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.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
FARMINGTON HEALTH SERVICES
 
Employer identification number

20-0100365
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 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 the 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) 2020
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Schedule L (Form 990 or 990-EZ) 2020
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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 LETICH - DAUGHTER OF CAROL RAW, CEO 105,003 EMPL -ADMIN FHS   No
(2) ANDY RAW - SON OF CAROL RAW, CEO 45,131 EMPL -MAINT BVHS   No
(3) KAITLYN PENISKA - RELATIVE LAURIE PENISKA, DON 34,258 EMPL -NUR ASST BVHS   No
(4) DENNIS LINDOR - HUSBAND OF DAWN BJORGE, DON/TR 36,411 EMPL -CORP STAFF PCS   No
(5) JUSTIN NELSON - SON OF LEAH NELSON - VP HR 44,629 EMPL -IT ANALY SFHS   No
(6) CHANTEL TRIGGS - WIFE OF JOHNATHON TRIGGS, DON 12,504 EMPL -RN ZHS   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
SCHEDULE L, PART V DURING THE YEAR, THE ORGANIZATION EMPLOYS INDIVIDUALS WHO MAY BE RELATED TO AN OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE. PAYMENTS FOR SERVICES ARE MADE ACCORDING TO EMPLOYMENT CONTRACTS AND DONE AT ARMS LENGTH. DUE TO THE RURAL LOCATION OF THE ORGANIZATION AND THE NEED TO FIND QUALIFIED STAFF, THESE EMPLOYMENT RELATIONSHIPS ARE NECESSARY TO FURTHER THE ORGANIZATION'S EXEMPT PURPOSE.
Schedule L (Form 990 or 990-EZ) 2020


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