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ObjectId: 202421279349303047 - Submission: 2024-05-06
TIN: 36-4413031
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SCHEDULE N
(Form 990)
Department of the Treasury
Internal Revenue Service
Liquidation, Termination, Dissolution, or Significant Disposition of Assets
Complete if the organization answered "Yes" on Form 990, Part IV, lines 31 or 32; or Form 990-EZ, line 36.
Attach certified copies of any articles of dissolution, resolutions, or plans.
Attach to Form 990 or 990-EZ.
Go to
www.irs.gov/Form990
for the latest information.
OMB No. 1545-0047
20
22
Open to Public
Inspection
Name of the organization
Weiss Memorial Hospital Foundation
Employer identification number
36-4413031
Part I
Liquidation, Termination, or Dissolution.
Complete this part if the organization answered "Yes" on Form 990, Part IV, line 31, or Form 990-EZ, line 36.
Part I can be duplicated if additional space is needed.
1
(a)
Description of asset(s)
distributed or transaction
expenses paid
(b)
Date of
distribution
(c)
Fair market value of
asset(s) distributed or
amount of transaction
expenses
(d)
Method of
determining FMV for
asset(s) distributed or
transaction expenses
(e)
EIN of recipient
(f)
Name and address of recipient
(g)
IRC section
of recipient(s) (if
tax-exempt) or type
of entity
Cash
05-01-2023
400,962
Cash
36-2167761
Jewish Federation of Metropolitan Chicago
30 South Wells Street No 4049
Chicago
,
IL
60606
501(c)(3)
Cash
06-08-2023
160,365
Cash
36-2177139
University of Chicago
6054 South Drexel Avenue
Chicago
,
IL
60637
501(c)(3)
Yes
No
2
Did or will any officer, director, trustee, or key employee of the organization:
a
Become a director or trustee of a successor or transferee organization?
...........................
2a
Yes
b
Become an employee of, or independent contractor for, a successor or transferee organization?
.....................
2b
Yes
c
Become a direct or indirect owner of a successor or transferee organization?
.....................
2c
No
d
Receive, or become entitled to, compensation or other similar payments as a result of the organization's liquidation, termination, or dissolution?
........
2d
No
e
If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50087Z
Schedule N (Form 990) (2022)
Page 2
Schedule N (Form 990) (2022)
Page
2
Part I
Liquidation, Termination, or Dissolution
(continued)
Note.
If the organization distributed all of its assets during the tax year, then Form 990, Part X, column (B), line 16 (Total assets), and line 26 (Total liabilities), should equal -0-.
Yes
No
3
Did the organization distribute its assets in accordance with its governing instrument(s)? If "No," describe in Part III
.............
3
Yes
4a
Is the organization required to notify the attorney general or other appropriate state official of its intent to dissolve, liquidate, or terminate?
......
4a
Yes
b
If "Yes," did the organization provide such notice?
.....................
4b
Yes
5
Did the organization discharge or pay all of its liabilities in accordance with state laws?
.....................
5
Yes
6a
Did the organization have any tax-exempt bonds outstanding during the year?
.....................
6a
No
b
If "Yes" on line 6a, did the organization discharge or defease all of its tax-exempt bond liabilities during the tax year in accordance with the Internal Revenue Code and state laws?
6b
c
If "Yes" on line 6b, describe in Part III how the organization defeased or otherwise settled these liabilities. If "No" on line 6b, explain in Part III.
Part II
Sale, Exchange, Disposition, or Other Transfer of More Than 25% of the Organization's Assets.
Complete this part
if the organization answered "Yes" on Form 990, Part IV, line 32, or Form 990-EZ, line 36. Part II can be duplicated if additional space is needed.
1
(a)
Description of asset(s)
distributed or transaction
expenses paid
(b)
Date of
distribution
(c)
Fair market value of
asset(s) distributed or
amount of transaction
expenses
(d)
Method of
determining FMV for
asset(s) distributed or
transaction expenses
(e)
EIN of recipient
(f)
Name and address of recipient
(g)
IRC section
of recipient(s) (if
tax-exempt) or type
of entity
Yes
No
2
Did or will any officer, director, trustee, or key employee of the organization:
a
Become a director or trustee of a successor or transferee organization?
.........................
2a
Yes
b
Become an employee of, or independent contractor for, a successor or transferee organization?
.....................
2b
Yes
c
Become a direct or indirect owner of a successor or transferee organization?
.....................
2c
No
d
Receive, or become entitled to, compensation or other similar payments as a result of the organization's significant disposition of assets?
........
2d
No
e
If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50087Z
Schedule N (Form 990) (2022)
Page 3
Schedule N (Form 990) (2022)
Page
3
Part III
Supplemental Information.
Provide the information required by Part I, lines 2e and 6c, and Part II, line 2e. Also complete this part to provide any additional information.
Return Reference
Explanation
Part I, Line 2e:
Person(s) Involved: Peter Chiswick, Assistant TreasurerDeborah Covington, SecretaryRose Jagust, Assistant SecretaryJames A. Pinkston, Assistant TreasurerAndrea Yablon, Vice President
Part I, Line 2e:
Explanation of Involvement: Peter Chiswick, Deborah Covington, Rose Jagust, and James A. Pinkston are employees of Jewish Federation of Metropolitan Chicago.Andrea Yablon is a director of Jewish Federation of Metropolitan Chicago.
Schedule N (Form 990) (2022)
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