12/07/2010

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DEPARTMENT Of HEALTH AND HUMAN SERVICES ~ ~

Office of Inspector General Special Investigations Branch 330 I n d e p e i t o Avenue, S,W. Washing!, DC 20201

NOV
Timothy C. Bagwell 5872N.IL 130 Olney, IL 62450 RE: Complaint of Misconduct - Browne OIFile#:H10003784

g2010

Dear Mr. Bagwell: The United States Department of Health and Human Services (HHS), Office ofInspector General (OlG), Office of Investigations (OI), Special Investigations Branch (SIB), is in receipt of your letter dated Odober 11, 2010. In your letter, you allege potential misconduct on the part of Douglas Browne, an employee of the Centers for Disease Control and Prevention (CDC). Specifically you state that CDC may have improperly approved Browne's outside activities with the Save-A-Life-l<oundation, and that Browne may have exceeded the scope of the approval which he received from CDC management. HHS/OIG/OI/SIB has reviewed the information you provided, and has determined that there is not enough information presented to warrant an investigation for potential violation of criminal statutes. HHS/OIG/OI/SIB has referred this matter to CDC for further review, and appropriate administrative action as this matter appears to be more appropriately addressed through CDC's administrative review process. Should you have any additional questions, please feel to contact Assistant Special Agent in Charge Scott A. Vantrease at (202) 619-1485.

Sincerely, Elton Malone Special Agent in Charge Special Investigations Branch

DIVIDER

Subject: FW: Constituent Request From: "Murray, Chase" <Chase.Murray@mail.house.gov> Date: 5/10/2012 10:54 AM To : "'Peter M. Heimlich'" <pmh@medfraud.info>

From: Murray, Chase Sent: Wednesday, May 09, 2012 5:27 PM To: 'sob8@cdc.gov' Subject: Constituent Request Ms. Berger, Attached are documents submitted to our office by Peter Heimlich, a constituent of Congressman Woodall. Mr. Heimlich has requested that our office ask on his behalf if a Mr. Douglas Browne, who works/has worked with the CDC, signed the accompanying documents. I look forward to your response, thank you for your help with this matter.

Chase Murray Legislative Assistant Congressman Rob Woodall 7th District of Georgia 202-226-2036

Attachments:

Heimlich.pdf

774 KB

forOffte?

PMT#

ffitVin^lILUN0IS
VA\Q 0^^

CHARITABLE ORGANIZATION ANNUAL REPORT

Attorney General LISA M A D I G A N State of Illinois Charitable Trust Bureau, 100 West Randolph CO# 3rd Floor, Chicago, Illinois 60601 Report for the Fiscal Period: Beginning^ & EndingiL
MO E Yes D No
01026498

FormAG990-1L Revised 1/03

AMT

INIT

/ 31

-L
/ 03

Check all items attached: E7J Copy of IRS Return *a*c/>*j 0 Auuited dinancial Statements ftyawsto Copy of Form IFC altX* n $15.00 Annual Report Filing Fee a w * * n $100.00 Late Report Filing Fee
MO DAY YR ,93

Federal ID # 3869459 Are contributions to the organization tax deductible?

LEGAL NAME ^ a v e ^ ^e Foundation MAIL ADDRESS "
5 0 w

DAY YR Year-end amounts

A)ASSETS A) $460309 B) $ 364,284
C

D)ate Organization if/as created: 0 2

/ uy

' Lawrence #300

B) LIABILITIES C ) N E T ASSETS

CITY, STATE Schiller Park, IL 50176 I. S U M M A R Y O FA L L R E V E N U E ITEMS D U R I N G T H E YEAR: D) PUBLIC SUPPORT. CONTRIBUTIONS & PROGRAM SERVICE REV, (GROSS AMTS.) E) GOVERNMENT GRANTS & MEMBERSHIP DUES F) OTHER REVENUES G) TOTAL REVENUE, INCOME AND CONTRIBUTIONS RECEIVED (ADD D,E. * F)

) $ 96.025

PERCENTAGE 88.B8 10.27 0,85 % % % 100% D)$

AMOUNT 324,331

E) $ 37,488 F ) $ 3,113 G)$ 364,932

II. SUMMARY OF ALL EXPENDITURES DURING THE YEAR:

H) 1) J> OPERATING CHARITABLE PROGRAM EXPENSE EDUCATION PROGRAM SERVICE EXPENSE TOTAL CHARITABLE PROGRAM SERVICE EXPENSE (ADD H & 1 1 $ 7S.77 76.77 % H ) $ 861,501

%
%

l)S
J) $ 861,501

Ji) JOINT COSTS ALLOCATED TO PROGRAM SERVICES (INCLUDED IN J): K) GRANTS TO OTHER CHARITABLE ORGANIZATIONS L) TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD J & K ) M) MANAGEMENT AND GENERAL EXPENSE N) FUNDRAISING EXPENSE O) T O T A L E X P E N D I T U R E S THIS PERIOD ( A D D L, M, & N)

%
76.77 8.25 14.98 % % % 100%

K)$ L ) $ 861,501
M ) $

92,611 168,086 1,122,198

N)5 )$

III. SUMMARY OF ALL PAID FUNDRAISER AND CONSULTANT ACTIVITIES:

(Attach Attorney General Report ot Individual Fundraising Campaign- Form IFC. One for each PFR.) PROFESSIONAL FUNDRAISERS: P) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISERS Q) TOTAL FUNDRAISERS FEES AND EXPENSES R) NET RECEIVED BY THE CHARITY (P MINUS Q=R) PROFESSIONAL FUNDRAISING CONSULTANTS: S) TOTAL AMOUNT PAID TO PROFESSIONAL FUNDRAISING CONSULTANTS 100% P) $ 0 Q)$ 0 R)$ 0

% %

S)$ o

IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS

T) NAME, TITLE: Carol Spizzim, CEO U) NAME TITLE: Dane Neal, National Program Coordinator

re-fT-fc W>g!g2^,yEBL'V
^ O t " 1 ATTORNt^ i f l M ^ V T)$ U) $ 71,250 49,638 40,385

,
V) NAME, TITLE: Linda Post, Accountant

VkAL
V)$

^TnUST

V. CHARITABLE PROGRAM DESCR\PT\OM:CHAHITABLE W) DESCRIPTION: Life Saving First Aid Training X) DESCRIPTION: Y) DESCRIPTION:

List on back side of instructions CODE PROGRAM (3 HIGHEST BY SEXFENIXDI CODE CATEGORIES

CHAWlABtfei

w># on
X)# Y)#

IF THE ANSWER TO ANY OF THE FOLLOWING IS YES, ATTACH A DETAILED EXPLANATION: 1. 2. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION, FINE, PENALTY OR JUDGMENT? HAS THE ORGANIZATION OR A CURRENT DIRECTOR, TRUSTEE, OFFICER OR EMPLOYEE THEREOF, EVER BEEN CONVICTED BY ANY COURT OF ANY MIDSDEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY?

0
.2. .4.

3.

DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES OWNS AN INTEREST; OR WAS IT A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES HAS A MATERIAL FINANCIAL INTEREST; OR DID ANY OFFICER, DIRECTOR OR TRUSTEE RECEIVE ANYTHING OF VALUE NOT REPORTED AS COMPENSATION? 3. HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER, DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES? IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION?

5.

5.

J
B E

6.

DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER? (ATTACH FORM IFC ) _ _ 6.

7a. DID THE ORGANIZATION ALLOCATE THE COST OF ANY SOLICITATION, MAILING, ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES?

B
ra

7b. IF "YES", ENTER (i) THE AGGREGATE AMOUNT OF THESE JOINT COSTS5 ;(ii) THE AMOUNT ALLOCATED TO PROGRAM SERVICES $ ; (iw) THE AMOUNT ALLOCATED TO MANAGEMENT AND GENERAL $ ; AND (iv) THE AMOUNT ALLOCATED TO FUNDRAISING $ 8. DID THE ORGANIZATION EXPEND ITS RESTRICTED FUNDS FOR PURPOSES OTHER THAN RESTRICTED PURPOSES? 9. HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION OR TAX EXEMPTION SUSPENDED OR REVOKED BY ANY GOVERNMENTAL AGENCY? 9.

8.

10. WAS THERE OR DO YOU HAVE ANY KNOWLEDGE OF ANY KICKBACK. BRIBE, OR ANY THEFT, DEFALCATION ^ W = MISAPPROPRIATION, COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS? 10. | I l/l 11. LIST THE NAME, ADDRESS AND THE ACCOUNT # OF THE FINANCIAL INSTITUTIONS WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST ACCOUNTS: Bank One, NA Illinois Market, P.O. Box 260180, Baton Rouge, LA 70826-0180, i

12 NAME AND TELEPHONE NUMBER OF CONTACT PERSON: Carol Sptaiffi (B47) 92B-9693 ALL ATTACHMENTS MUST ACCOMPANY THIS REPORT - SEE INSTRUCTIONS UNDER PENALTY OF PERJURY, I (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS ANNUAL REPORT AND THE ATTACHED DOCUMENTS, INCLUDING ALL THE SCHEDULES AND STATEMENTS AND THE FACTS THEREIN STATED ARE TRUE AND COMPLETE AND FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE STATE OF ILLINOIS RELY THEREUPON. I HEREBY FURTHER AUTHORIZE AND AGREE TO SUBMIT MYSELF AND THE REGISTRANT HEREBY TO THE JURISDICTION OF THE STATE OF ILLINOIS. h

BE SURE TQ INCJ^UDE ALL FEES DUE: 1.') REPORTS AREDUE wfTHIN fx" " " MONTHS OF YOUR FISCAL YEAR END. 2.) FOR FEES DUE SEE INSTRUCTIONS. 3.) REPORTS THAT ARE LATE OR INCOMPLETE ARE SUBJECT TO A $100.00 PENALTY,

PRESIDENT oAVTRUSlfctt(PRINT TAME)

sh' fiGNATURE~T

f BATE'

TREASURER or TRUSTEE (PRINT NAME)

SIGNATURE

DATE

AZ-^-g E m PREPARER (PRINT NAME}

SIGNA'UKt

DATE

fprPKic*' r -.-lOnl' PMT

T ^ T ^ - p ^ ) 4 L J N O I S CHARITABLE ORGANIZATION ANNUAL REPORT PlenL )" ID / ' A t t o r n e y General L I S A M A D I G A N State o f Illinois ttomey Charitable Trust Bureau, 100 West Randolph 3rd Floor, Chicago, Illinois 60601 Report for the Fiscal Period: Beginning 01 / pi / 3P / 04
C Q

Form AG990-T] Revised I/O

&Ending___06 MO Federal ID # Yes No Are contributions to the organization tax deductible? LG L EA NAMESave A L i f e MAIL ADDRESS 9 9 5 0 CITY. STATE , . ZIP CODE
w n l

/ 04

nin^ftigs Check alf items attached: Q Copy of IRS Return M*.ch*j CS Audited Financial Statements p^wto Copy of Form IFC S 0 ' 1 O H5.00 Annual Report Filing Fe. 8 u ^</ D $100.00 Late Report Filing Fee
MO
DAY

YR

Date Organization was created: Year-end amounts

A)ASSETS A) $

Q2 /OQ / Q3

Foundation

- Lawrence S u i t e 300 _ . rark,

TT

1,403.584 333,61j_ 1,069;"973

AMOUNT

B) LIABILITIES C) N E T ASSETS

,.,,. iL bU17b

B)$ C)$

I. SUMMARY OF ALL REVENUE ITEMS DURING THE YEAR:

D) PUBLIC SUPPORT, CONTRIBUTIONS & PROGRAM SERVICE REV. {GROSS AMTS.) E) GOVERNMENT GRANTS & MEMBERSHIP DUES F) OTHER R E V E N U E S G) TOTAL REVENUE, INCOME AND CONTRIBUTIONS RECEIVED (ADD D.E. & F)

PERCENTAGE 10.04 *
QO-11 D) S E)$ F)$

115,844 ,000 (1,689! 1.154.155 151.664

:.i5'
100%

G)$
H)$

II. SUMMARY OF ALL EXPENDITURES DURING THE YEAR:

H) 0 J) OPERATING CHARITABLE PROGRAM EXPENSE EDUCATION PROGRAM SERVICE EXPENSE TOTAL CHARITABLE PROGRAM SERVICE EXPENSE (ADD H & I)

/ 84.16 %

i) $

84.16 %
J

J)$

151,664

Ji> JOINT COSTS ALLOCATED TO PROGRAM SERVICES (INCLUDED IN J ) : K> GRANTS T O OTHER CHARITABLE ORGANIZATIONS L) T O T A L C H A R I T A B L E PROGRAM SERVICE EXPENDITURE ( A D D J & K )

K)X

^16

L)$ M)$ N)$

151.664 21.328 7.215 180.207

M) MANAGEMENT A N D GENERAL EXPENSE N) FUNDRAISING EXPENSE

11.84 % 4.00 %
100 %

O) T O T A L E X P E N D I T U R E S THIS P E R I O D ( A D D L, M, & N)

o>$

III. SUMMARY OF ALL PAID FUNDRAISER AND CONSULTANT ACTIVITIES:

(Attach Attorney General Report of Individual Fundraising Campaign- Form IFC. One for each PFR ) PROFESSIONAL FUNDRAISERS: P) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISERS Q) TOTAL FUNDRAISERS FEES AND EXPENSES R) NET RECEIVED BY THE CHARITY (P MINUS Q=R) PROFESSIONAL FUNDRAISING CONSULTANTS: S) TOTAL AMOUNT PAID TO PROFESSIONAL FUNDRAISING CONSULTANTS

100 % % %

P) $
Q)$ R)$
arxJiaUgS

S) $

IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS DURING THE YEAR: T) NAME, TITLE: C a r o l S p i z z i r r i . U) NAME, TITLE:
Dane

CEO Coordinator

T)$
U)$

20.000 21,663

Neal.

N a t i o n a l Program Accountant

V) NAME, TITLE: Donna A c h s .

ATTORNEY GENERAL.v CHARITABLE TRUST

IF THE ANSWER TO ANY OF THE FOLLOWING IS YES, ATTACH A DETAILED EXPLANATION: 1. 2. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION, FINE, PENALTY OR JUDGMENT? HAS THE ORGANIZATION OR A CURRENT DIRECTOR, TRUSTEE, OFFICER OR EMPLOYEE THEREOF, EVER BEEN CONVICTED BY ANY COURT OF ANY MIDSDEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY?

YES

NO

2.

3.

DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES OWNS AN INTEREST; OR WAS IT A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES HAS A MATERIAL FINANCIAL INTEREST; OR DID ANY OFFICER. DIRECTOR OR TRUSTEE RECEIVE ANYTHING OF VALUE NOT REPORTED AS COMPENSATION? 3. HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER, DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES? IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER?( ATTACH FORM IFC )

4.

5.

5. 6.

6.

7a. DID THE ORGANIZATION ALLOCATE THE COST OF ANY SOLICITATION. MAILING. ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES?
7

7b. IF "YES". ENTER (I) THE AGGREGATE AMOUNT OF THESE JOINT COSTS $ ;(ii) THE AMOUNT ALLOCATED TO PROGRAM SERVICES $ ; (iii) THE AMOUNT ALLOCATED TO MANAGEMENT AND GENERAL $ ; AND (iv) THE AMOUNT ALLOCATED TO FUNDRAISING $ 8. DID THE ORGANIZATION EXPEND ITS RESTRICTED FUNDS FOR PURPOSES OTHER THAN RESTRICTED PURPOSES? HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION OR TAX EXEMPTION S U S P E N D E D OR R E V O K E D BY ANY GOVERNMENTAL AGENCY? 9. X

8.

9.

10. WAS THERE OR DO YOU HAVE ANY KNOWLEDGE OF ANY KICKBACK, BRIBE, OR ANY THEFT. DEFALCATION MISAPPROPRIATION, COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS? 10. 11. LIST THE NAME, ADDRESS AND THE ACCOUNT # OF THE FINANCIAL INSTITUTIONS WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST ACCOUNTS:

Bank One. NA I l l i n o i s

kei

I. Box 2 6 0 1 8 0 . B a t o n R o u g e . LA 7 0 8 2 6 - 0 1 8 0

W a c h o v i a Bank N . A . , P . O . Box 5 0 0 1 5 , R o a n o k e , VA 2 4 0 4 0 - 7 3 5 0 12. NAME AND TELEPHONE NUMBER OF CONTACT PERSON: C a r o l S p i z z i r r i

ALL ATTACHMENTS MUST ACCOMPANY THIS REPORT - SEE INSTRUCTIONS UNDER PENALTY OF PERJURY. 1 (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I IWE) HAVE EXAMINED THIS ANNUAL REPORT AND THE ATTACHED DOCUMENTS. INCLUDING ALL THE SCHEDULES AND STATEMENTS AND THE FACTS THEREIN STATED A R E TRUE AND COMPLETE A N D FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE STATE OF ILLINOIS RELY THEREUPON, t HEREBY FURTHER AUTHORIZE AND AGREE TO SUBMIT MYSELF AND THE REGISTRANT HEREBY TO THE JURISDICTION OF THE STATE OF ILLINOIS.

(847) 928-9683

BE SURE TO INCLUDE ALL FEES DUE: 1.) REPORTS ARE DUE WITHIN SIX MONTHS OF YOUR FISCAL YEAR END. 2.) FOR FEES DUE SEE INSTRUCTIONS. 3.) REPORTS THAT ARE LATE OR INCOMPLETE ARE SUBJECT TO A $100.00 PENALTY.

PRESIDENT or TRUSTEE (PRWT NAME)

TREASURER or TRUSTEE (PRINT NAM

PREPARER (PRINT NAM~

SIGNATURE

DATE

For O f f l o U i e Only

PMT#

ILLINOIS CHARITABLE ORGANIZATION ANNUAL REPORT

Attorney General U S A M A D I G A N State o f Illinois Charitable Trust Bureau, 100 West Randolph 11th Floor, Chicago, Illinois 60601 CO # 01026498 Report for the Fiscal Period:

Form AG990-IL Revised 3/05

AMT

INIT

Beginning o?
& E n d i n g . 06
MO

/ o*
/ 30
DAY

/
/ 05

Check all items attached: H Copy of IRS Return & Audited Financial Statements ay**,*, n Copy of Form IFC S^0" El $15.00 Annual Report Filing Fee Bum.uFiiim 100.00 Late Report Filing Fee
MO DAY YR

Federal ID # I Are contributions to the organization tax deductible? LEGAL NAME MAIL ADDRESS CITY, STATE ZIP CODE "950 W- Lawrnce', Sutte 30

B Yes D N O

Date Organization was created: 02

/ 09

/ 93

Save A Life Foundation

Year-end amounts
A)ASSETS B) LIABILITIES C) NET ASSETS

A)$ 1643498 B)S 669348

c

Schiller Park, IL 60176

)$

974150
AMOUNT

I. SUMMARY OF ALL REVENUE ITEMS DURING THE YEAR:

D) PUBLIC SUPPORT. CONTRIBUTIONS & PROGRAM SERVICE REV. (GROSS AMTS.] E) GOVERNMENT GRANTS & MEMBERSHIP DUES F) OTHER REVENUES G) TOTAL REVENUE, INCOME AND CONTRIBUTIONS RECEIVED (ADD D,E, & F) II. SUMMARY OF ALL EXPENDITURES DURING THE YEAR: H) I) J) OPERATING CHARITABLE PROGRAM EXPENSE EDUCATION PROGRAM SERVICE EXPENSE TOTAL CHARITABLE PROGRAM SERVICE EXPENSE (ADO H & I) $

PERCENTAGE

D ) $ 533339 E)$ 1196000

F ) $ 2801 100% G ) $ 1732140

H ) $ 1713050 l)$ J ) $ 1713050

J1) JOINT COSTS ALLOCATED TO PROGRAM SERVICES (INCLUDED IN J): K) GRANTS TO OTHER CHARITABLE ORGANIZATIONS L) TOTAL CHARITABLE PROGRAM SERVICE E X P f D f B ( f p W E J M) MANAGEMENT AND GENERAL EXPENSE N) FUNDRAISING EXPENSE

% Q

K)$ L ) $ 1713050 M ) $ 80431

JAN 3 ' , M r l 9 - 2000/^2^

100%

N ) $ 34482

O) TOTAL EXPENDITURES THIS PERIOD (ADO l _ W R N E Y G E N E R A L

>* 1827963

III. SUMMARY OF ALL PAID FUNDRAISER AND^C^lJl^lf^C^TviTIES:

(Attach Attorney General Report of Individual Fundraising Campaign- Form IFC. One for each PFR.; PROFESSIONAL FUNDRAISERS: P) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISERS Q) TOTAL FUNDRAISERS FEES AND EXPENSES R) NET RECEIVED BY THE CHARITY (P MINUS Q=R) PROFESSIONAL FUNDRAISING CONSULTANTS: S) TOTAL AMOUNT PAID TO PROFESSIONAL FUNDRAISING CONSULTANTS IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS DURING THE YEAR: T) NAME, TITLE: Carol Spizzirri, President/Founder U) NAME, TITLE: Dane Neal, National Policy Director V) NAME, TITLE: Ciprina Spizzirri, National Communication Director % 100% P) $ Q)$ R)$
'H-M^U-

S)$

T)S 120000
U ) $ 54381 V ) $ 35446

List on back side of instructions V. CHARITABLE PROGRAM DESCRIPTION CCHARKABLE PROGRAM VHKHEST BY, EXPEHDEO, CODE CATEGORY* CODE W) DESCRIPTION: Life Saving First A i d Training X) DESCRIPTION: Y) DESCRIPTION: W)#0U X)# Y)#

IF THE ANSWER TO ANY OF THE FOLLOWING IS YES, ATTACH A DETAILED EXPLANATION: 1. 2. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION, FINE, PENALTY OR JUDGMENT? HAS THE ORGANIZATION OR A CURRENT DIRECTOR, TRUSTEE, OFFICER OR EMPLOYEE THEREOF, EVER BEEN CONVICTED BY ANY COURT OF ANY MIDSDEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY? 1.

YES NO

2.

3.

DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES OWNS AN INTEREST; OR WAS IT A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES HAS A MATERIAL FINANCIAL INTEREST; OR DID ANY OFFICER, DIRECTOR OR TRUSTEE RECEIVE ANYTHING OF VALUE NOT REPORTED AS COMPENSATION?._ . _. 3. HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER, DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES? .4. IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER?( ATTACH FORM IFC )

5.

5. 6.

6.

7a. DID THE ORGANIZATION ALLOCATE THE COST OF ANY SOLICITATION, MAILING, ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES? 7

7b. IF "YES", ENTER (i) THE AGGREGATE AMOUNT OF THESE JOINT COSTS $ ;(ii) THE AMOUNT ALLOCATED TO PROGRAM SERVICES $ ; (iii) THE AMOUNT ALLOCATED TO MANAGEMENT AND GENERAL S ; AND (iv) THE AMOUNT ALLOCATED TO FUNDRAISING $ 8. DID THE ORGANIZATION EXPEND ITS RESTRICTED FUNDS FOR PURPOSES OTHER THAN RESTRICTED PURPOSES? HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION OR TAX EXEMPTION SUSPENDED OR REVOKED BY ANY GOVERNMENTAL AGENCY? 9.

8.

9.

10. WAS THERE OR DO YOU HAVE ANY KNOWLEDGE OF ANY KICKBACK, BRIBE, OR ANY THEFT, DEFALCATION MISAPPROPRIATION, COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS? 10. 11. LIST THE NAME AND ADDRESS OF THE FINANCIAL INSTITUTIONS WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST ACCOUNTS:

Bank One N.A., P.O. Box 260180, Baton Rouge, LA 70826-0180 Wachovia Bank N.A. P.O. Box 50015, Roanoke, VA 24040-7350
12. NAME AND TELEPHONE NUMBER OF CONTACT PERSON: Carol Spizzirri (847) 928-9683 ALL ATTACHMENTS MUST ACCOMPANY THIS REPORT - SEE INSTRUCTIONS UNDER PENALTY OF PERJURY, I (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS ANNUAL REPORT AND THE ATTACHED DOCUMENTS, INCLUDING ALL THE SCHEDULES AND STATEMENTS AND THE FACTS THEREIN STATED ARE TRUE AND COMPLETE AND FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE STATE OF ILLINOIS RELY THEREUPON. I HEREBY FURTHER AUTHORIZE AND AGREE TO SUBMIT MYSELF AND THEKEGISJRANT HEREBY TO THE JURISDICTION OF THE STATE OF ILLINOIS. rt.^) J " CCi<^ \2f3lr^ $i.a BE SURE TO INCLUDE ALL FEES DUE: 1.) REPORTS ARE DUE WITHIN SIX MONTHS OF YOUR FISCAL YEAR END. 2.) FOR FEES DUE SEE INSTRUCTIONS. 3.) REPORTS THAT ARE LATE OR INCOMPLETE ARE"SUBJECT TO A $100.00 PENALTY. Jrtuh)i>ifl<L

jjt/o lJJJt/0J
DATE

lETKiTiJdJlJJfliMIWJiJJH!

NAME)

SIGNATURE

T TREASURER or TRUSTEE (PRINT NAME)

SIGNATURE

(DATE

RINT NAME)

SIGNATURE

DATE

A*t**^fe~-r>i~i

FOfOfflc U n O n i

ILLINOIS CHARITABLE ORGANIZATION ANNUAL REPORT

Attorney General LISA MADIGAN State of Illinois Charitable Trust Bureau, 100 West Randolph 11th Floor, Chicago, Illinois 60601 CO l 0 1 0 2 6 4 9 8
Check ail items

Fo

T G < ? 3; 05i l Kev,sed

'

attached:

Report for the Fiscal Period: Beginning^ 0 7

Federal ID #| Are contributions to the organization tax deductible?
n7

z copy of IRS Return >

*.. 5E a*** H D E! n Audited Financial Statements Copy of Form IFC $15.00 Annual Report Filing Fee $100.00 Late Report Filing Fee
MO DAY YR

0. Q 1

05

in

Ol HA yn

& Ending^ ^
0

MO

DAY

Yes No

Date Organization was created: 02

/ 09

/ 93

I.

S U M M A R Y OF A L L REVENUE ITEMS DURING THE YEAR: O) PUBLIC SUPPORT, CONTRIBUTIONS & PROGRAM SERVICE REV. (GROSS AMTS.) E) GOVERNMENT GRANTS & MEMBERSHIP DUES F)OTHER REVENUES G) TOTAL REVENUE. INCOME AND CONTRIBUTIONS RECEIVED (ADD D,E, & F)

PERCENTAGE

AMOUNT

21.30 78.59 .11

100%

D)$ 189,738 E)$ 700,000 F)$ 956 G) $ 890,694 H) $ 1,005,527

l)$

II. SUMMARY OF ALL EXPENDITURES DURING THE YEAR:

H) OPERATING CHARITABLE PROGRAM EXPENSE I) J) EDUCATION PROGRAM SERVICE EXPENSE TOTAL CHARITABLE PROGRAM SERVICE EXPENSE (ADD H 4 I) $_

94.75

<%

94.75

j ) $ 1,005,527

Ji) JOINT COSTS ALLOCATED TO PROGRAM SERVICES (INCLUDED IN J): K) GRANTS TO OTHER CHARITABLE ORGANIZATIONS L) TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD J & K) M) MANAGEMENT AND GENERAL EXPENSE N) FUNDRAISING EXPENSE O) TOTAL EXPENDITURES THIS PERIOD (ADD L, M, & N)

% 5.25 % %
100%

K)$ L)S

M)S 55,716
N)$ 0 0)$ 1,061,243

III. SUMMARY OF ALL PAID FUNDRAISER AND CONSULTANT ACTIVITIES:

(Attach Attorney General Report of Individual Fundraising Campaign- Form IFC. One for each PFR.) PROFESSIONAL FUNDRAISERS: P) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISERS Q) TOTAL FUNDRAISERS FEES AND EXPENSES R) NET RECEIVED BY THE CHARITY (P MINUS Q=R) PROFESSIONAL FUNDRAISWO CONSW.TANTS: S) TOTAL AMOUNT PAID TO PROFESSIONAL FUNDRAISING CONSULTANTS 100% P)$
Q)$

% %

R)$ S)$

IV. COMPENSATION TO THE (3) HIGHEST PAID PERSONS DURING THE YEAR: T) NAME, TITLE: Carol Spizzirri, President/Founder U) NAME, TITLE: Dane Neal, National Policy Director V) NAME. TITLE: Robert Barnes, Director

m$MMiM*h^m<i
T ) $ 130,000

U) $ 63,500 V) S 55,000

. p s t o n ^ s ^ i n ^ o n s V . C H A R I T A B L E P R O G R A M DESCR\PT\ON:cHARmBLE PROGRAM (JH/GHEST BY $ EXPENDED, ooKCATEGomes W) DESCRIPTION: Life Saving First A i d Training X) DESCRIPTION: Y) DESCRIPTION:

W)# 0J1
X)d Y)#

IF THE ANSWER TO ANY OF THE FOLLOWING IS YES, ATTACH A DETAILED EXPLANATION: 1. 2. WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION. FINE. PENALTY OR JUDGMENT? HAS THE ORGANIZATION OR A CURRENT DIRECTOR. TRUSTEE, OFFICER OR EMPLOYEE THEREOF. EVER BEEN CONVICTED BY ANY COURT OF ANY MIDSDEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY?

YES NO

2.

3.

DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES OWNS AN INTEREST; OR WAS IT A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS OFFICERS. DIRECTORS OR TRUSTEES HAS A MATERIAL FINANCIAL INTEREST; OR DID ANY OFFICER, DIRECTOR OR TRUSTEE RECEIVE ANYTHING OF VALUE NOT REPORTED AS COMPENSATION? 3. HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER. DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES? IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER?{ATTACH FORM IFC )_

.4.

5.

. 5. 6.

6.

7a. DID THE ORGANIZATION ALLOCATE THE COST OF ANY SOLICITATION, MAILING, ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES?

7.

7b. IF "YES". ENTER (i) THE AGGREGATE AMOUNT OF THESE JOINT COSTS $ :() THE AMOUNT ALLOCATED TO PROGRAM SERVICES $ ; (iii) THE AMOUNT ALLOCATED TO MANAGEMENT AND GENERAL $ ; AND (iv) THE AMOUNT ALLOCATED TO FUNDRAISING 8. DID THE ORGANIZATION EXPEND ITS RESTRICTED FUNDS FOR PURPOSES OTHER THAN RESTRICTED PURPOSES? HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION OR TAX EXEMPTION SUSPENDED OR REVOKED BY ANY GOVERNMENTAL AGENCY? 9.

8.

9.

10. WAS THERE OR DO YOU HAVE ANY KNOWLEDGE OF ANY KICKBACK. BRIBE, OR ANY THEFT, DEFALCATION MISAPPROPRIATION, COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS? 10. 11. LIST THE NAME AND ADDRESS OF THE FINANCIAL INSTITUTIONS WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST ACCOUNTS:

Bank One N.A., P.O. Box 2601SO, Baton Rouge, LA 70826-0180 TCF National Bank, 500 W, Joliet Rd., Willowbrook, IL 60527
12. NAME AND TELEPHONE NUMBER OF CONTACT PERSON: Carol Spizzirri (847) 928-9683

ALL ATTACHMENTS MUST ACCOMPANY THIS REPORT SEE INSTRUCTIONS UNDER PENALTY OF PERJURY, I (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS ANNUAL REPORT AND THE ATTACHED DOCUMENTS. INCLUDING ALL THE SCHEDULES AND STATEMENTS AND THE FACTS THEREIN STATED ARE TRUE AND COMPLETE AND FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE STATE OF ILLINOIS RELY THEREUPON. I HEREBY FURTHER AUTHORIZE AND AGREE TO SUBMIT MYSELF AND THE REGISTRANT HEREBY TO THE JURISDICTION OF THE STATE OF ILLINOIS.

i*.e\
PRESIDENT or TRUSTEE (PRINT NAME)

MONTHS OF YOUR FISCAL YEAR END. 2.) FOR FEES DUE SEE INSTRUCTIONS. 3.) REPORTS THAT ARE LATE OR INCOMPLETE ARE SUBJECT TO A $100.00 PENALTY.

,\st>l*A* TREASURER or TRUSTEE (PRINT NAME)

PREPARER (PRINT NAME)

SIGNATURE

DATE

For Office Use Only

Illinois Charitable Organization Annual Report

Attorney Genera! Lisa Madigan State of Illinois Charitable Trust Bureau, 100 West Randolph 11th Floor, Chicago, Illinois 60601
Report for the Fiscal Period: Beginning 7/01/06 &Endinq~67T0/07
MO DAY YR

Form AG990-IL Revised 3/05 ID-I U

CO#
Check all items

01026498
attached:

KhkeCheett

Copy of IRS Return Audited Financial Statements Copy of Form IFC 515.00 An rti/al Report Filing Fee 5100.00 Late Report Filing Fee

Federal ID # Are contributions to the organization tax deductible? |X| Yes | ~ | No Year-end amounts A ASSETS LIABILITIES NET ASSETS

Date Organization was created:

LEGAL

N* SAVE A LIFE FOUNDATION

ADDRESS 9950 LAWRENCE # 3 0 0 -

R E C E I V E D
O
J

2/09/1993 A$ B$

MO

DAY

YR

449,823. 191,214. 258,608.

AMOUNT

CITY, STATE
I

ZIP CODE SCHILLER PARK, IL 60176

MAY l 6 2008

B C

c$

Attorney General
SUMMARY OF A L L REVENUE ITEMS DURING THE Y ^ R 1 - * 1 ' ^ D PUBLIC SUPPORT, CONTRIBUTIONS AND PROGRAM SERVICE REVENUE ^
PERCENTAGE

22.81%
75.63%

D$ E$ F$ G$ H$ 1$ J$

211,116.
700,000.

F OTHERREVENUES
G II

See..Statement.1

1.56% 100% 90.46%

%

TOTAL REVENUE, INCOME AND CONTRIBUTIONS RECEIVED (ADD D, E, AND F) S U M M A R Y OF A L L EXPENDITURES DURING THE YEAR:

14,429. 925,545. 1,330,239. 1,330,239.

90.46%
J l JOINT COSTS ALLOCATED TO PROGRAM SERVICES (INCLUDED IN J) $

1
K$
L$ M$

%
L TOTAL CHARD"ABLE PROGRAM SERVICE EXPENDrTURE (ADD J AND K)

90.46%
9.54%

1,330,239. 140,299. 1,470,538.

N O III

FUNDRAISING EXPENSE TOTAL EXPENDITURES THIS PERIOD (ADD L, M, AND N) S U M M A R Y OF A L L PAID FUNDRAISER A N D CONSULTANT ACTIVITIES: (Attach Attorney General Report of Individual Fundraising Campaign - Form IFC. One for eacJh PFR.) PROFESSIONAL FUNDRAISERS:

100%

N$ 0$

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^H

P Q R

TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISERS TOTAL FUNDRAISERS FEES AND EXPENSES NET RECEIVED BY THE CHARITY (P MINUS Q=R) PROFESSIONAL FUNDRAISING CONSULTANTS:

100%
% %

P$ Q$ R$ S$

S IV T

TOTAL AMOUNT PAID TO PROFESSIONAL FUNDRAISING CONSULTANTS C O M P E N S A T I O N T O T H E (3) HIGHEST PAID P E R S O N S D U R I N G T H E Y E A R : NAME. TITLE: CAROL S P I Z Z I R R I , PRESIDENT/FOUND

Hl^H^H
T$

130,000.
63,520.

U NAME, TITLE: DANE NEAL, DIRECTOR V NAME, TITLE: VINCENT DAVIS, DIRECTOR
V C H A R I T A B L E P R O G R A M D E S C R I P T I O N : CHARITABLE PROGRAM (3 HIGHEST BY $ EXPENDED) CODE CA TEGORIES

u$ v$
W# X# Y#
ILVA0212L 0/V16TO

50,000. See instructions for list CODE

W DESCRIPTION: LIFE SAVING FIRST AID TRAINING

X Y DESCRIPTION: DESCRIPTION:

011

SAVE A LIFE FOUNDATION

IF THE ANSWER TO ANY OF THE FOLLOWING IS YES, ATTACH A DETAILED EXPLANATION: 1 2 WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION, FINE, PENALTY OR JUDGMENT? HAS THE ORGANIZATION OR A CURRENT DIRECTOR, TRUSTEE, OFFICER OR EMPLOYEE THEREOF, EVER BEEN CONVICTED BY ANY COURT OF ANY MISDEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY?, DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES OWNS AN INTEREST; OR WAS IT A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES HAS A MATERIAL FINANCIAL INTEREST; OR DID ANY OFFICER, DIRECTOR OR TRUSTEE RECEIVE ANYTHING OF VALUE NOT REPORTED AS COMPENSATION? HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER, DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES? IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION? DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER? (ATTACH FORM IFC ) 1

Page 2

YES NO

X
I X

3 4 5 6

4 5 6

_x_
X

7a DID THE ORGANIZATION ALLOCATE THE COST OF ANY SOLICITATION, MAILING, ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES? 7b IF 'YES', ENTER (.) THE AGGREGATE AMOUNT OF THESE JOINT COSTS $ ; (ii) THE AMOUNT ALLOCATED TO PROGRAM SERVICES $ ; (ii) THE AMOUNT ALLOCATED TO MANAGEMENT AND GENERAL $ ; AND (iv) THE AMOUNT ALLOCATED TO FUNDRAISING $ 8 9 10 11 DID THE ORGANIZATION EXPEND ITS RESTRICTED FUNDS FOR PURPOSES OTHER THAN RESTRICTED PURPOSES? HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION OR TAX EXEMPTION SUSPENDED OR REVOKED BY ANY GOVERNMENTAL AGENCY? WAS THERE OR DO YOU HAVE ANY KNOWLEDGE OF ANY KICKBACK, BRIBE, OR ANY THEFT, DEFALCATION MISAPPROPRIATION, COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS?.

8 9 10

LIST THE NAME AND ADDRESS OF THE FINANCIAL INSTITUTIONS WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST ACCOUNTS:

See Statement 2

ALL ATTACHMENTS MUST ACCOMPANY THIS REPORT - SEE INSTRUCTIONS UNDER PENALTY OF PERJURY, I (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS ANNUAL REPORT AND THE ATTACHED DOCUMENTS, INCLUDING ALL THE SCHEDULES AND STATEMENTS AND THE FACTS THEREIN STATED ARE TRUE AND COMPLETE AND FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE STATE OF ILLINOIS RELY THEREUPON. I HEREBY- FURTHER AUTHORIZE AND AGREE TO SUBMIT MYSELF AND THE REGISTRANT HEREBY TO THE JURISDICTION OF THE STA

BE SURE TO INCLUDE ALL FEES DUE: 1 2 3 REPORTS ARE DUE WITHIN SIX MONTHS OF YOUR FISCAL YEAR END. FOR FEES DUE SEE INSTRUCTIONS. REPORTS THAT ARE LATE OR INCOMPLETE ARE SUBJECT TO A $100.00 PENALTY.

PREPARE R (Pfiiw NAME)

SIGNAT

CBIZ ACCTG., TAX & ADVISORY SERVICES, LL One South Wacker Dr., Ste 1800 Chicago, IL 60606-4630

1LVA0212L 08/16/05

ILLINOIS CHARITABLE ORGANIZATION ANNUAL REPORT

Attorney General L I S A M A D I G A N State of Illinois
Chantabie Trust Bureau, 100 West Randolph 11th Floor, Chicago, Illinois 60601
R p n n f t w ^ c i o ^ i B ^ r (T

Fom)AG990-IL Revised 3/05

r\\**j>ixr>& CO# (J \Q Q.&Lf\)/)

Check aft ttmma attached:

Report for the Frscal Penod: f joggf ms R*m Beoinninn Beginning^ it , 1 , i * " *#om** u Audited Financial Statements eeainnma * / -j , \W>_ j ^ %* a $15.00of FormReport Filing Fee C p Annuaf IFC oy S X " & Ending,^ / ? P J > ( * ? < BUWF** n $100.00Late ReportFiBngFee
fderal(D#_ a contributions to the organization tax deductible? LEGAL NAME
MAIL
fl

MO

"DAY -WI

MO Date Organization W ^ create*

OAY

f j Y i N

**

^L

SAVE A LIFE FOUNDATION ^ f a c p C I U C n Attorney G e n e r a l Of i7479 W Dartmqor IL Dr 60030

A.DDRESS rv, STATE ZIP CODE

JUN 1 0 2010

Grayslake,

Charitable Trust

SUMMARY OF ALL REVENUE HEMS DURING THE YEAR D) PUBLIC SUPPORT. CONTRIBUTIONSftPROGRAM SERVICE REV. (GROSS AMTS.)) E) GOVERNMENT GRANTS 4 MEMBERSHIP nuES F, OTHER REVENUES G) TOTAL REVENUE, INCOME AND CONTRIBUTIONS RECEIVED (ADD D,E, & F) SUMMARY OF ALL EXPENDITURES DURING THE YEAR: H) I) J) OPERATING CHARITABLE PROGRAM EXPENSE EDUCATION PROGRAM SERVICE EXPENSE TOTAL CHARITABLE PROGRAM SERVICE EXPENSE (ADD H At)

J i) JOINT COSTS ALLOCATED TO PROGRAM SERVICES (INCLUDED IN J): K) GRANTS TO OTHER CHARITABLE ORGANIZATIONS L! TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE {ADD J 4 K) GENERAL EXPENSE

M) MANAGEMENT AND

ti] FUNDRAISING EXPENSE OI TOTAL EXPENDITURES THIS PERIOD (ADD L, M, N) SUMMARY OF ALL PAID FUNDRAISER AND CONSULTANT ACTIVITIES: mttBCh Afioffny G9frai Report of hdivfcJuai Fundrsisrng Campaign- For* 1FC. Owfor each PFR. PROFESSIONAL FUNDRAISERS: P) TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISERS G} TOTAL FUNDRAISERS FEES ANO EXPENSES *) NET 4eCElVED BY THE CHARITY {P MINUS Q=R) PROFESSIONAL FUNDRAISING CONSULTANTS; 3) TOTAL AMOUNT PAID TO PROFESSIONAL FUNDRAISING CONSULTANTS :OMPENSAT)ON TO THE (3) HIGHEST PAID PERSONS DURING THE YEAR; r; NAME. TITLE
1) N A M E , T I T L 6

'**

') NAME, TITLE W R I T A B L E PROGRAM D E S C R I P T 1 0 N : w m o * p B W Br t Exp&aeo) cooe CA TEGORES List on b a i * side of Instructions CODE

ANSWER TO ANY OF THE FOLLOWING 13 YES, An/SnTDErwiiD^PLAKATlON:

WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION. FINE. PENALTY OR JUDGMENT? I, HAS THE ORGANIZATION OR A CURRENT DIRECTOR. TRUSTEE, OFFICER OR EMPLOYEE THEREOF EVER BEEN CONVICTED BY ANY COURT OF ANY MIDSDEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY?

YES/W

2.

).

D10 THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS DIRECTORS OR TRUSTEES OWNS AN INTEREST; OR WAS IT A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES HAS A MATERIAL FINANCIAL INTEREST; OR DID ANY OFFICER, DIRECTOR OR TRUSTEE RECEIVE ANYTHING OF VALUE NOT REPORTED AS COMPENSATION? 3 1 HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER, DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES? IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSONOR ORGANIZATION? DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER?(ATTACH FORM IFC) DID THE ORGANIZATION ALLOCATE THE COST OF ANY SOLICITATION, MAILING. ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAlSlNG EXPENSES?

4.

5. 6.

7.

IF T c S " , ENTER <i) THE AGGREGATE AMOUNT OF THESE JOINT COSTS | ;(B) THE AMOUNT ALLOCATED TO PROGRAM SERVICES $ : (Hi) THE AMOUNT ALLOCATED TO MANAGEMENT AND GENERAL S ; AND (iv THE AMOUNT ALLOCATED TO FUNDRAISiNG DID THE ORGANIZATION EXPEND ITS RESTRICTED FUNDS FOR PURPOSES OTHER THAN RESTRICTED PURPOSES? HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION OR TAX EXEMPTION SUSPENDED OR REVOKED BY ANY GOVERNMENTAL AGENCY? 9.
fi

WAS THERE OR DO YOU HAVE ANY KNOWLEDGE OF ANY KICKBACK, BRIBE, OR ANY THEFT. DEFALCATION MISAPPROPRIATION. COMMINGLING OR MISUSE OF ORGANiZATiONAL FUNDS? 10. LIST THE NAME AND ADDRESS OF THE FINANCIAL INSTITUTIONS WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST ACCOUNTS:

NAME AND TELEPHONE NUMBER OF CONTACT PERSON: ATTACHMENTS MUST ACCOMPANY THIS REPORT - SEE INSTRUCTIONS : PENALLY OF PERJURY. I (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS ANNUAL REPORT HE ATTACHED DOCUMENTS, INCLUDING ALL THE SCHEDULES AND STATEMENTS AND THE FACTS THEREIN STATED ARE \HD COMPLETE AND FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE
OF ILLINOIS: RPl'Y T H E R E U P O N I HEREBY FURTHER AUTHORIZE AMD AfiRFF TO SUBMIT MYSFI F AMD TMF RERIOTRAMT

Y TO TH^RMrfiTOT*N&ATE OF ILLINOIS

"= u *

MI3CLr

*""

m e W

"

w n

tifwaul
? TO iMCLUPeALL FEES PU.fr RTSAKE DUE WITHIN SIXT HS drfYOUR FISCAL Y&l&SND. *Pl_ET ARE SUBJECT TO A

CAROL SPI2ZXRRI RESIDENT or TRUSTEE PRINT NAME)

TRJASURER or TRUSTEE (PRINT NAME)

afr/jtef
SIGNATURE

DIVIDER

l a y . 22. 2 0 1 2 1 1 : 4 2 A M f

h. 1418

P. 2

Mr

US. DEPARTMENTOF HEALTH AND HUMAN'SERVICES

PubHcHwlUiServiw
Centers for Disease Control andPmvenilon(CDC) Allanta <$A3te33

May 21,2012 TteirojipiaWefobWdodall.

i ^ g m .B.d; 20315
DsarRepiessmative Woodall: ThfflA-Jrdttfiir pte.*ftKr3,2Dl!31 e-matl O behalf bf^iiij watim H %.*&* Heimlicl*, r&jiie^hstMr, OauglasBi'Q^e, 9 Dente -fattifeesseControl *md Prevention ( ) ) ^qye^verify that he signed flfcdocyraeutsatt^iedtoyoiire-mfdl.

Mr.^oWnrbviewed;tte domwrn tmtf veriM that they look tomato Ww,^:thatii^

sighatttreonpagesix of the d e m i e s dated JDeoembw 30,2005, appears tobehis writing, Mi;, Browne cannot confirm with certainty that he^ied;tfe*fhft j i ^ because htfl unable tb thatik yQM.agaiiifbl'y^.eHiiailvand^lGas& let me knowifl can be 6f fuitlier assistance $ineemly,

DIVIDER

May 29, 2012 Thomas R. Frieden M.D., M.P.H. Director Centers for Disease Control and Prevention (CDC) 1600 Clifton Road Atlanta, Georgia 30333 Dear Dr. Frieden: I'm responding to a letter you sent last week to my Congressman, Rob Woodall (GA, 7th District). Your letter was in reply to a May 9, 2012 inquiry sent on my behalf by Rep. Woodall's office to CDC Chief Operating Officer Sheri Berger. That inquiry asked Ms. Berger to verify whether or not CDC employee Douglas R. Browne signed six sworn AG990-IL financial reports filed with the Illinois Attorney General's Charitable Trust Bureau by the Save-A-Life Foundation (SALF), a Chicago-area nonprofit. I asked Congressman Woodall's office to help me obtain the information because there are serious legal matters regarding the reports that I wish to bring to the attention of federal and Illinois state officials. In your May 21, 2012 reply, you wrote to Congressman Woodall: Mr. Browne reviewed the documents and verified that they look familiar to him, and that the signature on page six of the documents, dated December 30, 2005, appears to be his writing. Mr. Browne cannot confirm with certainty that he signed the other pages, because he's unable to verify the signatures. All due respect, I believe a more definitive response is required. As you may be aware, in recent years SALF has been the subject of scores of critical media reports. For example, from a November 2006 ABC7 Chicago expose: One of Illinois' highest profile charities teaches the Heimlich maneuver to children while maneuvering the truth to get money from government and big business. It's called the Save-A-Life Foundation and is known across Illinois as an organization that teaches schoolchildren how to respond in emergencies. For the past few years, Save-A-Life has received millions of dollars in government funds and corporate donations. An ABC7 ITeam investigation has uncovered a series of misleading claims and deceptive credentials that raise doubts about Save-A-Life's integrity, funding and training. According to the Department of Health and Human Services, $3,335,578 of those funds were awarded to SALF by your agency.
1

In a November 10, 2010 reply to a complaint of misconduct filed with the Inspector General of the Department of Health and Human Services, that office responded: In your letter, you allege potential misconduct on the part of Douglas Browne, an employee of the Centers for Disease Control and Prevention (CDC). Specifically you state that CDC may have improperly approved Browne's outside activities with the Save-A-Life-Foundation, and that Browne may have exceeded the scope of the approval which he received from CDC management. ...HHS/OIG/OI/SIB has referred this matter to CDC for further review, and appropriate administrative action as this matter appears to be more appropriately addressed through CDC's administrative review process. According to a numerous records, Mr. Browne served on SALF's Executive Board as the organization's Treasurer. According to the six AG990-IL reports, he appears to have started the job on January 1, 2003 although tax returns filed by SALF with the Internal Revenue Service indicate he started on January 1, 2004. According to the minutes of a January 26, 2007 meeting of SALF's board, he was voted a $40,000 salary and retirement plan. Apparently his job ended on September 17, 2009 when, after a vote by the corporation's directors - presumably including Mr. Browne - SALF filed Articles of Dissolution with the Illinois Secretary of State. Regarding Mr. Browne's memory lapse about whether or not he signed the six AG990-IL reports, your letter didn't indicate if you asked him to produce copies. Since he was the organization's Treasurer, he presumably retained those. If not, he can certainly request unredacted copies from the Illinois Attorney General's office, from other former SALF executives, and from the Certified Public Accountants who cosigned the six reports. Undoubtedly you share my interest in bringing any potential legal concerns to the attention of governmental oversight agencies. Therefore, would you please ask Mr. Browne to provide you with definite answers as to which if any of the six reports he signed and that you provide me with that information? Thank you for your consideration and I look forward to your reply so that I may know how to proceed. Sincerely,

Peter M. Heimlich Duluth, GA 30096 ph: (208)474-7283 e-mail: pmh@medfraud.info website: Medfraud blog: The Sidebar cc: The Hon. Rob Woodall, US House of Representatives % Chase Murray Daniel R. Levinson, Inspector General, Department of Health and Human Services Sherri Berger, Chief Operating Officer, CDC The Hon. Tim Bivins, IL State Legislature Brent Stratton, Chief Deputy IL Attorney General
2

DIVIDER

. J " " " It

S. DEPARTMENT OF HEALTH AND H U M A N SERVICES

Public Health Service

Centers for Disease Control and Prevention {CDC} Atlanta GA 30333

June 5. 2012

Mr. Peter M. Heimlich Dulufh, Georgia 30096 Dear Mr. Heimlich: This letter is in response to your latest correspondence to CDC. Previously you were provided with all agency documents that arc subject to and responsive to your request under the Freedom of Information Act. At this time, the agency has completed its review of this matter and intends no further action.

Sherri A. Berger, M.S.P.H Chief Operating Officer, CDC

DIVIDER

Subject: inquiry re: your letter of 6/5/12 From: "Peter M. Heimlich" <pmh@medfraud.info> Date: 6/7/2012 3:57 PM To: "Berger, Sherri (CDC/OCOO)" <sob8@cdc.gov> CC: Tim Bagwell, Ph.D., Dan Levinson, Chase Murray, Francie Pastor, Thomas Frieden MD MPH Sherri A. Berger, MSPH Chief Operating Officer Centers for Disease Control and Prevention (CDC) Atlanta, Georgia 30333 Ms. Berger: I received your letter of June 5, 2012 (attached) and would appreciate clarification re: the following. 1) You wrote, "This letter is in response to your latest correspondence lo CDC." It's unclear to which letter you're referring. Therefore would you please provide me with date of my letter and a brief description of its contents? 2) You wrote, "Previously you were provided with all agency documents that are subject to and responsive to your request under the Freedom of Information Act." Based on your statement, my understanding is that the CDC considers the following FOIA requests to be complete: #11-00272 and #12-00603. If my understanding is incorrect, please advise. 3) You wrote, "At this time, the agency has completed its review of this matter and intends no further action." Are you referring to the review described in the attached November 8, 2010 letter to Tim Bagwell PhD from Special Agent Elton Malone of the Office of the Inspector General of the Department of Health and Human Services? Also, would you also please provide me with the name of the CDC employee who was responsible for conducting the review? Thank you for your continued attention and I look forward to your reply so that I may know how to proceed. Sincerely, Peter M. Heimlich n Duluth, GA 30096 ph: (208)474-7283 website: Medfraud blog: The Sidebar cc: The Hon. Johnny Isakson, US Senate, % Francie Pastor, legislative correspondent, HELP Committee The Hon. Rob Woodall, US House of Representatives, % Chase Murray Daniel R. Levinson, Inspector General, Department of Health and Human Services Thomas R. Frieden MD MPH, Director, CDC The Hon. Tim Bivins, IL State Legislature Tim Bagwell PhD

NO REPLY FROM BERGER

SBBVCfis

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Centers for Disease Control and Prevention (CDC) Atlanta GA 30333

r

JUN 1 4 2012

Peter Heimlich Duluth, Georgia 30096 Dear Mr. Heimlich: Your e-mail dated June 7, 2012, addressed to Ms. Sherri Berger, CDC's Chief Operating Officer, has been referred to me for response.
o

FOIA request #11-00272 relates to HFIS documents and is being processed by this office. FOIA request #11-00562, which you appealed (FOIA Appeal #12-00009) the adequacy of search, is pending final review after a subsequent search of CDC's files. FOIA request #12-00603 is a new request as a result of your appeal of FOIA request #11-00562. Sincerely,

^V- Katherine Norris CDC/ATSDR FOIA Officer Office of the Chief Information Officer (770)488-6399 Fax:(404)235-1852 11-00272-FOIA 11-00562-FOIA 12-00603-FOIA 12-00009-FOIA Appeal

August 25, 2012 Thomas R. Frieden M.D., M.P.H. Director Centers for Disease Control and Prevention (CDC) 1600 Clifton Road Atlanta, Georgia 30333 Dear Dr. Frieden: I haven't received a reply to my May 29, 2012 letter to you. You'll recall that I requested that you ask CDC employee Douglas R. Browne to verify whether or not he signed six sworn AG990-IL financial reports submitted to the Illinois Attorney General's Charitable Trust Bureau (CTB) in the capacity of chief financial officer of the Save-A-Life Foundation (SALF). According to an October 11, 2010 report in The Hill and other media outlets, SALF is under investigation by the CTB. (That office recently confirmed that the investigation is ongoing.) You may not be aware that the investigation was triggered by the most recent AG990-IL submitted by SALF. That report, which bears Mr. Browne's name and purported signature, was rejected by the CTB as incomplete. Sworn AG990-IL reports are signed under penalty of perjury, a Class 3 felony in Illinois. Reports bearing Mr. Browne's purported signature include what appears to be false information. If Mr. Browne did not sign the reports, that would appear to constitute forgery, a Class 3 felony in Illinois. I'm preparing a complaint that I intend to submit next week to law enforcement agencies requesting that criminal charges be initiated regarding these matters. So that I may provide those agencies with accurate information, I'm again asking you to discuss this with Mr. Browne, and that you or another CDC employee provide me with a list of of which if any of the six AG990-IL reports he signed. I look forward to receiving the requested information by August 31, 2012, otherwise it will be my understanding that the information will not be forthcoming, which may constitute obstruction. Thank you for your continued attention to these matters and I look forward to your reply. Sincerely,

Peter M. Heimlich Duluth, GA 30096 ph: (208)474-7283 e-mail: pmh@medfraud.info website: Medfraud blog: The Sidebar cc: Daniel R. Levinson, Inspector General, Department of Health and Human Services Sherri Berger, Chief Operating Officer, CDC Brent Stratton, Chief Deputy IL Attorney General The Hon. Rob Woodall, US House of Representatives % Chase Murray Elise Viebeck, Staff Reporter, The Hill

.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Public Health Service Centers for Disease Control and Prevention (CDC) Atlanta GA 30333

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August 30, 2012

Peter M. Heimlich Duluth, Georgia 30096 Dear Mr. Heimlich: I am in receipt of your correspondence to the Director of the Centers for Disease Control and Prevention (CDC) dated August 25, 2012. Please note that CDC has responded on a number of occasions to your inquiries. Accordingly, I believe that no further response is indicated. Further, I understand that separately you have submitted several Freedom of Information Act (FOIA) requests, and that these have been or are being processed by the FOIA office. To the extent that you have any future requests for documents, please submit those through the FOIA office for processing. Sincerely,