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
2015
Open to Public Inspection
Name of the organization
BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER
 
Employer identification number

11-1704595
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) 2015
Page 2
Schedule L (Form 990 or 990-EZ) 2015
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) T CULLEN SEE PART V 600,069 VENDOR   No
(2) J DUDEK SEE PART V 139,006 EMPLOYMENT   No
(3) L B SCHWARZ SEE PART V 118,191 EMPLOYMENT   No
(4) A SINKOFF SEE PART V 65,619 EMPLOYMENT   No
(5) P MAYER-RIVETTA SEE PART V 52,646 EMPLOYMENT   No
(6) D KNAPP SEE PART V 35,329 EMPLOYMENT   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
PART IV: 1) T. CULLEN, DIRECTOR, IS THE PRESIDENT & CEO OF CROWN ADVERTISING, INC. WHICH PROVIDED ADVERTISING SERVICES TO THE ORGANIZATION. 2) J. DUDEK IS THE SISTER OF J. MAYER, DIRECTOR. 3) L. B. SCHWARZ IS THE DAUGHTER OF R. W. SCHWARZ, DIRECTOR. 4) A. SINKOFF IS THE SISTER OF S. NORTON REMMER, DIRECTOR. 5) P. MAYER-RIVETTA IS THE SISTER OF J. MAYER, DIRECTOR. 6) D. KNAPP IS THE STEP-DAUGHTER OF M. KNAPP, DIRECTOR.
Schedule L (Form 990 or 990-EZ) 2015


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