Via the Heimlich Institute's 2011 IRS 990, the nonprofit has total assets of $1000

8/3/2019 Via the Heimlich Institute's 2011 IRS 990, the nonprofit has total assets of $1000

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l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93491174002002

Form990 PF Return o f P r i v a t e Foundation OMB No 1545-0052or Section 4947 a) 1) Nonexempt Charitable TrustTreated as a Private Foundation 2 0 1 1e p a r t m e n t o f th eI n t e r n a l

Revenue S e r v i c eT r e a s u r y Note . Th e foundation may be able to us e a copy o f t h i s r e t u r n t o s a t i s f y s t a te r e po r ti n g requirementsI n t e r n a l

For calendar year 2011, or tax year beginning 01-01-2011 and ending 12-31-2011G Check a l l that apply r Initial return r Initial return o f a former public charity r Final return

r-Amended return (Address change Name changeName o f foundation A Employer identification numberTHE HEIMLICH INSTITUTE FOUNDATIONC /O P AT RI C K I WARD TRUSTEE 23-7303161

Number an d s t r e e t o r P 0 bo x number i f mail i s not delivered to s t r e e t address) Room/suite U ieiepnone number s ee page 1u o f the i n s t r u c t i o n s311 STRAIGHT STR T 513) 559-2391

C i t y or town, s t a t e , an d ZI P code C I f ex em ptio n a p p l i c a t i o n i s pending, check here CINCINNATI, OH 45219 D 1 . Foreign o r g a n i z a t i o n s , check here H C heck type o f organization ection 501 c) 3) exempt private foundation

2 . Foreign organizations meeting the 85 t e s t , r-Section 4947 a) 1) nonexempt charitable trust r'Other taxable private foundation c h e c k h e r e an d a t t a c h c o m p u t a t i o n

I Fair ma rke t value o f a l l assets a t end J Acco un t i ng method Cash ccrual E I f p r i v a t e foundation s t a t u s was terminatedd 507 b 1 A h k h 0 - o f y e a r from P a r t 7 7 , c o l . c , Other specify) un e r s e c ti o n , c ec er eline 16)x 1,000

_Part I column d ) must be on cash basis.) F I f the foundation i s i n a 60-mon th termination under s e c t i o n 507 b 1 B, check here 0 -

Analysis of Revenue and Expenses T h e a Reve n ue an d d) Disbursementst o t a l of a m o u n t s i n co lu m ns b , c , a nd d may no t ex penses pe r b ) Ne t investment c Adjusted ne t f o r c h a r i t a b l en e ce s s an l y e qual the a m o u n t s i n column a se e p age 11 of books income income purposesthe i n s t r u c t i o n s cash b a si s o n ly1 C o n t r i b u t i o n s , g i f t s , g ra n t s , e t c received attach schedule) 3,7952 Check f the foundation i s n ot r e q u i r e d t o attach Sch B3 I nt er es t o n s avi n gs a n d t e mp or ar y c as h inves tm ents 259 2434 Dividends and interest from secu rities. . . 335 3355a Gross rents b Ne t r e n t a l i nco me or loss)

q } 6a Ne t ga in o r loss) from sale o f assets no t on l i n e 10 1,452

7 5 b Gross s a l e s p r i c e f o r a l l assets on l i n e 6a 66,8137 Capital ga in n et i nco me from Pa rt I V, l i n e 2) 1 , 4 5 28 Ne t short-term capital gain 9 Income modifications


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Form 990 PF 2011) Panes Attached s chedu l es an d amounts i n th e d e s c r i p t i o n column Beginning o f year End o f yearBalance Sheets s hou ld b e f o r end-of - ea r amounts o n l Se e i n s t r u c t i o n s B k V b B k V F M k Vy a ) oo a ue oo a ue c ) ai r ar e t a ue

1 Cash non interest bearing 99,232 1,000 1,0002 Savings a nd t e mp or a ry c a s h investments . . . . . . .3 Accounts receivable

Less allowance f o r doubtful accoun ts O i l 3 5 , 5 4 3 Ple d g e s receivable

L es s a ll owa nc e f o r doubtful accoun ts O i l5 Grants receivable . . . . . . . . . . . . . .6 Re ce i va b le s d u e from o f f i c e r s , directors, trustees, a nd other

disqualified persons attach s c h e d ul e) se e page 15 o f th einstructions) . . . . . . . . . . . . . . . . .

7 Other notes a nd loans receivable attach s c h e d ul e) I l kLess allowance f o r doubtful accoun ts O i l

8 Inventories f o r sale or us e . . . . . . . . . . . .9 Prepaid expense s a nd deferred charg es .

10a Investments U S a nd state government obligations attach s c h e d ul e)b Inve stment s-corpora t e stock attach s c h e d ul e) . . . . .c Inve stment s-corpora t e bonds attach schedule). . . . .

11 Inve stment s-land, buildings, a nd e q uipment basis O i lLess a c c umula t e d d epr e c i at i on a t ta c h s c h e d ul e)

12 Investments mortgage loans . . . . . . . . . . .13 Investments other attach s c h e d ul e) . . . . . . . .14 Land, buildings, a nd e q uipment basis O i l

Less a c c umula t e d depreciation attach s c h e d ul e) 15 Other assets d e s c r i b e 51,427 0 016 Total a ss e t s t o be compl eted by a l l filers-see the

instructions Also, see page 1, i t e m I ) 186,202 1,000 1,00017 Accounts pa ya b le a n d accru ed expense s . . . . . . . 3,57618 Gra nt s payabl e . . . . . . . . . . . . . . . .19 Deferred revenue . . . . . . . . . . . . . . .20 Loa ns from o f f i c e r s , directors, trustees, a nd other disqualified persons

u 21 Mort ga ge s and ot h er n ot e s payable attach s c h e d ul e)22 Ot h e r l i a b i l i t i e s describe 1,629 0


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Form 990-PF 2011) Page 3Ca ital Gains and Losses for Tax on Investment Income

a ) L i s t a nd describe t h e k i nd s ) o f property sold e g r e a l estate,2-story brick warehouse, or common stock, 200 sh s MLC Co

b) How acquiredP-PurchaseD-Donation

c Date acquiredmo day, yr

d ) Da t e soldmo day, yr

la JOHNSON INVESTMENTS Pb JOHNSON INVESTMENTS Pc CAPITAL GAINS DIVIDENDS Pde

e) Gross sales price f Depreciation allowed o r allowable)g ) Cost or o t he r b as isplus expense o f sale

h ) Gain o r l os s) e plus f minus g

a 20,271 20,338 -6 7b 46,320 45,023 1,297c 222 222deComplete only f o r assets showing gain i n column h a nd owned by the founda t i o n on 12/31/69 I Gains Co l h gain minus i F M V as o f 12/31/69 j Adjusted basisas o f 12/31/69

k ) Excess o f c o l iover c o l j , i a ny

c o l k , b ut no t less than - 0- ) o rLosses from c o l h

a -67b 1,297c 222de

2I f gain, also enter Part I , l i n e 7

Capital g ai n net income o r net capital loss) I f l o s s , enter -0- i n Part I , l i n e 7 2 1,4523 Ne t short-term capital g ai n or loss) a s d efi ne d i n sections 1222 5) a nd 6)

I f gain, also enter Part I , l i n e 8 , co lumn c se e p a g es 13 a nd 17 o f the instructions)I f l o s s , enter -0- Part I , l i n e 8 3ualification Under Section 4940 e) for Reduced Tax on Net Investment Income

For o p ti ona l us e by domestic private foundations subject t o the section 4940 a) tax on ne t investment income f section 4940 d) 2) applies, leave t h i s part blank

Was the foundation l ia b l e f or th e section 4942 tax on the distributable amount o f a ny y ea r i n the base period? fl Ye s F NoI f Yes, the foundation does no t q u a l i f y under section 4940 e) Do no t complete t h i s part1 Enter the appropriate amount i n e a c h column f o r each year, see p a g e 18 o f t he i n st ruc t i ons before mak in g a ny entries


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Form 990-PF (2011) Page 4Mxcise Tax Based on Investment Income Section 4940 a ) , 4940(b), 4940(e), or 4948see page 18 of th e instructions)

la Exempt operating foundations described i n s e c t i o n 4940(d)(2), check here O i l F_ and enter N/A on l i n e 1Date o f r u l i ng or determination l e t t e r attach copy of letter i f necessary-seeinstructions)

b Domestic foundations that meet the section 4940(e) requirements i n Part V, check 1 20here Rand enter 1 o f Part I l i n e 27b

c A l l other domestic foundations enter 2 o f l i n e 27b Exempt f o r e i g n organizations enter 4 o f P a r t I l i n e 1 2 , co l b )2 Ta x under s e c t i o n 511 (domestic s e c t i o n 4947(a)(1) t r u s t s and taxable foundations only O ther s enter - 0 - ) 2 03 Add l i n e s 1 and 2 3 204 S u b t i t l e A (income) tax (domestic s e c t i o n 4947(a)(1) t r u s t s and taxable foundations only O ther s enter - 0 - ) 4 05 Tax based on investment income Subtract l i n e 4 from l i n e 3 I f zero or l e s s , enter -0- 5 206 Credits/Paymentsa 2011 estimated tax payments and 2010 overpayment credited t o 2011 6ab Exempt foreign organizations-tax withheld a t source 6bc Tax paid with application f o r extension o f time t o f i l e (Form 8868) 6cd Backup withholding erroneously withheld 6d7 Total credits and payments Add l i n e s 6a through 6d 7 08 Enter any penalty f o r underpayment o f estimated tax Check here f Form 2220 i s attached 89 T ax du e I f the t o ta l o f l i n es 5 and 8 i s more than l i n e 7 , enter amount owed 9 20

10 Overpayment I f l i n e 7 i s more than the t o ta l o f l i n es 5 and 8 , enter the amount overpaid. 1011 Enter the amount o f l i n e 10 t o be Credited to 2012 estimated tax O r Refunded 1 k 11

Statements Re g ardin g Activitiesla During t he t ax ye ar , d i d the foundation attempt t o influence any national, state, or l o c a l legislation or d i d Yes No

i t participate or intervene i n any p o l i t i c a l campaign la Nob Did i t s pe nd m or e than 100 during th e year (either directly or indirectly) f o r p o l it i ca l purposes (see page 19 o f

the instructions f o r definition)? lb NoI f th e answer is Yes t o la o r 1b, attach a detailed description o f the a c t i v i t i e s and copies o f any materialspublished or distributed by th e foundation i n connection w it h t he a c t i v i t i e s .

c Di d the foundation f i l e Form 1120-POL f o r t h i s year? 1c Nod Enter th e amount i f any) o f tax on p o l i t i c a l expenditures (section 4955) imposed during the year

(1) O n th e foundation 0 (2) O n foundation managers I k 0e Ente r th e r eimbur sement i f any) paid by th e foundation during the year f o r p o l it i ca l expenditure tax imposed

on foundation managers 02 Has the foundation engaged i n any activities that have not previously been reported t o the IRS? 2 No

I f Yes, attach a detailed description o f th e a c t i v i t i e s .


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Form 990-PF 2011) Page 6Statements Regarding Activities for Which Form 472 May Be Req uired continued)

5a During the year d i d th e foundation pa y or i nc ur any amount t o1) Carry on propaganda, or otherwise attempt t o influence legislation section 4945 e))? fl Yes No2) Influence the outcome o f any specific public election se e s ec t io n 4955), or t o carry

on, directly or i n d i r e c t l y , any voter registration drive? fl Yes No3) Provide a grant t o an individual f o r t r a v e l , study, or other similar purposes? Yes No4) Provide a grant t o a n o rg an iz at io n o t he r t h a n a charitable, etc organization described

i n section 509 a) 1), 2 , or 3 , or section 4940 d) 2)? s ee pa ge 22 o f the instructions). - Yes No5) Provide f o r any purpose o th er t ha n r e l i g i o u s , charitable, s c i e n t i f i c , l i t e r a r y , or

educational purposes, or f o r th e prevention o f cruelty t o children or animals?. . - Yes Nob I f any answer i s Yes t o 5a 1 )- 5 d i d any o f the transactions f a i l t o q u a l i f y under the e x ce p ti o ns d e sc r ib e d

Regulations section 5 3 4945 or i n a current notice regarding disaster assistance s ee page 22 o f the instructions)? 5bOrganizations relying on a current notice regarding disaster assistance c h e c k here. -

c I f the answer i s Yes t o question 5a 4), does th e foun dati on c l aim ex emptio n from thetax b e c a u s e i t maint a ine d e xpe ndit ure responsibility f o r the grant?. Yes - NoI f Yes, attach the statement required b y Regulations section 53.4945-5 d).

6a Di d the foundation, during t h e ye ar , receive any funds, directly or i n d i r e c t l y , t o pa ypremiums on a personal benefit contract? fl Yes No

b Did the foundation, during t h e ye ar , pa y premiums, directly or i n d i r e c t l y , on a personal benefit contract? 6b NoI f Yes to 6 b , f i l e Form 8870.

7a At any time during t he t ax ye ar, was th e foundation a party t o a p ro hibi ted ta x shelter transaction? Yes Nob I f y e s , d i d t h e foundation r e c e i v e any proceeds o r have any n e t income a t t r i b u t a b l e t o t h e transaction? 7b

Information About Offic e rs irectors Trustees, Foundation Managers, Hi gh l y P ai d Employees,and Contractors

1 L i s t a ll officers, directors, trustees foundation managers and their c ompensation s ee page 22 of t h e instructions).b ) T i t l e , and average c Compensation d) Contributions t o e) Expense account,a) Name and address hours pe r week I f no t paid, enter employee benefit plans other allowancesdevoted t o position 0 - and deferred c ompensation

HENRY HEIMLICH MD TRUSTEE 3,000 0 0311 STRAIGHT STREET 1 00CINCINNATI,OH 45219P H I L I P M HEIMLICH VICE CHAIRMAN 0 0 0311 STRAIGHT STREET 3 00CINCINNATI,OH 45219E ANTHONY WOODS CHAIRMAN 0 0 0311 STRAIGHT STREET 3 00CINCINNATI,OH 45219PATRICK WARD TRUSTEE 0 0 0


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Form 990-PF 2011) Page 7Information About Officers , Directors, Trustees , Foundation Managers Hig hl y Paid Employeesand Contractors continued)

3 Five highest - paid independent contractors for professional services see page 23 of th e instructions . I f none , enter NONE .a) Name and address o f each person paid more than 50 000 b ) Type o f service c ) Compensation

NONE

Total number o f o t h er s r e c e iv i n g over 50,000 f o r p r of e ss i on a l s e r v i c e s.Summary of Direct Charitable Activities

L i s t the foundation s four l a r g e s t d i r e c t c h a r i t a b l e a c t i v i t i e s during the tax year Include relevant s t a t i s t i c a l information such as th e number o forganizations and other b e n e f i c i a r i e s served, conferences convened, research papers produced, e t c

1EDUCATION OF THE GENERAL PUBLIC THE PRINTING AND DISTRIBUTION OF EDUCATIONLITERATURE TO PUBLIC PLACES ABOUT THE HEIMLICH M N UV R DISTRIBUTED APPROXIMATELY213 POSTERS TO THE PUBLIC

2

3

4

0

Expenses3,433

Summary of Pro g ram - Related Investments see p a g e 23 o f t h e i n s t r u c t i o n s Describe the tw o l a r g e s t program-related investments made b y the foundation during the tax y e ar o n l i n e s 1 and 2 A mount1


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Form 990-PF 2011 Pa g e 8Minimum Investment Return A l l domestic foundations must complete t h i s p a r t . Foreign foundations,see page 24 of the instructions.

1 Fair market value o f assets not used o r held f o r use directly i n ca rry in g out charitable, etc purposes

a Average monthly f a i r market value o f securities la 19,176b Average o f m o nt hly c a sh balances lb 66,704c Fair market value o f a l l other assets see pa ge 24 o f the instructions . 1c 0d T o ta l a dd l i n e s la, b , a nd c ld 85,880e Redu ction cla imed f o r blockage or other factors reported on l i n e s la a nd

1c attach detailed explanation . le 02 Acquisition indebtedness applicable t o l i n e 1 assets 2 03 Sub tra ct l i n e 2 from l i n e ld 3 85,8804 Cash deemed held f o r charitable activities Enter 1 1/2 o f l i n e 3 f o r greater amount, see pa ge 25

o f the instructions 4 1,2885 Ne t value of noncharitable use assets Subtract l i n e 4 from l i n e 3 Enter here a nd on Pa rt V , l i n e 4 5 84,5926 Minimum investment return Enter 5 o f l i n e 5 6 4 23

Distributable Amount see page 25 o f t h e i n s t r u c t i o n s Section 4942 j 3 and j 5 p r i v a t e operatingfoundations and c e r t a i n f or e i g n o r g a n i z a t i o n s check here fl and do n o t com p l e t e t h i s a r t .

1 Minimum investment return from Part X , l i n e 6 1 4 232a Tax on investment income f o r 2011 from Part VI, l i n e 5 . 2a 20b Income tax f o r 2011 This does no t include th e ta x from Part V I 2bc Add l i n e s 2a a nd 2b 2c 20

3 Distributable amount before adjustments Subtract l i n e 2c from l in e 1 . 3 4 214 Recoveries o f amounts treated as qualifying distributions 4 05 Add l i n e s 3 a nd 4 5 4 216 Deduction from distributable amount see pa ge 2 5 o f the instructions . 6 07 Distributable amount as a dj u st ed S ub tr a ct l i n e 6 from l i n e 5 Enter here a nd o n Pa rt XIII,

l i n e 1 7 4 21Qualifying Distributions see page 25 of the instructions

1 Amounts paid including administrative expenses t o accomplish charitable, etc purposesa Expenses, contributions, g i f t s , etc -total from Part I column d , l in e 26 . la 151,378b Program-related investments-total from Part IX-B lb 0

2 Amounts paid t o acquire assets used o r held f o r use directly c arryi ng out charitable, etc purposes 2


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Form 990-PF (2011) Page 9 Undistributed Income see p a g e 26 o f t h e i n s t r u ct i o n s

(a) (b) c (d)Corpus Years priorto 2010 2010 2011

1 Distributable amount f o r 2011 from Part XI , l i n e 7 4 , 2 1 02 Undistributed income, i a ny, a s o f th e en d o f 2011a Enter amount f o r 2010 only. 7,466b Total f o r p r i o r years _ _ _ 03 xcess distributions carryover, i any, t o 2011a From 2006. b From 2007. c From 2008. d From 2009. e From 2010. f Total o f l i n e s 3 a t hr ou gh e . o4 Qualifying distributions f o r 2011 from Part

X I I , line 4 151,378a Applied t o 2010, bu t n ot more than l i n e 2a 7,466b Applied t o undistributed income o f p r i o r years

(Election r eq ui re d- se e pa g e 2 6 o f the instructions) 0c Treated as distributions out o f corpus (Election

required-see p age 26 o f th e instructions). 0d Applied t o 2011 distributable amount. 4 , 2 1 0e Remaining amount distributed out o f corpus 1 3 9 , 7 0 25 xcess distributions carryover applied t o 2011 0 0

I f an amount appears i n column d , th esame amount must be shown i n column a .

6 Enter the n et tota l of each column a sindicated below:

a Corpus Add l i n e s 3 f , 4c , a nd 4 e Subtract l i n e 5 1 3 9 , 7 0 2b Prior years undistributed income Subtractl i n e b from l i n e 2b 0

c Enter th e amount o f p r i or years undistributedincome f o r which a notice o f deficiency h a sbeen issued, or on which th e section 4942 ata x h a s been previously assessed. 0

d Subtract l i n e 6c from l i n e 6 b T ax abl eamount-see page 27 o f the instructions 0

e Undistributed income f o r 2010 Subtract l i n e4a from l i n e 2a T a xable amount-see page 27o f the instructions 0f Undistributed income f o r 2011 Subtractl i n e s 4d a nd 5 from l i n e This amount mustbe distributed i n 2011. 0


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orm 990-PF 2011) Page 10 Private Operating Foundations see p a g e 27 of th e instructions and Part VII-A q uestion 9

la I f the foundation ha s received a r u l i n g or determination l e t t e r that i t i s a private operatingfoundation, and the r u l i n g i s effective f o r 2011, enter the date o f the r u l i n g .

b Check box t o indicate whether the organization i s a private operating foundation described i n section 4942 j) 3) or 4942 j) 5)2a Enter the lesser o f the adjusted ne t Tax year Prior 3 years e) Totalincome from Part I or the minimum a) 2011 b) 2010 c 2009 d) 2008investment return from Part X f o r e ach

year l i s t e d b 85 o f l i n e 2a c Qualifying distributions from Part XII,

line 4 for each year listed d Amounts i n c l u d e d i n l i n e 2c not used d i r e c t l y

f o r a c t i v e conduct o f exempt a c t i v i t i e s e Qualifying distributions made directly

f o r active conduct o f exempt activitiesSubtract l i n e 2d from l i n e 2c

3 omplete 3a, b , or c f o r thealternative test r e l i e d upon

a Assets alternative test-enter1) Value o f a l l assets 2) Value o f assets qualifying

under section 4942 j) 3) B) i)b Endowment alternative test- enter 2/3

o f minimum investment return shown i nPart X , l i n e 6 f o r e ac h y ea r l i s t e d .

c Support alternative test-enter1) Total support other th an g ro ss

investment income i n t e r e s t ,dividends, rents, paymentson securities loans section512 a) 5)), or royalties) 2) Support from general publicand 5 or more exempto rg aniz ations as provided i nsection 4942 j) 3) B) iii).

3) Largest amount o f supportfrom an exempt organization

4) Gross investment incomeSupplementary Information Complete this part only the organization had 5 , 000 or more i nassets at any time during the yearsee page 27 of the instructions.)

1 I n f or m at io n R eg a r di ng F o un d a ti o n M a na g e rs :a L i s t any managers o f the foundation who have contributed more than 2 o f the t o t a l contributions received by the foundationb efore t he close o f any ta x year but only i f they have contributed more than 5,000) S ee section 507 d) 2)


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Form 990-PF 2011 Page 11Supplementary Information continued

3 Grants and Contributions Paid During the Year or Approved fo r Future PaymentRecipient f recipient s an individual Foundationshow any relationship t o Purpose o f grant orany foundation manager status o contribution AmountName a nd a dd r es s home or business or substantial contributor recipient

a Paid during the yearTHE UNIVERSITY OF CINCINNATI N/A TAX EXEMPT TO SUPPORT BLOOD 115 000FOUNDATION RESEARCHPO BOX 19970CINCINNATI OH 45219DE ONESS HOSPITAL N/A TAX EXEMPT UNRESTRICTED 36 378311 STRAIGHT STREET CONTRIBUTIONCINCINNATI OH 45219

Total 3a 151 378b Approved f o r future payment

Total 3bForm 990 PF 2011


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orm 99 PF 2011) Page 12Analy sis of n ome - Producin g Activities

Enter gross amounts unless otherwise indicated Unrelated business income E xc lu de d b y s e c t i o n 5 1 2 , 5 1 3 , o r 514 e)Related or exempta ) b) c d function income

1 Program service revenue Bus in e ss c o d e Amount Exclusion c ode Amount Se e page 28 o fthe instructions abcdefg Fe es a nd c o ntr ac ts from government agencies

2 Membership dues and assessments3 I n t e r e s t on savings an d temporary cash investments 14 25 94 D iv id e nd s a n d interest from securities. 1 4 33 55 Ne t r e n t a l income or loss) from r e a l estate

a Debt-financed property. b No t debt-financed property.

6 Net r e n t a l income or l o s s from personal property7 Other investment income. 8 G ain or l o s s from s a l es o f assets other than inventory 18 1,4529 Ne t income or loss) from special events

10 Gross p r o f i t or loss) from sales o f inventory.11 Otherrevenue a

bcde F2 Subtotal Add columns b , d , and e . 0 2 , 0 4 6 0

13 Total Add l i n e 12, columns b , d , and e 1 3 2,046S ee worksheet n l i n e 13 instructions on page 2 8 t o v e r i f y calc ulations

nshi p of Activities to the Accom p lishment of Exem p t Pur posesLine No Explain below how each activity f o r which income s reported n column e o f Part XVI A contributed importantly t othe accomplishment o f the organization s exempt purposes other than by provid ing fu nd s f o r such purposes) Se e

Daae 28 o f the instructions


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orm 990-PF (2011) age 13Information Regarding Transfers To and Transactions and Relationships WithNoncharitable Exempt Organizations

1 D i d the organization d i r e c t l y or i n d i r e c t l y engage i n any o f the f o l l o w i n g with any other organization described i n s e c t i o n Yes No501(c) o f the Code (other than s e c t i o n 501(c)(3) organizations) or i n s e c t i o n 527, r e la t in g t o p o l i t i c a l organizations?

a Transfers from the reporting foundation t o a noncharitable exempt organization o f(1) Cash la(1) No(2) Other assets la(2) No

b Other transactions(1) Sales o f assets t o a noncharitable exempt organization lb(1) No(2) Purchases o f assets from a noncharitable exempt organization lb(2) No(3) Rental o f f a c i l i t i e s , equipment, or other assets lb(3) No(4) Reimbursement arrangements lb(4) No(5) Loans or loan guarantees lb(5) No(6) Performance o f services or membership or fundraising solicitations lb(6) No

c Sharing o f f a c i l i t i e s , equipment, mailing l i s t s , other assets, or paid employees 1c Nod I f the answer t o any o f the above i s Yes, complete the following schedule Column (b) should alw ays show the f a i r market value

o f the goods, other assets, or services giv en b y the reporting foundation I f the foundation received less than f a i r ma rket valuei n any transaction or sharing arrangement, show i n column (d) the value o f the goods, other assets, or services rece ived

2a I s the foundation directly or indirectly a f f i l i a t e d w i t h , or related t o , one or more tax-exempt organizationsdescribed section 501 c o f the Code other than section 501 c)(3)) or i n section 527 7. fY es No


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dditional Data

Software IDSoftware Version

EIN 23 7303161Name THE HEIMLICH INSTITUTE FOUNDATION

C O PATRICK W R TRUSTEE

Form 990PF pecial Condition DescriptionSpecial C ondition Description


15/24

efile GRAPHIC p rint DO NOT PROCESS As Filed Data DLN: 9349 74 2 2

TY 2 Accounting Fe es ScheduleName THE HEIMLICH INSTITUTE FOUNDATION

C/O PATRICK WARD TRUSTEEEIN: 23 7303161

Category Amount Net Investment Adjusted Net Disbursements forIncome Income Charitable

Purposes OUNTING FEES 7 116


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TY 2 DissolutionStmt

Name THE HEIMLICH INSTITUTE FOUNDATIONC/O PATRICK WARD TRUSTEE

EIN: 23 7303161Dissolution Name Dissolution Address Expl an at ion Di ssol ut ion Amount

UNIVERSITY OF CINCINNATI FOUNDATION PO BO X 19970 CASH 115 000CINCINNATI OH 45219

DEACONESS HOSPITAL 311 STR I HT STREET ACCOUNTS RECEIVABLE 36 378CINCINNATI OH 45219


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efile GRAPHIC p rint DO NOT PROCESS As Filed Data DLN: 93491174002002

TY 2011 LiquidationExplanationStmt

Name THE HEIMLICH INSTITUTE FOUNDATIONC/O PATRICK J WARD TRUSTEE

EIN: 23-7303161Statement THIS STATEMENT I S SUBMITTED IN ACCORDANCE WITH REG.

1.6043-3(A)(1) AND FORM 990-PF GENERAL INSTRUCTION T TOREPORT THE DISTRIBUTION OF CASH THAT RESULTED IN ASUBSTANTIAL CONTRACTION OF ASSETS DURING THE CURRENTTAX YEAR. DURING 2011, THE HEIMLICH INSTITUTE FOUNDATION(HIF) MADE A DISTRIBUTED OF ASSETS FROM SOURCES OTHERTHAN CURRENT INCOME. SUCH DISTRIBUTION REPRESENTS 100OF HIF S NE T ASSETS OF 150,659 (AS MEASURED BY FAIRMARKET VALUE) AT THE BEGINNING OF 2010. INFORMATIONREGARDINGTHESE DISTRIBUTIONS RE AS FOLLOWS: NAME ANDADDRESS OF DISTRIBUTEES: UNIVERSITY OF CINCINNATIFOUNDATION P.O. BOX 19970 CINCINNATI, OH 45219 ASSETDISTRIBUTED: CASH DATE OF DISTRIBUTION: 7/11/11 FAIRMARKET VALUE OF DISTRIBUTION: 115,000 THE UNIVERSITY OFCINCINNATI FOUNDATION I S TAX EXEMPT UNDER IRC SEC. 501(C)(3)AND I S AN ORGANIZATION OPERATED FORTHE BENEFIT OF THEUNIVERSITY OF CINCINNATI, DESCRIBED IN SECTION 170(B)(1)(A) I I . I T I S NOT CONTROLLED (DIRECTLY OR INDIRECTLY) BY HIFOR ANY DISQUALIFIED PERSON WITH RESPECT TO H I F . THEDISTRIBUTION WAS MADE TO SUPPORT RESEARCH PROJECTS ATTHE HOXWORTH BLOOD CENTER. 2 . DEACONESS HOSPITAL 311STRAIGHT STREET CINCINNATI, OH 45219 ASSETS DISTRIBUTED:ACCOUNTS RECEIVABLE DATE OF DISTRIBUTION: 12/31/2011 FAIRMARKET OF DISTRIBUTION: S36,378.13 DEACONESS HOSPITAL I SEXEMPT FROM TAXES UNDER IRC SEC 501(C)(3)AND I S AHOSPITAL DESCRIBED I N SECTION 170(B)(1)(A)(III). I T I S NOTCONTROLLED (DIRECTLY OR INDIRECTLY) BY HIF ORANYISQU LIFE PERSONS WITH RESPECT TO H I F .


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TY 2 Legal Fe es ScheduleName THE HEIMLICH INSTITUTE FOUNDATION



PurposesLEGAL FEES 1 264


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efile GRAPHIC p rint DO NOT PROCESS As Filed Data DLN: 93491174002002

TY 2011 Other Assets Schedul eName THE HEIMLICH INSTITUTE FOUNDATION

C O PATRICK WARD TRUSTEEEIN: 23 7303161

Description Beginning of Year Book Value

En d of Year BookValue

En d of Year FairM ar k e t Val u e

JOHNSON INVESTMENTS 51 085 RUED INTEREST DIVIDEND RECEIVABLE 27

DEPOSITS 315


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TY 2 Other Decreases ScheduleName THE HEIMLICH INSTITUTE FOUNDATION


Description AmountUNREALIZED DEPRECIATION IN INVESTMENTS 795PRIOR PERIOD ADJUSTMENT 10 000


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TY 2 Other Expenses ScheduleName THE HEIMLICH INSTITUTE FOUNDATION


Description Revenue an d E xp e ns e spe r Books

Ne t nv stm ntIncome

Adjusted Ne t Income D isbu rs em ents fo rCharitable Purposes

SUPPLIES 1 480 MISCELLANEOUS EXP 89BANK FEES 84


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TY 2 Other i a b i l i t i e s ScheduleName THE HEIMLICH INSTITUTE FOUNDATION


Description Beginning of Year Book lue

End of Year Book lue

ACCRUED PAYROLL TAXES 1 629 0


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TY 2 Other Professional Fe e s ScheduleName THE HEIMLICH INSTITUTE FOUNDATION

C O PATRICK WARD TRUSTEEEIN: 23 7303161


PurposesOUTSIDE SERVICES 4 7 7


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TY 2 Taxes Schedule

Name THE HEIMLICH INSTITUTE FOUNDATIONC O PATRICK WARD TRUSTEE

EIN: 23 7303161Category Amount Net Investment

IncomeAdjusted NetIncome

Disbursements forCharitablePurposes

PAYROLLTAXES 886 OH TAX FEDERALTAX 7

Documents

Via the Heimlich Institute's 2011 IRS 990, the nonprofit has total assets of $1000