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Form 990-EZ
Department of the TreasuryInternal Revenue Service
2015Open to•Public
Inspection
Short FormReturn of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(aX1) of the Internal Revenue Code(except private foundations)
► Do not enter social security numbers on this form as it may be made public.
► Information about Form 990-EZ and its instructions is at www.irs.gov/form990.
OMB No 1545 1150
A For the 2015 calendar year , or tax year beginning , 2015 , and endingB Check if applicable C D Employer identification numberFlAddress change
F] Name change 2 BIG HEARTS FOUNDATION 20-1580312Initial return 2 912 ROSLYN TRAIL E Telephone number
^Finalreturn/terminatedLONG BEACH, IN 46360
LI Amended returnExemption
FGroup
11 Application pending Numbe r
G Accounting Method Cash [ Accrual Other (specify) ► H Check ► if the organization is not
I Website : ► N/A required to attach Schedule B
J Tax- exempt status (check only one) - ^X 501(c)(3) [] 501(c) ( ) 4(Insert no) [ 4947(a)(1) or 527 (Form 990, 990-EZ, or 990-PF)
K Form of organization Corporation Trust Association Other
L Add lines 5b, 6c, and 7b to line 9 to determine gross receipts If gross receipts are $200,000 or more, or if totalassets (Part II, column (B) below) are $500,000 or more, file Form 990 instead of Form 990-EZ ' $ 19 , 760.
Part I Revenue , Expenses , and Changes in Net Assets or Fund Balances (see the instructions for Part I)Check if the organization used Schedule 0 to respond to any question in this Part I
c.)O
MJ-I
1 Contributions , gifts, grants , and similar amounts received 1 1 , 976.2 Program service revenue including government fees and contracts 2
3 Membership dues and assessments 3
4 Investment income 4 124.5 a Gross amount from sale of assets other than inventory 5 a
b Less cost or other basis and sales expenses 5 b
c Gain or ( loss) from sale of assets other than inventory ( Subtract line 5b from line 5a) 5 c
6 Gaming and fundraising events
RE a Gross income from gaming (attach Schedule G if greater than $ 15,000) 6a 1vE b Gross income from fundraising events (not including $ of contributions
N from fundraising events reported on line 1) (attach Schedule G if the sumu
of such gross income and contributions exceeds $ 15,000 ) 6b 17 , 660.c Less direct expenses from gaming and fundraising events 6c 8 , 426.
d Net income or (loss ) from gaming and fundraising events (add lines 6a and6b and subtract line 6c ) 6d 9 , 234.
7 a Gross sales of inventory , less returns and allowances 7a
b Less cost of goods sold 7
c Gross profit or (loss ) from sales of inventory (Subtract line 7b from If 7c
8 Other revenue (describe in Schedule 0) 0 8
9 Total revenue . Add lines 1, 2, 3, 4, 5c , 6d, 7c, and 8 ch 9 11 , 334.10 Grants and similar amounts paid (list in Schedule 0) N S^^ 0 10
11 Benefits paid to or for members Q `S^ 11
E 12 Salaries , other compensation , and employee benefits 12
E 13 Professional fees and other payments to independent contractors 13 750.
Ns
14 Occupancy , rent, utilities, and maintenance 14
ES15 Printing , publications . postage, and shipping 15
16 Other expenses (describe in Schedule 0) See Schedule 0 16 2 523.17 Total expenses . Add lines 10 through 16 17 3 273 .
18 Excess or (deficit) for the year (Subtract line 17 from line 9) 18 8 , 061.A
NS
19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with end-of-year'
--- ---T E s return)figure reported on prior year 19 150 , 821.
5 20 Other changes in net assets or fund balances (explain in Schedule 0) 20
21 Net assets or fund balances at end of year Combine lines 18 through 20 21 158 , 882.
BAA For Paperwork Reduction Act Notice, see the separate instructions. Form 991.1-EL (LUlb)
TEEA0803L 10/12/15 /1^^
Form 990-EE (2015) 2 BIG HEARTS FOUNDATION 20-1580312 Page 2
iPar.t111 ! Balance Sheets (see the instructions for Part II) qCheck if the or anization used Schedule 0 to res pond to any q uestion in this Part II
(A) Bealnnlna of year (B) End of year22 Cash, savings, and investments 150 821. 22 158 , 882.23 Land and buildings 23
24 Other assets (describe in Schedule 0) 2425 Total assets 150 821. 25 158 , 882.26 Total liabilities (describe in Schedule 0) 0. 26 0.27 Net assets or fund balances (line 27 of column (B) must agree with line 21) 150 821. 27 158 , 882.
IR. ftNI11U Statement of Program Service Accomplishments (see the instructions for Part III )Check if the organization used Schedule 0 to respond to any question in this Part III
Expenses
(Required for section 501What is the organization's primary exempt purpose? See Schedule 0Describe the organization's program service accomplishments for each of its three largest program services, asmeasured by expenses In a clear and concise manner, describe the services provided, the number of personsbenefited, and other relevant information for each program title
(c)(3) and 501 (c)(4)organizations, optionalfor others.)
28 See Schedule-0--------------------------------------------------
---------------------------------------------------
-- ------------------------------------------(Grants - ) If this amount Includes foreign grants, check here 8a , 539.
29---------------------------------------------------
---------------------------------------------------
--------------------------------------------(Grants $ ) If this amount in cludes foreign grants, check here 9a
30------------------------------------------------------------------------------------------------------
-------------------------------------------------(Grants $ ) If this amount includes foreign grants, check here 0a
31 Other program services (describe in Schedule 0)(Grants $ ) If this amount includes foreign grants, check here q 31 a
32 Total program service expenses (add Ilnes 28a through 31 a) 32 3 , 539 .Part-mu List of Officers , Directors , Trustees , and Key Employees (list each one even if not compensated - see the instructions for Part IV) ._
l.necR if ine organization uses >cneauie v to respona to any q uestion in mis hart iv LJ
(a) Name and title (b) Average hours pe rweek devoted to
position
(W ReportableW-2/1 099-MISC)
compensation(Forms(if not pa id,,
ent e renter
-- 00-))
(d) Health benefits,contributions to employeebenefit plans, and deferred
compensation
(e) Estimated amount ofother compensation
JEFFREY LEVOFF _ _ _ _ _ _ _ _ _ _Secretar 0 0. 0. 0.PATRICIA CREPEAU _ _Treasurer 0 0. 0. 0.RICHARD CLARKE__________Vice President 0 0. 0. 0.MICHAEL UNETICH_________Director 0 0. 0. 0.
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BAA ItbAcu3l21- 10112l5 Form 990-EZ (2015)
Form 990-EZ (2015) 2 BIG HEARTS FOUNDATION 20-1580312 Page 3
Pait V Othe'r Information (Note the Schedule A and personal benefit contract statement requirements inSee Schedule 0the instructions for Part V) Check if the organization used Schedule 0 to respond to any question in this Part V
33 Did the organization engage in any significant activity not previously reported to the IRS? Yes No
If 'Yes,' provide a detailed description of each activity in Schedule 0 33 X' '34 Were any significant changes made to the organizing or governing documents? If attach a conformed copy of the amended documents if they reflectYes,
a change to the organization's name Otherwise, explain the change on Schedule 0 (see instructions) 34 X
35a Did the organization have unrelated business gross income of $1,000 or more during the year from business activities(such as those reported on lines 2, 6a, and 7a, among others)? 35a X
b If 'Yes,' to line 35a, has the organization filed a Form 990-T for the year? If 'No,' provide an explanation in Schedule 0 35b
c Was the organization a section 501 (c)(4), 501 (c)(5), or 501 (c)(6) organization subject to section 6033(e) notice,reporting, and proxy tax requirements during the year? If 'Yes,' complete Schedule C, Part III 35c X
36 Did the organization undergo a liquidation, dissolution, termination, or significantdisposition of net assets during the year? If 'Yes,' complete applicable parts of Schedule N 36 X
37a Enter amount of political expenditures, direct or indirect, as described in the instructions 1" I 37a 0.
b Did the organization file Form 1120-POL for this year? 37b X
38a Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or wereany such loans made in a prior year and still outstanding at the end of the tax year covered by this return? 38a X
th lb If 'Y l h l P t II t t t' t S d L d ercomp ar an en e o aes, e e c e u e ,amo nt involved 38b N/Au
ay. ;6
39 Section 501(c)(7) organizations Enter
a Initiation fees and capital contributions included on line 9 39a N/A
b Gross receipts, included on line 9, for public use of club facilities 39b N/A
40a Section 501(c)(3) organizations Enter amount of tax imposed on the organization during the year under
section 4911 0 section 4912 0 section 4955 0.
b Section 501(c)(3), 501(c)(4), and 501 (c)(29) organizations Did the organization engage in any section 4958 excessbenefit transaction during the year, or did it engage in an excess benefit transaction in a prior year that has not been
reported on any of its prior Forms 990 or 990-EZ' If 'Yes,' complete Schedule L, Part I 40b X
c Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations Enter amount of tax imposed on organizationmanagers or disqualified persons during the year under sections 4912, 4955, and 4958 0
d Section 501 (c)(3), 501 (c)(4), and 501 (c)(29) organizations Enter amount of tax on line 40c reimbursedby the organization P. 0
r3+
e All organizations At any time during the tax year, was the organization a party to a prohibited taxshelter transaction? If 'Yes,' complete Form 8886-T 40e X
41 List the states with which a copy of this return is filed ► IL IN
42 a The organization'sGroup Telephone no 708-535-2400books are in care of ► The Stajleton ------------_
---Located at 11 15420 South 70th Court Orland Park IL ZIP + 4 60462
--------------------------------------------------b At any time during the calendar year, did the organization have an interest in or a signature or other authority over a Yes No
financial account in a foreign country (such as a bank account, securities account, or other financial account)? 42b X
If 'Yes,' enter the name of the foreign country
See the instructions for exceptions and filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR) =s .f
c At any time during the calendar year , did the organization maintain an office outside the U S ' 42c X
If 'Yes,' enter the name of the foreign country 01
43 Section 4947(a)(1) nonexempt charitable trusts filing Form 990 - EZ in lieu of Form 1041 - Check here -F] N/Aand enter the amount of tax-exempt interest received or accrued during the tax year 43 N/A
Yes No
44a Did the organization maintain any donor advised funds during the year? If 'Yes ,' Form 990 must be completed insteadof Form 990 - EZ 44a X
b Did the organization operate one or more hospital facilities during the year? If 'Yes,' Form 990 must be completed "x -." `'k
instead of Form 990-EZ 44b X
c Did the organization receive any payments for indoor tanning services during the year? 44c X
d If 'Yes' to line 44c, has the organization filed a Form 720 to report these payments?If 'No,' provide an explanation in Schedule 0 44d
45a Did the organization have a controlled entity within the meaning of section 512(b)(13)' 45a X
b Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If 'Yes,'Form 990 and Schedule R may need to be completed instead of Form 990-EZ ( see instructions) 45b X
TEEAO812L 10/12/15 Form 990-EZ (2015)
11 Form 990-EZ (2015) 2 BIG HEARTS FOUNDATION 20-1580312 Page 4Yes No
46 Did the organization engage, directly or indirectly, in political campaign activities on behalf of or in opposition to
candidates for public office? If 'Yes,' complete Schedule C, Part t 46 X
Part VIi Section 501 (cX3) organizations onlyAll section 501 (c)(3) organizations must answer questions 47-49b and 52, and complete the tablesfor lines 50 and 51.Check if the organization used Schedule 0 to respond to any question in this Part VI n
Yes No47 Did the organization engage in lobbying activities or have a section 501(h) election in effect during the tax year? If 'Yes,'
complete Schedule C, Part II 47 X
48 Is the organization a school as described in section 170(b)(1)(A)(ll)' If 'Yes,' complete Schedule E 48 X
49a Did the organization make any transfers to an exempt non-charitable related organization? 49a X
b If 'Yes,' was the related organization a section 527 organization? 49b
50 Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key
employees) who each received more than $100,000 of compensation from the organization. If there is none, enter 'None '
(a) Name and title of each employee(b) Average hoursper week devoted
to position
(c) Reportable compensation(Forms W-2/1099 MISC)
(d) Health benefits,contributions to employeebenefit plans, and deferred
compensation
(e) Estimated amount ofother compensation
None------------------------
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- - - - - - - - - - - - - - -- - - - - - - - -
None-----------------------------------
a i otal numoer or otner inaepenaent contractors each recelvlny
52 Did the organization fete Schedule A7yN^'te : All section
rmmnlatari Srharwiu A ,
May the IRS discuss this return with the preparer shown above? See I
f Total number of other employees paid over $IOU,000 W
51 Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 ofcomoensatlon from the oraanlzatlon If there is none, enter 'None '
Public Charity Status and Public SupportSCHEDULE A
Complete if the organization is a section 501(cx3) organization or a section(Form 990 or 990-EZ)4947(aX1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ.
Department of the Treasury Information about Schedule A (Form 990 or 990-EZ) and its instructions isInternal Revenue Service at www irs.gov/form990.
Name of the organization Emplo
OMB No 1545-0047
1 2015Open to Public,
Inspection ^,
identification number
2 BIG HEARTS FOUNDATION 120-1580312Part I' I Reason for Public Charity Status (All oraanlzatlons must complete this Dart.) See Instructions.The organization is not a private foundation because it is (For lines 1 through 11, check only one box
1 A church, convention of churches, or association of churches described in section 170(bX1XAXi).
2 A school described in section 170(bX1XAXii). (Attach Schedule E (Form 990 or 990-EZ) )
3 A hospital or a cooperative hospital service organization described in section 170(bXlXAXiii).
4 A medical research organization operated in conjunction with a hospital described in section 170(bXlXAXiii). Enter the hospital's
name, city, and state-----------------------------------------------------
5 q An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section170(bx1 )(AXiv). (Complete Part II.)
6 q A federal, state, or local government or governmental unit described in section 170(bx1XAXv).
7 An organization that normally receives a substantial part of its support from a governmental unit or from the general public describedin section 170(bX1XAXvi ). (Complete Part II )
8
F]
A community trust described in section 170(bX1XAXvi ). (Complete Part II )
9 FX] An organization that normally receives (1) more than 33-1/3% of its support from contributions, membership fees, and gross receiptsfrom activities related to its exempt functions - subject to certain exceptions, and (2) no more than 33-1/3% of its support from grossinvestment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization afterJune 30, 1975 See section 509(aX2). (Complete Part III )
10 q An organization organized and operated exclusively to test for public safety See section 509(aX4).
11 An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of oneor more publicly supported organizations described in section 509(aXl) or section 509(aX2). See section 509(aX3). Check the box inlines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g
a q Type I . A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supportedorganization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization You mustcomplete Part IV, Sections A and B.
b q Type II . A supporting organization supervised or controlled in connection with its supported organization(s), by having control ormanagement of the supporting organization vested in the same persons that control or manage the supported organization(s) Youmust complete Part IV , Sections A and C.
c q Type III functionally integrated . A supporting organization operated in connection with, and functionally integrated with, its supportedorganization(s) (see instructions ) You must complete Part IV , Sections A, D, and E.
d q Type III non-functionally integrated . A supporting organization operated in connection with its supported organization(s) that is notfunctionally Integrated The organization generally must satisfy a distribution requirement and an attentiveness requirement (seeinstructions ) You must complete Part IV, Sections A and D, and Part V.
e q Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionallyintegrated, or Type III non-functionally integrated supporting organization
f Enter the number of supported organizations
g Provide the following information about the supported organization(s)
(i) Name of supportedorgan zat ion
(ii) EIN (iIi) Type of organization(described on tines 1-9above (see instructions))
(iv) Is theorganization listedin your governing
document
(v) Amount of monetarysupport (see instructions)
(vi) Amount of othersupport (see instructions)
Yes No
(A)
(B)
(C)
(D)
(E)
Total a'r . \ Y,
BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule A (Form 990 or 990-EZ) 2015
TEEA0401L 10/12/15
Schedule A (Form 990 or 990-EZ) 2015 2 BIG HEARTS FOUNDATION 20-1580312 Page 2
Part It Support Schedule for Organizations Described in Sections 170(bx1XAXiv) and 170(bXlXAXvi)(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III If theorganization fails to qualify under the tests listed below, please complete Part III )
Sectinn A. Public Sunnnrt
Calendar year (or fiscal yearbeginning in)
(a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
1 Gifts, grants, contributions, andmembership fees received (Do not
'include any unusual grants )
2 Tax revenues levied for theorganization's benefit andeither paid to or expendedon its behalf
3 The value of services orfacilities furnished by agovernmental unit to theorganization without charge
4 Total . Add lines 1 through 3
5 The portion of total - =contributions by each person(other than a governmentalunit or publicly supportedorganization) included on line 1that exceeds 2% of the amountshown on line 11, column (f)
6 Public support . Subtract line 5
r I I I 1 1, 1from line 4
Calendar year (or fiscal yearbeginning in)
7 Amounts from line 4
(a) 2011 1 (b) 2012 (c) 2013 1 (d) 2014 1 (e) 2015 (f) Total
8 Gross income from interest,dividends, payments receivedon securities loans, rents,royalties and income fromsimilar sources
9 Net income from unrelatedbusiness activities , whether ornot the business is regularlycarried on
10 Other income Do not includegain or loss from the sale ofcapital assets (Explain inPart VI )
11 Total su pport . Add lines 7through 10
12 Gross receipts from related activities, etc (see instructions) 12
13 First five years . If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3)organization, check this box and stop here No.
Section C . Computation of Public Su pport Percentage14 Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) 14 %
15 Public support percentage from 2014 Schedule A, Part II, line 14 15 %
16a 33-113% support test - 2015 . If the organization did not check the box on line 13, and line 14 is 33-1/3% or more, check this box qand stop here . The organization qualifies as a publicly supported organization ►
b 33-1/3% support test - 2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33-1/3% or more, check this box q
and stop here . The organization qualifies as a publicly supported organization ►
17a 10%-facts-and -circumstances test - 2015 . If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10%or more, and if the organization meets the 'facts-and-circumstances' test, check this box and stop here . Explain in Part VI how qthe organization meets the 'facts-and-circumstances' test The organization qualifies as a publicly supported organization ►
b 10%-facts-and -circumstances test - 2014 . If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10%or more, and if the organization meets the 'facts-and-circumstances' test, check this box and stop here . Explain in Part VI how the ►organization meets the 'facts-and-circumstances' test The organization qualifies as a publicly supported organization
18 Private foundation . If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions ► HBAA Schedule A (Form 990 or 990-EZ) 2015
TEEA0402L 10/12/15
Schedule A (Form 990 or 990-EZ) 2015 2 BIG HEARTS FOUNDATION 20-1580312 Page 3
Part III Support Schedule for Organizations Described in Section 509(aX2)(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II If the organization fails
to qualify under the tests listed below, please complete Part II )
Section A. Public SuooortCalendar year (or fiscal year beginning in) - (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
1 Gifts, grants, contributionsand membership feesreceived (Do not includeany 'unusual grants ' ) 12 , 203. 81095. 6 957. 7,483. 1976. 36 , 714.
2 Gross receipts from admis-sions, merchandise sold orservices performed, or facilitiesfurnished in any activity that isrelated to the organization'stax-exempt purpose 0.
3 Gross receipts from activitiesthat are not an unrelated tradeor business under section 513. 13,005. 18,242. 14,401. 9,180. 17,660. 72,488.
4 Tax revenues levied for theorganization's benefit andeither paid to or expended onits behalf 0.
5 The value of services orfacilities furnished by agovernmental unit to the
0organization without charge .
6 Total . Add lines 1 through 5 25,208. 26,337. 21,358. 16,663. 19,636. 109,202.7a Amounts included on lines 1,
2, and 3 received fromdisqualified persons 0. 0. 0. 0. 0. 0.
b Amounts included on lines 2and 3 received from other thandisqualified persons thatexceed the greater of $5,000 orI% of the amount on line 13for the year 0. 0. 0 . 0 . 0 . 0.
c Add lines 7a and 7b 0. 0. 0. 0. 0. 0.
8 Public support . (Subtract line7c fromline6) 109,202.
Section B. Total Su pportCalendar year ( or fiscal year beginning in)
9 Amounts from line 6
10a Gross income from interest, dividends,payments received on securities loans,rents, royalties and income fromsimilar sources
b Unrelated business taxableincome (less section 511taxes) from businessesacquired after June 30, 1975
c Add lines 10a and 10b
11 Net income from unrelated businessactivities not included in line 10b,whether or not the business isregularly carried on
12 Other income Do not includegain or loss from the sale ofcapital assets (Explain inPart VI )
13 Total support . (Add lines 9,1 Oc, 11, and 12 )
(a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
25 , 208. 26 , 337. 21 , 358. 161663. 19 636. 109 202.
428. 266. 110. 119. 124. 1 , 047.
0.428. 266. 110. 119. 124. 1 , 047.
0.
0.
25,636. 26,603. 21,468. 16,782. 19,760. 110,249.14 First five years . If the Form 990 is for the organization ' s first, second , third, fourth, or fifth tax year as a section 501 (c)(3)
organization , check this box and stop here IN.
Section C . Computation of Public Support Percentage15 Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) 15 99.05 %
16 Public support percentage from 201 4 Sc hedu l e A, Part III, line 15 16 98.57 %
Section D. Computation of Investment Income Percentage17 Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) 17 0.95 %
18 Investment income percentage from 2014 Schedule A, Part III, line 17 18 1.43 %
19a 33-113% support tests - 2015 . If the organization did not check the box on line 14, and line 15 is more than 33-1/3%, and line 17
is not more than 33-1/3%, check this box and stop here . The organization qualifies as a publicly supported organization Bo- XX
b 33-1/3% support tests - 2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33-1/3%, andline 18 is not more than 33-1/3%, check this box and stop here . The organization qualifies as a publicly supported organization
po. H20 Private foundation . If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
BAA TEEA0403L 10112/15 Schedule A (Form 990 or 990-EZ) 2015
Schedule A (Form 990 or 990-EZ) 2015 2 BIG HEARTS FOUNDATION 20-1580312 Page 4
Part IV Supporting Organizations(Complete only if you checked a box in line 11 on Part I. If you checked 11 a of Part I, complete SectionsA and B. If you checked 11 b of Part I, complete Sections A and C. If you checked 11 c of Part I, completeSections A, D, and E. If you checked 11 d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting OrganizationsYes No
1 Are all of the organization's supported organizations listed by name in the organization's governing documents' aY4If 'No,' describe in Part VI how the supported organizations are designated If designated by class or purpose, describe -the designation. If historic and continuing relationship, explain 1
2 Did the organization have any supported organization that does not have an IRS determination of status under section509(a)(1) or (2)v If 'Yes,' explain in Part VI how the organization determined that the supported organization was - ^tdescribed in section 509(a)(1) or (2) 2
3 a Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If 'Yes,' answer (b)and (c) below 3a
ay x .
b Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) andsatisfied the public support tests under section 509(a)(2)? If 'Yes,' describe in Part VI when and how the organizationmade the determination 3b
c Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B)purposes? If 'Yes,' explain in Part VI what controls the organization put in place to ensure such use 3c
4a Was any supported organization not organized in the United States ('foreign supported organization')? If 'Yes' andIf you checked 1 I a or I 1 b in Part 1, answer (b) and (c) below 4a
b Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported"organization? If 'Yes,' describe in Part VI how the organization had such control and discretion despite being controlled - -
or supervised by or in connection with its supported organizations 4b
c Did the organization support any foreign supported organization that does not have an IRS determination under*^ A L"
sections 501(c)(3) and 509(a)(1) or (2)' If 'Yes,' explain in Part VI what controls the organization used to ensure that -all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes 4c
? ' ' answer (b)If Yes,5 a Did the organization add, substitute, or remove any supported organizations during the tax year , yand (c) below (if applicable) Also, provide detail in Part Vl, including (Q the names and EIN numbers of the supported 'organizations added, substituted, or removed; (n) the reasons for each such action, (III) the authority under the r = _organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as byamendment to the organizing document) 5a
b Type I or Type II only. Was any added or substituted supported organization part of a class already designated in theorganizations organizing document? 5b
c Substitutions only. Was the substitution the result of an event beyond the organization's control? 5c
6 Did the organization provide support (whether in the form of grants or the provision of services or facilities) toanyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one Vor more of its supported organizations, or (in) other supporting organizations that also support or benefit one or more ofthe filing organization's supported organizations? If 'Yes,' provide detail in Part V1 6
l l t bth t t b t t tl t coner simi ar paymen an ia ri oroan, compensa ion, or o o a su s u7 Did the organization provide a grant, ,:3(defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with _ >
regard to a substantial contributor? If 'Yes,' complete Part I of Schedule L (Form 990 or 990-EZ) 7
8 Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If 'Yes,'complete Part I of Schedule L (Form 990 or 990-EZ) 8
9a Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified personsas defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))'If 'Yes,' provide detail in Part V1 9a
b Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which thesupporting organization had an interest? If 'Yes,' provide detail in Part VI 9b
c Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, -V°` -J-assets in which the supporting organization also had an interest? If 'Yes,' provide detail in Part V1 9c
10 a Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding Kcertain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If 'Yes,' - ^ ix"answer 10b below 10a
b Did the organization, have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determinewhether the organization had excess business holdings) 10b
BAA TEEAoaoai 10/12/15 Schedule A (Form 990 or 990-EZ) 2015
Schedule A (Form 990 or 990-EZ) 2015 2 BIG HEARTS FOUNDATION 20-1580312 Page 5
Part.IV Supporting Organizations continuedYes No
11 Has the organization accepted a gift or contribution from any of the following persons?
a A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the -governing body of a supported organization' 11a
b A family member of a person described in (a) above' 11b
c A 35% controlled entity of a person described in (a) or (b) above? If 'Yes' to a, b, or c, provide detail in Part VI 11c
Section B. Type I Supporting OrganizationsYes No
1 Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appointor elect at least a majority of the organization's directors or trustees at all times during the tax
year? If 'No,' describe in
Part VI how the su erated ervisedortedY anization(s) effectivel o su or controlled the or anization's activitiesor' 2 e
y p , p , gpp gIf the organization had more than one supported organization, describe how the powers to appoint and/or removedirectors or trustees were allocated among the supported organizations and what conditions or restrictions, If any,applied to such powers during the tax year 1
2 Did the organization operate for the benefit of any supported organization other than the supported organization(s)' ' 'Yes, explain In Part VI how providing suchthat operated, supervised, or controlled the supporting organization? If --
benefit carried out the purposes of the supported organization(s) that operated, supervised, or controlled thesupporting organization 2
Section C. Type II Supporting OrganizationsYes No
1 Were a majority of the organization's directors or trustees during the tax year also a majority of the directors or trusteesof each of the organization's supported organization(s)' If 'No,' describe In Part VI how control or management of the - -supporting organization was vested in the same persons that controlled or managed the supported organization(s) 1
Section D. All Type III Supporting OrganizationsYes No
1 Did the organization provide to each of its supported organizations, by the last day of the fifth month of theorganization's tax year, (i) a written notice describing the type and amount of support provided during the prior tax
> > ,.
t
;i
-05
fez
a`
year, (n) a copy of the Form 990 that was most recently filed as of the date of notification, and (in) copies of theorganization's governing documents in effect on the date of notification, to the extent not previously provided? 1
' ° °^s officers, directors, or trustees either (i) appointed or elected by the supported2 Were any of the organizationanization' If 'No ' ex lain in Part VI howf rtedth b d(it
- • _pe governing org ,ii) serving on o y o a suppoorganiza ion(s) or
the organization maintained a close and continuous working relationship with the supported organization(s) 2" F a
3 By reason of the relationship described in (2), did the organization's supported organizations have a significantvoice in the organization's investment policies and in directing the use of the organization's income or assets atall times during the tax year? If 'Yes,' describe in Part VI the role the organization's supported organizations playedIn this regard 3
Section E. Type III Functionally-Integrated Supporting Organizations
1 Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a F1 The organization satisfied the Activities Test Complete line 2 below
b The organization is the parent of each of its supported organizations Complete line 3 below
c El The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)
2 Activities Test Answer (a) and (b) below. Yes No
a Did substantially all of the organization's activities during the tax year directly further the exempt purposes of thesupported organization(s) to which the organization was responsive? If 'Yes,' then in Part Vl identify those supportedorganizations and explain how these activities directly furthered their exempt purposes, how the organization wasresponsive to those supported organizations, and how the organization determined that these activities constitutedsubstantially all of its activities 2a
b Did the activities described in (a) constitute activities that, but for the organization's involvement, one or more of' 'Yes, explain in Part VI the reasons forthe organization's supported organization(s) would have been engaged in? If
the organization's position that its supported organization(s) would have engaged in these activities but for theorganization's involvement 2b
3 Parent of Supported Organizations Answer (a) and (b) below.
directors or trustees ofa Did the organization have the power to regularly appoint or elect a majority of the officers '•'s, ,each of the supported organizations? Provide details in Part V1 3a
b Did the organization exercise a substantial degree of direction over the policies, programs, and activities of each of itssupported organizations? If 'Yes,' describe in Part VI the role played by the organization in this regard 3b
BAA TEEA0405L 10/12/15 Schedule A (Form 990 or 990-EZ) 2015
Schedule A (Form 990 or 990-EZ) 2015 2 BIG HEARTS FOUNDATION 20-1580312 Page 6
Part W Type III Non-Functionally Integrated 509(aX3) Supporting Organizations
1 [] Check here if the organization satisfied the Integral Part Test as a qualifying trust on November 20, 1970 See instructions. Allother Type III non-functionally integrated supporting organizations must complete Sections A through E
Section A - Adjusted Net Income (A) Prior Year (B)(optional)ear
1 Net short-term capital gain 1
2 Recoveries of prior-year distributions 2
3 Other gross income (see instructions) 3
4 Add lines 1 through 3 4
5 Depreciation and depletion 5
6 Portion of operating expenses paid or incurred for production or collection of grossincome or for management, conservation, or maintenance of property held forproduction of income (see instructions) 6
7 Other expenses (see instructions) 7
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for shortax year or assets held for part of year)
t
a Average monthly value of securities la
b Average monthly cash balances lb
c Fair market value of other non-exempt-use assets lc
d Total (add lines 1a, 1b, and 1c) 1d
e Discount claimed for blockage or otherfactors (explain in detail in Part VI )
,'`"'
2 Acquisition indebtedness applicable to non-exempt-use assets 2
3 Subtract line 2 from line ld 3
4 Cash deemed held for exempt use Enter 1-1/2% of line 3 (for greater amount,see instructions) 4
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5
6 Multiply line 5 by 035 6
7 Recoveries of prior-year distributions 7
8 Minimum Asset Amount (add line 7 to line 6) 8
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1 g"
2 Enter 85% of line 1 2 <. ..
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3
4 Enter greater of line 2 or line 3 4
5 Income tax imposed in prior year 5 .%
6 Distributable Amount . Subtract line 5 from line 4, unless subject to emergencytemporary reduction (see instructions) 6
7 [] Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization(see instructions)
BAA Schedule A (Form 990 or 990-EZ) 2015
TEEA0406L 10/12/15
Schedule A (Form 990 or 990-EZ) 2015 2 BIG HEARTS FOUNDATION 20-1580312 Page 7
Part V Tvbe III Non-Functionally Intearated 509(a)(3) SuDoortina Oraanizations (continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations,in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI ) See instructions
7 Total annual distributions . Add lines 1 through 6
8 Distributions to attentive supported organizations to which the organization is responsive (provide detailsin Part VI ). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount
Section E - Distribution Allocations (see instructions) ExcessDistributions
UnderdistributionsPre-2015
DistributableAmount for 2015
1 Distributab le amount for 2015 from Section C, line 6
2 Underdistrlbutions, if any, for years prior to 2015 (reasonablecause required - see instructions)
3 Excess distributions carryover, if any, to 2015
a
bca 3.x ^.
dFrom 2013
e From 2014
f Total of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder Subtract lines 3g, 3h, and 3i from 3f
4 Distributions for 2015 from Section D,line 7 $ Jt^
a Applied to underdistnbutions of prior years
b Applied to 2015 distributable amount
c Remainder Subtract lines 4a and 4b from 4 A
5 Remaining underdistributions for years prior to 2015, if anySubtract lines 3g and 4a from line 2 (if amount greater thanzero, see instructions) -
6 Remaining underdistnbutions for 2015 Subtract lines 3h and 4bfrom line 1 (if amount greater than zero, see in structio ns)
7 Excess distributions carryover to 2016. Add lines 3j and 4c
8 Breakdown of line 7ab -
c Excess from 2013 -
d Excess from 2014
e Excess from 2015 -
BAA Schedule A (Form 990 or 990-EZ) 2015
TEEA0407L 10/12/15
Schedule A (Form 990 or 990-EZ) 2015 2 BIG HEARTS FOUNDATION 20-Part .V1 Supplemental Information . Provide the ex p lanations required by Part II, line 10; Part II, line 17a or 17b;Part III, line 12; Part IV,
Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11 a, 11 b, and 11 c; Part IV, Section B, lines 1 and 2, Part IV, Section C, line 1;Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line le; Part V,Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information.(See instructions.)
BAA TEEAo4o8L 10/12/15 Schedule A (Form 990 or 990-EZ) 2015
Supplemental Information Regarding Fundraising or Gaming ActivitiesSCHEDULE ,G Complete if the organization answered 'Yes' on Form 990, Part IV , lines 17 , 18, or 19 , or if the(Form 990 or 990-EZ) organization entered more than $15 , 000 on Form 990 - EZ, line 6a.
Department of the Treasury' Attach to Form 990 or Form 990-EZ
Internal Revenue Service ► Information about Schedule G (Form 990 or 990-EZ ) and its instructions is at www.irs.gov/form990.
OMB No 1545-0047
2015DpentoPubIic.•'^.Inspection = t
Name of the organization Employer identification number
2 BIG HEARTS FOUNDATION 20-1580312
Part IFundraising Activities . Complete if the organization answered 'Yes' on Form 990, Part IV, line 17Form 990-EZ filers are not required to complete this part
1 Indicate whether the organization raised funds through any of the following activities Check all that apply
a Mail solicitations e Solicitation of non-government grants
b Internet and email solicitations f r] Solicitation of government grants
c Phone solicitations g R Special fundraising events
d F] In-person solicitations
2 a Did the organization have a written or oral agreement with any individual (including officers , directors, trustees or keyemployees listed in Form 990, Part VII) or entity in connection with professional fundraising services? []Yes No
b If 'Yes,' list the ten highest paid individuals or entities (fundraisers ) pursuant to agreements under which the fundraiser is to becompensated at least $5,000 by the organization
(i) Name and address of individualor entity (fundraiser)
(ii) Activity (ill) Did fundraiserhave custody or control
of contrlbutlons7
(iv) Gross receiptsfrom activity
(v) Amount paid to( or retained by)
fundraiser listed incolumn (i)
(vi) Amount paid to(or retained by)organization
Yes No
1
2
3
4
5
6
7
8
9
10
Total
3 List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registrationor licensing
BAA For Paperwork Reduction Act Notice , see the Instructions for Form 990 or 990-EZ. Schedule G (Form 990 or 990-EZ) 2015TEEA3701L 12/02/15
Schedule G (Form 990 or 990-EZ) 2015 2 BIG HEARTS FOUNDATION 20-1580312 Page 2
Part u, Fundraisin g Events . Complete if the organization answered 'Yes' on Form 990, Part IV, line 18, or reportedmore than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b.List events with gross receipts greater than $5,000.
(a) Event #1 (b) Event #2 (c) Other events (d) Total events
5K RUN None(add column (a)
through column (c))RE
(event type ) (event type ) (total number)
V
N 1 Gross receipts 17, 660. 17,660.uE
2 Less Contributions
3 Gross income (line 1 minus line 2) 17 , 660. 17 , 660.
4 Cash prizes
5 Noncash prizesD
R 6 Rent/facility costsECT 7 Food and beverages
E
XP 8 EntertainmentEN
9 Other direct expenses 8 , 426. 1 8 , 426.Es
10 Direct expense summary Add lines 4 through 9 in column (d) 8 , 426.11 Net income summary Subtract line 10 from line 3, column (d) 9,234.
Part, 111' Gaming . Complete if the organization answered 'Yes' on Form 990, Part IV, line 19, or reported more than$15,000 on Form 990-EZ, line 6a.
(a) Bingo (b) Pull tabs/Instant (c) Other gaming (d) Total gamingRbingo/progressive (add column (a)
v bingo through column (c))ENU
E 1 Gross revenue
2 Cash prizesE
D XI PR E
3 Noncash prizesE NC 5T E
s4 Rent/facility costs
5 Other direct expenses
Yes % Yes % Yes %
6 Volunteer labor No H No No
7 Direct expense summary Add lines 2 through 5 in column (d)
8 Net gaming income summary Subtract line 7 from line 1, column (d)
9 Enter the state (s) in which the organization conducts gaming activities
a Is the organization licensed to conduct gaming activities in each of these states? F] YesF1
No
b If 'No,' explain---------------------------------------------------------
-----------------------------------------------------------------
----------------------------------------------------------------10a Were any of the organization ' s gaming licenses revoked, suspended or terminated during the tax year? n Yes
F]No
b If 'Yes,' explain---------------------------------------------------------
-----------------------------------------------------------------
BAA TEEA3702L 06/02115 Schedule G (Form 990 or 990 -EZ) 2015
Schedule G (Form 990 or 990-EZ) 2015 2 BIG HEARTS FOUNDATION 20-1580312 Page 3
11 Does the organization conduct gaming activities with nonmembers' Yes No
12 Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity formed toadminister charitable gaming? F]Yes n No
13 Indicate the percentage of gaming activity conducted in
a The organization's facility 13a %
bAn outside facility 13b %
14 Enter the name and address of the person who prepares the organization's gaming/special events books and records
Name 11-------------------------------------------------------------
Address 11-----------------------------------------------------------
15a Does the organization have a contract with a third party from whom the organization receives gaming revenue? E Yes LI No
b If 'Yes ,' enter the amount of gaming revenue received by the organizations $ and the amount-----------
of gaming revenue retained by the third party' $-----------
c If 'Yes,' enter name and address of the third party
Name 11 ------------------------------------------------------------
Address-----------------------------------------------------------
16 Gaming manager information
Name 11-------------------------------------------------------------
Gaming manager compensation $
Description of services provided------------------------------------------------
R Director/ officer Employee Independent contractor
17 Mandatory distributions
a Is the organization required under state law to make charitable distributions from the gaming proceeds to retain thestate gaming license? F] Yes No
rt IV' Supplemental Information . Provide the explanations required by Part I, line 2b, columns (III) and (v);and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additionalinformation (see instructions).
b Enter the amount of distributions required under state law to be distributed to other exempt organizations or spent in the
organization's own exempt activities during the tax year 11 $
BAA TEEA3703L 06/02/15 Schedule G (Form 990 or 990-EZ) 2015
111
SCHEDULE 0 Supplemental Information to Form 990 or 990-EZ(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.Attach to Form 990 or 990-EZ.
Department of the Treasury ► Information about Schedule 0 (Form 990 or 990-EZ) and its instructions isI nternal Revenue Service at www. irs.gov/form990.
OMB No 1545-0047
1 2015
Name of the organization Employer identification number
2 BIG HEARTS FOUNDATION 20-1580312
Form 990-EZ, Part I , Line 16Other Expenses
LICENSE AND FEES $ 10.Office Expenses 137.SCREENINGS 1,439.WEBSITE DEVELOPMENT 937.
Total 2,523.
Form 990- EZ, Part III - Organization 's Primary Exempt Purpose
2 BIG HEARTS FOUNDATION HEIGHTENS AWARENESS OF HEART DISEASE AMONG WOMEN BY
COMMUNICATING THE TRAGIC STORY OF GIGI CLARKE AND SALLY CZECHANSKI AND BY WORKING
WITH THE HEALTHCARE COMMUNITY TO EDUCATE INDIVDUALS AND FAMILIES ABOUT THE CAUSES
AND PREVENTION OF HEART DISEASE IN WOMEN.
Form 990 -EZ, Part III, Line 28 - Statement of Program Service Accomplishments
2 BIG HEARTS FOUNDATION HEIGHTENS AWARENESS OF HEART DISEASE AMONG WOMEN BY
COMMUNICATING THE TRAGIC STORY OF GIGI CLARKE AND SALLY CZECHANSKI AND BY WORKING
WITH THE HEALTHCARE COMMUNITY TO EDUCATE INDIVIDUALS AND FAMILIES ABOUT THE CAUSES
AND PREVENTION OF HEART DISEASE IN WOMEN.
Form 990-EZ, Part V - Regarding Transfers Associated with Personal Benefit Contracts
(a) Did the organization, during the year, receive any funds, directly or
indirectly, to pay premiums on a personal benefit contract? No
(b) Did the organization, during the year, pay premiums, directly or
indirectly, on a personal benefit contract? No
BAA For Paperwork Reduction Act Notice , see the Instructions for Form 990 or 990 -EZ TEEA4901L 10/12/15 Schedule 0 (Form 990 or 990-EZ) (2015)
