Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
HACKENSACK UNIVERSITY MEDICAL CENTER
 
Employer identification number

22-1487576
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No









2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2014
Page 2
Schedule L (Form 990 or 990-EZ) 2014
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) ELIZABETH SIMUNOVICH FAMILY MEMBER OF GOVERNOR 121,215 HACKENSACKUMC EMPLOYEE   No
(2) MARY R KOZIBRODA FAMILY MEMBER OF GOVERNOR 73,505 HACKENSACKUMC EMPLOYEE   No
(3) PIA SISON FAMILY MEMBER OF GOVERNOR 145,920 HACKENSACKUMC EMPLOYEE   No
(4) DOREEN A PROWITZ FAMILY MEMBER OF GOVERNOR 103,672 HACKENSACKUMC EMPLOYEE   No
(5) MARY P DONNALLEY FAMILY MEMBER OF OFFICER 106,942 HACKENSACKUMC EMPLOYEE   No
(6) BARRY M DAVIDOFF FAMILY MEMBER OF OFFICER 131,912 HACKENSACKUMC EMPLOYEE   No
(7) THERESA M EBEL FAMILY MEMBER OF OFFICER 164,930 HACKENSACKUMC EMPLOYEE   No
(8) WARREN E SCOTT FAMILY MEMBER OF OFFICER 57,163 HACKENSACKUMC EMPLOYEE   No
(9) LISA SANZARI FAMILY MEMBER OF GOVERNOR 20,076 HACKENSACKUMC EMPLOYEE   No
(10) AMI ATUL FAMILY MEMBER OF GOVERNOR 103,780 HACKENSACKUMC EMPLOYEE   No
(11) SANZARI 2001 LLC COMPANY OF GOVERNOR 3,475,934 CONSTRUCTION SERVICES   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
SCHEDULE L, PART IV JOSEPH M. SANZARI IS AN OWNER IN SANZARI 2001, L.L.C. THE HOSPITAL UTILIZED THE SERVICES OF SANZARI 2001, L.L.C. DURING 2014. TOTAL FEES PAID TO SANZARI 2001, L.L.C. BY HACKENSACKUMC WERE $3,475,934. SERVICES WERE RENDERED AT FAIR MARKET VALUE RATES PURSUANT TO ARM'S LENGTH NEGOTIATIONS.
Schedule L (Form 990 or 990-EZ) 2014


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