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,j Form , 9 9 0 Return of Organization :Exempt From IncomeTax i 0MBNo. 1545±0U4
<br /> Under section 501 (c) of the Internal Revenue Code (except black lung benefit trust or
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<br /> Department of the Treasury private foundation) or section 4947 (a) ( 1 ) nonexempt charitable trust
<br /> r • , - - ,
<br /> Internal Revenue Service ► The organization may have to use a copy of this return to satisfy state reporting requirements.
<br /> A For the 2000 calendar year, OR tax year period beginning 10 / 01 2000 and ending 09 / 30 / 2001
<br /> B
<br /> Check
<br /> Chfngeof : Please C Name of organization D Employer Identification number
<br /> Change et P �
<br /> address use IRS
<br /> Change of label or
<br /> name INDIAN RIVER MEMORIAL HOSPITAL INC . 59 - 2496294
<br /> name
<br /> Initial rehan �e r Number and street (or P.O. box if mail is not delivered to street address) Room/suite E Telephone number
<br /> Final return See
<br /> Specific 1000 36TH STREET 561 567 - 4311
<br /> Instruc-
<br /> Amend return dons. City or town, state or country, and ZIP code F check ► 1:1 If application pending
<br /> IVERO BEACH FL 32960
<br /> G Organization type (check .only one) ► X 501 (c) ( 3 ) , (insert no.) 27 OR 4947 (a)(1 ) Note: (H and I are not applicable
<br /> to section 527 orgs.)
<br /> • Section 501(c)(3) organizations and 4947(x)(1) nonexempt charitable trusts must H(a) Is this a group return for affiliates? a Yes ❑X
<br /> No
<br /> attach a completed Schedule A (Form 990 or 900-EZ), HP If "Yes, " enter number of affiliates ►
<br /> H�c� Are all affiliates included?
<br /> J Accounting method: Cash X Accrual Other (specify) ► _ (if "No," attach a list. See inst.) Yes X No
<br /> K -- Check here_ ► if the organization's gross receipts are normally not more than Hid is this separate er�m fled by an Yes X
<br /> No
<br /> organizationby a group ruling? Li
<br /> $25,000. The organization need not file a return with the IRS; but if the organization I Enter 4-digit group exemption no. (GEN)
<br /> ►
<br /> received a Form 990 Package in the mail, it should file a return without financial Aata, - L Check this box if the organization
<br /> is not required -
<br /> Some states require a complete return, - to attach Schedule B (Form 990 or 990-EZ) ► X
<br /> Revenue, Expenses, and Changes In Net Assets or Fund Balances See Specific Instructions on page 16.
<br /> 1 Contributions, gifts, grants, and similar amounts received:
<br /> a Direct public support , , , , , , , , , , , • • 0 1 a
<br /> b Indirect public support , , , , , . . . a . . . . lb
<br /> c Government contributions (grants) . . 1 c
<br /> d Total (add lines to through 1c) (cash i noncash 5 ) 1 d
<br /> 2 Program service revenue including government fees and contracts (from Part VII, line 93) , 2 125 , 379r6270
<br /> 3
<br /> 25379627 -
<br /> 3 Membership dues and assessments -, _ • . . . . . . 3
<br /> 4 Interest on savings and temporary cash investments • , , _ . . 4 62 0 92 6 .
<br /> 5 Dividends and interest from securities . . _ 0 . y 0 0 a _ 5 2 5 9 6 5 41 .
<br /> 6 a -Gross rents . . . . . . . 0 . . . a . . . li a -
<br /> . . _ , , . 533f9600
<br /> b - Less: rental expenses , , , , , , , , , , , . : 6 b - 2 3 6 3090
<br /> C Net rental income or (loss) (subtract line 6b from line 6a) - 0a- . , 6c
<br /> � 2977r6510 -
<br /> 7 Other investment income (describe 10* SEE STATEMENT 1 7 425 205 .
<br /> 8a Gross amount from sales of assets other A Securities s Other
<br /> re- than inventory . . . ease, , , , 8a r'r..e
<br /> _ 145 103 .
<br /> b Less: cost or other basis and sales expenses . - 8 b 94 2 4 9 . ra
<br /> c Gain .STMT 24 , , , , , , , 1 , 087 , 212 . 8c 50 854 . :=.,
<br /> d Net gain or. (loss) (combine line 8c, columns (A) and ( B)) , , , , , , a a • 0 0
<br /> 8 d 1 , 138r0660
<br /> 9 Special events and activities (attach schedule) `
<br /> a Gross revenue (not including $ of
<br /> contributions reported on line 1a) , , , , , , • • • • . . • • . 9a
<br /> b Less : direct expenses other than fundraising expenses , , , , , 9 b 3; :
<br /> c Net income or (loss) from special events (subtract line 9b fromline9a) , , , , , , 9 c
<br /> 10a Gross sales of inventory, less returns and allowances oa
<br /> b Less: cost of goods sold . • • , , 0 kob
<br /> c Gross profit or (loss) from sales of inventory (attach schedule) (subtract line 10b from line 10a) 1 oc
<br /> 11 Other revenue (from Part VII, line 103) , , , , , , , , 9 0 a , . . . . . .
<br /> 0 0 , • . . . ssee s . . 11 1 660 170 -
<br /> 12 Total revenue add lines 1d 2 31 41 51 6c 7t 8d 9c 10c and 11 12 W 132 118r186 ..
<br /> 13 Program services (from line 44, column (B)) , , l m : , , , , , , �p, PAYER � p 1 4 113 2
<br /> 94 2 95 .
<br /> N14 Management and general (from line 44, column C N 16 414 , 8 9 6 .
<br /> acs 15 Fundraising (from line 44, column (D)) RETAIN FOR YOUR FILE • 1 s
<br /> CL ,
<br /> X 16 Payments to affiliates (attach schedule) , , , , , , , , , , , , , • • .
<br />• , . . . , . 16
<br /> 17 Total expenses add lines 16 and 44 column A 17 129 r 709 191 -
<br /> 18 Excess or (deficit) for the year (subtract line 17 from line 12) , 18 2 J08P995 .
<br /> 19 Net assets or fund balances at beginning of year (from line 73, column (A)) • , , , , , , 19 111
<br /> , 4 4 8 r 9 95 .
<br /> ZO Other changes in net assets or fund balances (attach explanation) ;STMT, 20 , , , $ TMT, ;30 , 20 —
<br /> 10 941 274 -
<br /> Z 21 Net assets or fund balances at end of year combine lines 18 19 and 20 21 102 r 916 t 716
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<br /> .1sA For Paperwork Reduction Act Notice, see page 1 of the separate instructions, Form 990 (2000)
<br /> OE 1010 2. 000
<br /> . B9A003 2830 111986
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