Deficit)

547,720 (69,570)

478,150

(643,543) 1,139,543

496,000

(93,823) 1,069,973 974,150




For the Six Months Ended June 30, 2004 Temporarily


INCOME


850 $ 84,500

73,000 3,238

850 84,500 73,000 3,238

Total Public Support 77,088 84,500 161,388

Government Contracts State of Illinois - DCCA Rural Training HHS/CDC

20,000 -

20,000

23,160 (1,698) 1,340 3,356

-1,020,000

1,020,000

.

---

20,000 1,020,000

1,040,000

23,160 (1,698) 1,340 3,356


Other Income Program Service Fees Miscellaneous Course Materials Branch Fee




TOTAL INCOME (balances carried forward)

9

9

123,255

-

-

1,104,500

9

9

1,227,735




For the Six Months Endedjune 30, 2004 Temporarily


TOTAL INCOME (balances brought jorward) 123,255 1,104,500 1,227,755

EXPENSES _ _ _ _

Program Kids Program 62,138 - 62,138 Corporate Program 8,021 - 8,021 Expansion Program 134,505 - 134,505 Allied Health Gram 20,000 - 20,000


Fundraising


TOTAL EXPENSES

Release from Restrictions - HHS/CDC Change in Net Assets Beginning Net Assets

Ending Net Assets (Deficit)

224,664 21,328

7,215

253,207 600

253,807

64,957 (65,595)

(3,975) (69,570)

-

-

-

-

-

(64,957) 1,039,543

100,000

1,139,543

224,664 21,328

7,215

253,207 600

233,807

-

973,948

96,025 1,069,973



STATEMENT OF FUNCTIONAL EXPENSES For the Year Ended June 30,2005

PROGRAM

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 Web Site



Total Expenses

Kid's Program

$ 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

Corporate Program

$ 3,355 84

374 ------9 ---

13,754 ---------

51 -

(20) ----

16 ---

17,621

917

18,538

Expansion Program

$ 311,512 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

Other Grants

S 9,506 239

1,061 -----

30 --------

640 ---

1,171 -

2,594 -----

297 1,051 1,679

--

18,267 950

1 9 4 1 7

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

322,188 30,938

3,345 106,466

1,899,745

98,816

1,998,561


a


STATEMENT OF FUNCTIONAL EXPENSES For the Year Ended June 30, 2005

SUPPORT


$ 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)

-

Fundraising Total

$ - $ 31,174 ----------------

119 ---2 -

25 ----

24 -----

170 -

170

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

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



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


PROGRAM


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


Total Expenses

$ 44,000 $

7,721

3,315 250

15

13,973

77

523

285

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

-1,496 7,850

20 10

919

-(661) 867 439

1,000

670 48,376

3,979 (285)

5,446 1,475 1,803

-1,950

---

9,026

_ 913

-70

-

_ -

1,053 ----

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

62,136 5,899

68,037

8,021

761

8,782

134,505

12,769

147,274

20,000

1,899

21,899

224,664

21,328

245,992



STATEMENT OF FUNCTIONAL EXPENSES For the Six Months Ended June 30, 2004

SUPPORT


$

75 524

16,958

607

3,008 (37)

-

-

-

193

21,328

(21,328)

-

Fundraising

$ - $

-

-

1,250

19

-

-

-

5,946

7,215

-

7,215

Total

-

75 524

16,958

607

1,250

3,008 (37)

19

-

-

-

5,946

193

28,343

(21,328)

7,215

Organization Total

$ 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

6323 465 867 543

1,000

670 62,349

5,109

11392 1,998 1,996

253,207

-

253,207


11


COMPARATIVE STATEMENTS OF CASH FLOWS

For the Year Ended June 30, 2005 and the Six Months Ended June 30, 2004

2005 2004




Non-cash in kind donations - fixed assets Depreciation


$ (95,823) $ 973,948

(4,500) 30,301

(8,839) (2,130)

561,000 5,429 13,184

453,709

-16,958

9,300 12,648

(957,000) (6,334)

(22,309) 48,897


Cash Flows front Investing Activities:

Purchase of fixed assets

952,331

(20,490)

76,108




(20,490)

6,210 (137,366) (57,261)

Net cash provided by (used in) financing activities (131,156) (37,261)

Net increase (decrease) in cash & cash equivalents 800,685 18,847

Cash & cash equivalents at beginning of period 13,291 (5,556)

Cash fix cash equivalents at end of period 813,976 13,291



n



For the Year Ended June 30, 2005 and the Six Months Ended June 30,2004


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.






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






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.


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.




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




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.


At June 30, 2005 and 2004, the costs of such assets were as follows:

June 30, Increase 2QQ5 2Sm meoeasej

Land $ 20,000 $ 20,000 $ Building 181,912 181,912 Office Equipment 146,717 121,727 24,990 Vehicles 39,132 39,132 -

387,761 362,771 24,990 Less accumulated depreciation 138,533 108,232 30,301 Net book value 249,228 254,539 (5,311)

Depreciation expense for the year ended June 30, 2005 and the six months ended June 30, 2004 is $30,301 and $16,958, respectively.


The mortgage payable at J u n e 30 , 2005 and 2004 consis ted of the following:

200_5_ Mortgage payable to Bank O n e originally d u e on $0 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.

2004 $137,155

15





Temporarily restricted net assets at June 30, 2005 and 2004 consist of the following:

2QQ5. 2004 Illinois Department of Commerce and Community $ - $100,000 Affairs - restricted for the purchase of a building in Sprmgfield, IL

United States Department of Health and Human Services/ 496,000 955,043 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 - 74,500 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 -__ 10.000 school year

Total 496.000 1.119.543


SALF has a vesting vacation policy. The amount of existing vacation time remaining as of June 30, 2005 and June 30, 2004 is immaterial.


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





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.



Year Ended Tune 30, 2005 £SY£HH£ Expenses H& $145,401 $34,144 $111,237

308 168 140 4,380 - 4,380

Summit Race for Life Cubs Game Other

Six Months Ended Tun* 30. 2004 Revenue Expenses Nei $ - $ - $ -

2,588 - 2,588

l p.pfTO

17

» T « *

FnOffic

PMT#

AMT

IHIT

lUaaOife

JT\5 T J c < _


Charitable Trust Bureau, 100 West Randolph 11th Floor, Chicago, Illinois 60601 CO # 01026498


Federal I D S 3 6 ' 3 8 6 9 4 5 9

Report for the Fiscal Period: Beginning 07 ,01 / 05

& Endino <* / 3Q / 06 MO DAY YR

Are contributions to the organization tax deductible? g) Y»* O No

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

Date Organization was created: 02 / 09 / 93

LEGAL NAME MAIL

ADDRESS

Save a Life Foundation

9950 W. Lawrence, Suite 300

C , i ^ S d , a k r P r t - I L a i 7 6


D) PUBLIC SUPPORT, CONTRIBUTIONS & PROGRAM SERVICE REV. (GROSS AMTS.)

E) GOVERNMENT GRANTS S MEMBERSHIP DUES

F) OTHER REVENUES

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




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 M) MANAGEMENT AND GENERAL EXPENSE

H) FUNDRAISING EXPENSE

O) TOTAL EXPENDITURES THIS PERIOD (ADD L, M, ft N)

III. SUMMARY OF ALL 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

Year-end amounts

A) ASSETS


PERCENTAGE

A) 5 1,161,576

B>$ 357,975

C>$ 803,601

21.30 %

78.59

.11 %

100%

AMOUNT D)I 189,738

E) $ 700,000

F)» 956

G) J 890,694

94.75 %

%

94.75 %

%

H) S 1,005,527

»>

%

5.25 %

%

100%

J)S 1,005,527

K)S

L)S

M) S 55,716

N)$ 0

CO* 1,061,243

100%

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


T) NAME, TITLE: Carol Spizzini, President/Founder

%

P ) *

Q ) $

R) l

S)S

T)$ 130,000

U) NAME, TITLE Dane Neal, National Policy Director LJ> * 63,500

V) NAME, TITLE: Robert Barnes, Director V) $ 55,000

V. CHARITABLE PROGRAM DESCKPJlOH:cHMiTMUPiwaiumpHKM^BYtexpaio^MMtJih^c^

W) DESCRIPTION: Life Saving First Aid Training

List on beck side of instructions CODE

W)#011

X) DESCRIPTION Xl>#>

Y) DESCRIPTION Y)#

• WT *


1. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION. FINE, PENALTY OR JUDGMENT? _ _ 1.

2. 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.

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.


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-

YES

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? _ - _ _ 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 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

NO

TCF National Bank, 500 W. Joliet Rd., Willowbrook, H. 60527

12. NAME AND TELEPHONE NUMBER OF CONTACT PERSON: C a r o 1 Spizzirri (847) 928-9683


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&HKAkkFJ iBLQ!^ 1.) REPORTS ARE DUE WITHIN SIX

MONTHS OF YOUR FISCAL YEAR END. 2.) FOR FEES DUE SEE INSTRUCTIONS. 3.) REPORTS THAT ARE LATE OR


PRESIDENT or TRUSTEE (PRINT NAME)

TREASURER or TRUSTEE (PRINT NAME)

i t / A j t o * 4 c f t < -1**-** PREPARER {PRINT NAME) SIGNATURE

uplifts

DATE

http://BE.3MRE.TJl

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

A B

For the 2005 olendaryear.ortaxvearBeglnnlng J u l 1 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.

, 2005, and ending J u n 30 2006 C Name ol afganiwtion

Save A L i f e F o u n d a t i o n Nunbaf and street (M F-O. bo* it mail it not delivered to street addr) Room/suite

9950 Lawrence 300 City, toon or country

S c h i l l e r Park State

I L ZIP code* 4

60176

D emoto»wld*n«rl«e«iMun**f

36-3869459

• Section S01(cX3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A (Form99Bor990-EZ).

S WebsHe:^www.sa l f .o rg Organization (check only one; 3^ J*L 501M 3 * fruertno.) n «W(a)P) »r in 527

K 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.

L Gross receipts: Add lines 6b. Sb. 9b. and 10b to line 12 902_j_426.

E TeleetHMem

(847) 928 -9683

|~1 o r (wwcifr)1* m Accrual

H tnd\ me nol applicable to section 527 otgamzatkirri-

H (a) is this a grout return tar affiliates? . . . Q Ye* 0 He

H ( b ) lfTe«/enternurntnrofaffiliWu*'

H (C) Are all affiliates included? ' - L J V n 0 * » (If No,' attach a ksL See iistrudjansj

H (d ) Is Hihs a separate return filed by an oroaniation covered by a gnxip ruling? | | y w [ x | Mb

I Group Exemption Number empti Check * * O i f the organization is not required to attach Schedule S (Form 990,990-EZ, or 99C-PF).

a b c d

Z 3 4 5 6a

b c

7

8a

b c d

Revenue, Expenses, and Changes in Net Assets or Fund Balances (See instructions) Contributions, gifts, grants, and similar amounts received: Direct public support Indirect public support Government contributions (grants) T r t K f t l e P w * S 7 9 4 . 4 0 3 . *™asr, $ Program service revenue including government fees and contracts (from Part Vlt, line 93) Membership dues and assessments Interest on savings and temporary cash investments Dividends and interest from securities

l a l b 1c

9 4 , 4 0 3 .

7 0 0 , 0 0 0 . )

Gross rents Less: rental expenses Net rental income or floss) (subtract line 6b from line 6a) Other investment income (describe *"

6a 6b

7 9 4 , 4 0 3 . 9 5 , 3 3 5 .

4 , 8 8 2 ,

8a 8b

Gross amount from sales of assets other than inventory Less: cost or other basis and sales expenses Gain or (loss) (attach schedule) .. See, -L-.8. .St int . ■. Net gain or (loss) (combine line 8c, columns (A) and (B)) Special events and activities (attach schedule). If any amount is from gaming, check here * Q Gross revenue (not including $ of contributions

(A) Securities

8c

(B) Other

6c

5 , 8 0 0 . 11 ,732 .1 - 5 , 9 3 2 . 1

8d - 5 , 9 3 2 .

c 10a

b c

11 12

reported on line 1a) Less: direct expenses other than tundraising expenses Net income or Ooss) from special events (subtract line 9B from line 9a) . . . Gross sales of inventory, less returns and allowances Less: cost of goods sold Gross profit or (loss) tram sales of irwentory (attach schedule) (subtract line 10b from line 10a) Other revenue (from Part VII, line 103) Total revenue (add lines I d . 2 .3, 4 ,5 , 6c, 7. 8d, 9c, 10c, and 11)

9a 9b

101 10b

9c

10c 11 12

2 , 0 0 6 , 8 9 0 , 6 9 4 ,

13 Program services (from line 44, column 03)) 14 Management and general (from line 44, column (O) 19 Fund raising (from line 44, column (D» 16 Payments to affiliates (attach schedule) 17 Total expenses (add lines 16 and 44, column (A)) .,

13 1 , 0 0 5 , 5 2 7 . 14 5 5 , 7 1 6 . 15 16 17 1 , 0 6 1 , 2 4 3 .

18 19 20 21

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) .

18 - 1 7 0 , 5 4 9 .

20_ 21

9 7 4 . 1 5 Q .

8 0 3 , 6 0 1 , BAA For Privacy Act and Paperwork Reduction Act Notice, see the separate Instructions. TEEAOIOI 02103m Form 990 (2005)

http://www.salf.org

Form 990(2005) Save ft L i t e F o u n d a t i o n 36-3B69459 Page 2 Statement Of Funct ional Expenses 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 $ 4 1 2 , 2 7 3 . non-cash $ 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 paid to or 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):

a _Auto_ Expense

c _Cgmjm t er_ Expenses _ d Webs i t e «_Dues_ & _ S u b s c r i £ t i o n s f Îndependent^ . 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 tolab to lines 13-15).

27 28 29 30 31 32 33 34 35

37 38 39 40 41

43a 43b 43c 43d 43* 431 43g.

44

3 1 3 , 1 4 1

9 ,033 46 ,426

10 ,707 13 ,170

3,883 19 ,846

6 ,160

49 ,419 8 ,653 8 , 1 8 1

3 3 , 6 0 2

6 ,165 1,084

68 ,110 701 115

36 ,829 296 ,018

7,.529 41 ,166 .

9 .990 12 ,897 .

3^865 15,234.

6 ,069

49 ,142 8,583 6,320

33 ,602

6,119 1,084

68 ,110 701 115

3 6 , 8 2 9

289,686

1 ,061 ,243 .1 1 .005,527

28 ,155

1,504. 5 ,260 .

717. 273.

18. 4 , 6 1 2 .

91

277. 70

1,861

4 6 . 0 . 0 . 0 .

0 6,332

55 ,716

JL 0.

JL JL i o.

JL JL JL 0,

JL JL JL JL JL o.

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? w\_j Yes [x] No If 'Yes,' enter (i) the aggregate amount of these joint costs $ ;(i i)the amount allocated to Program services S ; (I'D the amount allocated to Management and general $ ; and (Iv) the amount allocated

to Fundraising $

BAA Form 990 (2005)

TEEM102 l l« l«M

' ' I

Form 990 (2005) Save ft. L i fe Foundation 36-3BiM19 _PageJ Statement of Program Service Accomplishments

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. What is the organization's primary exempt purpose? » J3ee J i 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) and (4) organ-izations and 4947(a)(1) nonexempi charitable trusts must also enter the amount of grants and allocations to others.)

Program Service Expenus iund tor 501<c)(3) and

ipanizatons and '<a)tlf trusts; but

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 rN_ aJ^_FI^_uti_l izing -?.?ij2^?!l _comp_ensated _ i n s t r u c t p r s _(_26 ,_114 _ taught 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 tuden ts . _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) 11 _ _ I _ I

(Grants and allocations $ 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. donat ions_from.volunteer . 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;) 1,005,527.

BAA Form 990 (2005)

TEEA0103 10/1*05

Form 990 (2005) Save A L i f e F o u n d a t i o n 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. Beginning of year iSPy End of year 45 Cash — non-interest-bearing 46 Savings and temporary cash investments


3 , 7 5 8 , 8 1 0 , 2 1 8 .

5 , 4 9 5 ,



2 2 , 2 5 4 .


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 FMV 55a Investments - land, buildings, & equipment: basis .


56 Investments - other (attach schedule), 57a Land, buildings, and equipment: basis.

55a

55b

bLess: accumulated depreciation (attach schedule) L-5.7. .S tmt .

58 Other assets (describe *•

57a

57b

3 9 5 , 9 6 4 ,

156 ,380 . ) ■

59 Total assets (must equal line 74). Add lines 45 through 58

4 9 6 , 0 0 0 . 49 4Bc

5 6 , 5 0 1 . 52 5 , 5 3 9 . 53

50

51c

2 4 9 , 2 2 8 .

1 , 6 4 3 , 4 9 8 ,

54

55c 56

57c 58 59

1 , 0 0 7 . 5 9 1 , 7 8 6 ,

5 , 4 9 5 .

2 5 6 , 0 0 0 .

5 6 , 4 0 0 , 1 1 , 3 0 4 ,

2 3 9 , 5 8 4 ,

1 , 1 6 1 , 5 7 6 . 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

505,204. 60 61 62

1 6 3 , 6 5 4 . 63 6 4 a

64b 490. 65

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

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 ..

6 6 9 , 3 4 8 ,

4 7 8 , 1 5 0 , 4 9 6 , 0 0 0 . 68

[~~| and complete lines

71 72


74 Total liabilities and net assets/fund balances. Add lines 66 and 73 9 7 4 , 1 5 0 .

1 , 6 4 3 , 4 9 8 .

1 8 7 , 3 4 2 .

1 7 0 , 1 8 3 .

4 5 0 . 3 5 7 , 9 7 5 ,

5 3 2 , 6 0 1 . 2 7 1 , 0 0 0 .

8 0 3 , 6 0 1 . 1 , 1 6 1 , 5 7 6 .

BAA Form 990 (2005)

TEEA0104 1*17(135

Form 990 i Save A L i f e F o u n d a t i o n 36-3869459 Page5 | Reconciliation of Revenue per Audited Financial Statements with Revenue per Return (See instructions.)

c d

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 40ther (specify): .Donated _SyEE?-_ies

b1 b2 b3

b4

9 7 3 f 6 8 7 .

1 , 8 7 7 , 0 8 1 .

1 2 , 7 0 0 . Add lines bl through M | h Subtract line b from line ■ | c Amounts included on Part I, line 12, but not on lines:

9 8 6 , 3 8 7 , 8 9 0 , 6 9 4 .

11nvestment expenses not included on Part I, line 6b 20ther (specify):

d l

d2 Add lines dl and d2 Total revenue (Part I, line 12). Add lines c and d

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 40ther (specify): .Donated J i u g g l i e s

b l b2 b 3

b4

9 7 3 , 6 8 7 .

1 2 , 7 0 0 . 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):

d l

d2 Add lines dl and d2 Total expenses (Part I, line 17). Add lines c and d

8 9 0 , 6 9 4 ,

2 , 0 4 7 , 6 3 0 .

9 8 6 , 3 8 7 . 1 , 0 6 1 , 2 4 3 ,

1 , 0 6 1 , 2 4 3 . Current Officers, Directors, Trustees, and Key Employees (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.)


C a r o l S j a i z z i r r i

R i t a M u l l i n s

Doug las Browne

Peggy T r i m b l e


See List of OfficerSj.Etc. Statement


to position

Chairman/Exec D i r 4 0

V i c e Chairwoman

T r e a s u r e r

V i c e Chairwoman

D i r e c t o r

(C) Compensation (If not paid, enter-0-)

1 3 0 , 0 0 0 .

0 .

0 .

0 .

0 .


plans and deferred compensation plans

1 , 9 0 0 .

0 .

0 .

0 .

0 .


allowances

0 .

0 .

0 .

0 .

0 .

BAA TEEA0105 KV17/M Form 990 (2005)

Form 990 < Save A Li fe Foundation 36-3869459 Page 6 I Current Officers, Directors. Trustees, and Key Employees (continued)

75a 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 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.)

(A) Name and address (B) Loans and

Advances (C) Compensation (D) Contributions to

employee benefit plans and deferred compensation plans


allowances

None

P u t V j y Other Information (See the instructions") Yes No T

i f i . & 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?



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| b Did the organization file Form 1120-POL for this year?

76 X 77

78a 78b

79

80a

■ * - ■ ■ - " *

81b BAA Form 990 (2005)

TEEAG1D6 11/03/05

Form990 (2005) Save A L i f e F o u n d a t i o n 36-3869459 Page 7 I Other Information (continued) Yes Ho

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 9 8 6 , 3 8 7 .

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?


b If Yes,' did the organization include with every solicitation an express statement that such contributions or gifts were nnl tax dedutfihle? . . . . . . not tax 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

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?


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


86a 86b 87)


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


82)

83a 83b X 84a

84b 85a 85b

85g

85 h

88

89b

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 0 .

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 Lawrence S u i t e 3 0 o / s c h i l l e r P a r k IlT zTp + 4 * 60176

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

91b

91c

Yes No

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 * Q and enter the amount of tax-exempt interest received or accrued during the tax year H 92 I

BAA Form 990 (2005)

TEEAM07 QMS/OS

Form 990 i) Save A L i f e F o u n d a t i o n 36-3869459 Page 8 Analysis of Income-Producing Activities (See the instructions.)


93 Program service revenue: ■ p rogram F e e s bCourse Materials c Branch d e

Fee

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 Net rental income or (loss) from real estate:

a debt-financed property , b not debt-financed property

9S 99

100

101 102 103

Net rental income or (loss) from pers prop . Other investment income Gain or (loss) from sales of assets other than inventory Net income or (loss) from special events . . dross profit or floss) from sates of inventory . Other revenue: a

b M i s c e l l a n e o u s c d

104 Subtotal (add columns (B), (D), and (E)) . 105 Total (add line 104, columns (B), (D), and (E))


Business code Amount

Excluded by section 512, 513, or 514 <C>

Exclusion code

14

Amount

4 , 8 8 2 .

18 - 5 , 9 3 2 .

<E> Related or exempt function income

2 3 , 7 8 0 , 6 7 , 1 3 3 .

4 , 4 2 2

B» 31 - 1 , 0 5 0 .

2 , 0 0 6 ,

9 7 , 3 4 1 .

Note: Line 105 plus line Id, Parti, should equal the amount on line 12, Parti. 9 6 , 2 9 1 .

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) N/A (A)


<B)


<0)

Nature of activities Total income

End-of-year assets

% P i t X I Information Regarding Transfers Associated with Personal Benefit Contracts (See the instructions.)

B a Did the organization, rturing the year, receive any funds, directly or indirectly, to p^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}.

Please Sign Here

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 ^

Signature of officer Data

Type oi cainl name and tiHa.

Paid Pre-parer's Use Only

Preparer's denature

D*M

1 1 / 0 1 / 0 6 Chock if self-employed n

Preparer's SSN « PTIN (See Geifnal Instruction W)

F»m"* name (or A h l b e c k & Company yours if sell- . _ . _ „ , , _ , employed), ft» 1 6 6 5 E l k B l v d address, and "~ _ , ZP + 4 Des P l a i n e s

EIN

IL 60016 Phone no. ► ( 8 4 7 ) 8 2 4 - 4 0 0 0 BAA TEEAOiOS iCviarOS Form 990 (2005)


Department of the Treasury IrteinM RCVMMM S t n t e


(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 fttrna at n t aganizalion

Save A L i f e F o u n d a t i o n Employer WmWterton w n h r

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.1)


than $50,000


devoted to position

(c) Compensation (d) Contributions to amployet benefit plans and dstarred

compensation


allowances

,Dane_ Nea l 9950 Lawrenc*. Suite 3Q0, Schiller Park, IL 60176 National Policy Director 40 6 3 , 5 0 0 . 1 ,800 ,


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

J*59.an_% .Ha^^son _L_. L . J \ Columbia Square, 555 Thirteenth Street ww, Washington P.c. 200404-1109 Governmen ta l C o n s u l t i n g 68,671, _Nawajra_Pinancia. . Adisors_ Jnc_._ 7420 W. College Drive, Ste. 2E*. Palos Heights, TL 60463 Accounting Service 51 ,663

Total number of others receiving over $50,000 for professional services None ■ P i r t iP '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

Total number of other contractors receiving None


" " , . , S

BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 and Form 990-EZ. Schedule A (Form 990 or 990-EZ) 2005

TEEA0401 08/W05


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 +• $ <ûste<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.)



c Furnishing of goods, services, or facilities? See P a r t V, Form 990


• 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? ,

2a

2 b

2c

2d

2e

3a 3b 3c

4a 4b

X

X


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>.


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.)

13 \_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 of supporting organization: ► p j T y p e 1 [ ~ ] T y p e 2 | | Type 3



Schedule A (Form 990 or 990-EZ) 2005 Save A L i f e F o u n d a t i o n 36-3869459 Page 3 Suppor 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 tor converting from the accrual to the cash method of accounting.

Caltndar yaw (or fiscal year beginning in) & 2003 A Total 15 Gifts, grants, and contributions

received. (Do not include unusual grants. See line 28.) . 1 , 8 8 2 , 8 2 2 . 4 4 6 , 6 2 1 . 1 , 3 7 1 , 6 8 4 . 8 2 0 , 2 8 2 . 4 , 5 2 3 , 4 0 9 ,


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 3 9 9 , 5 4 6 , 1 2 0 , 3 1 6 . 207.836. 1 9 7 , 5 3 5 . 925 ,233

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 organization after June 30,1975 1 ,933 . 7 9 5 . 2 , 1 5 4 . 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



23 Total of lines 15 through 22 . 2 , 2 8 4 , 3 0 1 5 6 9 , 7 3 2 . 1 , 5 8 1 , 6 7 4 . 1 , 0 2 1 , 0 9 2 . 5 , 4 5 6 . 7 9 9 . 24 Line 23 minus tine 17 1 , 8 6 4 , 7 5 5 , 4 4 9 , 4 1 6 . 1 , 3 7 3 , 8 3 8 . 8 2 3 , 5 5 7 . 4 , 5 3 1 , 5 6 6 . 25 Enter 1 % of line 23 2 2 , 8 4 3 . 5 , 6 9 7 . 1 5 , 8 1 7 . 1 0 , 2 1 1 . aa _ j 26 Organizations described on lints 10 or 1 1 : * Enter 2% of amount in column (e), line 24

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

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

22 8 , 1 5 7 . 19

26b 0 . e Public support (line 26c minus line 26d total) f Public support percentage (line 26« (numerator) divided by lint 26c (denominator!)

26a 9 0 , 6 3 1 . p§lljpi

26b 26c 4 , 5 3 1 , 5 6 6 .

26d 6 , 1 5 7 . 26e 4 , 5 2 3 , 4 0 9 , 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 received in each year from, each 'disqualified person." Donotfilethia list with your raturn. Enter the sum of name of, and total amounts such amounts for each year: (2004) (2003) (2002) (2001)

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: (2004) (2003) _



(2002) (2001) 15 20

and line 27b total

16 21

271 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)) h Investment Income percentage (line IB, column (*) (numerator) divided by lint 271 (denominator))

27c 27d 27f

27 j 27 h %

28 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.

BAA TEEAM03 92/03/06 Schedule A (Form 990 or 990-EZ) 2005

Schedule A (Form 990 or 990-EZ) 2005 Save A L i f e F o u n d a t i o n 36-3869459 I Private School Questionnaire (See instructions.) <To be completed OHLY by schools that checked the box on In* 6 in Part IV)

paaM N/A



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? ,

29

If 'Yes,' please describe; if 'No,' please explain. Of you need more space, attach a separate statement.)











• Educational policies? ,




If you answered Yes' to any of the above, please explain. (If you need more space, attach a separate 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 ,

32a

32b

32c 32d

33a

33b

33c

33d

33*

33f

33ft

33 h

34a

34b

* / * ■

35 Schedule A (Foim 990 or 990-EZ) 2005 BAA TEEAMW 0*0*05

Schedule A (Form 990 or 990-EZ) 2005 Save A L i f e F o u n d a t i o n 36-3869459 [Lobbying Expenditures by Electing Public Charities (See instructions.) (To be completed ONLY by an eligible organization that filed Form 5768)

Page 5

H/A I if the organization belongs to an affiliated group. Check ► h f l i t von checked 'a' and limited control' provisions apply. Check


Affiliated group totals

(b) To be completed for ALL electing organizations

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 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 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.




Calendar year for fiscal year beginning In) •

2005 ( t )

Total


46 Lobbying ceiling amount (150% of Una 45(e))


48 Grassroots non-taxable amount

49 Grassroots ceiling amount (150% 0lHne48<a»


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


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 Schedule A (Form 990 or 990-EZ) 2005

TEEA0405 0BWQ5

Schedule A (Form 990 or 990-EZ) 2005 Save A Lite F o u n d a t i o n 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 b Other transactions:

0)Sales or exchanges of assets with a noncharitable exempt organization (U)Purcnases of assets from a noncharitable exempt organization

(NQRental of facilities, equipment, or other assets (^Reimbursement arrangements (v) Loans or loan guarantees

(vl) Performance of services or membership or fundraising solicitations c Sharing of facilities, equipment, mailing lists, other assets, or paid employees

51a© a (11)

b<rj bOD bflH) b(iv> b(v) b(vi) c

Yes No X X

X X X X X X 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 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


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: (»)

Name of organization 0>)

Type of organization (cl



TEEAOWS 08/06705


Stat«ni«frt

Schedule of Gains and Losses from Sale of Assets Other than Inventory

•■ Attach to return

2005

Name Save A L i f e Foundat ion

Employer Identification Number 36-3869459


Public Securities

Description

P u b l i c l y Traded S e c u r i t i e s

Gross Sales Price Basis

Cost Selling Expenses Basis




Gross Sales Price


Total Securities


Parti, Line 8, Column (B)

Description

Vehicles acA Equinant

Date Acquired and Method

v a r i o u s s o l d

Other Assets


v a r i o u s

Gross Sales Price

5 ,800 .


Cost Depreciation Basts Donation FMV Cost Depreciation Basis Donation FMV Cost Depreciation Basis Donation FMV Cost Deoreciation Basis Donation FMV

11 ,732 .

11 ,732 .

Total Other Assets 5,800. 11,732 .

Gain or (Loss) from Sale of Other Assets - 5 , 9 3 2 .

TEEW0201.SCR 10O7TO


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.


Form 990, Page 2, Part II, Line43 Other Expenses Stmt


I n s t r u c t o r s F e e s I n s u r a n c e L i c e n s e s & P e r m i t s M a r k e t i n a M i s c e l l a n e o u s P a y r o l l S e r v i c e R e c r u i t m e n t T r a i n i n g S u p p l i e s P r o f e s s i o n a l F e e s Temporary S t a f f i n q C o n s u l t i n q Training & Development Proqram Mini G r a n t s

(A) Total

1 3 , 0 4 4 . 5 , 9 2 1 . 2 , 9 9 1 .

1 4 , 7 8 2 . 7 7 0 .

2 , 8 0 1 . 2 . 2 5 7 .

3 0 , 4 1 2 . 6 8 , 9 9 4 . 2 1 , 0 2 8 . 8 7 . 6 7 7 .

7 4 1 . 4 4 , 6 0 0 .


1 3 , 0 4 4 . 5 , 3 0 1 . 2 , 9 0 0 .

1 4 , 7 8 2 . 0 .

2 , 7 8 1 . 2 , 2 5 7 .

3 0 , 4 1 2 . 6 4 , 9 6 6 . 2 0 , 2 2 5 . 8 7 , 6 7 7 .

7 4 1 . 4 4 , 6 0 0 .


0 . 620 .

9 1 . 0 .

7 7 0 . 2 0 .

0 . 0 .

4 , 0 2 8 . 8 0 3 .

0 . 0 . 0 .

(D) Fundraising

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

Total 296,018. 289,686. 6 ,332. 0.

Form 990, Page 5, Part V-A List of Officers, Etc Statement


I r v Bock

Emil J o n e s , J r .

S t e v e n Orebauqh

E r n e s t o P r e t t o

Note: The individuals above, except as noted, spend time as needed in the i r capacity on the Board, Thev can be contac ted c/o Save a Life Foundation, 9950 Lawrence See 300, S c h i l l e c P a t k , IL 60176

(B) Title and


to position

D i r e c t o r

D i r e c t o r

D i r e c t o r

D i r e c t o r

(C) Compensation

Of not paid, enter -0-)

0 .

0 .

0.

0.

(D) Contributions to employee benefit plans and deferred compensation

0 .

0 .

0 .

0.

(E) Expense account


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

Land Bui ldina Office Equipment Vehic les

(a) Cost/Other

Basis

2 0 , 0 0 0 . 1 8 1 , 9 1 2 . 1 6 2 , 8 6 2 .

3 1 , 1 9 0 .


0 . 2 7 , 2 8 6 .

1 2 5 , 9 7 5 . 3 , 1 1 9 .

(c) Book Value

2 0 , 0 0 0 . 1 5 4 , 6 2 6 .

3 6 , 8 8 7 . 2 8 , 0 7 1 .

Total 395,964. 156,380. 239,584.



Form 990 p 2/Line 25 column (B)

Description

Proaram Serv ice S a l a r i e s : Carol S p i z z i r r i

Amount

123,500.

Total 123,500.


Form 990 p 2/Line 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

Amount

6,500.

Total 6,500,


Form 990 p 2/Line 42 column (B)

Description

Bui ld ing Eauipment Vehic les

Amount

9,096. 22,624.

1,882.

Total 33,602.

Supporting Statement ol:

Form 990 p 4/Line 63, column (A)

Description

Due to Carol S p i z z i r r i , P res iden t /Exec . Di rec tor I n t e r e s t Rate - Va r i ab l e

Amount

163,654.

Total 163,654.



Form 990 p 4 /Line 63, column (B)

Description

Due to Carol S p i z z i r r i , Pres ident /Exec . D i r ec to r I n t e r e s t Ra te -Var iab le

Amount

170.163.

Total 170.183.


Form 990 p 5 /Pa 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 su rance

Amount

1 . 9 0 0 .

Total 1.900.

SAVE A LIFE FOUNDATION, INC. AUDITED FINANCIAL STATEMENTS JUNE 30, 2006 AND JUNE 30,2005

AHLBECK&COMPANY CERTIF1FD PUBLIC ACCOUNTANTS



June 30, 2006 andjune 30,2005



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 11 For the Years Ended June 30, 2006 andjune 30, 2005


AHLBECK Sr COMPANY

CERTIFIED 1665 ELK BOULEVARD TELEPHONE: 847/824-4000 PUBLIC DE5 PLAINES, ILLINOIS FACSIMILE: 847/B24-40O ACCOUNTANTS 60016-1776 WEB: www.ahlbcckco.com

August 11,2006



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.



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

http://www.ahlbcckco.com



2006 2005

A S S E T S

Current Assets Cash and Cash Equivalents Inventory Trade Receivables Grants Receivable Other Receivables Prepaid Expenses


Fixed Assets at Net Book Value Land Building Office Equipment Program Equipment Vehicles


TOTAL ASSETS

$ 592,793 56,400

5,495 256,000

-11,304

921,992

20,000 154,626 32,561

4,326 28,071

239,584

1,161,576

$ 813,976 56,501 22,254

496,000 1,660 3,879

1,394,270

20,000 163,721 49,861

-15,646

249,228

1,643,498


2



2006 2005


Current Liabilities Accounts Payable $ 43,198 $ 19,671 Accrued Expenses - 395,576 Credit Card Payable 13,520 Instructor Deposits 450 490 Rent Payable - 89,957 Mini-Grants Payable 130,624


Other liabilities ) Carol Spizzirri

Total Other Liabilities

TOTAL LIABILITIES

170,183

170,183

357,973

163,654

163,654

669,348

Net Assets Temporarily Restricted 271,000 496,000 Unrestricted 532,601 478,150

Total Net Assets 803,601 974,150

TOTAL LIABILITIES AND NET ASSETS 1,161,576 1,643,498


3





INCOME

Public Support Contributions Private Grants Contributions In Kind

655 64,500

1,000,635 15,000

655 79,500

1,000,635

Total Public Support 1,063,790 13,000 1,080,790

Government Contracts State of Illinois-IDPH 700,000 700,000


Other Income Course Materials Training Program Fees Branch Revenue Sharing Miscellaneous Loss on Asset Disposal

67,133 23,780 4,422 2,006

(5,932)

700,000 700,000

67,133 23,780 4,422 2,006

(5,932)




Total Income (balances carried forward)

4,882

4,882

1,162,081

-

-

713,000

4,882

4,882

1,877,081


4



For the Year Ended June 30, 2006 Temporarily


Total Income (balances brought forward) 1,162,081 713,000 1,877,081

EXPENSES

Program National State Branch Programs

401,055 691380 899,479

Release from Restrictions - HHS/CDC Release from Restrictions - DCCA Building Purchase Release from Restrictions - State of Illinois - IDPH Release from Restrictions - Private Grants

240,000

700,000

(240,000)

(700,000)

401,055 691,380 899,479


Total Expenses

1,991,914 55,716

2,047,630

1,991,914

55,716

2,047,630

Change in Net Assets Beginning Net Assets Ending Net Assets (Deficit)

54,451 478,150 332,601

(225,000) 496,000 271,000

(170,349) 974,150 803,601


5





INCOME

Public Support Contributions Contributions In Kind Special Events Gross Income

5,545 S 209,580 150,089

5,545 209,580 150,089


Government Contracts State of Illinois - 1DPH HHS/CDC

700,000 496,000

700,000 496,000

Total Government Contracts 1,196,000 1,196,000

Other Income Program Service Fees Course Materials Product Sales Conference/Seminar Income Branch Fee Miscellaneous

35,265 259,353

62,234 10,920 5,433

868

35,265 259,353 62,234 10,920 5,433

868




TOTAL INCOME Qwlances carried forward)

1,933

1,933

741,220

-

-

1,196,000

1,933

1,933

1,937,220


6



For the Year Ended June 30,2005

Program Kids Program Corporate Program Expansion Program Allied Health Grant

Temporarily

TOTAL INCOME (balances brought Jorward)

Unrestricted

741,220

Restricted

1,196,000

Total

1,937,220

EXPENSES

813,454 17,621

1,050,403 18,267

Release from Restrictions - HHS/CDC Release from Restrictions - DCAA Building Purchase Release from Restrictions - State of Illinois - IDPH Release from Restrictions - Private Grants

955,043 100,000 700,000 84,500

(955,043) (100,000) (700,000) (84,500)

813,454 17,621

1,050,403 18,267

Total Program

Management and General Fundraising


TOTAL EXPENSES

1,899,743 98,816

170

1,998,731 34,312

2,033,043

1,899,743 98,816

170

1,998,731 34,312

2,033,043

Change in Net Assets 347,720 (643,343) (93,823) Beginning Net Assets (69,570) 1,139,543 1,069,973

Ending Net Assets (Deficit) 478,130 496,000 974,130


7


STATEMENT OF FUNCTIONAL EXPENSES For the Year Ended June 30,2006

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

PROGRAM

National

$ 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

Branch Programs

$ 160,325 --------

130,000 287,917

-8,641

-----

12,700 ----

298348 -----

1,548 -~

899,479 25,159

924,638

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

SUPPORT


$ 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


8



PROGRAM


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 Promotional 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

i 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

207,566 1,272 2,808

74,397 813,454

42.312

855,766

3.355 84

374 ------9 ----

13,754 ---------

51 -. -

(20) ----

14 ---

17,621 917

18,538

$ 311.512 $ 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

113,552 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 1,050 1,679

--

18,267 950

19,217

$ 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


9



SUPPORT

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

Management and General Fundrateing

$ 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 --

( -----------------

119 ---2 -

25 ------

24 ---

-

Total

i 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 --

Organization Total

$ 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



Total Expenses

98^16 (98,816)

170 98,987 (98,816)

170 171

1,998,731

1,998,731


10


COMPARATIVE STATEMENTS OF CASH FLOWS

For the Years Ended June 30,2006 andjune 30,2005

2006 2005




Non-cash in kind donations - fixed assets Depreciation Loss on disposal of fixed assets


$ (170,549) $ (95,823)

-33,602 5,932

16,759 101

240,000 (5,765) 23,527

(341,429)

(4,500) 30,301

-

(8,639) (2,130)

561,000 5,429 13,184

453,709 Net cash provided by (used in) operating activities


Purchase of fixed assets Disposal of fixed assets

(197,822) 952,331

(35,690) 5,800

(20,490)




(29,890) (20,490)

6,529 6,210

(137,366) Net cash provided by (used in) financing activities 6,529 (131,156)

Net Increase (Decrease) in Cash and Cash Equivalents (221,183) 800,683

Cash and Cash Equivalents at Beginning of Period 813,976 13,291

Cash and Cash Equivalents at End of Period 592,793 813,976

Supplemental Disclosures: Interest paid 728


11



For the Years Ended June 30,2006 and June 30,2005


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.





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.


Inventories Inventories are stated at cost using the average cost method.

12



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.


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.


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



For the years Ended June 30,2006 and]unc 30,2005


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.


At June 30, 2006 and 2005, die costs of such assets were as follows:

Land Building Office Equipment Program Equipment Vehicles


June 30, 2006

$ 20,000 181,912 158,363

4,500 31,190

395,965 156,381 239,584

2005 $ 20,000

181,912 146,717

-39,132

387,761 138,533 249,228

Increase (Decrease) $

-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



For the Years Ended June 30,2006 and June 30,2005


Temporarily restricted net assets at June 30, 2006 and 2005 consist of the following:

2006 2005 United States Department of Health and Human Services/ $256,000 $496,000 Center for Disease Control - restricted to use according to the grant agreement and also according to time release restriction

VELCO 15000 ;

Total 271000 496,000


SALF has a vesting vacation policy. The amount of existing vacation time remaining as of June 30, 2006 and June 30, 2005 is immaterial.


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.


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, Rent 2007 $ 107,737 2008 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



For the Years Ended June 30, 2006 and June 30, 2005



Year Ended lune 3D. 2006 Year Ended lune 30. 2005 Revenue Expenses £ & B£2£0J1£ Expenses Hfit

Summit $ - $ - $ - $145,401 $34,144 $111,257 Race for Life . . . 308 168 140 CuhsGame - : - 4.380 - 4.380

- : - 150089 34.312 115.777

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

Form AG990-IL Revised 3/05 iD:30ii

CO# 01026498 Check all items attached:

Report for the Fiscal Period: Beginning 7/01/06 & Ending 6/30/07

MO DAY YR

Make Checks Payable to the Illinois Charity Bureau Fund

Federal ID # 36 -3869459

Copy of IRS Return Audited Financial Statements

Copy of Form IFC

515.00 Annual Report Filing Fee

$100.00 Late Report Filing Fee

MO DAY YR

Are contributions to the organization tax deductible? |X| Yes | | No Date Organization was

LEGAL NAME SAVE A LIFE FOUNDATION P T T ^ F l V F T t l

ADDRESS 9950 LAWRENCE # 3 0 0

CITY, STATE ' } MAY 1 « 2008 j ZIP CODE SCHILLER PARK, I L 60176 J(

x Attorney General

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 ta tement . . 1 G TOTAL REVENUE, INCOME AND CONTRIBUTIONS RECEIVED (ADD Dr Er AND 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 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) 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)

Year-end amounts

A ASSETS

B LIABILITIES

C NET ASSETS

PERCENTAGE

2 2 . 8 1 %

7 5 . 6 3 % 1.56%

100%

9 0 . 4 6 % o, "5

9 0 . 4 6 %

*6 9 0 . 4 6 %

9 . 5 4 % %

100%

created: 2 / 0 9 / 1 9 9 3

HHBHi A$

B$ C$

4 4 9 , 8 2 3 .

1 9 1 , 2 1 4 . 2 5 8 , 6 0 8 .

AMOUNT

D$ E$

F$ G$

H$

2 1 1 , 1 1 6 . 7 0 0 , 0 0 0 .

1 4 , 4 2 9 .

9 2 5 , 5 4 5 .

1 , 3 3 0 , 2 3 9 . 1$

J$ 1 , 3 3 0 , 2 3 9 .

K$

L$ M$

1 , 3 3 0 , 2 3 9 .

1 4 0 , 2 9 9 . N$ 0 $ 1 , 4 7 0 , 5 3 8 . BRHH

100% 0,

%

PROFESSIONAL FUNDRAISING CONSULTANTS:

S TOTAL AMOUNT PAID TO PROFESSIONAL FUNDRAISING CONSULTANTS IV COMPENSATION TO THE (3) HIGHEST PAID PERSONS DURING THE YE/

T NAME. TITLE: CAROL S P I Z Z I R R I , PRESIDENT/FOUND

KR:

U NAME, TITLE: DANE NEAL, DIRECTOR V NAME, TITLE: VINCENT DAVIS, DIRECTOR

V CHARITABLE PROGRAM DESCRIPTION: CHARITABLE PROGRAM (3 HIGHEST BY $ EXPENDED) CODE CA TEGORIES

W DESCRIPTION: L I F E SAVING F I R S T A I D T R A I N I N G

X DESCRIPTION:

Y DESCRIPTION: ^ ^ ^ ^ ^ ^ ^ _ ■^H

P$

Q$ R$

S$

T$

U$ V$

1 3 0 , 0 0 0 .

6 3 , 5 2 0 . 5 0 , 0 0 0 .

See instructions for list CODE

W# 011 X# Y#

1

SAVE A LIFE FOUNDATION 36-3869459 Page 2 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 2 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, 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

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 COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? 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

7 b IF 'YES', ENTER (i) THE AGGREGATE AMOUNT OF THESE JOINT COSTS $ ; (ii) THE AMOUNT ALLOCATED TO PROGRAM SERVICES $ ; (ii) 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? 8

9 HAS THE ORGANIZATION EVER BEEN 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:

See Statement 2

YES NO

X

X

X

1? X X

X

X

X

X


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 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 $100.00 PENALTY.

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.

OMB No. 1545-0047

2006 Open to Public

Inspection For the 2006 calenda^year, or tax year beginning 7 / 0 1 Check if applicable:

Address change

Name change

Initial return

Final return

Amended return

Application pending


See specific instructions.

, 2006, and ending 6 / 3 0 2007

SAVE A LIFE FOUNDATION 9950 LAWRENCE #300 SCHILLER PARK, IL 60176

Section 501 (cX3) organizations and 4947faX"D nonexempt charitable trusts must attach a completed Schedule A (Form990or990-EZ).

G Web site: * www. s a l f . o r q

Organization type (check only one). m 501(c) (insert no.) D 4947(a)(1) or D 527

K 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 organization chooses to file a return, be sure to file a complete return.

L Gross receipts: Add lines 6b, 8b, 9b, and 10b to line 12. . * 9 2 5 , 5 4 5 .

D Employer Identification Number


(847) 928-9683

TT~ method:

| j Other (specify)

Cash m Accrual

H andl are not applicable to section 527 organizations.

H ( a ) ts this a group return for affiliates?. . . . | j Yes | X [

H ( b ) If 'Yes,' enter number of affiliates

H (C) Are all affiliates included?. [ _ j Y e s \_J (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 y e s [ } ( ] N o

No

No

I Group Exemption Number... *" M Check »• | | if the organization is not required

to attach Schedule B (Form 990,990-EZ, or 990-PF).

Bart I I Revenue, Expenses, and Changes in Net Assets or Fund Balances (See the instructions.)

a b c d

2 3 4 5 6a

b c

7

8a

b c d

l a l b 1c I d

Contributions, gifts, grants, and similar amounts received: Contributions to donor advised funds Direct public support (not included on line la) Indirect public support (not included on line la) Government contributions (grants) (not included on line la) la through Id)%ash $ 7 3 1 , 9 4 5 . - noncash $


31,945

7 0 0 , 0 0 0

)

Gross rents Less: rental expenses Net rental income or (loss). Subtract line 6b from line 6a. Other investment income (describe **

6a 6b


c 10a

b c

11 12

Gross amount from sales of assets other than inventory Less: cost or other basis and sales expenses Gain or (loss) (attach schedule) 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 reported on line lb) Less: direct expenses other than fundraising expenses Net income or (loss) from special events. Subtract line 9b from line 9 a — Gross sales of inventory, less returns and allowances Less: cost of goods sold 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 1e, 2, 3, 4, 5, 6c, 7, 8d, 9c, 10c, and 11

(B) Other

■□ 9a 9b

10a 10b

1e

10c 11 12

731,945 179,171

13,684

745 925,545

13 14 15 16 17

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)

13 1,330,239 14 15 16

140,299

17 1 , 4 7 0 , 5 3 8 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 . . .

18 19 20 21

-544,993 803,601

258,608 BAA For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Form 990 (2006)

Form 990 (2006) SAVE A LIFE FOUNDATION 36-3869459 Page 2 R a M l l l i Statement of Functional E>

required for section 501(c)(3) and Do not include amounts reported on line

6b, 8b, 9b, 10b, or 16 of Parti.

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 $ ) If this amount includes .—. foreign grants, check here - • *" | |

23 Specific assistance to individuals (attach schedule)

24 Benefits paid to or for members (attach schedule)

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 Salaries and wages of employees not included on lines 25a, b, and c

27 Pension plan contributions not included on lines 25a, b, and c

28 Employee benefits not included on lines 25a - 27.

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):

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)

Cpenses All organizations must complete column (A). Columns (B), (C), a (4) organizations and section 4947(a)(1) nonexempt charitable trusts but opl ■

22 a

22 b

23

24

25 a

25 b

25 c

26

27

28 29 30 31 32 33 34 35 36 37 38 39 40 41 42

43 a

43 b 43 c 43 d 43 e 43 f 43 g

44

(A) Total

1 3 0 , 0 0 0 .

0 .

0 .

2 9 9 , 7 5 3 .

8 , 4 2 6 . 4 0 , 0 4 0 .

5 6 , 4 6 2 . 1 5 , 0 7 6 . 1 0 , 2 2 6 .

1 0 2 , 7 5 6 . 6 , 6 9 8 .

5 3 , 1 8 7 .

8 , 5 2 3 .

7 3 9 , 3 9 1 .

1 , 4 7 0 , 5 3 8 .


1 2 3 , 5 0 0 .

0 .

0 .

2 7 1 , 8 7 3 .

7 , 7 5 2 . 3 6 , 8 3 7 .

5 6 , 4 6 2 . 1 3 , 2 6 7 .

9 , 9 1 9 . 1 0 2 , 7 5 6 .

5 , 8 2 7 .

5 2 , 0 8 3 .

8 , 5 2 3 .

6 4 1 , 4 4 0 .

1 , 3 3 0 , 2 3 9 .

(C) Management and general I

6 , 5 0 0 .

0 .

0 .

2 7 , 8 8 0 .

6 7 4 . 3 , 2 0 3 .

1 , 8 0 9 . 3 0 7 .

8 7 1 .

1 , 1 0 4 .

9 7 , 9 5 1 .

140,299.1

nd (D) are ional for others.

(D) Fundraising

|

0 .

0 .

0 .

0 . 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 Statement of Program Service Accompl ishments 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.

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 clients served, publications issued, etc. Discuss achievements that are not measurable. (Section 501(c)(3) and (4) organizations and 4947(a)(1) nonexempt charitable trusts must also enter the amount or grants ana allocations to others.)

Program Service Expenses (Required for 501(c)(3) and

(4) organizations and 4947(a)(1) trusts; but 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 n 302,613 b_STATE_ PROGRAMS_-_ JifflrcH J3ELIVER_IJFE _SUPP_ORTING_FIRST_ AID. TRAINING, T0_ iG 12_ STUDENTSÛTILIZING _LpCAL_EMERCENCY _MEDICAL _SERVICE _PRQVipERS__AS. INSTRUCTORS.

(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__ $ ) If this amount includes foreign grants, check here.. ^ | [ e Other program services.

(Grants and allocations, ) If this amount includes foreign grants, check here . . ►* | | f Total of Program Service Expenses (should equal line 44, column (B), Program services) 1,330,239

BAA Form 990 (2006)

Form 990 (2006) SAVE A LIFE FOUNDATION 36-3869459 Page 4 ffiuifliyjl B a l a n c e Shee ts (See the instructions.)


(A) Beginning of year End of year



1,007 45

591 ,786 46

48a Pledges receivable b Less: allowance for doubtful accounts.


47 a 47 b

48a 48b

3,250 5 , 4 9 5 . 47 c

48c 2 5 6 , 0 0 0 . 49

50 a Receivables from current and former officers, directors, trustees, and key employees (attach schedule) 50 a

b Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) (attach schedule) 50 b

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..



51a 51b 51c

56,400 52

11 ,304 53

55 a

55 b

Cost Cost

FMV FMV

54a 54b

I 55 c 56

b Less: accumulated depreciation (attach schedule) S t a t e m e n t . 3 . . .

58 Other assets, including program-related investments (describe *

57 a

57 b

399,685

186 ,092 2 3 9 , 5 8 4 57 c

58 59 Total assets (must equal line 74). Add lines 45 through 58 1 , 1 6 1 , 5 7 6 59

5 2 , 9 0 9 130 ,655

3,250.

4,899

2 , 7 5 0

4 1 , 7 6 7

2 1 3 , 5 9 3

449 ,823 60 61 62

Accounts payable and accrued expenses. Grants payable Deferred revenue

187 ,342 60 61 62

63 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

1 7 0 , 1 8 3 63 64a 64b

450 65 3 5 7 , 9 7 5 66

9,540

178 ,974

2 , 7 0 1 191 ,215

[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 Organizations that do not follow SFAS 117, check here

70 through 74. Capital stock, trust principal, or current funds Paid-in or capital surplus, or land, building, and equipment fund Retained earnings, endowment, accumulated income, or other funds

5 3 2 , 6 0 1 67 271 ,000 68

69 j ~ | and complete lines

70 71 72

70 71 72

73

74

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

803,601 73 1 , 1 6 1 , 5 7 6 74

258 , 608

258 ,608 449 ,823

BAA Form 990 (2006)

Form 990 (2006) SAVE A LIFE FOUNDATION 36-3869459 Page 5 Baft-ilVgAX Reconci l iat ion of Revenue per Aud i ted Financial S ta tements w i th Revenue per Return (See the

instructions.)

a Total revenue, gains, and other support per audited financial statements. b 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):

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):

b1 b2 b3

b4

1 , 2 5 6 , 1 5 5

3 3 0 , 6 1 0 .

d l

d2 Add lines dl and d2. Total revenue (Part I line 12). Add lines c and d.

330 ,610 925 ,545

9 2 5 , 5 4 5 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 nanc ia l S t a t e m e n t s w i t h E x p e n s e s pe r 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): _ __ .

b l b2 b3

b4

3 3 0 , 6 1 0 .

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): _

d l

d2 Add lines d l and d2. Total expenses (Part line 17). Add lines c and d

1 , 8 0 1 , 1 4 8

3 3 0 , 6 1 0 1 ,470 ,538

1 , 4 7 0 , 5 3 8 Bai i t lV IA^ ! Current Off icers, Directors, T rus tees , and Key Employees (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.)


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 j SCHILLER PARK, IL 60176 ANDY KNAPP 9950 LAWRENCE #300 SCHILLER PARK, IL 60176

BAA


to position

P r e s i d e n t & CEO 40

S e c r e t a r y 0

T r e a s u r e r 0

D i r e c t o r 0

D i r e c t o r 0

(C) Compensation (if not paid, enter -0*)

1 3 0 , 0 0 0 .

0 .

0 .

0.

0.



0 .

0 .

0 .

0 .

0.


allowances

838 .

0 .

0 .

0 .

0.

Form 990 (2006)

Form 990 (2006) SAVE A LIFE FOUNDATION 36-3869459 Page 6 RaMViff i 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.)

(A) Name and address (B) Loans and Advances

(C) Compensation (if not paid, enter -0-)




allowances

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


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?



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?

76 77

78 a 78 b N,

79

80 a

81b BAA Form 990 (2006)

Form 990 (2006) SAVE A LIFE FOUNDATION 36-3869459 Page 7

O t h e r I n f o r m a t i o n (continued) Yes No


bl f '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 b 3 3 0 , 6 1 0 .

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?



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.

85 c 85 d 85 e 85 f

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?.


N/A N/A N/A N/A


87 501(c)(l2) organizations. Enter: a Gross income from members or shareholders


86 a 86 b 87 a

87 b

N/A N/A N/A

N/A 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 ** 0 .


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 0 .

0. e All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction?.. 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, PA , A Z , VT

82 a

83 a X 83 b X 84a

84b I ' A 85 a N.' 85 b N A

85 q N/A

85 h N/A

88a

88b X

89 b X

89 e X 89 f X

89 g X

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 Located a t - 9950 LAWRENCE SUITE 300% SCHILLER PARK IL

90b

Jj? i l ) _ 928-9683. ZIP~+4 > 60176

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.

91b Yes No

X

BAA Form 990 (2006)

Form 990 (20Q6) SAVE A LIFE FOUNDATION 36-3869459 Page 8

91c Yes No

X i E a r t i y i Other Information (continued)

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. N/A. . . *■ \ \ and enter the amount of tax-exempt interest received or accrued during the tax year...._._._.__._._.__._.... ..._. ■._.___**! 92 [ N/A

Baff lTO Analysis of Income-Producing Activi t ies (See the instructions.)


93 Program service revenue: a COURSE MATERIALS b PROGRAM FEES c d 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:


98 Net rental income or (loss) from pers prop... 99 Other investment income

100

101 102 103

Gain or (loss) from sales of assets other than inventory. Net income or (loss) from special events... Gross profit or (loss) from sales of inventory . .

Other revenue: a b MISCELLANEOUS c d e

104 Subtotal (add columns (B), (D), and (E))... 105 Total (add line 104, columns (B), (D), and (E)>


Business code (B)

Amount

Excluded by section 512, 513, or 514

Exclusion code

14

(D) Amount

1 3 , 6 8 4 .

1 3 , 6 8 4 .


165,155 14,016

745

179,916 193,600

Note: Line 1'05 plus line le, Part I, should equal the amount on line 12, Part I. Relationship of Act ivi t ies to the Accompl ishment 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 PROVIDE LIFE SAVING FIRST AID SKILLS TO VOLUNTEERS TO AID IN AN EMERGENCY. 103-B MISCELLANEOUS INCOME TO CARRY OUT THE LIFE SAVING FIRST AID PROGRAMS.

fjattjIXf Information Regarding Taxable Subsidiaries and Disregarded Entit ies (See the instructions.) (A)


(B) Percentage of

ownership interest

(C) Nature of activities

(D) Total

income

(E) End-of-year

assets N/A

RaljtfXi Information Regarding Transfers Associated with Personal Benefit Contracts (See the 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), file Form 8370 and Form 4720 (see instructions).

Yes Yes

No No

BAA Form 990 (2006)

Form 990 (2006) SAVE A LIFE FOUNDATION 36-3869459 Page 9 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

b

c

(A) Name, address, of each

controlled entity

Totals

(B) Employer Identification

Number

■■■■

R Description of

transfer

■■■■

Yes No

X

(D) Amount of transfer

107 Did the reporting organization receive any transfers from a controlled entity as defined in section 512(b)(13) of the Code? If

a

b

c


controlled entity

Totals

(B) Employer Identification

Number

■■■■

(C) Description of

transfer

■■■^^1

Yes No

X


108 Did the organization have a binding written contract in effect on August 17, 2006, covering the interest, rents, royalties, and

Please Sign Here

Paid Prepare Use Only

BAA

r's

Yes No

X

S C H E D U L E A (Form 990 or 990-EZ)



(Except Private Foundation) and Section 501(e), 501(0,501 (k), 501 (n), or 4947(aXl) Nonexempt Charitable Trust


OMBNo. 1545-0047


SAVE A LIFE FOUNDATION Employer identification number

36-3869459 l l l a l ^ i l P l l f f l Compensat ion of the Five Highest Paid Employees Other Than Off icers, 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


devoted to position

(c) Compensation (d) Contributions to employee benefit plans and deferred

compensation


allowances

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.)


None

Total number of other contractors receiving over $50,000 for other services *" 0


3BHKSHS9HH BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 and Form 990-EZ. Schedule A (Form 990 or 990-EZ) 2006

Schedule A (Form 990 or 990-EZ) 2006 SAVE A LIFE FOUNDATION 36-3869459 Page 2

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 inst ruct ions. ) Yes No

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.)


b Lending of money or other extension of credit?.

c Furnishing of goods, services, or facilities? S e e F o r m 9 9 0 , P a r t V



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

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

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..

BAA

2a

2b

2c

2d

2e

3a

3b

3c

3d

4a

4b

4c

X

X

X

X

X

X

X

N.

N A

N/A

N/A

0. 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 M 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 Q A hospital or a cooperative hospital service organization. Section 170(b)(l)(A)(iii).

8 Q A federal, state, or local government or governmental unit. Section 170(b)(1)(A)(v).

9 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 *• _,

10 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.)

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 nType III-Other

Provide the following information about the supported organizations. (See instructions.) (a)

Name(s) of supported organization(s)

(b) Employer identification

number (EIN)

(c) Type of

organization (described in lines 5 through 12 above or JRC section)

(d) Is the supported

organization listed in the supporting organization's

governing documents?

Yes No

Total ►

(e) t Amount of

support

0.

14 | | An organization organized and operated to test for public safety. Section 509(a)(4) (See instructions.) BAA 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: [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.

Calendar year (or fiscal year beginning in)

(a) 2005

(b) 2004

(c) 2003

(d) 2002

(e) Total

15 Gifts, grants, and contributions received. (Do not include unusual grants. See line 28-)... 1 ,034 ,403 1 ,882 ,822 448 ,621 1 , 3 7 1 , 6 8 4 4 , 7 3 7 , 5 3 0

16 Membership fees received 0

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 112,094 399,546 120,316 207,836 839,792

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 organization after June 30,1975 4 , 8 8 2 1,933 795 2 , 1 5 4 9,764


20 Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf.


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. 2 ,006 2 ,006

23 Total of lines 15 through 2 2 . . . . 1 , 1 5 3 , 3 8 5 . 2 , 2 8 4 , 3 0 1 . 5 6 9 , 7 3 2 . 1 , 5 8 1 , 6 7 4 . 5 , 5 8 9 , 0 9 2 24 Line 23 minus line 17. 1 , 0 4 1 , 2 9 1 . 1 , 8 8 4 , 7 5 5 . 4 4 9 , 4 1 6 . 1 , 3 7 3 , 8 3 8 . 4 , 7 4 9 , 3 0 0 25 Enter 1% of line 23. 1 1 , 5 3 4 . 2 2 , 8 4 3 . 5 , 6 9 7 . 1 5 , 8 1 7 . 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 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 . 19

22 2 , 0 0 6 . 26b e Public support (line 26c minus line 26d total) f Public support percentage (line 26e (numerator) divided by line 26c (denominator))

26 a

26 b

94 ,986

26 c

26 d

4 , 7 4 9 , 3 0 0

11 ,770 26 e 4 , 7 3 7 , 5 3 0

26 f 99 .75 % 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) _



15 20

(2003) (2002) 16

and line 27b total. 21

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))

27 c 27 d

27 e

27 h 28 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.

Schedule A (Form 990 or 990-EZ) 2006 BAA

Schedule A (Form 990 or 990-EZ) 2006 SAVE A LIFE FOUNDATION 3 6 - 3 8 6 9 4 5 9 Page 5

R»Vj Private School Questionnaire (See instructions.) (To be completed ONLY by schools that checked the box on line 6 in Part IV) N/A



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.)







b Admissions policies?.





g Athletic programs?.



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


29

30

31

32 a

32 b

32 c

Yes No

111

ma 33 a

33 b

33 c

33 d

33e

33 f

J3fl

33 h

34a

34b

35

mm


Schedule A (Form 990 or 990-EZ) 2006 SAVE A LIFE FOUNDATION 36-3869459 Page6

.BaTsflKlfAl Lobbying Expendi tures by Elect ing Publ ic Char i t ies (See instructions.) (To be completed ONLY by an eligible organization that filed Form 5768) N/A

Check •" a f l i f the organization belongs to art affiliated group. Check * b if you checked 'a' and 'limited control' provisions apply.

Limits o n Lobbying Expendi tures

(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 - The lobbying nontaxable amount is -Not over $500 000 20% of the amount on line 40 1 Over $500,000 but 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



36 37 38 39 40

41 ■ 42 43 44


totals

■ ■

(b) To be completed

for all electing organizations

■ ■ I I




Calendar year (or fiscal year beginning in) ■

(a) 2006

(b) 2005

(c) 2004 2003

(e) Total


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

47 Total lobbying expenditures..


49 Gra ss roots cei I i ng amount (150% of line 48(e))

50 Grassroots lobbying expenditures.

BatflWl'BJl Lobbying Activity by Nonelect inq Public Charit ies (For reporting only by organizations that aid not complete Part VI-A) (See instructions.) N/A


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.

Yes 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: (i)Cash


(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


51 a (i) afli)

b(i) b(i i) b(iii) b(iv) b(v) b(vi) c

Yes No X X

X X X X X X 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 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.

N/^ Amount involved

(c) 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 .__ . . described in section 501 (c) of the Code (other than section 501 (c)(3)) or in section 527? ■* | | Yes jXj No

b If 'Yes,' complete the following schedule:


N /A

(b) Type of organization



2006 Illinois Statements Page 1 Client 18015 SAVE A LIFE FOUNDATION 36-3869459, 5/14/08 02:53PM

Statement 1 Form AG990-IL, Page 1, Line F Other Revenues

INTEREST INCOME $ 13, 684 . INSTRUCTOR DUES 745.

Tota l $ 14,429.

Statement 2 Form AG990-IL, Page 2, Question 11 Name and Account Number of Institutions Holding Three Largest Accounts

JP MORGAN CHASE BANK, N.A.

2006 Client 18015 5/14/08

Statement 1 Form 990, Part II, Line 43 Other Expenses

AUTO EXPENSE 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 OFFICE SUPPLIES PAYROLL SERVICE PROGRAM MINI-GRANTS TEMPORARY STAFFING TRAINING AND DEVELOPMENT UTILITIES WEBSITE

Statement 2 Form 990 , Part III

Federal Statements SAVE A LIFE FOUNDATION

(A) 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.

Total $ 739,391.

Organization's Primary Exempt Purpose

(B) Program Services

2,948.

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.

(C) Management & General

156. 1,850. 2,806. 8,422. 27,566.

182.

8,386. 10,916.

520.

20. 303. 402.

36,422.

$ 97,951.

TRAINING AND DEVELOPING "BYSTANDERS", INCLUDING CHILDREN, AS VOLUNTEERS WITH LIFE SAVING FIRST AID

Statement 3 Form 990, Part IV, Line 57 Land, Buildings, and Equipment

Cateaory Machinery and Equipment Buildings Land Miscellaneous

SKILLS TO AID IN AN

$

Total $

EMERGENCY.

Basis 166,583. $ 181,912. 20,000. 31,190. 399,685. $

Accum. DeDrec. 140,353. $ 36,382. 9,357.

186,092. $

Pagel 36-3869459

02:53PM

(D) Fundra^sing

$ 0.

EQUIPPED

Book Value 26,230. 145,530. 20,000. 21,833. 213,593.

2006 Federal Statements Page 2 Client 18015 SAVE A LIFE FOUNDATION 36-3869459 5/14/08 02:53PM

Statement 4 Form 990, Part IV, Line 63 Loans from Officers, Directors, Trustees, and Key Employees

Balance Due Lender's Name: CAROL SPIZZIRRI Lender's Title: PRESIDENT Repayment Terms: DUE ON DEMAND Interest Rate: 5.00% Purpose of Loan: OPERATIONS Original Amount: 61,496. Balance Due: 178, 974 .

Total $ 178,974.

Statement 5 Form 990, Part IV, Line 65 Other Liabilities

INSTRUCTOR DEPOSITS $ 2 ,700. Rounding 1^

Total $ 2 ,701 .

Statement 6 Schedule A, Part I Compensation of Five Highest Paid Employees

T i t l e & Average Compen- Contribut. Expense Name and Address _ Hours Worked s a t i o n EBP & DC Account

DANE NEAL NATL POLICY DIR 63,520. 0. 584. 9950 LAWRENCE, SUITE 300 40 SCHILLER PARK, IL 60176

VINCENT DAVIS DIR -STATE/MILI 50,000. 0. 724. 9950 LAWRENCE, SUITE 300 40 SCHILLER PARK, IL 60176

Total $ 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 5erv ice Compensation HOGAN & HARTSON LLP CONSULTING . 77,039. COLUMBIA SQUARE, 555 THIRTEENTH ST WASHINGTON, DC 20004

Total $ 77,039.

2006 Federal Statements Page 3,

Client 18015 SAVE A LIFE FOUNDATION 36-3869459 5/14/08 " . - 02:53PM

Statement 8 j Schedule A, Part IV-A, Line 22 I Other Income

Descr ip t ion (a) 2005 fb) 2004 fc) 2003 (d) 2002 fe) Tota l Miscel laneous $ 2 ,006. $ 0^ $ 0^ $ g _ $ 2 ,006.

To ta l $ 2 ,006 . $ (K $ 0^ $ 0^ $ 2 ,006. I



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


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 -

http://www.mhm-pc.com


STATEMENTS OF FINANCIAL POSITION

June 30,2007 and 2006

2007

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

236,229

213.593

2006

A S S E T S

$ 183.563 41,767

3.250

7,649

$ 592,793 56,400 5,495

256,000

11,304 921,992

239,584

$ 449,822 $ 1,161,576

L I A B I L I T I E S

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 A S S E T S

178.974 191,214

170,183 357,975

NET ASSETS Temporarily restricted Unrestricted

TOTAL NET ASSETS


258,608 258,608

271,000 532,601 803,601

$ 449,822 $ 1,161,576

See Notes to Financial Statements - 2 -


STATEMENTS OF ACTIVITIES AND CHANGES IN NET ASSETS

Year Ended June 30,2007


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 $

1,445 $ -

334,110

-• 165,155

14,016 745

998,000

1,513,471

318,932 218,280

1,123,637 140,299

1,801,148

(287,677)

13,684

(273,993)

532,601

258,608 $

$ 27,000

-

700,000 ---

(998,000)

(271,000)

-----

(271,000)

-

(271,000)

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

(558,677)

13,684

(544,993)

803,601

258,608



STATEMENTS OF ACTIVITIES AND CHANGES IN NET ASSETS - Continued

Year Ended June 30, 2006


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 $

655 $ 64,500

1,000,635.

-67,133 23,780 4,422 2,006

(5,932)

940,000

2,097,199

401,055 691,380 899,479 55,716

2,047,630

49,569

4,882

54,451

478,150

532,601 $

$ 15,000

-

700,000 --

. . --

(940,000)

(225,000)

---- ■

. -. .

(225.000)

-

(225,000)

496,000

271,000 $

655 79,500

1,000,635

700,000 67,133 23,780 4,422 2,006

(5,932)

-

1,872,199

401,055 691,380 899,479

55,716 2,047,630

(175,431)

4,882

(170,549)

974.150

803,601



STATEMENTS OF FUNCTIONAL EXPENSES


Program Support

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

National

$ 64,463 $ 1,264 6.006

71,733

310 * --

36.756 3,346 1,608

---

84,054 9,160

17,281 2.194

8 1,278 2,121

278 716

21,192 29,800

670 4,372

-•

22,585 7,726

-1,744

318,932

26,942

$ 345.874

State

21,488 421

2,002

23,911

931 ---

9,189 29,865

37 -•

1,841 14,191

729 --

8 426 909 93

409 70,949 8,940

268 1.809

--

33,877 14,900 4,804

194

218.280

18,439

$ 236,719

Branch Programs

$ 309,422 $ 6,067

28,829

344.318

1,707 -

' -47,726

110,267 ♦

-137,083

3,216 ---

139,820 4.454

369 6,819

11.816 2,320 8,794

• 259,264

4,889 7,086 1,126

388 ■ -

31,457 718 -

1,123,637

94,918

$ 1,218.555

Total

395.373 7.752

36,837

439,962

2,948 -♦

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


$ 34,380 674

3,203

38,257

156 1,850 2,806 8.422

27,566 -182 --

8,386 10,916

520 --20

-303 402 307 --871

1,809 36.422

-•

1,104 --

140.299

(140,299)

S

Organization Total

$ 429,753 8,426

40,040

478,219

3,104 1,850 2,806

56,148 183,778 33,211-1,827

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

.

$ 1,801,148



STATEMENTS OF FUNCTIONAL EXPENSES - Continued


Program

Salaries ! 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

National

I 187,174 $ 3,510

12,133

202,817

. 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

State

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

-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

Branch Proqrams

$ 160,325 $ --

160,325

_ --• --

130,000 287,917

-8,641

-----

12,700 • ---

298,348 ♦

---*

1,548 --

Total

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

. 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

TOTAL PROGRAM EXPENSES 401.055

Administration allocation 11,218

TOTAL EXPENSES $ 412.273

691.380

19,339

899.479

25,159 55,716

Support Management and General

1,991,914

41,419

46

4,028 91

770 ,861 717 20 18

4,612 91

273

277

Organization Total

34,655 $ 1,504 5,260

55,716

(55,716)

603,466 9,033

46,428

658,927

6,164 1,084

68,110 87,677 33,602

115 204,030 300,961

5,921 77,635 2,991

14,782 8,652

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

$ 710.719 $ 924,638 $ 2,047,630 $

2.047,630

$ 2,047,630



STATEMENTS OF CASH FLOWS

Years Ended June 30, 2007 and 2006

2007 2006

CASH FLOWS FROM OPERATING ACTIVITIES Change in net assets Adjustments to reconcile change in net assets to net

cash flows from operating activities: Depreciation Loss on disposal of assets Accrued interest on short-term debt Decrease (increase) in operating assets:

Accounts receivable Inventory Grants receivable Other current assets Prepaid expenses

Increase (decrease) in operating liabilities: Accounts payable Accrued expenses Mini-grants payable Other payables

NET CASH FLOWS FROM OPERATING ACTIVITIES

CASH FLOWS FROM INVESTING ACTIVITIES Purchase of fixed assets Disposal of fixed assets

NET CASH FLOWS FROM INVESTING ACTIVITIES

CASH FLOWS FROM FINANCING ACTIVITIES Etorrowing (repayment) of short-term debt

NET DECREASE IN CASH

CASH, BEGINNING OF YEAR

CASH, END OF YEAR

$ (544,993) $

33,211 -

8,523

2,245 14,633

256,000 (7,649) 11,304

(36,185) 1,788

(130,624) (10,531)

(402,278)

(7,220) -

(7,220)

268

(409,230)

592,793

$ 183,563 $

(170,549)

33,602 5,932 8,181

16,759 101

240,000 (5,765)

-

23,527 --

(341,429)

(189,641)

(35,690) 5,800

(29,890)

(1,652)

(221,183)

813,976

; 592,793




Summary of significant accounting policies

Nature of organization and operations - Save A Life Foundation, Inc. ("SALF") is a not-for-profit organization licensed by the State of Illinois 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 54% and 49% of its total income in the years ended June 30, 2007 and 2006, respectively, 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 accompanying financial statements have been prepared on the accrual basis.

Basis of presentation - SALF is required to report information regarding its financial position and activities according to three classes of net assets as follows:

Permanently restricted net assets - Net assets subject to donor-imposed stipulations that they be maintained permanently by SALF.

Temporarily restricted net assets - Net assets subject to donor-imposed stipulations that may be met by actions of SALF or by the passage of time.

Unrestricted net assets - Net assets not subject to donor-imposed stipulations. Revenues are reported in unrestricted net assets unless use of the related assets is limited by donor-imposed stipulations. Expenses are reported as decreases in unrestricted net assets. Expiration of temporary restrictions on net assets (i.e., the donor-imposed stipulated purpose has been fulfilled or the stipulated time period has elapsed) is reported as reclassifications between the applicable classes of net assets:

Use of estimates - The preparation of financial statements in conformity with U.S. generally accepted accounting principles requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of support, revenues and expenses during the reporting period. Actual results could differ from those estimates.

Functional allocation of expense - Operating expenses directly identifiable with a functional area or program are charged to that area or program, and, where expenses affect more than one area, they are allocated on the basis of estimated usage as determined by management.

Accounts receivable - Trade receivables are obligations due under normal trade terms requiring payment upon demand. There is no interest or fees charged on receivables. 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.

- 8 -



(1) Summary of significant accounting policies (continued)

Inventory - Inventory, which is composed of training materials, is stated at cost using the average cost method.

Property and equipment - Property and equipment, with estimated useful lives in excess of one year, are recorded at acquisition cost or fair market value at date of donation. Depreciation is computed on the straight-line method over estimated useful lives ranging from five to twenty years. Depreciation expense for the years ended June 30, 2007 and 2006, was $33,211 and $33,602, respectively.

Grants and contributions - Grants and contributions are recorded as revenue in the year earned. Donor-restricted amounts are reported as temporarily restricted support until the donor restriction expires, at which time the temporarily restricted net assets are reported in the statements of activities and changes in net assets as net assets released from restrictions. Temporarily restricted net assets as of June 30, 2006, were restricted for use for costs related to the Vermont VELCO program and to the expansion of training sites.

(2) Property and eguipment

Property and equipment consist of the following:

Years Ended December 31, 2007 2006

20,000 $ 20,000 181,912 181,912 165,583 158,363

4,500 4,500 31,190 31,190

403,185 395,965 189,592 156,381

Land $ Building Office equipment Program equipment Vehicles __

Total Less accumulated depreciation

Net property and equipment $ 213,593 $ 239,584



(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 years ended June 30, 2007 and 2006, of $133,362 and $25,842, respectively.

Donations of use of facilities are recorded at their fair market value. Such donations are reported as unrestricted support. During the year ended June 30, 2006, SALF received rent forgiveness of $75,314 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 years ended June 30, 2007 and 2006, SALF received donations of this type for $200,748 and $899,479, respectively.

(4) Concentrations

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, 2007, SALF's uninsured cash balance totaled $133,362.

(5) Temporarily restricted net assets

Temporarily restricted net assets at June 30, 2007 and 2006, consist of the following:

2007 2006

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 $ - $ 256,000

VELCO 1 _ 15,000

Total $ - _ $ 271,000

(6) Due to related party

SALF's founder and current executive director, Carol Spizzirri, loaned SALF start-up and operations funding. As of June 30, 2007 and 2006, the amount of this loan is $178,974 and $170,183, respectively. Interest is accrued and added to the principal balance annually using the Internal Revenue Service Applicable Federal Rates.

-10-



Leases

The estimated future minimum rental and operating lease obligation for the succeeding year under the noncancelable lease for office facilities in effect at June 30, 2007, is $110,242 for the year ending June 30,2008.

Rental expense under the operating leases was $298,004 and $363,685 for the years ended June 30,2007 and 2006, respectively.

Income taxes

SALF qualifies as a tax-exempt organization under Internal Revenue Code Section 501(c)(3) and, therefore, has no provision for federal income taxes. In addition, SALF qualified for the charitable contribution deduction under Section 170(b)(1)(A)(vi) and has been classified as a organization other than a private foundation under Section 509(a)(2).

-11 -

For OW.ee Use Oily FotmAG990-IL Revised 3/05

Federal ID# 3 6 - 3 8 6 9 4 5 9 Are contributions to the organization tax deductible?

LEGAL NAME SAVE A L I F E FOUNDATION MAIL

ADDRESS 9 9 5 0 LAWRENCE, NO. 3 0 0 CITY.STATE SCHILLER PARK, I L

ZIP CODE 6 0 1 7 6


Charitable Trust Bureau, 100 West Randolph co# 01-026498 11th Floor, Chicago, Illinois 60601 r- V . .

Check all items attached: Report for the Fiscal Period: [ X ] Copy of IRS Return

Make Checks on Audited Financial Statements Beginning 0 7 / 0 1 / 2 0 0 7 Payable to □ copy of Form IFC

the Illinois nr] —* «« • Charily L i J *15 00 Annual ReP°rt Filing Fee

& Ending 0 6 / 3 0 / 2 0 0 8 Bureau Fund □ $100.00 Late Report Filing Fee MO DAY YR M Q 0 A y yR

I X I Yes I I No Date Organization was created 0 2 / 0 9 / 1 9 9 3

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

Year-end amounts

A)ASSETS B) LIABILITIES C) NET ASSETS

A)$ B)$ C)S

PERCENTAGE 9 8 . 7 8 7 %

»«JBCetVEl> 1 . 2 1 3 %

Attorney Gen«**a Charitable Tr

G) TOTAL REVENUE. INCOME AND CONTRIBUTIONS RECEIVEO (A _ II. SUMMARY OF ALL EXPENDITURES DURING THE YEAR.

H) OPERATING CHARITABLE PROGRAM EXPENSE Q££ £ $ AMI








0) TOTAL EXPENDITURES THIS PERIOD (AOD 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:



R) NET RECEIVED BY THE CHARITY (P MINUS Q=R)

100 %

95.863<

D)$ E) F) $

G)S

9 5 . 8 6 3 %

H)S

I) S

J) S

9 5 . 8 6 3 %

4 .137«

K) S

ILL

N)S

100% P)S

Q)S

PROFESSIONAL FUNDRAISING CONSULTANTS: S) TOTAL AMOUNT PAID TO PROFESSIONAL FUNDRAISING CONSULTANTS

IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS DURING THE YEAR-T) NAME.TITLEPANE NEAL, NATIONAL POLICY DIRECTOR U) NAME.TITLEBERNARD BALTZ, NATIONAL PROGRAM MANAGER V) NAME.TITLE.CARRIE VEIHWEG, STATE DIRECTOR

V. CHARITABLE PROGRAM DESCRIPTION: S^5-TftSfelES?SRAM ® HI=HEST av $ EXPENDED) CODc CATEGORIES

W) DESCRIPTION X) DESCRIPTION

__Y) DESCRIPTION

SEMINARS AND CONFERENCES

R)$

S)$

T) $

U)$ V)$

4 5 1 , 7 4 1 . 2 9 9 , 6 2 9 1 5 2 , 1 1 2 .

AMOUNT 6 1 9 , 7 5 7 .

7 , 6 1 1 .

6 2 7 , 3 6 8

703 ,505 .

703 ,505 .

703,505

M)$ 30,359

ioo% 0) s 733,864

6 3 , 6 0 2 48,225 3 9 , 1 6 3

List on Back side of instructions CODE

W)# O i l X) 0 Y) f

http://OW.ee


1. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION. FINE. PENALTY OR JUDGMENT? 1.

2. HAS THE ORGANIZATION OR A CURRENT DIRECTOR. TRUSTEE. OFFICER OR EMPLOYEE THEREOF. EVER BEEN CONVICTEO BY ANY

COURT OF ANY MISDEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY? 2

3. DIO 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 DIO ANY OFFICER. DIRECTOR OR TRUSTEE RECEIVE

ANYTHING OF VALUE NOT REPORTED AS COMPENSATION? ■>

YES NO

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 COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? s

6. OID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER? (ATTACH FORM IFC) 6.

7a. DIO THE ORGANIZATION ALLOCATE THE COST OF ANY SOLICITATION. MAILING. ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNORAISING EXPENSES? 7

7b. IF "YES1. ENTER (i) THE AGGREGATE AMOUNT OF THESE JOINT COSTS S

ALLOCATED TO PROGRAM SERVICES $ ; (ii) THE AMOUNT

; (iii) THE AMOUNT ALLOCATED TO MANAGEMENT AND GENERAL $ ; AND (iv) THE AMOUNT ALLOCATED TO FUNORAISING $

8. OID THE ORGANIZATION EXPEND ITS RESTRICTED FUNOS 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 KNOWLEOGE OF ANY KICKBACK. BRIBE. OR ANY THEFT, DEFALCATION. MISAPPROPRIATION. COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNOS? 10.

11 LIST THE NAME AND ADDRESS OF THE FINANCIAL INSTITUTIONS WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST ACCOUNTS:

JP MORGAN CHASE BANK N.A., P.O. BOX 260166, BATON ROUGE, LA 70826-0166


UNDER PENALTY OF PERJURY. I (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS ANNUAL REPORT AND THE ATTACHED OOCUMENTS, 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

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


798101 04-27-07

2211201 758549 6065

ul/r/oi DATE

H!&* DATE

STEVEN D. GARRELS, CPA PREPARER (PfWT NAME) SIGNATURE

3 2 0 0 7 . 0 7 0 0 0 SAVE A LIFE FOUNDATION

OfeTE

6065

Form 990 OepartfTieflt of the Treasufy I'-temai 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.

OVIBNo 154S-CQ47

2007 Open to Public

Inspection

Please use IRS label or print o' type See

Specific Instate lions


SAVE A LIFE FOUNDATION

A For the 2007 calendar year, or tax year beginning B Chock il

applicable

□Address change □Name cnange

1 Initial I I return □Termin

ation □ A m e n d e d

return □ Applca'-on

pending

J U L 1 , 2 0 0 7 andending J U N 3 0 , 2 0 0 8

Number and street (or P 0 box if mail is not delivered to street address) 9950 LAWRENCE

Room/suite 300

City or town, state or country, and ZIP + 4 SCHILLER PARK, I L 60176

• Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A (Form 990 or 990-EZ).

G Website:»HTTP;//WWW.SALF.COM J Organization type (fje»oniyont)>> [ X j 501(c)( 3 )•< (msertno) □ 4947(a)(1) m P I 527 K 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 organization chooses to file a return, be sure to file a complete return.

0 Employer identification number


( 8 4 7 ) 9 2 8 - 9 6 8 3 F Accounjfig, metnea | | Casn I X I Accrual □Other w

(specify) w

H and I are not applicable to section 527 organizations. H(a) Is this a group return for affiliates? I IYBS I X I No H(b) If "Yes," enter number of affiliates ► N / A H(c) Are all affiliates included? N / A I I Yes I JNo

(If'No,'attach a list.) H(d) Is this a separate return filed by an or-

ganization covered by a group ruling? I JYes LXJNo I G roup Exemption Number ► N/A

L Gross receipts: Add lines 6b. 8b, 9b. and 10b to line 12 ► 6 2 7 , 3 6 8 , M Check ► |_XJ if the organization is not required to attach

Sch. B (Form 990.990-EZ. or 990-PF)

Part 11 Revenue, Expenses, and Changes in Net Assets or Fund Balances Contributions, gifts, grants, and similar amounts received:

a Contributions to donor advised funds b Direct public support (not included on line 1a) c Indirect public support (not included on line 1a) d Government contributions (grants) (not included on line 1a) e Total (add lines 1a through id) (cash $

1a 1b 1c id

7 5 0 .

noncash $ 750 . 2 3 4 5 6 a

b c

7 8 a

b c d

9 a b c

10 a b c

11 12

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

le

Gross rents Less: rental expenses Net rental income or (loss). Subtract line 6b from line 6a Other investment income (describe ► Gross amount from sales of assets other than inventory Less: cost or other basis and sales expenses Gain or (loss) (attach schedule)

6a 6b

(A) Securities Ba 8b 8c

(B) Other

Net gain or (loss). Combine line 8c, columns (A) and (B) Special events and activities (attach schedule) If any amount is from gaming, check here ► n Gross rewnuc (not including S 0 . c! contncutiors reported on line 10) 9a

9b 3 , 1 2 5 . 1 , 7 6 4 .

SEE STATEMENT 1 10a | 1 7 , 5 2 3 .

Less: direct expenses other than fundraising expenses 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 Gross profit or (loss) from sales of inventory (attach schedule). Subtract line 10b Itom line 10a S T M T 2 Other revenue (from Part VII. line 103) Total revenue. Add lines le. 2.3.4.5.6c, 7.8d. 9c, 10c, and 11

6c

750 5 9 8 , 3 5 9 ,

774

8d

10b 6 , 0 5 0 .

9c

10c 11 12

1 , 3 6 1

1 1 , 4 7 3 . 6 , 8 3 7

6 1 9 , 5 5 4 .

I 13 Program services (from line 44, column (B)) 14 Management and general (from line 44, column (C)) 15 Fundraising (from line 44, column (D)) 16 Payments to affiliates (attach schedule) 17 Total expenses. Add lines 16 and 44. column (A)

13 6 9 5 , 6 9 1 14 3 0 , 3 5 9 15 16 17 7 2 6 , 0 5 0 .

I I 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

18 < 1 0 6 , 4 9 6 . > 19 2 5 8 , 6 0 8 . 20 21

0 . 1 5 2 , 1 1 2

723001 12-27-07 LHA For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.

4 2211201 758549 6065 2007.07000 SAVE A LIFE FOUNDATION

Form 990 (2007)

6065 1

http://WWW.SALF.COM

Form 990 (2007) SAVE A LIFE FOUNDATION Part II I Statement of

Functional Expenses

36-3869459 Paoe2 All 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 lor others

Do not include amounts reported on line 6b, 8b, 9b, 10b, or 16 of Part I.

22a Grants paid from donor advised funds (attach schedule) (cash $ U . noncash S 0 . If this amount includes Foreign grants, check here ^ I I

22b Other grants and allocations (attach schedule) (casn $ U » ncncasni O^J

II this arrojnt mciufles foreign grants, check here ^ I I

23 Specific assistance to individuals (attach schedule)

24 Benefits paid to or for members (attach schedule)

25a Compensation of current officers, directors, key employees, etc. listed in Part V-A

b Compensation of former officers, directors, key employees, etc. listed in Part V-B

c Compensation and other distributions, not included above, to disqualified persons (as defined under section 4958(f)(1))and persons described in section 4958(c)(3)(B)

26 Salaries and wages of employees not included on lines 25a, b, and c

27 Pension plan contributions not included on lines 25a, b, and c Employee benefits not included on lines 25a-27 Payrolltaxes Professional fundraising fees 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)

a b c d

22a

22b

(A) Total

23

24

25a

25b

25c

26

28

29 30 31

27

26 29 30 31 32 33 34 35 36

I

37 36

41 42

43a 43b 43c 43d 43B

g SEE STATEMENT 3 44 Total functional expenses. Add lines 22a through

43g. (Organizations completing columns (B)-(D), carry these totals to lines 13-15)

43t 43q

44_

3 6 , 0 4 2

0 .

2 5 3 , 9 9 5

9 , 5 7 6 , 5 5 , 2 2 4 .

2 0 , 3 2 5 . 3 1 , 0 4 2 4 9 , 5 9 7 . 1 1 , 7 8 0

9 , 6 0 6 6 2 , 6 6 6 .

5 9 3

45,522 315

8 , 3 4 3 . 1 4 , 4 0 9 .

1 1 7 , 0 1 5

7 2 6 , 0 5 0 .


33,159.

233,675.

8,810. 50,806 20,325. 31,042. 49,557. 11,427. 9,510. 62,666

593. 44,611.

315. 8,343. 14,409

116,443.

695,691


2 , 8 8 3 .

0 .

20 ,320

7 6 6 . 4 , 4 1 8 .

40, 353,

96

911

572

3 0 , 3 5 9 .

(0) Fundraising

0 .

0 .

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? ► (ZH Yes O No If 'Yes; enter (i) the aggregate amount of these joint costs S N / A ; (ii) the amount allocated to Program services $ N / A (iii) the amount allocated to Management and general $ 723011 12-27-07

N / A ; and (iv» the amount allocated to Fundraisino $ N/A

12211201 758549 6 0 6 5 2007.07000 5


Form 990 (2007)

6 0 6 5 1

Form 990 (2007) SAVE A LIFE FOUNDATION Part 111 1 Statement of Program Service Accomplishments (See the instructions.)

36-3869459 Page3

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.

What is the organization's primary exempt purpose? ► S E E S T A T E M E N T 4

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) and (4) organizations and 4947(a)(1) nonexempt charrtable trusts must also enter the amount of grants and allocations to others.)

a NATIONAL PROGRAMS - WHICH DELIVER AGE-APPROPRIATE LIFE SUPPORTING FIRST AID TRAINING TO K-12 STUDENTS IN PA, WI, INy VT UTILIZING LOCAL EMERGENCY MEDICAL SERVICE PROVIDERS AS INSTRUCTORS

(Grants and allocations $ ) If this amount includes foreign grants, check here ► I I b STATE PROGRAMS - WHICH DELIVER AGE-APPROPRIATE LIFE SUPPORTING FIRST AID TRAINING TO K-12 STUDENTS IL UTILIZING


(Required for 501(c)(3) and (4) orgs, and

4947(a)(1) trusts; but optional for others.)

LOCAL EMERGENCY MEDICAL SERVICE PROVIDERS AS INSTRUCTORS

(Grants and allocations $ ) If this amount includes foreign grants, check here ► I 1 c BRANCH PROGRAMS - WHICH DELIVER AGE APPROPRIATE LIFE SUPPORTING FIRST AID TRAINING K-12 STUDENTS AL, AK, AZ, AR, CA, FL, GA, HI, IL, IN, KY, LA, MA, MI, MS, MO, NJ, NM, NC, OK, OR, PR, SC, TX, WV, WI, WY UTILIZING LOCAL EMERGENCY MEDICAL SERVICE PROVIDERS AS INSTRUCTORS. (Grants and allocations $ ) If this amount includes foreign grants, check here ► I I

(Grants and allocations $ ) If this amount includes foreign grants, check here ► I I e Other program services (attach schedule)

(Grants and allocations $ f Total of Program Service Expenses (should equal line 44. column (B), Program services)

) If this amount includes foreign grants, check here ► L_J

181,849

63,434

450,408

695,691. Form 990 (2007)

6 .2211201 758549 6065 2007.07000 SAVE A LIFE FOUNDATION 6065 1

Form 990 (2007) SAVE A LIFE FOUNDATION PartIV Balance Sheets (See the instructions.)

36-3869459 Page 4

Note: Where required, attached schedules and amounts within the descnption 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


41

<

47a 47b

48a 461)

67 ,329


49 Grants receivable 50 a Receivables from current and former officers, directors, trustees, and

key employees b Receivables from other disqualified persons (as defined under section

51 a b

52 53 54 a

b 55 a

4958(f)(1)) and persons described in section 4958(c)(3 51a 51b

(B) Other notes and loans receivable Less: allowance for doubtful accounts Inventories for sale or use Prepaid expenses and deferred charges Investments - publicly-traded securities ► I I Host Investments - other securities ► I I Cnst Investments - land, buildings, and equipment: basis 55a

□ FMV □ FMV

b Less: accumulated depreciation 55b 56 57 a

b 58

Investments • other Land, buildings, and equipment: basis Less: accumulated depreciation Other assets, including program-related investments (describe ► SECURITY DEPOSIT

57a 57b

4 0 3 , 9 3 5 . 2 0 4 , 0 0 1 .

.o a

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 S T M T 5 64 a Tax-exempt bond liabilities

b Mortgages and other notes payable 65 Other liabilities (describe ► SEE STATEMENT 6

8 o c a m ■o c 3 u.

e u

i z

66 Total liabilities. Add lines 60 through 65 Organizations that lollow SFAS 117, check here ► Q Q and complete lines

67 through 69 and lines 73 and 74. 67 Unrestricted 68 Temporarily restricted 69 Permanently restricted Organizations that do not follow SFAS 117, check here ► □ and

complete lines 70 through 74. Capital stock, trust principal, or current funds Paid-in or capital surplus, or land, building, and equipment fund Retained earnings, endowment, accumulated income, or other funds Total nel 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

5 2 , 9 0 9 130 ,655

45

3,250

4 , 8 9 9 .

2 , 7 5 0 .

(B) End of year

1 4 2 , 6 5 3 . 107 .

47c

48c 49

50a

50b

6 7 , 3 2 9 .

3 , 2 4 8 .

4 1 , 7 6 7 51 c 52 3 5 , 7 1 7 . 53 54a 54b

55c

2 1 3 , 5 9 3 .

0 . 4 4 9 , 8 2 3 .

9 , 5 4 0 .

178 ,974

56

57c

58 59 60 61 62

2 , 7 0 1 .

1 9 1 , 2 1 5 .

2 5 8 , 6 0 8 .

63 64a 64b 65

199,934

2 , 7 5 3 4 5 1 , 7 4 1

49 ,817

247 ,112

66

2,700

299 ,629

67

2 5 8 , 6 0 8 .

68 69

70 71

152,112

72

4 4 9 , 8 2 3 . 73 74

152,112 451 ,741

Form 9 9 0 (2007)

7J3031 12-?707

2211201 758549 6065 2007.07000 SAVE A LIFE FOUNDATION 6065

Form 990 (2007) SAVE A LIFE FOUNDATION 3 6 - 3 8 6 9 4 5 9 p a g e5 | Part IV-A j Reconciliation of Revenue per Audited Financial Statements With Revenue per Return (See me

instructions.)

a Total revenue, gains, and other support per audited financial statements a 1 , 0 0 3 , 1 5 8 . D Amounts included on line a but not on Part 1, line 12: 1 Net unrealized gains on investments . b1

b

2 Donated services and use of facilities b2 3 7 5 , 7 9 0 .

b

3 Recoveries of prior year grants b3

b 4 Other (specify): S E E S T A T E M E N T 7

Add lines b1 through b4 b4 7 , 8 1 4 .

b 4 Other (specify): S E E S T A T E M E N T 7

Add lines b1 through b4 b 3 8 3 , 6 0 4 . c Subtract line b from line a c 6 1 9 , 5 5 4 . d Amounts included on Part I. line 12. but not on line a: 1 Investment expenses not included on Part I, line 6b . . . . m

d 2 Other (specify): d2

d Add lines d1 and d2 ... d 0 . e Total revenue (Part I. line 12). Add lines c and d ► e 6 1 9 , 5 5 4 . Part IV-B Reconciliation of Expenses per Audited Financial Statements With Expenses per Return a Total expenses and losses per audited financial statements a 1 , 1 0 9 , 6 5 4 . b Amounts included on line a but not on Part I, line 17: 1 Donated services and use of facilities bl 3 7 5 , 7 9 0 .

b

2 Prior year adjustments reported on Part I, line 20 b2

b

3 Losses reported on Part I, line 20 b3

b 4 Other (soecifv): S E E S T A T E M E N T 8 b4 7 , 8 1 4 .

b Add lines b1 through b4 b 3 8 3 , 6 0 4 . c Subtract line b from line a . . . . . . . c 7 2 6 , 0 5 0 . d Amounts included on Part I, line 17, but not on line a: 1 Investment expenses not included on Part I, line 6b d1

d 2 Other (specify): d2

d Add lines d1 and d2 . e Total expenses (Part I, line 17). Add lines c and d

d 0 . Add lines d1 and d2 . e Total expenses (Part I, line 17). Add lines c and d ► e 7 2 6 , 0 5 0 . Part V-A | Current Officers, Directors, Trustees, and Key Employees (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.)



(C) Compensation II not paid, enter

•0-.)

(D)Ccntnbuttoflsto errptoyee Benefit plans & eefcrred

corrpensot.on plans


other allowances CAROL S P I Z Z I R I PRESIDENT & C

4 0 . 0 0

EO

3 3 , 3 8 0 . 2 , 6 6 2 . 9950 LAWRENCE # 3 0 0

PRESIDENT & C

4 0 . 0 0

EO

3 3 , 3 8 0 . 2 , 6 6 2 . SCHILLER PARK, I L 6 0 1 7 6

PRESIDENT & C

4 0 . 0 0

EO

3 3 , 3 8 0 . 2 , 6 6 2 . 0 . RITA MULLINS 9950 LAWRENCE # 3 0 0

SECRETARY

2 . 0 0 0 . 0 . SCHILLER PARK, I L 6 0 1 7 6

SECRETARY

2 . 0 0 0 . 0 . 0 . DOUGLAS BROWNE 9950 LAWRENCE # 3 0 0

TREASURER

2 . 0 0 0 . 0 . SCHILLER PARK, I L 6 0 1 7 6

TREASURER

2 . 0 0 0 . 0 . 0 . JOHN DONLEAVY DIRECTOR

2 . 0 0 0 . 0 . 9950 LAWRENCE # 3 0 0

DIRECTOR

2 . 0 0 0 . 0 . SCHILLER PARK, IL 6 0 1 7 6

DIRECTOR

2 . 0 0 0 . 0 . 0 . ANDY KNAPP 9950 LAWRENCE # 3 0 0

DIRECTOR RESI

2 . 0 0

GNED 6 / 2 0

0 .

08

0 . SCHILLER PARK, I L 6 0 1 7 6

DIRECTOR RESI

2 . 0 0

GNED 6 / 2 0

0 .

08

0 . 0 . ERNESTO A PRETTO 9950 LAWRENCE # 3 0 0

DIRECTOR

2 . 0 0 0 . 0 . SCHILLER PARK, IL 60176

DIRECTOR

2 . 0 0 0 . 0 . 0 . MARK MITCHELL 99~50 LAWRENCE # 3 0 0

DIRECTOR

2 . 0 0 0 . 0 . SCHILLER PARK, IL 60176

DIRECTOR

2 . 0 0 0 . 0 . 0 .

723041 12-2707

2211201 758549 6065 8

2007.07000 SAVE A LIFE FOUNDATION

Form 990 (2007)

6065

Form 990 (2007) SAVE A LIFE FOUNDATION Part V-A1 Current Officers, Directors, Trustees, and Key Employees (continued)

36-3869459 page6

75 a Enter the total number of officers, directors, and trustees permitted to vote on organization business at board meetings ^.

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? If "Yes." attach a statement that identifies the individuals and explains the relationship(s)

75c

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 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?

Part V-B | Former Officers, Directors, Trustees, and Key Employees That Received Compensation or Other Benef i ts (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.)

tP.\ rnmnAncifinn tf\\ r>__•_*.. .* ._ ( /^» »*. (A) Name and address

Yes No

75b

75d I I X

NONE (B) Loans and Advances

(C) Compensation (if not paid, enter-0-)

(0 ) CcnlnButions to employee benefit plans & deferred

compensation pian3

(E)Expense account and

other allowances

Other Informat ion (See the instructions.) Part VI 76 Did the organization make a change in its activities or methods of conducting activities? If 'Yes.' attach a detailed

77

78 a b

79 80 a

statement of each change

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.

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 990-T for this year? N / A Was there a liquidation, dissolution, termination, or substantial contraction during the year? If "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 other exempt or nonexempt organization? If "Yes," enter the name of the organization^ N / A

and check whether it is exempt or IZZ) nonexempt laia | 0 .

76 77

81 a Enter direct and indirect political expenditures. (See line 81 instructions.) b Did the organization file Form 1120-POL for this year?

78a 78b

Yes

79

80a

81b

No

Form 9 9 0 (2007)

723161/12270?

.2211201 758549 6065 2007.07000 SAVE A LIFE FOUNDATION 6065

Form 990 (2007) [Part VII Other Information (continued)

SAVE A L I F E FOUNDATION 36-3869459 page7 Yes No

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? If "Yes," you may indicate the value ol 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.) I 82b I 3 7 5 , 7 9 0

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?

64 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 85 a 501(c)(4), (5). or (6). Were substantially all dues nondeductible by members? N/A

b Did the organization make only inhouse lobbying expenditures of $2,000 or less? N/A ... 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 85c N/A d Section 162(e) lobbying and political expenditures 85rJ N/A e Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices 85e N/A 1 Taxable amount of lobbying and political expenditures (line 85d less 85e) I 851 N/A g Does the organization elect to pay the section 6033(e) tax on the amount on line 85f? N/A 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? N/A

86 501(c)(7) organizations. Enter: a Initiation fees and capital contnbutions included on

82a

83a 83b 84a

84b 85a 85b

87

86a 86b 87a

87b

N / A N / A N / A

N / A

line 12 Gross receipts, included on line 12, for public use of club facilities 501(c)(12) organizations. Enter: a Gross income from members or shareholders


86 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)(l3)? If'Yes,'complete Part XI

89 a 501(c)(3) organizations. Enter: Amount of tax imposed on the organization during the year under: section 4911 ► G L ; section 4912 ► 0 . . section 4955 ► 0 . 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year cr did it become aware of an excess benefit transaction from a prior year? If "Yes," attach a statement explaining each transaction 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 on line 89c, above, reimbursed by the organization ►

85g

85h

88a

88b

89b

0 . 0 .

e All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? f 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? 90 a List the states with which a copy of this return is filed ► SEE STATEMENT 9 r—,

b Numberof employees employed in the pay period that includes March 12,2007 I 90b 9 l a The books are in care of ► C A R O L S P I Z Z I R I Telephone no>- ( 8 4 7 )

89e 891

89g

9 2 8 - 9 6 8 3 Located at ► 9 9 5 0 W. LAWRENCE, SCHILLER PARK, IL ZiP + 4 ► 6 0 1 7 6 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 ► N/A See the instructions for exceptions and filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.

91b Yes No

Form 9 9 0 (2007)

723162/ 1J?7 07

2211201 758549 6065 10

2007.07000 SAVE A LIFE FOUNDATION 6065

Form 990 (2007) SAVE A LIFE FOUNDATION Part VI Other Information (continued)

3 6 - 3 8 6 9 4 5 9 Paoe8

91 c Yes

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 ► N / A

92 Section 4947(a)(1) nonexempt charitable trusts filing Form990 in lieu ofForm 1041-Check here ► [ |

No X

and enter the amount of tax-exempt interest received or accrued during the tax year Part VH j Analysis of Income-Producing Activities (See the instructions.)

92 N/A


93 Program service revenue: a DARE MIGHTY THINGS b BRANCH DEVELOPMENT c PROGRAM FEES 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 MISCELLANEOUS b c d e


Business code

(B) Amount

Excluded by section 512. 513, or 514

(C) Exclusion code

Amount (E)


5 9 3 , 4 3 0 . 4 , 9 2 9 .

14 774

104 Subtotal (add columns (B), (D), and (E)) 105 Total (add line 104, columns (B).(D), and (E)) Note: Line 70S plus line 1e, Part I, should equal the amount on line 12, Part I.

01 1 , 3 6 1 .

2 , 1 3 5 .

1 1 , 4 7 3 ,

6 , 8 3 7 .

6 1 6 , 6 6 9 6 1 8 , 8 0 4

Line No. T

Part V H| Relationship of Activities to the Accomplishment of Exempt Purposes (See the 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).

SEE STATEMENT 10

Part IX Information "TO Name, address, and EIN of corporation

partnership, or disregarded entity

N/A

Regard ng Taxable Subsidiaries and Disregarded Entities (See the instructions.) m ' ™ ' fD) TO

Percentage of ownership interest Nature of activities Total income

— m End-of-i 'ear

assets

Part X | Information Regarding Transfers Associated with Personal Benefit Contracts (See the instructions.)

(a) Oid the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? □ Yes [ X ] No (b) Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ___ Yes L___ No Note: If "Yes" to (b), file Form 8870 and Form 4720 (see instructions).

Form 9 9 0 (2007)

723163 12-27-07

.2211201 758549 6065 11 2007.07000 SAVE A LIFE FOUNDATION 6065

Form 990 (2007) SAVE A L I F E FOUNDATION Part XI

3 6 - 3 8 6 9 4 5 9 Page9 Information Regarding Transfers To and From Controlled Entities. Complete only if the organization is i controlling organization as defined in section 512(b)(13). N / A

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,


controlled entity

Totals

c (B) Employer

Identification Number

Description of transfer

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 "Yes,' complete the schedule below for each controlled entity.


controlled entity

(Bl Employer

Identification Number

Totals

(C) Description of

transfer

Yes No

(D) Amount of

transfer

108 Did the organization have a binding written contract in effect on August 17,2006. covering the interest, rents, royalties, and annuities described in Question 107 above?

Please Sign Here

Paid Preparer's Use Only

Yes No

l^! !?r^n . - l l l eî ,^ e i ' " y - ' f^""" m ? t ' h o ^ f «xo™n«>.""s -»"""• mcluaing accompanying scneoulco ana statements, ana to tne best ol my knowledge ana belief it ,s inje correct ana complete Declaration of preparer (other man olteer) is Baseo on all intormalion ol which ptcparer has anv knowleooe wwrew.




Date

Fimvsnameio, BORHART SPELLMEYER & COMPANY sell.emp.oyea). k 2 2 0 5 POINT BLVD. S U I T E 1 6 0 address, and ^r

ZIP.4 ^ E L G I N , I L 6 0 1 2 3 - 7 8 4 0

Check if self-employed ► I I

Proparefs SSN o< PTIN (See Gen Inst X)

EIIM ►

Phone no ► ( 8 4 7 ) 6 9 5 - 1 7 7 5 Form 9 9 0 (2007)

723164/12-2707

2211201 758549 6065 12

2007.07000 SAVE A LIFE FOUNDATION 6065

http://sell.emp.oyea


Oepartmenl o* the Treasury inlemai Revenue Service

Organization Exempt Under Section 501(c)(3) (Except Private Foundation) and Section 501(e). 501(1). 501 (k),

501 (n), or 4947(a)(1) Nonexempt Charitable Trust Supplementary lnformation-(See separate instructions.)

► MUST be completed by the above organizations and attached to their Form 990 or 990-EZ Name of the organization

Parti SAVE A LIFE FOUNDATION

OM3r»e -.545-0047

2007 Employer identification number 36 3 8 6 9 4 5 9

Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (See page 1 of the instructions. List each one it there are none, enter "None")

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

DANE_NEAL_ 9950 LAWRENCE~#300y SCHILLER PARK, if


position

NATL POLICY DIR 40.00

Total number ot other employees paid over $50.000

(c) Compensation

6 3 , 5 2 0

(d) Contnoutions to employee benefit plans & defeirea compensation


allowances

Part »-A | Compensation of the Five Highest Paid Independent Contractors for Professional Services (See page 2 ot the instructions. List each one (whether individuals or firms). If there are none, enter "None')


NONE


Total number of others receiving over $50.000 for professional services

Part ll-B | 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 page 2 of the instructions)

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

NONE

(c) Compensation

Total number of other contractors receiving over $50,000 tor other services

723ioi/i2-27 07 LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 and Form 990-EZ 13

.2211201 758549 6065 2007.07000 SAVE A LIFE FOUNDATION Schedule A (Form 990 or 990-EZ) 2007

6065 1

Schedule A (Form 990 or 990-EZ) 2037 SAVE A L I F E FOUNDATION 3 6 - 3 8 6 9 4 5 9 Page 2 Part III Statements About Activities (See page 2 of the instructions.) Yes No

During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative 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.)

2a 2b 2c 2d 2e

3a

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? d Payment of compensation (or payment or reimbursement of expenses if more than $1.000)? S E E P A R T . V - A / F O R M 9 9 0 e Transfer of any part of its income or assets'

3 a 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 [ 3c d Did the organization provide credit counseling, debt management, credit repair, or debt negotiation services?

4 a Did the organization maintain any donor advised funds? If 'Yes.* complete lines 4b through 4g. It 'No,' complete lines 4f and4g

b Did the organization make any taxable distributions under section 4966? N/A c Did the organization make a distribution to a donor, donor advisor, or related person? N/A d Enter the total number of donor advised funds owned at the end of the tax year 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 year (excluding donor advised funds included on

line 4d) where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts g Enter the aggregate value of assets in all funds or accounts included on line 4f at the end of the tax year

3b

3d

4a 4b 4C

► N/A ► N/A

► 0 . ► 0 .


14 12211201 758549 6065 2 0 0 7 . 0 7 0 0 0 SAVE A LIFE FOUNDATION 6065 1

Schedule A (Form 990 or 990-EZ) 2007 SAVE A L I F E FOUNDATION 3 6 - 3 8 6 9 4 5 9 Page3

Part IV j Reason for Non-Private Foundation Status (See pages 4 through 8 of the instructions)

I certify that 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 l70(b)(1)(A)(i) A school. Section l70(b)(l)(A)(ii). (Also complete Part V.) A hospital or a cooperative hospital service organization. Section 170(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)(1 )(A)(iii). Enter the hospital's name, city, and state ►

5 6 7 8 9

□ □ □ □ 10 □ 11a m 11b 12

□ □

13 □

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.) 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)(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.)

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: □ Type I □ Type II □ Type lll-Functionally Integrated □ Type Ill-Other

Provide the following Information about the supported organizations. (See page 8 of the instructions.) (a)

Name(s) of supported organization(s) (b)

Employer identification number (EIN)

(c) Type of organization (described in lines 5 through 12 above

or IRC section)

(0) Is the supported

organization listed in the supporting organization's

governing documents?

(e) Amount ol

support

(b) Employer

identification number (EIN)

(c) Type of organization (described in lines 5 through 12 above

or IRC section)

Yes No

Total f

1< L ~ ] An organization organized and operated to test for public safety Section 509(a)(4). (See page 8 of the instructions


15 12211201 758549 6065 2007.07000 SAVE A LIFE FOUNDATION 6065 1

Schedule A (Form 990 or 990-EZ) 2007 SAVE A L I F E FOUNDATION Par t I V - A I 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.

3 6 - 3 8 6 9 4 5 9 Page4

27

Calendar year (or fiscal year beginning in) ► (a) 2006 (b) 2005 (C) 2004 (d) 2003 (e) Total 15 Gifts, grants, and contributions

received. (Do not include unusual grants. See line 28.) 9 8 3 , 0 4 6 . 1 , 0 3 4 , 4 0 3 . 1 , 8 8 2 , 8 2 2 . 4 4 8 , 6 2 1 . 4 , 3 4 8 , 8 9 2 .

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 1 8 1 , 4 1 6 . 1 1 2 , 0 9 4 . 3 9 9 , 5 4 6 . 1 2 0 , 3 1 6 . 8 1 3 , 3 7 2 .

18 Gross income from interest, dividends, amounts received from pay ments on securities loans (section 512(a)(5)), rents, royalties, income from similar sources, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organization after June30,1975 1 3 , 6 8 4 . 4 , 8 8 2 . 1 , 9 3 3 . 795 . 2 1 , 2 9 4 .



21 The value of se rvices 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

22 Other income. Attach a schedule. Oo not include gain or (loss) from sale of capital assets 745 . 2 , 0 0 6 .

SEE STATEMENT 11 2 , 7 5 1 .

23 Total of lines 15 through 22 1 , 1 7 8 , 8 9 1 . 1 , 1 5 3 , 3 8 5 . 2 , 2 8 4 , 3 0 1 . 5 6 9 , 7 3 2 . 5 , 1 8 6 , 3 0 9 . 24 Line 23 minus line 17 9 9 7 , 4 7 5 . 1 , 0 4 1 , 2 9 1 . 1 , 8 8 4 , 7 5 5 . 4 4 9 , 4 1 6 . 4 , 3 7 2 , 9 3 7 . 25 Enter r/oot line 23 1 1 , 7 8 9 . 1 1 , 5 3 4 . 2 2 , 8 4 3 . 5 , 6 9 7 . 26 Organizations described on lines 10 or 11: a Enter 2% ot amount in column (e), line 24 ►

mental line 26a.

►

► ►

26a 8 7 , 4 5 9 . b Prepare a list for your records lo show the name of and amount contributed by each person (other than a govern

unit or publicly supported organization) whose total gifts for 2003 through 2006 exceeded the amount shown in Do not file this list with your return. Enter the total of all these excess amounts

► mental line 26a.

►

► ►

26b 0. c Total support for section 509(a)(1) test: Enter line 24, column (e)


►

► ►

26c 4 , 3 7 2 , 9 3 7 . d Add: Amounts from column (e) for lines: 18 2 1 , 2 9 4 . 19

22 2 , 7 5 1 . 26b


►

► ►

26d 2 4 , 0 4 5 . e Public support (line 26c minus line 2( I Public support percentage (line 26e

idtotal)


►

► ► 26e 4 , 3 4 8 , 8 9 2 . e Public support (line 26c minus line 2(

I Public support percentage (line 26e (numerator) divided by line 26c (denominator)) ► 261 99 .4501% 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 lite this list with your return. Enter the sum of such amounts for each year: N / A (2006) (2005) (2004) (2003) ' For 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 11b, 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: N / A (2006) (2005) (2004) (2003) Add: Amounts from column (e) for lines: 15 16

17 20 21

►

27c N/A d Add: Line 27a total .. and line 27b total

► 27d N/A

e Public support (line 27c total minus line 27dtotal) N/A

► 27e N/A f Total support for section 509(a)(2) test: Enter amount on line 23. column (e) ► I 2711 N/A

►

27q N/A g Public support percentage (line 27e (numerator) divided by line 271 (denominator)) ►

27q N/A % h Investment income nercentaue (line 18, column (e) (numerator) divided by tine 271 (denominator)) ► 27h N/A %

28 Unusual Granis: For an organization described in line 10,11, or 12 that received any unusual grants during 2003 through 2006. 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.

723131 12-27-07 N O N E Schedule A (Form 990 or 990- EZJ 2007

12211201 758549 6065 2007.07000 16

SAVE A LIFE FOUNDATION 6065

Schedule A (Form 990 or 990-EZ) 2007 SAVE A L I F E FOUNDATION 3 6 - 3 8 6 9 4 5 9 Pages PartV Private School Questionnaire (See page 9 of the instructions.)

(To be completed ONLY by schools that checked the box on line 6 in Part IV) N/A

29 Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, other governing Yes No instrument, or in a resolution of its governing body? 29

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? 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? 31 If "Yes,* please describe; if "No," please explain. (It you need more space, attach a separate statement.)

32a 32a 32a 32a 32 Does the organization maintain the following:

a Records indicating the racial composition of the student body, faculty, and administrative staff? 32a b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? 32b c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student

admissions, programs, and scholarships? 32c d Copies of all material used by the organization or on its behalf to solicit contributions? 32d

If you answered "No" to any of the above, please explain. (If you need more space, attach a separate statement.)

33a 33a 33 Does the organization discriminate by race in any way with respect to:

a Students' rights or privileges? 33a b Admissions policies? 33b c Employment of faculty or administrative staff? 33c d Scholarships or other financial assistance? 33d e Educational policies? 33e 1 Use of facilities? 33f g Athletic programs? 33q h Other extracurricular activities? 33h


34a 34a 34a 34 a Does the organization receive any financial aid or assistance from a governmental agency? 34a b Has the organization's right to such aid ever been revoked or suspended? 34b

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 | 35 Schedule A (Form 990 or 990-EZ) 2007

723141 12-27-07

12211201 758549 6065 2007.07000 17

SAVE A LIFE FOUNDATION 6065

Schedule A (Form 990 or 990-EZ) 2007 SAVE A LIFE FOUNDATION 3 6 - 3 8 6 9 4 5 9 Page6 Part Vl-A Lobbying Expenditures by Electing Public Charities (Seepage 11 of the instructions.)

(To be completed ONLY by an eligible organization that filed Form 5768) N/A

Check ► a l_l if the organization belongs to an affiliated qroup. Check ► b U if you checked "a" and "limited control' provisions applv

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


totals

(b) To be completed for all electing organizations

36 Total lobbying expenditures to influence public opinion (grassroots lobbying) 36 N/A

37 Total lobbying expenditures to influence a legislative body (direct lobbying) 37 38 Total lobbying expenditures (add lines 36 and 37) 38 39 Other exempt purpose expenditures 39 40 Total exempt purpose expenditures (add lines 38 and 39) 40 41 Lobbying nontaxable amount. Enter the amount from the following table -

If the amount on line 40 is - The lobbying nontaxable amount is -Mot over SSOO.OOO 20% ol the amount on line 40

41 Over $500 000 but not over $1,000,000 . . . $100,000 plus 15°/4 of trie excess over $£00,000

Over $1,000,000 out net over S1.500,000 $175,000 plus 10% oftne excess over $1.000,000 41 Over $1,500,000 but not over SI 7.000,000 $225,000 plus 5% of trie excess over $1,500,000

Over $17,000,000 $1,000,000

42 42 Grassroots nontaxable amount (enter 25% of line 41) 42 43 Subtract line 42 from line 36. Enter -0- if line 42 is more than line 36 43 44 Subtract line 41 from line 38. Enter -0- if line 41 is more than line 38 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 on page 13 of the instructions.)

Lobbying Expenditures During 4-Year Averaging Period N/A Calendar year (or fiscal year beginning in) (►

(a) 2007

m 2006

(c) 2005

GO 2004

(e) Total





49 Grassroots ceiling amount (150% of line 48(e)) 0 .

50 Grassroots lobbying expenditures 0 .

PartVI-B Lobbying A ictivity by Nonelec ting Public Chariti es (For reporting only by organizations that did not complete Part Vl-A) (See page 14 of the instructions.) N/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: Yes No Amount

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.) 0 .

If 'Yes' to any of the above, also attach a statement giving a detailed description of the lobbying activities. 723151 12-27-07

L2211201 758549 6 0 6 5 18


200 7 . 0 7000 SAVE A LIFE FOUNDATION 6065

Schedule A (Form 990 or 990-EZ) 2007 SAVE A L I F E FOUNDATION 3 6 - 3 8 6 9 4 5 9 Page 7 PartVH Information Regarding Transfers To and Transactions and Relationships With Noncharitable

Exempt Organizat ions [See page 14 of the instructions.) 51 Did the reporting organization directly or indirectly engage in any of Ihe 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 (il) Other assets

b Other transactions: (i) Sales or exchanges of assets with a noncharitable exempt organization (li) Purchases of assets from a noncharitable exempt organization (Mi) Rental of facilities, equipment, or other assets (iv) Reimbursement arrangements (v) Loans or loan guarantees

(vi) Performance of services or membership or fundraising solicitations 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:

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

b(i) X b(ii) X b(iii) X b(iv) X b(v) X b(vi) X

c X

N / A (a)

Line no. (b)

Amount involved (e)

Name of noncharitable exempt organization (d)


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 (otherthan section 501(c)(3)) or in section 527? ► \ZZ\ Yes Q D No

b If "Yes,* complete the following schedule: N / A


(b) Type of organization


723152 12-27-07

19 Schedule A (Form 990 or 990-EZ) 2007

12211201 758549 6065 2007.07000 SAVE A LIFE FOUNDATION 6065

SAVE A LIFE FOUNDATION 36-3869459

FORM 990 SPECIAL EVENTS AND ACTIVITIES STATEMENT

GROSS CONTRIBUT. GROSS DIRECT NET INCOME DESCRIPTION OF EVENT RECEIPTS INCLUDED REVENUE EXPENSES OR (LOSS) GOLF OUTING 3,125. 3,125. 1,764. 1,361. TO FM 990, PART I, LINE 9 3,125. 3,125. 1,764. 1,361.

12211201 758549 6065 20 STATEMENT(S) 1 2007.07000 SAVE A LIFE FOUNDATION 6065 1


FORM 990 INCOME AND COST OF GOODS SOLD STATEMENT 2 INCLUDED ON PART I, LINE 10

INCOME 1. GROSS RECEIPTS 17,523 2. RETURNS AND ALLOWANCES 3. LINE 1 LESS LINE 2 17,52 3 4. COST OF GOODS SOLD (LINE 13) 6,050 5. GROSS PROFIT (LINE 3 LESS LINE 4) 11,473 COST OF GOODS SOLD 6. INVENTORY AT BEGINNING OF YEAR 41,767 7. MERCHANDISE PURCHASED 8. COST OF LABOR 9. MATERIALS AND SUPPLIES 10. OTHER COSTS 11. ADD LINES 6 THROUGH 10 41,767 12. INVENTORY AT END OF YEAR 35,717 13. COST OF GOODS SOLD (LINE 11 LESS LINE 12). . 6,050

21 STATEMENT(S) 2 12211201 758549 6065 2007.07000 SAVE A LIFE FOUNDATION 6065 1


FORM 990 OTHER EXPENSES STATEMENT 3

(A) (B) (C) (D) PROGRAM MANAGEMENT DESCRIPTION TOTAL SERVICES AND GENERAL FUNDRAISING

AUTO EXPENSE 5,895. 5,600. 295. BANK SERVICE FEES 782. 782. COMPUTER EXPENSES 4,420. 4,420. CONSULTING 70,404. 70,404. DUES AND SUBSCRIPTIONS 2,475. 2,228. 247. INSURANCE 8,712. 8,712. LICENSES AND PERMITS 3,880. 3,880. MARKETING AND PROMOTIONAL 4,667. 4,667. MISCELLANEOUS 60. 57. 3. PAYROLL SERVICE 2,692. 2,665. 27. PROGRAM MINI-GRANTS 6,500. 6,500. TRAINING AND DEVELOPMENT 215. 215. UTILITIES 5,316. 5,316. PROFESSIONAL FEES -OTHER 997. 997. TOTAL TO FM 990, LN 4 3 117,015. 116,443. 572.

FORM 990 STATEMENT OF ORGANIZATION' S PRIMARY EXEMPT PURPOSE STATEMENT 4 PART III

EXPLANATION TO EQUIP CITIZENS, STARTING WITH CHILDREN (K-12), WITH BASIC LIFE SUPPORTING FIRST AID (LSFA) SKILLS TO EMPOWER BYSTANDERS IN AIDING THE INJURED OR ILL IN A TIME OF AN EMERGENCY.

22 STATEMENT(S) 3, 4 .2211201 758549 6065 2007.07000 SAVE A LIFE FOUNDATION 6065 1


FORM 990 LOANS PAYABLE TO OFFICER'S, DIRECTOR'S, ETC. STATEMENT

LENDER'S NAME AND TITLE CAROL SPIZZIRI, PRESIDENT DATE OF MATURITY NOTE DATE TERMS OF REPAYMENT

DUE ON DEMAND SECURITY PROVIDED BY BORROWER PURPOSE OF LOAN NONE

DESCRIPTION OF CONSIDERATION NONE

OPERATIONS

ORIGINAL LOAN AMOUNT

61,496.

INTEREST RATE 5.00%

FMV OF CONSIDERATION BALANCE DUE

247,112.

TOTAL TO FORM 990, PART IV, LINE 63, COLUMN B 247,112

FORM 990 OTHER LIABILITIES STATEMENT 6

DESCRIPTION INSTRUCTOR DEPOSITS ROUNDING TOTAL TO FORM 990, PART IV, LINE 65

BEGINNING OF YEAR

2,700. 1.

2,701.

END OF YEAR 2,700

2,700.

FORM 990 OTHER REVENUE NOT INCLUDED ON FORM 990 STATEMENT 7

DESCRIPTION SPECIAL EVENT EXPENSE NETTED AGAINST REVENUE ON 990 "OST OF GOODS SOLD NETTED AGAINST REVENUE ON 990 TOTAL TO FORM 990, PART IV-A

AMOUNT 1,764 6,050 7,814

23 STATEMENT(S) 5, 6, 7 12211201 758549 6065 2007.07000 SAVE A LIFE FOUNDATION 6065 1


FORM 990 OTHER EXPENSES NOT INCLUDED ON FORM 990 STATEMENT 8

DESCRIPTION AMOUNT SPECIAL EVENT EXPENSE NETTED AGAINST REVENUE ON 990 1,764 COST OF GOODS SOLD NETTED AGAINST REVENUE ON 990 6,050 TOTAL TO FORM 990, PART IV-B 7,814.

FORM 990 LIST OF STATES RECEIVING COPY OF RETURN STATEMENT PART VI, LINE 90

STATES

IL,AL,AK,AR,AZ,CA,CO,CT,DE,FL,GA,HI,ID,IN,KS,KY,LA,ME,MD,MA,MI,MN,MS,MO,MT NE,NV,NJ/NM,NY,NC,ND,OH,OK,OR,PA,RI,SC,SD,TN,UT,VT,VA,WA,WV,WI,WY,TX,NH,IA

FORM 990 PART VIII - RELATIONSHIP OF ACTIVITIES TO STATEMENT 10 ACCOMPLISHMENT OF EXEMPT PURPOSES

LINE EXPLANATION OF RELATIONSHIP OF ACTIVITIES 93A SALF WAS GRANTED $590,000 TO TRAIN 170 EMERGENCY MEDICAL SERVICE

PROVIDERS AS INSTRUCTORS AT 33 MILITARY BASES IN 27 STATES AL, AK, AZ, AR, CA, FL, GA, HI, IL, IN, KY, LA, MA, MI, MS, MO, NJ, NM, NC, OK,OR, PR, SC, TX, WV, WI, WY TO TEACH THEIR 7,000 AT-RISK HIGH SCHOOL AGE STUDENTS LIFE SUPPORTING FIRST AID TRAINING AND PROVIDE ALL TRAINING EQUIPMENT, MATERIALS, TESTING SUPPLIES FOR BOTH NEW INSTRUCTORS AND STUDENTS. SALF MONITORED AND EVALUATED TRAINING, COLLECTED DATA AND REPORTED SUCCESS OF TESTING COMPONENT FOR EACH INSTRUCTOR AND OF THE STUDENTS.

93B PROGRAMS TO PROVIDE LIFE SAVING FIRST AID SKILLS TO VOLUNTEERS TO AID IN AN EMERGENCY.

103A MISCELLANEOUS NON-CLASSIFIABLE INCOME

SCHEDULE A OTHER INCOME STATEMENT 11

2006 2005 2004 2003 DESCRIPTION AMOUNT AMOUNT AMOUNT AMOUNT MISCELLANEOUS 745. 2,006. 0. TOTAL TO SCHEDULE A, LINE 22 745. 2,006.

24 STATEMENT(S) 8, 9, 10, 11 12211201 758549 6065 2007.07000 SAVE A LIFE FOUNDATION 6065 1

«4562-FY Oepari(T«n! of !ne Treasury Internal Revenue Scrvjce

D e p r e c i a t i o n a n d A m o r t i z a t i o n 990 (Including Information on Listed Property)

► See separate instructions. ► Attach to your tax return.

OMB No 1546-0172 «4562-FY Oepari(T«n! of !ne Treasury Internal Revenue Scrvjce

D e p r e c i a t i o n a n d A m o r t i z a t i o n 990 (Including Information on Listed Property)

► See separate instructions. ► Attach to your tax return.

2007 Attachment Sequence No 6 7

Nome(s) shown on return

SAVE A L IFE FOUNDATION

Business or activity to which this term relates

FORM 990 PAGE 2

Identifying numocf

36-3869459 Par t 1 Election To Expense Certain Property Under Section 179 Note: If you have any listed property, complete Part V before you complete Part I. 1 Maximum amount. See the instructions for a higher limit for certain business 2 Total cost of section 179 property placed in service (see instructions)

ss 1 1 2 5 , 0 0 0 . 1 Maximum amount. See the instructions for a higher limit for certain business 2 Total cost of section 179 property placed in service (see instructions) 2 3 Threshold cost of section 179 property before reduction in limitation 3 5 0 0 , 0 0 0 . 4 Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -0- 4 5 Dollar 'imiiation tor tax year. Subtract lire 4 from Itne 1 If zero or iess^ enter >0- If married fling separately, see instructions 5 g (a) Description ol property (b) Cost (business use only) (c) Elected cost

7 Listed property. Enter the amount from line 29 8 Total elected cost of section 179 property. Add amounts in column (c), lines (

7 7 Listed property. Enter the amount from line 29 8 Total elected cost of section 179 property. Add amounts in column (c), lines ( 3 and 7 8 9 Tentative deduction. Enter the smaller of line 5 or Iine8 9

10 Carryoverof disallowed deduction from line 13 of your 2006 Form 4562 10 11 Business income limitation. Enter the smaller of business income (not less than zero) or line 5 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 2008. Add lines 9 and 10. less line 12 ► 13 Note: Do not use Part II or Part III below for listed property. Instead, use Part V.

Part II Special Depreciation Allowance and Other Depreciation (Do not include listed property.) 14 Special depreciation allowance for qualified property (other than listed property) placed in service during

thetaxyear 15 Property subject to section 168(f)(1) election 16 Other depreciation (including ACRS) Part III I MACRS Depreciation (Do not include listed property.) (See instructions.)

14 15 16 1 4 , 3 7 6

Section A

17 MACRS deductions for assets placed in service in tax years beginning before 2007 18 if VCJ are eiecti.no !a crct.p any assets placed in service during the tan year into cne or more general asset accounts, check here W" I I

17 33 .

Section B • Assets Placed in Service During 2007 Tax Year Using the General Depreciation Syst em

(a! Classification ol property (b) Month and year placed in service

(c) Basis for depreciation (business/investment use

only • see instructions)

(d) Recovery penod

(e) Convention (1) Method (g) Depreciation seduction

19a 3-year property b 5-year property c 7-year property d 10-year property e 15-year property f 20-year property q 25-year property 25 yrs. S/L

h Residential rental property 27.5 yrs. MM S/L h Residential rental property 27.5 yrs. MM S/L

i Nonresidential real property 39vrs. MM S/L i Nonresidential real property MM S/L

Section C - Assets Placed in Service During 2007 Tax Year Using the Alternative Depreciation System 20a Class life

12-year 12 yrs. S/L S/L

40-year 40 yrs. MM S/L Part IV Summary (see instructions)

21 Listed property. Enter amount from line 28 22 Total. Add amounts from line 12, lines 14 through 17, lines 19 and 20 in column (g), and line 21.

Enter here and on the appropriate lines of your return. Partnerships and S corporations - see inslr. 23 For assets shown above and placed in service during the current year, enter the

portion of the basis attributable to section 263A costs , 23

21

22 1 4 , 4 0 9

042908 LHA For Paperwork Reduction Act Notice, see separate instructions. 25

12211201 7 5 8 5 4 9 6 0 6 5 2 0 0 7 . 0 7 0 0 0 SAVE A LIFE FOUNDATION

Form 4562-FY (2007)

6065 1

http://eiecti.no

Form 4562-FY (2007) SAVE A LIFE FOUNDATION PartV

36-3869459 Page 2 Listed Property (Include 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 24a, 24b columns (a) through (c) of Section A, all of Section B. and Section C if applicable.

Section A - Depreciation and Other Information (Caution: See the instmctions for limits for passenger automobiles.) 24a Do you have evidence to support the business/investment use claimed? CZJ Yes 1~H Nn

(a) Type of property (list vehicles first)


(c) Business/


(d) Cost or

other basis

<e) Basis for depreciation (business/investment

use only)

24b If 'Yes.' is the evidence written? [ _ ] Yes E Z I No

(f) Recovery

period

(9) Method/

Convention

25 Special depreciation allowance for qualified listed property placed in service during the tax year and used more than 50% in a qualified business use

26 Property used more than 50% in a qualified business use: 25


(i) Elected

section 179 cost

% % %

27 Property used 50% or less in a qualified business use: % S/L-% S/L-% S/L-

28 Add amounts in column (h). lines 25 through 27. Enter here and on line 21. page 1 28 29 Add amounts in column (i), line 26. E nter here and or i line 7. oaae 1 ■ - 29

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. 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.


Vehicle (b)

Vehicle (c)

Vehicle (d)

Vehicle (e)

Vehicle (f)

Vehicle year (do not include commuting miles)

31 Total commuting miles driven during the year 32 Total other personal (noncommuting) miles

driven 33 Total miles driven during the year.

Add lines 30 through 32 34 Was the vehicle available for personal use Yes No Yes No Yes No Yes No Yes No Yes No

during off-duty hours? 35 Was the vehicle used primarily by a more

than 5% owner or related person? 36 Is another vehicle available for personal

use? I

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. 37 Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, by your

employees? 38 Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your

employees? See the instructions for vehicles used by corporate officers, directors, or 1 % or more owners 39 Do you t reat all u se of vehicles by employees as personal use? 40 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? 41 Do you meet the requirements concerning qualified automobile demonstration use?

Note: If your answer to 3 7. 38. 39. 40, or 41 is "Yes," do not complete Section B for the covered vehicles. Part V I Amortization

(a) Description of costs

(b) Oiteiflwtueon

twins

(c) Amort izaolo

amount

(d) Cooe

ocction 42 Amortization of costs that begins during your 2007 tax year:

(e) AmcflttMen

oenoa or cttvoae

(0 Amortization lor this year

43 Amortization of costs that began before your 2007 tax year 44 Total. Add amounts in column (f). See the instructions for where to report 71627? 04-29-Ca

43 44

.2211201 758549 6065 26 2007.07000 SAVE A LIFE FOUNDATION

Form 4562-FY (2007)

6065 1


FINANCIAL STATEMENTS AND


JUNE 30, 2008

CONTENTS

Page

INDEPENDENT AUDITORS' REPORT 1


STATEMENT OF FINANCIAL POSITION 2

STATEMENT OF ACTIVITIES 3

STATEMENT OF FUNCTIONAL EXPENSES 4

STATEMENT OF CASH FLOWS 5



FINANCIAL STATEMENTS AND


JUNE 30, 2008

i

i

i


i CONTENTS

Page INDEPENDENT AUDITORS' REPORT

■


STATEMENT OF FINANCIAL POSITION

STATEMENT OF ACTIVITIES 3

STATEMENT OF FUNCTIONAL EXPENSES A

STATEMENT OF CASH FLOWS I 5


B O R H A R T SPELLMEYER & C O M P A N Y

certified public accountants and consultants

INDEPENDENT AUDITORS" REPORT

Board of Directors Save A Life Foundation Schiller Park, Illinois

I We have audited the accompanying statement of financial position of Save A Life Foundation (a not-for-— S E S F V * °V U n e 3(!' 2 0 0 S l a n d t h e relaled 9 t a t e m e n t s o f a c t i v i t i e s a " d cash f loU fo?ihe S O B « t h S S ? ! l I nC'a ? t a t e m e n l s *"*tne responslbflity of the Foundation's management. Our responsibility is to express an opinion on these financial statements based on our audit. 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 whather th?f?nandal S K r ^ * 1 1 8 ° f T*!*tmisatatement- ^ audJt includes consideration of irtemaTconS wer ™?22ZL P 9 aSra b3SiS f 0 r des '9nin9 a u d i t Procedures thai are appropriate in the circumstances but fininr flte2nSe ? exp™as,n9 s n °P i n ion o n , h e effectiveness of the Foundation's internal control over manaai reporting. According, we express no such opinion. An audit also Includes examining, on a test ^ • , n 7 „ d e n - 6 MPPOrt'nS *e*mo™* ™* disclosures in the financial statements, ass^sTng the X S ^ K F S " USe? 3 n d * * * * * e s t i m 9 t e s m a d e ^ management as well as etSSing the S o n statement presentation. We believe our audit provides a reasonable basis for our

In our opinion, the financial statements referred to above present fairiv in all material rmn»rh> «%. E S S i E R ? ° f Sa?K A L f f e / ^ a t i o n as of June 3 ( > P ? 0 0 a n d t h 5 l j ^ K S L 2 . n d its cashflows for the year then ended in conformrty with U.S. generally accepted S w n B n S K S S

Elgin), Illinois November 25, 2008


STATEMENT OF FINANCIAL POSITION

Juno 30,2008

ASSETS

CURRENT ASSETS Cash and cash equivalents Accounts receivable Ernployco advances Inventory Security deposit

! Total current assets

PROPERTY AND EQUIPMENT, at coal Building Office equipment Vehicles Program equipment Land

Less accumulated depreciation

Total assets

$ 142.760 67,329

3,248 35,717 2,753

251.807

181,912 166,333 31,190 4.500

20.000

403.935 204.001

_ 199.934

S 451,741

LIABILITY AND NET ASSETS

CURRENT LIABILITIES Accounts payable Ajccrued expenses Credit card payable Instructor deposits Other current liabilities

; Total current liabilities

LONG-TERM LIABILITIES Due to officer

Total liabilities

HE\ ASSETS Unrestricted Temporarily restricted

Total net assets

! Total liabilities and net assets

The accompanying notes are an integral part of these financial statements.



Year ended June 30,2008

Unrestricted net assets

Revenue and support | In-kind contributions (Branch development * 376,540 ;Course materials 593,430 Training program fees 1 7 - 5 2 a

(Miscellaneous 4,929 _ 9,962

Tola) revenue and support

Total expenses

Other income Interest income

Decrease in unrestricted net assets

Net assets at beginning of year

Net assets at end of year

The accompanying notes are an integral pan of these financial statements.

1,002,384 Expenses

National State 304.157 Branch programs 66,681 Management and general 688,383

30.433

1,109,654

774

(106.496)

258.608

S 152.112

SAVE AUFEFOUNDATION

-STATEMEKT-OF-F-UHCHQUALEXPENSED

Year ended June 3D, 2008

P

Compensation and related expense Salaries Payroll taxes Employee ben efts

Rent Legai and aooounting ConsUling Markeiing arid promotional Training supplies Travel Depreaafjon Telephone Postage Insurance Interest Program mirtkgranb Training materials Automobile Utilities Computer Licenses and permits Payroll service Dues and subscriptions Office supplies Miscellaneous Bank servise fees Repairs arxf maintenance Meetings Training and development

TDSS) expenses

National State

$ 43.106 514.369 8.284 2.761 1.836 612

53.226 17.742

27.B91 B.367 138,683 20.733 10.561 3.520 2.858 1.715

38,072 9.51B 6.438 3.219 1.441 12.9SB 3,416 1.414

672 364 7.144 1.553 1.251 417

4^40 1.210 - 2.358

691 42S 442 221

3.414 272 81 81

2.178 50 80 120 27 27

626 117 59 24 66 6

- 215

253.931 68.939

8304.157 566.681

Thaaccompajiying notes are an integral part oJ these financial statements.

4

Support

Branch Subtotal Management and general Total

$206,910 39,761 6,811

255,482

S 264.385 50,806 11.259

326.450

22,990 4.418

979

28,387

267.375 55.224 12.238

354.837

242.656

56.323 52.594

35.409

6.S97 8.454

6,675 6.500

3.242 4.200 3.7S7

194 2.503

1.767 1.238

39 510 243

432.901

276.914 159.406

70.404 57.167 47.590 45.066 K4CB 11.427 9.51D B.712 B.343 6,500 6.050 5.600 5,316 4,420 3.880 2.665 2.226 1.9S7 1.292

782 593 315 215

752.771

930

353 96

295

27 247 40 68

27B.914 159.406 70.404 57.167 47.59D 45,966 14,409 11.780 9.608 8,712 8.343 6.500 6.050 5.895 5.316 4.420 3.B80 2.692 2.475 2.007 1.360

782 593 315 215

Z.046 754.817 ? 6 f l B - 3 B 3 81.0T9.221 E 3Q.433 5 1,109,654


STATEMENT OF CASH FLOWS

Year ended June 30,2003

Net cash used by operating activities

Cash flows used by Investing activities Purchase of property and equipment

Caah flows provided by financing activities Proceeds from officer

Net decrease in cash and cash equivalents

Cash and cash equivalents at beginning of year

Cash and cash equivalents at end of year

Cash flows from operating activities Decrease in net assets Adjustments to reconcile decrease in net asests to net cash $ 006.496)

used by operating activities: ; Depreciation

Accrued interest on due to officer 14,409 ! Changes In assets and liabilities: 8,343

(Increase) decrease in: Accounts receivable

1 Employee advances (84.079) i Inventory 4.401

Security deposit 6 - 0 5 0

Increase (decrease) in: (2,753) Accounts payable Accrued liabilities 10,978 Other current liabilities 3 - 9 4 5

25.354

(99,848)

(750)

59.79S

(40,803)

183.563

_$ 142,760

The accompanying notes are a n Integral pan of these financial statements.



June 30,2008

NOTE A • NATURE OF BUSINESS

NOTE B . GENERAL ANO SUMMARY OF ACCOUNTING POLICIES

l.j Basis of accounting i

2. j Financial statement presentation,

The Foundation has adopted Statement of Financial Accourttina Standard* r <;FAQ\ M« -M ? -a-Statements of Not-for-Profi! Oraanlzaiinn* » 11,,^. « « * 1! - 9 . , ? i (or AS) No. 117, Financia

3. '■ Estimates

of assets and liabilities and i S S ^ S S ^ ^ ^ ^ J ^ ? l e c < t h e 3 p o n e f l a m o u m s

statements and the reported amount?of ^ K ^ e S S l ^ S ? ^ d ? " t h B flnanCia' resjutts could differ from those estimates. expenses during the reporting period. Actuai

4. ; Accounts rflneivahlfl

Trade receivables are obligations due under normal terms requiring oavment u a a n w « m . ^ -n. ■ Inlerest or fees charged on receivables M 9 n a n o m „ 7 ^ 1 7 ? * J?r p a y m B n l u P° n demand. There is no

5- j Cash ano cash equivalent*



June 30, 2008

NOTE B • GENERAL AND SUMMARY OF ACCOUNTING POLICIES . continued 6. Inventory

Inventory, which is composed of training m a w * , k stated at cost using ,he average cost method. 7-| Property and eoulog^gpt

Building o n Office equipment SSS Program equipment °J *f!'f

! V8hWes IS

*•: Restricted and ugrgy triced revaruiB

9- '■ Income taxae

™-; FungtiQPal allnnaHnn nf a y r ? f l » .

programs and aborting services bwSSE. b M n a " ° c a , e 0 " " " B < h e

I

i NOTE C • OPERATING LEASES

S ^ ^ " ^ " - * - - c a n c e l s opera«ng lease for its caneelable lease for office fi3^£5^fcfKi2' PTtm?Iesse c ° ™ « ™ n t s under the non. monthly inslallmenls of $2,753. y end '"9 J u n e 3 0 ' 2 0 0 9 - T h e l e a a e

is paid in Rent expense was $278,914 for the year ended June 30.2008.


NOJTES TO FINANCIAL STATEMENTS

June 30,2008


£ a ^ ^

ended June 30, 2008 of $107,042 ao™BO. I he Foundation receded donations of this type in year

uSc^Zlon30^ ^ r e C 0 r d 6 d a l t h e i r A* " » * « va,ue. Such donations are reported as

l £ ^ relationships with other expenses through these r e S s h M Duhno the S ^ 5 S ? ^ S K f S e r v i c 8 s a n d o t h e r

donatons of this type for $216 248 V U " e 3 0 , 2 0 ° 8 , t h f i F ° ^ 3 « o n received NOTE E - CONCENTRATION OF CREDIT RISK

A ^ n " ^ ^ ^ ^ depository institution in the nonhern Illinois area.

uo $ ° S ^L^ 0 5 1 1 lnstjrance c - n " - " - (TOW) UB o i, *uua. un January 1, 2010 the guaranree will return to $100,000.

NOTE F - DUE TO OFFICER

an( added to the p r i n * * b , i . „ ! . % S % ? f i £ ! ! 2 l S%. *"" * K W 1 2 ' l n t e , e s ' i s «»<"«■

Documents

Save-A-Life Foundation annual reports to IL Atty Gen'l w/IRS 990s+audits, 1/1/94-6/30/08 (download!)