SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2017
Open to Public
Inspection
Name of the organization
Knoxville Academy of Medicine Foundation
 
Employer identification number

62-1458199
Return Reference Explanation
Member election for additional members Part VI line 7a Board members all have equal voting rights in selection of additional members.
Governing body decisions Part VI line 7b Board members all have equal voting rights in governing body decisions.
Form 990 governing body review Part VI line 11 Form 990, Part VI, Section B, Line 11b: the form 990 is reviewed by the board prior to its filing.
Conflict of interest policy compliance Part VI line 12c Form 990, Part VI, Section B, Line 12c: All Board members have read the conflict of interest policy and are aware that they are to report any potential conflict of interest that they might have and are to report any potential conflict of others that they might suspect.
CEO executive director top management comp Part VI line 15a CEO, executive director and top management salaries are approved at board level.
Other officer or key employee compensation Part VI line 15b Form 990, Part VI, Section B, Line 15b: All salaries of key employees are approved at the board level.
Governing documents etc available to public Part VI line 19 Form 990, Part VI, Section C, Line A: All governing documents, conflict of interest policy and financial statements are available in the office of Kim Weaver, 115 Suburban Road, Knoxville, TN 37923.
General explanation attachment PART IX-A Summary of Direct Charitable ActivitiesThe purpose of the Foundation is to provide an appropriate entity for the receipt of inter vivos gifts, testamentary bequests and other philanthropic support from interested persons and/or entities for the maintenance, restoration, preservation and/or for such other appropriate professional/medical initiaves and programs and other lawful provisions of the Tennessee Nonprofit Corporation Act, TCA Section 48-51-101 et seq., and the provisions of Section 170(C)(3) and Section 201(C)(3) of the Internal Revenue Code. We have a program to provide no-cost health care to families who have no insurance and do not qualify for the states low income insurance program. In the past year, the Foundation assisted more than 4500 individual patients. SCHEDULE A - The Foundation began a 60 month period on January 10, 2010, after which time, the organization will no longer be considered a foundation but will instead come under Section 509(a)1 and 170(b)(1)(A)(VI) of the code. During the four years previous, Section A was not included. Section A is included in the 2015 tax year.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2017


Additional Data


Software ID:  
Software Version: