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
2018
Open to Public
Inspection
Name of the organization
HENRY FORD MACOMB MEDICAL STAFF
FOUNDATION INC
Employer identification number

20-2385667
Return Reference Explanation
FORM 990, PART VI, SECTION B, LINE 11B PREPARER COMPLETES FORM #990 & PRESENTS TO PRESIDENT OF ORGANIZATION. PRESIDENT REVIEWS RETURN WITH OTHER MEMBERS OF GOVERNING BODY. IF QUESTIONS ARISE, HE RESOLVES & CORRECTS ITEMS WITH PREPARER TO BEST OF HIS KNOWLEDGE. THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS BY-LAWS & FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. REQUESTS SHOULD BE SUBMITTED IN WRITING TO THE ORGANIZATION'S OFFICE. THE ORGANIZATION'S FOUR MEMBERS OF ITS GOVERNING BODY DO NOT HAVE ANY CONFLICTS OF INTEREST WITH THE ORGANIZATION.
FORM 990, PART VII, LINE 1A AMOUNTS LISTED ON PART VII AS #1099 COMPENSATION TO OFFICERS PAID TO THE ENTITIES WHICH OFFICERS ARE SHAREHOLDERS OR MEMBERS AS FOLLOWS: D/B/A CARDIAC EP CONSULTATNS (DR. ALI SHAKIR) ID#81-2377747 AMOUNT = 100,000 LAILA SHEHADEH SS#XXX-XX-XXXX AMOUNT = 12,000 BRIAN LODER DPM PLLC ID#26-3677100 AMOUNT = 13,800
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2018


Additional Data


Software ID:  
Software Version: