Heimlich Institute IRS 990s, 1989+1995 Through The Most Recent (2022)

/ Return of Organization
Return of Organization Exempt

Exempt From
FromIncome
IncomeTax
Tax OMB
OViB No. 1545-0047
No. 1545·0047
Form
Form 990 Under section
section 501(c)
501(c) (except black lu lung benefit trust
ng benefittru st or private
private foundation)
foundation)
of thee Internal
ofth Internal Revenue
RevenueCode Code or section
section4947(a)(l)trust
4947(a)(1) trust
Department
Departmentof
Internal
of the Treasury
Revenue ServIce
Internal Revenue Service
Note:
Note:YYruo urm;
mbeayrequired
be requred
to l.ffitoa us
(See separate Instructions.)
a:pfa ctcopy of this to
thisreturn return to statereporting
satisfysatisfy state reporting requrements
requirements Seetion
Seeinstruction
~®89
instruction
EE | E
For the
For th calendar
ecaenI daryearyear 1989
1989.. or
orfifiscal eglnnlng ..:::J
year beginning
sea lveerbeoi
year j U-.J~t I , 1989
,1989, , and
and en d'
Ing
ending /^^.u
I--(~u =?/
='1 . 19 ....
:.) .
vc>
Name
ame OTorganization
of organization A Empoyer
A Employeridentification
Identification number
number((see instruction$)S)
seeinstruction
Use IRS
UseIRS
label. -1lJiWc../".~ n.s."...,7"_'~ ,£i;~...Ji);~~ON ;:..Je. . *£3\ 7302/6/
...?.$: 7..303/0/
~bel.
ther.
Other "Address (number and street)crorP.o.
dress(numberandstreet) PO.box
boxnumber
number B
B State registrationnumber(seeinstruction
registrationnumber (see instruction E)
E)
wise.
wise.
please
please "':;.~(,.,7 .')/(:!.7Z>2.l.fA.eK4)Af_..:$UI'J'l.:r _' .//,
print
print City
City or town.state.andZIPoode
town. state. and ZP code I
or
or type.
type. .C If applicationfor
application for exemption
exemption is
is pending,
pending,ccheck
heck
C!/N--!. ;? /tP/c ■*ji£S*06
~.:;l()6 here ► . .'.
here s- . ■ . . . . . . . . 0 D
D Checktype
D Check typeof organization-Exempt under section ~► 3
oforganization-Exemptundersection 501(c)(:3
13501(c) ( 3 ))(insert
(insertnumber). Accounting method:BI
number), EE Accountingmethod: Cash D
E l Cash □ Accrual
Accrual
OR ►0
CR .... D section
section4947(a)(1) trust (see instruction C7 and question
4947(a}(1) trust(seeinstructionC7andquestion 92.)
92.1 D Other (specify) ►
Other(specifv)...
F Isthis
Is thisaagroupreturn(seeinstructionQ)
group return (see instructionQ)filed foraffiliates?
filedfor affiliates? Dyes I8I\b
DYes ETNo G If either answer in F is Yes" enterfour·digitgroup
G IfeitheranswerinFisYes" enter four-digit group
"Yes." enterthe
If 'Yes." enter the numberof
number of affiliatesforwhichthis
affiliates for which thisreturnis
return isfiled
filed .dJ~
AJ/& exemption number
exemptionnumber (GEN)
(GEN)" ►
Jsthis a separate
Isthis separatereturnfiledOf
return filed byagroupaffiliate?
a group affiliate?. o
QYES
Yes~ ElI\b
No
H Check here0
H Checkhere D ifif ~r
vourgross
grossreceiots
receotsare
arenormally
normallynotmorethan
not more than$25.000
$25.000(seeinstruction
(see instruction9111.
811).Yru
Y ou do not
do not havehave to file
to file a completed
a completed return with
returnwith IRS: IRS: but if you
but ifVOU
received aaForm
received Form990
990Package
Package nth;mail.
nth; mail.
'y{lUyou should
should fileafilereturnwithout
a return wthout financial
financial data (see instruction
daIa (seeinstruction A. Some
A) Serre states requireacompleted
statesrequirea completed return.return.
Note: Forrn990EZis
Note: Form990EZ isavailable
available fororganizations
for organizations withreceiots
with gross gross receipts less thanand
less than $100.000 $100.000 andless
total assets total
thanassets less than
$250.000at .250.000at
end of vear. end of vear.
501(c)(3) organizations 4947(a)(1) trusts
organizations and 4947(a)(1) trusts must
must also complete
complete and attach
attach Schedule
Schedule A(Form
A (Form 990).
990). (See instructions.)
instructions.)
'Wi'l Statement Revenue, Expenses

Statement of Revenue, Expenses and Changes
Changes in
inNNet
et Assets
Assets 0orr Fund Balances
Balanc
1 Contributions, gifts, grants, and similar amounts received:

Contributions, received
a publicsupport .
Direct publicsupport
b Indirect public support . . . . . . . . . . ..
Indirect
cc Govetnment grants*
GoveUlmentgrants .
d
d Total (add
Total (add lines
lines Il a
a through
through Ic)
lc) (attach
(attach schedule-see
schedule-see instructions)
instructions) .
2 revenue (from Part VII, line 93) . .
Program service revenue(from
3
3 Membership dues and assessments
Membershipdues assessments . . . . . •
4 savings and temporary
Interest on savingsand temporary cash
cash investments
investments .
5 Dividends and interest from securities.
securities
6a Grossrents . . . .
b Less: rental
rental expenses.
expenses . . . . .
c income (loss) . . . • .
Net rental income(loss)
7 Other investment income (describe ► ...
8a Gross amount
amount fromfrom sale of assets other I--t----..---t-......,.-----,r---
th an inventory . . . . . . . . . ~7_t.QoC.l~~O:::-f--I-=:~--- ......
than I--
b Less:cost
Less: cost or other basisandsalesexpenses
basis and sales expenses !-==-+~.:....;:::.;.~f--I....:.;~----I--
c Gain (loss) (attach
(attach schedule) . . . . .. . L..:=-..t.~"-K.....L.l:!:.L...L_......L.=...L.... _,__
9
9 Special fundraising eventsand
fundraising events and activities (attach schedule-see instructions):
schedule-see instructions):
a Grossrevenue(not
Gross revenue (not including $$ _
of contributions reported on line Ia) la)
b Less:direct
Less: direct expenses.
expenses . . . .
c Net income(line 9a less line
income (line9aless 9b) .
line9b)
lOa Grosssales less
10a Gross sales less returns and allowances .
b Less: cost ofof goods sold . . . . .
c Gross profit (toss)(attach
(toss) (attach schedule) .
11
11 Other revenue (from Partvil, line 103
m PartVlI,line 103)
12 Total revenue (add lines ld. 2,3,4,5,6c, 7,8d. 9c, 10c, and 11)
linesld.
13 Program services (from line
Programservices(from line44,column(B))(see instructions). ,
44, column (6») (see instructions).
::
lit 14 Management andgeneral (from line
Managementandgeneral(from 44, column(C»(seeinstructions)
line44, column(C))(see instructions)
c:
GJ 15 Fundraising (from line 44,
Fundraising(from 44, column (D))
(D)) (see instructions) .
! 16 Payments to affiliates (attach schedule-see
schedule-see instructions) .
17 Total expenses (add lines 16 and 44, column (A)).
18 Excess
lit (deficit) fortheyear(subtract
Excess(deficit) for the year (subtract line 17 from
from line 12) .
-; 'it 19 Net assets or fund balances at beginning of year (from line 74, column
balancesat (A))
column(A))
z.:2 20 Other changes in net assetsassets or fund balances
balances(attach
(attach <>vn"",n,::>TI
explanation)
21 Net assetsorfund
21 assets or fund balancesat
balances at end of year (add lines18
lines 18,19,and 20).
For
For Paperwork Reduction Act Notice, see page 1 of the Instructions.
ReductionAct Notice. seepage 1 of the Instructions. Form 990
Form 9 9 0 (1989)
(1989)
ft)
1ihl
form90(l989)
j'''ri9''I5:atement
Statement of
Functional
Functional Expenses
Expenses
Do not include amounts reported on line
AI Toosnu;!
501(c)(3) and
501{c) and (c){4)
complete "''''mAl
All organizations must 00)1lieIe
(cX4)organizationsand
organizations and44947(a)(1)
(A)ToUI
(B), (el'
Columns (8).
column (A). Cd.Jrrs (C), Old(D)..,
butOPlonalfor
trustsbut
7{a)(1) trusts optionalfor others. ee
others.(
r'i~ ~ ..~,
and (D) are required for section^ "-
(See instructions.)
instructions.)
IIII;
6b. 8b, 9b, 10b, or 16 of Part I.
22 Grants and allocations (attach schedule).
Grantsandallocations(attach schedule).
23 Specificassistance
Specificassistanceto to individuals.
individuals • .
24 Benefits paid to or for members. . . .
Benefitspaidto
25 Compensation
Compensationof of officers,
officers, directors, etc..
etc.
26 Other salariesand
salaries and wages.
wages ,.
27 Pension plan contributions
Pensionplan contributions .
28
28 Other employeebenefits
Other employee benefits.•
29
29 Payroll taxes.
Payroll taxes . . . .
30
30 Professional fundraising fees
Professionalfundraisingfees
31
31 Accounting fees
Accountingfees.
32
32 Legal fees • . . . . .
33
33 Supplies
Supplies. . . . . . . /*** j£&_ /<//£
34
34 Telephone rr 4/77.';"'~.$
Telephone &rzj~er9fi$ ##0/ &<?<?/
3 35
35 Postage and shipping
Postageandshipping. . . ??></7 ^3?7
c
36
36 Occupancy
Occupancy. . . . . . S *>A0 / c&£>
a 37 ;5<x>
37 Equipment rentaland maintenance
Equipmentrentaland maintenance . . g^n 2*3-
38
38 Printing and publications . . .
39
39 Travel
Travel. • . . • . . . . . 7 ^ / 3&LL
40
40 Conferences, conventions, and meetings
Conferences,conventions,and meetings . . . &a> <***>
41
41 Interest
Interest. • . • . • . . . . .
42
42 Depreciation, depletion, etc. (attach schedule).
Depreciation,depletion, schedule) .
43
43 Other expenses
expenses (itembe): a~.~J!m!lj~
ajSa/SfefcT.ÂC^SWii.
b _~~ __••• __••••• _••••••••••••••••••••• _•••
e X6..'1H~"'[',s.. T¢.X'!l~l~ .V!':!! y !!tl'iT.I. O'Jo!
d ~JV~J~~~~_~~_ __._ _..
e ~CM:t:.".&Ir'H.(f.!lCfS.,:r~~!eF.~ ...
f ~~~ •••_•••••••••••••• __••••• _••••• _._.
44 Total functional expenses lines22 through 43)
columns these totals to lines13-15.
Describe wha
Describe VItf1a: was achieved in carryingout
wasachievedin carrying outyour
yourexemptpurposes.Fully
exempt purposes. Fullydesaibe
describethe
theservicesprovided;the
services provided; thenumber
numberof
of Expenses
persons benefited: or other
personsbenefited:or other relevant information for each
relevantinformation program title. Section
eachprogramtitle. 501(c)(3) and (4)
Section501(cX3) (4) organizations
organizationsmust RnuintftersKtieo
501<cX3) ind (4) crpna*.
also enter the amountof
alsoenterthe amount of grants to others.
grantsto others. tw-nt oplioml te ottun
a :nt~M~f..._~~~_';Z __~__:{~<.t
.Lev„ iJ*lt»S».>jRf?.wjr—, i r f 4 f .....y.tfV<?.S..
~.&/!_~n d.R.~
yK. sr&h. ...Zt?-.~t!??(P.?r..
*£&£2!£jZv?&?r. _ _~
- .^g**rv .•........•....
. . _ . . . . . . . . . . . . .__
..
!fr.~Clr;_/.:'~~/.;$/!e
^&Z?G.Jz£A&&jss..r>.A.i$. ,(_~./'~~.~i't'~_.JB7'.~'~.o:-!~ •.r.N..!'Z7~ •••••.•....•.•
S.'i'.4.TZ&Z??&. &p ./fe*#&.&i.?k>£7?.ZigZ.
lP.l:lP.~N ••~~~~~6:\ •.I.N..~.{/F.._~~...Y.~~.M'~~~ff.~tt.r.-r.~JC-=lK~~_'.
J:4MJut~!:I.~n#2u •.qt:.1d{:{. M""'l'k(),;;.••~.tfHc ••4.e. Y_'77,,~=
&&/IL. . (Grants and allocations I ) 75,197
b • RA!-?'!n:.l1.nt2t?#.t7A;.~ .. ~.??7'€-1!!:L-!... ..fe.~
«-cf.#£.J:-'t:.f':~~-;':'~?! ..
•~b.4.~~.~(C~.~~~.A.f: ••tJ!~ •• ~~.r.£~~~
"e._-,=-·v~"-.,,.--
'. ..
.7;)...t-S.~ __A(i7.&e?l8#iP'.~M._ /#f;.4(€#..€~~k:~,;;. ~~~~'
.K~de:.-,:, •.&'..9~.Ir ••••:?M.,LP!lI2_.Z:Z:.~/.~.,]!;JC
jfezuas/Ue:.„.49j&su.*r.
~~ , (rants* and allocation's" I 1 n.QQO
c .•• _•••••....•• _..••..••••..••••••••• _••_._.• _•••.•••••••..••••••••.••••• _••••••• _••.• _._•••.•• _.••••••
......_-- ...--------- ....-----_._---_._---------------._.----- ..----.-_._-_._----_.- .._-_.--- ...----_.-
--_.---------------------------------------------._-----_.---_ ..--_._------_.---_ _---_ _-----
.....----- - - - - ---....................... ... ·anifinoCiikins .
d ._ •••••••••• _•• _••• _•• _••••••••••••••• _••••••••••••••••••• __•• _•••••••••••• _•• _••••••••••••••••••••••• _
--------------------------------_._--------------------------_._--._ ..._--_._---_._._-------._--------.
--------------------------------------------------.-----------.------------------_ ..._-------_._-------
(Grants and allocations $'
e schedule). (Grants l
1 Total (add lines a through el (should column (B)). 2./1? /
Page 3
Page 3
f
«8»S
BalanceSheots
(A)
(A) (8)
(8)
E ^ ^ S i - s ^ f e ^ j ^ ^ j j ^ j e ^ f t i t e f and amounts <ntfiedescription column should Beginning
Beginning of
of year
year End of
End of year
year
.fUrJuhoimtsdnly-
¥.-■'':
Assets
45
"45 ^h^-npninterest-bearing . . . . ''itg-P'*
' 4 6 . ^Whgsandterhporary cash investments m.&i 46 /74./.4L,
~~~'~lS,~,!Vible. . . . . . .
4 7 « Accounts receivable 47a
47b 47c
LiSlS: :,alla,walnee·'for
.';T'"b Iftf*: doubtful accounts
allowance for doubtful accounts .
48a
48a ·,PledgeSreceivable
Pledges receivable . . . . . . .
b. 'Less::
Less: .allowance doubtful accounts
allowance for doubtful accounts . . . . 48b 48c
49 . Grants
Grants receivable
receivable. . . . . . . . . . . . . . . . .
Receivab1es due from offl'cers,directors,
50 Receivables due from officers, directors, trustees, and keytrustees, and key employees (attach
employees(attach
schedule)
schedule) . . . . . . . . . . . . ., . .50 ,
Other notesand loansreceivable(attach schedule)
51a Other notes and loans receivable (attach schedule) . I 51a[
51a . j-:5:;1~a:..j- --I-_-I
I
Less: allowance
bb Less: allowancefor for doubtful accounts
accounts . I 51b| I 5lc
Inventoriesfor
52 Inventories
52 saleor
for sale or use
use . . . . . .
53 Prepaid expensesand
53 Prepaid expenses and deferred deferredcharges
charges .. . .
54 Investments-securities (attach
54 Investments-securities (attach schedule) schedule) . .
Investments-land, buildings,
55a Investments-land,
55a buildings, and and equipment:
equipment:
basis. . . . . . . . . . . . . . .
basis 55a
bb Less:
Less: accumulated
accumulated depreciation
depreciation (attach (attach
schedule) . • . . . • . . . .
schedule)
56 Investments-other (attach
56 Investments—other schedule). . . . . .•
(attach schedule)
Land. buildings. and equipment:
57a Land, buildings, and equipment: basis basis . . . . .. .. 57a y.^Â
b Less: accumulated depreciation (attach
accumulated depreciation (attach schedule) schedule) . 57b / 3 » »
L.=..::...::J_~~::..L::::""'..L.._+- ~4_-+=~+-
JL 57c __ -o
-="'::::""_-+- __
58 f»h»r assets ~ _-.....:a.c~
Other assets/Hpcrrihofc. ....o.=.=-:..:..:.:;:.'-'-
S g ^ e i f i i ~&g7fas,- _
;o
59 Total assets (add lines 45 through 58) ■ /14.4O4 <Z/?<fr75'
Uablllties
Liabilities
60 Accounts
60 Accountspayable
payableand accruedexpenses
and accrued expenses . . . .
661 Grantspayable
1 Grants payable .• • . . . . • . . . . .
62 Supportandrevenuedesignated
62 Supportand'revenue designatedfor future periods
for future periods(attach schedule) , . .
(attach schedule)
63 Loans
63 Loansfrom officers,directors,
from officers, directors. trustees, andand key
key employees
employees(attach schedule)
(attach schedule)
64 Mortgages
64 Mortgages and and other
other notes
notes payable
payable (attach
(attach schedule)
schedule) . '
65
65 Other
Other liabilities
liabilities (describe ►... )) I-----+--f-=+---~:-I--
66 Total
66 Total liabilities (add lines 60 through 65)
Fund Balan~ or
Fund Balances or Net
Net Assets
Assets
OrganlzatJons that
Organizations th atuse
use fund
fund accounting,
accounting. check
check here
here ►... !!Sf0 and
andcomplete
completelines
lines
67 through
67 through 70 70 and
and tines
lines 74
74 and
and 75.
75.
67a Current
67a Currentunrestricted
unrestrictedfund fund . . . .
bb Current
Current restricted
restricted fund
fund. . . . .
Land,buildings,
68 Land,
68 buildings,and equipmentfund
and equipment fund
69 Endowment
69 Endowmentfund. fund . . . . . .
70 Other
70 Otherfunds(describe
funds (described.. _
Organlzatlonsthat
Organizations that do not use
donot use fund
fund accountln
accounting, •• check
checkhere
here^D ... 0 and
and complete
complete
lines71
lines through 75.
71 through 75.
Capitalstuck
71 Capital
71 stuckor ortrust principal. . . . .
trust principal
72
72 Paid-in
Pald·ln or
orcapital
capital surplus
surplus . . . . . .
73
73 Retained
Retained earnings
earnings or oraccumulated
accumulated income
income.
74
74 Total
Total fund
fund balances
balances or ornet
netassets
assets(see
(seeinstructions)
instructions) .
75 Total liabilities and fund balances/net assets assets (see instructions) . . .
5°-
'11
Form 990(1989)
List of Officers, Directors, and Trustees (List each one even if not compensated. See instructions.)
(B) Title and average (C) Compensation (0) Contnbutions (E) Expense
(A) Name and address hours per week (it not paid, to employee account and other
devoted to position enterteto) benefit plans allowances
. £>£.<f . j9f7K/r«£i .vS..tKOUK«= .

-- 6-
<5-
-o- -c'
Other Information
76 Did youengagein
Didyou engage inany anyactivity
activitynotnotpreviouslyreportedto
previously reported tothe theInternal
Internal Revenue Service? . .
RevenueService?
If" Yes,"
If' Yes," attach aadetaileddescriptionof
detailed description ofeachactivity.
each activity.
77 Were
Wereany any changesmadein
changes made inthe theorganizingor
organizing orgoverningdocuments,but
governing documents, but notnot reported IRS?
reportedto to IRS? .
If
If' "Yes,"
Yes," attach aaconformedcopyof
conformed copy ofthe thechanges.
changes.
78a
78a Did
Didyouryourorganizationhaveunrelatedbusinessgrossincomeof
organization have unrelated business gross income $1,000 of $ 1,000 or more during the
or moreduringthe year covered by return?
yearcoveredbythis this return?
b If
If' "Yes," have youfifiled
Yes," haveyou a taxreturn
fed atax returnononFormForm 990-T,
990· Exempt Organization
T, ExemptOrganization Business Income Tax Return,thisyear?
BusinessIncomeTall.Return,for for this year?
*I/JI
c At anytime
any time duringtheyear,
during the year,didyou did you CWlown a 50%greaterinterestinataxablecorporationor
a 50%or or greater interest in a taxable corporation or partnership?
partnership? . . . .
If Yes,"
Yes" completePartIX.
complete PartIX.
79 W
\J\Ji£asthere
thereaaliquidation,
liquidation,dissolution.termination,
dissolution. termination, oror substantial contraction
substantialcontraction during
during thethe year? (See
year?(See instructions.)
instructions.) . . .
If 'Yes,"
"Yes," attach a statement as described,
attach a statementas describeq inthe instructions. in the instructions.
80a
80a A
Pre reyou
yourelated(other
related (otherthan thanbybyassociation
association with
with a statewide or
a statewideor nationwide organization)
nationwideorganization) through
through common
common membership,
membership,
governing
govemingbodies, bodies,trustees,officers.etc••to
trustees, officers, etc., toanyany other
other exempt or
exemptor nonexempt
nonexempt organization?(See
organization?(See instructions.) . . . . .. .
instructions.).
b
b If"Yes."
If 'Yes." enter ent.he the name
nameof ofthetheorganization
organization_ •••••••••••••• _•••• _•••• _._•••• _•••••••••••••••••••••••••••
"" •••• "". ,,'_ •• _•• _••••••••• _••••••••••••••••• check whetherititisis 0
_ and checkwhether Q exerrlp~OR
exempt OR D'nonexempt.
81 a
81a Enter amount
amount of political
political expenditures.direct
expenditures. director orindirect,
indirect,as asdescribedinthe
described in theinstructions.
instructions. 1..:'
L§lsJ—A'//* __
=:..L-~~;'_
b Did you file

Didyou file Form
Form1120-POL,U.s.
1120-POL,U.S IncomeTax Income TaxReturn ReturnforforCertain
CertainPolitical
Political Organizations,
Orpnlzations. forfor
thisthis year?
year?
82a
82a Did youyou receive
receive donatedservicesor
donated services orthe theuseuseofofmaterials,
materials,equipment,
equipment,ororfacilities
facilitiesatatnonocharge
chargeororatatsubstantially
substantially
less
lessthan than fair
fair rental
rentalvalue?
value? • . • • . . • . • • • . . . • . • . • • • • 82a
b If 'Yes,"
"Yes" you may indicate the value of these items here. Do not include this amount as
revenueiin
revenue n Part
Partlorlor asasan anexpenseinPart
expense in Partll.SeeII. See instructions
instructionsfor forreportingi
reportingninPartlll.
P a r t l l l•. . . . 1 8 2 b I /J/A
83a
83a anyonerequestto
Did anyone request toseeeitheryour
see either yourannual annualreturn
returnororexemptionapplication(or
exemption application(orboth)? both)? •
b If Yes,"
Yes" did you youcomply
complyas asdescribedin
described inthe thelnstructlonsasee
instructions?(SeeGeneralInstruction
General Instruction L.)L.)•
84a Did youyousolicit
solicitany anycontributions
contributionsororgifts giftsthat
thatwere
werenottax
not taxdeductible?
deductible? • • • • • •
b IIffYes,"
Yes" did didyouyouinclude
includewithwitheverysolicitation
every solicitationananexpressstatement
express statement thatsuch
that such contributions
contributions oror gifts
gifts were
were notnottaxtax
deductible?(SeeGenerallnstruction
deductible?(See General InstructionN.) N) • • • . • • • . • • . • • • . • . • • . . • • •
85a
85a Section 501(c)(5) or (6) (6) organizations.—Did
otpnizations.-Oid you you spend any any
spend amounts
amounts in attempts
in attempts to influence
to influence public opinion
public opinion
aboutlegislativematters
about legislativemattersor or referendums?(Seeinstructions
referendums?(See instructions and Regulations section1.16
andRegulationssection 116220(c).),
b IfYes,"
If 'Yes," enter the total total amount spent for for this
this purpose.
purpose . 185b I *#*.
86 Section 50J(c)(7)
501(c)(7)organizations.
organizations.-Enter:
-Enter:
a Initiation fees
Initiation fees andandcapital
capitalcontributionsincluded
contributions includedonon line
line 12.12.•
b Gross receipts, included
Grossreceipts, includedon onlineline12,
12,for
forp.ublicuse
public use ofof club
club facilities
facilities (See instructions.)•
(Seeinstructions.)
c Does
Does the club's governing instrument or any written written policy statement provide for discrimination against any any
person because of race. color, or religion?(See
personbecauseof race.color, or religion?(Seeinstructions.) . instructions.)
87 Section501(c)(12) organizations.—Enter
Section50J(c)(l2)olpnizations.-Enter amount amount
of: of:
a Grossincome
Gross incomereceived receivedfrom frommembersor
members orshareholders.
shareholders . .
b Grossincome
Gross income receivedfromreceived fromother othersources(Do
sources (Donot notnetnetamounts
amountsdue dueoror paidpaidto to
other
othersources
sources
againstamounts
against amounts due dueor orreceivedfrom
received fromthem.). them.) • . . . • . . . . . • • , . . L:.:~--"'~~---:
.
88 Publicinterest
Public in te res tlawlaw//r/ns Attachinformationdescribedi
firms.-Attac:h info rmat io n d escribednthe instructions.
in the instructions.
89 Ustthestates
List the stateswith withwhich
whicha a copy
copy ofthis return
of this retuisrnfiled
is filed~ ••••
► ~~_.{$&/>. _••• _••••• __._. __ .-,_ ••• __••• _••
90 Duringthis
During thistaxtaxyeardidyoumaintain
year did you maintain part
anyany of youraceountinB/tax
part of your accounting/tax recordson
recordsacomputerized
on a computerized system?system? • . • • •
91
91 The booksare
books areinincare careofof_ A'c!VNt..~.~'7i'~~~~M
M&MUs&.JZJWT&tt.i.AH.&A, ..~ .lephone no. ►.s[:t:-.~:r;.=~"'A-n.u......
Telephoneno." j . ..9:Sy.r<5?ft^w n
Locatedat
Located at ._ e,.,Ha~1(d77.,.lPd/.t;}
£//S&6*<4£&72.+&?/,<&. ••••_.,•••,•••__•.
, .... .,_"
. . . . . .0'
.. ••••••••• _., •••••••• _- ••••. . . .__
. .••••
. . . _.
. . __•••••• --
92 Section
Section 4947(aXl)trusts
4947(aX1) trustsfilingfiling
FormFom 99Qjrfijffip&urt)£M ^
99QWrl~PWDf..J.fJJ.PI J comeJ come Tax Return.—.-*-.
Tax Retum.-.· Check
. . here ...
-. • • . • Checkhere ►D--
and enterthe
enter the amountoftax-exemptintereslrecelveiiofecsrU8
amount of tax-exempt interestreceiveooraccruli nn th th , ,,t» 192192 ,.{I""
) ///.- I
:•'.£** «jr«0 Jr«tf ^ A eetafk) 9 ? t t
feas/ / Page 5
I sSj I* YJ-tmOlf Analysis of Income-Producing Activities
£nt8rgross amounts unlessotherwise
£nt.rgross unless otherwise indicated. Unrelated business income Excluded by section 512,513. or 514
§):? servicerevenue:
93 program service revenue: (a) (b) (c) (d> Relate Je)
or exe!lll1:
Related (J" exempt
Business code Amount Exclusion code Amount function.ncome
function income
~)--------------------------
(»)
(b)
(b)
_
-------------_
(c)
(~)
(d)
(«J)
(e)
(f) _
-+ +- ~--------r_------_+---------
(0
(g) Fees from government
(g) Feesfrom government agencies
agencies • . . . . . f----+------+-----+-------t-----
94
94 Membershipdues
Membershipduesand and assessments.
assessments . . . . . I----+------+-----+-------if---:---
95 Interest
Interest on cash investments . t----+------+-----+--------ir--~-.r-~:::-..
savings and temporary cashinvestments
onsavingsandtemporary
96 Dividends
Dividendsandand interest on securities.
securities . .
97 Net rental
rental income (loss)
(loss) from
from real estate:
(a) debt-financed property.
(~) property . . . .
(b) not debt-financed property.
property . . .
98 Net rental
rental income (loss)
(loss) from
from personalproperty
personal property . .
99 Otherinvestmentincome
Other investment income . . . . . . .
100 Gain
100 Gain(loss)from sales ofassets
(loss) fromsalesof assetsotherthan
other thaninventory
inventory *L/>-/?>
101
1 0 1 Net income from special fundraising events
events . . .
102 Gross
102 profit (loss)
Grossprofit (loss) from sales of inventory . . . .
103 Other revenue:
103 Other revenue: (a)
(a) _
(b) _
(~)
(d) ------------_
(e) _
(e)
104
104 Si SL (add columns (b), (d). and(e».
(b),Cd). and (e)) . . /■3 &r
105 TOTAL (add line 104,
105 TOTAL(add 104, columns
columns (b),
(b) Cd),
(d), and
and (e))
(e)) ...................
(line 105 plus line ld.
(Line PartI,I should equalthe
Id, Part equal the amount on on iind 12, Part
iind 12 Part I.)
1:r.Ti.'JlI Relationship of
Relationship Activities to the
of Activities the Accomplishment
Accomplishment of of Exempt
Exempt Purposes
Purposes
UneNo.
Line No. Explain below how each activity for which income is re~ortedi
Explainbelow reported in column
n colu VII contributedi
mn (e) of Part VII contributed importantly to the
mportantlyto
• accomplishment of your exempt
accomplishmentofyour exempt purposes (other than byy providing
purposes(other funds for such purposes).
providingfunds
,JI A
r ! I
Name,address.
N a m e , a d d r e sandeQ1)loyeridentification
s . a n d employer identification Percentage
Percentage of
of Nature o
Natureof Total
Total End-of-year
nurmer of corporation
number corporationo(J"r partnership
partnership CWlershipinterest
ownership interest businessaeiivities
business activities inrome
in come assets
-/Hr-
I
Under penaltii declarejhaf I nave examined this return, including accompanying schedulesand statements. andtothe best of my knowledge and
Please
Please belief, it is tr e. r/ej^rationgj^pnlpa'er (other than officer) IS based on all information of which preparer has any knowledge.
Sign
Here *' bafe' f Title
Oate
Preparer's Check if
Paid
Preparer's
signature
Finn's name (or
222a! 4 g t A . » ^
* &
?!(*/*>
ZIP code
sell-employed* L I
Use Only yours it sell-employed)

and address
•U.S. Gov*rns*nt
.U.$. Gover frlntlnt Offlcti
...... tTln.ln~ HJ0-26J-ISUO006C
orrl.OI 1990-261-UII0006~
-. \ti\\_
, \,,~
SCHEDULEA
SCHEDULE A Organization Exempt
Organization Exempt Under SO 1(c)(3)
501(c)(3) OMBNO.l54~
990)
(Form 990) (Except prfvate
Private Foundation),
Foundation), 501(e),
501(e). 501(f), 501(k), or Section 4947(a)(1)
501(f). 501(k). 4947(a)(1) Trust
Department
Department ofof the
Internal Revenue
Internal
Treasury
the Treasury
RevenueServ'ce
Service
Supplementary Information
Attach to Form990
Information
Form 990 (oror Form990
Form990EZ).
i1@89 ~
Name
Name Employer Identification
, Employer Identlfteatlon number
number
Compensation of t h ee Five Highest

Compensation ofth Highest Paid Employees Other Other Than Officers.
Officers. Directors,
Directors, and Trustees
andTrustees
(See specific
specific Instructions.)
instructions.) (list eachone.
(List each arenone,enter'None.")
one. Ifthere are none, enter 'None.")
(b) Titleand average
(b)Titleand (d) Contributions
Contnbutions to
to (a) Expense account
account
(a) Name and address
(a) Name address of
of emDloyees
employees Daid
paid mOte
more than
than$30.000
$30,000 hours per week
hours per week (c) Compensation
(e) Compensation employee
employee and other
and other
devoted to
devoted to posItion
position benefit plans
benefit lans allowances
allowal\C:6
.......-- ...---.-------- .._----- ..------------.

------ ..._-_ ..... ---- ..-_. __ ._ .._-- ....--- ...--
Total number
number of other employees paid over
other employees over
$30,000.
$30,000 . ►...
.. iI61IM Compensation
Compensation of tthh ee Five Highest
Highest Paid
Paid Persons
Persons for Professional Services
Professional Services
(See specific
specific instructions.)
instructions.) (List
(List each one. If there arenone,enter'None.')
eachone.Ifthere are none, enter 'None.")
(a) Name and
Cal Name and address
address of
of persons
persons paid
paid more
morethan
than$30,000
$30,000 (b) Type 01
of service
service
(b) Type (c:) Compensation
-----_.------- ....-----_ .._---------------------_ ..--- .._-------_._-----
--••-------
••------------
••••••
---••••• ••• •• • ._••a.
^w^mi»"
Total number of others receiving over $30,000 for
professional services ►
Statements About Activities
1 hav'e you attempted to influence national, state, or local regislation,including

, During the year. hav'eyou legislation, including any attempt to to
influence public
public opinionon legislativematter
opinion on a legislative matter or referendum?
referendum? . . • . . . . . . . . • . . • • •
If "Yes,"
''Yes,'' enterthetotal expensespaidor
enter the total expenses paid or incurred
incurred in
in connectionwith
connection withthethe legislativeactivities.
legislative activities. $$ _
Complete Part VI of this form for organizations
CompletePart madean
organizations that made electionunder
an election sectionSOl(h)
under section other
501(h) on Form 5768 or other
statement. For
statement. other organizations
For other organizations checking'
checking "Yes," statement giving a detaileddescriptionof
Yes," attach a statementgivinga detailed description ofthe
thelegislative
legislative
activities and a classified
activitiesand schedule of the expenses
classifiedscheduleofthe expensespaidpaid or incurred.
orincurred.
During the year, haveyou,
2 Duringthe have you, either directly
directly or indirectly.
indirectly, engagedin
engaged in any of the followingacts
following acts with a trustee, director,
director,
principal officer, or creator
principalofficer, creator of your organization,or
organization, or anytaxableorganizationor
any taxable organization or corporation
corporationwithwith which such person
whichsuch personis is
affiliated as an officer,
officer, director,trustee,
director, trustee, majority owner,orprincipalbeneficiary:
owner, or principal beneficiary:
a Sale,exchange,or
Sale, exchange, or leasingof
leasing of property?
property?. . . •
b Lendingof
Lending of moneyor
money or other extensionof
extension of credit?
credit? . . . . . . . . . .
ec Furnishingofgoods,
Furnishing of goods, services.or
services, or facilities? . • • . . . . . . . . . , . . .
Payment of compensation(or
d Paymentof compensation (or paymentor
payment or reimbursementof
reimbursement of expensesif
expenses if morethan
more than $l,OOO)?•
$1,000)?
e Transfer of any part of your incomeor
income or assets?
assets? • • . . . . . . . • . . . • . .
If the answer
answerto questionis
to any question "Yes." attach a detailedstatementexplainingthe
is "Yes," detailed statement explaining the transactions.
transactions.
3 Doyou
Do you makegrants
make grants for scholarships.fellowships,
scholarships, fellowships, student
student loans,etc.?
loans, etc.? . . . . • . • •
4 Attacha
Attach a statement
statement explaininghowyoudeterminethat
explaining how you determine thatindividualsor
individuals ororganizations
organizationsreceivingdisbursementsfrom
receiving disbursements fromyou you
in furtherance of your charitable programs ms qualify to
to receive
receive payments. (See specific instructions.)
For Paperwork Reduction Act Notice, seepage 1 of the Instructions to Form 990 (or Form990EZ). Schedule A (Form 990) 1989
........ ~,.......... ~
Page 2
'.:mlnizatlcln not a private

:ion is not private foundation
foundation because it is (please check
check only ONE applicable
applicable box):
Q *1 A church,
church, convention
convention of churches,
churches, or association
association of churches.
churches. Section
Section 170(b)(1)(A)(i).
170(b)(l)(A)(i).
5
6
8
s□ 2
2 Ascheel.
3
3A
4
Aschool. Section
Ahospital
4 A Federal,
Section 170(bXl)(A)(ii).
Federal, state,
170(bXl)(A)(ii). (Also complete
hospital or a cooperative
cooperative hospital
state, or local
local government
complete PartV,
hospital service
Part V, page3.)
service organization.
page 3.)
organization. Section
government or governmental
governmental unit.
Section 170(b)(lXA)(iii).
unit. Section
170(b)(lKA)(iii).
Section 170(b)(lXAXv).
170(b)(l)(AXv).
9 □ 5
5 A medical
medical research
research organization
of hospital
of hospltal~►
organization operated
operated in
in conjunction
conjunction with
with a hospital.
hospital. Section
,
Section 170(b)(lXA)(iii).
170(b)(lXA)(iii). Enter
Enter name,
,
name, city,
city, and
and state
state
.
10 a
0 6
6 An organization
operated for the
170(bXl)(A)(iv). (Also complete
170(b)(1)(A)(iv).
the benefit
benefit of a college
complete Support
college or university
Support Schedule.)
Schedule.)
university owned or operated
operated by a governmental
governmental unit. Section
Section
1 ESI 77 An
~ An organization
organization that
that normally
normally receives
receives a substantial
substantial part of its support
support from
from a governmental
governmental unit or from
from the
the general
general public.
Section 170(b)(1)(AXvi).
Section 170(b)(l)(AXvi). (Also complete
complete Support
Support Schedule.)
Schedule.)
12 a
0 8 An organization that normally receives: (a) no morethan of its support from gross investment income and unrelated business
An organization that normally receives: (a) no more than V}
l/;! of its support from gross investment income and unrelated business
taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975, and (b) more than If3
taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975, and (b) more than Vi
support from
of its support from contributions.
contributions. membership
membership fees. and gross receipts from from activities
activities related
related to its charitable,
charitable, etc..
etc..
functions-subject to certain
functions-subjectto certain exceptions.
exceptions. See section
section 509(a)(2).
509(a)(2). ((Also
Also complete
complete Support Schedule.)
Support Schedule.)
13 a
D 9
9 An organization
organization that
described
that is not controlled
controlled by any disqualified
(1) boxes 5 through
described in: (1) through 12
disqualified persons (other
12 above; or (2)
(2) section
(other than
section 501(c)(4).
than foundation
foundation managers)
managers) and supports organizations
501(c)(4), (5), or (6), if they
they meet the
the test
organizations
test of section
section 509(a)(2).
509(a)(2). See
section
sectio .n509(a)(3).
.5 0 , ,,).
following information
Provide the following about the supported
information about supported organizations.
organizations. (See instructions
instructions for PartIV,
Part IV, box 13.)
I (b)
(a) Name
(a) Name of supported
supported organizations
organizations
I Box number
from
number
from above
I
14 0 organization organized and operated
I I °0 An organization operated to test
test for public
public safety. Section
Section 509(a)(4).
509(a)(4). (See specific
specific instructions.)
instructions.)
S
Support Schedule (Complete only If you checked box 1 0 , 1 1 , or 12 above.) Use cash method of accounting.
year (or fiscal
Calendar year
Calendar
year beginningln)
year beginningin) ..
15 GII:s. grams, and contributions
Gits. grants contriburonsreceived.
received.(Do
(00
not include
rd unusualgrams.
includeunusual grantsSee
Seeline
line28.)
28) , . . . 1'80·
Membership fees received i .
11
17 G ro ssreceipts
C3m; receiptsfrm
fromadrrissOls,
admissions merchandise
17
sold cr senm
or services petnred furnishingcto f
performed ocrr fumishing
facilities av activity
facilities in any activity that
that is rd
not a business
urueIated
unrelated to tothe
theClPmzation's
organization'scharitable,
charitable,etc
etc
..
purpose
18 Gross
Gross income frm interest,
income from dividends.
nterest, dividends
amouris received
amounts receivedrom paymentsmon~securities
fom p3J1'THlIs
loans (secfun
loans (section 512(a)(5».
512(a)(5)), rents, loyalties. and
rentsroyalties, and
unrelaed bbusiness
unrelated usinesstaxablemrre (less
taxable in c o me section
(less section
taxes) from
511 taxes) rom businesses
businl!$$e$ acquiredby
acquired by the
organization after June30,1975
30,1975 ..
19 Net income
income from
from unrelated
unrelated business
riot included
actlvlti'es not
activities nne' 1 a8 .. ..
Included in line
20 Tax revenueslevied
Tax re\'ellue5 leviedfor benefitand
your benef~
foryour andeither
either
paid to you Of expended on your behalf. . . . .
paidtoyouorexpendedcnyourbehalf
211 Ire
2 value ct
The value of services r facilities
servicescor facilitiesfumished
furnishedtoto
you by
'PJ Of aa governmental
govemmentalunt unit without c:I1ag=.
withoutcharge.
Do rd not intlude va lue ctof selVices
the v.ir
include the services cr
or
facilities generally furnished to the public
facilitiesgenerallyfumishedto
without chai
2 2 Other income. Attach schedu le . Do not i n
dude gain (or lass)fromsale of capital asset
2 3 Total of lines 15 through 22
24 Line 23 minus line 17
25 Enter 1 % of line 2 3
2 6 Organizationsdescribed
Organizations described in box 10 or 111:
1:
8 Enter2%of
8 Enter 2 % of amount
amount in column
column (e), line 24
24 . . . . • . . • . • • . • • . . • . .
b Attach
Attach a list
list (not
(not open
open to
to public
public inspection)
inspection) ",nl'1"'''''<7
showing the name of and amount contributed by each person
t* 305
(other than a governmental
governmental unit
unit or publicly supported organization) whose total gifts for 1985 through 1988
Ii L_"_.,,, .. sum o f all excess amounts here
exceeded the amount shown in line 26a. Enter the Q
(Continued on page 3)
THE HEIMLICH INSTITUTE
THE HEIMLICH INSTITUTE FOUNDATION, INC.
FOUNDATION, INC. FORM
FORM 990
FISCAL YEAR 19~
199° 23-7303161
23-7303161
SCHEDULE A -
~ PART III
111 ~
- LINE 33
Patient need For financial assistance is determined on an
individual basis.
basis.
Each paciencls
pacienc's ability to meet medical and related
related expenses is
reviewed in terms o£ information or through investigation
of referral information
by itself.
by the Foundation itself.
PAR! VI - LIST OF OFFICERS, DIRECTORS AND TRUSTEES

PART
-
TITLE
TITLE COMPENSATION
COMPENSATION
Harry W
K Whittaker President
President None
Cincinnati, OH 45202
Philip M. Heimlich
Heimlich Vice-president None
45208
Cedric W. Vogel Treasurer None
45202
Joseph J. Dehner Secretary None

M.D.
Henry J. Heimlich, M.D. Trustee None
45207
Mrs. Winston C. Atteberry

Atteberry Trustee None
Eunice, LA 70535
Kathy and Ray Carr Trustee None

Mrs. Mark P.
Mrs. P. Herschede (Joni)
(Joni) Trustee None
Arthur and Kathryn Murray Trustee None

Honolulu, HI 96815
Monte L
1. Rovekamp Trustee None
Cincinnati, OH 45219-0129
William P. Sheehan Trustee None
45255
Charles ~
J Squeri Trustee None
Anson Williams Trustee None
Los Angeles, CA 90035
Winchell
Dr. Paul WinchelL Trustea
Trus tea None
Hone
Wesr.laWe. CA 91361
Wp.~r.1Ake.
zy-MQuuiizig
L~4(10jUU II Z, 9 QfjlB-NoT T*35-e^_
Return of
Return of Organization
Organization Exempt
Exempt From
From Income
Income Tax
Tax i ^- ^^
990 Under section 501(c)
Under section 501(c) ofof the
the Internal
Internal Revenue
Revenue Code Code (except
(except black
black lung
lung benefitr?'Lj
b e n e f i t ^ / / A/C ' \ | § f T ^
Department
Depart",ent of the Treasury -
the,Treasury- trust or
trust or private
private foundation)
foundation) or or section
section 4947(a)(1)
4947(aX1) nonexempt
nonexempt charitable
charitable trust 7
trust I ttl a ? ^ ~-_"'~
-- :
ffj^> r
^'
Internal Revenue S.~vlce
Service Note: The or anization ma have to use a co of this return to satis state re ortin
Note: The organization may have to use a copy of this return to satisfy state reporting requirements. re uirements.
A
A For the the 1995
1995 cale
calendar year OR tax vear
ndar vear year Deriod
period beainnina
beginning 06/01 1995.
1995 and ending
and endill_a 05/31
B Check if: if: C Name of organization
C organization o
D Employer
Employer Ider,
Iden _.~rnDer
Please
Please
0
□ Change of
use IRS
use IRS
THE.HFIHLICH INSTITUTE
THE~LICH INSTITUTE
address FOUNDATION
FOUNDATION 23-7303161
labalor
label or
Number and street
street (or P.O. box If mall Is not delivered
delivered to street address)
address) E State
0
□ Initial return
return print
print or
maills Room/suite
Room/suite E State registration
registration number
number
0
CH Final return type. See
See VICTORY PARKYAY
2368 VICTORY PARKWAY
Specific
0
O Amended return Specific
Instruc
Instruc
SUITE 410
SUITE
(required also for
tions.
tlons.
City, town, or post
City, town, post office,
office, state, and ZIP code FF Check ...
0|
^ | If exemption
application
application
State reporting)
State reporting) CINCINNATI^ OH 45206
CINCINNATI OH Is oendino
IS pending
► [Xl
G Type of organization ... 0 Exempt under section 501(C)(
501(c)( 3 ) 4 (Insert number) OR...
)~ 0
O R ^ CD section 4947(a)(1) nonexempt charitable trust
Note: Section 501(c)(3) exempt organizations and 4947(a)(1) nonexempt charitable trusts MUST attach a completed Schedule A (Form 990).
H (a)
H ( a ) Is this
this a group
group return
return flied
filed for
for affiliates?
affiliates? • • • • • • • • • • • □ ves S No I either box
If either box In
in H Is
is checked
checked "Yes;
"Yes," enter four
four digit
digit group
(b) If "Yes;
(b) "Yes," enter the
the number of affiliates
affiliates for
for which
which this
this return
return Is filed
flied: ► N/A exemption
exemption number (GEN) ► _
(C) Is this
(c) this a separate return
return filed
filed by
by an
an organization
organization JJ Accounting method:
Accounting method: Dcash E Accrual
covered bv a Qrouprullno? I I Yes M l No l~l Other fspecifv) ►
K Check here ►! I If the organization's gross receipts are normally not more than $25,000. The organization need not file a return with the IRS; but If it
received a Form 890 Package In the mall. It should file a return without financial data. Some states require a complete return.
Note- Form 990 EZ may be used bv organizations with gross receipts less than $100.000 and total assets less than S250.000 at end of year.
■JPiatrag.il Revenue. Expenses, and Changes in Net Assets or Fund Balances (See instructions.^
Contributions, gifts, grants, and similar
similar amounts received:
a
a Direct public support
support . . . . . . . 1a 64,010.
b
b Indirect public support
support. . . . . . . . . . . . . . . . . . . 1b 50,000.
c Government contributions (grants)
(grants). . . . . . . . . .... 1c
d Total (add lines 1a
ta through 1c)
tc) (attach schedule of contributors)
contributors) SEE 990 PT I - 1
(cash $
(cash 114,010.
114,010. noncash $ _-) Id 114,010.
2 Program service revenue including government fees and contracts (from Part VII, line 93).
3 Membership dues and assessments rTTTirr"r-r-«-~~t_.
4 j O J~ /*•» — V T j ~
5 Interest on savings and temporary cash investments .„...,'. ! v".^-f. . . ' T " / ^ . . . i . . . 24,398.
£a Dividends
Gross rentsand. interest
rents. . . . . from
. . . securities
. . . . . . .. . . . ..
:'fa OC7 2 JS_
b Less: expenses . . . . . . . . . . . .
Less: rental expenses / : : ?:a«:
Jb_
i s9 Net rental income or (loss) (subtract line 6b fromjline 6a57_r,~?l 6c
R
e r-
?■ Other investment income (describe ► ... L____ /'■■•"' '~-
v
e 8k
8.it Gross amount from sale sale of assets
assets other ( A ) Securities (B) Other
n
u
e
i n v e n t o r';J~?-.'?
than inventory yP?^. ^ T Tf:"."T
t f T .<1.9.0. ?t·:r:- V .
°^P. P + T T Y . 173,799. 8a
b Less: cost or other basis and sales expenses expenses . . 160.072. 8b
c Gain
Gain or (loss) (attach schedule) . 13,727. 8c
d Net gain or (loss)
(loss) (combine line 8c, columns (A) (A) and (B))
(8») SEE
SEE 99.0.
99.0.P.
T ..I.-.
PJ I. -. 2 8d 13,727.
9 Special events and activities (attach schedule):
Special
a Gross revenue (not including ""- $_ _ of
contributions reported on line 1a) 1a) 9a
b Less: direct expenses other than fundraisingfund raising expenses
expenses. . . . . . . . . . 9b
c Net income or (loss) from special events (subtract line 9b from line 9a). 9a)...... . . 9c
10a
lOa Gross sales
sales of inventory, less returns and allowances
allowances . . . . . . . . . . . . . .I-"!!!O-+-
10a ~
b Less: cost of goods sold . . . . . . . . . . . . . . . . . . . . . . . . . . . . . L...!.,!,!!!-l-.
10b -'
c Gross profit or (loss)(loss) from sales

sales of inventory (attach schedule) (subtract line 10b from line 10a)
10a~ . 10c
11 Other revenue (from Part Part VII,
VII, line 103)
103) . 11
12 Total revenue (add lines I d , 2. 3. 4. 5. 6c, 7. 8d, 9c. 10c. and 11) 12 152,135.
E 13 Program services (from line 44, column (B)) . . . . 13 151,304.
x
p 14 Management and general (from line 44, column (C)) 14 56,184.
e
n 15 Fundraising (from line 44, column (D)) 15
e 16 Payments to affiliates (attach schedule) 16
17 Total expenses (add lines 16 and 44. column (A)). , 17 207,488.
18 Excess or (deficit) for the year (subtract line 17 from line 12) 18 -55,353. )
N 5
e 19 Net assets or fund balances at beginning of year (from line 73, column (A)) 19 ^ 28,885.
t e
t 20 Other changes in net assets or fund balances (attach explanation) 20
21 Net assets or fund balances at end of year (combine lines 18, 19, and 20) . 21 473,532.
For Paperwork
Paperwork Reduction
Reduction Act
Act Notice,
Notice, see instructions.
instructions. 990
Form 9 9 0 (1995)
(1995)
JXB
JXB F 02/01/96
02/01/96
THE HEIMLICH INSTITUTE'
THE HEIHLICH INSTITUTE
Form 990>"S351
(19aS) FOUNDATION
23-7303161 Page 2
Mltililti Statement
S t a t e m e n t of
Of AM organizations must complete column (A). Columns (B), (C), and (D) are required for section 501(c)(3)
P.Jnctional
R jnctional E xpenses
E'lCII]RI'~'~~ and (4) organizations and section 4947(a)(1) nonexempt charitable trusts but optional for others. (See instr.
Do not
not include amounts reported on line
reported on ' (A) Total
( B ) Program ( C ) Management
( D ) Fundraislng
6b, se,
6b, 8b, 9b, 10b, or
or 16 of Part
Part I. services and general
??
22 Grants and allocations
allocations (attach schedule) ..... ■*
(cash S
$ noncash£
noncash $ ) 22 ' :
23
23 Specific assistance to individuals (attach schedule) . . . .
SpecifiCassistanceto 23
24
24 Benefits paid to or for schedule)
for members (attach schedule). 24
25 Compensation of officers, directors, etc . 25
26 Other salaries and wages . 26 72.500. 60,713. 11.787.
27
Xl Pension plan contributions. 27
28 Other employee benefits. . 28 14,976. 9,382. 5.594.
29 Payroll taxes . . . . . . .
Payrolltaxes. 29
30 Professionalfundraising fees. 30
31
31 Accounting fees . 31
32 Legal fees. 32
33
33 Supplies . 33
34 Telephone . 34
35 Postage and shipping 35
36 Occupancy ..... 36 15.600. 10,400. 5.200.
37
37 Equipment rental and maintenance 37
38 Printing and publications. . . . . . 38
39
39 Travel . 39
40 Conferences, conventions, and meetings 40
41 Interest . 41
42
42 Depreciation, depletion, etc. (attach schedule). 42 4,727. 4.727.
43
43 expenses (itemize):
Other expenses (Itemize): a _ 43a
b OUTSIDE
OUTSIDESERVICESSERVICES 43b 58,370. 44,364. 14.006.
c MISCELLANEOUS
MISCELLANEOUS 43c 41,315. 26,445. 14,870.
d 43d
e 43e
44 T o t a ! ffunctional
Total expenses
unctional e xpenses (add lines 22
(add lines 22through
through 43)
43) Organ-
Organ
izations complettna columns ( B W D ) . carry these totals 44

I to lines 13-15 207,488. 151,304. 56,184.
184. NONE
Reporting
Reporting ofof Joint Costs. - Did you report in column (B)(B) (Program services) any joint costs from a combined
educational
educational campaign
campaign and fundraising solicitation? ..... ► Q Yes
Yes 0 .... 0
[X) No
No
(i) the aggregate
If 'Yes," enter (i) 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 $
.„ FaftMl, Statement of Program Service Accomplishments (See instructions/!
What is the organization's primary exempt purpose?►purpose?'" RESEARCH_AND_ D~~A.!I_9~ E~
~E~~~C~_A~D_~EDUCATION 0N_ ~A!!..~~
VARIOUS^~I~~~~
p_ISEASES _ Program Service
Program Service
Expenses
All organizations
organizations must describe their exempt purpose achievements. State State the
the number of clients served, publications issued, etc.
etc. (Required for 50
(Required for 501(cX3)
1(cX3)
Discuss achievements
achievements that are not not measurable. (Section 501(c)(3) and (4)
(4) organizations and 4947(a)(1) nonexempt charitable trusts and
and (4) organizations
(4) organizations
Discuss and
and 4947(aX1)
4947(aXl) trusts;
must also enter the amount of grants and allocations to others.! ut optional for
but for others.)
a
_Ti?5.i!?.'!!!''JE.'
a _T_!1~ 1 In 1
_ £ LiLute ~o~~~tJ~_!
~':.i~lJ~h_ ~~tJ!.u.!':. Foundation; _}~c..:
Inc. _i~
is~ a _
corporation ~designed
_c..?ry~r:_a!i..?~ to
':_S.!.g~':.d_ conduct _s~!_e~tJ!.i~!....
~ _c~~~c.! scientific, _
"cultural
^ L ^ C ? !and social research
- ^ social_ research into_
into issues
issues ofof
------------------------------------------------------------------
importance to to the medical
med and (Grants and allocations $
scientific _c~nJ!.i.!:~
b _s~.!.e~0!.i~ communities. _ _Its primary _e~~e~~.!:.s
..!!.s_p..:i.m~'2' endeavors _
_ include research ..!~t~
i~~l~~ _r~~e~r:=!: into .!!:e_ !!,=-a_!~~!' ~f_
the treatment of ~a~c::.!:..
cancer, _
lyme disease, emphysema, and cystic fibrosis.
-~-~~~~~-~~~~~~~-~~~~!.~~~~~-------------------------------------
(Grants and allocations £ 4,206.
4 206.
c AIDS research
AIDS research and
and education
education
(Grants and allocations $ 106,178.

d _E..9~c~!.i~n_
** _|ducat_ion_of_the ~f_0:. ~':.n.!:r:_a!.P ^ i ~~.!~
j9enera]_ p::b~ 1_r
_p":i.".!0g
c ^ JH*1?_PT !lITE _
and distribution
d i s t r i b u t i o n of
of educational
educational lliterature
i t e r a t u r e to to
------------------------------------------------------------------
public El~~e~~~o~!.
_p~~l..!.~ places about !h~_H.!:!_m~i~~~~:.~~.:.
the Heimlich Maneuver. _
e Other program services (attach schedule) , , (Grants .and all9catipns$
f Total of Program Service Expenses (should equal line 44, column (B), Program services). 151,304.
F 01/30/96
F 01/30/86
THE HEIHL1CH
HEIMLICH INSTITUTE
~E9~r~m~9~90~\~-19~9~5~1
Form99<K-1995) F~_OU~N~D~AT~1~O~N~
FOUNDATION 2=3~-~73~O~3~16~1~P~a~ge~3
25-7303161 Page 3
~jl.rlBalance Sheets
f»Qrt I V Balance Sheets (See instructions.)
instructions.)
Note:
Note: Where required,
required, attached schedules and amounts within the description column (A) (8)
(B)
should be for end of year amounts only, Beginning of year End of year
45 Cash non interest bearing 12.569. M. 48,171.

48
46 Savings
Savings and temporary cash investments JS.
47a Accounts receivable.

receivable . . . . . .,. . . 47a
b doubtful accounts .
Less: allowance for doubtful 47b 47c
48a Pledges receivable

Pledges receivable . . . . . . . . . . 48a
b allowance for doubtful
Less: allowance doubtful accounts 48b 4Sc
49 Grants receivable
receivable . . . . . . . . . . . . . . . . . . . _49_
50 Receivables directors, trustees, and key employees
Receivables from officers, directors,
A
(attach schedule) . . 1---------- 3L
51a Other notes and loans receivable (attach schedule)
schedule).. 51a
e allowance for doubtful
b Less: allowance doubtful accounts . . . . . . . .
t 51b 51c
52 Inventories for sale
sale or use . . . . . . . . . . . . . . . .52.
53 Prepaid
Prepaid expenses and deferred charges.
charges . . . . . . . . . . _53_
.:X e .~T!,"\:-t:
54 Investments securities (attach schedule) . ^ ^ . v 1 ) f \ T J ^ P . C t \Y~. J. 489,814. JKL 404,480.
55a
558 Investments land, buildings, and equipment:
equipment:
basis . I 55a
Less: accumulated depreciation (attach
b
schedule) . 55b £5c
56 Investments other (attach schedule) .
57a Land, buildings, and equipment: basis . 57a. 39,381. SEE 990 PT IV - 1
b Less: accumulated depreciation SEE .990. PJ. I.V.-. 2 57b 17,402. 24 t 340. 57c 21.979.
58 Other assets (describe ► SEE 990 PT IV - 3 8,133. .3L 5,811.
_59_ Total assets fadd lines 45 through 58) (must equal line 74) 534,856. -53. 480,441.
60 Accounts payable
payable and accrued expenses 5,971. _SP_ 6.909.
~ 61 Grants payable
payable -~ . M.
~ 62 Deferred revenue.
revenua . . . . . . . . . . . . 62
I
I 63 Loans from officers, directors,
Loans directors, trustees, and key employees . 31.
64a liabilities (attach schedule)
Tax-exempt bond liabilities . 64a
e b Mortgages and other notes payable (attach schedule).
schedule) . . . 64b
s
65 Other liabilities (described 65
■£§_ Total liabilities fadd lines 60 through 65). 5,971. 6,909.
N
8 Organizations
Organizations that
that follow
follow SFAS 117,
117, check
check here ►
.... [X] and complete
\j\
t
lines 67 through
through 69 and lines 73 and 74.
A
67 Unrestricted......
Unrestricted 458,668. JJZ. 478.478.
S
8 68 Temporarily restricted . 70,217. JBL
t
69 Permanently restricted . . . . . . . . . .
Permanently ja. -4.946.
o Organizations that
Organizations that do not
not follow
follow SFAS 117, check here ►
.... o
L H and complete
lines 70 through
through 74.
E
u 70 Capital stock, trust principal or current funds
funds. . . . . . . . . . . . . ZQ_
n
d 71 Paid-in or capital surplus, or land]
land; bldg., and equipment fund .... 71
B 72 Retained earnings, accumulated income, endowment, or other funds
Retained 72
a
I 73 Total
Total net assets
assets or fund
fund balances
balances (add lines 67 through 69 OR lines 70 through 72;
a
n column (A) must equal line 19 and column (B)
(8) must equal line 21) 528,885. 73_ 473.532.
1----=.=.:~=-=--_+..LJiI.4----:!.!..:!..C~.:...-
e
s
74 Total liabilities and net assets/fund balances (add lines 66 and 73). 534.856. 74 480.441.
E 02/16/96
F02/16/96
THE HEIKLICH
THE HEI~LICH INSTITUTE
INSTITUTE
Form 990 (IBas) FOUNDATION 23-7303161 paqe 4
■ 1 H Reconciliation of
Reconciliation of Revenue
Revenue per
per Audited
Audited Wifflmmm Reconciliation of
Reconciliation of Expenses
Expenses per
per Audited
Audited
financial Statements
Financial Statements with
with Revenue
Revenue per
per Financial Statements
with Expenses
Expenses per
per
Return Return
a. Totalrevenue,
Total revenue,gains,
gains,andandother
other support
support Totalexpenses
Total expensesand andlosses
lossesper per
peraudited
per auditedfinancial
financialstatements
statements . . . . . ....
► 227,135. auditedfinancial
audited financialstatements
statements . . ► .... 282,488.
b Amountsincluded
Amounts includedononlineline.a but
but not
not on
on Amountsincluded
Amounts includedon online
line a• but
butnot
noton
on
line12,
line 12,Form
Form990:
990: line17,
line 17,Form
Form990:
990:
(1) Net
(1) Netunrealized
unrealizedgains
gains (1) Donated
(1) Donatedservices
services
oninvestments
on investments . ... i ..._ _ anduse
and useofoffacilities
facilities $$ 75,000.
75,000.
(2) Donated
(2) Donatedservices
services (2) Prior
(2) Prioryear
year adjustments
adjustments
and use of facilities J$L
and use of facilities 75,000.
75,000. reported on line20,
reported on line 20,
(3) Recoveries
(3) Recoveries of of prior
prior Form
Form 990990 . $
year grants ...
year grants . . . . $ (3) Losses reported
(3) Losses reported on on
(4) Other
(4) Other (specify):
(specify): line20,
line 20,Form
Form990.
990 . . . $
----------
----------
Add amounts
Add amountson
on lines
lines(1)
(1)through
through(4)
(4) ► ... 75.000. $_
Add amounts
Add amounts on
on lines
lines(1)through(4)
(1) through(4) .. . .► 75.000.
c Une aaminus
Line minus line
linebb . 152,135. c Une aa minus
Line minus line
linebb. . . . . . ► £■ 207,488.
c
d Amounts included
Amounts included on on line
line 12,
12, d Amounts included
line 17,
17,
d
Form 990 but not on line
Form 990 but not on line a: a: Form 990 but not on
Form 990 but not on line a:linea:
(1) Investment expenses
(1) Investment expenses (1) Investment
expenses
not included
not included onon line
line not included
line
ss,Form
6b, Form 990
990 .. . . _$ 6b, Form 990 . . .. . $
6b, Form 990 .
(2)
Other (specify): (2) Other (specify):
----------
---------- $_
Add amounts
Add amounts onon lines
lines(1)and
(1) and (2)
(2) Add amounts
lines(1)and
(1)and (2)
(2)
e Total revenue per line 12, Form 990 Total expenses per line 17, Form 990
fline c plus line d ) . 152J35. fline c plus line d) 207.488.
f i i i l l List of Officers, Directors, Trustees, anc K e y E m p l o y e e s fList each one even if not compensated: see instructions.')
(C) Compensation (D) Contributions to (E) Expense
(A) Name and address (B) Title and average hours per account and other
(if not paid, enter employee benefit plans &
week devoted to position allowances
-0-) deferred compensation
SEE STATEMENT
SEE STATEMENT 990
990 PART
PART VV - 1
NONE NONE
NONE NONE
75
75 Did any
Did any officer,
officer, director,
director, trustee,
trustee, or
or key
key employee
employee receive
receive aggregate
aggregate compensation
compensation of
of more
more than
than $100,000
$100,000 ffrom
r o m your
your
organization and
organization and all
all related
related organizations,
organizations, of
of which
which more
more than
than $10,000
$10,000 was
was provided
provided by
by the
the related
related organizations?
organizations? ►
... □ Yes
DYes Ii]
0 No
IfIf "Yes,"
"Yes," attach
attach schedule
schedule -- see
see instructions.
instructions.
F 02/07/96
F 02/07/96
HEIMLICH INSTITUTE
THE HEIHLICH INSTITUTE
F rm 990 f1995> FOUNDATION ' 23-7503161 Page 5
" .. ..
Illicit Other Information fSee instructions.-) XfiS.
76 Did the organization
Did engage in any
organization engage any activity not previously
previously reported to the IRS?
IRS? IfIf 'Yes,"
"Yes," attach
attach a detailed description of each
each activity Z6_
77 Were
Were any any changes
changes mademade in the organizing or governing documents, but not reported to the IRS? IRS? . . . . . . . . . . . 77
If 'Yes,"
If "Yes," attach
attach a conformed copy of the changes.
78a Did
78a Did the organization have have unrelated business gross income
income of $1,000
$1,000 or more during the year year covered by this return?
return? zsa.
b IfIf "Yes,"
"Yes," has it filed a tax return on Form
has it F o r m 990-
990-T T,, Exempt
Exempt Organization Business
Business Income
Income TaxTax Return, for this year?
year? .. Z£b_ N/A
79 Was there a liquidation, dissolution, termination, or substantial
Was substantial contraction during the year?
year? If ''Yes,''attach
'Yes," attach a statement
statement 79
Is the organization
BOa Is
80a related (other than by association
organization related association with a statewide
statewide or nationwide
nationwide organization)
organization) through common membership,
governing bodies, trustees, officers, etc., to any any other exempt or nonexempt organization?
organization? . 203,
b If "Yes," enter
If "Yes," enter the name organization ►
name of the organization ...
_______________________ = = = = = = = = = = = = = and
a~d ~h-;~k whether• it
check -wh;rthe~ is r::r
it i; CU - -exempt
- - - -OR-lJO -------
nonexempt.
81a
81a Enter the amount of political
Enter political expenditures, direct or indirect, as ms ...
as described in the instructions
instructions I 81a I NONE
b
b Did the organization file Form 112O-POL,U.S.
1120-POL, U.S. Income Tax Return for Certain Political
Political Organizations, for this year?year? N/A
82a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially m.
less
less than fair rental value?
value? . J&
b If 'Yes," you may indicate the value of these items here. Do not include this amount as
''Yes,''you
revenue in Part
Part I or as an expense in Part
Part II. (See
(See instructions for reporting in Part
Part III.)
111.). . . • . . . • . . 182b
.......__ -'-I __ ....:..::c.t..:::=:......_
75.000.
83a Did the organization comply with the public inspection requirements for returns and exemption applications?
applications"Z .22a
b Did the organization comply with the disclosure requirements relating to quid pro quo contributions"Z
contributions? . . . . _S2b
84a Did the organization solicit any contributions
contributions or gifts that were not tax deductible? . 84a
b If 'Yes,"
'Yes," did the organization include with every solicitation an express statement that such contributions
contributions or gifts were not
tax deductible? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ML N/A
85 Section 501(c)(4),
Section 501(c) (4), (5), or (6) organizations.
organizations.-a -a Were substantially
substantially all dues nondeductible by members? .851. N/A
b in-house lobbying
Did the organization make only In-house lobbying expenditures
expenditures of $2,000 or less? . 25JB. N/A
If 'Yes" was
''Yes''was answered to either 85a or
8Sa 8Sb,85b, do not complete 85c
8Sc through 85h
8Sh below unless
unless the organization received
a waiver for proxy tax owed for the prior year.
c Dues, assessments, and similar amounts from from members £5S_ N/A
d Section 162(e) lobbying and political expenditures ... 85d N/A
e
* Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices. notices £5JL N/A
f Taxable
Taxable amount of lobbying and political expenditures (line 8Sd 85d less line 85e).
85e) 85f N/A
g Does the organization elect to pay the section 6033(e) tax
tax on the amount in 8517
85f? . J559L N/A
h If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount in 8Sf85f to its reasonable
reasonable
estimate of dues allocable
estimate allocable to nondeductible lobbying and political expenditures for the following tax year? . JKb N/A
86
86 Section 501(c)(7) organizations. - Enter:
Section
a Initiation
Initiation fees
fees and capital
capital contributions included on line
line 12
12 . -8SA N/A
b
b Gross
Gross receipts, included on line
line 12,
12, for public use
use of club facilities
facilities. . . . . . . . . . . . . _SSb_ N/A
87a
87a Section 501
Section 501(c) (12) organizations. - Enter:a Gross
(c)(12) Gross income
income ffrom shareholders
r o m members or shareholders _SZ& N/A
b
b Gross income from other sources. (Do
Gross income (Do not net amounts
amounts due or paid
paid to other
sources against
sources against amounts
amounts due or received from
f r o m them.). _SZb_....___
them.) . . . . . . . . . . . . . . . . . . . . . . . . . ............. N/A __
..:.:.t...:..:.... ~
88
88 any time
At any time during the year,
year, did the organization own a 550% greater interest
0 % or greater interest in a taxable
taxable corporation or
partnership? If "Yes,"
partnership? "Yes," complete
complete Part
Part IX
IX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -88.
89
89 Public law firms. - Attach information described in the instructions.
Public interest law instructions.
90
90 Ust the states
List states with which a copy of this return is filed ►OHIO,
~H.!.~ _C~,=-I!.O~~I~
_CAL_I F0RNIA _
91
9 1 The books are
The books are in care
care of ►i°AN_STEI_NBUItt
"'~O~N_~T~~~U~~ Telephone no. ►
Telephone ... ~.!31_2~~~0~~
C_51_3_)_221_-0q02 _
Located at ►
Located ... 2368
2368 VICTORY
VICTORY PKWY,
PKWY, STE
STE 4410, CII NTI,
10, C N T I , OH ZIP code ►
ZIP ... 45206
45206
92
92 Section 4947(a)(1) ~~n;x-;~Pt
Section nonexempt ~ha;it;blet~;t;fili;g
charitable trusts filing-F~~-900i~
Form 990 in iie~
lieu ~fF~r~-1041
of F o r m 1041U~S~I~comeTax
U.S. Income Tax Ret .: tor
Return
:urn for IEst~t;; f~;-
Estates a-;;dTr~s~s~':-
and Trusts. - C h-;~kh;r~O
Check hereÔ
and enter the amount
and amoun of tax-exempt interest received or accrued during the tax veat I 92 I N/A
F02/12/86
F 02/12/86
THE HEIMLICH
HE1MLICH INSTITUTE
INSTITUTE
Form 990 M99S1 FOUNDATION 23-7303161
23-730316 Paqe 6
HiHH! Analysis of Income-Producing Activities fSee instructions.}
Enter gross amounts unless otherwise indicated. Unrelated business income Excluded bv section 512.513. or 514
(E)
(A) (8)
(B) (C) (D)
(D) Related or exempt
Business code
Business code Amount Exclusion
Exclusion code Amount function
function Income
93 Program service revenue:
a
b _
b
c
d
d __ ~-------------------------------
e
f
g
9 Fees and contracts from government agencies . . .
assessments. . . . . . . . .
95 Interest on savings
savings and temporary cash investments. . . .
96 Dividends and interest from securities
securities. . . . 14 24,398.
97 Net rental income or (loss)
(loss) from real estate: ,
a debt-financed
debt-financed property
property .
b not debt-financed property .
ss rorn
98 Net rental income or (l°
(loss)) ffrom personal property
property . . . .
99 Other investment income . . . . . . . . . . . . .
100 Gain
Gain or (loss) from sales
sales of assets
assets other than inventory . . 18 13.727.
101 Net income or (loss) from special events. ..
102 Gross profit or (loss) from sales
sales of inventory
inventory.
103 Other revenue: aa
b
c
d ___
d
e __
e
104 Subtotal (add columns (8),(B), (D), and (E»
(E)) .... llljlllllllllf 38.125.
105 Total 104, columns (8),
Total (add line 104, (B), (D), and (E»
(E)) . 38,125.
38 125.
Note: (Line 105 plus line I d . Part I. should equal the amount on line 12. Part 1.1
ftarfVm Relationship of Activities to the Accomplishment of Exempt Purposes
Line No. Explain
Explain how each activity for which income is reported in column (E) of Part
Part VII contributed
contributed importantly to the
T accomplishment of the organization's exempt purposes (other than by providing funds for such purposes).
purposes). (See instructions.)
N/A
fiSHlX Information Regarding Taxable Subsidiaries (Complete this Part if the "Yes" box on line 88 is checked.)
Name, address,
address, and employer Identification
Identification Percentage of Nature of Total End-of-year
number of corporation
corporation or partnership
partnership ownership Interest business activities
business activities Income
Income assets
N/A
Under penalties of perjury,

perjury, I declare that
that I have examined this
this return,
return, including
Including accompanying
accompanying schedules
schedules and statements,
statements, and to the best of my knowledge
knowledge and belief
Please
PJ~Sd
y^-
':': Is true, corrett,
corr t, and complete.
complete. D Declaratlon-of (other than
cl atlorrof preparer (other than officer)
officer) Is based on all Information
allinformat which preparer
n of which has any knowledge.
prepare<'has knowledge. (See
(See Specific
Specific Instructions.)
instructions.)
Sign
Sigrl
Her©
Here t. Si .• ~
,f
!-h~IEl;f lie
Quaint
Type 0
I'm
title.
nt name and title.
lid, I Pl4Sch./
'
Preparer's Date Check

Cheek (f
If Preparer's social security
security no.
Paid
Preparer's
Preparer's
signature <\AJJU tOl0l% self-employed
self-employed ►|
.... | 296-64-1856
Firm's name (or ARTHUR ANDERSI EiN ►
EIN .... 36-0732690
Use Only yours If self-employed)
and address 425 WALNUT STREET ZIP code
ZIP code ► .... 45202
F 12/22/95
12/22/95 CINCINNATI, OH
CINCINNATI, OH
SCHEDULE
SCHEDULE A Organization
Organization Exempt Under Section
Section 501(c)(3) OMS No.
OMB No. 1545-0047
1545-0047
(Form 990) (Except Private

Private Foundation)
Foundation) and Section
Section 501(e), 501(f), 501(k),
or Section
Section 4947(a)(1)
4947(aX1) Nonexempt
Nonexempt Charitable
Charitable Trust
Trust
Department of the
Department of the Treasury
Treasury
Supplementary Information 1995
See separate
separate instructions.
instructions.
Internal Revenue Service anl io and attached
► Must be completed bv the above organizations d to
a their Form 990 (or Form 990-EZV
Name of the organization THE HEIMLICH INSTITUTE Employer Identification numbe
FOUNDATION
UtmU::: Compensation of the Five Highest
Compensation Highest Paid Employees Other Than Officers,
Officers, Directors,
Trustees
(See instructions. Ust each one. If there are none, enter "None.")
( d ) Contributions
Contributions to ( e ) Expense
Expense
((b)
b ) Title
Title and
and average
average
((a)
a ) Name and
and address
address of each
each employee
employee paid more
paid more employee benefit
employee benefit account
account
hours
hours per week ((c)
c ) Compensation
Compensation
than $50,000
than $50,000 plans deferred
plans & deferred and other
and other
devoted to position
devoted to position compensation allowances
allowances
NONE
Total
Total nnumber
u m b e r of other employees
employees paid
paid over
over
$50.000 ► NONE
Part II Compensation of the Five Highest Paid Independent
Compensation Independent Contractors
Contractors for Professional
Services
(See instructions. List each one (whether individuals or firms.') If there are none, enter "None.")
( a ) Name and address of each independent contractor paid more than $50,000 ( b ) Type of service ((c)
c ) Compensation
Compensation
NONE
Total
Total nnumber
u m b e r of others
others receiving
receiving over
over $50,000
$50,000 for
professional services , „ , _ , , ,„„,.,,,„ , ► NONE
Paperwork Reduction
For Paperwork Act Notice,
Reduction Act Notice, see instructions.
instructions. Schedule
Schedule A (Form 990) 1995
1995
JXB
JXB F 02/15/96
THE HESMLICH
HEiMLICH INSTITUTE
INSTITUTE
Schedule I) [form 9901 1995 FOUNDATION 23-7303161 page
23-7303161 2
P$ri ffl Statements About

About Activities
Activities Yes No
During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to
influence public opinion on a legislative
legislative matter or referendum?.
referendum? . . . . . . . . . . . . . . . . . . . . . . . . .
If "Yes," enter the total expenses paid or incurred in connection with the lobbying activities ... $ ...:.N:L/.o.;A'
activities. . . . . . ►$ M/A -- _
Organizations
Organizations that made an election under section 501(h) by filing Form 5768 must complete Part Part VI-A.
VI-A. Other
organizations checking 'Yes," must complete Part
''Yes,''must Part VI-B
VI-B AND attach a statement giving a detailed description of
the lobbying activities.
2 During the year, has the organization, either directly or indirectly, engaged in any of the following acts with any
of its trustees, directors, officers, creators, key employees, or members of their families, or with any taxable organization
affiliated as an officer, director, trustee, majority owner, or principal beneficiary:
with which any such person is affiliated
Sale, exchange, or leasing
a Sale, leasing of property? .... 2A.
b Lending of money or other extension of credit?

credit? JSCL
c Furnishing of goods, services, or facilities?

facilities?. . . 2c
d Payment
Payment of compensation (or payment or reimbursement of expenses if more than $1,000)? 2sL
e Transfer of any part of its income or assets?
assets? . . . . . . . . . . . . . . . . . . . . . . . . 2a.
If the answer to any question is 'Yes," attach a detailed statement explaining the transactions.
''Yes,''attach
3 fellowships, student loans, etc.? .....

Does the organization make grants for scholarships, fellowships, JLUL
4 Attach a statement to explain how the organization determines that individuals or organizations receiving grants or
loans from it in furtherance of its charitable programs qualify to receive payments. fSee instructions.)^ <e t.TKT ^ c h A. Pr SE-
~:R":]Mm Reason for

for Non-Private
Non-Private Foundation
Foundation Status
Status (See instructions.)
instructions.)
The organization is not a private foundation because it is (please
(please check only ONE applicable box):
5 D
[ H A church,
church, convention of churches,
churches, or association of churches.
churches. Section 170(b)(1)(A)Q).
170(b)(1) (A) (i).
6 D
□ A school.
school. Section 170(b)(1)(A)Qi).
170(b)(1)(A)(ii). (Also complete Part V, V, page 4.)
7 D
fZI A hospital or a cooperative hospital service organization. Section
Section 170(b)(1)(A)Qii).
170(b)(1)(A)(iii).
8 D
CD A Federal, state, or local government or governmental unit. Section 170(b)(1)(A)(v).
170(b)(1)(A)(v).
9 D
C ] A medical research
research organization operated in conjunction with a hospital. Section Section 170(b)(1)(A)(iii)Enter
170(b)(1)(A)Qii)Enter the
the hospital's
hospital's name, city,
city,
and state ... ►
10
10 D organizati~n-op;r;rt;df;
[~l An organization operated for th-;;b;n~f~
the benefit ~f~
of a~~I;g~~;
college or ~~;r;n;
university ;:;-';n;d-;
owned or ~pe;ated by
operated by a-g~~e;n;~~~
a governmental ~ntt~Se~i~;
unit. Section '-70(b)(1)(A)Q~)~
170(b)(1)(A)(iv). - - - --
(Also complete the Support
(Also Support Schedule
Schedule in Part
Part IV-A.)
IV-A.)
11a
11. IX]
E An organization that normally receives a substantial part of its support support from
from a governmental unit or fromfrom the general public.
public.
Section 170(b)(1)(A)(vi).
Section 170(b)(1)(A)(vi). (Also
(Also complete thESupport Schedule in Part
theSupport Schedule Part IV-A.)
11b D EH A community trust. Section
Section 170(b)(1)(A) (vi). (Also
170(b)(1)(A)(vi). (Also complete thSupport
thSupport Schedule
Schedulein in Part
Part IV-A.)
IV-A.)
12 D
[ D An organization that normally receives: (a) no more more than
than 33 1/3% of its support from gross investment income and unrelated business
taxable income (less section 511 tax) from businesses
taxable businesses acquired by the organization after June 30, 30,1975, more than 33 1/3%
1975, and(b) more
of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc., functions - subject
from contributions,
See section 509(a)(2).
to certain exceptions. See 509(a)(2). (Also
(Also complete theSupport
theSupport Schedule
Schedule in PartPart IV-A.)
IV-A.)
13 D
LJ An organization that is not controlled by any disqualified persons (other than foundation managers) managers) and supports organizations
organizations described
in: (1) lines 5 through 12 above: or(2) section 501(c)
in: 50Uc)f4), (5). or (6).
(4). (5), f6). if thev 509(a)(2). (See section 509(a)(3).)
they meet the test of section 509(a)(2). 509fa)(3).)
Provide the following
Provide organizations. (See instructions.)
followina information about the supported oraanizations.
(b) Line
Une number
(a) Name(s)
Name(s) of supported organization(s) from above
D An organization organized and operated to test for public safety. Section 509(a)(4). (See instructions.)
14 M
F 12/22/95
F 12122195
HE~MLICH INSTITUTE
THE HE!MLICH INSTITUTE
Schedule fFnrm 990)
Schedule A [FWm B90) 1995 FOUNDATION
FOUNDAT I ON 23-7303161 Pass
Paoe 3
3
]liri;nt;A:~ SSupport.
'îiiîliliiii upport SSchedule
chedule 11, or 12.)
(Complete only if you checked a box on line 10, 11, 12.)Use method of accounting.
Use cash method accounting.
Note: You mav use the worksheet in the instructions for converting from the accrual to the cash method of accounting.
Calendar vear (or fiscal year beginning in) (a) 1994 (b) 1993 (c) 1992 (<i) 1991 (e) Total
15 Gifts, grants, and contributions received. (Do
not include unusual grants. See line 28.1 . . 85.274. 190,020. 499,123. 146,624. 921,041.
16 Membership fees received NONE
17 Gross receipts
Gross receipts from admissions,
admissions, merchandise
merchandise sold
or services
or services performed, or
or furnishing of facilities
facilities
in any
in any activity
activity that is
is not aa business
business unrelated
to the organization's charitable, etc.. purpose . NONE
18
18 Gross income
Gross income from interest,
interest, dividends, amounts
received ffrom
received payments on
r o m payments on securities
securities loans
(section 512(a)(5)),
(section 512(a)(5», rents,
rents, royalties,
royalties, and
and unrelated
business taxable
business taxable income
income (less
(less section
section 511
511 taxes)
from businesses
from businesses acquired
acquired by
by the
the organization
after June 30. 1975 28.994. 25,462. 18,962. 20,612. 94,030.
19
19 Net income
Net income from unrelated
unrelated business
business activities
not included in line 18 NONE
20
20 Tax revenues
Tax revenues levied
levied for the
the organization's
organization's benefit
and either paid to it or expended on its behalf. . NONE
221
1 The value
The value of
of services
services or
or facilities
facilities furnished
furnished to
to the
organization by
organization by aa governmental
governmental unit
unit without charge
Do not
Do not include
include the
the value
value of
of services
services or
or facilities
facilities
generally furnished to the public without charge. NONE
22
22 Other income.
Other income. Attach
Attach aa schedule.
schedule. Do
Do not
not include
gain or (loss) from sale of capital assets NONE
23 Total of lines 15 through 22 114,268. 215.482. 518.085. 167,236. 1,015.071.
24 Une 23 minus line 17 . . . 114,268. 215,482. 518,085. 167.236. 1,015,071.
25 Enter 1% of line 23 1.1*3- 2,155. 5.181. 1,672.
26 described in lines 10 or 11: a Enter 2% of amount in column (e), line 24
Organizations described 26a 20,301.
b Attach a list
Attach list (which
(which is
is not open to
to public inspection)
inspection) showing the name
name of
of and
and amount
amount contributed by each
each person
(other
(other than
than a governmental
governmental unit
unit or
or publicly supported organization)
organization) whose
whose total
total gifts
gifts for
for 1991
1991through
through 1994
1994
exceeded
exceeded thethe amount
amount shown in in line
line 26a.
26a. Enter
Enter the
the sum of all
all these
these excess
excess amounts
amounts. 26b 363,796.
c Total support
Total support for
for section
section 509(a)(1)
509(a)(1) test:
test: Enter
Enter line
line 24,
24, column
column (e),
(e) . 26c $ 1 , 0 1 5 , 0 7 1 .
d Add: Amounts
Add: Amounts from
from column
column (e)
(e) for
for lines:
lines: '18
18 $$ 94,030.
94.030. 19
19
22
22 $_ 26b £_
26b ~$ 3~6~3~,7~9~6~.
363,796. __ 26d 457,826.
ee Public support (line
Public (line 26c minus
minus line
line 26d total).
total), ► 26e 557,245.
J Public support percentage (line 26e (numerator) divided bv line 26c (denominator)) 2SL 54.90%
27
Zl Organizations described
Organizations described on on line
line 12:
12: aa For
For amounts
amounts included
included on
on lines
lines 15,
15, 16,
16, and
and 17
17that
that were
were received
received from
from aa "disqualified
"disqualified
person," attach
person," attach aa list
list to
to show
show the
the name
name of,
of, and
and total
total amounts
amounts received
received in
in each
each year
year from
from each
each "disqualified
"disqualified person."
person." Enter
Enter the
the sum
sum N/A
N/A
of
of such
such amounts
amounts for
for each
each year:
year:
(1994) _ _ _ _ _ _ _ _ _ _ _ _ _ _
(1994) (1993) _ _ _ _ _ _ _ _ _ _ _ _ _ _ (1992)
(1993) (1992) _ _ _ _ _ _ _ _ _ _ _ _ _ _ (1991) (1991) _
bb For any
For any amount
amount included in in line
line 17
17 that was
was received
received from a nondisqualified
nondisqualified person, attach
attach a list
list to show the name
name of,
of, and
and amount
amount
received for
received for each
each year,
year, that
that was
was more
more than
than the
the larger
larger of
of (1)
(1) the
the amount
amount on
on line
line 25
25 for
for the
the year
year or
or (2) $5,000. (Include
(2) $5,000. (Include in
in the
the list
list
organizations described in
in lines
lines 55 through
through 11,
11,as
as well
well as
as individuals.)
individuals.) After
After computing
computing the
the difference
difference between
between the
the amount
amount received
received
and the
and the larger
larger amount
amount described
described in in (1)
(1) or
or (2),
(2), enter
enter the
the sum
sum ofof all
all these
these differences
differences (the
(the excess
excess amounts)
amounts) for
for each
each year:
year:
(1994)
(1994) (1993)
(1993) _ (1992)
(1992) (1991)
(1991)
c Add:
Add: Amounts
Amounts from
from column
column (e)
(e) for
for lines:
lines: 15 $_
15 "'- _ 16 £_
16
17
17 $ 20
20 $_ 21 3L
21 2Z£_
d Add:
Add: Line
Une 27a
27atotal
total. . $ and line
and line 27b
27b total
total . ► 2ZsL
e Publicsupport
Public support (line
Oine27c total minus
27c total minus 27d
27d total)
total) .. ► 2ZM.
Totalsupport
Total support forfor section
section 509(a)(2)
509(a)(2) test:
test: Enter
Enter amount
amount on on line
line 23,
23, column
column (e) (e). . . . . . . . ► ~ IZ7f |$
g Public support
Public support percentage
percentage (line
(line 27e
Zle (numerator)
(numerator) divided
divided byby line
line 27f
Zlf (denominator))
(denominator» ....•
iza.
Investment income percentage (line 18. column (e) (numerator) divided bv line 27f (denominator)) ZZh.
28
28 Unusual Grants:
Unusual Grants: For
For an
an organization
organization described
described in in line
line 10,
10, 11,
11,or
or 12
12that
that received
received any
any unusual
unusual grants
grants during
during 1991
1991through 1994,attach
through 1994, attach aa list
list
(which is
(which is not
not open
open toto public
public inspection)
inspection) for
for each
each year
year showing
showing thethe name
nameof of the
the contributor,
contributor, the
the date
date and
and amount
amount of
of the
the grant,
grant, and
and aa brief
brief
description of
description of the
the nature
nature of
of the
the grant.
grant. Do
Do not
not include
include these
these grants
grants in
in line
line 15.
15. (See
(See instructions.) t\J 0 "5:..
instructions.) t^Qne.
FF 12/22/95
12/22/95
HEIMLICH INSTITUTE
/
ftcheifcl» A fForm 99011995 FOUNDATI ON 23-7303161p age /4
P*arfV,, Private School Questionnaire (See instructions.)
(To be completed ONLY bv schools that checked the box on line 6 in Part \Y\ N/A
29 Does the organization have a racially

racially nondiscriminatory policy toward students by statement in its charter, bylaws,
other governing instrument, or in a resolution of its governing body? . . . . . . . . . . . . . . . . . . . . . . . 3SL
30 Does the organization include a statement of its racially
racially nondiscriminatory policy toward students in all its brochures,
brochures,
catalogues, and other written communications with the public dealing with student admissions, programs, and
:::~a~~~~~~nd.
scholarships? o.th.e~~r~~n. c~~~u.ni~~ti~n.s '" ~e. P.U~Ii~~~al~n~~~. s~u~~n~~d~i~~io.n~,~r~~r~~s: a.n~ . . . . /~ , J3Q.
31 Has the organization publicized its racially
racially nondiscriminatory policy through
through newspaper or broadcast media during / /
the period of solicitation
solicitation for students, or during the registration period if it has no solicitation program, in a way / /
serves? . . . • . . . . . . . . ..
that makes the policy known to all parts of the general community it serves? .. /. . . . ,50.
If ''Yes,''please
'Yes," please describe; if "No," please explain. (If you need more space, attach a separate statement.) ./
/
/1
/ !
------------------------------------------------------~---------
- - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - ~_
- - - - - - - - - -- -i/ 7.':""
- - - - - - - - --
- -- - ------- - - - - - - - - - - -- - - - - -- -- - -- - - - - -- -- - - - - - - - - ~~7
/ -- - - - - - - - - --
^_
--------------------------------------------------~-------------
32 Does the organization maintain
maintain the following:
following: //
I
a Records indicating the racial cornposltion
composition of the student body,
body, faculty, and administrative staffJ!:
staff?..' . _32a_
b Re~ords documenting
Records documenting that scholarships and other financial assistance
assistance are awarded on a ra~jailY
racially
nondiscriminatory basis?
basis? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ./:./ . . . . . . . . . . . . . . . . .
c Copies of all catalogues, brochures, communications/to the public dealing
brochures, announcements, and other written communicati0l)1to
with student admissions, programs, and scholarships?
scholarships? . . . . . . . . . . . . . . ./. /- . . . . . . . . . . . . 33SL
d Copies of all material used by the organization or on its behalf to solicit contrlbutions?
contributions? . . . . . . . . . . . . . 3&
If you answered "No" to any of the above, please

please explain. (If you need more s(5ace,
/
ace, attach a separate statement.)
33 Does the organization discriminate by race in any way with respect to'
to;
a Students' rights or privileges? 33a
b Admissions policies? . . . . 33b_
c Employment of faculty or administrative staff? . 32c.
d Scholarships or other financial assistance?

assistance?. . 33d
e Educational policies?
p o l i c i e s. ? . . . . 33e
f Use of facilities?
facilities? . . 32L
g
9 Athletic programs? . 333.
h Other extracurricular activiti

activities'?.
?
m.
If you answered ''Yes''t
'Yes" tj/any please explain. (If you need more space, attach a separate statement.)
any of the above, please
-------;r-------------------------------------------------------
34a
34a
T
Does the organization receive any financial aid or assistance from a governmental agency? . . . . . . . . . . . . . . . . . .
Does the organization receive any financial aid or assistance from a governmental agency?
34a
b
/
/
b Has
Has the
the orqanlzation's
organization's right
right to
to such
such aid
aid ever
ever been
been revoked
revoked oror suspended?
suspended? ...........•.•............
If you answered ''Yes''to
'Yes" to either 34a or b, please
please explain using an attached statement.
m.
35 D~es
/
Does the organization certify that it has complied with the applicable requirements of sections 4.01
4.01 through
through 4.05 of Rev. Proc.
75-50. 1975-2 C.B. 587. covering racial nondiscrimination? If "No." attach an explanation .25.
F 12/22/95
12/22/95
THE HEIMUCH
INSTITUTE
SchzduleAAfForm
Schedule 999)1995
fForm 990) 1995 FOUND AT I ON
23-7303161 pPage
e
M 55
Ha?:jid~nA~ii
iliiiTOi Lobbyir:'lgExpenditures
Lobbying Expenditures by
by Electing
Electing Public
Public Charities
Charities (See
(See instructions.)
instructions.)
(To be completed ONLY by an eligible organization that filed Form 5768) jyA.
Checkhere
Check here ►
.. aa CH if the organization belongs to an affiliated group.
Check here ► b D if vou checked " a " above and "limited control" provisions apply.
(a)
(a) (b)
(b)
Limits on
Limits on Lobbying
Lobbying Expenditures
Expenditures Affiliated group
Affiliated group Tobe
To becompleted
completed
(Theterm
(The term "expenditures"
"expenditures"means
meansamounts
amountspaid
paidor
or incurred.)
incurred.) totals
totals for
lorALL
ALLelecting
electing
organizations
36
38 Totallobbying
Total lobbying expenditures
expendituresto to influence
influencepublic public opinionopinion (grassroots
(grassrootslobbying)
lobbying).
37
37 Totallobbying
Total lobbyingexpenditures
expendituresto to influence
influenceaalegislative legislativebodybody (direct
(direct lobbying).
lobbying). 3L.
38
38 Totallobbying
expenditures (add (addlineslines36 36and and37). 37). ..... .38_
39
39 Other exempt purpose expenditures
Other exempt purpose expenditures . . . . . . . . . . . . . . . . . . . ^9_
40
40 Total exempt purpose expenditures (add
Total exempt purpose expenditures (add lines 38 and lines 38 and39)39) .
41
41 Lobbying nontaxable amount. Enter the amount
Lobbying nontaxable amount. Enter the amount from the following table- from the following table-
IfIfthe
the amount
amount onon line
line 40
40is-
is- The lobbying
The lobbying nontaxable
nontaxable amountamount is-
is-
Not over $500,000.
Not over $500,000 . . . . . . . . . . . 20% of the amount on
20% of the amount on line 40 line 40. . . . . . . . . . . . .
Over $500,000 but not over $1,000,000 . . $100,000 plus
Over $500,000 but not over $1,000,000 . . . . $100,000 plus 15% of the excess over $500,000.15% of the excess over $500,000...
Over $1,000,000 but not over $1,500,000 . $175,000 plus 10%
Over $1,000,000 but not over $1,500,000 . . . $175,000 plus 10% of the excess over $1,000,000. of the excess over $1,000,000. 4JL
Over $1,500,000
Over $1,500,000but
but not
not over
over $17,000,000.
$17,000,000. . .. $225,000 $225,000plusplus 5%
5%ofof the
the excess
excessover
over $1,500,000
$1,500,000 .
Over $17,000,000
Over $17,000,000 $1,000,000
$1,000,000 .
42
42 Grassrootsnontaxable
Grassroots nontaxableamount
amount (enter(enter 25% 25% of of line
line41)41) .
43
43 Subtract line
Subtract line42
42from
from line
line36.
36. EEnter
n t e r --0-
0 - i fif line
line 42
42isismore
more than
than line
line 36
36.
44
44 Subtract line 41 from line 38. Enter -0- if line 41 is more than
Subtract line 41 from line 38. E n t e r - 0 - i f line 41 is more than line 38 line 38.
Caution: If there is an amount on either line 43 or line 44. file Form 4720.
4- Year Averaging
4-Year Averaging Period
Period Under
Under Section
Section 501(h)
501(h)
(Some organizations
(Some organizations that
that made
made aa section
section 501(h)
501(h) election
election do
do not
not have
haveto
to complete
complete all
all of
of the
the five
five columns
columns below.
below.
1e tne instructions Tor lines i a inrouan su.i . __

Lobbying Expenditures During
During 4-Year
4-Year Averaging
Averaging Period
Period
Calendar year
Calendar year (or
(or (a)
(a) (b) (c)
(c) (d)
(A (e)
<•>
fiscal vear beainnina in) ► 1995 1994 1993 1992 Total
46 Lobbying ceiling amount C150% of line 45(el1. . .
47 Total lobbying expenditures
48 Grassroots nontaxable amount
49 Grassroots ceiling amount C150% of line 48 fell . .
5ft Gjassroofs lobbying expenditures

l ^ l i t ^ H l l Lobbying Activity
Activity by Nonelecting
Nonelecting Public Charities
Charities
(For reporting only bv organizations that did not complete Part Vl-A'i (See instructions.')
During the
During the year,
year, did the organization
organization attempt to influence influence national,
national, state
state or
or local
local legislation,
legislation, including any
any Yes Amount
No
attempt
attempt to influence public
influence public opinion on a legislative matter or referendum,
a legislative matter or referendum, through the use
the use of:
aa Volunteers
Volunteers........................................... *
b Paid
Paid staff
staff or management
management (Include compensation in In expenses
expenses reported on lines c through h.). . . .
c Media advertisements.
c Media advertisements . . . . . . . . . . . . . .
d Mailings
Mailings to members, legislators, or the public public. . .
e Publications,
Publications, or published or broadcast statements
f Grants
Grants to other organizations
organizations for lobbying purposes purposes.
g Direct
Direct contact with legislators,
legislators, their staffs, government officials, or a legislative legislative body
body.
h Rallies,demonstrations,
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means.
means
i Total lobbying expenditures (add lines c through
through h) h). . . . . . . . A/Q//f
Iff 'Yes"
'Xes" to anv
any of the above,
aboye. also
also attach
anach a statement giving a detailed description of the lobbying
Igbbying activrties.
actiyqies.
F 12/22/95
F 12/22/95
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE
Schedule A fform 9901.1995 FOUNDATION 23-7303161 Page 6
f*«tt V I I ' Information
Information Regarding Transfers To and Transactions
Regarding Transfers Transactions and Relationships
Relationships With Noncharitable
Noncharitable
Organizations
Exempt Organizations
51 Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section
501(c) of the Code (other than section 501(c)(3)
501(c) (3) organizations) or in section 527, relating to political organizations?
organizations?
a Transfers from the reporting organization to a noncharitable exempt organization of:
Transfers Yes No
(i) Cash ..... 51a(i) X
(ii) Other assets
assets. . . . . . . . . . . . . . . . . . . . . . afii) X
X
b Other transactions:
(i) Sales
Sales of assets
assets to a noncharitable exempt organization b(» X
(ii) Purchases
Purchases of assets
assets from a noncharitable exempt organization b(ii) X
Rental of facilities or equipment .
(iii) Rental bflii) X
Reimbursement arrangements.
(iv) Reimbursement arrangements . b(iv) X
(v) Loans
Loans or loan guarantees
guarantees. . . . b(v) X
Performance of services or membership or fundraising solicitations
(vi) Performance solicitations. b(v\) X
■ Sharingofoffacilities,
c ,'Sharing facilities,equipment,
equipment,mailing
mailinglists,
lists,other
otherassets,
assets,ororpaid
paidemployees.
employees c X
d If the answer
answer to any of the above is 'Yes,"
"Yes," complete the following schedule. Column (b) should alwaysalways show the fair market value of the
goods, other assets, or services given by the reporting organization. If the organization received less than fair market valuevalue in any transaction
or sharing
s'larina arrangement, show in column (dl (d) the value of the goods,
aoods other assets,
assets or services received:
(8)
(a) (b) (c) (d)
Line no,
Un?nOi Amount
Amount Involved Name ncncharltabte exemDt
of noncharitable
Nam~of ,>I,
exemet oroanlzation Descrlotion
in of transfers, transactions,.and
and shartnc.
sharlna arranaements
N/A
52a
52a Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt
tax-exempt organizations
described in section 501(c) of the Code
Code (other than section 501(c)(3))
501(c) (3» or in section 527?
52n ► 0
~ CD Yes [[]]3 No
b 'Yes." complete. tha
If "Yes." the following
_II, schedule:
I schedule:
(8)
(a) (b) (c)
Name of oraanlzatlon
Nameof oroanlzation TvDe oroanlzation
Tvoe of oreantzation DescriDtion,of
of relallonshlD
relationship
N/A
F02/16/86
F 02/16/86
SUPPLEMENTARY STATEMENTS
1995 SUPPLEMENTARY STATEMENTS
HEIMLICH INSTITUTE
THE HEIMLICH INSTITUTE FOUNDATION
23-7303161
STATEMENT: 990 PT I - 2
STATEMENT:
LINE 8c(A)
8c(A) - SECURITIES
SECURITIES ACQUIRED
ACQUIRED ACQUISITION
ACQUISITION SOURCE
SOURCE GAIN
GAIN
DESCR IPTION
DESCRIPTION SOLD PURCHASER
PURCHASER & IMPR
EXP & DEPR PROCEEDS
PROCEEDS BASIS
BASIS (LOSS)
(LOSS)
SALE OF INVESTMENTS
INVESTMENTS VARIOUS
VARIOUS JOHNSON
JOHNSON INVESTMENTS
INVESTMENTS
VARIOUS
VARIOUS 173,799.
173,799. 160,072.
160,072. 13,727.
13,727.
AMOUNT
TOTAL AMOUNT 173,799.
173,799. 160,072.
160,072. 13,727.
13,727.
E\Nl 2 3 - 7 3 0 3 1 6 !
REALIZED CAPITAL
CAPITAL GAINS AND
AND LOSSES A c c o u n t ft
Account 06390287
# 06390287
JUNE 1 . 1995
JUNE 1, MAY
1995 - M AY 3 1 , 1996
31, 1996 HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE FOUNDATION,
FOUNDATION, INCORPORATED
INCORPORATED
QUISITION
ACQUISITION PROCEEDS DOLLAR
DOLLAR DOLLAR
DOLLAR $ GAIN
GAIN I/
QUANTITY
QUANTITY ASSET DESCRIPTION
ASSET DESCRIPTION DATE
DATE DATE
DATE COST
COST PROCEEDS
PROCEEDS LOSS
lOSS
SHORT TERM
SHORT TERM CAPITAL
CAPITAL TRANSACTIONS
TRANSACTIONS
60 MINNESOTA
MINNESOT MINING & MANUFACTURING
A MINING MANUFACTURING COMPANY
COMPANY 1 2/22/94
12/22/94 0925/95
09 25/95 3,171.60
3,171.60 3,257.89
3,257.89 86.29
86.29
10,000 UNITED STATES
UNITED STATES TREASURY BOND
TREASURY BOND 09/28/94
09/28/94 0705/95
07 05/95 9,281.25
9,281.25 9,737.50
9.737.50 456.25
4 56.25
5.125 %% DUE 12/31/98
12/31/98 DATED 12/31/93
DATED 12/31/93
10,000
10,000 UNITED
UNITED STATES
STATES TREASURY BOND
TREASURY BOND 0 9/28/94
09/28/94 07 27/95
27/95 9,281.25
9 ,281.25 9,687.50
9 .687.50 406.25
4 06.25
5.125 % DUE
DUE 12/31/98
12131198DATED 12/31/93
DATED 12/31/93
TOTAL NET SHORT
TOTAL NET TERM CAPITAL
SHORT TERM CAPITAL GAINS
GAINS $21,734.10
$ 21,734.10 $22,682.89
$ 22,682.89 $948.79
$ 948.79
lONG TERM
LONG CAPITAL TRANSACTIONS
TERM CAPITAL TRANSACTIONS
100 ABBOTT LABORATORIES
ABBOTT lABORATORIES 1 0/08/92
10/08/92 05
05 02/96
02/96 2,820.50
2,820.50 3,978.37
3 ,978.37 1,157.87
1 ,157.87
20,000
20,000 BELL
BELL SOUTH CORPORATION
SOUTH CORPORATION 06/09/93
06/09/93 0801/95
06 01/95 19,837.S0
1 9,837.50 19,310.00
1 9,310.00 -527.80
-527.80
6.375 % DUE 06/15/04
06/15/04 DATED 06/15/93
DATED 06/15/93
10.000 CAROLINA TELEPHONE
CAROLINA TELEPHONE AND AND TELEGRAPH
TELEGRAPH 0 4/21/93
04/21/93 07 13/95
07 ~3195 9,857.00
9 ,857.00 9,560.00
9 ,560.00 --297.00
297.00
6.125 % DUE 05/01/03
05/01/03 DATED 05/05/93
DATED 05/05/93
10,000
10,000 FEDERAL LAND
FEDERAL LAND BANK DEBENTURE
BANK DEBENTURE 0 8/24/87
08/24/87 05 222/96
05 2/96 8,768.75
8 ,768.75 10,087.50
1 0,087.50 1,318.75
7.350 % DUE 01/20/97
7.350 01/20/97 DATED 01/20/77
DATED 01/20177
10,000 FEDERAL NATIONAL
FEDERAL NATIONAL MORTGAGE ASSOCIATION
MORTGAGE ASSOCIATION 1 2/19/91
12/19/91 0 4 03/96
Ot. :3/96 10,084.38
1 0,084.33 10,240.63
1 0,240.63 156.25
1 56.25
7.050 % DUE
7.050 DUE 12/10/98 DATED
DATED 12110/91
12/10/91
213 FEDERAL SIGNAL
FEDERAL CORPORATION
SIGNAL CORPORATION 1 2 / 2 1 / 9 2 02..
12/21/92 02. ' 22/96
/96 3,287.66
3 ,287.65 5,678.48
5 ,678.48 2,390.82
2 ,390.82
60 HEWLETT-PACKARD COMPANY
HEWLETT-PACKARD COMPANY 08/10/94 05 2JI96
0 8 / 1 0 / 9 4 05 20/96 2,412.00
2,412.00 6,596.18
6,596.18 4,184.18
4,184.18
15,000 INTERNATIONAL LEASE
INTERNATIONAL LEASE FINANCE
FINANCE CORPORATION
CORPORATION 12110/91 112J:95
1 2 / 1 0 / 9 1 11 3 0/95 14,989.65
14,989.6; 15,004.50
1 5,004.50 14.85
1 4.85
6.875 % DUE 12115/95
6.875 12/15/95 DATED
DATED 12110/91
12/10/91
120 MALLINCKRODT GROUP,
MALLINCKRODT INCORPORATED
GROUP, INCORPORATED 0 3/08/93
03/08/93 09
09 :3;95
05/95 3,534.6J
3,534.60 4,550.25
4,550.25 1,015.65
110 MAY DEPARTMENT
MAY DEPARTMENT STORES
STORES COMPANY
COMPANY 0 3/19/92
03119/92 11
11 •. 5f95
5.'95 3,256.C:)
3,256.CO 4,765.59
4,765.59 1,509.59
80 MEAD CORPORATION
MEAD CORPORATION 09118192
09/18/92 09 25f95
0925'95 2,950AJ
2,950.-10 4,633.84
4,633.84 "\,683.4~
1,683.44
50 MEAD CORPORATION
MEAD CORPORATION 03/22/94
03/22/94 OS 05/95
0925.95 2,174.2~
2,174.25 2,896,15
2 ,896.15 7 21.9C
721.90
20,000
20,000 NORWEST CORPORATION
NORWEST CORPORATION SUBORDINATED
SUBORDINATED NOTE 06/18/93
06/18/93 01 :?
01 : ; 96 20,103.6:
20,103.60 20,455.00
2 0,455.00 351.20
3 51.20
6.625 % DUE 03/15/03
6.625 03:15/03 DATED 03/15/93
DATED 03/15/93
140 PIEDMONT NATURAL
PIEDMONT NATURAL GAS COMPANY
GAS COMPANY 04/26/93
04/26/93 05
05 '':
•- 96 3,376.80
3,376.80 2.931,50
2 .931.50 ·445.30
-445.30
140 PIEDMONT NATURAL
PIEDMONT GAS COMPANY
NATURAL 'GAS COMPANY 0 7/16/93
07/16/93 05
05 •'':- 96 3,189.76
3,189.76 2,931.50
2,931.50 --258,26
258.26
1
11010 STEWART
STEWART & STEVENSON SERVICES
STEVENSON SERVICES 0 3/18/92
03/18/92 1C ::.
10 3- 95 2,887.5:
2,887.53 2,530.00
2 ,530.00 ·357.5C
-357.50
UNITED STATES TREASURY
TREASURY NOTE NOTE 10114192
10H4/92 07::"
07 3" 95 14,817.·,~
1 4,817.19 14,943.75
1 4,943.75 126.56
1 26.56
6.375
6.375 %% DUE 08.'15/02
08/15/02 DATED
DATED 08115/92
08/15/92
10,000 XEROX CREDIT
XEROX CORPORATION
CREDIT CORPORATION 0 4/14/89
04114/89 0': .::
04 - ; 96 9,990.C2
9 ,990.00 10,000.00
1 0,000.00 10.00
1 0.00
10.125
10.125 % % DUE
DUE 04/1
04115/99 04/15/89
DATED 04/1
5/99 DATED 5/89
TOTAL NET LONG
TOTAL NET LONG TERM
TERM CAPITAL GAINS
CAPITAL GAINS $138,338.0
$ 1 3 8 , 3 3 8 . 0 4.. $151,093.24
$ 151,093.24 s'2,755.20
S 12.755.20
CAPITAL DISTRIBUTIONS
0 JOHNSON OPPORTUNITY
JOHNSON OPPORTUNITY FUND
FUND 95
12 L ~ 95 23.08 23.05
23.03
TOTAL
TOTAL CAPITAL DISTRIBUTIONS
CAPITAL DISTRIBUTIONS $0.00 $23.08
$23.08 $23.08
$23.08
TOTAL GROSS
TOTAL GROSS PROCEEDS
PROCEEDS *fi/foO;Ol'd..
I 4 O , 0 n $173.799.21
$173,799.21 « | 3 .. 1'J7
<l ^ 7
1l13
This report summarizes

';'his summarizes the portfolio
portfolio transactions convenience.
transactions for your convenience.
V.'e do not guarantee
""'e guarantee its appropriateness
appropriateness for use in tax preparation.
preparation.
Johnson Investment Counsel, Inc.

Inc.
S+rrd- 990 ?t
•b-t-ivvt-ô P tIr -- 44
1995 SUPPLEMENTARY
STATEMENTS
HEIMLICH INSTITUTE
THE HEIHLICH INSTITUTE FOUNDATION
23·7303161
STATEMENT: 990 PT IV -1
STATEMENT: ·1
LAND .- BASIS
BASIS
DESCRIPTION
DESCRIPTION BEG.YEAR
BEG.YEAR ADDITIONS
ADDITIONS RETIREMENTS
RETIREMENTS TRANS/OTH
TRANS/OTH END YEAR
EQUIPMENT
EQUIPMENT 37,015.
37,015. 2,366.
2,366. 39,381-
39,381.
TOTAL AMOUNT
AMOUNT 37,015.
37,015. 2,366.
2,366. 39,381-
39,381.
STATEMENT:
LAND - DEPRECIATION
DEPRECIATION
DESCRIPTION
DESCRIPTION BEG. YEAR
BEG.YEAR ADDITIONS
TRANS/OTH END YEAR
EQUIPMENT
EQUIPMENT 12,675.
12,675. 4,727.
4,727. 17,402.
17,402.
TOTAL AMOUNT
AMOUNT 12,675.
12,675. 4,727.
4,727. 17,402.
17,402.
STATEMENT:
OTHER ASSETS
ASSETS END
;ND OF
DESCRIPTION
DESCRIPTION YEAR
ADVANCES AND OTHER ASSETS

ADVANCES ASSETS 5,811-
5,811
TOTALS
TOTALS 5,811-
5,811
').
>
--
INDUSTh. ANALYSIS
INDUSTh. ANALYSIS Account
Account tt 06390287
# 06390287
-s
v9 ~
,
('[) MAY
MAY 3 1 , 1996
31.1996 HEIMLICH
HEIMLICH INSTITUTE FOUNDATION, INCORPORATED
INSTITUTE FOUNDATION, INCORPORATED " > >-
o \-
t-
(V) AVG.
AVG. EST.
EST, YLD. TO (l-
YlD.
rr-
i
QUANTITY
ASSET DESCRIPTION
TOTAL
TOTAL
COST
COST
UNIT
UNIT
COST
COST
MARKET
MARKET
PRICE
PRICE
MARKET
MARKET
VALUE
VALUE
UNIT
UNIT
INCOME
INCOME
ANNUAL
INCOME
INCOME
CURRENT
CURRENT
YIELD
YIELD
% OF
% OF
PORT.
PORT.
DUE 0-
DUE
DATE
DATE 0
o
0-
BONDS
BONDS·- TAXABLE o
Y) cr
(J
BANK
BANK AND FINANCE
FINANCE BONDS
BONDS
r6
.. 15,000
15,000 BANKERS TRUST
BANKERS
7.500%
TRUST OF NEW
7.500% DUE
NEW YORK
DUE 01/15/02
01/15/02
YORK
DATED 01/15/92
DATED 01115/92
1 4,432
14.432 96.21
96.21 100.75
1 00.75 1 5,113
15.113 75.00
7 5.00 1,125 7.4 2.9 7.3
t
$
2:
20,000
20,000 FIRST CHICAGO NBD
FIRST CHICAGO
(FORMERLY
{FORMERlY NBD
7.250%
7.250% DUE
NBD CORP
CORP
BANCORP)
NBD BANCORP)
DUE 08/15/04
08/15/04 DATED 08/24/92
DATED 08/24/92
20,789
2 0,789 1 03.95
103.95 98.75
9 8.75 19,750
19.]50 72.50
7 2.50 1,450
1.450 7.3
7.3 3.8 7.4
j1!P
LU 10,000
10,000 PNC FUNDING CORPORATION
PNC FUNDING CORPORATION 10,130
10,130 101.30
101.30 97.25
97.25 9,725
9,725 68.75
68.75 6688
88 7.0 1.9
1.9 7.4
SUBORDINATED DEBENTURE
6.875% DUE
6.875% 03/01/03 DATED
DUE 03/01/03 DATED 02123193
02/23/93
8ANK AND FINANCE
TOTAL BANK BONDS
FINANCE BONDS . $45,350
$45,350 $ 44,588
$44,588 $3,263
$ 3,263 8.6%
-s:6%
GOVERNMENT AGENCY BONDS

GOVERNMENTAGENCY BONDS
10,000
10,000 FEDERAL NATIONAL MORTGAGE
FEDERALNATIONAL MORTGAGE ASSOCIATION 9 ,486
9,486 94.86
94.86 91.13
9 1.13 9 ,113
9,113 58.75
5 8.75 5 88
588 6.4 1.8
1.8 7.1
7.1
5.875% DUE 02/02/06
5.875% DUE 02/02/06 DATED 02/02/96
DATED 02102196
1 5,000
FEDERALNATIONAL MORTGAGE ASSOCIATION
ASSOCIATION 14,747
1 4,747 98.31
9 8.31 98.16
98.16 1 4,723
14,723 72.00
72.00 1,080 7.3 2.8 7.6
7.200%
7.200% DUE
DUE 01/10/02
01/10102 DATED 01/10/92
DATED 01/10/92
1 0,000
FEDERALNATIONAL MORTGAGE ASSOCIATION
ASSOCIATION 10,000
1 0,000 1 00.00
100.00 105.53
1 05.53 1 0,553
10,553 87.00
87.00 870
870 8.2 2.0 6.6
8.700% DUE
8.700% DUE 06/10/99
06110/99 DATED
DATED 06/12/89
06/12/89
TOTAl GOVERNMENT
TOTAL GOVERNMENTAGENCY BONDS
AGENCY BONDS $34,233
$ 34,233 $34,389
$ 34,389 $2,538
$ 2,538 -s:6%6.6 %
GOVERNMENT
GOVERNMENT BONDS
BONDS
15,000
TREASURY NOTE
NOTE 13,976
1 3.976 93.17
9 3.17 91.69
9 1.69 1 3,753
13,753 56.25
56.25 8 44
844 6.1 2.7 6.8
5.625%
5.625 % DUE
DUE 02/15/06
02115/06 DATED 02/15/96
DATED 02115/96
20,000
TREASURY NOTE
NOTE 2 0,344
20,344 101.72
101.72 103.66
103.66 20,731
2 0,731 7 5.00
75.00 1,500 7.2 4 .0
4.0 6.6
7.500%
7.500% DUE
DUE 11/15/01
11/15/01 DATED
DATED 1 1/15/91
11115191
1 5,000
TREASURY NOTES
NOTES 15,213
1 5,213 101.42
1 01.42 100.19
1 00.19 1 5,028
15,028 6 5.00
65.00 9 75
975 6.4 2.9 6.4
6.500% DUE
6.500% DUE 04/30/99
04/30/99 DATED 05/02/94
DATED 05/02/94
TOTAL GOVERNMENT
GOVERNMENT BONDSBONDS $49,533
$ 49,533 $49,512
$ 49,512 $3,319
$ 3,319 ~% 9 . 6 %
INDUSTRIAL
INDUSTRIAL BONDS
BONDS
15,000
15,000 AMOCO CANADA 15,167
1 5,167 101.12
1 01.12 97.13
97.13 1 4,569
14,569 67.50
6 7.50 1,013 6.9 2.8 7.2
6.750%
6.750% DUE
DUE 02/15/05
02/15/05 DATED 02/15/93
DATED 02115193
20,000
20,000 INTERNATIONAL BUSINESS MACHINES
INTERNATIONAL BUSINESS MACHINES CORP.
CORP. 20,025
2 0,025 100.13
1 00.13 98.88
98.88 19,775
19,775 63.75
63.75 1,275 6.4 3.8 6.6
6.375% DUE 06/15/00
6.375% DUE 06115/00 DATED
DATED 06/1 5/93
06/15/93
15,000
15,000 WAL-MART STORES,
WAL·MART STORES, INC. 14,967
1 4,967 99.78
9 9.78 96.25
96.25 14,438
14,438 65.00
65.00 975
975 6.7 2.8 7.1
7.1
6.500% DUE
6.500% DUE 06/01/03
06/01/03 DATED 06/01/93
DATED 06/01/93
INDUSTRIAL BONDS
TOTAL INDUSTRIAL BONDS $50,159
$ 50,159 $ 48,781
$48,781 $3,263
$ 3,263 ~% 9 . 4 %
Johnson Investment Counsel,

Inc.
~
INDUSTh
INDUSTh ANALYSIS
ANALYSIS Account II 06390287
A c c o u n t tt 06390287
MAY
M 31,
AY 3 1 , 1996
1996 HEIMLICH
H E I M L I C H IINSTITUTE FOUNDATION,
NSTITUTE F O U N D A T I O N , INCORPORATED
INCORPORATED
AVG.
A VG. EST.
EST. YLD.
Y L D . TTO
O
TOTAL
TOTAL UNIT
UNIT MARKET
MARKET MARKET
MARKET UNIT
UNIT ANNUAL CURRENT
CURRENT %OF
% OF DUE
DUE
QUANTITY
ASSET DESCRIPTION COST
COST COST
COST PRICE
PRICE VALUE
VALUE INCOME
INCOME INCOME
INCOME YIELD
YIELD PORT.
PORT. DATE
DATE
SOVEREIGNBONDS
SOVEREIGN BONDS
20.000
2 0,000 PROVINCEOF
PROVINCE ONTARIO GLOBAL
OF ONTARIO GLOBAL BOND
BOND 19,947
1 9,947 99.74
9 9.74 97.38
9 7.38 19,475
1 9,475 61.25
6 1.25 1,225
1,225 6.2
6.2 3.8
3.8 6.8
6.8
6.125%
6 DUE 006/28/00
. 1 2 5 % DUE DATED 06/17/93
6 / 2 8 / 0 0 DATED 06/17/93
TOTAL SOVEREIGN
TOTAL SOVEREIGNBONDS
BONDS $$19,947
19,947 $19.475
$ 19,475 $1,225
$ 1,225 ---:3:8%
3.8%
UTILITY BONDS
UTILITY BONDS
115.000
5,000 GTE WISCONSIN
GTE WISCONSIN 113,900
3,900 992.67
2.67 999.38
9.38 114,906
4,906 777.50
7.50 1,163
1,163 7.7
7.7 2.9
2.9 7.8
7.8
77.750% DUE 005/01/03
. 7 5 0 % DUE DATED 06/01173
6 / 0 1 / 0 3 DATED 06/01/73
110.000
0,000 HAWAIIAN
H TELEPHONECOMPANY
A W A I I A N TELEPHONE COMPANY 88,578
,578 885.78
5.78 999.88
9.88 99,988
,988 667.50
7.50 675
675 6.7
6.7 1.9
1.9 6.8
6.8
FIRST MORTGAGE
FIRST MORTGAGE
66.750% DUE 004/01/98
. 7 5 0 % DUE DATED 03/28/68
4 / 0 1 / 9 8 DATED 03/28/68
220.000
0,000 PUBLIC SERVICE
PUBLIC SERVICE ELECTRIC
ELECTRICAND GAS COMPANY
A N D GAS COMPANY 119,908
9,908 99.54
99.54 94.50
94.50 118,900
8,900 65.00
65.00 1,300
1,300 6.8
6.8 3.7
3.7 7.4
7.4
66.500% DUE 005/01/04
. 5 0 0 % DUE DATED 05/01/93
5 / 0 1 / 0 4 DATED 05/01/93
TOTAL UTILITY
TOTAL UTILITY BONDS
BONDS $$42,385
42,385 $$43,794
43,794 $$3,138
3,138 -a:5%8 . 5 %
TOTAL BONDS
TOTAL BONDS -- TAXABLE $$241,608
241,608 $$240,539
240,539 $$16,746
16,746 446.5%
6.5%
STOCKS -- COMMON
STOCKS COMMON
BASIC INDUSTRY
BASIC INDUSTRY
100
100 MINNESOTA MINING
MINNESOTA MINING && MANUFACTURING
MANUFACTURING COMPANY
COMPANY 44,734
,734 447.34
7.34 668.25
8.25 66,825
,825 1.88
1.88 188
188 2.7
2.7 1.3
1.3
2294
94 SONOCO PRODUCTS
SONOCO PRODUCTS COMPANY
COMPANY 55,880
,880 220.00
0.00 227.38
7.38 88,048
,048 0.66 194
194 2.4
2.4 1.6
1.6
TOTAL BASIC
TOTAL BASIC INDUSTRY
INDUSTRY $$10,614
10,614 $$14,873
14,873 $$382
382 ~% 2.9 %
CAPITAL GOODS
CAPITAL GOODS
125
125 DOVER CORPORATION
DOVER CORPORATION 55,639
,639 445.11
5.1 1 447.50
7.50 55,938
,938 00.60
.60 75
75 1.2
1.2 1.1
1.1
130
130 GENERALELECTRICCOMPANY
GENERAL ELECTRIC COMPANY 55,596
,596 443.05
3.05 882.75
2.75 110,758
0,758 1.84
1.84 2239
39 2.2
2.2 2.1
2.1
TOTAL CAPITAL
TOTAL CAPITAL GOODS
GOODS $$11,235
11,235 $$16,695
16,695 $$314
314 ~% 3 . 2 %
CONSUMER/CYCLICAL
CONSUMER/CYCLICAL
880
0 DISNEY (WALT)
DISNEY (WAL T) COMPANY
COMPANY 44,650
,650 558.12
8.12 660.75
0.75 44,860
,860 00.44
.44 35
35 0.7
0.7 0.9
0.9
1100
00 DONNELLEYIR.R.l
DONNELLEY (R.R.) & SONS COMPANY
& SONS COMPANY 22,959
,959 229.59
9.59 336.75
6.75 33,675
,675 00.72
.72 72
72 1.9
1.9 0.7
0.7
100
100 ECHLIN INCORPORATED
ECHLIN INCORPORATED 3,121
3,121 331.21
1.21 334.38
4.38 33.438
,438 00.88
.88 88
88 2.5
2.5 0.7
0.7
2200
00 SHERWIN WILLIAMS
SHERWIN WILLIAMS COMPANY
COMPANY 66,257
,257 331.28
1.28 444.88
4.88 88,975
,975 00.70
.70 140
140 1.5
1.5 1.7
1.7
2200
00 WALGREEN COMPANY
WALGREEN COMPANY 33,935
,935 119.68
9.68 331.88
1.88 66,375
,375 00.44
.44 88
88 1.3
1.3 1.2
1.2
TOTAL CONSUMER/CYCLICAL
TOTAL CONSUMER/CYCLICAL $$20,921
20,921 $$27,323
27,323 $$423
423 -s:2%
5.2%
CONSUMJ:;R/NON-CYCLICAL
CONSUMER/NON-CYCLICAL
1150
50 ALBERTSON'S, INC.
ALBERTSON'S, INC. 44,643
,643 330.96
0.96 339.88
9.88 5,981
5,981 00.60
.60 990
0 1.5
1.5 1.2
1.2
100
100 GILLETTE COMPANY
GILLETTE COMPANY 2:?<1G8
,168 2211.68
4.68 559.13
9.13 5.913
5,913 0.72
0.72 72
72 1.2
1.2 1.1
1.1
Johnson Investment
Johnson lnvostmont Counsel,
Counsel, Inc.
Inc.
INDUSTr. . ANALYSIS
INDUSTK. ANALYSIS
\ >r
06390287
Account
A ccount # 06390287
MAY
M A Y 31,1996
31,1996 HEIMLICH
H E I M L I C H INSTITUTE
I N S T I T U T E FOUNDATION,
F O U N D A T I O N , INCORPORATED
INCORPORATED
AVG.
AVG. EST.
EST. YLD.
YLD. TO
TO
TOTAL UNIT MARKET
MARKET MARKET
MARKET UNIT ANNUAL CURRENT
CURRENT %OF
% DUE
DUE
QUANTITY
COST COST
COST PRICE
PRICE VALUE
VALUE INCOME
INCOME INCOME
INCOME YIELD
YIELD PORT. DATE
200
200 MCDONALD'S CORPORATION
CORPORATION 7,289
7,289 36.45
36.45 48.13
48.13 9,625
9,625 0.30
0.30 60
60 0.6
0.6 1.9
1.9
140
140 PROCTER& GAMBLE COMPANY
PROCTER & GAMBLE COMPANY 6,930
6,930 49.50
49.50 87.88
87.88 12,303
12,303 1.60
1.60 224
224 1.8
1.8 2.4
2.4
TOTAL CONSUMER/NON-CYCLICAL
TOTAL CONSUMER/NON-CYCLICAL $21,330
$21,330 $33,821
$33,821 $446
$446 ---s:6%
6.6%
ENERGY
ENERGY
100
100 MOBIL
MOBIL CORPORATION
CORPORATION 9,815
9,815 98.15
98.15 112.88
112.88 11,288
1 1,288 4.00
4.00 400
400 3.5
3.5 2.2
2.2
75
75 ROYAL DUTCH
ROYAL DUTCH PETROLEUM
PETROLEUMCOMPANY
COMPANY 7.071
7,071 94.28
94.28 149.94
149.94 11.245
11,245 4.70
4.70 352
352 3.1
3.1 2.2
2.2
(NETHERLANDS)
(NETHERLANDS)
TOTAL
TOTAL ENERGY
ENERGY $16,886
$16,886 $22,533
$22,533 $752
$752 ~% 4.4 %
FINANCIAL
FINANCIAL SERVICES
SERVICES
120
1 20 COREST ATES FINANCIAL CORPORATION
CORESTATES CORPORATION 4.755
4,755 39.62
39.62 39.38
39.38 4,725
4,725 1.68
1.68 202
202 4.2
4.2 0.9
0.9
55
55 GENERALRE
GENERAL RE CORPORATION
CORPORATION 5.694
5,694 103.53
103.53 146.00
146.00 8,030
8,030 2.04
2.04 112
112 1.3
1.3 1.6
1.6
200
200 REGIONSFINANCIAL
REGIONS FINANCIAL CORPORATION
CORPORATION 6,400
6,400 32.00
32.00 47.25
47.25 9,450
9,450 1.40
1.40 280 2.9
2.9 1.8
1.8
TOTAL FINANCIAL
TOTAL FINANCIAL SERVICES
SERVICES $16,849
$16,849 $22,205
$22,205 $594
$594 --0%
4.3%
HEALTH CARE
HEALTH CARE
170
170 MYLAN LASORATORIES.INC.
M Y L A N LABORATORIES, INC. 3,956
3,956 23.27
23.27 19.00
19.00 3,230
3,230 0.16
0.16 27
27 0.8
0.8 0.6
0.6
170
170 SCHERING-PLOUGHCORPORATION
SCHERING-PLOUGH CORPORATION 5.531
5,531 32.53
32.53 58.63
58.63 9,966
9,966 1.32 224
224 2.2
2.2 1.9
1.9
80
80 SMITHKLINE
SMITHKLINE BEECHAM
BEECHAM PLC
PLC ADR
ADR 4,005
4,005 50.06
50.06 51.00
51.00 4,080
4,080 1.24
1.24 99
99 2.4
2.4 0.8
0.8
TOTAL HEALTH
TOTAL HEALTH CARE
CARE $13.492
$13,492 $17,276
$17,276 $350 ~% 3.3 %
MID-SIZED COMPANIES
MID-SIZED COMPANIES
498.432
4 98.432 JOHNSON
JOHNSON OPPORTUNITY
OPPORTUNITY FUND
FUND 7,840
7 ,840 15.73
15.73 21.68
21.68 10,806
10,806 0.08
0 .08 40
4 0 0.3
0.3 2.1
2.1
TOTAL MID-SIZED
TOTAL MID-SIZED COMPANIES
COMPANIES $7,840
$7,840 $10,806
$10,806 $40
$40 ~% 2.1 %
TECHNOLOGY
TECHNOLOGY
60
60 COMPUTER
COMPUTER ASSOCIATES
ASSOCIATES INTERNATIONAL,
INTERNATIONAL, IINC.
NC. 4.342
4,342 72.37
72.37 72.75
72.75 4,365
4,365 0.14
0.14 8 0.1
0.1 0.8
250
250 E M C CORPORATION
CORPORATION 5.523
5,523 22.09
22.09 22.00
22.00 5.500
5,500 0.00
0.00 0 1.1
200
200 GENERALMOTORS CORPORATIONCLASS
GENERAL MOTORS CORPORATION CLASS EE 6.686
6,686 33.43
33.43 56.38
56.38 11.275
11,275 0.60
0.60 120
120 1.0
1.0 2.2
2.2
(ELECTRONICDATA
(ELECTRONIC D A T A SYSTEMS)
SYSTEMS)
100
100 HEWLETT-PACKARD
HEWLETT-PACKARD COMPANY
COMPANY 4.020
4,020 40.20
40.20 106.50
106.50 10,650
10,650 0.80
0.80 80
80 0.7
0.7 2.1
2.1
70
70 MOTOROLA INC.
MOTOROLA INC. 3.927
3,927 56.10
56.10 66.75
66.75 4,673
4,673 0.40
0.40 28
28 0.5
0.5 0.9
0.9
TOTAL TECHNOLOGY
TOTAL TECHNOLOGY $24.498
$24,498 $36,463
$36,463 $236
$236 77.1
.1%%
TRANSPORTATION
TRANSPORTATION
i\
US ~i IlUl11INl
m iTON NOI1IIII
i l l ! INCiTON NOIlIIIIIINUN SAN
SAN I1/\ II
A I'L !,.II:I
!>. I 111 ()O.l!)
(iO. 1!) IJtI.7!i
IJ4.75 'I.LOtl
7,204 1.:10
1.20 102
102 1.'l
1.4 1.4
1.4
CUIlI'OIIAIION
COKI'OHATION
TOTAL TRANSPORTATION
TOTAL TRANSPORTATION $5,
$ 5 , 1113
13 $7,204
$ 7,204 $102
$ 102 ~% 1.4 %
Johnson Investment
Investment Counsel, Inc.
Inc.
\ s^
INDUSTh. ANALYSIS
INDUSTh . ANALYSIS Account## 06390287
Account 06390287
MAY 3 1 , 1996
MAY31.1996 HEIMLICH INSTITUTE
HEIIVILICH INSTITUTE FOUNDATION,
FOUNDATION, INCORPORATED
AVG.
A VG. EST.
EST. YlO. TO
YLD. TO
TOTAL
TOTAL UNIT
UNIT MARKET
MARKET MARKET
MARKET UNIT
UNIT ANNUAL
A NNUAL CURRENT
CURRENT % OF
% OF DUE
DUE
QUANTITY
COST COST
COST PRICE
PRICE VALUE
VALUE INCOME
INCOME INCOME
INCOME YIELD
YIELD PORT.
PORT. DATE
DATE
UTILITIES
UTILITIES
100 A TT && TT CORPORATION
CORPORATION 5.214
5 ,214 52.14
5 2.14 62.38
6 2.38 6.238
6 ,238 1.32
1.32 132
132 2.1
2.1 1.2
1.2
275
275 GTE
G T E CORPORATION
CORPORATION 8.881
8 ,881 32.79
3 2.29 42.75
4 2.75 111,756
1,756 1.88
1.88 517
5 17 4.3
4.3 2.3
2.3
TOTAL UTILITIES
TOTAL UTILITIES $14.095
$ 14,095 $$17.994
17,994 $649
$ 649 ---:3.5%
3.5%
TOTAL STOCKS
TOTAL STOCKS·- COMMON
COMMON $$162.872
162,872 $$227.192
227,192 $$4,288
4,288 444.0%
4.0 %
CASH
CASH AND
AND EQUIVALENTS
EQUIVALENTS
CASH AND
CASH AND EQUIVALENTS
EQUIVALENTS
5.669.290 ACCRUED
5,669.290 ACCRUEDINTEREST AND DIVIDENDS
INTEREST AND DIVIDENDS 55.669
,669 1.00
1.00 1.00
1.00 5.669
5,669 0.05
0.05 2259
59 4.5
4.5 1.1
1.1
43.234.050 CASH
43.234-.050 CASH AND
AND EQUIVALENTS
EQUIVALENTS 443.234
3,234 1.00
1.00 1.00
1.00 443.234
3,234 0.05
0.05 1,978
1,978 4.5
4.5 8.4
8.4
TOTAL CASH
TOTAL CASH AND
AND EQUIVALENTS
EQUIVALENTS $$48,903
48,903 $$48.903
48,903 $$2,237
2,237 ---s:5%
9:5%
TOTAL CASH
TOTAL CASH AND
AND EQUIVALENTS
EQUIVALENTS $$48.903
48,903 $$48.903
48,903 $$2.237
2,237 99.5%
.5%
PORTfOLIOTOTAL
I'ORTPOLIO TOTI\l. $$453.383
453,383 $$516.634
516,634 $ 223.271
3,271 44.5%
.5% 1100.0%
00.0%
Ie s.~ c 0<...\, n,,_J Ef (.)ilP-{(I)~~_' (.I/t; 103)
4W3 ■>
It£ V6\!U£ 0
L/C/~l!2()
Johnson Investment
Counsel, Inc.
E\N: d.3-13031~J
E\M: 23-^303161
Revised 9/20/96
THE HEIMLICH
HEIHLICH INSTITUTE FOUNDATION, INC.
THE BOARD OF TRUSTEES
HEIMLICH 1995-1996
1995-1996
INSTITUTE
RlUNDAnOH, INC.
P.O.BOU858 w. Whittaker, Pres,
*Harry W. Pres. Soc. Sec. ##L
ClrCIIIlII.oH4520S 2497 Grandin Road Gradison & Co.
51J.22HI()(]2 Cincinnati, OH 45208
Cincinnati, 580 Walnut Street
III ~\ 3-221{JOO3 Cincinnati, OH 45202
cincinnati,
(513)
(513) 579-5000
Philip M. Heimlich, Vice Pres.
Pres. Soc. Sec. #^
6680 Lyceum Court Cincinnati CCity
ty Hall
Cincinnati,
Cincinnati, OH 45230 801 Plum Street
(513)
(513) 624-9155 Cincinnati, OH 45202
cincinnati,
(513)
(513) 352-3647
Joseph J. Dehner, Secretary Soc. Sec. #| #____
822 Yale Avenue
Avenue Frost & Jac~
Jacobs
Terrace Park, OH 45174 2500 Central Trust Tower
Cincinnati, OH 45202 45202
(513)
(513) 651-6800
(513) 6 5 1 - 6 1 6 6 - K a t h y Barrett
(513) 651-6166-Kathy Barrett
(513) 651-6819
(513) 6 5 1 - 6 8 1 9 Fax
*Cedric W. Vogel,
Vogel, Treasurer S o c . Sec.
Soc. S e c . ##|
2270 Madison Road 500 Atlas Bank Building
Cincinnati,
Cincinnati, OH 45208 524 Walnut Street
Cincinnati,
cincinnati, OH 45202
(513)
(513) 421-4225
Heimlich, M.D.
*Henry J. Heimlich, Soc. Sec. ##^^^^^^^^H.
17 Elmhurst Place Heimlich Institute
Cincinnati,
Cincinnati, OH 45208 2368 Victory Pkwy., #410
(513)
(513) 221-0002
Mrs. Winston C. Atteberry Soc. Sec. # .
Box 629
Eunice, LA 70535
(318)
(318) 457-2705
Mr. George Blake Soc. Sec.
Cincinnati Enquirer (513) 768-8094 direct
(513)
312 Elm Street
Cincinanti,
Cincinanti, OH 45202
Benefiting Kathy Carr S oc. S
Soc. e c . #1
Sec. #
Humanity carr
Ray Carr
3057 Saddleback Drive
S oc. S
Soc.
K
K wk.
e c . #[
Sec.
Wk. (513)
#
(513) 871-2221
871-2221
Through Cincinnati,
cincinnati, OH 45244 R wk. (513) 621-4777
wk. (513) 621-4777
(513)
(513) 231-3010
Health
and
Peace
^TMT Sa,0PT V-l V
Mrs.
Mrs. Arthur
Arthur Murray
Murray (Kathryn)
(Kathryn) Soc. Sec. ##
Soc. Sec.
22877
877 Kalakuau
Kalakuau Avenue
Avenue
THE Honolulu,
Honolulu, HI
HI 96815
HEIMLICH (808)
(808) 924-4094
INSTITUTE
FOUNDATION, INC. Monte L.
Monte L. Rovekamp Soc.
Soc. Sec.
Sec.
PO sox 8858 2864 Crescent Springs Pike
2864 Pike P.O.
P.O. Box
Box 19129
19129
CIICllUlI. Ill!45208 Erlanger, KY
Erlanger, KY 41018 Cincinnati,
Cincinnati, OH
OH 45219-0129
45219-0129
513-271-0002 (606)
(606) 341-6050
III 513 221-0003
William P.
William P. Sheehan Soc.
Soc. Sec.
Sec. #|
41
1673 Braintree
1673 (614)
(614) 466-3206
466-3206
Cincinnati,
Cincinnati, OH
OH 45255
45255
(513)
(513) 231-7467
Charles
Charles J.
J. Sgueri
squeri (Chuck)
(Chuck) Soc.
Soc. Sec.
Sec. #|
41
c/o
c/o Squeri Food
Food Service
Service Inc
Inc Squeri
Squeri Foods
Foods
619
619 Linn
Linn Street 619
619 Linn
Linn Street
Street
Cincinnati, OH
OH 45203
45203 Cincinnati,
Cincinnati, OHOH 45203
45203
(513)
(513) 381-1106
381-1106
Anson Williams
Anson Williams Soc.
Soc. Sec. #1
24615 Skyline View Drive
24615 Drive (213)
(213) 850-2685
850-2685 (office)
(office)
Malibu, CA
Malibu, CA 90265 (213)
(213) 657-4861
657-4861 (home)
(home)
Dr. Paul
Dr. Paul winchell
Winchell Soc. Sec.
Soc. Sec.
32262
32262 Oakshore
Oakshore Drive
Westlake Village,
Village, CA
CA 91361
(818)
(818) 991-5754
* These trustees
* trustees have the discretion as to the distribution of
contributions.
Benefiting
Humanity
Through
Health
and
Peace
~/
THE HEIMLICH
INSTITUTE
FOUNDATION
23-7303161
PART:III LINE:3
PART:III LINE:3
Patient need
Patient need for
for financial
financial assistance
assistance is
determined on
determined on an
an individual
individual basis.
basis.
Each patient's
Each patient's ability
ability to
to meet medical and
meet medical and
related expenses
related expenses is
is reviewed
reviewed in
in terms
terms of
of referral
referral
information or
information through investigation
or through investigation byby the
the
foundation itself.
foundation itself.
bTKT Sc(\A p + l £ - /
OMB
.
No. 15450047
OM B No. 1545 0047
.
990 Return of Organization Exempt From Income Tax
Form
Under section 501 (c) of the Internal Revenue Code (except black lung benefit
trust or private foundation) or section 4947(a)(1) nonexempt charitable truslt/
1996
Department of the Treasury This Form is Open to
Internal Revenue Service Note: The organization may have to use a copy of this return to satisfy state reporting requirements, ^^^JblicJnsjyscUon^^
A
B
For the 1996
1996 calendar
cale ndar year.
year OR tax year period perlod beginning
bealnnlnq 06/01
06/01 . 1996
1996. and
.
and ending
ending 05/31
05j31
o Employer
D
■1997
1997
Employer identification
identification number
number
Check if:
Please
Please
C Nameof
C Name of organization
organization
,..r·'--I
~~4C'O ~C·· n(n~~
,."
0
O Change of
Change of
use IRS
use IRS
THE ...!!.S.1.MU
THE HEIJUJCH CH INSTITUTE
INST ITUTE /4~
/ \- I..J • - _. J.J ....
address FOUNDATION
label or label or
0 Initial
Initial return print or
Number and street (or
Number and P.O. box
(or P.O. box if
if mail
mail is not delivered to street address)
address) Room/suite E State
E State registration number
number
0 Final
Final return type. See
See 2368
2368 VICTORY
VICTORY PARKWAY
PARKWAY
Specific
0
LJ Amended return
lInstruc
Instruc
SUITE 410
SUITE
((required
r e q u i r e d also
State
alSO for
for nsuuc
tions.
tiens.
City, town,
town, or
or post
post office, state,
state, and
and ZIP+4
ZIP+4 pF Check
Check ....
0
1^.! I If exemption
If exemption
application
application
State reporting) CINCINNATI OH 45206 'S
i i Pending,
Dendino
G ► ~
G Type of organization .... H Exempt under section 501(c)(
501 (c)( 33 ) ) <l1li
-4 (insert
(insert number)
number) OR....
OR ► LJ section
section 4947(a)(1)
4947(a)(1) nonexempt
nonexempt charitable 0
charitable trust
trust
H (a) Is trus
H this agroup return filed
filed for affiliates?
affiliates? ..... LjYes I x l No If
If either box
box in
in H
H is
is checked
checked "Yes,"
'Yea.' enter four digit
enter four digit group
group
(b) If
If "Yes/
'Yes,' enter
enter the number
number of affiliates
affiliates for which
w h i c h this return is filed:.
filed:. . ► N/A exemption number
number (GEN)
(GEN) ►
(c)
(C) Is separate return
Is this a separate return filed by
by an
an organization
organization J Accounting
Accounting method: | | Cash
OCash [X]
[Xj Accrual
Accrual
covered by agroup ruling? ;, „• • ■„.• ■ I I Yes iXiNo | | Other (specify) ►
K Check h e r e ^ l I if the organization's gross receipts are normally not more than $25,000. The organization need not file a re turn with the IRS; b u t i f i t
received a Form 990 Package in the mail, it should file a return without financial data. Some states require a complete return.
Note: Form 990 EZ mav be used by oraanizations with qross receipts less than $100,000 and total assets less than $250,000 at end of vear.
Part I Revenue. Expenses, and Changes in Net Assets or Fund Balances (See Specific instructions.)
1 Contributions, gifts,
Contributions, gifts, grants,
grants, and
and similar
similar amounts
amounts received:
•i a Direct public support.
Direct support . . . . . . . 1a 78,164.
\ b Indirect public support . 1b 200,000.
1
{
c (grants) . . . . . . . . . . . .
Government contributions (grants) 1c
d Total (add lines 1a through
Total through 1c) (attach
(attach schedule of contributors) SEE 990 PT I - 1
(cash $
(cash 278 164.
278,164. noncash $ _) 1d 278,164.
t 2 93)
2 Program service revenue including government fees and contracts (from Part VII, line 93). 2
3 assessments . . . . . . . .
Membership dues and assessments 3
i
4
4 Interest on savings and temporary cash investments
Interest 4
R
fi
e
5
6a
7
b
c
Gross
Gross rents
rents
securities . . . . . .
Dividends and interest from securities.
Less: rental expenses . . . . . . . . . . . .

.
(loss) (subtract line 6b from line 6a)

Net rental income or (loss)
Other investment income (describe ► ...
6a
6b
)
■
6c
23.410.
1
V
e 8a
Sa Gross amount from sale
sale of assets other
assets other (A) Securities (B) Other
n
u than inventory
inventory. . 114,466. 8a
e
b Less: cost or other basis and sales expenses 94,738. 8b
c (loss) (attach schedule) ....
Gain or (loss) 19,728. 8c
(loss) (combine line 8c, columns (A)
(A) and (8))
(B)) .SEE. 990 .PT J . - . 2 19,728.
i
9 Special events and activities (attach
(attach schedule)
a includino. "'-
Gross revenue (not including $ _ of
contributions reported on line 1a) 9a
b Less: direct expenses other than fundraising expenses.
expenses . . . . . . . . 9b
c Net income pr_(loss)-fFomispecial
speclel events (subtract line 9b from line 9a)
9a) . . . . .
^lOa— tQiHk^PeWtftpflvintory, ifess returns and allowances . . . . . . . . . . . . . 10a
■ b,«--Lessr-cost-of goods sdldj).l 10b
1 \ ir*"H
s of inventory (attach schedule) (subtract line 10b from line 10a)
om 10a) 10C
\ cj Gross profit orOoss) frpM Sales of inventory (attach schedule) (subtract line 10b f
^ | { $ f ^ r $ e S u J ^ f r > Pkrfjill,I, line 103)
103). . . . . . 11
12 ! Total revenufi-iacW4if)e£ld. 2. 3. 4. 5, 6c, 7, 8d. 9c, 10c. and 11) 12 321,302.
E 13
E ^ i ^ f l ^ E e M c e l J f r ^ m Iina44, column (B)) 13 128,856.
p yi ânaaeB»nt-afid-qeTreT5rffrom line 44, column (C)) 14 50,581.
e
15 Fundraising (from line 44, column (D)) 15
s
16 Payments to affiliates (attach schedule) 16
s
17 Total expenses (add lines 16 and 44, column (A)) 17 179,437.
A 18 Excess or (deficit) for the year (subtract line 17 from line 12) 18 141,865.
N Ss
N
e es 19 Net assets or fund balances at beginning of year (from line 73, column (A)) 19 473,532.
t
t 20 Other changes in net assets or fund balances (attach explanation) SEE
SEE .990.
99Q PT.
~T. I.L : 33. 20 105,890.
s
21 Net assets or fund balances at end of vear (combine line 3 18, 19, and 20) . . . -21 721,287.
For Paperwork Reduction
Reduction Act Notice, instructions.
Notice, see separate instructions. Form 990
9 9 0 (1996)
(1996)
JXB
JX8 P 12/17/96
F 12/17/96
THE HEIMLICH
INSTITUTE
Form
Form 990
990 (1396)
(13961 FOUNDATION
FOUNDATION 23-7303161 Page 2
P a r t it Statement
S t a t e m e n t ofOf All organizations must complete column (A). Columns (B), (C), and (D) are required for section 501(c)(3)
Functional
F u n c t i o n a l Ex nses
Expen ses and (4) organizations and section 4947(a)(1) nonexempt charitable trusts but optional for others. (See Instr)
(C)
6b, 8b, 9b, 10b, or 16 of Part
Part I.
(A) Total
(B) Program
services rsr (D) Fundraising
11H
22 Grants and allocations (attach
Grants (attach schedule) . . . . .
(cash $
(cash £ noncash $
noncasb -') 22
23
23 Specific assistance
assistance to individuals (attach schedule)
schedule) . . . . 23
24
24 Benefits
Benefits paid to or for members (attach schedule)
schedule) . 24
25
25 Compensation of officers,
officers, directors, etc 25
26 Other
Other salaries
salaries and wages . 26 48.220. 40,333. 7.887.
27
27 Pension
Pension plan contributions
contributions. 27
28
28 Other employee benefits.
benefits . 28 8.811. 3,716. 5.095.
29 Payroll taxes . . . . . . .
Payroll taxes. 29 3.507. 2,933.
30 Professional
Professional fundraising fees
fees. 30 llillllllllllll
31
31 Accounting fees . 31
32
32 Legal fees
Legal fees. 32
33
33 Supplies . 33 4.770. 2,821. 1.949.
34 Telephone . 34 4.322. 2,868. 1.454.
35
35 Postage and shipping .
Postage 35 2.345. 2,030. 315.
36 Occupancy . 36 16.200. 10.800. 5.400.
37 Equipment rental and maintenance 37
38 Printing and publications. . . . . . 38
39
39 Travel
Travel. 39 17.625. 14.470. 3.155.
40 Conferences,
Conferences. conventions,
conventions. and meetings 40
41 Interest
Interest . 41
42
42 Depreciation, depletion, etc. (attach
(attach schedule) . 42 6.945. 6.945.
43 Other expenses (itemize):
Other expenses (itemize): a a 43a
b OFFICE INSURANCE
OFFICE INSURANCE 43b 6.375. 1,497. 4.878.
c OUTSIDE SERVICES
OUTSIDESERVICES 43c 51.867. 41,511. 10.356.
d
d MISCELLANEOUS
MISCELLANEOUS 43d 8.450. 5,877. 2.573.
e 43e
444
4 Total
T o t a l functional
f u n c t i o n a l expenses
e x p e n s e s (add
(add lines 22 through
through 43)
43) Organiza-
Organiza
tions comDletina columns (B)-(D). carry these totals to lines 13-15 . . 44 179.437.
179 437. 128,856.
128 856. 50,581.
50 581. NONE
Reporting
Reporting of of Joint
Joint Costs. - Did yyou o u report
report in ccolumn
o l u m n (B) (Program
(Program services)
services) any joint costs
costs ffrom
r o m a combined
combined
educational c a m p a
educational campaign andi g n a n d fundraising solicitation?
solicitation? . . . . . ...... D
► LJ Yes ~
[x] No
No
If "Yes,"
"Yes," enter
enter (i) the aggregate
aggregate amount of these joint costs $ _ ; (ii) the amount allocated to Program services $
(iji) the amount allocated to Management and general $ ; and (iv) the amount allocated to Fundraising $
illafilrll Statement of Program Service Accomplishments (See Specific instructions.)
What is the organization's primary
primary exempt purpose?
purpose?'"► RESEARCH_AND_ ~~ Eli.
EDUCATION
~E~~~C!, _A!!~ ~D~~A.! 0N_ ~~!_o~~
yA_RK)US_ ~I~~A~E_S
DI_SEASE_S_ _ Program Service
Expenses
All organizations
organizations must describe their exempt purpose achievements. State
achievements. State the number of clients served, publications issued, etc. (Required for 501 (c)(3)
501(c)(3)
Discuss and
and (4) orgs.,.• and
(4)orgs
achievements that are not measurable. (Section
(Section 501(c)(3)
501 (c)(3) and (4)
(4) organizations
organizations and 4947(a)(1)
4947(a)(1) nonexempt charitable
charitable trusts 4947(a)(1)
4947(a)(l) trusts; but
must also enter the amount of grants and allocations to others.) . optional for 0others.)
tional for
I
a _T_!l!:_
_T_he .!!~i~lJ~h_
_He_imlJch_I_nsti tute_ Foundatj"on, _Inc.
I_n~tJ!.u.!~ ~o_I:J~d~0'?_nJ. _is _a_
J!2c_:_i~ _a _
corporation ~designed
_c_?ry.!?~a!i_?~ to
~2.g.!:1~d_ conduct scientific,
t_?_c.9~d~c..!_s_E:~e!20!.i_E:, _
cultural and social research into issues of
importance to the medical and (Grants and allocations $
s e c n 1 _s..!!.s_~!._m~ry_e.!:1~e~,:?!:,s
m e
b _ -5L I]i)ii5_ °'!FH Jl f^.-_il _PTL J[!y_ J?£l JYi Il _
_s~i.e.!:1!_iii~_c.!?'!!'1~nJ!.i~s_: e ) s _
b
_ include research J~t~
i.!:1~l_I:J<!e_r~~e~~~into ..!~e_!_r~a..!l!!e.!:1!_
the treatment ~f_ of ~a.!:1c:_e!:.,
cancer, _
lyme_ disease^ êrnphyserna^
_ l_yf!!e_<!i~e~~eJ.
_e~p_!lts~~aL. and_cyst_ic_
~~d_c_y~tJ.c:_ f i b r e s i_s^
ii_P~o~~.:.. _
38 750.
c AIDS research
AIDS research and education
education

d _Ejl::!.c~!_i
_Edy_catjon_of_the
~n_'?_f_ jjenera^ p u b li~L.
~~ il~n~r:._al.p~~ i c ^ .!~e_p~!._n.!~nl1_
_the_p_ri_nting _
and d i s t r i
distributionb u t i o n of educational
educational l i t e r a t u r e to
literature to
------------------------------------------------------------------
_pubUc_ E~~e~
places _a~_I:J!_.!~_H~~m~
_p_I:J~lJ.c:_ _about^ the Heimlich Maneuver.
~~ !I~n~~~r..: _
(Grants and allocations S 33.970.
e Other program services (attach schedule) (Grants and allocations $
f Total of Program Service Expenses (should egual line 44, column (B), Program services) 128,856.
128,856.
F12/17/96
F 12/17/96
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE
Form 990 (~996) FOUNDATION
23· 7303161 Page
Pase 3
:::IIR:·:~.
PartiV . Balance Sheets
Balance Sheets (See
(See Specific Instructions.)
Specific Instructions.)
Note: Where attached schedules

Where required, attached schedules and amounts
amounts within the description 'column
description'column (A)
(A) (8)
(B)
should be for end of vear amounts onlv. Beginning of year End
End of
of year
45 Cash non interest bearing 48,171. 45 6,374.

46
47a
47a
b
Savings and temporary cash
Savinqs
Accounts receivable.
Less:
cash investments
investments
receivable . . . . . . . . .
allowance for doubtful accounts
Less: allowance
47a
47b
■ 37,725.
48a
48a Pledges receivable . . . . . . . . . .
Pledges receivable 48a
b Less: allowance for doubtful accounts
Less: allowance accounts 48b 48c
49
49 Grants
Grants receivable
receivable . . . . . . . . . . . . . . . . . . . 49
50
50 Receivables from officers,
Receivables officers, directors, trustees,
trustees, and key
key employees
employees
(attach
(attach schedule)
schedule). . . . . . . . . . . . . . . . . . . . 50
A
s
51a
51a Other notes
Other notes and loans receivable
receivable (attach
(attach schedule)
schedule) . . 51a
e 51c
b Less: allowance
Less: allowance for doubtful accounts
accounts . . . . . . . . 51b
s 52
52 Inventories
Inventories for sale
sale or use
use . . . . . . . .
53
53 Prepaid
Prepaid expenses
expenses and
and deferred
deferred charges
charges. 53
54
54 Investments securities (attach
Investments securities (attach schedule)
schedule) . See 970 P+ W'H 404.480. 54 664,543.
55a
55a
b
Investments
Investments land,
basis
basis
Less:
Less: accumulated
schedule)
schedule)
.
equipment:
land, buildings, and equipment:
accumulated depreciation (attach

(attach
.
55a
55b
1
56
56 Investments other
Investments other (attach schedule)
(attach schedule) .
57a
57a Land,
Land, buildings, and equipment: basis
basis . . . . . . . . 57a 55,616. SEE 990 PT IV - 1
b Less:
Less: accumulated SEE .99Q
accumulated depreciation SEE .990 PT. IV. -. 2
P.T.iv. 57b 24.347. 21,979. 57C 31,269.
58 Other assets
Other assets (describe
(describe P
► __ SEE 990 PT IV - 3
_.;:=.-.:...:...:::......;_:.......:-=-_=- ---' ) 5.811. 6,387.
59 Total assets (add lines 45 throuqh 58) (must equal line 74) 480.441. 59 746,298.
60
60 Accounts
Accounts payable
payable and accrued expenses
and accrued expenses 6,909. 60 25,011.
L
61
61 Grants
Grants payable
payable. 61
a
~ 62
62 Deferred revenue
Deterred revenue.
1 63 Loans from officers,
Loans officers, directors,
directors, trustees, and key
key employees
employe es 63
i
64a Tax-exempt bond liabilities
liabilities (attach
(attach schedule)
schedule) 64a
~ b Mortgages other notes
Mortgages and other notes payable
payable (attach
(attach schedule)
schedule) 64b
s
■
65 Other liabilities (describe ► ) 65
66 Total liabilities (add lines 60 throuqh 65) 6.909. 25,011.
N
N
e Organizations
Orgs follow SFAS
mizations that follow SFAS 117,
117, check here
h e r e ...
^ [X)
Q and complete
t
lines 67 through 69
lines 67 69 and lines
lines 73 and 74.
A
s 67
67 Unrestricted .....
Unrestricted 478,478. 682,368.
67
s
68 Temporarily restricted
Temporarily restricted .
t
s 69
69 Permanently
Permanently restricted
restricted . . . . . . . . . . -4,946. 69 38,919.
o
r
F
u
n
Orgs
Organizations
70
70
lines
lines 70
follow SFAS
nizations that do not follow
70 through 74.
Capital
SFAS 117,
117, check here ►
stock, trust principal, or current funds

Capital stock.
...
. . . . .
o
D and complete
■1
70
d
d 71
71 Paid-in or
or capital
capital surplus,
surplus, or
or land,
land, building, and
and equipment fund
. . 71
B 72
72 Retained earnings,
Retained earnings, endowment, accumulated
accumulated income, or other
other funds M,„
a
1
I
a
a
73
73 Total net assets or fund
fund balances (add
(add lines
lines 67
67 through 69
69 OR
OR lines
lines 70
70 through 72; mm
n
n column (A)
column (A) must equal line
must equal line 19
19 and column (8)
(B) must
must equal
equal line
line 21)
21) . 473,532. 721,287.
c
e
e
s
s
74 Total liabilities and net assets/fund balances (add lintss66 eind 73) 480,441. ™. 746,298.
F 02/12/97
F 02/12/97
THE
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE
Form 990 (1996) FOUNDATION
F 25-7303161
23-7303161 Page 4
J i l l } ! ! ! ! ! Reconciliation
Reconciliation of
of Revenue
Revenue per
per Audited
Audited Reconciliation of
Reconciliation of Expenses
Expenses per
per Audited
Audited
Financial
Finajrcial Statements
Statements with
with Revenue
Revenue per
per
mmmm Financial Statements
with Expenses
Expenses per
per
' Return (See Specific Instructions) Return
a Total revenue, gains, and other support Total
'Totalexpenses
expenses and
and losses
losses per
per
per
per audited
audited financial
financial statements
statements .. ,. .....
► J&, J£L830. audited
audited financial
statements ....► JL 254,437.
b Amounts included
Amounts included on
on line
line aa but
but not
not on
on Amounts
Amounts included
included on
on line
line aa but
but not
not on
on
line
line 12,
12, Form
Form990:
990: line
line 17,
17, Form
Form990:
990:
(1)
0) Net unrealized
Net unrealized gains
gains (1)
0) Donated
Donated services
services
on investments .... $$
on investments 41,528.
41.528. and
and use
use of
of facilities
facilities ... . $$L_--=75-"..1.'-"'O.:::.OO,,_.,___
75.000.
(2)
(2) Donated
Donated services
services (2)
(2) Prior
Prior year
year adjustments
adjustments
and
and use
use of
of facilities
facilities $$ 75,000.
75.000. reported
reported on on line
line20,
20,
(3)
(3) Recoveriesof
Recoveries of prior
prior Form
Form 990
990 . $
year grants
year grants. .$ (3)
(3) Losses
Losses reported
reported on
on
(4)
Other (specify): line
line 20,
20, Form
Form 990990 .. . . $
(4)
(4) Other
Other (specify):
(specify):
Add amounts
Add amounts on
on lines
lines (1)
(1)through (4) ►
through (4) 116,528.
Add
Add amounts
amounts on
on lines
lines (1)
(1)through
through (4)
(4) >.... 75.000.
c Line aa minus
Line minus line
line bb .. .. .. .. . 321,302. c Line
Line aa minus
minus line
line bb. . . J79 437.
d Amounts included
line 12,
12, d Amounts
Amounts included
included on line
on line 17,
17,
Form 990
Form 990 but
but not
not onon line
line a:a: Form 990
Form 990 but
but not
not on
on line
line a:
a:
(1) Investment
expenses (1) Investment
0) Investment expenses
expenses
not included
not included on
on line
line not included
line
6b, Form
6b, Form 990
990 . . . _$_ 6b,
6b, Form
Form 990
990 .. . . . 5
(2) Other
(specify): (2)
(2) Other
Other (specify):
(specify):
Add
Add amounts
amounts onon lines
lines (1)
(1) and
and (2)
(2) ► Add
Add amounts
amounts onon lines
lines (1) and (2)
(1)and (2) . . .
e Total
Total revenue
revenue per
per line
line 12,
12, Form
Form 990990 Total expenses per line 17, Form 990
(line
I c plus line d ) ► 321,302. (line c plus line d) 179.437.
j ! List of O f f i c e r s , D i r e c t o r s , T r u s t e e s , a n d K e y E m p l o y e e s (List each one even if not compensated; see Specific Instructions.)
(C) Compensation (D) Contributions to (E) Expense
(A) Name and address (B) Title and average hours per
(if not paid, enter employee benefit plans &. account and other
week devoted to position
-0-) deferred compensation allowances
SEE STATEMENT 990
SEE 990 PART V -- 11
NONE NONE NONE
75 Did anyany officer,

officer. director,
director, trustee, or key employee
employee receive
receive aggregate
aggregate compensation of more
more than $100,000
$100.000 from your
organization
organization and all all related
related organizations, of which more
more than $10,000
$10,000 was provided by the related
organizations? ►
... □ Yes
DYes E l No
~
IfIf "Yes,"
"Yes," attach
attach schedule
schedule - seesee Specific
Specific Instructions.
Instructions.
F 12/17/96
12/17/96
THE INSTITUTE
Form 990 (1996) FOUNDATION 23-7303161 Page 5
Part VI Other I n f o r m a t i o n (See Specific Instructions.) Yes.
76 Did
Did the organization
organiz~tion engage
engage in any activityactivity notnot previously
previously reported
reported to the IRS?IRS? If "Yes,"
"Yes," attach
attach a detailed
detailed description
description of each activrty _Z§_
each activity.I-'-"-+-_-+----'-:.....
n Were
77 Were any changes
changes made made in the organizing
organizing or governing documents documents butbut not reported
reported ttoo the IRS?
IRS? . M*-
If "Yes,"
If "Yes," attach
attach a conformed
conformed copy copy of the changes.
78a Did
organization have unrelated business
have unrelated business gross gross income
income of $1,000
$1,000 or moremore during the year year covered
covered by this return?
return? . ISa
bb IfIf "Yes,"
"Yes," has it filed a tax return
return on Form F o r m ~T
9 9 0 - T for for this
this year?
year? . 78b
79 Was there
Was there a liquidation, dissolution, termination, or substantial substantial contraction
contraction during
during the year?year? If "Yes,"
"Yes," attach
attach a statement
statement. . 79
80a Is
SOa Is the organization
organization related
related (other than by association
(other than association with a statewide
statewide or nationwide
organization) through ccommono m m o n membership,
membership,
governing bodies,
bodies, trustees,
trustees, officers,
officers, etc., to any other other exempt
exempt or nonexempt
nonexempt organization?
organization? . . . . . . . . . . . . . . . . . . . 80a
b If "Yes," enter
If "Yes," enter the name
name of the organization
organization ► .... _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ and and check
check whether
whether it is L 0J exempt OR L0J nonexempt. nonexempt.
81a Enter
81a Enter the amount
amount of political
political expenditures,
expenditures, direct direct or indirect,
indirect, as described
described in the instructions
instructions. . . . . . . IL...X""""-'-
81a I __ "!!':= NONE _
bb Did
organization file F o r m 11120-POL
Form 1 2 0 - P O L ffor
o r this year?
year? . . . . . . . . . . . . . . . . . . . . . . . . .
82a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially
82a
m
less than fair
less fair rental
rental value?
value? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . £24
b IfIf "Yes,"
"Yes," you may indicate
indicate the valuevalue of these
these items
items here.
here. Do not
not include
include this
this amount
amount as as
revenue in Part
revenue Part I or as an expense
expense in Part Part II.
II. (See instructions
instructions for reporting
reporting in Part
Part III.)
111.) I 82b I __
w.!!Ad:!...J...... 75,000.
"'!"':::""":::=':"'__
83a Did Did the organization

organization comply
comply with with the public inspection
inspection requirements
requirements forfor returns
returns and exemption
exemption applications?
applications? 83a
bb Did
organization comply
comply with with the disclosure
disclosure requirements
requirements relating
relating to quid pro q u o contributions?
pro quo contributions? . . . . 83b
84a Did Did the organization
organization solicit
solicit any contributions or gifts gifts that
that were
were not tax deductible?
deductible? . . . . . . . . . . . . . . 84a
bb If If "Yes,"
"Yes," did the organization
organization include with every every solicitation
solicitation an express
express statement
statement that such such contributions
contributions or gifts
gifts werewere not
not
tax deductible? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
tax 84b
85
85 501(c)(4), (5), or (S)
501(c)(4), (6) organizations.
organizations. - a Were Were substantially
substantially all dues
dues nondeductible
nondeductible by members? members? . jB5a
b DidDid the organization
organization make make only
only iin-house
n - h o u s e lobbying expenditures
expenditures of $2,000
$2,000 or less?
less? . . . . . . . . . . . . . . . . . . 85b
If "Yes" was
If w a s answered
answered to eithereither 85a or 85b, d doon o t complete
not complete 85c through 85h below below unless
unless the organization received
organization received
a waiver
a waiver for proxy
proxy tax owed
o w e d for the prior year. year.
Dues, assessments.
cC Dues. assessments, and a n d similar
similar amounts
amounts from members members . 85c N/A
d Section
Section 162(e) lobbying and political
1S2(e)lobbying political expenditures
expenditures . 85d N/A
Aggregate nondeductible
e Aggregate nondeductible amount amount of sectionsection 6033(e)(1)(A)
S033(e)(1)(A) dues dues notices
notices. . . . 85e N/A
f Taxable amount of lobbying and political
Taxable amount political expenditures
expenditures (line (line 85d less
less line
line 85e)
85e) . 85f N/A
Does the organization
g9 Does organization elect
elect ttoo pay the section
section 6033(e)
S033(e) tax
tax oonn the amount
amount in 85f?
85f? . 85q
hh If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount in 85f to its reasonable
estimate
estimate of dues
dues allocable
allocable to nondeductible lobbying and political
political expenditures
expenditures for the following tax year?
year? . 85h
86
86 501(c)(7) organizations.
501(c)(7) organizations. - Enter:
Enter:
a Initiation
a Initiation fees
fees and capital
capital contributions
contributions included on lineline 12
12. 86a N/A
bb Gross receipts, included on line
Gross receipts, line 12, for
for public use of club facilities
facilities. 86b N/A
87
87 501 (c)(12) organizations.
501(c)(12) organizations. - Enter:
Enter: a Gross
Gross income
income from members
members or shareholders.
shareholders 87a N/A
bb Gross income from
Gross income from other
other sources.
sources. (Do not not net
net amounts
amounts due or paid paid to other
sources
sources against
against amounts
amounts due or received
received from them.)
them.) . 87b N/A
88
88 At any time
At time during the year,
year. did the organization
organization oown w n a 550%
0 % or greater
greater interest
interest in a taxable
taxable corporation
corporation or or
partnership?
"Yes," complete
complete Part
Part IX . . . . . . . . . . . . . . . . . . . . . 88
89a
89a 501(c)(3) organizations.
501(c)(3) organizations. - Enter: Amount of tax paid during the year
Enter: Amount under:
year under:
Section
Section 4911 ► .... NOAIE
A/QA/E ; section
section 4912 ► .... A/OP?
NQ}.IE section 4955
; section 4955 ► ....__ tl'--o-'N___:;E
fi/OfJG _
bb 501(c)(3)
501(c)(3) and
and 501(c)(4)
501(c)(4) organizations,
organizations, - Did the organization
organization engage
engage in any section
section 4958
4958 excess
excess benefit
transaction during the year?
transaction year? If "Yes,"
"Yes," attach a statement
statement explaining
explaining each
each transaction
transaction . 89b
cc NOIJ~
dd
Enter: Amount
Enter: Amount of tax paid by the organization
Enter: Amount
Enter:
organization managers
Amount of tax in 89c, above, reimbursed
managers or disqualified persons
reimbursed by the organization
persons during the yearyear under
under section
section 4958
organization. . . . . . . . . . . . . . . . . . . . . . . . . .
4958 . . . t
> NO/JE
NCIlE
/w^
90 List
List the states
states with which a copy of this return
return is filed ►OJU0_,_CAL_I F0_RN_IA
~Hl.0...!_C~,=-I£O!~I~ _
91
91 The
The books are in care care of ►J_0AN_STEI_NBURG_
....o!_O~N_
~T~I.!'I~U~~ Telephone
Telephone no. ► <..?.!31_2~!:QO~~
.... <Jl3J_221_-0002_ _
Located at ►
Located .... 2_368_VI£T0RY_PKWY_,
2l~8_'{_I~T'p~Y_ _STE_ 410,_
~~Y...!_S.!E_ CINTI_, _0H
~1~L .s.I~!.I..!_O!!_ ZIP+4 ►
ZIP+4.... J*|206
45206
92 Section 4947(a)(1)
Section 4947(a)(1) nonexempt
charitable trusts filing Form
Form 990 in lieu
lieu of Form 1041-Check
1041- Check here here. - - - - - - - - - - - ~~~~~~~~~~ ~..:tJ
>D
and enter.the
enter.the amount
amount of tax-exempt
tax-exem interest received or accrued during the tax year ► I 92 I N/A
N/A
F 12/17/96
F 12/17/96
THE.HEIMLICH INSTITUTE
THE,HEIMLICH INSTITUTE
„ftB0/i99B>
,,990 '19961 FOUNDATION
FOUNDATION 2:
23-7303161
i-7303161 Paoe
Paae 66
Analvsis of
ipHSili Analysis of Income-Producing
Income-Producina Activities
Activities (See
(SeeSoecitic
Soecific instructions.}
In<>+, , .... inn' '.)
lter gross
-iter gross amounts
amounts.unless
,unlessotherwise
o1herwiseindicated.
indicated. Unr_el~t~,business
Unrelated business income
iocome Excluded
Excluded bv
b' section
eolion 512.
512.513.
513.or
or 514
514
(E)
(E)
(A)
(A) (6)
(B) (C)
(C) (0)
(D) Relatedor
Related or exempt
exempt
Business
Business code
code Amount
Amount Exclusion
Exctustcn code
code Amount
Amount function income
function income
33 Program service
Program service revenue:
revenue:
aa
hb
cc
dd
ee
ff
Feesand
g9 Fees and contracts
contracts from
from government
government agencies
agencies , , ,
Membership dues and assessments. . ...
-- --
35 Intereston
Interest on savings
savings and
and temporary
temporary cash cash iinvestments.
nvestments....
36 Dividends and
Dividends and interest
interest from
from securities
securities . , . , , . 14 23 410
23,410.
97 Net Net rental
rental income
income or or (loss)
(loss)from
from real
real estate:
estate: lil!i!!!ii iiilittiiliiiiiiiii ':::':'::'::::::::::::::
aa debt-financed
property , , , , , . , ,
debt-financed property . , .
not debt-financed
bb not . , , . . .
98
98 NetNet rental
rental income
income or or (loss)
(loss) from
from personal
personal property
property .
99 Other investment
99 Other investment income
income
:00 Gain or
00 Gain or (loss)
(loss)from
from sales
sales of of assets
assets other
other than
than inventory
inventory . . _'8
18 19.728.
19,728
101
101 NetNet income
income or or (loss)
(loss)from
from special events. , .
special events
102 Gross profit
102 Gross profi1or (loss) from
or (loss) sales of
from sales of inventory
inventory .
103 Other revenue:
103 Other revenue: aa
bb
cc . ,, , ,
.-
dd
ee
104 Subtotal (add
104 Subtotal (add columns
columns (B),
(8), (D),
(D), and
and (E))
(E)). . . . . . llllllli 111111111 43.138.
43.138
105 Total
105 Total (add
(add line
line 104,
104, columns
columns (B),
(8), (D),
(0), and
and (E))
(E» , , . 43,138.
43 138.
Note: (Line 105 plus line 1d. Part I. should equal the amount on line 12. Part I
Part VIII Relationship of Activities to the Accomplishment of Exempt Purposes (See Specific instructions.)
Line No. Explain how
Explain how each
each activity
activity for
for which
which income
income is
is reported
reported in
in column
column (E)
(E) of
of Part
Part VII
VII contributed
contributed importantly
importantly to
to the
the
▼ accomplishment of
accomplishment of the organization's
organization's exempt
exempt purposes
purposes (other
(other than
than by
by providing funds
funds for
for such
such purposes).
purposes),
N/A
J i i i i i Information Regarding Taxable Subsidiaries (Complete this Part if the "Yes" box on line 88 is checked.1)
Name, address, and employer identification Percentage of Nature of Total End-of-year
numberof
number corporation or
of corporation or partnership
partnership ownership interest businessactivities
business activities income
income assets
assets
N/A
.Under pe erjury, i decJare that I have examined

examined this return,
return. including
including accompanying
schedules and
and statements,
statements. and
and to
to the
the best
best of
of my
my knowledge
knowledge and
and belief
betlle-f
Please
Ple~sEl it is true, i corr^lete/L^claratjj»rfo'f • preparer
preparer (other
lot her than
than officer)
officer) is based on
ISbased on all
all information of which preparer
in~orma(ionof has any
pre-parerhas any knowledge.
knowledge, (See
(See General instructions.)
General Instructions.)
Sign
Sign
Here ^MrJuL^
Date / ' W Type s r p r i n t name and title.
Date Check if Preparer's SSN

Preparer's
Paid
Paid signature self-employed ►P j 296-64-1856
Preparer's
Preparer's Firm's name (or NDERSEN LLP EIN ► 36-0732690
Use Only yours if self-employed)
and address 425 WALNUT STREET ZIP code ► 45202
F 12/17/96
F 12/17/96 CINCINNATI, OH
CINCINNATI, OH
--
Form
Form 2758 Ap» R a t i o n for
Ap():ation for Extension
Extension of
of Time
Time TqTlle
TOle
(Rev.May
(Rev. 1995)
May 1995) Certain Excise, Income, Information, and Other Returns
Certain Excise, Income, Information, and Other Returns OMB No. 1545-0148
OMB No. 1545-{)148
Departmentof
Department ofthe
the Treasury
Treasury
InternalRevenue
Internal RevenueService
Service ..... File aa separate
► separate application
application ffor each rreturn.
o r each eturn.
Name
Name Employer
identffic.atioQ number
number
Pleasetype
Please type oror
print.File
print. Filethe
the THE HEIMLICH
INSTITUTE FOUNDATION
3-7303161
original and
original and Number,street,
Number, street. and
and room
room or
or suite
suite no.
no. (or
(or P.O.
P.O. box
boxno.
no.ifif mail
mail isis not
notdelivered
deliveredto
to street
street address)
address)
one copy
one copy by by the
the
duedate
due datefor filing
for filing
your return.
your return.See
See 2368
23 VICTORY PARKWAY,
68 VICTORY PARKWAY, SUITE
SUITE 410
410
instructionson
instructions on City,town
City, town or
or post
post office,
office, state,
state, and
andZIP
ZtP code.
code. For
Foraa foreign
foreignaddress,
address, see
see instructions.
instructions.
back.
back.
CINCINNATI,
CINCINNATI, OHIO
OHIO 45206
452 06
Note:
Note: Corporate
Corporate income
income tax tax return
return filers
filers must
must use
use Form
Form 7004 7004 to to request
request an an extension
extension of of time
time toto file.
file. Partnerships,
Partnerships, REMICs,
REMICs, andand
trusts must
trusts must use
use Form 8736 to
Form 8736 to request
request an an extension
time toto file
file Form
Form 1065,
1065, 1066,
1066, or or 1041.
1041.
11 II request
request an extension
extension of time time until J JANUARY
ANUARY 1 155 ,19J58
,19 98 ,,to file (check
(check only one):one):
o
□ Form 706-GS(D) 0□ Form Form990-T
990-T (401
(401(a) or 408(a)
(a) or 408(a)trust)
trust) 0 Form1120-ND
□ Form 1120-ND(4951 taxes)
(4951 taxes) □
o Form
Form8612
8612
o
□ Form Form 706-GS(T)
706-GS(T) 0
f j Form Form990-T
990-T (trust
(trust other
otherthan
thanabove)
above) 0
Q FormForm 3520-A
3520-A □
o Form
Form8613
8613
[X]
~ Form
o
Form990990 or
or 990-EZ
990-EZ 0
f j Form Form 1041
1041 (estate)
(estate) (see
(seeinstructions)
instructions) |0 Form4720
| Form 4720 □
o Form
Form8725
8725
□ Form990-BL
o
Form 990-BL 0
f j Form Form 1041-A
1041-A 0 Form 5227
□ Form 5227 □
o Form 8804
Form8804
□ Form990-PF
Form 990-PF 0□ Form Form 1042
1042 0□ Form
Form 6069
6069 □
o Form
Form8831
8831
0
IfIf the
the organization
organization does does notnot have
have an an office
office oror place
place of of business
business in in the
the United
United States,
States, check
check thisthis boxbox. ...► □
2a For
2a For calendar
calendar year
year 19 19 __ ,, or
or other
other tax
tax year
year beginning
beginning JUNE JUNE 11(, 11996 996 and
and ending
ending MAY MAY 331, 1 , 11997
997
bb IfIf this
this tax
tax year
year isis for
for less
less than
than 12 12 months,
months, check
check reason:
reason: j~J 0 Initial
Initial return 0 Final
return [~J return]"] Change
Final returnQ Change in in accounting
accounting period
period
33 Has Has an an extension
time to
to file
file been
been previously
previously granted
granted for for this
this tax
tax year?
year? 0 Yes
□ Yes \K\
~ NoNo
44 State in detail detail why
why you need the extension extension THE THE INFORMATION
INFORMATION NECESSARY NECESSARY TO TO FILE FILE A A
COMPLETE AND
COMPLETE AND ACCURATE
ACCURATE RETURN
RETURN IIS NOT YET
S NOT YET AVAILABLE.
AVAILABLE.
5a
5a IfIf this
this form
form isis for
for Form 706-GS(D),706-GS(r),990-BL,990-PF,990-T,1041 (estate),1042,1120-ND,4720,
Form706-GS(D),706-GS(T),990-BL,990-PF,990-T,1041 (estate),1042,1120-ND,4720,
6069,8612,
6069, 8612,8613,8725,8804,
8613, 8725, 8804, oror 8831,
8831,enter
enterthe
the tentative
tentativetax, lessany
tax, less any nonrefundable credits. See
nonrefundablecredits. See instructions
instructions $
$ N_O_N_E_
NONE
bb If this formform is for FormForm 990-PF,
990-PF, 990-T,
990-T, 1041
1041 (estate),
(estate), 1042,
1042, or 8804,
8804, enter
enter any refundable
refundable credits
credits and
and vrnKTTr
estimated tax
estimated tax payments
payments made.
made. Include
Include anyany prior
prior year
year overpayment
overpayment allowed
allowed asas aa credit
credit $
$ N_;O:._N_E_
NONE
cc Balance
Balance due. due. Subtract
Subtract line 5b from
from line 5a.Sa. Include
Include your payment
payment with this form,
form, or deposit FTD
deposit with FTD
coupon if
coupon if required.
required. SeeSee instructions
instructions $
$ NONE
NONE
Signature and Verification
Verification
Under penalties
Under penalties ofof perjury,
perjury, II declare
declare that
that II have
have examined
examined this
this form,
form, including
schedules and
and statements,
statements, and
and to
to the
the best
best of
of my
my knowledge
knowtedge and
and belief,
belief,
itrt is
is true,
true, correct,
correct, and
and complete;
complete; and
and that
that IIam
am authorized
authorized to
to prepare
prepare this
this form.
form.AARTHUR
R T H U R ÂNDERS
^ j ÊN LLLPL p I N .
EEIN: _ 0 732690
36-
36 07 3 2690
. 425
425 WALNUT STREET, CINCINNATI,
CINCINNATI, OHIO 45202 , . I
Signature^ '~f\
Signature..,. > A y,;".,;_' I:
' U " j I 11 ./ ) ; U
'XjJ^Q Trlle..,.'
Titled ( l~.
£]]_ Date..,.
Date» \Q ',~ I l^J
,;I... ^+-
FILE ORIGINAL
ORIGINAL AND
AND ONE
ONE COPY.
COPY. The
The IRS
IRS will show below whether or
or not your application
application is approved
approved and will return
return the copy/
copy.
Notice to Applicant—To
Applicant-To Be Completed by the IRS
IRS
o
□ WeWe HAVE
HAVE approved
approved your
your application.
application. Please
Please attach
attach this
this form
form to your
your return.
return.
o
JTJ We
We HAVE
HAVE NOT approved
approved your
your application.
application. However,
However, we have granted
granted a 10-day grace
grace period
period from the later of the date
shown
shown below
below or the due date of your returnreturn (including
(including any prior extensions).
extensions). This grace
grace period
period is considered
considered to be a valid
extension
extension of time for elections
elections otherwise
otherwise required
required to be made on a timely return.return. Please attach
attach this form
form to your return.
return.
o
[~J We
We HAVE
HAVE NOT approved
approved your
your application.
application. After
After considering
considering the reasons
reasons stated
stated in item 4, we cannot
cannot grant
grant your request
request for
an extension
extension of time
time to file. We
We are not granting
granting the 10-day
10-day grace period.
period.
o
(~J We
We cannot
cannot consider
consider your
your application
application because
because it was filed after the due date of the returnreturn for which
which an extension
extension was
was
requested,
requested.
o
□ Other:
Other: _
By: ___
By:
Director Date
Date
IfIf you
you want
want aa copy
copy of
of this
this form
form to
to be returned
retumed to
to an
an address
address other
other than
than that
that shown
shown above,
above,please enterthe
please enter address to
the address to which
which the
the copy
copy should
should be sent.
sent.
Name
Name
Please
Please
Type
Type
~~~~~--~----~--~~~----~~--~~~~~~77~~-------------------------------
surte no. (or P.O. box no. if mail is not
Number, street, and room or suite not delivered
delivered to street
street address)
address)
or
Print post office, state, and ZIP code. For a foreign address,
City, town or post address, see instructions.
instructions.

Reduction Act Notice,
Notice, see back of form.
form. 2758
Form 2 7 5 8 (Rev. 5-95)
{Rev. 5-95)
ISA STf FED4663F

STFFED4663F
SCHEDULE
Section 501(c)(3) OMB No. 1545-0047
OMS No.
(Form 990) (Except Private Foundation)

Foundation) and Section 501(e), 501 (f), 501(k),
501(f), 501 (k),
501 (n), or
501(n), or Section
Section 4947(a)(1) Nonexempt Charitable
4947(a)(1) Nonexempt Trust
Charitable Trust 1996
1996
Department
Department of the Treasury See
See separate instructions.
instructions.
Internal Revenue
Internal Revenue Service ... Must be com Dieted bv the above oraanizations
completed oroanizations arid attached to their
and attached their Form 990 or 99O-EZI.
990 tor 990-EZ).
Name of the organization
Nameof organization THE HEIMLICH
THE HE I MLI CH IINSTITUTE
NST ITUTE Employer identification number
Employer iden1ifica1ionnumber
FOUNDATION
l::::P8itd)
liiliil Compensation of the Five Highest
Compensation Highest Paid Employees Other Than Officers,
Trustees
(See instructions. List each one. If there are none, enter "None.")
(b) Title and
(b) average
and average
(d)
(d) Contributions
Contributions to (e) Expense
Expense
(a) Nameand
(a) Name and address of each
each employee paid more employee
employee benefit account
than $50,000
hours per week
per week (e) Oomperisation
(c) Compensation
plans deferred
plans & deferred and other
and other
devoted
devoted to position compensation allowances
allowances
NONE
NONE
Total number of
Total number of other
other employees
employees paid over
over
$50,000 . , ► NONE
Part II Compensation
Compensation of the Five Highest Paid Independent Contractors for Professional
Independent Contractors Services
(See instructions. List each one (whether individuals or firms). If there are none, enter "None.")
(a) Name and address of each independent contractor paid more than $50,000 (b) Type of service (c) Compensation
Compensation
NONE
NONE
Total number
Total number of
of others
others receiving over $50,000
receiving over $50,000 for
professionalI services ► NONE
Reduction Act Notice, see Instructions.
Instructions. Schedule A (Form 990) 1996
990) 1996
JXB
JXS F 12/17/96
THE HEIMLICH
INSTITUTE
Schedule A (Form 990) 1996 FOUNDATION 23-7305161 paae 2
P$tl Mi Statements About

Statements About Activities
Activities Yes No
During
Duringthe the year,
year, has
has the
the organization
organization attempted
attempted to to influence
influence national,
national, state,
state, or
or local
lo~allegislation,
legislation, including
including any
any attempt
attempt to to
influence
influence public
public opinion
opinion on on aa legislative
legislative matter
matter oror referendum?
referendum? .....
IfIf "Yes,"
"Yes,"enter
enter the
the total
total expenses
expenses paidpaid or
or incurred
incurred in
in connection
connection with
with the
the lobbying
lobbying activities
activities. . . . . . ► ....$$ ...:N:..t.I..:.A;.._
W/A _
Organizations
Organizationsthat
that made
made an
an election
election under
under section
section 501
501(h)
(h) by filing Form 5768 must complete Part VI-A.
Vl-A. Other
organizations
organizations checking
checking "Yes,"
"Yes,"must
must complete
complete Part
PartVl-B
VI-B AND
AND attach
attach aa statement
statement giving
giving aa detailed
description of
of
the lobbying
activities.
2 During the year,
During the year, has hasthethe organization,
organization, either
either directly
directly or
or indirectly,
indirectly, engaged
engaged inin any
any of
of the
the following
following acts
acts with
with any
any
of its trustees, directors, officers, creators, key employees, or members of their families, or with any taxable
of its trustees, directors, officers, creators, key employees, or members of their families, or with any taxable organization organization
with which any such person is affiliated as an officer, director, trustee, majority owner, or principal
with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary: beneficiary:
a Sale,
Sale, exchange,
exchange, oror leasing
leasing of
of property?
property? . . . . . . . . . . . . . . .. . _2a_
bb Lending
Lending of
of money
money or
or other
other extension
extension of
of credit?
credit? J2tL
cc Furnishing
Furnishing of
of goods,
goods, services,
services, or
or facilities?
facilities? . -2£_ x
dd Payment
Payment of
of compensation
compensation (or
(or payment
payment or
or reimbursement
reimbursement of
of expenses
expenses rfif more
more than
than $1,000)?.
$1,OOO)? 2A. x
ee Transfer
Transfer of of any
any part
part of
of its
its income
income oror assets?
assets? . 2s.
IfIf the
the answer
answer to
to any
any question
question is is "Yes,"
"Yes," attach
attach aa detailed
detailed statement
explaining the
the transactions.
transactions.
33 Does
Does the
the organization
organization make
make grants
grants for
for scholarships,
scholarships, fellowships,
fellowships, student
student loans,
loans, etc.?
etc.? . r^^r-.
~. -1 J ' f Y t S1-«l+, "l'1.o.
( 'P. %c-n A. .,Pt.
Sc.I--\ A r + . -II[-:-
Uf . \
I X
44 Attach
Attach aa statement
statement toto explain
explain how
how the
the organization
organization determines
determines that
that individuals
individuals or
or organizations
organizations receiving
receiving grants
grants or
or
loans from it in furtherance of its charitable programs qualify to receive payments. (See instructions.!
Pari JV Reason
Reason for Non-Private Foundation
Foundation Status
Status (See instructions.)
instructions.)
The
The organization
organization is
is not
not aa private
private foundation
foundation because
because itit is
is (please
(please check
check only
only ONE
ONE applicable
applicable box):
box):
55 0
0 A church, convention
convention of of churches, or association of churches. Section 170(b)(1)(A)(i).
or association of churches. Section 170(b)(1)(A)(i).
66 0 A school. Section
□ Section 170(b)(1)(A)
170(b)(1)(A)(ii).
(ii). (Also
(Also complete
complete Part
Part V, page
page 4.)
4.)
77 0 A hospital
I I hospital or a cooperative
cooperative hospital service
service organization. Section
Section 170(b)(1)(A)(iii).
170(b)(1)(A)(iii).
88 IDI A Federal,
Federal, state,
state, or local
local government or governmental
governmental unit. Section
Section 170(b)(1)(A)(v).
170(b)(1)(A)(v).
9 QD A medical
medical research
organization operated in conjunction with a hospital.
hospital. Section
Section 170(b)(1)(A)(iii). Enter the hospital's
170(b)(1)(A)(iii),Enter hospital's name, city,
city,
and state
state ►.... _
10
10 0D An organization
organization operated for the benefit of a college
university owned or operated by a governmental
governmental unit.
unit. Section
Section 170(b)(1)(A)(iv).
170(b)(1)(A)(iv).
(Also
(Also complete
complete the
the Support
Support Schedule
Schedule in
in Part
Part IV-A.)
11a
11a IKJ An
[x~l An organization
organization that
that normally
normally receives
substantial part
part of
of its
its support from a governmental
governmental unit
unit or
or from the
the general
general public.
public,
Section
170(b)(1)(A)(vi). (Also
(Also complete thethe Support
Support Schedule in in Part
Part IV-A.)
IV-A.)
11b D
CD A community
community trust.
trust. Section
Section 170(b)(1)
170(b)(1)(A)(vi).
(A) (vi). (Also
(Also complete the Support
Support Schedule
Schedule in Part IV-A.)
12
12 1DI An organization that normally
normally receives: (1) more more than
than 33 1/3%of
1/3% of its support from contributions, membership fees, and gross
receipts
receipts from activities
activities related
related to its
its charitable,
charitable, etc.,
etc., functions - subject
subject to certain
certain exceptions,
exceptions, and (2) (2) no more than 33 33 1/3%
1/3%ofof
its
its support from gross
gross investment
investment income and unrelated
unrelated business
business taxable
taxable income
income (less
(less section
section 511
511 tax)
tax) from businesses
businesses acquired
acquired
by the organization
organization after
after June 30, 1975.
1975. See
See section
section 509(a)(2).
509(a)(2). (Also
(Also complete
complete thethe Support
Support Schedule
Schedule in PartPart IV-A.)
13
13 D
CD An
An organization
organization that is is not controlled by any any disqualified persons
persons (other
(other than foundation managers)
in: (1)
in: (1) lines
lines 5 through 12 12 above:
above; oror (2)
(2) section
section 501
501(c)(4),
(c)(4), (5),
(5). or
or (6),
(6), ifif they
they meet
meet the
the test
test of
of section
section 509(a)(2).
509(a)(2). (See
(See section
section 509(a)(3).)
509(a)(3).)
Provide
followina information about the supported organizations.
oraanizations. (See (See instructions.)
instructions.)
(b)
(b) Line
Line number
number
(a)
(a) Name(s)
Name(s) of of supported organization(s)
organization(s) from above
14 0
14 | J An organization
organization organized and operated to test for public safety.
safety. Section 509(a)(4).
509(a)(4). (See
(See instructions.)
instructions.)
F 12/17196
12/17/96
THE
THE HEIML1CH
HEIMLICH INSTITUTE
INSTITUTE
SCheduleAAIForm9901
Schedule (FormS 1996 FOUNDATION
23-7303161 pPese
aae 33
::P:ia'n144
P&tt I V - A SSupport
u p p o r t SSchedule
c h e d u l e (Complete
(Complete only
only ifif you
you checked
checked aa box
box on
on line
line 10,
10, 11,
11,or
or 12.)
12.)Use
Use cash
cash method
method of
of accounting.
accounting.
Note: You may use the worksheet in the instructions for converting from the accrual to the cash method of accounting.
Calendar year (or fiscal year beginning In) (a) 1995 (b) 1994 (c) 1993 (d) 1992 (e) Total
15 Gifts, grants, and contributions received. (Do
not include unusual grants. See line 28.) . . 114,010. 85,274. 190,020. 499,123. 888,427.
16 Membership fees received. NONE
17 Gross receipts from admissions, merchandise sold
or services
or services performed,
performed, or
or furnishing
furnishing of
of facilities
facilities
in any
in any activity
activitythat
that isis not
not aa business
business unrelated
unrelated
to the oroanization's charitable, etc.. purpose . . NONE
18
18 Gross income
Gross income from
from interest,
interest. dividends,
dividends, amounts
amounts
received from
received from payments
payments on
on securities
securities loans
loans
(section 512(a)(5)), rents,
rents, royalties,
royalties. and
and unrelated
unrelated
businesstaxable
income (less
(less section
section 511
511 taxes)
taxes)
from businesses
acquired by
by the
the organization
organization
111,543.
after June 30. 1975 38,125. 28,994. 25,462. 18,962.
1"
19
19 Net income
Net income from
from unrelated
unrelated business
business activities
activities
not included in line 18 NONE
20
20 Tax revenues
Tax revenues levied
levied for
for the
the organization's
organization's benefit
benefit
and either paid to it or expended on its behalf. . NONE
21
21 The value
The value of
of services
services or
or facilities
facilities furnished
furnished to
to the
the
organization by
organization by aa governmental
governmental unit
unitwithout
without charge,
charge
Do not
Do not include
include the
the value of services
value of services or
or facilities
facilities
generally furnished to the public without charge. NONE
22
22 Other income.
Other income. Attach
Attach aa schedule.
schedule. Do
Do not
not include
include
gain or (loss) from sale of capital assets NONE
23 Total of lines 15 through 22 152,135. 114,268. 215,482. 518,085. 999,970.
24 Line 23 minus line 17 152,135. 114,268. 215,482. 518,085. 999.970.
25 Enter 1% of line 23 1,521. 1,143. 2,155. 5,181.
26
26 Organizations described in lines 10
Organizations described in lines 10 or 11: aor 11: a Enter 2% of amount in column (e), line 24 19,999.
bb Attach
Attach a list
list (which
(which is not open to public inspection)
inspection) showing the name name ofof and amount
amount contributed by each person m
(other
(other than
than aa governmental
governmental unit
unit or
or publicly
publicly supported
supported organization)
organization) whose
whose total
total gifts
gifts for
for 1992
1992through
throug~ 1995
1995 I
exceeded the
exceeded the amount
amount shown
shown inin line
line 26a.
26a. Enter
Enter the
the sum
sum ofof all
all these
these excess amounts 6
excess amounts. e e ScK
,See S c Y', .h.'?+ .\. ~ A.-- ,I
A TH \ v - 4 J6b, $ 3 0 0 , 0 0 6 .
c Total
Total support for section
section 509(a)(1)
509(a)(1) test:
test: Enter
Enter line
line 24,
24. column (e). . £§£. 999,970.
d Add: Amounts from column (e) (e) for lines:
lines: 1818 $$ 111,543.
'11 1543. 19
19
22
22 $ 26b ,.,$ __ 300,006.
-=3..::.0",,0,-,,0;..:;0,;:,6.:;..._ £&. 411,549.
e Public support (line
Public (line 26c
26c minus line
line 26d total)
total). ► 26e 588,421.
f Public support percentage (line 26e (numerator) divided by line 26c (denominator)) 2§L 58.84%
27
27 Organizations
Organizations described
described on line 12: a For For amounts
amounts included in
in lines
lines 15,
15, 16,
16, and
and 17
17 that
that were
were received
received from a "disqualified
"disqualified
person." attach
person," attach a list
list to show
show the
the name
name of,
of, and
and total amounts
amounts received
received inin each
each year
year from each
each "disqualified
"disqualified person." person." Enter
Enter the sum
sum N/A
N/A
of such
of such amounts
amounts forfor each
each year:
year:
(1995)
(1995) (1994)
(1994) (1993)
(1993) (1992)
(1992) _
b For
For any amount included in line 17
17 that was received from a nondisqualified person, attach a list to show the name of, and amount
received for each
received each year,
year, that was more than the larger of
of (1) the amount
amount on line
line 25 for the year
year or
or (2)
(2) $5,000.
$5,000. (Include
(Include in the list
list
organizations described in lines
organizations lines 5 through 11, as well
well as
as individuals.)
individuals.) After
After computing the difference
difference between the amount
amount received
received
and the larger
and larger amount
amount described in (1)
(1) or
or (2), enter
enter the sum of these
these differences
differences (the
(the excess
excess amounts)
amounts) for each
each year:
year:
(1995)
(1995) (1994)
(1994) (1993)
(1993) (1992)
(1992) _
c Amounts from column (e) for lines:

Add: Amounts lines: 15
15 16
16
17 $
17 20 21
21 ► 22S.
d Line 27a
Add: Line 27a total . $ line 27b total . .
and line $_ zra
e Public support
Public support (line
(line 27c
27c total
total minus
minus line
line 27d
27d total)
total)
f Total support
Total support for
for section
section 509(a)(2)
509(a)(2) test:
test: Enter
Enter amount
amount on
on line
line 23,
23, column
column (e)
(e) ...... 27f l $ m,
g support percentage
Public support percentage (line 27e27e (numerator)
(numerator) divided
divided by line 27f27f (denominator))
(denominator)). . . . 2ZSL
h 7f (denominator))
Investment income percentage (line 18. column (e) (numerator) divided bv line 27f de 0 _%
28
28 Unusual Grants: For an organization described in line 10, 11, or 12 that received any unusual grants during 1992 through 1995, attach a list
zm.
(which is
(which is not
not open
open to
inspection) for
for each
each year
year showing
showing the
the name
name of
of the
the contributor,
contributor, the
the date
date and
and amount
amount of
of the
the grant,
grant, and
and aa brief
brief
description of
description of the
the nature
nature of
of the
the grant.
grant. Do
Do not
not include
include these
these grants
grants in
in line
line 15.
15. (See
(See instructions.)
instructions.) tV
A/OyVF
0 Jlf
F 12/17/96
F12/17/96
Schedule
Schedule A fForm
(Form 9901 1996
1996 FOUNDATION
FOUNDATION ag e 4
23-7303161 ;'age
::fMte~:
Par! V Private School
Private School Questionnaire
Questionnaire (See
(See instructions.)
instructions.)
(To be completed ONLY bv schools that checked the box on line 6 In Part \V) N/A
Yes
Yes No
No
29 Does the organization
organization have a racially
racially nondiscriminatory
nondiscriminatory policy toward students by statement
statement in its charter, bylaws,
other governing instrument, or in a resolution of its governing body? . .
other JSL
Does organization include a statement of its racially nondiscriminatory policy toward students in all its brochures,
catalogues, and other written communications with the public dealing with student admissions, programs, and
scholarships? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
scholarships? M.
31 Has the organization
organization publicized its racially
racially nondiscriminatory policy through newspaper or broadcast media during
the period of solicitation
solicitation for students, or during the registration
registration period if it has no solicitation
solicitation program, in a way
that makes the policy known to all parts of the general community it serves? £L
"Yes," please
If "Yes," please describe; if "No," please explain. (If
(If you need more space, attach a separate
separate statement.)
statement.)
32 Does
organization maintain the following:
a Records indicating the racial composition of the student body, faculty, and administrative
administrative staff?
staff? . 222.
b Records documenting that scholarships and other financial assistance
assistance are awarded on a racially
nondiscriminatory basis? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
nondiscriminatory basis? 32b
c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing
with student admissions, programs, and scholarships?
scholarships? . . . . . . . . . . . . . . . . 32c.
d Copies of all material
material used by the organization or on its behalf to solicit contributions? . . . . . . . . . . . . 32d
If you answered "No" to any of the above, please

please explain. (If
(If you need more space, attach a separate statement.)

Does organization discriminate by race in any way with respect
respect to:
a Students' rights or privileges?

privileges? 33a
b Admissions policies? .... 33b
c Employment
Employment of faculty or administrative staff? . 33c
d Scholarships or other financial assistance?

assistance? 33d
e Educational policies? 33e
f facilities?
Use of facilities? . 33f
g
9 Athletic programs? 33q
h Other extracurricular
extracurricular activities? 33h
If you answered "Yes"

"Yes" to any of the above, please
please explain. (If
(If you need more space, attach a separate statement.)
34a Does
organization receive
receive any financial aid or assistance
assistance from a governmental agency? . Ma.
b Has the organization's right to such aid ever been revoked or suspended? . . . . . . 34b
"Yes" to either 34a or b, please
please explain using an attached statement.
statement.

Does organization certify
certify that it has complied with the applicable requirements
requirements of sections 4.01 through 4.05 of Rev.
Rev. Proc.
Proc.
75-50. 1975-2 C.B. 587, covering racialI nondiscrimination? If "No." attach an explanation 35
F12/17/96
F 12/17/96
THE HEIMLICH
HEIML1CH INSTITUTE
INSTITUTE
Sfrf]edule
iibedul. A IForm
(Form 990)
990) I1996
996 FOUNDATION
FOUNDAT ION 23-7303161
23-7303161 Pag. 5
Page 5
n~lia)ltiiA(
ftttVI-A Lobbying Expenditures by Electing Public Charities (See instructions.)
instructions.)
(To be completed
Ie e ONLY
ON Y bv an eligible organization that filed Form 5768)
7 8
Check
Check here ► a LJ if the organization belongs to an affiliated group.
...
Check here ► b G if vou checked "a" above and "limited control" provisions apply.
(a)
(a) (b)
Limits on Lobbying Expenditures Affiliated group
Affiliated group To be completed
To be completed
(The
(The term "expenditures" means amounts paid or incurred.) totals for ALL
ALL electing
36 Total lobbying expenditures to influence public opinion (grassroots

(grassroots lobbying) . 36
37 Total lobbying expenditures to influence a legislative
legislative body (direct lobbying) . 37
38 Total lobbying expenditures (add lines 36 and 37).....
37) 38
39 Other exempt purpose expenditures.
expenditures . . . . . . . . . . . . . . . . . . . 39
40 Total exempt purpose expenditures (add lines 38 and 39) . 49
41 Lobbying nontaxable amount. EnterEnter the amount from the following table-
table-
If the amount on line 40 Is-is- The lobbying
lobbying nontaxable amount isis- *
Not over $500,000
$500,000 . . . . . . 20% of the amount on line 40
40. . . . . . . . . . . . .
Over $500,000 but not over $1,000,000
Over $500,000 $1,000,000 . . . . $100,000
$100,000 plus 15%
15% of the excess
excess over $500,000
$500,000 ... . . .
Over $1,000,000
Over $1,000,000 but not over $1,500,000.
$1,500,000. . . . $175,000
$175,000 plus 10% of the excess over $1,000,000
$1,000,000.. . . > 41
Over $1,500,000
Over $1,500,000 but not over $17,000,000
$17,000,000 . . . $225,000
$1,500,000 . . .
Over $17,000,000
Over $17,000,000 . . $1,000,000
$1,000,000 . . . . . '
42 Grassroots nontaxable
Grassroots nontaxable amount (enter
(enter 25% of line 41) . 42
43 Subtract line 42 from line 36. Enter
Enter --0-
0 - if line 42 is more than line 36 . 4?
44 Subtract line 41
41 from line 38. Enter
Enter --0-
0 - if line 41
41 is more than line 38 . 44
Caution: If there is an amount on either line 43 or line 44. file Form 4720.
4-Year Averaging Period Under
Under Section 501(h)
501(h)
(Some
(Some organizations that made a section 501(h)
501 (h) election do not have to complete all of the five columns below.
Sese the instructions for lines 45 through 50.)
Lobbying Expenditures During 4--YearAveraging
Calendar
Calendar year (or
(or (a) (b) (c) (d) (e)
(•)
fiscal vear beainnina in) ► 1996 1995 1994 1993 Total
45 Lobbying nontaxable amount
46 Lobbying ceiling amount (150% of line 45(e)) . . . I

49 Grassroots ceiling amount (150% of line 48(e)) . . iI

50 Grassroots lobbying expenditures
lîtslriiiiEli Lobbying Activity by Nonelecting Public Charities
(For reporting only bv organizations that did not complete Part Vl-A) (See instructions.)
During the year, did the organization
organization attempt to influence national, state or local legislation,
legislation, including any Yes Amount
No
attempt to influence public opinion on a legislative
attempt legislative matter
matter or referendum, through the use
use of:
a Volunteers...........................................
Volunteers X.
b Paid staff or management (Include compensation in expenses reported on lines c through through h.)
h.).. . .
X.
c advertisements . . . . . . . . . . . . . . .
Media advertisements X
d Mailings to members, legislators, or the public.
Mailings public . . . z
e statements .
Publications, or published or broadcast statements x
f Grants to other organizations
Grants organizations for lobbying purposes.
purposes JL
g Direct contact with legislators, their staffs, government officials, or a legislative
Direct legislative body.
body X
h Rallies, demonstrations, seminars, conventions, speeches, lectures.
Rallies. lectures, or any other means.
means X,
i lobbying expenditures (add lines c through
Total lobbying through h) . A/Oo/g'
If "Yes" to any of the above,

"Yes"to above. also attach a statement
statement oivino
giving a detailed description of the lobbying activities.
activities.
F 12/17/96
12/17/96
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE
Schedule A
Schedule A (Form 990)
99011996
1996 FOUNDATION
23-7303161 p
Pase 6
aa£_g,
~~::~It
§|§§|$||| .Information Regarding
Regarding Transfers
Transfers To
To and
and Transactions
Transactions and
and Relationships
Relationships With
With Noncharitable
Noncharitable
51 Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section
501 (c) of the Code (other
501(c) (other than section 501(c)(3)
501 (c)(3) organizations)
organizations) or in section
section 527, relating to political organizations?
organizations?
a organization of:
Transfers from the reporting organization to a noncharitable exempt organization Ye? No
(i) Cash ..... 51am X
(ii) Other assets.
Oil assets . . . . . . . . . a(ii) x
X
(i) Sales of assets
assets to a noncharitable exempt organization b(i) x
X
(ii) Purchases
Oil Purchases of assets
assets from a noncharitable
noncharitable exempt organization bfm x
X
(Hi) Rental
Oil) Rental of facilities or equipment
equipment. b(im x
X
(iv) Reimbursement
Ov) Reimbursement arrangements
arrangements. . . . . . . . . . . . . . . . . b(iv) x
X
(v) Loans or loan guarantees . . . . . . . . . . . . . . . . . . . b(v) x
X
Performance of services or membership or fundraising
(vi) Performance fund raising solicitations
solicitations. b(vi) x
X
c employees
Sharing of facilities, equipment, mailing lists, other assets, or paid employees. c X
X
d "Yes," complete the following schedule. Column (b) should always show the fair market value of
If the answer to any of the above is "Yes," of the
assets, or services given by the reporting organization. If the organization
goods, other assets, organization received less than fair market
market value in any transaction
orssharino
or haring arranoernent
arrangement. show in column (d) (d) the value of the goods,
coods. other
other assets,
as ets or services received:
received:
(a) (b) (c) (d)
Line
I no.
ine no. Amount involved
involved Name of noncharitable
Nameof noncharitable exempt oraanizalion
exemot oruanizatton Description transfers, uansacuons
D~rlQtlon of tIlInsfers transactions, an_d
and sharino
sharina arranaements
arranaements
N/A
N/A
52a Is the organization

organization directly or indirectly affiliated
affiliated with, or related
related to, one or more tax-exempt
described in section 501(c)
501(c) of the Code (other
(other than section 501(c)(3))
501(c)(3)) or in section 527? ►
52?? . . . . . . . . . . . . . .... 0
D Yes
Yes ~C3 No
No
b "Yes." comolete
If "Yes" complete the followinc
following schedule:
(a) (b) (c)
Name oraanization
Name of oroaruzatton Tvoe
Tvce of oreani
oraanization
ation Description of
_D_escriQJian relationship
of relationshie
N/A
F12/17/96
F 12/17/96
REALIZED CAPITAL GAINS
REALIZED CAPITAL GAINS AND
AND LOSSES
LOSSES Account ## 06390287
Account 06390287
JUNE'1.
JUNE 1 , 1996
1996 - MAY
MAY 31.1997
3 1 , 1997 HEIMLICH INSTITUTE. INCORPORATED
HEIMLICH INSTITUTE. INCORPORATED
ACQUISITION PROCEEDS
ACQUISITION DOLLAR
DOLLAR DOLLAR
DOL-LAR ($GGAIN
A I N /I
QUANTITY
QUANTITY ASSET
ASSET DESCRIPTION
DESCRIPTION DATE
DATE DATE
DATE COST
COST PROCEEDS LOSS
lOSS
SHORT TERM
SHORT TERM CAPITAL
CAPITAL. TRANSACTIONS
TRANSACTIONS ~ ""
60 CITICORP
CITICORP 06/24/96
06/24/96 03/21/97
03/21197 4.920.66
4.920.66 6.950.44
6.950.44 2,029.78
2.029.78
0.500 COLUMBIA/HCA
0.500 COL.UM81A1HCA HEALTHCARE CORPORATION
HEAL THCARE CORPORATION 06/12/96
06/12/96 10/31/96
10/31196 17.57
17.57 17.78
17.78 0.21
0.21
127 COLUMBIA/HCA HEALTHCARE CORPORATION
COLUM81A1HCA H£ALTHCARE CORPORATION 06/12/96
06/12/9a 05/30/97
O~/30/97 4,463.21
4.463.21 4,672.89
4.872.89 209.68
209.68
70 E M C CORPORATION
CORPORATION 05/29/96
05/29196 04/07/97
04107197 1,546.30
1.546.30 2.698.92
2.898.92 1.162.62
1.152.82
70 ELECTRONIC DATA
ELECTRONIC DATA SYSTEMS CORPORATION
SYSTEMS CORPORATION 11/04/96
11/04196 05/20/97
05/20197 3.156.30
3.156.30 2.538-41
2.538.41 -617.89
-617.89
(f:ORMERL
(FORMERLY Y GENERAL
GENERAL MOTORS
MOTORS CORP
CORP CL.ASS EI
CLASS E)
TOTAL NET SHORT TERM CAPITAL
TOTAL NET SHORT TERM CAPITAL GAINSGAINS ♦ 14.104.04
.14.104.04 ♦ 16.878.44
.16.878.44 « . 774.40
n.774.40
LONG
LONG TERM
CAPITAl TRANSACTIONS
100 AT&
AT &TT CORPORATION
10/07/94 12/06/96
12106196 3,754.60
3.754.60 3,777.20
3.777.20 22.60
22.60
150 ALBERTSON'S, INC.
ALBERTSON'S. INC. 03/24/95
03/24/95 01/06/97
01/06197 4,643.25
4.643.25 6,428.32
5.428.32 785.07
785.07
100 DONNELLEV (R.R.) at
DONNELLEY IR.R.) & SONS
SONS COMPANY
COMPANY 09/30/92
09/30/92 11/07/96
11/07/96 2,959.00
2.959.00 3,090.90
3.090.90 131.90
131.90
125 ELECTRONIC
EL.ECTRONIC DATA
OATA SYSTEMS CORPORATION
SYSTEMS CORPORATION 11/16/93
11/16/93 05/20/97
05120197 3,491.88
3.491.88 4,532.87
4.532.87 1,040.99
1.040.99
(FORMERLY GENERAL
IFORMERL.Y MOTORS CORP
GENERAL MOTORS CLASS E)
CORP CLASS
75 ELECTRONIC DATA SYSTEMS
ELECTRONIC DATA SYSTEMS CORPORATION
CORPORATION 06113/95 05/20/97
06/13/95 05/20197 3.194.25
3.194.25 2.719.72
2.719.72 -474.53
-474.53
(FORMERLY
IFORM£RL GENERAL MOtORS
Y GENERAL MOTORS CO~P
CORP C\.ASS
CLASS E)
15.000
15,000 FEDERAL
FEDERAL NATIONAL MORTGAGE ASSOCIATION
NATIONAL MORTGAGE ASSOCIATION 02/05/92 01/10/97
02/05(92 01/10/97 14,746.88
14,746.88 15.000.00
15.000.00 253.12
253.12
7.200
7.200 % DUE 01/10/02 DATED
Due 01/10/02 DATED 01/10/92
01/10/92
75 G T E CORPORATION
GTE CORPORATION 08/16/93
08/16193 03/31/97
03/31/97 2,744.25
2,744.25 3.414.11
3.414.1' 669.86
669.86
25 G T E CORPOAATION
GTE CORPORATION 12/28/94
12/28/94 03/31/97
03/31/97 771.25
771.25 1,138.04
1,138.04 366.79
366.79
7 IMATION CORPORATION
IMATION CORPORATION 03/13/92
03/13192 08/06/96
08/06196 124.07
124.07 157.53
157.53 33.46
33.46
3 IMATION CORPORATION
IMATtON CORPORATION 12/22/94
12122/94 08/06/96
08/06196 62.50
62.50 67.51
67.51 5.01
0.408 LUCENT
0.408 LUCENT TECHNOLOGIES,
TECHNOL.OGIES, INC.INC. 10/07/94
10/07/94 10/23/96
10/23196 18.37
18.37 17.73
17.73 -0.64
.(1.54
32 LUCENT TECHNOLOGIES,
LUCENT TECHNOLOGIES. INC. INC. 10/07/94
10107/94 02/26/97
02/26197 1.441.03
1.441.03 1.758.02
1,758.02 316.99
316.99
70 MINNESOTA MINING
MINNESOTA MINING & MANUFACTURING
COMPANY 03/13/92
03(13/92 08/12/96
08(12(96 3,024.18
3.024.'8 4,604.80
4.604.80 1.580.62
1.580.62
30 MINNESOTA MINING
MINNESOTA MINING & MANUFACTURING
COMPANY 12/22/94
12/22194 08/12/96
08/12196 1,523.30
1,523.30 1,973.48
1.973.48 450.18
4!jO.18
70 MOTOROLA INC.
MOTOROLA INC. 03/09(95
03/09/95 01/02/97
01102/97 3.927.00
3.927.00 4,176.51
4.176.51 249.51
249.51
170
170 MYLAN LAaORATORIES.
MYLAN LABORATORIES, INC.INC. 09/06/95
09/06/95 12/06/96
12/06/96 3.956.43
3,956.43 2.407.80
2.407.80 -1.54863
.1.548.63
40
40 ROYAL
ROYAL DUTCH
~UTCH PETROLEUM
PETROLEUM COMPANY
COMPANY 11{25/92
11/25/92 05/16/97
05fI6/9? 3.313.00
3.313.00 7.528.86
7.528.86 4.215.86
4.215.86
(NETHERLANDS)
(NETHERLANDS)
35 ROYAL DUTCH
ROYAL DUTCH PETROLEUM
PETROLEUM COMPANY
COMPANY 12/22/94 05/16/97
12/22/9. 05/16/97 3,757.95
3,757.95 6.587.75
6.587.75 2,829.80
2.829.80
(NETHERLANDS)
(NETHERLANDS)
70 SCHERING-PLOUGH CORPORATION
SCHERING·PLOUGH CORPORATION 03/03/92
03/03/92 11/06/96
11106/96 2,087.40
2.087.40 4,728 14
4.728.14 2,640.74
2.640.74
94
94 SONOCO PRODUCTS
SONOCO PRODUCTS COMPANY
COMPANY 11/28/94
11128/94 09/09/96
09/09/96 1.88000
1.880.00 2.731.04
2.731.04 851.04
851.04
200
200 SONOCO
SONOCO PRODUCTS
PRODUCTS COMPANY
COMPANY 11/28/94
11/28/94 01/30/97
01130/97 4.000.00 5.387.82
5.387.82 1,387.82
1,387.82
15.000
15.000 UNITED
UNITED STATES TREASURY NOTES
STATES TREASURY NOTES 08/02/95
08102195 08/23/96
08/23/96 15.213.28
15.213.28 15,098.44
15,098.44 -114.84
-114.84
6.500
6.500 % % DUE
DUE 04/30199 DATED 05/02/94
04/30/99 DATED 05/02/94
TOTAL NET LONG
TOTAL NET LONG TERM
TERM CAPITAL
CAPITAL GAINS
GAINS $80.633.87
$80,63387 $96,326.59
$96.326.59 $15,692.72
115.692.72
0 JOHNSON OPPORTUNITY
JOHNSON OPPORTUNITY FUND
FUND 12/30/96
12/30196 1,260.63
1.260.63 1.260.63
1.2&0.63
TOTAL CAPITAL
TOTAL DISTRIBUTIONS
CAPITAl DISTRIBUTIONS SO.OO
$0.00 $1,260.63
$1.260.63 $1.260.63
$1,260.63
TOTALS
TOTAlS ~^'1 L{,
1 3., '32
2 $114,465.66
'114.465.66 ~\| 19,1)-'6
^ ^ 13^?
This report surntnlrizes

summarizes the portfolio
portfolio transactions for yoU( convenien«.
your convenience.
We do
dq not
",ot guarantee its appropriateness for use in tax
tall preparation.
preparation.
S+o__-\..e_ {Ylf'v'..l ~90

?~[+-:c - d-.
STATEMENTS
THE HEIMLICH iNSTITUTE

INSTITUTE FOUNDATION 23-7303161
STATEMENT:
STATEMENT: 990 PT I - 3
LINE 20 - OTHER CHANGES

DESCRIPTION AMOUNT
AMOUNT
UNREALIZED GAIN ON SECURITIES 41,528.

41,528.
ADJUSTMENT FOR THE ADOPTION OF FASB 124 BY THE 64,362.
HEIMLICH INSTITUTE FOR
FOR FISCAL YEAR 1996.
1996_

THE
THE HEI'MLICH INSTITUTE FOUNDATION
23-7303161
STATEMENT:
STATEMENT: 990
990 PT IV -1
LAND, BUILDINGS, and

LAND, BUILDINGS, and EQUIPMENT
EQUIPMENT : BASIS
BASIS
DESCRIPTION
DESCRIPTION IEG.YEAR
BEG.YEAR ADDITIONS
RETI REMENTS TRANS/OTH
TRANS/OTH END
END YEAR
YEAR
EQUIPMENT
EQUIPMENT 39,381.
39,381. 16,235.
16,235. 55,616.
55,616.
TOTAL AMOUNT
39,381. 16,235.
16,235. 55,616.
55,616.
STATEMENT:
STATEMENT: 990
990 PT IV -2
-2
LAND,
LAND, BUILDINGS,
BUILDINGS, and
and EQUIPMENT
EQUIPMENT : ACCUMULATED
ACCUMULATED DEPRECIATION
DEPRECIATION
DESCRIPTION
DESCRIPTION BEG.YEAR
BEG. YEAR ADDITIONS
TRANS/OTH END
END YEAR
YEAR
EQUIPMENT
EQUIPMENT 17,402.
17,402. 6,945.
6,945. 24,347.
24,347.
TOTAL AMOUNT
17,402. 6,945.
6,945. 24,347.
24,347.
STATEMENT:
STATEMENT: 990
990 PT IV -3
OTHER ASSETS
OTHER ASSETS END
END OF
DESCRIPTION
DESCRIPTION YEAR ,AMOUNT
YEAR AMOUNT FMV
ACCRUED INTEREST RECEIVABLE

ACCRUED INTEREST RECEIVABLE 6 ,245.
6,245.
SECURITY DEPOSITS
SECURITY DEPOSITS 10.
10.
WORKER'S COMPENSATION
WORKER'S COMPENSATION DEPOSIT
DEPOSIT 132.
132.
TOTALS
TOTALS 6,387.
6,387.
iNVESTMENT PORTFOLIO
SNVESTMENT PORTFOLIO VALUATION
VALUATION Account' 06390287
Account # 0 6 3 8 0 2 8 7
MAY 331.
1 . ~997
1997 HEIMUCH INSTITUTE. INCORPORATED
HEIMUCH INSTITUTE, INCORPORATED
QUANTITY
QUANTITY ASSeT DESCRIPTION
ASSET DESCRIPTION MARKET PRICE I\IlARKET VALUE
MARKET PRICE MARKET VALUE
15.000
15,000 AMOCO
AMOCO CANADA CANADA 99.000 14.850.00
99.000 14,850.00
66.750% DUE 02/15/05
. 7 5 0 % DUE 02/15/05 DATED DATED 02/15/93
02/15/93
, 5.000
15,000 BANKERS TRUST
BANKERS TRUST OF OF NEWNEW YORKYORK 101.625 15.243.15
101.625 16.243.75
77.600% DUE 001115(02
. 5 0 0 % DUE 1 H 5/02 OATED 01"5/92
DATED 01M 5/92
15,000
15,000 CORESTATES CAPITAL
CORESTATES CAPITAL 96.380 14,45700
96.380 14.457.00
6~.625%
. 6 2 5 % DUEOUE 003115/05 DATED 03/18/93
3 / 1 5 / 0 5 DATED 03!'8/93
40,000
FEDERAL NATIONAL MORTGAGE
MORTGAG£ ASSOCIATION
ASSOCIATION 93.093 37.237.60
93.093 37,237.60
5S.875l)b
. 8 7 5 % DUE Due 002/02/06 DATED 02/02/96
2 / 0 2 / 0 6 DATED 02/02/96
10,000
MORTGAGE ASSOCIATION
ASSOCIATION 104.406 10.440.60
104.406 10,440.60
88.700%
. 7 0 0 % DUE DUE 0<>e/10/99 DATED 06/12/89
6 / 1 0 / 9 9 DATED 06/12/89
20,000
20,000 FIRST CHICAGO
FIRST CHICAGO NBD CORP NBO CORP 100.450 20,090.00
100.450 20,090.00
(FORMERLY NBD
(FORMERLY NBD BANCORP)
BANCORPI
7.250% DUE 08/15/04
7 . 2 5 0 % DUE 0 8 / 1 5 / 0 4 DATED DATED 08/24/92
08/24/92
15,000
15,000 GTE WISCONSIN
GTE WISCONSIN '01.125 15.168.75
101.125 15,168.75
77.750%
. 7 5 0 % DUE DUE06/01/03
06/01/03 DATED DATED 06/01/73
06/01/73
10.000
10.000 HAWAIIAN TELEPHONE
HAWAIIAN TELEPHONE COMPANY COMPANY 100.000 10.000.00
100.000 10,000.00
FIRST MORTGAGE
FIRST MORTGAGE
6.750%
6 . 7 5 0 % DUE DUE004/01198 DATED 03/28/68
4 / 0 1 / 9 8 DATED 03128/68
20,000
20.000 INTERNATIONAL BUSINESS
INTERNATIONAL BUSINESS MACHINES
MACHINES CORP.
CORP. 99.375 19,815.00
99.375 19,875.00
6~.375%
. 3 7 5 % DUE DUE006115/00 DATED 06/15/93
6 / 1 5 / 0 0 DATED 06/15/93
10.000
10,000 PNCFUNDING
PNC FUNDING CORPORATION
CORPORATION 98.625 9,862.50
98.625 9.862.50
sueORDINATED DEBENTURE
6.875% DUE 03/01103
6 . 8 7 5 % DUE 03/01/03 DATED DATED 02/23/93
02/23(93
20,000
20,000 PROVINCE OF OFONTARIO
ONTARIO GLOBAL GLOBAL BOND
BONO 99.000 19,800.00
PROVINCE 99.000 19,800.00
66.12!5%
. 1 2 5 % DUE OUE00i)/28/00 DATED 06/17/93
6 / 2 8 / 0 0 DATED 06117193
20,000
20,000 PUBLICSERVICE SERVICEELECTRIC
ELECTRICAND ANDGAS
GAS COMPANY
COMPANY 96.700 19.340.00
PUBLIC 96.700 19.340.00
66.500%
. 5 0 0 % DUE DUE05/01/04
05/01/04 DATED DATED 05/01/93
05/01/93
15,000 UNITEDSTATES STATESTREASURY
TREASURYBOND BONO 97.156 '4,573.40
15,000 UNITED 97.156 14,573.40
66.250%
. 2 5 0 % DUE Due 02/15/07
02/15/07 DATED DATED 02/15/97
02/15/97
15.000 UNITEDSTATES STATESTREASURY
TREASURYNOTE NOTE 93.093 13.963.95
15.000 UNITED 93.093 13,963.95
5 5.625%
. 6 2 5 % DUE DUE02/15/06
02/15/06 DATED DATED 02/15/96
02115198
20,000 UNITEDSTATES STATeS TREASURY
TREASURYNOTE NOTe 103.781 20.756.20
20,000 UNITED 103.781 20,756.20
7 7.500%
, 5 0 0 % DUE DUE11/15/01
11/15/01 DATED DATED 11/15/91
11/15/91
15.000 WAL·MART STORES, STORES,INC. INC. 98.250 14,137.50
15,000 WAL-MART 98.250 14,737.50
6 .e.5OO%
5 0 0 % DUE DUE06/01/03
06/01/03 DATED DATED 06/01/93
06/01/93
100 AIRPRODUCTS
PRODUCTSAND ANDCHEMICALS,
CHEMICALS, INC. INC. 77.750 7,775.00
100 AIR 77.750 7,775,00
2.800 BAlLARD MEDICAL MEDICAL PRODUCTS
PRODUCTS 19.250 53.900.00
2.800 BALLARD 19-250 53,900.00
BURLINGTONNORTHERN NORTHERNSANTA SANTAFEFE 83.000 7,055.00
8585 BURLINGTON 83.000 7,055.00
CORPORATION
CORPORATION
150 CINTASCORPORATION
150 CINTAS 62.000 9,300.00
COMPUTERASSOCIATES ASSOCIATESINTERNATIONAL,
INTERNATIONAL, INC.
INC. 54.750 4,927.50
9090 COMPUTER 54.750 4,927.50
175 CONSECO.INC. INC. 40.000 7,000.00
175 CONSECO, 40.000 7,000.00
120 CORESTATESFINANCIAL FINANCIAL CORPORATION
120 CORESTATES 52.875 6,345.00
DISNEY(WALT) (WALTI COMPANY
COMPANY 81.876 6,550.00
8080 DISNEY 81.875 6,550.00
170 DOVERCORPORATION
170 DOVER 57.375 9,753.76
280 DRESSER INDUSTRIES,INCORPORATED
INCORPORATED 34.250 9.590.00
260 DRESSER INDUSTRIES, 34.250 9,590.00
lS0 E M C CORPORATION 39.875 7.177.50
180 E M C CORPORATION 39.875 7,177.50
100 ECHLININCORPORATED
INCORPORATEO 33.315 3,337.50
100 ECHLIN 33.375 3,337.50
44.'25 7,721.88
175
175 G GTE CORPORATION
T E CORPORATION 44.125 7,721.88
260
260 GENERALELECTRIC ELECTRICCOMPANY
COMPANY 60.375 15,697.50
GENERAL 60.375 15,697.50
GENERAL RERE CORPORATION 175.250 9,638.75
5555 GENERAL CORPORATION 175.250 9,638.75
100 GILLETTECOMPANY
GILLETTE COMPANY 88.875 8,887.50
100 88.875 8,887.50
200 HEWLETT ·PACKARDCOMPANY
HEWLETT-PACKARD COMPANY 51.500 10.300.00
200 51.500 10,300.00
130 JOHNSON& &JOHNSON
JOHNSON JOHNSON 60.000 7,BOO.00
130 60.000 7,800.00
1.200.095 JOHNSONOPPORTUNITY
JOHNSON OPPORTUNITYFUND FUND 24.360 29,234.33
1,200.095 24.360 29,234.33
200
MCDONALD'S CORPORATION 50.250 '0,050.00
50.250 10,050.00
9,990.00
135
135 MEDTAONIC.INCORPORATED
MEDTRONIC, INCORPORATED 74.000
74.000 9.990.00

<'_'h~ ...,e/- 9'10

V U . W e A - WO
?+- \V-L( l/
INVESTMENT
If~VESTMENT PORTFOLIO VALUATION
PORTFOLIO VALUATION Account' ## 06390297
Account' 06390287
MAY 331.1997
MAY 1 , 1997 HEIMUCH INSTITUTE,
HEIMUCH INSTITUT!.INCORPORAT£O
INCORPORATED
QUANTITY
QUANTITY ASSET DESCRIPTION MARKET PRICE
MARKET PRICE MARKET VALUE
MARKET VALUE
100 MOBIL CORPORATION
MOBIL CORPORATION 139.875
139.875 13.987.50
13,987.50
140 PROCTER & GAMBLE
PROCTER GAMB~E COMPANY
COMPANY 137.875
137.875 19,302.50
19,302.50
200 REGIONS FINANCIAL
REGIONS FINANCIAL CORPORATION 59.750
59.750 , 1,950.00
11,950.00
130 ROCKWELL INTERNATIONAL
ROCKWELL INTERNATIONAL CORPORATION (NEW) 64.500
64.500 8,385.00
8,385.00
220 lEE CORPORATION
SARA LEE 40.875
40.875 8.992.50
8,992.50
100
100 SCHERING-PlOUGH CORPORATION
SCHERING-PLOUGH 90.750
90.750 9,075.00
9,075.00
400
400 SHERWIN WILLIAMS
5HERWIN WIlliAMS COMPANY
COMPANY 30.000
30.000 12.000.00
12.000.00
230
230 SIGMA-ALDRICH CORPORATION
SIGMA-ALDRICH 30.~25
30.625 7,043.75
7,043.75
80
80 SMITHI(UNE BEECHAM
SMITHKUNE BEECHAM PLC
PLC ADR
ADR 87.500
87.500 7,000.00
7,000.00
245
245 SYSCO CORPORATION
SYSCO 34.875
34.875 8,544.37
8,544.37
240
240 TECO ENERGY, INCORPORATED
TECO ENERGY. INCORPORATED 24.875
24.875 5.970.00
5,970.00
280
280 USX -• MARATHON
USX MARATHON GROUP
GROUP INCORPORATED 2S.87!;i
29.875 8.365.00
8,365.00
200
200 WALGREEN COMPANY
WALGREEN 46.750
46.750 9,350.00
9,350.00
160
160 WASHINGTON MUTUAL,
WASHINGTON MUTUAL. INC.
INC. 55.625
55.625 8,900.00
8,900.00
300
300 WMITMAN CORPORATION
WHITMAN 24.125
24.125 7,237.50
7,237.50
325
325 WORTHINGTON INDUSTRIES,
WORTHINGTON INDUSTRIES. INC.
INC. 18.500
18.500 6,012.50
6,012.50
TOTALPORTFOLIO
TOTAL PORTFOUO VALUE
VALUE
<W,^3
JohnsonInvestment
Johnson Counsel,inc.
InvesCrn8llt Counsel, Inc.
'::l+c....-kMe.-,f- '1'1<7
?-r\V-L/J/
Revised
Revised 9/20/96
THE HEIMLICH FOUNDATION, INC.
HEIMLICH INSTITUTE ~OUNDATION, tNC.
BOARD OF
BOARD OF TRUSTEES
TRUSTEES
MUCH 1995-1996
INSTITUTE
fwarouc
r1 lila *Harry w. Whittaker,
♦Harry H. Whittaker, Pres. Soc. t
Sec. #|
Soc. Sec.
wow, sea
QlaW1.'W 2497 Grandin Road
Grandin Road Gradison k Co.
Gra<1iaon ,
513-m-IIlC' Cincinnati, OK
Cincinnati, OH 45208 Walnut street
580 Walnut
1c51So11lG3 Cincinnati, OH 45202
Cincinnati,
)?hP ';J#::OO~~
(5131 579-5000 _
Philip M. Heimlich, Vice
M. Heimlich, Vice Free.
Pres. Soc. Sec. ~
Soc. Sec.
Lyceum Court
6680 Lyceum Court Cincinnati
Cincinnati~ City Hall
Cincinnati, 801 Plum
Plua Street
Street
(513) 624-9155
624-9155 Cincinnati, OH 45202
Cincinnati,
(513) 352-3647
Joseph J. Dehner,
Joseph
Terrace
Dehner, Secretary
822 Yale Avenue
Avenue
Terrace Park, OH
OH 45174
Soc.
Soc.
Frost Sec.
Frost
2500
& t~""""
f^^^^^^^|
Jacobs
, Jacobs
2500 Central
Central Trust
Trust Tower
Cincinnati,
(513) 651-6800
651-6800
(513) 651-6166-Kathy
651-6166-Kathy Barrett
(513)
(513) 651 6el~ Fax
651-6M*
"''$(
*Cedric w. Vogel, Treasurer
W. Voqal, Treasurer Soc. Sec.
Soc. Sec._
2270 Madison
Madison Road
Road 500 Atlas
Atlas Bank Building
Building
Cincinnati,
Cincinnati, OH 45208 524 Walnut
walnut street
Street
Cincinnati, O H 45202
Cincinnati, OH
(513) 421-4225
421-4225
*Henry J. Heimlich,
*Henry M.D.
Heimlich, M.D. Sec. I^HÎ^^Î
Soc. Sec.
17 Elmhurst Place
Elmhurst Place Heimlich
Heimlich Institute
Institute
Cincinnati,
45208 2368 Victory Pkwy,,
Pkwy., #410
'410
Cincinnati,
Cincinnati, OK
OM 45206
(513) 221-0002
Mrs.
Mrs. Winston Atteberry
Winston C. Atteberry Soc. Sec. f
Soc. Sec.
Box 629
Eunice,
Eunice, LA 70535
70535
(316) 457-2705
(318) 457-2705
Mr. George
Mr. George Blake
Blake Soc. S~C.
Soc. Sec.
Cincinnati Enquirer
Cincinnati Enquirer (513) 768-8094 direct
(513) 768-8094 direct
312 Elm Street
Street
Cincinanti,
Cincinanti, OH 45202
Benefiting Kathy Carr Soc. Sec.
Soc.
Humanity Ray Carr
3057 Saddleback
Sad41eback Drive
Drive
Soc. Sec.
tfOCt tfVvt
K wk. (513) 871-2221
~ wk.
Through Cincinnati,
(513) 231-3010
231-3010
R wk.
wk. (513) 621-4777
HeaJth
Health
and S+o...-k.,.\(' / ~ q -10
Peace Po.f>
?0.r- V- v~\ \ V II
Mrs. Arthur
Mrs. Arthur Murray
MUrray(Kathryn)
(Kathryn) Soc.Sec.
Soc. Sec.
2877 Kalakuau Avenue
Honolulu, HI
Honolulu, HI 96815
96815
MS (808)924-4094
(808) 924-4094
mm Monte L.
Monte Rovekamp
L. RoveKamp Soc.Sec.
Soc. Sec.
msun.K
PI.~" 2864 Crescent Springs Pike
2864 crescent Springs Pike P.O.
P.O. Box
Box 19129
19129
aIU1.l. Erlanqer, XV 41018
Erlanger, KY 41018 cincinnati,
Cincinnati, OH 'OH 45219-0129
45219-0129
jMWM_
a»MIZ (606) 341-6050
341-6050
(606)
fa51Hll_
IjMMjB William P.
William P. Sbeehan
Sheehan Soc. sec.
soc. Sec.
1673 Braintree
1673 Braintree (614)
(614) 466-3206
466-3
cincinnati, OH
Cincinnati, 45255
OH 45255
(513) 231-7467
(513) 231-7467
Charles J.
Charles Squeri (Chuck)
J. Squeri (Chuck) Soc. Sec.
Soc. ~ec • .-
clo Squeri FOOd Service
c/o Squeri Food Service Inc Inc squerlF~Foods
Squeri
619 Linn street
619 Linn Street Linn Street
619 Linn
619 street
cincinnati, OH
45203 Cincinnati,
Cincinnati, OH OH 45203
45203
(513) 381-1106
(513) 381-1106
Anson Williams
Anson Williams Soc. Sec.
24615 Skyline view
Drive (213) 850-2 5 (office)
(213) 850-2685
Malibu, CA
Malibu, 90265
CA 90265 (213)
(213) 657-4861
651-4861 (home)
Dr. Paul
Dr. Paul Winchell
Winchell Soc. t
Sec. #1
Soc. Sec.
32262 Oakshore Drive
Westlake Villaqe,
Westlake Village, CACA 91361
91361
(818) 991-5754
(818) 991-5754
*• These
These trustees
trustees have the
the discretion
discretion as to the distribution
distribution of
of
contributions.
contributions.
Benefiting
Benefiting
Hum~ity
Humanity
Through
Through
HeaJth S+a...le.ne t':- 4 ~0
Health i='cd +- v- I J/
and
and
I Peace
Peace
THE HEIMLICH
INSTITUTE
FOUNDATION
23-7303161
PART:III
PART:III LINE:3
LINE:3
Patient
Patient need
need for
for financial
assistance is
determined
determined on
on an
an individual
individual basis.
basis.
Each
Each patient's
patient's ability
ability to meet
meet medical
medical and
related
related expenses
expenses is reviewed
reviewed in terms
terms of referral
referral
information
information or through
through investigation
investigation by the
foundation
foundation itself.
itself.
<^+rt*V <tto S c W A ?+ B E - (
-----------------------------------------------------------------------
• , OMB
OMB No1546-0047
No. 1545·0047
Return of
Organization Exempt
Exempt From
From Income
Income Tax
Tax
-orm
r'orm 990
990 Undersection
Under section501(c)
501 (c)ofoltha Inlemal Revenue
the Internal
private foundation)
loundation) ororsection
RevenueCodB
section4947(a)(1)
Code(except
(except black
4947(a)(1) normxampt
black lung
nonexemptcharitable
lung benefit
lIenefillrusl
charitable trust
trust
trust oror j997
1997
Oeparlmenlof 111.T_IY
Department of Ui« Treasury
private This
ThIsForm
FormisIsOpBn
Open
IntemalRevenueService
Internal Revenue Sorvico
Nota:The
Note: Theorganization
organizationmay mayhavB
have to
to use copy 01
use aa copy of this
this return
return toto satisfy
satisfy state
state reportinq
reporting requirements.
requirements. totoPublic
PublicInspection
Inspection
A For
Forthe
the1997
1997calendar
calendaryear,
year.OR
ORtax
tax year
year period
period beginning
beginning 6/ 1
67~1 • 1997.and
,1997, andending
ending 55/31
/31 .1998
•~9 98
BCheck
Chodcit.
if:
OOChange
Please
Please
GCName
Nameofoforganization
organization DDEmployer
Jdentllicalion number
number
nsB ~.eIRS
jXjo?"of
addressuse IHS
label or
label or THE HEIMLICH
HE!MLICH INSTITUTE
23-7303161
IHE
I
address
print or
□
print or
DIniHai type.
Initial
return typo- Numberand
Number andstreet
street(or
(orP.O.
P.O.box
boxififmail
maills notdelivered
is not delivlmd to
to street
street address)
address) Room/suite EEStata
Room/suite Stateregistration
registration number
number
DAnai return
□ F i n a l
See
See
Speclnc3
retum Specific
return
311 T R A I G H T SSTREET
1 1 SSTRAIGHT TREET
□ DAmonde<l
retum
return
tnstruc-
A m e n d e d Instruc
liens.
tions.
City.town,
City, town, ororpost
postoffice,
office, state,
state. and
and ZIP+4
ZIP+4 FFCheck
Check ► ,... □ ififexemptionD
exemption
!~fb'0f1if:aISQ
for Stats CCINCINNATI,
I N C I N N A T I , O OH
H 45219
4 5 2 1 9 applicationisIspending
application pending
GG Type
reporting)
T~e ^'organization
Type ~)organilation - .......
of o > Q D Exempt 00
Exemptunder 501(e)( {33 H)....(insert
under501(c) (Insertnumber)
number)OR
OR► ,... □ section 0
section4947(a)(1)
4947(a)(1) nonexBmptchariitablB
nonexemptchartitable trust
trust
H(a) Is this a group return filed for affiliates? □ Yes [ X I No 1 If either box in H is checked "Yes." enter four-digit group
(b) If "Yes," enter the number of affiliates for which this exemption number (GEN) ► , .
return is filed: ► J Accounting method: C3 Cash O D Accrual
( e ) Is this a separate return tiled by an organization covered by a group ruling? □ Yes LX1 NO I I Other (specify) ►
K Check here ► O f f the organization's grossreceiptsare normally not more than $25,000. The organization need not file a return with the IRS; but
if it received a Form 990 Package in the mall,ftshould file a return without financial data. Some states require a complete return.
Note: Form 990-EZ may be usBd by organizations with gross receipts less than $100,000 and total assets less than $250.000 at end of year.
$ H i f l Revenue, Expenses, and Changes in Net Assets or Fund Balances
Contributions. gifts,
Contributions, Oifts.grants,
grants. and ann similar
similar amounts
amounts received:
received: £^
aa Direct public support
Direct public support .. 1a 24,749
bII Indirect public support
Indirect public support . 1b
cc Govemment contributions
Government contributions (grants)
(grants) . 16
dd Talal(add
Total (addlines
lines1ata through
through 1c) 1c)(attach
(attachschedule
schedule ofofcontributors)
contributors)
a (cash $
(casli$ 224,749.
4 , 7 4 9 . noncash$ noncash $ .) . it
24 749.
24,749.
22 Program
Program service
service revenue
revenue including
including government
govemment fees taes and
and contracts
contracts (from
(from Part
Part VII,
VII. line
line 93)
93) !-!:....:t---------
Q 3 Membership dues and
3 Membership dues and assessments assessments 1-~+---------
44 Interest
Interestononsavings
savlngs andandtemporary
temporary cash cash Investments
Investments .
55 Dividends and interest from
Dividends and interest from securities securities .. . 23,348,
o 5 a Gross
5 a Gross rentsrents .. 5a
bb Less:
Less: rental
rental expenses
expanses . Eb
ID cc Net
Netrental
rental income
income or or (loss)
(loss) (subtract
(subtract line
line 6b
6b from
from line
Hne6a)6a) " .. 6c
;:,
e 77 Otherinvestment
Olherinvestment Income Income (describe
(descrlbe ► ...
~II) 8Baa Gross
Gross amount
amount fromfrom sale
saleofofassets
assets other
other (A) Securities (B) Other
a: than Inventory
than Inventory . 198,782, 8a
b Less: cost or other basis and sales
b Less: cost or other basis and sales expenses expenses . 145^177, 8b
cc Gain
GaIn or
or (loss)
(loss) (attach
{attach schedule)
schedule) . 5 3 , 6 0 5 , 8c
d Net
Netgain
gain or
or (loss)
(loss) (combine
(combine line 8c, columns
line 8c, columns (Al (A) and
and (Bl)
(B)) § T M T ,.1 M 53 605.
53,605.
9 Special events
Special events andand activities
activities (attach
(attach schedule):
schedule):
a Gross
Gross revenue
revenue (not including $$
(not including ofofcontributions
contributions
reported on
reported on line
lina 1a)
la) . 9a
bb Less: direct
Less: direct expenses
expenses otherother than
than tundralslng
fundraisingexpenses
expenses . 9b
e; Net income
Net income or Dr (loss)
(loss) from
from special
spacial events
events (subtract
(subtractline
line9b
9bfrom
fromline
line9a)
9a) . 9e
10
10 aa Gross sales of
Gross of Inventory,
inventory, less
less returns
returns and
andallowances
allowances , . 10a
bb lass: cost of
Less:cost of goods
goods sold
sold .. 10b
cc Gross profit
Gross pro1it or
or (loss)
(Joss) from
from sales
sales of
ofinventory
inventory (attach
(attach schedule)
schedule) (subtract
(subtract line
line10b
10b trom
fromline
line 10a)
10a). . 10c
11 other revenue (from Part VII, Une
Other revenue (from Part VII, line 103) 103) .. 11
12 Total revenue (add lines Id. 2.3.4,5,6c. 7.8d, 9c, 10c/and^r7£U^s««»i^^CTcr7r. I. 12 101,702.
13 Program services (from line 44, column (B)) 13 114,665.
Management and general (from line 44, column (C))
o 14 60,018.
14 _£Q.
15 Fundraising (from line 44, column (D)) 15
:MJ1:!???::M 16
18
17
1B
Payments to affiliates (attach schedule)
Total expenses (add lines 16 and 44, column (A))
ma44,column«w
Excess or (deficit) fortho year (subtract Sn
i....rr.....„
i e 17 from line k)
,....,..yf
LKJUfcl^t U \ t
4.
1
t 17
18
174,683.
-72,981,
19 Net assets orfund
or fund balances
balances at beginning
beginning ofyaar
of year (from
(from liniTVm^^TZ. .. 19 721,287.
Z . [ft 20 Other changes
changes In
in net
net assets
assets or fund
fund balances
balances (attach
(attach explanation)
explanation) ~.¥.!.¥.! $..',J,lb'J'.¥.!.~¥.!.:w.';l;'
SJ3E...STJ\TJESffiNT >< _2_ ? .. 2D 55,342,
21 ortund
Nat assets or balances at
fund balances at end
end of year (combine
combine Jines
lines 118,19, and
and 20) . 21 703,648.
page 11 01
fc
LHA For For Paperwork
Paperwork Reduction
Ro~ucllDn ActAct Notice,
Notice, sea
see paga ofthe
thessparata
separateinstrUctions.
instructions. Form 990 (1997)
72J001
7230O1
OO·12·ga
03-12-98
1 1
11021001 758050 23-12053HEI

23-12053HEI 062 THE HEIMLICH
062 INSTITUTE FOUNDAT * 23-12051
HEIMLICH INSTITUTE
11021001
23-7303161 Page
Page22
Form 990 (1997) THE HEIMLICH INSTITUTE FOUNDATION
mizations must complete column (A). Columns (B), (C), and (D) are required for sectio n 501(c)(3) and
|;KSif%lE£ F u n c t i o n a l E x p e n s e s (4) organizations and section 4947(a)(1) nonexempt charitable trusts but optional for others.
Do not include amounts reported on line (B) Program 1 (C) Management (D) Fundraising
8b, 8b, 9b. 10b, or 16 Of Parti. ;§$ (A) Total services and general
22 Grants and allocations (attach schedule) s
22
cash $, _
cash S noncash $ 22
23 Specific
23 assistancetotoindividuals
Specificassistance Individuals (attach
(attachschedule)
schedule) t-=+--------+------~
23 ' \
■>^
V S
24 Benefits
24 paidtotoororfor
Benefitspaid formembers
members (attach
(attachschedule)
schedule) 24
25 Compensation
25 Compensation ofofofficers,
Officers,directors,
directors, etc.
etc. 25 0. 0.
r+-----;:,....""-:;-;:rl----=-=~=_=_=_+--__::_=__:::=_~I_------- 0. 0.
26 Othersalaries
26 other salariesand
andwages
wages 54,015. 40,511. 13,504.
,t=+------=.....::...c<--..:..::....:--j----=....::...L::.....::=-+--__;;;;;.;;;_L,.;;;,-=-=-=-J--------
26
27 Pension
27 Pensionplan
plancontributions
contributions . 27 !
2S Other
28 Otheremployee
employeebenefits
benefits . 2B 8,341. 6,256. 2,085.
29 Payroll
29 Payrolltaxes
taxes . 29 10,477. 7,858. 2,619.
3D Professional
30 Professional fundratsing
tundralsing fees
fees . 30
31 Accounting
31 Accounting fees
fees 31 1,975. 1,481. 494.
p+----~~~;:-::.J------:~~~=-t-----~~~I--------
32 Legal
32 tees
Legalfees 32 2,231. 1,673.' 558.
p+----~~-T;;..-:-J------:~i-;;07-=+-------=;;~~!--------
33 Supplies
33 Supplies . 33 2,747. 2,061. 686.
34 Telephone
34 Telephone .. 34 3,204. 2,403. 801.
35 Postage
38 Postageand
andshipping
shipping .. 35 2,871. 2,153. 718.
36 Occupancy
36 Occupancy p'+-__
36 14,952. 3,738.
__;;;;..;;:...~;;::_.:;~ 11,214.
--=:....!.....:.....;;...;;...+--__;;;:...;;;..~=-=-=-I--------
37
37 Equipment rental
Equipment rental and
and maintenance
maintenance 37
F-t--------i--------l----------'I--------
38 Printing and publications
3B Printing and publications . 38
39 Travel
39 Travel . .. _3jJ 29,776. 22,332.
7,444.
40 Conferences,
40 Conferences, conventions,
conventions, and meetings
meetings 1-'-'+-------1--------1----------'1--------
40
41 interest
41 Interest p'+-----;:--;:;--.;:::-!-------+---"'7--;::;:o-;~I--------
41
42 Depreciation,
42 Depreciation, depletion,
depletion, etc.
etc. (attach
(attach schedule)
schedule) 42 6,945. 6,945.
43 Other expanses (itemize):
43 Other expenses (itemize):
aaOFFICE
OFFICE IINSURANCE
NSURANCE 43a 7,325. 1,831. 5,494.
t,bOUTSIDE
OUTSIDE SERVICES
S ERVICES 43b 25,709. 19,282. 6,427.
cMISCELLANEOUS
BMISCELLANEOUS 43 c 4,115. 3,086. 1,029.
rjd
0
~T_----------_4------------_r------------+-------------
__ 43d
0 43e
44 Total
44 Totalfunctional
functio"" expenses
OXpen5as(add
(addlines
tines22
22through
through43)43)
OrgIIni2',tion'. completing
Organizations colmpll,Ung coliimns
columns (B)-p),
(9)-(0), carry
CNrf these
these
44 174,683. 114,665. 60,018. 0o.
.
Reporting ofofJoint
Reporting Joint Costs.
Cosls••■ Old
Old you
you report
report in
in column
column {B){B) (Program
(Program services)
services) any
any Joint
Jointcosts
costsfrom fromaacombhed
combinededucational
educationalcampaign
campaignandand
tundraising solicitation?
fundraising solicitation? ► □ 0 Yes 00
Yes [ X I No
No
IfIf"Yes,"
"Yes,' enter
enter [i)
(I) the
the aggregate
aggregate amount
amount of
of these
th9ssIoint costs $
joint costs $_ ; (Ii)) the
tile amount
amount allocated
allocated to Program services $$ .
Program services _
ill the
(iii) the amount
amount allocated
allocated to
to Management
Mana ement and 6n6ral $$
and general ;;and Iv the
and (tv) the amount
amount allocated
allocated to Fumlralsin $$
to Fundraising
J a W i i l l Statement of Program Service Accomplishments
What isis
What Ihe organization's
the organization's primary exemptpurpose?
primary exempt purposo?►
....
_S..;.,E..;;,E_.;_S...;,T...;,A;.;,;T.;.;..:.,E.:.,;M.;_E...:.N..:.:.;:T:__3;:;._
S EE STATEMENT 3 -;
Program
PrO!ll'am Service
Service
organization.must
All organizations must describe
describe their exempt purpose
lIleir exempt pUIl'OSOechl in aa clear
.....""""'1a in clear and
and concise
concise manner.
"Expenses
bpenses
manner. State
State ttie
tho number
number 01cllents.etved, """ed.•
All achievements of clients aeived, l'ubllClltions tc. DI5ctlss
publications (ssuBd, etc (Raqulreclfor501
Discuss (Required rorS01(cl(3j and
(c)(3) and
achillVe~ts that
achievements lIlat are
ant not measurabl .. (Sectlo" 5Dl(c)(3) and (4) organizations and 4947(al(1) nonexempt charilnble wat. "",5t also enter tho amount 01grants and
not measurabla (Section 501 (c)(3) and (4) organizations and 4947(a)(1) nonexempt ehahtabla trusts must also enter the amount of grants and (4) orgs.,
(4) and 4947(.)(1)
QIglI.. and 4947(a)(1)
allocations to others.) wsts; but
trusts; but optional
optlOl1a1lor others.)
for others.)
allocations to others.) „ _ _ ^ ^ — — ^ ^ — — - ^ — ^ — " —
aa SEE
SEE STATEMENT
STATEMENT 44
(Grants and allocations $ 34,400

34,400.
AIDS
bb AIDS RESEARCH
RESEARCH AND EDUCATION
AND EDUCATION
Grants and
1,599,
cEDUCATION
cEDUCATION OF THE
OF THE GENERAL
GENERAL PUBLIC,
PUBLIC, THE PRINTING
THE PRINTING AND
AND
DISTRIBUTION
DISTRIBUTION OF EDUCATION
OF EDUCATION LITERATURE
LITERATURE TO PUBLIC
TO PUBLIC PLACES
PLACES
ABOUT THE
ABOUT THE HEIMLICH
HEIMLICH MANEUVER.
MANEUVER.
Grants and
(Grants allocations $$
and allocations 228,666.
8,666.
d __-- ~
Grants and allocations

(Grants allocations $
e Other program services (attach schedule) (Grants and allocations $
f Total ol Program Service Expenses (should equal line 44, column (B). Program services) 114,665.
723011
03-27-98
11021001 758050 23-12053HEI 062 THE HEIMLICH INSTITUTE FOUNDAT 23-12051
.---_.------------------------------------------------------------------------------
Form980
Form 990(1997)
{19971 THE THE HEIMLICH
HEIMLICHINSTITUTE
INSTITUTEFOUNDATION
23-7303161 Pace 3
Page3
.-~.
titflt]JI: Balance Sheets
ffjjaljlill Balance Sheets
Note:Where
Note: Where required.attached
required, attached andamounts
!,,'!nl~I1I1IA~
schedules and amountswithin
withinthethedescription
descriptioncolumn
columnshould
shouldbebe (A) (B)
(B)
forend-of-year
for end-of-yearamounts
amountsonly. Beginning of year Endof
End of year
4545 Cash-non-interest-bearing
Cash- non-lnterest-bearlng 6,374. 45 458.
46 Savings and temporary cash investments , .. 37,725. 46 15,464.
4747a a Accounts
Accountsreceivable
receivable .. 47a
Lass:allowance
b b Lass: allowancetor doubtfulaccounts
for doubtful accounts ......•........... 47I) 47B
ill —
49
49
a a Pledges
4848 ·Pledgesreceivable
receivable
allowancefor
less:allowance
b b Less:
Grantsreceivable
Grants receivable
doubtfulaccounts
for doubtful
.•••.•.•
accounts ............•....•
I-'-"=-l!----------I
48a
48b
.
I
49
f
505D Receivablesfrom officers, directors, trustees, and key employees(attach
Receivables from officers, directors, trustees, and key employees (attach
schedule)
schedule) .. l--------~~+-------- 50
in
i
*-• 5151a a Other
Othernotes
notes andandloans
loansreceivable
recoivable
b less: allowancefor doubtful accounts
.. I 51a
.. | 51b no
IS!
8~ 52b Less: allowance for doubtful accounts
52 Inventoriesfor
Inventories torsale
saleoruse
oruse 1---------1-'''''-+--------
a. 5353 Prepaid
Prepaidexpensesand deferredcharges
expenses and deferred charges , 1- +-""'-+-
53 _
5454 Investments - securities (attach schedule)
Investments-securities (attach schedule) l---------tt 54
55aa Investments
Investments- -iand, buildings,and
ami
55 land, buildings,
*8
equipment:basis
equipment:
bb Less:
basis
less: accumulated
accumulateddepreciation
schedule)
schedule)
(attach
depreciation (attach
r=-t---------t
55a
1
;; T:1'T,;;=;i;'m~;;;:;;;;:rn::;::m;;-~-i---"C:;;::-;,,:;;--::;-r:~:---Z2'7\-;:;'i'i'i;-
55b
55 Investments -otner .. S E"".7.,
E STATEMENT ..O:.-:-:. 5 6 6 4 , 5 4 3 . 56 660,797.
J
55 Investments-other :"."':O::::~ •.,.,.;~:::':':,
57aa Land,
57 land, buildings,
buildings,and
andequipment:
equipment:basis
basIs l-"-~I-------;~...L...i~~
57a 55,616.
hb Less:
less: accumulated
accumulateddepreciation
depreciation 31,292. 31,269. 24,324.
T!1':r.~;,'rn;:;;r:;;;;rn~~7:...:::.:T---~7"'5'~rl-.::::=-t----"F"5'TI:
57b
58
58 Otherassets
Other assets(describe ....
(describe ► ----------~~~~~~~~---~
S SEE STATEMENT 6 ) 6,387. 5,316.
59 Total assets (add lines 45 through 58) (must equal line74) 746,298. 59 7706
0 6 , 3359.
59.
Accountspayable
60 Accounts
60 payableand accruedexpenses
and accrued exPenses 2 5 , 0 1 1 . 60
r--_=...L-c....::..:::..;+-,.,,_+- _
61 Grantspayabte l---------j--:::.!....+--------
61
\n l----------j--:"-!O..+--------
:ei!l 62 Deferredrevenue 62
B:ii Loansfrom
63 Loans
63 officers,directors,
from officers, directors,trustees,
trustees,and
andkey
!ceyemployees
employees .
~ 64 aa Tax-exempt
64 Tax-exemptbond liabllitJes
bond liabilities .. 64a
III Mortgagesand andother
othernotes
notespayable
payable .p~+-
bb Mortgages I- 64b ---.::--;=-:;--
65
BS OIherliabilHies(describe .... PAYROLL TAX WITHHOLDINGS
other liabilities describe ► P A Y R O L L T A X W I T H H O L D I N G S j )!- -+~-!-
65 2,711.
__;;:..L..:...::..;::...:..
25,011. 65 2,711.
in
Organizations til at follow SFAS117,
Organlzationsthatfollow
67
67
andlines
69 and
69 lines 73
Unrestrictad
Unrestricted
SFAS 117, chack
and74
73 and 74
checkhere
hero ► andcomplete
.... U L J and completelines
lines67 through
67 through
.. 682,368.
1 67
664,729.
s 68
68 Temporarilyrestricted
Temporarily restricted .
c
to 59 Permanentlyrestricted .. 38,919. 69 38,919.
c organlzallons that
Organizations donot
that do nat follow SFAS 117, check
lallow SFAS117, chackhero....
here ► 0 and
L~Z3 aM complete
complete lines
llnes
s. through 74
70through
70 74
0 70
70 Capitalstock,trust
Capital prinCipal,or
stock, trust principal, currenlfunds
or current funds 1- +-.:.:...+-
70 _
% 71
71 Pald-inor
Paid-in or capital
capitalsurplus,
surplus, or
orland, building, and
land, building, and equipment
equipmentfund
fu nd I---------I-.!..!..-:I--------
71
9 72
72 Retainedeamlngs,
Retained endowment,accumulated
earnings, endowment, accumulatedIncome, or othe
income, or funds
otherrfunds . 72
z
73
73 Total net
Total net assets
assets or
Drfund balances (add
fund balances (add lines
lines67 through 69
67through ORlines
69 3R through 72;
70 through
lines 70 72; II 703,648.
column (A)
column (A)must
must equal
equalllna and column
19 and
line 19 column (B) must eaual
(B) must equaliina 21)
line21) . 721,287. 73
74
74 llabillUes and
Total liabilities
Total nat assets
and net assets / fund
fund balances lines 56
balancDs (adti lines and73)
66 and 746,298. 706,359.
Form990
Form 990 isIs available
availablefor public inspection
for public Inspection and,
and,for
for some
some people,
people,serves
servesas
asthe
the primary
primary or
or sole
sole source
source of
of Information
Informallon about
about aa particular
particularorganization.
organization.How
Howthe
the public
public
perceivesan
perceives organizationin
an organization such cases
in such casesmay
may be
bedetermined
determined by
by the
the Information
Information presented
presentedon Its return.
on fts return. Therefore,
Therefore.please
pleasemake surethe
make sure the return
relurn isIscomplete
complete and
and accurate
accurate
and fully
and fully describes,
descrlbes,ln PartIII,
in Part Ill, the
the organization's
organization's programs
programs and
and accomplishments.
accomplishments.
723021
723021
03·12·911
03-12-98 3
11021001 758050 23-12053HEI
11021001 758050 23-12053HEI 062 THE HEIMLICH
062 HEIMLICH INSTITUTE
INSTITUTE FOUNDAT
FOUNDAT 23-12051
23-12051
Form 990(1997) THE HEIMLICH
FOUNDATION 23-7303161 Page4 4
ParUV-A Reconciliation ofofRevenue Revenueper perAudited
MI.JIUII.t::U fllrliJPBN Reconciliation of Expenses per Audited
Financial Statements Statements with withRevenue
Revenueper per Financial Statements Statements With WithExpenses
Expensesper
per
Return Return
a a Total
lotalrovenue,
revenue,gains, gains,and
andother
othersupport
support a a Total exoensesand
Totalexpenses lossesperper
andlosses
jleraudited
per auditedfinancial
tinancialstatements N/A
statements ...............•. .,. ).,;,Ih=~;"';;';~ auditedfinancial
audited financialstatements
statements _ ~ N/A
b b Amounts
Amountsincluded
includedononline lInea abut
butnot
notonon
n h Amounts
Amountsincluded
includedononline
linea abut
butnot
notonon line17,
line 17,Form
Form990:990:
IIna 12, form 990;
line 12, Form 990: (1)(1) Donated
Donatedservices
services
>*V
(1) Net unrealized gains andanduse
useofoffacilities ... $
facilities...5 _
(1) Net unrealized gains
on Investments ...... $ _ (2)(2) Prior
Prioryear
yearadjustments
adjustments
on investments $
(2)(2) Donated
Donatedservices
services reportedononline
reported line20,
20, *3K».
and use offacilities ... $
and use of 1301111163...$,
_ !4?^ Form990
Form 990 $$ _
s\s,
■&?
(3)(3) Recoveries
Recoveriesofofprior
prior nH'!;tf*m~;l}l: (3) Losses
(3) Lossesreported
reportedon on
R;ilmrnjM% line20,
20,Form
Form990 990 ...$ .•. $ _
yeargrants
year grants $.$_- line
(4) other (specify):
(4) Other (specify): (4) Other (specify):
----------_$_-------
__$
Add amounts on iines (1) through (4)
s.*V<
------------_$------------
m
Addamounts
Add amountsononlines
►
$ $ &
lin es(1) through
Ihrough(4)
~ .1-!!-1f------- (4)
Add amounts on lines (1) through (4)
c LineLineaaminus
minusline
linebb ~
c Una a minus line b
: ~~:uant~:~~I:~::
d Amounts included on line 12, Form
··....~mlijillll~
:~·,i~~·1iF~·~·
..·.... d Amounts
AmountsIncluded
Includedononline line17.
17,Form
form
►
990but
butnot
notononline
linea:a; 990but
990 butnot
notononline
linea:a:
(1)
990
(1) Investment
Investmentexpenses
expenses sS.il*?
(1) Investment
(1) expenses
Investment expenses
not Included
not included on on net Included
not included on on
If
!lne 6b, form 990 ... $ _ lin& 6b, Form
line 6b, Form 990 990...$_... $ _
line 6b, Form 990 ...$
(2) othor (speCify); (2) Other (specify):
(2) Other (specify): t ;
------$.------P-4~~
Addamounts
amountson onlines
$
lines (1)
(1)and
and(2)
(2)
:§ Addamounts
amounts on
-----------_$------------
onlines
$_
lines(1) and(2)
(1)and (2) ~~I-
>rw»'
_
Add ► Add ►
e Total
Totalrevenue
revenueper perlfne12,form
line 12, Form 990990 e TotalTotalexpenses
expensesper perline
line17,17,Form
Form990
990
(line cplus
plusfined)
fine d) (lineccplus
(line plusline
lined)d) ^
(linec >■
ili^lj List of Officers, Directors, Trustees, and Key Employees (List each one even if not compensated.)
(B) Title and average hours C) Compensation _employee 1 Contributions to (E)Expense
Benefit account and
(A) Name and address per week devoted to if not paid, enter plans & deferred
eonroansation other allowances
position
SEE ATTACHMENT G
0. 0. o.
0.
75 Did
75 Old any
any offer,
officar, director,
director, trustee,
trustee, or key employee
or key employee receive
receive aggregate
compensation ofof more
more than
than $100,000
$100,000 from
tram your
your piganizatfonand
or all related
or anlzations, of
organizations, of which
whIch more
more than
than $10,000
$10,000 was
was provided
provided by
b the
the related
or anlzatlons? IfIf "Yes,"
'Yes' attach
attach schedule.
schedule. ►
~ 1 I Yes i X I Wo
-.----------------------------~----------------------------------------------------------------------
Form 990 (1997) THE HEIMLICH
I l i i C T i f Other Information Yes No
7876 Did Didthe organizationengagein
the organization engage in any anyactivity
activitynotnotpreviously
previouslyreported
reportedto theIRS?
to the IRS?IfIfYes,'
'Yes.'attach
attacha detaileddescripliORof
a detailed eachactivity
description of each activity X
I-'-~_-+--=-=-_
78
7777 Wereany
Were changesmadein
any changes made in the theorganizing
organizingor governingdocuments
or governing documents but butnotnotreported
reportedto theIRS?
to the IRS? ~~~ffi$~rr77
"Yes.'attachaconformed
IfIf"Yes,' attach a conformed copy copyofofthe thechanges.
changes. p
7878aa Did Didthe theorganization
organizationhave unrelatedbusinessgross
have unrelated business gross income incomeofof$1,000$1.000orormore moreduring
during thetheyear
yearcovered
covered by bythis
thisreturn?
retum? .. 78a
bb IfIf*Yes,"
"Yes,'hashas ititfiled
filedaatax laxreturn
returnon on Form
Form990-T 990-T for torthis
thisyear?
year? 1:f!.I.lJ:.........
N/A 78b
}-!.::.t:.....l---t-:-:--
79 Was
79 Wasthere thereaaliquidation,
liquidation.dissolution,
dIssolutIon,terminatIon,or substantialcontractionduring
termination, or substantial contraction during the the year?
year? . 79
JfIf Yes,"
'Yes; attach
attachaastatement;
statement;
80 aa IsIsthe
80 Iheorganization
organizationrelated (olherthan
related (other lhanby byassociation
associationwith with aastatewide
stalewldeor natfonwideorganization)through
or nationwide organization) through common common membership,
membership,
goveming bodies,trustees,
governing bodies, trustees, officers, officers, etc, to any other exemptor nonexemptorganization?
exempt or nonexempt organization?..,, .. 80a
bb If11"Yes,'enter
Yes," enter the the nameof the organization ~ -------------------------;=""'i"-----"""F==;----
name of the organization ► ,
_^___^___ andcheck
and checkwhether 0
whether itItisis I I exBmptOR 0
exemptOR\ I nonexempt
nonexempt.
;
81aa Enter
81 Enterthe amountofofpolitical
the amount pOliticalexpenditures,direct
expenditures, direct or orindirect,
Indirect.as describe!!in
as described in the
the \
instructionsfor
instructions torline
line81 81 . I 81a | P_
bb Did Oldthe organizationflle
the organization Form1120-POLforthis
fileForm 1120-POL. tor thisyear? year? . 81b X
82 a Didthe organizationreceivedonatedservicesor the use of materials,equipment,or facilitiesat
82 a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially less than no charge or at substantiallylessthan
faIrrental
fair rentalvalue?
value? .. 82a
b IfIfYes,"
"Yes,'you rnaylndicate the value oflhese items here. 00 notlndude this
you may indicate the value of these items here. Oo not include this amount as revenue in Part) or as an amount as revenueIn Part I Dr an
expensein PartII.II.(See
(Seeinstructions forreporting
reportingininPart PartIII)
III) .. | B2b I
\
expense in Part instructions for 7 5 , OOP
83aa Did
83 Oidthe organizationcomply
the organization comply with with thethepublic
public inspection
Inspectionrequirementsfor
requirements for returns retums andandexempUonapplications?
exemption applications? .. 83a
bb Did Didthe organizationcomply
the organization comply with w~hthe thedisclosure
disclosurerequiramentsrelatfngto
requirements relating to quid quid pro quo
quo contribulfons?
contributions? 83b X
I-"'=-t.....:;;.;'-l--:-:--
84aa Did
84 Oldthe organizationsolicit
the organization solicit anyanycontributions
contributions or or gifts
gifts that
that were
werenot not tax
tax deductible?
deductible? ~mlmWl\~w
p
84a X
bb IfIfYes,'
"Yes,'did theorganization
did the organizationinclude include with withevery
everysolicitation
solicitation an anexpress
expressstatementthat
statement that such suchcontributions
contributions or orgifts
giftswere
werenot
not
taxdeductible?
tax deductible? 'f!.I~ . 84b
N/A
85
85 501(C)(4),
501 (c)(4), (5), or
or (6) orQanizalions.
organizations. - a W&resubstantiallyall
Were substantially all duesnondeductibleby
dues nondeductible by members?
members? 'f!.I..l!'!:
N/A 85a
I-"'=-t---t--
b DidDidthe organizationmake
the organization make only only in-house
In-houselObbyingexpendituresof
lobbying expenditures of $2,000 $2.000 orless?
or less? N/A
N/A .. 85b
IfIfYes'
'Yes'was wasanswered
answeredto eitller85a
to either B5a or or 85b,
aSb,do donot not complete
complete8ScIhrougl18511
85c through 85h below belOWunless
unlessthe organizationreceived
the organization receiveda waiverfor
a waiver proxy tax
for proxy tax K? *■
owedforlhe
owed prioryear.
for the prioryear.
^
c Dues,
Oues,assessments,and
d Section
assessments, and similar
Sectlon162(e)162(e)lobbying
lobbyingand
Similaramountsfrom
amounts from members
andpolitical
politicalexpenditures
expenditures
membars , .
, .. 55d
85c N/A
N/A
m ■ ft ^
e Aggregate
Aggregatenondeductibleamount
nondeductiblB amount of ofsection 6033(e)(1HAl dues
section6033(e)(1)(A) dues notices
notices N/A
~=..;r----......,="-::--~
B58
Taxableamount
f Taxable
g Does
Doesthe
amount of oflobbying
lobbying and
organizationelectto
the organization
andpolitical
elect to pay
politioalexpenditures
paythe
expenditures(line
section6033(e)
the section 6033(e) tax
(Iine85d
tax on
85d less
on the
less 85e)
85e)
the amountln
amount in 85f? 851?
.. 85f N/A
N .lJ:
N/A
mm )-'<':.L..j_--+__
h IfIf section 6033(0)(1)(Al duBS

section6033(e)(1)(A) cues notice
notice werewere sent,
sent.doesdoes the the organizationagreeto
organization agree to add add the
the amount
amount In in 85t
85f toto its
its reasonableestimateof
reasonable estimate of dues dues
allocableto
allocable nondeductiblelobbying
to nondeductible lobbying and andpolitical
expendituresfor forthethefollowing
followingtaxtaxyear?
year? ~.t.~ .N/A.. 85h
86
86 501 (C)(7) organizations.·
501 (c)(7) organizations. - Enter Enter.
aa Initiation
InitIationfees and capital
fees and capitalcontributions
contributions Includedon
Included on line 12 12 ~=:.!!.....I---
86a N/A __
--::.::-:..,~
b b Gross
Gross receipts,included
receipts, included on line
line 12.for
12, for public useof
use of club facilities
facilities 66b N/A
1-"'=-I--------::.::-:..,-::--~
87 501(c)(12)
87 501(c}(12) organizations.-Enter
organizations.- Enter: aa Gross GrossIncometrom
Income from members membersor or shareholders.
shareholdal'L .. 87a N/A
b Gross
GrossIncomefrom
income from other othersources.
sources.(Do (Do notnot net
net amounts
amounts due due or or paid
paidto to other
other sources
sources
againstamountsdue
against amounts due or received receivedfrom tnem)
from thBm.) .. 87b N/A
B8
88 At anytime during the year. did the organizationown a 50% or grealerinterest
At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or partnership? in a taxablecorporation or partnership?
IfIf Yes,"
'Yes,' complete
completePart PartiX IX . 88
6S a 501 (c)(3l organizations.- Enter.Amount of
89 a 501(c)(3) organizations. - Enter Amount of tax imposed during the year under. tax imposedduring the yearunder:
section4911
section 4911"" ►■ 0 • ;section
P_i.; section4912 4912....► 0 • ;;section
P_^ section4955 4955 ► .... 0O..
b 501(c)(3)
501(c)(31and 501(c)(4) organizations.
and 501(c)(4) organizations.-Did - Did thethe organization
organization engage engagein in any
any section4958
section 4958 excessbenefit
excess benefit "■• <
transactionduring
transaction during the the year?
year?IfIf Yes,"
'Yes,' attach
attachaa statement
statementexplainingeachtransaction
explaining each transaction . 89b
c Enter
Enler.Amount
Amount of of tax
lax imposed
Imposedon on thethe organization
organizationmanagersmanagers or or disqualified
disqualifiedpersonsduring
persons during the the year under
year under
sections4912,4955,
sections 4912, 4955. and and 4958
4958 > 00 .•
dd Enter.
Enter:Amount
Amount of tax In 89c. 89c, above,reimbursedby
above, reimbursed by the the organization
organization > 0•
90 aa Ust
90 Usl the states
stales with which aa copy of ofthis retum Is
this return is filed ~ ► ... ..9J~J.Q.
.OHIO ]", >.. r ..
2
bb Number
Number of of employees
employeesemployedin
employed in the pay payperiod
period that tilat Includes
IncrudesMarch 12,1997 12, 1997 I. 9°P
90b .\
91
91 Thebooks
The arein
books are care at
in care of .... JOAN STEINBERG Telephone no ►
. Telephoneno. ( 5 1 3 )559-2391
► ;::..J..::O;::..AN=.;......;::.S,;;;;T,;;;;E;.;:;I:;.::N.:.:B::,;E::.R=G;__
~ (513) 559-2391
located at
located ► 311
at .... 3 1 1 STRAIGHT
STRAIGHT STREET
STREET CINCINNATI,
CINCINNATI, OHIO
OHIO ZZIP
I P+4 ~_4_5_2_1_9
+ 4 »>45219 _
92
92 Section4947(a)(1)
Section nonexemptcharitabletrusts
4947(a)(1) nonexempt tiling Form 990
charitable trusts filing 990 in
In lieu of Form 1041.- Check
Checknere
here. ►0
□
and enterthe
and enterthe amount of
ot tax-exempt
tax-examptjnterest receivedor
Interest received accruedduring
oraccrued during the tax year
yBar .." "".. I 92
92 I N/A
N/ A
723041
723041
!J3.12·98 5
03-12-98
11021001 758050
758050 23-12053HEI
23-12053HEI 062
062 THE HEIMLICH
INSTITUTE FOUNDAT
FOUNDAT 23-12051
23-12051
11021001
, THE HEIMLICH 3 - 7303161
223-7303161 Page6
rorm 990
Form 990 (1997) ' THE H E I M L I C H IINSTITUTE FOUNDATION
N S T I T U T E FOUNDATION Page 6
Analysis of lncorne-Producinq
l-l*isii^ftl Analysis of Income-Producing Activities Actlvltles
grossamounts
Enter gross
Enter amountsunless
unlessotherwise
otherwise Unr! latedbusiness
Unrelated businessincome
income Exc:luledby
Excluded bvsection
section512,513,
~12. !l13,or514
or ~
(E)
JC)
Indicated.
indicated.
Programservice
93 Program
93
(a)
(a)
servicerevenue;
revenue;
Business
lu~g:SS
code
(B)
(B)
Amount
Amount
Exclu
sion
code
(D)
(D)
Amount
Relatooor
Belated or exempt
exempt
functionincome
function Income i
Ib)
lb)
Ie)
le)
(II)
It)
(e)
(8)
MedicarelMedicaldpayments
II) Medicare/Medicaid
(1) payments .••.•..••.•.•..•........•.....
(g) Feesand
(g)Fees tromgovernment
contractsfrom
and contracts agl1ncies ......
government agencies
MembershIpdues
94 Membership
94 duesandandassessments
assessments ..................~ ......
Inlereston
95 interest
95 onsavings
savingsandandtemporary
temporary
cashinvestments
cash investments •••••••••••••••••••••••••••••• 06 ••••••••••••••••
Dividendsand
96 Dividends Interestfrom securities ..................... l:_4
14 23,348.
96 and interest tram securities
m'}l~41:
97 Net rental income
(a)debt-financed
(a)
{b)not
(&)
Netrental
9a Net
98 income or
otherinv6stment income
99 Otherinvastment
99
or (loss) from
97 Net rental income or (loss) from real estate:
realestate:
property .....................................
dobt-flnancedproperty
notdebt-financed
debt-financedproperty
rental income
property .................................
or (loss)
(loss) from
from personal
personal property
property •..•..
income .......................................
Ml~1;VI:* -.':>^
% ". ,.* ^ * ^.~
i.:":\::.~,:·:,·:-,,:
■,*■*'•' \ °.:: ^^ : ..:: ~"> . I
-'
% C ^ ? 4 ^ o ^ ^ ^, . ^ '.^~:y:N"~~:1
i ^ V ^
GaInOr(loss)
1DO Gain
100 from sales
or (loss) from salesofofassets
assets
otherthan
other thaninventory
Inventory ................................................
, 18
18 553,605.
3,605.
101 Net
101 incomeoror(loss)
Net income (loss)from
from special events ..................
specialevents
Grossprofit
1 D2 Gross
102 profit or(loss)
or {loss) from
from sales
salesofofinventory
inventory .............
other revenue:
1 D3 Other
103 revenue:
aa
bb
B;
dd
ee
Subtotal(add
104 Subtotal
104
105 TOTAL
105
(addcolumns
columns (B),
(addline
TOTAL(add line 104,
(8), (O),
(0),and
columns (B),
104, columns (8), (D), and (E))
(0), and
'.':,':'
(E» .................. - * ^ ' * * »,'::-:
and(E)) * w .* * ^ * 0 . 111!; O._.
(El) ............................................................................................................
776,953.
6,953.
.. 0O.
776,953•
6,953,
.
Note: (Line 105 plus line 1 d, Part I, should equal the amount on line 12, Part i.)
H l l L J i I Relationship of Activities to the Accomplishment of Exempt Purposes
Lin No.
Line Is reported In
Explain how each activity for which income is in column (E) of Part VII contributed importantly
importantly to the accomplishment
accomplishment of the
the organization's
T tor such
exempt purposes (other than by providing funds for purposes).
SUCh purposes).
N/A
End-of-year
assets
Please
"""
SIgn
Here
Paid
Paid
Prepare!"s
Prepares Firm'ss name
Firm' name(or
{oryours
yours CLARK, , SCHAEFER, , HACKETT
HACKETT && CO. CO. EIN ► 3110800053
Use Only
Use Only iiff self-employed) k.....! 105
0 5 EAST FOURTH S STREET, SUITE 1600
T R E E T , SUITE 1600
and address
and "CINCINNATI re
C I N C I N N A T I , OHIO
OHIO ziP + 4 ► 45202-4093
723161
03-12-98
11021001 758050
11021001 758050 23-12053HEI
23-12053HEI 062 HEIMLICH INSTITUTE
THE HEIMLICH INSTITUTE FOUNDAT
FOUNDAT 23-12051
_.----------------.-------------------------------------------------------------------------------
SCHEDULEA'
SCHEDULE A1 Organization
Organization Exempt Under 501
Exempt Under 501 (c)(3) OMB
OMS No.
No. 1845-0047
1!S45-0047
(Form
(Form 690)
990)
(ExceptPrivate
(ExcBpt PrIvataFoundation),
FoundatIon). and and Section
SectIon 501(B),
501(e), 501(f),
501(1). 501{K),
5D1(k). 501 (n) or Section
501(n) Se~lllln 4947(a)(1)
0'
Department of Via
Department 111ft
Intern .. Revenue
Internal
Treasury
Tmastuy
R""enuft Service
Service ►Must ba completed
.... Must be complelall byby the
Supplementary
tl1aabove
above organizations
Charitable Trust
Nonexempt
organizations and
Trust
Information
aUaclledto
am' attached Ihalr Form
to their Form S90
990 (or Form 930EZ).
Fonn 990EZ).
1997
1997
Nameof
NamB the organization
of the organization Employeridentification
Employer number
JdenUllcallon number
THE HEIMLICH
FOUNDATION 23i7303161
23! 7303161
Compensation of
IjjjijijM Compensation of the
the Five
Five Highest
Highest Paid Paid Employees
Employees Other Other Than
Than Officers,
Directors, and
and Trustees
Trustees
instructi
(See instructions.) eachone.
(List each ona.IfIfthere
thereare
arenone, enter'None.')
(b) Title and average hours (d) ContriDutlons to (B)Expense
(a) Nameand
(a) Name address ()f
and address each employeepaid
of each employee paid empbyea benefit
morethan
than $50,000
$50.000
per week devoted to (c)
(c) Compensation
Compensation plans & deferred er
account and other
more position compensation allowances
NONE
NONE
Total number of other employeespaid

employees paid
over $50,000 0o .>..>A.st>AV ^..s „.?V^\...>...>.^.. ■>.■>..
jrjjjttll Compensation of the Five Highest
Five Highest Paid
Paid Independent
Independent Contractors
Contractors for
for>r Professional
Services
Namaand
(a) Name and address of each independentcontractor
Independent contractorpaid
paidmore
morethan
than$50.000
$50,000 (b) Type of service
(bl Type service Compensation
(e) Compensation
(c)
NONE
NONE
Totalnumber
Total number of
of others receiving
receiving over
over
0o
lHA
LHA Reduction Act Nolleo,
Paperwork Reduction
For Paperwork Notice, see
see page 1 of Ihe
thB Instructions
Instructions to Form 991)(or
ta Form 990 (or FlIrm
FormggO-EZI.
990-EZ). Schedule AA (Form gilD) 1997
(Form SOD) '997
723101
723101
03-12-9B
03-12·9B 77
11021001
11021001 758050 23-12053HEI 062
062 THE
INSTITUTE FOUNDAT 23-12051
23-12051
1997
Schedule AA (Form 990) 1997
Schedule THE HEIMLICH
I:iiffifi:-od
lîlJtll Statement About
Statement About Activities
Activities Yes No
Duringthe
During theyear,
year,has
hasthe
theorganization
orqanlzatlon attempted
attemptedto10Influence national,state,
Influence national, slale, or
orlocallegislatlon, any attempt
local legislation, Including any attempl to
to Influence
Influence public
opinion on
opinion on aa legislative
legislative matter or referendum?
referendum? , . 1 X
IfIf"Yes," enterthe
'Yes,' enter thetotal
lotal expenses
expensespaid or Incurred
paid or IncurredInInconnection
connection with
with the
thelobbying
lobbying acttvites.
actlvltes. ► $$ _
**r*
Organizatlonsthat
Organizations made an
that made anelection
electionunder
under section
sectlon 501(h)
501{hl by
by filing
filing Form
form 57685768 must
must complete
complete Part
PartVl-A.
VI-A. Other
Other
organizationschecking
organizations
thelobbying
the
2 During
Ouringthe theyear,
officers,creators,
officers,
checking"Yes,"
lobbying activities.
activities.
year, has
nas the
creators, key
affiliatedas
affiliated asan
keyemployees,
anofficer,
must complete
'Yes,' must
the oganization,
complete Part
oganization,either
employees, ormembers
officer,director,
or members of
director, trustee,
trustelt, majority
PartVl-B
of their
AND attach
VI-B AND
either directly or Indirectly,

their families,
majority owner,
owner, or
attach aa statement
indirectly, engaged
engagedin
families, or
or with
or principal
statement giving
with any
any taxable
giving a detailed description of
any of the following acts

in any
taxable organization
beneficiary:
princIpal beneficiary:
acts with any
organization with
with which
any of its
which any
Its trustees, directors,
any such
such person
person Is
^"sn*
f U>5i
irfcU
aa Sale,
Sale, exchange,
exchange,or or leasing of property? .
Lending of money
bb Lending money or
or other extension
extension of
of credit? .. 2b X
c Furnishing of goods, services, or facilities? , _2p_ X_
d Payment of compensation (or payment or reimbursement of expenses if more than $1,000)? , 2d X
ae Transfer
Transfer of of any
any part
part of
of Its
Its income
income or
or assets?
assets? . 2a
IfIf the answerto
1Manswer to any
any question
question isis "Yes
"Yes," attachaadetailed
* attach detailedstatement
exPlainingIhe transactions.
the transactions. .
33 DoesDoesthe organizationmake
Iha organization grants for
maxe grants tor scholarships,
fellowshIps, student
studentloans, etc.? ....]:,,'.
loans, etc.? r.';-;.... ~~!.~~.':-: ::t:C..
...l-r,»,:: ... f '~::d!•.~
rt\-.y.....W.V.'.lV.-...>..-..Z.....\.':^....-.v.!
vH \\'i \
„ , , A .. }~.JiL.\
4 Attach a statement
4 Attach statement explaining explaining how the organization
organization determines that individuals or organizations receiving grants or loans trom It
from ft inIn vX*.
0S Sj*,-,.,-,
furtherance of its charitable programs qualify to receive payments. (See instructions.)
I t ^ & i M Reason for Non-Private Foundation Status (See instructions.)
organizationIs
Tho organization
The not aa private
is not prtvatefoundation becauseftit isis (please
foundation because (pleasecheck only ONE
cllacl< only applicable box):
ONE applicable box):
5Ii □
D Achurch, convention
Achurch, convention of of churches,
churches, orassociation
or,assoclation of of churches.
churches. Section
Secllon 170(b)(1)(A)(i).
170{b)(1)(A)(i).
66 □
0 AA school.
school. Section
Section 170(b)(l
170(b){ll(A)(ii). (Also complete
){A)(fT). (Also complete Part PartV,
V, page
page4.)
4.)
77 □
0 AA hospital
hospital or or aa cooperative
hospital service
Section 170{b)(1
170(bl(1 )(A)(iI~.
)(A)(iii).
88 □
0 A Federal,state,
AFederal, state, or or local
local government
government crgovernmental
or governmental unit. Section 170(b)(1)(A)(v).
unit. Section 170(b)(1 )(A)(v).
9gOA □ research organization
A medical research
and slate ~
and slate P~
operatlld in In conjunction withWiUl a hospital.
hospital. Section 170(b)(1){A)(iII).
170(b)(1)(A)(iii). Enter the hospital's
hospital's nama,
name, city,
city,
_
10
10 □
0 An organization
An organizatronoperatlld
(Also complete
(Also cOl11Jllate
for the benefit
operated forthe
the Support Schedule
the
benefit of
Schedule in
of aa college or university owned or operated by aa governmental unit. Section 170(b)(1)(A)(iv).
In Part
Part IV-A.)
170(b)(1)(A)(iv).
m
11a [Xl An organizationorganizationthat
Section
normally receives
that normally
receivesa
170(b)(ll(A)(vl). {Also complete
substantial part
a substantial
complete the Support Schedule
part of its support from a governmental
Schedule In Part IV-A.)
in Part
governmental unit or from the the general
general public.
11b
12
n
0
□
0
community trust.
A community
organizationthat
An organization
Section I70(b){1
trust, Section 170{b){1l(A){vi),
normally receives:
that normally
)(A)(vi). (Also complete the Support Schedule In Part IV"A.)
Ifceives: (1) (1) morB
mora than 331/3%
331/3% of of its
IV-A.)
lts support from contributions, membership
membership fees, andand gross
receiptsfrom activities
receipts activities related
relatedto its charitable,
charitable, etc.ate.•functions exceptions, and (2)
functions - subject to certain exceptions, mora than 331/3%
(2) no more 331/3% of of
its support from gross investment Income Income and unrelated
unrelated business
business taxable
taxable Income
Income (less
(less section
section 511 tax) from businesses
businesses acquired
acquired
by the
by the organization
organl'Z3tionafter 30.1975. See
after June 30,1975. Seesection (AlSOcomplete
section 509(a)(2). (Also complete the Support Schedule In Part Part IV-A.)
IV-A.)
13
13 0
CD An organization
An organization that is not controlled by any
any disqualifiad
disqualified persons
persons {other
(other than foundation managers)
managers) and
and supports organrzations
described in:
in:
lines 5 through 12
(1) lines 12 above; or 12) section 501(c)(4),
(2) section 501(0)(4). (5), or (6),
(6). if they meet the test of saction
section 509(a)(2).
509(a)(2). (See section 509(a){3),)
509(a)(3).)
PrOvidethe
Provide about the supported organizations. (See
the following information about (See instructions
instructlons on page
paglt 4.)
4.)
Una number
(b) Line
lalNamels\ of supported
(a)Name(s^ SUDoortodoroanizatlonls\
organization^) above
from above
14 0|
I organization organized
An organization organized and operated
operated to test for
tor public safety. Section
Section 509(a)(4).
509(a)(4). (See
(Sse instructions on page
page 4.)
723111
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11021001 758050
11021001 758050 23-12053HEI
23-12051
Schedule A (Form 990) 1997 THE HEIMLICH INSTITUTE FOUNDATION 23-7303161 Page33
$m&!ffiB Support Schedule <Complete only if you checked a box on line 10,11, or 12 above.) Use cash method of aci:ounting.
Note: Yuu may use ihe worksheet in the instructions forconvertinq from the accrual to the cash method of accounting.
Calendar year (or fiscal year
(a) 1996 (b) 1995 frj) 1994 (d) 1993 Total
(e) Total
t g QIRs, grants, uid contributions received.
(Do not include unuiual grants. See
27'8,164. 114,010. 5 , 2 7 44. •.
885 1190
9 0 , 0020.
20. 6667
6 7 , 4468.
68.
16 Membership fees received
17 Gross
17 Grossreceiptsfrom admissIons,
receiptsfromadmissions,
merchandisesold
merchandise sold ororservices
servlces
partormad, or
performed, orfurnishing
fumlshing of of facilities
I
ininany
anyactivity
activitythat
thatisIsnot
notaabusiness
business
unrelatedto
unrelated theorganization's
to the organIzation's
charitable,etc., purpose
charitable, OSII
GrassIncomefrom
18 Gross
18 Interest,
income from Interest,
dividends,amounts
dividends, receivedfrom
amounts received from
paymentson
payments securitiesloans
on securities (sec-
loans (sec
tion512(a)(5)),
tion 512(a)(5», rents,
rents,royalties,
royanies,andand
unrelatDdbusinesstaxable
unrelated In como
business taxable Income
(lesssection511
(less taxes)from
section 511 taxes) from
businessesacquiredby
businesses acquired by the the
afterJune
organization after June30,1975
30. 1975 43,138. 3 8 , 1125.
25. 228
8 , 9994.
94. 25,462. 135,719.
19 Net income from unrelated business
19
activities not included In line 18 ...
20 Tax
20 Taxrevenues
lINenueslevied
leViedfoe
Ibrtl1e organlzation's
ttieorganization's
benenl and
benefit ei~'Ietpaid
andeither 10ItItor
paid to expended
Of'expended
on Its behalf
21 The
21 Thevalueof servicesor
value of services or facilities
facilities
fumishedJo10the
furnished theorganization
organizationby by aa
govemmentalunit
governmental without charge.
unit without charge.
notinclude
00not
Do lncludethe
thevalue
valueof services
of services
orfacilities
or facilitiesgenerallyfurnished
generally furnished to
thepublic without
the withoutcharge
charge
22 OHier
22 OU,orlnccme. AttacIlli
Income. Attach schedule. Do
a schedule. 00 not
nat
Include gain
Include orOou)
gain or from sate
doss) from sale of
of capital
capital

24 Una 23 minus line 17 321,302. 152,135. 114,268. 215,482. ; ■ " .
803,187.
< *
25 Enter 1% of line 23 3,213. 1,521. 1,143. 2,155.

26 Organizationsdescribed
Organizations descrlbod in In lines
Jines10or 11: aa Enter
10 or 11: Enter2% of amount
2% of amount inIn column (e),
(el. line
llne 24 ►
~ 26a 16,064.
b Attacha
Attach list (which
a list (which isis not
not open
open toto public
public inspection) showing tho
inspection)showing the name
name of of and
and amount
amount contributed by each
contributed by eachperson
person (other than a
(0therthana
goYammentalunit
governmental lInit or
or publicly
publicly supported
organization)whose
whose total
total gifts
gifts for 1993 through
for 1993 through 1996 exceededthe
1996 exceeded amountshown
the amount shown
In Hne 26a.Enterthe sum of aJilheseexcessamounts
In line 26a. Enter the sum of all these excess amounts .. . 26b 518,616.
► \
cc Total
Totalsupport
support for section509(a)(~)
section 509(a)(1) test:
test: Enterline
Enter line24.
24, column
column(e)
(e) .26c 803,187.
Add:Amounts
dd Add: Amountsfrom
from column/eHorlinss:
column (e}forlines: 18 135,719.
1 35,719. 19
19 ► *• *
22
22 2Gb
2Gb 5518
1 8 , ,6616.
16 .. .. 26a 654,335.
eB Public support (line
Publlc support (line 26c
26c minus
minus line
line 26d
26d totsh
lotal) . ► 26s 148,852.
~ ~~f----::-:-::..f:..;;:.;:,.;::..=-
ff Public support percentage (line 2B
Public 2GB
a (numerator) divided byUna IIno 26c
26~ (denominator)
► 261 18.5327%
27
27 Organizatlonsdescribed
Organizations described onon line
line 12:
12: aa ForForamountsIncludedInlines 15,15,and
amounts included in lines 15,16, 17that
and 17 werereceivad
that were received from aa "disqualified
'disquali1i&dperson,"
person:
► attacha
attach a list 10show
to the name
show the name
of, and
of, andtotal amountsreceived
total amounts mcelvedIn yearfrom
each year
in each from each
each'disqualified person.' Enter
"disqualified person." Enterthe sum of
the sum of such
such amounts
amounts for
tor each
eachyear.
year. N/
N /A A
(1996)
(1996) (1995)
(1995) (1994)
(1994) (1993)
(1993) ..
For any
bb For any amount
amountincludedin line 17
included in line that was
17 that was received from aa nondisqualified
receivedfrom nondisqualifiedperson, attachaa listto
person, attach listto showtho
show tho name
name of,
of, and
and amount
amount received
rBeeNedfor eachyear,
foreach year,
that was
that wasmore thanthe
more than largerofof (1) the
the larger the amount
amounton Une25 for
on line tor the year or (2) $5,000.
tile year (Include in the
$5,000. (include the list organizations
organlzaUonsdescribedIn lilies 51hrough
described fn lines 5 through 11,
11, as well as
Individuals.)After
individuals.) computing the
After computing the difference
differencebetweenthe amountreceived
between the amount receivedand larger amount
and the larger amountdecribed
decribedln enterthe
(1) or (2). enter
in (1) the sum
sum of these
thesedifferences(the
differences (the
excessamounts)
excess amounts) fortor each
eachyear:
year: N N/ A A I
(1996)
(1996) (1995)
(1995) (1994)
(1994) (1993)
(1993) .
G c Add:
Add: Amounts
Amounts from
from column
column (e)
(e) for
for lines:
lines: 15
15 16
16
17
17 2D
20 21
21 ~ 27c N
N/A/A
Add: Une
d Add: Line 27a
27alotal
total ...... ......... andline 27b total
and line 27b total ~ 27d N /IA
A
e Public suppo rt {lina 27c, total minus line 27d tota 1) ► 27e N/A
f: Total
~~~:~:~~~~
suoport~~~~~~~o~ 509(a)(2) test: :~:rt:~~u~t~~
for section ~~;'(~;;~~~:~~ 'Ii~~' ·i~)..:::::::::..~'T..27;1$
23:'~~i~'~~
Enter amount on line 23. column (e) ► f 27f j $ ·· ii/A...... ~ ,;&{~t;M~1~'RHWi1t(:~~u~~i~
N/A
gg Public support
support percentage
percentage (line 27e (numerator) divided by line 27f, 271,(denominator»
(denominator)) 270
~ 27B N/A
N/ A % %
hh Investment
Investment Incomeincome Dercentalle
percentage !line (line 18
18 column
column (e) (e) (numerator) divided by
(numerator) divided by line 27f (denominator»
line 271 (denominator)) ~ 27h
► N/A
NI A % %
28 Unusual
28 Unusual Grants:
Grants: ForFor an
an organization
organlzaliondescribedIn line 10,11,
described In line 10,11, or or 12,
12.that receivedany
that received unusualgrants
any unusual during 1993
grants during 19931hrough 1996. attach
through 1996, attachaa list
Jist(WhiCh
(which Is
ii1not
notopento
open to
public Inspection)
public Inspection)for eachyear
for each showIngthe
year showing name of
the name of the
Ihe contributor,
contributor, thethe date
dateand amount of
and amount of the
the grant,
grant, and
and aa brief
brief description
description of
of the
the nature
natureof grant. Do
of the grant. Donot Include
not include
thesBgrantsIn
these lIne 15.
grants in line 15. (See
(SeeInstructions.)
instructions.) NONE
N ONE
723121
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_.------------------,-----------
ScheduleAtForm990) 1997
SchecluleA(Form~gO) 1997 THE
THE HEIMLICH
HEIMLICH INSTITUTE
23-7303161 Page
Page44
!'P:~itl\tt
' S ^ i V ? ' Private School Questionnaire
PrivateSchool Questionnaire
(To be ONLYby schools
be completed ONLY schoolsthat checked
che on line
the box on line 6
6 in Part
Part IV) N/A
Yes No
29 Does
Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, other governing
instrument,
lnstrumenl, or orinin aa resolution of its governing
resolutlon otlts body?
governing body? 29
b;~r.-.,-""""I=~
30 Doestha
Does the organization Includeinclude aa statement of otlts racially nondiscriminatory policy toward students in all its brochures,
its racially brochures, catalogues,
communications with the public dealing with student admissions, programs, and scholarships?
and other written communications scholarships? .. 30
31 Hasthe
Has the organization publicized
pubHcizeditsits racially nondiscriminatory policy through newspaper newspaper or broadcast media during thethe period of
solfcitation for
solicitation for students,
students, oror during
during the
the registratlon period Ifif itit has
registration period no solicitati()n
has /l0 solicitation program.
program, In
in a
a way
way that
that makes
makes the
the policy
policy known
known
to all parts of the general community It
to all parts of the general community It serves? serves? .. 31
If 'Yes:
"Yes," pleasedescribe;
please describe; If if 'No:
"No," please explain. (If{If you
you /lead
need more more space, attach a separatestatement.)
s
>
\
32 Doesthe
Does the organization maintain Ihe following:
the following:
a Records
a Records Indicating
Indicating the
the racial
racial composition
composition ofthe
of the student body, faculty,
student body, faculty, and
and administrative
staff? .. 32a
b Records Ilocumenting assistance are awarded all
documenting that scholarships and other financial assistance on a racially
nondiscriminatory basis? . 32b
c& Copies of aJlcatalogues,
alt catalogues, brochures,
brochures, announcements, and other
olner written ccmmunlcanons
communications to the public dealing with
with student
student
admissIons, programs, and scholarships? . 32C
d Copiesof
Copies of all material used by the organizatlon
organization or on its behalfto
behalf to solicit contributions? . 32d
If you answered 'No' to any of the above, please
answered 'No* please explain. (If
{If you need more space, attach a separate
separatestatement.)
statement.)
*-; *
8* *
,!>*»
33 Doesthe
Does the organization discriminate by race in any way with wHhrespect
respect to: * v •!'
a
a Students' lights or prlvneges?
Students'rights privileges? .. 333
b
b Admissions policies?
policies? . 33b
cC Employment of
Employment of faculty
faculty or
or administrative
staff? . 33c
d
d Scholarships or
ScholarshIps or other
other financial
financial assistance?
assistance? .. 33d
e
Educationalpolicies? , .. 338
Useof taciUlies? .. 33f
g
9 Athletic programs?
Athletic programs? . 33o
fi
h Other
Other extracurricular activities?
extracurricular actMUes? . 33h
answered "Yes"
If you answered "Yes' to any of the above, pleaseexplain.
please explain. {If
{If you
you need
need more
more space,
space,attach
attachaaseparatestatement.)
separate statement.) s
v.
34 a Ooesthe organization receive any financial aid or assistancefrom a govemmental agency? 34a
}-"-=-I----'I---
b Hasthe
Has the organization's right to such aid Elverbeen
over been revoked or suspended? . . 34b
If you answered
answered"Yes'
"Yes* to eilher
either 34a or b, please explainusing
explain using an attached statement.
35 Doesthe
Does the organization certify that ithas
it nas complied with the applicable
applicable requirements of sections 4.01 through
throug h 4;05
4,05 of Rev. Proc.
Proc. 75-50,
75-50,
1975~2C.B.587,
1975-2 C.8.587, covering racial nondiscrimination? If'Wo,'attach an explanation . 35
723131
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03-12·98 10
11021001 758050
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THE HEIMLICH FOUNDAT
23-12051
SCheduloA
Schedule A (Form 990) 1997
(Form gg(J) 1997 THE HHEIMLICH
THE E I M L I C H IINSTITUTE
NSTITUTE FOUNDATION
3-7303161 Pages
Pa 05
frp.~fl';V'~A':Lobbying Expendituresby
^ ^ l i M s } Lobbying Expenditures Electing Public
by Electing Public Charities
Charities
ONLY by an eligibleI organization that
(To be completed ONLY that filed
filed Form
Form 5768) N /A
N/A
Check here ► a U3 if the organization belongs to an affiliated group.
Check here ► b If vou checked "a" above and "limited control" provisions apply.
(b)
Limits on
Limits on Lobbying
Expenditures la)
(a) To
To be
be completed
completed for
for ALL
All
Affiliated group
Affiliated group totals
totals electing organizations
tann "expenditures"
(The term 'expenditures' means
means amounts
amounts paid
paid or
or incurred)
N/AA
3B
36 Total lobbying
expenditures to to influence
influence public
public opinion
opinion (grassroots
(grassroots lobbying)
lobbying) . 36
37
37 Total lobbying
axpendllures to to Influence
Influence aa legislative body (direct
(directlobbylng)
lobbying) . 37
38
38 Total
Total lobbying
lobbying expenditures
expenditures {add (add lines 36 and
lines 36 37)
and 37) .. 38
39
39 Other exempt
Other exempt purpose
purpose expenditures
expenditures 39
~~~ -+ _
40
40 Total
Total exempt
exempt purpose
expendItures (add (add lines 38 and
lines 38 and 39)
39) . 40
41
41 lobbying nontaxabls
Lobbying
IfIfthe
Not
nontaxable amount.
thB amount
over $500,000
Notove,$ljOO,OOO
on lino
amount on
amount. Enter
40 IsIs --
lino 40
Over$5W,000butnotover*l,CO0,0CO
,
OverS500,OOO but not IIVI>I'$l,ooo.OOO
Over$1,000,0006utnotavBr$1,500,000
OverS1,OOO,OOO l>ut not Dvsr$l,500,ooo
Enter thethe amount
amount from
Tho
trom the
the following
Tho lobbying
following table
lobbying nontaxable
. . . . . 20%oftoeamountonllne40
20% oflhe amount on 11"&40
$100,000
$100,000 plus
plus 15%
table--
nontaxable amount is ••
amount is
01111. excess over $1500.000

15% ofthtexcessover$SOO,000
$17S,O0Oplus1094of
S175,OOOp1U910% of tha«eessover$1,000,000
the "'ICI!S5 OV&,SJ,ooo.OOO
.
.. V
*|
}
41
^^B
^1-t^^S^VS.ôV
42
42
:::~~:::U.t.~.~:~~~~.~:.~:~~.:.:::::::::
Over $1,300,000 but jiotover$17,000,000
Over*17,000,000
Grassrootsnontaxabla
Grassroots amount (enter
nontaxabls amount
:::::::::iSIMt-+^5^gg|j_
:.~~:~~.~~.~:~.~.=~.~~~:~~=:=
(enter 25%
25% of
$225,000 plus 594 of thtsxcsss over $1,500,000
$1,000,000
ofllne41)
line 41)
1
J
42
I---":::...~
43
43 Subtract line 42 trom line 36. Enter -0- if line 42 is
Subtract line 42 from line 36. Enter - 0 - if line 42 is more
more than
than line 36
line 36 43
I---"~~ -+ _
44
44 Subtract
Subtract line
line 41
41 from
trom line
line 38.
38. Enter -0- ifHline
Enter-o- line 41 Is more
41 is more than
than line
line 38
38 .. 44
Caullon: //
Caution: If thsre is an amount on
there is on either
either line 43 or
line 43 or line
lina 44,
44, you must
must file
file Form 4720.
Form 4720. S mm&SISIS^^
4,Yoilr Averaging
4-Yoar Averaging Period
Period Under
Under Section
Section 501(h)
5Dl(h)
(Somo
(Somo organizations
organl7atlons that
Ihat made
made aa section
section 501
501 (h) election
ejection dodo not
not have to complete
complete all
all of the five columns
five columns
below. See
below. See the
the instructions
instructions for
for lines
lines 45
45 through 50.)
Lobbying During 4-YBar
Expendllures During 4-Year Averaging
Avaraglng Period
Parlod N
N/ A
Calendar year (or (iI)
W (b) Ie) (d) (B)
llscalyear beginning In) ► 1997
1997
(b)
1996
1996 1995
1995 m
1994 Total
Tolal
1994
45 Lobbying nontaxable
O.
mam
amount
46 Lobbying ceiling amount
4B
. V ^ O.
{150% of line 45(e))
47 Total lobbying
47
expenditures ., _0_
O.
48
amount 0,
O.
49 Grassroots ceiling amount
49
(•150% of line 48(e))
fÂ^^>S>.
.> ,<v S#.
Vv.*S'*4 SSfPSl j A * 3V) _0,
O.
50 Grassroots lobbying
expenditures O.
0,
i j j j j j i i i i Lobbying Activity by Nonelecting Public Charities
(For reporting only by organizations that did not complete Part Vl-A) N/A
organization attempt
During the year, did the organization attempt to Influence
Influence national,
national, state or local legislation,
including any attempt
attal1)fJtto
to
Yes No Amount
influence public
influence publlc opinion
opinion on a legislative
legislative matter
matter or referendum,
roforendum, through
through the use of:
a Volunteers
Volunteers .
management (include
b Paid staff or management (Include compensation
compensation In expenses reported
reported on lines c through
through h)h) ..
c Media advertisements
advertisements , .
d Mailings
Mailings to members,
members. legislators,
legislators, or the public
public .
eD Publications
Publications or published
published or Dr broadcast
broadcast statements
statements _ ..
, Brants
Grants to 10 other
o!hf;'r organizations
organizatJons for lobbying purposes
torlobbyfng purposes I--l--l---------
g Direct contact
contact with
with legislators,
legislators, their
their staffs,
staffs, government
government officials,
Officials, or a legislative
legislative body
body , ..
demonstrations, seminars,
h Rallies, demonstrations, seminars, conventions,
conventions, speeches,
speeches, lectures,
lectures, or any other means ..
I Total lobbying
expenditures (add lines JInescc through
through h) ..
%mmm o.
IfIf "Yes"
"Yes' to
to any
any ofof the
the above,
above, also
also attach
attach a statement
statement giving
giving a detailed
description of of the
the lobbying
activities.
723141
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11
11021001 758050
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FOUNDAT 23-12051
23-12051
Schedule
Schedule AA (Form
(Form 930)
99Cl)19971997 THE HEIMLICH
THE HEIMLICH INSTITUTE INSTITUTE FOUNDATION FOUNDATION 223-7303161
3-7303161 Page6
Page 6
j.Paft.:Vua Information
Mjresflflre Information Regarding Regarding Transfers Transfers To To and
and Transactions
Transactions and and Relationships
Relationships With With Noncharitable
Noncharitable
51 Did
51 Didthethe reporting
reporting organization
organization directly
directly or indirectly
Indirectly engage
engagein any of the
in any the following with
with any
any other
other organization
organiution described
described in In section
section
501(c)
50~ (c) ofofthe
theCoda
Coda (other
(other than
than section
section 501(c)(3)
50l{c){3) organizations)
organizations) oror in
In section
section 527,
527, relating
(Illallng to
to political
political organizations?
organizations?
aa Transfers
Transfersfromfrom thethe reporting
organizationto to aa noncharitable
noncharitable exempt organization
organization of: Yos No
Yes No
{!)
(I} Cash
Cash , . 5la(l)
51a(l) X
X
(H)
(II) Other
other assets
assets . a(il)
a(lI) X
X
b Other
Othertransactions:
transactions:
(i)
(I) Sales
Salesofof assets
assetsto to aa noncharitable
noncharitable exempt
exempt organization
organization bll)
. 6(1) X
X
(ii)
{II) Purchases
Purchasesof of assets from aa110ncharitable
assetsfrom noncharitable exemptexempt organization
organization .. 13(11)
b(lI) X
X
(Hi)
(iii) Rental
Rentalofof facilities
facilitiesor or equipment
equipment . MM)
b(lll) X
X
(iv)
(Iv) Reimbursement arrangements
Reimbursementarrangements b(iv)
. b(iv) X
X
Iv) Loans
(v) loans oror loan
loan guarantees
guarantees .. b(v)
b(vl X
X
(vi)
(vi) Performance
Performanceof of services
servicesor or membership
membership or or fundraising
fundraising solicitations
Solicitations . b(vl)
b(vll X
X
I: Sharing of facilities, equipment,
Sharingoftacflitios, equipment, mailing
mailing lists,
lists, other
other assets,
assets,or Drpaid
paid employees
employees ., , . c
I: X
X
d ifIUhe answerto
the answer to anyanyofcttne aboveisis Yes,'complete
the above 'Yes: completethe thefollowing
following schedule.
schodule.Column
Column <b)
(b) should
should always
alwaysIndicatethe fair market
indicate the fair market value
value of
oHhe
the
goods, other
goods, otherassets,
assets,or servicesgiven
or services givenbyby the
Ihe reporting
reporting organization.
organization. If thBthe organization
receivedless than fair market
less than marketvalue
value inIn any
any
transactionor
transaction or sharing
sharing arrangement,
arrangement,showshow inIncolumn
column (d)(dl the
the value
valueofot the
the goods,
goods. other assets,
assets, ororservices
servIcesreclllved.
received. N/A
N/A
(a) (b)
(b) te) (d)
Lineno.
Line no. Amount involved
Amount Involved Nameof
Name noncharitableexempt
of noncharitable exempt organization
organization Description
Descriptionofof transfers,
transfers, transactions,
transactions, and
andsharing
sharing arrangements
arrangements
52 a Is the organizationdirectly
:15 thB organization directly or Indirectly
indirectly affiliated
affiliated with, or relatedto,
related to, one or more tax-exempt organizations
organizations descrioedIn
described in section 501(c)
501 (c) at
of the
the __
Code(otherthan
Code(other than section
section 501(c)(3)) orin
orin section527?
section 527? ► Q 0 Yes [X] No
DO No
b ifIf Yes,*
'Yes: completethe
complete the following
followingschedule
schedule. NNI A/A
(a)
(a) (b)
(n) Ie)
Nameof
Name organization
of organization Typeof
Type of organization
Description of
of relationship
relationship
72315'
723151
03-12·98
03-12-98 12
12
11021001 758050
11021001 758050 23-12053HEI
INSTITUTE FOUNDAT
FOUNDAT 23-12051
23-12051
- ~ ------ ....---------------------------------------------------------------------------
,
OMB No. 1S45-0172
Form 4562
4562 Depreciation and
Depreciation and Amortization
Amortization
(IncludingInformationon
(Including UstedProperty)
Information on Listed Property) 990
990 1997
1997
Deportmentofof
Department 111.
ttie Treasul)'
Treasury Attachment
InternalRevenueService
Internal Revenuo Service ►~ Attach
Attachthis
thisform
10nnto yourreturn.
to your return. Sequence No. 6 7
~Jame(s)shown on retum activitytoto
Business ororactivity wnlchthis
wnich Inisform
formrelates
relales Identifying number
Namefs) shown on return
THE HEIMLICH INSTITUTE FOUNDATION FORM 990 PAGE 2 '3-7303161

IUltM Election To Expense Certain Tangible Property (Section 179) (Note: If you have any 'listed prop8rty.'complBt6 Part V before you completa Part I.)
Maximumdollar
Maximum dollarlimitation.
limitation. IfIfan
anenterprise
enterprise zone
zonebusiness,
business, see
seeinstructions
Instruotions . 18,000.
Totalcost
2 Total costofofsection
section 179 property piaced
179property placedinInservice
service ..
3 Threshold
Thresholdcost
costofofsection
section 179179property
property before
beforereduction
reduction inInlimitation
limitation . $200.000
4 Reduction
Reductionininlimitation.
limitation. Subtract
Subtract line
line33from
fromline
line2.2.lf zerooror[ess,
If zero less,enter o-
enter-0- .
5 Dollar
Dollarlimitation
limitationfor
fortax
taxyear.
year.Subtract
Subtract line
line44from
fromlineline1.1.IfIfzero
zeroororless,
less.enter
enter-e-,
-0-. IfIfmarried
marriedfiling
filing
separately, see Instructions ,
(a) Description of property (b) Cost (business use only) (c) Elected cost
% $ & & & ■
m
77 Usted
Llsted property.
property. Enter
Enteramount
amount from
from line 27
line27 .. ! 7_
Total elected
88 Total elected cost
cost of
ofsection
section 179 property. Add
179property. Add amounts
amounts inIncolumn
column (c), and 77
llnes66and
(c),lines .
Tentative deduction.
99 Tentative deduction. Enter
Enterthe
the smaller
smallerof ofline
lfne55or
orline
line8S ..
Carryoverof
10 Carryover
10 ofdisallowed
disallowed deduction
deduction from
from 19961996 _ . 10
11
11 Business Income limitation. Enter the smaller of business income (not less than zero) or line 5 11
12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 12
13 Carryover of disallowed deduction to 1998. Add lines 9 and lOJessllne 12 ► ) 13 s«?
Note: Do notvse Part II or Part III below for listed property (automobiles, certain other vehicles, cellular telephones, certain computers, or property
îîigiii
used for entertainment, recreation, or amusement), Instead, use Part V for listed property.
i ^ l J i W MACRS Depreciation For Assets Placed in Service ONLY During Your 1997 Tax Year [Do Not Include Listed Property.)
Section A - General Asset Account Election
14 ifIfyou
14 you are
aremaking
making the
the election
election under
under section
section 168(i)(4) to group
1680)(4)to group any
anyassets
assets placed
placed inInservice
service during
during the
the tax
tax year
yearinto
into one
one or
ormore
more general
general asset
asset —
accounts. check this box. See instructions " 0
SectionBB-- General
Section General Depreciation System (GDS) (See instructions.)
(b) Month and (c) Basis for depreciation {d) Recovery
Classl~caUonQf
(8)Classiftcation
(a) property
of property (business/investment use {d)Recovory (e) Convention (1)
(e)Convention M.tIIod
(I)Method Depreclalfon deduction
(g) Depredation
<g) c!educUan
period
period
only - see Instructions)
15 a 3-year property
b 5-year property
c 7-vear property
d
e
f
10-year property
15-year property
20-year property
Ml
q 25-year property 25yrs. S/L
/ MM27.5 yrs. S/L
h Residential rental property
h Residential rental property S/L
/ MM27,5 yrs.
/ MM S/L
NonreSidential real property
i Non residential real property MM S/L
/
Section C - Alternative Depreciation System (ADS) (See Instructions.)
16 a Class life S/L
b 12-year 12 yrs. S/L
c 40-year 40 yrs. MM S/L
j j j j f j j l i l Other Depreciation (Do Not Include Listed Property.) (See instructions.) I
17 GDS and ADS deductions for assets placed In service In

17 GDS and ADS deductions for assets placed in service in tax years beginning before tax years beginning before 1997
1997 17 6,945.
J-:..!...+--------~~-=:....:..
18 Property subject to section 168(f)(1)
18 Property subject to section 168(f)(1) election election . 18
19 ACRS
19 ACRSand and other depreciation 19
l & H i t i V i Summary (See instructions.)
20 Listed Listed property.
property. Enter
Enter amount
amount from from line
line 26 . 20
21 Total.
21 Total. Add Add deductions
deductions onon line 12, lines
line 12, lines 1515 and
and 16
161n column (g),
in column (g), and lines 17
and lines through 20.
17 through 20. Enter
Enter here
here
and on
and on the
the appropriate
appropriate lines
lines ofof your
your return.
return. Partnerships
Partnerships andand S corporations' - see
S corporations mnru~:!EUE!,.=.:;"""'.:..:..:..:."""""""".:..:..:..:.:.....l.~.!.....:
see Instructions. 21 6,945.
22 For assets shown above and placed In service during the
22 For assets shown above and placed in service during the current year, enter the current year. enter the I
portion of the basis attributable to section 263A costs 1 22
« « ! » :
lHA For
LHA For PaperworkReduotionAct
Paperwork Reduction Act Notioe,see
Notice, see the
the separate
instructions. Form4562(1997)
Form 4562 (1997)
~~'\B
716251
rvj-T2"-98
16
16
11021001 758050 23-12053HEI 062 THE HEIMLICH INSTITUTE FOUNDAT 23-12051
23-12051
11021001 758050 23-12053HEI 062 THE HEIMLICH INSTITUTE FOUNDAT
~ • a. ~. _
Form 4562 (1997) Page 22

'3§§K$&0 Listed Property - Automobiles,
Listed Property Automobiles, Certain Certain Other
Other Vehicles,
Vehicles, Cellular
Cellular Telephones,
Telephones, Certain CertaIn Computers,
Computers, and and Property
Property Used
Used for
for
Entertainment,
Entertainment, Recreation,
Recreation, or or Amusement
Amusement
Note: For any vehicle
Note: vehicle for which
which you you are using
using the
the standard
standard mileage
mileage raterata or deducting
deducting lease expense,
expense, complete
complete only
only 23a, 23b, columns
23a, 23b, columns (a)
through (c) of Section
through Section A, all of Section
Section B, and and Seatlon
Section C If applicable.
applicable.
23a Co
s r
eClon A
Section
Do you
youhave
-
0 epreclation and
A - Depreciation
haveevidenceto
and Other
evidence to support
support the
Information ({Caution:
Other Information
the businesslinvestmant
Caution: See Instructions
business/Investment uusese claimed?
Instructions for
claimed? Dves□ Yes DNo
for limits
□
for passanger
limits for
No I 23blf
passanger automobi
23blf 'Yes
automobiles.)
'Yes,''Isis the
Ies.)
the evidence
evidence written?
written? DvesL
I I Yes I I No NnJ
(a) (b)
IW Date (c) (d) (e)
W | (f) (g>
(9) (h) (i)
Type of
Type property
of prope~ placedin
placed in Businessl
Business/ Cost or
Cost Buis for
B»sis for lIaprecJaticn
depreciation j Recovery
R 8C overy Mathe!!!
Method/ Depreciation
Depreciation Elected
Elected
vehicles first)I
(list vehiclestirs
{list Investment
Investment
service use percentage other basis
(busJnosS/lnvt!!ltment I
(business/investment narinii
pariod
pBn0a Convention
Convention deduction
deduction section 179
section
percentage useonty)
use only) 1 cost
24 P roperty use
Property usedd more
more than
than 50
50% % in
In a qualified
( ua lfiIled business
business use:
I : , %1
%'
: , %
%
: : %
: : %
% :
25 Property used 50% or less in a qualified business use:
25
%
%
S/L-
S/L-
SfSSIf
* t % S/L-
% S/L-
26 Add
Add amounts
amounts In column
column (h). Enter the the total
total here
here and
and on line 20,20, page
page 1■ . 1 26 ^ $ & &
27 Add
Add amounts
amounts In column total here and
column (i). Enter the total c>n line
and on line77, page 1 1 27
Section
Section B - Information
Information on on Use
Use of Vehicles
Vehicles
Complete this
Complete this section
section for vehicles
vehicles used
used by a sole proprietor,
proprietor, partner,
partner, or other
other 'more
'more than
than 5%
5% owner,'
owner," or related person.
related person.
you provided
If you provided vehicles
vehicles to your
your employees,
employees, first
first answer
answer the
the questions
questions In
In Section
Section C
C to
to see
see ifif you
you meet
meet an
an exception
exception to
to completing
completing this section for
this section
those vehicles.
those vehicles.
(a)
<a) (b)
lb) (c)
(o) (d) (e) (f)
W
Totalbusiness/inv8slment
28 Total business/investment m iles driven during
miles duringthe the Vehicle
Vehicle Vehicle
Vehicle Vehicle
Vehicle Vehicle
Vehicle VehIcle
Vehicle Vehicle
Vehicle
year (DO NOT include commutingmiles)
year(DONOTIncludecommullng miles)..................
29
29 Total
Total commuting
commuting miles mnes driven
driven during
during the year ...
the year
30 Total
Total other
other personal (noncom muting) miles
personal (noncommuting) miles
driven
driVen...............................................................
31 Total
Total miles
miles driven during the
driven during the year.
year. ,
Add
Add lines 28 through
through 30 ....................................
Ves
Yes No
No Yes
Ves No Yes ,
Yes
No Yes
Ves Noo
N Ves
Yes No Yes
Yes No
32
32 Was the
the vehicle
vehicle available
available for personal
personal use use
!1 I, ,
during hours? ..................~
off-duty hours?
during off·duty ..................
33 Was
Was the
the vehicle
vehicle used
used primarily
pl1marlJyby by a more
more
than 5%
than 5% owner
owner or related person? ,..,
related person? ..............
34 another vehicle
34 Is another vehicle avanable
available for for personal
personal
..
U3e? ., ,.................................. ,......................
use?
Section C - Questions
Section Questions for for Employers
Employers Who
Who Provide
Provide Vehicles
Vehicles for
for Use
Use by
by Their
Their Employees
Employees
Answer these
Answer these questions determine if you
questions to determine you meet
meet an exception
exception to completing Section 8
completing Section B for vehicles
vehicles used
used by employees
employees who
who are
are not
not more
more than
than 5%
5%
owners or related
owners related persons.
rrersrcmst,
Yes No
35 Do you
33 you maintain
maintain aa written
written policy
policy statement
statement that
that prohibits
prohibits all
all personal
personal use
use ofof vehicles,
vehicles, including
including commuting,
commuting, by
by your
your
employees?
employees? .
36 Do you you maintain
maintain aa written
written policy
policy statement
statement that
that prohibits
prohibits personal
personal use
use of
of vehicles,
vehicles, except
except commuting,
commuting, byby your
your
employees? instructions for
employees? See instructions for vshlclas
vehlcies used corporate officers,
used by corporate directors, or 1%
officers, directors, % or
ormore
moreowners
owners _ ..
37 Do you you treat
treat all use
use of vehicles
vehicles by employees
employees as personal
personal use?
use? .
38 Do you you provide
provide more
more than
than five
five vehicles
vehicles toto your
your employees,
employees, obtain
obtain information
information from
from your
your employees
employees about
about
the
the use of the the vehicles,
vehlcles, and retain
retain the information received?
the Information received? _ _ .
39 Do you you meet
meet the
the requirements
requirements ccncemlnq.quallfled
concemingiqualified automobile
automobile demonstratIon
demonstration use?use? _ ..
Note: If your answer
Note: answer toto 35,36,37,38,
35, 36, 37, 38, or 39 Isis 'Yes,'
'Yes,' you need
need not
not complete Section
Section B for
for the
the covered
covered vehicles.
vehicles.
i | { ^ j | | | f f Amortization
(a) (b) (0 (d) (e)
Description of costs OaMinwtizalon Cods Amortization
begins Amortizablo section ptrtodwperctnaos far this ye»r
amount
40 Amortization of costs that begins during your 1997 tax yean kW,r**^
41 Amortization of costs that began before 1997 41

42 Total. Enter here and on "Other Deductions' or 'Other Expenses" line of your return
i·le252:!!.~~~~~~~!!!.::!!!..~~~~~~~:!._~~~:!:!:!~~~~~~~~~ . 42
....."""''''''''........,.==-~~..l...2L1.---------
7162S2 V 7
(13-12·98
03-J2-&S J. /
11021001
11021001 758050
758050 23-12053HEI
23-12053HEI 062
062 THE HEIMLICH
INSTITUTE FOUNDAT
FOUNDAT 23-12051
23-12051
THE HEIMLICH
THE HEIMLIeH INSTITUTE
23-7303161
FORM 990
FORM 990 GAIN
GAIN (LOSS)
(LOSS) FROM
FROM PUBLICLY
PUBLICLY TRADED
TRADED SECURITIES
SECURITIES STATEMENT
STATEMENT 11
GROSS
GROSS COST
COST OR
OR EXPENSE
EXPENSE NET
NET GAIN
GAIN
DESCRIPTION
DESCRIPTION SALES PRICE
SALES PRICE OTHER BASIS
OTHER BASIS OF SALE
OF SALE OR
OR (LOSS)
(LOSS)
SEE ATTACHMENT
SEE ATTACHMENT B
B 198,782.
198,782. 145,177.
145,177. o.
0. 53,605.
53,605.
TO FORM
TO FORM 990,
990, PART
PART I,
I, LINE
LINE 88 198,782.
198,782. 145,177.
145,177. o.
0. 53,605.
53,605.
990
FORM 990 CHANGES IN
OTHER CHANGES IN NET
NET ASSETS
ASSETS OR
OR FUND
FUND BALANCES
BALANCES STATEMENT
STATEMENT 22
DESCRIPTION
DESCRIPTION AMOUNT
AMOUNI
UNREALIZED GAINS
UNREALIZED GAINS ON
ON INVESTMENTS
INVESTMENTS 555,342.
5, 342.
TOTAL TO FORM 990,

TOTAL 990, PART I, LINE 20
20 555,342.
5, 342.
FORM 990 STATEMENT

STATEMENT OF ORGANIZATION'S
ORGANIZATION'S PRIMARY
PRIMARY EXEMPT
EXEMPT PURPOSE STATEMENT
STATEMENT 33
PART III
PART III
EXPLANATION
EXPLANATION
PERFORM RESEARCH
RESEARCH AND PROVIDE
PROVIDE EDUCATION
EDUCATION TO THE PUBLIC ON VARIOUS
VARIOUS DISEASES.
DISEASES.
13 STATEMENT(S)
STATEMENT(S) 1, 2, 3
11021001
11021001 758050
758050 23-12053HEI
23-12053HEI 062
062 THE HEIMLICH
INSTITUTE FOUNDAT
FOUNDAT 23-12051
23-12051
THE HEIMLICH
HEIMLICH INSTITUTE
23-7303161
FORM 990 STATEMENT PROGRAM SERVICE

STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS
ACCOMPLISHMENTS STATEMENT
STATEMENT 4
DESCRIPTION OF PROGRAM
DESCRIPTION PROGRAM SERVICE
SERVICE ONE
ONE
THE
'l'HEHEIMLICH INSTITUTE FOUNDATION,
HEIMLICH INSTITUTE FOUNDATION, INC..IS
INC. IS A CORPORATION
CORPORATION
DESIGNED CONDUCT SCIENTIFIC,
DESIGNED TO CONDUCT SCIENTIFIC, CULTURAL
CULTURAL AND
AND SOCIAL RESEARCH
SOCIAL RESEARCH
INTO ISSUES OF IMPORTANCE
IMPORTANCE TO THE MEDICAL AND SCIENTIFIC
MEDICAL AND SCIENTIFIC
COMMUNITIES.
COMMUNITIES. ITS PRIMARY
PRIMARY ENDEAVORS
ENDEAVORS INCLUDE
INCLUDE RESEARCH
RESEARCH INTO THE
THE
THE TREATMENT
TREATMENT OF CANCER, LYME DISEASE, EMPHYSEMA, AND
CANCER, LYME DISEASE, EMPHYSEMA, AND
CYSTIC
CYSTIC FIBROSIS.
FIBROSIS.
GRANTS
GRANTS EXPENSES
EXPENSES
TO FORM 990, PART III, LINE A
PART III, 34,400,
34,400.
FORM 990
990 OTHER INVESTMENTS
OTHER INVESTMENTS STATEMENT
STATEMENT 5
VALUATION
VALUATION
DESCRIPTION
DE:SCRIPTION METHOD
METHOD AMOUNT
AMOUNT
MARKETABLE SECURITIES
~~~KETABLE SECURITIES COST
COST 660,797.
660,797.
TOTAL
TOTAL TO FORM
FORM 990, PART
PART IV, LINE
LINE 56, COLUMN
COLUMN B 660,797
660,797.
FORM 990
990 OTHER ASSETS
OTHER ASSETS STATEMENT
STATEMENT 6
D:E~SCRIPTION
DESCRIPTION AMOUNT
AMOUNT
SECURITY DEPOSIT
S:E:CURITYDEPOSIT 10.
10.
WORKERS COMPENSATION
WClRKERS COMPENSATION DEPOSIT
DEPOSIT 132.
132.
ACCRUED
INTEREST RECEIVABLE ,174.
55,174.
TOTAL
TOTAL TO FORM
FORM 990, PART
PART IV, LINE
LINE 58, COLUMN
COLUMN B 5 ,316.
5,316.
14 STATEMENT(S)
STATEMENT(S) 4, 5, 6
11021001 758050
11021001 758050 23-12053HEI
FOUNDAT 23-12051
23-12051
REALIZED CAPITAL
GAINS AND
AND LOSSES
LOSSES AAccount
c c o u n t *# 006390287
6390287
JUNE 11., 1997

JUNE 1997 --MAY
MAY 331.1998
1 , 1998 HEIML1CH
HEIMLICH INSTITUTE,
INSTITUTE. INCORPORATED
INCORPORATED
FISCAL YEAR
FISCAL YEAR END
END
ACQUISITION PROCEEDS DOLLAR
DOLLAR DOLLAR
DOLLAR $$ GAIN
GAIN/I
QUANTITY
QUANTITY ASSETDESCRIPTION
ASSET DESCRIPTION DATE
DATE DATE
DATE COST
COST PROCEEDS
PROCEEDS LOSS
LOSS
SHORTTERM
SHORT CAPITALTRANSACTIONS
220
220 AVERYDENNISONCORPORATION
AVERY OENNISON CORPORATION 06118197
06/18/97 02/25/98
02125/98 8,590.01
8.590.01 11,112.25
11.112.25 2,522.24
2.522.24
175
175 DIEBOLD,INCORPORATED
OIEBOLO, INCORPORATED 06124197
06/24/97 04/30/98
04130/98 7,320.74
7,320.74 7,122.23
7,122.23 -198.51
·198.SJ
43
43 MERITORAUTOMOTIVE.
MER1T0R lNC.
AUTOMOTIVE, INC. 02128197
02/28/37 10/20/97
10/20/97 1,083.51
1,063.51 1,007.89
1,007.89 ·75.62
-75.62
0.333 MERITOR
0.333 MERITORAUTOMOT/VE, INC.
AUTOMOTIVE, INC. 02/28/97
02/28/97 J 0121197
10/21/97 8.39
B.39 8.17
8.17 ·0.22
-0.22
130
130 ROCKWELLINTERNATIONALCORPORATION
ROCKWELL (NEW)
INTERNATIONAL CORPORATION INEW) 02/26197
02/28/97 , 1114197
11/14/97 7,365.90
7.365.90 5,815.02
5.815.02 -1,550.88
'1.550.88
240
240 TEeOENERGY.
TECO ENERGY.INCORPORATED
INCORPORATED 09113196
09/13/96 06/09197
06/09/97 5,733.00
5.733.00 5,805.41
5.805.41 72.41
72.41
60
60 WASHINGTONMUTUAL,
WASHINGTON MUTUAL,INC.
INC. 04102/97
04/02/97 11106/97
11/06/97 2,875,44
2.875.44 4,049.86
4,049.86 1.174.42
1,174.42
100
100 WASHINGTONMUTUAL,
WASHINGTON MUTUAL. INC.
INC. 04/02197
04/02/97 03/05/98
03/05/98 4.792.40
4,792.40 6.781.79
6,781.79 1,989.39
1,989.39
300
300 WHITMAN CORPORATION
WHITMAN CORPORATION 04/21197
04/21/97 12116/97
12/16/97 7,141.68
7.141.68 7,760.65
7.760.65 61B.97
618.97
325
325 WORTHINGTONINDUSTRIES.INC.
WORTHINGTON INDUSTRIES, INC. 09126196
09/26/96 06/18/97
06/18/97 6,378.13
6,378.13 6.02B.22
6.028.22 ·349.91
-349.91
TOTALNET
TOTAL NETSHORT
SHORTTERM CAPITAL GAINS
TERM CAPITAL GAINS $51,289.20
$51.289.20 $55,491.49
$55.491.49 $4,202.23
$4,202.29
MIDTERM
MID TERMCAPITAL
CAPITALTRANSACTIONS
TRANSACTIONS
230
230 SIGMA·ALDRICHCORPORATION
SIGMA-ALORICH CORPORATION 01130/97
01/30/97 05/27/98
05/27/98 7,245.00
7.245.00 8,629.31
8.629.31 1,384.31
1.384.31
TOTALNET
TOTAL NETMID
MID TERM
TERMCAPITAL
CAPITALGAINS
GAINS $7,245.00
$7,245.00 $8,629.31
$8.629.31 $1,334.31
$1.384.31
LONGTERM
LONG CAPITALTRANSACTIONS
120
120 COAESTATESfiNANCIAL
CORESTATES CORPORATION
FINANCIAL CORPORATION 05130196
05/30/96 06117197
06/17/97 4,754.76
4.754.76 6,838.14
6,838.14 2,083.38
2,063.38
110
110 EEM
MC C CORPORATION
CORPORATION 05129/96
05/29/96 03/10/98
03/10/98 1,214,95
1.214.95 3,869.05
3.B69.05 2,654.10
2.654.10
100
100 ECHLlNINCORPORATED
ECHLIN INCORPORATED 08/17/94
08/17/94 06/24/97
06/24/97 3,120.50
3.120.50 3,499.45
3.499.45 378.95
378.95
100
100 GGTE
T E CORPORATION
03/09/92 07/17/97
07/17197 3,051.50
3.051.50 4,533.91
4,533.91 1,482.41
1.482.41
75
75 GGTE CORPORATION
T E CORPORATION 12/28194
12/28/94 07l17{97
07/17/97 2,313.75
2.313.75 3.400.43
3,400.43 1.086.68
1,086.68
60
60 GENERALELECTRICCOMPANY
GENERAL ELECTRIC COMPANY 09124193
09/24/93 09/19/97
09/19/97 1.427.48
1,427.48 4.196.26
4,196.28 2.768.78
2,768.78
30
30 OENERALRE
GENERAL CORPORATION
RE CORPORATION 03/18/92
03/18/92 08114/97
08/14/97 2,768.28
2.768.28 5.B32.48
5,832.48 3,064.20
3.064.20
25
25 GENERALRE
GENERAL CORPORATION
RE CORPORATION lOr22193
10/22/93 08114/97
08/14/97 2,925.63
2.925.63 4,860.41
4,860.41 1,934.78
1.934.78
15.000
15,000 GTEWISCONSIN
GTE WISCONSIN 06/05/91
06/05191 03/31/98
03/31/98 13,899.90
13.899.90 15.193.50
15,193.50 1,293.60
1.293.60
7.750 %
7.750 DUE06/01/03
% DUE 06/01103 DATED
DATED 06/01/73
06/01/73
10,000
10,000 HAWAIIAN TELEPHONE
HAWAIIAN TELEPHONECOMPANY
COMPANY 04/16187
04/16/87 10/01/97
10/01/97 8,677.80
8,577.80 10,000.00
10.000.00 1,422.20
1.422.20
FIRSTMORTGAGE
FIRST MORTGAGE
6.750 %
6.750 DUE04/01/98
% DUE 04101198OATED
DATED 03/28/63
03128/68
200
200 HEWLETT-PACKARDCOMPANY
HEWLETT-PACKARD COMPANY 08110194 11/21/97
08/10/94 1112H97 4,020,00
4,020.00 12,674.32
12.674.32 8,654.32
8,654.32
200
MCDONALD'S CORPORATJON 05/05(95 10/09/97
05/05/95 10/09/97 7,289.00
7.289.00 9.363.B1
9,363.81 2,074.81
2,074.81
20.000
20,000 PROVINCEOF
PROVINCE ONTARIOGL08AL
OF ONTARIO BOND
GLOBAL BOND 06117193 10/29/97
06/17/93 10129/97 19,947.20
19.947.20 19.960.40
19.960.40 13.20
13.20
6.125 %
6.125 DU: 06/2B/00
% DUE 06/28100 DATED
DATED 06/17/93
06/17/93
200
200 REGIONSFINANCIAL
REGIONS CORPORATION
FINANCIAL CORPORATION 06111193
06/11/93 05/26/98
05/26/9S 3,200.00
3.200.00 8,324.72
8.324.72 5,124.72
5.124.72
100
100 SCHERING·PlOUGHCORPORATION
SCHERING-PLOUGH CORPORATION 12/02/94
12/02/94 05/26/98
05/26/98 1,875.38
1.875.38 8,633.46
8.633.46 6,758.08
6.758.08
200
200 SHERWINWILLIAMS
SHERWIN COMPANY
WILLIAMS COMPANY 12117/92
12/17/92 01/21/98
01121/98 3,095.50
3.095.50 5.369.14
5,369.14 2,273.64
2,273.64
200
200 SHERWJNWILLIAMS
SHERWJN WJLLIAMSCOMPANY
COMPANY 06/28/93
06/28/93 01/21/98
01121/98 3,161.00
3.161.00 5,369.14
5,369.14 2,208.14
2.208.14
TOTAL
TOTAL NET
NET LONG
LONGTERM
TERMCAPITAL
CAPITAL GAINS
GAINS $86,642.63
$86.642.63 $131,918.62
$131.918.62 $45,275.99
$45.275.99
MID TERM
MID TERMCAPITAL DISTRIBUTIONS
0 JOHNSONOPPORTUNITYFUND
JOHNSON OPPORTUNITY FUND 12/30/97 763.60 763.60
TOTAL MID TERM
TOTAL TERM CAPITAL
DISTRIBUTIONS $0.00 $763.60 $763.60
reoort summarizes
This report summanzes Ibe the portfolio transactions
transacnons for your convenience.
convenience.
guarantee its
We do not guarantee apprconatanesa for use
Its appropriateness use in tax preparation.
preparanon.
. __.. '.. ..,._ ,'-

< tt .' \ .
~ '; '- • .. ~'I '(
.11.
,,-,.
•
I
'.
J
_
Johnson Investment
Counsel,Inc.
Inc. '. ,
REALIZED CAPITAL
GAINS AND
AND LOSSES
LOSSES Account# 0 606390287
Account* 390287
JUNE 1. 1997 _ MAY 31. 199B

JUNE 1 , 1997 - M A Y 31 1998
HEIMLICH
HEIMLICHINSTITUTE,
INSTITUTE.INCORPORATED
INCORPORATED
fiSCAL YEAR END
FISCAL YEAR END
PROCEEDS
ACQUISITION DOLLAR
DOLLAR DOLLAR
DOLLAR $ $GAIN
GAIN/ 1
QUANTITY ASSJ;T DESCRIPTION DATE
DATE DATE
DATE COST
COST PROCEEDS
PROCEEDS LOSS
LOSS
_ _ ^ _
LONG TERM CAPITAL DISTRIBUTIONS
LONG TERM CAPITAL DISTRIBUTIONS 1,978.57
00 JOHNSON OPPORTUNITY FUND
JOHNSON OPPORTUNITY FUND 12130{97
12/30/97 1,978.57
1.978.57 1.978.57
TOTALLONG
LONGTERM
TERMCAPITAL
DISTRIBUTIONS $0.00
$0.00 $1,978.57
$1,978.57 $1,978.57
$1.978.57
TOTAL

TOTAL GROSS PROCEEDS $198,781.59
$198,781.59
This report
summarizes the
the portfolio
portfolio transactions
transactions for
for vour
your convenience.
convenience.
We do
We do not
nor guarantee
guarantee its
us appropriateness
aopropnateness for for use
use in
m tax
tax preparation.
preparanon.
v ^ i .;
t I' _ ...
I· .- ._
Johnson Investment
Counsel.Inc.
Inc.
Revised: June
Revised: June 1998
1998
THE HEIMLICH
INSTITUTE
MUCH BOARD OF
BOARD OF TRUSTEES
TRUSTEES
INS1TTUIE 1998
1998
:mSTRAIGHT
311 STRAIGHT
*John Gall,
Gall, President
President (513) 751-9600
751-9600
STREET *John (513)
STREET
CINCINNATI
CINCINNATI Massachusetts Casualty Ins.
Massachusetts Casualty Ins.Co.
Co. (513) 751-9613
(513) 751-9613 (Fax)
(Fax)
OHIO
OHIO 2150 Gilbert
2150 Gilbert Avenue
Avenue (513) 221-8112
(513) 221-8112 (Home)
(Home)
45219
45219
513-559-2391 Cincinnati, Ohio 45206
Cincinnati, Ohio 45206
513-559-2391
FAX513-559-2403
FAX 513·559-2403
helmlich@iglou.com Philip M. Heimlich, Vice President
hefmlich@iglou.com Cincinnati City
Cincinnati City Hall
Hall
Philip M. Heimlich, Vice President
6680 Lyceum
6680 Lyceum Court
Court 801 Plum Street
801 Plum Street
Cincinnati, Ohio
45230 Cincinnati, Ohio
45202
(513) 352-3647
(513) 352-3647
(513) 352-4640
(513) 352-4640 (Fax)
(Fax)
Joseph J.J. Dehner,

Joseph Dehner, Secretary
Secretary &Jacobs
Frost &
Frost Jacobs
822 Yale Avenue
822 Yale Avenue 2500 Central
2500 Central Trust
Trust Tower
Tower
Terrace Park,
Terrace Park, Ohio
Ohio 45174
45174 Cincinnati, Ohio 45202
(513) 651-6800
(513) 651-6800
(513) 651-6166
(513) 651-6166 (Kathy
(Kathy Barrett)
Barrett)
(513) 651-6981
(513) 651-6981 (Fax)
(Fax)
"Cedric W.
*Cedric W. Vogel,
Vogel, Treasurer
Treasurer Vogel, Heis,
Vogel, Heis, Wenstnip
Wenstrup & & Cameron
Cameron
2270 Madison
2270 Madison Road
Road 817 Main
817 Street, 88thth Floor
Main Street, Floor
Cincinnati, Ohio 45208 Cincinnati, Ohio
45202 -- 2134
2134
(513) 421-4225
(513) 421-4225
(513) 639-2547
(513) 639-2547 (Fax)
(Fax)
"Henry J.J. Heimlich,

*Henry Heimlich, M.D.
M.D. The Heimlich
The Heimlich Institute
Institute
17 Elmhurst Place
17 Elmhurst Place 311 Straight Street
311 Straight Street
Cincinnati, Ohio
45208 Cincinnati, Ohio
(513) 559-2391
(513)
(513)
(513) 559-2403
559-2403 (Fax)
Mrs. Winston
Mrs. Winston C.
C. Atteberry
Atteberry
Box 629
Box 629
Eunice. LA
Eunice, LA 70535
70535
(318) 457-2705
(318) 457-2705
Benefiting
Benefiting • I George Blake
George Blake 768-8298 (Direct)
(513) 768-829S
Humamty
Humanity The Cincinnati
The Cincinnati Enquirer
Enquirer (513) 768-8079 (Fax)
(513)768-8079
Through
Through 312 Elm Street
Cincinnati. Ohio 45202
Cincinnati,
Health
Health
and
and >Aac
,\...1;\Cl( \ \, n,~,
\1' I_'
Peace
Peace Affiliated with
Affiliated with The
The Deaconess
Deaconess Associations,
Associations,Inc.
Inc.
\
". \.;..,:- \
:
------------,----------------------------------------------------------
Kathy
Kathy Carr
Carr (513)
(513) 871-2221
871-2221 (Work)
(Work)
Ray
Ray Carr
Carr (513)
(513) 621-4777
621-4777 (Work)
(Work)
3057
3057 Saddleback
Saddleback Drive
Drive (513)
(513) 231-3010
231-3010 (Home)
(Home)
lEINILICH Cincinnati,
Cincinnati, Ohio
Ohio 45244
45244 (513)
(513) 621-4771
621-4771 (Fax)
(Fax)
NSfflUTE
Mrs.
Mrs. Arthur
Arthur Murray
Murray (Kathryn) (808)
(808) 924-4094
924-4094
311
311 STRAIGHT 2877 Kalakuau
Kalakuau Avenue
Avenue
STRAIGHT
STREET
STRET
2877
ClNCINNATj
CINCINNATI Honolulu,
Honolulu, Hawaii
Hawaii 96815
OHIO
OHIO
45219
45219 Monte L.
513-55~2391 ' Monte
L . Rovekamp
R ove k an:'p P.O.
P.O. Box 19129
19129
513-559-2391
513-559-2403 2864
ffl.X513-55~2403
P\X 2864 Crescent Springs
Spnngs Pike
Pike Cincinnati,
Cincinnati, Ohio 45219-0129
45219-0129
ht~mlich@iglou.com Erlanger,
. heimlich@iglou.com Erlanger, Kentucky
Kentucky 41018 (606) 341-6050
341-6050
(606) 341-6950
341-6950 (fax)
William
William P. Sheehan (614)466-3206
(614) 466-3206
1673 Braintree (513) 231-7467
231-7467
Cincinnati,
Richard Weiland 2444 Madison Road, #1406

1055 St. Paul Place Cincinnati,
Cincinnati,
Cincinnati, Ohio 45202 (513) 421-8527
421-8527 -- 421-8430
421-8430
(513) 871-5248
871-5248 (Home)
(Home)
(513) 381-0124
381-0124 (Fax)
Harry W. Whittaker
Whittaker Gradison & Co.
Co.
2497 Grandin Road
Road 580 Walnut Street
Cincinnati,
Cincinnati, Ohio 45208 Cincinnat, Ohio 45202
45202
(513) 579-5000
579-5000
(513) 579-5982
579-5982 (Fax)
Anson Williams
Williams (213) 850-2685
850-2685 (Office)
24615 Skyline View Drive (213) 657-4861
657-4861 (Home)
Malibu, California 90265
Dr. Paul Winchell

Winchell
Westlake Village,
Village, California 91361 (818) 991-5754
991-5754
Benefiting *
Benefiting These trustees
These trustees have the discretion
discretion as 10
to the distribution
distribution of contributions.
contributions.
Humanity
Humanity
Through
Through
Health
Health
and
-Vttl'A
Peace
Peace Affiliated with The Deaconess
Affiliated Deaconess Associations.
Associations,Inc.Inc.
· ,
THE HEIMLIC
THE HEIMLIC! "NSTITUTE
-~STITUTE
'FOUNDATION
'FOUNDATION 23-7303161
23-7303161
SUPPLEMENTARY
STATEMENTS
PART:III LINE:3
PART:III LINE:3
Patient need
Patient need for
for financial
assistance isis
determined on
determined on an
an individual
individual basis.
basis.
Each patient•s
Each patient's ability
ability to
to meet
meet medical
medical and
and
related expenses
related expenses is
is reviewed
reviewed in
in terms
terms of
of referral
referral
information or
information or through
through investigation
investigation by
by the
the
foundation itself.
foundation itself.
S-UV Wo ScV\ A P+ TH- f

"
SHORT PERIOD
SHORT PERIOD RETURN
RETURN- C-mme_ ' \r\
- Ctalrwe, . \(\ o..C.LCU( "'J'~' ~f"u'':c\
CMLLOafPJ^^Ciod
.-J '-.), OMSNo.
No.ia*a»Q047
11!o&aoOO47
;:'orm
Farm 990
990 Return of
Organization Exempt
Und.rf i••c tetlan S01(c:)
Exempt From
01the
From Income
Income Tax
InternalRevenue
Tax
RevenulCode
Codl (except blacklung
(Ixcept black lungbenefit
benefit
OMB
~@98
1198
Under i o n 501(c) of the Internal
trult ororprivate
truat prIvatafoundation)
foundation) ororaectlon
.. etlon 4847(a)(1)
4G47(a)(1)nonexempt chlrlt.bl. truat
nonexempt charitable tru.t Tnli Form It
~'DIftIT'.M
SiOinrPtrt :t ~~.
at:»» "!"'•• lUry
Trtuury Optn to Public
irntrrti ~."""t.'
:1"t1'''',..113 «vtnn 3arvici
Note; Tha organization may havo :o uao a^Soy or this
3<rvici Wnra a racarilng naulnmants, Impwtlort
A Far the 1898 oilendir year, OR tax year period beginning 1-1 , 1098, And •ndlng 12-11 jfl_2S_
a Check:(:
PI....
Pt«lM C N«m< of orginizitlon ^,;, / =jg> D Imploytr Idantjflfletton nuinbtr
UUHI"S
HSHS
O Chirgt of icoriti 1.~I~~~~~~~~T~U~~~~~~~~~~~~~
T q F HFTMTTrff TM^TTTTTTF VOTTOTUTTrW ~ __ ~ __ 1-~?~~-k~~~'_
^ : 7303161 _
I I I H I or
~r1"1or Numctr»na
Inajtrwt
mHt (or
(orP.O.
?O. oox
:lOX.f.,.titi)
:,,.11'.
■■»net
notaillver.u
aailvarw:0:oslr"1
»trwt10ar... II'Scam/iuiti
~OOml'Ult. I Ttlaprione number
[_] initial rtturn flrlrn
V/o*.~.
of Numc»r iacr»«»i
L J Final -»turn
' ■ Arrtndtd -itum
~P~I~o~~~~~~~~~~~~----------------------~------~~~~~~D~~~--
$ft
3#*
SpMlflo
'n,wo"
inttnjo-
I 1 "T'sn-sqq-27io'!;'
City zt town, state or country, ano ZIP*-* FprChtck

ChllClC *■• .xtmc~onao
itIItxtmctlon application
plication
:r*quir*o aiaa 'or tloni.
~IQnL , T T T '. ~ 'l 1 a itilganaing
g."IlI"Q
•tat* ■•cortingj rT\rr wTAT OR O ^'''iQ
Q Tycecf crganizat!Qn—»"3 Sxampt uncer section 501(c]( 3 ) ^ (Insert .turncar) OR > i_j section 4947(a)(1) nonexempt charitable truat
Note: Section 501(cj(3) exempt organizations and 4947(a)(1) nortoxamot charitabla trvata MUST attach a compMad Schtdula A (Fcrm 990).
H(II) 'a'5rrira
H(a) :t115
a~grouo
:;;rcuo'eturn
'9lum 'Ned
'i1&<:l
'oraffili
'or 3Hi1iato~?•
atea? D Yas C 3 No I ~11t1er
ifif aither nox n
Sox .nHHis1$clacked
c!'Iecked*Yea,"
"Y~ •enter
enlerfour-digit
~cur~git group
group
9xomellon numcer
axamction "umller ;GEN)
;GEN)*» ., ••••• , ••• ""., ••••••• " •••••
[bl if!f-Yes."
[b( 'Yes," enter
enrar:ne
:t1enumcer
numcer of
otaffiliates
affiliates for
'orwmen
wnlch this
thISreturn
:elurn ia15~IO():,
Sled:. . • >,. JJ Accounting
Acccununq .-natnad:
,"'ett1oo: a0 Cash
Cash ~ Accrual
U3 Accrual
(el :5 :nls a seoarate '!!!Um Wed by an CtganfZ,:lllonc::vered :lY a grouo ,.Wing?
(c) s tnis a separate -eturn filed by an organization covered oy a group fining? [ j Yas Q No
Yes '[j.'Jo 0 O 0 Cmer 'soacify)
Ctner 'SO!!Clfy),..
> _ ^ _ _ _ _ _
KK Ch!!C)(nere
Checx hera *■ 0
,..L J ifItthe
:"a organization's
organlIStll,ln's gross recerots are
gross receiots are normally notmora
nOrmallynot than525,000.
more than 525,000.The
Theorganization
orqaruzancn need :1otfile
!'Ieeanot fileaaratum
(arumwitti the IflS:
WIththe IRS;but
but ififititreceived
received
aa-orm ~90Package
=-;,rm990 P'3Cl<aga inin:na
:namail.
mall,:t:tshould
should *ila
'ile a3return
return without
·...lthout financial
~nanclalJala.
csta, Senna stat" require
Some states completll return.
r~uire aillcomplete retlJm.
Note: Form 33Q-EZ may Oe used oy organizations with gross receipts less than 51QQ.CQQ ana total assets less :han 3250,000 at end of year,
Revenue, Expenses, and C h a n g e s in Net Assets or Fund Balances iSee Specific Instructions on page 13.)
I
Contributions. gifts,
II 1 Contributions, gifts. grants,
grants. and and similar
similar amounts
amounts received:
received:
a Direct public
! a Direct public support support , la 18,016
b Indirect public support 1b I
I b Indirect public support
cc Government
Government contributions
contributions (grants) (grants) 1c
I
I d Total
(cash S
(cash
(add
$
lines 1a through 1c) (attacn
d Total (add lines 1a through 1c) (attach schedule of contributors)
r.oncasn $$ ---
noncash
schedule of contributors)
-l
) . 1d 13,016
I 22 Program service revenue :ncluding govemment fees and
Program service revenue including government fees and contracts (from Part VII, line 93) contracts (from Part 'III. line 93)
Membership dues
3 Membership dues and and assessments
assessments , ^ V t H i ^ i l i V I ' R ' I I"
Interest on savings and temporary cash cash investments
investments . . . ■ f j H S l l | | ^ " f \ l « :
II :
4 Interest on savings and temporary
Dividends and
5 Dividends
6a Gross
6a Gross rents rents
and interest
interest from from securities
securities
L§S
30,372
I Less: rental
bb Lass: rental expenses
expenses , Lj>S_
.,/:=i
cc Net
Net rental
77 Other
rental income
income or
ether investment
investment income
or (loss)
(Joss)(subtract
income (describe
(subtract line
(describe ►
line 6b
....
6b from
from line
line 6a)
6a) Ll?_
ii, —' ' ?._
,: 8a Grass amount trom sale at assets other f---:....:.....;_-----r---:,_----------~ (A) Secunties (B) Ctner
~I
»c:: i
8a Gross amount from sale of assets other
than inventory
than inventory 151.657 8a
c
b Less: cost or other basis and
b Less: cost or other basis and sales expenses. salesexpenses. f-~!:....!...l.2~~-~...=.:~~------------~
111,959 8b
C Gain or (loss) (attach schedule) . 39,698 3c
c Gain or (lass) (attach schedule) . . . .
d Net gain or (loss) (combine line 8c,
d Net gain or (loss) (combine line 8c, columns (A) and (B)) columns (A) and (8)) 39,698
9 Sj:lecial events and actiVities
} Special events and activities (attach schedule) (attach schedule)
aa Gross
Grass revenue
revenue (not (nat including
inclUding S 5 ; of
of
contributions reported
contributions reported on line 1a) on line 1a) . 9a
b Lass:
Lass: direct
direct expenses
expenses other other than than fundraising
fundraising expenses
expenses 9b i
Net income
0 Net Income or or (loss)
(loss) fromfrom special
special events
events (subtract
(subtract lineline 9b
9b from
from line
line 9a)
9a)
10a Grass sales of inventory, less
10a Gross sales of inventory, less returns and allowances . returns and allowances . 10a!
bb Less:
Less: cost
cost of of gopds
99Pds sold sold . 11(^b i
Gress profit
c0 Gross profit oror (loss) salesof
frem sales
\\055) from inventory (attach
af inventory (attachschedule)(subtractline
schedule) (subtract line 10b from line
lOb from nne 10a)
lOa) ..
11 Other
11 Other revenue
revenue (from (from PartPart VII,VII, line
line 103}
103)
12 Total
12 revenue (add
T(ltal revenue (add lines
lines 1d,1 2, 2. 3,
3. 4.
4, 5, 6c, 7,
S, 6c, ad 9c,
7, 3d, 9c. 10c.
lac, and
and 11)
11 88,086
13 Program services (from line 44, column (8» 13
'"OJ 13 Program services (from line 44, column (B)) . .
14 Management 14 28.723
'" 15 Management
<:
<D
14
FlJndraising
and general
and
(from
general (from
line 44.
(from line
column
line 44,
(0»
column (Q)
44, column (C)) .
, 15
0..
a.
>< 15 Fundraising (from line 44, column (D)) , . . . ■
U.I
X 16 Paymsnts to affiliates (attach schedule) , 16
ui
16 Payments to affiliates (attach schedule) . . . .
17 Total lines 16 t 6 and
and 44.
~.j.. column 17
17 Total expenses (add lines column (A))
...
0;18 E..,cess or
or (deficit)
(deticrt) for
for the
the year
year (subtract
(subtract line
line 17
17 from
from line
line 12)
12) .. . . . • 18
18 Excess
.,
'"19 Net assets or fund balances at beginning of year (from line 73. column
column (A))
(A) 19
< 19 Net assets or fund balances at beginning of year (from line 73,
20
Q 20 Other changes in net assets or fund balances (attach explanation)
Other changes in net assets or fund balances (attach explanation) . . . . 20 ., n 6 . 5 7 1
z 21 Net assets
assets or
or fund
fund balances
balances at
at end
end of
of year (combine
(combine lines
lines 18,
1 19,
19 and
and 20) 7ATf?71
21 Net 20) 21
For Paperwork Reduction Act
Act Notice,
Notice, see
see p
page 1 of
of the
the separate
instructions, Cat. NQ.
Cat. No. H2B2Y
11282Y Farm 9 9 0 (1998)
F or P a p e r w o r k Reduction age 1
Form
Form 990
990 (1998)
/1998)
Pag,
I:HIII
L SLlJ Statement of
Statement of All organizations .iiust complete
organrzatlOnsmust column (A). Columns (B), IC),
complele column (C), and
and(O)ate
(0) arerequired
reaurw for
forsection
section501(c)(3)
501(c)(3)and
and(4)
(41~ anarin*~
Functional
Functional Expenses and
and section
se-;tion 4947fa|(1)
.t947IaI11) notieaemot
ilOnaemot chamable
chamable irusts
~lS but
but optional for others.
O~llionallor tSee Specific
others. (See SPetlfic instructions
Instructions on page 1ypnea,c'
page 17.)
Co not
not include
include amounts
amounts reported
reported on line
an fine (Bl Program
(8) (C) Uanagemam
(A) Total
6b.
6b. abo
3b. 9b. t Ot»,or
9b. 10b, or 16 of Part
16 of Part I.I. (AI Total services
SSNrCes and gstwal P) Funaraoing
2
222 Grants and allocations
allocations (attach schedule)
schedule) .
'«sn SS
'casn _ noncasn 3S „
noncasn _
23
23 5Decilic assistance ro individuals
Soacific incflvlduals (ariacii
(arracn scneoulei
acneaufe
24
24 Benefits aard
3enetits said ,0 ;o cr
or for members
msmders (attach
(attacfi schedule].
schedule)
25
25 Ccrncensation
C a m c e n s a t i o n of officers.
officers, directors,
directors, etc.
etc.
26 Other saianes
ether salanes and w a g
wages .e s 54.346 40,759
27 Pension plan
Psnsrcn ccntnbutions
plan ccntnbutions I 27
23
28 Other amployee
employee benefits
benefits 28 5,376 4,032 I 1,344
29 Payroll taxes
raxes 29 3.856 2,892 964
30 ProfeSSIonal runcraismq fees
Professional funcraising tees r 30
31
3 1 Acccuntinq:ees
Accounting fees ' 31
32
3 2 L=gal tees
Legal fees 32 1.3-64 1,023 341
33
33 Sucplies
Sucpiies 33! 8.907 6,680 2,227
3
344 Telephone 34 I 117 95 32
35 Postaqe
Postage and shipping shipping j 35 JJJ 384 128
36 i' 36 6,924 2,308
Occupancy
Occupancy 9.232
37
37 Equipment rental and maintenance maintenance . . . . j 37
3
388 ?'inting and publications
Panting publications . i 38 122 91 31
39
39 Travel
i ravel 39 10,662 7,996 2,666
40 C..::nierences. conventions,
~O Conferences, c o n v e n t i o n s , ana meetings . 40
41
41 Interest.
Interest 41
42
42 Cecrec:ation.
- e c r e c i a t i o n . depletion.
depletion, src. etc. (attach scneouts)
scnedule) 42 I
43
43 Other 3xpenses (itemize):
Other expenses (itemize): a _. 43a;
EUSCHA5ED..SEHyXCEa.
b P'URCHd.SED.. SER.~r.CES. .. 43b! 20.380 I 15,235 5,095
c _ . 43cl
dd !43dl
44
44
e ......... -
iotallunctional
_ -
excensa laca
Total functional e~nStS iaca'illes
'ires 22
-
22:mcugn
_ _ .. -
'.rrcugn!JIOrganizations
^3) Organizations
i43e
IRIGINAL
.
■•.ontoleinq columns jBHD),carry thl!!!.totais
thtse.totals
to !Jilesio13-
lines
15 13-15
. 4.4 114.884 86,161 28.723
Reporting
R e p o r t i n g of 01 JJoint
oint CCosts.-Did
o s t s . — C i d yyou
o u rreport
e p c r t i·:ncolumn (B) (Program services) any
n c o l u m n (B) any joint
ioint costs from a combined
comcined
educational campaign and fundraising
ecucationai fundraising solicitation?
solicitation? .....
> D Yes 0 ca
[}1 NO
No
If "Yss." enter (i) (ij :he
the aggregate
aggregate amount
amount of these joint
01 these casts 3
JOIntcosts :; Oi) 'he
; (ii) amount allocated
!he amount allocated to Program
Program services S
$, _
t(iii)
i j f l j:he
h e aamount
m c u n r auccated
allocated to Management
Management and general general S 5 :; and
and Ii,,}
(iv) ~lieamount
'.he amount allocated
allocated ~aFundraisingS
»o Fundraising S
'I ~rf1
^ " l l l Statement
S t a t e m e n t of
o f Pro9!am
P r o g r a m Service
S e r v i c e Accomplishments
A c c o m p l i s h m e n t s (SeeSoecitic
( S e e S p e c i f i c Instructions
I n s t r u c t i o n s on cace
on p a g e 20.)
20.) ~
What
W h a t is the organization's primary exempt purpose? ►-
organization's primary , Program
Program ServicoSorvie©
Expenses
All organizations
All organizations must descnbe ,heir;heir exempt
exempt pureose
puroose achievements
achievements in a clear
clear and
and concise manner.
manner. State
State ~henumber
the number (RI!a~3' 501(c)(3) Vld
(RNWMtw am
of ciients
or cflents served,
served. publications
publications issued,
Issued, ate.
etc, Discuss
acruevements that
that are not
not measurable.
measurable. (Section
(Sectlon 501(c)(3)
501 (c)(3) and
and (4)
(4) (~u~~p!!'~~l~'
(4) sm, ami 4g47(iHD
organizations and -1947(a)(1)
organizatIons and 4947(a)(1) nonexemot
nonexemot cnantabrs
charitable trusts :nust
must also enter
enter tne
the amount at
of grants ana
and allocations
allocations to others.)
others.) truss: 0l1li1"11
aut cpntiiai (or
stfurs.)
a ........•....••..••. _.••.•••...• _.•...•.......•..•.......•......••.....•.......•.•............•..... _.•......•••••.••••••..
. .SEE. ATTACHED.....•.................................................
.SEE . .AI'll.CHED _..............•...•.......•...
...... - aliocatfon~i.. ·S······
"(Gra';ts'~iricj
(Grants and allocations S
.. ·..······ j.
2*5.848
25.848
b ~ ..
•AIDS.ilE
..... .)..IDS SEARCH.•..AND.
. .RESEARCH ANB.EDUCATION.
EDUCA1:IDN . , •.•.•.
...... ."((iran's' anci'<iliacatforis' "$'S
(Grants and allocations
""""j'
) i a ^77?
j 1R izz—.
e
c .EDU~1' ION ••OF.. G£.'1ERAL . .PUBLI C . .THE.. ER!NT D:IG. ..fu'ffi. D ISl'RI.Bll'I'.IDN .
.EDUCAIION..aF..GENEIUL.J?UBUC.XHE.ERI^ .or...En llC..A.l'ION•..
-LITERATURE. .TO. .PUBLIC.
.LI:tEUXURE •.TD.;P PLACES.. .d..BG.UTl1
UBLIC _.EUCES. ABGLUIH.:THE. HE.IMLICR.HA5ilEliy.EIU
..THE.. HE.IMLlCH. M.fu.'tEUV.ER _ .
.. - "{Gra'';ts'a'r;d'aliocai(ons" ·s···· ·.. ······r
(Grants and allocations S ) J±*5£l
d ..
................... - - - '{G'rants'
~i;;(;aliocat(oris·..Ss·····
···.. ··· .. ··.. ·· "'r
e
Other program services (attach schedule) (Grants and allocations $
f Total
_f__T o t a l at
of Program
S e r v i c e E;Yr"u"""'
P i n s n f l....
m I",h...".trl
tehnnw ~,...,
a~ ,~I r;M~ '.f ~" ..,,,,M (0\ ~._..----- ........ - .~--_\
ra\ a oz 1'::1
, Form 99Q (1998) Pago33
Paga
, Form 990 (1998)
l I@'a
l f f m j Balance Sheets
Balance Sheets(See
(SeeSpecific
SpecificInstructions
Instructions ononpage
page20.)
20.)
Note: Where
required. attached
attachedschedules
schedules andand
amounts
amountswithin the description
within the description (A)
(A) (8)
(B)
column should
column should be
be far
for end-of-year
end-of-year amounts
amountsonly.
only. Beginningof
Beginning year
of year Endofofyear
year
End
45 Cash—non-interest-bearing
45 Cash-non-interest-bearing . . . . . _A53_ 45 .50.
46 Savingsand
46 Savings andtemporary
temporarycash
cashinvestments
investments. 13,464 46
47a Accounts
47a Accountsreceivable
receivable. . . .
b Less: allowance for doubtful accounts
b Less: allowance for doubtful accounts 0
48a Pledges
48a Pledgesreceivable
receivable . . . .
b less: altowance
b Less: allowance for fordoubtful
doubtful accounts
accounts . .
49 Grants receivable.
49 Grants receivable . . . . .' 49
50 Receivables
50 Receivables from from officers,
directors, trustees,
trustees, and
and key
key employees
employees
(attachschedule)
(attach schedule). . . • _ . . 50
-
CQ
cD
<IJ
til
«
51a Other
51a
b
Other notes
schedule)
Less:
notes and
schedule). .
allowance
and loans
.
loans receivable
.
for
. .
receivable (attach
doubtful
. •
b Less: allowance for doubtful accounts . .. 51b
.
(attach
accounts
.
.
51a
52
52 Inventoriesfor
52 Inventories forsale
saleororuse use .
53 Prepaid expenses
53 Prepaid expenses and deferredand deferredcharges
charges .
54 Investments-securities (attach
54 Investments—securities (attach schedule) schedule)
55a Investments—land,
55a lnvestmente=ianc. buildings,
buildings, and
and
equipment: basis
equipment: basis. . . . . • 55a
b Less:
Less: accumulated-
(attach
schedule). • . . • , . . . 55b 55c
schedule)
56 invesnnents=omer(attach
56 Investments—other (attachschedule)
schedule) . . . • 660-7^7 751 Sflfi
57a Land, buildings, and equipment: basis .
57a 57a
Land, buildings, and equipment: basis . .
b Less: accumulated depreciation
b Less: accumulated depreciation (attach (attach
schedule). . . . • • • . . . 57b 9M.^7L
58 schedule)
Other assets (describe'" _
58 Other assets (describe ► s.nfi X 58
59 "Totatassets
59 Total assets (add lineslines45 45 through
throu 58) (must equal line 74) 7Q6.isq 59 7511sqfi
60~ 'Ace'ol-jnts.payable and accrued
60 Accounts payable and accrued expenses expenses . 60 ajas
61 Grants payable
61 Grants payable . . . . . . • . . . • • • . . . • . 61
(II 62 Deferred revenue
62 Deferred revenue ......•........ nD.IIi.?5~Hlh9""__---k-o~~-------- 62
~ 63 63 Loans
Loans from
from officers,
directors. trustees,
trustees, andand key
key employees
employees (attacf
'raftlct
:cIII schedule). ..
schedule). ..... ....
64a Tax-exempt
::i 64a Tax-exempt bondbond liabilities
liabilities (attach
(attach schedule)
schedule) 64a
b Mortgages and other notes payable
b Mortgages and other notes payable (attach (attach schedule)
schedule) . . . . . 64b
65 Other liabilities (describe j- _
2,711 65
65 Other liabilities (describe ► )
66 Total
66 Total liabilities
liabilities (add lines 60 through
lines 60 thro 65)
Organizations that fallow SFAS 117,
Organizations that follow SFAS 117, check here check here ► ... 0I1D and
and complete
complete lines
lines
<IJ 67 through 69 and lines 73
67 through 69 and lines 73 and 74. and 74.
~ 67 67 Unrestricted
Unrestricted.
c
~ 68 68 Temporarily
Temporarily restricted
restrtcted
III 69 69 Permanently
restricted • . . . . • •. .•.
-g Organizations
Organizations thatthat Ido
'do not
not follow
follow SFAS
SFAS 117,117, check
check here here ► ... D0 and
and
If complete lines 70 through
complete lines 70 through 74. 74.
(5 70 70 Capital
Capital stock,
stock. trust
trust principal,
principal. or or current
current funds
funds . . ~ . .
71 Paid-in or capital surplus, or land, building. and equipment fund.
and equipment fund . ..
(II
~w. 71 Paid-in or capital surplus, or land, building,

72 Retained earnings. endowment. accumulated income, or other funds
72 Retained earnings, endowment, accumulated income, or other funds
~
..... 73
73 Total
Total net assets or fund fund balances
balances (add lines 67 67 through
through 69 69 OR
OR lines
cD
Z 70 through
70 through 72: 72: column
column (A) (A) must
must equal
equal line
line 19
19 andand column
column (B)(8) must
must
equal line
equal line 21)
21) . . . . .• .
74 Total
liabilities and
and net
net assets
assets /I fund
fund balances
balances (add lines lines 66
66 and
and 73)
F~rm
Form 990 is available for public inspection
inspection and, for some people.
people, serves as the primary or sole
sale source of ~f information
inform,ation atout
about a
particular organization.
particular organization. How How the
the public
public perceives
perceives an an organization
organization in in such
such cases
cases may
may be
be determined
determined byby the,
the information
lntormation P«s«TOra
pr~se~tad
on its
on its return.
return. Therefore,
Therefore, please
please makemake sure
sure the
the return
return is is complete
complete and and accurate
accurate andand fully
fully describes,
describes, in
in Part
Part III,
III, the
the orqanizatlcn's
organizations
programs and
programs and accomplishments.
accomplishments. .
Form 990 (1998)
990 (1998J
.,'
Page
Part 1V-A Reconciliation
Reconciliation ofof Revenue
Revenue per per Audited
Audited Part IV-B Reconciliation of Expenses
Reconciliation of Expenses per
per Audited
Audited
Financial
Financial Statements
Statements with
with Revenue
Revenue perper Financial Statements
with Expenses
Expenses per
per
Return
Return (See Specific
ific Instructions,
Instructions, page 22.)
22 Return
Return
a Total revenue.
revenue, gains, and other support p W~~~-:---:;:To~t~a~I
Total --:e:x~p~en~s~e~s~a:n:d~:lo:s:s:e:s~p~e:r~~~
expenses and losses
per audited
audited financial
financial statements. .,..
.►la audited financial
financial statements ,• . ....
b Amounts included
included on
on line
line aabut
butnot
noton
on Amounts included on line a but but not
not
line 12.
12. Form 990:
990: on line 17,
17, Form 990:
990:
{1)
(1) Net unrealized
unrealized gains
gains (1) Donated services
(D
investments ., . .=$'--
on investments $_ _ and use of
of facilities s
S
(2) Donated services (2) Prior
(2) year adjustments
Prioryearadjustments
and use
use of facilities $
.:;;
§ _ reported
reported on line
line 20,
20,
(3) Recoveries of pnor Form
Form990990 ., . . . s
S
year grants
grcmts . . . .=$
$ _ (3) Losses
Losses reported
reported on on
(4) Other (specify): line 20,
20, Form
Form 990 . S s
(specify):
$
Add amounts
amounts on
on lines
lines (1)
(1) through
through (4) ....
> s
Add amounts
amounts on lines
lines (1)
(1) through {4)>
(4)....
cc Line
Une aa minus line b.
b. . . . Line
Une a minus line b . . .. .. . .....►
d Amounts included
included on
on line 12.
12. Amounts included onon line 17,
17,
Form 990 but
but not
not on
on line a: Form 990
990 but
but not
not on
on line a:
(1) Investment
Investment expenses
expenses (D Investment
(1) Investmentexpenses
expenses
not included on line
not included line not
not included
included on line line
Form990
6b. Form 990 . . . $_ .::::.$ _ 6b, Form990.
Form 990. , $
$
(2) Other (specify): (2) Other (specify):
(specify):
.................. _ ......... _ ... _--
s ........ _ ........ _ .... -_ ............ .- sS
Add amounts on on lines (1) and (2)
(1) and (2) ► Add amounts on an lines (1) (1) and
and (2)
(2) ►
....
Total revenue
e Total revenue perper line
line 12.
12. Form
Form 990
990 e Total expenses per per line 17, Form 990990 N/ A
(line
(line c plus
Ius line d) . . , . . ...... ► N/A
N/ A (line c pluss line dl d) . . . . ...
iVtnVM Officers, Directors,
List of Officers, Directors, Trustees,
Trustees, and Key Employees (List (List each one even :ff not compensated; see Specifi
Instructions
Instructions on page 22.)
22.}
(A)
(AI Name and
and address !! (BJweak
Title
Titte ana
(6) average
ana average hours
ncurs per
:0 position
cevoted '.a
week cevotec position
per
(C) Compensation
(e) Comcensation
(It not
(It n 01 paid, enter
paid. enter
(D) C~nlnilutions
10)
emDloyw
Conmbutions to
~DIO'!ee benefit
b et1efi1
to
clans 4&
ofsns
(E) Expense
[E) EXpense
account
account aand othe
nd o1he,
·O·,J
-0-.) JeienM camoensation
Jelene<l cnmOens<lllon allowances
~'.: Ij,
....................................... • ORIG
ORIG,INAl
IN " b e
.......... SEE
SE'E"ATTAC'HED'
ATTACHED 'LIsi
LIST .. ······ j
.... · .. ··· .. · ........ ·· .. · .. ·· .. · ........ · .. · .. ··· .. · .. · .. · .. · .. 1
.... ···· ·.. ·· .. ·· .. ···· .. ·.. · ······ .. ·.. ··· .. ·1

................................................................,
..··· · ·..· i
.. ···· ...... ··· .. ·· .. ·.. ····· .......... ·.. ·.. ········ .. ···· .... ·1
•
................................. - - _ ..
.... _-- _---- .
..................... __ _ -_ - ..
75 Did any officer,

Did officer, director, trustee, or key employeereceiveaggregatecompensationof
director, trustee.or employee receive aggregate compensation of mere
more than
than SlOO.OOO from your
$100,000(rom your
orgamzationand all relatedorganizations,
organization related organizations, ooff '.~hichmore
which more than
than $10,000was
$10,000 was providedby
provided by the
the relatedorganizatIOns?....
related organizations? ► ffiJ Yes 0
Ii] Yes No
U No
If "Yes." attach schedule-see
schedule—see Spacrfic
Specific Instructions
Instructions on 22.
on page 22.
Form (1998)
Farm 990 (1998) Paga 5
Other I n f o r m a t i o n (See Specific Instructions on page 23.) Ye3 No
76 Didtheorganization
Did the organization engageengagein inanyactivity notpreviously
any activity not reponedto
previously reported totheIRS?
the IRS? IfIf "Yes,"
"Yes,"attach
attacha detailed
detaileddescription
description of each
of eachactivity
activity . 76 -X.
77 Were Were any changes made in the organizing ·or or governing documents
documents but not reported to the IRS? IRS? . . . 77
If "Yes," attach a conformed conformed copy of the changes.
78a Did Did the
the organizationhaveunrelatedbusinessgrossincomeof
organization have unrelated business gross income of 31,000 $1.000 or moremore during
during the yearcoveredby
year covered by this this return?,
return?. 78a -X.
b If "Yes," has it filed filed a tax return on Form Form 990-T for this year? . . , . . , . . . . . 78b
79 Was Was therea
there a liquidation, dissoluticn, termination, or
liquidation,dissolution,termination, or substantial
substantialcaniraction during the year?
contractionduringthe year? If "Yes,''
"Yes,"attacha attach a statement
statement 79
f~IS SOalls the organizationrelated(other
organization related {other than by associationwith
association with a statewide or nationwide organization)throughcommon
organization) through common
"""* membership, governing
membership. governing bodies, trustees, officers, etc.,
trustees. officers, etc, to any other
other exempt
exempt or nonexempt
organization? . . . 80a
b If "Yes,"
"Yes." enter the name of the organization ► R!l.~.~RJ;l.~~~
D e a c o n e s s... A~.~.C?~~.~.~~9}!!'.?
A s s o c i a t i o n s , .._ ~~S Inc . ^
.................................................... and check whether it is 0 rn exempt OR D 0 nonexempt.
nonexempt.
81aa Enter the amount of political expenditures, direct or indirect.
81
instructions for
instructions
b i DDid
for line
line 8
i d the organization file Form
81,1 . .
Form 1120~POL
, • • • • • ,
described in the
1120-POL for this year? , . , . . . . . , . . , . , . . .

81a I
'~8:...1:..::a::....J.. _ I§
81b
■
&Jud
/fea^^pfd the organization receive donated
or at substantially
donated services or the use of materials, equipment,
substantially less than fair rental value?
equipment. or facilities at no charge
. . . . . . . . , . . , . . . • • . • . 82a
~ "Yes," you may indicate the value at
"Yes." of these items here. Do not include this amount
as revenue
revenue in Part I or as an expense in Part II. (See (See instructions for reporting in
Part 111.).
111.) • • • • • , • • • • 182b |
83a Did the organization
organization comply with the public inspection requirements for tor returns and exemption
exemption applications? applications? 83a
organization comply
b Did the organization comply with with the disclosure requirements relating to quid quid pro quo contributions?
contributions? •. . 83b
84a Did the organization solicit any contributions contributions or gifts that were not tax deductible?
deductible? . . • . , • • • 84a
b
b ItIf "Yes,"
"Yes," did did thethe organization
organization include include with
with every solicitation
solicitation an express statement
statement that that such contributionscontributions
or gifts were not tax deductible? deductible? , . . . • . • , • . . . . • 84b
85 50 1(c)(4),(5),or
501(c)(4), (5), or organizations.-a
(6)(6) organizations.—a Were substantiallyall
Were substantiallydues nondeductible
all dues nondeductible by members?
by members? . . . . • . 85a
b Did the organization
organization make only in-house lobbylnq lobbying expenditures of $2,000 32,000 or less? . . ..•... . . . . . . 85b
If "Yes" was answered to either 85a or 85b, do not not complete 85c through 85h below unless the organization
received a waiver for proxy tax owed for the prior year. year. '
c Dues, assessments,
assessments, and similar amounts amounts from members , . . . 85c
d Section
Section 162(e)162(e) lobbying
lobbying and political political expenditures . . • . • • S5d
e
nondeductible amount of section 6033(e)(1)(A)dues
6033(e)(1)(A) dues notices . . 856
f
Taxable amount of lobbying and political political expenditures (line 85d less 85e) 85e) 85f
g
9 organization elect to pay the section 6033(e) 6033(e) tax on the amount in 85f.? 85f? . • . . . • • •
h
If section 6033(e){1
h 6033(e)(1)(A)dues
)(A) duesnotices
noticesweresent,
were sent,doesthe
does theorganizationagreeto
organization agree toadd addthe
theamount
amountinin85f 85ftotoits
itsreasonable
reasonable
ex
estimate
estimate of dues allocable
allocable to nondeductible
nondeductible lobbying
lobbying and political P e n d i M e f ^ | ^ | l f S ^ r t ^ f 2 x year?.
political expendi~ffiIGi~~ year? . .• 85b
86 501(c)(7)organizations.-Enter:
organizations.—Enter, a Initiation
a Initiation fees
fees andand capital
contributions i~i>in^h||p%$«si' ,n'~ ^
line 12 . . . . . , . . . . . . . . . . . • . . . . . , . S6a
line
b Gross receipts,
receipts, included
included on line 12, for public use of club dub facilities.
facilities 86b
87 501 (c)(12) organizations.-Ente(:
501(c)(12) organizations.—Enter.
a Gross income from from members or shareholders.
shareholders 87a
Gross income
b Gross income from
from other
other sources.
sources. (Do(Do notnot net
net amounts
amounts due due oror paid
paid to to other
other
sources against
sources against amounts
amounts duedue oror received
received fromfrom them.)
them.). . . . . . . 87b
88
88 At
At any
any time during the
time during the year,
year, did
did the organization own
the organization own a 50%
50% or
or greater
greater interest
interest in a taxable
taxable corporation
corporation oror
partnership? complete Part
"Yes," complete Part IX
IX. . . . " . . , . • . . .
89a
89a 501(c)(3) organizations.-Enter:
organizations.—Enter: Amount of tax imposed on the organization during the year under:
section 4911 ► .. ; section 4912 .. ► ;I section ►'------4-"-;
section 4955 ..
b organizations.—Did the organization engage in any section
501(c)(3) and 501(c)(4) organizations.-Did section 4958 excess benefit
benefit
transaction during the year? If "Yes." attach a statement explaining each transaction
transaction during transaction . . , . . . • 89b * ■
I
cC Enter: Amount
Amount of tax imposed
imposed on the organization managers or disqualifieddisqualified persons
persons during the year under
sections 4912, 4955. and 4958 4958, ..."..,.... • . , • . . . ► ...." —
d Enter; Amount
Enter: Amount of tax on line 89c, above, above, reimbursed by the organization.
organization . . • . .... ►
90a Ust
List the states with
with which a copy of this return is filed filed" ►• 9.J:l.~~
9J?.?P.... .
b Number of employees
Number employees employed
employed in the pay period period that includes March
March 12, 1998 (See instructions.)
instructions.) •. . 190b l 9 0 b I 3^ —
91 The books are in care of ► M~.C;%;J:
........ MICHAEL ..9B-~¥.1'g~.............................
CROFT ON no. ►( A L 3 . J.^?.?".
Telephone no...
2
l~?..~.:~?.!~ (_~.~?
.7.L 0 ...- ..
.......
92
Located
Located at
at ► :?.u...
..... 311 .STRAIGHT.
~IMI9~:r:
Section 4947(a)(1) nonexempt
STREET
..~ ^..CINCINNATI,..
:,n~;F;f:l OHIO
..~~.~.qWBA?.J.L.9.~~9.......... ZIP ++ 44 ....
ZIP
nonexempt charitable trusts filing Form 990 in lieu of Form 1041-Check
► ..£?.? A?-
~.-?~J:~'''''''''''''····''''''''·D
1041—Check here . . . , • , ....► □
and enter the amount of tax~exempt
tax-exempt interest received or accrued during the tax year , . ... ► I 92 I| __
Form 930
Form 990 [19931
[199BI ., Y'p
aga 66,
Paga
nlilITi&!l1l
SByiTl Analysis of
Analysis ot IIncome·Producing
n c o m e - P r o d u c i n g AActivities {See Specific
c t i v i t i e s (See Specific Instructions
InstructiOns on page V.}
on page 27.)
Enter gross
Enter gross amounts
amounts unless
unless otherwise Unrela ..
Unrelated ad businessincome
business income Exc!tided
Excluded by
by section
section 512.513.
512. 513.oror514
514 (El
indicated.
indicated.
Related or
Related or
(AI
(A) (Bl
(B) (C) (0)
(D) exemptfunction
exempt function
93 Program service
revenue: Business cede
Susiness code Amount
Amount IE.~CiUS\~~code
Exclusion code Amount
Amount incomo
income
aa
bb
cc
dd
ee
ff Medicare/Medicaid
Medicare/Medicaid payments payments .
g9 FeesFeesandand contracts
contracts fromfrom government
government agencies
94 Membership
94 Membership dues dues andand assessments
assessments . . .
95 Interest
95 Interest on
onsavings and temporary cash
savingsandtemporary investments
cashinvestments
Dividends and
96 Dividends
96 and interest
interest from
from securities
securities . . . 14
14 30,372
30.
~ ~ ~
97 Net
97 Net rental
rental income
income or or (loss)
(loss) from
from real
real estate:
estate: ~
aa debt-financed
property I
bb not not debt-financed
property .
98 Net
98 Netrentalincomeor (loss) from
rental income or (loss) from personal
personalproperty
property
99 Other
99 Other investment
investment incomeincome
100 Gain
100 Gainor
or (loss)fromsalesof
(loss) from sales of assetsotherthaninventory
assets other than inventory 18 18 39,698
39,698
101 Net
101 Net income
income or or (loss)
(loss) from
from special
special events
events . .
102 Gross
102 Gross protit
profit or
or (Soss)
(loss) from
from sales
sales ofof inventory
inventory .
103 Other
103 Other revenue:
revenue: aa
bb
cc
dd
ee
~ 770,070
0,070
104 Subtotal (add
104 Subtotal (add columns
columns (B), (8). (D),
(D), and
and (E))
(E) . , ~
105 Total (add
105 Total (add line
line 104, columns (B),
104. columns (8), (D),
(D), and
and (E))
(El) • . . . . 770.070
0,070
Note:
Note: (Line
(Une 105105plusplus, line 1d Part II,, should
Id,, Part should equal
equal the amount 12,, Part
amount on line 12 Part J)
I.)
JIll .' Relationship
P a r t ill'
1:F.Tii VIII Relationship of of Activities
Activities to to the
the Accomplishment
Accomplishment ofof Exempt
Exempt Purposes
Purposes (See
(See Specific
Instructions on
on page
page 28.)
No~ r.:.:Explaini'1_9w
Line No. Explain how eeach activity for
ach activity for which
which income
income isis reported
reported in
in column
column (E)
(E) of
of Part
Part VII
VII contributedimportantlyto
contributed importantly to the
the accomplishment
accomplishment
Y' (. offhe ·orgailiz;ation's
'ofthe exempt purposes
organisation's exempt purposes(other than by providing
(other than providingfunds
funds for
for such
such purposes).
purposes).
fr
K'~CIr-nl\ll1l
OHIOBNAL
.""". T.\1I~IJII1JD ....
l:fflIHI Information Regarding Taxable Subsidiaries (Complete this Part if the "Yes" box on line 88 is checked.)
Name, address, and employer identification Percentage of Nature of Total End-of-year
number of corporation or partnership ownership interest business activities income assets
%
%
%
%
Ithis return, including accompanying schedules and statements, and
ar.d statements, andto
totM
thebest
best01
ofrrrt
my knowledge
I f preparer (other thary6fficer)
th:,,\It1HirMI is
IS eased
easec on all information
ruormancn of at which
which praparer has any Knowledge.
knowledge.
SCHEDULE A
Organization Exempt
Exempt Under
Under Section
Section 501(c)(3)
501(c)(3) OMBNo.
QMB No.1S4S-O047
154a~7
) (Form
(Form 990)
9&0) (Exctpt
(Except Prlvata
Privata Foundation)
Foundation) and
and Sactlon
Siaiion 601(a),
1501(." 601(f),
1501(I), 501(k),
1501(k),
&l1(n),
601 Saailon 4947(a)(1)
(n), or Saotlon 04Q.47(a)(1)Nonaxampt
Nonlxampt Charttabl*
Charltabl. Truat
Trult
Qtovtmtnt
O.Dattm.", deI Wi
'""'"1' P«vinut
Inwril
tn. TrMiury
TrNluty
SfNlCl
FI.... n~.S«viei .. Muit
► MUlt ba
be complatad
com I,t,d by tha
Saa laparata
th' abova
Ilparati Inatructloni,
IIbove organization!
or .nlutlanl
Inltruailonl •
Ittached to thair
and attachad th.lr Form
Form 900 ~.EZ.
~ or 9flO«EZ.
Supplementary
s••
Information ~@98
■198
Nima
Nam. of of tnt
tn. orginiution
orOIn'tl110n Empioyw
!mj:lloy., IdantMlottion numbtr
IdMtIt!cationnumb.,
WV
TT HFTMT.TrW TWSTTTIITE FOTTNDATION 23
23 I1 7303161
7303161
Compensation
Compensation of 01 the
the Five
Five Highest
Highest Paid
Paid Employees
Employees Other Other Than
Than Officers,
Directors, and
and Trustees
Truatees
(See instructions
instructions on
on page 1.1. List
List each
each one,
one. IfIf there
there are
are none/enter
none enter "Nona.")
"None. .
(b) (d) Contriouilcns to (•) ExptnM
(a)
(.) Nama
Nlm. ind
Ind addrtu
addr... at01 aicn
ncn ampioyee
emplOy" paid
paid mora
more (b) Tills
Title and
ana average
averllO' nours
not;tS (c)
[e) Corr.penwtlon
Comcensatlon amoloyii oeruilt alans 4 account ind othtr
mm
tnlll 350.000
SSO.000 ett weoK
per weeK aevotad
devoted :o:0 ocaition
0051110n dalirrsd cornpsnMtlan allowancM
·.... ····..····...... ·.. ···.. ····..··.. ··.......... ·.. ···1

NONE
NONE !
.................................................... .o .
.................... _ .
Total number
Total number of
of other
other employees
employees paid
paid over
over
$50,000
0
$50.000 . . . . . . ► ....
nsation of
Compensation of the
the Five
Five Highest
Highest Paid Independent Contractors flap PrrJfessional Services
. -,.
(See instructions 1. List
on page 1, List each
each one (whether individuals or firms). If there are none, enter "None.")
(a)
Ie) Nama andaddress
Name and address of
of each
sach independent contractor p8ldmore *han
contractor paid S50.QCO
than S~O.OOO (hI Type of
(b) serviee
at service (e) Compensation
CompenSlltlon
........ _ --- _ .._ _-_ -_ .. --- - -- _ .. _ _ - ---

NONE
...................................... _- - --.- - .. - .. _ ------_ ...
.......... "' __ _ _ - 'O- .. .. _ ~ ----"
Total number
Total number of
of others
others receiving
receivingover 350,000
$50.000tor
for
professionalservices.
professional services ..... ....
► o
0
For
For Paperwork
Paperwork Reduction
Notice, see
see page
page 1 of tho
the Instructions for
tor Form
Form 990
990 and
and Form
Fonn 990-EZ.
990-EZ. Cat. No.
No. 1133SF
11285F Schedule
Sehedul.AA (Form
(Fann990)
9901 19S8
1998
SchlMiulaA (Farm
Schedule (Form 990) 1998
990)1998
Pago
1#1111 Statements About Activities

Activities Yes No
1 During the year,

DUring year, has the organization
attempted to influence
influence national,
national. state,
state, or local legislation,
legislation. including
including any
attempt to influence
attempt public opinion
influence public opinion on
on a legislative
legislative matter
matter or referendum?
referendum?
If "Yss."
"Yes." enter the total expenses paid or incurred
incurred in connection
connection with
With the lobbying
!obbYlng activities *■ $S
activrtiss ,.. _
Organizations that made
Organizations that made an election
election under
under section
section 501(h)
501 (h) by filing
filing Form
Form 5768
5768 must
must complete
complete Part VI-A. Other
VI·A. Other
organizations checking
organizations checking "Yes,"
"Yes," must complete Part VI-B
must complete Vl-B AND attach a statement
AND attach statement giving
giving a detailed
description of
the
2 During the
During the year.
year, has
has the
the organization.
either directly
directly or indirectly,
indirectiy, engaged
engaged in any 01 of the following
following acts
acts with
with any
of its trustees,
trustees, directors,
directors. officers,
officers. creators,
creators, key
~ey employees,
employees. or members
members of their
~heir families,
families. or with
with any taxable
taxable
organization 'with
orgamzation 'mth which
whIch any
any such
such person
person isis affiliated
afliliated as
as an
an officer.
officer. director,
director. trustee,
~rustee. majority
rnaiontv owner,
owner. or principal
or onncipat
beneficiary:
bsneflcrary:
Sale, exchange.
a Sale. exchange, or leasing
property?
b Lencing
Lending of
of money
money or
or ather
other extension
extension of
of credit?
credit? 2b x
c FurniShing
Furnishing of
of goads,
goads, services,
services, or
or facilities?
facilities? • 2c xX
d Payment of
d Payment of compensation
compensation (or payment
payment or
or reimbursement
reimbursement of
of expenses
expenses if more
more than
than $1.000)?
$1,000)? 2d x
X
e Transfer
Transfer of any
any part
part of
of its
its income
income or assets?
assets? . 2e x
ifIf the
the answer
answer to
to any
any question
question is "Yes,"
"Yes," attach
attach a detailed
detailed statement
explaining the
the transactions.
transactions.
3 Qge~Does th~
the o~ganizatjon
organization make
make grams
grants ~or
for schotarsruos,
scholarsniDS, fellowships,
student loans,
loans, etc.?
etc.? .
4a ..-Do you.'have
Do you. have a 'section
section 403(b) annuity
annuity plan
plan lor
for your
your employees?
employees? . 4a
.Attach a"st~t~ment
b .t\ttaCh a statement to to explain
explain now
how the
the organizatfon
determines that
that individuals
individuals or
or organizations
organizations receiving
receiving grants
grants
loans from
or loans fram it in furtherance
furtherance of its charitable programs qualify to receive
trs charitable receive payments. ISee
(See instructions on
on page 2.)
httl"'.
Isfflll^ Reason
R e a s o n for Non-Private
Foundation Status (See
(Seeinstructions on pages
instructions on pages 22 through
through 4.)
4.)
The organization is not

The organization not a private
private foundation
foundation because
because ,tit is:
is: (Please
(Please check
check only ONE applicable
only ONE applicable box.)
cox.)
0
ORIG INAl
5 D A church, convention
A church, convention of
of churches,
churches, or
or association
association of
of churches.
churches. Section
Section 170(b)(1HA)(i).
170(b)(1)(A)(i), ft.
6 0
n A school.
A school. Section
Section 170(b)(1)(A)(iij.
170(b)(1)(A)(ii). (Also
(Also complete
complete Part V, V, page
page 4.) ORSOliNl ALo
7
1 0
D A hospital
A hospital or
or aa cooperative
hospital service
Section 17Q(b)(1)(A)(ilij.
170(b)(1)(A)(iii).
8
8 0
□ A Federal,
A Federal, state.
state, or
or local
local government
government or
or governmental
governmental unit.
unit. Section
Section 170(b)(1HA)(V).
170(b)(1 ){A)(v).
9 0
□ A medical
A medical research
operated in
in coniunction
conjunction with with a hospital.
hospital. Section
Section 1iO(b)(1)(A)(iii).
170(b){1)(A)p). Enter
Enter the hospital's
hospital's name,
name, city,
city.
and
and state
state ►~ >.. _••••••.• _•• _•••.••••••••..• _•..•.•.•.••••••••••••••••••••• _••• __•• _ .
10 0
G An organization
operated for
:o{ the benefit of a college
~hebenetit college or university
university owned
owned or operated
governmental unit.
unit. Section
Section 170(b)(1 ){A)(iv)
170(b)(1)(A)(iv)
(Also complete
complete the
the Support
Support Schedule
Schedule in Part iV~A.}
Part IV-A.)
C. An organization
11a L_. organization that
that normally
normally receives
receives a suostantlal
suostantial partpart of its
its support
support fromfrom a governmental
governmental unitunit or from
from the
the general
general public.
public.
Section 170(b)(1)(A)(vi). {Also
Section 170(b)(1)(A)(vi). (Also complete
complete the
the Support
Support Schedule
in Part IV·A.)
11b 0
11b □ AA community
community trust.
trust. Section
Section 170(b)(t)(A)(vi).
170(b)(1)(A)(vi). (Also
(Also complete
complete the the Support
Support Schedule
Schedule in in Part
Part IV-A.)
IV·A.)
12 0
12 An organization
LJ An organization that
that normally
normally receives:
receives: (1)
(1) more
more than 33%% of
than 33Vb% of its
its supoort
supnort fromfrom contnbuttons,
ccntnbutlons, membership
membership fees, fees. and
and gross
gross
receipts from activities
receipts from activities related
related to
to its
its charitable.
charitable, etc
etc... functions-subject
functions—subject :0 to certain
certain exceptions.
exceptions, and
and (2)
(2) no
no more
more than
than 33'/3%
33Va% o:0:
its
its support
support (rom gross investment
from gross income and
unrelaled business
business taxable income (less
taxable income \less section
section 511 tax) from
511 tax) tram businesses
businesses acquirac
acquirec
(j by
by the
the organization
organization after
13 | ~0 An organization
organization that
described in:
described
after June
in: (1) lines 5 through

section 509fa)(3).)
~se~ct~i~0~n~5~0~9(~a~I!3~).~)
30, 1975.
June 30,
that is not controlled
1975. See
controlled by
through 12 above:
See section
by any
section 509(a)(2).
any disqualified
above: or (2) section
509(a)(2). (Also
(Also complete
persons (other
section 501(c)(4),
complete the
(other than
--~
the Support
than foundation
501 (c)(4), (5), or (6),
__ ~~--~
Schedule in
Support Schedule
(6). if they
managers) and
they meet
meet the test
in Part
Part IV-A.)
and supports
test of
~~
at section
IV-A.)
organizations
supports organizations
section 509(a)(2).
__ --
509(a)(2). (See
-
Provide the
Provrda the tcllowmq
information about
about thethe supported
supported organizations.
organizations. (See instructions
instructions onon page
page 4.)
(b) Line number
Une number
Name(s) of supported
(a) Name{s) organization(s)
supported organization(s) from above
above
from
DEACONESS HOSPITAL
THE HEAHONKSS
THF 7
7
14 0 An organization
□ organization organized
organized and operated to test
and operated test for public
public safety.
safety. Section
Section 509(a)(4). (See instructions
instructions on page
page 4.)
Schedule
Scl1Cdufe AA (Form
(Form 990)
990) 1998
199B 3
Page 3
Page
.MiW Support Schedule
Support Schedule(Complete (Complete onlyonly ifif you
you checked
checked aa box
box on
on line
line 10,
10. 11,
11, or
or 12.)
12.)Use cash fTlfJthodof
Use cash method ofaccounUng.
accounting.
Note:
Note: YouYou maymay use the worksheetin
worksheet in the theinstructions
instmctions for
for converting
convertingfromfromthe
theaccrual
accrualto
tothe
thecash
cashmethod
method of
ofaccounting..
accounting.'
Calendar year (or fiscal year beginning in) (a) 1997 (b) 1996 (c)1995 Id) 1994 {©) Total
15 Gifts,
Gifts. grants,
grants. and
and contnbutions
contnbutions received.
received. (Do(Do
not
not include
include unusual
unusual grants.
grants. See See line 28.).
line 28.). 24 749
24,749 278,164
278 164 114 01
114.010 85,274
85,274 502,197
502,197
17 Gross
Gross receipts
receipts from
from admissions,
admissions.
merchandise
merchandise sold sold or or services
services performed,
performed. or or
furnishing
furni$hing of of facilities
facilities in
in anyany activity
activity that
that is
is
not
not aa business
business unrelated
unrelated to to the
the organization's
organization's
chantabie,
chantable. etc.,
etc. purpose
18
18 Gross
Gross income
income from from interest,
interest. dividends,
dividends.
amounts
amounts received
received from
from payments
payments on on securities
securities
loans
loans (section
S12(a)(5)},rents,
rents. royalties,
royalUes. and
and
unrelated
unrelated business
business taxable
taxable income income (less(less
section
section 511511 taxes)
taxes) from
from businesses
businesses acquired
acquired
by
by the
the organization
organization after
after June
June 30.30. 1975
1975 .. . 76^953 43,138 38,125
38 125 28,994
28 994 187,210
187 210
19
19 NetNet income
income from from unrelated
unrelated business business
activities
activities not
not included
included in in line
line 18
18
20
20 Tax
Tax revenues
revenues levied
levied for
for the
the organization's
organization's
benefit
benefit and
and either
either paid
paid to
to itit or
or expended
expended onon
its
its behalf
behalf.
21
21 The
The value
value of
of services
services oror facilities
tacinties furnished
furnished toto
the
the organization
organization by by aa governmental
governmental unit unit
without
without charge.
Charge. Do 00 not
not include
include the
the value
'Jalue of
of
services
services or
or facilities
facilities generally
generally furnished
furnished toto the
the
public without
without charge
charge.
22 Other income. Attach a schedule. Do not
include gain or (loss) from sale of capital assets
23 Total of lines 15 through 22. 101,702 321,302 152,135. .UAJ£63 689,407
24 Line 23 minus line 17. 101,702 321,302 152,13J YSumsaBm ?89,407
25 Enter 1 % of line 23 1,017 -3,213 l,52rT 1,143
26 Organizations
described on
on lines
lines 10
10 or
or 11:
11: aa Enter
Enter 2%
2% of
of amount
amount in
in column
column (e),
(e). line
line 24.
24. , . .► 13,788
b Attach
Attach a list (which
(which is not open
open to public
public inspection)
inspection) showing
showing the
the name
name of and amount
amount contributed
contributed by each
each
person
person (other than
than aa governmental
governmental unit or publicly
publicly supported
organization) whose
whose total
total gifts for
for 1994
1994 through
through
1997 exceeded
exceeded thethe amount
amount shown
shown in line 26a. Enter thethe sum
sum of all these excess amounts
amounts. ►..
c Total
Total support
support for section
section 509(a)(1) test: Enter line 24, column
column (e) .
dd Add:
Add; Amounts
Amounts from
from column
column (e) for lines: 18 187 ,,210
187 210 19
22 26b 4411,060
11,060 t
e Public
Public support
support (line 26c minus
minus line 26d total)
Public support percentage (line 26e
f Public 26e (numerator) divided by line 26c (denominator))
27 Organizations
Org<:!nizations described
described on line
line 12:
12: a For amounts
amounts included
included in lines 15,
15. 1'6,
1'6. and 17 that were
were received
received from a "disqualified
"disqualified
person,"
person," attach
attach a list to show the name of,
of. and total
total amounts
amounts received
received in each year from,
from. each "disqualified
"dlsquallfied person."
person. It Enter the
the sum
of
01 such
such amounts
amounts for each year:
(1997) (1996) (1995) , (1994) •••••••••• _ _.. _••••••.•.

bb For
For any amount
amount included
included in line
line 17 that was
was received
received from
from a nondlsqualified
nondisqualified person.
person, attach
attach a list
list to show
show the
the name
name of,
of, and
and amount
amount
received tor each
received for each year, that .was
was more than
than the larger
larger of (1) the amount
amount on line 25 for the year or (2) 35,000.
$5.000. (Include
(Include in the list
Ust
organizations
described in lines 5 through
through 11,
11. as well
well as individuals.)
indlviduals.) After computing
computing the difference
difference between
between the amount
amount received
received
and the larger amount
amount described
described in (1) or (2), enter
enter the sum
sum of these
these differences
differences (the excess
excess amounts)
amounts) for each year:
year:
(1997) ,.r (1996) (1995) (1994)

(1994) - -.
cc Add:
Add: Amounts
Amounts from
from column
column (e) for lines:
lines: 15 16
17
17 20 21
d Add:
Add: Une
Line 27a
27a total
total . and
and line 27b
27b total
total.
e PubliC
Public support
support (line
(line 27c total minus
27c total minus line 27d
27d total).
total) ~~~~
ft Total
Total support
support for section
section 509(a)(2) test:
test: Enter amount
amount on line 23, column
line ,23. column (e)
(e) 27f
... ~27!!fu_~ ~~~~ ~
g Public support
9 Public support percentage
percentage (line 27e (numerator) divided
divided by line 271(denominator».
27f (denominator)). . . . . . . ► ■
h Investment
Investment income
income percentage (line 18, column (e) (numerator) divided
ine 18. divided by line
line 27f (denominator)). ►
28 Unusual
Unusual Grants:
Grants: For an organization
described in line 10, 11, or 12 that
10,11. that received
received any unusual
unusual grants
grants during
during 1994 through
through 1997,
1997,
attach
attach a list (which
(which is not
not open
open to public
publfc inspection)
inspection) for each
each year
year showing
showing the
the name
name of the contributor,
contributor, the
the date
date and amount
amount of the
the
grant,
grant, and
and a brief description
description of the
the nature of the
the grant.
grant. Do not include
include these
these grants
grants in line 15. (See instructions
instructions on page
page 4.)
Schedule
Sched\;fe A
A (Form
{Form 9901
9901 1998
1998
Page 4
Page 4
1:tH1!J Private School
Questionnaire (See
(Seeinstructions
instructions on
on page
page 4.)
4.)
be completed
(To be com ONLY by schools
ONLY schools that
that checked
checked the
the box
box on
on line
line 66 in
in Part
Part IV)
Yes
Yes No
No
29
29 Does
Does the
the organization
organization have
have aa racially
nondiscriminatory policy
policy toward
toward students
students by
by statement
statement in
in its
its charter,
charter, bylaws,
bylaws,
other
other governing
governing instrument,
instrument. or
or in
in aa resolution
resolution of
of its
its governing
governing body?
body? 29
30
30 Does
Does the
the organization
organization include
include aa statement
statement ofof its
its racially
policy toward
toward students
students in
in all
all its
its
brochures,
brochures, catalogues,
catalogues. and
and other
other written
written communications
communications with with the
the public
public dealing
dealing with
with student
student admissions,
admissions,
programs,
programs, and
and scholarships?
scholarships? . 30
31
31 Has
Has thethe organization
organization publicized
publicized its
its racially
poiicy through
through newspaper
newspaper oror broadcast
broadcast media
media during
during
;he
;/1eperiod
penod ofof solicitation
solicitation for
for students,
students. oror during
during the
the registration
registration period
period ifif itit has
has no
no solicitation
solicitation program,
program. in
in aa way
way
that
that makes
makes the
the policy
coucy known
known to to all
all parts
parts of
of the
the general
general community
community itIt serves?
serves?
IfIf "Yes."
"Yes.' please
please describe;
describe: ifif "No."
"No:' please
please explain.
explain. (If
(If you
you need
need more
more space,
space, attachattach aa separate
statement)
.............. _ _--_ --- _ _- .. -. ---_ --- -_- -_ ..

32
32 Does
Does the
the organization
organizatior. maintain
maintain the
the following:
following:
aa Records indicating the
the racial composition
composition of the student body, faculty, and administrative
staff? 32a
bb Records documenting
documenting that scholarships
scholarships and other financial assistance are awarded on a racially nondiscriminatory
nondiscriminatory
basis?
basis? . 32b
cc Copies of alt
all catalogues,
catalogues. brochures,
brochures, announcements,
announcements, and other written
communications to the public dealing
with
with student
student admissions,
admissions. programs,
programs, and
and scholarships?
scholarships? . 32c
,d
.d Copies of ail
Copies..of all material
material used
used by
by the
the organization
organization or
or on
on its
its behalf
behalf to
to solicit
solicit contributions?
contributions? , 32d
IfIf you
you answered
answered "No"
"No" to
to any
any of
of the
the above,
above, please
please explain.
explain. (If
(If you
you need
need more
more space,
space, attach
attach aa separate
33
33 Does
Does the
the organization
organization discriminate
discriminate by
by race
race in
in any
any way
way with
with respect
respect to:
to:
aa Students'rights
Students' rights or privileges? . 33a
b Admissions
Admissions policies?
·ORIGI·NAl 33b
ce Employment
Employment of faculty or
Of administrative
administrative staff? . . . 33c
33c
d Scholarships
Scholarships or other financial assistance?
assistance? . . . . 33d
e Educational
Educational policies?
pollcles? 33e
iacilities? • 33f
33g
g9 Athletic
Athletic programs?
programs?
extracurricular activities?
activities? 33h
If you answered
answered "Yes" to any of
at the above, please explain. (If
tlf you need more space,
space. attach a separate statement.)
,I
...... _-_ - -.--- .. _-_ _--_._ -- --- ..
34a Does the organization receive any financial

financial aid or assistance from a governmental
governmental agency? 34a
34b
b Has the
the organization's
right to such
such aid ever
ever been
been revoked
revoked or suspended?
suspended?
If you answered
answered "Yes"
"Yes" to either 34a or b, please explain using an attached statement.
attached statement.
S5
organization certify that it
it has complied
complied with the applicable
applicable requirements
requirements of sections
sections 4.01 through
through 4.05
of Rev. Prog
Proc. 75-50.
75-50, 1975-2 C.B.
C.B, 587,
587 covering racial nondiscrimination?
nondiscrimination? If "No,"" attach
attach an explanation . . . 35
..
Schedule AA(Form
[Form990)
990)1993
1998
Schedule Pago 55
Page
0110
KETiyjp.l Lobbying Expenditures
Lobbying Expenditures by
byElecting
ElectingPublic
PublicCharities
Charities (See
(Seeinstructions
instructionsan
onpage
page6.)
6.)
(Tobe
(To becompleted
completedONLY
ONLYby aneligible
by an eligibleorganization
organizationthat
thatfiled
filedForm
Form5768)
5768)
Check here
Check j- aa Q0 if ifthe
here ► theorganization
organization belongs
belongs totoan
anaffiliated
affiliated group.
group.
Check here II- b 0 if checked "a" above and "Iimited control" N/A
N/ A
Check here ► b Q if you checked "a" above and "limited control" provisions apply.
(a) (b)
(b>
Limits on
Limits onLobbying
Expenditures Affiliated group To10bebecompleted
completed
totals for
lorALL
ALLelecting
electing
(Theterm
"expenditures" means
means amounts
amounts paid
paid ororincurred.)
.ncurred.) crqanuations
organizations
36
36 Total iobbying
Total ioboY/()9 expenditures
exosncltures totoinfluence
iniluerice public
public opinion
op.nion (grassroots
(grassroots lobbying)
lobbying)
37
37 Total robbying expenditures to influence a legislative
Total lobbying expenditures to influence a legislative body (direct lobbying) .body (direct lobbying)
38
38 Total lobbying
Total iobbying expenditures
exoenditures (add (addlines
lines 3636and and37) 37) .
39
39 Other exempt purpose
Other exempt purpose expenditures expenditures
40
40 Total exempt
Total exempt purpose
sxpendttures fadd raco lineslines 38 38andand 39)
39).
41
41 LobbYing nontaxable
Lobbying nontaxable amount.
amount. EnterEnterthett':eamount
amount from from the
thefollowing
fallowing table—
:able-
IfIfthe
Not
theamount
Not over
amount on
over 3500,000
Over3500,000
Over $500,000but
on line
5500.000 .
butnot
line40
notover
40is—
is-
over31,000,000
31,000,000.
The lobbying
The
.20%
. .3100,000
lobbying nontaxable
20% ofot the
$100,000 pius
nontaxable amount
the amount
amount on
plus15%
on line
15%ofofthe
amount is—
fine40
theexcess
40.
excess over
is-
over$500,000
5500,000
1
Over $1,000.000 but not over $1.500.000 . $175,000 plus 10% of
Over 31.000,000 but not over 31.500,000 S175.000 pius 10% of the excess over 31,000,000 the excsss over $1 ,000,000
Over31.500,000
Over 31.500.000but butnot
notaver
over317,000.000
S17.DOO.OOO .3225,000
5225.000plus plus5%5%ofof the
theexcess
excessover
over31,500.000
S1.500.000 J
Over317,000,000
Over S17,QCO,COO . .31,000,000
$1 ,OOO,OCO •
42
Grassroots nontaxable amount amount (enter
(enter 25%25% of of line
line 41)
41)., . . , . .
43
43 Subtract line
Subtract line 42
42 from
from line
line 36.
36. Enter
Enter -0-
-0- ifif line
line 4242 isis more
more than
than line
line 3636
44
44 Subtract line
Subtract line 41
41 from
from line
line 38.
38. Enter -0- ifif line
Enter -0- line 4141 isis more
more than
than line
line 3838
Caution: there isisan

Caution: IfIf there an amount
amount on
on either
either line 43 or
line 43 or line 44,you
line 44, mustfile
you must file Form
Form 4720.
4720.
4-YearAveraging
4.Year Averaging Period
Period Under Under Section
Section 501(h)
501(h)
(Some organizations
that made
made aa section
section 501(h)
501(h)election
election do do not
not have
have to
to complete
complete all
all of
of th^ti
th.QnlOJ~tAL
See the
See the instructions
instructions for
for lines
lines 45
45 through
th 50 on
50 on page 7.)
7.1 ~IIY.M.
Lobbying
Expenditures During
During 4-Year
4-Year Averaging
Averaging Period
Period
Calendar year
Calendar year (or
(or (a)
(a) (b)
(b) (c)
(c) (d)
(d) (e)
<e>
fiscal year beginning in)
fiscal in) >
• 1998
1998 1997
1997 1996
1996 1995
1995 Total
Total
45
Lobbying nontaxable amount.
amount.
46
46 LObbying ceiling
Lobbying ceiling amount
amount (150%
(150% of
of line
line 45(e)).
45(e1).
48
Grassroots nontaxable amount
amount
49
49 Grassroots ceiling
Grassroots ceiling amount
amount (150%
(150% of
of line
line 48(e))
48(el)

Public Charities
Lobbying Activity by Nonelecting Public Charities
that did
(For reporting only by organizations that did not
not complete
com Part Vl-A) (See instructions on page 8.)
During the
During the year,
year. did
did the
the organization
attempt to to influence
influence national,
national, state
state or
or local
local legislation,
including any
any Yes No Amount
attempt to
influence public
public opinion
opinion on
on aa legislative
legislative matter
matter or
or referendum,
referendum, through
through thethe use
use 'ot:
of:
aa Volunteers.
Volunteers " .• .•.•...... . .
bb management (Include
Paid staff or management (Include compensation
compensation in expenses
expenses reported
reported on lines
fines c through
through h.) . . , X
cc Media advertisements
Media advertisements . '
dd Mailings to
members. legislators,
legislators, or or the
the public
publiC •
ee Publications, or
Publications, or published
published or or broadcast
statements
ff Grants to
Grants to other
other organizations
organizations for for lobbying
lobbying purposes
purposes
g9 Direct contact
Direct contact withwith legislators,
legislators, their
their staffs,
staffs, government
officials. or a legislative
legislative body
body .
h RaHies. demonstrations,
Rallies, demonstrations, seminars,
seminars. conventions,
speeches, lectures,
lectures. or any other
other means
means. . . . .
i Total robbying
TotaJ lobbying expenditures
expenditures (add(add Jines
lines cc through
through h).
h)
If "Yes" to any ot the above. also attach a statement giving a detailed descnption of the lobbying activities.
Schedule
Schedule A (Form
(Form 990)
990) 1998
1998
,Page 6
.Page
'@C!'
■:ETl*fJH Regarding Transfers To
Information Regarding To and Transactions and Relationships With Noncharltable
Noncharitable
Exempt
Organizations
51
51 Did the reporting
Did reporting organization
indirectly engage
engage in any of thethe following
following with
with any other
other organization
described in section
section
501(c) of the
SOl(C) the Code
Code (other
(other than section.501{c)(3)
section 501(c)(3) organizations)
organizations) or in section 527.
527. relating
relating to political
organizations?
Transfers from
a Transfers from the
the reporting
organization to a noncnarttacte
exempt organization
organization of: Yes No
0) Cash S1a(i)
51a(il X
(ii) Other
Other assets
assets . a(ii)
alii) X
Other transactions:
(i) Sales of assets
(I) assets to a noncnantable
exempt organization
organization b(i)
b(l) X
(ii) Purchases
Purchases of assets
assets from
from a noncharitable exempt organization
non charitable exempt organization b(ii)
b(ii) X
X
(iii)
Oil) Rental of facilities
facilities or equipment
equipment • b(iii)
bUill X
(iv) Reimbursement
Reimbursement arrangements
arrangements b(lv)
blivl X
loan guarantees.
(v) Loans or loan guarantees . b(v) X
(vi) Performance
{vi) Performance af of services
services or membership
membership or fundraising
solicitations bW
b(lIil X
Sharing of facilities.
c Sharing facilities, equipment,
equipment, mailing
mailing lists.
lists, other
other assets,
assets. or paid
paid employees
emptoyees . c X
J
d If the answer to any of the above is "Yes,"
Yes," compfete
complete the following schedule. Column (b) should always show the fair market value of the the
goods, other assets.
goods. assets, or services given by the reporting
organization. If
if the organization
organization received less than fair market
market value in any
transaction or sharing arrangement,
arrangement. show in column
column (d) the value of the.
the goods.
goods, other assets, or services received:
received:
(a)
[a) (b) [e)
(c) (dl
(d)
Una no.
Une no. involved
Amount Involved Name ot
of noncharitable
nonchantabta axempt organization
exempt organization Description
Oescnptfon of transfers, transactions,
transactions, and sharing arrangements
arrangements
..
--
if^
Q
• o iI"
fM
IPoI. ,
1t\\UII~"
KIW * — ~
N&
1.1\\
1 -
IIIl
. . .. . • > . " -1
-" .. " .
52a
523 Is the organization
organiz.ation directly
aftiliated with,
with, or related
related to,
to, one
one or more
more tax-exempt organizations
tax-@xempt organiz.ations
described section 501(c)
501 (C) of the
the Code (other than
Code (other than section
section 501
501(c)(3)) or in section
(c)(3»)or section 527?
52?? 0 Yes
....► □ Yes E
I[J No
"Yes."
b If "Y complete
as, camp the
h ffollowing
Iete teal schedule:
Iowing schedule:
(a) (b)
lb) (e)
(c)
Name of organization
organization Typa
Description of relationship
relationship
.. -. . ..
.~ •
Form 2758
2758 Application for
Application for Extension
Extension of
of Time
Time To
To File
File
iRev,May 1S=S^
<Rev,Mav 19;5\ Certain Excise,
Certain Excise, Income,
Income, Information,
Information, and
and Other
Other Returns
Returns CMB
CMa No.
No.1545.0148
1545-0148
Z: jo
.'c~nme,,(,:r;:-,
arm ant 3:7** i/e~syt"'i
"'aisurv
tl"'~( R~~,.,,:~ .!:.C!I..... '~e >-
,. File
File aaseparate
separate application
application for eachreturn.
for each return.
Name s.*nDicytf idintrficatKin num&»r
::;'easervce
-■ease tyce crcr
crmt = r='ie
;r:m :r.e
ie tf.e The Heimlich
The Heimlich IInstitute
nstitute 23-7303161
23-7303161
oanginal
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na Numcer. street.
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suneno. lorPP O.
no. lof ':J ba*
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no.ifIfmail
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cch..."rP<310street
10 accressr
street adaressj
n e ccopy
oone o p y ov T.S ='1
:r.e j
juecats
due cafe for
(orfiling
%ng j
lour return.
your return. Sea
3e!! j 311
311 SStraight
t r a i g h t Street
Street
nstrucucns en
nstriic:tens ~:1 :.ty. townqrorposi
I.ty. lown ~OSIcrtice, stare.ana
artice. siate. anaZIP
Z::Pecce. For aaioreign
cose. For lorcign aaaress.
aoaress. see
seeinstructions.
mstrueucns.
::;aCI<;.
sacn.
cincinnati Ohio
45211 _^__^____
Note: Co.-aerate
Note: ccrcc rate income
Income tax tax racurn
return lifers
tifers must
must use
use Form
Form 7004 7004 to Corecuest
raauesr, an an extension
extension of time to
of time file. Partnerships,
[0file. Partnerships, REMICs,
REMICs, andand
trusts must use
trusts must use FormForm 87366736 to to request
recuest an an extension
extension of oi time
time to to file
tileForm
Form 1065,
1065. 10S6, 1066, or or1041.
1041.
1 :: -ecuest
·eCl.!astan311 axtsnsion
sxtensron of ·~f5me until' 88/16
::me until /16 (. -59
':9 _9999 . to;Qfile
_ fj| e(check
(check aniyonly ona):
one):
_ ;~rm7C6.GS(O)
_ j Form 7C6-GS(0) ~ Farm 990-7
Form990·i (401
(40Ha)fa) or
or d03(a)
J.08(a) trust)
trust) □ Form
r:arm 0
1120-ND
1120·NO(4951(4951 taxes)
taxes) □ Form 0
3612
Form8612
F~rm 706-GS(n
2 2 r s r m 7G6-GS(T) ._j Form
Form SS0-T
990- r (trust
(trust other
other Inan
man above)
above} Q Form3520-A
Form 3S20·A0 Q Form 0
8613
Form8613
~ F:Jrm990
3 ? Farm 990 ar 990-EZ or 990·~ ;_j Form 1041
Form 1041 (estate) (sea instructions)
(saa msrruencns) Q Form 4720
~orm 4720 0 Q Form 0
8725
Form8725
iU Fcrm 9990·aL
j Form 90-3L I I Form Form1041-A
1041-,).
u □ Form Form 5227
5227 0 Q FormaS040
Form8804
.='Jrm990-PF
i ; i I Form 990-PF U Form Form1042
1042
u Q Form Form6069 0
6C69 '-'. 0
Fcrm8831
Q Form 8831
2<1 For
2a
the organization
IfIf the organIZation does
For calendar
calendar yearyear 19
does not ncr have
19......2..a_,
have an an office
or other
oiffee or
other tax
or place
tax year
place of
year oeoinnino
business in
of business
oeglnning
in the
the United
United States,
States. check
check this
andending
this box.
ending
box.
_
► 0
a
98 , or and
bb IfIf "his
this tax
tax year
year isIS for
for less
less than
than 12 12 months,
months. cnecx
cnecx reason:
reason: J2j ~ Initial
Initialreturn
rerurn jI_ j i Final
Final retumQ
return: I Change
Change in in accounting
accounting period
period
33 Has Has an extension of
an extension of time
time toto file
file been
been previously granted for
previousry granted for this
this tax year? .·
tax year? ···· " .. ,·" Q Yes 0
Yes □ No No 0
44 State
State in detail why
In detail why youyou need
need the extension
the extension _ _ _ _ _ _ _ _ _ _ ^ _ — ^ —
Sa ifif tTIS
5a :Omis
i s crm IS fcr Fom 7C&GSD),
:i:r Form iC6-GSm,$)8LS9J.PF,$). T.t~l
Jt6.GSiCl. X&GS{T),39C-8L,3SC-PF,2S0T, 104.1 (esta1a). trn2,112J.ND,4'74l
(esiaiB),104ai120-ND,472a
Eai9. 861Z
606a 2612.861a
8513. 3725
8725. 88C4,
~ cr 8831.
a 8831, ertEf'
enEr '1"e tenanve tax less
the o=natI'.e less any raTei.n::!atie
ncrretroaUe creci1s.
crerits. See
See irsru:ti(;('S
instructiens S
S
this form
bb IfIf this form isis for
for Form
Form 990-PF,
990.PF, 990-T,
9SO-T. 1041 (estate). 1042.
1041 (estate), 1042. oror 3804. enter any
a804. enter any refundable
refundable credits and
estimated tax
estimated payments made.
tax payments made. Include
Include anyany pnor
pnor year
year overpayment
overpayment allowedallowed as as aa credit
credit ., ..........• _... .SS
Balance due.
cQ Balance due. Subtract
Subtrac'fWne" 5b'ft'om line
line" 5bTram Sa. Include
line Sa. Include your
your payment
payment 'with
with this
this form,
form. oror deposit
deposit with
coucon ifif reauired.
coupon reauired. See See instructions
instructions ." . ..'.' , , ,.,_ , , .. . .
Signature and
Verification
Under penaliies
penal"",,, of
of perjury,
~erjury. IIdeclare
dec1ar" that
Ihat IIha\i«
have examined
e:r:am,nedthi:olform. Including accompanying
acctJmoanying schedules
schedules and
and statements,
stalemen~. and
and to
to tho
Ihlt hast
bllSl of
of my knowledgll and
my knowledge :andbellllf.
I'
Under
is true,
il is true. correct,
correct. and
Qndcomolete: and that
complete: and 11l1l11 lIlI1hcnzed to
I arn authorized
this form, including
preparethis
to prepare fonn.
this form.
belief,
Signature ►■ TTfle*-
£
FILE flgTgjE&tt. AND ONE COPY. The IRS will show below whether or not your application is approved and will return thc/opy.'
'(.,J.irt
■VJJl '.DCal."
ata*-
■sim
(
Notice to Applicant—To
Notice Applicant-To Be
Be Completed by
by the IRS
IRS
n
Q We HAVE approved your your application.
application. Please
Please attach this
this form to your return.
return.
II We
f~] We HAVE
HAVE NOTNOT approved
approved your your application.
application. However,
However. we we have
have granted
granted aa 10-day
10-day grace
grace period
period from'
fram' the
the (ater
rater of the date
of the
shown below
shown below or or the
the due
due datedate of
of your
your return
return (including
(including any
any prior
prior extensions).
extensions}. This
This grace
grace period
period is considered to
'is considered be aa valid
to be valid
. -extension of
extension
We HAVE NOT
'2~ We
of time
time for
NOT approved
elections otherwise
for elections
approved your
otherwrse required
your application.
required toto be
be made
acoucanon. After considering
mace on
con:>lderingthe
on aa timely
timely return.
return. Please
reasons stated
the reasons stated in
Please attach
in item
item 4,
attach this
4. we
this form to your
form to
we cannot grant your
your return.
return.
your request
request for
for.
an extension
an extenSion ofof time
time toto file.
life. We
VVe are
are not
nor granting
grantmg the 10-day grace
the 10-day grace penod.
penod.
We cannot consider your
(2j We your application
application because
because it was filed
tiled after
after the due
due date
date of
of the return for which an
the return an extension
extension waswas
requastec.
requested.
O~er: _. __
n Other: . —
3~ _
By.
Oirec1Qr
Director Data
Oat"
ifit yqu
you want
'Nan! a copy of
at this
thrs form to be returnee
returned to an address other than
than that shown
shown above.
above, please enter the whichthecopy
the address to which the copy should
should be
besent
sent
j Name
Name
Please
Please
Type Number. slreel,
.Number, slre"l. and room or suite
suue no. (or
(CItP.O. bOl(no.
P.O. box no. if'f mail
mall is not
not delivered
deli'lered to street ~ddreS$)
address)
Type
or
Print
Print ::;Iy. lown or
r.tv. lown or post ottlea. stale,
_COSIatfiea. s!ale. and ;:IP cooa.
and ZIP ecce. For
For a
a ioreign
rO'''19n address, see insirucnons.
addr"ss, sea mstrucncns.
For Paperwork
For Reduction
Paperwork R Act
eduction A see back
Notice. see
c t Notice, back of form.
form. Fo,," 22758
Form 7 5 8 (Rev. 5-95)
(Rev.5-95)
,
'r
.
Form
• Form'
Department
Internal
A For the
■a
·s
t·,
~ .•
Dep.r1me;,t of
990 .990
trie Treasury
or the Treasury
Inlemal Revenue Service
Serv;ce
tha 1999 calendar year,

year, OR
Return
Under s.
Ôrganization Exempt
Return alrganization
Under sePm 501
Exempt From .ome
501(c)
ftome Tax
Tax
Internal Revenue Code
(c) of the Internal
private foundation)
Colle (except black lung^mefil
foundatfon) or section 4947(a)(1)
lung elil trust or
trust
4947(a)(1) nonexempt charitable Irust
Dr
Note: The organization may have to use a copy of this return to satisfy state reporting requirements.
ORtax year period beginning
beginning and ending
requirements.
OMBNo.
OMS No. 1545-00-17
1999
1999
1545·0047
This Form Is Open

Open
to Public Inspection
fj8 Chech it
Chec~ it
Please
Please
C Nameof
Name of organization D Employer identificallon
r — j c Change
hang.
D 01
addfess
address
use
use lASIRS
label or
IrHEHEIMLICH INSTITUTE FOUNDATION 23-7303161
23-7303161
□
D□
D
Initial
lnltial
return
return
Final
RnaJ
return
print or
type.
See
See
Specific
Speciftc
Numberand
311
3 11 SSTRAIGHT
P.O.box
Number and street (or P.O.
T R A I G H T STREET
box ifif mail
STREET
mail is
is not
notdelivered
delivered to
to street
street address)
address) I Room/suite EETelephone
Room/suite Telephone number
(513)559-2391
(513)559-2391
e n d e d Instruc
□ A m Amended lnstrue-
D return
return
(required also
Il!QUlredais
tions.
lions. City or town, state
stale or country,
country, and
andZIP+4
ZIP+4 F Check'"
Check ► f D1 ifexemption
if exemption
For IItporting)
stale
or stale
0
~INCINNATI,
CINCINNATI, OR
OH 45219
45219 application is pending
G organization -—►
G Type of organization [X]Exempt under 501(c) ( 3
.... [ZJExempt )M (Insert
)<I11III (insert number) OR OR ....
►□ Ds e cSection4947(a)(1)
t i o n 4947(a)(1) nonexempt charitable trust trust
H(a) Is this a group return filed for affiliates? E D Yes E D N O I If either box in H is checked "Yes," enter four-digit group
(b) If 'Yes:
'Yes.' enter the number of affiliatesfor
affiliates for which this exemption numbar (GEN) ►
return is
return is filed:
filed: ► _==-_-==-_
_^=^ J Accounting method: I I Cash 1X1 Accrual
(C) Is this a separateretum tiled by an organization covered by a group ruling7 Io Yes [Xl
I Yes l~Xl No
No E D Other (specify) ►
K Check here ► ifif the organizalion's
organization's grass
gross receipts are normally
normallynol notmore
morethan
than$25,000.
$25,000.Tha
Theorganization
organization
needneed
not not
file afilerelum
a return
withwith
the the
IRS;IRS;
blJtbut
if it received a Form 990 Package in the mail, it should file a return without financial data. Some states require a complete return.
Note: Form 990-EZ may be used by organizations with gross receipts less than $100,000 and total assets less than $250,000 at end of year.
1Ma$& Revenue, Expenses, and Changes in Net Assets or Fund Balances
1
Contributions, gi1ls,grants,
gifts, grants, and similar amounts
amounts received:
a Direct public support .. 1a 1 8 6 , 2 9 5 . T--V;
b Indirect public support . 1b
c Governmentcontributions
Government contributions (grants) 1c
> . . ..
o ..
P d Total contributors) STMT
Total (add lines 1a through 1c) (attach schedule of contributors) STMT 1 1 STMT 2 ' . ■ ■ * =
(cash $
(cash$ 176,
1 7 6 , 2295.9 5 . nnoncash
oncash$$ 10·,
1 0 ,0000.
0 0 . )) 1d 1 86,2
186 95.
295.
i-H
2 revenue including government fees and contracts (from
Program service revenueincluding (from PartVII,
Part VII, line
line93)
93) .. 2
3 Membership dues
Membership dues and
and assessments
aisessments... . 3
4
4 Interest on savings and and ttemporary
emporary cash investments . 4
5 Dividends and interest from
Dividendsand fr om securities
securities .. 5 21,926.
6
6 aa Gross rents 6a
SI b
b Less:
rants
Less: rental
rental expanses
expenses
.
.. 6b
2 c Net rentalincome
rental income or (loss) (subtract line 6b from from line 63)
6a) ... . Gc
5?a> 7 other
erf Other investment income (describe .... ► ) 7
8 aa Gross amount from
0 from sale
sals of assets other (A) Securities (B)Other
than
than inventory
inventory .. 1 3 8 , 4 3 0 . 8a ""=! -■-■""
b Less:cost
Less: cost oror other
other basis
basisandand sales
salesexpanses
expenses .. 1 2 5 , 0 3 4 . 8b
c Gain or sclsdufe)
or (loss) (attach schedule] , .. 1 3 , 3 9 6 . 8c
d Net gain or (loss) (combine
(comb ne linaline 8c,
Be, columns (A)(A) and (8))
(Ei)) STMT 3 ad 1
133 , 3396.
96.
■ > ■■ .' :
9 Specialevents
Special events and and activities
activi ;les (attach schedule) . / ■ s ■
a Gross revenue(not includtnq $

revenue (not including S of contributions "-T--V
" ■ . . m
: •
reported on line
reported on line 1a} la) . 9a >■::*•
>
<' --
b less:
Less: direct
direct expensesother
expenses other than thanfundraising
expenses .. 9b
c Net income or (loss) from from special events(subtract
events (subtract line 9b from
from line 9a) .. ... 9c
p-llLa— Gross sales_ofjnv9ptoryJass
I returns and allowances
allowances .. 10a
" 7 JT^psT^g'iôld i 10b
TT-GrBSs'p rof it; dr( l<JS57f f o[HjaJes of inventory (attach schedule) (subtract line froinline
line 10b from line 103)
10a) .. 10c
iV1 Other revenue (from Par jfiminea 103)
103) . 11
^2 M.J2.3,4,5,6c, 7,3d, 9c, 10c, and 11) 12 221,617.
131 __EiQgiam.services [from i f & K column
column (B))
(8») . . . . . 13 106,033.
~
in
1/1 14 /TMaTWgtmeTifiand defTera I (Irom line
line 44,
44, column
column (e))
(C)) . 14 53,868.
c5i r-l:l--~
1
— -15 Eundraisirig-(ffom-lin&44 Teotumn(D))
rrOllil-lIlle"44,.GOlUmn (0)) . 15
Co
41
&
~ 16 Payments to affiliates(attach
Paymentsto affiliates (attach schedule) .. 16
17 Total BXDenses (add lines 16 and 44. column (A)) 17 159,901.
18 Excess or (deficit) for
Excessor for the
the year
year (subtract
(subtract line
line 17
17 from
from line
line 12)
12) .. 18 61,716.
III
a;:a;: 19Net assets or fund balances
balancesatat beginning
beginning of
of year
yaar (from
(from line
line 73,
73, column
column (A))
(A)) .. 19 762,867.
ztll
Z U)
<t 20
20Other changes
other changes inin net
net assets
assets or
or fund
fund balances (attach explanation)
balances(attach explanation) J?~.~
SEE S §.?;'.~?;'.~.~~.N?;'
TATEMENT A 4 . 2D 11,204.
< 21
21 Net assets or fund balan
balances at end
ces at end of year (combine linlines 1
es 18,19, and 20) .. 21 835,787.
LHA For Paperwork Reduction
Reducllon Act Notice,
NoticB, see
sell page 1 of the separate Inslructions.
altha Instructions. Li Form 990 (1999)
(1999)
923001 1
12·14-99
12-14-99 1
-L
10000530 758050 23-12053HEI
10000530 1999.05200 THE HEIMLICH INSTITUTE
1999.05200 INSTITUTE FOUN 23-12051
Farm 990 (1999) THE HE: CCH INSTITUTE FOUNDATION 23-7303161 Page 2
" 1 nizations must complete column (A). Columns (H), ((J), ^ V ) are required ior sectio 1501(c)(3) and
■^'"'Si-Vi" otatement OT ^ ^ ^ ânimations /
i\tati:\\m Functional Expenses (4forg and section 4947(a)(1) nonexempt charitable tiusts b i t optional for others.
Do not include amounts reported on line (B) Program (C) Management
(A) Total and general (D) Fundraising
6b, 8b, 9b, 10b, or 16 of Part t. services
22 Grants and allocations (attach schedule) .
22
cash %
cash $ noncash$$,
noncash .+..::=+
22 +- _ '■■ ■ ■ • . :■'■''.'■'■ .■'■'■y ' . ' ■ ' - :
23
23Specific
Specificassistance
24 Benefits
24
assistance totoindividuals
Benefilspaid toororfor
paid to formembets
(attach schedule)
individuals(attach
members (attach
(attachschedule)
schedule)
23
schedule) 1--='+----------1---·-------1
24
'
t:gS±ISS]·:..:l1~11112
-
L
- . ■ ■ ■ " . ' ■ ■ . " = . " ' ■ : : '
: : ' ■ ■
■■:;■■:-■:'
'■':■ -\y_
: * ' : * . " '

.'.'-'.
■■' ' A
^
Compensationol01officers,
25 Compensation
25 oHicers,directors, etc
directors, etc. ' . 25 0. 0. 0. 0.
26 Other
26 salariesand
othersalaries andwages
wages .. 26 90,816. 68,112. 22,704.
Pensionplan
27 Pension
27 plancontributions
conlribulions ,..,..,." ..,..,.., .. 27
other employee
28 Other
28 employeebenefits
benefits , 28 12,132. 9,099. 3,033.
PayrolllaxBs
29 Payroll
29 taxes . 29 7,409. 5,557. 1,852.
30 Professional fundraisingfees
30 Professional fundraising fees . 30
Accountingfees
31 Accounting
31 toes .. 31
Lagalrees
32Legal
32 fees . 32 787. 590. 197.
Supplies
33Supplies
33 . 33 2,564. 1,923. 641.
Telephone
34 Telephone
34 . 34 691. 518. 173.
Postage and
35 Postage
35 and shipping
shippIng . 35 3,592. 2,694. 898.
Occupancy
36 Occupancy
36 . 36 13,848. 3,462. 10,386.
EQuipment,enlal
37 Equipment
37 and maintenance
rental and maintenance .. 37
Printingand
38 Printing
38 publications
and publications ' 36 4,641. 3,481. 1,160.
ag Travel
39 T[~el ' ~~
39 7,501.
~~~~ 5
~~ , 6 2
__ 6 . ~~~_~~_~~~~ 1 , 8 7 5 . _
Conferencos,conventions,
40 Conferences,
40 conventions, and
and meetings
meetings ~~_~
40 ~- ~~_~ ~~~ _
Interest
41 Interest
41 . 41
Depreciation,depletion,
42 Depreciation,
42 etc. (attach
depletion, etc. (attach schedule)
schedule) ,. 42 6,946. 6,946.
other expenses
43 Other
43 expenses (itemize):
(itemile):
aaOFFICE INSURANCE
OFFICE INSURANCE 43a 3,523. 881. 2,642.
bOUTSIDE
bOUTSIDE SERVICES
SERVICES 43b 1,887. 1,415. 472.
B& MISCELLANEOUS
MISCELLANEOUS 43c 3,564. 2,675. 889.
d
d . ~ __ 43d
e ~ __
G 43e
44 [addlines 22
Total functional expenses [add Una 22 through
tI1~9h 43)
43)
Omanlzatlenscompleting
Organizations column.
coon~18Ulna (8)·(0),cany
columns (BHO), callY these
tnesa
0. o.
totals to lines 13-15 44 159,901. 1106
0 6 , 0033. 33. 553,868.
3,868.
Reporting 01 Joint Cosls.· Didyou report in column (B) (Program services) any lolnt costs Irom
Reporting of Joint Costs. - Did you report in column (B) (Program services) any joint costs from a combined educational campaign and a combined educational campaign and
fund raisingsolicitation?
fundraising solicitation? ^ LD Yes E[X]
Z H Yes J NoNo
'Yes,' enter
IfIf 'Yes," enter (I) the aggregate
(I) the aggregate amount
amount ofottnese joint costs
these Joint costs $$ ;;(II) the amount
(II) the amount allocated
allocated toto Program
Program services
services $$ _ ;
(ill) the
(ill) the amount
amount allocated
allocated to
to Management
ManaQementand nenaral $$
and general ;. and
and (iv)
(ivlthe amount allocated
the amount allocated toto Fundraising
Fundraisin[J$$ -
lp.~HjWil Statement of Program
fP^rtjlfi^l Statement of Program Service Accomplishments Service Accomplishments
What isis the
What the organization's
organization's primary
primary exempt
exempt purpose?
purpose? ► .. SSEE E E SSTATEMENT
TATEMENT 5 5
pro~am Service
Program Service
xpenses
Expenses
AIrorganizations
All mustdescnbeIhelrexempt
orgaLrlizatlons must PUIPoseachievements
describe Iheir exempt puipose acI1levements In a crear
In clear end concise "",nner.
and concise manner. S Slate the number
lale the number 0of1clients served, publrcatians
clients seoved, publications IIssued, etc. Ols~ss
ssued, ~c. Discuss (~urred
(Required for
lor 501(c)(3)
501(~(3) and
and
achr""eme<11s
achievements thaIore
thai notmeasurable.
are not measurable.(Section
(SccIl0ll501(c)!3) and(4)
501(c)(0) and 0llilll1rzations
(4)organizations and 4947(3)0)
and nonellern;>t
4!147(a)(ljnonexempt trustsmust
charitabre Iru3ts
charitaMe must also enter the
0100 enter amountol01grants
1/1. amount 9r;antsand
and (4) arss.,
(4) and4947(a)(1)
Ofll$., and 49 7(eJ(l)
elteeatens to
allocations toothers.)
othe",.) butopUonallor
trusll!; but
_ ^ ^ ^ ^ ^ _ ^ ^ _ _ _ ^ ^ _ ^ ^ ^ _ _ trusts; olhars.]
optional for others.)
a THE THE HEIMLICH HEIMLICH INSTITUTE
INSTITUTE FOUNDATION,
FOUNDATION, INC.
INC. IS A
IS A CORPORATION
CORPORATION
DESIGNED
DESIGNED TO CONDUCT
TO CONDUCT SCIENTIFIC,
SCIENTIFIC, CULTURAL
CULTURAL AND SOCIAL
AND SOCIAL RESEARCH
RESEARCH
INTO
INTO ISSUES
ISSUES OF IMPORTANCE
OF IMPORTANCE TO THE
TO THE MEDICALMEDICAL AND SCIENTIFIC
AND SCIENTIFIC
COMMUNITIES.
COMMUNITIES. (Grants and
allocations $$ I 331,810.
1,810
b AIDS RESEARCH
b AIDS RESEARCH AND EDUCATION AND EDUCATION
---._ ..
(Grants and
allocations $$ I 447,715.
7,715
c EDUCATION OF THE GENERAL PUBLIC, THE
c EDUCATION OF THE GENERAL PUBLIC, THE PRINTING AND PRINTING AND
DISTRIBUTION
DISTRIBUTION OF EDUCATION LITERATURE TO PUBLIC PLACES
OF EDUCATION LITERATURE TO PUBLIC PLACES
ABOUT
ABOUT THE HEIMLICH
THE HEIMLICH MANEUVER.
MANEUVER.
IGrant~ and allocations
(Grants and allocations $$ f 226,508.
6,508,
d
(Grallts and
allocations_1_
$ I
ee Cither
OUteroroararn services (attach
program services (attach schedule)
schedule) (Grants and
allocations S$ I
ff Tolal ol
Total 01Program Service Expenses
Program Service (should equal
Expenses (should equal line
line 44, column (B),
44, column Program services)
(B), Program services) .. ~ 1106,
0 6 , 0033
33 •
~~?l~
923011
12-14-99 2 Form 990
990(1999)
(1999)
10000530
10000530 758050 23-12053HE!
758050 23-12053HEI 1999.05200
1999.05200 THE
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 23-12051
23-12051
.. 990 (1999)
Form 990
Form THE
THE HEMfclCH
HE H INSTITUTE
INSTITUTE FOUNDATION.
F'OUNDATION. 223-7303161
3-7303161 Page 33
IE~d~
RiMff«l Balance
Balance Sheets
Sheets
Note: Where
Note: Whererequired,
required, attached
attached schedules
schedules and
and amounts
amounts within
within the
the description
descxiption column
column (AI
(A) (8)
(B)
should be
should be for
for end-ot-year
end-ot-yeer amounts
amounts only.
only. Beginning of
Beginning 01year
year End of
End vear
atyear
-----4---4---------~-------
7 , 1 1 9 . 45 22 22 ,, 334411. •
45
45 Cash- non-Interest-bearing
Cash-non-interest-bearing __.._ _ . ~----~~ 7 , 119. -~r-------~~~~
45
46
45 Savingsand
Savings and temporary cash investments
Investments 77 6 ,, 222299.. 46
46 1111 , 667777 .•
r--------
47 aa Accounts
47 Accounts receivable
receivable . 47a
47a
is
II Less:
Less; allowance tor doubtful
accounts .. 47b
4Th 47c
4~
Pledgas reeelvable
48 aa Pledges receivable
48
.. . ... ... \~:~;:::
48a
lilllSlill
:r_H:-_#_{_)'_{:_::i:_:i_:::i_:F_t]:_T_t_::::~'_:t-j(' t!i1!.ir.~!;:
Lass: allowance
bb Less: allowancetor accounts
for doubtful accounts L....:..:48::-b'-'-
48b . -t- t---'-48::.:c'+
48c _
49
49 Grantsreceivable
Grants receivable _ _ _ . 49
49
50
50 Receivablesfrom
Receivables officers, directors,
from officers, directors, trustees,
50
50
en ;~e~e:o~:p~~~el::n~·r~~·~i~~~·I~··::::::::::::::::::::::::··i··~·~~T .... ······..·······..··..·..··..·..
Qj 51 a Cither notes and loans receivable
51a 51a
en
en
(fl
Less:allowancefor
bb Less: allowance lor doubtful
doubtful accounts ~51!.!b'-l...
51b t- -t-~61!.!C'+
51c __
<
62
52 Inventoriesfor
Inventories sale or
for sale or use
use _.........................
.... 62
62
53
53 Prepaidexpensesand
Prepaid deferred charges
expenses and deferred charges _................. 53
53
54
54 Investments-- securities
Investments securities ... 54
54
66 aa Investments
55 Investments--land, buildin!;ls, and
land, buildings,
equipment: basis
equipment: _............. 1-"'55::..:3'+---
55a --1
bb Less: accumulated depreciation

Less:accumulated 55b
L,,5~5~b~=-==,-- __ ---::-_-If-- __ 55c __
-:;;-=-=,........,=-::'-=--+-5~5~c-+- ---;=-=-::----::--=--,,::--
56
56 Investments~other
Investments-other . SSEE
EE S STATEMENT
T A T E M E N T 66 6655,
5 5 , 7711.
11. 56
56 7781,
8 1 , 1117
1 7 .•
Land, buildings,
57 aa Land,
57 buildings, and 57a ..·.......... ·..5 5 , 6 1 6 .
and ~~·~i~·~~~i;·b·~~·I~·::::::::::::::::::·'r5·.;~l
equipment: basis 5·5·;·6'1'6·•
Less:accumulated
bb Less: accumulated depreciation 57b
57b 441,
1 , 7711
1 1 .• 220,851.
0 , 8 5 1 . 57c
57c 113,905.
3,905.
58
58 othor assets
(describe ►... S E E STATEMENT
SEE STATEMENT 7 \ -'5,668.
5 , 6 6 8 . 58
58 66,747.
,747.
59
59 Tolal assets
Total assets (add
(add lines
lines 45 through 58)
45 through 58Hmust equal line
(must equal line 74)
74}... __ 7765,
6 5 , 5578.
7 8 . 59
69 8835,787.
35,787.
60
60 Accounts payable
Accounts payableand accrued expanses
and accrued expenses 60
60
61 Grantspayable
Grants payable _ _ _.... 61
61
en
in
62 62
II! 62 Deferredrevenue
Deferred revenue __ _...... 62
~
4 +j
63 Loansfrom
Loans from officers, directors, trustees, and key
key employees _................. 63
53
:c
.o
aIII 54
64 Tax-exemptbond
a Tax-exempt liabilities
bond liabilities _ _.............................. 64a
_::i
l
Mortgages and other notes payabla
b Mortgages payable __ 64b
Mil
65 othertiabilities
Other (describe ►
liabilities (describe ... PPAYROLL
AYROLL T TAX
AX W WITHHOLDINGS
ITHHOLDINGS )) 1- 22....:,_7_1--'.1_0+-"'6:..6+-
, 7 1 1 . 65 O.
0_.
66 liabilities (add lines

Total liabilities lines 60 throuqh
throucn 65) __ . 22,711.
,711. 66 0O.
.
OrganJzallam. that
Organizations fallaw SFAS117,
Ihal follow SFAS 117, check hers'"►
chee" hers !.XJ and compJ9telin9S671hraugh
and complete lines 67 through
and lines
69 and lines 73 and 74.
74. ■ o"o"
57 Unrestricted
67 Unrestricted . 7723,948.
2 3 , 9 4 8 . 67 7796,868.
96,868.
c 68 .
68
Temporarily _ _ .
69 Permanentlyrestricted _ .. 3 8,919.
38,919. 69 3 8,919.
38,919.
■D
C thai do
Organizations that 110not follow SFAS
not follow SFAS117,
117, check here'"
here ► D and complete lines !"■" *. -
..
3 >" . ' . ■ .
u. 74
70 through 74 ''.•.'■•'■' ■
o
o 70 Capitalstock,
Capital currant funds
stock, trust principal, or current __ _.__ .. 70
71 Paid-in orcapital
Paid-in orcapital surplus,
surplus, or land, tiuilding,
building, and
and equipment
equipment fund
fund .. 71
5 72 Retainedearnings,
Retained earnings, endowment,
endowment, accumulated income,
income, or
or other
other!unds
funds _ 72
72
Z 73 nat assets or fund
Total net lund balances (add lines
lines 67 through
through 69 ORlines
3R lines 70 through 72;
72;
column (A)(AImust
must equal line 19 and column (B) linee21)
(8) must equal lin 21) .. .. 7 6 2 , 8 6 7 . 73 8 35,787.
835,787.
74 Tolaillabililies
Total liabilities and net assets /!Iund (addI lines 66
fund balances (adc and 73)
56 and .. 7 6 5 , 5 7 8 . 74
765,578. 8 35,787.
835,787.
Form 990 isIs available
availablefor for some
for public inspection and, lor some people, serves
serves as the primary
prlmary or sole source of information about a particular organization.
organization. How the public
perceives an organization
perceives organization in such cases
cases may
may be
be determined
determined by the information presented
presented on its return. Therefore, please
pleasemake complete and accurate
make sure the return is complete accurate
Part III, the organization's programs and
and fully describes, in Part and accomplishments.
923021
923021
12-14-99
1Z-14-99 3
10000530
10000530 758050 23-12053HEI
758050 23-12053HEI 1999.05200
1999.05200 THE HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 23-12051
23-12051
" Form,990 f1999> THE H E O ^ I C H INSTITUTE FOUNDATION 23-7303161
■ : PaMM&, Reconciliation
Reconciliation of
'Financial
of Rev I I per
aer Audited
Audited
Revenue per
■Financial Statements with Revenue per m
Rarti-iVfeBS Reconcl V f i o n of Expenses per Audited
Financial Statements With txpenses per
Return Return
a Total revenue,
Total
b Amounts
revenue,gains,and
peraudiled
per audited financial
Amounts included
included on
othersupport
gains, and othersupport
statements --
line aa but
on line but not
not on
on
► a 1tGl0l00008
~:,
:::">.7
N/A
' a Total expenses
expenses and
Amounts included
line 17,
and tosses
included on
17, Form
Form 990:
990;
losses per
audited financial statements
b Amounts on line
per
line aa but
but not on
not on
► a
..- ~III!I~ :^:;:.:;::;:::.::s:.:L«;;:;:-;::;;a.::v::.:.:::::;:-
■ ■ . - ■ " " '

N/A
■ - " " ■ ■ " -
line
line 12, Form
Form 990;
990: (1) Donated services
(1J Donated services ." " ■ . " " " ■ . : " - " ■ ■ " .
(1) Net unrealized

unrealized gains
gains and use
and use of
offacilities ... $$
facilities... _ :; ■'■■.■■■}■ ■■'-■■':■■ '■' '-'■.:. 1
: ■;:.:■'■ v ; : f - ' . ■ . ' ■ ' . ;
on investments
investments $$ _ (2) Prior year
(2) Prior year adjustments
adjustments
■■ ■
■ .
(2) Donated
Donated services
services reported on
reported on line
line 20,
20,
and use o1iacilities
and ... $
of facilities ...5 _ Form 990
Form 990 $$ __
■ y v . ■ : ■ : . . .. -
(3) Recoveries
Recoveries of
of prior
prior Losses
(3) Loss es reported
reported on on -;
year grants
grants $
$ _ line
line 20,
20, Form
Form 990 ...
... $ "",o,.,,,.._,_..., ..,..,,
'm: 'm ~"~,,·,';\i,':,:}}:~:'A~:,:·:,',~:
other (specify): (4) other
Other (specify):
(specify):
S S -;:.<. ■;,:.:. =>.i-.,.::.:.. -j
---------$_------------ -------------$------------- -■..
Add
Add amounts on lines
amounts on lines (1)
(1) through
through (4)
(4) ► b Add
Add amounts
amounts on lines (1) through
lines (1) through (4)
(4) ► f-!'-If-------------
b
cc Line
Line aa minuslina
minus line bb ► c
"-1+.+==="""""",=="", cc Line a minus line
Line a minus line b b ------ -- ► l-i'cm=""""==""""""'=
c ". ■
d Amounts included
Amounts included ononline Form
line 12, Form d Amounts included
Amounts included an on line
line 17, Form
Form >■■■■•■: v - ^ ^ - v
990 but not on
online
line a:
a: 990 but not on line
990 line aa: ■■',." : ',.:-;v 5 ;"v;.. v.: :

tnvestment expenses ;SllllSllPi| (1) Investment
Investment sxpe
expenses
nses
: ■ .
:
not included
not includ ed on
on not
not included
included on
on -:U->.-->:-r1L:-.---.-"------a--
line 6b, Form 990 $ Form 990 ..
line 6b, Form ... $ __ :. W . y. -V,"1 '-.* ::: -.^
(2) Other
line 6b,(specify):
$
Form 990 ... s -------------II:I~ij]~ii:~l;J~;~j!:;;{~~~t~~:~!~~~~1~~>~~1
(2) other
Other (specify):
(specify):
5
: i -
\ - " " - . I - ' " . " : . - - " -'_,
bJ9%§ht
■■":
iv.o;;--.-.:;*.-fs ■■--'.
: - . ■ r 1
.^ *,■.■:_■■- ■■,■'■: :
---------_$_------- --------------$--------------
Add amounts on
Add amounts lines (1)
on lines (1) and
and (21
(2) ► d Add amounts on
lines (1)
(1) and(2)
and(2) ►
..- 1-"-'1-
a __
B Total reve nue per lin e 12, Fo rm 990 e Total exp
Total expenses per line
ensas par line 17,
17, Form
Form 990
990
(line c plus line d) ^ (line
(line cc plus
plus line
line d)
d) ^.
B a
ijRaiittii List of Officers, Directors, Trustees, and Key Employees (List each one even it not compensated.)
(B) Title and average Hours (C) Compensation (D)Conlributlonsto (E)Expense
employee benefit
(A) Name and
(AI Name and address
address per week devoted to (llnDt paid, enter plans & deforced account and
position compensation other allowances
SEE ATTACHMENT
SEE ATTACHMENT C
C
o.
0. o.
0. o.
0.
a.
+
;
/;;; 75 Did any officer,
75 Did officer, director,
director, trustee,
trustee, or
or key
hey employee
employee receive
receive aggregate
compensation of of more
more than
than $100,000
$100,000 from
from your
your or
anlzatlon and all related
related
~ organizations,
organizations, of01 which
which more than $10,000
more than $10,000 was provided by the
was provided the related
organizations? If Yes,'
"Yes,' attach
attach schedule.
schedule. ►
.... L J Yes
Yas |_XJ No00
No Form
Form 990
990 f1999>
1999
Form 990(1999) CHH
THE H E M | I C INSTITUTE
I N S T I T U T E FOUNDATION
FOUNDATION i 2 3-7303 161
23-7303161 Poge5
:
i;£art ::VE Other Information ^ P '• — Yes No
76
76 Did
Did the
the organization
orqanlzatlon engage
engage in
in any
any activity
activity not
not previously
previously reported
reported to
to the
the IRS?
IRS? If "Yes," attach
If'Yes," attach aa detailed
description 01each
ol each activity
activity 76 X
71
77 Were
Ware any
any changes
changes made
made in the organizing
in the organizing orgoveming
or governing documents
documents but
but not
not reported
reported toto the
the IRS?
IRS? __....... _. . .. _..... _ 77 X
II'Yes,"
If attach aa conformed
"Yes," attach conformed copy copy of the chances.
of the changes. ...: .
78 a Did
78 a Did thethe organization
organization have have unrelated
unrelated business
business gross
gross income
income of $1 ,000 or
$1,000 or more
more during
during the
the year
year covered
covered by by this
this return?
return? _ 78a "x"
bb IfIf 'Yes:
"Yes,* has
has itit filed
filed aa tax.
tax return
return on
on Form
Form 990-T
990-T for
for this
this year?
year? . __._..... ........ ..... . N /A
Ij!_(_lJ: _ 76b
79
79 Was there a llquidation,
Was there liquidation, dissolution,
dissolution, termination,
termination,ororsubstantial
substantialcontraction
contraction during
duringthetheyear?
year? ._ __. _ 79 X
80 a
80 a
IfII 'Yes,"
Is
"Yes." attach
the
attach aa statement;
organization
statement;
related (other
the organization related
governing bodies,
governing bodies, trustees,
(other than
than by
by association
officers,etc.,
trustees, officers, etc.,totoany
anyother
with aa statewide
association with
otherexempt
statewide or
or nationwide
exemptorornonexempt
organization) through
organization?
through common
common membe
.
rship,
membership,
__
1 „x„.
■■
b
b Ifif 'Yes,'
"Yes," enter
enter the
the name
name of
of the
the organization
organization IJ!.
► s mmKffiMSl
and
and check
check whether
whether it is
is exempt OR nonexempt. lllis
81
81 aa Enter
Enter the the amount
Instructions
amount of
instructions for for line
of political
line 81
61
expenditures, direct
. __.
direct or
._.
or indirect,
described in
:
in the
the
. __ _ aia! 0. 111
bb Did the organization tile Form 1120-POL
Did the organization tile Form 1120-POL for this year?for this year? _. .. .__ _ _.. ._._.. _ .. X
82 aa Did
Did thethe organization
receive donated
donated services
services or or the useuse of materials,
materials, aquipment,
aquipment, or or facilities
facilities at no
no charge
charge oror at lass than
substantially less than
at substantially Witt III Hi
fair
fair rental value?
rental value? ._ ._ _ 82a X
bb IfIf 'Yes:
"Yes," you
expense in
expense
you may
mayindicate
in Part
Part II.
indicate the
ll. (See
thevalue
value ofof these
instructions for
(See instructions
theseitems
items here.
for reoortinq
reporting in
here. 00
in Part
Donot
not include
III.)
Part III.)
include Ihis
..
this amount
amount as as revenue
revenue inin Part
_..
Part IIor
or as an
I I
_ I 82b I 75,000. 11i111
ll III
111
83 a
83 a Did
Old thethe organization
organization comply
comply withwith the
the public
public inspection
requirements lor for returns
returns and
and exemption
applications? .. . ...
.__ _ . _ 83a X
b Did
b Did thethe organization
organization comply
comply wilh the dlsclosure
with the disclosure requirements
relating toto quid
quid pro
pro quo
quo contributions?
contributions? . _ 83b X
84 a
84 a Did
Did the organization solicit
the organization soHcit any
any contributions
contributions or !lifts that
or gifts that were
were not
not tax
tax deductible?
deductible? .. _ _ . 84a X
b
b IfIf 'Yes,'
"Yes," did
didthe
taxdeductibla?
tax deductible?
the organization
,.
include with
with every
every solicitation
solicitation an
,._
anexpress
express statement
_.
statement that
that such
such contributions
gifts were
were not
not
.iH.l~
N/A _ IS
1 1 SI
84b
85
85 501(c)(4),
501(c)(4), (S), (5), or organizations. a Were
or (6) organizations, Were substantially
dues nondeductible
nondeductible byby members?
members? ..... __. ......... . N/A "f:JI~ _
b DId
b Did the
the organization
organization make
make only
only In-house
In-house lobbying
expenditures 01$2,000
of $2,000 or
or less?
less? N/A w/b . 85b
...... .j..
If'Yes'was
If 'Yes' was answered
answered to either 85a or
to either or S5b,
85b, do
do not
not complete
complete 85c85c through
through 85h
85h below
below unless
unless the organization i receh
the organizatio receivedfed a waiver
waiver for
for proxy
proxy tax
tax
v-'" ■
■
owed
owed for
for the prior
prior year.
year_ : ■.
c Dues,
Dues, assessments,
assessments,andandsimilar
similaramounts
amountsfromfrommembers
members .__ .. _ _ 85c N/A ■■■. ■ : :
: : - ■ ■ !
dd Section
Section 162(e)
162(e) lobbying
lobbying and
and political
expenditures _ _ 85d N/A :■ . . .
: ■
:
- :■!
e Aggregate
nondeductible amount
amount of of section
section 6033(9)(1 HAl dues
6033(a)(1)(A) dues notices
notices . _ 85B N/A i ;■ ■■
:j .
f Taxable amount
Taxable amount of
of lobbying
lobbying and
and politlcalaxpenditures
political expenditures (line
(line 85d
85d less
less 85e)
85e) ._ _.. _ 85f N/A .: :. .
- ■ . : = ■ ;
gg Does
Does the the organization
organization elect
elect to
to pay the
the section
section 6033(e)
6033(e) tax
tax anon the
the amount
amount in
in 85f?
85f? _.. .__ N
N / ..
A~ _ B5q
h
h IfIf section
section 6033(e)(1)(A)
6033(e)(1)(A) dues
dues notice
notice were
were sent,
sent,does
does the
the organization
organization agree
agreetoto add
addthe
theamount
amount inin 85fto
85f to its
its reasonable estiniate of
reasonable estimate 01 dues
dues
allocable to
lobbying and and political
expenditures forthB
forthe following
fallowing tax t~x year?
year? __.. _ _. .. .. _ NI.~
N/A . 8Sh
organiZations. Enter:
Enter: a a Initiation
Initiation fees
fees and capital contributions
and capital contributions included
included on on line
line 12
12 86a N
N // AA ■ . :
^
.: ■ :■ ■■
: '*-.■ ■'■':
bb Gross
Gross receipts,
receipts, included
included ononline
line 12,
12,for
for public
public useuse ofof club
clubfacilitlas
facilities ..... _..... _ 86b N/A 1 ■
-. ■- ".
87
67 501(c)(12) organizations. Enter: Enter: ■■". >
sCx;
. ."■: ■
a Gross
Gross income
income from
from members
members or or snarenolders
shareholders 87a N/A •*•'.-■". "■
:■■: "■ ! . . •
0 J
m
■• :
bb Gross
Gross income
income from
from other
other sources.
sources. (Do (Do notnot net
net amounts
amounts due due or
or paid
paid to
to other
otherSources
sources : : _ ■
■ j
. : .
. ■
.-■
against amounts
against amounts duedue or
or received
received from
from them.)
tham.) ._ __. ._._ _ 87b N/A
88
88 At
At any
any time
time during
during the
the year, did the
year, did the organization
organization awn own aa 50%
50% oror greater
greater interest
interest inin aa taxable
taxable corporation
corporation oror partnership,
partnership,
or an entity
or entity disregarded
disregarded as as separate
separate from from Ihe
the organlzalion
organization under
under Regulations
Regulations sections
sections 301_7701-2
301.7701-2 andand 301.7701-3?
301.7701-3?
,,'Yes,'
If "Yes," complete Part IX
complete Part IX _ _.. . __• . •__. _ _ 88 X
89 a
89 a 501(c)(3)
501 (c)(3) organizations. Enter: Amount of
Enter: Amount ol lax
tax imposed
imposed on on the
the organization
organization during
during the the year
year under:
under: _:_ ■■ .............
O.. ::section O.. ;.sactlon 0_ .
m
"■ . : ■ ;
section 49111J!.
section 4911 ► 0 section 4912
4912....► 0 section 4955
4955 ► ....
b 501(c)(3) end
IJ and 501(c)(4) organIzations.
organizations. Did Did thethe organization
organization engage
engage in in any
any section
section 4958 4958 excess
excess benefit
benelit '■:.\'-"-
transaction during the

transaction during the year?
yBar? If'Yas,'
If "Yes," attach
attach IIa statement
explaining each
each transaction
transaction .__.. _
X
e Enter: Amount of
Enter: Amount of tax
tax imposed
imposed on
on the
the organization
managers or
or disqualified
persons during
during Ihe
the year
year under
under
sections 4912,4955,
sections 4912, 49~5, andand 4958
4958 . ._ _. ► 0 .•
d Enter:
d Enter: Amount
Amount 01of tax
tax inin S9c,
89c, above,
above, reimbursed
reimbursed by by the
the organization
organization .. __ ._:_ :......... 0 .•
90 aa List
90 the states
List the states with
with which
which a a copy
copy of this
this return
return is tiled
tiled ► IJ!. _O_H_I_O
OHIO -.--_-.--
__ -::-
b Number
b employees employed
Number of employees employed inIn the
the pay
pay period
period that
that includes
includes March
March 12,1999.
12, 1999 . ._ _ I 90b
90b I 3
91
91 The
The books are InIn care
books are care 01 K J_J_O_AN__;__:__S_T.,::E:_::I:_;;N_;,::B::_:E..c:.R-'-'--G
of ..... OAN STEINBERG Telephone
Telephone no ► (513)
no_.... ( 5 1 3 )559
5 5 9-2
- 2 391
391
Located at ► 311
LocatedatlJ!. 3 1 1 STRAIGHT
STRAIGHT STREET
STREET CINCINNATI,
CINCINNATI, OHIO
OHIO ZIP+4 ► 45219
ZIP +4 .... 45219
-------
92
92 Section 4947(a)(1)nonexempt
charitable tlllsts
trusts filing
filing Form
Form990
990 in
inlieu
lieuofofForm
Form1041-Check
1041-Checkhere
here .. _ _.. ._______IJ!. ►D□
923041
and enter
and enter the amount
tax-exempt interest
interest received
received or
or accrued
accrued during
during the
the tax
tax year
year IJ!. I 92
92 I N// A
N
~~~f.t.1:o
01-31-00 5
5 Form 990
Form 990(1999)
(1999)
10000530
10000530 758050
758050 23-12053HEI
23-12053HEI 1999.05200
1999.05200 THE
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 23-12051
23-12051
Form
Enter
990(1999).
For~_990(1999)
U?iit:t::vn::-I
;:Jf?art;Vi|;:;- Analysis
Analysis o
gross amounts
Enter gross amounts unless
f
•. T
I n
unless otherwise
otherwise
HE
THE
of III\.iUI"",,-,
c o m e - P r o
~_CH
H E U ^ I C H IINSTITUTE
l ^ P n g A
NSTITUTE
LCtivities
fng Activities
Unrelaled b~ness
FOUNDATION
FOUNDATION •^ ^
income
^ P
Excluded by section
Excludedby section 512,
512. 5I3,
5t~. or
2
514
or514
3 -7303161
23-7303161
(E)
(E)
Page6
Page I)
indicated.
indicated.
93 Program
93 Program service
(a)
(a)
service revenue:
revenue:
(M
Bujness
BUSiness
code
(B)
(B)
Amount
Amount I~~~~-
(C)
Exclu
sion
code
(D)
(D)
Amount
Amount
Related
Related or
function
or exempt
exempt
function income
income
(b)
(b)
(0
(e)
Id)
(d)
(e)
(e)
(1)
(I) Medicare/Mgdicaid
Medicare/Medicaid payments
payments ..............................
(g) Fees
Fees and
and contracts
contracts from
Irom government
government agencies
agencies .....-
.:
94 Membership
Membership duesdues and
and assessments
assessments ........................
95 interest on
savings and
and temporary
temporary
cash
cash investments
investments ................................................
95 Dividends
96 Dividends and
and interest
interest lrom securities .....................
from securities 14
14 2 1,926.
21,926.
, , .,.:(';':,sF,:r:,~
: :',
97 Net rental
97 Net rental income
income oror (loss)
(loss) Irom
from real
real estate:
estate: i,;grtH?{i:il~,:::;.
iilllll\iffi:si£lisS!:i;
(t,(·" 8lli ;;!:SSs ,'::::::::: '>'.".'::'@
':".'.":',.j mmmmmmm m&m§mm^^m
(a)
(a) debt-financed property ....................................
(a)
(b) not
1I0t debt-financed
property .................................
98 Net rental
9B Net rental income
income or or (loss)
(loss) from
from personal
personal property
property ......
99 other Investment income .........__ ............................
99 Other Investment income
11 DD
DOGain
Gainoror (loss)
(loss) from
from sales
sales ofof assets
assets
other than
other inventory .............................................
than inventory 18
18 1 3,396.
13,396.
101 Net
1D1 Net Income
Income or or (loss)
(loss) from
Irom special events ....... - ..........
special events
102 Gross profit
1 D2 Gross profit or
or (loss)
(loss) from
from sales
sales of
01 inventory
inventory ....._ ......
103
1 D3 Other
Other revenue:
revenue:
a
a
b
b
e
e
d
d
a
e
104
104 Subtotal
Subtotat (add columns (B),
(add columns (B), (D),
(D), and (E)) .... -............. ,
and (El)
mmm ?f/ o. itEM
0. ""- "'f ■- 3 5,322.
35,322. o.
0.
105
105 TOTAL (add line
TOTAL (add 104, columns
IIn9104, columns (8),(B), (D),
(D), and
and(E))
(E)) ............................................................................................................... 35,322
3 5,322 .
Note: (Line 105 plus line Id, Part 1, should equal the amount on tine 12, Part 1.
I Relationship of Activities to the Accomplishment of Exempt Purposes
wmn
Line No. Explain how each
Explain how each activity
activity for
for which
which income
income isis reported
reported inin column
column (E)
(E) 01
of Part
Part VII
VII contributed
contributed Importantly
Importantly to
to tha
tha accomplishment
accomplishment of
of the
the organization's
organization's
T exempt purposes (other
exempt purposes (other than
than by
by providing
providing funds for such
funds for such purposes).
purposes).
N/A
i - M i r ^ M Information Regarding Taxable Subsidiaries (Complete this Part il the 'Yes" box on 68 is checked.)
Name, address, and employer Identification Percentage of End-of-yaar
End-ol-year
Nature of business activities Total income
number of corporation or partnership ownership interest assets
assets
N/A %
%
%
%
accompanying schedules arid statements, and to U19 best ol my knowledge and belief, 1113 tnje,
I Inbimallan at which preparer has any knowledge. (Important Sea General Inaltuctlon U.)
SCHEDULE A
SCHEDULE OrgaAation
OrgaAation Exempt Under
Under SectioAOl
Sectiol01 (c)(3)
(c)(3) OMB
OMS No. 1~45-0047
1545-00-17
(Form 990)
(Form ^^pxcept
"IItf'xcept Private
Private Foundation)
SBclion 501(e),
501(e), 501 (I), 55 0 ^j(.
501(1), t),
Department
Oepartment of trie Treasury
or tne
rjitemal Roy~nue
In'emal Revenue Service ► MUST be
.....MUST
501(n);
he completed
completed bV
by the
Section 4947(a)(1)
501 (n); or Section
the above
4947(a)(1) Nonexempt
above erqanlzattans
Information
organizations and
and attached
Charitable Trust
attached to
lo their
Trust
their Form
Form 990
990 or
or 991HZ.
990-EZ.
1999
1999
Nameof
organization Employer identification number
Emplover Identlflcatfon
THE HEIMLICH FOUNDATION
INSTITUTE FOUNDATION 23! 7303161
23: 7303161
Employ ees Other Than Officers,
I p J t t M Compensation of the Five Highest Paid Employees Officers, Directors,
Trustees
instructions. List Bachone.
(See instructions. each one. If there ara enler 'None.')
are none, enter
(b) Title and average hours (O) Contributions to (e)Expense
Nameand address of each
each employee
employee pak)
paid employee benefit
per week devoted to (e) Compensation
(c) ptans & deferred account and other
$50,000
more than $50,000 position compensation allowances
NONE
NONE
Total number of other employees paid

over$50.000.... oO ► ". .'./ -". j .'.":■■■ "o J"".^ J J . "". . . J ""-J " J - " ■" ■ " ' - ■-: ■: .^
: :
:- £art; III Compensation of the Five Highest
Hiqhest Paid Independent
Indepe ndent Contractors
Contractors for
f or Professional
Profession;al Services
(Seeinstructions. List each one (whether Individuals or firms). If there are nona, enter 'None.')
Name and address of each independent contractor paid more than $50,000
(a) Name (b) service
(Il) Type of service (:) Compensation
(~) Compensation
NONE
NONE
;~~a'~~~~::~~f~!~~~~:~~:~:~~SO~.~~
_ _...................
.... .......... , M . M . . . ......,..; .. . . . . . . . . ; . . . ; . „ L y . . „ . . . , . . , ,,... .
- . - - - ' - . ' v : -..-■ " V " ■ ' ■ > ■ ■ : ■ ■ ■ ■ " ' , ' - . ' ■ ■ " - v ■ " .
Total number of others receiving over ■■.».■■:. :
I
$50,000 for professional services :!:~t:!ii!i~.i~~~!~!ili!;~~!l!~I:·:li:[l!t~~~l~~~~rn~i~iit~ij·
► 0
..-...■■„> ■ ■ . : .,-. ■ ■ ■ i .\-s-:■:■.■;,; ^ -.-■.- r,;.\t; ■■..
LHA Fteductlan Act Noti~e,

For Paperwork Reduction Notice, see page 1 of tile
the Instructions
Instructions for Form 990 and Form 990·EZ.
990-EZ. Schedule A (Form 990) 1999
Schedule
923101
12-14-99
12-14-99 7
10000530
10000530 758050
758050 23-12053HEI
23-12053HEI 1999.05200
1999.05200 THE
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE FOUN 23-12051
FOUN 23-12051
THE HEMfclCHH INSTITUTE
Schedule A (Forrn990) 1999
Schedule 1999 INSTITUTE FOUNDATION 23-7303161 Page2
■" ' ^m i^
FPaH:Jif!
^rtjil?: Statements
Statements About Activifle's Yes No
1 During the year, has the organization attempted to inlluence influence national, state, or local legislation,
including any attempt to influence
inlluence public
legislative matter or referendum? . 1 X
IfII 'Yes,'
'Yes,' enter the total expenses
expenses paid or incu rred in connection wilh
incurred with the lobbying activites ► $ $ _ IS
Organizations
Organizationsthat that made
made an election under section 501 501(h)(h) by
by filing
filing Form 5766
5768 must
must complete Part Vt·A.
Vl-A. other
Other
organizations checking "Yes," "Yas,' must complete Part Vt-BVI'B AND attach a statement
statement giving a detailed description of of
the lobbying[I activities.
th& lobbyin
22 During the year, has the oganization, either directly or indirectly, engaged in any of the following following acts with any of its trustees, directors,
directors,
officers,
officers, creators,
creators, key
key employees,
employees, or or members
members of of their
their families,
families, oror with
with any
any taxable
organization with
with which
which any
any such
such person is
person is lilt
affiliated
affiliated asas an
an officer,
officer, director,
director, trustee,
trustee, majority
rnaiority owner,
owner, oror principal beneficiary:
principal beneficiary:
aa Sale,
Sale, exchange,
exchange, or or leasing
leasing of
of property?
property? ... . 2a
'"x"""
h ot credit?
b Lending of money or other extension of credit? . .... . X
cC Furnishing at
ot goods, services, or facilities? . . . . . . 2c X
rt
II Payment of compensation (or payment or reimbursement 01
of expenses $1,000)?
expenses if more than $l,Ooo)? . X
ee Transfer 01
of any part of its income or assets? . . . 2e X
If the answer to any question is "Yes,"
lithe "Yes: attach a detailed statement explaining the transactions.
33 Does the organization make grants lor for scholarships,
fellowships, student loans, etc.? ............................•.............................................. 3 X
4 aa Do you have a section 403(b) annuity plan foryour
foryour employees?
employees?.. .... . 4a X
;■ v;.-.7v* : " e . ; - ' ; . : ■'
b Attach a statement to explain how theUIB organization determines that individuals Ororganizations
or organizations receiving grants or loans Irom from it in
s . - \ \ \ * ' " ■ - ' > ■ - ■■.
furtherance 01
of its charitable programs qualify to receive
receive payments. (See
(See instruclions.)
instructions.)
?Jfî$H!| Reason for Non-Private Foundation Status (See instructions.)
The
The organization is not a private foundation
foundation because
because it Is: (Please
(Please check
check onlyONE
onlyONE applicable
applicable box.)
box.)
5 □
D
□ A church,
church. convention of churches, or association otcnurcnas.
of churches. Section 170(b)[l)(A)(i).
170(b)(1)(A)(i).
6 D A school. Section 170(b)(1)(A)(ll).
170(b)(1)(A)(U). (Also
(AlSOcomplete
complete Part V, page 4.)
6
7
7 □
D
□
4.)
A hospital or a cooperative hospital service organization. Section 170(b)(1)(A)(iiI).
170(b)(1)(A)(iii).
8 D A Federal, state, or
Federal,state, or local
local government
government oror governmental
governmental unit.
unit. Section
Section 170(b)(1
170(b)(1)(A)(v).
)(A)(V).
g
9 □
D A medical research
research organization operated in conjunction
conlunctlcn with a hospital. Section 170(b)(1)(A)(iii).
170(b)(1 HA)(iii). Enter the hospital's
hosJlilal's name, city,
city,
and slate
state ....
►
10 □
D -----------------------------------------------------------------------------
for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(1)(A)(iv).
An organization operated forthe 170(b)(1)(A)(iv).
(Also complete the Support Schedule in Part IV'A.) IV-A.)
11a
11a IS
[K] An organization that normally receives a substantial part of its supportlrom
support from a governmental unit ortrom
or from the general public,
public.
Section 170(b)(1)(A)(vi). comptete lbs
170(b)(l)(A)(vi). (Also complete tha Support Schedule
S~hBdule in Part IV·A.)
IV-A.)
11b
12
12
□
D
n
D
trust. Section 170(b)(1)(A)(vi).
A community trust. 170(b)(I)(A)(vi). (Also complete the Support Schedule
An organization that normally receives: (1) mora morsfhan
SchedUle in Part IV'A.)
IV-A.)
3 3 1 /
than 33113% ot 3 % of its support from contributions, membership fees, and gross
contributions,
receipts from
receipls Irom activities related
relaled to its charitable, etc., functions - subject
fUllctions • sUblectto to certain 9Xc9ptions, and (2) no more than 33113%
exceptions, 3 3 1 / 3 % of
of
its support from
Irom gross investment income and unrelated business taxable
taxable income (less section 511 tax) from businesses acquired
by the organiZation
organization after June 30,30,1975. See section 509(a)(2).
1975. See 509(a)(2). (Also complete the Support Schedule in Part IV-A.)
13 0
I . f foundation managers) and supports organizations described in:
An organization that is not controlled by any disqualified persons (other than foundation
(1) lines 5 through 12
12 above; or (2)
(2) section 501(c}(4), (5).
501(c)(4), (5), or (6), if they meet the lest
test of section 509(a)(2).
509(a)(2). (See
(See section 509(a)(3).)
509(a)(3).)
following information the supported organizations. (See
information about Ihe (See page 4 olthe
of the lnstruetlcns.I
instructions.)
(b) Line number
number
(a)Name(s)
(a) Name(s) of supported organlzatlon(s)
organization^} from above
from above
14 D
I I An organization organized and operated to test for public safety. Section 509(a)(4).
509(a)(4). (See
(See page 4 otthe
ot the instructions.)
instructions.)
99D) 1999
Schedule A (Form 990)
923111
12-11-99
12-14-99 8
10000530 758050 23-12053HEI 1999.05200
Schedule A (Form 990) 1999 THE HE ICH INSTITUTE FOUNDATION 23-7303161 Page3
mm Support Schedule (Complei ,
■Note: You may use the worksi
if you checked a box on line 10,11, or 12 above.T^pe cash method of accounting.
tetieet iin the instructions for converting from the accrual to the cash method of accounting.
Calendar year (or liscal year
beginning In) (a) 1998 (ti) 1997 (c) 1996 (d) 1995 (a)
(e) Tolal
Total
1Q Girts,
Girts, grants,
gran Is, and
and contributions
contributloos received.
received.
(Do
(Oa not
nat Include
Include unusual
unusual grants. Sea '.
grants. See
I~ne ............
line 28.) 1146
4 6 , 9952.
52. 24,749. 2278,164.
78,164. 1114
1 4 , 0010.
10. 5563
6 3 , 8875.
75
16 Membership fBes received
17 Gross receiptsfrom
receipts from admissions,
merchandise sold or sen/ices
services
performed, or furnishing
lurnishing of facilities
facilities
in any activity that is not
not aabusiness
business
unrelated to the
lhe organization's
charitable,
cha etc.,
etc. purpose
18 Gross income from interest,
dividends, amounts receivedfrom
dividends, amounts received from
payments on.seeurnles
on securities loans (sec
(sec-
tion 512(a)(5)),
512(a)(5)), rents, royalties,and
royalties, and
unrelated
unrelated business taxable income
(less
(lass section
section 511
5f 1 taxes)
taxes) from
from
businesses acquired by the
organization
0 after
after June
June 30,1975, 14,134 776
6 , 9953.
53. 4
433 , 1138.
38. 338
8 , 1125.
25. 1172
7 2 , 3350.
50
19 Net income
Wet income trom
from unrelated
unrelated business
activities not included in line 18 ..
200
2 Tax revenues l""ied
Tax revenues levied rer
(or the
the org.nll.llan's
oiganUatlon's
benefit and either
benefit and either paid
paid to or expended
to it or expended
onitsbenall
on its bellall ■
21 The
Tha value of of sBrvicesor
services or 'acilities
facilities
furnished to the organization
organization by aa
governmental unit without charge.
Do not Include
include the value of services
or facilities generally furnished to
generallyfumished to
the public without charge
Ihe charge.... .._-
222
2 Other
Other Income.
Income. Attach
Att.ch a • schedule. Do not
schedule. Da not
Include
Include gain or [loss)
gain or from sare
possllrom sale of capital
01capital
assets
assets

24 Line 23 minus line 17 161,086 101,702 321,302 152,135. 736,225.
25 Enter 1% of line 23 1,611. 1,017. 3,213. 1,521
26 Organizations
organizations described In In lines
lines 10 or 11: a Enter 2%of
10 Dr11: 2% of amount in
in column
column (e), tine 24
line 24., ► [F5TP77E
26a 14,725.
b Attach aa IIsl
list(which
(whichisisnot
notopento
open topubliCinspection)
public inspection)showing
showingthe
thename
nameofofami
andamount
amountcontributed
contributedbybyeach
eachperson
peison(other
(otherthan
thana a
governmental unit or or publicly supported organization) whose total gifts forfor 1995 through
through 19Q8exceededthe
1998 exceeded the amount
amount shown
shown
in line
In line 26a,
26a. Enterthe
Enterthe sum
sum ofof all
all these
theseexcess
excessamounts
amounts ~.r.f:.:r.~.~~.N";l;'
S E E . S T A T E M E N T ...8
~.~.~ ....!L "380,159."
►t:lEfd7:0S7=J78
26b
-. ■'■■■\,'■'■'_■■'■ ■/i-.'î[>'i
Total support for section 509(a)(1) test: Enter line 24, column (e) 26c ^736; 2 2 5 ^
Add: Amounts from column (e) for lines: 18 172 , 350 19 ■vsv."/-"-":.v*:.V-1
22 26b 380,159, 26d 552,509.
Public support (line 26c minus line 26d total) 26o 183,716.
Public support percentage (line 26a (numerator) divided by line 26c (denominator)). .► 26f 24.9538%
27 described on line 12: aa Foramounls
Organizations described Foramounts included in lines 15, 15,16,16, and
and 17 that were receivedfrom
received from aa 'disqualified
'disqualifiedperson:
person,"attach
attachaalist
listtotoshowtha
show thenamaname
of, and total
totalamounts
amounts receivedin
received ineach eachyear
yearfrom,
from,each
each'disqualified
"disqualifiedperson.'
person.'Enler
Enterthe
thesum
sumofofsuch
suchamountsamountsfor foreach year. N/N/A
eachyear. A
(1998)
(1998) (1997) (1996) (1995) ..
b For any amount
amount included in in line 17 that
that was received fromaanondisqualified
wasreceivedfrom nondisqualifiedperson, attacha alistlisttotoshow
person,attach show thethename
name of,of,and amount
and amountreceivedfor
received for eacheach year,
year,
that was more than tha larger of (1)
lhelargerof (1) Iha
the amount
amount onon line 25
25 for
forthe
theyear
yearor
or (2)
(2)$5,000,
$5,000.(Include
(Includeininthe thelist
listorganizations
organizationsdescribed
describedininlines
lines55through
through11, 11,asaswall
wallas
as
individuals.)
individuals.) After computing
computillg the difference between 1M trie amount received and the larger
receivedand larger amount
amount decribeddeer/bed in in (1}
(1}or(2), enter Ille
or (2}, enler (tie sum
sum otof Ihesedifferences
these differences (Ihe (the
excess amounts) for for each year:year: N /N/A A
(1998)
(1998) ,...................................... (1997)
(1997) (1996)
(1996) (1995)
(1995) ..
ce Add:
Md: Amounts
Amounts from
from column (a)for
column (e) toilines:
lines: 15
15 16
17
17 20
20 __ 21 _ ►
... 27c N/A
N/A
d
d Add: Line 27a total;
Add: line total .. and line
and line 27b
27b total
total . , . .... 27d
27d N/A
N/A
e
~
1 ~~::::;:~~~~~i::!~oC~ ~O~;I(;;;~~~:~~·Ij~~·
Public support (line 27c, total minus line 27d total)
23:·~·~i~·~~·i~)
Total support for section 509(a)(2) test: E2~:rl~~~un·i
Enter amount ~~ ► '1]' ·2·~r·1"
..::::::::: ~.
on line 23, column (e) 27f I ·..·..··N/A······
N/A
. ► 27e
... 210
)~?~?t~r
N/A
N/A
)~·]n~;:)~~.~~~~l)ft3.~)~~n~%fu
^
9 Public
9 support percentage
Public support percentage (line
(line 279
27e (numerator)
(numerator) divided
divided byby line 27f, (denominator))
line 27f, (denominator)) . ► 27q 27q '"" N/A
N /A % %
h Investment
Investment income percentage (line
income percentaae (line 18 column
column (e) (numerator)
(numerator) divided
divkled by
by line 27f (denominator))
line 211 (denominator)) . ► 27h 27h N/A
N/ A % %
28 Unusual
Unusual Grants:
Grants: For an organization'described
organization described in line 10,
10,11,
11, or 12, that
that r,eceivadany
received any unusual grants
grants during
during 1995
1995 through
through 199B,
1998, attach
attachaalist
list(which
(whichIsIsnot
notOpento
open to
public inspection) for each year
year showing
showing the
the name
name of
ofthe
the contributor,
contributor, the
the date
date and
andamount
amountofofthe
thagrant,
grant,and
andaabrief
briefdescription
descriptionottha
of thanature
natureoftha
of thegrant.
grant.DoDonot
notinclude
include
these
these grants line 15. (See
grants in tine (See instructions.) NONE
NONK
923121
92312.1 9 Schedule A (Farm
(Form 990) 1999
12-14-99
12·14·99 9
10000530 758050
10000530 758050 23-12053HEI 1999.05200 THE
1999.05200 THE HEIMLICH INSTITUTE FOUN 23-12051
2 3 -12051
Scheduled (Form.990) 1999 CH INSTITUTE
THE HEMItlCH INSTITUTE FOUNDATION
F'OUNDATION 223-7303161
3-7303161 Page4
Page 4
M4WM Private School Questio/^Tre
ols that
(To be completed ONLY by schools that checked
checked the
the box
box on
on line
line 6 in Part IV) N /A
N/A
YYes No
es N o
29
29 Doesthe
Does organizationhavea
the organization raciallynondiscriminatory
have a racially nondiscriminatory policy
policytoward
toward studenis
students by
by statement
statementinin its
its charter,
charter, bylaws,
bylaws,other
othergoverning
governing
Instrument, or
instrument, or inin aaresolution
resolution of itsgoverning
01 its governing body?
body? . 29
aD
30 Does Ihe organization
00115 the organizationinclude
include aa statement
statementof
of its
its racially
raciallynondiscriminatory policytoward
nondiscriminatory policy toward students
students inin all
all its
its brochures,
ill ill! W?M
31
31
and overwritten
and
Has
other written communications
Hasthe
SOlicitationlor
solicitation
communications with
theorganization
organizattonpublicized
publicizedits
students,or
lor students, or during
tna public
withthe
during the
publicdealing
irs racially
dealingwith
with student
raciallynondiscriminatory
student admissions,
the legislration
registrationperiod
admissions, programs,
pOlicythrough
programs, and
newspaperor
through newspaper
hasno
andscholarships?
scholarships? .
broadcastmedia
or broadcast
no solicitation
mediaduring
during the
Ihe period
period of
program, in a way that makes
makesthe
ot
Known
the policy known ■
t:;J)ili;uISS;t(ifS
F v'wJ.w.v
111!
i
to all
to all parts
parts ot
of the
thegeneral
generalcommunity
community itItserves?
serves? .
'Yes; please
IfIf "Yes," pleasedescribe;
describe: ifil "No,*
'No,' please
pleaseexplain.(If you need
explain. (If you nsed more space, attach
attach aa separatestatement.)
separate statement.) ;Hsls;!j
S'ijSpj
£a&s.;j
?*£?■:■:;>
32
32 Doesthe
DOBS 0lga11i2atioflmaintain
the organization tna 101l0wi11g:
maintain the following: Wm%
aa Records
Recordsindicating
Indicating the
the racial
racialcomposition tile student
01 the
composition of student body,
body, faculty, and administrative staff? .....................................................•...... 32a
bII Records
Recordsdocumenting scholarships and
documenting that scholarships and other
other financial
assistanceare awarded on a racially
are awarded racially
nondiscriminatory basis? : . 32b
cc Copies
Copies01 all catalogues,
of all catalogues,brochures,
brochures, announcements,and
announcements, and 01118r
other written
communications to
to the
the public
public dealing
dealing with
with student
sludant
acrnissions, programs, and scholarships? . 326
dd Copies
Copiesof 01all mat9rial used
all material used by
by the
the organization
organIzationor on its
or on its behalf
behalfto
to solicit
contributions? m;:;"''''''''",",",,=
32d ..M.M...
IfIf you
you answered
answered'No' to any
any of
of the
the above,
above,plaaseexplain.
please explain. (If you
you need more space,attach
space, attach a separatestatement.)
■.■>."■.".■,■ 5
"No" to separate statement.) '. '■ . i
':■■':. ■':■
: : ■ ■■ ■■
:
'. ■-■! :
■ J" ;=! V-
v. \ ,
33
33 Doesthe
Does organizationdiscriminate
the organization race in any way
discriminate by race way with
witl1 respect
respectto:
to: ■ -t : :■
; ■.'... 1.
[ >
a Students' rights or privileges? .........................................................................................................................................•...... 33a

b Admissions policies? : . 33b
•j: Employment of faculty Oradministratlve staff? . 33c
Scholarships or other
dd Scholarships otherlinancial assistance? ................................................................................................................................•
financial assistance? „ 33d
ee Educational
Educationalpolicies?
policies? . .... .... . 33a
Useof
t1 Use facililles?
of facilities? .... .... .... . 331
g9 Athletic
A!hre!ic programs? ,... . 33q
other extracurricular
h Other extracurricular activities? .....•...........................................................................................................................................
. . „ 33h
Iflfyou answered'Yas'
you answered to any
'Yes' to any of
oft'ne
the above, pleaseexplain.
please explain. (It you you need more space,attach
space, attach aaseparateseparatestatement)
statement.) ....... .. .
■;-."■ • ■ ; -
J
-ys- ""■ "j ■! '
.■:-.?•' ; V".."1 .5-
■ : ■ . ■
: " . \r. ■ ..'■'; ' , \
a4 a Does
34 Doesthe organization receive
the organization receiveany financial aid
any financial aid orasslstance
or assistancefrom
from aa governmental agency?
agency? . 34a
bII Has the organization's rigtrlloto such aid
aid ever been ravoked or
099nrevoked suspended?
orsuspended? . 340
■ : ■" .
you answered
IfII you answered'Yes' to either
"Yes" to either 34a or b, preaseexplain
b, please using an attached
explain using attachedstatement.
statement. ■■■:v- :■ : (
■ J
■■
v ; -" ."1 ■ " J • '
35 Doesthe
Does thg organization certify that it has complied with the applicable
applicable requirements of sections 4.01
4.01 through
through 4.05 of Rev.Proc.
Rev. Proc. 75-50,
75-50,
1975-2 C.B. C.B.587 cove
587, coveting racial nondiscrimination?
racial nondiscriminatlon? ifIt "No," attach an explanation
'No; attach ... 35
Schedule A (Farm 990)
Schedule ggO) 1999
923131
923I31
12·14·99
12-14-99 10
10
10000530 758050
10000530 758050 23-12053HEI
23-12053HEI 1999.05200 THE
THE HEIMLICH INSTITUTE FOUN 23-12051
THE HEJ^fclCHH INSTITUTE
1999
Schedule A (Form.990) 1999 INSTITUTE FOUNDATION
3-7303161 Page 55
: Lobbying Expe Electing Public Charities
Ma%M$mi Lobbying E x p e n d i t u r e s ^ Electing Public Charities
■ [Tobebecompleted
(To completedONLY
ONLYbybyananeligible
eligibleorganization
organiza\hinthat
thaifiled
filedForm
Form5768)
576B) N/A
N/A
Check here
Chech here ► a a DIf the organization belongs to an affiliated group.
If the organization belongs to an affiliated group.
Check here►- bb I D
Checkhere I ifIIyou
youchecked
checked"a" aboveand
"a"above and"limited
'Hmited~~"'--'===~~
control' provisions apply. r- '__
r-__ . _
(b)
(h)
LimItson
Limits onLobbying
LobbyingExpenditures
Expenditures (a)
(a) Tobebecompleted
To completedfor All
forALL
Affiliatedgroup
Affiliated tota Is
grouptotals .
electing organizations
_ (The
(The.term 'expendltu re?'means
term 'expenditures' meansamounts
amountspaid
paidororincurred)
in~cu_r~re~d-,--- --.-_.-j- __ -:;-;-
...-=:- -I-~e~le~c~tln~g_o~r_g_~an~iz~a_tio_n_s_
N/AA
Tolallobb,{ing
36 Total
36 expenditurestotoinfluence
lobbying expenditures influencepublic
puhlicopinion
opinion(grassroots
(gr(lssrool~lotabyinrj).
lobbying) . 36
37 Total
37 Totallobbying
lobbyingexpenditures influenceaalegislative
expenditurestotoinfluence legislativebody
bOdy(direct
(directlobbying)....
lobbying) . 37
36 Total
36 Totallobbying
lobbyingexpenditures
expenditures(add
(addlines
lines3636and
and37)
37) . 38
otherexempt
39 Other
39 exemptpurpose
purposeexpenditures
expenditures .. 39
4D
40
41
41
Total
Totalexempt
exemptpurpose
purposeexpenditures
LObbyingnontaxable
Lobbying
expenditures(add
(addlines
amount.Enter
nontaxable amount. Enterthe
lines38
38and
theamount
and39)
amountfrom
39)
fromthe
thefollowing
followingtable
table--
'0fI0S!iIT80fl~V8P:::ji~I0i111111
L
40
ji/
II tile amnunt on nne 40 Is
it Ule amount on line 4Q is - - Tile
The lobbying
lobbying nontaxabte
nontaxable amountIsts--
amount
:::;:~~::t~~;~~~~·~~·.~~·,~·~··::::::::::::
Not over $500,000
:~:':::::~::~::~~~.~~~~.~~~.~~~
■.
Over$500,000 but not over $1,000,000

....:::::::::} 20% of Iho amount on lino 40
$100,000 plus 15% ol the excess over $500,000
Over
OverS1,000,000 but not
$1 ,000.COObut notover
over$1,500,000
$1 ,500,000 $175,000
$175.000 plus 10%ororthe
plu. IOM theexcess
excessover
ever$1,000,000
$1 ,000,000 'Yfh1i0GSZ15Rff3GIf708J0f0IGB7Wf/8B8Ti%B0J0R
41
DYer $1.500.000 but
Over$1,500,000 butnot
notover
0"..-$17.000,000
$17,000,000 ... plu~SM
$225.000 plus
5225,000 5%ot the
theexcess cr
excessover
O'.'er$I,:;CO.Coo
S1,500.000 [
Over$17,0((),OOO
OverS17,000,000 $1.000,000......................................................
$1,000,000 f:i)}Ht>t;t::(;':?//\/:':"hY\ 111
42
42 G(assroatsnontaxabte
Grassroots amOllnt(enter
nontaxabll3amount (linter 25%
25%ofofline
line41)
41) .. 42
43
43 Subtract line 42 from line 36. Entsr -D- if tine 42 is
Subtract line 42 from line 36. Entsr -0- if line 42 is more morethan
thanline
tine36
36 .. 43
44
44 Subtract line 41 from line 38. Enter -0- if line 41 is more than line
Subtract line 41 from line 38. Enter -0- if line 41 is more than line 38 38 .. 44
Caution: IfIfthere
Caution: thereisisan
anamount oneither
amounton eitherline
line43 orline
43or line44, you must
mustfile
fileForm
Form4720.
4720. - :■ J - :
4·Year Averaging
4-Year A.veraglngPeriod
P8rln~ Under
UndarSsellan
Section501(h)
501(hl
(Someorganizations
(Some organizationsthat
thatmade
madeaasection
section501(h) electiondo
501(h)election donot
nothave
havetoto complete
complete all
all ofofthe
thefive
fivecolumns
columns
below.See
below. Seethe instruclions for
the instructions for lines
lines45 th
45 through 50.)
During4-Year
4-YearAveraging
Averaging Period
Pariod
N/A
N/A
Calendaryear
Calendar year(or (a)
(a) (b)
(b) (e)
(B) (d) (a)
(B)
"seal year
fiscal year beginning
b In) ► 1999
1999 1998
1998 1997
1997 1996
1996 Total
Total
Lobbyingnontaxable
45 Lobbying
45 nontaxable
amount 0.o.
46 '.'".■■'■ '■'".' v
■" ! ,J
.V '.*■>':'^ *, " . ' '.-.' * S-."' ."
- ■ : - ■ . - . ■ ■> * . ' - rt y-/?::.y?\;y<l':
(150% of line 45(e))
■ i '..'"" ■ J " -" ' ■ . . . 0O..
47 Total lobbying
47
expenditures 0.o.
48
amount o.
0.
49 ■■■■'< ■ ■ \ .■■ ■■ *■ -;.v.
Vi+z'l-?:'''y'/.x''- ^-;■'-■■■
0o.
■ .i'. j
■ --."..■ ■ -■ ■ - ■ ■ ' K - . : - - . ^ . ■>■:<■■■■ :■■:■■
(150% of line 48(e))

■" ■" ! ■ " ■ ■ ' > . I'"1! j
\ - ■ ' ■ v
■\C: ■;^.-s:i-:"^- .
Grassroots lobbying
50 Grassroots
50 lobbying
expenditures 0o.
.
WmWlM Lobbying Activity
Lobbying/ by Noneiecting
Activity by Nonelecting Public
Public Charit
Charities
es
(For reporting
(For reporting oonly organizations that
by organizations
nly by that did
dJdnol complete Part
not complete Part Vl-A)
VI-A) N/A
N /A
During the
During the year,
year, did
did the
the organization
attempt to
to influence
influence national,
national. state
state or
or local
localleglslatron.
including any
any attempt
attempt to
to
Yes
Yes No
No Amount
Amount
influence public opinion on a legislative matter or referendum. through the use
influence public opinion on a legislative matter or referendum, through the use of: of:
.:::::1--t---I!~;:~~1:j~ll~,~:1~~i~l~
Volunteers
: Paid
~~~~:~:;:; ~~'~~~~~'~~t
staff or management <'I~~;~d~
(include ;~~~rt~d
·~~~~~~~~~·i~~·i~~~~~~·~~~·
compensation in expenses reported .~~
on · il~~·~·~·~~;~·~~~·
lines '~}"::'.::
c through h) :::::::::
::::::::::::::
c Media
Media advertisements
advertisements .
d Mailings
Mailings to to members,
members, legislators,
legislators, or
or the
Ihe public
pllblic ..
Publications, or
II Publications, or published
published oror broadcast
statements ..
ff Grants
Grants to to other
other organizations
organizations for
tor lobbying
lobbying purposes
purposes ..
9g Direct
Direct contact
contact with
with legislators,
legislators, their
their staffs, government
staffs, government officials, or aa legislative
officials, or legislativebody
body ..
h Rallies, demonstrations, seminars, conventions, speeches, lectures, orany
11 Rallies.demcnstiatiQlls. seminars, tOlwl'lntlons. speeches, lectures. er anyother
othermeans
means ..
Total lobbying
expenditures (add lines cc through
(add lines through h)
h) "''i:'' 'F' ' t' ' /' ' 'W' ' ?' ' §' ' /L- 0.
.....;O_.
IfIf "Yes"
'Yes' to
to any
any ottha
of the above,
above. also
also attach
attach aa statement
statement giving
giving aa detailed
description of the lobbying
of Ihe lobbying activities.
activitias.
923141 Schedule A (Form
(Form 990)
990) 1999
1999
923141
12-14-99
12-14-99 11
11
10000530 758050
10000530 758050 23-12053HEI
23-12053HEI 1999.05200 THE HEIMLICH INSTITUTE
3-12051
Schedule A (Form 990)1999
c.==~=
PartVa
1999
Information Regarding
T H E HE
THE
m
H E ~ y j f c TCH
riIJ
INSTITUTE
[sfers To and
FOUNDATION
and Transactions and
and RelatioiBnips
Relati
23-7303161
23-7303161
With Noncharitable
Noncharitable
Page66
Page
51 Did the reporting orqanlzatlon

the reporting organization directly indirectly engage
directly or indirecUy engage in anyany of the
the following
following with
with any
any other
other organization
dasciihed in in section
section
501 (0)
501 (o) ofof the
the Code
Code (other
(other than
than secnon
section 501
501(0)(3)
(c)(3)organizalions)
organizations)ororininsection
section527,
527,relating
relatingtotopolitical
politicalorganizations?
organizations?
a Transfers from
Transfers from thethe reporting organization to
reporting organization to aa noncharitable
exempt organization
organization of:of: Yes No
(II casn
(i) Cash 51a(i)
. 51 aU) X
(il) Other
other assets
assets . a(ii)
a(ii) X
Other transactions:
(I) Sales
Sales of assets
assets to to aa noncharitable
noncharitableexempt
exempt organization
organization . h(i)
b(i) X
(ii| Purchases of assets from a noncharitable
(III Purchases at assets from a noncharitabre exempt organization exempt organization . b(fl|
b(ll) X
(iti) Rental
(iii) Rental of of facilities
facilities oror equipment
equipment . b(iii) X
(Iv) Ralmbursernent arrangements . b(iv)
b(lv) X
(v) Loans
Loans or or loan
loan guarantees
guarantees . b(v) X
(vl)
(vi) Performance
Performance of 01 services
services Or or membership
membership or orfundraising solicitations
fund raising solicitations .. b(vl) X
c Sharing offacilities,
Sharing of facilities, equipment,
equipment, mailing
mailing lists,
lists, other
other assets,
assets, oror paid
paid employees
employees : . ce X
II IIIf the answer to any of the above
the answer above is 'Yes,"
'Yes," complete
complete Ihethe folJOlVing
following schedule.
schedule. COlumn
Column (b)(b) should
should always
always indica
indicate the fair
Ie Ihe fairmarket
market value
value ofof Ihe
the
goods, other
goods, other assets,
assets, or or services
services given
given by
by the
the reporting
organization. II the organization
llihe organization received lass than
received less than fair
fair market
market value any
value in any
transaction or
arrangement , show show in column
column (d)(d) the
tha value
value of the
the goods
goods,, other assets,,or
other assets or services received:
services received' NN // A
(a) (b) (c) (~)
Une no.
Amount involved Name of
Name of no
no ncharitable
ncharitable exe
exempt
mpt organization
Description of transfers,
transactions, and
and sharing
arrangements
52 a Is thathe organization directly or

organization directly or indirectly
indirectly affiliated with, or related
affiliated with, related to,
to, one
one or more tax-exempt
organizations described section 501(0)of
described in section 501(c) of the
tha
Code(otherthansection501(c)(3))orin
Code (other than section 501(c)(3)) orin section
section 527?
527? ~..........................................► D□ Yes
Yes G O No
[Xl No
IJb If 'Yes,'
"Yes,' complete
complete tha
the following
following schedule'
schedule: N /A
N/ A
Ca)
(a) (b) (r:)
Nama
Name of organ ization
of organization Type
organization Description o( relationship
Description 01 relationship
923151
923151
Schedule
Sche~ulB A (Form 990)
A (Form 990) 1999
1999
12-14-99
12-14·99 12
12
10000530 758050
10000530 758050 23-12053HEI
23-12053HEI 1999.05200 T
1999.05200 THE
HE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 2 3-12051
23-12051
, THE HEIMLICH INSTITUTE
THE HEIMLICH
FORM 990
INSTITUTE EflgNDATION
F1IINDATION
^^JI
GAIN (LOSS)
•
(LOSS) FROM PUBLICLY TRADED SECURITIES
23-7303161
23-7303161
STATEMENT 3
GROSS COST OR EXPENSE NET GAIN

DESCRIPTION
DESCRIPTION SALES PRICE OTHER BASIS OF SALE OR (LOSS)
(LOSS)
SEE ATTACHED DETAIL
- SHORT TERM
TERM 26,155. 43,221
43,221. o.
0, -17,066,
-17,066.
SEE ATTACHED DETAIL
- LONG TERM
TERM 110,134. 81,813
81,813. o.
0. 28,321,
28,321.
SEE ATTACHED DETAIL
- CAPITAL GAIN
GAIN
DISTRIBUTIONS
DISTRIBUTIONS 2,141. o.
0 o. 2,141,
2,141.
TO FORM 990, PART I, LINE 8 138,430. 125,034. o. 13,396,
13,396.
FORM 990
990 OTHER CHANGES IN NET ASSETS OR FUND BALANCES STATEMENT 4
DESCRIPTION
DESCRIPTION AMOUNT
NET CHANGE - UNREALIZED
UNREALIZED GAINS ON INVESTMENTS 11,204.
TOTAL TO FORM 99
990,
0, PART
PART I,
I, LINE
LINE 20
20 11,204.
FORM 990 STATEMENT OF ORGANIZATION'S PRIMARY EXEMPT PURPOSE STATEMENT 5

PART III
EXPLANATION
EXPLANATION
PERFORM RESEARCH AND PROVIDE EDUCATION TO THE PU~IC
PUBLIC ON VARIOUS DISEASES,
DISEASES.
FORM 990 OTHER INVESTMENTS STATEMENT 6
VALUATION
DESCRIPTION METHOD AMOUNT
MARKETABLE SECURITIES COST 781,117
781,117.
TOTAL TO FORM 990, PART IV, LINE 56, COLUMN B 781,117
781,117.
15 STATEMENT(S) 3, 4, 5, 6
10000530 758050 23-12053HEI
1999.05200 INSTITUTE FOUN 23-12051
OMBNo.
OMB No,1545-0172
1~45·01"T2
Form 456'2
4562 &preciationon and
fepreciati and Amortizatk
Amortizati. 1999
Department of
Department or the Treasury
I~cTreasury
(Including Information
(Including Information on
on Listed
Listed Property)
Property) 990
990 Allachrrcnt
Attachment
In Cema!rlc,C"""
Menial ServCce (99)
Revenue Service (99) .... See separate
► separate instructions.
instructions. .... Attach
► Attach this form
form to your
yoUr return.
return. No. 667
Sequer.ccNo.
Sequence 7
Narr.e(.)shown
Namefs) shown on
on return
relum Busines or
Business or activity to which
activity to whIchthis lormrelate:
lhls form ralaCos :d~nti~ir,g number
Identifying nurr.ber
THE HEIMLICH
FOUNDATION ORN 9990
FORM PAGE 22
9 0 PAGE 223-7303161
3-7303161
^;'p';'_"":l Election To
P l r t i j J l Election To Expense
Expense Certain
Certain Tangible
TangIble Property
Property (Section
(Section 179)
179) (Note:
(Note: IfIf you
youhave
have any
any 'lisled
'nsledproperty:complele Part VV before
property ,'complete Part before you
youcomplste
completePart I.)
Part l.)
1 Maximum
Maximum dollar
dollar limitation.
limit;ltion, IfIfan
an enterprise
enterprise zone
zone business,
business, see
see instructions
instructions ."...................................................... 1 119,000
9,000 .
2 Total
Total cost
cost of
of section
section 179179property
property placed
placed in
Inservice.
service. See
Seeinstructions
instructions "." f--_2-+_~. _
3 Threshold
Threshold cost
cost of section 179
of section 179propertybefore
property before reduction
reduction in
in limitation
limitation "............................................. 3 $200,000
$200,000
Reduction in
4 Reduction in limitation;
limitation, Subtract
Subtract line
line33 from
from line
line2.
2, IfIfzero
zero or less, enter
or less, enter -0-
,0· 1--_4-+ _
5 Dollar
Dollarlimitation
limitation for
for tax
tax year.
year.Subtract
Subtract line
line 44 from
from line
line 1.
1. IfIfzero
zero or
or less,
less. enter
enter -0-.
.0-, IfIf married
married filing
filing
separately, see
separately, see instructions
instructions , " .."" , " ,."." , 5
::.:.::.::''::
6 (a)Description
(a) Description of
01 property
prope:...._rty..:....._ (bj Cost {business
1 _:.(b..:.l_CO_5_C use orWy)
(b:....u_s_in_es_s_u_se_o_ro'y..:..:l----t (cj fleeted cost
.:.c(cl:....E_lcc_t_cd_t"O_SC_---1
77 Listed
Listed property.
property. Enter
Enteramount
amount from from line
line 27
27 "."." "."." ". 1L__7!........1'---- _+==="""'""""'===
Total elected
88 Total elected cost
cost ofof section
section 179 179 property.
property. Add Add amounts
amounts in in column
column (c),(c), lines
lines 66 and
and 77 " 1---=8=-+ _
99 Tentative
Tentative deduction.
deduction. Enter
Enter the
the smaller
smaller of of line
Hne 55 or
or line
line 88 "..... f--...!9~ _
10 Carryover
10 Carryover of of disallowed
deduction from from 19981998 " " " "....... 1--'1c.=O'+
10 _
11 Business
11 Business income
income limitation.
limitatlon. EnterEnterthe
the smaller
smaller of of business
business income
income (not(not less
less than
than zero)
zero) or
or line
line 55 " "" !---"1:.,!1'-+
11 _
12 Section
12 Section 179179 expense
expense deduction.
deduction. Add Add lines
llnes 99 and
and 10,10, but
but do
do not
not enter
enter more more than
than line
line 11
11 " " "............ 12
12
13 Carryover
13 Carryover of of disallowed
deduction to to 2000.
2000, AddAdd lines
lines 99 and 10,less
and 10, less line
line 1212 ." ► 1 1313 }r?i<Ut;g}00R{38;TI~
Note: Do
Note: Do not
not use Part II/I or
use Part or Part
ParllllIII below
below forfor listed
listed property
property (automobiles,
(automobiles, certain
certain other
other vehicles,
vehicles, cellular
celfular telephones,
telephones, certain
certain computers,
computers, or property
orproperty
used for
used for entertainment,
entertainment, recreation,
recreation, or or amusement).
amusement). Instead,
Instead, use use Part
Part VVfor
for listed
listed property.
property,
keArtrWl
^RaWHi MACRSMACRS Depreciation
Depreciation For For Assets
Assets Placed
Placed in in Service
Service ONLY
ONLY During
During Your Your 1999
1999Tax
Tax Year
Year (Do (Do Not Not Include
Include Listed
Listed Property.)
Property.)
Section A
Seclion A -- General
General Asset Asset Account
Account Election
Election
14 IfIf you
14 you are
are making
making the
the election
election under
under seclion
section 168(i)(4)
1680)(4) to to group
group any
any assets
assets placed
placed inin service
service during
during the the tax
tax year
year into
into one
one oror more
more general
general asset
asset
accounts, check
accounts, check this
this box.
box. See
See Instructions
Instructions "." ,.,,' " ," " " "., , ► I—I D
SecUon B
Seclion B - General Depreciation
Depreciation System (GDS) {See instructions.)
(b) Month
4b) lV.onlh and
000 (c) Basis
(c) for depreciation
BasI. for eepreclaUoo
(a) Classification
Classlncation 01 property
property yOiJi placed
placed (Dusines!lln~""tment use (d)
(dl Recovery
Recovery Convention
(0) Convention (~ Method
(0 (9) Depreciation
Is) DepteGia~ondeduction
deduction
(a) of year (business/Investment use pericd
' period (e) 'I
ill service
in service only -- see
only see Instructions)
Inatruc~ons)
-------------------------_,~~ ~~~--------------_r--------_r------+-.----;----------------
15 a 3-year property 5
- -■ : -.- ■ " -" ■ :
b 5-year property
c 7-year property
.-'•■ .■ ,■:<'< ■ '.
d 10-year property
e 15-year property
f 20-year property
g 25-year property 25yrs. S/L
1 27.5 yrs. MM S/L
hh Residential
Residential rental
rental property
property 27.5 yrs. MM S/L
1
1 MM 39 yrs. S/L
i Nonresidential
Non residential real
real property
property
1 MM S/L
Section C - Alternative Depreciation System (ADS) (See instructions.)
16 a Class life
16 .'■; VV ' -: -'- - S/L
b 12-year 12 yrs. S/L
c 40-year t 40 yrs. MM S/L
SPS'rij-lll Other Depreciation (Do Not Include Listed Property.) (See instructions.)
tax years beginning before 1999
GDS and ADS deductions for assets placed in service in tax
17 GDS . 17 6,946.
168(Q(1)election
18 Property subject to section 168(f)(1) elec;tion ,," 18
ACRS and other rI"rm"'~rAtrnn
19 ACRS depreciation 19
:>.':>;,:M-7.V,:.\ ■ —— - ^ — ^ ^ — ^ ^ ^
iifSftFt'Wfl Summary (See instructions.)
Listed property.
20 Lisled property. Enter
Enter amount from line 26 " " " . 20
21 Total.
Total. Add deductions line 12, lines '15
deductions on line 5 and 16 in column (g), and lines 171hrough
17 through 20. Enter here
her a
and on the appropriate lines
lines of your return.
retijrn. Partnerships
Partnerships and S corporations
corporations' - see instructions 21 6,946.
instrur=r.:.:.:..::..:..:.:.:.:.:.:c"-'..:.;=':":":"'...J.....=..!.-k""",=
22 For assets shown above and placed in sservice
22 ervice during the
th B current year, enter the
the
263Acosts
portion of the basis attributable to secticsn263A costs.. 22 ■• ■ -• ■ ■ ■ . . ■ i% - . . . • J
LHA For Paperwork

Paporwork Reduction
Notice, see the separate
instructions. Form4562
Form 4562 (1999)
91S2~1
916251
01·24·00 117-7
01-24-00 -L /
10000530 758050
10000530 759050 23-12053HEI 1999.05200 THE
1999.05200 INSTITUTE FOUN 23-12051
HEIMLICH INSTITUTE 23-12051
Form 4562 (1999) Page 2
PartV Listed Property
Listed Property - A u t o m o b i l e s ^ ^ a i n Other Vehicles,
Vehicles, Cellular
Cellular Telephones,
Telephones, Certain puters, and
and Property
Property Used ii^Pir
Used for
for
Entertainment, Recreation,
Entertainment, Recreation, or or Amusement
Note: For
Note: For any
any vehicle
vehicle for
for which
which you you are
are using
using the
the standard
standard mileage
mileage rate
rate or
or deducting
deducting lease
lease expense,
expense, complete
complete only
only 23a,
23a, 23b,
23b, columns
columns (a)
through (c)
through (c) of Section A,
of Section A, all
all of
ofSection
Section B, B, and
and Section
Section CCifif applicable.
applicable.
Section
Section A
A - Depreciation
Depreciation and Other Information
Information (Caution:
(Caution: See instructions
instructions for
for limits
limits for
for passenger
passenger automobiles.)
automobiles.)
23a Doyou
Do you haveevidence
have evidence to
to supportthebusiness(rnvestment
support the business/investment useclaimed? Yes [1 ] 1NoNo23b If 'Yes,'
use claimed? [|_ JYes l 'Yes' is the evidence writlen?
written? [1 ] 1Yes
Yes[ 1 ] 1NoNo
■if!
(a) Date
(b) Date
lb) (c) (d) M
(e) (I)
to (g)
<g) (h)
lh) (i)
Type of property
Typeof property placed
placed inin Business! Cost
Costor or Basis
Basi. tor depreciation Recovery
lor depreciation Recovery Method/
MeUtod! Depreciation
Elected
service investment Ibuslne.sr.westmeotperiod
|ouslness/">nvesUT;ent
period Convention deduction section 179
section 179
(list vehicleslirst
(list vehicles first)) service otherbasis
other basis useonly) Convention deduction
usepercentage use only) cost
cost
24 prope rttv use
Property used
d more than
t han 50%
5OMl'
0 in rriedb'business
In a qualified
ouan usrness use:
: : 0/0
%
: : %
: : %
25 Property used 50% or
or less in a qualified business use:
a_qualifiedbusiness
% S/L-
% S/L-
"■-.■-'■'■-' ■ i ■: '■;':'■>':
% S/L- '■■ ■ W ■ ■ "■;
-2-6-A-d-d-a-m-o-u-n-ts-in-c-o-lu-m-nt-(h-)"";.
'--E-n"":te-r-t-th-e-to-t-a-I
h-e-r-e-~.!.C;"-dt-o-n-l-in-e-2-0-,-p-a-g-e-1l-
..-..-..-..-..-..- -..-..-..-..-..--1
.. '--.. -.. -.• -.. -.. - - ..r.~::::;C::~'_·-"-"-~'~2:6::~~~~~~:~~~:pl",[""i""I""I""~;:;:,l,,,i,,,1""
26 Add amounts in column (h). Enterthe total here and on line 20, page 1 26
27 Add amounts in column (i). Enter
Enterthem.
the total here and on line 7 7, paqe
paqe 1 .. 27 I
Section
Section 8 B-- Information
Information onon Use 01Vehicles
at Vehicles
Complete this section for
for vehicles used by a sole proprietor,
proprietor, partner, or
or other "more
'more than 5% owner,'
owner," or
or related person.
person.
If you provided vehicles to
to your employees, first answer the questions in Section C toto see if you meet an exception to
to completing
completing Ihis
Ihis section
section for
those vehicles.
(a) (b) (c) (d) (e) (0

(f)
28 Totalbusiness(rnvestment
Total business/investment milesdrivenduringthe
miles driven during the Vehicle
Vehicle Vehicle
Vehicle VehiclB
Vehicle Vehicle
Vehiela Vehicle
Vehicle Vehicle
Vehicle
year {DO NOT
year(00 NOTincludecommutingmiles)
include commuting miles) ..................
29 Total commuting
commuting miles driven during dUring the year ... ...
30 Total other personal (noncammutlng)
3D (noncommutlng) miles
driven ...............................................................
31 Total miles driven during the year.
Add lines 28 through 30 30 ....................................
Yes No Yes No Yes No Yes No Yes No Yes No
32 Was the vehicle available for for personal use use
during off·duty
off-duty hours? ....................................
33 Was the vehicle used primarily by by a more
than 5% owner or related person? ..................
34 Is anolher
another vehicle
vehicle available
available for forpersonal
personal
use? .................... _ ..........................................
Section
Section C - Questions
Questions for
for Employers
Employers Who Provide
Provide Vehicles
Vehicles 10r
for Use by Their Employees
Employees
Answer these questlone
questions to
to determine if you meet an exception
exception to
to completing
completing Section B for vehicles used by
by employees who are not
not more
more than
than 5%
5%
ownera or related persons.
owners or
Yes No
35 Do you maintain a written policy
polley statement that prohibits
prohibits all personal use of
of vehicles, including
including commuting,
commuting, by
by your
employees?
employees? ..
36 Do you maintain a written policy statement that prohibits
prohibits personal use of vehicles, except
e>wept commuting,
commuting, by your
employees? See Instructions for vehicles used by by corporate
corporate officers, directors, or 1%
directors, or 19ia or
or more owners .
37 Do you treat
treal all use
use of
ofvehicles
vehicles by
byemployees
employees asas personal
personal use?
use? : .
38 Do you provide more than five vehicles to
38 to your employees,
employees obtain information from your employees about
the use of receivec ?
of the vehicles, and retain the information received? .
39 Do you meet the requirements concerning qualilied
qualified automobile
automobile demonstration use? ..
Note: If your answer toto 35,36,37,
35, 36,37,38, or 39 is 'Yes,"
3B, or 'Yes,' you
you need not
not complete Section B for the covered
for the covered vehicles.
vehicles. '''. 'i.' • ^^■?,->"<
Fi?1frBiEl :
:;Ma!lfc:Vi :: Amortization
Amortization
(a) (b) (O
(e) (d) (e) (fl
(f)
DescrlpUon or
Description or costs
costs Dale imortzatioi Amartizable
Amortizable Coda
Code .rImormrlon
Amcnrndon Amortization
AmortlzaHon
begins amount
amount section
sec lion period ororpcn:entlge
percentage tor this
lor thisyear
year
40 Amortization of costs that
4D Amortizalionof begins during your 1999lax
Ihatbeginsduringyour 1999 tax year:
year: '*'"'.'■ J
\- -",">.1. '■■'."■}■',,■'■■'.••'. ■:\\ ^y:y^'---. ■'\r--'"':. "■:■ ■i~"iy-*'.-'-—:'~*% i'&
I
I
41 Amortization of
41 Arnortizatlon of costs lhat
that began before 1999
1999 I 41
42 Total. Enter here and on
42 Total. on 'Other
'other Deductions* or "Other
Deductions" or 'other Expenses' line of your return I 42
Form 4562 (1999)
Form4562
91S252
916252
10-18-99
10-18·99 18
10000530 758050 23-12053HEI
10000530 758050 23-12053HEI 1999.05200 THE HEIMLICH INSTITUTE
INSTITUTE FOUN 2 3-12051
23-12051
• > RE~lIZED
REALIZED CAPITALGAl
1, 1
\m AND
CAPITAL GAINS
JANUARY 1. 1999
AND LOSSES
9 9 9 -• DECEMBER31,
DECEMBER 3 1 , 1999
1999
• HEIMLICH INSTITUTE
HEIMLICH INSTITUTE FOUNDATION.
FOUNDATION,
INCORPORATED
INCORPORATED
ACQUISITION
PROCEEDS DOLLAR DOLLAR
DOLLAR $ GAIN I/
DESCRIPTION DATE DATE COST PROCEEDS
PROCEEDS LOSS
SHORT TERM
SHORT TERM CAPITAL TRANSACTIONS
150 CAMPBELL
CAMPBELL SOUP
SOUP COMPANY 12/16/98
12/16/98 04/01/99
04/01/99 8,254.19
B.254.19 6,165.50
6.165.50 -2,088.69
-2.088.69
200 ' COMPAQ COMPUTER
COMPUTER CORPORATION
02/22/99 11/19/99
11/19/99 8,495.00
8,495.00 5,286.08
5.286.08 -3,208.92
-3,208.92
0.023 CORPORATION
0.023 EXXON MOBIL CORPORATION 01/13/99
01113/99 12/28/99
12/28/99 1.47
1.47 1.89
1.89 0.42
200 RITE
RITE AID CORPORATION
11/25/98 04/20/99
04/20/99 9,587.00
9.587.00 4,532.39
4.532.39 -5,054.61
-5.054.61
220 SERVICE CORPORATION
SERVICE CORPORATION INTERNATIONAL 12/01/98
12/01/98 02/11/99
02/11199 8,473.85
8.473.85 3,650.82 ■4,823.03
·4,823.03
200 BANCORP
SUMMIT BANCORP 06/10/99
06/10/99 10/04/99
10/04/99 8,409.54
8,409.54 6,518.06
6.518.06 -1,891.48
-1,891.48
SHORT TERM CAPITAL LOSSES
TOTAL NET SHORT LOSSES $43,221.05
$43.221.05 $26,154.74
$26.154.74 -$17,066.31
-$17,066.31
LONG
LONG TERM CAPITAL TRANSACTIONS
200 PRODUCTS AND CHEMICALS, INC.
AIR PRODUCTS 08/12/96
08/12196 04/19/99
04119/99 5,509.00
5,509.00 9,238.61
9.288.61 3,779.61
3,779.61
175 CONSECO, INC.
CONSECO, 05/14/97
05/14/97 01/11/99
01111/99 7,119.38
7,119.BS 5,839.75
5.839.75 -1,280.13
-1.280.13
240 . DISNEY
DISNEY (WALT) COMPANY 11/16/95
11116/95 03/10/99 4,649.60
4,649.60 8,341.78 3,692.18
3,692.18
110 CORPORATION
EMC CORPORATION 05/29/96
05/29196 02/08/99
02/08/99 1,214.95
1,214.95 10,724.75 9,509.80
9.509.80'
FEDERAL MORTGAGE ASSOCIATION 04/03/96
04/03/96 03/16/99
03116199 9,485.94
9,485.94 10,140.00
10,140.00 654.06
654.06
5.875%
5.S75% DUE 02/02/06 DATED 02/02/96
DUE 02102/06 02/02/96
1 5,000
15.000 FEDERAL NATIONAL
ASSOCIATION 08/22/96
OB/22/96 03/16/99
03116199 13,994.53
13,994.53 15,210.00 1,215.47
1,215.47
5.875% DUE
DUE 02/02/06 DATED
DATED 02/02/96
02/02/96
1 5,000
15.000 FEDERAL NATIONAL
ASSOCIATION 08/23/96
08/23/96 03/16/99
03/16/99 13,907.81
13,907.Bl 15,210.00
15,210.00 1,302.19
1.302.19
5.875% DUE
DUE 02/02106
02/02/06 DATED 02102/96
02/02/96
·110,000
~.OOO FEDERAL NATIONAL MORTGAGE
FEDERAL ASSOCIATION.
MORTGAGE ASSOCIATION. 06/06/89
06/06/S9 06/10/99
06/10/99 10,000.00
10,000.00 10,000.00
10,000.00
8.700% DUE 06/10/99
06/10/99 DATED 06/"2/89
06/12/89
200
;200 REGIONS
REGIONS FINANCIAL CORPORATION
06/11/93 05/20/99
OS/20/99 3,200.00
3.200.00 7,539.43
7.539.43 4,339.43
4.339.43
4.40
4.40 SARA LEE CORPORATION
LEE CORPORATION 03/05/97
03/05/97 04/22/99
04/22/99 8,599.80
8.599.BO 10,009.14
10.009.14 1,409.34
1,409.34
" 1 100
00 SYSCO CORPORATION
SYSCO CORPORATION 10116/96
10/16/96 10106/99
10/06/99 1,673.25
1.673.25 .: 3,262.64
3.262.64 1,589,39
1.589.39
,. 140 CORPORATION
SYSCO CORPORATION 02127/97
02/27/97 10/06/99
10/06/99 2,458.40
2.458.40 4,567.70
4.567.70 2,109.30
2,109.30
TOTAL NET LONG TERM CAPITAL GAINS . ,. $81;813.16
$81;813.16': ■: $110,133.80
$110,133.80 $28,320.64
$28,320.64

DISTRIBUTIONS
0
0 OPPORTUNITY FUND
JOHNSON OPPORTUNITY 12/30/99 2,141.45 2,141.45
2.141.45
TOTAL LONG TERM CAPITAL DISTRIBUTIONS
DISTRIBUTIONS $2,141.45 $2,141.45
$2,141.45
TOTAL GROSS
GROSS PROCEEDS
PROCEED.S $138,429.99
$138,429.99
This
summarizes the portfolio transactions
transactions for your convenience.
convenience.
We do not guarantee
guarantee its appropriateness for use
appropriatenessfor use in tax preparation.
preparation.
Johnson Investment
Counsel, Inc.
Inc.
.1 ...
e e·
Revised: June
Revised: June 1998
1998
_ITHEI THE HEIMLICH

INSTITUTE
HEIMLICH BOARD OF TRUSTEES
BOARD TRUSTEES
iNsmurt 1998
311 STRAIGHT
STRAIGHT (513) 751-9600
STREET
STREET
*John Gall,
*John Gall, President
President (513)751-9600
CINCINNATI Massachusetts Casualty
Massachusetts Casualty Ins.
Ins. Co.
Co. (513) 751-9613
(513) 751-9613 (Fax)
(Fax)
OHIO
OHIO 2150 Gilbert Avenue
Avenue (513) 221-8112
(513) 221-8112 (Home)
(Home)
45219
45219
513-559-2391
513-559-2391
Cincinnati,
45206
FAX513-559-2403
R\X 513-559-2403
heimlich®iglou.rom
heJmlich@iglou.com M. Heimlich,
Philip M. Heimlich, Vice President
President Cincinnati City Hall
Cincinnati
6680 Lyceum
Lyceum Court 801 Plum
801 Plum Street
Street
Cincinnati,
Cincinnati, Ohio
Ohio 45230
Cincinnati, 45202
(513)
(513) 352-3647
352-3647
(513) 352-4640
352-4640 (Fax)
(Fax)
Joseph J.
Joseph 1. Dehner,
Dehner, Secretary
Secretary Frost & Jacobs
Frost & Jacobs
822 Yale
822 Yale Avenue
Avenue 2500 Central Trust Tower
2500 Central Trust Tower
Terrace Park, Ohio 45174
Terrace Park, Ohio 45174 Cincinnati, Ohio
45202
(513) 651-6800
(513) 651-6800
(513) 651-6166
(513) 651-6166 (Kathy
(Kathy Barrett)
Barrett)
(513) 651-6981
(513) 651-6981 (Fax)
(Pax)
*Cedric W. Vogel,
"'Cedric W. Vogel, Treasurer
Treasurer Vogel, Heis,
Vogel, Heis, Wenstrup
Wenstrup & & Cameron
Cameron
th
2270
2270 Madison
Madison Road
Road 817 Main Street, 8
817 Main Street, 8 Floor
th Floor
Cincinnati, Ohio 45208 Cincinnati. Ohio
Cincinnati, Ohio 45202 2134
45202 -- 2134
(513) 421-4225
(513) 421-4225
(513)
(513) 639-2547
639-2547· (Fax)
(Fax)
"Henry J.1. Heimlich,

*Henry Heimlich, M.D.
M.D. The Heimlich
The Heimlich Institute
Institute
17 Elmhurst
17 Elmhurst Place
Place 311 Straight
311 Straight Street
Street
Cincinnati, Ohio
(513) 559-2391
(513)559-2391
(513) 559-2403
(513) 559-2403 (Fax)
(Fax)
Mrs. Winston
Mrs. Winston C.
C. Atteberry
Atteberry
Box 629
Box 629
Eunice, LA
Eunice, LA 70535
70535
(318) 457-2705
(318) 457 -2705
Benefiting
Benefiting (513) 768-8298
768-8298 (Direct)
(Direct)
George
George Blake
Blake (513)
Humanity
Humanity The
The Cincinnati
Cincinnati Enquirer
Enquirer (513) 768-8079 (Fax)
(513)768-8079 (Fax)
Through
312 Elm Street
Cincinnali,
Cincinnati, Ohio
Ohio 45202
45202
Health
Health
and
and MOfJfAfYMU'vV'C
,»!. f t - n.
•
J
•
Kathy
Kathy Can-
Carr (513) 871-2221 (Work)
.(513)
Ray
Ray Carr (513) 621-4777 (Work)
JTHEL 3057 Saddleback Drive (513) 231-3010 (Home)
HEIMUCH Cincinnati, Ohio 45244 (513) 621-4771 (Fax)
IMSTTTUFE
Mrs.
Mrs. Arthur Murray (Kathryn) (808)
(80B) 924-4094
311
311 STRAIGHT
STREET
CINCINNATI
CINCINNATI Honolulu, Hawaii 96815
OHIO
OHIO
45219
45219
513-559-2391
Monte L.
L. Rovekamp P.O.
P.O. Box 19129
513-559-2391
FAX 513-559-2403
513-559-2403 2864 Crescent Springs Pike Cincinnati, Ohio 45219-0129
heimlich@iglou.com
heimlich@jglou.com Erlanger, Kentucky 41018 (606) 341-6050
(606) 341-6950 (fax)
William P. Sheehan
WjlHam (614) 466-3206
1673 Braintree (513)231-7467
(513) 231-7467
Richard Weiland 2444 Madison Road, #1406

1055 St. Paul Place Cincinnati, Ohio 45208
Cincinnati, Ohio 45202 (513)421-8527
(513) 421-8527 --421-8430
421-8430
(513) 871-5248 (Home)
(513) 381-0124 (Fax)
Harry W. Whittaker Gradison & Co.

2497 Grandin Road
Road 580 Walnut Street
Cincinnati, Ohio 45208 Cincinnat, Ohio 45202
(513) 579-5000
(513) 579-5982 (Fax)
Anson Williams (213) 850-2685 (Office)

(Office)
24615 Skyline View Drive (213) 657-4861 (Home)
Malibu, California 90265
Dr. Paul Winchell

Drive
Westlake Village, California
California 91361 (818) 991-5754
Benefiting
Benefiting These trustees have the discretion as to the distribution of contributions.
** These contributions.
Humanity
Humanity
Through
Through
Health
Health
and -'/
Ppanp
pp~~p Affilintari with Thp Da^rnnPCQ AQcnrfatinnt} Inr Afed vnU' c
I •
Form 2758
2758, Application for Extension of Time To File
Application
(Rev. June 1998)
(Rev.June Certain Excise, Income.
Income, Information,
Information, and Other Returns 0MB
OMB No. 1545-0148
1545-0148
Department of tha Treasury
Oep~rtment01tIT.. Treasui)' ► File aa separate
~ File separate appJiullon
application lor
for aaen
each raiurn.
return.
Internal Hevtnua
Revenue Service
Se",lee
Name
Name Emplover
Employe. Identification
[dentl~catlon number
Please type or
Pleasetype THE HEIMLICH
THE INSTITUTE
HEIMLICH INSTITUTE FOUNDATION
FOUNDATION 23 17303161
23i7303161
print.
print. File the
Filethe Number, street, and room or suite no. (or P.O.box no. ifit mail is not delivered to street address)
P.O. box no.
original and one
origInal and
copy by the due
data forfillng
date for filing 311
311 S STRAIGHT
T R A I G H T STREET STREET
your return. City, town,
town, or post office, state,
state, and
and ZIP
ZIPcode.
coda.For
For aaforeign
foreignaddress,
address,see
see instructions.
instructions.
CINCINNATI,
C INCINNATI, OH
OH 45219
45219 _ _ _ _
Note:
Note: Corporate income tax return filers must use Form
Farm 7D04
7004 to request an extension ol
of time to file. Partnerships, REMICS, and
trusts must use Form 8736 fileForm
8735 to request an extension of time to file 1065,1066,
Form 1065, 1066, or 1041.
1 I request an extension
1 extension oHime
of time until
until OCTOBER
O C T O B E R 15 15 ,, 2000
2000 ,, toto file
tile (check
{check only
only one):
one):
o
□ Form 706-68(D)
Form 706-GS(D) 0 □ Form Form 990-T
990-T (s8c.401(a)
(sec.401 (a)oror408(a)
408(a)lrust)
trust) 0 □ Form Form1120-ND
112Q-ND(sec.
(sec.4951
4951taxes)
taxes) 0 I I Form
Form B612
8612
o
I I Form Form 70B-6S(T)
706-GS(T) D
□ Form Form990-T
990-T (tru~t
(trust other
otherthan
than above)
above) 0
□ Form Form3520-A
3520-A DForm
□ Form 8613
[XJ
H O Form
Form990or990-EZ
990 or900-EZ 0 Form 1041
□ (estate)
1041 (estatel DForm472D
□ Form4720 0 FormB725
□ Form 3725
o
□ Form990-BL
Form 990-BL D
□ F o rForm
m 1 01041-A
41-A D
□ F oForm
r m 5227
5227 DForm
□ Form 8804
8804
D
I I Form Form 9S0-PF
990-PF D
□ Form 1042 0
O Form Form 6069
6069 0 Form
□ Form 8831
8631
Za
IfII the organization does not have an office or place of business in the United States, check
2a For calendar yBar yaar 19991 9 9 9 ,, or other tax year beginning ^
check this
this box
box
and ending
, >□ 0
b If thisthis tax
tax year
year Isis for
for less
lessthan
than12
12months,
months,check
checkreason:
reason: D InitialInitialreturn
return 0 irr Final
Finalreturn
return----.O=-,--Ch-a-ng-e-in-a-c-co-u-nt-in-g
Change in accountingperiod
period
3 Has an extension of time to file been previously previously granted for
for this
this tax
tax year?
year? [XJ yes 0
I X | Yes □ NO
No
4 Slate
State in detail why why you you need the
the extension
AD D IT IONAL TIME
ADDITIONAL TIME IS
IS ::C:N=E=EC=D-=EC=D----=T=O----=G=A-=T=H=EC=R---::::T=H=E:--::::r=N=F=O=RMAc:":'
NEEDED TO GATHER THE INFORMATION NECESSARY TO FILE A
COMPLETE
COMPLETE AND ACCURATE
AND ACCURATE RETURN.
RETURN.
5a IIthis
If this form isforForm706-GS(D),706-GS(T),
form is 990-BL, 990-PF,
for Form 706-6S(D), 70B-GS(T), 990-BL, 990-PF, 990-T,
990-T, 1041 (estate), 1042,
1042,1120-ND, 4720,
1120-ND, 4720,
6069,8612,8613,8725,8804,
6069,8612,8613,8725,8804, or 8831, enter the tentative tax, less any nonrefundable credits. credits. S
$ _
b11 IIIf this
this form
form is lor
for Form 990-PF, 990-T,
990-T, 1041 (estate), 1042,
1042, or
or 8804,
8804,enter
enterany
any refundable
refundable credits
credits ami
and
estimated tax payments made. Include any prior year overpayment allowed as a credit S
$ _
c Balance
Balance due. dua. Subtract line 5b from
from line 5a. Include your
your payment with
with this form,
form, or deposit
deposit with
with FTO
FTD
coupon if required.
required $ N /A
N/ A
Verification
Under penalties of perjury, I declare that I have examined this
this form,
form, including
schedules and
and statements,
statements, and
and to
to the
the bast
bast of
of my
my knowledge
knowledge and
and belief,
belief,
it is true, correct,
correct, and complete; and that
that I1am
amauthorizsd
authorizedtotoprepare
preparethis
thislorm.
form.
Signature ► Titled Cjjft^ Oate ► " ^ / < ^ / O f ' * -

ORIGINAL AND ONECOPY.TheiRS
FILE ORIGINALAND ONE COPY. The IRSwilt willshow
showbelow
belowwhether
whetherorornat notyour
yourapplication
applicationIsIsapproved
approvedand andwill
willreturn
returnthe
thecopy.
copy.
Applicant - To Be
Notice to Applicant Be Completed by by IRS
D
I 1We WeHAVEapproved
HAVE approvedyour yourapplication.
application.PleaseaHach
Please attachthis
thisform
formtotoyour
yourreturn.
return.
D
I I We HAVE
HAVE NOTapproved
NOT approved your your application.
application. However, W9 wehave
havegranted
grantedaa10-day
10-daygrace
grace period
periodfrom
fromthe
the later
later 01the
of the date
date
shown below or thethe due date of your return (incruding
(including any prcoraxtenslons).
prior extensions). Tltls
This grac€Iperiod
grace period is considered
considered a valid
extension oHime
of time for elections otherwise required to be made on a timely timely return.
return. Pleaseattach
Please attach this
thisform
form totoyour
your return,
return.
o
I I We HAVE
HAVE NOT
NOT approved
approvedyouryourapplication.
application.Atter
AfterconSidering
consideringyour
yourreasons
reasonsstated
statedininitem
item4,4,we
wecannot
cannotgrant
grantyour
yourrequest
requestfor
for
an extension oftime
of time to file. We are not granting the 10-day grace period.
o
I I We cannot
cannot constder
consider your
your application
application because
because itit was
wasfiled
filedafter
afterthe
the due
duedate
dateofofthe
the return
returnfor
for which
which an
anextension
extensionwaswasrequested.
requested.
D
□ Other:
other:
---------------------------------------------------------------------------------------
--------------------------------------~:-------------------------------------
Director
By..
Date
If you want a copy

copy of
of this
this form
form to
to be
be returned
returned to
to an
an address
address other
other than
thanthat
thatshown
shownabove,
above,pleaseenter
please enterthe
theaddress
addresstotowhich
whichthe
thecopy
copyshould
shouldbe
besent.
sent.
Name
Please
Pleasll CLARK,
CLARK, SCHAEFER, HACKETT
SCHAEFER, HACKETT CO.
& CO.
Type Number, street and
Number. street and room
room or
or suite
suite no.
no. (or
(or P.O.box
P.O. box no.
no. ilif mail
mail isis not
not delivered
delivered to
to street
street address)
address)
or 105 EAST FOURTH
105 EAST FOURTH STREET,
STREET, S U I T E 1600
SUITE 1600
Print City, town,
town, or
or post
post office,
office, state,
state, and
and ZIP
ZIP code.
code. For
For aa foreign
foreign address,
address,see
seeinstructions.
instructions.
CINCINNATI, OHIO 45202-4093
45202-4093
lHA
LHA For Paperwork
Paperwork Reduction
Rodurllon Act
A~I Notice,
NOIJ~8,se8
see separate Inst,u~lians.
separate Instructions. Form 275B
2758 (Rev. 6-98)
6-98)
913941
11-23-99
11-23-99
0 9390810
09390810 7 5 8 0 5 0 23-12053HEI
758050 23-12053HEI 1 9 9 9 . 0 5 2 0 0 THE
1999.05200 THE HEIMLICH
I N S T I T U T E FOUN
FOUN 23-12051
23-12051
Form
Form' 2758"
27SS ^ A p p l i c a t i o n for Extension
A\pplication Extension of Time
Time To
To •JJ^^
(Rev.J~ne199B~
(Rev. June 1998). C e r t l m Excise, Income, Information,
Cert_Excise, Income, Information. and Othe and Othe^ffeturns
eturns OMB No. 1545-0148
0MB
Department
Department ofor the Treasury
ll1eTr.... ury ► File aa separate
.... File separate application
application lor
for each
each return.
return.
Internal Revenue SeNlco
Internal Ravenue Sen/lco
Name
Name Employer
Employer Identification
IdentiHcalion number
numbor
Pleasetype
Please type or THE HEIMLICH
FOUNDATION 23 I7303161
23j7303161
print. File
FiIethe
the Number,
Numbsr, street, room or
sheet, and room or suite no. (or
(or P.O.box-no.i1mail
P.O. box no. il mail is
is not
not deli'Jeredto
delivered to street address~
address!
original
original and one
due
copy by the due
date for filing 311
3 11 S STRAIGHT
T R A I G H T STREET STREET
your return. City, town, or
City,town, or post
post office,
office,state,
state,and
andZtP
ZIPcode. Foraaforeign
code.For foreignaddress,
address,seeinstructions.
see instructions.
C INCINNATI,
CINCINNATI, OH
OH 45219
45219
Note: Corporate income tax return filers must use Form 7004 to request an extension of time to file. Partnerships, REMICS, and
trusts must use
use Form 8736 to request an extension of time to file Form 1065,1066,
1065, 1066, or 1041.
1 _l request anextension
Irequestan extension
of of time
time until
until AUGUST
A U G U S T 151 5 , , 2000
2000 ,to ,file
to file (check
(check onlyonly one):
one):
o Farm70E.-GS{O)
□ Form 706-GS(0) 0
□ Form
Form990-1
990-T(secA01(a)
(sec.401 (a)oror406{a)
408(a)trust)
trust) 0□ Fmm
Form112.0-NO(sec,4951
112Q-N0 (sec. 4951tax-ss)
taxes) 0 Form 8612.
□ 8612
o Form706-GS(T)
□ Form 706-GS(T) 0
□ Form 990-T (trust
(trust other than above) D
□ Form 3520-A
3520-A D FormB613
□
Form 8613
[X]
□ 3 Form 990 or 990-EZ
990-EZ D Form 1041
□ 1041 (estate)
(estate) □
D Form 4720
4720 D
□ 8725
Form 8725
D
□ Form990-BL
Form 990-BL D
□ F o rForm
m 1 01041-A
41-A D Form5227
□ Form 5227 D
□ Form 8804
8804
D
□ Form 990-PF D
□ Form 1042 D Form 6069
□ 6069 D
□ Form 8831
If the organization does not have
organizationdoes haveanan office or
or place of business in
in the United States,checkthis
States, check thisbox
box >D
□
calendaryear
2a For calendar year 1 1999
999 ,,or other
other lax
tax year beginning
beginning _ ^ and ending
ending_---;=,-- _
b If this tax yearis
year is for less than 12 months,
months, check
check reason:
reason: D Inilial
Initial return
return D Final
Final return
return D
Change in accounting period
Changein
3 Has an extension
Hasan extension of time to file beenpreviously
01time been previously granted for this tax year? IDYesI Yes [00
3 No
No
44 need the extension
State in detail why you needthe extension
AD D IT IONAL TIME
ADDITIONAL TIME IS
IS -N=E=E=D-=E=D""'-':T=-=O""--'G=-=AO-T=H=E=R=-T=H=E--=I::-::N=F-=-O=RMA~-:T=I:-:
NEEDED TO GATHER THE INFORMATION NECESSARY TO =F=I=L-=E:--:::AFILE A
COMPLETE
COMPLETE AND
AND ACCURATE
ACCURATE RETURN.
RETURN.
5a If this form is for Form 706-GS(D), 706-GS(T), 990-BL, 990-PF, 990-T, 1041 (estate), 1042,1120-NQ, f ? 2 0 p £ \ V t - ^
6069,8612,8613,8725,8804, or 8831, enter ttia tentative tax, less any nonrefundable credits. ...£>..Vrr..7T'. $
b If this form is for Form 990-PF, 990-T, 1041 (estate), 1042, or 8804, enter any refundable credits and »v fi Pi ?Q00
estimated tax payments made. Include any prior year overpayment allowed as a credit ,\!\r*:...„. $
c Balance due. Subtract line 5b from line 5a. Include your payment with this form, or deposit with FTD F V E N U E SERVICE
coupon if required. iMÊ.R^cl^î....Oht)Q. $ N/A
Signature
Signature and
and Verification CI~
Under penaltiesof
Under penalties of perjury, I declarethat
declare that I haveexaminedthis
have examined this form,
form, including accompanying schedulesand
schedules and statements,and
statements, and to
to the best of
of my
my knowledge and belief,
it is true,
true. correct, and
and complete;
complete: and that I am authorized
authorizedto
to preparethis form.
prepare this form.
Signature ► ~ ^ ^ S N . U L ^ Titled < ^ J ^ \ ► "f-)

Date .... " r V
;:"l.:~
g ^j~~
j g ^
FILE ORIGINAL AND ONE COPY. The
FILEORIGINALANDONECOPY.The IRS will
tRSwitt show
show below
below whether
whether or not
or not your
your application
application Is approved
Is approved andand
~villwill return
return the the copy.
copy-
Notice to Applicant
Notice Applicant - To To Be Completed by IRS
Be Completed IRS
D We HAVE
HAVEapproved Pleaseattach
approved your application. Please form to your return.
attach this form
D We HAVENOTapproved
□ HAVE NOT approvedyour yourapplication.
application.However,we
However, wehavegranted
have granteda a1O-daygrace
10-day graceperiod
periodfrom
from thethelaterof thethe
later of date
date
shown below or ortha
the due dale
date of your return (including any prior extensions). This This grace
grace period
period is
is considered
considered aavalidvalid
extension of time for elections
elections otherwise
otherwise requiredto
required to be made on a timely
timely return.
return.Pleaseattachthis
PleasB attach this form
formto toyour
your return.
return.
□D We HAVENOTapproved
HAVE NOT approved your your application.After
application. Afterconsidering
consideringyouryourreasons
reasonsstated
statedin
in item
item4,4,we
we cannot
cannotgrant
grantyour
yourrequestfor
request for
an extension
extension of tima
time to file. We are not granting the 10-day
10-day grace pariod.
period.
DWe
□ We cannot consider your
your application
application becauseit
because it was
was filed
filed after
afterthe
thedue
duedate
dateofofthe
the return
returnfor
forwhich
whichananextension
extensionwaswasrequested.
requested.
D Other:
□ Other: _
.By:.
----------------------------------~:-------------------------------------
Director
Director Date
Date
If you want a copy

copy of
ofthis
this form
formto
to be
be returned
returned to
to an
anaddress
address other
otherthan
thanthat
thatshown
shownabove,pleaseenter
above, please enterthe
theaddressto
address towhich
whichthe
thecopy
copyshould
shouldbe
besent.
sent.
Name
Name
Please CLARK,
CLARK, SCHAEFER,
SCHAEFER, HACKETT
HACKETT & CO,
CO.
Type Number, street
streetand
androom
roomororsulte
suiteno.
no.(or
(orP.O.
P.O.box
boxno.
no.if ifmail
mailis is
notnot delivered street
delivered10 to street address)
address)
or 1 0 5 EAST
105 E A S T FOURTH
F O U R T H STREET,
S T R E E T , SUITE S U I T E 1600 1600
Print
City, town,or
City,town, orpost
postoffice,
office,state,
state,and
andZIP
ZIPcode.
code.For
Foraaforeign
foreign address,
address, seesee instructions.
instructions.
CINCINNATI,
CINCINNATI, O OHIO
H I O 45202-4093
45202-4093
LHA
lHA For Paperwork Reduction Act Notice, see separate instructions.
instructions. Form 2758 (Rev.
(Rev. 6-98)
913941
913941
11-23-99
11-23·99
10460426
10460426 758050 23-12053HEI
758050 23-12053HEI 1 9 9 9 . 0 5 2 0 0 THE
1999.05200 HEIMLICH INSTITUTE
FOUN 23-12051
OMBNo 1545-0047
OMS No 1545-00~7
Return of Organization From Income
Organization Exempt From Income Tax
Form
Form 990 990 !
»,. ,
Under section
prlnte
section 501 (c) 01
private loundation),
loundation),
ol the Internal
section
section
Internal Revenue Code (eJl:eeptblack
527,
527, or section
section
(except black lung
4947(a)(1)
nonexempt
lung beneliltrust
benelil trust or
charitable
charilable trust
trust
2000
.:. OpenlO.PU&liC:::":
- '" I
Department
Dep.rtment ol ot the
the Treasury
Treaoury
Internal
Internal Revenue
R....enue Service
ServIce j►
... The
The organization
organization may
may have
have to
to use
use aa copy
copy of
of this
this return
return to
to satisfy
satisly state
state reporting
requirements. ■:v.::.:.'^.tRsjjart!6n'::-::: ■:::.:■:
A For the 2000 calendarcalendar year,
year, OR
OR ta*
lax year period beginning
period beginning and ending
B
B Clock it
CheckII Please
Please
C Name of organization D Employer
Employer Idenliliealion
number
apDiicaole.
.pDlicatJle. use
useIRSIRS
□
D;~~~;ot Change ot label or
THE HEIMLICH
~~~:~;THEHEIMLICH
address print or INSTITUTE
INSTITUTE FOUNDATION 2 3-7303161
23-7303161
□
D~~~ge %: Change of type
nime 01 Number and street (or P.O. box if
if mail is not delivered to street address)
address) I A oom'sune E Telellhone
Room/suite Telephone number
number
□
D~~~ Initial
3
311
return
S«
1 1 STRAIGHT
STRAIGHT
Specific
Spoc:I6c STREET ((513)559-2391
513)559-2391
□
D..:~:r. Fi
Final
return
Instruc
Instruc-
tion).
bons. City ortown,
or town, state or
or country,
country, and
and ZIP
ZIP F Check ...
F Check ► I 01 Iirf application
application pending
pending
CINCINNATI,
C I N C I N N A T I , OH OH 45219
45219
*DAmended
—'«
~~~~~~,--~~~~~~~~--~~--~~~------------------~--------------~----------------
(use also for
state reporting)
reportingj (H
(H and
and I are not applicable
applicable to
to section 527 orqs.)
secuon 527 orgs.)
G Organization type
G Organization type (check
(check only
only one)'" IX!501(c) (3
one) ► I X I 501(C) ( 3 ).... (insertno.)
)< (insert no.) □ 527 0 H(a)
H(al Is this
ls group return
this a group return tor
tor affiliates?
affiliates? _ _ Yes I X I No
DYes No 00
OH □ 4947(a)(1)
__ =-=---:::-----:-::-:-:--:-:::::--_---:---:-:-o~R__=D==_:4,:.:9:::::4_:_77(a~)(_:_1
)!__-----:----:----:-:-:-:--:------l H(b)
H(b) If "Yes," enter number of affiliates ...
It 'Yes," enter numbe r at affiliates ► _ _ _ _ _ _ _ _
• Section
Section 501 501(c)(3) organizations and
(c)(3) organizations and 4947(a)(1)
nonexempt eharitabje
charitable trusts H(c) Are
Are all affiliates
affiliates included?
included? □
DYes Yei [XJ
_ D No
No
must
must attach
attach a completed
completed Schedule Schedule A (Form
(Form 990 or or 900-EZ).
900-EZl. (It °No: attach a list.)
(It'No.'attach hst.)
JJ Accounting
Accounting i—i
method:
D nn
rvl
LX.!
i—i
D ^
H(rJ) this a separate return
H(d) Is this return filed
filed by an
method: ' ' c<=n
Cash L A J Acc ™ 1 * I I oth»tsp»ary,p-
I\ccnjal Oth.(s_,tyl'"
~~~~------------------------------------------------4organization covered by a group
organization covered ruling? 0
group ruling? __ Yes [XJ
Yes I X I Nn
No
K Check here"
here ► D I I ifil the organization's
organization's gross
gross receipts
receipts are normally
normally not
not more
more than
than $25,000.
$25,000. The I Enter 4-digit
Enter 4-digit group
group exemption
exemption no.
no. (GEN)
(GEN)...►
organization
organization need
need not
not tile
tile aa return
return with
with the
the IRS:
lAS: but
but ifitthe
the organization
received aa Form
Form 990
990 Package
Package L
L Check this
Check this box
box ifif the organization
organization is
is not
not required
requiredtoto
in the mail,
mail, it should file a retum
should fite return without
without financial data. Some slales
stales require
require a complete
complete return.
return. attach
attach Schedule
Schedule B (Form(Form 990 990-EZ)
990 or 990-EZ) ...
► | | 0
I: Partl\
part·.-1 Revenue, Expenses,
Expenses, and Changes
Changes in Net Assets or Fund Balances
1 Contributions, gifts,grants,
grants,and
and Similar
similaramounts
amountsreceived:
received: ::-:.: ... :.:.
Contributions, gifts,
a Direct public
a Direct support
public support . 1a
1a 1106,140 tr::\:
0 6 , 1 4 0 .::.::
..
::
Indirect public
bb Indirect public support
support . 1b
cc Government contributions (grants)
Government contributions (grants) .. 1c L-.:~.:.:-,- --{',"~
Total (add
d Total
d ta through
(acld lines la through 1c)
(cashS
(cash s 1 0 6 , 140 .
106,140 . noncash$
noncash $ ) . 1d 1106,140.
06,140.
2 Program service revenue including
Program including government
govemment fees and contracts
contracts (trom
(from Part VII,
VII, line 93) . . 2
Membership . . 3
5 Dividends and interest from securities 2 5,535
25,535.
6 a Gross rents 6a I
b Less, rental expenses Eb I
c Net rental income or (loss) (subtract line 6b trom line 6a) 6c
7 Other investment income (describe ► 7
8 a Gross amount from sale of assets other (A) Securities (B) Other
r---_.(A:.:.Jn'-;~'=:eO~\;-:'rit"",ie-=~-::0:-:1;--io
--8a--,----'-=(IB:.L)0I=he::.:.r-------I:!:·::·.;:::::~.:::':
than inventory
than inventory . 101,501 Ba
b
b Less: cost or other basis and sales expenses
c
c Gain or
01 (loss) (attach schedule)
expenses .
.
1----_;9;_;~:::-~:i~~--=:~_;_:~:~~------~:::i::!!,;!::i,:::
95j_395, 8b
6 , 1 0 6 . 8c
d
(loss) (combine line 8c, columns
Be. columns (A) and (B)) .
(B)) STMT L1
~':r.M.':r . Bd
8d 6,106
Special events and activities (attach schedule)
9 a Gross
~~:~~a:ee:ee;~:
revenue ~(not
~:t ~~~~~~~:g(~tt_ac_h_s_c_he_d_U_le_)
including S of contributions
of contributions :.·l:il:i:.:i·::
reported on line 1a) 1a) . lr9"'a_t-1
9a ---;::·::·,,::·
b
b Less: direct e~penses
expenses other than fundraising
tundraising expenses
expenses..... 9b
9b :i:.>.::.':"
c Net income or (loss) from special events (subtract line 9b from line 9a)
~~--------------~ 9c
c Net income or (loss) from special events (subtract line 9..b..f.r.o ..m I.i.n.e93.) 11.0,-. r··· 1-::"-':r9~.:.~:....::.:.+----------------
10 a Gross sales of inventory, less returns and allowances 10a
10 a Gross sales of inventory, less returns and allowances I ,,) :..::::
...
:::
..::.:
...
:::
..:::
..:
..:..::::::::
...
:.:
...
b
b Less: cost otgoods
ot goods sold
sold .. . 10b
._l;:_:O:=b_._ ---i •
c
c Gross profit
profit or (loss) lrom
inventory (attach schedule
schedule))(subtract
(subtract line 110b from line lOa)
Ob from 10a). . . 10c
10c
11 Other
other revenue (Irom
(from Part VII.
VII, line 103).
103) . _r, - .. 1. . .. ... 11
12 Total revenue
Total revenue (add lines i d , 2
1d 2 345 , 3 , 4 , 5 . 6 c F
6c ,O( !6ilb'tlFD.. .. . . 12 137,781.
137j_781
13
13 Program services
Program services (from
(from line
line 44, column ( ) .~'--
44,column(8 gt..
.~ ... 13 118,737.
118,737
2001 9.'\.. .
II)
411
. 56,105.
56,105
I
II) 14 Management and general (from line
Management and general (from line 44, 44, col
co u~ 14
c;
qj
Q,
IoC
15 Fundraising (from line 44, column (D))
Fundraisinq (from line 44, column (0)) .. ~ g?_:\........... . . 15
UJ 16
16 Payments to affiliates (attach schedule)
schedule) .__ .. ~ ~; ~ .. __ . . . 16
17
17 Total expenses
Total eiDense5 (add lines 16 and 44 colun n IAllr\r-nI=N
44,colu LJT ... . . . 17 174,842
174,842.
II)
18
18 Excess
Excess or (deficit) tor
or (deticit) for tne
the year
year (subtractline
(subtract Iine\l7.1
17frnrn'iiM0\ . 18
18 - 337,061.
7,061
-;C; 19
19 Net assets ortund balances at beginning
Net assets or fund balances at beginning of year (tram
of year (trom line
line 73,column
73, column (A))
(A)) . . 19 835,787.
8 35j_787
H
zt:lC( 20
20
21
Other
other changes
changes in in net
net assets
assets or
fund balances at
Net assets or lund
or fund
fund balances
balances (attach
(anacn explanation)
al end of year (combine
explanation)
(combine lines 18,
18.19,
19, and 20)
SEE. ~.T-ATE.-M.E.N'r. ~2 .
S.EJ!: .. STATEMENT
. . .
20
21
-6,885.
-6j_8 85
791,841.
791,841
023001
~~~-~
12-19-00 LMA
LHA For Paperwork Reduction
Notice, see page i1 ol
01 the separateListructicns.
separalelnstruclions. Form 990 (2000)
990 (2000)
0 9 3 6 0 8 2 0 758050
09360820 7 5 8 0 5 0 23-12053HEI
23-12053HEI 2 0 0 0 . 0 6 0 0 0 THE HEIMLICH
2000.06000 H E I M L I C H INSTITUTE
I N S T I T U T E FOUN 23-12051f}\
23-1205
^
pPage 2
Form 990 (2000)
Form990(2000) , THE
THE HEIMLICH INSTITUTE FOUNDATION 23-7303161
2 3 -7303161 age 2
:
l·parfU·:'1
■p "jl-:- .'-;:1 S t a t e m e n t of
:"': Statement
■Part■■II;-'-;
t
Functional
of
F u n c t i o n a l Expenses
Expenses
All
All organizations
(4)
organizations must
(4) organizations
must complete
organizations and
complete column
and section
column (A).
section 4947(a)(
(A). Columns
Columns (8).
1) nonexempt
4947(a)(1)
(8). (C).
(C). and (0)
charitable trusts
(D) are required
trusts but
required for section
but optional
optional for
section 501
tor others.
others.
(c)(3) and
501(c)(3)
Do not include amounts reported on line (B) Program

tS) Program tC) Management
(C) Management
6b,
6b, Bb,
8b, 9b, 1Db,
10b, or
or 16 of Part I.1. 1:::::\:':: (A) Tolal
Total and general
and gimeral (D) Fundraising
Fundraising
services
22 Grants
Grants and
and allocations
allocations (attach
(attach schedule)
schedule) ..........
:', :':.::,.::)\
^ : r : : \ ·:/':·:··::'_'i:L·
^ m ■■:"::■■ .'::
: : :
■:;.■::
_'::'·:::::"·,'i' ..
, "':..::. ':;; :
,."',/::'.'
cash $
C85~ $ 3,690
3 , 6 9 0 .•noncash $S 22
22 3,690.
3,690. 3,690.
3 , 6 9 0 . ~~ATEMENT -4
STATEMENTS $&$ ^^;!m^W^-/ :M
' . ' , -
23 Specific
Specific assistance
assistance toto individuals
individuals (attach
(attach schedule)
schedule) 23 23 c a£f£$> iix:&Wi"$.
!·:::::}':i::!I!:·:;i::',':;::::::::i::::·'m(.·:::::.
: :::1·
Benefits paid
24 Benefits to or lor
paid to lor members
members (attach
(attach schedule)
schedule) 24 24 ._ l*:;i&^ffiw£&)$£ &.\
25 Compensation
Compensation of of officers,
officers, directors.
directors, etc.
etc. ............ 25
25 0. o. o.
0. 0. o. O.
0.
26 Other
Other salaries and wages
salaries and wages ...... _ ...... . ......... 26 92,147.
9 2,147. 69,110.
69,110. 23,037.
2 3,037.
Pension plan
contributions ._..__._.._. .. ............. 27
27
28 Ott\er
Other employee benefits ..... ...... ....... ..........
employee benefits 28 13,299.
1 3,299. 9,974.
9,974. 3,325.
3,325.
29
29 Payroll
Payroll taxes
taxes ... . .. .......... ... ........ ......... 29
29 7 ,651.
7_L651. 5,738.
5,738. 1,913.
1,913.
30
30 Professional
Professional fund raising fees _.... _.._.._.._.__.._.....
fundraising 3D
30
31
31 Accounting
Accounting fees ..... .......... ........ ........ ...... 31
31 5,955.
5 ,955. 4,466.
4,466. 1
It., 4489.
89.
32
32 Legal
Legs) fees
fees ............ .. .. ... . ........ "' .. 32
32
33
33 Supplies ... _.._........
Supplies .... .. . .. .. ...... 33
33 3,151.
3,151. 2,363.
2,363. 788.
788.
34
34 Telephone
Telephone _.._........ _....... ....... ....... ...... 34
34 719.
719. 539.
539. 180.
180.
35
35 Postage
Postage and shipping ...... . ..... .... ... .. ......... .
and shipping 35
35 1,903.
1,903. 1,427.
1,427. 476.
476.
36
36 Occupancy _. ...... ........ .. .. .... . .' .................
Occupancy 36
36 14,657.
14,657. 3,664.
3,664. 10,993.
1 0,993.
37 Equipment rental and maintenance
Equipment rental maintenance . ... .......... 37
Printing and publications ........... ................. 36
38 8,011.
8,011. 6,008.
6,008. 2,003.
2,003.
39 Travel
Travel .............. . .............. ..... .................. 39
39 3,745.
3,745. 2
2 , 8809.
09. 936.
936.
40 Conferences,
Conferences, conventions.
conventions, and meetings ............
and meetings 40
40
41 interest ............ ............................ ............
Interest 41
41
42 Depreciation,
Depreciation, depletion.
depletion, etc.
etc. (attach schedule) _._
(attachschedule) 42
42 6,946.
6,946. 6,946.
6 ,946.
43 Other
Other expenses
expenses (itemize):
(itemize):
aOFFICE
a O F F I C E INSURANCE
INSURANCE 43a
43a 1,559.
1,559. 390.
390. 1,169.
1 ,169.
bOUTSIDE
bOUTSIDE SERVICES
SERVICES 43b
43b 5,623.
5,623. 4,217.
4,217. 1,406.
1,406.
cMISCELLANEOUS 43c
43c 5,786.
5 ,786. 4,342.
4,342. 1,444.
1 ,444.
dd 43d
43d
Be 43e
43&
44
44 Total functional
functional expanses
expense (lIdcllines
(add lines 22 through
through 43) 43)
Organizatlonscompl.~ng
Organizations come I e ting columns(8)-(0). cany IIIeso
columns (B)-(D),cany these
101&Is
totals 1
to0lines 13-15 .....
lines 13·1:\ .. ...... ... ... . 44
44 174,842.
174,842. 118,737.
1 18,737. 56,105.
5 6,105. O..
0
Reporting 01
Reporting Joint Costs.
of Joint Costs. Oid
Did you
you report
report in column
column (B) (Program services)
(B) (Program services) any joint
joint costs tram aa combined
costs from combined educational campaign and
educational campaign and
fundraising
fundraising solicitation?
solicitation? ... _.__._.._.._.._.._._.._..... _.._.._.._.._._.. ► IZZI Yes [X]
I X 1 No .......
D
11
If "Yes:
"Yes," enter
enter (f)
(f) the
the aggregate
aggregate amount
amount of of these
these joint costs S$
joint costs ;;(ii)
(ii) the
the amount
amount allocated
allocated to
to Program services $$
Program services _
iIIll
fill) the amount
amount allocated Manaoement and
allocated to Management general SS
and oeneral .; and
and (iv) the amount
liv) the amount allocated
allocated to
to Fundraising
Fundraising $ .
\·parfiir·1 Statement of
Part;III I Statement of Program
Program ServiceAccomp'ishments
Service Accomplishments
the organization's
What is the organization's primary
primary exempt ► SEE
purpose? ....
exempt purpose? STATEMENT
SEE S TATEMENT 3
3
Program Service
Pro~am Servl~B
Ipenses
Expenses
All otgal'lizstlon't
All organizations must describe
must describe their
the4r exempt purpose achh:rv~tJ
e.xanpt purpose achievements In cletlr and
In •■ deer and concise
concise ITlW'lner. State the
manner. State the number
number of of dients lerved, pubhc.Lions
clients served, publics Lion a iS5Uect.
issued, etc.
etc. DiSCLISli
Discuss ~ulr'lld
(Required for 501(c)(3).."d
501(c)(3) and
achievements that are not
IIcturarement:!i Ih.l.rw not measurablo. (Section 501(el(3)
measurable. (Section 501(c)(3) ana
ana (~) organization. and
(4) organizations 4947(a)(1) nonexempt
and 44947(a)(1) charitable trus~
nonexempt charitab!e trusts must
must also
also enter
enter the
the amount
a m o u n t ot
ot grants
grants and
and (4) o~
(4) .. and 49471aX11
orgs., 4947(aXU
allocations to
oIl0e.0tion. to ot~ers
others)) trusto.
trusts, but optional
options! for
lor otners
others))
aaTHE HEIMLICH INSTITUTE FOUNDATION,

FOUNDATION, INC.
INC. IS IS A A CORPORATION
CORPORATION
DESIGNED TO
TO CONDUCT SCIENTIFIC, CULTURAL AND AND SOCIAL RESEARCH
INTO ISSUES OF IMPORTANCE TO
OF IMPORTANCE THE MEDICAL AND
TO THE AND SCIENTIFIC
COMMUNITIES.
COMMUNITIES. (Grants and
(Grants allocations $S
and allocations ) 35,621.
bAlDS
b AND EDUCATION
AIDS RESEARCH AND EDUCATION
(Grants and
allocations $ I 53,432.
53,432
c EDUCATION
c EDUCATION OF THE GENERAL PUBLIC,
OF THE PUBLIC, THE
THE PRINTING AND
PRINTING AND
DISTRIBUTION
DISTRIBUTION OF EDUCATION LITERATURE TO PUBLIC PLACES
OF EDUCATION LITERATURE TO PUBLIC PLACES
ABOUT THE MANEUVER
(Grants
(Grants and
and allocations
allocations $S I 29-,684.
29,684
d
(Grants and
and allocations 1
e Other
Other program
program services
services (attach
(attach schedule)
and allocations I
ff Total
Total ot
of Program
Program Service
Service Elpenses
Expenses (should
(should equal
equal line 44.
44, column
column (B).
(B), Program
Program services)
services) _.._.. . _.. 118,737
118,737 .
~~PJ.1o
023011
12-19-00 22 Fonm 99D
Form 990 (2000)
(2000)
009360820
9 3 6 0 8 2 0 758050
7 5 8 0 5 0 23-12053HEI
23-12053HEI 2000.06000
2 0 0 0 . 0 6 0 0 0 THE 23-12051
Form990(2000)
Form 990 (2000) THE
THE HEIMLICH
HEIMLICH IINSTITUTE
NSTITUTE FOUNDATION
3-7303161 Page3
Page 3
PartIV Balance Sheets

Nole: Where
required, attached
attached schedules
schedules and amounts within the description
and amounts description column
column fA)
(A) (8)
(B)
should be for end-of-year
should be end-of-year amounts
amounts only.
only_ Beginning of year
ol year End of
ol year
45 Cash-non-interest-bearing
Cash - non-mterest-beannq ._.._ _ _ _.._ _ _ _. 22,341.
22,341. 45 7,911.
7,911.
46 temporary cash investments
Savings and temporary 11,677.
11,677. 46 1 5,761.
15,761.
Accounts receivable.
47 a Accounts receivable .. 47a
f---:!.47!_!a'-+ ----l
b Less: allowance
b Less: allowance for
tor doubtful
doubtful accounts
accounts __.__.... _........ 47b
r.47"""b;.+,--,-,...,.-y~~~-:---:_:_:_:_~:t--------_+c4~7~c 47c +- _
.:)(;)~;: ;1~~~~~~~~~~1·~
.~~::~~~:}j:~:::t:t:~~r~~::~~r:~~~)::~t~~:;.~~~~~~t~~~~~t{~
tiMZ!Mtf±Wte:WmZi
48 aa Pledges
46 receivable
Pledges receivable . . 48a ,..',,,,,/,"
b Less: allowance
b Less: allowance lOTdoubtful
tor doubtful accounts
accounts _ . 48b
48b 48c
48t
49 Grants receivable _.._.._ _.._..__._ _.__.._._ _ _ _ _._._._ _ _._._ _.__ 49
50
SO from officers,
trustees,
-
11'1
4"
11'1
:J.
and key employees
~~e~e:o~:p~~~el::n~ ·r~c~i~~·b·I~··
51 aa Other notes and loans receivable
b Less:
Less: allowance
allowance lor
tor doubtful
..:-::-::. ::..':
doubtful accounts
accounts
:.:_::_.""1"
_
5·~
51a
~T····
~51!..!:b~
51b
.
+-
50
-+..!:5:..!.1~C
51C +- _
52 Inventories
Inventories for sale or use 52
53 Prepaid expenses and deterred
deferred charges _ _ _.._ _.._._._._.._ . 53
54 Investments - securities
Investments-securities _.._.._ ► I 0I Cost IDI FMV 54
55 a Investments --land,
I Investments land, buildings,
buildings, and
equipment:
equipment: basis
basis . 55a
b Less: accumulated
Less: accumulated depreciation
depreciation .. 55b
.. .. .~55"-'b'='=::-::-=-=::-:-:-=:c=-=--=:--_+- __ 55c +-__ --==-=---:--=--=-:::--
---::::-:::-=----::-::-::-+...!5'""5"-c
56
55 Investments - other S EE
STATEMENT 5 7 8 1 , 1 1 7 . 56 754,102.
~navne:~~:i~~~n;~~::~
57 a Land, ~~·~i~·~~~i·:-b~~·i~·:::::::::::::::~:~1~~·7:r1>.';I'·~·M.~·~I·;·~i6·.
buildings, and equipment: basis 57a 55,616. 781, 11 7 • ,::.::G):,;~ 754, 102 •
b Less:
Less: accumulated
depreciation _._ _ 57b
_.._.._ L5:o:..:7~b...J._ 48,657.
4=-8.:=....L,...:6:-;5=--=-7...:.+- 1 3 , 9 0 5 .• ...:5:o:..:7~C+-
57c
-=1--=:3~,~9:::-::0...:::5:-=-! 6,9
-----,6=--,-' 59.
.-:;9--=:5:,...:9=-=-.
56
58 ►
Other assets (describe ..... S EE
SEE S TATEMENT
STATEMENT 6 ) t-- 6 , 7 4 7 . 56 +-
...;;6_.,_7;_4.;;;...;;.7...;;..t-=5;:.8 ----'-77.....,,...;;1'
1 -00;_8"--.
8.
59 Total
Total assets
assets (add lines 45 through
throuqh 58) (must equal line 741.
74) . . 8
8353 5 , 7 87.
787. 59 7 91,841.
791,841.
60 Accounts payable and accrued expenses
Accounts expenses............... . . 60
61 Grants
Grants payable _ _.._ . 61
s 62 Deferred revenue _.._ _.._... . . 62
**
~ 63 Loans
loans from
from officers,
otficen>, directors,
trustees, and key employees . . 63
:a
.o
~ 64 a Tax-exempt bond
bond liabilities _ _ . 64a
64a
:::::i
_l
b Mortgages
Mortgages and other notes
notes payable 64b
54b
65 Other liabilities
Other (describe .....
liabilities (describe ► _ ) 65
66 Tolaillabilities
Total throuan 65)
liabilities (add lines 60 throuqh _._._._._.__.._ _ _._.._._. 0
O.. 66 o.
O.
Organizations that
Organizations that follow SFAS 117, check here
10110111 SFAS117, here.....
► [K] and complete
LXI complete lines 67 through
through
lines 73 and 74.
69 and lines
cu
in
67 Unrestricted
Unrestricted 7 96,868.
796,868. 67 7 52,922.
752,922.
c
c::
n
III 68
6B rernoora
Temporality
rily restricted _.._ _ _.._... .. . _.._._ _.._ _._._._ _ . 66
68
IS
~
m 69 Permanently
Permanently restricted _ _.._.._.._ _.. 3 8,919.
38,919.69 69 3 8,919.
38,919.
■o
'tI
c::
c Organizations that
Organizations that do not
notlollow
follow SFAS 117, check here.....
SFAS117, here ► D and complete lines
..o
3
:::I
U.
LL
o
70
70 through
through 74
74..
stock, trust
Capital stock, trust principal,
principal, or current funds
funds
□ and complete lines
_._ _ _ . 70
9 71
in 71 Paid-in or caoital
capital surplus,
surplus, Orland,
or land, building,
building, and equipr
equipment fund ._._............ . .
in nentfund
72 Retained earnings,
earnings, endowment,
endowment, accumulated income,
income, or other funds
funds ..... _.._._._._ _._.._ 72
<41 ..:.:.::.: ... :...
:..:~.:
73 Total net assets or fund
Total lund balances
balancBS (add lines 67 through
through 69 OR
OR lines 70 through 72;
through 72: .:.:
::.: ..:.....:
z 835,787.
835,787. 73 7 91,841.
791,841.
column (A)
column (AI must
must equal line 19 and column
column (B)
(8) must equal line 21) _ _ _ _ .
74 Total liabilities and net assets I/ lund
Total liabilities fund balances (add lines 66
balances (adc 56 and 73) . 8 35,787.
835,787. 74 7 91,841.
791,841.
Form 990 is available lor
tor public inspection and, lor
for some people, serves as the primary
primary or sole source
sou ice of
ol information
information about
about a particular
public
perceives an organization
organization in such cases may be determined by the information
information presented on its return.
return. Therefore, please make sure the return IS
is complete and accurate
and fully
lulfy describes,
describes, in Part III, the organization's
programs and accomplishments.
accomplishments.
023021
12-19-00 3
09360820
09360820 758050 23-12053HEI
758050 23-12053HEI 2000.06000
2000.06000 THE
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 23-12051
23-12051
Form 990
990(2000)
(20001 THE HEIMLICH
HEIMLICH INSTITUTE
2 3-7303161 Page44
Page
bParfiWA:1
Part IV-A Reconciliation of Revenueper
Reconciliation Revenue per Audited
Audited :Parnv.::B'il
Part IV-B Reconciliation
Reconciliation of Expenses per
Expensesper Audited
Financial
Financiat Statements
Statements with Revenue per
Revenueper Financial Statements
Financial With Expenses
StatementsWith per
Expensesper
Return
Return Return
Return
.:.:~.. :'.:.:.:::~:.,:..:~~::-.:.-;:.:.
;.:;::-;.:-.::.:~:.:,;.:::~:.-:~::
'. a Total
Total expenses
expenses and and losses per .;,.-.,.~,.,.,:;".-,'
..,',,';,.,'..,',.~.-
...,..,,'.,:.,;,:,':,."',,
a Total revenue, gains, and other
other support
support a losses per
per audited financial statements
statements . .... a N/A audited financial
financial statements a N
N/A /A
II Amounts
b Amounts included
included onon Ime
line aa but
but not
not on
on
II
b Amounts
Amounts included
included on
on line aa but
but not
not on line 17, Form 990:
990:
line 12,
line 12, Form
Form 990:
services
(1) Net unrealized
unrealized gains
gains and use of facilities ... $
facilities... _
on investments s
$ (2) Prior year adjustments
adjustments
(2) Donated services reported on
20,
facilities ... $
and use of facilities... Form 990
Form990 $ _
(3) Recoveries of prior
prior (3) Losses reported
reported on
on
year grants ............ $ line20,Form990 ... $
line 20, Form 990 ...$ _
(specify): (4) Other (specify):
(specify):
s _____________ $ _
Add amounts on lines (1) through
through (4) 1-'11"+ --1 Add amounts on lines (1)
amounts on (1) through
through ((4)
4). I-'b,_ _
ce Lina a minus
Line minus line bb.. ~t~ __ __"".,.,.""""",,.,....,___.I ce Line a
Line a minus
minus line
line b
b r,:C;+.,.,."...",.,..".,.,.,-.--,=...".....
d Amounts
Amounts included
included on
on line 12,
12, Form
Form d Amounts included
Amounts included on on line 17,
17, Form
Form
lIut not
990 but not on I:
on line a: but not
990 but not on
on line a:
a:
(1) Investment expenses (1) Investment
.;:■:-::>■::?:■:::;::::::■::■::
Included on
not included on included on
not included
line 6b, Form
line Form 990
990 $
...$ _ line 6b, Form 990
6b,Form 990 ...S
... $
(specify):
_____________
$------------- _____________ $ _
Add amounts on
Add amounts on lines (1) and
lines (1) (2) ...
and(2) I-'d~------_l Add amounts
I-'d"+ on lines (1)
amounts on (1) and
and(2)
_ ( 2 ) . ..
a
(I Total revenue perper line 12,
12, Form 990
Form 990 Total expenses par per line 17, Form
Form 990 990 IIa
(line
(line ct plus
plus line
line rJ)
d) II (line
(line ec plus
plus line
line d)
dl e
PPfirt:'·V.J
Part V- List of Officers,
List Officers, Directors,
Directors, Trustees,
Trustees,and Key Employees
and Key Employees (List (List each oneeven
each one evenif ifnotnotcompensated.)
compensated.)
(A)
(A) Name
Name and address
and address
(8) Title and average hours
(B)
per
per week devoted to
we;~s1tr~~ted
position
hours (C)
to
(e) Compensation
(II not
(II not paid, enter
enter
D Contributions to
Compensation (~ContribUbOnS
_ nploVM beflflUt
plans A dnfvred
eotpptflMUon
to (EI Expense
(E)Expense
account and
account and
other allowances
allowances ~8-'~' < JS P:.!~=t
SEE ATTACHMENT
SEE ATTACHMENT C
o.
0. o. o.
O.
~ 75 Did any
any officer, director, trustee, or key employee
director, trustee, employee receive aggregate compensation
compensation ofof more than $100,000
$100,000 from
from your
your rrgarlzatlOn all related
~ organizations. 01which
organizations, ol which more than
than $10,000
$10,000 was provided
provided by the
the related organizations?
organizations? II
If "Yes_'attach
' Y e s ' attach schedule.
schedule. ...
► | _ | YesYes [}[J
L X J No
No Form 990 (2000)
990(2000)
Form 990 f2Q0Q) THE
THE HEIMLICH
HEIMLICH INSTITUTE
3-7303161 Page 5
PartVI: Other Information N/A
N/A Yes
Yes No
No
organif3tion en(lage activity not
engage in any activity not previously reported to the IRS? If "Yes,"
"Yes: attach
attach a detailed description
description of
ot each activity
activity 76 X
77 Were any changes made in the organizing
organizing or governing
governing documents
documents but not reported
reported to the IRS? . 77 X
II"Yes:
If at1acha
"Yes," attach contorrneo copy
a contoimed copy of the changes.
changes.
78 aa Did the organization have unrelated
unrelated business
business gross
gross income of $1,000
$1.000 or more during trns return?
during the year covered by this ...... 78a
II "Yes,"
b If "Yes: has itII filed a tax return
return on Form990-T
Form 990-T for this year? . .. . ..........
N/A
N / A ...... 78b
79 liquidation, dissolution,
Was there a liquidation, dissolution, termination,
termination, or substantial contraction
contraction during
during the year?
year? .. 79
II "Yes."
If "Yes: attach a statement.
statement.
80 aa Is the organization
organizatIOn related (other assoclauon with a statewide or nationwide
(other than by association nationwide organization)
through common
common membership,
membership,
governing bodies,
trustees. officers, etc., to any other exempt or nonexempt organization?
officers, etc., organization? . 80a
b Itlt "Yes,"
Yes," enter the name of ofthe organization
the organization ....
►
and check whether it is D OR
exempt OR D
nonexempt.
nonexempt.
81 aa Enter the amount of political
expenditures, direct
direct oi indirect, as described in the
01 indirect,
instructions for line 81

instructions . .. .. . . 81a
b Did the organization file Form Form 1120-POL
1120-POl for this year? .. 81b
82 aa Did
Old the organization receive donated
donated services or the use of materials,
materials. equipment,
equipment, or facilities
facilities at no charge or at substantially
lair
fair rental value? 82a
b If "Yes,"
"Yes: you
you may
may indicate
indicate the
the value
value of
of these
these items
items here.
here. Do not
not include
include this
this amount
amount as
as revenue
revenue in in Part
Part I or
or as an
expense in Part
Part II. (See
(See instructions
instructions for
lor reporting
reporting in Part III.)
Ill.) IL-"'82~b,--,-
82b [ ---,7:.._5=:...L'_:0::....=0-=0:......::..t
7 5 , O O P •. .
83 aa Did
83 Old the organization comply
comply with the public inspection
inspection requirements for returns
retums and exemption
applications? . 83a
b Did the organization comply
comply with
with the disclosure
requirements relating to quid
Quid pro quo
QUO contributions?
contributions? . 83b
84 a
B4a solicit any contributions
Did the organization solicit contributions or gifts that were not
nottax deductible?
tax deductible? .. . 84a
b IfII"Yes:
b include with every solicitation
"Yes," did the organization include solicitation an express statement that such
such contributions
contributions or gifts were not
tax deductible?
tax deductible? . .. .. . .. ......N'NI'A
. / . A ..... 84b
B5 501(c)(4),
85 501(c)(4), (5), or (6)
(5), or organizations. aa Were
(6) organizations, Were substantially
substantrally all
all dues
dues nondeductible
nondeductible byby members?
members? . NN/A /.A 85a
b Did
Did the
the organization
organization make
make only
only in-house
in-house lobbying
lobbyinll expenditures
expenditures of of $2,000
$2,000 or
or less?
less? . N N/A
/.A 85b
IfIf "Yes"
"Yes· was
was answered
answered to to either
either 85a
8Sa or
or 85b,
8Sb. do
do not
not complete
complete 85c8Sc through
through 85h
8Sh below
below unless
unless the
the organization
received aa waiver
waiver tor
tor proxy
proxy tax
owed for
owed lor the
the prior
prior year.
~ Dues,
Dues. assessments,
assessments. andand similar
simitar amounts
amounts from
from members
members . 85~
85c N/A
N/A
d Section
Section 162(e)
162(e) lobbying
lobbying and
and political
expenditures .. 85!!
8Sd N/A
N/A
ee Aggregate
Ar;jgregate nondeductible amount
amount of section 6033(e)(1)(A)
01 section 6033(e)(1 )(A) dues notices
notices... .. . B5~~
85e. N/A __ ~
~N~/TA=-
I Taxable
Taxable amount
amount ofof lobbying
lobbying andand political
expenditures (line
(line 85d
85d less
less 85e)
85e) B51
851 N/A
N/A
g Does
Does the
the organization
organization elect
elect to
to pay
pay the
the section
section 6033(e)
6033(e) taxtax on
on the
the amount
amount in in 85f?
85f? .. ............
f1I'A
.N./.A 85g
n 111section
1 section6033(e)(1)(A)
6033(e)(1)(A) dues
dues notice
noticewerewere sent,
sent,does
doesthetheorganization
otganizationagreeagreeto to add
add the
the amount
amount inin85fto
S5f to its
its reasonable
reasonable estimate ofdues
estimate 01 dues
allocableto nondeductible lobbying
lobbying and and political expanchures for
political expenditures fat the
the following
following tax tax year?
year? . N .// .AA .
N 85h
86 501(c)(7)
86 501(c)(l) organizations. Enter: aa Initiation
organizations. Enter: Initiation fees
fees and
and capital
contributions included
included on on line
line 12
12 "86~I
8Ea N/ A
N/A
b Gross
Gross receipts,
receipts. included
included onon line
line 12,
12. for
lor public
public use
use of
of club
club facilities
facilities. 8Bb
86b N/A
N/ A
87
87 501(c)(12)
501 organizations. Enter:
(c)(12) organizations. Enter: aa Gross
Gross income
income from
from members
members or or shareholders
shareholders. 871
67a N/A
N/ A
b Gross
Gross income
income from
from other
other sources.
sources. (Do (Do not
not net
net amounts
amounts due due oi paid to
01 paid to other
other sources
sources
against amounts
against amounts due
due or
or received
received from
from them.)
them.) .. 87b 87b N/A
N/A
88
88 At any
At any time
time during
during the
the year,
year, did
did the
the organization
organization own own aa 50%
50% or or greater
greater interest
interest in in aa taxable
taxable corporation
corporation or
or partnership,
partnership,
or an entity
or an entity disregarded
disregarded as as separate
separate fromfrom the
the organization
organization under
under Regulations
sections 301.7701-2
301.7701-2 andand 301.7701-3?
301.7701-3?
If "Yes: complete Part IX
lt"Yes,"completePartlX .. 68
89 aa 501(c)(3)
89 501 (c)(3) organizations.
section
b 501(c)(3)
organizations. Enter:
section 4911
4911 ►
501(c)(3)and
..
Enter: Amount
Amount of
of tax
501(c)(4)organizations.
and 501(c)(4)
tax imposed
organizations. Did
°.;
imposed on
on the
( K ; section
Did the
the organization
organizatIon during
section 4912
4912 ►
the organization
..
organization engage
during the
enllage in
the year
in any
year under:
under:
any section
section 4958
00^"; ;section
4958 excess
section 4955
4955 ►
excess benefit
benefit
....
------------------ °"
transaction during
transaction during the
the year
year or
or did
did itit become
become aware
aware ofof an
an excess
excess benefit
benefit transaction
transaction from
from aa prior
prior year?
year?
IfIf "Yes," attach aa statement
"Yes: attach statement explaining
explaining each
each transaction
transaction .. 89b
89b X
e Enter:
Enter: Amount
Amount of of tax
tax imposed
imposed on on the
the organization
managers or or disqualified
persons during
during the
the year
year under
under
sections 4912,4955,
sections 4912,4955, and and 4958
4958 .. .. .. -=:0:-._
0.
dd Enter:
Enter: Amount
Amount of of tax
tax on
on line
line 89c,
89c. above,
above. reimbursed
reimbursed by by the
the organization
organization .. ►' ---,O=-=-"
.... __:;O:;";H:..:..=I:....;O:;,,,_ .-_.-
9D aI List
90 List the
the states
bb Number
states with
Number of
with which
of employees
which aa copy
employees employed
employed in
copy of
in the
of this
the pay
this return
pay period
return is
period that
is filed
filed ►
that includes
includes March
OHIO
March 12,2000
12,2000 I 90b
90b I °
_=_
91
91 The books
The books are
are in
in care
care ot .... DDEACONESS
ot ► EACONESS HOSPITAL
HOSPITAL Telephoneno"
Telephone no. ► (513)559-2391
( 5 1 3 ) 5 5 9 - 2 3 9 1
Located at ► 311
Located at" 311 STRAI~~T_STREET
STRAIGHT STREET CINCINNATI,
CINCINNATI, OHIO
OHIO ZIPcode
ZIP .... .;:,4..=5-=2:..,:1::...:9=--
code ► 4 5 2 1 9 _
92
92 Section 4947(a)(1)
Section 4947(a)(1)nonexempt charitable trusts
nonexempt charitable trusts filing
filing Form990in
Form 990 in lieu
liev ot
of Form
Form 1041-
1041- Check
Check here
here
and enter
and enter the
the amount
amount oi
oftax-exempt interest received
tax-exempt interest received or
or accrued
accrued durinq
during the
the tax
tax year
year . ....I 92 I
► 0.
?~~~.~
023041
12-19-00 55 form 990
Form 99D (2000)
(2000)
09360820
09360820 758050
758050 23-12053HEI
23-12053HEI 2000.06000
FOUN 23-12051
Form990(2000)
Form 990(2000) THE H E I M L I C H IINSTITUTE
HEIMLICH N S T I T U T E FOUNDATION
3-7303161 Pagee
Page 6
Part VII: Analysis of Income-Producing Activities
r·pa·rf.vil:-IAnalysis Activities
Enter gross amounts unless
gross amounts unless otherwise
otherwise Unrelated business
business income
Income Excluded Dy
oy section
E.><cluded .ection 512.
512. 513,
~1~, or 51 i
or~14
(E)
<E)
(A)
(AI (8)
(B) (C)
(C) (D)
(D)
indicated.
indicated. Business Exclu
Exclu- Related or exempt
exempt
Business Amount
Amount sion Amount
Amount
Program service
93 Program service revenue-
revenue' code
code code function
fu nction income
inca me
a
a
b
ce
dd
e
fI Medicare/Medicaid payments
MedicarelMedicaid payments
U
g Fees and
and contracts
contracts Irom
fiom government
government agencies.....
agencies .. ..
94 Membership
Membership dues and assessments
and assessments .
Interest savings and
and temporary
temporary
cash investments
cash investments
96 Dividends and interestlrom
Dividends interest trom securities
securities .. 14
14 2 5,535.
25,535.
97 rental income
Net rental income or (loss)
(loss) Irom
trom real estate:
estate: .. -. \ ■ " . " . ■ . - . - . - , . - . > ■ . . . ■ = ■
a
a debt-financed property
debt-financed property . .... ...
b not debt-financed
notdebHinanced property property .
98 Net rental
rental income
income or (loss)
(loss) from
Irom personal
personal property
property
99 Other investment
investment income
income ..
100 Gain or (loss)
(loss) from
from sales of assets
otherr tha
othe than n inventory
invento ry . 18
18 6 ,106.
6,106.
101
101 Net income
income or (loss)
(loss) from
from special
special events
events .
102
102 Gross prolit
Gross profit or (loss)
(loss) from
inventory
103
103 Other revenue:
revenue:
a
a
b
ce
d
d
e
104 Subtotal
Subtotal (add
(add columns
columns (B),
(B), (D). and (E))
(0). and (E)) ..... J.....':-'-\"'-'.:,-:.....::.'-', .. ,""<....
",.';.L.: O .
O;:;,_;;,.I,..;,·:.....;' ::'..;..·:·:.;..L:: 31,641. =-=_::-:--=0....;:_.
.......:;3...::1:....i,~6::......::.4..::1.....;.:.J...... 0.
105 Total
105 Total (add
(add line 104, columns
columns (8),
(B), (0).
(D). and
and (E))
(E))... "...................... .. . .. " 33=-=1;...1,:....6::......::.4..::1:....;.:;,..
1,641
N
NOIB:
ole: Line 105 plusplus line
line Id,
Id, Part
Part /,1.should
shouldequsJ
equalthe
theamount
amountononline line12,12. Part/. 1.
Part
lPart VI 1 Relationship of Activities
Part Villi Activities to
to the Accomplishment
Accomplishment of Exempt Purposes
Purposes
Line
line No.
No. Explain how
how each activity
activity for
for which
which income
income is reported
reported in column
column (E) of Part VII contributed importantly
VII contributed importantly to
to the
the accomplishment
accomplishment 01the
of the organization's
organization's
T
~ exempt purposes (other
exempt purposes (other than
than by
by providing
providing funds
funds lor
for such
such purposes).
purposes).
N/A
Part IX '■
j.part·IX :1 Information Regarding
Regarding Taxable
Taxable Subsidiaries
Subsidiaries and Disregarded
Disregarded Entities
(AI
(A) (8) (C) (D)
(D) IE)
(E
.End-of-year
<>
Name. address.
Name, addiess, and
and EIN
EIN of
of corporation,
corporation, Percentage
Percenta~e of Nature
Natu re of
01 activities
activities Total income
Total income End-Ol-{;ea r
partnership. or
partnership, or disregarded
disreoarded entity
entity ownership interest
ownership Interest assets
asse s
%
%
N /A
N/A %
%
%
0/.
%
%
rparfX'·\·:1
PartiX:;;: Information Regarding
Regard ng Transfers Associated with
with Personal
Personal Benefit Contracts
Contracts
(a) the organization,
[a] Did the organization,during
duringthe
theyear,
year,receive
receiveany
anyfunds,
funds,directly
directly ororindirectly,
indirectly,totopay
paypremiums
premiums ononaapersonal
personalbenefit
benefitcontract?
contract? 1 I Yes
DYes CKJ
I X I No
No
(b) Did the organization, during the
organization. durrng the year,
year, pay
pay premiums,
premiums,directly
directly ororindireclly,
indirectly,on
onaapersonal
personalbenefit
benefit contract?
contract? D
L J YeE
Yes CKJ
I X 1NoNo
Mole:// "Yes" to (b), file Form 8870 and Form 4720 (see instructions).
mpanying
i schedules
Information or
of whiCh
whicn p~p.""
stalementt, and
pnsparv h.,
has .ny
.nd to the
any knowledge.
(he best or my
~nowlec1ge. Pmpartanb
my knowledge
kl"lowledgeand
s.. General
pmportant S*«
.andbail*', It Is true,
Instruction W.)
G"" ... I In3111.1ctlon
W.I
true, bell_'.
,
'i I) J. /tFfMUcJf^ fttg/cfaZt
J
te W Type or print/am
ame and title
OMB No. 1545-0047
01',18No. 1545-0047
SCHEDULE A
SCHEDULE A - Organization
Organization Exempt
Exempt Under Section 501(c)(3)
Under Section
(Form 9 9 0 or
990 or 990-EZ)
990-EZ) (Except Private Foundation}
Foundation) and Section 501(e),
501(e), 501(1), 501(k),
501(k),
Department of ine Treasury

DepBrtmcmt01tne Treasury
501(n), or
501(n), or Seclion
Section 4947(aI(1)
4947(a)(1) Nonexempt Charitable
SupplementC)ryInformation
Charitable Trust
2000
2000
Internal
Intem •• Revenue Service t.... MUSTbe
* MUST compteted by the above organizations
be completed organizations and aHached
attached to their
their Form 990 or 990·EZ.
990-EZ.
Name ol the organization
Name 01 Employer identification
number
THE HEIMLICH
HEIMLICH INSTITUTE
FOUNDATION 23: 7303161
23: 7303161
■Part:I ■■ | Compensation
Compensationofofthe
theFive
FiveHighest
HighestPaid
PaidEmployees
EmployeesOther
OtherThan
ThanOfficers,
Officers,Directors,
Directors,and
andTrustees
Trustees
(See instructions. List
(See instructions. list each one. It there are none, enter ·None.")
onalttnere 'None.')
l b[b)) Title and average
average hours (d) Contributions to
(01Contnbuucns (e) Expense
(e)Expense
ta) Name
(a) Name and address of
01 each employee paid
eachemployee
more than $50,000
per week devoted to
to (c) Compensation
(e) ;':.'~~~!'=t
employee benefit
account and other
plans & deferred
position compens.tion
compensation allowances
NONE
----------------------------------
----------------------------------
----------------------------------
----------------------------------
----------------------------------
Total number ot
of other employees paid
over$50,000
over $50,000 .. 0 . ►
[··Pain!'l
Partllj Compensation of the Five Highest Paid Independent Contractors for Professional Services
Contractors for
(See instructions,
instructions. List each one (whether individuals
individuals or lirms).
firms). ItIf there are none, enter 'None.")
'None.')
(a) Name
Name and address of each
each independent contractor
contractor paid more than $50,000
$50,000 (b) Type of service (e) Compensation
(c) Compensation
NONE
Total number of others receiving over

;~~~~~~:re
$50,000 lor ~r~,;!~~O~:~~:~::~s
professional servicesov.er ....... .. . ..... ........... .. I 0
0 :::{..:::~:
:1:);:,;{::. ;:.:~::::i':::·:;: :;::·/::·:J!~;!:{::·:::,::'.::!::i::!'ii:::::..:u:::~!::i:::·::·/:I·:'::!!::il:·:!:,::;:;i:~::::;::::·
:::i:i::
LHA
lHA For Paperwork
Paperwork Reduction Act NDtice.
Reduttion Att Notice, see page 1 ot
of the Instructions
Instructions for
tnr Form 990 and Form 990·El.
990-EZ. Schedule A (Form
(Form 990 or
Dr 990-EZ)
990-El) 20DO
2000
023101
12-09-00
12·09·00 7
09360820 758050 23-12053HEI 2000.06000 THE
ScheduleA'(F 990 01 990-EZj 2000 THE
0tm99001390-EZ)2000
Schedule A'(Fofm THE HEIMLICH
HEIMLICH IINSTITUTE
N S T I T U T E FOUNDATION
3-7303161 Page2
I,Parf:lit!
Part 111 Statements About Activities
Activities Yes No
1 DUling
During the
the year.
year, has the
the organization attempted to
to influence
influence national.
national, state.
state, or local legislation.
legislation, Including
including any attempt to
to influence
influence public
public
opinion
opinion on a legislative matter or referendum? . .
1
x
X
'Ves: enter the total
If 'Yes," total expenses paid or incurred
incurred in
In connection
connection with
with the lobbying
lobbying activites ► $ _ m 11
Organizations that made an election under section 501(h)
organizations checking "Yes,'
organizations
501(h) by filing
"Yes: must complete Part Vl-B
filing Form
Form 5768 must
must complete Part Vl-A.
VI-B AND attach a statement givinll
VI-A. Other
giving a detailed description
description of
ot
§
1SIi
the lobbying
2 During the year.
year, has the organization.
organization, either directly
indirectly, engalled
engaged in any oflhe
ol the following
following acts with
with any of its trustees,
directors,
officers, creators,
officers, creators, key employees, or members of their families.
families, or with
with any taxable
laxable organization
orllanization with which
which any sucn
such person
person is
officer, directoi,
affiliated as an officer, director, trustee,
trustee, majority
majority owner,
owner, or principal
principal beneficiary.
beneficiary.
a Sale, exchange,
exchange, or leasing of
ol property?
property? . . 2a iii X
X
b Lending of money
b Lending money or
or other extension of credit?
credit? . 2b x
X
c Furnishing
Furnishing otgoods.
of goods, services.
services, or tacilities?
facilities? __ _._ __._.._ _ _ _ __ _._._.._.__ _ __._.__. 2c X
compensation (or payment or reimbursement
reimbursement of expenses
expenses it more than
than $1 ,OOO)?
$1,000)? _ _._ _ _.._.._._._.._.._._.. 2d X
e Transfer
Transfer of any part of its income or assets? ._ _.._._ _._._._.... .._ _._ _.._ _._ _ _ _ _.._._._.._._... 2e
20 X
It the answer
If answer to any Question
question is 'Yes:
"Yes." attach a detailed statement
statement explaininll
explaining the transactions.
transactions.
organization make grants for scholarships,
student loans,
loans, etc.? _.._.._.._ _ _ _._ _._ _... 3
3 X
4 a Do you
you have a section
section 403(b)
403(b) annuity plan for your
your employees?
employees? _ _.._.._.._ _._ _... 4a
41 X
11 Attach
h Attach a statement
statement toto explain how the organization
determines that
that individuals
individuals or
or organizations
organizations receiving grants
grants or loans
loans from
from itit in :f,?v::v^S?i'â-:
■:: ■ : ■ . : . ■ : : : : ■.:■:■ :■■:: ■:■■■.■■ .
furtherance of its charitable

furtherance chantable programs
progiams Qualifyto payments. (See page 2 ol
qualify to receive payments. 01the
tde instructions.)
instructions.) :..::.-.:::::.:.v.::\:.:.:.:::::::::: ■ : : ■ :
Part IV i Reason for Non-Private

I:ParfIV::1Reason Non-Private Foundation Status (See
(See pages
pages 22through
through5 of
5 the
of the instructions.)
instructions.)
The organization
organization is not a private foundation because it is:
toundation because is: (Please
(Please check
check onlyonly ONEONE applicable
applicable box.)
box.)
5 □
D A church, churches, or association of churches.
church, convention of churches, churches. Section t70(b)(1
170(b)(1)(A)(i).
HA)(i)-
6 □
D A school.
school. Section 170(b)(1)(A)(ii).
170(b)(1)(A)(ii). (Also complete Part V, page 5.) 5.)
7 □
D A hospital oroi a cooperative hospital service organization. 170(b)(1)(A)(iii).
olganization_ Section 170(b)(I)(A)(iii)_
8 □
D A Federal,
Federal, state.
state, or local government
govemmental unit. unit. Section 170(b)(1
170(b)(l)(A)(v).
)(A)(v).
9 □
D A medical research organization operated in conjunction
conjunction with with a hospital.
hospital. Section 170(b)(1)(A)(iii).
hospital's name,
name, tHy,
city,
and itate
state ► ....
10 □
D An organization operated
operated tor the benefit olof a college or or university
univerSity owned or or operated by a governmental
governmental unit.
unit Section 170(b)(1
170(b)(1)(A)(iv).
)(A)(iv).
(Also complete the Support ScheduleSchedule in in Part
Part IV-A.)
IV-A.)
tta
11a m
00 An organization
orllanization that normally receives a substantial
substantial part of its support
support from a governmental
governmental unit or from
from the general public.
public.
i70(b)(l)(A)(vi). (Also complete the Support Support Schedule
Schedule in in Part
Part IV-A.)
IV-A.)
ttb
11b □
D A community
community trust trust. Section 170(b)(I)(A)(vi).
170(b)(1)(A)(vi). (Also complete
complete the Support Schedule in Part IV-A.)
12 □
0 An organization that normally receives: (I) (1) more than
than 331/3%
3 3 1 / 3 % 01its
ol its support
supportlrom contributions, membership
lrom contributions. membership fees.
fees, and gross
gross
receipts from
from activities
acuvlties related
related to its charitable, etc.,
etc .• functions
functions - subject to certain exceptions,
exceptions, and (2) no more
more than
than 33 1/3% of 01
support from
its support trom gross investment
Investment income
Income and unrelated
unrelated business taxable income (less section 511 lax) tax) from
acquired
by the organization after arter June 30,1975.
30, 1975. See
See section
section 509(a)(2).
509(a)(2)_ (Also complete the Support Schedule in in Part IV-A.)
13 D
I I An organization that is not controlled
controlled by any disqualified foundation managers) and supports
disqualified persons (other than foundation supports organizations
organizations described in:
(1) 5 through t2
(I) lines 5thlough 12 above;
above: or (2) section 501 (c)(4),
(c)(4). (5),
(5), or
or (6),
(6). ifif they
they meetlhe
meet the test
test of
of section
section 509(a)(2).
509(a)(2). (See
(See section
section 509(a)(3).)
509(a)(3).)
Provide following information
Provide the following information about
about the supported
supported organizations. (See page 5 of the instructions.)
instructions,)
(b) Line number
(a) Name(s) of supported
supported organlzation(s)
organization(s) from
from above
14 D|
| An organization organized
organized and operated to test tor public
public safety.
satety. Section 509(a)(4).
509(a)(4). (See
(See page 5 of the instructions.)
instructions.)
Schedule
Schedule A (Form 990 Dr
or 990-EZ)
99D-EZ) 2000
023111
023111
01 (19-01
01 09-01 8
23-12053HEI
09360820 758050 23-12053HEI 2000.06000 THE HEIMLICH INSTITUTE FOUN 23-12051
Schedule A (Form990
ScheduleA'(Form 990m or 990-EZ)
990-EZ) 2000
2000 THEHEIMLICH
THE HEIMLICH INSTITUTEI N S T I T U T E FOUNDATION
FOUNDATION 2 3 - 7 30 3 1 6 1
23-7303161 Page 3
Page3
ParfIV::A:
I. P a r t 1V-A 1 Support
Support Schedule
Schedule (C omplete only
(Complete you checked a box
only if you box on line 10.
1 0 , 111.
1 , or 12.) Use
Use cash method
cash method accounting.
of accounting.
Note:
N o t e , You
you may
may use
ubn tlthe
e worksheet in the instructions for
worksheet In tor convenin
converting from the accrual
accrual to the cash
cash method
method of accounting.
accounting.
fiscal year '
Calendar year (or fiscal
beginnina in)
beginning Inl . ► (a) 1999 (b) 1998 (c)
(e) 1997 (d) 1996 (e) Total
15
15 Gifts
GIt3 grants,
g.. nts. and ccntrinunons
contributions received.
recewec.
(DD
('DD not Induae
Induce unusual grants See
Iine28.)
line 28.) ..... . .. 1 8 6 ,295
186 , 2 9 5 .• 1 4 6 ,952
146 , 9 5 2 .. 2 4 ,749
24 , 7 4 9 .. 2 778
8 ,,164
1 6 4 .• 6 3 6 ,160
636 , 1 6 0 .•
received .
17 Gross
Gross receipts from
Irom admissions.
merchandise
merchandise sold or services
performed,
performed. or furnishing facilities
fu mishing of tacultles
in
10 any
any activity
activity that
that is
is not
not aa business
unrelated to the
unrelated to organization's
the organization's
chantable,
chantable. etc., purpose
etc., purpose .
1B
18 Gross from interest,
Gross income from interest.
dividends, amounts
amounts received
received trom
from
payments
payments on securities loans (sec (sec-
tion 512(a)(5)),
512(a)(5)). rents,
rents. royalties, and
unrelated
unrelated business taxable
taxable income
(less
(less section
section 511 taxes) from
511 taxes) from
businesses acquired
businesses acquired by by the
the
organization after
organization after June
June 30.
30,1975...
1975... 2 1,926.
21,926. 1 4,134.
14,134. 7 6,953.
76,953. 4 3,138.
43,138. 1 56,151.
156,151.
19 Net income from
Net from unrelated
unrelated business
activities not included in line 18 ...
20
20 Tax
T""revenues
_enues levied fOrtile
tor the arganizabon·.
organization's
benefit
ceneftt end paid to it
.nd either p.id expended
It or e><pended
on It* behllll
on Its behalf .
21 The value of
The ol services or facilities
furnished to the organization
organization by a
governmental Unitunit Without
without charge
not include the value 01services
Do nol of services
or facilities generally
generally furnished
furnished to
the public without
the public without charge...
charge
22
2 2 Other income. Attacfi
OthOl"inca_. An.dI a schedule.
lChedule. Do
Do not
no!
include gain
gaIn or fjosaj
pass) from
frum male
.ale ot capital
asset*
..... ts . . .
23
23 01 lines 15 through
Total of through 22 . 208,221.
208,221. 161,086.
161,086. 101,702.
101,702. 321,302.
321,302. 792,311.
792,311.
24 Line 23 minus
Line minus line
Ime 17
17 208,221.
208,221. 161,086.
161,086. 101,702.
101,702. 321,302.
321,302. 792,311.
792,311.
25 Enter 1% 01line 23
Enter 1 % of line 2,082.
2,082. 1,611.
1,611. 1,017.
1,017. 3,213.
26 Organizations
described on
on lines or 11:
line5 10 Dr Enter 20/.01amount
11: a Enter 2% of amount in column (e).
(e), line 24 . ....
► 26a 1 55 , 88 4 6 .•
b Attach a list (which is not open to public inspection) showing the name of and amount contributed by each person (other than a
b ~:~~:~'~~~!~;~~th~: ;~~,~~;~~;~~~~~
governmental unit or publicly supported i~r::~:i:'~~:)h;~~:;
organization) whose ~::a~:;: ~~ra~:;~~~;~;~~~~~:eX~::d:~c~h~:::~~~~~~~:an
total gifts for 1996 through 1999 exceeded the amount shown a ::~
..::':.::::=;'::; :::::;:.::;:::::::::::::j:':~:i·::::::::·.::;:;::'~:::::!::i·:::::!:::;:·:;;·;;:;::.:;:·::::!;
in line 26a. Enter the sum 01all

ot all these excess
excess amounts . ~.E~
SEE ~'rbr.EMF;:N.'r..1....
STATEMENT 7 ► 26b 5 3 2 , 9959
532, 5 9 ..
c Total support
support lor
tor section 509(a)(1) test: Enterline
Enter line 24, column (e) .. . ► 26c 7 9 2 ,311
792 , 3 1 1 .•
d Add: Amounts
Amounts from
from column (e) lor
for lines: 18 156,
1 5 6 / 1151
5 1 .. 19)
1 :::::;:::tt :)::::::\.:::::::\:::_:::/.;/::}::::.\::.{jjj
22 3b
26b
2( 5 3 2 , 9 5 9 .. .
532,959 ► 26d 6 8 9 , 1110.
689, 10.
e Public support
support (line 26c minus line 26d total) . . .. . ► 26e
268 1 0 3 ,
103, 201 2 0 1 ..
tI Public $ul!]_Orlpercent~ge
support percentage (line
(line 268
26 a (numerator)
(numerator) divided
divided by
b\ line 26c (denominator) )
2Bc (denominator)) ► 26f
261 1 3 . 0
13 .0253%2 5 3%
27 Organizations described on line 12: a For amounts included
mcluded in lines 15. 16, and 17 that were received
15,16. received from
from a 'disqualified person:
person,' attach a list (which is not open
inspection) to Showthe
show the name of.
of, and total amounts leceived
received in each year from.
from, each "disqualified
'disqualified person.·
person.' Enter
Enter the sum of such amounts for each year:
(1999)
(1999) N /IAA,.
);~ . (1998)
(199B) (1997)
(1997) .. (1996)
(1996) . .
b For
For any amount included in line 17 that was received
received 110ma
from a nondisquallfiad
nondisqualified person.
person, attach a list to show the name
name of.
of, and amount received
received for
tor each year.
year,
that was more than the larger
targerolof (1) the amount on line 25 for the year or (2) $5.000.
$5,000. (Include In
in the list organizatIOnsdescribed
organizations described in lines 5 through
through 11.
11, as well as
indivlduals.) After
individuals.) Aller computing
computing the difference between
between the amount received
received and the larger amount described in (1) or (2). enter the sum of
ot these differences (the
excess amounts)
excess amounts) lor
for each year: NNI/ AA
(1999)
(1999) . (1998)
(1998) (1997)
(1997) . (1996)
(19961 . .
c
e Add: Amounts
Amounts from
from column (e)foi
(e) lor lines: 15 16 _
17 20 21 27c N /IAA
d
d Add: Line 27a
27a total and line 27b total ► 27d N I/ AA
Public support (line 27c total minus line 27d total)
e Public support (line 27c total minus line 27d total) . .[.. I..... 27e N
NI / AA
1
I Total support
support tor
lor section 509(a)(2) test: Enter
Enter amount on line
Ime 23. column
column (e) ► ! 271 271 | NNI/ AA :,:::.:::
..:..::.··::::·\i):··::::::::·::/.::Y::=-::;::.\·:::\():: m
g
q Public support
Public support percentage
percentage (line
(line 27e
27e (numerator)
(numerator) divided
divided by
by line
line 27f
271 (denominator)).
(denominator)) . . ► 27q
2711 N/'A"
N/ A %
%
h
h Investment income
Investment income percentage
DercentaRe (line
mne 18,
18 column
cotumn (e)
le]_(numeratorl divided by
(numerator) divided bv line
tine 27f271 (denominator!)
Idenominatorll... ..... ► 27h N / A
IA % %
28 Unusual
Unusuat Grants:
Grants: For an organization described
desciibed in line 10.
10,11. 12. thai
11. or 12, that received
received any unusual grants during
during 1996
1996 through
through 1999,
1999. attach a list (which is not open to
public mspection) 101each
inspection) tor each year showing the name
name ofthe
of the contributor.
contributor, the date and amount 01the
of the grant. brref description
grant, and a brief description of
ofthe ofthe
the nature of the grant. Do not include
these grants in line 15. (See
these (See page
page 5 ot
otthe
the instructions.)
instructions.) . . _ „ „
NONE
023t21
o ^foo
12·27·00 9
9" Schedule A (Form
(Form 990 or 990-EZ) 2000
09360820 758050
09360820 758050 23-12053HEI
23-12053HEI 2000.06000
2000.06000 THE
THE HEIMLICH INSTITUTE FOUN
HEIMLICH INSTITUTE FOUN 23-12051
23-12051
Schedule
Schedule A'
(Fomi 990
A«Fonn 990oror990·EZ) 2000THE
990-EZ)2000 THE HEIMLICH
HEIMLICH INSTITUTE
3-7303161 Page4
Page4
jPartV:
I;Par1V.1 Private
PrivateSchool
School Questionnaire
Questionnaire
(Tobee completed
(To completed ONLY
ONLY by
by schools
schools that
that checked
checked the
the box
box on
on line
line 66 in
in Part
Part IV)
IV) N /A
N/A
Yes
Yes No
No
29
29 Does the
organization have
have aa racially
polICYtoward students by
toward students by statement
statement inin its
its charter,
charter, bylaws,
bylaws, other
other governing
governing
instrument, or inin aa resolution
instrument, or resolution of
of its
its governing
governing body?
body? . 29
3D
30 Does the
Does the organization include aa statement
organization include statement ol Its racially
01 its racially nondiscriminatory
policy toward
toward students
students inin all
all its
its brochures,
catalogues,
and other
and other written
communications with
with the
the public
public dealing
dealing with
with student
student admissions,
programs, and
and scholarships?
scholarships? . . . , .. , . 3D
31
31 Has the
Has the organization
organization publicized
publicized its
its racially
policy through
through newspaper
newspaper or
or broadcast
broadcast media
media during
during the
the period
period of
01
solicitation for
students, or
or during
during the
the registration
registration period
has no
no solicitation
program, inin aa way
way that
that makes
makes the
the policy
polley known
known
to all
to all parts
parts ofof the
the general
general community
community itit serves?
serves'? , " . 31
IfIf "Yes,"
"Yes,' please
please describe;
describe; ifil'No: please explain.
'No,' please explain. (II youneed
(IIyou need more
more space,
space, attach
attach aa separate statement)
32
32 Does the
organization maintain
maintain the
the following:
following:
aa Records
Records indicating
indicating the
the racial
racial composition
composition of
of the
the student
student body,
body, faculty,
faculty, and
and administrative
staff? .. , ....... , 32a
32a
bb Records
Records documenting
documenting that
that scholarships
scholarships and
and other
other financial
assistance are
are awarded
awarded on
on aa racially
racially
nondiscnminatOTy
nondiscnminatory basis?
basis?....... . ,.... . , ,.. ,.... 32b
1-3~2""b'-t-_-+-
__
cc Copies
Copies of
of all
all catalogues,
catalogues, biochures,
announcements, and
and other
other written
communications to
to the
the public
public dealing
dealing with
with student
student
admissions, programs, and
and scholarships?
scholarships? . 32c
Copies of
dd Copies 01311 material used
all material used by
by the
the organization
organization or
or on
on its
its behalf
behal1to solicit contributions?
to solicit contributions? . 32d
IfIIyou answered 'No'
you answered 'No' to
to any
any of
of the
tM above,
above, please
please explain.
explain. (If
(If you
you need
need more
more space,
space, attach
attach aa separate
statement)
33
33 Does the
discriminate by
by race
race in
in any
any way
way with
with respect
respect to:
to:
Students' rights
aI Students' rights or
or privileges?
privileges? . . . 33a
33a
bb Admissions
policies? . . ............., ..,. .. 33b
33b
cc Employment of ot faculty
faculty or administrative
staff? 33c
33e
dII Scholarships
SCholarships or or other
other financial
assistance? 33d
ee Educational
policies? 33e
I, Use of facilities?
facilities? 331
gD Athletic
Athletic programs?
programs? . 33g
hh Other extracurricular
activrties? . 33h
IfIIyou answered "Yes"
you answered "Yes· to any of the above,
above, please explain.
explain. (If you need more space,
space, attach
attach a separate statement.)
statement.)
34 aa Does
34 Does the
the organization
receive any
any financial
financial aid
aid or
or assistance
assistance from
from aa governmental
governmental agency?
agency? . 34a
bb Has the organization's
organization's right to such
such aid ever been revoked or suspended?
suspended? , . 34b
IfIf you
you answered
answered "Yes"
'Yes' to
to either
either 34a
34a or
or b,
b, please
please explain
explain using
using an
an attached
attached statement.
statement.
35
35 Does the
organization certify
certify that
that itit has
has complied
complied with
with the
the applicable
requirements of
of sections
sections 4.01
4.01 through
through 4.05
4.05 of
of Rev.
Rev. Proc.
Proc. 75-50,
75'50,
1975·2 C.B,
1975-2 C.B, 587,
587, covering
covering racial
racial nondiscrimination?
nondiscrimination? IIff 'No,' attach an
No,' attach an explanation
explanation 35
35
Schedule
Sthedule A (Farm 990 or
(form 990 990'U12000
or 990-EZ) 2000
023131
023131
12·~OO
12-09-00 10
09360820 758050
09360820 758050 23-12053HEI 2000.06000 THE HEIMLICH INSTITUTE
Schedule A (Form 990 or-990-EZ) 2000 THE HEIMLICH I N S T I T U T E FOUNDATION 23-7303161
2 3-7303161 Pages
Pa e 5
PartVI-A: Lobbying Expenditures by
Lobbying Expenditures Electing Public
by Electing Public Charities
Charities
completed ONLY by an eligible
(To be completed eligible organization
Olganizalion that
thattiled
tiledForm
Form5768)
5768) N/A
N /A
Check here Ill>
Check
►
Ill>
Check here ►
o If the organization
organization belongs to an
belongs to an affiliated
affiliated group.
group
DI!It you checked 'a'above and 'limited control' provisions apply
[a)
(a) (b)
Limits on Lobbying Expenditures
Expenditures Affiliated group completed for
To be completed for ALL
term 'expenditures'
(The term 'expenditures' means amounts paid or incurred.)
01 incurred.) totals
N/A
N/A
36 Total lobbying expenditures to
to influence
influence public
public opinion (grassroots lobbying)
lobbying) . 36
37 Total lobbying
lobbying expenditures to
to influence
influence a legislative body (direct lobbying)
lobbying) . 37
37
36
38 Total lobbying
expenditures (add lines
tines 36 and 37)
37) ........ 38
39 Other
Other exempt purpose expenditures
expenditures .. 39
40 Total exempt purpose expenditures 39)
expenditures (add lines 38 and 39) 4D
■ :
; - - ; :
;
: w-r—r. :•.-..■. ■. :
nontaxable amount.
41 Lobbying nontaxable amount. Enter
Enter the
the amount
amount trom the following
fOllo''''';ngtable
table -- :■
:
■:
::
■ : ■:
:
: : - :
: ■ :
■ : : :
: ■
:.
W&h^vfeS# ^/■'::^-j.!^.\.J:;:^"A:^>i.:C;.1.|:-
II11 the amount
amount on line 40 is - The lobbying nontaxable
The nontaxable amount isIs --
Not
Not over
over $S5O:I,ooo
500,000 .. 2 0 H of
20% ot the
the amount on line
amounton line 'AO
0 ... . .. ">
} m
Over($500,000but
Over not over
5 0 0 , 0 0 0 but not over SSI,CXXl.CXXl
I,000.000 SI00 000 plus
1100.000 plu. 15W
1~% ot Bie
Ille excess
e>.cesoover
over S500,CXXl
J5O0.0O0 . . . m
41
■■:■.:■■: ■:■■■■::■:■ :■ :■;■■:
■■■■l
Over $ 1 , 0 0 0 , 0 0 0 b u ! no!
OverSI.ooo,ooobul over
not 0" $1,500,000
e,$1,500.000 $ 1 7 5 , 0 0 0 plu.l0%
$175.000 plus 10W 01
ol the
the e>.cesl
excess ov,",$I,ooo,ooo
over $ 1 , 0 0 0 0 0 0 ►~::"..,.j-,..,.,~,.,....,__....",...,..,......",~,."....".,..,.....,r".,.,.."..,...,."...."=c~"...,,..~~~
I
: : :
Over r
OverSSI , ,500.000but
5 0 0 . 0 0 0 but not
nol over
over $$17,CXXl,ooo
17,000,000 $$225,000
2 2 5 , 0 0 0 plus
plus 5~%
H of
ot the
the excess
e>.eessover $1,500,000
OVerSI,500.ooo . ..:,:,....
■;: :YV :.
: ■ : ■ ■ : ■ :
■:■:,::.: :;\::V:-: -i :■■■ :,:.:.':: :V..:.: .
. ■ : ■ : . : : . :
Over
Over$S17.000,000
17,000,000 $51,000,000
1,000,000 . .. >
amount (enter 25%
25"1. of line 41)
41) . .. .. 42
42 from
43 Subtract line 42 tram line 36. -0- H11line
36. Enter -0- 42 is
line 42 is more
moie than
than line
line 36
36 . 43
38. Enter -0-
44 Subtract line 41 from line 38. -0. if line 41 is more than line 38
38 .. 44
Clution: IfIf there

Caution: there is an amount
is an amount on
on either
either line
fine 43 or line
43 or line 44. you must
44. you mtIst file
fife Form
Form 4720.
4720. it Illllili1II1I11II
4-Year Averaging
Period Under
Under Srjctlon
Section 501(h)
501 (h)
(Some organizations
that made
made aa section
section 501(h)
501(h) election
election do
do not
not have
have to
to complete
complete all 01 the
all ol the five
five columns
columns
below. See
below. Seethe
the instructions
instructions for
tor lines
lines 45
45 through
through 50
50 on
on page
page 99 of
of the
the instructions.)
instructiens.)
lobbying Expenditures
Lobbying Elpendllures During
During 4-Year
4·Year Averaging
Averaging Period
NN/A
/A
-------------------+--------------.--------------.--------------,r--------------r------~~~---
Calendar year (or
Calendar year (or (a) (b)
(b) (t) (a) (d)
(d) (e) (0 (e)
fiscal
Iiscal year
year beginning
beginning in)
In) ► 2000
2000 1999
1999 1998
1998 1997
1997 Total
Total
45
45 Lobbying
lobbying nontaxable
amount
: ■ : : . : . . : ■ . . . : : : : ■ : ■ : : ■ : ■ ■ : ■ : ■ : ■ : ■
0O.
.
. . ■ : ■ ■ ■ ■ . : . : : :■ :■■■:::..■..:..:..:.:::■■:
.:.V:::::j:; : : ! : : : :!;:::-: : ,:,!-:::-;.::! : :-: ■:..7:: : -.:7:::Yy.; : -:;-:;-,.^:;:V:-:::::

46 :s^Tv-:--=-.=h*^;o
(150% of line 45(e))
■ . . . ■ : . . : : ■ ■ : : ■:■:■ ■: . : : .:■■.: :■:■:■■■: ■
0O.
.
47
47 Total lobbying
expenditures ........
~.I!dilures o.
0.
46
amount 0O.
.
49
(150% of line 48(e)) "^Wîi^W^v^. 0O.
.
50
50 Grassroots
Grassroots lobbying
tobbying
expenditures
ex enonures 0O.
.
Part VliB Lobbying
Lobbying tActivity by Nonelec
Activity by •ting Public
Nonelecting Public Chant
Charities
es
(For reporting
(For reporting only
only by
by organizations
organizations that
that did
did not
not complete
complete Part
PartVl-A)
VI·A) N/A
N /A
During the
During the year,
year, did
did the
the organization
attempt to
to influence
influence national,
national, state
state or
or local
local legislation,
including any
any attempt
attempt to
to
Yas
Yes No
No Amount
Ameun,
Influence public
influence public opinion
opinion on
on aa legislative
legislative matter
matter or
or referendum,
referendum, through
through the
the use 01:
use of:
aa Volunteers
Volunteers................................. .. .. mmm^mmm
bb Paid
Paid staff
staff or
or management
management (include
(include compensation
compensation in
in expenses
expenses reported
reported on
on lines
lines cc through
through h)
h). .. .. msmmmmmm
cc Media
Media advertisements ..
dd Mailings
Mailings to
to members,
legislators, or
or the
the public
public
ee Publications,
Publications, or
or published
published or
or broadcast
statements
11 Grants
Grants to othei
othel oiganizations
organizations lor
lor lobbying
lobbying purposes
purposes. . .
g9 Direct
Direct contact
contact with
wi1hlegislators,
legislalors, their
their staffs,
staffs. government
offtcials, or
or aa legislative
legislative body
body
hh Rallies,
Rallies, demonstrations,
seminars, conventions,
speeches, lectures,
lectures, or
or any
any other
other means
means
1I Total
Total lobbying
lObbying expenditures
expenditures (add
(add lines
lines cc thiough
through h)
h) ..... .. ... . . . ... ......... ... ;:&;.::-.::::v 0O.
.
IfIf *Yes*
'Yes· to
to any
any of
ofthe
the above,
above, also
also attach
attach aa statement
statement giving
giving aadetailed
description of
of the
the lobbying
activities.
Schedule A
Schedule A (Form
(Form 990
990 or
or 990-EZ)
990-EZ) 2000
2000
023141
023141
12-09-00
12·09·00 111
1
009360820
9 3 6 0 8 2 0 7758050
5 8 0 5 0 223-12053HEI
3-12053HEI 22000.06000
INSTITUTE FOUN
FOUN 23-12051
23-12051
Schedule A (Form990990or or990-EZj
Schedule A'(Form 990-EZ) 2000THE
2000 THEHEIMLICH
HEIMLICH INSTITUTE
23-7303161 Page 66
Page
PartVII Information Regarding
!.parfVlrllnformation Regarding Transfers
Transfers To and Transactions
Transactions and Relationships
Exempt
Exer,nptOrganizations
Organizations
51 Did the reporting
reporting organization directly
directty or indirectly
indirectly engage in any
any of
ofthe
thelollowing
following with
with any
any other
other organization
described inin section
section
501(c)
501(e) of the Code (other than
than section
section 501(c)(3)
SOl(c)(3) organizations)
organizations) or
or in section
section 527,
527,relating
relating to
topolitical
organizations?
a Transfers
Transfers Irom
from the reporting
organization 10
to a noncharitable
noncharitable exempt organization
organization 01:
ot: Yes No
(i) Cash .
ti) . 5la(i)
. 51 ali) X
(ii) Dther
(ii) Otherassets
assets . a(il)
alII) X
b Other
Cither transactions:
transactions:
(i) Sales or exchanges 01assets
of assets with
with a noncharitable
exempt organization
organization . b(l)
btl) X
(ii) Puichases
(ii) Purchases ofof assets from
from a noncharitable
exempt organization
organization . t(il)
bIll) X
(iil)
[III) Rental ot facilities, equipment,
01facilities, equipment, or assets
or other assets . b(lii)
b(lU) X
(iv)
(iv) Reimbursement
arrangements . 6(lv)
b(lv) X
X
(v)
tv) Loans or or loan guarantees .. .. . . 6(v)
b(v) X
(vl)
(vi) Performance
Performance of services or or membership
membership or or tundraising
lund raising solicitations
solcltauons . b(vl)
b(vl) X
ce Sharing
Sharing 01facilities,
of facilities, equipment.
equipment, mailing
mailing lists,
lists,other
otherassets, or paid
assets, Or paid employees
employees . ct X
d IIIt the answer
answer toto any olthe
otthe above
above is
is 'Yes:
'Ves,' complete
complete the lollowing
following schedule.
schedule. Column
Column (b)
(b) should
should always show
show the
the fair
fair market
market value of the
goods, assets, or services
services given
given by thethe reporting
reporting organization. organization received less than
organization. If the organization than fair market
market value in any
any
transaction
transaction or sharing arrangement
or sharing arrangement, show
show in column
column (d)
(d) the value of the goods
goods, other assets
assets, or
or services received:
received: N/ A
A
(a) (b) (e)
(O (d)
(d)
Line no.
no. Amount
Amount involved Name 01 oncna ritable exempt organization
ot nnoncharitable 0rganization Description ot transfers, transactions,
Description ettransters, transactions, and
and sharing
arrangements
52 aa Is the organization
organization directly or
or indirectly
indirectty affiliated with, or related to,
with, or to, one or
or more
more tax-exempt
section 501
501(c) otthe
(e) 01the
Code (other than
(other than section 501 (c)(3)) or in section
501(c)(3)) or section 527? 527? .. . . .. . ..1"" E Z ] Yes
► Yes D [X]
I X I No
b IIIf "Yes:
"Yes," complete
complete the
thefollowing
following scheculs:
schedule: NN/ /AA
(a) (b)
(h) (e)
Name 01
of organization
organization Type
Type ot organization
01 organization Description 01
relationship
023IS1
Schedule
Schedule AA (Form
(Form 990
990 oror 99D-EZ)
990-EZ) 2000
2000
0231~1
12-09-00
12·()9.00 12
758050 23-12053HEI
09360820 758050 HEIMLICH INSTITUTE
23-12051
Schedule
Schedule B
B' Schedule
Schedule of
of Contributors
Contributors OMB No. 1545-0047
O"-1BNo. 1545·0047
(Fonn 990
(Form 990 or
or 990-EZ)
990-EZ)
Department of
Department orOie
meTreasury
T.-su;Y
SupplementaryInformation
Supplementary Information for
line 11 of
line of Form
for line
line 11d
Form9990-EZ
Form 9990
d of Form 9 0 or
(see instructions)
9 0 - E Z {see
2000
Name
N of organization
a m e of organization Employer
Employeridentification
number
THE HHEIMLICH
THE E I M L I C H IINSTITUTE FOUNDATION
N S T I T U T E FOUNDATION 223-7303161
3-7303161
Or~iz.ati~n_type type (check
Organization (check one)-Section:
onej-Sectlon: [XJ
D 501(c)(
C 501 (c)( 33 ))- -4
4 (enter number)
(enter number) I0I 527 or
527 or o
L J 4947(a)(1) nonexempt
charitable trust
trust
A
A Section 501
Section 501 (c)(7),
(c)(7), (8), or (10)
(8), or organizations-
(10) organizations-
Check this
Check this box
box ifif the
the organization
organization had
had no
no charitable
charitable contributors
contributors who
who contributed
contributed more
more than
than $1,000
$1,000 during
during the
the year.
year. (But
(But see
see General
General
rule
rule below.)
below.)..................... ► 0□
Enter here
Enter here the
the total
total gifts
gifts received
received during
during the
the year
year for
for aa religious,
religiOUS, charitable,
charitable, etc., purpose ► $$
etc., purpose
Note:
Note: This
This form
form is
is generally
generally not
not open
open to
to public
public inspection
inspection except
except for
for section
section 527
527 organizations.
organizations_
General Instructions
General Instructions greater of
greater
aa total
ot $5,000
total of
$5,000 or
or $14,000
$14,000 (2%
$11,000 would
01$11,000 would not
not be
(2% of ot $700,000).
be reported
$700,000), Thus,
reported in in Parts
Thus, aa contributor
Parts'I and
contributor who
and IIII for
for this
who gave
this section
section
gave
501(c)(3)
501 (c)(3) organization.
organization. Even
Even though
though the the $11,000
$11,000 contribution
contribution to to the
the
Purpose of
Purpose of Form organization
organization exceeded
exceeded $5,000.
$5,000. itit did
did not
not exceed
exceed $14,000.
$14,000.
Schedule BB (Form
Schedule (Form 990
990 oror 99O-EZ)
990-EZ) is is used
used by
by organizations
organizations required
required toto file Form
Form 990,
990,
Section
Section 501(c)(7),
501 (c)(7), (8),
(8), oror (10) organizations. For
(1 OJorganizations. nonchahtable
For noncharitable
Return of
Organization Exempt
Exempt From
From Income
Income Tax,
Tax, oror Form
Form 990-EZ,
990-El. Short
Short Form
Form
Return ol
Organization Exempt
Exempt From
From Income
Income tax,
tax. to
to provide
provide (he
the information
information contributions
contributions to
to one
one ofof these
these organizations,
organizations, list
list in
in Part
Part II contributors
contributors who
who gave
gave
regarding their
regarding their contributors
contributors that
that is
is requited
required tor
tor line
line 1d
1d ot
at Form
Form 990
990 (or(or line
line 11of
of 55,000 or
S5.000 or more
more as
as described
described in in the
the General
General rule
rule discussed
discussed above.
above.
Form 990-EZ).
Form 99Q-EZ) IfIf aa section
section 501(c)(7),
501 (c)(7), (8), or (10)
(8), or (10) organization
received contributions
contributions oror
Attach the
Attach Schedule BB (Form
the Schedule (Form 990
990 oror 990-EZ)
990-EZ) to to Form
Form 990
990 or
or 990-EZ.
990-EZ. Attach
Attach bequests for
bequests lor use
use exclusively
exclusively tortor religious,
religious, charitable,
charitable, etc.,
etc., purposes
purposes (sections
(sections
Schedule BB after
Schedule after Schedule
Schedule AA (Form (Form 990990 or
or 990-EZ),
990-EZ). Organization
Organization Exempt
Exempt Under
Under 170(c)(4), 2055(a)(3).
170(c)(4), 2055(a)(3), oror 2522(a)(3))-
2522(a)(3))-
Section 501(c)(3),
Section SOl (c)(3), ifif that
that return
return is
is required
required for
tor the
the organization.
organizallon.
List in
List in Part
Part II each
each contributor
contnbutor whose
whose contributions
contributions total
total more
more than
than $1.000
$1.000
during
during the
the year
year that
that were
were for
for aa religious,
religious, charitable, etc., purpose.
charitable, etc., purpose. ToTo determine
determine
Who
Who Must
Must File
File Schedule
Schedule B
B (Form
(Form 990
990 or
or 990-EZ) the
the $1,000.
~1.000, aggregate
aggrBjjate all
all of
of aa contributor's
COntributor's gifts
gifts for
for the
the year
year (regardless
(regardless of
01
organizations must
All organizations
All must tilelile Schedule
Schedule BB (Form
(Form 990
990 or
or 990-EZl
990-EZ) unless
unless they
they certify
certify that
that amount).
amount). For For aa noncash
noncash contribution,
contribution, complete
complete Part
Part II.
tt.
they do
they do not
not meet
meet the
the filing
filing requirements
requirements ofat Schedule
Schedule B B (Form
(Form 990
990 or
or 9090-EZ)
9090-EZ) by by
All section
All section 501(c)(7),
SOI(c)(7), (8), or (10)
(8), or (10) organizations
orgamzations that
that received
received any
any charitable
charitable
checking the
checking the box
box in
in item
item LL ot of the
the heading
heading ol
01their
their Form
Form 990
990 or
or Form
Form 990-EZ.
99o-EZ. contributions and
contributions and listed
listed any
any charitable
contributors on
on Part
Part II must
must also
also
See the
instructions tor
tor item
item LL in
in the
the Instructions
Instructions for
lor Form
Form 990
990 and
and Form
Form 990-EZ.
990-EZ. complete Part
complete Part III.
III.
Caution: Schedule
Caution: Schedule B B (Form
(Form 990
990 or
or 990-EZ) is not
990-EZ) is not aa substitute
SUbstitute for
for the
the list
list of"
of If11section
section 501(c)(7).
501 (c)(7), (8).
(8), or
or (10)
(10) organization
received charitable
charitable gifts,
gifts, but
but
"contributors' required
"contributors' required for
for Part
Pan tV-A,
IV-A, Support
Support Schedule,
Schedule, of of Schedule
Schedule A
is not
is not required
required to
to list
list any
any charitable
contributors on Part I,I.check
on Part check the
the box
box on
on
(Form 990
(Form 990 or
or 990-EZ).
990-EZ).
line A
line A at
at the
the top
top ot
at Schedule
Schedule B B (Form
(Form 990
990 or
or 990-EZ)
990-EZ) and
and enter
enter the
the amount
amount of of
charitable contributions
charitable contributions received
received in in the
the space
space provided.
provided. The
The organization
organization need
need
Public Inspection
Public Inspection not complete
not complete and
and attach
attach Part
Part III.
III. .
Schedule B
Schedule B (Form
(Form 990
990 or
or 990-EZ)
990-EZ) is:
is: Specific
Instructions
•• Open
Open to
to public
public inspection
inspection for
for aa section
section 527
527 political
political organization.
organization.
•• Generally
Generally not
not open
open to
to public
public inspection
inspection for
tor the
the other
other organizations
organizations that
that must
must file
file Nole: You
Note: may duplicate
You may duplicate Parts
Parts I,I, II,
II, and
and III
III ifif more
more copies aro needed,
copies are needed.
this lorm.
form. Number each
Number eecn page
page of
of each
each Part.
this
IfIf aa non-section
non-section 527
527 organization
organization tiles
files aa copy
copy of
of Form
Form 990,
990, or
or Form
Form 990-EZ.
99G-EZ,andand Pill! 1.1. In
Part In column
column (a), identify the
(a), identify the first
first contributor
contributor listed
listed as
as no.
no. 11 and
and the
the second
second
attachments with
attachments with any
any state,
state, itit should
should not
not include
include its
its Schedule
Schedule B B (Form
(Form 990
990 or
or contributor
contributor as as no.
no. 2,
2, etc.
etc. Number
Number consecutively.
consecutively. ShowShow thethe contributor's
contributor's name,
name,
99G-EZ) in
990-EZ) in the
the attachments
attachments tor
tor the
the state
state unless
unless aa schedule
schedule ofof contributors
contributors isis address,
address, aggregate
aggregate contributions
contributions fortor the
the year;
year; and
and the
the type
type ofof contribution
contribution (e.g.,
specifically required
specifically required by
by the
the state.
state. States
States that
that do
do not
not require
require the
the information
information might
might whether
whether an an individual,
individual, payroll,
payroll, or
or noncash
noncash contribution).
contribution). Report
Report payroll
payroll
make the
make the schedule
schedule available
avaitabte tor
tor public
public inspection
inspection along
along with
with the
the rest
rest of
01the Form
the Form contributions
contributions by by listing
listing the
the employer's
employer's name,name, address,
address, and
and total
total amount
amount given
given
990
990 or or Form
Form 990-EZ. (unless
(unless an an employee
employee gave gave enough
enough to to be
be listed
listed individually).
individually).
See the
See the Instructions
Instructions lor
tor Form
Form 990
990 and
and Form
Form 990-EZ
990-EZ tor
for phone
phone help
help and
and the
the public
public Part
Part II.
II. In
In column
column (a), (a), show
show thethe number
number thatthat corresponds
corresponds to to the
the contributor's
contributor's
inspection rules
inspection rules for
tor those
those forms
forms and
and their
therr attachments,
attacnments, which
which include
include Schedule
Schedule B number
number in In Part
Part I.I. Describe
Describe thethe noncash
noncash contribution
contribution fully.
futly. Report
Report on on property
property
(Form 990
(Form 990 or
or 990-EZ).
990-EZ). with
with readily
readily delerminable
determinable market market value
value (i.e.,
(i.e., market
market quotations
quotations for for securities)
securities) by by
listing
listing its
its fair
fair market
market value
value (FMV).
(FMV). For For marketable
marketable securities
securities registered
rEllJistered and
and listed
tisted
Contributors Required To Be Listed
Contributors Listed On Part I on
on aa recognized
recognized securities
securities exchange,
exchange. measure
measure market
market value
value by by the
the average
averalle of
of
the
the highest
hlghesl and and lowest
lowest quoted
quoted selling
seiling prices
prices (or
(or the
the average
average between
between the the bona
bona
'Contributor" includes
"Contributor" Includes individuals,
individuals, fiduciaries,
fiduciaries, partnerships,
partnerships, corporations,
corporations, fide
fide bid
bid and
and asked
asked prices)
prices) on
on the
the contribution
contribution date.
date. See
See Regulations
Regutations section
section
associations, trusts,
associations, trusts, and exempt organizations.
organizations. 20.2031-2
20.2031-210to determine
determine the the value
value ofof contributed
contributed stocks
stocks and
and bonds.
bonds. WhenWhen
General rule.
General rule. Unless the organization is covered
covered by one of ot the special
special rules below.
below, market
market value
value cannot
cannot be be readily
readily determined,
determined, use use an
an appraised
appraised or or estimated
estimated value.
value.
itrt must
must list on Part I every contributor
contributor who
wIlo during
during the year,
year. gave the organization To
To determine
determine the the amount
amount of at aa noncash
noncash contribution
contribution that that is
is subject
subject to to an
an
directly indlreclly, money,
money, securities,
securities, or any other type ot at property
property totaling
totaling $5,000
$5,000 outstanding debt, subtract the debt from the property's
outstanding debt, subtract the debt tram the property's tair market value. fair market value.
or more for the year. Also complete Part II for for a noncash
noncash contribution.
contribution. InIn
determining the $5,000
determining ~5,000 amount,
amount. total all of the contributor's
contributor's gifts
gifts of $1,000
$1 ,000 or more Section 501(c)(7),
Part III. Section S01(c)(7), (8),
(8), or (10) organizations
organizations that received
received
for the year.
for contributions or bequests
contributions bequests for
tor use exclusively for religious,
charitable, etc.,
purposes,
purposes, must
must complete
complete Parts I through
through III
III for those persons
persons whose
whose gifts
Section 501(c)(3)
Section 501(c)[3) organizations.
organization5. For
For an organization
described in section 501(C)(3)
501(c)(3) totaled more
more than $1,000
$1,000 during
during the year. Show also,also, in the heading
heading ofot Part 111.
III,
support test of
113% support
that meets the 33 1/3% ot the Regulations
Regulations under sections
sections total
totat gifts
gifts that were $1,000 or less and were
were loi
tor a religious,
charitable, etc.,
509(a)(1)fI70(b)(I)(A)(vi)
509(a)(l)/170(b)(t)(A)(vi) organization is otherwise
(whether or not the organization otherwise described
described in
in purpose.
purpose. Complete
Complete this information
information only
only onon the
the first Part
Part III page.
III page.
section 170(b)(1)(A))-
section HO(b)( 1HA»)-
list in Part I only those contributors
List contributors whose
whose contribution
contnbutlon otat $5,000
$5,000 or more is is
greater than 2% ot at the amount
amount reported on line 1d ld of Form 990 (or line 11 of Form
99G-EZ) (Regulations
990-EZ) (Reg utations section
section 1.6033-2( a)( 2)(iii)( a).
1.6033-2(a)(2)(iii)(a)). II
If an amount
amount is set aside fortor a religious,
charitable, etc..
etc .. purpose,
purpose. show
show in
column
column (d) how the amount
amount is held (e.g., whether itIt is mingled
mingled with amounts
with amounts
Eumple. A section
Example. section 501(c)(3)
501(c)(3) organization,
organization, ot the type described
described above,
above, reported
reported held for other
other purposes).
purposes). ItIIthe
the organization
organization transferred
transferred the gift
gift to another
another
$700,000 in total contributions,
$700,000 contributions, grfts.
grtts. grants,
grants, and similar
similar amounts
amounts received on line organization,
organization, show
show the
the name
name and
and address
address ofat the
the transferee
transtaree organization
organization in
in
lei ot its Form 990.
1d 990. The organization
organization is only
only required
reQuired to list in Parts I and IIII ol
01 its column
column (e)(e) and
and explain
explain the
the lelationship
relationship between
between the
the two
two organizations.
organizations.
Schedule B (Form
Schedule (Form 990 or 990-EZ) each person
person who contributed
contributed more
more than the
0234S1 12-19-00
Schedule a
Schedule B (Form
(Form 990
990 or
or Q9D-Ell
990-EZ) 12000)
(2000)
Scnrtule B (Form
Scneeufe B (Form MO or 99O-EZ)(2C1OO1
990 or 990-EZX2000) Page
Page 1
1 to 1
1 01
ol P.r1
Ptn II
Name ol organlzalio"
Name 01 organization Employer identification number
Employer Identlflcallon number
HEIMLICH INSTITUTE
THE HEIMLICH INSTITUTE FOUNDATION 2 3-7303161
23-7303161
Parti : Contributors
(a) (b)
(b) (c)
(e) (d)
(eI)
No.
No. I Name, address and ZIP code
Name.address Aggregate contributions
contributions Type
Type of contribution
of contribution
1
1 Individual 00
--- - Payroll D□
-
—
$
$ 15,000.
15,000. Noncash D
| [
(Complete Part II if a
(CompletePart
noncash contribution.)
-
(a)
(a) (c)
(e) (eI)
(d)
No.
No. Aggregate contributions
contributions Type of contribution
Type contribution
5
5 Individual 00
--- -
Payroll D[
1
—
-
$
$ 10,000.
10,000. Noncash D|
|
(CompletePart
-
(a) (c)
(c) Id)
(eI)
No.
No. Aggregate contributions
contribution
---66 —
- Individual rx□ [S
Payroll D
-
$
$ 77,570.
77,570. Noncash D|
|
(CompletePart
-
(a)
(a) (b) (c) <d)
(eI)
No.
No. Name,
Name, address and ZIP code Aggregate contributions
contributions of contribution
Type of contribution
7
---7 Individual D
Payroll 0
1 1
$ Noncash [D]
(CompletePart
noncashcontribution.)
(a)
(a) (b)
(b) (c) (d)
No.
No. Name, address and ZIP code
Name,address Aggregate contributions
contribution
---
8
8 Individual D
Payroll D|~" 1
$
$ Noncash |0 |
(Complete Part II if aa
(CompletePart
noncash
(a)
(a) (b)
(b) (c) (d)
(eI)
No.
No. Name,
Name, address and ZIP code Aggregate contributions
contribution
9
---9 Individual D
Payroll 0
1 1
$ Noncash D
| |
(CompletePart
023452 12-23-00
cr.>3~5212·23·00 114
4 Schedule
Schedule B (Form
(Form 990
990 Dr99D-EZ)
or 990-EZ) (2000)
(2000)
09360820
0 758050
9360820 7 5 8 0 5 0 23-12053HEI
23-12053HEI 2 0 0 0 . 0 6 0 0 0 THE
2000.06000 H E I M L I C H INSTITUTE
THE HEIMLICH I N S T I T U T E FOUN 23-12051
23-12051
THE HEIMLICH. INSTITUTE
THE HEIMLICH. INSTITUTE FOUNDATION
23-7303161
FORM 990
FORM 990 OTHER INVESTMENTS
OTHER INVESTMENTS STATEMENT
STATEMENT 5
VALUATION

754,102.
TOTAL TO FORM 990, PART IV, LINE 56, COLUMN B 754,102.
FORM 990 OTHER ASSETS STATEMENT 6
DESCRIPTION AMOUNT
SECURITY DEPOSIT 10.
10.
WORKERS COMPENSATION DEPOSIT 132.
ACCRUED INTEREST RECEIVABLE 6,966.
TOTAL TO FORM 990, PART IV, LINE 58, COLUMN B 7,108
7,108.
SCHEDULE A IDENTIFICATION
IDENTIFICATION OF EXCESS CONTRIBUTIONS
CONTRIBUTIONS STATEMENT 7
INCLUDED ON PART IV, LINE 26B
2 6B
***
*** NOT OPEN TO PUBLIC INSPECTION ***
+ **
TOTAL EXCESS
CONTRIBUTOR'S NAME CONTRIBUTION
CONTRIBUTION CONTRIBUTION
CONTRIBUTION
40,000. 24,154
24,154.
25,000. 9,154
9,154.
250,000. 234,154
234,154.
281,343. 265,497
265,497.
TOTAL EXCESS CONTRIBUTIONS TO SCHEDULE A, LINE 26B 532,959
532,959.
16 STATEMENT(S) 5, 6, 7
09360820 758050 23-12053HEI 2000.06000
- -------
OMB No 1~5-01 n
1S45-017?
4562
4562 Depreciation
Depreciation and Amortization
Amortization 2000
2000
D_rtmen, 01'he Trez""l (Including Information on Listed Property) 990
990
Attachmoont
Attachment
In'
Internal
e mol Revenue
Revenue Service (99) ~ See separate
instructions. ~
► Attach this form
Attach this form to your
your return.
return. Sequence No. 67
5equoonce 67
Name(}} snovun on
Name{s} snO'Nn on return
return 8us~nes5or
Business or activity to wh~CI"J
whicn ~hi'S relates
this form relates Identifying
Identifying number
number
THE
THE HEIMLICH
HEIMLICH INSTITUTE
FOUNDATION FORM 9990
IFORM 9 0 PAGE PAGE 2 23-7303161
23-7303161
I, Part-11
PaTtI:l Election
Election To Expense
Expense Certain
Certain Tangible
Tangible Property
Property (Section
(Section 178)
179) Note: II you havean_y
Note: have any'listed property.'complete Part V before
'listed property:completePartV you complete
beforeyou Part I.)_
completePart I.)
1 Maximum dollar limitation.
limitation. If an enterprise zone business, see instructions
instructions .. .. 1 2
20,0 , 0000
00 •
2 Total cost of section 179 property placed in In service. See instructions
instructions 1-2_+- _
3 Threshold cost of section 179 property before reduction in limitation . 3 $200,000
$200.000
4 Reduction in limitation.
limitation. Subtract line 3 from line 2. 2.lfIf zero or less, enter ()
-0- f--4_+- _
5 Dollar
Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, enter -0-. () .. If married filing
filing
separately, see instructions
instructions 5
iB_l Description of property
---tllliillll\11i!
(B) (b) Cost [business use only) (c) Elected cost
_6 D_es_cn_.p_'io_n_o_1
P_ro_pe_rty -+_(1;>_' c_o_S_'(b_U_S_ln_e5_S_U_SB_o_n_ty)_t- iC_'E_I_ec_tBCI_oos_t
7 Usted
Listed property.
property. Enter amount from line 27 11...-..!.7_..l. .-----t'.'.:;::.':::·:;'.::::.':;·::.:;':·.':.:: ..::,';.::.i::;.::::.:;,':;,'.':,:;:; ..:::,::::::,;;.:.:;;
8
8 Total elected
elected cost of section
section 179 property. Add
property. Add amounts in column (c),
(c). lines 6 and 7 . 8
90 Tentative deduction.
deduction. Enter the smaller of line 5 or line 8 .. . 1---'9~-+- _
10 Carryover
Carryoverofof disallowed deduction
deduction from 1999 . .. 10
1--'1..:::0'-+ _
11 Business income lirnttatlon.
limitation. Enter the smaller of business income (not less than than zero) or line 5 .. 11
1--'1...!1-+ _
12 Section 179 expense deduction.
deduction. Add lines 9 and 10, 10. but do not enter more than linehne 11 . 12
13 Carryover of disallowed deduction
deduction to 2001. Add Add lines 9 and 10, less line 12 ► 1 13 ·:W/),':\.',(,:/:·',>,;·}":\}/:';·:·;{/:·\
Note:
Note: Do not use Part II or Part III below for listed property (eutomooites.
Pert /1/ (automobiles, certain other vehicles, cellular telephones, certain computers, or property property
used for entertainment, recreation, or amusement). Instead, use Part V for listed property. property.
,,"part'·lfl
P a r t 111 MACRS Depreciation
Depreciation For Assets
Assets Placed
Placed in Service Your 2000 Tax Year 100
During Your
Service Only During (Do not include listed property.)
Section
Section A - General AssetAsset Account
Account Election
Election
14 ~!CO~u~~:.~~~~
accounts, check this :~t~~
box. See~~~~~~~~~n t~~:
14 If you are making the election under section 168(i)(4) to group any assets placed in service during the tax year into one or more general asset
instructions 168(i)~~)..t~ gro.u~.~~y..a~~et.s.plac.e~ in S~~i.c.e.~~~~ngth.e t~ y~r. i~~~one.~r.~or~ ..g~~~r~l.~~;;t
► I DI
Section B - General
Section B General Depreciation
Depreciation System
System (GDS)
(GDS) (See instructions.)
instructions.)
(b) Month
Month and.nd (c) Basis for depl'l!Ciatlon
(cl Basis depreciation
(a) Classification ol property rbuslness/lnvestment use (d) Recovery
id) Aocovery (Q) Depredation deduction
year plooced
pi t e w ('bu,lnesslinvestment UIII (e) Convention
(el Convention (l)Metnod
[~Metnod
Inser.-I~
In service only
only·- ....
see Insttucbon.l
Instructions) penO<l
period
:
::. : I. :...■..■■■:■
"
::■■:■■.;■
.
15 a 3-year property
b 5-year property
c 7-year property
d 10-year property
-15___;~:......cl'-:f'-'~:..::~;;_i.<:.;
e 15-year property
t 20-year property
:;----------li\~!;!~'!I\~f:jl----------+-----j----j---+---------
~'-'T:'""':-=.::'"'"...'~:~
mmm.
.
mm®
: : : : , V
. - . : : : : : . . : ■
. . , , . , . : , ; : ; : ■ : , : :
:■.■■■.-.
g 2S·year
g 25-year property i<'
:.{\;:'. :';::,.;, ;, ., 25yrs.
25 YTS. S/L
iI MM yrs.
27.5 YTS. S/L
h
h Residential
Residential rental
rental property
property
i MM
MM yrs.
27.5 yTS. S/L
S/L
39iIvrs.
39_yrs. MM S/L
i Nonresidential
Non residential real
real property
property
iI MM S/L
SIL
Section
Section C - Alternative
Alternative Depreciation
Depreciation System
System (ADS) (See Instructions.)
instructions.)
16 a Class life
b 12-year
llllll 12 yrs.
S/L
SIL
S/L
SIL
c 40·year
40-year /I 40 yrs. MM S/L
j: Pa:rt
P a T tJill
l H Other
Other Depreciation
Depreciation (00
p o not include
include listed property.)
property.' (See instructions.)
(See instructions.)
17 GDS and ADS deductions
deductions for assets placed in service in tax years beqinnino,
beginning before 2000
2000 . 17
17 6 ,946.
6,946.
18 Property subject to section 168(f)(1) ele(:tion
section 168(1)(1)election .. . . 18
19 ACRS and other depreciation
depreciation .. .. .. . . 19
l:pari:,J\II
P a r t IV Summilry
Summary (See instructions.)
instructions.)
20 Usted
Listed property.
property. Enter amount from line 26 20
Total. Add deductions
21 Total, deductions from line 12, lines
lines515
15 and 16 in column (g).
16in (g), and lines 17 through
through 20. Enter here
and on the appropriate lines of your return.
retu rn. Partnerships and S corporanona-
corporations - see Instruc~ti",o::.:n",s"T.'""
instructions ..".-.'-."'-'
..-'."'-'
..-'."'-' 21 6 ,, 997."7":4
4 6 . 776_".,..-
..---'....:...._L......:2=..:1'-+c::-"""'""'"""',.".,.,.."...,.6.".,~
22 For assets shown above and placed in s ervice during th e current year, enter the ■
22 :~:~~;t~:ob:i:~~;rieb:~=:~~~~:ti:~~~~:~::~st~~.~.~~.e.nt "" enter the. .... 1 221 :?:t:::::\:.:::::::::::·.::·::·.::::::::.:::·:::~!:;)·!i·.:;:·:.':·~ti:'!i/:::.:::::

portion of the basis attributable to secticsn263A costs .. 22
LHA Paperwork Reduction
For Paperwork Reduction Act Notice,
Notice, see the separate
instructions. Form 4562
4562 (2000)
?:~~1:J
016251
11JO-00
1 'l
17
1 /
09360820
09360820 758050
758050 23-12053HEI
23-12053HEI 22000.06000
INSTITUTE FOUN
FOUN 23-12051
23-12051
Form
Form 456^ (2000)
456~ (2000) Page
Page 2 2
PartV Listed
Listed Property
Property (Include
(Include automobiles,
automobiles. certain
certain other
other vehicles,
vehicles. cellular
cellular telephones,
telephones. certain
certain computers,
computers. and
and property
property used
used for
for entertainment.
entertainment.
recrealion, or
recreation. amusement.)
or amusement.)
Note:- For any "vehicle
Note:· torwhich
'vehiclefor youare
whichyou areusing
usingthe
thestandard
standardmileage
mileagerate
rateorordeducting
deducting lease
leaseexpense.
expense,complete only 23a.
complete only 23a,23b.
23b, columns
columns (a)
(a)
through (c) of Section A. A, all of Section B, and Section C if applicable.
Section
Section A - Depreciation
Depreciation and Other lnformation
Information (Caution:
(Caution: Seeinstructions
See instructions for limits for passenger automobiles.)
automobiles.)
23a Do you have
Doyou haveevidence 10 support
evidence to the business/investment use
supportthebusinessfinveslment claimed? E
useclaimed? Z ] Yes IZZI
DYes DNo No 23b If 'Yes,*
'Yes' is the evidence written? IDYes
J Yes I I No D
(a) Dale
(b) Date
01 (c) (d) (e) If)
(t) (9)
(g) (h) (i)
Type
Typeof of property
property placed in
placedin Business/
Business! Cost or
Costor
B*fi* tor depreciation
Basls for depredation
Recovery
Recovery Method/ Depreciation
Elected
Method!
(list
(list vehicles
vehides Iifirst)
rst ) service
service investment
investment other basis
otherbasis
(bu»ln ess/i n veatmen t
(bU'Ilnesslinvestment
period
period Convention deduction
deduction section 179
section
use percentage
usepercentage ute
use only) Convention
cost
cost
24 Properly used more than 50% in a qualified business use:
%
%
%
25 Property used 50% or less in a
a_qualified business
business use:
26 Add amounts
amounts in column (h).
%
%
%
(h). Enter
Enter the total
S/L-
S/L-
---------+-___;_--l-----...!.::"-t------1r------t----+"~:::..~==--:
S/L-
total here and on line 20,
20. page 11..
---+------ii)!H~illll!M.--_+:i:-'.:·;.':"-'M-jyH^fH^
1L....:2:..:6::......L
26
^^mwi-i
■iSP^li^^
^M ;:::>■
:'-:·""i""";·':: :':"-::?,;...?:""{,;...H.,;...::,';_;.':
27 Add amounts in column (i).
(Q. Enter
Enter the total
total here and on line 7,
7. page 1 ..... .. .. 1 27
Section B - Information
Section Information on Use of Vehicles
Vehicles
Complete this section for vehicles used by a sole
sale proprietor,
proprietor. partner,
partner. or other "more
'more than 5% owner,'
owner,' or related person.
If you provided
provided vehicles to your employees.
employees, first answer the questions
questions in Section C to see if you meet an exception
exception to completing
completing this section for
those vehictes.
vehicles.
(a) (b) (c) (d) M
(e) (t)
28 Total businessanvestrnent miles
Total business/investment driven during the
milesdrivenduringthe Vehicle
Vehicle Vehicle
Vehicle Vehicle
Vehicle Vehicle
Vehicle Vehicle
Vehicle Vehicle
Vehicle
year (DO
'lear NOT include commuting miles) . " ..... .......
(DONOTincludecommutingmiles)
28 Total commuting miles driven during the year ...
29
30 Total other personal (noncommuting)
(noncommuting) miles
driven ...............................................................
31 Total miles driven during the year.
Add lines 2828 through
through 30 30 .............................
Yes No Yes No Yes No Yes No Yes No Yes No
32 Was the vehicle available
available for personal use
during
during off-duty hours? .................................
33 Was the vehicle used primarily
primarily by a more
than 5% owner or related person? .. .............
34 Is another vehicle available
available for personal
use? .............................................................
Section Questions for
Section C - Questions for Employers
Employers Who
Who Provide
Provide Vehicles
Vehicles for
for Use by Their
Their Employees
Employees
Answer these questions
questions to
1o detennine
determine ifif you
you meet
meet an
an exception
exception to
to completing
completing Section
Section B
B for
for vehicles
vehicles used
used by
by employees
employees who
who are
are not
not more
more than
than 5%
5%
owners or related persons.
Yes
Yes No
35 Do you maintain a written policy statement that prohibits
prohibits all personal use of vehicles, including commuting.
vehicles. including commuting, by your
employees? .
36 Do you maintain a written policy statement
statement that prohibits
prohibits personal use of vehicles. 0'
vehicles, except commuting.
commuting, by your
corporate officers,
employees? See instructions for vehicles used by corporate directors, or 1%
officers. directors. 1 % or more owners .. .
37 Do you treat all use of vehicles by employees as personal
person al use? .. . . .. .......... .. .. " .
38 Do you provide more than five vehicles to your employees.
employees, obtain infonnation
information from your employees about
the use of the vehicles,
vehicles. and
and retain
retain the information
infonnation received? ..
concerning qualified automobile
39 Do you meet the requirements conceming automobile demonstration
demonstration use?
use? .
Note:
Note: If your answer to 35.
35, 36.
36. 37,
37, 38,
38, or 39
39 is "Yes,"
'Yes, • you need not complete Section B for the covered vehicles. '/?,.::+:t·i{';i)i·:::
I:p'art:vH
Pfflrt-Vl Amortization
Amortization
(a)
Descr1ption01
Description costs
of costs
(b) Ion: (c)
DfKvnonaitr
W1(It1Il;a~(I1
(d)
Amortiztble
Arrortizllble
■mount
(e)
Code
Code Amnzition
.t.maJzi~on
mwdorpenanage
m
(f)
Amortization
Amortization
begins amount section periodor peI'tl:nl;lge Ie. tI1is year
(or ttiia year
40 Amortization of costs
Amortizationof that begins during your. 2000 lax
coststhatbeginsduringyour tax year:
year:
1
1
41 Amortization
Amortization of costs
costs that began before 2000
2000 11--4;...;1'-+
41 _
Total. Add amounts in column (fl.
42 Total. (f). See instructions
instructions for where to report
10 report. .. 1 42
Form 4562
4562 (2000)
016252
10-2100
10-21·00 18
09360820 758050 23-12053HEI 2 3-12051
THE HEIMLICH-INSTITUTE
THE FOUNDATION
HEIMLICH· INSTITUTE FOUNDATION 23-7303161
23-7303161
FORM 990
FORM 990 GAIN (LOSS) FROM
GAIN (LOSS) FROM PUBLICLY
PUBLICLY TRADED
TRADED SECURITIES
STATEMENT 1

FIRSTAR - SEE
ATTACHED DETAIL 20,829. 24,005. o.
0. -3,176.
FIRSTAR - SEE
ATTACHED DETAIL 77,998. 71,390. 0.
O. 6,608.
FIRSTAR - CAPITAL
GAINS DISTRIBUTIONS 2,674. o.
0. 0.
O. 2,674.
TO FORM 990, PART I, LINE 8 101,50l.

101,501 95,395.
95,395 o.
0. 6,106.
6,106
FORM 990 OTHER

OTHER CHANGES IN NET ASSETS OR FUND BALANCES STATEMENT 2
DESCRIPTION AMOUNT
CHANGE IN NET UNREALIZED
UNREALIZED GAINS/LOSSES -6,885
-6,885.
TOTAL TO FORM 990, PART I, LINE 20 -6,885.
FORM 990 STATEMENT OF ORGANIZATION'S PRIMARY EXEMPT PURPOSE

STATEMENT STATEMENT 33
PART III
EXPLANATION
PERFORM RESEARCH
RESEARCH AND PROVIDE EDUCATION TO THE PUBLIC ON VARIOUS DISEASES.
DISEASES.
FORM 990
990 CASH GRANTS AND ALLOCATIONS STATEMENT 4
DONEE'S
CLASSIFICATION DONEE'S NAME DONEE'S ADDRESS RELATIONSHIP AMOUNT
CHARITABLE UNDERGROUND CINCINNATI, OHIO NONE
RAILROAD FREEDOM
CENTER 300.
CHARITABLE BIG PIG GIG CINCINNATI, OHIO NONE ,390.

3,390.
3,
TOTAL INCLUDED 990, PART II, LINE 22

INCLUDED ON FORM 990, 22 ,690.
3,690.
3,
15 STATEMENT(S) 1, 2, 3, 44
758050 23-12053HEI
09360820 758050 2000.06000 THE HEIMLICH INSTITUTE
2000.06000 INSTITUTE FOUN 23-12051
REALIZED CAPITAL lOSSES
AND LOSSES
GAINS'AND
JJANUARY
ANUARY 1
1., 22000
0 0 0 - DECEMBER 3 1 , 2000
DECEMBER 31. 2000 HEIMLICH INSTITUTE FOUNDATION,
HEIMLICH
INCORPORATED
INCORPORATED
ACQUISITION
ACQUISITION PROCEEOS
PROCEEDS DOLLAR
DOLLAR DOLLAR $ GAIN /I
QUANTITY ASSET
ASSET DESCRIPTION DATE DATE
CATE COST PROCEEDS
PROCEEDS ' LOSS
I.OSS
SHORT
SHORT TERM TRANSACTIONS
145 COCA-COLA ENTERPRISES
COCA·COLA ENTERPRISES INC. 10/27,'99
10/27/99 01/27/00
01/27/00 3.491.60
3.491.60 3,603.21
3.603.21 i l l\ .61
H
150 LOWES
LOWES COMPANIES, INCORPORATED
COMPANIES, INCORPORATED 05/25/99
05/25/99 02/17/00
02;'17/00 7,795.01
7,795.01 6,395.60
6,395.60 ■1.399.41
·1.399.41
100 MERCK
MERCK 8.
& COMPANY, INCORPORATED
COMPANY, INCORPORATED 03/24/99
03/7.4/99 01/27/00
01127100 8,233.00
8.233.00 7,418.21
7,418.21 ■614.79
·814.79
90 WORLDCOM, INC.
WORLDCOM. INC. 09/29/99
C9/29/99 05/31/00
05/31100 4,485.00
4,485.00 3,412.17
3,412.17 -1,072.83
",072.83
TOTAL NET SHORT TERM
TERM CAPITAL LOSSES
LOSSES $24,004.61
$24.004.61 S20.829.19
820,829.19 -»3,175.41
'$3.'l75.~
LONG TERM CAPITAL TRANSACTIONS

0.667
0.667 AVAYA,
AVAYA. INC. 12/01/98
12/01/98 10/30/00
10(30/00 19.01 9.18 -9.83
·9.83
230 . COCA·COLA
COCA-COLA ENTERPRISESINC.
ENTERPRISES INC. 1 2/22/98
12/22/98 01/27/00
01/27/00 7,752,15
7,752.15 5,715.42
5.715.42 -2.036.73
-2,036.73
120 COMERICA,
COMERICA. INC. 12/02/98
t 2/02/98 02/25/00
02/25/00 7,767.00
7.767.00 4,257.98
4,257.98 -3,509.02
·3.509.02
200 GILLETTE COMPANY
GILLETTECOMPANY 06/14/93
06/14/93 10/18/00
'0/18/00 2,468.00
2.468.00 .5,627.87
.5,627.87 3,169.87
3.159.87
20,000
20.000 INTERNATIONAL BUSINESS
BUSINESS MACHINES CORP.
CORP. 06/10/93
06/10!93 06/15/00
OS/15tOD 20.025.00
20.025,00 20,000.00
20.000,00 -25.00
·25.00
6,375% 06/15/00 DATED 06115193
6.315% DUE 06/15/00 06/15/93
160
160 LEXMARK
LEXMARK INTERNATIONAL,
INTERNATIONAL. INC.
INC, 02/10/99
02/10/99 10/18/00
10/18100 8.006.40
8.006.40 4,870.34
4,870.34 -3.136.06
·3.136.06
140 MEOTRONIC, INC.
MEDTAONIC, INC. 02/27/97
02/27/97 04/28/00
04/28/00 2,248.58
2.248.58 7,531.95
7.531,95 5,283.37
5,283,37
ioo
100 MEDTRONIC, INC.
MEDTRONIC. INC. 02/27/97
021'27/97 06/22/00
05/22/00 1,606.13
1.606.13 4,977.33
4.977.33 3,371.20
3.371.20
250 SYSCO
SYSCO CORPORATION 10/16/96
lO/lar96 06/01/00
06/0 t 1('0 4,183,13
4.183.\3 10,487.16
10,487.10 6.304.02
6.304,0:1.
130.
130 TARG!:;:TCORPORATION
TARGfcT CORPORATION 03/29/99
03/29/99 04/19/00
04/19/00 8,906.86
B.90S.BS 8,834.20
8.834.20 -72.66
··72.66
150 WORLDCOM,
WORLDeOM. INC. INC. 04/20/99
04/20/99 05/31/00
05/31/00 8,408.00
8,408.00 5,686.94
5,686.94 -2,721.06
.21721.06
TOTAL NET
NET LONG TERM CAPITAL GAINS $71,390.26
$71.::190.28 $77,998.36
$77 .998.36 $6,608.10
46,608.10
Q
CP
LONG
TERM CAPITAL
0 JOHNSON OPPORTUNITY FUND 12/28/00
, 2/28/00 2,673.67
2,673.97 2,673.97
2,673,!:)7
TOTAL
TOTAl,. LONG TERM CAPITAL DISTRIBUTIONS
CAPITAL DISTRIBUTIONS 42,673.67
112,673.97 ♦ 2,673,97
$2,673.97
o
(})

GROSS PROCEEOS S101.601.52
6101,601.52
bb
2&- C^lDl*— ^ ^ g**-r-
This report summanzes

This report summarizes the portfolio transactions for
portfolio traosecncns lor your
your convenience.
convenience.
We do not
We not guarantee
guarentee us appropriateness tor
119IIPpropriatel1811s tor use
use in tax preparation.
preparation.
1
1-&..--- _ .•
311 SJRAKlHf
STRAIGHT
STREET
STREET
*John President
• John Gall, President
THE
..
HEIMLICH INSTITUTE
BOARD OF TRUSTEES
TRUSTEES
(513)751-9600
(513) 751·9600
CItCINMTI
ONCtNNMI Massachusetts
Massachusetts Casualty Ins. Co.
Co. (513) 751-9613 (Fax)
(513)
OHIO 2150 Gilbert Avenue
Avenue (513) 221-8112
(513) (Home)
221-8112 (Home)
46219
452'9
513-559-2391
Cincinnati, Ohio
Cincinnati, 45206
Ohio 45206
513-559-Z391
RAX 513-5-2403
fA)( 513-559-2403
helmfchOlglotLCMn
helmid'IOIgIou.a)n Philip M.
Philip M. Heimlich,
Heimlich, Vice President
Vice President Cincinnati City
Cincinnati City Hall
Hall
6680 Lyceum
6680 Lycewn Court
Court 801 Plum
801 Plum Street
Street
Cincinnati, Ohio
Cincinnati, Ohio 45230 Cincinnati, Ohio 45202
45202
(513) 352-3647
(513) 352-3647
(513) 352-4640 (Fax)
Joseph J. Dehner,
Joseph Dehner, Secretary
Secretary Frost & Iacobs
Frost Jacobs
822 Yale
822 Avenue
Yale Avenue 2500 Central
2500 Central Trust
Trust Tower
Tower
Terrace Park, Ohio 45174
TerracePar~ 45174 Cincinnati,
45202
(513)651-6800
(513) 651--6800
(513) 651·6166
(513) (Kathy Barrett)
651-6166 (Kathy Barrett)
(513) 651-6981
(513) 651-6981 (Fax)
(Fax)
*Cedric W. Vogel, Treasurer

-Cedric Treasurer Vogel, Heis,
Vogel. Heis, Wenstrup
Wenstrup & Cameron
Cameron
2270 Madison
2270 Madison Road
Road 817 Main
817 Street, 81b
Main Street, 8* Floor
Floor
Cincinnati, Ohio
Cincinnati, Ohio 45208 Cincinnati, Ohio 45202
45202 - 2134
2134
(513)421-4225
(513) 421-4225
(513) 639-2547
(513) (Fax)
639·2547 (Pax)
•Henry J.
"Henry 1. Heimlich,
Heimlich, M.D.
M.D. The Heimlich
The Institute
Heimlich Institute
17 Elmhurst
t7 Place
Elmburst Place 311 Straight
311 Straight Street
Street
Cincinnati, Ohio
Cincinnati, 45208
Ohio 45208 Cincinnati, Ohio 45219
(513)559-2391
(513) 559-2391
(513) 559-2403
(513) 559-2403 (Fax)
(Fax)
Mrs. Winston
Mrs. Winston C. Atteberry
Atteberry
Box 629
Box 629
LA 70535
Eunice, LA
..
457-2705
(318) 457-2705
Benefiting
Benefiting
George Blake
George Blake (513) 768-8298
(513) 768-8298 (Direct)
(Direct)
Humanity
Humanity The Cincinnati
The Cincinnati Enquirer
Enquirer (513)768-8079
(513) 768-8079 (Fax)
Through
312 Elm Street
Cincinnati,
Ohio 45202
Health
Health
/
and
and
N&adrvYMAVC
Kathy Can-
Kathy Carr 871·2221 (Work)
(513) 871-2221 (Work)
Ray Can
Carr (513)6214m
(513) 621^777 (Work)
3057
3057 Saddleback
Saddleback Drive
Drive 231·3010 (Home)
(513) 231-3010 (Home)
Cincinnati,
Cincinnati, Ohio
Ohio 45244
45244 (513) 621·4771 (Fax)
(513)621-4771 (Fax)
«*?».'
)
311 STRAIGHT
STRAIGHT
STREEf
STHffiT
CINClJfiATI
CINCINNATI
OHIO
45219
45219 'Monte L Rovekamp
Monte L. P.O. Box 19129
19129
51J.551r2391
513-559-2391
FAX51~2403
FWC 513-559-2403 2864
2864 Crescent
Crescent Springs
Springs Pike
Pike Cincinnati, Ohio
Cinciunati, Ohio 45219-0129
45219-0129
hefnictiQitfnijGon)
hei'nl~ou.curn Erlanger,
Erlanger, Kentucky
Kentucky 41018
41018 (606) 341-6050
341-6050
(606) 341-6950 (fax)
(606)
William
William P.
P. Sheehan
Sheehan (614) 466-3206
466·3206
1673 Braintree
1673 Braintree 231·7467
(513) 231-7467
Cincinnati,
Cincinnati, Ohio
Ohio 45255
45255
Richard
Richard Weiland
Weiland 2444 Madison
2444 Madison Road,
Road, #1406
st. Paul
1055 St.
1055 Paul Place
Place Cincinnati, Ohio
45208
Cincinnati,
Cincinnati, Ohio
Ohio 45202 (513) 421-8527 -421-8430
(513)421-8527 - 421-8430
(:513)871-5248
(513) (Home)
871·:5248 (Home)
381-0124 (Fax)
(513)381-0124
(513)
Harry W.
Harry W. Whittaker
Whittaker Gradison &
Gradison & Co.
Co.
2497
2497 Grandin
Grandin Road
Road 580 Walnut
580 Walnut Street
Street
Cincinnati,
Ohio 45208 Cincinnat,
Cincinnat, Ohio 4S202
Ohio 45202
(513) 579-5000
(513) 579-5000
(513) 579-5982 (Fax)
(513) 579-5982 (Fax)
Anson Williams
Alison (213) 850-2685
(213) 850-2685 (Office)
24615 Skyline
24615 Skyline View
View Drive
Drive (213) 657-4861 (Home)
(213)657-4861 (Home)
Malibu,
Malibu, California
California 90265
90265
Dr.
Dr. Paul
Paul Winchell
Winchell
32262 Oakshore
Drive
Westlake Village,
Westlake Village, California
California 91361
91361 (818) 991-5754
(818) 991-5754
Benefiting
Benefiting *• These
These trustees
trustees have
have the
the discretion
discretion as
as to
10 the
the distribution
distribution of
of contributions.
contributions.
Humanity
Humanity
Through
Through ~ ,
Health
Health
)
and
and
- f f.. -_.. MWUJ.VV O
Form 8868
Form 8868 Application for Extension
Application for Extension of
of Time To
To File an
(December
(December 2000) Exempt Organization
Organization Return
Return OMBNo. 1545-1709
OMB No. 1545·1709
Department
Departmenlof the Treasury
the1r'easury
Internal Revenue Service ► File a separate
~ Filea separate appfication
application for
for each
each return.
return.
lnternal Revenue Service
•• IfII you are filing

filing for
for an Automatic
Automatic 3-Month
3-Month Extension,
Extension, complete onfyPart
only Part II and
and check
check this
this box
box > [X] m
are hling
• If you are filing for
foran
an Additionaf
Additional (not
(notautomatic)
automatic) 3-Month
3-Month Extension,
Extension, complete
complete only
only Part
Part IIII(on
(on page
page 22of
ofthis
this form).
form).
Note: Do not complete Part II unless
not complete unless you
you have
have already
already been
been granted
granted an
anautomatic
automatic 3-month
3-month extension
extension ononaapreviously
previouslyfiled
filedForm
Form8868.
8868.
I PPart
a r t I I| Automatic
A u t o m a t i c 3-Month
3 - M o n t h Extensionof
E x t e n s i o n Of Time
Time - Only submit original (no copies needed)
Note:
Note: Form 99O-T
990-T corporations
corporations requesting
requestingananautomatic
automatic6-month
6-month extension
extension - check
- check thisthis
box box
and and complete
complete Part IPart I only
only. D
► □
All other corporations (including
Ail (mcluding Form 990-C filers) must
must use
useForm
Form 7004
7004 to
to request
request anan extension
extension ofof time
time 10
tofile
file income
income tax
returns. Partnerships. REMICs and
and trusts must use Form 8736 to request an extension of of time to file Form 1065, 7056.1066. or 1041.
1041.
Type or Name of Exempt Organization ;er identification
, lEnwJoxer identificatio number
print
print
THE
FOUNDATION fWCE
File by the
Fileby the
due Dale
due dlte lor
lor Number,
Number. street, P.O. box.
street. and room or suite no. If a P.O. box, see
see instructions.
instructions.
filing your
(ding your
3 1 1 STRAIGHT STREET
311 STRAIGHT STREET
return.s..
re-fum. & M
instructions. City, town
instructions.City. town or post office,
oHice. state, and ZIP code.
and ZIP code. For
Foraaforeign
foreignaddress.
address,see
seeinstructions.
instructions.
'•WQôoi
C INCINNATI,
CINCINNATI OH
OH 45219
45219
Check type of return to be

return to be filed
filed (file a separate application for each retum):
return):
CMMWBJ, Off
[Xl Form
Form 990
990 o 990-T (corporation)
Form 990·T (corporation) D Form 4720
4720
o
□ 990-BL
Form 990·BL DI Form 990·1
I 990-T (sec. 401(a) or
or 408(a) trust)
trust) DI Form 5227
I 5227
o
C D Form 990-EZ
Form 990·EZ D Form 990-T (trust other than above)
990·1 (trust D Form 6069
□ 6069
o
□ 990-PF
Form 990·PF D Form 1041·A
1041 A D Form 8870
•• If
If the organization
organization does does not
not have an offtce
office or
or place of business in
in the
the United States,
States, check this
this box ► D □
•• IfIf this is for
for a
a Group
Group ReturnReturn enter the
the organization's four digit Group
Group Exemption Number (GEN) (GEN) .. If
If this is for
for the whole
whole group,
group, check this
this
box ~ D.
► I I. If If itit is lor
lor part of the 0
the group, check this box ► .... I I and
and attach a list with the
the names and EINs
ElNs of all members the the extension
extension will cover.
cover.
1 II request
request an
an automatic
automatic 3·month
3-month (6·month.
(6-month, for
for 99O-T
990-T corporation)
corporation) extension
extension of
of time
time until_-"'A,._,U"'G=->U"-'S!::<..!!T'-_,,1:..:5~._~2_,0<-0"'-"1=--_
until AUGUST 1 5 . 20 0 1 .
to file the
the exempt organization
organization return for the
the organization
organization named above. The extension
extension is for the
the organization's
orqanizauon's return for:
~ [XJ calendar year 22000 0 0 0 or
or
~D tal'. year beginning
tax ., and ending _ .
2 tax year is for

If this tax for less than 12 months, check reason: D Initial return
return D Final return
a D Change in accounting
accounting period
period
3a application is for
If this application for Form 990·BL.
990-BL, 990·PF.
990-PF. 990·T.4720.
990-T. 4720, or 6069.
6069. enter the tentative
tentative tax, less any
any
nonrefundable credits.
nonrefundable credits. See instructions
instructions . $
b this application
If this application is tor
tor Form 990·PF
990-PF or
or 990-1,
990-T, enter any refundable
refundable credits
credits and
and estimated
estimated
tax payments
payments made. Include any any prior year overpayment
overpayment allowed as a a credit . $
c Balance Due.
Balance Due. Subtract
Subtract line 3b
3b from line 3a. Include your payment
payment with this
this form.
form, or,
or, ifif required.
required, deposit with FlD
FTD
coupon or,
coupon required, by
or. if required, by using EFTPS (Electronic Federal Tax Payment System). See instructions
EFTPS(ElectronicFederaITaxPaymentSystem).See instructions $
:!:$:...,_ N / A __
-'N~/_'A~
Signature
S and
ignature a n d Verification
Verification
Under penallies of
Underpenalties ol perjury,
perjury, I declarethal
declare thai lI haveexamined
have examined this
this form,includingaccompanying
form, including accompanying schedulesand
statemenis, andto
and to the
the best
besl 01
ol my
my knowledgeand
knowledge and belief,
belief,
itil is true,correct.and
true, coirect, and complete,
complete,andand that
thai I am authorized to prepare
amauthorized uus form.
preparethis
Signature ► * = = 5 g ^ ^ tJE* Tjfe^ C ' f i ^ pjle_fc

Date... §II..}~"
^ / \ I O (
LHA
LHA For
For Paperwork Reduction Act
Paperwork Reduction Act Notice,
Notice, see instruction
instruction Form 8868 (12-2000)
Form (12-2000)
023eJ'
12·1e·oo
15210430
15210430 758050 23-12053HEI
758050 23-12053HEI 2000.03031 THE
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 23-12051
23-12051
ff
• Form 8868
Form 8868(12-2000) s
(12-2000) \ Page
Page22
• II
If you are filing
filing tor
Note: Only complete
tor an Additional
complete Pan
Additional (not
Part II if
(not automatic)
automatic) 3-Month
you have already
3-Month Extension,
Extension, complete
complete only
only Part
Part II and check this
this box
box ...................... ► m
[XJ
if you already been granted
granted an automatic
automatic 3-month
3-month extension
extension on a previously
previously filed
filed Form
Form 8868-
8868.
• It you are filing for
for an
an Automatic
Automatic 3-Month
3-Monlh Extension,
Extension, complete only Part I (on page 1).
1)
I Part
Part II
II automatic) 3-Month
Additional (not automatic) 3-Month Extension
Extension of Time - Must
Must file Original
Original and One
One Copy.
Copy.
Name of Exempt Organization Employer identification number
Employer identification number
Type oror
print.
print.
THE H
HEIMLICH N S T I T U T E FOUNDATION
E I M L I C H IINSTITUTE FOUNDATION 23-7303161
2 3-7303161
FII, tne
File by the
emended
" ..Iended
Number, street, and room or suite no. If a P,O.
P.O. box, see instructions.
see instructions. For
For IRS use only
date fa
due date
due
'~"ng the
ta 311
3 STRAIGHT
11 S TRAIGHT STREET
return Sea
See City, town or post office,
oHice, state, and ZIP code. For
For a foreign address,
address, see instructions.
see instructions,
instructions.
Instructions.
("INCINNATI
C I N C I N N A T I , OH 45219
45219
Check type of return to
of return to be
be filed
filed (File a separate application for
for each return):
retum):
[X]
E x ] FForm
o r m 9990
90 0
[ Z I ] Form 990-EZ
990·EZ D EZ1 Form 990-T (sec. 401(a)
Form990·T 401(a) or 408(a) trust) DI Form 1041
1 -A
1041-A D! Form 5227
I D| Form 8870
| 8870
D
I I Form 990-BL
990-BL 0
I I Form 990-PF D I I Form990·T
Form 990-T (trust
(trust other
other than
than above) DI Form 4720
I 4720 o
I I Form 6069
6069
STOP: Do
Do not complete Part
not complete Part II if you
you were
were not
not already granted
automatic 3-month
3-month extension
extension on
on aapreviously
previously filed
filed Form
Form 8868.
8868.
• II
II the organization
organization does not
• If this is for
for a Group
Group Return,
not have anan omce
office or ptace
place of
Return, enter the organization's
of business
business in
orqanization's four
in the
the United States,
States, check this
tour digit Group Exemption Number (GEN)
this box
(GEN)
box , , ,.....
. If this is for the whole group, check this >D
n
box Ill>
► D. . II
If it ISlor
is for part
part of the
the group, check this box'"
box ► 0 and attach aa list with the . Ifall
the names and EINs of this is for thethe
members whole
the group,ischeck
extension for. this
tor.
4 I request anan additionat

additional 3-month extension of time until NOVEMBER 15, 15, 22001.
001.
5 For calendar year 2000 2 0 0 0 ,or
. or other tax
tax year beginning _,........- -.-- and ending
ending
6 tax year ISfor
If this tax is for less than 12
12 months,
months, check
check reason:
reason:
"0
O Initial return
return 0 Final return o Change in accounting
accounting period
7 detail why
State in detail why you
you need
need the
the extension
extension
ADDITIONAL TIME IS NEEDED TO
TO GATHER THE
THE INFORMATION NEEDED TO
TO
AND ACCURATE RETURN.
FILE A COMPLETE AND
8a
Sa ItII this application ISfor
thtSapplication is for Form 990-BL,
990·BL. 990-PF, 990·T,4720,
990-T, 4720, or 6069, enter the tentative tax, less any
nonrefundable credits,
nonrefundable credits. See instructions
instructions $
b If this application
application is for
for Form 990-PF,
990·PF, 990-T, 4720, or 6069.
6069. enter any
any refundable credits and estimated
estimated
tax payments made. Include any any prior year
year overpayment allowed as a credit and any
any amount paid
previously
previously with
with Form 8868 .. .'
Form 8868 ..,. , , :::;$ _
c Balance
Balance Due.
Due. Subtract
Subtract line 8b
8b from line 8a.
Sa. Include
Include your payment with this form, or, if required, deposit
deposit with
with FTD
FTD
coupon or,
coupon or, II
if required.
required, by
by using EFTPS
EFTPS (Electronic
(Electronic Federal Tax Payment System),
System). See instructions.
instructions $ N /A
N/A
Signature Verification
Under penalties of perjury, I declare that I have examined this lorm, including accompanying
Underpenalties01 perjury,I declarethat haveexaminedthis lorm,Includmgaccompanyingschedules schedules andstatements,
and slatements,aand
nd 10tothe
thebestof
best ofmy
myknowledge
knowledgeand
andbelief.
beliel,
it is true,
true,correct,and complete, and
correct, and complete, that I am
and Ihat amauthorizedto
authorized toprepare
preparethis
thisform,
form.
Signature ►•"' ^ X ^ ^ S ^ i J e ^ Title ► C U P j ^ Date^ r l/=<<^/KS\

,
\ / ' - Notice to Applicant
Notice Applicant· - To
To Be
Be Completed
Completed by the IRS
IRS
T 3 i J We have approved
approved this application.
application. Please attach this form toto the organization's
organization's return.
I ] We have have not
not approved
approved this
this application.
application. However, wewe have
have granted
granted aa 1O·daygrace
10-day grace period from
from the later of
of the
the date
date Shown
shown below or or the
the due
due
date of the
the organization's
orgamzation's return (including any
any prior extensions).
extensions). This grace period is considered
considered to
lo be
be aa valid
valid extension
extension of
of time
time for
for elections
elections otherwi
otherwi
required to
to be
be made on
on a timely return.
return. Please the organization's
Please attach this form to the organization's return.
D
I I We
We have
have not
not approved
approved this
this application.
application. After considering
considering the
the reasons stated
stated In
in Item
item 7,
7, we
we cannot
cannot grant
grant your request forfor an extonsrcn
extension 01of time
time to
to
file. We
We are
arenot
notgranttng
granting the
the 10-day
10-day grace
grace period,
period.
D
□ cannot consider
We cannot consider this
this application
application because Itit was filed
filed atter
after the
the due
due date
date 01
ol the
the return
return lor
for which
which an extension
extension was
was requested.
requested.
c=JOther
□ Other __
By:.
Director
Director By:-------------:E,X"'(:-::-:-
iJFSslOhl AF'P"-OVED
E X T'~P4$ION APPROVED
Alternate
Alternate Mailing
Mailing Address
Address - Enter
Enler the
the address if you want the
the copy of this application
application for an 3-month extension returned to
an additional Grnonth an address
to an address
different
diHerent than the one entered
the one entered above
above ... ...,
.~. I, ~~, .'■• • ....-,.i
: •• , '!
•... '. '.. ' .. , uJo 1
l....J...J
Name
CLARK,
CLARK SCHAEFER, HACKETT & CO.
SCHAEFER CO.
Type
Type Number and street (include
(Include suite,
suite. room, or apt. no.) Or a P.O. box
box number L!!JDA WfclisROW, HtLD DiRECTOP,
or print
print
105
1 0 5 EAST
E A S T FOURTH
F O U R T H STREET
STREET, SUITE 1500
SUITE 1 500
City or town.
town, province or
or state, and country (including postal or liP
ZIP code)
code)
C INCINNATI,
CINCINNATI 45202-4093
OHIO 45202-4093
023832
1?-16-00
12-16-00 Foim (12-2000)
Form 8868 (12-2000)
· 990 Return of
of Organization Exempt From Income Tax
Tax
OMS ...c 1~5-0047
OMBNo 1S45-0047
Form
Form'
O__
Oep*rtrnentt of
01tn.
990
trie T......
Tiwaury ul)'
Unller sechon 501(C).
Under section 527, or
501(c), 527, or 4947(a)(1)
4947(a)(1) of
benelltlrust
benefit
olthe
trust Dr
Internal Revenue
the Internal
or private
Revenue Code
lounllallon)
private foundation)
Colle (except
(ucept black
black lung
tung 2001
. . Open to
~,Ollan to Public
Public
IntOtNl Revenue Se<vk:e
Intemd Rorvenue Servtca ~► The
The orgamzatlDn
organization may
may have
have to
to use copy 01
use aa copy of this
this retum
return to
tosallsfy
satisfystate
statereportmg
reportingreqUirements
requirements -' ~™ lnspettlOfl,
hlSBBCtlflit -
A For the 2001 calendar
For the calendar year or tax
year,t or tn year perloll beginning
year period beginning and ending
ending
a
B Check II
Ctleclt
oppllc;al:)l
..
nppllcnole. Please C Name of orgamzatlon
PI_ C Name of organization D Employer
Employer Identlflcallon
number
o
□ AcId_
Address
O»noe
Cfl.nge
use lAS
use IRS
labetor
libel or
pnnt or trHE HEIMLICH INSTITUTE FOUNDATION
tTHE 2 3-7303161
23-7303161
□
er
DNeme
□
Name
cI1"'ge
change
Dlnlti Initial
..
typo
typo!
See
Number and
Number and street
street (or
(or PObox
P 0 boxrtIf maills
mail is not
not delIVered
delivered to
to street
street address)
address) I Room/suite
Room/suite E Telephone
Telephone number
number
return
nitum Specific 311 STRAIGHT STREET
Spcgfic: 3 1 1 STRAIGHT STREET ((513)559-2391
513)559-2391
□DAn Firm ..
lnetruc
InslNe
or town,
City or town. state or
or country,
country, and ZIP
ZIP + 44 0
□ Cal>
F Ia:cIJnq rrd10ct [Xl Ao:;tu
c-h[X] Accrual..
□
nsttim
return rjons
tions
□ Amended
OAmendeci
ratum
",tum _ C I N C I N N A T I . OH
bINCINNATI, OH 45219
45219 0=1'11 ....OtJiar t.
OAppllca~on
□ Appllcatjc-n
•> Secllon
Section501
501(c)(3)
(c)(3)organlzallons
organizationsand
and4947(3)(1)
4947(a)(1)nonerempt
nonexemptcharitable
charitabletrults
trusts H and
and II are
are not
not applicable
applicable to
to section
section 527
527 organizations
organizations
pending
pending
must attach
must attach a completed
completed Schedule
Schedule A
A (Form
(Form 9QODr
930 or 990-EI)
990-EZ)
Is thiS
H(a) Is this aa group
group return
return for
for affiliates?
affiliates? o Vel IX]
I No
I Yes I X I Nn
G Web site ~r » N / A
Website N/A Hill) If "Yes,"
H(b) "Yes: enter number
number of
of affiliates
affiliates ►
....
H(c) Are all affiliates Included?
affiliates included? N/A
N / A DVelYes DNa
□ C J N O
J
J Organlzallon
Organization type td»*<rty«) ► [X]
type (dVIck(l'lly-1~ 501(c)(( 3
l~Xl 501(c) 3 0
))<.... Qns.r:rtno)
(in«ftr»i Q 4947(.1)(1)
4947(aWU or nr IDI 527
527 (If "No,"
'No: attach
attach a list)
list)
K Check here
K Check here ~► \Z3 Ifrf the D
the orcanuanen's
gross receipts
receipts are
are normally
normally not
not more
more than
than $25,000
$25,000 The
The Is thiS
H(d) Is this aa separate
separate return
return filed
filed by
byan
anor-
or-
organization need
organizatIOn need not
not file
file aa ranrrn
return wrth
with the
the IRS,
IRS,but
butIIitthe
thBorcanuauon
organization receIVed
received aaForm
Form 990
990Package
Package uanuauon covered
ganization covered by
by aa arOUD Yes [X]
ruling? C Z 1 VIII
group rulma? No
U L I No D
In the
in the mall,
mail, ItA should
shouldfile
fileaareturn
returnwlthoul
withoutfinanCial
financialdata SomeJlates
data Some renulreaa,omplete
statesrequire completereturn
return I Enter 4-dlort
4-digrt GEN
GEN...
► __
M Check'"
Check ► I 0 I rt
rf the
the organization is not
organization IS not rsquued
required to
to attach
attach
L Gross
Gross receipts
receipts Add
Add Imes
lines 6b,
6b, ab,
8b, 9b,
9b, and
and lOb
10b to
to line
line 12
12 ~► 1182,777.
82,777. Sch B (Form
Sch (Form 990,
990, 990-EZ,
99D-EZ, or
or 990-PF)
990·PF)
I PPart
a r t II
1 j Revenue,
R e v e n u e , Expenses.
E x p e n s e s , and
a n d Changes
C h a n g e s in
in Net
N e t Assets
A s s e t s or
or Fund
F u n d Balances
Balances
~~
1 Contnbullons, gJlts,
grants, and SImilar
similar amounts receIVed
amounts received
~" "
a Direct pubhc
public support
support 1a
la 4 3,548.
43.548. ' 0
I~
lb
m b lndnect publiC
Indirect
e Government
c
public support
support
contnouuons (grants)
(grants)
1b
1c
1c o
"
,
"
Total (add lines
d Total Imes 1.1through tc)
1a through 1c) 0
"
(cash$
(cash $ 43 548.
4 3 t, 5 4 8 . noncash$S
noncash )) 1d
id 4 3,548
43,548.
2 2 Program service
Program Includmg government
service revenue including government tees
fees and contracts
contracts (from
(trom Part VII,
VII, line
Ime 93)
93) 2
~ 3 MembershIp dues
Membership dues and
and assessments
assessments 3
m
0 4 Interest on savings
savings and temporary
temporary cash Investments
investments 4
D 5 Dlvldeendsand
Divid nd s a ndinte rest
inte resttram
f romsecu ntiss
secu nties 5 224,920.
4,920
~
Or.
L-
n
6 a Gross rents
rents I 6a
6a I c
0
b Less Ie nlal expen

rental expenses ses Bb
Eb
~
"-.J
(.CI) c Nel rental income
Net Income or or (loss)
(loss) (subtract 6b Irom
(subtract line Gb from line 6a)
6a) 6e
6c
~ 7 other investment
Other Investment incomeIncome (describe
(descnbe ... ► \ 7
GlOSSamount from sate
sale of
of assets other IA) Securities
Secunlies IHIOther
(B) Other ,~ ,
B aa
8 Gross amount fiom assets other (A) >,
~ than mventory
inventory 1 14,309.
114,309. 8a
8a
b Less cost
cost oror other
other baSISand
basis and sales expenses
expenses 1 33,135.
133,135. 8b
8b ,
e
c or (loss)
Gain or (loss) (attach
(attach schedule)
schedule) --18,826.
18,826. 8c
8t ,0
d Net gain or
or (loss)
(loss) (combme
(combine Ime line ac.
8c, columns
columns (A)(A) and (al)
(B)) STMT 1 1 6d
811 --18,826.
18,826.
9 SpeCialevents
acnvmes (attach
(attach schedule)
schedule)
a revenue (not
Gross revenue including S
(not mcludmg $ ot contributions
ot contnbutLOns ,~
reported on
reported on hne 1a)
line 1a) I 9a
9a I ,
gil
b less direct
Less direct expenses
expenses other other than
than fundrarsmq
expenses 9b --
c
c Net mcome
income or or (loss)
(loss) tram
from special
special events
events (subtractlme
(subtract line 9b from
trom line 9a)
9a) 9c
9t
I ,
a
10 a Gross sales of 01 mventory,
inventory, less
less returns
returns and
and allowances
allowances
™Kr
lUi!
-
b less cost
Less cost of goods sold
ot goods SOld 1Db\I.~
10tji IcivbJ
1.,..t: I 'v L:: f}
- iI ,
0
c profit or (loss)
Gross profit (loss) from
Of trorn sales of inventory
mventory (attach
01 (attach schedule)
scheuutej (subtract
(subtract line lOty froIn
10 fro n Ime
line lOa)
10a) Ii{ lOt
10c
0
11
11 revenue (from
Other revenue (from Part VII, Ime 103)
VII. line 103)
...
(0
SE? 1 2 ZCG2
SEP 2{102 9 11
11
12 Total revenue
revenue (add
(add lines 1d.
ld 2 . 3 , 44, 55, 66c 7 Bd 9c 10c and 11)
11)
U)
co 12
12 449,642
9,642 .
13
13
Total
Program services
Program services (Irom
(from line
Ime 44,
44, column
column (B))
(B))
c , 7,3d, 9c, 10c,
...... 13
13 4,573.
4,573.
III
CD
III 14 Management
Management and general general (from
(from Ime
line 44,
44, column
column (C))(C)) 06f)EN;-tfl~
066ENT-UT- 14
14 8,481.
8,481
c::
II
Q.
15 Fundralsmg (from
Fundraising (tram Imeline 44,
44. column
column (0))
(0)) 15
15
'"
w 16
16 Payments to to affiliates (attach schedule)
affiliates (attach schedule) 16
16
17
17 Totll
Total eJpenses
expenses (add(add lines
lines 16
16 and 44 44. column
column (All
(A)) 17 13,054.
13,054
III
18 Excess oro r (defiCit)
(deficit) tor
tor the
the year
yea r (subtract
(su btractIme
line 17
17trom
fromtme
tine 12)
12) 18
18 36,588.
36,588
C;i 19 Nel assels or
Net assets or fund
fund balances
balances at at begmnmg
beginning ot of year (Irom
(Irom Ime
line 73,
73, column
column (All
(A)) 19
19 7791,841.
91^841
Zlll
=3
.:2 20 Other changes
changes In net assets
in net assets or tund balances
01 fund balances (attach
(attach explanatron)
explanation) SEE STATEMENT 22
SEE 20
20 --137,776.
137,776
21 Net assets or
or fund
fund balances
balances at end
end of
of year (combine
(combine lines
Imes 18.19.
1B. 19, and
and 20)
20) 21
21 690,653.
690,653
123001
~r~-k
01 04-02 UiA
LHA For
For Paperwork
Papel"lllork Reduction
Reduction Act
Act Notice,
Notice, see
lee the
the separate instructions!
separate Instrucllonsl Form 990 (2001)..!X
990 (2001) ^ X
15070826 758050 23-12053HEI
15070826 23-12053HEI 2001.06000 THE HEIMLICH INSTITUTE FOUN 23-12051 N'
p
Fom99oc2ooi)
Form 990 (20011 T H E HEIMLICH
THE HEIMLICH I N S T I T U T E FOUNDATION
INSTITUTE 23-7303161
23-7303161 aoe22
Page
[ParUI 'I
f a n i f Statement
Functional of
Functional Expenses
Expenses
All
(4)
mzations must
orqamzanons must complete
organimations and
(4) orqanuauons
complete column
and section
column (AI
(A) Columns
Columns (8),
49471al{ 1) nonexempt
section 4947(a)(1)
(B). (Cl,
(C), and (0)
cnarnable trusts
(D) are requued
trusts but
required for
but optional
tor section
optional tor
section 501(c)(31
for others
others
501(c)(3) and
and
not Include
Do not include amounts
amounts reported
reported onon line (B) Program
Program (e) Management
(C) Management
(AI Tolal
(A) Total (D) Fundr31slng
Fundraising
6b, 8b, 9b, tOb,
6b,Bb,9b, or 76
10b, or 16 of
of Part
PartiI selVlces
services and Qimeral
general
~ ,, ' ,
>"-;
22 Grants allocations {attach
(attach schedule)
schedule) , , , , 0
0
, , ,
cash
casIl %
$ %
noncash S 22
22 " , -,
■■ ,,
o
Specific assistance
23 Specific assistance to
to individuals
indIVIduals (attach
(attach schedule)
schedule) 23
23
rr
24 Benefits
Benefits paid to
to or lor members
orfor members (attach schedule)
(attach schedule) 24
25 Compensation
Compensation of of officers,
directors, etc
etc 25
25 o.
0. 0
O.. o.
0. 0
O..
26 Other salanes
salaries and wages 26
26
Pension plan contnbutiens
27 Pension contributions 27
27
28 Other employee benefits
employee benefits 28
28
29 Payroll
Payroll taxes 29
29
30
3D ProfeSSional fundraising
Professional fundralsmg fees 30
3D
31 Accounllng
Accounting fees 31
31 1 ,551.
1,551. 1,163.
1,163. 3 88.
388.
32 Legal tees 32
32
33 Supplies
Supplies 33
33
34 Telephone
Telephone 34
34
35 Postage and shiPPing
shipping 35
35
36 Occupancy
Occupancy 36
36
37 Equipment
Equipment rental and maintenance
maintenance 37
38 Pnntlng
Printing and publications
publications 38
38
Travel
39 Travel 39
39 7 55.
755. 5 66.
566. 1 89.
189.
40 Conferences, conventions, and meetings
Conferences, conventions, meetings 40
40
41 Interest
Interest 41
41
42 DepreCiation,
Depreciation, depletion,
depletion, etc (attach
(attach schedule)
schedule) 42
42 6 ,959.
6,959. 6 ,959.
6,959.
43 Other expenses
expenses not covered above (Itemize)
covered above (itemize)
a OUTSIDE SERVICES
a OUTSIDE SERVICES 433
43a 1,820.
1,820. 1,365.
1,365. 455.
455.
bMISCELLANEOUS
bMISCELLANEOUS 43b
43b 1,969.
1,969. 1,479.
1,479. 4 90.
490.
c
c 43c
43c
d
d 43d
43d
44
44
e
e
Tot-llunctlO....
Total
!Dial. 10 lines
totals to lines
_sa
function*! expenses (add
Organization* oompl"bng
OrganlzatJon.
lin"" 22
(~d lines
completing ooIutnllS
13-15
22 througll
columns (BHD)
through 43)
(BHD) cany
43)
<:any these
these
438
43a
44 1 3,054.
13,054. 4,573.
4,573. 8,481.
8,481. o.
0.
Joint Costs Check'"
JDlnt Costs Check Drt rt you
you arefollowing SOP 98-2
fOllOWIngSOP 98-2
any joint
Are any 10lnt costs
costs from
from a combined
combined educational
campaign and
and fundraising
lundralsmg solicitation
sonotauon reported
reported in (B) Program
In (B) services?7
Program services ...D
► □ v eVes
s Q D NNo
O 00
It "Yes;
it "Yes." enter (I)
(I) the aggregate amount
the aggregate amount of
01these JOintcosts
these joint S
costs $ ,,III)
(ii) the
the amount
amount allocated
allocated to
to Program
Program services
services $$_ _
(hll I the
the amounl
amount allocated
allocated 10
to Manaaement
Management and general SS
and aeneral , and
and[lvllhe
(Iv) theamount
amountatlocated
allocated10
toFundralslna
FundraisingSS
I Part 1111
Part IH Statement of Program
Statement Program Service
Accomplishments
What IS
What the organlzallOn's
is the pnmary exempt
organization's pnmary purpose' iii>
exempt purpose? ► SEE SEE STATEMENT
STATEMENT 3
3
Program Service
Pro~am Service
Expenses
l!laMes
All organlza~ons
organizations musl
must describe th""
their .. empl pUrpoMechl
exempt .. emenlllin
purpose achievements in _ and oondse
a clear ""d concise """,ner
manner Sllole the number
State the number 01 of Cllenlll.. ,,,,,, publlcanons
clients served publications ISSUect, etc Discuss
issued, etc. Discuss {Requll'lldtor
(Required 501(c)(3) ....d
1015D1(clI'3land
..aJ1... emenllllnal
achievements that ""'
are nollT'le8Sulllbl.($«:lIon
not measurable (Section 501rcJ(3)
501fc)r3) .and (4) oogoonlze~ons
.,., (41 oiyanizabons IIIld 4947(a)(1) nonexempl
and 4947(a)(11 rwnexempt cchantable trusts musl
hltt1t1b1. trusts also enler
must "'SO me ....,unl
enter th" amount 01g .... ts and
cl grants an(! (4) orgs and 4947(8)(1)
(~I0",," 4347(a)(1)
allocations to others)
"'Ioc:abom to .,.,1
trusts But optional
opUonlllfor
lor othen
others )
a THE
THE HEIMLICH INSTITUTE FOUNDATION,
FOUNDATION, INC.
INC. IS IS A A CORPORATION
CORPORATION
DESIGNED TO
TO CONDUCT SCIENTIFIC, CULTURAL AND
AND SOCIAL RESEARCH
RESEARCH
INTO ISSUES OF
INTO ISSUES OF IMPORTANCE TO
TO THE
THE MEDICAL AND AND SCIENTIFIC
COMMUNITIES.
COMMUNITIES, (Grants and
(Grants allocations St
and allocations ) 1,373.
1,373,
bAlDS
b AIDS RESEARCH AND
AND EDUCATION
IGrants and
(Grants and allocations S
allocations $ )_ 2,057,
2,057.
c EDUCATION OF
c OF THE
THE GENERAL
GENERAL PUBLIC, THE PRINTING AND
PUBLIC, THE AND
DISTRIBUTION OF EDUCATION LITERATURE
DISTRIBUTION OF EDUCATION LITERATURE TO
TO PUBLIC
PUBLIC PLACES
PLACES
ABOUT THE
MANEUVER.
IGrants and
allocations $ ) 1,143
1,143.
d
(Grants and
JGrants and allocations
allocations $ )
e Other program
e program services
services (attach
(attach schedule)
allocations S
$ )
ff Tolal
Total 01Program
of Program Service
Service Elpenses
Expenses (should
(should equal
equal line 44,
44, column
column (6),
(B), Program
Program seTVl~s)
services) .... 4 ,573
4,573.
6~~-k
123011
01-O2-O2 2
2 Form
Form 990 (2001)
990 (2001)
15070826 758050
758050 23-12053HEI 2001.06000 THE HEIMLICH INSTITUTE FOUN 23-12051
Farm 990 (2001 )
Form990(2001) THE HEIMLICH
23-7303161 PPage
age33
Ipar11~I
Part iV 1 Baiance
Balance Sheets
Sheets
Note Where
Note Whererequired,
reqUIred,attached scneoutes and
attached schedules and amounts
amounts within
wlthrn the oescnotion column
the description column IAI
(A) (8)
(B)
should be
should for end-of-year
be for enCi-of-yearamounts onfy
amounts onty Belllnnlng of
Beginning of year
year End of
End at year
year
45
45 Cash-- non-mterest-beanng
Cash non-mtarast-beannq 77,91!.
,911. 45
45 111,183.
1,183.
46
46 Savings and
Savings and temporary
temporary cash
cash investments
Investments 115,761.
5,761. 46
46 336,366.
6,366.
47 aI Accounts
47 Accounts receivable
recervable 471
47a
bb Less
Less allowance
allowance tor
lor doubtful
doubtful accounts
accounts 47b
47b 47c
47c
48 Pledges receivable
481a Pledges recervable 481
48a
Less allowance
bb Less allowa nee for
for doubtful
d oubtfu I accounts
accou nts 48b
48b 46c
48c
49
Grants receIVable 49
49
50
50 Recervables from officers,
trustees,
-
~
CD
~
~
51
and key
and
51 a1 Other
bb Less
key employees
employees
Other notes
notes and
and loans
less allowance
allowance for
loans receivable
recervable
for doubtful
doubtful accounts
accounts
I 51a
511 I
51b
51b
50
SO
51c
51C
52
52 Inventones tor
Inventories tor sale
sale or
or use
use 52
52
153 Prepaid
53 Prepaid expenses
expenses andand deferred
deferred charges
charges 53
53
54
54 Investments - securmes
Investments - securities .... IDCost
► I Cost OFMV
I I FMV 54
54
55 aa Investments
55 Investments --tanc, bUildings, and
land, buildings, and
equipment bass
equipment basis 55a
553
bb Less accumulated
cepreceuon 55b
55b 55c
55e
56
56 Investments -- other
Investments other S E E STATEMENT 4
SE1ESTATEMENT 4 7754,102.
54,102. 56
56 6636,459.
36,459.
57 a land, bUildings,
57 a Land, buildings, andand equipment
equipment basis
baSIS 5721 I
57a 55,616.
5 5 , 6 16.
less accumulated ceoreceucn
bb Less accumulated depreciation 57b
57b 55,616.
5 5 , 6 16. 66,959.
,959. 57c
57c
58
58 Other assets
(cescnoe ► .... SEE STATEMENT 55 ))
S E E STATEMENT 77,11108.
08. 58
58 66,645.
,645.
59
59 Tolal assets
Total assets (add
(add lines
Imes 45
45 throuqh
through 58)
58) (must
(must eaual
equal line
line 74) 7791,841.
91,841. 59
59 6690,653.
90,653.
60
60 Accounts payable
Accounts payable and and accrued
accrued expenses
expenses 60
6D
61 Grants payable 61
»
!
♦*
.E
.13
62
63
Deferred revenue
loans from
Loans trom officers,
trustees, and key employees
employees
62
63
III
a 64 I
a Tax-exempt bond habllrtles
liabilities 64a
6421
_.:i
i
b Mortgages
Mo rtgages and otherotne r notes payable 64b
65 Other liabilities (describe
(dsscnbe ► .... )) 65
66 Tolaillabillties
Total liabilities (add lines
hnes 60 throuqh
throucn 65) o.
O. 66 O
0..
Organizations that
Organizations that follow
follow SFAS117,
SFAS 117, check
check here
here ■*■
... 00 and
and complete
complete lines
Imes 67
67 through
Ih rough
69 and lines
11I18S 73 and 74
74
C
'"
CD
u
c::
67 Unrestncted
Unrestricted 7752,922.
52,922. 67 6651,734.
51,734.
I'll
eg 68 Temporanly restricted
Temporarily restncted 68
68
"iii
n
1:11 69 Permanently restricted
restricted 338
81, 9919.
19. 69 338,919.
8,919.
m
"cc:: Organilatlolllthat
Organizations that do not follow
follow SFAS
SFAS 117,
117, check here ► .... D and complete
complete lines
..
::::I
LL.
LL
70 through
tn rough 74
-
~
0
O
•IUII
in
ID
c.
UI
70 Capital stock
70
71
72
Pald-m
Paid-in
Retained
stock trust
or
trust pnncipal,
capital
eammgs,
nnncipar, or current
surplus,
surplus, or
endowment,
current lunds
land
funds
building, and equipment
bUilding,
accumulated
Retained earnings, endowment, accumulated income,
equipment fund
income. or
fund
other funds
funds
70
7D
71
72
<
-; 73
Z
Z Total net assets
Total assels or fund balances
balances (add lines
Imes 67 through
through 69 OR
OR lines 70 through
through 72,
column (A) must equal line
column hne 19, column
column (B)
(8) must
must equal
equatllne
line 21) 7791,841.
9 1 , 8 4 1 . 73 6 90,653.
690,653.
74
74 Tolal liabilities
Total lIablhhes and net assets
assets /I fund
fund balances
balaneel (add lines 66i and
ines 6( and 73)
73) 9 1 l,841.
7791 8 4 1 . 74
Jot 690,653.
6 90,653.
Form 990 isIS available for public
public inspection
inspection and, tor some people,
people, serves as the pnmary
pnmary or sole
sale source
source of
01 information
mtormanon about a particular
parllcular organization
organization How the public
publiC
perceives
percerves an organization
organization inm such cases may be determined
determmed by the information
mtormalJon presented on its
rts return
return Therefore,
Therefore, please make sure the return is
IS complete
complete and accurate
accurate
and fully desenbes,
descnbes, inIn Part III,
III, the organization's
programs and accomplishments
accomplishments
123021
123Q21
01-02-02
01-02-0? 3
3
15070826 758050
990(2001)
Form 990
Form {2001} THE HEIMLICH INST ITUTE FOUN DATION
THE HEIMLICH INSTITUTE FOUNDATION 223
3 --77303161
303161 Page
Page 4
IPart iV-A
Part IW-AI Reconciliation
Reconciliation of of Revenue
Revenue perper Audited Reconciliation of
IV-8 Reconciliation
Part IV-B
Part 1 Expensesper
01 Expenses per Audited
financial Statements
Financial Statements w with Revenue per
i t h Revenue per Financial Statements
Financial Statements With With Expenses
Expenses perper
Return
Return Return
Return _ _
~, -
• Total revenue,
a Total revenue, gains,
1M! r audited
per
gains, and olhBr
aud Ited financial
oUler support
statements
support
.... I N/A
N / A
Total expenses
a Total expenses and and losses
lossesper
nnancut statements
3udrte<l financial
audited statements
per
ill N/A
N/A
,
...
Amounts included
bb Amounts mclud ed on on line
line aa but
but no)
not on
on "
b Amounts Included on Ime
b Amounts included on line a but not ona but not on ~ ~ 17.Form
line 17,
line Form 990
990 "
12,Form
line 12,
line Form 990990 ,
, ,
,,'
,:
-
Net unrealized
(1) Net
(1) unrealized gains
gams
-
~,
'~ ,
(')
(1) Donated
Donated
and use
and use of
services
services
of facilities
facllrtles iS
,
"
h
h
,
on investments
on Investments $S , ~ v
Pnor year
(2) Prior
(2) year adjustments
admstrnents -
(2) Donated
(2) Donated services
services - reported on
Ime 20,
and use
and 01facilities
use ol facilities $S , , Form 990
Form 990 S$ .
(3) Recoveries
(3) Recove nes olof prior
pnor ,
(3) Losses
(3) losses reported
reported on
on ,
,
year grants
year grants $S line 20,
20, Form 990
Form 990 S , ...~
~..
line S ,,
~ ~, '-
(4) Other
(4) Other (specify)
{specify} Other (specify)
(41 Other
(4) (specify) , c
,
$S ~ ~
, v , $S c
Add amounts
Add amounts on on lines (1) through
(4) .... b Add amounts
Add amounts on on tines (1) through
(4) .... b
cc Line
Line a minus line
I minus line bb .... e ce line aa minus
Line minus line
line bb .... e
Amounts included
Included on on line 12,Form
Ime 12, Form
v
Amounts included
Included online
on line 17,
17, Form
Form
,
dd Amounts dd < ,
990 but
990 but not
not on
on line
Ime aa , - - ,
Amounts
990 but
990 but not
not on
on line
Ime aa "
(1) Investment
expenses
""
,
, ..... «:_.:-".......:-y..- ....
,
(1) Investment
expenses
- 0
,,
, n ........ :.. ~
~- ,>
not included
not Included on
on , not included
not Included on
on , -~ - >
line se, Form

hne 6b, 990 $S
Form 990 line 6b,
line 6b, Form 990
Form 990 $S .
(2) Other
(2) Other (specify)
(speCIfy) (2) Other
(2) Other (specify)
(specrty) -
,
$S ~ IS ~
Add amounts
amounts onon tines (1) and
tines (i) and (2)
(2) ....
-d ,
Add amounts
Add amounts on on lines
lines (1)
(1) and
and (2)
(2) ... d
"
Add
Total revenue per line
eII Total 12, Form
~ne 12, Form 990 ee expenses per line
Total expenses Form 990
Ime 17, Form 990
(hne cc plus
(line plus line
line d)
d) e... (Ime ce plus
(line plus line
Ime d)
e d) ....
IPart
Part VVI List of
List of Officers,
Trustees, and
and Key
Key Employees
Employees (List (list each
each one even
evenIfifnot
notcompensated)
compensated)
(8) Title
(B) Title and
and average hours (C)
average hours (e) Compensation
Compensation 1% (~Contrtbunon. to
Contributions to (E)Expense
(E) Expense
_ iployw B*n«flt account
account and
and
(A) Name
(A) Name and
and address
address per week
per week devoted
devoted toto (II
(II not
n01 paid,
~H.I~,enter
enter pl:,I~~:=t
plans & deferred
position
nosmen compernaticn
com~'Saban other
othe, allowances
allowances
SEE ATTACHMENT
SEE ATTACHMENT CC
---------------------------------
--------------------------------- 0o.
. o. o.
O
------------_--------------------
-------~-------------------------
--------------------------~~-----
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
-------------------------~-------
----------------------~----------
---------------------------------
--------------------------~------
-------~-------------------------
---------------------------------
---------------------------------
---------------------------------
l?
9
---------~~-----~~---------------
o
;;; ni Did
75 Old any
any officer,
officer, director,
director, trustee,
trustee, or
or key
key employee
employee receIVe
recerve aggregate
compensation of of more than $100,000
more than $100,000 tram
from your
your ~mzallon
organization and
and all
all related
related
~ organIZations, of which
organizations, wInch more
more than '10 000
than $10 000 was
was provided
proVIded by the related
related organizations? "Yes: attach
organizations? II "Yes," attach schedule
schedule ....
► L_j Yet [Xl
I I Yes l~X] ND
No Form 990
Form (2001)
990(2001)
Form990(2001)
Fonn 990 (2001 ~ THE H EIMLICH
HEIMLICH IINSTITUTE
FOUNDATION 2 3-7303161
23-7303161 Page 5
IPart VII Other Information
VI Other Information Yes No
76 Did
Old the oruanzatron engage
the organization engage in
In any activity
actMty not
not previously
prevIOusly reported
reported to
to the
the IRS
9
IRS? It "Yes,"
"Yes; attach
attach a detailed dascnpncn of each actIVIty
detailed description activity 76
76 X
77 Were
Were any
any changes in the organrzmg
changes made In organizing or governing
governing documents
documents but
but not reported 10
not reported to the IRS 7
the IRS? n
77 X
If "Yes," attach aa contonned
"Yes; attach conformed copy
copy of
of the
the changes
changes -~ --
-- -< < -■O V
y
78 a Did the organrzatlon

Old the unrelated busmess
organization have unrelated business gross
gross Income
income of $1
$1,000 more dunng
,000 or more dunng the
the year
year covered
covered by thIS
this return?
return? 76a
78a X
b If "Yes;
"Yes," has
has Itit filed
filed a tax
tax return on Form
return on Form 990-T for trus
990-T for this year?
year? N /A
N/A 78b
78b
79 Was
Was thore
there a liquidation,
liqUidation, dissolution, terrmnanon, or substantal
dissolution, termination, substantial contracnen
contraction dunng
dunng the
the year?
yeaJ? 79 X
, c
"Yes; attach
If "Yes," attach a statement
statement
80 a Is the
the organizatIOn
organization related (other
(other than
than by assocanon with
by association WTthaa statewide
stateWide or
or nationwide
nationWide organization)
organlzallon) through
through common membe rship.
common membership, ................
governing
gove m Ing bodies, trustees, office
bodies, trustees, rs, etc,
officers, etc, to
to any
any other
othe r exempt
exempt or
or nonexempt organization?
nonexempt orga mzatlon? 80a
80a X
b "Yes," enter
If "Yes; enterthe name 01
the name of the
the organization
organization ..► \
and
and chBck
check whBther
whether rt
It is
IS DT
[Zl exempt
e~empt OR
OR D nonexempt
nonexempt
\r i
81 a direct or merreet
Enter direct indirect political
expenditures See line
line 81 Instructions
instructions 1a! I
881a 0
0..
b Old
Did the
the organlzallon
organization file
file Form
Form 1120-POL
1120-POL for
for ttus
this yea r'
year? 81b
8lb X
82 a
I Did the organizatIOn
Old the organization receIVe
receive donated
donated services
services or the
the use of matenals,
matenals, equipment,
equipment, or tlcllll.les
facilities at no
no charge
charge or at substantially
less than
fair rental
fair rental value?
value? 82a
823 X
b "Yes," you
If "Yes; you may
may mdlCate
indicate the
the value
value of
of these
these Items
items here
here Do
Do not
not mclude
include llus
this amount
amount as
as revenue
revenue In
in Part
Part II or a ian
or aTsan I . ,
I- ,
:
expense in
expense m Part IIII (See instructions
mstructlons in Part III
10 Part III)) 82b I
._82=b:....L.. 6 3 , 8 2 3 .-t
63,823.
...L.__
"
83 a Did the organlzallon
Old the organization comply
comply wllh
with the
the public
public inspection
inspection requirements for returns
requirements for returns and
and exsmptlon applications •>
exemption appllcallons? 83a
83a X
b Old
Did the
the organrzatlOn
organization comply
comply WTththe
with the disclosure
relating to
to quKl
quid pro quo contntenons?
pro quo contributions? 83b
83b X
84 a Did
Old the
the organization
organization solicit
solicit any eentnbunens
contnbutions or gifts
gifts that
that were
were not
not tax
tax deducllble?
deductible? 84a
84a Xx
b If "Yes;
"Yes," did
did the
the organlzallon include W1tl1
organization mclude with every
every solicitation
solicitation an
an express
express statement
statement that
that such
suchcontnbullons
contnbutions or
or grfts
grits were
were not
not
" ' ^L
tax deductible?
tax deductible? N
N/A /A 84b
84b
85 501(c)(4), (5), or (6)
S01(c)(4), organizations a Were substantially
(6) organIZatIons substantially all dues
dues nondeductible by members'
nondeductible by members? N/A
N/A 85a
853
b Old
Did the
the organrzatlon
organization mah
make only
only in-neuse
in-house lobbymg
$2,000 or
or less?
less? N/A
N/A 85b
L
If "Yes"
"Yes' was
was answered
answered to
to either 85a or
eltrm85a or 65b,
B5b, do
do not
not complete
complete 85c
B5c through
through 85h
85h below unless the orqamzanon
below unless organizatior receiv
received waner lor
ed a waIVer for proxy
proxy tax
owed forr the pnn
owed fo pnorr year
--
Dues, assessments, and
and Similar
simitar amounts
amounts from
from members
members 65c
85c N
N/A /A
d secncn
Section 162(e)
162(e) lobbymg
lobbying and
and political
expenditures 85d
85d N/A
N/A '
B Aggregate
a Aggregate nondeductible
nondeductible amount
amount of section
section 6033(e)(1 )(A) dues
6033(e)(1)(A) dues notices
notices 85e
858 N
N/A /A
f
1Taxable amount of
Taxable of lobbymg
lobbying andand political
expenditures (line
(line 85d
85d less
less 85e)
85e) 65)
85f N/A
N/A ..
gg Does the
the orgamzatlon
organization elect
elect to
to pay the
the section
section 6033(e)
6033(e) tax
tax onon the
the amount
amount In in 85t?
85f? N
N/A /A 85q
850
h If sectmn
section 6033(e)(1 HA) dues
6033(e)(1)(A) dues notices
notices were
were senl,
sent, does
does the
the orgamzatlOn
organization agree
agree to
to add
add the
the amount
amount In
in 85110
85f to Its
its reasonable esti nateofdues
reasonable estimate of dues
allocable to
lobbying and sxpendnures for
and political for the
the following tax year?
follOWing tax year? N / AA
N/ 85h
86
86 SOl(c)(7)
501 organIZations Enter a Initiation
(c)(7) organizations Initiation fees
fees and capital contnbunons
and capital contnbutions Included
included on
on fine
line 12 86a
86a N / AA
N/ "
b Gross
Gross receipts,
receipts, Included
included on
on Ilnli
line 12,
12, for
for public
public use
use of
of club
club faCilities
facilities 86b
86b N
N// AA
87
87 501(c)(12) organizations Enter a Gross
SOl(c)(12) organIZatIons Gross Income
income from
from members
members or shareholders
shareholders 87a
87a N
N// A
A ■■
..
b Gross
Gross Income
income Irom
from other
other sources
sources (Do
(Do not
not net
net amounts
amounts due
due or
or paid
paid to
to other
other sources
sources
against amounts due
agamst amounts due or recewed
received from
from them
them ) 87b
L8=:;7:..:b:....L N/A
--=Nc.:....:..../..:.A-=---_--I~
88
68 At any
At any lime
time dunnllthe
dunng the year,
yeai, did
did the organization
organization own
own a 50% or greater mterest
50% orgreater interest m
in a taxable
taxable corporation
corporation or ppartnership,
artnership,
or
or an entity
entity disregarded
disregarded as separate
separate from
from the
the organization
organization undar
under Regulations
sections 301
301 7701-2
7701-2 and 301 7701-3?
and 301 7701-3?
If "Yes,'
"Yes," complete
complete Part IX 68
88 X
89 a 501(c)(3)
69 SOl(c)(3) organizations
organIzations Enter
section
section 4911 II-
4911 ►
b S01(c)(3)and
501(c)(3) and 501
501(c)(4)
Amount ottax
Enter Amount
organizations Old
(c)(4)organIZatIons Did the
°.
of tax Imposed on the
imposed on the organization
organization dunng
0 . ..section
section 4912
the orqannanon
II-
4912 ►
organization engage
engage In
dunng the
the year
any seenon
in any
year under
section 4958
under
4958 excess
excess benefit
benefit
°. section 4955 II-
0 . ,.section4955 ► 0.
_;O=-=-.
-
transaction
transaction dunng
dunng the year
year or did It
or did it become
become aware
aware of
of an
an excess
excess benefit
benefit transaction
transaction from
from aa pnor year?
pnor year?
II "Yes." attach
II"Yes; attach aa statement
statement explammg
explaining each
each transaction
transaction 69b
8gb X
Enter Amount
cEnter Amounl of taxtax Imposed
imposed on the organization
managers or disqualified
persons dunng
dunng the
the year under
under
sections
sections 4912,4955,
4912,4955, and 4958
and 4958 ... 0
----:0;:--.
dd Enter Amount
Amount of taxtax on line 89c,
89c, above, reimbursed by the orqaruzanon
above, reimbursed organization .. 0.
---'0:.....:....
.. ---'O;....;H=I;....;O;;...._ -.-_-.-
90 a List
List Ihe states with
the states wllh which
Number of employees
b Number
which a copy
employees employed
copy of this
employed In
thiS return
return is
IS filed
in the pay penod
filed ►
period that
that mcludes
OHIO
includes March
March 12,2001
12,2001 I 90b
90b I ~~0 °=_
91
91 The books are Inin care
books are careofof II-THE
► THE HEIMLICH
FOUNDATION Telephonenono II-
Telephone ► ( 5 1 3 )559
(513) 5 5 9-2391
-2391
Locatedat^
Located at II- 3 11
311 STRAIGHT S
STRAIGHT TREET
STREET C INCINNATI,
CINCINNATI, OHIO
OHIO ZIP +
+ 44 II-
►..::.4.=;..5.,;::2,-=1:...:09
4 5 2 1 9 _ _ _ __
92 Section 4947(a)(1)
SectIon 4947(9)(1) nonexempt
chantable trusts filing Form
Form 990 in
In lieu of Form
lIeu of Form 1041-
1041 - Check
Check here
here ► □
and enter
enter the amount
tax-exempt interest
interest received
recerved or accrued
accrued dunng
dunng the
Ihe tax
tax year ... 92
92 N/A
123041
01-02-02
Ol-lJ2-tt1: Form 990(2001)
Form 990 (2001)
- Form990(2001)
23-7303161 PPage
age66
IPPart:llil
art VII I A
AnalysIs
nalysis of
of IIncome-Producing
ncome-Producing A
Activities
c t i v i t i e s (See
(See Specific
Specific instructions
Instructions on
on page 32)
page 32)
Note Enter
Note Enter gross
gross amounts
amounts unless
unless otherwise Unrelated business
Income ucluded oy
Excluded r71section
MC1>On 512
512 513
513 or
or514
514
(E)
(E)
mdlcated
indicated (A)
(A) (BI
(B) (e)
(C) (D)
(D)
Business
Business EU<:iu-
lu Related or
Related or exempt
exempt
Amount
Amount sion
sIon Amount
Amount
93 servee revenue
Program service
93 Program revenue code
code code ...- function mcorne
function income
aa
bb
cc
dd
B
B
1I Medicare/Medicaid
MedlcarelMedlcald payments
gg Fees
Feesand contracts from
and contracts from government
govemment agencies
agenCies
Membe~hlp dues
94 Membership
94 dues and
and assessments
assessments
Interest on
95 Interest
95 on savings
savmgs and
and temporary
temporary
cash investments
cash Investments
DMdends and
96 Dividends
96 interest from
and interest secermes
from securities 14
14 224,920.
4,920.
v
-,
y
Net rental
97 Net
97 rental income
Income or
or (loss)
(loss) from
fro m real
real estate
estate
aa debt-financed
bb not
not debt-financed
property
98 Net
96 Net rental
rental income
Income or
or (loss)
(loss) Irom
Irom personal
personal property
property
Other investment
99 Other
99 Investment income
Income
Gamor
100 Gam
100 0 r (loss)
(loss) from
tram sales
sales of
of assets
assets
other than
other than inventory
Inventory 18
18 --18,826.
18,826.
Net income
101 Net
101 Income or
or (loss)
(loss) from
from special
special events
events
Gross profit
102 Gross
102 profit or
ar (loss)
(loss) from
from sales
sales of
at inventory
Inventory
Other revenue
103 Other
103 revenue
aa
bb
cc
dd
ee
Subtotal (add
104 Subtotal
104 (add columns
columns (B).
(8), (D). and (E))
(D), and (E» o•
O. 66,094.
,094. O.
O.
105
105 Total
To1ll (add
(add line
Ime 104,
104, columns
columns (B),(D).
(8), (D), and
and (E))
(E)) ..
► ___,;6'-','-O;.....;9;.....;4~.
6,094 .
LJ ne 105
Nole Line
Nole p /u s line
105 plus 1d, Part
Ime Id, Poart,sou
I,I should
h Id equalequ aJ theth e amount
amount onon line 12, Part
me 12, Part I
Part VI
LPart Villi
| Relationship
R e l a t i o n s h i p of
of Activities
A c t i v i t i e s ttoo the
t h e Accomplishment
A c c o m p l i s h m e n t of
of Exempt
E x e m p t Purposes
P u r p o s e s (See Spectfic
Instructions on page 32)
32)
No
Line No Explam how
Explain how each
each activity
actIVIty tor
tor which
whICh income
Income is reported in
IS reported In column
column (E)
(E) of
ot Part
Part VII contnbuted importantly
VII contributed Importantly to
to the
the accomplishment
accomplishment of
of the
the organization's
orqanuanon's
T ... exempt purposes
exempt purposes (other
(other than
than by
by providing
prOViding funds
funds tor
for such
SUChpurposes)
purposes)
N/A
~/A
IPPart X I IInformation
a r t IIX nformation R egarding T
Regarding axable S
Taxable u b s i d i a r i e s aand
SubSidiaries nd D isregarded E
Disregarded n t i t i e s (See Specific instructions
Entities Instructions on page 33)
33 )
(AI
(A) (III Ie)
(C) (D)
(D) (~
Name address,
Name address, and
and EIN
EIN of
of corporation
corporation Percentalle of
Percentage ot Natu re of
Nature of activities
actMtl9S T otat income
Total mcorne End-of-year
End-o -year
_partnershiP, or disreqarded
partnership, or dlSreaarded entity
entrtv ownership interest
ownership Inlerest assets
assets
%
%
N/A
N /A %
%
%
%
%
%
IPParta r t XX "i IInformation
nformation R egarding T
Regarding ransfers A
Transfers ssociated w
ASSOCiated ith P
With ersonal B
Personal enefit C
Benefit o n t r a c t s (See Specific instructions
ContractsJSee Instructions on page 33))
paoe 33
(a) Did
Old the organization,
organization, during
durmg the year, receive
recerve any funds,
funds, directly
directly or Indlreclly,
indirectly, to
to pay premiums
premiums on on aa personal
personal benefit
benefitcontract?
contract? Dve.
I I Yes [X]
I X I No
No
(b) Did
0 dunng the year, pay premiums, directly or indirectly, on a personal
personal benefit
benefit contract?
contract' o Vel
I I Ye* [X]
I X I No
No
OMBNo
OMeNa 1S4S-0M7
SCHEDULE
SCHEDULE A
A Organization
Organization Exempt
Exempt Under
Under Section
Section 501(c)(3)
501(c)(3) 1~~7
(Form 900
(Form or 990-EZ)
~90 or 99O-EZ) (ucept Private
(Except Private Foundation)
Found all on) and
and Section 501 (e), 501(1),
Section 501(e), 501(h),
501 (1),501 (k),
D~tot~T~y~
Department
In_
ot me Treasury
Revenue $eno,.. ^... MUST
501(n),
501
be completed
MUST be
(n), or
completed by
or Section
by Ihe
Section 4947(1)(1)
Supplementary lnformation-{See
Supplementary
theabove
4947(a)(1) Nonelempl
aboveorgamzatlons
Noneiempt Charitable
Informatlon-(See separate
organizations and
Charitable Trust
andattached
attachedtototheir
Trust
separate instructions.)
mstrucnons.)
theirForm
Form990
990
oror 990-EZ
99D·EZ
2001
of the
Name of
Name the org anuanen
organization Emp layer identification
Employer Id enllfl cation number
nu mb er
THE HEIMLICH
INSTITUTE FOUNDATION 223 3 7303161
7303161
Compensation of
Part 1 1 Compensation of the
the Five
Five Highest
Highest Paid Paid Employees
Employees Other Other Than Than Officers,
Directors, and and Trustees
(See page 11cttne
(See page ot the instructionsListList
mstrucnons each
each oneone If there
Ifthere are are
nonenone,
enterenter'None')
-None ')
'bl Title
(b) TItle and
and average
average hours
hours (d)
(d) Coritnbubon*
ContnbuDon.to to (e)Expense
(e) Expense
(a)
Name and addressofofeach
eachemployee
employeepaid paid ,._,per
per week
week devoted
devoted to
to (c)
(e) Compensation
Compensation employee benefit
omplo)'ee beneftt account
account and other
and other
plan* & deferred
more
more than $50,000
than $SO,OOO position
position ':"~:.~
oompen matron allowances
allowances
NONE
NONE
----------------------------------
----------------------------------
----------------------------------
----------------------------------
----------------------------------
Total number of
Total number of othe
otherr employees
employees paid
paid
over
over $50 000
S50 000 ►
... 0 '
IPart
Part IInl Compensation of
Compensation of the Five
Five Highest Paid
Paid Indepe
Independent or Profession:
Contractors ffor
ndent Contractors at Services
Professional
{See page 2 of the Instructions List each one (whether mdlVlduals or firms) If there are none, enter "None")
(a) Name and

(a) Name andaddress
addressofofeach
eachIndependent
independentcontractor
contractorpaid
paidmore
more than
than S50$50
000000 (b)
(bl Type
Type of service
service (c) Compensation
(e) Compensation
NONE
Total number ofof others

Total number others receIVing
receiving over
over
$50,000 for protessional
S50,OOOtor professionalservices
se rvices ... ► 1 o
0 '
LHA
LHA For Paperwork
Paperwork RerJucllcn Act Nollte,
Reduction Att Notice,see
teethe
theInstructions
Instructionslor
lorForm
Form990
990andandForm
Form99D-EZ
990-EZ ScheduleAA (Form
Schedule (Form990
990Dror990·EZ)
990-EZ)2001
2001
123101
123101
12-n.c1
12-29-01 7
15070826 758050 23-12053HEI
15070826 2001.06000 THE HEIMLICH INSTITUTE FOUN 23-12051
Schedule THE
A (Form 990 or 990-EZ) 2001
ScheduleA(FOrm9g00r9g0-EZ}2001 T H E HEIMLICH
FOUNDATION 2 3-
2 3 730
- 7 3 033161
161 Page2
Page 2
IPart-IB
Parl'ln I Statements About Activities
Activities (See page22ofotthetheinstructions)
(See page instructions) Yes No
1 Dunng
During the
the year, has
has the
the organization
attempted to
to InHuence
influence national,
national, state,
state, or
or local
local legislation,
including any
any attempt
attempt 10
to Influence
influence
public opuuon
public opinion on a legislatIVe matter or referendum''
legislative matter referendum? If "Yes,"
"Yes: enter
enter the
the total
total expenses
expenses paid
paid or
or Incurred in connection
incurred In connection with
with the
the
lobbying actrvrtes ►
lobbying actlVltes .... $
$ s
$ (Musl equal amounts
(Must equal amount* on line
line 38, Part VI-A,
38. Par1 Vl-A,
Dr line
or line Ii 01
ol Part VI,B
VI-B ) 1 X
Y h
OrganizatIOns that made an election

Organizations election under
under section 501 (h) by
section 501(h) by filing
filing Form
Form 5768 must complete
5768 must VI-A Other orqanuanons
complete Part Vl-A organizations checking
checking -, .0
', c
"Yes: must
"Yes." must complete
complete Part VI-B attach a statement
Vl-B AND attach giving a detailed
statement grvlng detailed descnptron lobbying acnvmes
description of the lobbYing activities ,
- - ,
2 Ounng the year, has the organizatIOn,
organization, erther
either directly
indirectly, engaged in any of the follOWing
engaged In following acts
acts wrth substantial contnbutors.
with any substantial contributors, '
trustees, dnectors, officers,
officers, creators, employees, or members
creators, key employees, members of their
therr families,
families, or with
with any
any taxable
organization with
with which
which any such
such c
person
person is affiliated as an officer,
IS affiliated officer, director,
director, trustee,
trustee, malonty
maionty owner,
owner, or pnncipal beneficiary'7 (If the answer
principal benefiCiary? answer to any
any questIon
question IS
is ·Yes,·
'Yes,'
attach a detwled
attach detailed statement
statement explammg
explaining the transactions)
transactions)
a Sale, exchange, or leasing of property? 2a
2. X
a Sale, exchange, or leasing ot property'
bLend Ing of money or otne r extensicn of crec It? 2b

2b X
b Lending of money or other extension of credit9
e Furnishing of goods, services, or lacillties' 2c

2c X
c Furnishing of goods, services, or facilities7
d Payment of cornpensauon (or payment or reimbursement 01 expenses If more than $1,000)' 2d

2d X
d Payment of compensation (or payment or reimbursement of expenses if more than 51,000}'
B Transfer of any part of rts Income or assets? 2e

2e X
e Transfer of any par) of its income or assets9
3 Does the orgamzatlon make grants for scholarships, fellowships, student loans, etc' (See Nole below) 3 X
3
4 Does
Do youthehave
organization
a section make
403(b)grants for plan
annUity scholarships, fellowships, student loans, e t c ' (See Note below)
for your employees? 4 X
4 Do you have a section 403(b) annuity plan tor your employees'
Note Attach a statement to explam how the organrzatron detennlnes that IndIVIdualsor organIZations recelVmggrants or loans
Note Attach a statement to explain how the organization determines that individuals or organizations receiving grants or loans
from It In tuttnerence of ItS chantable programs "qualify· to receIVepayments
from it in furtherance of its charitable programs 'qualify' to receive payments
I Part tV
I V II Reason
Reason for Non-Private Foundation Status (See through6 6otof
pages33through
(See pages tnethe instructions)
instructions)
organization is
The organization IS not
not a private
pnvate foundation
loundatlon because
because itillSis (Please check
check only
only ONE
ONE applicable
applicable box)
box)
50□
5 church, convennon
A Church, of churches,
convention 01 churches, or association
association of churches
churches Section
Section 170(b)(1 )(A)(I)
170(b)(1)(A)(i)
6□
&0 A school secnon
Aschool Section 170(b)(1 )(A)(II) (Alsocomplete
170(b)(1)(A)(n) (Also complete PartV
Part V )
7 □
0 hospital or a cooperanve
A hospital cooperative hospital
hospital service
service organization
organization Section
Section 170(b)(I)(A)(IIi)
l70(b)(i)(A)(m)
80
e □
gO□
A Federal, state,
state, or local
local government
governmental unll Section 170(b)(t)(A)(v)
unit Section 170(b)(1){A)(v)
9 A medical
medical research
research organization operated m
organization operated in conjunction
conjunction wrth
with a hospital
hospital Section
Section 170(b)(1 )(A)(m) Enter the hospital's
l70(b)(1)(A)(in) hospital's name,
name, city,
city,
state ►
and state ....
10
10 □
0 An organization
operated lor
for the benefit of a college
benefit 01 college or unlVersrty
university owned operated by a governmental
owned or operated governmental unn
unit secnon
Section 170(b)(I)(A)(IV)
170(b)(1)(A)(rv)
(Also complete
(Also complete the Support Schedule m
Support Schedule in Part IV-A)
IV-A)
11a
l1a m
[X] organlzallon that normally
An organization normally receives a substantial
substantial part
part of lis
its support
support lrom
from a governmental unrt or from
governmental unit from the general
general public
public
Section 170(b)(1)(A)(vi)
Section 170(b)(1 )(A)(vl) (Also
(Also complete
complete the Support
Support Schedule
Schedule in
In Part IV-A)
IV-A)
l11b
ib □
0 A community
community trust
trust Section
Section 170(b)(Ij(A)(vl)
170(b)(l)(A)(vi) (AlSO
(Also complete
Support Schedule in Part IV-A)
Schedule In IV-A)
12
12 □
0 An organization
An organization that
that normally
normally recerves (1) more
receives (1) more than
than 33 1"%
1/3% of rts
its support
support from
from contnouuons,
contributions, membership
membership lees,
tees, and gross
gross
receipts Irom
receipts from actIVIties
activities related to Its chantable, etc
its charitable, etc, , functions
tuncnons - subject certam exceptions,
sub|ect to certain exceptions, and (2) no
no mor!
more Ihln
than 331/3% 01
3 3 1 / 3 % of
Its support
its support lrom
from gross investment mcorne
gross Investment unrelated business taxable Income
income and unrelated income (less
(less section
section 511 tax) Irom busrnesses
tax) lrom businesses acquired
acquired
organization after June 30,1975
by the organization 30, 1975 See section 509(a)(2) (Also
section 509(a)(2) (Also complete
Support Schedule
Schedule in
In Part IV-A)
IV-A)
13 0I
I An organization
An olgamzallon that
that is
IS not controlled
controlled by
by any disqualified
persons (other
(other than foundation
and supports descnbed in
organizations descnbed m
(1) lines
(1) lines 5 through
through 12 above,
above, or |2)
(2) section
section 501(c)(4), (5), or
501(c)(4), (5), oi (6),
(6), 11
if they
they meellhe
meet Ihe test
test of
ot section 509(a)(2) (See section
section 509(a)(2) section 509(a)(3))
509(a)(3»)
PrOVidethe follOWing information
Provide the following mtorrnanon about
about the
the supported
supported organizations
organizations (See page 5 ofof the instructions
instructions) )
(b) Line number
(b) number
(a) Name(s)
(a) Name(s) of
ot supported
supported organlzatlon(s)
orgamzation(s) from above
from above
14 0
QZH organization organized
An organization orqamzed and operated
operated to test for
10 test lor public
public safety
safety Section
Section 509(a)(4)
509(a)(4) (See page 6 ot
of the instructions
Instructions) )
Schedule A (Form
Schedule (Form 990
990 or 990-EZ)
990-EZ) 2001
2001
123111
123111
01-O7-O2
01-01-02
8
15070826 758050
15070826 758050 23-12053HEI
23-12053HEI 2001.06000
2001.06000 THE
THE HEIMLICH
HEIMLICH INSTITUTE
FOUN 23-12051
Schedule A (Form 990 or 990-EZ) 2001 THE
ScheduleA(Form990or990-EZ)2001 THE HEIMLICH
3-7303161 Paoe3
Page3
I PPart IV-A 1 ',Support
a r t 1V-A Schedule (O
Support Schedule amplete only
(Complete youchecked
only ifrfyou boxon
checked aa box on line
hne 10,11. or 12)
10, 11, or 12) Use
Use cash
cash method
method of of accounting
accounting
Note You
Note Youmaymay useuse ththe woricslleet in
e worksheet the instructions
In the instructions for
for converting fr om the
convertm:r from the accrual to the
8CClt./sJ to the cash
cash method
method of of accounttng
accounting
Calendar
Calendar year
yelil (or fiscal year
(Dlliscal yellr
beglnnlna in)
beginning In ► .... (al 2000
(a) 2000 (bt 1999
(b) 1999 (c)
(e] 1998
1998 (d)
(d) 1997
1997 (e)
(e) Total
Total
15
1~ Ciltt, I'W''-,and
Girt" grant*, IIlClcontribution!
oontrtbutlono received
",.,..,ed
(Do
(00not
not Include
IIlCIUIIoI
unusual
unusualgnnte See
gIWlb 5«e
In.28)
lln* 28) 1106,140.
06,140. 1186,295.
86,295. 1146,952.
46,952. 224,749.
4,749. 4464,136.
64,136.
16
16 Membership fees
Membership lees received
received
17
17 Gross receipts
Gross recelplsfrom admsnons,
Irom admissions,
merchandISesold
merchandise sold oror services
seMcas
performed,
furnishing of01
facilities
faCilitiesin
Inany
anyactivity
actIVItythat
that isIS
related
relatedtoto the
Ihe organization's
organization's
charitable,
charitable, etc,
etc, purpose
18
18 Gross Income from
GlOSS income from inte
Interest.
rest,
dIVIdends,amounts
dividends, recervedfrom
amounts received from
payments on
payments on securities
securmes loansloans (sec
(sec-
non 512(a)(5)),
tion 512(a)(5», rents,
rents, royalties,
royalties, and
unrelated busmess taxable
unrelated business taxabill income
Income
(less
(less section
section 511
5 11taxes)
taxes) liom
hom
businesses acquired
businesses accuirec by by the
Ihe
organization
organization after
after June
June 30,1975
30, 1975 225,535.
5,535. 221,926.
1,926. 114,134.
4,134. 776,953.
6,953. 1138,548.
38,548.
19
19 Net
Netincome
Income from
from unrelated
unrelated business
business
aclMtles not
activities not included
Included in rn line
line 18
18
220
0 Tax"",..,ua
Tax revenues levied fortne
Iwied for organl,IItIOn
th. organization *•
benefit
ben.ftt end dinar paid
..,11"Uti. p.l1I to It or
10It or upended
ellpBlded
onllo_r
on Iti behalf
21
21 The value of
The rvices aorrfaCilities
01se rvrces facilities
furnished
furnished to 10the
the organization
organtzallon by by a
governmental
governmental unit unrt without
wrthout charge
charge
Do
Do not include the
notmclude the value
value ot services
01seMCBS
or
or facilities
facllrtle5generally
generally furnished
furnished to to
the
the public
pubhc without
wrthout charge
charge
22
22
23
23
24
24
25
25
-
Other Income.
Ottier
assets
Total
Total of
Line
Line 23
Income. Attach
Indyde gain
Include
of lines
23 minus
Enter 1%
Enter
at (loss)
gain or
Imes 15
15 through
mmus line
1% of
through 22
line 17
01~ne23
line 23
17
22
edledule.Do
Attadl a• ectiedule.
from sal*
(loss) from
not
Do not
01e8P'taI
sal.ot capital
1131,675.
31,675.
1131,675.
31,675.
11,317.
,317.
2208,221-
08,221.
2208,221-
08,221.
22,082.
,082.
1161,086.
61,086.
1161,086.
61,086.
11,611.
,611.
1101,702.
01,702.
1101,702.
01,702.
11,017.
,017.
6602,684.
02,684.
6602,684.
02,684.
,
26
26 Organizations
Organlzallons described
described on
on lines
lines 10
10 or
or 11
11 a a Enter
Enter 2%
2% ot amount in
01amount In column
column (e), line 24
(e),lme 24 ....
► 26a 268 112,054
2 , 0 5 4 .•
b Prepare
Prepare a list
IIsl for your records to show the name ol of and
and amount contributed
contnoutec by each person (other than Ihan a governmental
governmental
,
unit
unrt or publicly
publiClysupported
supported organization) whose total lolal gifts for 1997
19971hrough
through 2000
2000 exceeded
exceeded the amount shown in 10 line
hne 26a
26a
,.. , 0' , ~
Do not
nolille
llle this list with your return Enter
Enter the total
ce Total support for section 509(a)(1) test Enter
tolal ol
01 all these excess amounts
Irne 24, column
Enter line column (e)
,..
► 26b
► 26c
2Gb 3389,805.
89,805.
6602,684.
02,684.
d Add Amounts from lrorn column (e) for lines 18
18
22
1138,548.
38,548. 1<193
2( 5b
26b 3389
8 9 t,805.
805. ,..,..
► 26d
r- 0
5528,353.
f.
o r. s*
28,353.
0 N
e Public support (line 26c minus line

1I Public support
support percenlage
percentage (line
Ime 26d total)
26e
(line 26
lotal)
tnurnerainr) divided
e (numerator) divided hibyi line 26c (denominator)
Idenomlnalorll )
,..
^ 26a
► 26f
26e
261 1
774,331.
2
4,331.
.
12.3333%3333%
27 Organizations
Organlziltlonl described
delCrlbed on line 12 a II For amounts included
Included in In lines
Imes 15,16,
15, 16, and
and 17 that were
were received tiom a 'disqualified
receIVedtrom 'dlsqualrfled person.'
person: prepare ust for your records
prepare aa list
to show the name
name of and and total
tolal amounts received
receIVedIn in each
each year
year from,
trom, each
each 'disqualified
'disqualilled person'
person' Do
Do not file
file Ihls
this IIsl
list with
with your
your return
return Enter the sum
sum of of such
such amounts
amounts
lor
for each year NN/
each year / AA
(2000) (1999) (1998) (1997)
(1997)
b For
For any
any amount included
Included in
In line
ltne 17 that was received from each
recervedfrom each peson (other than 'disqualified
'diSQualified persons'),
persons'), prepare a listnst tor your records to show the name of, and
01,and
amount received
amount for each
recervedlor each year
year that
thai was
was more than the larger
larger of
or (1) the amount on
on line 25 for
for the year 01
or (2)$5,000
(2) $5,000 (Include
(Include In
in the
the Itst
list organizations deSCribed
described in
In
lines
Itnes 5 through 11,
11, as well as individuals)
mdlVlduals ) Do
Do not file
1l1ethis
this list with
wLth your return After
After computing
cornputmq the difference
drfference between
between the
Ihe amount
amount received
recerved and
and the larger
laroer
amount described
descnbec in
In (1)
(1) or (2), enter
enter the sum
sum of these
these differences
drfferences (the excess
excess amounts)
amounts) for
lor each
each year
year N/N/AA
(2000) (1999) (1998) (1997)
ce Add Amounts fromfrom column (e) forlor lines 15

15 16 __
17 20
20 21 .... 27c
27r: N/A
N/A
d Add Line
une 27a total and line 27b total
lotal ►.... 27d N/A
N/A
lotal minus
e Public support (line 27c total mmus line 27d total) .... 27e N/A
N/A
tI Total support tor
for section
sectton 509(a)(2) test
lest Enter
Enter amount on line 23, column (e) ► I 2711 ,..I 271\ N/A
N /A
,.. v
v
N/i.~ %
N/A"
g Public
B PUblIC support
support percentage
h Investment
Investment income
percentage (line(hne 27e
27e (numerator)
percentage (line 18,
Income p_ercentagejllne
(numerator) divided
18 column
dMdecI by by line
column (e) (numerator)
hne 27f denominator))
27f ((denominator))
divicled by line
(numerator) diVided hne 271 (denominator))
27f_ldenomlnator))
,.. 27g
27h N/A
N/A %
%
%
2B
28 Unusual
Unusual Grants
Grants For an an organizalJondescnbed
organization descnbed In
in Irne
line 10,
10,11. or 12,
11, or 12, that
that recervedany
received any unusual
unusual grants
grants dunng
during 1997
1997 through
through 2000,
2000, prepare
prepare aa list
list for
for your
your rsecres
records to
to
show,lor
show, each year, the name
for each name otthe
ottne contributor,
ccntnoutor, the date
date and amount of 01the bnef description
the grant, and a bnel descnpuon of01the natura of the
the nature Ihe grant
granl Do not
nolille IIsl with
file this list with your
not Include
return Do not include these
these grants
grants In
in line
line 15
15 NONF
NONE
123121 12-2~1
123121 12-29-01 9
9 Schedule
Schedule AA (Form
(Form 990
990 oror990-EZ12001
S90-EZ) 2001
15070826
15070826 758050
758050 23-12053HEI
23-12053HEI 2001 ,06000 THE HEIMLICH INSTITUTE FOUN 23-12051
2001.06000 23-12051
Schedul
Schedul~e AA(Form'990
(Fomr990oror990-EZ)
990-EZ)2001
2001THE
T H E HE H EIMLICH
I M L I C H INSTITUTE
FOUNDATION 23-
2 3 - 7730
3 0 331
1 6611 Page4
Page 4
I Part
PartVV1 Private School
Questionnaire (See
(See page
page 7701
otthe
theinstructions)
instructions) N/A
(To be
(To be completed
completed ONLY by by schools
schools that
that checked
checked the
the box
box on
on line
line 6 in Part IV)
In Part
Yes
Yes No
No
organization have a racially
racialtv nondscnmmatory
nondiscnminatory policy
policy toward
toward students
students by statement in Its
statement In its charter,
charter, bylaws,
bylaws, other govemlng
governing
Instrument, or In
instrument, in a resolution Its governing
resolution of its governing body?
body' 29
29
3D
30 Does the
ttie organization include a statement
organization Include statement ot Its racially nonciscnrnmatory
its racially nondiscnminatory policy
policy toward students in
toward students In all its
ItS brochures
brochures catalogues,
catalogues,
and other written
and wntten communications
communications withwith the public
public dealing
dealing with
with student adrmsstens, programs,
student admissions, programs, and scnolarslups?
scholarships? 30
3D
31 orgamzatlOn publicized
Has the organization publiCized its
ItS racially ncnciscnrmnatcry policy
raCially nondiscnminatory polley through
through newspaper
newspaper or broadcast
broadcast media
media during
during the period
penod of
soncnanen lor
solicitation lor students,
students, or dunng registration penod
during the registration penod rfIf itIt has no solicitation
program, in
In a way that
that makes
makes the policy
poliCYknown
known
to all parts of the general
general community serves 7
community Itit serves? 31
31
'Yes: - please describe,
If "Yes, descnbe, itIf 'No,'
'No: please explain (II you
explain (It you need more
more space, attach a separate
space, attach separate statement)
statement)

maintain the follOWing
lollowing
a Records
a indicating the racral
Records Indlcatmg racial composition
composition of the student
student body,
body, faculty,
faculty, and administratIVe staff 9
administrative statt? 32a
32i1
b Records
Records documenting
documenting that that scholarships
scholarships and
and other
other financtal
assistance are awarded
awarded on
on a raCially
racially nondscnmmatory basis 7
nondiscnminatory baSIS? 32b
32b
c Copies of all catalogues,
c catalogues, brochures
brochures announcements,
announcements, and other wntten
and other written commumcatrons
communications to the publiC
public dealing
dealing with
with student
student
acrmssions programs,
admissions programs, and scholarships?
scholarships? 32c
32e
Copies 01
d Copies ol all
all matenal used by the orqanuation
material used organization or on Its
its beha"
beharf to solicit contnounonsv
to soliCit contributions? 32d
32d
you answered
If you answered "No" ottne above,
'No'toto any otthe above, please explain
explain {If
(II you
you need more
more space,
space, attach
attach a separate
separate statement)
statement)
33 orgamzatlon discriminate
Does the organization mscnrmnate by race in
In any way With
with respect
respect to
to
a Students'
a rights or pnvlleges?
Students' nghts pnvileges? 33a
33a
b AdmiSSions
Admissions poliCies?
policies? 33b
33 b
ce Employment 01
faculty or administrative
administrative staft?
staff? 33c
33e
d 'Scholarships
other finanCial
assistance? 33d
33d
e Educational
policies? 33e
33e
f Use of
ot facilities?
facilities? 33f
33f
g AthletiC
Athletic programs?
programs? 33q
3311
h Other extracutncular
extracurricular actIVities?
activities? 33h
33h
It you answered
answered 'Yes'
"Yes" to any at above, please explain
ot the above, (It you
explain (If you need more
more space,
space, attach
attach a separate
separate statement)
statement)
34 a Does the orqaruzatmn

organization receive any financial
financial aid or assistance
assistance from governmental agency?
from a governmental agency? 34a
34a
the orqanuation's
b Has the organization's nght
right to
to such
such aid
aid ever
ever been
been revoked
revoked or suspended?
suspended? 34b
34b
you answered
"Yes' to either 34a or b please exptam usmg an attached
explain using attached statement
statement
35 Does the orgamzatlOn certify that itIt has complied
organization certify compiled with
With the applicable
applicable requirements 01 sections
rsqunements of sections 4 01 through 405
through 4 at Hev
05 ot Rev Proc
Proc 75-50,
75-50,
1975-2 C B 587,
1975-2 587. covering racialnondiscnrnmanon?
covenng racial nondiscrimmation? It "No," attach an explanancn
'No,' attach explanation 35
35
Schedule A (Form
Schedule A (Form 990
990 or 990-EZ) 2001
990·EZ12001
123131
12-2941
12-29-01
10
15070826
15070826 758050 23-12053HEI
758050 23-12053HEI 2001.06000 THE HEIMLICH
FOUN 23-12051
Schedule A {Form990 or 990-EZ) 2001 THE HEIMLICH INSTITUTE FOUNDATION 2 3 - 77 3300 33 1166 11 Pa e 5
Part Vl-A Lobbying Expenditures by Electing
Electing Public Chanties (See
(See page
page 9901the
ol themstrucnons
instructions)
) N/A
N /A
completed ONLY by an eligible
(To be completed eligible organization
organlZalion that
that tiled
filed Form
Form 5768)
5768)
Check ► a
iii 1 If the
1rt rgamzatlon belongs
the0orrjanrzation belongstotoan
anaffiliated
affiliatedgroup
aroup Check
Check ► bb l 1If you CheckeO
if vou "3'"a"and
checked and',mrtl!d
limitedconner
control* provisionsapply_
provistons aootv
(iii)
(a) (b)
(t»
LobbYing Expenditures
Limits on Lobbying Expenditures AffilJated group
Affiliated group To be
To be completed
completed for
for ALL
ALL
term 'expenditures'
(The term ·expendltures· means
means amounts
amounts paid or incurred)
mcurrsd ) totals
electing organlzallons
N/A
N /A
36 Total
36 Tolallobbymq expendrtures to influence
lobbying expenditures rntluence public
publiC opinion
opinion (grassroots
(grassroots lobbying]
lobtlymlll 36
31 Totallobbymg expenditures to mfluence a legislatIVe body (dlrectlobbymg)
37 Total lobbying expenditures influence legislative body (direct lobbying) 31
37
38 Totallobbymg
Total Imes 36 and
expenditures (add lines
lobbying expenditures and 37) 38
39 Other exempt
exempt purpose
expenditures 39
40 Tolal exempt
Total exempt purpose
expenditures (add linesIUles 38 and 39) 40
40
",
41 lobbymg nontaxable
Lobbying nontaxable amount amount Enter Ihe amount from the following
the amount from lollowmg table -
cc , , ' ,
It the amount on hne

II the amount on line 4Q It 41] II - The lobbying nl)n!illible.
The lobbying nontaxable Imalln!
amount ,,,
Is -
,
NOICNer5500
Not over J500 OOO
[)(X) 20" or the antDunl o n
20W o( Ihe amount on lineline 40 ~1
_ -
Over Ilu' not
$500,000 Out
0.",5500,000 no' over
aver (1
$1 000000 SI00 000 plus
S100 plus 15H
15% ot
01 Che excess ovet'$5()(lOOO
the exceu over S500 000
-
}
[)(X) [)(X)
0. .. 51 ooo,OOObulll(JloverSl ~ooo
Over Jl 000,000 but nol over Si WO 000 $175,000 plus
Si 75.000 plus 10% or 111.e:.u:eu
olmeexcen over <IV. $1 ooa 000
5\ 000 > 41
, _
o.er *$11 500 000 but
Over bu' not
nol over
av. »17
$17 000 000
000000 S225 plus S~"H of
000 plus
1225000 01 trie
Ine execs
e;.c:ess over S, 500,000
""'" Si 51)0,000 =: ,
~
0. ... $17 000 000
OverS17000000 S1000 000
51000000 J ,
,
"^
,
. ,
42-
42 GI3'SS!OOtsnontaxable
Grasstoots amo\lnt (enter
nontaxable amount ~enteT25%
25% ol 41}
line 41)
011111& 42
42
43 Subtract une 421rom ~ne
Subtract line 42 from line 36 Enter -0. rr Une
-0- if line 42 tnan line 36
more than
is more
IS 43
44 sumract
Subtract line fiom line 38 Enler-O- it line 41 is more than line
une 41 hom Ime38 Enler -0. If hne 4115 more 38
Ime 38 44
44 _
, ' ,
■" ■"
-,
Caution
Caution there is
If there an amount
IS an amount on
on either
either line
Irne 43 or line
Irne 44, you
you must
roost file
file Form
Form 4720
4-'fear Averaging
4-Year Averaging Period Under Section
Settion 601(1))
501th)
(Some organizations
organizations that
that made a section
section 501 (h) election do not havetotocomplete
501 (h) elechan do not have completeall allofofthe
thefive
ftvecolumns
columns
below See
below See the
theinstructIons
instructions'ortorImes
lines4545
through 5050
through ononpage 1111
page oHM instructions)
of the instructions )
lobbying Expenditures
Lobbying clpendllures During 4-Yeal Averaging
During 4-Year Averaging Period
Period
N/A
N/A
Calendar
Calenllar year
year (or
(or (al
(a) (bl
(b) (e)
(0 (II)
(II) (e)
U,c:al year
llteal ye.8t beginning 1"1
be.glnnlng in) ....
► 2001
2001 2000 1999
1999 was
1992 lotal
Total
45
45 lobbymg nontaxable
Lobbying nontaxable
amount
amount 0O..
45 Lobbying
46 Lobbymg ceiling
ceiling amount
amount ; ~ ,
, - ,
~
(150% ot line
(150% ol hne 45(e))
451en v
,
-. __-■
" - _. _
VI
N
_.
<
0O..
47 Totallobbying
47 Totallobbymg
expenditures
expenditures o.
0.
48 Grassroots
nontaxable
amount
amount 0O..
~ , ,
49 Grassroots
49 Grassroots ceiling
cellmg amount
amount , , _ , , , ,
- -*
(150%
(150% ofetune
line 48(e))
4~))
..., ' s;
^~,t , 0O.
.
50
S Grassroots lobbying
O Grassroots lobbying
lOOlendlturSS
expenditures 0O..
IPart VJ-8 j Lobbymo/
|PartVI-B Lobbymg ActIVIty by Nonelec
Activity by NoneJectlng Public Charit
>ting Public Charities
es
(For reporting
(For reporting only
only by
by organizations
organizatIOns that
that did
did not
not complete
complete Part
Part Vl-A)
VI-A) (See
(See page
page 12
12 of
01the instructions) )
the instructions N/A
N /A
Ounng the
Ounng the year,
year, did
did the organization
Influence national,
national, state
state or
or localleglslallon,
local legislation, including
including any
any attempt
attempt to
to
Yes
Yes No
No Amount
Amount
rnfluence public opinion on a leglslatrw matter or referendum, tllrough the
influence public opinion on a legislative matter or referendum, through the use of use or
aII Volunteers
Volunteers - ~
bb Paid staff or management
management (Include
(I nclude compensation
compensation in expenses reported
In expenses nnes ct through
reported on lines th rough hh )) "-_, ■■
cc Medta advertISements
dd Mailings to
legislators, otor the
the public
pullilc
ee Publications, or publIShed or broadcast
Publications, or published or broadcast statements statements
ft Grants to
Grants to other
other organizations
organrzatlons fortor lobbying
lobbying purposes
purposes
gg Direct contact
Direct contact with
wrtIlleglsbtors,thelJ statts, government
legislators, then staffs, government officials,
officials, or
or aalegislatIVe
legislativebody
body
hh Rallies,
Rallies, dsrnonstrauons
demonstrations seminars,
speeches, lectures,
lectures,or or any
any other
other means
means
II Total
Totallobbymg expend Jlures (Add lines
lobbying expenditures unes ce through
through h ) ' 0O..
If11"Yes· to any ot
*Yes* lo of the
the above,
above, also attach aa statement
also attach statement gIVing
giving aadeta,led
detaileddescnatrcn
description01oltile
thelobbYing
lobbyingactIVIties
activities
123141
12 29-01 Schedule IForm 990
Schedule AA (Form or 990-EZ)
990 or 99D·EZ) 2001
20D1
11
11
15070826 758050
15070826 758050 23-12053HEI
23-12053HEI 2001.06000 THE
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 23-12051
- Schedule
Schedule AA(Form
(Form990
990oror990-EZ) 2001 THE
990-EZ)2001 T H E HEIMLICH
23-7303161 Page 6
PageS
!Part Vnllnfonnatlon
Part VII Information RegardingRegarding Transfers To To andand Transactions and and Relationships
Noncharitabte
Exempt
E xempt O Organizations
r g a n i z a t i o n s (See page
page 12 ottne
of the mstructions
instructions)}
51 Did
Old the reporting
organrzatlon directly
indirectly engage
engage inIn any of
at the following with any other organization
fOllOWingW1thany organization described
desenbed in
In section
section
9
501(c)
501(e) of the Code (other than section
(other Ihan section 501(c)(3)
SOl (e)(3) organizations)
organizallOns) or in
In section
section 527,
527, relating to political
relating to pohucal organizations
orllanrzatlons?
a Transfers hom
a Transfers trom Ihe
the reporting
reporting orqaneatron
organization to
to a nonchantable
nonchantable exempt
exempt organization
organization 01
ol Yes No
No
(I) Cash
(I) 51a(l)
51a(l) X
(li)
(II) Other assets afii)
a(lI) X
b Other
Other transactions
transactions
(I) Sales or exchanges
exchanges of assets with
with a nonchantable
noncharrtable exempt
exempt organization
orqamzatron bill
b(l) X
(u) Purchases
(u) assets trom
Purchases of assets hom a nonchantable
nonchantable exempt
exempt organlzallon
organization 11(11)
D(») X
(111) Rental
(lii) tacumes, equipment,
Rental of facilities, equipment, or other
other assets
assets b(HI)
b(llI) X
(Iv) Reimbursement
(tv) Reimbursement arrangements
arrangements bfrv)
b(lv) X
(v) Loans
Loans or
0 r loan guarantees
IIuaranlees m
b(v) X
(vl) Pertormance
(vi) Performance at of services
services Oror membership
membership or fund raising soncnanons
tundliuslng solicitations b(yl)
b(vi) X
cc Shanng facilities, equipment,
Sharing of facilities, equipment, mailing
mailing lists,
lists, other
other assets,
assets, or paid
paid employees
employees c
c X
d IfII the
the answer
answer toto any
any of
of the
the above
above 1$is "Yes:
"Yes." complete
complete the
the followmg
following schedule
schedule Column
Column (b)
(b) should
should always
always show
show the
the lair
lair market
market value
value 0'of the
the
goods, other
assets, or services
services given
IllVen by the
the reportlnll
organization If the organlzallon
organization receIVed
received less
less than fair rnanet
than talr market value
value In
in any
transaction sharing arrangement
arrangement, showshow In in column
column (d) the value of the cccos
(d) the goods, other
other assets
assets or services
services received
receIVed N/A
N/ A
(a) lb)
(b) (e) (d)
Line no
no Amount involved
Amount Involved Name
Name of nonchantable
noncha ntable exempt
exempt organization
organrzatlOn Description transfers, transactions.
Descnptlon of transfers, transactions, and
and shanng
arrangements
52 a Is the
52 a organization directly
the organization dlrBctly or indirectly
affiliated with,
With, or related
relaled to,
to, one or more
more tax-exempt
tax-exempt organizations described In
organizations descnbed in section
section 501
501(c) of the
(c) oltha
Code (other
(other than
than secnon
section 501 (c)(3))
(c)(3)) or In
in section
section 527?
527' ► DYes
.... 1 1 Yes 00
1 X No
1 No
b If "Yes·
b *Yes,'complete
complete the
the follOWing
following schedule
schedule N/N /AA
ID
(I) (b) (e)
(c)
Name of organlzallon Type
organization Descnption ot relationship
Descnptlon of relationship
123151
123151
12
1 2M
29-{)1
-01 Schedule
Schedule A
A (Form
(Form 990
990 or 990-EZ)
990-EZ) 2001
2001
12
12
15070826
Schedule
Schedule B Schedule Contributors
Schedule of Contributors OMBNo 1545-0047
OMB No 1::>45-0047
(Form'990, 990-EZ, or
(Form 990, 990-EZ,
990-PF)
Department
D~t
Internal
ol tl'IeT""",ury
ot
tntrmal Revenue
tne Treasury
Service
Revenue Semce
line
Supplementary
hne 1 of Form 990,
for
InformatIon for
990-EZ and 990-PF (see mstrucnons)
990, 990-EZ instructions) 2001
2001
Name of
ol organization
organization Employer
THE H E I M L I C H INSTITUTE
FOUNDATION 2 3-7303161
23-7303161
Organization
Organization type
type (check one)
Filers of-
Filers of" Section
Section
Form 990 or 990-EZ IX)

QD 501 (c)(
501(c)( 3)
3 ) (enter
(enter number)
number) organization
organization
D
□ nonexempt chantable
4947(a)(1) nonexempt charitable trust
trust not treated as a pnvate
not treated private foundation
foundation
D
□ political organization
527 political organization
Form 990-PF D
I I 501(c)(3)
501 (c)(3) exempt
exempt pnvate
private foundation
foundation
D 494
□ 4947(a)(1) nonexempt chantable
7(a)(1)nonexempt charitable trust treated as a pnvate
trust treated private foundation
foundation
D 501 (c)(3) taxable pnvate

501(c)(3)taxable private foundation
foundation
Check Ifif your organization IS

is covered by the
theGeneral rule or a Special
General rule Special rule
rule (Note Only a
a section 501(c)(7), (8),
(8), or (10) organization
orgamzatlon can check box(es)
boxfes)
for bo th the General Nle
both rule and 8
a SpeclaJrule-see
Special rule-see rnstructlons)
instructions )
General Rule-
General Rule-
[K] For EZ, or 990 PF that received,

For organizations filing Form 990, 990 EZ. rscerved, during
dunng the year, $5,000 or more On
~n money or property) from any one
anyone
contributor (Complete Parts I and IIII))
contnbutor
Special Rules-
D For a section
□ section 501(cl(3)
501(c)(3) organization
organization filing
filing Form 990,
990, or
or Form 990-EZ, Ihat
that met the
the 33 1/3%
1/3% support
support test
test of
of the
the regulations
regulations under
under
509(a)(1)/170{b)(1)(A)(vijand
sections 509(a)(1)/170(b)(1)(A)(vi) and received
received from anyone
any one contributor.
contnbutor, dunng
during the year, a contnbutlon
conlnbution of the greater of $5,000 or 2%
2%
of the amount on line 1 of these forms (Complete Parts I and IIII))
D For a section 501 (c)(7), (8), or

501(c)(7),(B), or (10)
(10) orgamzatlon
organization filing
filing Form
Form 990,
990, or
or Form
Form 990-EZ,
990-EZ, that
that received
received from
from anyone
any one contnbutor,
contnbutor, dunng
dunng the
the year,
year,
aggregate ccntnbuttona
contnbutions or bequests
bequests of more than $1,000 for use exclUSIvelyfor
exclusively for religiOUS,
religious, cchant able, scientific,
hantable, scientiflc, literary, or educational
educational
purposes,
purposes, or the prevention of cruelty to children or animals (Complete Parts I, II, and III)
III)
D For
For a section 501(c)(7),
501(cl(7l, (8), or (10)
(10) organization
organlzallon filing Form 990.
990. or Form 990 EZ, that received from any one contnbutor,
anyone contnbutor, dunng the year,
year,
some contnbunons
contnbutions for use exclUSIVelyfor
exclusively for religiOUS,
religious, charitable, etc , purposes,
chantable, etc, contributions did not aggregate to more than
purposes, but these contributions than
$1,000 (If this box isIS checked,
checked, enter here the total contnbutions
contnbutlons that were received
receIVed dunng the year for an exclusively religious,
exclUSIvelyreligiOUS,
charitable, etc,
chantable, etc , purpose Do not complete
complete any of the Parts unless the General rule applies to this organization
organizatIon because Itit receIVed
received
nonexclusrvefy religious,
nenexclusrvely religiOUS,charitable,
chantable, etc
etc, , contnbutions
contnounons of $5,000 or more dunng the year) year) ► $
... $ _
Caution
Caution Organizations
OrganIzatIons that are
are not covered by the General Ttlleand/or
rule and/or the SpecIal
Special TtI/es
rules do not file Schedule B
B (Form 990, 990-EZ, or 990-PF), but but
they must check the box
bOJ(in headmg of their Form 990, Form 990-EZ, or on Irne
In the heading line 1 of their
theIr Form 990-PF, to certify that they do not meet the filing
requirements of Schedule B (Form 990, 990-EZ, or 990-PF)
ScheduleB (Form 990,990-EZ,

Schedule 990, 990-EZ, or 990-PF) (2001,
(2001)
123451 12
12 ZS-Ol
29-01
13
15070826 758050 23-12053HEI
15070826 2001.06000 THE HEIMLICH INSTITUTE FOUN 23-12051
23-12051
Scti«iul»,B (Form 99IJ,
Sd>edul~ B Form 99b, 99(HZ.
990-EZ. or 99().PF)(2001)
990-PF) pOOl) Pajn
P_ 1
1 to
to 1
1 01P..-I
of POT I
Name 01organlzaUon
of organization Employer Identification number
Employer Identification number
THE HEIMLICH INSTITUTE FOUNDATION 2 3-7303161

23-7303161
Part)
Part) Contnbutors
C o n t r i b u t o r s (See Specific
Instructions) )
(a) (b) Ie)

(c) (ef)
<d>
No Name,
Name, address
address and
and ZIP
ZIP ++ 44 Aggregate contributions
Aggregate ecntnbunens Type
TyPe of contribution
of ccntnbunen
---1 ~
i
--- Person
Person IXl
Payroll
Payroll D|
|
$
$ 10,000.
10,000. Noncash
Noncash 0|
|
- ---
(Complete Part lilt
II if there
( is a noncash
IS contribution))
noncash contnbuuon
- ---
(a) (c)
(cl <d)
(d)
No Aggregate contributions
Aggregate eentnbunens Type of eontnbutten
TYPe of contribution
!\
IX]
---2 --- Person
Person [x]
Payroll
Payroll 0|
|
S
$ 25,000.
25,000. Noncash
Noncash 0|
|
- ---
(Complete Part lilt
II if there
< is a noncash
IS noncash contribution
contnbution )
C
---
(a)
(al (b)
<b) (c)
(cl (d)
No Name, address and
Name, address ZIP ++44
and ZIP Aggregate contributions
Aggregate contnbutlons Type
TyPe of contribution
of contnbunen
--- Person
Person 0□
Payroll
Payroll 0|
|
$
$ Noncash
Noncash D|
[
(Complete Part II Ifif there
is a noncash
IS contribution )]
noncash contnbunon
(a) (b) (c)

(cl (d)
No Name, address
address and
and ZIP
Aggregate contnbutlons Type of contribution
of contribution
--- Person
Person 0□
Payroll
Payroll 0
| !
S
$ Noncash
Noncash D
[ [
If there
(Complete Part II rf there
is a
IS a noncash contnbuhon )1
noncash contnbutton
(a) (b) (c) (d)

(ef)
No Name, address
address and
and ZIP
Aggregate contnbutlons Type of contribution
of contnbtmon
--- Person
Person 0
Payroll
Payroll 0|
1
$
$ Noncash
Noncash 0|
[
(Complete Part II Ifif there
is IIa noncash
IS noncash contribution
contnbutjon ))
(a) (b) Ic) (d)

No Name, address
address and
and ZIP
Aggregate contributions Type of contribution
of contribution
--- Person
Person 0□
Payroll
Payroll 01
|
£
$ Noncash
Noncash 0|
|
(Complete Part lilt
II rf there
is a noncash
IS noncash contnbunon
contnbution))
123452
12~ 12-29-01
12-29-(11 14
14 Schedule B (Form990,
ScheduleB (Form 990, 990-EZ, or 990-PF) (20011
(2001)
15070826 758050
15070826 758050 23-12053HEI
23-12053HEI 22001.06000
0 0 1 . 0 6 0 0 0 THE
THE HEIMLICH
HEIMLICH INSTITUTE FOUN 23-12051 23-12051
23-7303161
FORM 990
FORM 990 GAIN (LOSS) FROM
GAIN (LOSS) FROM PUBLICLY
PUBLICLY TRADED
TRADED SECURITIES
STATEMENT 1

SEE ATTACHED 114,309. 133,135. O.
0. -18,826,
-18,826.
TO FORM 990, PART I, LINE 8 114,309.

114,309 133,135. 0.
O. -18,826
-18,826.
FORM 990 OTHER CHANGES IN NET ASSETS OR FUND BALANCES STATEMENT 2
DESCRIPTION AMOUNT
CHANGE IN NET UNREALIZED GAINS/LOSSES
GAINS/LOSSES -65,776.
DONATED SERVICES -72,000.
TOTAL TO FORM 990, PART I, LINE 20 -137,776.

-137,776.

PART III
EXPLANATION
PERFORM RESEARCH AND PROVIDE EDUCATION TO THE PUBLIC ON VARIOUS DISEASES.

DISEASES.
FORM 990 OTHER INVESTMENTS STATEMENT 4
VALUATION
AMOUNT

636,459.
TOTAL TO FORM 990, PART IV, LINE 56, COLUMN B 636,459.

636,459.
15 STATEMENT(S)
STATEMENT(S) 1, 2, 3, 4
15070826
15070826 758050 23-12053HEI
23-12053HEI 2001.06000 THE HEIMLICH INSTITUTE FOUN 23-12051
23-12051
.~HE HEIMLICH INSTITUTE
23-7303161
FORM 990
FORM 990 OTHER
OTHER ASSETS
ASSETS STATEMENT
STATEMENT 5
DESCRIPTION
DESCRIPTION AMOUNT
SECURITY DEPOSIT
10.
WORKERS COMPENSATION DEPOSIT
DEPOSIT 132.
132.
ACCRUED INTEREST
RECEIVABLE 6,503.
6,503.
TOTAL TO
TOTAL TO FORM
FORM 990,
990, PART
PART IV,
IV, LINE
LINE 58,
58, COLUMN
COLUMN BB 6,645.
6,645.
16 STATEMENT(S) 55
STATEMENT(S)
15070826 758050
15070826 758050 23-12053HEI
OMBNo 1545-0172
OMBNo 1545-0172
Form
Form
(Rev March
(Rev
4562
Mart:h2(02)
2002)
Depreciation
Depreciation and
and Amortization 2001
Departnwli of
Department 011M Treasury
the Treasury (Including Information
(Including Information on
on Listed Property) 9990
Listed Property) 90
AAn.:tIment
nacfi men!
Inl_ Revenue
Internal Re.... y. Service
Service .... separate Instructions
► See separate instructions |v
.... Attach
Attach to
to your
your tax tall return
return Sequ....,.,
Sequence No 67
No 6 7
tume(~)shown
Name(s) onreturn
SIlOWn on .... m BuSIness
Business or
or activity
IICtMtyto which this
IDwhich thIS form
form relates
,._ Identifying
ldenbfylngnumber
numbor
THE HEIMLICH
INSTITUTE FOUNDATION FORM
WORM 9990
9 0 PAGE
PAGE 22 223-7303161
3-7303161
Part
1P a r t 1IIj ElectionTo
Election To Elpense
Expente CertainTangible
Certain Tangible PropertyUnderSecllon
Property Under Section 179 Note
Note If you
you have
have any
any listedproperty,completePart
listed property, complete Part V
V before
betore you completePart
complete Part I
11 Maximum amount
amount See instructions
mstrucuons for a higher limit for certain
certarn businesses 1 224,000.
4,000
22 Total
Total cost
cost of
of section
section 179
179 property
property placed
placed tn
In service
service (see
(see instructions)
Instructions) 2
33 Threshold
ThreShold cost cost of of section
section 179
179 property
property beforebefore reduction
reduction in 10 limitation
urnrtation 3 $200,000
$200,000
44 Reduction
ReductIOn in In limitation
limitation Subtract
Subtract line line 33 from
from line hne22 IfIf zero
zero or or less,
less, enter
enter -0 -0 4
55 Dollar
Oo"ar limitation
arT1l~tJon I<>< tux
tor tax year Subtract
y_ Subtract Una
II....i trom .n. 11 IfIl,,,,,,
Irgm line tero ororless
less. enter
ent... -0-
-0- IfIt,,_,_
mamed Cling
ftllroaseoar.tetv.
separately. see Inswc1Jons
see Instructions 5
~ Description
(a) o_.r;,tIon of
01property (b)
(b) Cost
Cos,(business
(bUSiness uae
..... only) (c) Elected cost
«:jEt_ ....t
, , ,,
e6 pmperty only!
,
-,
,
,
,
, ,
,,~
77 Listed
l..Jstedproperty Enter amount
property Enter amount from
from line
line 29 1 7 ,~
- ,
68 Total
Total elected
elected cost
cost of
of section
section 179
179 property
property Add Add amounts
amounts in In column
column (c), hnes 66 and
(c), Iine3 and 77 8
09 Tentative
TentatIVe deduction
deductIOn EnterEnter the
the smaller
smaller of of line
line 55 or hne88
or line 9
10 Carryover
10 Carryover ofof disallowed
drsaDoweddeduction
deduction fromfrom line
hne 1313 of
of your
your 2000 Form 4562
2000 Form 4562 10
10
11 Business
11 Busmess income
Income limitation
Irrnrtallon Enter
Enter the
the smaller
smaller of of business
busmess income
Income (not(not less
less than
than zero)
zero) or
Of line
line 55 11
11
12
12 Section
Section 179
179 expense
expense deduction
deduction Add Add lines
lines 99 and
and 10,10, but
but do
do not
not enter
enter more
more than
than line
line 11
11 12
12
, ,
Carryover of
13 Carryover
13 of disallowed
deduction to to 2002
2002 Add Add lines
lines 99 and
and 10,
10, less
less line
hne 12
12 ►
.... 1 13
13 ~,
»:
Note
Note Do Do not use Part
not use Part IIII or
or Part
Part III
III below
be/ow for
for listed
lIsted property
property Instead,
Instead, use Part Vv
use Part
IPPart ttl
art H 1 Special
SpecIal Depreciation
DepreCiation Allowance
Allowance and
and Other
Other Depreciation
DepreCiation (Do
(Do not
not include
Include listed
hsted property
prooertv ))
114
4 Special dep"""otonallowance
Speclal depredation allowance for CIIItaIn
lor certain property (oth....than
property (oDier ,,~ted property)
tIlan listed ..:qu,11IOd
property) acquired olt.. September
after Sep'ombef 10,
10, 2001
2001 (see Instructions)
(."" instructions) 14
14
15 Property
15 Property subject
subject to to section
section 168(f)(1)
168(0(1)election
election (see(see instructions)
Instructions) 15
15
18 Other
16 Other depreciation
deoreciatjon (including,
lincludlna ACRS)
ACRSI (see
(see instructions)
mstrucnons) 16
18
Part
1P 1111MACRS
a r t IHl MACRS Depreciation
DepreCiation (Do (Do not
not include
Include listed
listed property
property) ) (See
(See instructions
mstrucuons ))
Section
Section A A
17
17 MACRS
MACRS deductions
deductions for for assets
assets placed in In service
service in In tax
tax years
years beginning
beginning beforebefore 2001 17
17
18
18 IfIf you are electing under section I68(i)(4) 168(1)(4)toto group any any assets placed in In service dunng the tax
ear into
year Into one
one oror more
more general neral asset
esset accounts,
accounts check here ► □
Section
Section B B·- Assets
Assets Placed
Placed in In Service Dunna
Dunne 2001 2oo11all Tax Year Ustnq
UsmQ the General
General Depreciation
Deprecllltion System
System
(b) Monthand
(b) Month ..,(1 lelBasl~
(c) lord"l'leCIotlon
Basis for depredation
{d\
(eI) Recovery
Recovery
(01
(a) ClesslftClltion
Classification otproperty
of property y.....placed
year placed (business/investment
(buslnesslinvestmentuse use
penoCl
penod
(e)
(el Convention
Convennon (~MotnOd
(1) Matted (g) Oepreclatlon
(g) Depreciation deduc~on
deduction
Inservice
In servia! only
only see Ins""<;IIons)
.. Instructions)
16a
198 3 year property .,-
bb 5 year property
,
ce 7 year property
property
dd 1Q-yearproperty
10-year property
ee 15-year property
15-year
f 2Q-yearproperty
20-year property ,
pa 25 year property
property 25yrs
25yrs S/L
SIL
/I 27
2755yrs
yrs MM S/L
SIL
hh ReSidential
Residential rental
rental property
property
/I S/L
SIL 27
2755yrs
yrs MM
1I 39yrs
39 vrs MM S/L
SIL
iI Nonresidential
Nonresldential real
real property
property MM S/L
1I
Section
Section C -• Assets
Assets Placed
Placed in
In Service
SerVIce Dunng
Dunng 2001 Tax
Tall Year Using the Alternative
USingthe Ahemllbve Depreciation System
Depreeranon System
20aa
20 Class Irfe
life S/L
SIL
b 12-year
12-year I12
2 yyrs
rs S/L
SIL
ce 4Q-year
40-year /I 40yrs
40 yrs MM S/L
S/l
!Part
P IVi Summary
a r t 1VJ Summary (See mstrvcuons
instructions))
21 Listed
listed property Enter
Enter amount from linehne 28 21
Total Add amounts from line
22 Total lme 12, lines
hnes 14 through
through 17, lines
hnes 19 and 20 in In column (g), and line
line 21
Enter
Enter here and on the appropriate
appropnate lines
hnes of vour
your return Partnerships and S coroorations
corporancns - see instr
mstr 22 6 ,959.
6,959.
23
23 For assets shown above and placed in In sservice th e current year.
ervice dunng the year, enter the
,
c
basrs attributable
portion of the basis attnbutable to sectic
section)n 263A costs
costs 23 1231 "
"
, , ,, ,
M~~.k
11E251
lHA
03-21-Q2
LHA Paperwork Reduction
For Paperwork Reduction Act Notice,
Notice, see separate
separate Instructions
instructions Form 4562 (2001) (Rev
(Re\' 3 2002)
32002)
17
17
15070826
15070826 758050
758050 23-12053HEI
• Form 4562
■ 4562 (2001)(Rev
(2001) (Rev 3-2002)
3-2002) Page 2
IPart
PartV V I Listed
Listed Property
Property {Include
(Include automobiles,
automobiles, certain other vehicles, cellular telephones,
telephones, certain computers,
computers, and property used (or
for entertainment,
emertamrnent,
, recreation, or amusement)
amusement)
Note For any vehicle for writer) you are
which you are usmg
using the
the standard
standard rTrJleage
mileage rrate or deducting
ate or deducting lease
lease expense,
expense, complete
complete only
only 248.
24a, 24b,
24b, columns
columns (a)
(a)
throuqh
through (c) of Section all of Section B,
Secllon A, ell B. and SectIon
Section C Ifif applicable
Section
Section A -• DepreCiation
Depreciation andand Other
Other Information
Information (Caution
(Caution See instructions for IUTI/Is
limits for passenger automobiles)
automobiles)
24a
248 Do you haveevidence
00 you have evidence to
to supportthe
support the busmesssnvestment
business/investment useclaimed?
use claimed? Dyes
I I Yes DNo I I No 24b If 'Yes'
'Yes," is the eVidence
ISthe written? I _ J yes
evidence wntten? Yes D□ 0 No
(a)
(al (b) Date
Date (c) (d) (e) (f) (9) (h) (i)
Type01
Type ot property
property placed
placedin
In BUSiness!
Business/ Cost
Cosloror B s u tlr
BasIS lor depl'flC1lltlon
depreciation Recovery
Recovery Method/
Method! Depreciation
DepreCiation Elected
Elected
(iisl vehiclesfirst)
(list vehicles first) service
seMce (business/Investment
(buslnossJlnve$tment section179
section 179
investment
Investment othei basis
othel baSIS penod
penod Convention
Convention deduction
deduction
u»only)
useontyl cost
cost
use nercentane
25 Special depreciation allowance for listed'Isted property
property acquired after September 10, 10,2001,
2001,
and used more than 50% in a qualified
In e Qualified business
business use 25 125 :
- '" ' ..A:-_.).
26 Property used more than 50% in a qualified business use
%
%
%
27 Property used 50%
50% or less in
In a qualified
qualified business
business use
,
%
% S/L
SIl , -r
%
% S/L
SIl
%
% S/L
SIl -:< ,' ,
<; .......'.-'
28
28 Add amounts In
in column (h), lines
hnes 25 through
through 27 Enter here and on line 21, page 1 12828 "
20 in column (i), line 26 EEnter
29 Add amounts 10 nter here and or
oni Ime
line 7, page 1 29 129
Section
Section B --Information
Information on 0'
on Use of Vehicles
Vehicles
Complete this proprietor, partner, or other 'more
thiS section for vehicles used by a sole propnetor, 'more than
than 5% owner,'
owner,' or related person
person
If you provided vehicles to your employees,
employees, first answer the questions
questions in
In Section C to see rf
If you meet an exception to completing
completing this
trus section for
those vehicles
IB)
(a) (b) (c) (eI)
(d) M
Ie) If)
30 Totalbusnessnnvestrnant
Total business/investment rntles
miles cnven
dnven dUllllg
during the
the Vehicle
Vehicle Vehicle
Vehicle Vehicle
Vehicle Vehicle
Vehicle Vehicle
Vehicle Vehicle
VehICle
year (do not
year(do include commutingmiles)
not mcfude commuting miles)
31 Total commuting miles dnven dunng the year
32 Total other personal (noncommuting)
(ncncomrnutmq) miles
dnven
33 Total miles dnven during Ihe
the year
through 32
Add lines 30 Ihrough
34 Was the vehicle available for personal use Yes No Yes No yes
Yes No Yes No Yes No Yes
Yes No
dunng off-duty hours?
35 Was the vehicle used pnmanty
35 pnmanly by a more
than 5%
5% owner or related person?
36 Is another vehicle available for personal
personal
use?
Section
Section C - Ouestlons
Questions for
for Employers
Employers Who PrOVIdeVehicles
Provide Vehicles 'or
for Use by Their Employees
Employees
Answer these questions to determine Ifrf you meet an exception
exception to completing
completing Section B for vehicles used by employees who
who are
Bre not
not more than
than 5%
owners or related persons
37 Do you rnamtam
37 00 maintain a wntten
written policy statement that prohibits
poliCYstatement prohibits all personal
persona! use
usa of vehicles, including commuting,
vehicles Including commuting. by your yes
Yes No
employees?
rnamtam a written
38 Do you maintain wntten policy
pohcy statement that prohibits commuting, by your
prohibits personal use of vehicles, except commuting,
employees? See Instructions
instructions for vehicles used by corporate
corporate officers, directors,
directors, or 1
1%% or
or more
more owners
owners
39 Do you treat all use of vehicles by employees as personal use?
40 Do you provide more than
40 Ihan five
fIVe vehicles to your employees,
employees, obtain information from your employees about
the use of the vehicles, and retain retam the information receIVed?
received?
41 Do you meet meet the requirements
requtrements concerning
concernmg qualified
qualified automobile demonstration
demonstration use?
Note Ifyourenswer
Note If your answer to 37,38,39,40,
37, 38, 39, 40, or41
or 41 IS
is 'Yes,'
'Yes,' do not complete Section B for the covered vehicles
1 Part
p a r t VI 1 Amortization
Amortization
la)
(a)
Doscnptlon
Description 01 00$15
of costs I (b)
(b)
DnI~DI1
Qrta 1
tnoUifion
bOflins
bllgins
Ic)
(c)
Amortiieble
ol,mortiuble
■mounl
anxJun1 I
(d)
Coda
Coda
_on
section
(«)
Ie)
I
Amofznon
penod
pcn~ or poxtnbQC
I (f)
Amortization
AlrDrtIzJIbon
for triis year
lartnl3Y_
42 Amortization of costs that begins dunng your 2001 tax year

1 1 1 1
1 1 1 I
43 Amortization of costs
costs that began
began before your 2001 tax year 14343
44 Total
Total Add amounts in In column instruct ions for where
column (f) See Instructions where to report 144
44
Form
Fonn 4562 (2001) (Rev 3-2002)
(2001)(Rev 3-2002)
116252
03-JO-O2
18
18
758050 23-12053HEI
15070826 758050 INSTITUTE FOUN 23-12051
2001.06000 THE HEIMLICH INSTITUTE 2 3 -- 1 2 0 5 1
i ray 1C) ti«Ui "*-
j - a u - w ^ w
rri HI\ 1'4lJ
- i A >■«-> •
..n I •
neimiicn inbiiwiE
THE HEIMLICII INSTITUTE

TilE HEIMLIClJ INSTITUTE FOUNDATION
FOUNDATION
BOARD OF TRUSTEES
TRUSTEES
John Gall,
John President
Gall, President (513)751-9600
(S13) 751-9600
Health & Life Underwriters
Health Underwnters Agency, Inc
Agency, Inc (513) 751-9613
(513) (Fax)
751-9613 (Fax)
2344 Gilbert
2144 Avenue
Gilbert Avenue (513) 221-8112
(513) (Home)
22] -8112 (Home)
Cincmnau, 45206
Philip M. Heimlich,
Philip Heimlich, Vice President
VIce President (513)624-9155
(513) 624-9155
6680 Lyceum
6680 Lyceum Court
Court
Cincinnati,
45230
Joseph
Joseph J. Dehner, Secretary
Dehner, Secretary (513)651-6800(651-6949)
(513) 651-6800 (651-6949)
Frost Brown
Frost Brown & Todd
Todd (513) 651-6166 (Kathy
(Kathy Bantu)
Barrett)
201 E. Fifth Street
201 Street (513) 651-6981
(513) (Fax)
651-6981 (Fax)
Cincinnati, 45202
Cedric (Rick)
Cedric (Rick) W. Vogel.
Vogel, Treasurer
Treasurer (513)421-4225
(S13) 421-4225
Vogel, Heis, Wcnstrup
Vogel, Hets, Wcnstrup & Cameron
Cameron (513) 639-2547
(513) 639-2547 (Fax)
th
817 Main
817 Mam Street,
StTeet, gill
8 Fl.FI.
Cincinnati, DH
45202-2134
Henry I.
J. Heimlich,
Heimlich, M.D. (513) 559-2391
(513) 559-2391
The Heimlich
Heimlich Institute
Institute (513) 559-2403
559·2403 (Fax)
311 Straight Street
Straight Street (513)871-7711
(513) 871-7711
Cmcmnati, OR 45219
George Blake
George 6 lake (513)
(S 7719 1..
762-7719»-
1.3) 762·
Watchvove Court
624 Watcbvove (513)
(513) 762-7758 (Fax)
762-77~'{Fax)
Cincinnati, 45230 (513) 232-3434 (Home)
(513) 232-3434 (Home)
702-3173 (Cell)
(CeU)
John Davies
Davies (513) 791-6699
(513) 791-6699
8044 Montgomery
8044 Montgomery Road,
Road. Ste. 163 (513) 791-6729
(513) 791·6729 (Fax)
Cincinnati, 45236
Harry W. Whittaker
Harry Whittaker (513)961-8686
(513) 961-8686
2200
2200 Victory Parkway
V rcrory Parkway
Cinti., OH 45208
Cintr., 45208
,~\-l
.1 Uv...........
\....- ...-4--
I-HA INU i-siJ-oa^-CMuJ "°y -1" t u u t
i-Kuri
J-~UI'I n eim
Hel iich
milch Iiris
n st t1i tu
t u t.e
te
'w I
Richard WC11and
Rtchard V/ciland (513)421-8527
(513) 421-8430
421-R527 421-8430
1055 St Paul Place (513) 871
(.513) 871-5248 (Home)
-5248 (Home)
Cincinnati, 45202 (513)381-0124)
(513) 381-01 24)
Kathy
Kathy Carr (513) 871-2221
(513) (Work)
871-2221 (Work)
Ray Carr
Can (513) 621-4777
(513) (Work)
621-4777 (Work)
3057 Saddleback Dnve
3057 Saddleback Drive (513) 231-3010 (Home)
(513) 231·30lO (Home)
Cincinnati, OH
Cmcmnau, OH 45244
45244
Anson Williams
Anson Williams (310) 397-1746 (Work)
(310) 397-1746 (Work)
24615 Skyline
View Drive (310) 456-
(310) 456· 5775 (Home)
5775 (Home)
Malibu, CA 90265
Malibu, 90265
Monte Rovckamp
Monte Rovckamp (859) 341-6050
(859) 341-6050
2864 Crescent Springs Pike (859) 341-6950
(859) (Fax)
341-6950 (Fax)
Erlangcr, KY 41018
Erlanger, 41018
James L
James Palils
L Pahis (513) 272-2318
(513)272-2318
7522 Muchmore
7522 Muchmore Close
Close
Cincmnau, 45243
^ ,\
'\ ,- ~ _+ (
REALIZED
REALIZED CAPITAL G ii AND LOSSES
GAh...
AINS LOSSES Account
Account # 06390287
JANUARY
J 1,2001
ANUARY 1 , 2 0 0 1 - DECEMBER 31,
3 1 . 2001
2001 HEIMLICH INSTITUTE FOUNDATIQt.~,
FOUNDATION,
IINCORPORATEI
NCORPORATE!
ACQUISITION
ACQUISmON PROCEEDS DOLLAR
DOLLAR DOLLAR
DOLlAR $G A I N /1
GAIN
QUANTITY
QUANTITY ASSET
ASSET DESCRIPTION DATE DATE COST PROCEEDS
PROCEEDS LOSS
LOSS
SHORT TERM CAPITAL
CAPITAl. TRANSACTIONS
50 PROCTER & GAMBLE COMPANY 03/09/00
03109/00 02/20/01
02120/01 2,93525
2,935 25 3,779 B7
3,779 87 6446
844 6
TOTAL NET SHORT TERM CAPITAL
TOTAL GAINS
CAPITAl. GAINS $2,93525
$2,935 25 $3,77987
$3,779 87 $844Jj.
$844.6
LONG TERM
TERM CAPITAl.
CAPITAL TRANSACTIONS .
300
300 AMERICAN
AMERICAN EXPRESS COMPANY 12/07/98
12107/98 09/19/01
09/19101 9,97250
9.972 50 7,70860
7,708 60 -2,2639
-2.263 9
150
150 AT & T CORPORATION
CORPORATION 02108/99
02/08/99 05122101
05/22/01 B,91857
8,918 57 3,20989
3.209 89 -5,70866
-5.708
16 AVAYA.
AVAYA,INCINC 12/01/98
12101/98 02/02/01
02102101 45613 280 63
28063 -175 s-
-175 5-
160
160 BRISTOL-MYERS
BRlSTOL-MYERS SQUJBB
SOUJBB COMPANY 07/14/00
07/14/00 09/10/01
09/10/01 8,28289
8.282 89 9,249 77
9,24977 966 £
966S
60 CINTAS CORPORATION
CINTAS CORPORATION 04/14/99
04/14199 08/13/01
08113101 ~,55622
2,556 22 2,852 68
2,85268 296 4
296-4
250
02105196 10/04/01
10/04/01 5,63875
5,638 75 1,61675
7,616 75 1,978 C
1,978 C
02127/97 10/04/01
10/04/01 2.277 90
2,277 2,74202
2.742 02 4641
464 1
15.000
15,000 ENRON
ENRON CORPORATION. 12/28/98
121~8I98 11/30/01
11130/01 15,34020
15,340 20 2,77500 -12,565?
-12,565 Z
6 7 5 0 % DUE 08/01/09
6750% 08/01/09 DATED 07/24/97
07/24/97
25 FANNIE MAE
FANN1E 11/19/98
11/19/98 07/05/01
07105101 1,700 44
1,713044 2,14352,
2.143 52 * 443(1)
443 0>
50 FANNIE MAE 01/28/99
01128199 07/05/01
07/05'01 3,58639
3,586 39 4,28704
4.287 04 700&
700 6
0
o 080
080 GLAXOSMITHKUNE
GLAXOSMITHKUNE PLC - ADS 05/09/96
05109196 01/11/01
01111/01 176
1 76 415
4 15 2~
2i
110
110 JOHNSON
JOHN~ON & JOHNSON 11/06/96
11/06/96 08/09/01
08/09/01 2,86205
2,862 05 5,903 86
5,90386 3,041 f.
3,041 e
200
200 LUCENT TECHNOLOGIES,
TECHNOLOGIES. tNC
INC 12101198
12/01/98 03119101
03/19/01 8,20161
8.201 61 2,24702
2,247 02 -5,954 ~,
-5.954 E.
1 612
612 MCDATA CORPORATION·A
CORPORATION-A 05129196
05/29/96 02/23/01
02123/01 96
98 15 53
1553 14 ~,
14 £.
20 MCDATA CORPORATlON-A
CORPORATION-A 05/29/96
05129/96 12/10/01
12110/01 3214 543 99
54399 511 f;f.
100
100 PROCTER & GAMBLE COMPANY 02105199
02/05/99 02/20/01
02120101 8,80375
8,803 75 7,55975
7,559 75 -1,244
-1.244 01
(II
140
140 ROYAL DUTCH PETROLEUM CO (NETHERLANDS)
(NETHERLANDS) 10/13/99
10113199 04/27/01
04/27/01 8,288 70
8.288 8,381
6.381 16
16 92~
92 4
160
160 SCHERING-PLOUGH CORPORATION
03103192 05/04/01
05104/01 1,19280
1.192 80 6.070 20
6,07020 4.877 ~
4,877 i
' 40 SCHERING-PLOUGH CORPORATION
12102194 05/04/01
05104/01 375 07
37507 1,51755
1.517 55 1,142
1.142<~
330
330 STAPLES, INC
STAPLES. 05/12/99
05112/99 09/17/01
09f17/01 8,91000
8.910 00 4,29283
4,292 83 -4,61711
-4.617
220 STAPLES
STAPLES, INC 05/18/00
05118100 09/17/01
09117/01 3,90500
3.905 00 , 2,861
2,861 88 ·1,0431
-1,043 1
20.000
20,000 UNITED STATES TREASURY NOTE 09/15/94
09115194 11/15/01
11/15101 20,34375
20,343 75 20,00000
20.000 00 -343 7
·3431
7 500%
5 0 0 % DUE 11115/01
11/15/01 DATED 11/15/91
11/15/91
280 USX - MARATHON
MARATHON GROUP INC 05/16/97
05116197 ''02/21/01
02/21/01 8,13523
8,135 23 7,64069
7.840 69 -294 ~~
-294 :-
16
16 ZIMMER HOLDINGS INC 07/14/00
07/14/00 08/24/01
08124101 416 71
41671 42433
424 33 H,
7 f.
TOTAL
TOTAL NET LONG TERM CAPITAL LOSSES
LOSSES $130,199 54
$130,19954 $110.528 84
$110,52884 -$19,670 :
'.$19,6701
TOTAL
TOTAL GROSS PROCEEDS $114,308.71
$114,308.71

summartzes the portfolio
portfoho transactions tor
lor your convemence
convenience
We do not guarantee its
Its appropnateness for use in preparation
In tax preparation
'_L_~_~.~ __ .._~_ .. ,.. " •

Form
Form 990 Return
Return of
of Organization
Organization Exempt
Exempt From
From Income
Income Tax
Tax OMB
OMB No
No 1545 0047
15450047
Under
Under section
section 501(c).
501(c), 527,
527, or
or 4947(a)(1)
4947(a}(1) ofof the
the Internal
Internal Revenue
Revenue Code
Code (except
(except black
black tung
lung
benefit
benefit trust
trust or
or private
private foundation)
foundation) 2002
Departrneru01
Departmem the Treasury
of the
tntemal Revenue
Treasury
Revenue Service
Service
Open
Open to
to Public
Public J
Internal • The organization
The orcarnzanon may may have
have to useaa copy
to use COpyof of this
this return to satisfy
return to state reporting
satisfy slate reportmq requirements
requirements Inspection
Inspection
AA For
For the calendar year,
2002 calendar
the 2002 year, or or tax year beginning
tax year begmmnQ and
and ending
ending
BB Check
Check ifIf applicable
applicable CC NName
a m e of organization
of o rganization Oo Employer
Idenllflcatlon number
Please
Pitas*
O
I | Address change
change use IRS
use IRS THE HEIMLICH
THE HEIMLICH INSTITUTEINSTITUTE FOUNDATION 23·7303161
23-7303161
O
| | Name change
change
labelor
label
prlnlor
or Number and
Number ana street
street (or
(01PPObox malJ15not
O box if" mat) delIVeredto
is not delivered 5~reetaddress}
l o street addfes-s.
I
Room/suite
Room/SUite Telephone number
EE Telephone
o
prlnl or
type
[ trnual relurn
| Initial return ~::
See 311 STRAIGHT
311 STRAIGHT STREET
STREET . 1(513)559·2391
(513)559-2391
O
L J Final
Final return
return
Specific
Sp~C""
fn/tnT
In.INC
Instruc City or town
City or town SState r ccountry
t a t e oor ountry ZIP+
ZIP" 44 FF Accounting
Accounhno method
_thod D Cash
Cash 0 Accrual
Accrual
O
| Amended return
[Amended
c~ns
lions
CINCINNATI OH
OH 45219
45219 o
| | Olher
Other (specify)
(SPeCIfy)
• »-
o
| Application pending
| Apphcatron pending •• Section
Section 501(c)(3)
501{c)(3) organizations
trusts must
trusts must attach
organizations and
attach aa completed
and 4947(a)(1)
4947(a)(l) nonexempt
completed Schedule
Schedule AA (Form
(Form 930
chantable
or 9990-EZ)
990 or 90-EZ)
H and II are
H and
H(a)
H(a}
are not
not applicable
is
aponcabte to
Is this
IhlS aa group
secnon 527
:0 section
g<OUDreturn
rel"m for
orgarllzallOns
527 organizations
'or aifihaies^
a'f,IIales7 D Ye5 0 No
I I Yes [X] N
°
G Website
G Web site • N/A
► N/A H(b)
H(b} II""Yes"
"Yes " enter
enter number
number of
01affiliates
affiliaies ►
• :---_--==-_
H(c)
H(c) Are all
Are all affiliates
affihales included''
mctuded? N/A
N / A \_J 0 Yes 0 NoYes | | No
JJ O
ORGANIZATION
R G A N I Z A T I O N TTYPE (check only
Y P E (check only one)
one) ► x | 5 0 1 ( c ) ( (3
.. | [R]501(C) 3 )) ■*
... (insert
(Insert no
no)) Q
04947(3)(1) OR I05271527
4 9 4 7 ( a ) ( 1) OR (K "No·" attach
(II "No attach aa list
hst See
See instructions
mstrucuons ))
Check here
K Check
K here »*■ 0
... | | ifIf the organlzaliOnss gross
the organization gross receipts
receipts are
are normally
normally not
not more
more than
than $$25
2 5 0000
0 0 The H{d)
H(d) Is this
Is this aa separate
separate return
return filed
filed by an~nlzallon
by an organization
orqamzauon need
organization
rna" itIt should
mail
need not not file
file aa return
file aa return
should file return without
retum with
Withthe IRS but
the IRS
WIthoutfinanCIaldata
but itII the
financial data SSOME
the organization
organizatIOnreceived
O M E SSTATES
TATES R
received aa Form
REQUlRE
EQUIRE A
990 Package
Form 990
A CCOMPLETE
OMPLETE R
Package in
RETURN
ETURN
the
to the
covered by
covered by aa group
group ruling''
ruling? |L_j Yes [ X | No
| Yes No 0
II Enter 4-diqit
Enter 4-dIQltGEN
GEN •
246 425
M Check
Check. * " [
to
to attach
aaach Sch
D"
| il the
the organization
Sch BB (Form
orqamzauon is
(Form 990
990 990
990 E2
IS NOT
EZ or
NOT required
reqUited
or 990-PF)
990-PF)
LL Gross
Gloss receipts
receipts Add lines
hnes 6b, Bb 9b,
6b Sb, and 10b
9b and to line
lOb to lone12
12 • 246,425
IParti
Part I Revenue,
Revenue, Expenses,
Expenses, and and Changes
Changes in In Net
Net Assets
Assets or or Fund
Fund Balances
Balances (See page
(See page 17
17 of of the the instructions
instructions))
Contributions, giftS, grants,
grants, andand similar
Similar amounts
amounts received .,
a Direct
Direct public
pubhc support 1a
1a 112,467
112467 ~t
b Indirect
Indirect public
pubhc support 1b
1b
c Government
contnbullons (grants) 1c
1c
d TOTAL
TOTAL (add
(add lines
lines 1a1a through
through 1c)1c) (cash
(cash $$ 96,880
96880 noncash
noncash $$ 15587 )) 1d
15,587
.:..::::..J.:::..:::_:._ 1d 112467
112,467
2 Program
Program service
service revenue
revenue including
Including government
govemment fees fees and
and contracls
contracts (from
(from Part
Part VII,
VII, line
hne 93) 93) 2
3 Membership dues
Membership dues andand assessments 3
4 Interest on
Interest on savings
savings and and temporary
temporary cashcash investments
Investments 4
5 DIVidends and interest
Dividends mterest fromfrom securities
secunnes 5 21906
21,906
6 a Gross rents 6a
L6a I
b Less rental expenses 6b
c Net
Net rental income
Income or (loss) (subtract line line 6b from linehne 6a) 6c o
77 mvestment income
Other investment Income (describe
(descnbe ► • J_ ) 7
CI>
:::I
88 a Gross amount from sales of assets other (A) Securities (B) Other
~10~A~~S=e~c=u~nt=le~S~~+-~(B~~)~O~th~e~r__,-,
In Ihan
than Inventory
inventory 1--- 112,052 8a
__ 1:...:1~2CL::0:..::5:.::.2+_8::..:a=4_----___1, ~
> 118802 8b 8b -.~,
b Less
Less cost or other basis baSISand and sales expenses 118,802
iCI>
a::
c Gain or (loss) (attach schedule)
1-------~~~~~----------_4
-6 750 8c
-6,750 8e 0 .t.>
d Net
Net gain
gam oror (loss)
(loss) (combine line 8c, columns (A) (A) and (B»(B» 8d -6.750
·6750
9 activmes (attach schedule)
Special events and activities ~~"
a Gross revenue (not including

Including $
,'
of
contributions reported on line hne 1a)
1a) lJ-=.
9a91=-la ---11;-
b Less direct expenses other than fundraising fundrarsmq expenses 9b '--.,/
isK
c Net
Net income
Income or (loss) from special events (subtract line hne 9b from line 9a) 9c o
10 a Gross sales of inventory,
mventory, less returns and allowances 10a
110al
b Less cost of goods sold 10b
L.:1c.::O=b...__ -+_'->-j
c Gross profit or (loss) frem sales of inventory
(105:') from II"VentotY (attach
(attacb schedule)
sch=dulet (subtract line 10b from line 10a) 10a) 10c
10c o
11 Other revenue (from Part VII, line hne 103)
103) 11
11
CO 12 TOTAL REVENUE
REVENUE_ladd (add lines 1d,1d 2,2 3, 3 4,4 5.5 6c,
6c 7,7 3d.
8d 9c,
9c 10c,
10c and 11)
11) 12
12 127623
127,623
13
13
14
Program services (from line 44,
Program services (from line 44, column (B»
Management and general (from line
column
line 44,
(B))
column (C))
(C»
~ AE:CL.:tVco
ttECii.VeD
--'---~u
I13
13
14
14
69.770
69770
129571
129,571
O
8 15
15 Fundraising
Fundraismq (from line hne 44, column (D)) (D» 00 (f) I 15
15 o
0)
16 Payments to affiliates (attach schedule) ~ NOV 9
N0V 1 9 2003 W l Z003 ~: 1. 9l 16
16
** 17 EXPENSES_(add
TOTAL EXPENSES hnes 16 and 44,
(add lines 44 column (A)) (A)l. .ff, 17
17 199,341
199341
18 (deficll) for the year (subtract line 17 from line 12)
Excess or (deficit) 12) .! « p p cIVi I i„ f i^4 nr..DEN -_U-_
~" II 18
18 -71 718
-71,718
u. 19 Net assets or fund balances at beginning of year (from line 73, cqlurnnÂjjJ cJlumnXAW ' ^ I I
19
19 690,653
690653
~ 20 Other changes in In net assets or fund balances (attach explanation) explanation) 20 -28,089
·28089
•
:I 21 Net assets or fund balances at end of year (combine lines
orfund hnes 18,
18 19,
19 and 20) 21 590,846
590846
(HTA)
<HTA) For Paperwork
Reduction Act Act Notice,
Notice, see
see the separate
separate instructions feO Form 990 (2002)
Form 990
1
THE HEIMLJCH IINSTITUTE FOUNDATION
23-7303161 Page
Page 22
P a r t II S t a t e m e n t Of All
All organizations mustcomplete
organ.zallons must columl1
cornptetecolumn (A) Columns
(A) CO!UITl115 (8) (C)
(B) (C) and
and (0)(0)are
are required
requrredlor
lor section
secnor- 501(c)(3) and((4)
S01(CX3) and orqancatoos
4) organizations
FFunctional
u n c t i o n a l EExpenses
xpenses and section
and 4947(a)(1) nonexernot ch<lnlable
secnon 4947(a)(l)nonexemplchan able Irusls bulOpl.onal
trusts bul optional for others(See
for others (See page
page 21 Ihe'nslfUel,ons
o( ihe
21of mslruclrons ))
Do not
Do not include
Include amounts
amounts reported
reported on on line
hne (A)
(B) Program
(8) Program (C)
(C) Management
Management
(A) Total
Total (D) Funlralsrng
(O) Fundraismg
6b, 8b,
6b, Bb, 9b.
9b, 10b,
lOb, or or 1616 ofof Part
Part 1I services
services and general
and general
22
22 Grants and
allocations (attach
(attach schedule)
schedule)
l"1l ■'
(cash
(cash $$ noncash $$
noncash )) r--=2::.:2=........t
22 -:O+-
0 -l -•
" , .., I ~~,
Specific assistance
23 Specific assistance to individuals (attach
10individuals (attach schedule)
schedule) 23 00 , , 1
23 23
24
24 Benefits paid
Benefits paid toto or
or for
for members
members (attach (attach schedule)
schedule) 24
24 00 1
•
Compensation of
25 Compensation
25 of officers,
directors, etc etc 25
25 00
26 Other
26 Other salaries
salanes andand wages
wages 26
26 67,113
67,113 23,490
23490 43,623
43623
Pensron plan
27 Pension
27 plan contributions
contnbuuons 27
27 00
28 Other
28 Other employee
employee benefits
benefits 28
28 13,312
13312 4.659
4659 8,653
8653
Payroll taxes
29 Payroll
29 taxes 29
29 5,596
5596 1.959
1959 3,637
3637
30
30 Professional fundraismg
Professional Iundrarsmq fees fees 30
30 00
31
31 Accounting fees
Accounting fees 31
31 00
32
32 legal fees
Legal fees 32
32 00
Supplies
33 Supplies
33 33
33 11,288
11288 3,951
3951 7,337
7337
34
34 Telephone
Telephone 34
34 718
718 251
251 467
467
3S
35 Postage and
Postage and shipping 35
35 712
712 249
249 463
463
36
36 Occupancy
Occupancy 36
36 26,153
26 153 9,154
9154 16.999
16999
37
37 Equipment rental
Equipment rental and
and maintenance 37
37 248
248 87
B7 161
161
38
Pnntrnq and 38
38 4,238
4 238 1,483
1483 2.755
2755
39
39 Travel
Travel 39
39 00
40
40 Conferences, conventions,
Conferences, conventrons. and and meetings 40
40 4,864
4 864 1,702
1 702 3,162
3162
41
41 Interest
Interest 41
41 00
42
42 Deprecianon, depletion,
Depreciation, depletion, etc etc (attach
42 00
43
43 Otherexpensesnot
Other coveredabove(Itemize)
expenses not covered above (itemize) a3 _ 43a
433 00
bb PURCHASED
PURCHASED SERVICES 43b
43b 63,371
63371 22.180
22180 41,191
41 191
cc PROFESSIONAL
PROFESSIONAL FEES FEES 43c
43c 1,728
1728 605
605 1,123
1 123
d __ 43d 00
d 43d
ee _ 43e
43c 00
f __ 00
f 43f
43f
44
44 TOTAL FUNCTIONAL
TOTAL FUNCTlONAL EXPENSES
EXPENSES (add
(add lines n through
Irne'$22 "'rough 43)
43) ORGANIZATIONS
COMPLETING COLUMNS
COMPLETING COLUMNS (BHD)
(BHD) CARRY
CARRY THESE
THESE TOTALS
TOTAlS TO
TO LINES
LINES 13
13 15
15
44
44 199,341
199341 69,770
69770 129,571
129571 0o
JOINT C
JOINT COSTS Check ►
O S T S Check D
~ □ Ifif you are followmq
following SOP 98-2
98-2
Are any
Are anyJOint costsfroma
joint costs combinededucational
from a combined campaignandfundralSlng
educational campaign reportedIn
soncitauon reported
and fundraismg solicitation in (B) Programservices?
(8) Program services? ~ DYes
► | | Yes [R] No
No
If""Yes: enter(I)the
"Yes." enter aggregateamountof
(i) the aggregate theselomt
amount of these costs $$
|omt costs ,, (») the amount
(II) the amountallocated to to Program
Programservices
services $$ _
(m) the amount
(III) the amountallocatedto Manaqementand
allocated to Management andgeneral
general $ s and (iv)
, and theamount
(IV) the amountallocatedto FundralSlng $
allocated to Fundraismg s
IParti
Part III I Statement of Program
Statement Program Service
Accomphshments (See page 24 of of the instructions
mstructions )) Program Service
Program Service
9
What
What is IS the organization's primary exempt purpose? • SEE
purpose ► SEE ATTACHEDATIACHED Expenses
Expenses
Required
RequlI'l!d lor 50 I (eNJ) and
lor 501(c)(3) and
All organizations
All organizationsmust
mustdescnbetheirexemptpurpose acruevements in
describe their exempt purpose achievements a clear
In a clearand manner State
and concise manner Statethe number
the number (4\ ergs and
(4)oros 494 7(aH I)
and 4947(a)(1)
of clients
of clientsserved,publicationsISSUed, etc Discuss
served, publications issued, etc DISCUSS achievementsthat
achievements thatarenot measurable (Section
are not measurable (Sechon501(c)(3) and (4)
S01(c)(3) and (4) trust! but
trust! bu1 optional
ophonal lor
lor
organlzallonsand
organizations and4947(a)(l) nonexemptchantable
4947(a)(1) nonexempt chan tabletrustsmustalsoenterthe amount of
trusts must also enter the amount of grants
grantsandallocationsto others))
and allocations to others OllIe".)
others)
a THE HEIMLICH INSTITUTE FOUNDATION,FOUNDATION INC , IS A CORPORATION

CORPORATION DESIGNED TO CONDUCT
SCIENTIFIC CULTURAL AND SOCIAL RESEARCH IN TO ISSUES OF IMPORTANCE TO THE MEDICAL
SCIENTIFIC,
AND SCIENTIFIC COMMUNITIES _ _ _
and allocations
(Grants and allocallons $$ ) 20,932
20932
b AIDS RESEARCH AND EDUCATION EDUCATION
..
$
(Grants and allocations $ ) 31,396
31396
PUBLIC THE PRINTING AND DISTRIBUTION
c EDUCATION OF THE GENERAL PUBLIC, DISTRIBUTION OF EDUCATION
LITERATURE TO PUBLIC PLACES ABOUT THE HEIMLICH
HEIMLICH MANEUVER
MANEUVER
(Grants and allocations $

$ ) 17,442
17442
d
{Grants and allocations $

(Grants }
e Other orocram
program ssrvrces
services (attach schedule)
schedule) (Grants and allocations $$ )
f TOTAL OF PROGRAM SERVICE EXPENSES (should equal line
hne 44,
44 column (B),
(8) Program
Procrarn services) ... 69,770
69770
Form
Fonn 990 (2002)
(2002)
Form
Form 990 (2002)
f2002) THE
HEIMLICH INSTITUTE FOUNDATION 23-7303161
23-7303161 Page
Page 3
IPart IV Balance Sheets (See page

(See page 24 of the instructions
instrucuons )}
Note
Note Where
Where reouired. attached schedules
required, attached and amounts
schedules and amounts within
wlthm the
the descnpuon
description (A) <B)
(B)
column should
column should be
be for
for end-of-year
end-of-year amounts
amounts only
only Beginning of year Endof year
End
45 Cash - non-mterest-beannq
non-interest-bearing 11.183 45 24.485
46
46 Savings and temporary cash Investments
investments 36,366 46 29.913
47 a Accounts receivable
receivable 47a 0
b Less allowance
accounts 47b 0 0 47c o
0
48 a Pledges receivable 48a 0

b
b Less allowance for doubtful
doubtful accounts
accounts 48b 0 0 48c 0
49
49 Grants receivable 49
50 Receivables from officers, directors,
directors, trustees and key employees
employees
{attach schedule)
(attach schedule) 0 50 0
51 a Other notes and loans receivable (attach S
£
J!l schedule) 51a 0
GJ
in
1/1 b Less allowance
accounts 51b 0 0 51c 0
1/1
«
< 52 Inventories
lnventones for sale or use 52
53 Prepaid expenses and deferred charges 53
54 Investments - secunties
securities (attach schedule) ► 1 Icost DFMV 1 IFMV 0 54 0
55 a Investments - land, buildmqs,
buildings, and
equipment baSIS
basis 55a 0
b accumulated deprecration
b Less accumulated depreciation (attach
(attach
schedule) 55b 0 0 55c 0
56 Investments - other (attach schedule)
schedule) 636,459 56 578,333
57 a Land, buildings,
buudmqs, and equipment baSIS basis 57a 55.616
b Less accumulated
accumulated depreciauon
(attach
schedule) 57b 55.616 0 57c 0
58 Other assets (desenbe ► See attached worksheet
assets (descnbe ... ..::S~e~e::...;a~tt:.!:a:::c::!h.!!e~d!..w!!!:::o!.!.rk~s:!.!h~e!::.et:__
_ > 6,645 58 6,222
59 TOTAL ASSETS (add lines 45 throuqh 58) (must equal line 74) 690,653 59 638.953
60 Accounts
Accounts payable and accrued expenses expenses 60 48.107
61 Grants payable 61
62 Deferred revenue 62
8
~ 63 Loans from officers,
officers, directors, trustees,
trustees, and key employees (attach
{attach f^#
e
e 0 63
li schedule) 0
(II
64 a Tax-exempt bond liabilities
habrlitres (attach schedule)
schedule) 0 64a 0
..:::l
b Mortgages
Mortgages and other notes payable payable (attach
(attach schedule) 0 64b 0
65 (descnbe
Other liabilities (desenbe ...
► _ ) 0 65 0
66 TOTAL LIABILITIES (add lines 60 throuqh 65) 0 66 48,107

48107
Organizations
Organizations thatthat follow
follow SFAS 117, checkcheck here ► X and completecomplete lines
67 through 69 and lineshnes 73 and 74
en 67 Unrestncted
Unrestncted 651.734 67 551,927
K 68 Temporanly
Temporanly restricted
restricted 68
3 69 Permanently restncted
restneted 38,919 69 38,919
Organizations that
Organizations follow SFAS 117, check
that do not follow check here ...►Oand
I land
complete lines
hnes 70 through 74 •BfflEfe
70 Capital stock, trust principal,
pnncipal, or current funds 70
b
J3 71 Paid-in or capital surplus, or land, buildmq,
building, and equipment fund
fund 71
a> earnings, endowment, accumulated Income, funds 72
V) 72 Retained earnings, endowment, accumulated income, or other
in
73 TOTAL NET ASSETS
ASSETS OR FUND BALANCES (add lines 67 through 69 OR
<
a> hnes 70 through
lines through 72,
column (A) MUST equal line 19, column (B) MUST equal line 21) 690,653 73
m 590,846
74
74 TOTAL LIABILITIES AND NET ASSETS / FUND BALANCES { add lines 66 and 73) 690,653 74 638,953
Form 990 isIS available for public inspection
inspection and, for some people, serves
serves as the primary
pnmary or sole source of information
Information about a
particular organization
organization How the public perceives an organization in In such cases may be determined by the information presentedpresented
on Its
its retum
return Therefore,
Therefore, please make sure the return is complete and accurate
IScomplete accurate and fully describes,
descnbes, in
In Part III, the organization's
organization's
programs and accomplishments
accomplishments
Form -990 (2002) THE
THE HEIMLICH INSTITUTE FOUNDATION TION 23-7303161 Page 4
Part IV-A R e c o n c i l i a t i o n of Revenuo
Reconctlratron R e v e n u e per
per Audited
Audited Part IV-B Reconciliation
ReconCiliation of E x p e n s e s per
Expenses Audited
per Audited
Financial Statements with with R e v e n u e per
Revenue per Financial Statements with
Financial Statements Expenses per
With Expenses per
Return (See page 26 of the
Return the Instruct
instructions ) Return
Return
a gams and other support
Total revenue gains support a Total expenses
Total expenses and losses per
losses per
per audited financial statements N/A audited financral
statements *■
... N/A
t--+_,;.;.;_~--.--~
b Amounts Included
Amounts included on
on hne
line a but
but not
not b Amounts included on hne
Amounts Included line a but not
not
on line
hne 12, Form 990
Form 990 on line
hne 17, Form
Form 990990 - ~.
'-
,
,
(1) Net unrealized gains
unrealized gains (1) Donated services
Donated services • !~'
on investments
Investments $ and use
and use of facihnes
facilities S "
(2) Donated
Donated services
services and
and (2) Prior
Prior year adjustments
year adjustments ,
, ,
use of facilities
use Iacrhnes _$_ reported on line
reported 20,
hne 20,
Recoveries 01
prior Form 990
Form 990 S
year
year grants
grants _$_ i * (3) Losses
Losses reported
reported on
on
(4) Other (specify)
Other (specify) line 20, Form
hne 20, 990
Form 990
(4) Other (specify)
Other (specify)
Add amounts on lines (1) through (4)

hnes (1) through (4)
c Line
Line a minus
minus line
hne b c Line a minus
Line minus line
hne b
d Amounts included
Amounts Included on line 12, Amounts
Amounts included
Included on line
hne 17,
Form 990
Form 990 but not
not on line
line a Form 990 but not on line
Form 990 hne a
Investment expenses (1) Investment expenses
Investment expenses
not included
Included on hne
line not
not included line
Included on hne
6b. Form
6b, Form 990
990 _$ 6b, Form 990
6b, Form 990 _$
(2) Other
Other (specify)
(specify) (2) Other (specify)
Other (specify)
Add amounts on hnes

Add amounts lines (1) and
and (2) ►
....j---:==--t-------;~ Add
Add amounts
amounts on lines
hnes (1) and
and (2) ►
e Total revenue
Total revenue per line 12, Form
per hne Form 990
990 Total
Total expenses
expenses per line
hne 17,
17, Form 990
Form 990
(line c plus line d) ► 0 (line c plus lined) ►
II> e
PartV List of
List of Officers,
Trustees, and
and Key
Key Employees
Employees (List
(List each
each one
one even
even ifIf not compensated, see
compensated, see
page the instructions)
page 26 of the instructions )
(C) Compensation
Compensation (D) Contnbutions
ContnbutJons to (E) Expense
Expense
(B)
(8) Title and average hours per
TIUeand per (IF NOT PAID
(A) Name and address employee benefit plans & account and other
other
week devoted to posrnon
position
ENTER -o-)
-0-) deferred compensation
allowances
SEE ATTACHED
SEE ATTACHED
75
75 Did
Old any officer director, trustee, or key employee
and all related orgamzatJons,
employee receive aggregate compensatJon
compensation of more than $100,000 from your or9
organizations, of which more than $10,000 was provided
provided by the related organizations'?
organizations? ..
organization
Yes
0
■gani2 zatJon
[KjNO
No
If "Yes," attach schedule-see
schedule-see page 26 of the mstrucuons
instructions
990
Form 9 90 (2002)
Form 990 (2002) THE HEIMLICH INSTITUTE FOUNDATION 23-7303161 Page 5
Part VI Other Information {See page 27 of the instructions ) Yes No
7
76
76 Did
Old the organization engage in
In any activity
activity not previously
prevIously reported to the IRS
IRS? If "Yes attach
attach a detailed description
oescneuon of each activity
eecn acllvlty 76
77 Were any changes made In in the organizing or governing documents but not reported to the IRS? IRS 7 77
If "Yes," attach a conformed copy of the changes
78 a Did
Old the organization have unrelated
unrelated business
business gross Income
income of $1,000
Si ,000 or
or more
more dunng
during the
the year
year covered
covered by
by this
this return?
return'' 78a
b "Yes," has Itit filed a tax return on FORM 990-T for this year?
If "Yes," year'' N/A
N/A 78b
79 liquidation dissolution
Was there a hquidauon dissolution termination,
termination, or substantial
substantial contraction
contraction dunnq
during the year?
year'' If 'Yes,'
'Yes,' attach a statement
statement 79
80 a (other than by association with a statewideor
Is the organization related (other statewide or natronwrde
nationwide orqaruzauon)through
organizalion) through common
common iM; ~»-j j
governing bodies
membership, governing bodies trustees,
trustees, officers etc to any other
other exempt or nonexempt organization"?
organization? 80a
b
b IfIf "Yes."
"Yes," enter
enter thethe name
name ofof the
the organization
organization ... -------------;=;-------=::::-----------1 'V J *r r
_________________ and check whether It it IS
is Dexempt
| jexempt OR nonexempt mpt
81
81 a Enter direct or Indirect
indirect political expenditures See hne
line 81 Instructions
instructions 81a I
b Did the orqarnzanon
organization file FORM 1120-POL for ttus this year?
year? 81b
82 a Old the organization
Did organrzatlon receive donated services services or the use of matenals,
materials, equipment, or facrhnes
facilities at no charge
or at substantially
substantrallv less than fair rental value? value? 82a
b "Yes," you may indicate the value of these
If "Yes," these Items
items here Do not Include include thrs
this amount Vi't!
as revenue
revenue In in Part I or as an expense In in Part II (See mstructions
instructions In in Part III ) | 82b |
83 a Old the organization
Dtd orqaruzatron comply with With the public inspection requirements for returns and exemption apphcatrons? applications7 83a
b Did the organization
organization comply Withthewith the disclosure
disclosure requirements relating contributions9
relating to quid pro quo contnbutrons? 83b
84 a Did organization sohCitany
Old the organization solicit any contributions deductible 7
gifts that were not tax deductible?
contnbutrons or gIfts 84a
b "Yes," did the orqaruzation
If "Yes,"
or gifts
organization Include
deductible9
gIfts were not tax deductible?
include With
with every sohcrtanon
solicitation an express
express statement
statement that such contrrbullons
contributions
N/A
NIA 84 b
m
85 501(c)(4), (5),(5). or (6) orqamzauons
organizations a Were substantially all dues members 9
nondeductible by members?
dues nondeductible 85a
b Did the oruaruzanon
Old organization make only In-house m-house lobbying
lobbying expenditures of $2,000 less 7
$2,000 or less? 85b
If
It "Yes"
"Yes· was answered
answered to either 85a or 85b, DO NOT complete 85c 85e through
through 85h below unless the
organization
oraaruzauon received a waiver for proxy tax owed for the pnor year year
assessments, and Similar
similar amounts from members 85c
d Section 162(e) lobbvmq
lobbying and pohncal
expenditures 85d
e Aggregate
nondeductible amount of section 6033(e)(1)(A) dues notices notices 85e
f Taxable amount of lobbYinglobbying and political expenditures (hne (line 85d less
less 85e) 85f isMl
9
g Does the orqaruzatron
organization elect 10 to pay the section 6033(e) tax on the amount amount on line 85f?85P 85g
h If section
section 6033(e)(1 HA) dues notices were
6033(e)(1)(A) were sent, does the organization
organization agree to add the amount on hne line 85f to
Its reasonable estimate of dues allocable to nondeductible lobbymq
its lobbying and political expenditures for the
following year 9
followrnq tax year? 85h
86 501(c)(7) orgs Enter lrunatronfees
a Initiation contnbutions included
fees and capital contributions Included on line
hne 12 J 86a
b Gross receipts,
receipts, included
included on hneline 12, for pubhc
public use of club facihties
facilities 86b
87 501(c)(12)
501{c)(12)orgs orgs Enter a Gross incomeIncome from members or shareholdersshareholders 87a
b Gross
Gross Income
income trom
from other
other sources
sources (Do not net amounts amounts due or paid paid to other
other
88
sources against amounts due or received from them) them ) 87b
-......:8;..;.7..=b'-'- -+"""'_,
At any time during
dunng the year, did the organization
organization own a 50% or greater greater interest
mterest in
m a taxable corporation or
partnership, or an entity disregarded as separate from the orqamzat.on
partnership, organization under Regulations sections
301 7701-2 and 301 7701-3 7701-3?7 If'Yes,"
If "Yes," complete Part IX 88
89 a organizations Enter Amount of tax imposed
501(c)(3) organizations Imposed on the organization
organization during
dunnq the year under
section 4911 .... ► 0 ,.section
section 4912 .... ► 0_ , section
0 sect.on 4955 ► ....--------=-ti-'""~
b 501(c)(3) and 501(c)(4) orgs DId Did the orqaruzanon
organization engage m in any section
section 4958
4958 excess benefit trarrsacuon
transaction
dunng the year or did itIt become aware of an excess benefit transaction transaction from a pnor year? year 7 If "Yes," attach
a statement explammq
explaining each transaction
transaction 89b
c Enter Amount of tax Imposeriimposed nn the orqamzatron
organization managers or disqualified
disqualified persons durmgduring the year under
sections 4912, 4955, and 4958
d Enter Amount
Amount of tax on hne
line 8gc,
89c, above, reimbursed
reimbursed by the orqaruzatron
organization ►
90 a List the states with
With which a copy of this
thrs return is
ISfiled
filed ....__::O::.:H...!!.::IO::.....-
► OHIO ---;-__ -;-- _
b Number of employees
employees employed
employed In
in the pay penod
period that rncludes
includes March
March 12, 2002 (See Instructions)
instructions ) | 90b
91 The books are in of
In care ot ► THE HEIMLICH INSTITUTE FOUNDATION
.... FOUNDATION Telephone no ... (513)559-2391
Located at ►
.... 311 STRAIGHT STREET
STREET, CINCINNATI
CINCINNATI, OH ZIP + 4 ........:4=5=.21.:..;:9'--
liP ► 45219 ---:=:---_
92 Section 4947(a)(1) nonexempt charitable
chantable trusts filing Form 990 In
in lieu of FORM 1041 - Check here ■□
and enter the amount of tax-exempt interest received or accrued dunng
dunng the lax
tax year ►! 92
Form 990 (2002)
Form
Form 990
990 (2002)
(2002) THE
THE HEIMLICH
HEIMLICH INSTITUTE
23-7303161 Paqe
PaQe 66
I Part VII
Part VII A n I
a l y
Analysts s i s of
of Income-Producing
Income-Producing A c t i v
Activitiesi t i e s (Sec
(See page
page 31
31 01
of the
the instructions) )
instructions
Note
Note Enter gross
Enter gross amounts
amounts unless
unless otherwise
otherwise Unrelated
Unrelated business
business income
Income Excludedby
Excluded secuon 5512
by secnon 1 2 513 or 514
513 or 514 (E)
(E)
moicete«
indicated (A)
(A) (8)
(B) (e)
(C) (D)
(0) Related
Related or ()'exempt
exempt
93 Program
93 Program service
service revenue
revenue Business
Business code
code Amount
Amount Exclusion code
Exclusion code Amount
Amount function
function income
Income
aa
bb
cc
dd
ee
ff Medicare/Medicaid payments
Fees aand
g9 Fees fromgovernment
connects from
n d contracts agenCies
government agencies
Membership dues
94 Membership
94 dues and
and assessments
995
5 Interest
Inlere~t on
an savings and temporary
saving'Sand lempOtary cash IrNestmencs
c.aih investments
96
96 DIVidendsand
Interest from
from securities
securities 14
14 21906
21,906
97
97 Nel rental
Nei rental income
Income oror (loss)
(loss) from
from real
real estate
estate II
aa debt-financed
property
bb not
not debt-financed property
98
98 Net
Nel rental
rental income or (loss)
InClfT'N)or (5oS$)from
from personal
personal properly
ptopelly
99
99 Other investment
Other Investment income
Income
100
100 Gam
G"", or (Iontlrom
0( (loss) sales ol
from sales asselS other
01assets other man Invenle<y
!han inventory 18
18 -6750
-6,750
101
101 Net income
Net Income or or (loss)
(loss) from
from special
special events
events
1102
02 Grossprofitor
Gross (loss) from
profit or (loss) salesof
from sales oIlnventOly
inventory
103
103 Other revenue
Other revenue a
bb
cc
dd
e0
104
104 Subtotal (add
Subtotal (add columns
columns (B).
(B), (D),
(D), and
and (E))
(E))
"~;>'i'!11'
i fr'fSZ f "J f
s.' ^~.-^,:'
0 ;~,,}~~m~~~;
o m-mmmm< 15.156
15156 00
1105
05 TOTAL (add
TOTAL (add line
hne 104
104 columns
columns (B),
(B), (D),
(D), and
and (E))
(E» .... ..:.c15::.L..:..1.::..56::..
15,156
Noet
Note Lme 105
Line 105plus I line
pIUS Ime 1d,
1d Part I snout
Part 1, should equalI th
d eaue thee amount
amount on
on me
line 12, 12, part
Parti
I
Part VIII
Part Vlll I
Relationship
Relationship of Aeuvmes to
of Activities to the
the Accomplishment
Accomphshment of
of E x e m p t Purposes
Exempt Purposes (See page 32
(See page 32 of
of the
the instructions
instructions) )
Lille No
Line Explain
Explain how
how each
each activity
acuvity for
for which
which income
Income is
ISreported
reported in
In column
column (E)
(E) of
of Part
Part VII
VII conlnbuted
Importantly to
to the
the accomplishment
T
• of the organization's
01the organization's exempt purposes (other
(other than
than by
by providing
providtnq funds
lunds for such
such purposes)
N/A
N/A
IPart
Part IX I Information
Regarding Taxable
Taxable Subsidiaries
Subsrdiarres and
and Disregarded
Disregarded Entities
Entities (See page
(See 32 of the instructions
page 32 instructions) )
(A) (B)
(B) (e)
(C> (0)
(D) (E)
Name, address, and EIN of01corporation.
corporation, Percentage of
Percentage of Nature of acuvmes
of activities Total income
Income End-of-year
End-of·year
or disregarded entity
partnership, or ownership
ownership interest
Interest assets
%
N/A %
%
%
IPart
Part X I Information
Regarding Transfers
Transfers Associated
ASSOCiated with
with Personal
Personal Benefit
Benefit Contracts
Contracts (See page
(See page 33 of the instructions
instructions) )
(a) Did
organization, dunng the year, receive any funds, directly or indirectly,
mdrrectly, to pay premiums on a personal benefit contract'?
contract? □ Yes [K]NO
DYes [XJNO
(b) Did
(b) Oldthe
the organization,
dunng the year,
year, pay premiums,
premiums, directly
Indirectly, on a personal
personal benefit
benefit contract'
contract?
7
IDYes
I Yes [gJNO
No
Note if *• Yes" to (b), file Fonn
Form 8870 AND
AiyD Form 4720 /see instructions]
Indudlng accompanying
turn including accompanY1l1gschedules and statements and to to the best
bestof my knowledge
(otherthanofficer)IS
■ r(other than officer) isbased onan
basedon information ol whichpreparer
allInfonnatJon01which hasanykrl<l'lMedge
preparerhas any knowledge
r
Date /
SCHEDULE A
Organization Exempt Under
Under Section
Section 501
501(c)(3)
(c)(3) OMS No 1545-0047
OMB 15~5-0047
(Form 990
(Form 990 or 990-EZ)
990-EZ) (Except Private Foundation)
(Except Private Foundatton) and Section
Section 501(e), 501(f).
501(I), 501(k),
501(n), Section 4947(a)(1)
501{n), or Section 4947(3)(1) N
Nonexempt Charitable Trust
o n e x e m p t Charitable Trust
Department of the Treasury S u p p l e m e n t a r y Information
Supplementary I n f o r m a t i o n -- (See
( S e e separate
s e p a r a t e instructions)
instructions ) 2002
Internal Revenue Service MUST
MUST be completed
completed by the above organizations
orqaruzatrons and attached to their Form 990 990 or 990-EZ
990-EZ
Name organization Employer Identification
THE HEIMLICH INSTITUTE FOUNDATION 23-7303161
23-7303161
Parti Compensation of tthe
C o m p e n s a t i o n of h e Five Highest
Five H Paid
ighest P Employees
aid E mployees O Other
ther TThan
han OOfficers, Directors,
fficers, D and
irectors, a n d Trustees
Trustees
(See page 1 of the instructions List each one If there
(See there are none, enter "None ")
(a) Name and
address of each
each (b) and average
(b) Title and average (d) Contributions to
(d) Contnbubonsto (e) Expenseaccount
Expense account
employee paid
employee paid more
more than
than $50,000 hours per week
hours per week (c) Compensation employee benefit
employee plans &
benefit plans and
and other
other
devoted
devoted to posruon
position deferred compensation
deferred compensation allowances
allowances
NONE
NONE
Total number of other employees paid

over $50 000
000
Part II Compensation
C of tthe
o m p e n s a t i o n of Five
he F Highest
ive H Paid
ighest P a i d IIndependent
ndependent C Contractors
o n t r a c t o r s ffor Professional
or P r o f e s s i o n a l Services
Services
(See Instructions List each one (whether
(See page 2 of the instructions (whether individuals
Individuals or firms) If there are none, enter "None ")
(a) Name
Name and address of each independent contractor paid more
Independentcontractor more than $50,000
$50,000 (b) Type
Type of service
service (c) CompensalJon
Compensation
NONE
:?S^S;;E;;'îli'S^8l!K^:4K^f.SB
Total number of others receiving over
$50,000
$50 000 for professional
rofessional services
WffltiBfflEBM&EB&£&$8i^
(HTA)
(HTAJ Reduction Act Notice, see the Instructions
For Paperwork Reduction Instructions for Form 990 and Form 990-EZ
990-EZ Schedule A (Fonn
990-EZ) 2002
2002
Schedule A (Form 990 or 990-EZ) 2002 THE HEIMLICH INSTITUTE FOUNDATION 23-7303161
23-7303161 Page 2.
P
IPart
Part 1/1
III I StatementsAbout
Statements A b o u t Acnvrnes
Activities (See page
(See page 2 of the
the mstrucnons
instructions ) Yes No
1 During the
Dunng the year
year has
has the
the organization
attempted toto Influence
influence national
national state,
state, or
or local
local legislation,
including any
any
attempt to Influence
attempt influence pubhc
public Opinion
opinion on a legislative matter or referendum?
referendum"? If "Yes:
"Yes," enter the total expenses paid
or Incurred
incurred In
in connection with the lobbying acnviues
activities $ a0_(Must equal amounts
(Must equal amounts on line
hne 38,
Part VI-A,
Vl-A, or hne
line Ii of Part VI-B)
Vl-B )
Organizations that made an election
electron under section 501(h) by filing
fihng Form 5768 must complete Part Vl-A VI-A Other
/■ft'
organizations
orqantzauons checking "Yes "Yes" " must complete Part Vl-BVI-B AND attach
attach a statement giving
giVing a detailed descnpnon
description of
the lobbyrnq
lobbying actrvitras
activities
2 organization, either directly or mdrrectly,
Dunng the year has the orgamzaliOn, indirectly, engaged
engaged Inin any of the Iollowrnq
following acts With
with any
substantial contributors, trustees,
trustees, directors, officers, creators, keykey employees,
employees, or members of their families, or
with
With any taxable orqaruzatron
organization Withwhich
with which any such person ISaffiliated
is affiliated as an otncer,
officer, director, trustee majority
owner, or pnncrpal
principal beneficiary?
beneficiary? (If the answer to any queslion
question is "Yes ' attach a detailed statement explaining the
IS "Yes'
transactions)
transactions )
a Sale, exchange,
exchange, or leaSing
property'' 2a
b other extension of credit?

b Lending of money or other credit? 2b x
c Furrnshmqof
Furnishing of goods,
goods, services
services or faCilities?
facilities'' 2c
2c x
compensation (or payment or reimbursement of expenses
expenses If
if more than $1,DOO)?
$1,000)? 2d
e Transfer of any part of Its

its Income
income or assets?
assets? 2e
3 organization make grants for scholarships,

Does the organrzallon scholarships, fellowships,
student loans, etc?
etc ? (See NOTE below)
below)
4 Do you have a section 403(b) annuity plan for your employees?
Note Attach a statement to explain how the organization determines that individuals
mdlvldua/s or organizations receiving grants
grants
or loans from it in furtherance of Its
its chantabfe
chantable programs "qualify'' to receive payments
IPart
Part IV I I Reasonfor
Reason for Non-Pnvate
Foundation Status
Status (See pages 3 through
through 5 of the Instructions)
instructions )
The 0';f@.,nlzatlon
organization ISis not a private foundation
foundalion because itIt is
IS (Please check only ONE applicable box
box))
5 UA| _ | A church,
church, convention
churches, or associauon
association of churches
churches Section
Section 170(b)(1)(A)(I)
170(b)(1)(A)(i)
6 jOA| A school
school Section
Section HO(b)(l)(A)(u)
170(b)(1)(A)(n) (Also complete Part V)V)
7 IDA | A hospital
hospital or a cooperative
hospital service
service orqamzauon
organization Section
Section 170(b)(1)(A)(IlI)
170(b)(1)(A)(m)
8 IOA |A Federal,
Federal, state,
state, or local
local government
government or govemmental
governmental urut
unit Section
Section 170(b)(1)(AHv)
170(b)(1)(A)(v)
9 IOA | A medical
medical research
operated Inin conjunction
conjunction With
with a hospital
hospital Section 170(b)(1)(A)(IlI)
170(b)(1)(A)(in) ENTER THETHE HOSPITAL'S
HOSPITAL'S
NAME, CITY, AND STATE
10
10 DAn
\_j An o~an~atron
operated fo-r-th-e-b-e-n-e-fi-It-o-f-a-c-o-I-Ie-g-e-o-r-u-n-Iv-e-r-s-Ity~o-w-n-e-d-o-r-o-p-e-r-at-e-d-b-y~a-g-o-v-e-rn-m-e-n-t-a-
for the benefit of a college or university owned or operated by a governmental unit Section
170(b)(1)(A)(iv)
170(b)(1)(A}(lv) (Also complete the SUPPORT SCHEDULE In in Part IV-A)
IV-A )
11 a [R]
[ X j AAn
n organization
organization that normally receives a substantial part of Its its support from a govemmental
governmental umt
unit or from the general
public Section 170(b)(1)(A)(vi)
pubhc Section 170(b)(1 )(A)(vl) (Also complete the SUPPORT SCHEDULE SCHEDULE In in Part IV-A)
IV-A )
11 b ( ^ ] A community trust Secllon
bOA Section 170(b)(1)(A)(vl)
170(b)(1)(A)(vi) (Also complete the SUPPORT
SUPPORT SCHEDULE
SCHEOULE in In Part IV-A
IV-A))
12 | j An organizationthai
D organization that normallyreceives
normally receives (1)(1) MORETHAN
MORE THAN 33 33 1/3%
1/3% of ItSsupportfrom
its support from contnbunons,
contnbutions, membership
membership fees,andgrossreceiptsfrom
fees, and gross receipts from
activities related
acuviues related 10115
to its charitable,etc
charitable, etc functions-
functions - subjectto
subject to certainexceptions,and
certain exceptions, and (2) NO MORETHAN
MORE THAN 33 33 1/3%
1/3% of Its
its supportfromgross
support from gross
investment
Investmentincome
Incomeandand unrelated
unrelatedbusiness taxable income (less section 511 lax)
taxableIncome(tesssection tax) from
frombusinesses
businesses acquired by the the organization
organizationafter June 30
afterJune
1975 See section 509(a)(2)
Seesection (Also complete the SUPPORTSCHEDULEIn
509(a)(2) (Atsocompletethe SUPPORT SCHEDULE in Part Part IV-A)
13
13 | _ j A n organization
DAn organization that IS is not controlled by any disqualified persons
persons (other than foundation managers) and supports
organizations
orqaruzauons descnbed in In (1) lines
hnes 5 through 12 above, or (2) section
section 501(c)(4), (5), or (6), ifIf they meet the test of section
509(a)(2) (See section 509(a)(3))
509(a)(3) )
Provide the followmq
followinq mformauon
information about the supported oroaruzatrons
organizations (See_page5
(See paqe 5 of the instructions)
instructions )
(b) Line number
(a) Name(s) of supported orqarnzancnts)
organization(s)
from above
14
14 L J An organization
DAn organization organized
orgamzed and operated
operated to test for public
pubhc safety Section
Section 509(a)(4) (See page 5 of the instructions
mstrucuons )
Schedule
Schedule A (Form 990 or 990-EZ)
990-EZ) 2002
Schedule A (Form
Schedule Form 990
990 or 990990 EZ) 2002
EZ 2002 THE HEIMLICH
FOUNDATION 23-7303161 Pa
Pagee 3J
Part IV-A
Part Support
S u p p o r t Schedule
Schedule (Complete
(Complete only
only If
if you checked a box on line
you checked line 10, 11,
11. or 12)
12 ) USE CASH
CASH METHOD
METHOD OF ACCOUNTING
ACCOUNTING
Note You me use
You may use the
the worksheet
worksheet In
in the
the instructions
instructions for
for converting
converting from
from the
the accrual
accrual to the
the cash
cash method
method of rl"'r:<
accounting
>I n ntrtrr
C a l e n d a r year (or fiscal year b e g i n n i n g m) (a) 2 0 0 1 (b) 2000 (c) 1999 (d) 1998 (e) Total
15 GiftS
Gifts grants, and contnbunons
contributions received (Do
not include unusual grants See line 2B ) 43548
4 3,548 106,140
106140 186,295 146,952 482,935
16 Membership fees received 0
17 adrmssions merchandise
Gross receipts from admissions merchandise
sold or services performed or of furnishing of
facIlities in
facilities In any activity
actrvity that is
ISrelated
related to the
organization's charitable, etc , purpose
18 Gross Income
income from
ffom Interest
interest dividends,
dividends,
amounts received from payments on secunues securities
loans (section 512(a)(5)),
512(a)(5)}, rents royalties and
unrelated business taxable Income income (less
section 511 taxes) from businesses acquired acquired
by the organization after June 30, 1975 24
2 4.920 25,535 21 926
21,926 14
14,134 15
86,515
19 Net Income
income from unrelated business
activities not included in line 18 o
20
20 Tax revenues levied for the organization's
organization's
benefit and either paid 10It to it or expended on
lis behalf
its o
21 The value of services or Iaohbes facilities furnished to
the organization
organization by a governmental unit
without
Without charge Do not Include include the value of
services or tacurnes
facilities generally furnished 10theto the
public without charge
22
22 Other income Attach a schedule Do not
include gain or (loss) from sale of capital assets 0
23 Total of lines 15 through 22 68,468 131,675 208,221 161,086 569,450
24 Line 23 minus line 17 68,468 131,675 208,221 161,086 569,450
25 Enter 1 % of line 23 685 1,317 2,082 L611
26 ORGANIZATIONS
ORGANIZATIONS DESCRIBED ON LINES 10 OR 11 a Enter 2% of amount
amount inIn column (e), line 24 26a 11,389
b Prepare
Prepare a hst list tor
for your records to lo show the name of and amount contributed
contributed by each
each person (other than a governmental
governmental
urut or publicly supported organization) whose total gifts for 1998 through 2001 exceeded the amount shown In
unit in hne
line 26a
DO NOT FILE THIS LIST WITH YOUR RETURN Enter the total of all these these excess
excess amounts 26b 468,569
c Total support tor
C for section
section 509(a)(l)
509(a)(1) test Enter line 24, column (e) 26c 569,450
d Add Amounts
Amounts from column (e) for lines 1B
18 86515
86.515 19 o Q_
22 0
0_ 26b __ ----=:!:4~68~5~69~
468.569 26d 555,084
e Public support (line 26c minus line 26d total) 26e 14,366
f PUBLIC SUPPORT PERCENTAGE (LINE 26E (NUMERATOR) DIVIDED BY LINE 26C (DENOMINATOR)) 26f 2 52%
27
27 ORGANIZATIONS
ORGANIZATIONS DESCRIBED ON LINE 12 a For amounts Included
included In
in lines 15,15
15, 15 and 17 that were received from a "disqualified
person," prepare a list for your records to show the name of, and total amounts amounts received In in each year from,
Tram, each "disqualified person"
person "
DO NOT FILE THIS LIST WITH YOUR RETURN Enter the sum of such amounts amounts for each year N/A
(2001 )
(2001) (2000) (1999) (1998)
b For any amount included
Included in
In line
Ime 17 that was received from each person (other
(other than "disqualified persons"), prepare a list for your records to
show the name of, and amount received for each year, that was more than
amQl.lntreceived than the LARGER of (1) the amount on line
{I}the Ime 25 for the year or (2) $5,000
55,000
(Include in
In the list organizations
orparnzanons described inm lines 5 through 11,
11, as well as individuals
mdivrduals ) DO NOT FILE THIS LIST WITH YOUR RETURN Arter After
compulmg
compuhng the difference between the amount received and the larger amount amount described
described In
in (1) or (2), enter the sum of these differences (the
excess amounts) for each year
(2001) (2000) (1999) (1998)
cC Add Amounts from column (e)for

(e) for lines 15 _0 0
v 16 0 o
17 0
0 20 0 21 0 27c
27c 0
0
d Add Line
l.me 27a total 0
0 and line 27b total 0 27d
27d 0
0
e Public support (line 27c total minus line 27d total)
e 27e
27e 0
0
f Total support for section 509(a)(2) test Enter amount from line 23, column
column (e) J 27f
J 27f | I i&gc- I.;'~.%-
0oltk~'>~
mm&mm
9 PUBLIC SUPPORT PERCENTAGE (LINE 27E (NUMERATOR) DIVIDED BY LINE
g LIN E 27F (DENOMINATOR))
(DENOMINATOR)) 27R
2m 000%
0 00%
h INVESTMENT INCOME PERCENTAGE (LINE 18 18, COLUMN (El(E) (NUMERATOR}
(NUMERATOR) DIVIDED BY LINE 27F (DENOMINATOR»)
(DENOMINATOR)) 27h 000%
0 00%
28 UNUSUAL GRANTS For an organization describeddescnbed inIn line
hne 10, 11,
11. or 12 that received
received any unusual grants during
dunng 1998 through 2001.
2001, prepare a
list
hst for your records to show, for each year, the name of the contnbutor, the dale
date and amount of Ihe grant, and a brief description of the
bnef descnpbon
nature of the grant DO NOT FILE THIS LIST WITH WITH YOUR RETURN Do not include Include these grants in
In line 15
Schedule (Form 990 or 990-EZ)
Schedule A (Fonn 990-EZ) 2002
Form 990
Schedule A (Form 990 or
or990-EZ1
990-EZl 2002 THE
THE HEIMLICH
HEIMLICH INSTITUTE
23-7303161 Page
Pa e 44
I Part V Private
Private School
S c h o o l Questionnaire
Questionnaire (See
(See page
page 77 of
of the
the Instructions)
instructions )
(To be
(To be ccompleted ONLYby
o m p l e t e d ONLY by sschools that cchecked
c h o o l s that h e c k e d tthe
h e bbox
o x oon Ime66 m
n line Part IV)
In Part IV) N/A
N/A
Yes
Yes No
No
29
29 Does
Does thethe organization have aa racially
organization have racially nondiscnminatory
nondiscriminatory policy pohcy toward
toward students
students byby statement
statement in In its
ItS
charter,
charter, bylaws,
bylaws, other
other governing
governing instrument
Instrument or or inIn a
a resolution
resolution of of its
Its governing
governing body?
body? 29
29
30
30
31
31
Does
Does the
its
the organization
ItSbrochures
brochures catalogues,
admissions,
Has the
Has
Include aa statement
catalogues, and
programs, and
adrmssrons, programs,
the organization
statement of
and other
other written
and scholarships'
orqaruzatron publicized
pubhcized its
of its
Its racially
racially nondiscnmmatory
wntten communications
scholarships?7
Its racially
nondrscnrnmatorypolicy
commurncanons with
racrauvnondiscriminalory
noncrscnrmnatory policy
With thethe public
policy through
policy toward
pubhc dealing
toward students
deahngwith
through newspaper
students in
Withstudent
newspaper or
student
or broadcast
broadcast
In alt
all
30
30
.
■
r. r
media
media during
dunng thethe period
penod ofof solicitation
soucnauon for for students
students or or during
dunnq thethe registration
registration penod
penod ifIf itIt has
has no
no solicitation
sohcitauon /,
I---
program,
program, in In aa way
way that
that makes
makes thethe policy
policy known
known to to all
all parts
parts of
of the
the general
general community
community itIt servesserves?9 31
31
IfIf "Yes,"
"Yes," please
please describe,
descnbe, ifIf "No," please explain
"No," please explain (If (If you
you need
need more
more space,
space, attach
attach aa separate
separate statement)
statement)
., .
'r
4,
- i,
-
32
32 Does the
rnamtam the
the following
Iollowmq
aa Records indicating
Records Indlcatmg the racial composition
compositron ofof the
the student
student body,
body, faculty,
faculty, and administrative staff9
administrative staff? 32a
32a
bb Records
Records documenting that scholarships and other financial assistance
assistance are awarded on a racially
racially
nondiscnminatory baSIS?
nondrscnrrunatorv basis'? 32b
32b
cC Copies of all catalogues,
Copies catalogues, brochures announcements, and other written written communications to to the public
pubhc
dealing with
dealing With student
student admissions
adrmssions programs,
programs, and scholarships?9
and scholarships 32c
32c
dd Copies of
Copies of all material
matenal used by
by the organization
orqaruzatron or
or on its
ItSbehalf contributions?9
sohcit contributions
behalf to solicit 32d
32d
IfIf you
you answered
answered "No"
"No' to
to any
any of
of the
the above,
above, please
please explain
explain (If
(If you
you need
need more
more space,
space, attach
attach aa separate
separate statement)
statement)
33
33 Does the
organization discnminate
drscnmmats by race in
by race In any
any way
way with
With respect
respect to - i i . yt& *
- •l
pnvileqes?9
aa Students' nghts or pnvileges 33a
33a
b Admissions policies 9
Adrrussrons policres? 33b
33b
cC Employment of faculty or administrative staff9

adrrurustranve staff? 33c
33c
assistance?9
dd Scholarships or other financial assistance 33d
9
ee Educational
Educallonal policies
pohcies? 33e
33e
9
f Use of facilities
Use Iacihtres? 33f
33f
g9 Athletic
Athleticprograms?
programs? 33q
33_g
h Other extracurricular activities 9

extracurricular activitres? 33h

"Yes· to any of the above please
10any pleaseexplain (If
(II you need more
more space,
space, attach a separate statement)
statement) SI
■fc{*«3
,,- „ *' "sin ..( ■v. **£
34 a Does
Does the
Ihe organization receive any agency 9
any financial aid or assistance from a governmental agency? 34a
b Has the orqaruzatron's suspended 9

organization's right to such aid ever been revoked or suspended? 34b
34b
"^'3
35
uSing an attached
If you answered "Yes" to either 34a or b, please explain using
organization certify that itIt has complied with

attached statement
With the applicable

applicable requirements of sections 4 01 through
M lift
4 05 of Rev Proc 75-50,
75-50 1975-2 C B 587. 587 covering noncrscnmmauon?9 If "No,"
covenno racial nondiscrimination "No" attach an exolanatton
explanation 35
35
Schedule
Schedule A (Form
(Form 990 or 990-EZ) 2002
Schedule A (Form
Form 990 or 990-EZ)
990-EZ 2002 THE
23-7303161 Page
Pa e 55
Part Vl-A Lobbying E
Lobbymg x p e n d i t u r e s by
Expenditures b y Electing
Electmg Public Charities
Public Chanties (See page 9 of the mstrucbons
instructions )
(To be completed ONLY by an eligible orqaruzanon
organization that filed
filed Form 5768) N/A
Check a| jif the organization
aDlf organization belongs to an affiliated group Check bOil
Check b| |if you checked "a" and "limited
"limited control"
control" provisions
provrsions apply
(a) (b)
Limits on l.obbymg
Expenditures Affiliated
Affihated group To be completed
be completed
lolals
totals for ALL electing
for elecllng
(Theterm "expenditures" m
means amounts paid or incurred
eansamountspaidor ,ncurred ) organizations
or amzanons
36 Total lobbying
lobbymq expenditures to influence
rnfluence public
pubhc opinion (grassroots lobbvmq)lobbying) 36
37 Total lobbymq
lobbying expenditures to influence
Influence a leglslaltve
legislative body (direct
(direct lobbvinq)
lobbying) 37
38 Total lobbvmq
lobbying expenditures (add lineshnes 36 and 37) 38 o
0 o
0
expenditures 39
40 Total exempt purpose expenditures (add lines 38 and 39) 40
40 o
0 o
0
41 Lobbying nontaxable amount Enter the amount from the Iollowrnq
Lobbymq following table
table -
If the amount
amount on hne line 40 IS
is -- lobbying nontaxable
The lobbymg nontaxable amount
amount IS is -- - ~ .. 1 ~ I
NotoverS500000
Not over $500 000 20%of
20% the amount
of the amounton Ime40
on line 40 i~~'\ .::.
Over$500,000but
Over $500,000 but notover
not over $1
$1 000 000
000 000 S100 000 plus
$100000 plus 15%
15%ofof the
the excess
excess over $500 000
over$500000 }"\ ~J::
• • " ■
.~l.r~
Over$1
Over $1 000
000 000but
000 but not
not over
over $1,500000
$1,500 000 $175,000plus
5175,000 plus 10%of the excess
10% of the excess over
over$1000000
$1 000 000 \ 41 o
0 0
.. ~. f( \":,;,," <■"""&* '° • ■-' '
Over$1
Over $1 500
500 000but
000 but not
not over
over S17,000 000
$17,000 000 $225,000plus5%of
5225,000 the excess
ptus 5% of !he excess over
over $1
$1500000
500 000 J
Over$17,000000
Over $17,000 000 $1,000000
$1,000 000
*■>■
'..... ::
-
.~
;-! t.,,;1;
" 'i.I
v ? Is*
42 Grassroots nontaxable amount (enter 25% of line 41) 42 0 0
43 Subtract line
hne 42 from line
hne 36 Enter -0- ifIf line 42 isIS more than line 36 36 43
43 0 0
44 Subtract line 41 from line 38 Enter -0- if line 41 IS
-0- If is more than line 38 44 0 0
Caution
Caution If there is an amount on ettner
ssan either Ime
line 43 or Ime
line 44, you
4-Year Averagmg
ou must file
Averaging Penod
Me Form 4720
Period Under
Under Seellon
Section 501(h)
WtSM
(Some organizations
orqaruzauons that made a section 501(h) election do not have to complete all of the five columns below
See the instructions for lines 45 through 50 on page 11 of the instructions )
Lobbying
LobbYing Expenditures During 4-Year Averagmg
Expenditures Durmg Averaging Pertod
Period
Calendar
Calendar year (or (a) (b) <c)
(c) (d) (e)
fiscal year beginning in) 2002
2002 2001 2000 1999 Total
46 Lobbying ceiling amount (150% of line 45(e))

rr ? 5i
- -rjf Mri;
dnures
49 Grassroots ceiling amount (150% of line 48(e)) &4 ^ t *

Part Vl-B | Lobbying
Lobbymg Activity
ActiVity by Nonelecting
Nonelectmg Public
Public Charities
(For reporting only by organizations that did not complete Part VI-A)
Vl-A) (See page 11 of the instructions)
instructions )
During
Dunng the year, did the orgamzatton
organization attempt to Influence
influence naltonal,
national, slate
state or local legislation,
including any
attempt to Influence opinion on a legislative
legislative matter or referendum, through the use of
a Volunteers
b Paid staff or management
management (Include
(Include compensation
compensation In in expenses reported
reported on lines c through h )
ce Media advertisements
advertisements
d Mailings to members,
legislators, or the public
e Publlcaltons,
Publications, or published or broadcast statements
statements
f Grants to other organizations
organizations for lobbYing
lobbying purposes
g Direct contact With
with legislators,
legislators, their staffs, government officials.
officials, or a legislative
legislative body
h Rallies, demonstrations,
seminars, convenllons,
speeches, lectures,
lectures, or any other means
means
i Total lobbYing
I lobbying expenditures
expenditures (Add hneslines c through
through h ) '<•• T.I: 1- LlMLtiA
If "Yes" to any of the above, also attach a slatement
statement giving a detailed
deSCriptionofof the lobbYing
lobbying acnviues
activities
Schedule
Schedule A (Form
(Form 990990 or 990-EZ)2002
990-EZ) 2002
Form 990
or 990-EZ)
990-EZ 2002
2002 THE
THE HEIMLICH
HEIMLICH INSTITUTE
23-7303161 Page
Paoe 66
Part VII | Information
Regardmg Transfers
Transfers ToTo and
and Transactions
Transactions and
and Relationships
Relationships With
With Nonchantable
Nonchantable
Exempt
Organizations (See
(See page
lJage 12
12 of
of the
the instructions
instructions) )
51
51 Did
Old thethe reporting
directly or
or indirectly
indirectly engage
engage inm any
any of of the
the following
following with
Withanyany other
other organization
descrrbed in In section
section
501(c)
501(c) of of the
the Code
Code (other
(other than
than section
section 501(c)(3)
501(c)(3) organizations)
organizations) or or in
In section
section 527,
527, relating
relatmg to to political
aa Transfers
Transfers from from thethe reporting
crqaruzatron to to aa nonchantable
noncharrtable exempt
exempt organization
orqaruzauon of of Yes
Yes No No
(i) Cash
(I) Cash 51a(i)
51all) XX
(n) Other assets
(II) Other assets a(lI)
af.i) XX
bb Other
Other transactions
transactions
Sales or
(I) Sales
(i) or exchanges
exchanges of of assets
assets with
Withaa nonchantable
nonchantable exemptexempt organization
orqamzatron b(l)
b(.) XX
(n) Purchases of
(II) Purchases of assets
assets fromfrom aa nonchantable
nonchantable exempt exempt organization b(lI)
b(.i) XX
(MI) Rental of
(III) Rental of facilities,
faCilities, equipment
equipment or or other
other assets bfru)
b(.n) XX
(iv)
(IV) Reimbursement
Reimbursement arrangements buv)
b(.v) XX
(v) Loans or
(v) Loans or loan
loan guarantees b(v)
bev) XX
(vi) Performance of
(VI) Performance of services
services or or membership
fundraismq solicitations
sohcitanons b(v.)
b(vl) XX
cc Sharing
Shanng of of facilities,
facihtras, equipment, mailing lists other other assets, or or paid employees cC XX
dd IfIf the
the answer
answer to any any ofof the
the above is IS "Yes," complete the following schedule Column Column (b)(b) should always
always show
show the fair market
market value
of the
of the goods,
goods, otherother assets,
services given
given by by the
the reporting
orqaruzatron IfIf the the organization
orqaruzauon received
received less
less than
than fair
fair market
market value
In anv
in transaction or
an transaction or sha
shanng arrancernent
rinq arranqeme show in
nt, show In column
column |d)
(d) tthe value
h e va of tne
lue or the gooas,
qoods otnerother assets,
assets or or services
services received
received
(a]
(a) (b)
<b) Ic)
(c) (d)
(d)
Lineno
Line no AmountInvolved
Amount involved Nameof
Name nonchantableexempt
of nonchantable exemptorganization
organization DescnptJon
of transfers,transactions, andshanngarrangements
transactions, and shanng arrangements
52 aa Is
52 Is the
the organization
orqamzatron directly
directly or
or indirectly
mdirectly affiliated with,
With, or
or related
related to, one
one or
or more
more tax-exempt
described in
described 501(c) of
In section 501(c) of the
the Code
Code (other
(other than
than section
section 501
501(c)(3)) or in
(c)(3)) or In section
section 527?
527? DYes
\_\ Yes llil
[x] No
bb If "Yes,"
"Yes complete
I te the
compte the followinq
f 0 IIOWlnQ sc hedu Ie
schedule
la)
(a) (b) (c)
(c)
Nameof
Name organization
of organization of organization
Type of organization DescnptJon
Descnption of relationship
of relationship
Schedule
ScheduleAA (Form
(Fonn 990
990 or 990-EZ) 2002
990-EZ)2002
The Heimlich
Heimlich Institute Foundation
Institute Foundation
EIN
EIN 23-7303161
Form
Form 990990-2002
- 2002
Part
Part II
Line 20
OTHER
OTHER CHANGES IN
IN ASSETS OR FUND BALANCE
BALANCE
Change in
In Net
Net Unrealized
Unrealized Gams/Losses
Gains/Losses (59.021)
(59,021)
Non-cash Donations
Donatrons 30.932
30,932
Total other changes

changes in
In assets or fund balance
balance (28,089)
REALIZED CAPITAL GAINS AND
AND LOSSES
LOSSES Account #639
Acctlunt t183~
JANUARY 1, 2D02
JMUARY t, 2002 - DECEMBER
PECEMBER 3',
31, :2002
2002 HEIMUCH INSTTTUTE FOUNDATION,
HI!IMUCH rNSmUTE FOUNDATION,
INCORPORATED
INCORPORATED
QUANTITY
CUANnTY ASSET DESCRIPTION
ASSET DESCRIPTION
ACQUISmbN
ACQUISITI
CATEI
DATEf
l»
PROCEEDS
~OCEEDS
DATE
DATE
DOLLAR
DOLLAR
COST
C09T
DOLLAR
DOLLAR
PtlOCEEDS
PROCEEDS
S GAIN I/
$ GAIN
LOSS
SHORT TERM CAPITAL

CAPITAL TRAN5A~TIONS
TRANSACTIONS I
(50
ISO BEST BUY COMPANY
COMPANY INCORPORATED
INCORPORATED 03/01/0? 08l14J02
08/14/02 6;78700
67787 00 3,423 32
),423 - -33S3ea-
-3363ea-
230 lAUDER ESTEE
LADDER E5TEE COMPANIES-
COMPANIES - ClASS
CLASS A 11/2&01 0411~2
04/1G/02 7,6C3"80
7.6C3B0 E 312 SO
S 312 BO 7~OO~
708 00-
as
85 OMNICOM GROUP
OMNICOM GROUP O4/30/G,'. 00I12A}2
06M2/O2 7;'366..,0
7^66.10 4.768
4,76831 31 -2 B0T 79 -
-200119
270 PFIZER
PFIZER INCORPORATED
INCORPORAT50 11/12/Cfl 01l17J(l2
01/17/02 11;QiEl10
11:459 10 10 ace
606 24 .Q49"M -
0 230 TRAVELERS
0230 TRAVELERS PROf'e~TY
PROPERTY CASUALTY-A
CASUAJ.TY-A O4JW01 0911U)2
OB/12/02 tie
«3S
4 '343 .1.25-
-1.28-
0.080 TRAVELERS PRO?£;RTYCASUALTl'-B
0,080 TRAvt<LERS PROPERTY CASUALTY-B 04/30/0* 09i121n2
09/12/02 172 1.17
1,1] .055
.05:!!
150 TYCO
TVCO INTERNATIONAL LTD
INTERNATIONAl LTO D1/11/d> 04129102
CW2S/02 S;055.64
8.PS5.S4 2,713
2,71344 44 --893710"
653710"
TO'1'AL
TOTAL NET
NET SHORT TERM CAPITAL LOSSES
SHORT TERN LOSSES Uf&i 95
S4f.nl9S 530.023
S30.023 7171 -S11t2iTJ4'~
411,11",24
LONG TERM CAPITAL

LONG TERM TRANSACTIONS
15.000
15,000 BANKERS TRUST OF NEW YORK
BANKERSmUST O2/03/9 01/15/02
01/15/02: 14X31 50
1.,.43150 13,000
13,0000000 568 50"
SQ5Q-
T,600% DUE 01/15102
T,600% OUI:. 01/15/02 DATED
DATED 01/1GJij2
01/15/82
165 ClNTTAS CORPOAAilON
ClNTA9 CORPORATION 07/15/02
07f15102 T.029
1.0296161 7,336 eo
7,3!1tl SO 32319
329' 19
300
300 KROGER COMPANY
KROGER COMPANY 04/16/02
04116102 8;!)65:13
s;o65:i3 6,688
6,688 T177 -1,878,36-
-1,876,35-
100 KROGERcaJPANY
KROGER COMPANY 04/16/02
04/16102 .t958
3,053CO00 2.228 02
2.22892 1/002
111:192
10.000
10.oeO LOWES
lOWES COMPANIES
COMPA.NIE.9INC 00'04102
06/04/02 10,29T60 11,499 50
11.499 1.202 00-
1,20201J-
B 2 9 0 * DUE 06101/10
8250" 06/01/10 DATED 06105100
06/Q5/OO to,29rao
100
100 MEDTRONIC. INC
MEDTRONlC.INC 02127 07/11102
07/11/02 ,~e06"12 3,578
3,87889 89 2,onn
2.072 T7
70 MEDTRONIC
ME:OTRONlC INC INC 1031/02
10131/02 ljaoeia
'12429 3.145
3.14570 70 2 . 0 3 A''-
2,02"1.4"
100 MICROSOFT CORPORATION
MICROSOFT CORPORATION 11/01/02
11101102 4'.23f2S 6.19B.84
6, 199.,a. 9~!I9~
9SBS9~
240 SPRINT CORPORATION
SPRINT CORPORATION gz~~
OSflI 0 00/14/02
Oat1....a2 - 14';M374
1 124.2Q
4.231.25 2,43a 33
2,431'!~ yo
-11.9TO41-
-11.9'11).4 f'"
300
300 US6 BANCORP
U BANCORP 05124.' 04/16/02
041'16102 f!_03a:.82
14>W74 8,882.51
8.882.~1 -1.T48.3r
-1.T48.3t""
200 U
UBS BMI.coRP
BANCORP DJl1 0 04/16/02
().4/16102 3,73630
E£630".82 4,589-34
4,5Sa.3o& 9I!i2.04-
fusLW
400 WALGREEN CO.... PANY
COMPANY 001'301 3 07/15/02
07"5/02 1.967 50
3,736 30 13.32040
13,a200C0 11.M2.;O-
11.352.90~
TOTAL HET
NET LONG TI!AM
TERM CAPITAL CAINS
GAlNS ~-
I
5$77.o2.S
7 1.057
7 3 1 5 50
7&
76 U2.D2100
U:Z,1rZ1l 00 - S4,!ijI'i.if
~ S4,sp'(.24'
TOTAL 0R05S PROC£EDS

TorAL GR06S PROCEEDS *112,051.71
$112,051.71
Thig .■span eumtsrixas the portfolio vaneacbonB Vial rnay bo helpfulfeeax prepa/st on
¥
' Investmenteo"nSG),
JohnsonIn~1
JohMOn Counsel,metnc
/
J
T H E OJlFIMl
THE F I M I TCH F NSTITH E
rN~TITll FOUINDVTfON
£ FOLI\!J \1'rO,,"
BOARl) OF
BOARD O F TRf.S r i.s
T R I S fr
FRS
Tnhn Gall,
lnhn Gall, Presrdcnt
President (513)751-9600
(513) 751-9600
HcalTh
Health At Lite Underwriters
&. Lite Underwriters Agency,
Agency, IiInc (513) 751-9613
(513) 751-9613 (Fa\.)
(Fa\)
2144
21 4~ Gilbert
Gilbert AAvenue
V~I1lIt: (513) 221-8112 (Horne)
(5 I)) 221-8112 (.Home)
,
Cincinnati
Cmc OH 45206
mn ati OH 45206 johngflll@7oomro
J0hng;:l1l@?DOmTOWll A'n com
com
Phl]!p He irnhch Vice

Phibp M Hcimhch President
Vice President (513) 624-91 5b
(.) \3) 6:;4-\.)] (lloni^)
S) (Horne)
G63Q
G630 Lyceum Court
Lyceum Court 51 s- 7-l45 (Cd])
515-7445 (Cell)
ClnCI!ltl.JI1, 45230 3 ) 662~4-+ 0153
( 5 113) r ,:IX )
01 S 1 t(Fd*)
(513) 946-4409 (Office)
(~13) 946~4409 (Office)
phumhch(a;cinci
phLlml1ch@;ctncl corn
rr corn
Joseph J Dehner,
Joseph Dehner, Secretory
Secreuiry {513)651
(SU) (6M-tiiny)
-6S0D t6~1·ul)1,:))
6') 1-6g01)
Frost
frost Brown & Toddd
Brown &. l o d (513)651-6166 (Kithy I3,U'Tllt)
(S 13) oS 1·61 (i() lK.:..rhy B.imu)
201 E Fifth Street
flftll Streer (51V)
(SI')651651 6981
6961 (Fcv)
(FJ\)
Cinciruiau,
CmcHu13 11. OH 45202
45202 Jdehner@fbtl:lw com
jdehner@fbilaw
Henry
Henry T Hcimhch.
Hctrnhch, MD
MD (513) 5)'J':U'J1
(513) 53'M3yi
The
The. HLimhch lnsimiie
Heimlich Insurute (513) 559·'403
559-'»403 (Ha^cJ
(,.:3 ....)
311 Straight Street
311 Straight Street (513)871-7711
(513) 871-7711
Cincinnati,
Cmcinnan, OH O H 45219
45219
George BUkc
Gcore.: Bl.ikc (>}3) 762-7719
())J) 762-7719
624
62~ Watchcove
Watchcove COUrt Coun (513) 762-7777
(513) 762-7777(Fax) (Fa:x)
C i n n n r u l i , OH 45230
Clnnnn.:ll1, 45230 (51^)232-3434
(51~) ::!J::!-34)4 [Home) (Home)
702-3173
702-3l73 (Cd!) (Cell)
79 yjW Belle
Belle Isle Dr
Isle Dr 2)2-1097
(404)2^2-1097
(-W4)
AU-mu GA 3n34~
Al1..ml.J OA 30342 (404)259-5383(0-11)
(404) 259-:53RS (Cell)
m a i l y r b ^ a o l corn
mall!:,'TbG/.,,:1OI cord
Harry W Wmuaker
Harry Whuiak^r (513)271
(" 11) 17 I %656611
Dupree House
Houê h\vhiti2497'a.'f\i^t:
h\" net
hi [(1"97ra.'fll<;~ ner
3939
3939 Erie
Erie Avc. £212
Ave. #212
ClIlti OlI 45208
Cmri ,, OH 4520S
Rich-ird W£lland
RIChJJ'd Wei land (513)421-8527
(S 13) 421-8527 ( r a x j 42
(ra"'(J I-S4JU
421-8' ..+3U
o~s St Paul
I10>5 Paul Place
Place (513) 871-5248
(513) (Home)
871-S~4R (Horne)
Cincinnati. OH 4;,202
CIllCIIU1;ltl. 4i202 (S13) 381-0124
( ~13) ~81 -01 2 oJ
(S13) G'l-4777 (Ray
lSI~)Gll.47nlRJY Work)
\-\-llft)
K.nchy
Korhy Ccur/Ray
( Mr/Ray Carr
C3fT
"057
~05 7 Saddleback Drive
Saddlcback Dr ive
o2 1 J,n7 7711(R
( 'd 3) 021
(W3) ..I"
( R J N f ~tfr^l
-, )
1513)
lS 13) 23 1-3010 (H«mc)
1.'3010 (Hllm l')
Ciruimian
Cim mnan OH 45:.?A4
45244
(310) 397-1 746 (Work)
7-l6 (Work)
Prison VAllums
Anson Wrllv.ims
2^615 {310H56-
(310) ~5G- )T>) (Home)
')77) {Horne]
2,1615 Skylme
Skylme View Drive
V\e.w Dnve
Malibu
\tbllb1.J CA *;026l
')W6)
(859) l~
(8S£>) 1-(Ju5U
1J1-005U
Monic
Monte Rovek<imp
Rovekamp
(85
L) 30.1~ AlJ':;O po. I\,)
?S64
:?~6.l. Crescent
Crescent Springs
Spnnrs Pike
Pll-..c
Erldnger,
Erlenger. K.YKY 4101b
oltOn.
5/27/03
'927{03
fForm
o r m 8B6B
8868 112
112 3000)
2000) y -i
\,...-., \ _ _ p 3g,; 2
Page
• If
if you are ~hng
filing for an Addruonal
Additional (not (not automatic)
automatic) 3-Month
3-Month Extension,
E x t e n s i o n , complete
c o m p l e t e only
only Part
Part II and and check
check trus
this box > VI0
Do
Note OnlyOnly comptete
complete Part Part 1111
II if y
you have already
ou have already been
been granted
granted an eutomauc
automatic 3-month 3-month extension
previously filed
filed Form
Form 8868
8868
m
• IIff you are Tiling or an A.
ling ffor Automatic
utornatrc 3 .3-Month
Mont h E Extension,
xtension, comp comptete only P
Iete only Part
art I ({on page 1)
on page 1)
ES3I
l:FTiillll A d d i t i o n a l (not
Additional
Name
(not automatic)
Exempt Orqamzation
Name of Exempt Organization
3 - M o n t h Extension
a u t o m a t i c ) 3·Month E x t e n s i o n of
oF Time-Must
T i m e — M u s t FileFile Onqmal
O r i g i n a l and
a n d One
O n e Copy
Copy
Employer rdenuficanen
Type or or
pnnt
print _Heimlich Institute Foundation
Heimlich Institute Foundation Inc 23 7303161
7303161
|CJ'~^
li^m File by Ine
F,le ihe Number street
Numtler il'ld room or sUIte
sweet aid rvo If
suite no box see Instructions
I! a P 0 boll. instructions For IRS
IRS use Dnty
only
extended
eXiended
due
311 Straight
Straight Street
Street
due dale
date Tor
for
ZS3 r , filing
filing the
tne City [ownor
CllY town post office
or pOSI office state and ZIPcode
slate and ZIP code For a foreign address see
foreign adcrass see instructions
mstrucuons
reiuin
relurn See
ins true lions
msuuc lions Cincmnatt, OH
45219-1018
^ Check type
Check type of return
return to be filed
filed (File a separate
separate apphcauon
application for each
each return]
return)
"^
J> o
0 Form 990 0
□ Form 990·£Z
990-EZ 0
□ Form 990 T (sec
(sec 401(a]or
401(a) or 408(a) trust]
trusO o
□ 1041-A
Form 1041·A o
D Form 5227 0
Q Form 8870
o 0 0 o o
d
C
-......
_
D
STOP
Form 990·BL
990-BL
STOP Do nol
not complete
D Form 990·PF
990-PF
complete Part II ifIt you were

were not already
D
already granted
990-TT (trust
Form 990· (tjusi other
other than above)
automatic 3-month
3-month extension
D
previously filed
Form 4720
tiled Form 8863

8868
D Form 6069
Form 6069
c* —
• lfIf -the organization
— does
organization does nothave
not have an— r — of
office or place
office place TT -
business
business in the
In t h e United- - -States
United --
States check thrs
check this box
box ... ^Q
0
=
r--."
=
.__,
•• Ifif rhrs
rhis 15
is lor
for the whale
for a Group
Group Return,
whole group
group check trns
this box ►e- 0
organizationsS tour
Return, enter the orqarnzauon
O If It
it IS
four digit
is for part
digit Group
part or
Group Exemption
of the group,
Exemption Number
group, checkcheck trus
Number (GEN)
box ► 0
this box'" □ and attach
-IfIf this
attach a list With
thrs is
with the
IS
names and EINs EtNs of all members

members [he
the extension
extension ISis for
4 I request
request anan additional
additional 3·month
3-month extension
extension of of time u n t i l _ j j w e r n b . e r 15
time unlll~vemb.er 15 03
20 03.
20
5 For calendar
calendar year 02 "2 other tax year beginning.
or other beginning . .. . 20 ending
and ending . 20
6 If this
thrs tax year is than 12 months,
IS for less than check reason 0
months, check Initial return 0
D Initial return 0
□ Final return □ Change
Change In
in accounting
accounting period
period
7 State Inin detail
detail why you
you need
need the extension
extension Addinonal
Additional tim:
time .IS
is ~eede~.
n e e d e d to.
to gather
gather the
the mtorf!latl?n
information nec:ssary
necessary to prepare
prepare
a complete
complete and and accurate
accurate return
return
8a If trus
this appucauon
application IS
is for Form
Form 990-BL
990-BL, 990-PF
990-PF 990- T. 4720, or 6069
990-T, 6069 enter
enter the tentative
tentative tax,
tax, less any
any
nonrefundable crecns
credits See instructions
instructions *
.;0$ _
b If uus
this application
application IS
is for Form
Form 990·PF
990-PF 990-T,
990-T, 4720
4720 or 6069,
6069, enter
enter any refundable
refundable credits
credits and
and estimated
estimated
tax payments
payments made Include
Include any prror
prior year overpayment
overpayment allowed
allowed as a credit
credit and any amount
amount paid
paid
previously wah Form 8868
previously with 5
.::.$ _
c Balance
Balance Due
Due Subtract
Subtract line 8b from
from line
line 8a Include
Include your payment
payment With
with trusthis form
form or If
if requireo
required depose
deposit
with
With FTD coupon or If
FTO coupon if reqinred
required by uSing
using EFTPS
EFTP5 (Electroruc
(Electronic Federal
Federal Tax PaymentPayment System)
System) See
instructions
mstrucuons $
Signature and V e r i f i c a t i o n
Under penalties of perjury I declare that I have ied this forjn including a c c o m p a n y i n g schedules and statements and to the best ol my knowledge and belief
it is true correct and corHpiSte and that ' re Uiis form
Signalureto- T.tie ► Accountmg

TiUe II- A c c o u n t i n g Manager
Manager Dale ,.>
Date 0-/jtn
Jonce
o t i c c to A p p l i c a n t — T o Be
t o Applicant-To C o m p l e t e d by the
B e Completed t h e IRS
IRS
We have approved tlusthis appucauon
application Please
Please attach thrsthis form
Torm to the organization's
organization's return I " ' n r p C I \ / P n
o
□ We have not approved
date
approved thiSappncauon
this application However
However we have have granted
granted a j10-day grace penod
O-day qrace period from the tater
later of ttoe date snoT'T^plr"" T L^—\nrr\
e d/la!.!te~h~!!l~~~H~ie"'::lue1
date of the organization
crqamzauonss return (Including
(including any poor
pnor extensions)
extensions) This This grace
grace penod
period ISconsidered
is considered to be a vall
valii e eAension ume for electrons
ension of urnefor elections
otherwise required to be made
otherwise requireo made on a timely return
return Pleaseatrach
Please attach thrs this form
form to the organizationS
organization s return"r'
return IT*| ":I <- 1
o
D We have not approved this application
application After
After considennq
considering the reasonsslated
reasons stated In in uern
item 7 we cannot
cannot qraru
grant your
your nastiest f^êxlenStortof Vme
..- est ~U&ie:.1en~orW~me
to file
file We are not granung
granting a lO·day
10-day grace penod \.;..
□
o We cannot consider
~;:ra"not this app~cauon
consider trus application be~ause
because It. it was
was filed
fifed after
after the
the due
due .dale
date of
of the
the return
return for
for which
which an
an e~ten\,o WlJ~N
extenlionNvas-jaqupMEDM I M T UT
o
D Other . . . . '
- '
By
By
Director
D,rector Date
Alternate Mailing Address

Alternate Mailing Address -— Enter the address
address If
if you
you wan!
want the copy
copy of thiS
this appucauon
application for an additIOnal
additional 3-month
3-month extension
extension ~^ _
returned to an
returned to an address different than
address different than the
the one
one entered above
entered above _. .
1
Name !
I ExrE~ lSICN APPROVED
EXTENSION
\i
Type or Number and street (Include
(include SUite,
suite, room,
room, or apt no)
no) Or a P 0
O bOI:number
box number
print
pnru Alir,
AUf: 2 8 2003
City or town,
town, province or state,
state, and country (including postal
postal or liP
ZIP code]
code) '
ur:Of. '}''''_'S'J c=. FE' D"';-,ECTOR.
~1w~t,U'::''''''~~'.rY-CCiS-lnG.C-L&l
?1:-:"(::S,Jl"G,C_LEI~
Form BB68
Form BB68 (1? 2000}
(1] 2(00) Page 2
Page 2
•• If yyou
If are
ou a for aan
r e filing for AddltlOn;)1
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you have
have already
already been
been granted
granted an
an automatic
automatic 3-month extension
3-month on aa previously
extenssor: on preVIously filed
flied Form
Form 8868
886B
•• If you
y o u are
a r e filing for an
a n Automatic
A u t o m a t i c 3-Month
3 - M o n t h Extension.
E x t e n s i o n , complete
c o m p l e t e only
o n l y Part
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Type
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01 Exempt
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E d e n t i f i c a t i o n number
m p l o y e r isdenuhcanon number
print
p rint Heirnlrch
H e i m l i c h IInstitute Foundation
nstitute F oundation Inc
Inc 23
23 7303161
7303161
File
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and or suite no If aa PPO
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once slate and ZIP
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For aa foreign
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a d d r e s s see instructions
(eiurn
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Cmcinnau,
C OH
incinnati, O H 45219-1018
45219-1018
C
----_
Instructions
Check
h e c k ttype off rreturn
ype o e t u r n tto be
o b e ffiled [fIle aa sseparate
i l e d (File e p a r a t e aapplication for eeach
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0 Form
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orm 9 90 0
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orm 9 90-PF 0
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iled F 886B
o r m B86B
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4 II rrequest
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aa ccomplete
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p p l i c a t i o n is for FForm
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9 0 - P F , 9990-T, 720 oorr 66069
069 eenter
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bb If tims
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90-PF 9990·T
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ayment S System)
ystem) See
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iinstructions
nstructions S
Signature a n d Verification
Under penalties of perjury I declare that I have i ned this form including accompanying schedules and stalemenls and to the best of my knowledge and belief
it is Hue correct and corflpie\e and Ihal I an ifzed to praoare this form
Signature ► Tllte *■
Tnie ... AAccountmg
ccounting Manager
Manager Dale > 0-rTrXl
J once
o t i c e tto Apphcant-
o A p p l i c a n t — TTo Be
o B Completed
e C o m p l e t e d bby
y tthe
h e IRS
IRS
o We have approved uus application Pteaseattach this form 10 the orqamzanon 5 return
o
□
D W
W e h a v e a p p r o v e d this application
We have not approved trus application
e ha
Please a t t a c h this form to the o r g a n i z a t i o n s return
However we have qrantcd a 10-day grace penod trom the tater at the date shown betow or Ihe due
have g r a n t errus
dale orv ethen oorqamzauon
t a p p r o v e d this application
S return How
(Including anye v eprior
r w eextensionsl d a 1grace
0 - d a y penod
g r a c e IS
period f r o m the
consrdered to later
be a of the extension
valid d a t e shown belowfor
of lime oretecnoos
the due
dotherwise
a t e of the required
organization to bes made
return on
(including
a timelya return
n y priorPleaseattach
extensions) Tttn h i ss form
g r a c e top ethe
n o dorgarlllatlon's
is c o n s i d e r e d return
lo be a valid extension of time for elections
o
LJ
otherwise required to be m a d e o n o timely return Please attach t h i s f o r m to the organization's return
We have not approved thiSappncanon After considennq the reasons stated In Item 7 we cannot grant your request for an extension of urne
W e h a v e n o t a p p r o v e d this application After c o n s i d e n n g the r e a s o n s s l a t e d in i t e m 7 we c a n n o t grant your request for an extension of lime
to file We are not granting a 10 day grace period
to file W e are not granting a 10 d a y g r a c e p e r i o d
o WWee ccannot
a n n o t cconsider uus application
o n s i d e r this application bbecause
e c a u s e itIt w
was filed after
a s filed aner t[heh e ddueu e ddate
a l e olof tthe returnfor
h e return for wwhich an extension
h i c h an extension wwas requested
a s requested
o
D Other
Other
By
By
Dreclor
Director Date
Date
Alternate
A Mailing
lternate M Address
ailing A -
ddress — EEnter
n t e r tthe
h e aaddress
d d r e s s ifIf yyou want
ou w a n t tthe
h e ccopy
o p y oof
f ttrus appucanon
h i s a p p l i c a t i o n ffor
o r aan
n aadditional
d d i t i o n a l 33-month
-month extension
e xtension
rreturned
e t u r n e d tto
o aan
n aaddress
d d r e s s ddifferent
i f f e r e n t tthan
h a n tthe
h e oone
n e eentered
n t e r e d above
above
Name
N ame
TType or
y p e or NNumber
u m b e r aand
n d sstreet i n c l u d e sSUite,
t r e e t ((Include u i t e , rroom, or aapt
o o m , or o )IO
p t nno Orr aa PPObox number
O box n umber
pnnt
print
CCity or ttown,
i t y or o w n , pprovince
r o v i n c e oor
r sstate,
t a t e , aand
n d ccountry
o u n t r y {(including
i n c l u d i n g ppostal or ZZIP
o s t a l or I P ccode]
ode)
Farm 88868
Form il2 2000)
8 6 8 (12 2000)
_ , OMBNo
Return
Return of
of Organization
Organization Exempt
Exempt From
From Income
Income Tax OMB No 1545-0047
Form 990 ' 990 Under section 501(c), 527, or 4947(a)(1) ofthe
section 501(c), of the Internal
Internal Revenue Code (except black lung 2003
benefit trust or private foundation)
foundation)
01the Open to Public
Public
Internal Revenue Service ► The organization
... The organization may
may have
have to
to use
use aa copy
copy of
of this
this return
return to
to satisfy
satisfy state
state reporting
requirements. Inspection
Inspection
A For the 2003 calendar year, or tax year beginning and ending
B
B Check II
II
applicable
applicable
Please
Please C Name oforganization
C Nameof organization o Employer identification
O identification number
use IRS
□□
Address
change
Name
label or
print or
type
fTHE HEIMLICH I N S T I T U T E FOUNDATION 23-7303161
Room/suite E Telephone number
change See Number and street (or P.O. box if mail is not delivered to street address)
□Initial
return Specific311 STRAIGHT STREET (513)559-2391
□ Final
Instruc
tions City or town, state or country, and ZIP + 4 F Accounting method I lcashl~Xl Accrual
Accrual
□
return
□Amended
return
Application
CINCINNATI. OH 45219
• Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts
□ Other ^
(specify) ►
pending H and I are not applicable

Hand applicable toto section
section 527
527 organizations.
organizations.
must attach a completed Schedule A (Form 990 or 990-EZ).
H(a) Is this a group return for affiliates? 0 C D Yes [X]C x ] No
No
G Website: ►N/A
",,_==""-"':....::!~.:...._----;===;------.,,-----==----->==..---l H(b) If "Yes," enter number of affiliates^-
H(b) If ~es,· enter number of affiliates.... ----,=".----,=,...--
J Organization type (cma only one) ► [ x ] 501(c) ( 3 H (insertno) ] I 4947(a)(1) or I 1527
.:...._=;;,;.;.;...c..;..._~-l==i:;-____;,__.;..::........;==--;......!.,;;"-'-=--~--;-;.....--..;",-.==---'-""--'-=-==--__i H(c) Are all
H(e) Are all affiliates
affiliates Included?
included? N N / /AA DYes
I I YB« ID I Hn No
K Check here ► C Z l if the organization's gross receipts are normally not more than $25,000. The ·No,· attach a list)
(If "No," list)
H(d) Is thiS
this a separate
separate return flied
filed by an or-
organization need not file a return with the IRS; but if the organization received a Form 990 Package ganization covered by a group ruling? I I Yes L X J No
in the mail, it should file a return without financial data. Some states require a complete return. I Group Exemption Number ►
M Check ► H Z ) if the organization is not required to attach
Gross receipts: Add lines 6b, 8b, 9b, and 10b to line 12 ► 349,109, Sch. B (Form 990,990-EZ, or 990-PF).
Part I Revenue, Expenses, and Changes in Net Assets or Fund Balances
Contributions, gifts, grants, and similar amounts received: receIVed:
a Direct public support .. .. .. .. .. la 211,919.
b Indirect public support 1b
c Government contributions (grants) ...
Government 1c
d 1a through 1c) (cash $
Total (add lines 1athrough 211
2 1 1«, 9919.1 9 . noncash $ ).
). Id 211,919
2 Program service revenue
revenue includmg
including government fees and contracts (from Part VII, line 93)
4 Interest on savings and temporary cash investments 30,
5 Dividends
Dividends and interest from securities .. .... 21.961,
6 a Gross rents . . . . . . . . . I 6a
b expenses
Less: rental expenses 6b
c Net rental income or (loss) (subtract line 6b from line 6a) 6c
GI
7 Other investment income (describe ►
Other ...
::s Gross amount from sales of assets other (A) Securities (B) Other
e 8a sales
~
GI than inventory 115.199. 8a
a: b Less: cost or other basis and sales sales expenses 110.160. 8b
c Gain
Gainoror (loss) (attach schedule)
schedule). .... 5 . 0 3 9 . 8c
en d Net gain or (loss) (combine line Bc, 8c, columns (A) and (B)) STMT
STM'l'1.... 1 . . 8d 5 . 003
39 •
o here ► D
»
z
9
a
Special
Special events
Gross revenue
and activities
activities
revenue (not including $
(attach schedule). If any amount ISfrom gaming, check here'"
is from gaming,
contributions
of contributions
z reported on line 1a)
m
0 b Less: direct expensesother
expenses other than fundraising expenses.expenses
c Net income or (loss) from specialspecial events (subtract line 9b from line 9a) 9c
:z:
Gross sales of inventory, less returns and allowances
52 lOa Gross sales
Less: cost of goods sold
__. b ... .... .
0) c Gross profit
Gross profit or (loss) from
or (loss) sales ot
trom sales of inventory
inventory (attach
(attach schedule)
schedule) (sub~tr:ac~t~lin~e~~~~G!D;J~-~lt--'c=;.t-
(subtract line _
r-o Other revenue (from Part VII, line 103)
Other revenue
c::>
co Total revenue (add lines 1d. 2.3.4.5.6c, 7,8d. 9c, 10c, and 11)
~ Program services (from line 44, column (B))
Management and general (from line 44, column (C))
Fundraising (from line 44, column (D))
Payments to affiliates (attach schedule)
Total expenses (add lines 16 and 44, column (A))
Excessor
Excess or (deficit) for the year (subtract line 17 from Ime line 12)
Netassets
Net assets or fund balancesat beginning ot
balances at begmning of year (from line 73, column (A))
Other changes m
Other changes in net assets
assets or fund balances
balances (attach explanallon)
explanation) ..SEE
SEE STAT~MENT
STATEMENT 2
Net assets or tund
Netassets balances at end ot
fund balancesat of year (combine Imeslines 18,19, and 20) 650.398
12-17-03 LHA For Paperwork Reduction Act Notice, Notice, see the separate instructions.
instructions. Form 990 (2003)
1
08491027
08491027 758050
758050 23-12053HEI
23-12053HEI 2003.06030
2003.06030 THE
THE HEIMLICH
INSTITUTE FOUN lp
23-12051 [jp
THE
THE HEIMLICH HEIMLICH INSTITUTE FOUNDATION
INSTITUTE FOUNDATION 2 3-7303161
23-7303161
I Part
P II
a r t II I SState~ent
tatement of Allorganizations
All organizations m
must ustcompletecolumn(A).Columns(B),(C),and(D)are
complete column (A). Columns (B), (C), and (D) are requiredforsection501(c)(3)
required for section 501(c)(3) Page2
Page 2
i i ', Functional
F u n c t i o n a l Expenses
Expenses and(4*0nr^ganizrand
and(4)
n a n i 7 Q , i n n c a n 1 c D , n n 1 Q 1 7 a , n n n o v , l m n , , h a ^ r t : , h , p , r | | c , c h , | , nn,inn:,,fnrnthDrc
a Ions ' s ec' r*'Ion4947(a)(1)nonexempt
' ' ' ^'' ^ 'charrtabletrusts but optionalforothers.
Do nor
not include amounts reported on Ime line
(A)Total
(A) Total (B) Program
(B) Program (C)Management
(C) Management
(0) Fundraising
(D) Fundraising
6b.
6b 8b 8b. 9b9b. lOb
10b. or 16 of Part 1. I. services
and aimeral
22 Grantsandallocations(attachschedule).. ..
22 Grants and allocations (attach schedule)
cash
cash $ $ noncash $ 22
Specificassistanceto
23 Specific
23 assistance to individuals
individuals ((attach
attachschedule)
schedule) 23
24 Benefitspaidto
24 Benefits paid to or formembers(attachschedule)
for members (attach schedule) 24
25 Compensation
25 Compensation o offofficers,
officers, d irectors,eetc.
directors, tc. ... 25 1 2.000.
12,000. 1
111 . 9940. 40. 660.0 . 0
O..
26 Other
26 Othersalariesandwages
salaries and wages ... 26 6 7 . 2234.
67 34. 5 3 . 7706.
53 06. 1
111 . 8860. 60. 1
1 . 6668.68.
27 Pensionplancontribullons
27 Pension plan contributions .. ... 27
28 Otheremployeebenefits
28 Other employee benefits 28 7
7 . 6609.09. 6 .344.
6,344. 1
1 . 1110. 10. 1155.
55.
29 Payroll
29 Payroll ttaxes
axes .. ... .. 29 6 .
6,666.6 6 6 . 5 .
5,557.5 5 7 . 9
973.7 3 . 1 36.
136.
Professionalffundraising
30 Professional
30 undraisingfees
fees .. 30
31 Accounting
31 Accounting fees fees ... 31
32
32 Legalfees
Legal fees .. ... 32 53.000.
53,000. 5 3 . 0000.
53 00.
33
33 Supplies
Supplies .. . '"
33 3 .
3,098.0 9 8 . 2 .
2,583.5 8 3 . 4
452.52. 663.3 .
34 Telephone
34 Telephone .. . . .. 34 4 1
419. 9 . 3
349.4 9 . 6
61. 1 . 9
9. .
Postageandshipping
35 Postage
35 and shipping .. ... 35 5502.
02. 3347.
47. 1136. 36. 119.9 .
36 Occupancy
36 Occupancy... . ... .. 36 26.154.
26,154. 2 1.804.
21,804. 3
3 . 8816. 16. 5534.
34.
37 Equipmentrentaland maintenance
37 Equipment rental and maintenance ... 37
38 Printingandpublicallons
38 Printing and publications .... .. ......... 38 465.
465. 3388.
88. 668.8 . 9
9. .
39 Travel ...
39 Travel ... .. 39 1 .566.
1,566. 1 .425.
1,425. 1124.
24. 117.7 .
40 Conferences,
40 conventions,aand
Conferences, conventions, nd meetings
meetings 40 6 .150.
6,150. 6 .150.
6,150.
41 Interest
41 Interest . ... . .. ...... 41
Depreciation,depletion,
42 Depreciation,
42 depletion,eetc.
tc.(attachschedule)
43 Otherexpensesnotcoveredabove(Itemize):
Other expenses not covered above (itemize):
a OUTSIDE SERVICES
a OUTSIDE SERVICES 438
43a 5 4.098.
54,098. 2 .583.
2,583. 4452.52. 5
51,1 . 00636 3 .•
bMISCELLANEOUS
bMISCELLANEOUS 43b 3 .607.
3,607. 3
3 . 0007. 07. 5526.
26. 774.4 .
cINSURANCE
cINSURANCE 43c 2 .589.
2,589. 2
2 . 1158. 58. 378.
378. 553.3 .
d
d 43d
e
e 43e
. . Total,functional expanses (add linos 22 through 43)
444 4 6?o'rnI~~D~~~~:::pTe'lfn~g~~~,g)~Bf."ca~
OrjantoOons completing columhs (B)-iO). cany~,¥~~BSI:~llnes 13-15 44
Uieselfitals to lines13·15 245.157.
245,157. 1 1 2 . 1191.
112 91. 7
733 . 0016. 16. 5 9.950.
59,950.
JointCosts.Check....
Joint Costs. Check ► C D Z I ifIfyouarefollowing
you are following SOP SOP98-2.
98-2.
AreanyJOint
Are costs from
any joint costs fromaa combined
combinedenucanonal campaignandfundraistng
educational campaign and fundraising SOlicitationsolicitation reportedin(8) Programservices?
reported in (B) Program services? ~ D
► □ Yes [X]
Yes C x ] No
No
IfIf'Yes; enter(i)
'Yes," enter theaggregateamountofthesejointcosts
(i) the aggregate amount of these joint costs $ ;; (ii) theamountallocatedto
the amount allocated to ProgramservicesProgram services $ $_ _
(iii) theamountallocatedto Mana_g_ement
the amount allocated to Management and_n_eneral
and general $ . and (iv)theamountallocatedto
(iv) the amount allocated to FundralsinQ Fundraising $_
I Part III I Statement of Program Service Accomplishments
Accomplishments
Whatistheorganization's
What primaryexemptpurpose?
is the organization's primary ~
exempt purpose? ► SEE
S EE STATEMENT
S TATEMENT 3
Pro~am Service
Program Service
All organizations must desalbe
describe their exempt purpose
theorexempt purpose achievements
achIevements in a clear and concise manner State the number
conCIsemann... numb... of clients
chents served, publications
pueucaucns Issued,
issued, etc DiscuS3
Discuss
xpenses
Expenses
(Required for 501(cX3)and
501(cX3) and
achievements that ereare not measurable (Section 501(cX3)and
501(cX3) and (4)organizations
(4) organizations and 4947(aX1)nonexempt
4947(aXl) nonexempt charitable trusts
trusts must also ent...
enter the amount of grants
"ants and (4) orgs.,
orgs., and 4S47(aX1)
4947(aX1)
allocations
allocations to others)
oth...s ) trusts, others))
trusts. but optional for oth...s
a HEIMLICH MANUEVER
a HEIMLICH WEEK -- EDUCATION
MANUEVER WEEK EDUCATION OF
OF THE
THE GENERAL
GENERAL PUBLIC
PUBLIC ON
ON
USES OF THE HEIMLICH MANUEVER FOR DROWNING. CHOKING AND
USES OF THE HEIMLICH MANUEVER FOR DROWNING, CHOKING AND
ASTHMA.
ASTHMA.
j_Grantsandallocations
(Grants and allocations $ ) 8.676.
8_L_676.
b AIDS
b AIDS RESEARCH
RESEARCH AND
AND EDUCATION
EDUCATION
(Grantsand
(Grants allocations$
and allocations ) 40.208.
40,208.
c EDUCATION
C EDUCATION OF OF THE
THE GENERAL
GENERAL PUBLIC
PUBLIC. THETHE PRINTING
PRINTING AND AND
DISTRIBUTION
DISTRIBUTION OF OF EDUCATION
EDUCATION LITERATURE
LITERATURE TO PUBLIC
TO PUBLIC PLACES
PLACES
ABOUT THE HEIMLICH MANEUVER. DISTRIBUTED
ABOUT THE HEIMLICH MANEUVER. DISTRIBUTED APPROX. 26 APPROX. 26 VIDEOS
VIDEOS
AND
AND 365 POSTERS
365 POSTERS TO THE
TO THE PUBLIC.
PUBLIC. (Grantsandallocations
(Grants and allocations $ ) 62.319,
62_L_319.
d AA CARING
d WORLD -- COLLECTION
CARING WORLD COLLECTION AND AND DISSEMINATION
DISSEMINATION OF OF HISTORICAL
HISTORICAL
AND SCIENTIFIC
AND SCIENTIFIC EVIDENCE
EVIDENCE SUPPORTING
SUPPORTING THAT
THAT WE WE LIVELIVE IN
IN AA CARING
CARING
WORLD.
WORLD.
(Grantsandallocations
(Grants and allocations $ )) 9988.
88.
e Otherprogramservices(attachschedule)
e Other program services (attach schedule) (Grantsandallocations
(Grants and allocations $ ))
ff TotalofProgramServiceExpenses(shouldequalhne44,column(B),Programservices)
Total of Program Service Expenses (should equal line 44, column (B), Program services) ► 1 12.191.
112,191.
323011
12-17-03 Form990(2003)
Form 990 (2003)
2
08491027
08491027 758050 23-12053HEI
758050 23-12053HEI 2003.06030
2003.06030 THE
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 23-12051
23-12051
Form 990 (2003)
(2003) ,, THE HEIMLICH INSTITUTE
23-7303161 Page33
Page
I Part
Part IV I Balance Sheets
Sheets
Note: Where
Where required,
required, attached
attached schedules
schedules and amounts
amounts withm
within the desCription
description column
column (A) (8)
(B)
should be for end-Of-year
should end-of-year amounts
amounts only. Beginning of year End of year
45 Cash
Cash - non-interest-bearing
non-interest-bearing · .... . .... ... 2
244 , 4485.
8 5 . 45
45 2
200 . 4439.
39.
46 Savings and temporary
temporary cash investments ... ... 2 9 . 9913.
29 1 3 . 46
46 2 7 . 9999.
27 99.
47 a Accounts receivable .. ... 47a

47a
for doubtful
doubtful accounts
accounts .. 47b
47b 47c
47c
48 a Pledges receivable .. . ..... 48a

b Less:
for doubtful
doubtful accounts
accounts ... .. 48b
48b 48c
48c
49 Grants receivable . . .. .... ... .. .. .. 49
49
50 Receivables from officers,
Receivablesfrom officers, directors, trustees,
and key employees ... .. ...... .. .. .. . . 50
50
J!l
o> 51 a
"
1/1
Other notes and loans receivable I 51a I
%
~ b Less: allowance for
for doubtful
doubtful accounts
accounts .. 51b
51b 51c
51c
52 for
Inventories for sale or use
or use .. ...... 52
52
53 Prepaid expenses and deferred charges .. ... 53
53
54 Investments - securities
securities SSTMT...
TMT 4 4. ~tj·cost
► □ Cost l~X]
OOFMVFMV 5 7 8 . 3333.
578 33. 54
54 6 1 3 . 4462.
613 62.
55 a - land, buildings,
Investments -land, buildings, and
equipment:
equipment basis .. . .. .... ... ........ 55a
b accumulated depreciation
b Less: accumulated depreciation.. 55b
55b 55c
55c
56 Investments - other .. . . ... .. 56
56
buildings, and equipment
equipment basis
baSIS .. , 57a
57a , .
b Less: accumulated
depreciation 57b
57b 57c
57c
58
58 Other assets (describe ►
Other ~ S E E STATEMENT 5
SEE )) 6
6 . 2222.
2 2 . 58
58 5
5. 4409.
09.
59 assets (add lines 45 through

Total assetsiadd throuah 58)
58\ (must equal line 74)
eaualline 74\ . 6 3 8 . 9953.
638 5 3 . 59
59 6 6 7 . 3309.
667 09.
60 Accounts payable and accrued expenses .... .. .. ... 4 8 . 1 0 7 . 60
48,107. 60 1 6 . 9911.
16 11.
61 Grants payable .. .. .. · .. .. ... ........ 61
61
62 Deferred revenue .. · ... .. ....... 62
62
1/1
in
Loans from
from officers,
trustees, and key employees 63
63
;g" 63 ....... .. ...
9>
:sIII 64 a Tax-exempt bond liabilities ... ... ... . .. .... . .. .......... 64a
64a
(0
:J b Mortgages and otherother notes payable ...... .. .. ..... ... ... .. . . 64b
64b
65 Other liabilities (describe ► ~ ) 65
65 0
O..
liabilities (add lines 60 throuqh
through 65)
65) " .... .. .. 4
488 . 1107.
0 7 . 66
66 1
166 . 9911.
11.
Organizations
follow SFAS117,
SFAS 117, check here ►
~ LxJ and complete lines 67 through
through
69 and lines 73 and 74.
74.
n
1/1
5 5 1 . 9 2 7 . 67
551,927. 6 11.479.
611,479.
"
o
e
c
67 Unrestricted . .. ... .. .. '" . ... .. 67
68
III 68 Temporarily restricted
restricted ....... .. .. . .. .. . .. 68
n
iij
m
CD 69 Permanently restricted
restricted .. 3
388 . 9919.
19. 69
69 3
388 . 9919.
19.
here ~► D and
■D
"0
c Organizations
C Organizations that
that do not follow
follow SFAS 117,117, check
check here and complete·lin~~
complete lines .
3
:::I
u..
U. 70 through 74.
...
k.
0
through 74•
o 70 Capital stock, trust
trust principal,
principal, or current
current funds .... .. ......... 70
70
J!l
(0
ID
..""
10
1/1 71 Paid-in or capital surplus,
surplus, or land, bUilding,
building, and equipment fund ...... ......... .. 71
71
10
1/1
< 72 Retained earnings,
earnmgs, endowment, accumulated income, or other funds
endowment, funds ... ....... 72
72
<
z 73 Total net
Z net assets or fund
fund balances
balances (add lines 67 through
through 69 oror lines 70 through
through 72;
72;
column (A)(A) must equal line 19; column
column (8)(B) must equal line 21)
21) ... 5 9 0 . 8846.
590 4 6 . 73 73 6 5 0 . 3398.
650 98.
liabilities and net assets /fund
net assets / fund balances
balances (add hnes 66
(add lines 66 and 73)
73) . ..... . .. ... 6 3 8 . 9953.
638 5 3 . 74 6 6 7 . 3309.
667 09.
Form 990
990 is available for
for public inspection and, forfor some people, serves as the primary
primary or sole source of information
Information about a particular organization.
perceives an organization In in such cases may be determined by the information
information presented on on its
its return.
return. Therefore, please make sure the return
return IScomplete
is complete and accurate
and fully descnbes,
describes, in Part III, the organization's
organization's programs and accomplishments.
accomplishments.
323021
12-17-03
3
08491027 758050 23-12053HEI
08491027 758050 23-12053HEI 2003.06030
Form 990 (2003)
Form 990 (2003) , THE HEIMLICH INSTITUTE FOUNDATION 23-7303161
23-7303161 Page 44
I Part
Part IV-A I Reconciliation
Reconciliation of Revenue per Audited
Audited Part IV-B I Reconciliation
Part Reconciliation of Expenses
Expenses per Audited
Audited
Financial
Statements with
with Revenue per
Revenue per Financial
Financial Statements with Expenses
Statements with Expenses per
Return
Return Return
Return
a Total
Total revenue, gains,
gains, and
and other
other support
support a Total expenses and losses per
financial statements .. .. .. .... a N/A audited financial statements .... a N/A
b Amounts
Amounts included
included onon hne but not OIi·
line aa but"not on
b Amounts included
Amounts included on
on line
line aa but
but not
not on
on line 17, Form
hne Form 990:
990:
hne
line 12, Form
Form 990:
services
(1) Net unrealized
unreahzed gains and use of facilnles
facilities..
.. $$
on investments $ (2) Prior year adjustments
adjustments
(2) reported on line
hne 20,
and use of facilities $ Form 990 ... $
... $
(3) Recoveries of prior (3) losses
Losses reported on
year grants . . $
.. $ line 20, Form 990 $
$
(specify):
$ $
Add amounts
amounts on hnes lines (1)
(1) through
through (4) ....
► b Add amounts
lines (1)
(1) through
through (4)
(4) ► b ....
c Line 8
a minus
minus hne
line bb .. .. ....
► c c Line a minus line
line a minus hne b ....
► c
d
d Amounts included
Amounts included on on hne
line 12, Form
Form d Amounts
Amounts included
included onon line 17, Form
Form
990 but not on hne
line a: 990 but not on line 8:a:
(1) Investment expenses (1) Investment expenses
not included
Included on not included on
line 6b, Form 990
990 ...$
...$ hne 6b, Form 990 ...$
line ...$
(2) (specify):
$ $
Add amounts on lines (1) and (2) .... d Add amounts
amounts on
on lines
lines (1)
(1) and(2)
and (2) .. .... d
e
e Total revenue per hneline 12, Form
Form 990
990 e
e Total expenses per hneline 17, Form
Form 990
990
(line c plus line d) .... e (line
(hne c plus line d) .. e .......
I Part
Part V
VI List of Officers,
List Officers, Directors,
Trustees, and Key Employees
Employees (List (list each oneeven
each one evenif ifnot
notcompensated.)
compensated.)
(8) Title
(B) TItle and average
average hours le)
hours (C) Compensation (D)Contrlbutions
(~Conlrlbutlons toto (E) Expense
(E)Expense
(A) Name and
andaddress
address per week devoted to
position
nosmon
(IfIf not
not paid, enter
e nter ~8!l
employee
ployee benefit
plans & deferred
compensation
comDensatlon
account and
other allowances
~~~_~T~~~~~~~
SEE ATTACHMENT ____________________
--------------------------------- 12.000.
12 000. O.
0, o.
_Q^
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
officer, director,
75 Did any officer, trustee, or key employee receive aggregate compensation
director, trustee, compensation of more than $100,000
$100,000 from
from your
your organization and all
aUrelated
related
orcaneanons, which more than $10,000
provided by the related organizatIOns?
organizations? If ~es:
"Yes,' attach
attach schedule. I I Yes [XJ
schedule. ~► DYes IXI WNoo
323031 12-17-03
323031 12-17-03 990 (2003)
Form 990 (2003)
4
Form 990
Form 990 (2003)
(2003) , THE
THE HEIMLICH
HEIMLICH INSTITUTE
3-7303161 Page 5
Pages
IPart VI I Other
Part VI Other Information
Information Yes No
Yes No
76
76 Did the
organization engage
engage inin any
any activity
activity not
not previously
previously reported
reported to
to the
the IRS?
IRS? IfIf"Yes,"
"Yes,·attach description of each actIVity
attach a detailed description activity 76
76 X
77
77 Were any
Were any changes
changes made
made in
in the
the organizing
organizing or
or governing
governing documents
documents but
but not
not reported
reported to
to the
the IRS?
IRS? 77
77 X
X
IfIf"Yes,"
"Yes,· attach a conformed
conformed copy of the changes. changes.
78 aa Did
78 Did the the organization
organization have haveunrelated
unrelated business
business gross gross income
Income of of $1,000
$1,000 or or more
more during
during thethe year
yearcovered
covered by by this
ttus return?
return? . . . 78a
78a XX
bb IfIf "Yes,"
"Yes,·hashas itit filed
filed aataxtax return
return on on Form
Form 990-T for this uns year? ... .. .N/.~..
N/A. 78b
78b
79 Was
79 Was there there aa liquidation,
hquldation, dissolution,
termination, or or substantial
contraction duringduring the year? year? .... 79
79 X
IfIf "Yes,"
"Yes,· attach a statement
statement
80 aa IsIs the
80 the organization
organization related related (other
(other than
than by by association
association with wrth aa statewide
stateWideor nanonwde organization)
or nationwide organization) through through commoncommon membership,
membership,
governing bodies,
trustees, officers,
officers, etc.,
etc., to
to any other other exempt
exempt or nonexempt
organization? . . . . 80a
80a X
b IfII "Yes,"
"Yes,· enter the name of the organization ► ....
and check
and check whether
whether itit is IS IDI exempt or C D nonexempt
Z l nonexempt
81 aa Enter
81 Enter direct
direct oror indirect
indirect political
political expenditures.
expenditures. See See linehne81
81 instructions
instructions II 81a
81a I 0_.
0•
bb Did
Old the the organization
organization file file Form
Form 1120-POL
1120-POL for for this
this year?
year? . . 81b
81b X
82 aa Did
82 Did the the organization
organization receive receive donated
donated services
services or or the
the use
use ofof materials,
materials, equipment,
equipment, or facilities at no charge or at substantially substantially less thanthan
fair rental
fair rental value?
value? . 82a
82a X
b IfIf "Yes,"
"Yes,· you
you may indicate the value of these items here. Do not include this amount as as revenue in Part I or as an an
expense in
expense in Part
Part II.II. (See
(See instructions
instructions in in Part
Part III.)
III.) .. .... . .. .. .. . ... 1IL82b 8:<::2:.::b_,I
I N/A
--="-'-=-_---t
Did the organization comply with the public inspection requirements
83 a Did the organization comply with the public inspection requnements for returns and exemption applications? ..
83 for returns and exemption applications? 83a
bb Old
Did the
the oruanzaton
organization comply
comply with
with the
the disclosure
relating to
to quid pro quo contributions?
contributions? ... . 83b
84 a
84 8 Did
Old the the organization
organization solicit solicit anyany contributions
contribullons or or gifts
gifts that
that were
were notnot tax
tax deductible?
deducllble? .. ..... 84a
bb IfIf "Yes,"
"Yes,· did
did the
the organization
oruanzanon include include with
with every
every solicitation
solicitation an an express
express statement
statement that that such
such contributions
gifts werewere not
not
tax deductible?
tax deductible? N/A
N / A ... . 84b
84b
85 501(c)(4),
85 501(c)(4), (5), (5), or or (6) organizatIons. aa Were
(6) organizations, Were substantially
substantially all all dues
dues nondeductible
nondeductible by by members?
members? . .. ~/A N/A 85a
b Did
Did the the organization
organization make make only only in-house
in-house lobbying
$2,000 or or less?
less? ... .. ...N/~
N / A . .....
.. 85b
85b
IfII "Yes"
"Yes·was answered to
was answered to either
either 85a85a or or 85b,
85b, dodo notnot complete
complete 85c 85c through
through 85h 85h below
below unless
unless the the organization
organization receivedrenewed aa waiver waiver for
for proxy
proxy tax
tax
owed for
owed for the
the prior
prior year.
year.
e Dues,
Dues, assessments,
assessments, and and similar
similar amounts
amounts from from members
members .... .. .. .... 85c 8Se N/A
N/ A
d Section
Section 162(e)
162(e) lobbying
lobbying and and political
expenditures .. .. . .. 85d
8Sd N
N// AA
e Aggregate
nondeducllble amount amount of of section
section 6033(e)(1)(A)
6033(e)(1)(A) dues dues notices
notices . .. 85e N
N// AA
f Taxable
Taxable amount
amount of of lobbying
lobbYing and and political expenditures
expenditures (line (line 85d
85d less 85e) 85e) . .. . 85f
85f N/ A
N/A
Does the organization elect
g Does electto to pay the the section
secnon 6033(e) tax tax on the the amount on on line 85f?
SSt? .....
... .... ... N/N /A A 85g
t-8::.::5,_,a_-+ __
h If section 6033(e)(1)(A)
6033(e)(1)(A) dues notices were sent, does the organization agree to add add the amount on line 85f to its reasonable estimate of dues
allocable to nondeductible lobbying lobbYing and political expenditures for the following following tax year? . . . .. . .. . .. N 85h
N// AA . . 1-8::.::5:.!!h+-_+-_
86
86 501(c)(7)
501(c)(7) organizations.
organIZatIons. Enter: a Initiation fees and capital contributions contributions included on line hne 12 12 86a
868 N/ A
N/A
b Gross receipts,
b receipts, included on line 12, 12, for public use of of club facilities .. . . .. . . 86b N/ A
N/A
87 501(c)(12)
501(c)(12) organizations.
organIZations.Enter: a Gross income Income from members or shareholders .... .. . 87a N/ A
N/A
b Gross income Income from other sources. (Do not net amounts due or paid to other sources
against amounts due or received from them.) .. . . . 87b
L....:.;87c..:b'-'- N/A
-=N:.:..·""""
/ .A=--_--i
88 At any time during the year, did the organization own aa 50% 50% or greater interest in aa taxable corporation corporation or partnership,
partnership,
or an an entity disregarded as separate separate from the organization under Regulations sections 301.7701-2 301.7701-2 and 301.7701-3? 301.7701-3?
"Yes,·complete
If "Yes," complete Part IX ...
... .. .... .. . .. ..... ... .. 88 X
89 a a 501(c)(3) organizations. Enter: Amount
501(c)(3) organizations. Amount of of tax
tax imposed
imposed on on the
the organization
organization dUring during the the year under:under:
section 491 4911....
!► 0O.. ;; section 4912 4912.... ► O. ; section 4955 ►
0_j_; .... ~O,,-.'_
0*.
b 501(c)(3)
501(c)(3) and 50 1(c)(4)organizations. Old the organization engage in any section 4958 excess benefit
501(c)(4) organizations. Did the organization engage in any section 4958 excess benefit
transaction during the year or did it become aware of an an excess benefit
benefrt transaction from aa prior year?
"Yes,· attach
If "Yes," attach a statement explaining
explaining each transaction
transaction . . . . . . 89b XX
c Enter.
Enter: Amount
Amount of of tax
tax imposed
imposed on on the
the organization
organization managersmanagers or or disquahfied
persons duringduring the the year under
4912, 4955, and
sections 4912,4955, and 4958
4958. ... ► 00 .•
d Enter: AmountAmount of of tax on on hne
line 89c,
89c, above,
above, reimbursed
reimbursedby theorqamzanon
bythe organization ► 00 .•
90 aa List the states stales withWith which aa copy of this return is filed hied ► .... __,O~H=Ic:::O~
OHIO _,.-__r--------___:_
b Number of of employees employed in In the pay period that includes March 12,2003 12,2003 I I
. 90b 3
91 The
The booksbooks areare Inin care
careofof .... ►THE THE HEIMLICH HEIMLICH INSTITUTE I N S T I T U T E FOUNDATION FOUNDATION Telephone
Telephone no. ► (513)
no..... ( 5 1 3 ) 559
5 5 9-2391
-2391
Located at
at ....
► 3113 1 1 STRAIGHT
STRAIGHT STREET
STREET CINCINNATI,
CINCINNATI« OHIO
OHIO ZIP +4 ►
ZIP+4 45219
.... 45219
92 secaon 4947(a)(1)
Section charitable trusts
nonexempt chantable
4947(a)(1) nonexempt trusts fIling
filing Form
Form 990
990In in lieu of Form
lieu of Form1041-
1041- Check
Check here.
here ► □
amount of tax-exempt interest received or accrued during
and enter the amount during the tax year . . . ► 92 N/A
323041 Form 990 (2003)
12-17-03
12·17·03 (2003)
5
08491027
08491027 758050
758050 23-12053HEI
23-12053HEI 2003.06030
2003.06030 THE
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 23-12051
23-12051
Form 990
Form (2003),■
990.(2003) THE HEIMLICH
THE H E I M L I C H INSTITUTE
2 3- 7303161 Page6
Page 6
I Part
Part VII I Analysis
Analysis of Income-Producing
Income-Producing Activities
Activities (See page3301
(See page 33 of nsrucnens)
thethe instructions.)
Note: Enter gross amounts unless otherwise
Note: Unrelated business income
Income Excluded by section 512,513,
512, 513, or 514
(E)
indicated. (A) (8)
(B) Ie)
(C)
Exclu·
Exclu
(0)
(D) Related or exempt
Business Amount
Amount sion
ston Amount
Amount
93 Program
93 Program service revenue: code code function
function income
a
a
b
b
c
d
e
e
f Medicare/Medlcaid
payments -. - ---
g Fees and contracts
g contracts from
from government
government agencies
---
94 Membership assessments - -
95 and temporary
Investments 14
14 30.0 .
3
96 from securities - - - -
96 Dividends and interest from 14
14 21
2 1 . 9961.
61.
97 (loss) from
97 Net rental income or (loss) from real estate:
estate: >,
a debt-financed
property . ... . .... .......
b not
not debt-financed
property - -
98
(loss) from
from personal property
property
99
99 Other investment
investment income
Income - - - --
100 Gain or (loss)
100 (loss) from
from sales of assets
inventory ........... '" .... . 18
18 5 . 0039.
39.
101 Net income
101 income or (loss)
(loss) from
from special events ...,
102 Gross profit
102 profit or (loss)
(loss) from
from sales of inventory -., ...
103
103 Other revenue:
a
b
b
c
d
e
e
104 Subtotal
104 Subtotal (add columns (B), (0),
columns (B), (D), and
and (E»
(E))
-- - O..
0 277 . 0030.
2 30. o.
0.
105
105 Total 104,columns
Total (add line 104, columns (B), (0),and
(B), (D), and (E»
(E)) __ _ __ ___ _ _ ~ __ 27.030,
---=2"-'7'-',:..;::O-=3
Note· Lme
Note: Line 105
VI I
plus line Id,
105pluslme
I Part Villi Relationship of
.I, shouldequaltheamountonlme
1d Part I,
Relationship
should equal the amount on line 12
of Activities
Activities to
to the
the Accomplishment
, Partl
12, Part I.
Accomplishment of Exempt
Exempt Purposes
Purposes (See page34
(Seepage 34ofofthe
themstrucnons.)
instructions.)
Line No. Explain how each activity
activity for
for which
which income
income isIs reported
reported in
in column
column (E)
(E) of
of Part
Part VII
VII contributed
importantly to
to the
the accomplishment
accomplishment of
of the
the organization's
organization's
~
T exempt purposes (other than by providing
providing funds
funds for such purposes).
such purposes).
N/A
I PPart
art IX
IX I IInformation Regarding
nformation R Taxable
egarding T a x a b l e Subsidiaries
S u b s i d i a r i e s and
a n d Disregarded
D i s r e g a r d e d Entities
Entities (See page 34
34 of the lnstrucnons.)
instructions.)
(A) (8)
(B) N (C)
(~) activities
_. f
IP)
Name, address,
Name, address,and
andEIN
EINofofcorport~on,
corporation, Percenta$leof
Percentage of ature 0of actIVities
Nature Tota O)
Total income
income (~
,-&
End-o -year
End-ot-year
partnership, or disregarded
partnership, or enn
disregarded entity ownership Interest
ownership interest aim assets
%
%
N/A %
%
%
%
%
I Part X |I Information
Information Regard Regarding Transfers Associated
ng Transfers Associated with with Personal
Personal Benefit
Benefit Contracts
Contracts (See page
page34
34ofofthe
theinsnucnons.)
instructions.)
(a) Oid
Did the
the organization,
during the
the year,
year, receive
receiveany
anyfunds,
funds,directly
directlyororindirectly,
indirectly,totopay
paypremiums
premiumson onaapersonal
personalbenefit
benefitcontract?
contract? DYes
I I Yes [X]
L X J No
No
(b) Oid
(b) Did the organization,
during the
the year,
year,pay
paypremiums,
premiums,directly
indirectly,on
onaapersonal
personalbenefit
benefitcontract?
contract? __ _ __ __ DYes
C Z ] Yes [XJ
LXJ No
No
ccompanying schedules and statements, and to the best of my knowledge and belter, it is true,
' of.-.-...-.
II information prepj rerhas~~''
which preparer ■--■—
has any knowledge • , _ .
#*,. . . . , Quddt^
Type or print name and title.
7
SCHEDULE
Organization Exempt
Exempt Under
Under Section
Section 501(c)(3)
501 (c)(3) OMBNo
OMB No 1545-0047
1545-C047
(Form 990
99O-EZ) (ExceptPrivate
(Except PrivateFoundation)
Foundation)and andSection
Section501(e),
501(e), 501(f),
501(f), 501(k),
501(k),
Department of
Department of the
theTreasury
Treasury SSupplementary
501(n), or
501(n), or Section
Section4947(a)(1)
u p p l e m e n t a r y lInformation-(See
NonexemptCharitable
n f o r m a t i o n - ( S e e sseparate
Trust
Charitable Trust
e p a r a t e iinstructions.)
nstructions.) 2003
Internal Revenue
Service ^~ MUST
MUSTbe completed by
be completed by the above organizations and attached to their Form 990 990 or
or 990-EZ
990-EZ
Nameof
Name of the
the organization
organization Employeridentification
number
THE HEIMLICH
FOUNDATION 23 7303161
23'7303161
Part 1 Compensation of
Compensation of the
the Five
Five Highest
Highest Paid
Paid Employ ees Other
Employees Other Than
Than Officers,
Directors, and
and Trustees
Trustees
(Seepage
(See page 11 of
of the
the instructions.
instructions. list
List each
each one.
one. IfIf there
there are
are none,
none, enter
enter"'None.')
None.")
(b) Title
(b) lltle and
an~ average
average.nours
hours (d)
(d) Contributions
ContJ'lbutionsto
to (e)Expense
(a) Name
(a) Nameand
and address
address of
of each
each employee
employee paid
paid employee
emplo)leebenefit
benefit J.~p:xpense
per week
per week devoted
devoted to (c) Compensation
(c) Compensation plans
plans && deferred
deferred account and
account and other
more than
more than $50,000
$50,000 position
position compensation
allowances
NONE
NONE
----------------------------------
----------------------------------
----------------------------------
----------------------------------
----------------------------------
Total number
Total number of
of other
other employees
employees paid
paid
over $50,000
$50,000 ~
► 00
III Compensation
L Part II Compensation of the Five Highest
Highest Paid Indepe
Independent Contractors ffor
ndent Contractors Professional3l Services
or Professions Services
(See page 2 of the instructions. list each one (whether individuals or firms). If there are none, enter 'None.')
$50,000
(a) Name and address of each independent contractor paid more than $50,000 service
(b) Type of service (c) Compensation
~9~~
NONE
_
number of others receiving over

Total number
$50,000 for
$50,000 for professional
proressional services ~
►
I 0
323101/12-05-03
323101/12-05-03 LHA
LMA PaperworkReduction
For Paperwork Reduction Act Notice, see the Instructions for Form 990 and
and Form 990-EZ.
990-EZ. Schedule
ScheduleAA(Form
(Form990
990oror990-EZ)2003
990-EZ) 2003
7
7
08491027 758050 23-12053HEI 2003.06030
2003,06030 THE
Schedule
Schedule ■AA(Form
(Form990990
or or 990-EZ)
990-EZ) 20032003 THEHEIMLICH
THE HEIMLICHINSTITUTE
I N S T I T U T EFOUNDATION
FOUNDATION 2
233 -7303161
-7303161 Page2
Page 2
I PPart III I
a r t III Statements
S About
tatements A Activities
bout A c t i v i t i e s (See page 2 of the instrucnons.)
instructions.) Yes No
1 During the
DUring the year,
year, has
hasthetheorganization
organizationattempted
attemptedtotoinfluence
influencenational,
national,state,
state,ororlocal
locallegislation,
legislation,including
includingany
anyattempt
attempttotoinfluence
influence
public
public opinion
legislative matter
matter or
or referendum?
referendum? IfIf "Yes,·enter
"Yes," enterthe
thetotal
totalexpenses
expensespaidpaidororincurred
incurredininconnection
connectionwith
withthethe
lobbying
lobbying activities ► .... $ $ (Must
(Must equal amounts
amounts onon line
line 38,
38, Part
Part VI-A,
Vl-A.
or line iiof
of Part Vt-B.)
VI-B.) 1
1 X
Organizations that made an election election under section 501(h)
501(h) by filing
filing Form 5768
5768 must
must complete Part VI-A. Vl-A. Other organizations checking
"Yes," must complete
"Yes,· must complete Part Part VI-8
Vl-B AND
ANDattach
attachaastatement
statementgiving
givingaadetailed
detaileddescription
descriptionofofthe
thelobbying
lobbyingactIVities.
activities.
During the year, has
2 During hasthe theorganization,
organization,either
eitherdirectly
indirectly,engaged
engagedIninany anyofofthe
thefollowing
followingactsactswith
withany
anysubstantial
substantialcontributors,
contributors,
trustees, directors, officers,
trustees, directors, officers, creators,
creators, key employees,
employees, or or members
members of of their
their families,
families, or
or with
with any
any taxable
organization with
with which
which anyany such
such
person
person is affiliated as an officer,
ISaffiliated officer, director,
director, trustee,
trustee, majority owner,
owner, or or princpal
beneficiary? (If (If the
the answer
answer to to any
any question
question is is ·Yes,•
'Yes,"
attach a detailed
detaIled statement
explaming the transactions.)
a Sale, exchange,
exchange,ororleaSing
leasingofofproperty?
property? .. ... . . ..... . .. . .. . . .. . .. ... . .. 2a
2a X
b Lending
Lending of money or other
other extension
extension of
of credit?
credit? ... . .. ... .. .. . .. . ... ..... ... 2b
2b X
c Furnishing
goods, services,
services, or facilities?
facilities? .. .. .... ...... ....... . . .. . . . .. .. ... .. ... 2c
2c X
compensation (or payment
payment or reimbursement
reimbursement of expenses if more than $1,000)?
$1,000)7 .... . . . .. . .... 2d
2d X
e Transfer of any part of its income

income or assets? ... ... .. .. .... ... . '" .. 2e
2e X
3 a Do you
you make
makegrants
grants for
for scholarships,
scholarships,fellowships,
fellowships,student
studentloans,
loans,etc.?
etc.?(If(If"Yes,·attach
"Yes," attachananexplanation
explanationofofhow
how
you
you determine that recipients qualify to receive payments.) .. . .. .. .... .. .... 3a
3a X
b Do
Do you
you have
haveaasection
section403(b)
403(b)annuity
annuityplan
planfor
foryour
youremployees?
employees? . . . ..... ....... . .. ..... .... .. .. 3b
3b X
4
4
you maintain any separate account for partiCipating
Did you participating donors
donors where donors
donors have the
the right
right to
to provide
provide advice
advice
on the use or distribution funds? . ..... ... . . . .
distribution of funds? .. .. .. .. .. . - ... .. ..... .. ....... 4
4 X
X
I PPart IV |I R
a r t IV Reason
e a s o n ffor
or NNon-Private
on-Private F Foundation
oundation S Status
t a t u s (See pages 3 through
through 6 of the instructions.)
instructions.)
private toundanon
The organization is not a private foundation because
because itit is:
is: (Please
(Please check
check only
only ONE
ONE applicable
applicable box.)
box.)
5
5 □
D A church,
church, convention
churches, or association of churches.
churches. Section 170(b)(1)(A)(i).
170(b)(1)(A)(i).
6 □
D school. Section
A school. Section 170(b)(1)(A)(h).
170(b)(1)(A)(ii). (Also
(Also complete
complete Part
Part V.)
V.)
7
7 □
D A hospital or a cooperative
cooperative hosprtal
hospital service
Section 170(b)(1)(A)(ill).
170(b)(1)(A)(in).
8 □
D Federal,state,
A Federal, state,ororlocal
localgovernment
governmentororgovernmental
governmentalunit
unitSection
Section170(b)(
170(b)(1)(A)(v).
1)(A)(v).
9
9 □
D A medical research organization
organization operated in
In conjunction
conjunction with
with a hospital. Section 170(b)(1)(A)(iii).
hospital. Section 170(b)(1)(A)(iii). Enter
Enter the
the hospital's
hospital's name,
name, City,
city,
and state ►....
10 □
D organization operated
An organization operatedfor
for the
the benefit
benefit of
of aacollege
collegeororuniversity
universityowned
ownedororoperated
operatedby
byaagovernmental
governmentalunit
unitSection
Section170(b)(1)(A)(iv).
170(b)(1)(A)(iv).
(Also complete Support Schedule
11a
lla E
[XJ organization that
An organization that normally
normally receives
receives aasubstantial
substantialpart
partofofits
itssupport
supportfrom
fromaagovernmental
governmentalunit
unitororfrom
fromthe
thegeneral
generalpublic.
public.
170(b)( 1)(A)(vi). (Also complete Support Schedule
11b □
D community trust
A community trust Section
170(b)(1)(A)(vi). (Also
(Also complete
complete the the Support
Support Schedule
Schedule in
in Part
Part IV-A.)
IV-A.)
12 □
D An organization that normally
normally receives: (1) more than
from activities related to its
than 331/3% support from
33 1/3% of its support from contributions,
contributions, membership fees, and
and gross
gross
receipts from Its charitable, etc.,functions
charitable, etc., functions--subject
subjecttotocertain
certainexceptions,
exceptions,and
and(2)
(2)no
nomore
morethan
than33
331/3%
1/3% ofof
its support from
ItSsupport from gross
gross investment income and unrelated business taxable income
income (less section
section 511 tax)from
511 tax) from businesses
businessesacquired
acquired
by the orqanlzanon
organization after June 30,
30,1975. 509(a)(2). (Also complete
1975. See section 509(a)(2). complete the Support
Support Schedule
Schedule in
In Part IV-A.)
13 DI
I An organization that is not controlled
controlled by any disqualified
disqualified persons (other than toundauon
managers) and supports
organizations described in:
in:
(1) lines 5 through
through 12 above;
above:or
or(2)
(2)section
section501(c)(4),
501(c)(4).(5),
(5),or
or(6),
(6),ififthey
theymeet
meetthe
thetest
testofofsection
section509(a)(2).
509(a)(2).(See
(Seesection
section509(a)(3).)
509(a)(3).)
Provide the following information about the supported
following Information supported organizations.
organizations. (See page 5 of the lnsnuenons.)
instructions.)
(b)Line number
(blLine
(a)
(a) Name(s) of supported organization(s)
supported organizatlon(s) from above
from
14 DI
I An organization organized and
and operated to test for public
public safety. Section
Section 509(a)(4).
509(a)(4). (See page 6 of the msnucnons.)
instructions.)
Schedule
Schedule A (Form
990-EZI 2003
2003
323111
12-05-03
12-05-03
8
8
08491027 758050 23-12053HEI
08491027 758050 23-12053HEI 2003.06030 THE HEIMLICH
INSTITUTE FOUN
FOUN 23-12051
23-12051
Pa e
Schedule A (Form 990 or 990-EZ) 2003 2003 THE THE HE HEIM L I C H INSTITUTE
MLICH I N S T I T U T E FOUNDATION FOUNDATION 223-7303161
3-7303161 fl 3
Page3
Part IV-A Support
support Schedule
Schedule (Complete
(Complete
Part IV-A Note: Vou may use the worksheet in the instructions only if you
you checked
checked a box
box on line 10,11,
10, 11, or
or 12.) Use
Use cash
cash method
method of
of accounting.
accounting.
Note: You may use the worksheet In the instructIons for convertin converting J from
from the
the accrual
accrual to thethe cash method of accounting.
cash method accounting.
Calendar year (or fiscal fiscal year
beginning
beginning in) . ~► (a) 2002 (b) 2001 . (c) 2000 (d) 1999 (e) Total
15
15 Gifts, grants, and contributions
contributions
received.
received.(Do (Do not include
'~f'ude unusual
grants. See
See line 28. 28.),, . r 1
1121 2 . 4467.
67. 4
433 . 5548.48. 1 06.140.
106.140. 1
1868 6 . 2 95.
295. 4 4 8 , 4450.
448 50.
16 Membership
Membership lees fees recewed
received ... .
17 Gross receipts from admssons, admissions,
merchandise
merchandisesold sold or services
performed, or furnishing of
facilities
facihtiesin in any activity that is
related
relatedto to the organization's
charitable, etc., purpose
charitable,etc., purpose ..
18 Gross income from Interest, interest,
dividends, amounts receved received tram
from
payments
payments on securities loans (sec- (sec
tion 512(a)(5»,
512(a)(5)), rents, royalties, and
unrelated
unrelated business taxable taxable income
(less section 511 taxes) from from
businesses
businesses acquired by the
organization
organization after June 30, 30,1975
1975 2
211 . 9 06.
906. 2 4.920.
24_L920. 2
255 . 5535.35. 2 1.926.
21,926. 9 4.287.
94,287.
19 Net income from unrelated unrelated business
activities
activities not included in line 18
20
20 Tax revenuesI~vled.r.ort~e
revenues levied for the
organization's benefit and and either
paid to Itit or expendedon
expended on its behalf
21 The value of services or facilities
furnished to the organization by a
governmental
governmental unit without charge.
Do not include the value of services
or facilities generally
generally furnished to
the public
pubhc without charge
22
22 Other Other Income.
income. Attach a schedule.schedule,
Do not include gain or (loss) from
sale of capital assets .....
23 Total of hnes lines 15 through 22 1 34.373.
134,373. 6 8.468.
68,468. 1
131,3 1 , 6675.75. 2 0 8 . 2221.
208 21. 5
5424 2 . 7 37.
737.
24 Line 23 minus line hne 17 1 3 4 . 3373.
134 73. 6
688 . 4 68.
468. 1 3 1 . 6675.
131 75. 2 0 8 . 2221.
208 21. 5
5424 2 . 7737.37.
25 Enter Enter 1% of hne23line 23 '"
1 .344.
1,344. 6685.
85. 1
1 . 3317.
17. 2 .082.
2.082.
26 Organizations described on lines 10 or 11: aa Enter Enter2%2% of amount in column (e), line 24 . .. ► 26a
~ 1
100 . 8 55.
855.
b Preparea
Prepare a list for your records to show the name 01 of and amount contributed
contributed by each person (other than a governmental
unit
umt or publicly supported organization) whose total gifts for 1999 through 2002 exceededthe exceeded the amount shown In in line 26a.
Do not file
file this
this list
list with
with your return.
return. Enter excess amounts
Enter the total of all these excess .. ...... ► 26b
~ 4
4474 7 . 6 29.
629.
c Total support for section 509(a)(I) 509(a)( 1) test
test Enter line 24, column (e) . . . .. ~► 26c
26c 5
5424 2 . 7 37.
737.
d Add: Amounts from column (e) for lines: 18 18 9 41287.
94 ,287. 19
19
22
22 26b
26b 4 417629.
447 .629. .... ►~ 26d 26d 5
5414 1 . 9 16.
916.
e Pubhcsupport
Public support (line 26c minus line 26d total) .... ....... . . ..... . ............ .. ..... .... . ... ~ ► 26e 8 21.
821.
f Public support percentag_ejline
percentage (line 26c 26e (numerator) divided bY
(numerator) divided by line 26c (denominator))
(denominator)) .. ,. .. . .►
~ 26f .1513%
.1513%
27 Organizations described described on line 12: a For amounts included in In lines
hnes 15,16,
15, 16, and 17 that were received
received from a 'disqualified person; person," prepare a list
hst for your
records to show the name of, and total amounts receIVedin received in each year tram, from, each
each 'disquallfled
'disqualified person.'
person.' Do
Do not
not file
file this
this list
listwith
withyour
yourreturn.
return.Enter
Enterthe
thesum
sumofof
such amounts for eachyear: each year: N/A
N/ A
(2002) . . ... (2001) (2000) . . . (1999)
b For any amount included Included in line 17 that was received from each person (other than 'disqualified
receivedfrom 'dlsquahfled persons"),
persons'), prepare a list for your records to show the name name of,
and amount received
received for each year, that was more than the larger
eachyear, larger of (1) the amount on line 25 for the year or (2) $5,000. (Include In
hne25 in the list organizations
described
described in In lines
hnes55 through 11, 11, as well as individuals.) Do not file file this
this list
list with
with your
your return.
return. After computing the difference between the amount receivedand received and
the larger
larger amount described in In (1) or (2), enter the sum of these differences
differences (the excess amounts) for each year: N
excessamounts) N // AA
(2002) (2001) (2000) . (1999) .
c Add: Amounts from column (e) for lines: hnes: 15
15 16
16 _
17 20
20 21
21 __ ► 27c
~ N/A
N A
d
d Add: Line 27a total and hne27b
line 27b total ► 27d
~ 27d N/A
N A
e Public support (line 27c total minus line 27d total)
e ► 27e
~ N/A
NA
ff Total support for section 509(a)(2) test Enteramount Enter amount on line 23, column (e) ~► I 27fl N / AA
flg Public
Public support
support percentage
percentage (line (line 27e
27e (numerator)
(numerator) divided
divided by by line
line 27f (deilominator))
27f (denominator» ► 27fl
~ 27 N/A %%
hh Investment income percentage (line 18, column (e) (numerator) divided by line 27f denominator)) ► 27h
~ N/A %%
28 Unusual Grants: For an organization described in line 10,11, or 12 that received any unusual grants during 1999 through 2002, prepare a list for your records
to show, for each year, the name of the contributor, the date and amount of the grant, and a brief description of the nature of the grant Do not file this list with
your return. Do not include these grants in line 15.
323121 12-05-03 NONE
N ONE Schedule
(Form 990 or 990-EZJ
990-EZ)2003
2003
9
08491027
08491027 758050 23-12053HEI
758050 23-12053HEI 2003.06030
2003.06030 THE
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 23-12051
23-12051
Schedule
Schedule AA(Form
(Form990
990oror990-EZ) 2003THE
HEIMLICH INSTITUTE
3-7303161 P ^4
Page
I PartV
Part V I Private School
Questionnaire (See page
page 77ofofthe
theinstrucnons.)
instructions.) N/A
N/A
(To be completed ONLY by
be completed by schools
schools that checked the
that checked the box
box on
on line 6 in
in Part IV)
IV)
29 organization have a racially

Does the organization racially nondiscriminatory
nondlscrrminatory policy
policy toward
toward students
students by
by statement
statement in its
Its charter,
charter, bylaws,
bylaws, other governing
governing
Yes No
Instrument, or in resolution of governing body?
instrument, or in a resolution of its governing body? ....--- -- - ...... -- -- 29
29
30
3D Does the organization
include a statement
statement of itsIts racially nondiscriminatory
policy toward
toward students
students in in all Its
its brochures,
catalogues,
and other wrrtten
communications with with the public
public dealing
dealing with
with student
student admissions,
admissions. programs,
programs, and scholarships?
scholarships? ._ 30
3D
- --
31 Has the organization
organization pubflceed
publicized its its racially nondiscriminatory
policy through
through newspaper
broadcast media during period of
during the period
solicitation for
students, or
or during
durrng the registration
registration period
penod if itit has no solicitation
program, inm a way that makes the policypolicy known
known
parts of
to all parts of the general
general community
community itIt serves?
serves?
-- -- -- - --- 31
31
If "Yes," describe; Ifif 'No,'
"Yes; please describe; ·No; please explam.
explain. (If you need more space, attach
more space, attach aa separate
separate statement)
statement.)

organization maintain following:
maintain the following:
a Records
Records indicating
indicating the
the racial
racial composition
composition of
of the student
student body,
body, faculty,
faculty, and
and administrative
staff? 32a
32a
--- --- --
b Records
Records documenting
documenting thatthat scholarships
scholarships and other
other fmancial
assistance are awarded
awarded on
on a racially
basis? 32b
32b
--
c Copies of
of all catalogues,
catalogues, brochures,
announcements, andand other
other written
communications to to the public
public dealing
dealing with
with student
student
admissions, and scholarships?
programs, and scholarships? __ - -- .- ... . .... ..... 32c
32c
--
d Copies of
of all
all material
material used
used by
by the
the organization
organization or
or on
on its
its behalf
behalf to
to solicit
contributions? .... 32d
32d
-- --- --- - -- -- -
If you answered
answered ·No· to any of
"No' to of the above,
explain. (If
(If you need more space,
statement)

discriminate by
by race in any way with
with respect
respect to:
to:
a Students' rights or
Students'rights or privileges?
privileges? ... .... .. - 33a
33a
-- -- --- - - - --
b Admissions
policies?
-- ....... --- ....... --- - -- -- 33b
33b
Employment of
c Employment of faculty
faculty or
or administrative
staff? ........ .... --- .-- 33c
33c
-- -
d Scholarships
Scholarships or or other
other financial
assistance? 33d
33d
-- -- .... -- - .... - - --
e Educational
Educational poliCies?
policies?
-- - ..... - -- .. .. -- -- - ..... 33e
33e
I facilities? .......... .......... 33f
331
--- --- -- --
9g Athletic
Athletic programs?
programs?
-- ........ -- - - --- .... - -- 330
33a
extracurricular actIVities?
activities?
-- - -- .... - -- .......... 33h
If you answered
answered "Yes' to any of
"Yes· to of the above,
explain. (If you need more
more space,
statement)
a Does the organization

34 a organization receive any financial
fmancial aid or
or assistance
asslstance from
from a governmental
agency? ._
- - .... .... 34a
34a
b Has the
the organization's
organization's rrght
right to
to such
such aid ever been revoked
revoked or
or suspended?
suspended? - --
-- .... - -- ...... 34b
34b
If you answered
answered "Yes'
"Yes· to
to either 34a or or b,
b, please explain using
using an attached
attached statement
statement
35 organization certify
Does the organization certify that itIt has complied
complied with
with the applicable
requirements of
of sections
sections 4.01
4.01 through
through 4.05
4.05 of
01Rev. Proc. 75-50,
Rev. Proc. 75-50,
1975-2 C.B. 587.
587, covering
covering racal
nondiscrimination? If ·No,' explanation
'No," attach an explanation ,.... -- 35
35
Schedule
A (Form 990 or
or 990-EZ)
990-EZ) 2003
2003
323131
12-05-03
10
08491027 758050
08491027 758050 23-12053HEI
23-12053HEI 2003.06030 THE
HEIMLICH INSTITUTE
FOUN 23-12051
Schedule A
Schedule (Form9.90
A (Form 990oror990-EZ) 2003THE
FOUNDATION 2 3 - 7 3 0 3 1 6 1 Page
23-7303161 Page5
5
I Part VI-A
Vl-A I Lobbying
Expenditures by Electing
Electing Public Charities
Public Charities (See
(See page 99 ofofthe
the mstrucnons.)
instructions.) N/A
N/A
completed ONLY by an
(To be completed an ehglble
eligible organization that filed 5768)
filed Form 5768)
tiled a/bo)
Check .... D
► a EZ1 ifIf the organization
organization belongs to an
an affiliated group.
group. Check ► D ifIf you
.... b U3 YOUchecked 'a' and 'limited
checked "a" 'limited contror provisions apply.
controf provisions aoofv,
I Ja\
(a) (b)
Limits on Lobbying
Limits Lobbying Expenditures
Expenditures Affiliated group completed for ALL
To be completed
Affiliated group
(The term
term "expenditures'
'expenditures' means amounts
amounts paid or incurred.)
incurred.) totals
N/A
36 Total lobbYing
expenditures to influence public opinion
opinion (grassroots lobbying)...
(grassroots lobbying) 36
36
37 Total lobbYing
expenditures to influence a legislative body (direct
(direct lobbYing)
lobbying) 37
37
38 Total lobbying
expenditures (add
(add lines 36 and
and 37) . . 38
38
expenditures . ..... . . ... 39
39
Total exempt
40 Total exempt purpose
expenditures (add
(add lines
lines 38
38 and
and 39)
39) . .. 40
40
41 Lobbying
amount Enter the amount from
amount from the follOWingtable
following table -
If the amount on line
amount on line 40 is - The lobbying
lobbying nontaxable
nontaxable amount
amount is -
Not over $500,000
Not over$500,000 20%
20% of the amounton
olthe amount on lone
line 40
40 . }
Over $500,000 but not over $1,000,000
Over$500,000but $1,000,000 $100,000 plus 15%
$100,000plus 15% of the excess
01the over $500,000
excessover $500,000
~::::::::::::~:::::::::~~::~~::o
Over $17,000,000
Over$17,000,000 ...
. :~::::::::~:~:o~:~:::=:::~,:::::O.
Over $1,000,000 but not over $1,500,000
Over $1,500,000 but not over $17,000,000
.... ... ..
$1,000,000
$1,000,000 . . .
41
,__::4'-.!.1-+ f- _

amount (enter 25%
25% of line 41) .. . . 42
42
43 Subtract
Subtract line 42 from
from line 36.
36. Enter -0- if line 42 is more than line 36
Enter-0-if 43
43
44 Subtract line 41 from
from line 38.
38. Enter -0-
-O-Ifif line 41 is more than line 38 44
44
Caution: If there is an amount on either line 43 or line 44, you must file
Caution: 'lfe Form 4720.

4-Year Averaging Period Under Section
Section 501(h)
501(h)
(Some organizations that made a section
section 501(h)
501(h) election
election do
do not
not have to
to complete
complete allallof
ofthe
thefive
fivecolumns
columns
below. See the
the msnucnons
instructions for
for lines
lines 45
45 through
through 50
50 on
on page
page 11
11 of
of the
the msnucnons.)
instructions.)
Lobbying During 4-Year
Expenditures During Averaging Period
N/A
N/A
Calendar year
Calendar year (or (a) (b) (c) (d) (e)
fiscal year beginning in)
in) ^ 2003
2003 2002 2001
2001 2000
2000 Total
45 Lobbying
LobbYing nontaxable
amount
amount 0
O..
46 Lobbying amount
Lobbying ceiling amount
(150% of line
(150% 45(e)) .. .
line45(e)).. 0
0,.
47 TotallobbYlng
Total lobbying
expenditures . . 0.
0,
4S
amount
amount 0
0,.
amount
J150%
(150% of line 48(e))
48(e)) .. 0
0,.
lobbYing
expenditures .
e~enditures 0
0,.
I Part VI-B
Vl-B I Lobbying /activity by Nonelecting
Lobbying Activity Nonelec t i n g P
Public C h a r i t ies
u b l i c Charities
reporting only by organizations that did not complete
(For reporting complete Part VI-A)
Vl-A) (See page 12 of the msnuctlons.j
instructions.) N/A
During the year,
DUring year, did
did the
the organization
attempt to
to influence
influence national,
national,state
stateor
or local
locallegislation,
legislation,including
includingany
anyattempt
attempttoto
Yes
Yes No
No Amount
Amount
opnuon on a legislative matter or referendum,
referendum, through
through the
the use
use otoft
a Volunteers
Volunteers
b Paid staff or
or management (Include
(Include compensanon
compensation in expenses reported
reported on
on lines
lines cc through
through h.)
h.)
c Media advertisements
advertisements
d Mailings
legislators, or
or the
thepublic
public
e Publications,
Publications, or published
published or broadcast statements
f Grants to other orcamzations
organizations for lobbYing
lobbying purposes
g Direct contact
contact With
with legislators,
legislators, their staffs,
staffs, government
government OffiCials,or
officials, or a legislative body
body
demonstrations,seminars,
seminars,conventions,
conventions,speeches,
speeches,lectures,
lectures,ororany
anyother
othermeans
means
i Total
Total lobbying
expenditures (Add
(Add linesc
lines c through
through h.)
h.) o.
"Yes" to any of the above,
If Yes' above, also
also attach
attach aa statement
statement giVing
giving aa detailed
detailed descranon
description of
of the
the lobbymg
lobbying acnvities,
activities.
323141
323141
12-05-03
12·0S"()3 Schedule A (Form
Schedule (Form 990
990 or 990-EZ)
99HZ) 2003
2003
11
11
0 8 4 9 1 0 2 7 758050
08491027 7 5 8 0 5 0 23-12053HEI
23-12053HEI 2 0 0 3 . 0 6 0 3 0 THE HEIMLICH INSTITUTE
2003.06030 INSTITUTE FOUN 23-12051
23-12051
Schedule
Schedule A (Form990
A (Form 990oror990-EZ)
990-EZ)2003 2003THE T H E HEIMLICH
H E I M L I C H INSTITUTE I N S T I T U T E FOUNDATION FOUNDATION 223-7303161
3-7303161 Pages
Page 6
I Part VII
Part I
VII Information
Information Regarding Regarding Transfers Transfers To To and and Transactions
Relationships With With Noncharitable
Noncharitable
EExempt
xempt O Organizations
r g a n i z a t i o n s (See(Seepagepage 12
12of of the nsnucnons.)
the instructions.)
51 Did
51 Did thethe reporting
directly or
or indirectly
indirectly engage
engage inin any
any of
of the
the following
follOWingwith any other
with any other organization
descnbed inin section
section
501(c) of
501(c) of the
the Code
Code (other
(other than
than section
section 501(c)(3)
organizations) or or inInsection
section 527,
527, relating
relating to
to political
orqanlzanons?
aa Transfers
Transfers from from thethe reporting
organization to to aa nonchanlable organization ot
noncharitable exempt organization of: Yes No
Yes No
Cash .
(i) Cash
(i) 51a(i)
51a(i) XX
(ii) Otherassets
(ii) Other assets ... ... . . . a(ii)
a(ii) XX
bb Other
Other transactions:
transactions:
Salesor
(i) Sales
(i) or exchanges
assets with
with aa noncharitable
noncharilable exempt
exempt organization
organization ... . . . . b(i)
b(i) XX
(ii) Purchases
(ii) Purchases of of assets
assets fromfrom aa noncharitable
exempt organization
organization ..... .... . . . b(ii)
b(ii) XX
Rental of
(iii) Rental
(iii) of facilities,
facilities, equipment,
equipment, or or other
other assets
assets .. b(iii)
b(iii) XX
(iv) Reimbursement
(iv) Reimbursement arrangements
arrangements ..... b(iv)
b(iv) XX
(v) Loans
(v) Loans or or loan
loan guarantees
guarantees b(v)
b(v) XX
(vi) Performance
(vi) Performance of of services
solicitations b(vi)
b(vi) X
X
ce Sharing
Sharing of of facilities,
equipment, mailing
mailing lists,
lists, other assets,
assets, oror paid
paid employees
employees ce X
X
the answer
dd IfIf the answer to to any
any ofof the
the above
above isIS"Yes; complete the following
"Yes,* complete fo"owlng schedule.
schedule. Column
Column (b)
(b) should
should always
always show
show the
the fair
fair market
market value
value of
of the
the
goods, assets, or or services
services given
given byby the
the reporting
organization. If the the organization
received less
less than
than fair
fair market
market value
value inin any
any
transaction or
arrangement, show show in In column
column (d) (d) the
the value
value ofof the
the goods,
goods, other
other assets,
assets, or services received:
received: N/A
N / A
(a)
(a) (b)
(b) (e)
(c) (d)
(d)
Line no.
Amount involved Nameof
Name of noncharitable
exempt organization
organization Descnpnon of
transactions, and
and sharing
arrangements
Indirectly affiliated with,

52 a Is the organization directly or indirectly with, or related to, one or more tax-exempt organizations
described in section 501(c) of the
the
501(c)(3)) or in
Code (other than section 501(c)(3)) 5271 ..
In section 527? . . . ... .. . . . ~
► DYes
C D Yes [X]
C No
x ] No
"Yes; complete
b If "Yes,* complete the
the following
following schedule:
schedule: N/A
N/A
(a)
(a) (b) (c)
Name of
of organization
organization organization
Type of organization relationship
323151
12-0S"()3
12-05-03 Schedule
A (Form 990 or
or 99o-EZ)
990-EZ) 2003
2003
12
12
THE HEIMLICH
23-7303161
FORM 990
FORM 990 GAIN
GAIN (LOSS)
(LOSS) FROM
FROM PUBLICLY
PUBLICLY TRADED
TRADED SECURITIES
STATEMENT 1
GROSS
GROSS COST
COST OR
OR EXPENSE
EXPENSE NET
NET GAIN
GAIN
DESCRIPTION
DESCRIPTION SALES
SALES PRICE
PRICE OTHER
OTHER BASIS
BASIS OF
OF SALE
SALE OR
OR (LOSS)
(LOSS)
SEE ATTACHED
SEE ATTACHED 115,199.
115,199. 110,160.
110,160. O.
0. 5,039,
5,039.
TO FORM
TO FORM 990,
990, PART
PART I,
I, LINE
LINE 88 115,199.
115,199. 110,160.
110,160. o.
0. 5,039,
5,039.
990
FORM 990 OTHER CHANGES IN NET ASSETS OR FUND BALANCES STATEMENT 2
DESCRIPTION AMOUNT
CHANGE IN NET UNREALIZED GAINS/LOSSES 1 ,, 0 8 6 .
661,086.
PRIOR PERIOD ADJUSTMENTS 4, ,674.
4,674.
TOTAL TO FORM 990, PART I, LINE 20

20 65, ,760.
65,760.

PART III
PART III
EXPLANATION
FINDING SIMPLE SOLUTIONS FOR SAVING LIVES AND TEACHING THOSE SOLUTIONS TO
THE WORLD.
WORLD.
FORM 990
990 NON-GOVERNMENT SECURITIES STATEMENT 44
OTHER
PUBLICLY TOTAL
CORPORATE CORPORATE TRADED OTHER NON-GOV'T
SECURITY DESCRIPTION STOCKS BONDS SECURITIES SECURITIES SECURITIES
FIXED INCOME AND
EQUITY SECURITIES 613,462. 613,462,
613,462.
TO 990, LN 54 COL B 613,462. 613,462

613,462.
15 STATEMENT(S) 1, 2, 3, 44
08491027 758050
08491027 758050 23-12053HEI
THE
THE HEIMLICH
HEIMLICH INSTITUTE
23-7303161
FORM 990
FORM 990 OTHER ASSETS
OTHER ASSETS STATEMENT
STATEMENT 5
DESCRIPTION
DESCRIPTION AMOUNT
AMOUNT
ACCRUED
ACCRUED INTEREST
INTEREST AND
AND DIVIDENDS
DIVIDENDS 5,094
5,094.
SECURITY DEPOSIT
SECURITY DEPOSIT 10
10.
DEPOSIT 305
305.
TOTAL TO
TOTAL TO FORM
FORM 990,
990, PART
PART IV,
IV, LINE
LINE 58,
58, COLUMN
COLUMN BB 5,409
5,409.
16 STATEMENT(S} 5
STATEMENT(S) 5
08491027 758050
08491027 758050 23-12053HEI
.' ~
. (
REALIZED
REALIZED CAPITAL
CAPITAL GAINS
GAU,tS AND
AND LOSSES
LOSSES Account
Account # 639
JANUARY
JANUARY 1, 2003 •- DECEMBER 31,2003
1,2003 31,2003 HEIMLICH INSTITUTE FOUNDATION,
CALENDAR ENDING . INCORPORATED
CALENDAR YEAR ENDING
(
PROCEEDS. DOLLAR
DOLLAR- DOLLAR
DOLLAR $ GAIN I.A .
DESCRIPTION DATE DATE . COST PROCEEDS
PROCEEDS" LOSS
SHORT TERM CAPITAL

. TRANSACTIONS
.
,
PRE MAY 6 GAIN. OR LOSS
PRE MAY 6 GAIN OR LOSS, .
130 COLGATE-PALMOLIVE COMPANY
COLGATE-PALMOLIVE COMPANY 08/22/02
08/22102 04/15/03
04/15/03 7,137.00
7,137.00 " - 7,441.10
7,441.10, '304.10
'304.10
- _
, '. '$7,137.00
$7,137.00 " $7,441.10
$7,441.~~ '" $304.
$304.10}{:.,
LONG TERM CAPITAL TRANSACTIONS .

:
: ,( PRE
PRE MAY
MAY 6 GAINGAIN OR
OR LOSS
LOSS (HELD
(HELD MORE
MORE THAN
THAN 5 YEARS)
YEARS)
182 GLAXOSMITHKLINE PLC ADS " "
GLAxOSMITHKLlNE PLC - ADS>: ' '.' 05/09/96
05/09/96 03/31/03 . .', 4,003.04
03/31/03, 4,-00;3.04', 6,412.90
6,412.90 2,409.86:
2.40~:86:·
10,000-
10,000· PNC FUNDING CORPORATION"
PNG FU.NDI~G CORPORATIOW _ , 05/14/93
05/14/93 03/01/03
03/01/03 .10,129.50 .
,10,1f9_.50' 10,000.00
10,OOQ.OO -129.50
-129.50
SUBORDINATED ~, '
SUBORDINATED DEBENTURE '■' -• ,
, "', . DEBENTURE '.
'' ' \. . . . . 6.875%'
6.875% DUE'03/01/03
DUE03/01/03 DATED
DATED 02123/93
02/23/93 '
:'PRE MAY 6 ,GAIN
• PRE MAY' GAIN 'QR
OR U)SS
LOSS , .
\ ,
" .~,
" ,' GLAXOSMITHKLINE PLCPLC-- ADS'
ADS " 01/08/02
01/os'/02 ' 03/31/03
03/31/03 '■ 7,369.50 ' ,5,285.35.
,5,285.35. -2,084,15
150 GLAXOSMITHKLlNE 7,,369.50
. "
-2,Q84,.15
' ', . P;OSTPOST MAY 5 GAIN
M~Y GAIN OR
~,
OR LOSS'
LOSS .\ _'
' :'. ', \
"• • .-* ' '"; .. 1 , .:»
; ;
'. '.'L " • 85''
"85" . DUDUPONT (El.) DE
PONT (E:I.) DENEMOURS& COMPANY.'-: ',..
NEMOURS & COMPANY:': 04/30/02
",' '04130102 12/02/03 '':.;'
12102/03 ' / 3,783.35
3,783.35 ' -3.598.68
"3,598.68 -184.67
-184.67. '
, ,. 116060" EMC CORPORATION-
EMG CORPORATION, ., -. ■ '05/29/96'
' • . , - ' 05/29/96 ' 09/10/03 -,
09110103 ' , ~* 432.34
432.34 -. '~ 2,137.16
2.137.16 ; , .1,704.82,'
.1,704.82
. ' -140
·140 FIFTH
FIFTH THIRD BANCORP
THIRD BANCORP 05/26/98
05/26/98 .06/18/03'. ',~
_06/18/03'. ■; -.4,66667
4,666 67 .8,424,81
.8,424,81- .• 3,-758.14
3;758.1'4
" . ' 30b 300 INTEL CORPORATION'
, INTEL CORPORATION' 09/24/97
09/24/97 ■'.. '09/08/03·
09/08/03- - . 7,350.00',
7,350.00 . 8,651.65
8,651.65 1.301..65'
1,301-.6.5'
. ,( 100'
100' .' INTEL
INTEL CORPORATioN
06/o'9/9rf -09/08/03 - . ''2,656.25''
:09i08/03','. 2,656.25 ,~ 2,883.89
2,883.89 ,, 227·64
227.64
100 KRAFT-FOODS
KRAFT,FOODSINC INC 7A
7A" ' 08/05/02 :.11128/03:'
·'08105102 •'. 11/28/03' 3,794.00
3,794:00 ''-r- •3,170.03 ;"
'.3,17:0.03' :.. -623.97 :
20,000
20,000 NATIONAL
NATIONAL RURAL
RURAL UTILITIES
\JTILITIES, ' ' " 12/21/99 .•
12121/99 " 1,1119/03",
1,1/19/03" . 18,740.80';
18,740.80'; .'22,051.78
,'22,051.78 "'", "3,310.98
"3,31'0:98 _"
.' ' "' ' ,'.• .- 6.200%
6.200% DUE
DUE 02lQ1/08
02/01/08 DATED
DATED 02104/98
02/04/98 " . ,.
250
250. - SYSCO CORPORATION
, SYSCO CORPORAtlON 09/03/02 :: ,11/28/03',
,09j03/02 .11/28/03', ", .7,01500 .7,015 00 9,070.82..
,9,070.82" 2.055.82
.2:055.82 .
'.'. '. 70
70 TARGET CORPORATION
TARGET CORPORATION 08/29/02
08129/02 09/08/03 ' . '2,37580
09/08103', 2,375 80 2;723
2;72375'75- . '347.95;
'347.95
120 . TEXAS INSTRUMENTS.-INC.
TEXAS I~STRl)MENTS,:ING. , 05/11/01
05/1-1/0.1 09/08/03
09/08/03 .• 4,509.60,,-
4,509.60,- -. 3,040.6Q
3,040.66. -1;468 94 ~
. , '300 300 . TIME WARNER
TIME WARNER INC. INC. .. "''.. '11/29/()1
11/29/01 10/16/03
1Q/16/03' • 10;508.79'
10;508.79' __ - ' 4,757.78
4,757.78 -5,751.01' :
'-5)51.01'
11
. 11 TRAVELERS
TRAVELERS PROPERTY CASUALTY-A
PROPERTY CASUALTY-A 04/30/02
. '04/30102 10/16/03
10116/03 221.46
,221.46, 17-7.09 '
177.09' ---44:37'
-44.37
. -'- .- 2233 '.,' TRAVELERS PROPERTY
TRAVELERS PROPERTY CASUALTY-B
CASUALTY-B .:'' ,. ] 04/30/02,
04/30102, 10/16/03' - .'.499.70
10/1'6/03',·.' .499.70 . " ' '371.89
' 371.89 -127.81
-127.81
.... .,15,000-
15,000 . WAL-MART
WAL:-MART STORES.
STOR~S. INC. INC. , ' , ' - , / - ' " ,05/25/93 05/25/93 " •. 06101103'
06/01/03' ;" ' ••14.967.15
14,967.15 :,' 15.000.00 '
15,000:00 32.85 ' ':
-'32.85
',>
- - 6.500% DUE
6.500% DUE 06/0,1/03
06/01/03 DATED
DATED 06/01/93'
06/01193- ,_ ' '_''-:- . _'_
$103,022.95. - $107,758.24
• $1Q3,0~2.95. _ $1~7,?58.24 , $4,735.29;
$~,7_3_5.29)?
.',
TOTAL GROSS
GROSS PRQCEEDS
PROCEEDS $115,199.34 ." ,
$115,199.34
***** ~ ..
Please refer to your 1099-DIV

,
Form
Fonn for final information regarding
_
Total and Post-May 5 Capital Gain
.
Distributions.
Dlstnbuuons,
This report summarizes the portfolio transactions that may be.helpful

be helpful for tax preparation.
preparation.
Johnson
Investment Counsel, Inc.
"~2> I ~
·
".
THE HEIMLICH
HEIMLICH INSTITUTE
FOUNDATION
BOARD OF TRUSTEES
TRUSTEES
John Gall, President (513) 751-9600

(513)751-9600
Agency, Inc.
Health & Life Underwriters Agency, 751-9613 (Fax)
(513) 751-9613
2144 Gilbert Avenue (513) 221-8112 (Home)
(513) 221-8112
Cincinnati, OH 45206 jjohngall@Zoomtown.com
ohngall@zoomtown.com
President
Philip M. Heimlich, Vice President 624-9155 (Home)
(513) 624-9155
6680 Lyceum Court 515-7445 (Cell)
515-7445
Cincinnati, OH 45230 (513) 624-0153
(513) 624-0153 (Fax)
946-4409 (Office)
(513) 946-4409 (Office)
pheimlich@cinci.rr.com
pheimlich@cinci.rr.com
Dehner, Secretary
Joseph J. Dehner, (513) 651-6800 (651-6949)
(513)651-6800(651-6949)
Frost Brown && Todd (513) 651-6166
(513) 651-6166 (Kathy
(Kathy Barrett)
Fifth Street
201 E. Fifth Street (513)651-6981 (Fax)
(513) 651-6981
Cincinnati, OH 45202 jdehner@fbtlaw.com
jdehner@fbtlaw.com
Henry J. Heimlich, M.D. (513) 559-2391

(513)559-2391
Heimlich Institute
The Heimlich (513) 559-2403
(513) 559-2403 (Fax)
311 Straight
311 Straight Street
Street (513) 871-7711
(513)871-7711
OH 45219
Cincinnati, OH
George Blake
George (513) 762-7719
(513)762-7719
Watchcove Court
624 Watchcove (513) 762-7777
(513) 762-7777 (Fax)
OH 45230
Cincinnati, OH (513) 232-3434
(513) 232-3434 (Home)
(Home)
702-3173 (Cell)
702-3173 (Cell)
W. Belle Isle
79 W. Isle Dr. (404) 252-1097
(404)
Atlanta, GA
Atlanta, GA 30342
30342 (404) 259-5388
(404) 259-5388 (Cell)
(Cell)
mailgrb@aol.com
mailgrb@aol.com
Hany W.Whittaker
Harry W. Whittaker (513) 271-8661
(513)271-8661
Dupree House
Dupree hwhitt2497@fuse.net
hwhitt2497@fuse.net
3939 Erie
3939 Erie Ave,
Ave, #212
OH 45208
Cinti., OH 45208
Richard Weiland
Richard Weiland (513) 421-8527 (Fax)
(513)421-8527 (Fax) 421-8430
42f-8430
1055 St.
1055 St. Paul
Paul Place (513) 871-5248
(513) 871-5248 (Home)
(Home)
Cincinnati, OH
Cincinnati, OH 45202 (513) 381-0124
(513)381-0124
.'
KathyCarr/Ray
Kathy Carr/Ray Carr
Carr (513)621-4777
(513) 621-4777(Ray-Work)
(Ray - Work)
3057Saddleback
3057 Saddleback Drive
Drive (513)621-4771
(513) 621-4771(Ray fax)
(Ray fax)
Cincinnati, OH 45244 (513) 231-3010 (Home)
(513) 231-3010 (Home)
Anson Williams
Anson Williams (310)397-1746
(310) 397-1746(Work)
(Work)
24615 Skyline View Drive (310)456-5775
(310) 456- 5775(Home)
(Home)
Malibu, CA
Malibu, 90265
CA 90265
Monte Rovekamp
Monte Rovekamp (859) 341-6050
(859)341-6050
2864 Crescent Springs Pike
2864 Crescent Springs Pike (859) 341-6950(Fax)
(859) 341-6950 (Fax)
Erlanger, KY 41018
Erlanger.KY 41018
5/27/03
5/27/03
OMB
OMSNo.
No.1545-0047
1545·0047
Return of
Organization Exempt
Exempt From
From Income
Income Tax
Tax
Form
Form 990 990 Undersection
Under aection 501(c),
501(c), 527,
527, oror4947(a)(1)
4947(a)( 1)ofofthe
benefittrult
benefit
theInternal
trust ororprivate
Internal Revenue
Revenue Code
private foundation)
foundation)
Code(except
(except black
black lung
lung 2004
2004
Departmont ofofthe
Department theTreasury
T,8UUI'Y Open
OpentotoPublic
Public
tntern.Rovenu.
Internal Service
Revenue Service ►.... The
Theorganization
organization may
may have
havetoto use
useaacopy
copy ofofthis
this return
return to
to satisfy
satisfy state
state reporting
Inspection
AAFFororthe
th2004 CI I en d aryear,
e2004 calendar year, orortax
axyear b eg Innmg
year beginning. an d ending
and en d'Ing
BB Check
Check ifW CC Name
Name of
of organization
organization Do Employer
number
applicable: Ploase
applicable: u•• IRS
use IRS
□
D=- Address labellabelor or
HEIMLICH INSTITUTE
~HE HEIMLICH INSTITUTE FOUNDATION
FOUNDATION 223-73
3 - 7 3 0031§J,_____~_
3161
□
ONemo
change
Name
chango
change
□DlnHlai
Initial
retum
return
printoror
print
typo.
type.
See
See
Specific
Speclhc
THE
Number and
Number
3311
andstreet
street(or
STRAIGHT STREET
1 1 STRAIGHT STREET
P.O.box
(or P.O. box ififmail
mailisisnot
notdelivered
deliveredtotostreet
streetaddress)
address) 1Room/suite
Room/suite EETelephone
Telephone number
number
((513)559-2391
513)559-2391
□ DFlnai
Final
Instruc
I~truc-
Ilon8. City Cityorortown,
town, state
stateororcountry,
country, and
andZIPZIP++44 FF Accounting
AccounUngmethod:
memcc. | D| Cash l CXJ
~ash _ X j Accrual
Accrual
□
return
return tions.
| [X]Amended
v lAmended
return
L A J return rINCINNATI OH
1CINCINNATI. OH 45219
45219 IOg~~,fy)""
Othen -
(specify) W
□ DApp11cal1on
Application
pondlng
pending
•• Section
Section 501(c)(3)
must attach
must
501(c)(3) organizations
organizationland
.tllch aIcompleted Schedule AA(Form
completed Schedule
4947(1)(1) nonexempt
and 4947(a)(1)
(Form 990
990 oror990-EZ).
990-EZ),
charitable trusts
trusts HHand
and IIare
are notnot applicable
applicable to to section
section 527 organizations.
527 organizations.
---
H(I) IsIsthis
H(a) this aagroup
group return
return for for affiliates?
affiliates? DVel Yes [[X]
CZD No
x l No
QG Webaite: »....vN
Website: N /A/A H(b) IfII"Yes;
H(b) enter number
"Yes," enter number ofofaffiliates
affiliates► .... _^__^_^_^
JJ Organization type
Organization type (chtck
(checkonl y one)""
only .xJ
501(c)(( 3
one)>- [ x J 501(c) 3 ))-4
~ (insertno.)
(insert™.) [\_\] 4947(a)(l)
4947(a)(1) ornr [l ^ n
] 527
527 H(c)
H(e) Are
Are all
allaffiliates
included? NN/A / A IDYes I YBS IDNoI No
(II'No,' attach
(If'No," attach aa list)
KK Check here
Check here ► .... ID I ififthe
the organization's
gross receipts
receipts are are normally
normally not
not more
more than
than $25,000.
$25,000. The
The H(d)
H(d) IsIsthis
this aaseparate
list)
separate returnreturn filed
filed by byan
anor- or- — — D
organization need
organization neednot
not file
fileaareturn
return with
with the
the IRS;
IRS; but
but ifif the
the organization
received aa Form
Form 990
990 Package
Package ganization
ganization covered
covered by by aa group
group ruling?
ruling? [ ] Yes Ves L[XJ
X J NoNo
ininthe mail, ititshould
the mail, should file
fileaareturn
return without
without financial
financial data.
data.SomeSome states
Itatel require
require aI complete
complete return.
return. I I Group
Group Exemption
Exemption Number Number ► ....
MM Check
Check ► .... I I ifif the
the organization D
organization isis not not required
required to
to attach
attach
LL Gross receipts:
Gross receipts: Add linesUnes6b 8b 9b,
6b, 8b, 9b and 10blOb to line 12 12 ►.... 2261.458.
61,458, Sch.
Sch. B8 (Form
(Form 990,990-EZ,
990, 990-EZ, or or 990-PF).
990-PF).
IPart II Revenue,
Part 11 Revenue, Expenses,
Expenses, and
and Changes
Changes in
in Net
NetAssets
Assets or
or Fund
Fund Balances
Balances
grants, and and similar
similar amounts
amounts received:
received:
•
a
bb
Direct public
Direct public support
Indirect public
Indirect
support .... . .................. .... ..,. ........ .. ..... . .........................
public support
support ..................................... .. ..................................
1•
1a
1b
1b
1123.860.
23,860
cc Government contributions
Government contributions (grants) (grants) .... .......... . . . .. . . . . . .. ................................ 1c
1c
dd Total (add lines 1a
Total (add lines 1a through 1c) through (cash $$
1c) (cash 123,860.
123 , 8 6 0 . noncash noncash i$ ) 1d
1d 1123
2 3 , 8860.
60,
22 Program
Program service
service revenue
revenue including
including government
government fees
fees and
and contracts
contracts (from
(from Part
Part VII,
VII, line
line 93)
93) ... . ........ 2
33 Membership
Membership dues
dues and
and assessments
assessments .............................. ......... ... ..... ...... ....... .. ....... . . . . .. 3
44 Interest on
Interest on savings
savings and and temporary
temporary cash cash investments
investments .. ..... ....... ........... ..................... ... . .... .. .............. 4 3 , 7794.
113 94,
110
0 , 6624.
'T~~r
55 Dividends and
interest from from securities
securities .... .......................... . ........... ... ..... ... ............ 5 24,
66a• Gross Gross rentsrents ............................................................... ......... ............. 6a
bb Less:Less: rental
rental expenses
expenses ... .......................................... .... ....... .. ........ 6b
6b
cc Net Net rental
rental income
income or or (loss)
(loss) (subtract
(subtract lineline 6b6b from
from line line 6a)
6a) ......... . ..... ....... 6c
6c
II) 77 Other
Other investment
investment income
income (describe
(describe ....
► ) 7
:::l
c: 8
8a a Gross
Gross amount
amount from
from sales
sales of
of assets
assets other
other (A)
(A) Securities
Securities (B)Other
(B) Other
~
t) inventory .... ........................ ............ ..... ..
than inventory
than 1 3 , 1180.
1113 8 0 . 8a 8a
a:
bb Less:Less: cost
cost or or other
other basis
basis and and sales
sales expenses
expenses ......... 11010 1 , 5511- 1 1 . 8b 8b
cc Gain Gain oror (loss)
(loss) (attach
(attach schedule)
schedule) ........................... 111 1 . 666_9_.
6 9 . 8c 8c
dd Net Net gain
gain or or (loss)
(loss) (combine
(combine line line 8c,
Bc, columns
columns (A) (A) andand (B))
(8)) S . T M T . ....1........
....S.'l'M'l' 1 ..... ... ....... .... ........ 8d
8d 111
1 , 6669.
69.
B Special events
activities (attach
(attach schedule).
schedule). IfIt any any amount
amount is is from
from gaming,
gamlna, checkcheck here ► 0□
here ....
:. ■~.SrooG revenue, Innl (nnt inf'llIninl
inrlnrlinq$ $ of contributions
of contributions
R~~~eID······ ..·......
RB&BWB ·....···········
..·········
....··..·..···...............
... L 9a _I
9a
u .' ..... han fundraising expenses ............................... .... 9b
9b
~~ 10 :J~!:t~~~:~
~
— u ins: diitotoxponcas ottejfrttan fundraisingexpenses.
0 c I |Naiiinqorn& ocJlossl fro 62[ e~:~;~::~d(:~:~~~:e
a GrossSales onrwemon ^ ; returns and allowances
• eeet nf nnntic: <:nl,
ecial events (subtract line 9b from line 9a) .. :: .... ::: ..
~b.fr~~.lln~.9~)
g;:. ......................................................................
r10~·T 10a
10b
lOb
........... ...................... 9c
Bc
h liK?;ra?tnfrjnnr1'i < inhi! y les of inventory (attach schedule) (subtract line lOb from line lOa) ......
0G@BEtfr
@ f s i P W o i ' (MsTfrom tJTrom ss lies (subtract 10b from 10a). .......... 10c
10c
."'~ ,lll~m·D~rt 1111 11
-M Other rovonui (from Part V l | line 103)
h1~.................................................... ................... ................. ....
12
12 Total revenue (add lines 1d, 1d 2,3,4,5.6c,
2 3 4 5 6c 7,8d, 7 8d 9c, 9c 10c,10c and 11). 11) ... ........... ................... .. ...... ..... . ... .... . .... 12 1159
5 9 , 9947.
47.
III
13
13 Program services (from line 44, column column (B)) (8)) ... ....... ................. .... .... 13 1159
5 9 , 1105.
05.
~ 14
14 Management and general (from (from line 44, column column (C)) (e)) 14 228 8 , 4417.
17.
c
II)
c. 15 Fundraising (from line 44, column
column (0))
(D)) .................. ............... ................. . .............. ." ........ 15 22, 6632.
32.
>< 16 Payments to affiliates (attach schedule) ................... 16
UJ .. ......... ......... . ............. ...... .. ... ....................
17 eXDenles (add lines 16 and 44.
Total expenses 44 column
column (A)) (AI) ... .... ........ ...... . ......... ............. ....... ................ 17 1190,154.
90,154
1 ..K J!!
•11)11)
M
18
19
(defICit) for the year (subtract
Excess or (deficit)
Net assets or fund balances at beginning
z~ 20 Other changes in net assets or fund balances (attach explanalion)
(subtract line 17 from line 12) .... ......... ... .
beginning of year (from (from line 73, 73, column
explanation) ...
column (A)) (A» ..
...S.E.E
......
STATEMENT .2.
. SEE....S.'r.:A'rEMEN'l' 2
18
19
20
--30
3 0 , 2207.
6650
118
07,
5 0 , 3398.
98,
8 , 9959
59 .
21 Net assets or fund balances at end of year (combine (combine lines 18,19, lB, 19, and 20) .,... .. ...... 21 6639
3 9 ^ 1150.
50
8 423001
423001
01·13-05
01-13-05
,LHA...
LHA
For Privacy Act and Paperwork Paperwork Reduction
1
1
Notice, see the separate separate instructions.
instructions. Form
for ITI 990 (2U04)
(2U04)
\~
113580614 23-12053HEI
3 5 8 0 6 1 4 758050 23-12053HEI 2004.05060 THE HEIMLICH
2004.05060 INSTITUTE FOUN 23-12051
HEIMLICH INSTITUTE
I ICH INSTITUTE
THE HEIMLICH INSTIT TE FOUNDATION
3-7303161
i
I PartII
P . ., 1 S t a t e m e n t o f All
Allorganizations
organizations must
must complete
complete column
column (A).
(A).Columns
Columns (8),
(B), (e),
(C),and
and(D) (D)are
arerequired
required lorforsection
section501( c )(3)
501(c)(3) Page
Page22
I rarT
,'!."". Functional E x p e n s e s an d(4)
and orcanzs
. tiIons and
(4) organizations sec rIon 4947(a)(1)
an d section 4947( a )(1) nonexempt
nonexemp t charitable
c han'tabl e trusts
t rus tS but op riona Ifforor others.
b u t optional 0th ers,
Do not include
Do not includeamounts
amountsreported
reported on
on line
line (8) Program
(B) Program (e) Management
(C) Management ((0)
D ) Fundraising
Fundraising
6b 8b.
6b. 8b 9b.
9b 10b.
10b or
or 16 of Part
16of Part1.I. (A) Total
(A) TO!II services
and neneral
22 Grants
22 Glants and
and allocations
allocations (attach
(attach schedule)
schedule) ............
(cash
(cash $$ noncash $$
noncash 22
22
Specific assistance
23 Specific
23 assistance to
to individuals
individuals (attach
(attach schedule)
schedule) 23
23 iK.:W.:'.sr;:'\ ■ ■>•';
Benefits paid
24 Benefits
24 paid to
to or
or for
for members
members (attach
(attach schedule)
schedule) 24
24
25 Compensation of
directors, etc.
etc. ............ 25
25 112
2 . 0000.
00. 111
1 . 9940.
40. 660.
0. 0O..
26 Other
26 Other salaries
salaries and
and wages
wages .................... .......... 26
26 8 , 6609.
668 09. 5 . 5522.
555 22. 111
1 . 4474.
74. 11, 6613.
13.
27 Pension
27 Pension plan
plan contributions
contributions .................. ........... 27
27
Other employee
28 Other
28 employee benefits
benefits . 28
28 77. 1198.
98. 66. 0024.
24. 11. 0030.
30. 1144.
44.
29 Payroll
29 Payroll taxes
taxes ............................... .............. 29
29 66,116.
.116. 55. 1119.
19. 8875.
75. 112~!..
22.
30 Professional
30 Professional fundraising
fundraising fees
fees .......... ............... 30
30
Accounting fees
31 Accounting
31 fees .......................................... 31
31 22. 7783.
83. 22. 7783.
83.
fees .. .......- ...... ............. ...........- ..........
Legal fees
32 Legal
32 32
32 66. 2210.
10. 66. 2210.
10.
33 Supplies
33 Supplies ................................ ................. 33
33 8804.
04. 6673.
73. 1115.
15. 116
6 . !..
34 Telephone
34 Telephone ................................................... 34
34
35 Postage
35 Postage and
and shipping
shipping ............... .................... 35
35 5533.
33. 4446.
46. 776.
6. 1II.
1.
36 Occupancy
36 Occupancy ............................... ........... ..... " 36
36 228
8 . 9967.
67. 224
4 . 2243.
43. 44. 1145.
45. 5579.
79.
Equipment rental
37 Equipment
37 rental and
and maintenance
maintenance .... ............. 37
37
Printing and
38 Printing
38 and publications
pubUcatlons ............... .... . ........ 38
38
Travel .........................................
39 Travel
39 39
39
Conferences, conventions,
40 Conferences,
40 conventions, and
and meetings
meetings .. ........ , 40
40
41 Interest
41 Interest .., ....
.......................... ...........
".,.,., , 41
41
Deprecation, depletion,
42 Depreciation,
42 depletion, etc.
etc. (attach
(attach schedule)
schedule) ... 42
42
Other expenses
43 Other
43 expenses not
not covered
covered above
above (itemize):
(itemize):
•OUTSIDE SERVICES
.OUTSIDE SERVICES 43a
431 4 . 4408.
554 08. 5533 . 3363.
63. 9917
17. . 1128.
28.
bMISCELLANEOXlS
bMISCELLANEOUS 43b
43b 2
2 . 5 526.
2 6 . 11 . 7775.
7 5 . 7 3
732.2. 119.
9.
cc 43c
43c
dd 43d
43d
ee 43e
43e
444 bf~l=s~~~~'rli)~~
4 Organizations compWg columns (B)4uTcairy ~~"'IBGIs ~.n 13·15.
m jsetofistclinjs 44
13-15. 44 1190
9 0 . 1154.
54. 11595 9 . 1105.
05. 228
8 . 4417.
17. 22. 6632.
32.
Joint Costs.
Joint CoslI. Check
Check ► D
.... [ _ J ifif you
you are
are following
following SOPSOP 98-2.
98-2.
Are any
Are any joint
joint costs
costs from
from aa combined
campaign and and fundraising
fundraising solicitation
solicitation reported
reported in in (B)
(8) Program
Program services?
services? . ► □Yes
.... DYes [XJ
CXINO
No
IfIf "Yes,"
"Yes,' enter
enter (I)
(I) the
the aggregate
aggregate amount
amount ofof these
these joint costs $$
joint costs ;; (ii)
(Ii) the
the amount
amount allocated
allocated to
to Program
Program services
services $_
$ _
lliil the
(Nil the amount
amount allocated
allocated to to Management
Management and general $$
and general ;. and
and (iv)
Iivl the
the amount
amount allocated
allocated to Fundraisina $$
to Fundraising
I Part
PartIII Statement
1111 Statement ofProgram
of Service
Program Service Accomplishments
Accomplishments
What is
What is the
the organization's
organization's primary SEE
primary exempt STATEMENT
exempt purpose?
S purpose? ►
EE S ~
TATEMENT 3
3
pro~am Service
Expenses
xpenses
AJI
AUorganizations
organization. must
mUG describe
desaibe their
their exempt
exempt purpose
purpose achievements
achievementsin in aa clear
clear and
and concise
concise manner.
manner.State
State the
the number
numberof of clients
clients served,
served,publications
tesued,etc.
etc. Discuss
Discuss (Required
(Required for
for 501(cX3)
50 l(cP) and
and
achievements
achievements that thol",are not
not measurable.
m_"'able. (Section501(cX3)
(Section 501(cX3) and
and (4)
(4) organizations
organizations and
and 4S47(aX1)
41147(aXl) nonexempt
none .. mpt charitable
charitable trusts
trusts must
must also
also enter
ant ... the
the amount
amount of
of grants
l1ants and
and (4)
(4) orgs.,
orgs .• and
and 4947(aX1)
41147(aXl)
allocations
allocations toto others.)
oth ..... ) ■ trusts;
trusts: but
but optional
optional for
for others.)
others.)
a HEIMLICH
HEIMLICH MANUEVER WEEK -- EDUCATION
MANUEVER WEEK EDUCATION OF THE GENERAL
GENERAL PUBLIC
PUBLIC ON
USES OF THE HEIMLICH MANUEVER FOR DROWNING.
HEIMLICH MANUEVER CHOKING AND
DROWNING CHOKING AND
ASTHMA.
ASTHMA. :
allocations $
(Grants and allocations ) 88,075.
88 075.
AIDS RESEARCH
b AIDS RESEARCH AND
AND EDUCATION
EDUCATION
allocations $$
(Grants and allocations ) 57,321,
57 32I.
c EDUCATION
EDUCATION OF
OF THE
THE GENERAL PUBLIC. THE
GENERAL PUBLIC THE PRINTING
PRINTING AND AND
DISTRIBUTION EDUCATION LITERATURE
DISTRIBUTION OF EDUCATION LITERATURE TO PUBLIC
PUBLIC PLACES PLACES
ABOUT
ABOUT THE HEIMLICH
HEIMLICH MANEUVER.
MANEUVER. DISTRIBUTED
DISTRIBUTED APPROX.APPROX. 26 VIDEOS
AND 365 POSTERS
POSTERS TO THE PUBLIC.
PUBLIC. (Grants and allocations
allocations $$ 1 12.294,
12 294.
d A CARING WORLD -- COLLECTION
CARING WORLD COLLECTION AND
AND DISSEMINATION
DISSEMINATION OF HISTORICAL HISTORICAL
AND SCIENTIFIC
SCIENTIFIC EVIDENCE
EVIDENCE SUPPORTING
SUPPORTING THAT
THAT WE LIVE IN A CARING
WORLD.
WORLD.
allocations $
(Grants and allocations $ 1 1 415.
1,415
e Other program
e proaram services (attach
(attach schedule)
schedule) allocations $
(Grants and allocations )
ff Total of Program
Total Program Service
Service Expenses
Expenses (should
(should equal line 44,
44, column
column (B),
(8), Program
Program services)
services) ... 1159,105.
59.105.
423011
423011 Form
Form 990 (2004)
(2004)
01-13-05
01·,3·05
2
13580614 758050 23-12053HEI
23-12053HEI 2004.05060
HEIMLICH INSTITUTE
23-12051
990 (2004)
Form 990(2004) THE HEIMLICH
23-7303161 Page 3
Pages
I Part IV
Iv'l Balance Sheets
Sheets
Note~1 Where
Note: Whererequired, attached schedules
required, attached schedules and
and amounts
amounts within
within the
the description
description column
column (AI
(A) (8)
(B)
should
should be
be for
tor end-of-year
end-ot-year amounts only.
amounts only. year
Beginning of year year
End of year
45 Cash - non-interest-bearing 200 . 4439.

2 39. 45
46 4.792.
46 Savings and temporary cash investments 27.999.
2 7.999. 46 4.505.
47
47. a Accounts
Accounts receivable
receivable........ 47a
f-.:!.47!...!a4-- -l
b Less: allowance
for doubtful
doubtful accounts
accounts 47b
p47~bT -----+-------_t....:!.!.4--------
47c
48
481a Pledges
Pledges receivable
receivable 48a
~48!!!a4-- -l
bb Less: allowance
aUowance for doubtful accounts
doubtful accounts 48b
L....:!:48!!.!:b:...J.... + _t~4--------
4&c
48C
49 Grants
Grants receivable
receivable . 49
50 Receivables from
Receivables from officers,
and key employees 50
60
t!
& ~~e~e:o~:p~~~e,:n~·~·~~·~;~b·,~···:::.
51 a Other notes and loans receivable :.. ::·::::::::::::::··If-·...51a
!!..~·1!.!!·~'-Il_
.. ·_.._.. .;..__ ·_.. _.._.._..._.._..._.._.. _;---------+_.!!,!4--------
&
~ doubtful accounts
b Less: allowance for doubtful accounts ... ........ . L!!..51U!b.J._
51b + -+...!!l.!4-
51c _
52 Inventories for sale or use 52
62
53 Prepaid expenses and deferred charges . 53
54 Investments -- securities
securities .. ... . ..SS.'l'~'l'
T M T 5!;i ~ □
► Crc~~i
Cost Ltx:lFMV
X ] FMV f-__ 6613
1 3 . 4462.
6 2 . 54
~~~~!....!t~-!- 66~4..Y0~3~9~2..
40.392.
55 Investments -- land,
55 aa Investments land, buildings,
buildings. and
and
equipment
equipment basis . 55a
55.
bb Less: accumulated depreciation 55b 55c

65e
56
58 Investments - other 56
57
57 aa Land, buildings, and equipment basis 57a '.,
bb Less: accumulated depreciation 57b 57c

58
58 Other assets (describe ► SEE STATEMENT 4 ) 55 . 4409.
09. 58
58 4.746.
59
59 Tot.I assets
Total ... etl (add
(add lines
lines 45
45 throuph
throuch 58)
581 (must
(must equal
eaualline 74l ...
line 74) 6667
6 7 . 3309.
59 09. 6654
5 4 . 4435.
35.
60
60 Accounts
Accounts payable
payable and
and accrued
accrued expenses
expenses . . . 1166 . 991l.
60
60 11. 115
5 , 2285.
85.
61
61 Grants
Grants payable
payable .. .. 61
61
62
62 Deferred
Deferred revenue
revenue . 62
62
& 63
63 Loans
Loans from
from officers,
directors. trustees,
trustees, and
and key
key employees
employees ." . 63
63
1 64
64 aa Tax-exempt
Tax-exempt bond
bb Mortgages
bond liabilities
Mortgages and
liabilities
and other
other notes
notes payable
payable
.. 64a
64a
I----------+-"!!:!.!!.+---------
64b
64b
65
65 Other liabilities
Other liabili1ies (describe
(describe ► .... )) I- +~+-
?5
65 _
66
66 Total liabilities (add
Totalliabilitle8 (add lines
lines 60
60 throuoh
throuah 65)
65) . 116
6 . 991l.
11. Bfi
66 115
5 . 2285.
85.
Organizations that
follow SFAS 117. check
SFAS 117, check here
here....► 00 and
and complete
complete lines
lines 67 through
67 through
69 and lines
69 and lines 73
73 and
and 74.
74.
u 67
67 Unrestricted
Unrestricted . . 6611
1 1 . 4479.
7 9 . 67
67 6600
0 0 . 2231.
31.
cn
68
68 Temporarily
Temporarily restricted
restricted . 68
68
ID
m 69
69 Permanently
restricted. . .. . . 1--__ 338
8 . 9919.
1 9 . 69 3 8 . 9 1 9 ..'
=~-"'-"'-_4_=-t-----'3~8~.919
69
c
3
Organizations that
Organizations that do
do not
not follow
follow SFAS
SFAS 117, check here
117, check here....
► D and
and complete
complete lines
lines
LL
70 through 74.
70 through 74.
s 70
70 Capital
capital stock,
stock, trust
trust principal,
principal, or
or current
current funds
funds.......... .. . 70
70
V)
8 71
71 Paid-in or
Paid-in or capital
capital surplus,
surplus, or
or land,
land, building,
building, and
and equipment
equipment fun d ....
fund 71
71
<' 72
72 Retainedearnings,
Retained earnings, endowment,
endowment, accumulated
accumulated income,
income, or
or other
other funds
funds...... .. .. 72
72
z 73
73 Totll net
Total net assets
... el8 or
or fund
fund balances
balances (add
(add lines
lines 67 through 69
67 through 69 oor lines
lines 70 through 72;
70 through 72;
column (A)
column (A) must
must equal
equal line
line 19; column (B)
19; column (8) must
mU8tequal
equal line
line 21
21) . 5 0 . 3398.
6650 98.
73
73 6639
3 9 . 1150.
50.
74
Total liabilities and
and net
net assets
ulet81 / fund
fund balances
balances (add
(add lirlines 66 and
es66 and 73)
73) 6667
6 7 . 3309.
09.
74
74 6654
5 4 . 4435.
35.
Form
Form 990990 isISavailable
available for
for public
public inspection
inspection and,
and, for
for some
some people,
people, serves
serves as
as the
the primary
primary or
or sole
sole source
source of
of information
Information about
about aa particular
organization. How
How the
the public
public
perceives
perceives anan organization
organization inin such
such cases
casesmay
may be
be determined
determined by
by the
the information
information presented
presented on
on its
its return.
return. Therefore,
Therefore, please
please make
make sure
sure the
the return
return isis complete
complete and
and accurate
accurate
and
and fully
fully describes,
describes, inin Part
Part III,
III, the
the organization's
programs and
and accomplishments.
accomplishments.
423021
423021
01-13-08
01-13·0&
3
13580614
13580614 758050
758050 23-12053HEI
23-12053HEI 2004.05060 THE
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 23-12051
23-12051
Form 990 (2004)
990 (2004) THE HEIMLICH INSTITUTE
FOUNDATION 23 -73031 6 1
23-7303161 Page 4
Part l'\t-A1 Reconciliation of Revenueper
I PartlV-A Revenue per Audited
Audited Reconciliation of Expenses
PartIV-BI Reconciliationof
PartlV-B Expenses~per
er Audited
Financial
Statements with Revenue per
Revenueper Financial Statements with Expenses
FinancialStatements per
xpenses per
Return Return
Return
a Total revenue,
revenue, gains,
gains, and
and other
other support
support a Total
Total expenses
expenses and losses
losses per
audited financial
statements ........ ~ a , N/A
. ... , '
audited financial
statements ............ ~ a N/A
t> t b Amounts included on line a but not on
Amounts included
b
b Amounts
Amounts included
included on on line
line a but
but not
not on
on : :' , Form 990:
line 17, Form 990:
12, Form
line 12, Form 990:
990: (1)
(1) Donated
Donated services
services
(1)
(1) Net unrealized
unrealized gains
gains I;· and use of facilities
facilities ...$
$
....... I
on investments
investments ... .$ $ (2) Prior
(2) Prior year adjustments
adjustments
(2)
services <. reported on line 20,
reported 20,
and use of facilities
facilities .. . $$ I:; Form 990
Form990 ............ $$_
(3)
prior
.'./
, .(; ":'.' (3) Losses
(3) Losses reported
reported on
year grants
grants ............ $ $ 20, Form
line 20, Form 990
990 ...$_
...$ I·,'
1+ ['." I
li:';1'ld........ ·.··~r> >':!.::.:.. ..:
(..)
(4) Other (speCify):
(specify): (..) Other (speCify):
(4) (specify):
I>
$ . • " ••·>:,<ii····· $
amounts on lines
Add amounts lines (1)
(1) through
through (..)
(4).......... ~ b
► Add amounts
lines (1) t
1) through 4)
through (4) t ...... ~ b
cc Line a< minus
minus line b ................................. ~ c cc Line a minus
Line minus line b .................... ...... ►
~ c
d Amounts
Amounts included
included on line 12, 12, Form
Form d Amounts
Amounts included
included on
on line 17, Form Form
990 but not on line a:
990 "en· 990 but
990 but not on line a:
a:
(1) Investment
expenses it I : :.... (1) Investment
Investment expenses
expenses
'<
included on
not included on not included
included on '.
6b, Form 990
line 6b,Form 990 ...$
... $ 6b, Form
line 6b, Form 990
990 ..$
..$
Ii' ..•. ,.
(2) (specify):
".

(2) (specify):
$ :
. $
Add amounts
Add amounts on lines (1)
(1) and (21 ..............
and (2) , ~ d Add
Add amounts
amounts on lines (1)
(1) and (2) ...
and(2) ~ d
e
e Total revenue per
Total per line 12,
12, Form
Form 990
990 e
e Total expenses
Total expenses per
per line
line 17,
17, Form
Form 990
990
(line c plus
plus line d) ................................ ~ e (line c plus
plus line d) .... ........................ ....... e
Part V
I PartVl List of Officers, Directors,
Directors, Trustees,and Key Employees
Trustees, and Key Employees (List eachone
(List each oneeven
even if not
if not compensated.)
compensated.)
(8) Title and
(B) and average hours
hours Compensation (0~ContrjbutjOnSto
(C) Compensation Contributions to (E) Expense
(E)Expense
(A) Name and address
(A) address devoted to
per week devoted (If not
(If not paid,
pa~1'enter
iployee
enter eplans 1%
benefit
ployee benefit
& deterred account
account and
position
oosition -0-. P:'~;A~:!.tio~
compensation other allowances
other allowances
---------------------------------
sii-STATEMENT-6-------------------
SEE STATEMENT 6 1122 , 0000.
00. O.
0^ Sb.
O.
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
75 Did any officer,
officer, director,
director, trustee,
trustee, or key employee
employee receive aggregate
compensation of more
more than
than $100,000
$100,000 from
from your
your organization
organization and all related
organizations, which more
more than
than $10,000
provided by the related
organizations? If "Yes,' attach schedule.
"Yes,'attach schedule. ...
► | Yes [yf\ No
| Yea 0 CXJ
423031
423031 01-13-OS
01-13-05 Form 990 (2004)
990(2004)
4
13580614 758050 23-12053HEI
23-12053HEI 2004.05060 THE HEIMLICH
2004.05060 HEIMLICH INSTITUTE
23-12051
'"
Form 990(2004)
2 3 - 7 3 0 3161 Page
Page 55
I PartV,l
P a r t VI Other
O t h e r Information
Information Yes
Y es No
No
76
76 Did
Old the organization
organization engage engage in any activity activity not previously
previously reported reported to the IRS? If "Yes; "Yes," attach
attach a detailed
description of each each activity
activity 76
76 x
77-
77' Were any changes changes made in the organizing or governing documents
the organizing or governing documents but not reported to the IRS? '" but not reported to the IRS? . 77 x
X
"Yes," attach
If "Yes: attach a conformed
conformed copy copy of the changes. changes.
78 aa Did the organization
78 organization have unrelated unrelated business business gross income of $1,000 $1,000 or more during during the year covered by this return? return? . . 78a
7Ba x X
"Yes," has it filed a tax return
b If "Yes; return on Form 990-T 990-Tlorfor this year? .. N..I.A.
N/.A 78b
78b
79
79 Was there aa liquidation,
Was liquidation, dissolution,
termination,ororsubstantial substantialcontraction
contractionduring duringthe theyear?year? . 79
79 x
"Yes," attach
If "Yes: attachaastatement
statement
80 aa Is the
80 the organization
organization related related (other
(other than than by by association
association with with aa statewide
statewide or or nationwide
organization) through through commoncommon membership,
membership,
governing
governing bodies, trustees,officers,
bodies, trustees, officers,etc., etc., totoanyanyother otherexemptexemptorornonexempt
nonexemptorganization?
organization? 80a
BOa X
'Yes," enter
b If 'Yes; enter thethe namename of of the
the organization
organization ~►
and check
and check whether 0
whether it is 0
exempt
exempt or or I I nonexempt.
nonexempt.
81aa Enter direct
81 direct or indirect
indirect political
political expenditures.
expenditures. See See lineline 8181 instructions
instructions .: I to. I 81a
81a I 0_,
Did the
bb Did the organization
organization file file Form
Form 1120-POL
1120-POL forth for this year?
is year? 31b
81 b X
X
82 a Did the the organization
organization receive receive donated
donated services
services or or the
the useuse of of materials,
equipment,ororfacilities facilitiesatatno nocharge
chargeororatatsubstantially
substantially less
lessthan
than
rental value?
fair rental value? 82a
82a X
X
b If "Yes,"
"Yes: you you maymay indicate
indicate the the value
value of of these
these itemsitems here. here.Do Do not
notinclude
includethis thisamount
amountas as revenue
revenueininPart PartI Iororas as anan
expense
expense in in Part
Part II. II. (See
(See instructions
instructions in in Part
Part 111.)
III.) II 82b
82b II N_/
N /AA ...
83 aI DidDid the the organization

organization comply comply with with thethe public
public inspection
requirements for returns returns and exemption
applications? .. 83a83a X
b DidDid the the organization
organization comply comply with with thethe disclosure
requirements relating relating to to quid
quid pro pro quoquo contributions?
contributions? . 83b83b X
X
84 aI DidDid the the organization
organization solicit solicit anyany contributions
gifts thatthat werewere not not tax
tax deductible?
deductible? . 84a84a X
X
b If "Yes; "Yes," did did the
the organization
organization include include with with every
every solicitation
solicitation an an express
express statement
statement that that such
such contributions
gifts were
were not
not
tax deductible?
tax deductible? . .NNI.A
/A . 84b84b
88
85 501(c)(4),(5),
501(c)(4), (5),oror(6) (6)organizations.I
organizations. Were » Were substantially
substantially all all
dues dues nondeductible
nondeductible by by members?
members? N..I.A
.N/A .. 85a 85a
b DidDid the the organization
organization make makeonly onlyin-house
in-houselobbying lobbyingexpenditures
expendituresOf$2,000 of $2,000ororless? less? NI.A
N/A .. 85b 85b
If "Yes"
"Yes' was was answered
answered to to either
either 85a85a or or 85b,
85b, do do not not complete
complete 85c 85c through
through85h 85h below
belowunlessunlessthe theorganization
organizationreceived receivedaa waiver
waiver for
for proxy
proxytaxtax
owed for
owed for the
the prior
prior year.
year.
c Dues,
Dues, assessments,
assessments,and and similar
similaramounts
amountsfrom frommembers.
members 85c
85e N/ A A
Section 162(e)
d Section 162(e) lobbying
lobbying and political political expenditures
expenditures 85d
85d N/A A
e Aggregate
nondeductible amount amount of section section 6033(e)(1)(A)
6033(e)(1)(A) dues dues notices
notices 85e
85e N/A A
t Taxable amount amount of of lobbying
lobbying and and pOlitical
expenditures (line (line 85d
85d lessless85e)
85e) 85f
85t N/A A
Does the
II Does theorganization
organizationelect electtotopaypaythe thesection
section6033(e)6033(e)tax taxon onthetheamount
amounton online
line85t?85f? .. .NfAN/A S5g
I-"-'B
5",,)
D,-+_-+- __
h If section 6033(e)(1)(A) dues
section 6033(e)(1)(A) dues notices
notices were were sent,sent, does does the the organization
organizationagree agreetotoadd add thetheamount
amounton online
line851 85ftotoitsitsreasonable
reasonableestimate
estimate01dues
of dues
allocable to
nondeductible lobbying lobbying and and political
expendituresfor forthethefollowing
followingtax taxyear?
year? . '" NN I.A....
/A 85h
1-"-'85""h,-+_-+- __
86 501(c)(7) organizations. Enter:
501(c)(7) organizations.Enter: a Initiation
I Initiation feesfees andand capital
contributions included
included on on lineline1212 86a
86a N/ A A
b Gross
Gross receipts,receipts, included
included on on line
line 12,
12, forfor public
public use use of of club
club facilities
facilities 86b
86b N
N /A A
87
87 501(c)(12) organizations. Enter:I a
501(c)(12Jorganizations.Enter: Gross
Gross income
income fromfrom members
members or or shareholders
shareholders . 87a
87a N/A A
b Gross
Gross income income from from other other sources.
sources.(Do (Donot notnetnet amounts
amountsdue due ororpaid
paidtotootherothersources
sources
against amounts
against amounts due due or received
received from from them.)
them.) .. 87b
a7b N
Nl/ A A
88
88 At any any time
time during
during the the year,
year, diddidthe
the organization
organization own ownaa 50% 50% or or greater
greater interest
interest ininaataxable
taxable corporation
corporation or or partnership,
partnership,
or an entity entity disregarded
disregarded as separate separate from from the the organization
organization under under Regulations
Regulations sections sections 301.7701-2
301.7701-2 and 301.7701·3? 301.7701-3?
If "Yes,'
"Yes," complete
complete Part Part IX IX 88 X
89
89. a 501(c)(3) organizations. Enter:
501(c)(3) organizations.Enter: Amount
Amount of tax
of tax imposed
imposed on on
thethe organization
organization duringduring thethe year year under:
under:
section4911^
section 4911.... O. ; section 4912
CL_;section 4912.... ► (O.K . ;; section
section 49554955 ► .... .!::.O~.
b 501(c)(3)
50 1(c)(3)and and501(c}(4)organizations.Did
501(c)(4) organizations. Did thethe organization
organization engage
engage in anyin any section
section 4958 4958 excess
excess benefit
benefit
transaction during
transaction during the the yearyear or or did
did itit become
become aware aware of of anan excess
excess benefit
benefittransaction
transactionfrom fromaaprior prior year?
year?
IfIf "Yes;
"Yes," attach
attachaastatement
statementexplaining
explainingeach eachtransaction
transaction .. 89b89b X
c Enter:
Enter Amount Amount of of tax
tax imposed
imposed on the the organization
organization managers managers or disqualifieddisqualified persons persons during during the the year under
year under
sections
sections 4912, 4912,4955, 4955, and and 4958
4958 . ....
.► -=O~.
0.
Enter Amount
d Enter: Amount of tax tax on line a9c, 89c, above,
above, reimbursed
reimbursed by by the the organization
organization ....
>. -=O~.
90 a List
list the the states with which
states with which aacopy copyofofthis thisreturn
returnisisfiled filed .... ► .:::O~H~I=O:_
OHIO --,r----, _
b Number of employees employed employed in the pay period period that includes includes March 12, 12,20042004 ...1 90b
.:.;90::,::b'-JI..__ -=3
91
91 The books books are are inin care
careofof ~►THE THE HEIMLICH HEIMLICH INSTITUTE INSTITUTE FOUNDATION FOUNDATION Telephone Telephonenono......► (513) ( 5 1 3 ) 559-2391
559-2391
Located
Locatedatat ....
► 311
3 1 1 STRAIGHT
STRAIGHT STREET
STREET CINCINNATI, OHIO
CINCINNATI, OHIO ZIP
ZIP +
+ 44 ~►-=4=5-=2:...=1""'9'--
4 5 2 1 9 __
92
92 Section 4947(a)(l)
4947(a)(1)nonexempt
nonexemptcharitable
charitabletrusts
trustsfiling
filingForm
Form 990
990 in inlieu
lieuofof fotm1041-
Form 1041-Check here
Check here .. ....
01
►!
4230411
the amount
and enter the amount of
of tax-exempt
tax-exempt interest
interest received
received ororaccrued
accruedduring thetax
duringthe taxyear
year ....J T
► 19292 I N/A
N/A
Si??3- 05
01·13·05 Form 990 (2004)
(2004)
5
13580614
13580614 758050
758050 23-12053HEI
23-12053HEI 2004.05060
2004.05060 THE
THE HEIMLICH
HEIMLICH INSTITUTE
23-12051
.' ..
_ ,
Form990(2004)
Form 990 (2004) THE
T HE H E I M L I C H INSTITUTE FOUNDATION
HEIMLICH FOUNDATION 2 3 - 7303161
23-7 30 3161 PPage
agee6
I Part
PartVHJ
VH Analysis
Analysis of IIncome-Producing
n c o m e - P r o d u c i n g Activities (See page 33
33 of
ot the
the instructions.)
instructions.)
business income Excluded
Excludedby section 512, 513, or
by section512,513 or 514
514
Note: Enter gross amounts unless otherwise
otherwise (E)
(E)
indicated. (A) (8)
(B) (e)
(C) (0)
(D)
Exclu-
Exclu Related or exempt
Related or exempt
Business Amount
Amount sion Amount
Amount
93
93 Program
Program service
service revenue:
revenue: code code
code function income
function income
aa
bb
c
d
d
e
e
f Medicare/Medicaid
payments ....................... .........
g Fees and
and contracts
contracts from
from government
government agencies
agencies .... .......
94 Membership
94 Membership dues dues and assessments ............ ........... .
and assessments
95
95 Interest
Interest on savings
savings and temporary cash investments
and temporary investments ... 14 1 3.794.
13,794.
96 Dividends interest from
Dividends and interest securities . ... ........ ........
from securities 14 10,624.
10,624.
97 income or (loss)
(loss) from
from real estate:
estate: : :. ......... .......
97 Net rental income .
a debt-financed
property .. ........................... .......... .
b not
b not debt-financed
property ....................................
98
98 Net rental
rental income
income or (loss)
(loss) from
from personal property ......
personal property
99
99 Other investment
investment income
income ............................... .......
100 Gain or
100 or (loss)
(loss) from
from sales
sales of of assets
assets
inventory ............................................. 18
18 1
111 . 6669.
69.
101
101 Net income
income or or (loss)
(loss) from
from special events ........... ......
special events
102 Gross profit
102 profit or (loss)
(loss) from
from sales
sales of inventory
inventory ..........
103 Other revenue:
103 revenue:
a
a
b
b
c
d
d
e
e
104 Subtotal
104 Subtotal (add
(add columns
columns (B),
(B), (D),
(D), and
and (E)) .................. ..' '>'.' 0
O.. "
3
366 . 0087.
87. 0
O..
105 Total (add
105 Total line 104,
(add line 104, columns
columns (B), (0), and
(B),(D), (E))
and (E)) . ~ 336
6 .,087
0 8 7 ..
Note:
Note: Line 105 plus line 1d, Part I, should equal the amount on line 12, Part I.
I Part
Part VIII Relationship of Activities
Villi Relationship Activities to the Accomplishment
Accomplishment of Exempt
Exempt Purposes
Purposes (See page3434ofofthethe
(See page instructions.)
instructions.)
,.
Line No.
Line
▼
Explain how each activity
exempt purposes
exempt purposes (other
(other than
which income
activity for which income is reported
than by providing
reported in column
providing funds
funds for such
column (E) of Part VII contributed
such purposes).
purposes).
contributed importanlly
importantly to the accomplishment
organization's
IN/A
N/A
I Part IX J
Part IX Information Regarding
Regarding Taxable
Taxable Subsidiariesand
Subsidiaries and Disregarded
Disregarded Entities (See
(See page
page3434ofofthethe instructions.)
instructions.)
(A) (8)
(B) Nature (C)
(1)' .. (0) (E)
Name, address,
address, and EIN of corporation,
corporation, Percentage of
Percentage of Nature 0 activmes
of activities Total income
Total income End-at-year
End-of-year
partnership, or disreaarded entit'L
partnership, disregarded entity ownership
ownership interest
interest assets
assets
%
%
N/A
N /A %
%
%
%
I PParfX
a r t X I[ Information
Regarding Transfers
Transfers Associated
Associated with w i t h Personal
Personal Benefit
Benefit Contracts
C o n t r a c t s (See page 34
34 of the
the instructions.)
instructions.)
(a) Did the organization,
(a) during the year,
organization, during year, receive
receive any funds,
funds, directly
indirectly, to pay premiums
premiums on a personal
personal benefit
benefit contract?
contract? ............ IUVes
I Yes I[X]
X ) No
(b)
(b) Did the organization,
during the year,
year, pay premiums,
premiums, directly
indirectly, on a personal
personal benefit
benefit contract?
contract? I Ves
I Yes L x J No 0 CXJ
Note: If "Yes" to (baffle Form 8870 and Form 4720 (see instructions).
Under penalties of perjury, I declare that I haue examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, It is true,
Please
Please correct, and compjey. Declaration of prepare (Other than officer) is based on all information of which preparer has any knowledge.
Sign
Sign
Here
Preparer'. SSN Of PllN
Paid
Preparer't
Preparer'. Firm's name
Firm'. (or
Uae Only
Use yours
name (or
YO... 8Ifif
CLARK,
CLARK, SCHAEFER,
SCHAEFER, HACKETT
HACKETT &
& CO. EIN ►
423161
423161
01-13-05
01-13-05
self-employed),
....
Z
f-employed),
address,
IP+ 4
ZIP+ 4
and
addr... , and ► 105 EAST
~105 EAST FOURTH
~CINCINNATI
FOURTH STREET,
CINCINNATI, OHIO
STREET, SUITE 1500
OHIO 45202-4093
45202-4093 Phone
Phone no. ►513-241-3111
no. .... 513-241-3111
Form 990 (2004)
990(2004)
6
1~~~nh14 7^8050
nRftflKIA 23-12053HEI
7~Rn~O 23-12053HEI 2004.05060 HEIMLICH INSTITUTE
23-12051
SCHEDULE
SCHEDULE A
A Organization
Exempt Under Section 501(c)(3) OMB
OMS No. 1546-0047
No, 1545-0047
(Form 990 or 99O-EZ)

990-EZ) (Except Private Foundation) and Section 601(e),
601(e), 601(1), 601(k),
501(f), 501(k),
Department
Departmentof of the Treasury
Treasury
501(n), or Section 4947(1)(1)
Supplementary lnformation-(See
Supplementary
4947(a)(1) Nonexempt Charitable Trust
Information-(See separate instructions.)
instructions.) 2004
IntemalRevenueServiee ... MUST be completed
^ completed by the above organizations
organizations and attached
attached to their
their Form 990 or 990·EZ
990-EZ
Name01the
Name of the organization Employer identification
THE HEIMLICH INSTITUTE FOUNDATION FOUNDATION 23: 7303161
23' 7303161
Part 1 Compensation of the Five Highest Paid Employees Other Than Officers,
Compensation Officers, Directors,
Trustees
(See page 1 of the instructions.
instructions List
List each one. none,enter 'None.')
one If there are none, 'None ')
(b) Title
Titie and average hours
hours (d) Contributions to (e) Expense
(e)Expense
(a)
(a) Name and address 01each
and address of each employee paid
(c) Compensation
employee benefit
per week devoted to plans & account and other
deferred account
& deferred
more than $50,000
more than $50,000 position
position compensation
~9~~______________________________
NONE
----------------------------------
----------------------------------
----------------------------------
----------------------------------
,"
Total number
number of other employees
employees paid
over$50,000
over $50000,.,
.""'''" .."" ..,, . , ........ .......... .. "." 0
,,"'''''', ....
► . .: ". .'
Part II
IPart III Compensation
Compensation of the Five Highest Paid Indepeiident
Contractors f<Dr
for Professionsil
Services
01the
(See page 2 of instructions. List each one (whether
the instructions. (whether individuals
individuals or firms).
firms). If there
there are none, enter 'None.')
'None.')

(a) address of each independent
independent contractor
contractor paid more than $50,000
more than $50,000 (b) Type of service
(b) (c) Compensation
Compensation
~9~~
NONE _
Total number of others receiving over • . • , , ' I ■

;~~~~~~~:re~~f~~:~~;le~:~:~~so~er
$50,000 for professional services , , ,.. ,.. ,.. , ► 1 0
0 [I';r',f'inl "~jr:j,l\j'~jj;:i,!l>;;j'\{il:,/',:'i:,.··., ..i< .. i
423ioi/ii-24-o4
423101/11-24-04 LHA For Paperwork
Paperwork Reduction
Reduction Act
Act Notice, see the Instructions
Instructions for
for Form
Form990
990 and
and Form
Form990-EZ.
990-EZ. ScheduleAA (Form
Schedule (Form 990
990 or
or 990-EZ)
990-EZ)2004
2004
7
7
135Rnfi14
1~~ROn14 75R050
7~R050 23-12053HEI
23-12053HEI 2004.05060
HEIMLICH INSTITUTE
FOUN 23-12051
Schedule
Schedule AA(Form
(Form990990or or 990-EZ)
990-EZ) 2004
2004 THEHEIMLICH
THE HEIMLICHINSTITUTE
INSTITUTEFOUNDATION
FOUNDATION 2 32-37- 37 03 3161
0 3 1 6 1 Page
Page
2 2
Part lit -I
1 Part lit Statements
S t a t e m e n t s About
A b o u t Activities (See page
page 2
2 of
the instructions.) Yes
Y e s No
No
1 During
During thethe year,
year, has
has the
the organization
attempted to to influence
influence national,
national, state,
state, or
or local
local legislation,
including any
any attempt
attempt to
to influence
influence
public opinion
public opinion on a legislative referendum? If "Yes;
legislative matter or referendum? total expenses
"Yes," enter the total expenses paid or incurred
incurred in connection
connection with
with the
lobbying activities
lobbvina activities ~ ► $ $ (Must
(Must equal amounts
amounts on line 38,
38, Part VI·A,
Vl-A,
or line I] of Part VI-B.)
Vl-B.) 1 x
X
Organizations that
Organizations that made election under section
made an election section 501(h)
501(h) by filing
filing Form 5768 must must complete
complete Part VI·A. organizations checking
Vl-A. Other organizations checking
"Yes; must
"Yes," must complete
complete Part VI-BVl-B AND attach a statement
statement giving
giving a detailed
description of the lobbying activities.
2 During
During the year,
year, has
has the
the organization,
organization, either directly
indirectly, engaged
engaged in any
any of the following
following acts
acts with
with any
any substantial
substantial contributors,
contributors,
officers, creators,
employees, or members
members of their
their families,
families, or with
with any taxable organization
organization with
with which
which any such
such
person
person is affiliated
officer, director,
director, trustee, majority owner,
trustee, majority principal beneficiary?
owner, or principal beneficiary? (If the answer to any question is "Yes," "Yes,"
attach a detailed statement explaining the transactions.)
transactions.)
a Sale,
a Sale, exchange,
exchange, or
or leasing
leasing of
of property?
property? .. . .. .. .. .. . . . 2a
28 x
X
b Lending of
b Lending of money
money or
or other
other extension
extension of
of credit?
credit? _.......... . _.. 2b
2b x
X
cc Furnishing
goods, services,
services, or facilities?
facilities? _ .. 2c
2c x
X
d Payment
Payment of compensation
compensation (or
(or payment
payment or reimbursement
expenses if more
more than
than $l,OOO)?
$1,000)? .. S E E P A R T ...v......
S.E.lt ..l?AA'l' F O R M 9..9..
V j , F.ORM... 9 9 0....
0 2d
2d X
X
e Transfer
e Transfer of any
any part
part of its income
income or assets?
assets? .. . 2e
2e X
3 •a Do you
you make
make grants
grants for
for scholarships,
student loans,
loans, etc.?
etc.? (If "Yes;
"Yes," attach
attach an explanation
explanation of how how
you
you determine
determine that
that recipients
recipients qualify
qualify to receive payments.)
payments.) .. - .. --_ . 38 X
Do you
b Do you have a section
section 403(b)
403(b) annuity
annuity plan
plan for
for your
your employees?
employees? .. 3b X
4 •a Did you
you maintain
maintain any
any separate
separate account
account for participating
participating donors
donors where
where donors
donors have the right
right to provide
provide advice
advice
on
on the
the use
use or
or distribution
distribution of
of funds?
funds? .. 4a
48 X
b Do vou orovioe
Dovou provide credit
credit counselino.
counseling, debt
debt manaoement credit renair
management, credit repair, or debt
debt neootiation
negotiation services?
services? . 4b
4b x
X
1 PPart
a r l IIll:1
V Reasonfor Non-Pnvate
Reason for N o n - P r i v a t e FoundationStatus
Foundation Status (See pages
pages 3 through
instructions.)
organization is not
The organization not a private
private foundation
foundation because
because it is: (Please check
check only
only ONE applicable
applicable bOX.)
box.)
56 □
D church, convention
A church, convention of churches,
churches, or association
association of churches.
churches. Section
Section 170(b)( 1)(A)(i).
170(b)(1)(A)(i).
6 □
D school. Section
A school. Section 170(b)(1)(A)(ii).
170(b)(1)(A)(ii). (Also
(Also complete
complete Part V.)
7 □
D hospital or a cooperative
A hospital cooperative hospital
hospital service
170(b)(1)(A)(iii).
8 □
D Federal, state,
A Federal, state, or local government
governmental unit
unil Section
Section 170(b)( 1)(A)(v).
170(b)(1)(A)(v).
9 □
D medical research
A medical research organization
operated in conjunction
conjunction with
with a hospital.
hospital. Section
hospital's name,
name, city,
city,
and state ~
and .tate ►
10 □
D An organization
operated for the benefit
benefit of a college
university owned
owned or operated
governmental unit.
unit. Section
Section 170(b)(
170(b)( 1)(A)(iv).
1)(A)(iv).
(Also complete
(Also complete the Support Schedule in Part IV·A.)
Support Schedule IV-A.)
11a
lla Lx]
[XJ organization that
An organization that normally
normally receives
substantial part
part of its
Its support
support from
from a governmental
governmental unit from the general
unit or from general public.
public.
Section (Also complete
170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV-A.)
Support Schedule
11b
llb □
D community trust.
A community trust. Section
170(b)(1)(A)(vi). (Also
(Also complete
Support Schedule
12
12 □
D An organization
organization that normally receives:
that normally receives: (1)
(1) more
more than
than 33 1/3% of its support
331/3% support from
from contributions,
membership fees, and
and gross
gross
receipts from
receipts activities related
from activities related to Its charitable,
charitable, etc.,
etc., functions subject to certain
functions - subject certain exceptions,
exceptions, and (2) more than
(2) no more 1/3% of
than 33 1/3%
support from
its support from gross
gross investment
unrelated business
business taxable
taxable income
income (less
(less section
section 511
511 tax) from
from businesses
businesses acquired
acquired
by the organization
organization after June 3D, 1975. See section
30,1975. section 509(a)(2).
509(a)(2). (Also
(Also complete
Support Schedule IV-A)
13 DI
I An
An organization
organization that
that is not
not controlled
controlled by
by any
any disqualified
persons (other
(other than
than foundation
managers) and
and supports
described in:
in:
(1) lines 5 through
(1) through 12 above;
above: or (2)
(2) section
section 501(c)(4),
501(c)(4), (5),
(5), or (6),
(6), if they
they meet the test of section
section 509(a)(2).
509(a)(2). (See section
section 509(a)(3).)
509(a)(3).)
Provide information about
following information about the supported organizations. (See page 5 of the instructions.)
supported organizations. instructions.)
(b)
(b) Line number
number
(8) Name(s) of supported
(a) supported organization(s)
organization(s) from
from above
14 [ ] An organization organized and operated

organization organized operated to test for public
public safety.
safety. Section
Section 509(a)(4).
509(a)(4). (See page 5 of the instructions.)
instructions.)
423111 Schedule
12-03-04 Schedule A (Form
990-EZ) 2004
2004
8
113580614
3 5 8 0 6 1 4 7758050
5 8 0 5 0 223-12053HEI
3-12053HEI 22004.05060 THE HEIMLICH
0 0 4 . 0 5 0 6 0 THE HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 23-12051
23-12051
Schedule A (Form 990 or 990-EZ) 2004 THEHEIMLICH
HEIMLICHININSTITUTE TITUTE FOUNDATION FOUNDATION 2 3 - 77330a33161
161 Pa
ae33
Page
Part IV-A Support
Support Schedule (Complete only
Schedule (Complete only if you
you checked
checked a box
box on line 110,
0 , 111, Use cash
1 , or 12.) Use cash method
method of
of accounting.
accounting.
N ote: Yi
Note: Youou may
may use use tUrn he work sheet m
woihuheet in nea instiuctions
. tthe iinstructions
. t,orconvemn;
lot . tfrom
convertinu he accrual
romtlite accruaI to the aisl)
to the cash mat h0d of
method o f accountmg.
.
accounting.
Calendar
Calendar year (or fiscal year
fiscl' yelr
beginning
begjnning In)in) .................................. ► (a) 2003 (b) 2002
2002 (c) 2001 (d) 2000
2000 (e) Total
15
15 Gifts, grants,
grants, and contributions
contributions
received. (Do not not include
i~f'ude unusual
grants. See line 28.) 28. .. titi ...
... 2
2111 1 . 9919.
19. 1
1121 2 . 4467.
67. 4
433 . 5548.
48. 1 06.140.
106,140. 4 74,074.
474,074.
16 Membership
Membership fees received .........
17 Gross receipts from from admissions,
admissions,
merchandise sold sold or services
performed, furnishing of
facilities
facilitieS in any activity
activity that is
related to the organization's
organization's
charitable, etc., purpose ...... .....
18 Gross income from interest,
from interest,
dividends, amounts received from
dividends, amounts
payments on securities
securities loans (sec (sec-
tion 512(a)(5)),
512(a)(5)), rents, royalties,
royalties, and
unrelated business
(less section 511 taxes) from from
businesses acquired
acquired by the
organization after June 30, 30,1975
1975 2
211 . 9961.
61. 2 1 , 9906.
21 06. 2
24 4 . 9920.
20. 2
255 . 5535.
35. 9 4,322.
94.322.
19
t9 Net income fromfrom unrelated business
activities not included In in line 18 18 ...
20
20 Tax I ax revenues levied
leviedJorfor the
organization's
organization's benefit and either
paid to Itit or expended on its behalf
21 The value of services or facilities
furnished
furnished to the organization by a
governmental
governmental unit without without charge.
Do not Include
include the value of services
or faCilities
facilities generally furnished
furnished to
the public without
without charge
22 Other income. Attach a schedule.
22
Do not inl~rde
include gain or (loss) from from
sale of capital
ca ital assets ...............
23 Total of lines 15 through through 22 2
2333 3 . 8880.
80. 1 3 4 . 3373.
134 73. 6
688 . 4468.
68. 1 3 1 . 6675.
13L 75. 568.396.
568.396.
24 Line 23 minus
24 minus line 17 17 ...... ........ 2
2333 3 . 8880.
80. 1 3 4 . 3373.
134 73. 6
688 . 4468.
68. 1 3 1 . 6675.
131 75. 5 68.396.
568.396.
25 Enter 11%
25 % of line 23 ...... 2 . 3339.
39. 1 . 3344.
44. 685.
685. 17. .
1 . 3317.
26 Organizations
described on lines
line. 10 or 11: a I Enter 2% of amount in column column (e), line 24 24. . .... .. ► 26a268 1
111 , 3368
6 8 ..
b Prepare a list for
for your
your records
records to
to show
show the name of and amount amount contributed
contributed by each person (other than a governmental governmental
unit or publicly supported organization) whose total
publicly supported total gifts for 2000 through through 2003 exceeded the amount shown shown in line 26a.
Do not file
file this
thl. list with
with your return.
return. Enter the total
total of all these excess amounts amounts ..... . ....
............. ............................ , ► 26b 26b 4
4585 8 , 8897.
97.
c Total support
support for section
section 509(a)(1)
509(a)(1) test
test Enter line 24, column ....
column (e) ........ ............. , ...... .. ......... ..................... ....... . . ► 26c 26c
....
5
5686 8 , 3396.
96.
Amounts from
d Add: Amounts from column
column (e) for lines:
lines: 18 18 94,322.
9 4 , 3 2 2 . 1919
22 26b
26b 4458,897.
5 8 , 8 9 7 . .... ► 26d26d 5
5535 3 , 2219.
19.
support (line 26c minus
e Public support minus line 26d total)
total) .......................... ....
................ .. , ........ ....... .. .... ........ .. .. . .. , ........... ► 26e 1
15 5 , 1177.
77.
Public support
f Public support percentage
percentage (line
(line 26.
26e (numerator)
(numerator) divided
divided by line (denominator))
line 26c (denominatorll .... ............. ....
.... ► 26f 2.6701%
27 Organizations described on line 12: Ia For amounts
Organizations described amounts included in lines 15, 15,16,16, and 17 17 that were received from from a 'disqualified
"disqualified person;
person," prepare a list for your
records to show the name of, and total amounts amounts received in each year from, from, each "disqualified
'disqualified person."
person: Do not file file this
this list
list with
with your
your return.
return. Enter the sum of
such amounts
amounts for each yeanyear: NN/A/A
(2003)
(2003) (2002)
(2002) (2001)
(2001) (2000)
(2000)
b For any amount
amount included in line 17 that was received from from each person (other than "disqualified persons"), prepare a list for your records
'disqualified persons'), records to show the name of,
and amount received for each year, that was more than the larger larger of (1) (1) the amount
amount on line 25 for the year or (2) $5,000. $5,000. (Include in the list organizations
described in lines 5 through
through 11, as well as individuals.)
individuals.) Do not file file this
this list
list with
with your
your return.
return. After computing
computing the difference between the amount amount received and
the larger amount
amount described in (1) (1) or (2),
(2), enter the sum of these differences (the excess amounts) amounts) for each year: N N/ A
(2003)
(2003) (2002)
(2002) . .. .. .. (2001)
(2001) (2000)
(2000)
c Add: Amounts
Amounts from
from column (e) for lines: 15
15 __ 16
16 _
17
17 _ 20
20 __ 21
21 _ ... ► 27c N/A
d Add: Line 27a total and line 27b total 27d N/A
support (line 27c total minus line 27d total)
e Public support total) . 27e N/A
f Total support 509(a)(2) test
support for section 509(a)(2) test Enter amount
amount on line 23, column
column (e) .... 27f N/A
g Public support percentage
Public support percentage (line
(line Zle
27e (numerator)
(numerator) divided
divided byby line 27f (denominator))
line 27f (denominator)) ► 27g N/A %
h Investment income percentage (line 18, column (e) (numerator) divided by line 27f (denominator)) ► 27h N/A
28 Unusual Grants: For an organization described in line 10,11, or 12 that received any unusual grants during 2000 through 2003, prepare a list for your records
to show, for each year, the name of the contributor, the date and amount of the grant, and a brief description of the nature of the grant. Do not file this list with
your return. Do not include these grants in line 15.
423121 12-03-04 NONE
N O N E Schedule A
Schedule A (Form
(Form g90
890 or
or 990-EZ)
990-EZ) 2004
2004
9
13580614
13580614 758050 23-12053HEI
23-12053HEI 2004.05060
HEIMLICH INSTITUTE
Schedule
Schedule AA(Form
(Form990
HEIMLICH INSTITUTE
FOUNDATION 2 33 - 77330033161
161 Page4
Page 4
I PartV
Part V I Private School
Questionnaire (See page
page 77ofofthe
theinstructions.)
instructions.) N/A
N/A
(To be
(To be completed
completed ONLY ONLYby schools that checked
by schools checked the box box on line
line 66 in Part
Part IV)
IV)
Yes
Y No
e s No
29 organization have a racially
Does the organization racially nondiscriminatory
policy toward
toward students
students by
by statement
statement in its
its charter,
charter, bylaws,
bylaws, other governing
governing
instrument,
instrument, or
or in a resolution
resolution of
of its governing
governing body?
body? ........ . .............. . ......... ................ , .. ................ 29
29
....... -i--
30
30 organization include
Does the organization include a statement
statement of its racially
policy toward
toward students
students in in all its brochures,
catalogues,
and other written communications with
with the
the public
public dealing with
with student
student admissions,
programs, and scholarships?
scholarships? 30
31 organization publicized
Has the organization publicized its
its racially
policy through
through newspaper or
or broadcast
broadcast media during
during the
the period
period of
of
solicitation for
students, or
or during
during the
the registration
registration period
period if it has no solicitation
program, in
in a way that makes the policy
poliCy known
known
parts of the general community
to all parts community it serves?
serves? .... ............ ....... . ......... . . . . . . . . . .. . . .................... ...... 31
"Yes,' please describe;
If "Yes," describe; if "No,"
'No,' please explain.
explain. (If you need more space, attach a separate statement.)
statement)
32 organization maintain the

Does the organization the following:
following:
Records indicating
a8 Records indicating the
the racial composition
composition of the
the student
student body, faculty,
faculty, and administrative
staff? .. 328
32a
b Records documenting
documenting that scholarships
scholarships and other financial
financial assistance are awarded on a racially nondiscriminatory
nondiscriminatory basis? basis? 32b
32b
c Copies of of all catalogues,
communications to the the public
public dealing
dealing with
with student
student
admissions, programs, and scholarships?
scholarships? "" ....... ..... " ......... ........... . . . .. .. . . ..... ,. ......... . .... ...... 32c
32c
d Copies of allall material used by the
the organization
organization or on
on its behalf to
to solicit
contributions? 32d
,
32d -
IfIf you
you answered
answered "No"
'No' to any of the above,
explain. (If
(If you need moremore space, attach a separate statement) statement.)
33
33 Does the
discriminate by
by race
race in
in any
any way
way with
with respect
respect to:
to:
Students' rights
a8 Students' rights or
or privileges?
priVileges? 338
33a
........ .............................................. ........... ...................... ............. .............. . ............ -- i--
b Admissions policies?
Admissions policies? ........... ......... ............... _ ....... ......................... 33b
c Employment of
faculty or
or administrative
staff? ..................... ..... ....... .......... . ....................... , . 33e
33c
dd Scholarships or
other financial
assistance? ...... ........................ ...... ........ .... ....... ............... . ....... .......... ......... .................... 3Sd
33d
Educational policies? ................................................ .......... ...... ....... . .......................... ......................... ........... ... ......... S3e
33e
f Use of
Use of facilities?
facilities? ...... ................................... ............. ....... ........... ... .... .. ....... ............ ,., ......... . .... .. ...... 331
33f
Athletic programs?
0II Athletic programs? ........ .......... ........ .... ........ ........................... ........ ......... ................. .... .. ... 330
33g
hh Other
Other extracurricular
activities? .......................................................................................... .......... ........... ..... .. ....... .. .......... 33h
33h
IfIf you
you answered
answered "Yes"
"Yes' to
to any of the above,
explain. (If
(If you need more more space, attach aa separate statement)
statement)
34 aa Does
34 Does the
the organization
receive any
any financial
financial aid
aid or
or assistance
assistance from
agency? ., ... , ..... ........ ..... .. ...... 34a
34a
bb Has
Has the
the organization's
right to
to such
such aid
aid ever
ever been
been revoked
revoked or
or suspended?
suspended? ........... ........ .. .... . , . .. ...... 34b
34b
IfIf you
you answered
answered "Yes"
"Yes' to
to either
either 34a
34a or
or b,
b, please
please explain
explain using
using an
an attached
attached statement
statement
35
35 Does the
certify that
that itit has
has complied
complied with
with the
the applicable
requirements of
of sections 4.01 through
sections 4.01 4.05 of
through 4.05 of Rev.
Rev. Proc. 75-50,
Proc. 75-50,
1975-2 C.B.
1975-2 587,covering
C.B. 587, covering racial
nondiscrimination? IfIf "No,"
'No,' attach
attach an
an explanation
explanation . . ..,.. ........ 35
35
Schedule AA (Form
Schedule (form 990
990 or
or 990-EZ)
990·EZ) 2004
2004
423131
.23131
11-24-04
11-24-04
10
10
13580614 758050
13580614 758050 23-12053HEI
23-12053HEI 2004.05060 THE
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 23-12051
23-12051
Schedule A (Form 990 or 990-EZ) 2004 THE HEIMLICH INSTITUTE FOUNDATION 23-7303161
2 3 - 7 3 0 3161 Pages
Page 5
Part VI-A
Part Lobbying Expenditures
Vl-A 1 Lobbying by Electing Public
Expenditures by Public Charities
Charities (See page
page 99ofofthe
theinstructions.)
instructions.) N/A
N/A
(To be completed
completed ONLYby
ONLY by an eligible organization that tiled
filed Form 5768)
Check ~ aa 1
CheGk ► 01 ififthetheoroanization
organizationbelonos
belongstotoan
anaffiliated
affiliatedoroup.
group. Check
Check ~► bb 1 0 ififyouyouchecked
checked "a"and
and'limited
limitedcontrol'
control"provisions
"8" provisionsapply.
apply.
(a)
(a) (b)
(b)
Limits
L on
imits o n Lobbying
L o b b y i n g Expenditures
Expenditures Affiliated group
group To be completed
completed tor ALL
for ALL
term "expenditures"
(The term "expenditures' means amounts paid or
or incurred.) totals electing organizations
organizations
N /A
N/A
36 to influence public opinion
opinion (grassroots
(grassroots lobbying) . 36
36
to influence a legislative body (direct lobbying) . 37
38
Totallobbying expenditures (add
(add lines
lines 36
36 and 37)
and 37) . 38
38
39
39 Other
Other exempt purpose expenditures.....................................
exempt purpose expenditures 39
39
40 Total exempt purpose expenditures (add lines 38 and 39) . 40
amount Enter the amount
amount from the following following table
table-- .....•..
c.: 1 ....• ·
If the amount on line 40 is

IIthe Is - The lobbying
lobbying nontaxable
nontaxable amount is
Is - I.···. i;..f''■%■:,. ··I!'
: ":"':'":-'i4. ?. ' "' :
'
~~.~~~¥:*~
}
I
~~%~~~:f~
Not over $500,000 20% of the amount on line 40 "i
Over $500,000 but not over $1,000,000 $100,000 plus 15% of the excess over $500,000
Over $1,000,000 but not over $1,500,000 $175,000 plus 10% of the excess over $1,000,000 > 41
Over $1,500,000 but not over $17,000,000
Over$17,000,000
$1,000,000 .,
1-1~4~
..'._+-.,.- - m^^^^-f/
---:-
r
:,+.1-"-------
■■■■>"?&
42 Grassroots amount (enter
nontaxable amount 25% of
(enter 25% of line 41)
line 41) 42
r4"'2_+--------+---------
43
43 Subtract line 42 from line 36. Enter -0- if line 42 is more
Subtract line 42 from line 36. Enter -0- if line 42 is than line
more than line 36
36 43
r4~3_+--------+---------
-0- if line 41 is more than line 38
44 Subtract line 41 from line 38. Enter -0- 38 . 44
Caution: If there is an
Caution: an amount on
on either line 43 or
or line 44, you
you must file Form 4 720.
4720. '.'
4-Year
4-Year Averaging Period Under
Averaging Period Under Section 501(h)
501(h)
organizations that made a section 501(h)
(Some organizations 501(h) election do
do not
not have
have to
tocomplete
complete all
all of
ofthe
the five
five columns
columns
below. See the instructions
below. instructions for lines 45 through
through 50 on page 11 of the instructions.)
instructions.)
During 4-Year Averaging
Averaging Period
Period M/ a
N/A
Calendar year (or («)
(a) (b)
(b) (c)
(c) W
(d) (•)
(e)
fiscal beginning In)
in) ~
*> 2004 2003 2002 2001 Total
amount ........................ 0,
0.
.... ,
amount > .'c
: . : J l S , V : ' : . ^ - ' - " ': ■■'.•- ■
(150% of
(150% of line 45(e)) .........
•
C'c' ••••. i.
'" o.
0.
47 Total lobbying
expenditures ............ ..... 0
O..
0
O..
49
amount ........................
.... .
'.', ... ' . , ..... ,\ .. } .:-:. ....., c••..
. .. ^ i S S I - i '.^ - ; !, ■■■■
'' ■
!■
; c 1' 0
(150% of
(150% ofline
line 48(e)) ......... , c '. , O .•
lobbying ".'.
expenditures ................. 0
O..
I PPart VJ-B I Lobbying
a r t VI-B Lobbying Activity
/Activity by
b y Nonelecting Public Charities
N o n e l e c t i n g Public Charit es
reporting only by organizations
(For reporting organizations that did not complete Part Vl-A) of the msnucnons.)
VI-A) (See page 11 of instructions.) NA
N/A
During the year, did the organization attempt to influence national,
national, state or
or local legislation,
including any attempt to
Yes No Amount
Amount
opinion on a legislative matter or
or referendum,
referendum, through
through the use of:
ot
:; ;
a Volunteers r ':-..
a Volunteers .
b Paid staff or
or management (Include
(Include compensation
compensation in expenses reported on lines c through h.) ......
through h.)
cc Media
advertisements .
d Mailings to members,
legislators, or
or the public
public .
e Publications, or
or published
published or
or broadcast statements
statements .
f Grants to other organizations for
for lobbying
lobbying purposes
purposes ..
g Direct contact with
with legislators,
legislators, their staffs,
staffs, government officials,
officials, or
or a legislative body ..
conventions, speeches, lectures,
lectures, or any other means .
i Total lobbying
lobbying expenditures (Add
(Add lines c through
through h.)
h.) 0 .•
If "Yes"
"Yes' to any of the above, also
also attach
attach aa statement
statement giving
giving aa detailed
description of
of the
the lobbying
activities.
t~~i:.14
423141
11-24-04 Schedule A (Form 990 or
Schedule A or 99HZ)
990-EZ) 2004
11
11
113580614
3 5 8 0 6 1 4 758050
7 5 8 0 5 0 223-12053HEI
3-12053HEI 22004.05060
0 0 4 . 0 5 0 6 0 THE
THE HEIMLICH
HEIMLICH INSTITUTE
FOUN 23-12051
Schedule
Schedule A A(Form
(Form990
990oror99O-EZ) 2004TTHE
990-EZ)2004 E HEIMLICH
HEIMLICH INSTIT
I N S T I T UTE
T E FOUNDATION
3-7303161 Pages
Page 6
PartVU Information
L.:..::=':":"-=..3:~ Information Regarding
RegardingTransfers To and
Transfers To and Transactions
Relationships With
With Noncharitable
Noncharitable
EExempt
x e m p t OOrganizations
r g a n i z a t i o n s (See (See page
paoe 1111of of the
the instructions.)
instructions.)
51
51 ,• Did
Did the
the reporting
directly oror indirectly
indirectly engage
engage inin anyany ofof the
the following
following with
with any
any other
other organization
described inin section
section
501(c)
501(c) of of the
the Code
Code (other
(other than
than section
section 501(c)(3)
organizations) or or inin section
section 527,
527, relating
relating to
to political
organizations?
a• Transfers
Transfers from Irom thethe reporting
organization to to aa noncharitable
noncharilable exemptexempt organization
organization of:
ot Yes
Yes No
No
(!)
(I) Cash
Cash ,... . ,....... .., . 51a(i)
51a(i XX
(ii)
(lI) Other
Otherassets
assets . . a(ii)
a(ii) XX
bb Other
Other transactions:
transactions:
(i)
(I) Sales
Salesor or exchanges
assets with
with aa noncharitable
noncharitable exemptexempt organization
organization b(i)
b(i) XX
(ii)
(Ii) Purchases
Purchases of of assets
assets from
from aa noncharitable
noncharitable exempt exempt organization
organization b(ii)
b(ii) XX
(ill)
(iii) Rental
Rental of of facilities,
equipment, or or other
other assets
assets .,.,",.,., ... ,.. ,." .. ,. b(ili)
b(iii)
---'-.!.. . - XZ __
(iv)
(iv) Reimbursement
arrangements b(iv)
b(lv) I XX
(v)
(v) Loans
Loans or or loan
loan guarantees
guarantees ' .. . .. , .. ' . b(v)
b(v) XX
(vi)
(vi) Performance
Performance of of services
lundraising solicitations
solicitations .. b(vi)
b(vi) XX
ce Sharing
Sharing of facilities, equrpment,
offacilities, equipment, mailing
mailing lists,
lists, other
other assets,
assets, or or paid
paid employees
employees .. cc XX
dd IfIf the
the answer
answer to to any
any ofof the
the above
above isis "Yes,"
"Yes: complete
complete the the following
following schedule.
schedule. Column
Column (b)(b) should
should always
always show
show thethe fair
fair market
market value
value ofof the
the
goods,
goods, otherother assets,
services given
given by by the
the reporting
organization. IfIf the the organization
received less
less than
than fair
fair market
market value
value inin any
any
transaction or
arrancement, show show in in column
column (d) (d) the
the value
value ofof the
the goods,
goods, other
other assets,
assets, or
or services
services received:
received: N/A
N /A
(a)
(a) (b) (e)
(c) (d)
«f)
Line no.
Amount involved Name of
Name of noncharitable
noncharilable exempt
exempt organization
organization Description of
transactions, and
and sharing
arrangements
+-----
52 aa Is
52 Is the
the organization
directly or
or indirectly
affiliated with,
with, or
or related
related to,
to, one
one or
or more
more tax-exempt
described in
in section
section 501(c)
501(c) of
of the
the
Code
Code (other
(other than
than section
section 501(c)(3))
501{c)(3» or
or in
in section
section 527?
52?? _. . ,~► DYes
□ Yes [X]
C No
x ] No
II "Yes,"
bb If "Yes: complete
complete the
the following
following schedule:
schedule: N/A
N/A
(a)
(a) (b)
(b) (e)
(c)
Name of
organization Type of
organization Description of
relationship
-__
-_-_-----_
---- .-
423151
423'5'
11-24-04
"-24-04 Schedule A (Form 990 or 990-EZ)
99HZ) 2004
12
1 2
13580614 758050
13580614 758050 23-12053HEI
23-12053HEI 2004.05060 THE
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 23-12051
23-12051
'. " I
~REALIZED
.REALIZED CAPITAL
CAPITAL GAINS
GAfNSAND
AND LOSSES
LOSSES· Account # #639
Account 639
,.JANUARY
JANUARY 1,2004-DECEMBER
1,.2004.~DECEMBER 31,2004
31, 2004 . .HEIMLICH
HEIMLICHINSTITUTE
INSTITUTEFOUNDATION,
}:O!JNDATION.
., CALENDAR YEAR ENDING . ' INCO~PORATED
INCORPORATED
CALENDAR YEAR ENDING
"" .'
. . ACQUISITION PROCE~DS'DDOLLAR'·
ACQUISllic>rJ PROCEEDS OLLAR 'D01.LAA,-
DOLLAR ' . $$G'GAIN
AIN/I
. 'QUANTITY
'QUANTITY "ASSET DESCRIPTION
ASSET DESCRIPTION
.' DATE
DATE., DATE,
DATE - C OCOST-,.,
ST PROCEEDS,
PROCEEDS LOSS'
LOSS
" .; :SHORT TERM CAPITAL TRANSACtiONS

SHORT: TERM CAPITAL TRANSACTIONS
',SO -.;
.50
AUTOZONE.:INC."
A U T O Z O N E : I N C . '. v
. ■.;•■•
. - :■■
"12/,18/03
12/.18/03 q5J~5i04 . \ 4,1-15.50
05/25/04- 4,1'15.50 - 4;249.66
4249.66 . 134..16
134.16
""~ ~150
150 ~RAIt;lGERcW.,«:):_lNCORPORATEr).::
"GRAINGER (W.W.). INCORPORATED. . . 12129/03 .
"•12729/03^ 05110/04 , ~7,021.01.
05/10/04' 7.021.01. -■.. 7.~0821·
7,508.21' . 487.20
487.20
-'-,--=,--'--
... ;.. ... :~~1-~136.~1
$11,130.51 $11,757.87
, $11,757.87 .'fv)$621.36
(9$621.36
'. ',
"
, '
",'
, . . ,-,'"
} ..' h" '.:'
. : '(b~G:reRM'CA:P(TAL'mANSAtTIONS' . " '.' '. - .: : ..

LONG TERM CAPITAL TRANSACTIONS;
, .,.''•:'•'■
.. , i dOO', .. · Cf'.RPlIW.: Hi:AlTH:INC6fU~OAATEb . , ' ..
1'1127101'.. '".',q4Z00i04
■11/27/01 04/06/04 . ... ,-'.-:'6:905.82"
6,905.82 ■=
. ,.': 7,050.65.
7,ClS{f65 .' 144.83
144.83
100.'.' • CARDINAL HEALTH: INCORPORATED . „.
.~:':';"', '•'-;., .Too:
.':rqr '. -FAMNIE/MAE
'~f-ANNII;,MAE .:■':'. ■ .'•'■».'.• ... ; ' ■'.. . :.•' - ,..'■:■ '.,":' .... : /-':-
.: ·11n9/98 . ' 02/25/04-
• •11/19/98 6;89;1-.75: ....-,'." 7,555.01
02125104.-' . 6,'80.t.75 7..,555.01 7.53.2Q
753,26
'., .:...:>. '-.'280 . ,"RAlUI;3URTON COMPeANY,' b2128/97
"HALLieURTON COMPANY '"" '
. 12122104'· .' 8,565.2{)
">, ., 1'1.211'.95.' • •
02/28'97 • 12/22/04 ' " 8 56520 -i* 2 K - 9 5 ' .:2'6^6
2.:646.75
75
■" " 280
. . , '; 20.000'
20 000
. ,.J.P .. MoRGAN CHAS~&
COMP-ANY,
j p MORGAN CHASE & COMPANY
, •', " , :'iJ6l0'2l93
06/02/93 -' 08715/04ost,
si04·. " .20
20;789.4(>
789 40 20.'009.00
:: 20 000 00 ·789
..7.8~.40
40
..>." ··..(FORMERLY
.:',: (FORMERLYBANK,ONECORrOAATION)..'·,
'-, r.
BANK ONE CORPORATION) -, ,.
...... 7.250~ PUE.081151.q4 "Ai~D.~8(2~412·.
7 250% DUE 08/15/04 DATED 08/24/92
:,: <, ':" .', ." .' -, .'
• . • <
• ..... ' , . < .. .' <:.., • .... ",.: .
' ..." ":'..... 300
~OO. MASCQ MAscq~RPOAATION
CORPORATION .. _" : .. ..' '''s.' DW96J02·,.-. 09/21/04
'. " ' 08/06/02 09/4,1~05< ." 66;997;08'
9 9 7 08 .'. 10 10,416.. 89 '.; .~33.419.81-
476 89 479 81
".L .. 300 NATIONAL at?o' " :
"1AT.i9~COMMERO!=j:'INANCI~,;C9RPoRAtION·:.:P~.7101·
COMMERCE FINANCIAL CORPORATION 11/27/01 .,- JD5/12/04 D,511W04 >. ' ' 7,486 7.486:.35,
35 .., .:. 99.:}86.63.
386 63 !11;900.28;...
900 28
.'::: .. " 100
100 " PERSJCO
PEPSJCO.INCORPORATEO-;
INCORPORATED ".;" ". '~,':.;' " .' ::' 02/19/02 "021.19/02' "•04/15/04
-04/f~l04' .. 44.97t.OO-:·
971 00 ". 5,485
~~85.94··
94 ... '514.94
514 94 .
'·.> ...175
175'··.. :·f'.ROGR£;sS·.ENERGY.iNCoRP6AATED·;·~
PFJOGRESS ENERGY INCORPORATED ,:;t(. .: :07/3Ot02·...
07/30/02 ,··'.·02l?:5i64:·
02/25/04 ':',1.950:46'"
7 950 46 '8i~S:12'
8,045° 12 :';>:''94.66 $ 4 66 .
.' '.'.:' 15,000.
j5.900' :... PUBLJC SERw:e~E¢mC
'pllBi;JC SERVICE ELECTRIC ANDANti:GAS'COMPANY.,
GAS COMPANY . .' 05/18/93 05118193...' :'05101/04'
05/01/04 .... '14 14',892.15'.:
892 75 '." ··Y5.OQG.00
15 00a00 .. 107'107.25'
25 r
.~:~
~:';"~'
..:',.'"'.::_-.
.• ~~~~tf:~g;~~~~~6·p~~;~i;,:·.'.·':_,<··-,:
:,.::......
FIRSTMORTGAGE BOND . '. -. .':.......~:(:~>:':;'"
6 500% DUEQ5/Q1/04 DATED 05/01/93
.' ,.' .." ..,' " .' ...
. ".:/. "·5~OOO·. PUBLIC pus/..ic SERVICE ElECi'Ri 0AND
SERViCe ELECTRIC ANt) GAS cOMPANY. '.. 06/23/93
G~S COMPANY ooi2~3.. . . 05/01/04
05101104 : 55.01:4;80'.':'
0 1 4 80 '.55,000.00
00000 ~14.80
14£0
.\j/:'.'.::'\'~:.·.....,.'~~f~%~Sig~1~i~~;~~6~;1!9;·.~·'
..
r
5 000
FIRST MORTGAGE BOND r- ·;0 .•. : . '.;·.:'.:-: ..".,;' .: ·,' ',.'-.:. ..,., , ~",>
g 500% DUE 05/01/0& DATED 05/01/93
"'·":<.i;:·:,::··' , .. , \~. -:.:..::.~ ',.:.<~;.::::/.~-, ,'. $90;374.61··
$90,374 61 .: :, $99,212
$99.212.19.;....-~':'-r
19 ..;...8-"~,.-83-7-.5....;..8
©$8,837 58 .';'." ." .
.\~-:., .,,' ..
.:">,;..: ~ ,...'.': ~)...r t: ::.. '~".' :.~~~'~ .•:•• '. ~~";" •• • ~.: ••' •••• :,:~ .•'. •• '" • ~ .' ;•••• :~ :-;: •• >.,.'~t:.:-. · ,':' ':
..,' :~:< .; ..'
·:··;t6:~~~RM;c~rril:~IST~iB(J'rtc)N~<.<···.;· ::~.<: ... '.... ." '.,
JOHNWN FIXEDINCOME-FUI'ilD.-'. .' '.
, .: :- :-, ':. :'. ';O~.....
-o" JOHNSON FIXED INCOME FUND
.._,';.' «, 1V30i<i4 .:~.:.'.t2/AO(O«,"':
12730/04 12/30/04 00:.00"
00 ;,. '13irt
:'133:71
133 71 133 71 "
..... .: ':0" . 'JOHNSONOPJ::;9.RT:UNrrY,FUi\Jq:,·.·,
0 ., JOHNSON
. " ,'. :.121'30/04,
12/30/04 . 1~3oFci4
12/30/04 '.':))':'90
ooo :'~ ·::;:::"2;·~76:a4.
2 076 84 22;07(5.84
076 84
.'OPPORTUNITY
". ... t • " :'.1 "'" FUND
. ' •. ,,\:,;- .'
.;,. ..:'.~. .. . $0 00 $2.210.55
$2,210 55 ' (DS2
(0$2,210.55
210 55
\ ", . .; :'.:.
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This report summarizes the portfolio transacbpns that may bs helpful for taX preparation
. .
''':~,., .; ':' ~...: .
.~,~:-:~
:~"--,-.,;..-....;....;.;.'
_._.~..~._._'----' _.-,..--'~'.._'-':'"""""'-""-------'------~-- .•Jbhn~on I~vestme~t Counsel,
Johnson Investment Counsel, inc.
Inc '----
:·THE
; THE HEIMLICH
HEIMLICH INSTITUTE
23 -7303161
FORM 990
990 GAIN (LOSS) FROM PUBLICLY
(LOSS) FROM PUBLICLY TRADED
TRADED SECURITIES
SECURITIES STATEMENT 1
GROSS
GROSS COST
COST OR EXPENSE N E T GAIN
NET
DESCRIPTION
DESCRIPTION SALES PRICE
SALES OTHER BASIS
OTHER BASIS OF SALE OR (LOSS)
SEE ATTACHED
ATTACHED 113,180.
113,180. 101,511.
101,511. 0.
O. 11,669,
11,669.
TO FORM 990, PART I, LINE 8 113,180.
113,180. 101,511.
101,511, O.
0. 11,669,
11,669.
FORM 990
990 OTHER CHANGES
CHANGES IN NET ASSETS OR FUND
FUND BALANCES STATEMENT 2
DESCRIPTION
DESCRIPTION AMOUNT
CHANGE
CHANGE IN NET UNREALIZED GAINS/LOSSES
UNREALIZED GAINS/LOSSES 18,959,
18,959.
FORM 990, PART I, LINE 20
TOTAL TO FORM 18,959
18,959.
FORM 990 STATEMENT

STATEMENT OF ORGANIZATION'S
ORGANIZATION'S PRIMARY
PRIMARY EXEMPT
EXEMPT PURPOSE STATEMENT
STATEMENT 3
III
PART III
EXPLANATION
EXPLANATION
FINDING
FINDING SIMPLE SOLUTIONS FOR SAVING
SIMPLE SOLUTIONS SAVING LIVES
LIVES AND TEACHING
TEACHING THOSE SOLUTIONS
SOLUTIONS TO
THE WORLD.
FORM 990
990 OTHER ASSETS
OTHER STATEMENT 4
DESCRIPTION
DESCRIPTION AMOUNT
ACCRUED INTEREST AND DIVIDENDS

ACCRUED INTEREST DIVIDENDS 44,431-
,431.
SECURITY
10.
WORKERS COMPENSATION DEPOSIT 305.
305.
TOTAL TO FORM
FORM 990, PART IV, LINE 58, COLUMN
COLUMN B 44,746.
,746,
15
15 STATEMENT(S) 1,
STATEMENT(S) 1 , 2,
2 , 3,
3 , 44
113580614
3 5 8 0 6 1 4 758050
7 5 8 0 5 0 23-12053HEI
23-12053HEI 22004.05060
0 0 4 . 0 5 0 6 0 THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 23-12051
2 3-12051
.'
THE HEIMLICH
3-7303161
FORM 990
FORM 990 OTHER SECURITIES
STATEMENT 5
OTHER
OTHER
SECURITY DESCRIPTION
SECURITY DESCRIPTION COST/FMV
COST/FMV SECURITIES
SECURITIES
FIXED
FIXED INCOME
INCOME AND
AND EQUITY SECURITIES
EQUITY SECURITIES FMV 630,392.
630,392.
NOTE RECEIVABLE
NOTE RECEIVABLE FMV 10,000.
10,000.
TO FORM 990,
990, LINE
LINE 54,
54, COL B 640,392.
640,392.
FORM
FORM 990 PART
PART V - LIST
LIST OF OFFICERS,
OFFICERS, DIRECTORS,
DIRECTORS, STATEMENT
STATEMENT 6
TRUSTEES AND KEY
TRUSTEES EMPLOYEES
KEY EMPLOYEES
EMPLOYEE
TITLE AND
TITLE AND COMPEN
COMPEN- BEN PLAN EXPENSE
EXPENSE
NAME AND ADDRESS
NAME AND ADDRESS AVRG HRS/WK
AVRG HRS/WK SATION
SATION CONTRIB ACCOUNT
ACCOUNT
HENRY J. HEIMLICH
HENRY HEIMLICH M.D.
M.D. TRUSTEE
TRUSTEE
311 STRAIGHT STREET
STRAIGHT STREET
CINCINNATI, OH 45219
CINCINNATI,
40 12,000.
12,000.
°.
0. O.
JOHN GALL
JOHN GALL PRESIDENT
PRESIDENT
311 STRAIGHT STREET
STRAIGHT STREET 20 o.
0. 0
O.. 0.
CINCINNATI,
PHILIP M. HEIMLICH
PHILIP HEIMLICH VICE-PRESIDENT
VICE-PRESIDENT
311 STRAIGHT STREET
STRAIGHT STREET 5 o.
0. 0
0.. O.
CINCINNATI,
JOSEPH
JOSEPH J. DEHNER
DEHNER SECRETARY
SECRETARY
STRAIGHT STREET
311 STRAIGHT STREET
CINCINNATI,
5 o.
0.
°.
0.
°.
PIOTR CHOMCZYNSKI
PIOTR CHOMCZYNSKI TRUSTEE
TRUSTEE
STRAIGHT STREET
311 STRAIGHT STREET
CINCINNATI,
1 o.
0.
°.
0. O.
WILLIAM O. MASHBURN
WILLIAM MASHBURN TRUSTEE
TRUSTEE
STRAIGHT STREET
311 STRAIGHT STREET 1 0.
O. 0
O.. 0.
O.
CINCINNATI,
TOM POWELL
TOM POWELL TRUSTEE
TRUSTEE
311 STRAIGHT STREET
STRAIGHT STREET 1 0.
O. o..
0 0.
O.
CINCINNATI,
16
16 STATEMENT ( S ) 5,
STATEMENT (S) 5 , 66
13580614 23-12053HEI
13580614 758050 23-12053HEI INSTITUTE FOUN 23-12051
2 0 0 4 . 0 5 0 6 0 THE HEIMLICH INSTITUTE
2004.05060 2 3-12051
;: THE HEIMLICH
23-7303161
RICHARD. WEILAND
RICHARD. WEILAND TRUSTEE
311
311 STRAIGHT
STRAIGHT STREET
STREET 11 o.
0. 0.
O. 0.
O.
CINCINNATI,
CINClNNATI, OH
OH 45219
45219
HARRY
HARRY W.
W. WHITTAKER TRUSTEE
TRUSTEE
311
311 STRAIGHT
STRAIGHT STREET
STREET 11 o.
0. 0.
O. 0.
O.
CINCINNATI,
CINCINNATI, OH
OH 45219
45219
E.
E. ANTHINY
ANTHINY WOODS
WOODS TRUSTEE
TRUSTEE
311
311 STRAIGHT
STRAIGHT STREET
STREET 11 o.
0. 0.
O. 0.
O.
CINCINNATI,
CINCINNATI, OH
OH 45219
45219
TOTALS INCLUDED ON
ON FORM
FORM 990, PART V
990, PART 12,000.
12,000. o.
0. 0.
O.
17
17 STATEMENTS
STATEMENT (S)) 66
13580614 758050
13580614 758050 23-12053HEI
23-12053HEI 2004.05060 THE
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 23-12051
23-12051
OMS No 1545·0047
OMB 1545-0047
Return of
Organization Exempt
Exempt From
From Income
Income Tax
Form
Form 990 Under
Under section
section 501(c),
501(c), 527, or 4947(a)(
527, or 4947(a)(1)
benefit trust
benefit
of the
1) of
trust or
the Internal
or private
Internal Revenue
Revenue Code
foundation)
private foundation)
(except black
Code (except black lung
lung
2005
Departmentollhe
Department Treasury
of the Treasury Open to Public
Public
IntemalRevenueService
Internal Revenue Service ► The organization
~ The organization may
may have
have to
to use
use aa copy
copy of
of trus
this return
return to
to satisfy
satisfy state
state reporting
reporting requuements,
Inspection .
. A For the the 2005

2005 calendar
calendar year,
year, or tax year beginning
year beginning and ending
and ending
o Employer
8 Check
B Check if
II
applicable
applicable Please C Name
Please Name of oruanzanon
organization D Employer identification
number
use IRS
use IRS
□ Address
DAddress
change
change
label or
label or
print or
or tr_HE
THE HEIMLICH INSTITUTE FOtTNDATION
3-7303161
ID~';;;;~e
I change
type
iype
Number
Number and street
street (or P.O. box ifIf mail rs not delivered
rnau is delivered to street address)
street address) I Room/suite E Telephone
Telephone number
number
□ Dlnltlaireturn
Initial
return
See
See
Specific
Specific 311
3 STRAIGHT STREET
1 1 STRAIGHT
Room/SUite
((513}559-2391
513)559-2391
□ DFlnalFinal
return
return
Instruc-
Instruc
tions
trons City or town,
town, state or country,
country, and ZIP + 44 FF Accountng
Accounting m ethod" ID
method a s h[X]
I cCash P x l Acaual
Accrual
□
□
Amended
DAmended
return
Application
DApPlicatlon
[[CINCINNATI
• Section
OH
C I N C I N N A T I , OH
Section 501(c)(3) organizations and
and 4947(a)(1)
45219
45219
4947(a)(1) nonexempt charitable trusts
trusts
n
Df::,ty)~
Other
(specify) ^
^
pending
pending H and
and I are
are not
nor applicable
applicable to section
section 527 527 organizations.
organizations.
must
must attach
attach a completed
completed Schedule
Schedule A (Form
(Form 990 or 990-EZ).
990-El).
H(a)
H(a) Is this
this a group
group return
return for affiliates?
affiliates? CZlYes
DVes CX]NO
[X]No
G
G Website: ~N
Website: ► N/A /A H(b) If "Yes," enter number
number of affiliates^-
afflliates~ N[A
N / A
J Organization
Organization type
type (check
(checkonlyone)~[X] 501 (c)( (33 ) ....
only one) ► [ x ] 501(c) )< Onsertno)
(insert no)[ | ] |4947(a)(1)
4947(a)( 1)oror □ 527 D
527 H(c) Are all affiliates
Included? N/A
N / A CZlYes
DVes IDNo I No
K Check here
Check here ~► D I I Ifif the
the organization's
gross receipts
receipts are normally
normally notnot more
more than
than $25,000.
$25,000. The (If "No," attach a list)
'No," attach list)
H(d) Is this
trns a separate
separate return
return filed by an or- . .
organization
organization need not file a return
return with
With the IRS; but ifIf the organization
organization chooses
chooses to file a return,
return, be ganization
aaneanon coveredcovered by a group
group ruling?
ruling? IDVesI Yes L X J NNoO 00
sure to file a complete
complete return.
return. Some
Some states
states require
require a complete
complete return.
return. I Group
Group Exemption
Exemption Number
Number ► ~ N/A
N/A
M Check ~► D
M Check I I Ifif the organization
organization IS is not
not required
required to attach
attach
L Gross receipts:
receipts: Add lines 6b,6b, 8b, 9b, and 10b to line 12 ~► 210
2 1 0 , 3308.
08. Sch.
Sch. B 8 (Form
(Form 990,990-EZ,
990, 990-EZ, or 990-PF).
990-PF).
I Part III Revenue,
Revenue, Expenses,
Expenses, and
and Changes
Changes in
in Net Assets
Assets or
or Fund Balances
Balances
,
1 Contributions,
Contributions, gifts, giftS, grants,
grants, and similar Similar amounts
amounts received:
received: ,
a Direct public
public support
support 1a
la 661
1 , 1188.
88.
b Indirect
Indirect public
public support
support 1b
lb :
c Government
contributions (grants) (grants) 1c
lc --__...::...
d Total
Total (add linesImes 1athrough
la through 1c) (cash$ (cash $ 61,188.
6 1 , 1 8 8 . noncash noncash $$ ) 1d 1 , 1188.
661 88.
2 Program
Program service
service revenue including including government
government fees and contracts contracts (from
(from Part VII, line 93) 2 17
17,705.705.
3 Membership
Membership dues and assessments assessments 3
4 Interest
Interest on savings
savings and temporary temporary cash investments investments 4 1100 ,715.
L715.
55 Dividends
DIVidends and interest Interest from securities securities .. 5 99, 2274.
74.
I I
6 aa Gross rents
b Less:
Less: rental expenses
expenses
6a
6b m
(.v,,?'~~
}:~~:
cc Net
Net rental
rental income
Income or or (loss)
(loss) (subtract
(subtract line line 6b
6b from
from line
line 6a)6a) 6c
6c
QI
77 Other
Other investment
Investment income
Income (describe
(describe ►
~ ) 7
:::I
e 88 aa Gross
Gross amount
amount from from sales sales of of assets
assets other (A)
(A) Securities
Securities (B)
(8) Other
Other ~~ ;:":,.
"
[~
QI
> than
than inventory
Inventory 1111,426.
1 1 , 4 2 6 . 8a
8a " .
QI
II:
bb Less:
Less: cost
cost or or other
other basisbaSISand and sales
sales expenses 1110,408.
1 0 , 4 0 8 . 8b Bb
'- +
,
cc Gain
Gain oror (loss)
(loss) (attach
(attach schedule)
schedule) 11, 0018.
1 8 . 8c Bc - ~~~
dd Net
Net gain
gain or or (loss)
(loss) (combine
(combine line line 8c,
8c, columns
columns (A) (A) and
and (B)) (8)) STMT 1
STMT 8d
8d 11,018.
,018.
9 Special
Spectal events
events and and activities
acnvmes (attach (attach schedule).
schedule). IfIf any any amount
amount isISfrom
from gaming,
gaming, check
check here
here ► ~ I0 1 ",";2'
;;
~ a Gross
Gross revenue
revenue (not (not including
Including $$ of
of contributions
.' -,!J\
3
contnbunons ' ~
~
~
reported
reported on on line
line 1a) ta) I I 9a9a ',:'W
~;, ~-
iTO
iii) bb Less:
Less: direct
direct expenses
expenses other other thanthan fundraising
fundralslng expenses
expenses 9b
9b .-''';. ::J~"
OJ
a cc Net
Net income
Income or or (loss)
(loss) from from special
special events
events (subtract
(subtract line line 9b9b from
from line
line 9a)
9a) 9c9c
, ,
... ",:;,;
10
10 a a Gross
Gross sales
sales of of inventory,
Inventory, less less returns
returns and and allowances
allowances ]10a
10a ]
" ~¥
~ bb Less:
Less: cost
cost of of goods
goods sold sold 10b
lOb : ....
':i.~
~ cc Gross
Gross profit
profit oror (loss)
(loss) from from salessales of of inventory
Inventory (attach
(attach schedule)
schedule) (subtract
(subtract line line 10b
10b from
from line
line 10a)
10a) 10c
10c
~ 11
11 Other
Other revenue
revenue (from (from Part Part VII,VII, line
line 103)
103) 11
11
=>5
~ 12
12 Total
Total revenue
revenue (add (add lineslines 1d, 1d 2,3,4,5,6c,7,8d,
2 3 4 5 6c 7 8d 9c, 9c IQaanrl
10c and ]111 1) 12
12 9 , 9900.
999 00.
bc~ 13
13 Program
Program services
services (from (from line line 44,44, column
column (B)) (8))
RECE~V[ElD 1313 8 , 2217.
338 17.
1 -CII
elll
14
14 Management
Management and and general
general (from (from line line 44, colur n (f'1I
44, colui 0 1414 6 , 3335.
556 35.
c:: (/)
15
15 Fundraising
Fundralslng (from (from line line 44, 44, column
column (D)) (D)) 0 1515 7707.
07.
QI
a.
>C
w 16
16 Payments
Payments to
to affiliates
affiliates (attach
(attach schedule)
schedule) o NO\) 6 2006
th 1616
17
17 Total Total expenses
expenses (add (add lines lines 16 16 and
and 44, ~m)
44 column
column ~ 1717 9955 , 2259.
59.
CII
18
18 Excess
Excess or or (deficit)
(dencit) for for the the year
year (subtract
(subtract line
b~lO~~,Un
line 1'1
from 1818 44,641-
,641.
t;; 19 19 Net
Net assets
assets or or fund
fund balances
balances at at beginning
beginning of of ye|
ye 1919 3 9 , 1150.
6639 50.
z~ 20 20 Other
O1her changes
changes in In net
net assets
assets or or fund
fund balances
balances (attach
(attach explanation)
explananon) SEE
SEE STATEMENT
STATEMENT 22 2020 --6.1
6 , 7778.
78.
<
21
21 Net
Net assets
assets or or fund
fund balances
balances at at end
end of of year
year (combine
(combine lines lines 18,19,
18, 19, and
and 20)
20) 21 6637,013.
37,013.
523001
523001
02-03-08
02-03-06 LHA
LHA For For Privacy
Privacy Act Act and and Paperwork
Paperwork Reduction Reduction Act Act Notice,
Notice, see
see the the separate
instructions.
21
Form 990
Form 990 (2005)
(2005) e\!;;
14061026
14061026 758050
758050 12053-000
12053-000 2005.06000
11
2005.06000 THE
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 12053-0
12053-01i \b
\b
Form 990 (2005) THE
THE HEIMLICH
HEIMLICH INSTITUTE
2 3-7303161 Pa e2
Page2
Parjll Statement of All organizations
orcamzanons must complete
complete column (A). Columns (B),
(8), (C), and (D) required for section 501(c)(3)
(0) are required
Functional Expenses organizations and section 4947(a)(1) nonexempt
and (4) organizations nonexempt charitable
charitable trusts but optional for others.
others.
mclude amounts reported on line
Do not include Ime (8) Program
(B) Program (e) Management
(C) Management
---
-- (A) Total
(A) Total (0) Fundraising
(D) Fundraismq
6b, 8b, 9b, 10b, or 16 of
of Part
Part I.
1. services
and general
22 Grants allocations (attach
(attach schedule)
schedule)
(cash$$
(cash o.
noncash$$
O • noncash O.
U • I
IftrusamountIncludesforeigngrants, check here .....

If this amount includes foreign grants, check here
D
►a
22 .
Specific assistance
23 Specific assistance to individuals
Individuals (attach
(attach
, ,
f
schedule)
schedule) 23
I
Benefits paid to or for members
24 Benefits members (attach
(attach , ::::. "(~ ....'
"
-, .'
" '-.\ . .. ~ I
schedule)
schedule) 24 ' .,'. II
Compensation officers, directors,
directors, etc. * * ** 25 112
2 . 0000.
00. 111
1 . 9940.
40. 660.
0. 0O. .
26 salanes and wages
Other salaries wages 26 118
8 . 3352.
52. 114
4 . 7743.
43. 33,164.
.164. 4445.
45.
Pension contnbutrons 27
28
28 Other employee
Other employee benefits
benefits 28
28 22,592.
.592. 22. 0082.
82. 4447.
47. 663.
3.
29 33,777.
.777. 33. 0034.
34. 6651.
51. 992.
29
29
30
30
Payroll taxes
Payroll taxes
Professional fundraising
Professional fund raising fees
..
. 29
30
30
2.
31
31 Accounting fees
Accounting 31
31 88. 0057.
57. 88,057.
.057.
32 Legal fees
32 Legal 32
32 118
8 , 9927.
27. 118,927.
8.927.
33 Supplies
33 Supplies 33
33 1115.
15. 110l.
01. 112.
2. 22.
.
Telephone
34 Telephone
34 34
34 225.
5. 222.
2. 33.
.
35 Postage and
35 Postage and shipping
shipping 35
35 4464.
64. 4408.
08. 49.
49. 77.
.
36 Occupancy
36 Occupancy 36
36
37 EqUipment rental
37 Equipment rental and
and maintenance
maintenance 37
37
38 Printing and
publications 38
38
39 Travel
39 Travel 39
39 449.
9. 449.
9.
40 Conferences,
40 conventions, andand meetings
meetings 40
40
41 Interest
41 Interest 41
41
42 Depreciation,
42 depletion, etc.
etc. (attach
(attach schedule)
schedule) 42
42
43 Other
43 Other expenses
expenses not
not covered
covered above
above (itemize):
(itemize):
aa OUTSIDE
OUTSIDE SERVICES
SERVICES 43a
43a 55. 3309.
09. 44, 6667.
67. 5564.
64. 778.
8.
bMISCELLANEOUS
bMISCELLANEOUS 43b
43b 11. 3387.
87. 11,220.
.220. 1147.
47. 220.
0.
cPUBLIC
c PUBLIC RELATIONS
RELATIONS 43c
43c 77. 1157.
57. 77,157.
,157.
dPAYROLL
dPAYROLL TAXES/EMPLOYEE
TAXESLEMPLOYEE 43d
43d
eeBENEFITS
BENEFITS 43e
43e 116
6 , 8848.
48. 116,848.
6,848.
f• STATE
STATE TAX
TAX 43.
43f 2200.
00. 2200.
00.
fl9 43_g
43(1
44 TTotal
44 o t a l ffunctional
u n c t i o n a l eexpenses.
x p e n s e s . AAdd lines 222
d d lines 2
through 443.
through (Organizations completing
3 . (Organizations completing
columns (B)-(D),
columns (B)-(D),carry
carry these
these totals
totals to
to lines
lines
13·15)
13-15) ...... 4444 995,259.
5,259. 338,217.
8.217. 556,335.
6.335. 7707.
07.
Joint Costs.
Joint Costs. Check
Check ► ..... D
ifIfyou
you are
are following
following SOP
SOP 98-2.
98-2.
Areany
Are anyjoint
jomtcosts
costsfrom
from aa combined
campaign and fundrarsmq solicitation
and fundraising sohcrtatton reported
reported in
m (B)
(8) Program
Program services?
services? ~ □DYesYes L[XJ
► No
X ] No
IfII"Yes,"
"Yes; enter
enter(i)
(i) the
the aggregate
aggregateamount 01these
amount of thesejoint costs $$
JOintcosts NN /LAA ;; (ii)
(ii) the
theamount
amount allocated
allocatedto
to Program
Program services $__ _.:.;N:.LL,",A=-
services$_ N/A __ ;
(iii) the
(iii) theamount
amountallocated
allocatedto Managementand
to Management general$$
and general NN / /A
A ;;and
and(iv)
(iv) the
theamount
amountallocated
allocatedto Funcraismu$$
to Fundraising NN / LA
A
Form9990
Form (2005)
9 0 (2005)
**
** SEE
SEE STATEMENT 3
STATEMENT 3
523011
523011
02-03-OB
02-03-06
2
14061026 758050
14061026 758050 12053-000
12053-000 2005.06000 THE
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 12053-01
12053-01
-----------------------
Form 990 (2005)

990 (2005) THE HEIMLICH
2 3-7303161 Page 3
Page3
I Part 111I 1Statement
Parf:III Statementofof
Program
ProgramService
ServiceAccomplishments
Accomplishments(See
(See the instructions.)
the instructions}
Form 990 is available for

ISavailable for public inspection
Inspection and, for
for some people, serves as the primary
pnmary or sole source of information
Information about a particular organization.
How the public perceives an organization in such cases may be determined by by the information
Information presented on
on its
Its return Therefore, please
please make sure the
the
, return is complete and accurate
IScomplete accurate and fully describes, in
In Part III, the organization's programs and accomplishments.
accomplishments.
What is the organization's

ISthe .... --=S::..::E=.E=--=S:..;T:..:A==T:...=E=M=E:::.N.:..;T=---=4=---
organization's primary exempt purpose? ► SEE STATEMENT 4 ---l Program Service
Program Service
Expenses
Expenses
(Requiredfor
(Required for 501(c)(3)
501(c)(3)
All organizations must describe their exempt purpose achievements in a clear and concise manner. State the number of of and(4)
and orgs.,and
(4) orgs., and
clients served, publications
Issued, etc. Discuss
DISCUSS achievements
achievements that are not
not measurable. (Section 501(c)(3)
501 (c)(3) and (4)
(4) 4947(a)(1) trusts;
4947(a)(1) trusts;but
but
organizations
orqarnzanons and 4947(a)(1)
4947(a)(1) nonexempt charitable trusts
trusts must also enter the amount of grants and allocations to others
others)) optionalfor
optional for others.)
others.)
a HEIMLICH
HEIMLICH MANUEVER WEEK -- EDUCATION
M A N U E V E R WEEK EDUCATION O OFF TTHE GENERAL
HE G E N E R A L PUBLIC
P U B L I C ON
ON
USES
U S E S OF THE
T HE HHEIMLICH
EIMLICH M MANUEVER FOR DDROWNING
A N U E V E R FOR ROWNING, C CHOKING
H O K I N G AND
AND
ASTHMA.
A STHMA.
(Grants
$ Includes foreiqn
) If this amount includes foreign qrants,
grants check here .... IDI
► 5 . 7794.
5 94.
bAlDS
b A I D S RESEARCH
RESEARCH AND
AND EDUCATION
EDUCATION
(Grants
$ ) If this
this amount includes
Includes foreiqn
foreign qrants,
grants check here .... [ ] 166 , 0055.
1 55.
EDUCATION
c E
c DUCATION O OFF THE
T HE GENERAL
G ENERAL PUBLIC,
P UBLIC, THE
T HE PRINTING
P AND
RINTING
AND
DISTRIBUTION
D I S T R I B U T I O N OFOF EEDUCATION
DUCATION L LITERATURE
ITERATURE T TO
O P PUBLIC
U B L I C PLACES
PLACES
ABOUT TTHE
ABOUT HE H HEIMLICH
EIMLICH M MANEUVER.
ANEUVER. DISTRIBUTED
D ISTRIBUTED A APPROX.
PPROX. 14
1 4 VIDEOS
VIDEOS
AND
AND 28635
2 8 6 3 5 PPOSTERS
O S T E R S AND
A N D 41
4 1 WALLET
W A L L E T CARDS
CARDS TO
T O THE
T H E PUBLIC.
P U B L I C .
(Grants
$ )) IfIf this
trus amount includes foreiqn
forelan qrants,
arants check here .... D
here ► 1 1 155 . 5509.
1 09.
d
d A CARING WORLD
C A R I N G WORLD -
- COLLECTION
C O L L E C T I O N AND
AND DISSEMINATION
D I S S E M I N A T I O N OF
O F HISTORICAL
H I S T ORICAL
AND SCIENTIFIC
AND S C I E N T I F I C EVIDENCE
E V I D E N C E SSUPPORTING
U P P O R T I N G THAT
T H A T WE
WE LLIVE
I V E IN
I N A
A CARING
CARING
WORLD.
W O R L D .
(Grants
(Grants and
and allocations
allocations $$ )) IfIf this
trns amount
amount includes
Includes foreiqn
foreign qrants,
grants check
check here
here .... 1D1
► 8859.
59.
ee Other
Other program services (attach schedule)
(Grants and
allocations $$ )) IfIf this amount includes
trus amount includes foreiqn
foreign qrants,
grants check
check here
here .... Dn i
►
ff Total
Total of
of Program
Program Service
Service Expenses
Expenses (should
(should equal line 44,
eguailine 44, column
column (B),(B), Program
Program services)
services) 338,217.
8,217.
Form9990
Form (2005)
9 0 (2005)
523021
523021
02-03-08
02-03-08
3
14061026
14061026 758050
758050 12053-000
12053-000 2005.06000
2005.06000 THE
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 12053-01
12053-01
Form 990(2005)
FOUNDATION 2 3 - 7303161
23-7303161 Paqe4
Page 4
I Part
Part IV I Balance Sheets (See
Balance Sheets (Seethethe instructions.)
msttucttons.)
1\ Note:
N o t e : Where
Where reqUired,
required, attached
attached schedules
schedules and
and amounts within
within the description column
the description column (A)
(A) (8)
(B)
should be
should for end-of-year
be for end-of-year amounts
amounts only.
only. Beginning of year
Beginningof year Endof
End of year
year
45
45 Cash
Cash·- non-mterest-bsannq
non-interest-beanng 4 . 7792.
4 92. 45 4,721.
4_L_721.
46
46 Savings and temporary cash Investments
investments .. 4.505.
4,505. 46 2
233 . 1111.
11.
47 Accounts
47 a A c c o u n t s receivable
receivable 47a
47a ..
b doubtful accounts
b Less: allowance for doubtful accounts 47b
47b 47c
47c
._~ _ .. _- ---"-_._-
~. ~ -'-
48 a Pledges
48 a Pledges receivable
receivable 48a
48a ~T''"
b Less.
b Less, allowance for doubtful
doubtful accounts
accounts 48b
48b 48c
48c
49
Grants receivable 49
50
50 Receivables
Receivables from officers, directors, trustees,
trustees,
and key
key employees ....
.... .. 50
-
<
CII
CI)
CII
(0
CII
511 aa Other notes and loans receivable
5
b doubtful accounts
b Less' allowance for doubtful accounts
.... I ~1~
51a
1
51b
51b
_ •••••
51c
51c
>.
< 52
52 sale or use
Inventories for sale 52
53
53 Prepaid expenses and deferred charges
Prepaid charges 53
54 Investments • secunties
Investments· securities STMT
STMT 6
6 ...
►t□ J Cost
Cost L x ] FMV
OOFMV 6 4 0 . 3392.
640 92. 54
54 6 1 0 . 8813.
610 13.
55 a Investments
Investments· - land, buildings, and , '...
equipment:
equiprnent: basis 55a
55a
-,""" ...
b Less' accumulated
depreciation 55b
55b 55c
55c
56 Investments - other 56
,
buildings, and equipment: basis 57a
l57a I .i.:»: ~'ji.
b Less: accumulated
depreciation 57b
57b 57c
57c
58
58 Other assets (describe
Otherassets(describe ^~ S E E STATEMENT
SEE 5 )) 4 .746.
4,746. 58 4 .145.
4.L145.
59
59 Total assets
Total assets (must equal line 74). Add lines 45 throuah
through 58 6 5 4 . 4435.
654 35. 59 6 42,790.
642.1790.
60
60 Accounts
A c c o u n t s payable and accrued expenses
expenses 15.285.
15.285. 60 5 , 7777.
77.
61
61 Grants payable
Grants payable 61
62
62 Deferred revenue
Deferred revenue 62
(0
CII
CI)
4) 63
63 Loans from officers, directors, trustees, and key
key employees
employees 63
~
:ccara 64
64 a Tax-exempt
Tax-exempt bond b o n d liabilities 64a
64a
::; b Mortgages and other notes payable payable .. 64b
64b
65
65 Other liabilities (describe
Otherliabilities(describe ~ ► ) 65
66
66 Total
Total liabilities.
liabilities. Add
A d d lines
lines 60 throuoh
throuqh 65) .. 1
155 . 2285.
8 5 . 66 5
5 . 7777.
77.
,
Organizations
Organizations that
that follow
follow SFAS 117,
117, check
check here ~
► [][] and
and complete lines
67
6 7 through 69 and lines
lines 73 and 74. '.
(A
CII - ,--
CI)
o
u 67 Unrestricted
Unrestricted 6 0 0 , 2231.
600 31. 67 5 98,094.
598,094.
c
c::
n
ca 68
restricted 68
ca
ra
3 8 . 9919.
19. 3 8 , 9919.
19.
m
r:Il 69
69 Permanently restncted
restricted 38 69 38
■o
"C
c
c:: Organizations
Organizations tthat
h a t do not follow
follow SFAS 117, check
check here ►
~ Dand and
3
:I
u.
u,
...
u
o
0
complete lines 70 through 74. 74. _ .
...«
CII
4-*
CI)
70
70
71
71
Capital
Caprtal stock, trust pnncipal, or current funds
funds .
Paid-in or capital surplus, or land, binldmq,
Paid-In building, and equipment fund
fund
70
71
CII
(A
(0
CII
...
<
<
CI)
72
72
73
73
Retained earnings, endowment, accumulated Income,
Retained
Total
Total net assetsor
net assets fund balances
or fund
income, or other funds
balances(addlines67
funds
through69
(add lines 67 through or lines
69 or lines70 through72;
70 through 72;
72
zz
column(A)
column must equal
(A) must equalline
line 19;column(B)
19; column (8) mustequalline21)
must equal line 21) 639,150.
639.150. 73 6 3 7 , 0013.
637 13.
74
Total liabilities and net assets/fund balances. Add
assets/fund balances. lin es 66 and73
Addlines66 and 73 654.435.
654,435. 74 6 4 2 . 7790.
642 90.
Form
Form9990
9 0 (2005)
(2005)
523031
02-03-08
02-03-06
4
14061026 758050 12053-000 2005.06000 THE HEIMLICH INSTITUTE FOUN 12053-01
Form 990
990 (2005)
(2005) THE HEIMLICH INSTITUTE FOUNDATION FOUNDATION 23-7303161
23-7303161 PaoeS
PageS
1 Pa~
Part; IV-A I, Reconciliation of Revenue
Revenue per Audited Financial
Financial Statements With Revenue
Revenue per Return (See the
(See the
r tnstrucuons.)
instructions.)
a Total revenue, gains,
gams, and other support
support per audited
audited flnancial
statements .. a
a N/A
N /A
b Amounts
Amounts Included
included on line a but not on Part I,
1, line 12:
1 Net unrealized
unrealized gains on Investments
investments b1
2 Donated services and use of facilities
facilities b2
3 Recovenes of prior year grants b3
4 Other (specify): i t>4
b4 i ..
Add lines b1
b 1 through b4 b
c Subtract
Subtract line b from line a cc
d Amounts
Amounts Included
included on Part I, line 12, but not on line a:
1 Investment
Investment expenses not Included
included on Part I, line 6b
6b I d1
d11
2 Other (specify): d2 -- .
Add lines d1 and d2 d
revenue (Part I,I line 12). Add lines c and d
e Total revenue . . . . . .. ....► ee
IV~~J Reconciliation of Expenses
I Part IV-B Expenses per Audited Financial
Financial Statements With Expenses
Expenses per Return
Return
a Total expenses and losses per audited financial statements
statements a N/A
N /A
b Amounts
Amounts Included
included on line a but not on Part I, line 17: '_,
,_';':
1 Donated services and use of facilities
facilities b1
bl
adjustments reported on Part I, line 20
2 Pnor year adjustments b2
3 Losses reported on Part I, line 20 .. b3 ,,'
4 Other (specify): b4 ..
Add lines b1 through b4 "'b

..
c Subtract
Subtract line b from line a c
">
d Amounts included
Amounts Included on Part I,I, line 17, but not on line a:
1 Investment
Investment expenses not included
included on Part I, line 6b .. Idld11 ,
,
-,
2 Other (specify): d2 ", '

eXQ_enses(Part I,I line
e Total expenses line 17). Add lines
lines c and d ....
.. . .... . ....
► ee
iPart V-A I
I~~artV-A Direct~rs, Trustees, and Key
Current Officers, Directors, Key Employees
Employees (List each eachperson
person whowh.owas an officer,
officer, director, trustee,
or key
or key employee at
at any time during
dunng the
the year
year even
even ifIf they were
were not compensated.) (See (See thethe mstructions.}
instructions.)
(8) Title
(B) Title and average
averagehours
hours (C) Compensation (D)Contributionsto
(e) Compensation (~Cont"butlons to (E) Expense
(E)Expense
Nameand
(A) Name address
and address per week
per week devoted
devoted to
to (If not paid,
(If not
ployee benefit
enter employee
pai.~, enter plans &
benefit
& deferred
deferred account and
account
position
position ~-.
-Q-)
plans
other allowances
plans other
compensation plans
tl~~~~~J~!~~L_~
HENRY HEIMLICH«_ _MD__________________
_ TRUSTEE
311 .STRAIGHT _STREET_________________
~~~_~T~J9B~_~~~~EY
CINCINNATI OH 45219
CINCINNATI, 45219 40.00
40.00 12,000.
12,000. O. O.
~~~~~~~~_B~I~~~~H _________________
PHILI_p_ M_. _ HEIMLI_C_H_
~~~_~T~J9B~_~~~E~Y
_
________________
VICE-PRESIDEN
VICE-PRESIDENT rr
311 .STRAIGHT _S_TRE_ET_
CINCINNATI OH 45219
CINCINNATI, 45219 5.00
5.00 O.
0. O. O.
0,
~~~~_ ~.9lIB
BARBAR. LOHR _______________________ SECRETARY
~~~_~~~JgB~_~~~E~Y
311 ________________
_S_TRAIGHT _STRE_ET_.
CINCINNATI
45219 5.00
5.00 O.
0. O. o.
~~_~~~~_WQQQ~
E._ _ANTHONY_ WOODS,__________________ CHAIRMAN
~~~_~T~JgB~_~~~E~Y
311 _S_TRAIGHT _STREET_ ________________
CINCINNATI OH
45219 20.00
20.00 O.
0. O. O.
JOHN _DUNN
~Q~~~------------------------- TRUSTEE
ITRUSTEE
~~~_~T~9B~_~~~E~Y
311 _S_TRAIGHT _STREET_ ________________
CINCINNATI OH
CINCINNATI, OH 45219 45219 11.00
.00 0O., O. O.
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
Form9990
Form (2005)
9 0 (2005)
523041
523041 02-03-06
02-03-06
5
14061026
14061026 758050
758050 12053-000
12053-000 2005.06000 THE
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 12053-01
12053-01
Form 990 (2005) HEIMLIC H INSTITUTE F
THE HEIMLICH oUNDATION
FOUNDATION 3 --77303
223 3 0 3 1161
61 Page 6
Page6
I Parj
Part; V-A |I .Current Officers, Directors,
Current Officers, Directors, Trustees,
Employees (continued)
(contmued) Yes No
Yes No
trustees permitted to vote on organization business at board
75 a Enter the total number of officers, directors, and trustees ~
meetings .. ... ^..... 5
b Are any officers,
trustees, or key employees listed In
in Form 990, Part V'A,
V-A, or highest compensated
compensated employees
employees
In Schedule A, Part I,I, or highest compensated
listed in compensated professional and other independent
Independent contractors
contractors listed in
In Schedule A,
Part ll-A
II·A or MB, busmess relationships? IfIf "Yes," attach a statement that identifies
11·8,related to each other through family or business _.
the individuals
Individuals and explains the relationship(s)
relationstupts) .. 75iJ X
trustees, or key employees listed in
c Do any officers, directors, trustees, In Form 990, Part V-A,
V'A, or highest compensated employees I
L
In Schedule A, Part I,I, or highest compensated

listed in compensated professional and other independent
Independent contractors listed in In Schedule A, i
Part ll-A
Part or ll-B,
II·A or receive compensation from any
II·B, receive any other organizations, whether
whether tax exempt oror taxable, that are
are related
related to this _-
...
i
.. _-- _ _,- __ :1
organization through common supervision or or common control? 75c X
75c >
I
Related organizations include
Note. Related Include section 509(a)(3)
509(a)(3) supporting organizations.
)
IfIf "Yes,"
"Yes,'attacha
descnbesthe
describes
attach a statement
statementtthat
hat Identifiesthe
identifies the individuals,
cornpensanon arrangements,
the compensation
individuals,eexplains
arrangements,including
xplainsthe
includingamountspaidto
the relationship
relationship between
amounts paid to eacheachmdividual
betweenthis
this oreaneanonandthe
by each
individual by eachrelatedorganization.
related organization.
other orqarnzanorus),
organization and the other organization(s),and
and
---..._
-'" _.J
.,
dd Does
Does the organization have
have a written
wntten conflict of
of interest
Interest policy? 75d
75d X
Part V-B J1 Former
l.l~art Form~r Officers,
Employees That Received
Received Compensation
Compensation or Other Other
Benefits
B (If any
e n e f i t s (If any former
former officer,
officer, director,
director, trustee,
trustee, or
or key
key employee
employee received
received compensation
compensation or
or other
other benefits
benefits (descnbed
(descnbed below)
below) during
dUring
the year,
the year, list
list that
that person
person below
below and
and enter
enter the
the amount
amount of
of compensation
compensation oror other
other benefits
benefits in
In the
the appropnate
appropnate column.
column. See Seethe mstrucnons.)
the instructions.)
(D) Contributions
(D) Contributions to (E)Expense
to (E)Expense
(A) Name
(A) Nameandaddress
and address (8) Loans
(B) LoansandAdvances
and Advances (C) (e) Compensation employee
benefit accountand
plans&& deferred
plans deferred account and
NONE
NONE compensation
compensation plansotherallowances
plans other allowances
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
Part VI
LPart Other Information
VII Other Information (See the
instrucuons.) Yes No
Yes No
,.
. , ., .i
Old the organization engage In any activity not previously
76 Did the organization engage in any activity not
76 previously reported
reported to
tothe
the IRS?
IRS?IfIf"Yes,"
"Yes," attach
attach aadetailed
detailed _'f, ~_:.!
_u._j|
description
descrrptronof
of each
each activity
activity 76
76 XX
77
77 Wereany
Were anychanges
changes made madeinInthe
the organizing
organizingor orgoverning
governing documents
documents but but not
not reported
reported to
to the
the IRS?
IRS? 77
77 XX.,'j
IfIf"Yes,"
·Yes," attach
attach aaconformed
conformed copy copy of
ofthe
the changes.
changes. _ ....w
_.·_v
Oldthe
7B aa Did
78 the organization
organization have haveunrelated
unrelated business
busmessgrossgross income
income of of$1,000
$1 ,000or
ormore
moreduring
dunnqthethe year
yearcovered
covered by
bythis
this return?
return? 7Ba
78a X
bb IfIf "Yes,"
"Yes," has
has itItfiled
filed aatax
tax return
return on
on Form
Form 990-T
990- Tfor
for this
this year?
year? N/A
N/A 7Bb
78b
79 Was
79 Wastherethere aaliquidation,
liqUidation,dissolution,
termination,or orsubstantial
contraction during
duringthe
the year?
year? IfIf"Yes,"
"Yes,"attach
attach aastatement
statement 79
79 X
BOaa IsIsthe
80 theorganization
organization related
related(other
(otherthan
thanbybyassociation
association with Withaastatewide
statewide or
ornationwide
through common
common '~~:l_'" ',:-,"J
membership, governing
membership, governing bodies,
bodies, trustees,
trustees, officers,
officers,etc.,
etc., toto any
anyother
other exempt
exemptor ornonexempt
organization? BOa
80a XX
bb IfIf "Yes,"
"Yes," enter
enter the
the name
nameof
ofthe
the organization^
organization"" NN/A
/A ~> .;,
I
andcheck
and checkwhether
whether itItisIS 0
exemptDr
exempt or Dnonexempt
nonexempt ,~
Enterdirect
81aa Enter
81 direct or
orindirect
Indirectpolitical
polmcalexpenditures.
expenditures.(See
(Seeline
hne81
81 instructions.)
mstructlons.) . I81a
81a I 0O.
. - --
' .j
Oldthe
bb Did the organization
orqaruzationfile
fileForm
Form 1120-POL
1120-POL for
forthis
this year?
year? ...
. . 81b
81b X
523181/02-03-08
523161/02-03-06 Form9990
Form (2005)
9 0 (2005)
6
14061026
14061026 758050
758050 12053-000
12053-000 2005.06000 THE
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 12053-01
12053-01
Form 990 (2005)
23-7303161 Page 7
Page?
I Part
Part VI I Other
Other Infonnation
Information (contmued)
(continued) Yes No
Yes No
a Did the
82 a the organization
receive donated
donated services
services or
or the
the use
use of
of matenals,
equipment, or
or facilities
facilities at
at no
no charge
charge or
or at
at substantially
substantially
less than fair rental value? 82a X
b If "Yes," you may Indicate
indicate the value of
of these
these Items
items here Do Do not
notinclude
include this
this
amount as revenue in In Part I or as an expense inIn Part II.
II.
--
(See instructions
(See instructions in Part III)
III ) 82b I
| 82b I N/A
N /A I
a Did the
83 a the organization comply with the
b Did the
the organization comply with
the public inspection
with the
Inspection requirements for returns
the disclosure
requirements relating to
retums and exemption applications?
to quio
applications?
quia pro quo contnoutions?
contnoutions?
83a
iiJiI
..
X
A
84 aa Did the
the organization solicit any contnbutions
contnbutions or gifts that were not tax deductible?
not tax deductible? 84a X
·Yes,· did
b If "Yes," did the
the organization include
Include with every solicitation
soucnanon an express statement that such contnbutions
contnbunons or gifts
grfts were not
not . ----- .--.-~
. .-- _- _;
tax deductible?
deductible? .NN/ A 84b
85 501(c)(4), (5),
501(c)(4), (5), or (6)
(6) orgamzatlons.
organizations, aa Were
Were substantially
dues nondeductible
nondeductible by
by members? . .. N // A
A 85a
b Did
Did thethe organization make
make only in-house lobbying
lobbymq expenditures of $2,000 or less?
less? NN // A
A.. 8Sb
85b
IfIf "Yes" was answered to either 85a SSa or 85b,
SSb, do not complete 85c through 85h below unless the organization received a a
waiver for proxy tax
waiver tax owed for the prior
pnor year .-,
.'_\
..~ ';:"." iI
e Dues,
Dues, assessments, and similarsimilar amounts from members 8Se
85c NN/A
/A I
'0
d Section 162(e)
162(e) lobbying and political expenditures N/A -. . .1
expenditures 8Sd
85d N /A ~ ;, ~-~
.. I
e nondeductible amount of section 6033(e)(1)(A)
Aggregate nondeductible 6033(e)(1)(A)dues
dues notices 8Se
85e N/A
N /A j _o
t Taxable
Taxable amount of lobbying
lobbymq and political expenditures (line
(line 85d
SSd less
less 85e)
85e) 8St
85f N/A
N /A ::...-.--- .- '" ~ ~
l~:
g Does
Does the organization elect to pay the section 6033(e)
6033(e) tax on the
the amount on
on line SSt?
85f? N/A
N /A 8Sg
85g
h IfIf section 6033(e)(1)(A)
6033(e)(1)(A) dues notices were sent, does the organization agree
agree to add the
the amount on line
line 85f
SSf
to itsIts reasonable estimate of dues allocable to nondeductible
nondeductible lobbying and political expenditures
expenditures for the
following tax year? N/A.
N/A. 8Sh
85h
86 50 1(c)(7)organizations.
501(c)(7)
line 12
line 12
orgamzations. Enter,
Enter. a Initiation fees and capital contributions
contnbutions included
Included on
on
86a
86a N/A
N /A
.
"
a':"~
~"
.fl:l'.
b Gross
Gross receipts, included on line
line 12, for public use of club facilities
tacmtles !-'8=S,,_b
86b t--__ -=.;N:..L·l-=.;A,,__----j~·.';
N/A !; .: ~'V~f:
87 501(c)(12)
Enter: a Gross income
Income from members
members or shareholders 87a
87a N// A
N A "
"..>~~:/
" ,
. M
b Gross
Gross income
Income from other sources. (Do(Do not net amounts due or paid to other sources '.
.".
'\.,i
" ;" i
received from them)
against amounts due or received them) 87b NN/A
/A , "
. "J
88 At any
or an
or
any time dunng the the year,
year, did
did the
the organization own a 50%
an entity disregarded as separate from from the organization
50"/0 or greater
organization under
greater interest in
In a taxable corporation or partnership
under Regulations sections
sections 301
partnership,
.7701·2 and 301.7701·3?
301.7701-2 301.7701-3?
,:,~~\.- . ,}::._.
• 1r· , . ~
~ ....
~,,{~~~~
... ~. ~'_J
..._._ ... Ar
m
IfIf "Yes,"
'Yes," complete Part Part IX
IX 88
88 X
89 aa 501(c)(3)
89 50 1(c)(3)organizations.
Enter: Amount
Amount of of tax
tax imposed
Imposed on on the
the organization
organization dunng
dunng the
the year
year under: ^Vf m
if**
section 44911
section 9 1 1~ ^ (0K•. ;; section
section 4912
4912 ~► 0(K_;
• ; secuon
section 4955
4955 ~► ---'O~.
0.
bb 501(c)(3) and 50 1 (c)(4) orgamzatlons.
501(c)(4) organizations. Did the the organization
organization engage In in any section
section 4958
4958 excess
excess benefit
benefit
transaction dunng
transaction dunng thethe year
year or
or did
did itIt become
become aware aware of of an
an excess
excess benefit
benefit transaction
transaction from
from aa pnor
pnor year?
year?
IfIf "Yes,"
"Yes," attach
attach a a statement
explaining each each transaction
transaction 89b
89b X
X
ce Enter:
Enter: Amount of tax imposedImposed on the the organization managers managers or disqualified persons during the the year
year under
sections 4912,
sections 4912,4955,
4955, andand 4958 ►~ . O.^
0
dd Enter.
Enter. Amount of tax on line line 89c, above, reimbursed by the organization ►~ 0^•
0
90 a
90 a List
List the
the states
states with
with which
which aa copy
copy ofof this
this return
return is ISfiled
filed ►~-",O,-,H'-'-
OH --r_--' -=-
bb Number of employees employed in
In the
the pay
pay penod
penod that
that Includes
includes March
March 12,
12, 2005
2005 I90b
90b I 3
91a
91 a The books are
The books careof of~ ►THE
areInincare T H EHEIMLICH
FOUNDATION Telephoneno.n ~o . ^
Telephone (513)
( 5 1 3 559
) 5 5-
9 2391
-2391
Located at ~► 311
Located at 3 1 1 STRAIGHT
STRAIGHT STREET
STREET CINCINNATI,
OHIO ZIP ++44~» .=4.=5.=.2=1.=..9
ZIP 45219 _
bb At anyany time during the
the calendar
calendar year,
year, did
did the
the organization
organization have an Interestinterest In
in or
or aa signature
signature or
or other
other authonty
authority _
over aa financial
over financial account
account in
In aa foreign
foreign country
country (such
(such as
as a
a bank
bank account,
account, securities
secunties account,
account, or
or other
other financial
financial Yes No
Yes No
account)?
account)? 91b
91b X
X
IfIf "Yes,"
"Yes," enter
enter the
the name
name ofof the
the foreign
foreign country
country ►~ _;N=--'
N -/'....:A=-
A _ ~ (., ~I
1,
See the
Instructions for
for exceptions
exceptions andand filing
filing requirements
requirements for
for Form
Form TD TO FF 90-22.1, Report of
90-22.1, Report of Foreign
Foreign Bank
Bank
" - , • v-
and Financial
and Financial Accounts
Accounts _-,_ .. 1.-~_'';
. :_.:...
•-i.. 0
ce At
At anyany time
time dunng
dunng the
the calendar
calendar year,
year, did
did the
the organization
maintain an an office
office outside
outside of
of the
the United
United States? 91e
91c X"
X
IfIf "Yes,"
"Yes," enter
enter the
the name
name of of the
the foreign
foreign country
country ► ~ _;N=--'
N /-'....:A=-
A _
92
92 Section 4947(a)(1)
Section 494 7(a)(1)nonexempt
nonexempt chantable trusts filing Form 990 990 in lieu of Form
Form 1041-
1041- Check here . ~D□
►
and enter
and enter the
the amount
amount of
of tax-exempt
tax-exempt interest
Interest received
received or
or accrued
accrued dunng
dunng the
the tax
tax year ~ I 9292 N/A
N /A
Form9990
Form (2005)
9 0 (2005)
523162
02-03-OB
7
14061026
14061026 758050
758050 12053-000
12053-000 2005.06000 THE HEIMLICH
FOUN 12053-01
Form 990 (2005)
Form 990 (2005) THE
THE HEIMLICH
H E I M L I C H IINSTITUTE FOUNDATION
3- 7303161 Page 8
Page8
IPart; VII I Analysis
Part VII Analysis of
of Income-Producing
Income-Producing Activities
Activities (See theinstrucuons.)
Note: Enter
Enter gross
gross amounts
amounts unless
unless otherwise
otherwise Unrelatedbusiness
Unrelated businessIncome
income Excludedby
Excluded section
by section 512,513,
512, or 514
513,or 514
Note: (E)
mdlcated. (A)
(A) (8) (e)
(C) (0) (E)
indicated. (B) Exclu-
Exclu
(D) Relatedor orexempt
exempt
Business
Business Amount
Amount slon Amount
Amount Related
sion functionIncome
93 Program service
revenue: code
code code
coda function income
VIDEOS &&
EDUCATIONAL VIDEOS
aa EDUCATIONAL
b POSTERS
b POSTERS 117,705.
7.705.
cc
dd
ee
ff Medicare/Medicaid
payments
g Fees and contracts
g Fees and contracts from from government
government agencies
agencies
Intereston
95 Interest
95 savingsand
on savings temporarycashInvestments
and temporary cash investments 14
14 110.715.
0.715.
96 Dividends and Interest
96 Dividends and interest from from securities
secunnes 14
14 99,274.
.274. ,
Net rental
97 Net
97 rental income
Income oror (loss)
(loss) from
from real
real estate:
estate: ^~~A, -
~* ", ' ' -'-; (. ," .' "
..
* • ?:-'- " . ■ . . . - - ^~ :-" ' --* * ■ -- .....
. ^" . K.,*
~) "l( !},-
, - _ ~P;
« -1
aa debt-financed
b
b not debt-financed property ...
Net rental
98 Net
98 rental income
income oror (loss)
(loss)from
from personal
personal property
property
Other Investment
99 Other investment income
99 income
Gain or
100 Gam
100 or (loss)
(loss) from
from sales
sales of
of assets
assets
other than
Inventory 18
18 11.018.
.018.
Net income
101 Net
101 Income or or (loss)
(loss) from
from special
special events
Gross profit
102 Gross
102 profrt or
or (loss)
(loss) from
from sales
sales of
of inventory
Inventory
Other revenue:
103 Other
103 revenue:
aa
bb
cc
dd
ee
~~~i'-".
i"~r:>V?f- .~:
..• 221,007. 117
7 . 7705.
Subtotal (add
104 Subtotal
104 (add columns
columns (B), (D),and
(B),(D), and (E))
(E)) 0O.. 1.007. 05.
Total (add
105 Total
105 (add line
line 104, columns (B),
104, columns (8), (D),
(D),and
and (E))
(E)) ....
__ --=3:..::8:...1.
3 8 ......:.
7 1 2 . 7-=1.:,2..:
Lme 105
Note: Line 105 plus
plus line
line 1d,
1d, Part
Part I, should
should equal
equal the
the amount
amount on on line
Ime 12,
12, Part
Part I.I.
Part VI I Relationship of Activities to the Accomplishment of Exempt Purposes (See the instructions.)
Line No. Explainhow
Explain eachactivityfor
how each whichincomeISreported
activity for which income is reported in column(E)
In column of Part
(E) of PartVII contributedImportantlyto
VII contributed theaccomphshment
importantly to the of the
organization's
T exemptpurposes(otherthan
exempt proVidingfunds
purposes (other than by providing fundsfor suchpurposes).
for such purposes).
N/A
Part IX Information Regarding Taxable Subsidiaries and Disregarded Entities (See the instructions)
(A) (B) (C)
Name, address, and EIN of corporation, Percentage of Nature of activities
partnership, or disregarded entity ownership interest
%
N/A
%
%
PartX Information Regarding Transfers Associated witl
(a) Did the organization, during the year, receive any funds, directly or indirectly, to pa;
(b) Did the organization, during the year, pay premiums, directly or indirectly, on a per:
Note: If "Yes" to (b), file form 8870 and Form 4720 (see instructions).
:amined this return, including accompany!.
Please :her than officer) is based on all infoi^ ^
Sign
Sign
Here
Here
Paid
Paid
Preparer's Finn's name (or CLARK. SCHAEFER,
SCHAEFER, HACKETT
HACKETT
yours if CLARK,
Use Only
523163
02-O3-O6
self-employed),
address, and
ZIP+ 4 ►
~105 EAST FOURTH
105 EAST
~CINCINNATI
FOURTH STREET,
CINCINNATI, OHIO
STREET, S
IO 45202-40
45202-4
14061026 758050
14061026 758050 12053-000
12053-000 2005.06000 T
2005.06000
SCHEDULE
SCHEDULE A Organization Exempt
Organization Exempt Under
Under Section 501 (c}(3)
Section 501(c)(3) OMS No 1545·0047
OMBNo 1545-0047
(Form.990 or 99O-EZ)
(Form.990 or 990-EZ) Private Foundation)
Section 501(e),
501(e). 501(f),
501(f). 501(k).
(Except Private 501(k),
the Treasury
Department of the
IntemalRevenue
Treasury
RevenueService
SONlce
501(n). or
501(n), or 4947(a)(1)
Charitable Trust
Information-(See separate instructions.)
Supplementary lnformation-(See instructions.)
Trust
2005
Internal ^... MUST be completed
completed by the above organizations
organizations and attached
attached to their
their Form 990 or 990-EZ
Name of the orparuzanon
Name organization Employer identification
number
THE HEIMLICH INSTITUTE FOUNDATION 23 7303161
23 7303161
Parti Compensation of the the Five Highest Paid Employees Emp!oy~~sOther Other Than Officers, Diractcrs, and Trustees
Directmis, auu nusiees
(Seepage
(See the instructions. List each
page 1 of the each one.
one If there
there are none, enter
are none, enter 'None .)
'None.')
Nameand
(a) Name address of each
and address each employee
employee paid
paid Title and average
(b) Title averagehours
hours Contributions
(d) Contributions
(d) to
to (e) Expense
(e)Expense
per week
per week devoted
devoted to
to (c) Compensation
Compensation employeebenefit
employee benefit account and other
plans& deferred
plans deferred account
more than $50,000
more position compensation allowances
allowances
~9N~______________________________
NONE
----------------------------------
----------------------------------
----------------------------------
----------------------------------
Total number
Total number of other
other employees
employees paid
paid ' , -, ;. , ~.
:: .)
over $50,000
over ...
► 0
.,'
"
·1
I
I Part ll-A
II-A I Compensation of the the Five
Five Highest Paid Paid Independent Contractors Contractors for for Professional Services
(Seepage
(See page 2 of the
the instructions.
Instructions List each
each one
one (whether
(whether individuals
Individuals or firms).
firms) If there
there are none,enter
are none, enter 'None.')
'None 0)
(a) Name
Nameand address of each
and address each independent
Independentcontractor paid more
contractor paid more than
than $50,000 (b) Type
Type of service
Compensation
--------------------------------------------
NONE
--------------------------------------------
--------------------------------------------
--------------------------------------------
--------------------------------------------
;..
-~',:,:,~
:~t
' ^:'.E5 . - ^ 1 ; •''];1
Total number
Total number ofof others
others receiving
receiving over
over ,
--.~
, ' ,
;~->2'f> " .l'
l'~ Q."., ','
$50,000 for
$50,000 for professional
profeSSionalservices
services 00 ►
... 1
"
"
'~~Ili'-.. >" ,
I ~&
I Part ll-B
PartU-BJ Five Highest Paid
Compensation of the Five Paid Inde
pendent Contract) Other Services
ors for Other
(List each
(List eachcontractor
contractor who
who performed
performed services
services other
other than
than professional
protessional services,
services, whether
whether individuals
mdividuals or
or
firms. IfIf there
firms. there are
are none,
none, enter
enter "None."
'None.' See
Seepage
page22 of
of the
the instructions.)
mstructrons.)
(a) Name
(a) Nameand addressof
and address of each
each independent
Independentcontractor paid more
contractor paid more than
than $50,000 (b) Type
(b) Type of
of service
(c) Compensation
NONE
NONE
Total number
Total number ofof other
othercontractors
contractors receiving
receivingover
over "1'"
, . 'c. . ~ '', ,
$50,000 for
$50,000 for other
other services
services ►
... 1 0o 1 '.'
•i
523101/02-03-oe
523101/02·03-06 LHA For
LHA For Paperwork
Paperwork Reduction
Reduction Act
Act Notice,
Notice, see
see the
the Instructions
Instructions for
for Form
Form 990
990 and
and Form
Form 990-EZ.
990-EZ. Schedule A
Schedule A (Form
(Form 990
990 or
or 990-EZ)
990-EZ) 2005
2005
99
14061026
14061026 758050
758050 12053-000
12053-000 2005.06000
2005.06000 THE
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 12053-01
12053-01
Schedule A
Schedule (Form990
A (Form 990oror990-EZ)
990-EZ) 2005THE
2005 THEHEIMLICH
HEIMLICH INSTITUTE
2 3-7303161 Page
Page 22
I PPart
a r t III I Statements
S t a t e m e n t s About Activities
About A ctivities (See
(See page
page 2 01 the mstrucnons.)
of the instructions.) Yes No
1 DUring
During the
the year,
year, has
has the
the organization
attempted toto Influence
influence national,
national, state,
state, or
or local
local lepslaton,
including any
any attempt
attempt to
to Influence
influence
public opinion
public opinion on on a legislative
legislative matter
matter or referendum?
referendum? IfII "Yes,"
"Yes,' enter
enter the
the total
total expenses
expenses paid
paid or
or Incurred
incurred Inin connection
connection with
with the
the
lobbYing activities
lobbying activities ►~ $
$ $
$ (Must equal
(Must equal amounts
amounts on line 38.
38, Part
Part Vl-A.
VI-A, or
or
line ii01 Part Vl-B.)
of Part VI-B.) 1 X
X
OrganizallOns that
Organizations that made
made an election
election under
under section
section 501(h)
501(h) byby filing
IllIng Form
Form 5768
5768 must
must complete
complete Part
Part Vl-A.
VI-A. Other
Other organizations
organizations
checking "Yes'
checking "Yes' must
must complete
complete PartPart Vl-B
VI-B AND
AND attach
attach aastatement
statementgiving
givingaadetailed
detaileddescnpnon
description01the
of thelobbYing
lobbyingactivities.
activities.
DUring the
2 During the year,
year, has
has the
the organization,
either directly
indirectly, engaged
engaged in any of the
In any the following
following acts
acts with
with any
any substantial
substantial contributors,
contributors,
officers, creators,
employees, or members
members of 01 their tarnnes, or with
their families, with any taxable
organization with
with which
which any
any such
such
person is
person ISaffiliated
officer, director,
director, trustee,
trustee, majority
majority owner,
owner, or principal
beneficiary? (If the answer to any question is "Yes,•
IS "Yes,"
attach a
attach a detailed
detailed statement
explammg the the transactions
transactions)) y. i
a Sale, exchange, or leasmu
SaJe, exchange, leasing of 01 property?
property? 2a
2a X
X
bbLending
Lending 01
of money
money or
or other
other extension
extension of credit?
credit? 2b
2b X
c Furnishing goods, services, tacilmes?
services, or facilities? 2c
2c X
Payment of
d Payment 01compensation (or payment
compensation (or payment or reimbursement
expenses ifII more
more than
than $1,000)? SEE
$l,OOO)? S EE PART
P ART V --A..
V A., FFORM
ORM ~90
990 2d
2d X
T ransler of
e Transfer 01any part of its
any part ItS income
Income or assets?
assets? 26
2e X
a Do
3 a Do you
you make
make grants
grants for
for scholarships,
scholarships, tellowslups,
student loans,
loans, etc.?
etc.? (II
(If "Yes:
"Yes," attach
attachan
anexplanauon
explanation 01
of how
how
you determine
you determine that
that recipients
reCIpients qualify
qualify to receive
receive payments.)
payments.) 3a
3a X
b Do you
you have
have aa secuon
section 403(b)
403(b) annuity
annuity plan
plan lor
for your
your employees?
employees? 3b
3b X
X
DUring the year,
c During year, did
did the
the organization
receive a contribution
contribution of quahned real property
01 qualified property interest
interest under
under section
section 170(h)?
170(h)? 3c
3c X
4 aa Did
Old you
you maintain
maintain any separate
separate account
account for
lor participating
participating donors
donors where
where donors
donors have the right
right to provide
provide advice
advce
dlstnbunon of
on the use or distribution ollunds?
funds? 4a
4a X
b Do vou
you orovide
provide credit
credit counseling,
counseling, debt
debt manaaement
management, credit
credit repair
repair, ar debt neuonauon
or debt negotiation services?
services? 4b
4b X
I Pf_)artIX.
a r t IV,|I Reason
R e a s o n ffor Non-Private
or N Foundation
on-Private F Status
oundation S t a t u s (See pages
pages 3 through
mstructtons.)
organization is
The organization IS not a private
private foundation
toundanon because
because itIt is:
IS: (Please check
check only
only ONE applicable
applicable box.)
box.)
5 □
D A church,
church, convention
convention 01 of churches,
churches, oror association
association of
of churches.
churches. Section
Section 170(b)(1)(A)(I).
170(b)(1)(A)(i).
6 □
D A school.
A Secnon 170(b)(1)(A)(n).
school. Section 170(b)(1 )(A)(II). (Also
(Also complete
complete Part V.)
77 □
D A hospital
A hospital or
or aa cooperative
cooperative hospital service orpamzanon,
hospital service organization. Secnon
Section 170(b)(1)(A)(IiI).
170(b)(1)(A)(m).
88 □
D A Federal,
A Federal, state,
state, or
or local
local government
government or or governmental
governmental unit secnon 170(b)(1)(A)(v).
unit Section 170(b)( 1)(A)(v).
99 □
D A medical
A medical research orparuzanon operated
research organization operated inIn conjunction
conjunction with
With aa hospital.
hospital. Section
Section 170(b)(1)(A)(m).
170(b)(1)(A)(JII). Enter
Enter the
the hospital's
hospital's name,
name, city,
city,
and state
and state ►~ ^___
10
10 □
D An organization
An organization operated
operated for
for the
the benefit
benefit of
01aa college
college oror university
university owned
owned or or operated
operated by
by aa governmental
governmental unit unit Section
Section 170(b)(1)(A)(lv).
170(b)(1)(A)(iv).
(Also complete
(Also complete the
the Support
Support Schedule
Schedule in In Part
Part IV-A.)
IV-A.)
11a
118 Lx]
[X] An organization
that normally
normally receives
receives aa substantial
substantial part
part of
of its
Its support
support from
governmental unit
Unit or
or from
Irom the
the general
general public.
public.
Section 170(b)(1)(A)(vI). (Also
(Also complete
complete the
the Support
Support Schedule
Schedule in In Part
Part IV-A.)
IV-A.)
11b
llb □
D A community
A community trust
trust Section
170(b)(1)(A)(vI). (Also
(Also complete
Support Schedule
Schedule inIn Part
Part IV-A.)
IV-A.)
12
12 □
D An organization
receipts from
receipts
that normally
tram activities
normally receives:
activities related
receives: (1)
related to
to its
(1) more
more than
Its charitable,
than 33
charitable, etc.,
1/3% of
33 1/3%
etc., functions
of its
Its support
tuncnons -- subject
support from
subject to
tram contributions,
to certain
certain exceptions,
exceptions, and
membership fees,
and (2) no more
(2) no more than
fees, and
than 33
and gross
gross
1/3% of
33 1/3% of
ItS support
its support from
tram gross
gross investment
Investment income
Income and
and unrelated business taxable
Income (less secuon 511
(less section 511 tax)
tax) from businesses acquired
Irom businesses acquired
by the
by the organization
organization after
after June
June 30,1975.
30, 1975. See See section
section 509(a)(2).
509(a)(2). (Also
(Also complete
Support Schedule
In Part IV-A.)
13
13 □
D An orcarnzaton that
An organization
(1) lines
lines 55 through
that is
through 12
ISnot
not controlled
controlled by
12 above;
above; or
or (2)
by any
any disqualified
(2) sections
sections 501(c)(4),
persons (other
501 (c)(4), (5),
(5), or
(other than
or (6),
(6), ifII they
they meet
toundanon managers)
than foundation
meet the
the test
test of
managers) and
of section
and supports
section 509(a)(2).
509(a)(2). Check
Check the boxbox that
cescnbed in:
that describes
descnbes
In:
(1)
the type
the type of
of supporting
supporting organization:
organization: ► ~ ID Type 11
I Type D | Type 22
| Type D I Type 33
I Type
Provide the
mtorrnanon about
about the
the supported
supported organizations.
organizations. (See
(See page
page 66 of
of the
the instructions.)
mstructlons.)
(b) Line
(b) Line number
number
(a) Name(s)
(a) Name(s) of
of supported orqamzauonts)
supported organization(s) from above
from above
14
14
523111
523111
D AnAn organization
CZ1 organization organized
organized and
and operated
operated to
to test
test for
for public
public safety.
salety. Section
SecllOn 509(a)(4).
509(a)(4). (See
(See page
page 66 of
01the
the instructions.)
instructions.)
02-03-08
02-03-06 Schedule AA (Form
Schedule (Form 990
990 or
or 990-EZ)
990-EZ) 2005
2005
10
10
114061026
4061026 7758050
58050 12053-000
12053-000 22005.06000 THE HEIMLICH
0 0 5 . 0 6 0 0 0 THE HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 12053-01
12053-01
--------- -------- -----------------
Schedule AA(Form
Schedule (Form990
HEIMLICH INSTITUTE I N S T I T U T E FOUNDATION
3-7303161 Page 3
Page3
,M
Part
a r j IIV-A
V - A "■ Support
Support Schedule
Schedule (C(Complete only ifIf yyou
omplete only checked a box
o u checked box on
on line
line 10 1 1 , or
1D,, 11, 12.) Use
or 12.) Use cash
cash method
method of of accounting,
accounting.
Note: You
Note: 'r'ioumayuse
may use th
Ih ewo rksee
h t In
5 worksheet thee instructions
in th instructions ~ or converting
for t.rom the
ino from
converting th e accrual the cash
accrua Itto0 the cash method
me th 0d of
o f accountmg.
accountina.
Calendar year
Calendar year (or fiscal
fiscal year
year
beginning in)
beginning in) ► ....
(a) 2004
2004 (b) 2003
(b) 2003 (c) 2002
(c) 2002 (d) 2001
(d) 2001 (e) Total
(e) Total
15
15 Gifts., grants, and conmbunons
GiftS, grants, contributions
received. (Do not include
received. 1~)lude unusual
unusual
nne 28.)
grants. See line
grants. 28. 123,860.
1 23,860. 211,919.
2 11,919. 112,467.
1 12,467. 43,548.
4 3,548. 491,794.
4 91.794.
Membership
17
17 recerots from
Gross receiDts from admissions,
~rlmi<;<;lon5,
merchandise sold or
merchandise or services
services
performed, furnishing of
tacumes in any
facilities any activity
activity that
that is
IS
related to
related to the
the organization's
organization's
charitable, etc.,
charitable, etc., purpose
purpose
18
18 Gross income
Gross mcome from
from interest,
interest,
dividends, amounts
dividends, amounts received
received from
from
payments on
payments secunties loans
on securities loans (sec
(sec-
non 512(a)(5)),
tion 512(a)(5)), rents,
rents, royalties,
royalties, and
unrelated business taxable
Income
(less secnon 511
(less section 511 taxes)
taxes) from
businesses acquired
businesses acquired by by the
the
oraaruzanon after
organization after June
June 30,1975
30, 1975 224,417.
4.417. 221
1 . 9961.
61. 221
1 . 9906.
06. 224
4 . 9920.
20. 3 . 2204.
993 04.
19
19 Net income
Net mcome from
from unrelated business
unrelated business
activities not
activities not included
Included in Ime 18
10 line 18
20
20 Tax revenues
Tax revenues leviedlevied for
for the
the
orpamzanon's benefit
organization's benefit and
and either
either
paid to
paid to itIt or
or expended
expended on on its
ItSbehalf
behalf
21
21 The value
The value ofof services
services or or facilities
facilities
furnished to
furnished to the
the organization
orparnzanon by by aa
governmental unit
governmental Unit without
without charge.
charge.
Do not
Do not include
mclude thethe value
value ofof services
services
or tacilmes generally
or facilities generally furnished
furnished to to
the public
the public without
without charge
charge
22
22 Other income.
Other Income. Attach
Attach aa schedule.
schedule.
Do not
Do not include
mclude gain
gam oror (loss)
(loss) from
from
sale of
sale of capital
capital assets
assets
23
23 Total of
Total of lines
lines 15
15 through
through 22
22 1148
4 8 . 2277.
77. 2233
3 3 . 8880.
80. 3 4 . 3373.
1134 73. 8 . 4468.
668 68. 5584
8 4 . 9998.
98.
24
24 Lme 23
Line 23 minus
mmus line
line 17
17 148
1 4 8 , 2277.
77. 233
2 3 3 , 8880.
80. 1 3 4 . 3373.
134 73. 68
68,468. 468. 5 8 4 . 9998.
584 98.
25
25 Enter 11%
Enter of line
% of Ime 23
23 11,483.
.483. 22. 3339.
39. 11. 3344.
44. 6685. ',(~F::-)":' : -, ,:"J§J
8 5 . "4F5"0:. 'Y-j&'l
26
26 Organizations described
Organizations described on
on lines
lines 10
10 or
or 11: Enter 2%
11: aa Enter 2% of
of amount
amount inIncolumn
column (e),
(e), lin
line 24
e24 .... 26a
► 26a 1111 . 7700
0 0 ..
Prepare aa list
bb Prepare
Unit or
unit
list for
or publicly
for your
your records
publicly supported
records to
to show
show the
the name
orqaruzanon) whose
name of
whose total
of and
and amount
total gifts
amount contributed
gifts for
contributed by
for 2001
2001 through
by each
each pe
through 2004
person
2004 exceei
exceeded
(other than
rson (other than aa governmental
the amount
led the amount shown
governmental
shown in line 26a.
10line 26a.
~~;,:~:~.
, ..,
_._"""
< ~~
;~£i;~c":;')<:~:jj
~.A-U""""""~:' .._,..........::....
...:........:..~
Do not
Do not file
file this
this list
list with
with your
your return.
return. Enter
Enter the
the total
total ofof all
all these
these excess
excess amounts
amounts ....
► 26b
26b 1125
2 5 , 880l.
01.
Total support
cc Total support for
for section
section 509(a)(
509(a)(1) test Enter
1) test Enter line
line 24,
24, column
column (e)
(e) ....
► 26c
26c 5 8 4 , 9998
584 9 8 ..
Add: Amounts
dd Add: Amounts from
from column
column (e)
(e) for
for lines:
lines: 18
18 993£204.
3 , 2 0 4 . 19
19 _\~ .u..~,..;__ ..:L~''':~
..j_.f~_j
2222 26b
26b 1125£801.
25.801. ► 26d....
26d 22191 9 , 0005.
05.
Public support (hne 26c minus Ime 26d
ee Public support (line 26c minus line 26d total) total) ....
► 26e 26e 33656 5 , 9993
9 3 ..
Public support percentage (line 26e (numerator) divided by line
ff Public support percentage (line 26e (numerator) divided by line 26c (denominator)) 26c (denominator)) ....
► 26f 26f 62.5631%
62.5631%
27 Organizations described on line 12: a For amounts Included lines 15, 16, and 17 that were received from
27 Organizations described on line 12: a For amounts included in lines 15,16, and 17 that were received from a "disqualified person," prepare
10 a 'disqualified person,' prepare aalist
list for
for your
your
records to show the name of, and total amounts received each year from, each 'disqualified person.' Do not file this list with
records to show the name of, and total amounts received in each year from, each "disqualified person." Do not file this list with your return. Enter the sum
10 your return. Enter the sum ofof
such amounts for each year:
such amounts for each year: NN A/ A
(2004)
(2004) (2003)
(2003) (2002)
(2002) (2001)
(2001)
b For
For any
any amount
amount included
mcluded inin line
line 17
17that
that was receivedfrom
was received from each
eachperson
person (other
(other than
than "disqualified
'disqualified persons"),
persons'), prepare
prepare aalist
list for
for your
your records
records totoshow
show thethe name
nameof,of,
and amount
and amount received
received for
for each
eachyear,
year,thatthat was
was more
more than
than the
the larger
larger of of (1) the amount
(1) the amount onon line
line25
25 for
for the
the year
year or
or (2)
(2) $5,000.
$5,000. (Include
(Include in10the
the list
list organizations
orparuzatmns
described in lines 5 through 11b, as well as mdivrduals.) Do not file this list with your return. After computmg the difference
described in lines 5 through 11b, as well as individuals.) Do not file this list with your return. After computing the difference between the amount received between the amount received and
the larger amount described or (2), enter the sum of these differences (the excess amounts)
the larger amount described in (1) or (2), enter the sum of these differences (the excess amounts) for each year: N / A
10 (1) for each year: N / A
(2004)
(2004) (2003)
(2003) (2002)
(2002) (2001)
(2001)
c Add:
Add: Amounts
Amounts from
from column
column (e)
(e) for
for lines:
lines: 15
15 16 16
17
17 _ 20
20 _ 21
21 _ ►
.... 27c
27c N/A
N/A
dd Add:Add: Line
Lme27a
27atotal
total andline
and hne27b
27b total
total .... 27d
27d N/A
N/A
ee Public
Public support
support (line
(Ime27c27ctotal
total minus
mmus line line27d
27d total)
total) ►
.... 27e
27e N/A
N/A-,
f f Total
Total support
support for secnon 509(a)(2)
for section 509(a)(2) testtest Enter
Enteramount
amount on on line
line23,
23,column
column (e)
(e) ► I 2711 N/A ,
~ --- ~- " * " I,
gg Public
Public support
support percentage
percentage (line (line 227e (numerator) divided
7 e (numerator) divided by by line
line 27f
27f ( (denominator))
denominator)) ►.... 27f?
27g
__)
N/A % NiA-%
hh Investment
Investment income income percentage
percentaae (line Dine 18, column (e)
18 column Ie) (numerator)
(numerator) dividdivided ~line
ed by 27f (denominator))
line 27f (denominator}l ► 27h
.... 27h N/A %%
N/A
28 Unusual Grants: For an orqamzanon described In hne 10, 11, or 12 that received any unusual grants dUring 2001 through
28 Unusual Grants: For an organization described in line 10,11, or 12 that received any unusual grants during 2001 through 2004, prepare a list for your records 2004, prepare a list for your records toto
show, for
show, for each
eachyear,
year,thethename
nameofofthe
thecontributor,
contributor, the the date
dateand
andamount
amount ofofthe
thegrant,
grant, and
andaabrief
brief description
descnptron ofofthe
thenature
nature ofofthe
thegrant
grant Do Donot
notfile
file this
this list
list with
with your
your
return.
return. DoDonot
not include
melude these
these grants
grants in10line
hne15.15.
523121 02-03-08
523121 02-03-06 NONE
NONE ScheduleAA(Form
Schedule (Form990
gOOor g90-EZ)2005
or 990-EZ) 2005
11
11
14061026 758050
14061026 758050 12053-000
12053-000 2005.06000 THE
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 12053-01
12053-01
Schedule AA(Form
Schedule (Form990
990or or 990-EZ)
990-EZ) THE
2005
2005 THEHEIMLICH
HEIMLICH INSTITUTE
I N S T I T U T EFOUNDATION
FOUNDATION 2 3 - 7733 003161
3 1 6 1 Page4
Page 4
I Part
PartVVI Private School Questionnaire
Private School page77ofofthethemstrucnons.)
Questionnaire (See page instructions.) N/A
N/A
(To be completed
completed ONLY by schools
schools that
that checked
checked the the box
box on
on line
line 6 in Part
Part IV)
Yes No
29
29 Does the oruaruzanon
organization have a racially nondiscriminatory
nondiscriminatory policy toward toward students by statement in Its its charter, bylaws, other governing
instrument, or in
instrument, resolution of its
In a resolution Its governing
governing body?
body? 29
29
30 orpanzanon include
Does the organization Include a statement
statement of of Its
its racially
policy toward
toward students
students Inin all
all ItS
its brochures,
catalogues,
30
and other written communications with the Dubhe np.~hnlJwith student acm:s::::c;-:::;, pruyrams, and scholarstups?
! 30
30
,
31 Has the
the organization
organization publiCIZedIts
publicized its racially
nondiscriminatory policypolicy through
through newspaper
broadcast media
media during
during the
the period
period of
31 ,,
solicitation
sohcrtatron for students, during the registration
students, or dUring registration period Ifif Itit has no sohcitanon
program, Inin a way that makes the policy known
---- ._- „_ ___;__)
— _ ;
to all parts of the general community
community Itit serves? 31
31
"Yes; please describe;
If "Yes," describe; ifIf "No,"
'No; please explain. (If you need more space, attach attach aaseparate
separate statement)
statement) ,. _, -, !
, ' t .
'_'
....
i..~ .- r
'1
f I"" ~.
~{'i' •~ •
"
.,Y.
.~>..,'<. ~. ,
J
.. ,-~~
'.
';;:_~
.
- I ,
~...~~~ / .; ( 1
32
32 Does the organization maintain the following:
follOWing: .._--_ ...- "... ........ 1]
.~
"1
a indicating the racal

a Records Indicating racial composition
composition of the student
student body, faculty,
faculty, and administrative staff?
staff 32a
32a
bb Records documenting
documenting that
that scholarships
scholarships and other
other financial
financial assistance are awarded
awarded on aa racially
racially nonorscnmmatory
nondiscriminatory baSIS?
basis? 32b
32b
c Copies of all catalogues,
communications to the public
public dealing
dealing With
with student
student
admissions, programs, and scholarships? 32c
32c
dd Copies of all material used by the organization or on ItSbehalf
its behalf to sohcit
contributions? 32d
32d
'No' to
If you answered "No" to any
any of
of the
the above,
above, please
pleaseexplain.
explain.(If
(Ifyou
youneed
needmore
morespace,
space,attach
attachaaseparate
separatestatement)
statement) .t . , •v '~)
, JI
■i-ti '
.~~"I
~::. -
.~~
-■•>£, i f ' ' "
,iJ
V
'■' 1
33
diSCriminatebyby race In
in any way With
with respect to:
to:
-~ _"'_ _:"_,_J
a
a Students' rights
Students' rights or priVileges?
privileges? 33a
33a
bb Adrmssions
Admissions pohcies?
policies? 33b
33b
c Employment
faculty or adrmmstranve
administrative staff? 33c
33c
d
d Scholarships
Scholarships or otherother tlnancai
financial assistance? 33d
33d
e EducatIOnalpohctes?
Educational policies? 33e
33e
facilities? 33f
g AthletiC
Athletic programs?
programs? 33g
33g
activities? 33h
33h
If you answered "Yes" to any
"Yes' to any of
of the
the above,
above, please
pleaseexplain.
explain.(If
(Ifyou
youneed
needmore
morespace,
space,attach
attachaaseparate
separate statement)
statement) -.e. 'I
.o "
''""J 'i
,
1~~"j ~<~ ~>,~~
' - : ■-.
j.> : ~ -~- " v«J

{:.\~
::L -, - ^
-~jj ' i
34 a Does the orcanzatlon

34 organization receive any financial
nnancial aid or assistance from
from a governmental agency? 34a
34a
b
b Has the orparnzanon's
right to
to such
such aid ever been revoked or suspended? 34b
34b
~~-
. -i
,
If you answered 'Yes"
'Yes' to
to either 34a
34a or or b,
b, please explain using an
explain usmq an attached statement
statement -~ -~-- * ••. w:'<".J
v"
35
35 Does the
the orpamzatmn
certify that
that Itit has complied
complied With
with the applicable
applicable rsqmrements
requirements of
of secnons
sections 4.01
4.01 through
through 4.05
4.05 of
of Rev. Proc.
Proc. 75-50,
75-50,
covering racal
1975-2 C.B. 587, covering racial nondrscnrnmanon?
nondiscrimination? If "No,'
"No," attach
attach an
an explanation 35
35
Schedule A (Form
Schedule A (Form990
990 or
or 99Q-EZ)
990-EZ) 2005
2005
523131
02-03-06
02-03-oa
12
14061026 758050 12053-000 2005.06000 THE HEIMLICH
Schedule AA(Form
Schedule (Form990
990oror990-El)
990-EZ) THE
2005
2005 THEHEIMLICH
HEIMLICH INSTITUTE
2 3-7303161 Pages
Page5
I Part.VI-A
Part ,VI-A I1 ,Lobbying
-LobbyingExpenditures
Expendituresby
byElecting
ElectingPublic
PublicCharities
Charities (See
(Seepage
page9 of
9 the
mstructmns.) N/A
N /A
(To be completed
completed ONLYby
ONLY byan
aneligible
eligibleorganizationthat
organization thatfiled
filedForm
Form5768)
5768)
Check ~ a D If the organization belongs to an affiliated group.
Check ► a l_l if the organization belongs to an affiliated group. Check
Check ►~ b
b1 01Ififyouyouchecked
checked'a'"a"and'limited
and "limitedcontrol'
control"provIsions
provisionsapply.
aDDlv.
(a) (b)
Limits
Limits on Lobbying Expenditures Affiliated group completed for
for ALL
To be completed ALL
'expenditures' meansamounts
(The term "expenditures" means amounts paid or mcurred.)
incurred.) totals electing organizations
organizations
N/A
N/A
36 Total lobbying expenditures to Influencepublic
expenditures to influence public opinion (grassroots lobbYing)
lobbying) 36
37 lobbying expendituresto
Total lobbYing expenditures to Influencea
influence a legislative
legislative body (direct lobbying)
lobbYing) 37
38 Total lobbying
lobbYing expenditures
expenditures (add lines 36 and 37)37) 38
Other 39
40 Total exempt purpose expenditures (add lines 38 and 39) 39) 40
41 LobbYing
Lobbying nontaxableamount
nontaxable amounL Enterthe
Enter the amount from the following _, ,
follOWingtable-
table -
If the amount
amount on line 40 is - The lobbying
lobbying nontaxable amount is --
amount
Not over
over $500.000
$500,000 20% of the amount
2096ollhe amount on line 40 . ' , V i - •■
''*■-' V - ' , - ' '.
Over $500,000 but
Over $500,000 over $1,000,000
but not over $1,000,000 $100,000 plus 15%
$100,000 of the excess
159601the excess over $500,000
ov... $500,000 _. - ': -.-., , ^ ; _a >
Over $1,000,000 but not over $1,500,000
Over $1,000,000 $1,500,000 $175,000
$175,000 plus 10% of the excess
109601the excess over
over $1,000,000
$1,000,000 > 41
Over $1,500,000 but not over
Over $1,500,000 over $17,000,000
$17,000,000 $225,000 ptus
$225,000 plus 59601the
5% of the excess
excess over
over $1,500,000
$1,500,000
Over
Over $17,000,000
$17,000,000 $1,000,000
$1,000,000
nontaxableamount (enter 25% of line 41)
amount (enter 41) 42
43 Enter -0- ifIf line 42 is
Subtract line 42 from line 36. Enter ISmore
more than line 36
36 43
44 Subtract line 41 from line 38. Enter
Enter -0- If
if line 41 is more
ISmore than line 38
38 44
- ,■ ,! ',-V " r|
Caution:
Caution: If there is
IS an amount on either line 43 or fine
line 44,
44, you must file Form 4720.
. I*'". ,i
." • '"
~.,. <.
{>o.
, \.~ ,I
4-Year Averaging Period Under Section 501 (h)

501(h)
(Some organizationsthat haveto
organizations that made a section 501(h) election do not have to complete all of the five columns
below. Seethe
See the instructions for lines 45 through 50 on page 11 of
ofthe
themstrucnons.)
instructions.)
Lobbying Expenditures During 4-Year Averaging Period

Lobbying KT / A
N/A
Calendar year (or (a) (b) (c)
(e) (d)
(H) (e)
fiscal beginning in)
in) ^ 2005 2004 2003 2002 Total
45 LobbYing
Lobbying nontaxable
nontaxable
amount
, "
o.
0.
46 LobbYing
Lobbying ceiling amount -* •' " *' r " ~.
^ "•* -.' "" ' /
(150% of line 45(e)) 0,
0.
47 TotallobbYlng
Total lobbying
expenditures o.
0.
nontaxable
amount o.
0.
Grassroots ceiling amount
49 Grassroots
~ .... ~ - 'oJ" ~ , ,
,:;>-<.:" '':: • . s--' ^ ^ ;■■?
(150% of line 48(e)) _ ~'2~;~

,:~:~~"
},,_< ~ ~,. ~ Ji> i-"?; " "'X o.
0.
Grassroots lobbying
50 Grassroots lobbYing
expenditures 0,
0.
I Part VI-B
Vl-B J Lobbying Activity
/Activity by Nonelec ting Public Charities
by Nonelecting Chariti es
organizationsthat
(For reporting only by organizations PartVI-A)
that did not complete Part Vl-A) (See page 11 ofofthe
themstrucnons.)
instructions.) N/A
N A
DUringthe organization attempt to Influence
During the year, did the organization influence national, state or local
local legislation,
including any
any attempt
attempt to
to
Yes No Amount
influence public opuuon
Influence legislative matter
opinion on a legislative matter or referendum, through the use ot of;
a Volunteers • -."■<"'
t *:- ]
I
or management(Include
b Paid staff or management (Include compensation In in expensesreported
expenses reported on lines cc through
through h.)h.)
I---+--j' -
c Mediaadvertisements
d Mallmgs
Mailings to
to members, legislators, or the public
e Publications, or
or published or
or broadcast statements
f Grants to
to other organizations
organizations for
for lobbYingpurposes
lobbying purposes
with legislators, their staffs, government otnciats,
g Direct contact Withlegislators, officials, or aalegislativebody
legislative body
h Rallies,demonstrations,
Rallies, demonstrations, seminars, conventions, speeches,lectures,
speeches, lectures, or any other means
i Total lobbYing
lobbying expenditures (Add lines cc through
throughh.)
h.)
*■
o.
0.
If "Yes"
'Yes' to
to any
any of
of the
the above,
above, also
also attacha
attach a statement
statement giving
giving aa detaileddescripnon
detailed description of
of the
the lobbYing
523141
523141
02-03-00
(Form 990
990 or
or990-EZ)
990-EZ) 2005
13
13
1 4061026
14061026 7 58050
758050 12053-000
12053-000 2005.06000
12053-01
Schedule A (Form 990 or 990-EZ) 2005THE
ScheduleA(Form9900r990-EZ)2005 THEHEIMLICH
HEIMLICH INSTITUTE I N S T I T U T E FOUNDATION
23-7303161 PageS
Pages
Part VII Information Regarding
rE~rt.Vllllnfonnation Regarding Transfers To and Transactions Transactions and Relationships With Noncharitable
Exempt
E x e m p t Organizations
O r g a n i z a t i o n s (See page 12 of the instructions.)
mstrucnons.)
51 Did
Old the reporting organization directly or indirectly engage
orcaruzanondirectly engage in
In any of the
the following with any other organization described in
follOWingwith section
In section
501(c) of the
the Code (other than secnon
section 501(c)(3) orparuzanons)
organizations) or in
In section 527, relating to
to political orqanlzanons?
organizations?
a Transfers from the reporting organization to a noncharrtable
noncharitable exempt orcaneanon
organization of:
at Yes No
Yes No
(i) Cash
Cash 51a(i)
51a(i) X
X
(ii) D1herassets
(ii) Other assets at")
a{lI) X
X
b
(i) Sales or exchanges
Sales exchanges of of assets
assets with
with aa nonchantable
exempt orcamzanon
organization b(i)
b(i) X
(ii)
(ii) noncharitable exempt orcamzanon
Purchases of assets from a nonchantable organization b(ii)
b(ii) X
(iii)
(iii) Rental of facilities, equipment, or other assets
Rental b(iii)
b(iii) X
X
(iv) Reimbursement
Reimbursement arrangements b(iv)
b(iv) X
X
(v)
(v) Loans or loan guarantees
guarantees b(v) X
X
(vi)
(vi) Performance
Performance of services or membership or fundraising solicitations
fundraismq sohcitanons b(vi)
b(vi) X
X
c Sharing of of tacunes,
equipment, mailing lists, other assets, or or paid employees
employees c
c X
X
d If the
the answer toto any
any of
ofthe
the above
above IS
is 'Yes,'
"Yes,"complete
completethe thefollOWingschedule.
following schedule.Column
Column(b)(b)should
shouldalways
alwaysshow
showthethefair
fairmarket
marketvalue
valueofofthe
the
services given by the
goods, other assets, or services the reporting organization.
orcanzanon, If the the organization
oruaneanon received
receivedless
less than fair market value in any
arrangement, showshow Inin column
column (d)(d) the
the value
value of
of the
the goods,
goods, other
other assets,
assets, or
or services
services received:
received: N/A
N/A
(a) (b) (c) (d)
Involved Nameof
Name nonchantable exempt organization
of noncharitable orqaruzanon Descrtption of transfers, transactions, and sharing arrangements
Description arrangements
52 a
a Is the oraaruzanon
organization directly or indirectly affiliated
affiliated with,
With, or related to, one or more tax-exempt organizations
orqaruzancns described in section
secnon 501(c) of the
the
Code (other than section 501(c)(3))
501(c)(3)) or In
in section 527?
52?? ►
.. C Z I Yes
DYes [X]
L x ] No
No
b
b If "Yes,"
"Yes,' complete
complete the
the following schedule:
follOWingschedule: N
N/A / A
(a) (b) (c)
Name orparuzanon Type of organization
orqaruzation Descnpnon of relationship
Description
523151
02-03-08
(Form 990
990 or
or 990-EZ)
990-EZ) 2005
2005
14
14
1 4061026 7
14061026 58050
758050 12053-000
12053-000 2 005.06000
2005.06000 INSTITUTE FOUN
THE HEIMLICH INSTITUTE 12053-01
12053-01
THE
THE HEIMLICH
HEIMLICH INSTITUTE
23-7303161
FORM
FORM 990
990 GAIN
GAIN (LOSS)
(LOSS) FROM
FROM PUBLICLY
PUBLICLY TRADED
TRADED SECURITIES
STATEMENT 1
GROSS
GROSS COST OR
COST OR EXPENSE
EXPENSE NET GAIN
NET GAIN
JOHNSON
JOHNSON INVESTMENT
INVESTMENT -SEE
-SEE
ATTACHED
ATTACHED 111,426.
111,426. 110,408.
110,408. O.
0. 1,018.
1,018.
TO
TO FORM
FORM 990,
990, PART
PART I,
I, LINE
LINE 8 111,426.
111,426. 110,408.
110,408. 0.
O. 1,018.
1,018.
FORM
FORM 990
990 OTHER CHANGES
OTHER CHANGES IN NET
NET ASSETS
ASSETS OR FUND
FUND BALANCES
BALANCES STATEMENT
STATEMENT 22
DESCRIPTION
DESCRIPTION AMOUNT
AMOUNT
CHANGE
CHANGE IN NET
NET UNREALIZED
UNREALIZED GAINS/LOSSES
GAINS/LOSSES -6,776.
-6,776.
ROUNDING
ROUNDING -2.
TOTAL
TOTAL TO FORM
FORM 990,
990, PART
PART I, LINE
LINE 20
20 -6,778.
-6,778.
17
17 STATEMENT(S) 1,
STATEMENT(S) 1, 22
14061026 758050
14061026 758050 12053-000
12053-000 2005.06000 THE HEIMLICH INSTITUTE FOUN 12053-01
THE HEIMLICH
23-7303161
FORM
FORM 990 OFFICER
OFFICER COMPENSATION ALLOCATION
COMPENSATION ALLOCATION STATEMENT
STATEMENT 3
PART
PART II,
II, LINE
LINE 25
EMPLOYEE
EMPLOYEE EXPENSE
EXPENSE
NAME
NAME OF OFFICER,
OFFICER, ETC.
ETC. COMPENSATION
COMPENSATION BEN. PLANS
BEN. PLANS ACCOUNTS
ACCOUNTS TOTALS
TOTALS
HENRY HEIMLICH
HENRY HEIMLICH 12,000.
12,000. 12,000.
12,000.
A. PROGRAM SERVICES
PROGRAM SERVICES 11,940.
11,940. 11,940.
11,940.
B. MANAGEMENT
MANAGEMENT AND GENERAL
AND GENERAL 60. 60.
C. FUNDRAISING
FUNDRAISING
TOTAL PROGRAM SERVICES 11,940.

11,940,
TOTAL MANAGEMENT AND GENERAL 60.
60,
TOTAL FUNDRAISING
ETC.,, COMPENSATION INCLUDED

TOTAL OFFICER, ETC. INCLUDED ON PARTS V-A AND V-B 12,000.
12,000,
FORM
FORM 990
990 STATEMENT OF ORGANIZATION'S
ORGANIZATION'S PRIMARY EXEMPT PURPOSE STATEMENT
STATEMENT 44
PART III
PART III
EXPLANATION
FINDING
FINDING SIMPLE
SIMPLE SOLUTIONS FOR
FOR SAVING
SAVING LIVES AND TEACHING THOSE SOLUTIONS
SOLUTIONS TO
THE WORLD.
FORM
FORM 990
990 OTHER ASSETS
OTHER STATEMENT
STATEMENT 5
DESCRIPTION AMOUNT
AMOUNT
ACCRUED INTEREST
INTEREST AND DIVIDENDS 3,830.
3,830.
SECURITY DEPOSIT
SECURITY 10.
10.
DEPOSIT 305.
305.
TOTAL
TOTAL TO
TO FORM
FORM 990, PART
PART IV,
IV, LINE
LINE 58, COLUMN
COLUMN BB 4,145.
4,145,
18
18 STATEMENT(S) 3,
STATEMENT(S) 3, 4,
4, 55
14061026
14061026 758050
758050 12053-000 2005.06000 THE HEIMLICH INSTITUTE FOUN 12053-01
~-~ --------
THE HEIMLICH
FORM 990 OTHER SECURITIES STATEMENT 6
OTHER
SECURITY DESCRIPTION
DESCRIPTION COST/FMV SECURITIES
FIXED INCOME AND EQUITY SECURITIES F:MV

fMV 600,813.
bUU,eJ.-J.
NOTE RECEIVABLE
RECEIVABLE FMV 10,000.
TO FORM 990,
990, LINE 54, COL B 610,813.
19
19 STATEMENT(S) 66
STATEMENT(S)
14061026
14061026 758050
758050 12053-000
12053-000 2005.06000 THE HEIMLICH INSTITUTE FOUN 12053-01
i
OMB No 1545-0047
OMS No 1545-0047
Return of Organization Exempt From Income Tax
F 990
orm 9 9 U
Form Under section 501(c),
501(c), 527, or 4947(a)(l)
4947(a)(1) of the
benefit
Internal Revenue Code (except black lung
the Internal
trust or private foundation)
benefit trust foundation)
2006
Department of the
Departm""t of Treasury
the Treasury Open toPublic
Opento Public
Internal Revenue Service ► The orcaneanon
~ The organization may
may haveto
have to use
use aacopy
copy of
of this
this return
return to
to satisfy
satisfy state
state reportmg
A
A For the 2006 calendar year , or tax year beginning
calendar year, and ending
B Check Ifif
B
applicable
applicable Please C Name
Nameof
Please of organization
organization o
D Employer identification
useIRS
use IRS
DAddress
1 lAddress label or
label or
| |change
change print or H E I M L I C H INSTITUTE
23-7303161
DName
1
1
iiMame
|change
change
Olnltlai
I llnitial
type
type
See
See
Specific3
Number
Number and
and street
street (or P.O. box ifIf mail
P.O.box maillsis not delivered to street address)
deliveredto I Room/suite
Room/suite E Telephone number
ETelephone
1 Iretum
retum Specific
Instruc
311
1 1 STRAIGHT
S T R A I G H T STREET
STREET 513)559 -2391
((513)559-2391
lnstruc-
DFlnal Cash 00 Accrual
1 IFinal
City or town, state
state or country, and ZIP + 44 FF Accounting
Accounting, method 1
IcashLXj
metnod D Accrual
1
1
1
return
Iretum
DAmended
1 Am ended
return
Jrfttnm
tions
nons
irINC
C I N C INNATI,
I N N A T I . OH 45219
45219 o (SpeCify)
I
1
1 Other
Other ~ w
1 (specify)^-
DApPlicatlon
| |j5g?d!ng
pending
lon
•* Section
Section 501(c)(3)
organizations and
and 4947(a)(l)
charitable trusts
trusts H and I are are not applicable to to section
se ztion 527 organizations.
organizatIons.
must attach a completed Schedule A (Form 990 or 990-EZ).
must
H(a) Is this
tlus a group return for affiliates?
affili ates? CZ]Yes OONo
OYes L i ] No
G ►NN/A
Website: ....
G Website: /A H(b) IfIf "Yes,"
H(b) enter number
"Yes,' enter number ofof affillates~
affili.i t e s ^ NLA
N/A
J
J Organization type (checkonlyone)~ 00
501(c)( ( 3
(check only one) ► [ x ] 501(c) 3 ) )A (insertnono)
.... (lnsert ) | 0
|4947(a)(l)
4947(a)(1)oror □ 527 D
527 H(c) Are all affiliates
Included? N N/A / A 1DYesWes DNo 1 ~lNo
(If 'No,'
"No," attach a list)
list)
K Check here ~ 0Ifif the organizationISnot
organization is not a 509(a)(3) supporting
supporting organization and and ItSgross
its gross
H(d) Is this a separate
separatereturn flied by an or
return filed or-
receipts are normally not more than $25,000. A return ISnot is not required,
raquirad, but ifIf the
the organization ganization covered by a group ruling? DYes
ganlzatloncovered □ Yes [XJNo
LULINO
chooses to file a return, be sure to file a complete
complete return. Exemption Number~
I Group Exemotlon Number ► N
N/A/A
M Check ► [X]
Check~ I X I Ifif the organization ISnot
is not required to attach
L Gross receipts: Add lines 6b,
6b, Bb,
8b, 9b, and lOb
10b to line 12 ~► 2 8 7 ,249.
287 249. Sch.
Sch. 8B (Form 990,
990,990-EZ,
990-EZ, or 990-PF).
990-PF).
Part 1II Revenue, Expenses,
[Part Expenses, and Changes in Net Assets or Fund Balances
1 Contributions, giftS,
Contributions, gifts, grants, and Similaramounts
similar amounts received: ,:
a
Contributions to donor advisedfunds advised funds la
la -;
Direct public support (not Included

b included on line 1a)la) lb
lb 2211.
11.
c
Indirect public support (not Includedon included on line 1a)la) 1c
lc
d
Government contributions (grants) (not Included
d included on Ime
line 1a)
la) 1d
ld ,J_._
e Total
Total (add lines la 1a through ld) 1d) (cash $ 211.
2 1 1 . noncash $ )) 1e
Ie 211.
211.
2 revenue including government fees and contracts (from Part VII, line 93)
Program service revenueIncluding 2 1 7.133.
17,133.
3 Membership dues and assessments assessments 3
4 savings and temporary cash Investments
Interest on savmgs investments 4 9,957.
9,957.
5 Dividends and interest from securities
DIVidendsand ..
5 1
100 , 5539.
39.
6 a Gross rents I I 6a
6a
'
':,_i'...
b Less: rental expenses
expenses 6b
-
QI
c income or (loss). Subtract line 6b from line 6a
C Net rental Income 6c
3
::I
C
e 7 investment Income(describe
Other Investment income (describe ~► ) ,
7
.
QI
>
> 8 a Gross amount from sales
salesof of assets other (A) Securities
Securities (B)Other
(B) Other
4>
QI
a:
rr 2 4 0 , 4 8 1 . 8a
than inventory 240,481. ' '
b
b Less: cost or other baSIS basis and salesexpenses
sales expenses 2
201 0 1 , 9942. 4 2 . 8b
@5 3 8 . 5539. 3 9 . 8c
O
c Gain or (loss) (attach schedule)
c Gamor schedule) 38 "
-¥y"""'"
m
9
d Net gam
a
gain or (loss).
Special events
a Gross
Gross revenue
(loss). CombmeIme8c,
revenu i (noltncludtng
Combine line 8c, columns (A) and (8)
erents and activities
activities (attach schedule). If any amount
(not including SJ
(E5)
amount ISfrom
ofconlnbubons
o
STMT 11
is from gaming,
contributions reported
gaming, check1here
reported online
on line lb)
1b)
t
check here I ► 0
9a
□
^.
'
8d
,
3 8.539.
38,539.
o b
b Less: dire
directct expenses
expensesother other than fundraising
fundralsmg expenses
expenses 9b " "Yo•• "
> ■
c
C Net income
mcome or (loss) from special events. Subtract
events.Subtract line
Ime9b 9b from
from line
line 9a 9c
10 a Gross sales of inventory,
Inventory, less returns and allowancesallowances I 10a
110a V-' " l;~!:
ca© b Less: cost of goods sold 10b
lOb -:.::..._ - -
©
© c Gross proft!
profit or (loss) from sales of Inventory inventory (attach schedule). Subtract line lOb from Ime
10b from line 10a
lOa 10c
p o
i') 11 Other
Other revenue
revenue (from Part VII, Ime
PartVII, line 103)
103) 11 8 . 9928.
8 28.
C)
G
IC 3 12 Total revenue.
revenue. Add lines lines 1e,
te 22,3,4,5,6c,
3 4 5 6c,77,8d, 9c, 10c
Bd 9c 10c,and and 11 11 12 8 5 . 3307.
85 07.
"'" 13 Program services (from Ime44, line 44, column (B)) (8» 13 1 9 . 2269.
19 69.
UI
0)
QI
<0
UI 14 Management
Management and general general(from (from line 44,44, column (C))
(C» 14 8 , 1158.
8 58.
c
e
oj
QI 15 Fundraising
Fundralsmg (from line 44, column
column (D))
(D» 15
Q.
X
>C
w
UJ 16 Payments to affiliates
affiliates (attach schedule)
schedule) 16
17 Total
Total expenses.
exuenses. Add lines 16 and 44, 44 column (A) 17 27,427.
27,427.
18 Excess
Excess or (deficit) for the the year. Subtract line hne 17 from line 12 12 18 5 7 , 8880.
57 80.
UI
d)4;
a>S
19 Net assets or fund balances
Netassets balancesat at beginning of year (from line 73, column (A)) (A» 19 6 3 7 . 0013.
637 13.
z~ SEE STATEMENT
TATEMENT 2 8.363.
8-,-363.
<I: 20
< Other
Other changes in 10 net assets
assets or fund balances
balances (attach explanauon)
explanation) S EE S 2 20
~
703.256.
703,256.
cS/
21 N 3t asset s or fund balancesat
Netassets balances at end end of year. Combme
Combine lin es 18,19,
lines lB, 19, and 20 20 21
S23001
g~~~~-17
01-18-07 LHA For Privacy Act and Paperwork Paperwork Reduction Act Notice, see the separate instructions. instructions. Form 990 120<l6)
Form 99' (2006)
1
1
»
Form 990
Form 990 (2006)
(2006) THE HEIMLICH
3-7303161 Page 2
Page2
I Part II I Statement of All oroaneanons
organizations must complete column
column (A). Columns (8),
(B), (C), and
and (D)
(D) are
are required
required for
for secnon
section 501(c)(3)
501(c)(3)
Functional Expenses
Expenses and (4) orcaruzanons
organizations and section 4947(a)(1)
4947(a)(1) nonexempt chantable
charitable trusts
trusts but opnonal
optional for others.
Do'not (B)
(8) Program (C)
(e) Management
(A) Total
Total (D) Fundraising
(0) Fundraismn
6b,
6b, 8b, 9b, 10b, or 16 of Part I.
1. services and general
22a Grants
Grants paid
paid from
from donor
donor advised
advised funds
funds I
(attach schedule)
(attach schedule)
'.. ; i
o.
" '~ ~,
(cash $
(cash noncash$
0 » noncash O.
0 • !
If this
If thisamount Includesforeign
amount includes foreigngrants. check here
grants, check D
here ~ 22a -;,
~
22b Other
Other grants
grants and
and allocations
allocations (attach
(attach schedule
schedule) !
(cash $
(cash o. noncash$
U • noncash O.•
U
I
I
If this
If thiSamount Includesforeign
amount includes grants,check here ~
foreign grants, D 22b
23 SpeCific
Specific assistance
assistance to to Individuals
individuals (attach
(attach i
schedule) 23
I
schedule) iI
,
24 Benefits
Benefits paid
paid to
to or for
for members
members (attach
(attach , .-
, - I
schedule)
schedule) 24 "< " ~ \
25a Compensation of current officers,
officers, directors, key
directors, key
employees, etc. listed in
m Part V-A S S'I'M'I'
TMT 3 3 25a 1
122 , 0000.
00. 1
111 . 9940.
40. 60.
60. o..
0
b Compensation
Compensation of former officers,
directors, key
key
employees, etc. listed In
in Part V-8
V-B 25b 0
O.. 0
O.. 0
O.. 0
O..
c Compensation and and other distnounons,
distributions, not Included
included
above, to disqualified
disqualified persons (as defined under
section 4958(f)(1))
section 4958(f)( 1)) and persons described
descnbed in m
section 4958(c)(3)(8)
section 4958(c)(3)(B) 25c
26 Salaries
Salaries and
and wages
wages of employees
employees not not
included on
Included on lines
lines 25a,
25a, b, and
and c 26
27 Pension
Pension plan
plan contnbunons
contributions notnot Included
included onon
lines 25a,
lines and c
25a, b, and 27
28 Employee
Employee benefits
benefits not
not Included
included onon lines
lines
25a • 27
25a·27 28
29 Payroll
Payroll taxes
taxes 29 1 . 0044.
44. 1 . 0039.
39. 5
5..
30 Professional
Professional fund
fundraising fees
raismq fees 30
31 Accounting
Accounting feesfees 31 1
1 . 3361.
61. 1 , 3361.
1 61.
32 Legal
Legal fees
fees 32 5 . 2
5 264. 6 4. 5 . 2
5 264.6 4.
33 Supplies
Supplies 33 8814.
14. 8810.
10. 4.
4.
34 Telephone
Telephone 34 4419.
19. 4417.
17. 22.
.
35 Postage
Postage and shipping
and shipping 35
36 Occupancy
Occupancy 36
37 Equipment
Equipment rental
rental and
and maintenance
maintenance 37
38 Printing
Pnntmq and publications
and publications 38
39 Travel
Travel 39
40 Conferences,
conventions, and meetings
and meetings 40
41 Interest
Interest 41
42 Depreciatron,
depletion, etc,
etc. (attach schedule) 42
43 Other
Other expenses
expenses not
not covered
covered above
above (itemize):
(Itemize):
aa OUTSIDE
OUTSIDE SERVICES
SERVICES 43a 5
5 . 0088.
88. 5 .063.
5,063. 225.
5.
bMISCELLANEOUS
bMISCELLANEOUS FEES
FEES 43b 1162.
62. 1162.
62.
cTAXES
c TAXES 43c 2212.
12. 212.
212.
dCUSTODIAL
d CUSTODIAL FEES
FEES 43d 1 . 0063.
63. 1 , 0063.
63.
e 43e
f 43f
gg 43fj
43g
44 Total
Total functional
functional expenses.
expenses. Add lines 22a through
through
43g. (Organizations completing columns (B)-(D),
(Organlzallcns completing (8)-(D),
carry these totals
totals to lines 13-15) 44 2 7,427.
27,427. 1
199 . 2269.
69. 8 ,158.
8,158. o..
0
Joint
Joint Costs. Check ►
Costs. Check ~ D if you
you are
are following
followmq SOP 98-2
SOP 98·2
Are any joint
jomt costs
costs from
from a combined
educallcnal campaign and fundraising
fundraismu solicitation
sohcitanon reported in In (B)
(8) Program services?
services? ► D
.... □ YesYes [X] LX] No
No
If "Yes,'
"Yes," enter
enter (i)
(i) the
the aggregate
aggregate amount
amount ofof these
these JOint osts $
joint ccosts NN fA
/A ;; (ii)
(ii) the
the amount
amount allocated
allocated to
to Program services $__
Program services $_ N/A __
--=-N'-£f.,.:A~ :
(iii)
(iii) the amount
amount allocated to Management and and general $ N /fAA ; and (iv)
(iv) the amount allocated to Fundralsmg
Fundraising $ N/A
N fA
823011
01-23-07 Form 9 9 0 (2006)
2
11130718 758050 12053-000 2006.05070 THE
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 12053-01
Form 990 (2006)
Form 990 (2006) THE HEIMLICH INSTITUTE FOUNDATION 2 3-7303161
23-7303161 Page3
Page 3
I Part III I Statement of Program Service Accomplishments
Accomplishments (See the
mstructions.)
Form 990 is available for public inspection

9S0 ISavailable inspection and, for some people, serves as the primary or sole source of Information
information about a particular organization.
How the public
pubhc perceives an organization in In such cases may be determined
determined by the information
Information presented on its
ItS return.
return. Therefore, please make sure the
describes, In
return is complete and accurate and fully describes, in Part III, the organization's programs and accomplishments
accomplishments
What is the organization's primary exempt purpose? ►

ISthe ~ SEE
S STATEMENT
EE S TATEMENT 4
4 Program Service
ProgramService
Expenses
Expenses
(Requiredfor 501(c)(3)
(Required 501(c)(3)
All organizations must descnbe their exempt purpose achievements in In a clear and concise manner. State the number of and(4)
and orgs.,and
(4) orgs., and
clients served, publications
Issued, etc. Discuss
DISCUSS achievements
achievements that are not measurable. (Section 501(c)(3)
501 (c)(3) and (4)
(4) 4947(a)(1)
4947(a)(1) trusts; but
trusts;but
organizations and 4947(a)(1) charitable trusts
4947(a)(1) nonexempt charitable trusts must also enter the amount of grants and allocations to others)
others) optional for others.)
optionalfor others.)
a
a HEIMLICH MANEUVER WEEK -- EDUCATION
MANEUVER WEEK EDUCATION OF
OF THE
THE GENERAL
GENERAL PUBLIC ON
ON
USES OF THE HEIMLICH MANEUVER FOR DROWNING, CHOKING AND
ASTHMA.

b AIDS RESEARCH
allocations
RESEARCH AND EDUCATION
EDUCATION
$ )I If this
this amount
amount Includes
includes foreign grants
grants, check
check here rn
~ [ ] 5,810.
5,810
(Grants and allocations $ ) If this amount Includes

includes foreign grants,
grants check here ~jr~n
~ [ ] 110,554.
0,554.
c EDUCATION
c EDUCATION OF
OF THE
THE GENERAL
GENERAL PUBLIC
PUBLIC, THE
THE PRINTING AND
AND
DISTRIBUTION OF EDUCATION
EDUCATION LITERATURE
LITERATURE TO PUBLIC PLACES ABOUT
MANEUVER. DISTRIBUTED APPROX. 14 VIDEOS AND
831 POSTERS AND 104 WALLET
WALLET CARDS TO THE PUBLIC.
(Grants and allocations $ ))_ If this

this amount
amount Includes
includes toreion
foreign grants
grants, check
check here "►nzr
~ [ ] 1 ,937.
1,937.
d AA CARING WORLD
WORLD -- COLLECTION
COLLECTION AND
AND DISSEMINATION
DISSEMINATION OF HISTORICAL
HISTORICAL
AND SCIENTIFIC EVIDENCE SUPPORTING THAT WE LIVE IN A CARING
WORLD.
WORLD.
(Grants and allocations $ ) If

)
If thrs
this amount
amount Includes
includes foreign
foreign grants
grants, check
check here
here ~
► D□ 968.
9 68.
e Other program services (attach schedule)
e
$ )) If ttus
this amount
amount Includes
includes foreign grants,
grants, check
check here ~
► D□
f Total of Program
Total Program Service
Service Expenses
Expenses (should egualline
equal line 44, column (8),
(B), Program services)
services) 119,269.
9,269.
Form
Form9990
9 0 (2006)
(2006)
623021
01-18-07
3
Form990(2006)
Form 990 (2006) THE
T H E HEIMLICH
23-7303161 Page 4
Page4
I Part
Part IV I Balance
Balance Sheets
Sheets (See
(Seethethe instructions.)
mstructions.)
Note: Where requued, attached
Where required, attached schedules
schedules and amounts
amounts within
within the descnption
descnption column
column (A) (8)
(B)
should tor end-ot-year
should be for amounts only.
end-of-year amounts only. Beginning of year
Beginningof year Endof
End of year
year
45 Cash·■non-mterest-bearlnq
Cash non-interest-bearing .. 4.721.
4,721. 45 4 . 6679.
79.
46 Savings and
a n d temporary cash Investments
investments 2 3,111.
23,111- 46
46 2 . 7728.
28.
Accounts receivable
47 a Accounts 47a 1
144 . 3366.
66. ___ A_
b Less'
Less' allowance
allowance for
tor doubtful
doubtful accounts
accounts 47b
47b 47c
47c 1 4 . 3366.
14 66.
_ .. ...^
~_-- -_..._.
... -- - ......_ ~-- ~--~~"---- " "
48 a Pledges receivable
receivable 48a .~.-
Less.
Less, allowance for
b for doubtful
doubtful accounts
accounts 48b
48b 48c
receivable 49
50 a Receivables from current and former officers, directors, trustees, and
trustees, and
key employees
employees 50a
50a
Receivables from other disqualified persons (as
b (as defined
defined under section
section
-
<
in
UI
QI
UI
UI
4958(f)(1)) and
4958(f)(1)) and persons described In
51 a Other notes and loans
b Less:allowance
loans receivable
receivable
Less: allowance for doubtfulaccounts
doubtful accounts
in section 495,8(C)(3
4958(c)(3 (8)
51a
51b
(B) 50b
50b
___
r~
51c
52 for sale
Inventories for sale or use
use 52
53 Prepaid expenses and deferred charges
charges 53
Investments - publicly-traded-secunties
54 a Investments ... D
► □ Cost
Cost DFMV
□ FMV 54a
b Investments
Investments - other securities
securities STMT 6
STMT 6 ...
► D □ Cost
Cost [XJ FMV
C x ] FMV 6 10.813.
610,813. 54b
54b 6 8 0 . 6622.
680 22.
55 a Investments
Investments - land, buildings,
buildmqs, and
~, \
equipment: basts
equipment: basis 55a ~~1"~h~'
----
b Less:
Less: accumulated
depreciation 55b 55c
56
56 Investments - other
Investments 56
buildmqs, and equipment:
equipment: basis I 57a , .__E '
b Less:
Less: accumulated
depreciation 57b 57c
57c
58 Otherassets,Includingprogram-related
Other assets, including program-related Investments
investments
(descri
be ^-
(describe... SEE
SEE STATEMENT 5 )) 4.145.
4,145. 58 3 . 6643.
43.
59 Total assets
Total assets (must
(must equal line
line 74).
74). Add
A d d lines
lines 45
4 5 through 588
throuqh 5 6 42,790.
642,790. 59 7 0 6 . 0038.
706 38.
60 Accounts
A c c o u n t s payable and accrued expenses
expenses 5,777.
5,777. 60 2
2 , 7 8 2.
782.
61 Grants payable
payable 61
61
62 Deferred revenue
Deferred revenue 62
UI
in
QI Loans from
63 and key
f r o m officers, directors, trustees, and key employees
employees 63
~ a Tax-exempt bbond
o n d liabilities 64a
:cl'3 64 64a
.2 b Mortgages and other notes payable
payable 64b
64b
:J
65 Othernabihties
Other (describe ...
liabilities (describe ► ) 65
66 Total
Total liabilities.
liabilities. Add
A d d lines
lines 60
60 throuah 65
throuqh 65 .. 5
5 . 7777.
77. 66
66 2
2 , 7782.
82.
Organizations tthat
Organizations h a t follow
check here ...
► [XJ and
a n d complete lines
,
■>4
,';' \~.,:t-;f
in
UI
67 through
t h r o u g h 69 lines 73
69 and lines 73 and
and 74.
74. ~.::
---..uLr
QI
o 67 Unrestricted
Unrestricted 5 9 8 , 0094.
598 94. 67 6 64.337.
664,337.
e
c
ra
l'3 68 Temporarily
Temporanly restricted
restricted . 68
i5
ca
m 69
69 Permanently restricted
restricted 3 8 . 9919.
38 19. 69 3 8.919.
38,919.
■o
'tJ ' - ~
c:
c Organizations that
Organizations that do
do not
not follow
check here ...
► Dand and
:::I
3
II. complete lines 70
complete 70 through 74 .
through 74.
....
u.
___ A
-
0
o
UI 70 Capital stock, principal, or current funds
stock, trust principal, funds .. 70
<0
QI
in
UI 71 Paid-in or caprtal
Paid-in capital surplus, or land, buildmq,
building, and
a n d equipment fund
fund 71
71
-
UI
in
< 72 Retained earnings, endowment, accumulated income, or other funds
funds 72
<QI through12-
z 73 Total
Total net assets fund balances.
assets or fund balances. Add
Add lines67
lines 67 through69
through 69or
or lines70
lines 70through 72.
---
(Column(A)
(Column (A) must
must equalline
equal line 19 andcolumn(B)
and column (B) must
must equalline21)
equal line 21) 6 3 7 . 0013.
637 13. 73 7 0 3 . 2256.
703 56.
Total liabilities and net
net assets/fund
assets/fund balances. Addlines66
balances. Add and73
hnes 66 and 73 642.790.
642,790. 74 7 0
706 6 . 0 3 8.
038.
Form 990
990 (2006)
(2006)
623031
523031
01-20-07
4
Form 990(2006)
23-7303161 Page5
PageS
I Part IV-A
IV-A |f Reconciliation of Revenue
Revenue per Audited Financial Statements With Revenue
Revenue per Return (See the
(See the
a
. instructions.)
gams, and other support
Total revenue, gains, support per audited
statements a
a N/A
N/A
b Amounts Included
Amounts included on line a but not on Part I,1, line 12.
1 Net unrealized
Net unrealized gains
gains on
on investments
investments b1
b1
2 facilities
Donated services and use of facilities b2
3 Recoveries of pnor
Recovenes prior year grants b3
4 Other (specify): b4
- --
Add lines b1 through b4b4 b
c Subtract
Subtract line b from line a c
d Amounts
Amounts Included
included on Part I, line 12, but not on line a:
1 Investment
Investment expenses
expenses not
not Included
included on
on Part
Part I,1, line
line 6b
6b .. I d1
d11
2 Other (specify): d2 ---
Add lines d1 and d2 d +-
t-"-d _
e Total revenue
Total revenue (Part II, line 12}.
12). Add
Add lines c and d . . . . ..
... .. . ~► e
I Part IV-B
IV-B I Reconciliation of Expenses
Expenses per Audited
Audited Financial Statements With Expenses
Expenses per Return
a audited financial statements
Total expenses and losses per audited statements a
_-
N/A
N/A
b Amounts Included
Amounts included on line a but not on Part I, line 17:
1 Donated services
Donated services and
and use
use ofof tacilrtres
facilities b1
b1
2 adjustments reported on Part I,
Prior year adjustments 1, line 20 b2
3 Losses reported on Part I, 1, line 20 b3
4 Other (specify): b4
Add lines b1 through b4 b
c Subtract line b from line a
Subtract c
d Amounts included on Part I, line 17, but not on line a:
Amounts ~.
1 Investment expenses
Investment expenses not
not Included
included on on Part
Part I,I, line
line 6b
6b I d1
d11
2 (specify)-
Other (specify)' d2 , .
e Total
Total excenses
expenses (Part II, line 17) Add
Add lines c and d .. ~► e
I I
Part V-A Current Officers, Directors, Directors, Trustees, and Key Employees (List each eachperson who was an officer, director, trustee,
or key employee at any time during
dunng the year even ifIf they were not compensated.) (See the mstructions.)
instmctions.)
(8) Title and
(B) average hours (C)
and averagehours Compensation (D)Contributionsto
(e) Compensation (D~ConITlbullons 10 (E) Expense
(E)Expense
employee
Nameand
(A) Name and address
address per week
week devoted
devoted to
position
(If ~8!~'
(If not paid, enter
e ployee benefit
plans & deferred
& deferred
compensation plans
cornpensatron
account and
account and
other allowances
other allowances
-0-.)
HENRY HEIMLICH,_ MD TRUSTEE
C I N C I N N A T I . OH 4 5 2 1 9 40.00
40.00 112,000.
2.000. 0o.. 0o..
P H I L I P M. HEIMLICH
VICE-PRESIDEN T
VICE-PRESIDEN rr
C I N C I N N A T I , OH 4 5 2 1 9 55.00
.00 0o.. 0o.. 0o..
~~~~_~9~
BARBARA LOHR _ SECRETARY
~ll_~~~J~B~_~~~E~~
3 1 1 STRAIGHT STREET _
C I N C I N N A T I . OH 45219
CINCINNATI 45219 55.00
.00 0o.. 0o.. 0o..
~~_~T~9~_WQQQ~
E . ANTHONY WOODS _ CHAIRMAN
~ll_~T~J~B~_~~~E~~
C I N C I N N A T I , OH 45219
CINCINNATI 45219
L 20.00
20.00 0o.. 0o.. 0o..
JANE _~¥_
.J~~ MARY ~~~I:!Q_~~
TENHOVER TRUSTEE
_ rrRUSTEE
~ll_~~~J~B~_~~~E~~
C I N C I N N A T I . OH 45219
CINCINNATI 45219 11.
. 000
0 0o.. o.
0. o.
0.
Form 990
9 9 0 (2006)
(2006)
623041 01-18-07
01-18-07
5
Form
Form 990
990 (2006)
(2006) THE HEIMLICH
HEIMLICH INSTITUTE
23-7303161 Page 6
Page6
I Part
Part V-A I·Current
.Current Officers, Directors, Trustees, and Key Employees
Officers, Employees (continued)
(continued) Yes No
Yes
75 a E~ter
Enter the total number of officers, directors, trustees permitted to
directors, and trustees to vote on
on organization business at board
meetings ►
~ 5
b Are any officers, directors, trustees, or key employees listed In
directors, trustees, in Form 990, Part V·A, V-A, or highest compensated
In Schedule A, Part I, or highest compensated
listed in compensated professional and other Independent independent contractors
contractors listed In in Schedule A,
Part II·A
ll-A or ll-B,
II·B, related to
to each other through
through family or business relationships? If "Yes," attach attach a statement that Identifies
identifies ~---
the individuals
mdrviduals and explains the relationshipfs^PK L i p \:h=,,,,,,LIc.~
relatlonShlp(s(P" iILlp r \ t l ^ t - i < i ( \ jI ~ ~~r1
j , \Ê*ycu I-l£(Ioo-\LJd..'
W g a m t - i c l i '>. Saa w~ "))
ii 5 75b ~
c Do any
any officers,
trustees, or
or key
key employees
employees listed
listed In
in Form
Form 990,
990, Part
Part V·A,
V-A, or
or highest
highest compensated
employees
listed in
In Schedule A, Part I, or highest
highest compensated
compensated professional
professional and other Independent
independent contractors
contractors listed In
in Schedule
Schedule A,
A,
Part ll-A
II·A or ll-B,
II·B, receive compensation
compensation from any other organizations, whether tax exempt or or taxable,
taxable, that are related to the
to the - __
- -
organization? See the instructions
Instructions for
for the definition
definition of "related organization." 75c X
If "Yes," attach a statement
statement that includes
Includes the information
Information descnbed
descnbed in
In the instructions.
instructions. - __
----- _-- -------j
d the orqanlzanon
Does the organization have
have aa written
written conflict
conflict of
of Interest
interest policy?
policy? 75d X
I Part V-B I Former
Former Officers, Directors, Trustees, and Key Key EmployeesThat Received Compensation
Employees That Received Compensation or Other
Benefits
B e n e f i t s (If any former officer, director, trustee,
trustee, or key employee received compensation
compensation or other benefits (described
(dascnbsd below) dunnq
during
the year, list that person below and enter the amount of compensation or other benefits
benefits in the
the appropriate
appropriate column.
column. See the Instructions)
Seethe instructions)
(C) Compensation (D) Contributions
(C) Compensallon(0) to (E)Expense
Contributions to (E) Expense
(A) Nameandaddress
Name and address (B) Loans and Advances
(8) LoansandAdvances (if
(If not
not paid,
paid, employee
employee benefit
benefit
accountand
account and
plans& deferred
plans
NONE
NONE enter-0-)
enter-0-) compensation
compensation plansotherallowances
plans other allowances
---------------------------------
---------------------------------
- -
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
-~-------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
---------------------------------
Part VI I Other
\ Part Other Information (See the mstructrons.)
instructions.,) Yes No
76 Did
Old the
the organization make a change in its
ItS activities or methods
methods of conducting
conducting activities? If "Yes," attach
attach a detailed RR .R. __
- .~... _____ R
statement
statement of each change 76 X
77 Were any changes made in In the organizing or
the organizing orgoverning
governing documents
documents but
but not
not reported
reported to
to the
the IRS?
IRS? 77 X
If "Yes," attach a conformed
conformed copy of the changes.
changes. _ .. J'. ~ "-
78
7B a
a Did
Old the
the organization have unrelated business gross income Income ofof $1,000 or more during
dunnq the
the year covered by by this return? 7Ba
78a X
b If "Yes,"
"Yes," has Itit filed
filed aa tax retum
return on
on Form
Form 990-
990-T for trus
T for this year?
year? N/A
N/A 7Bb
78b
79 Was there a liquidation,
hquidanon, dissolution,
termination, oror substantial
contraction during the year?
dunnq the year? IfIf "Yes,"
"Yes," attach
attach aa statement
statement 79 X
80
BO at Is the organization related (other than by by association
association with a statewide or nationwide organization) through through common
common
- -,
membership, govemlng trustees, officers, etc., toto any other exempt or nonexempt organization?
organization? BOa
80a X
b If "Yes,"
"Yes," enter thethe name of of the
the organlzatlon~
organization^ N/A
N/A
and check whether It
it IS
is D exemptor
exempt or D nonexempt
nonexempt
81 a
Bl a Enter direct or indirect
Indirect political expenditures.
expenditures. (See line 81 instruction
Instructions)
5) I 81a
Bla II O.
0.
b Old
Did the
the oruanization
organization file Form
Form 1120-POL
1120-POL for thrs
this year? . ._ .. Blb
81b X
Form 990 (2006)
Form 2006)
823161/01-18-07
623161101-18-07
6
11130718 758050 12053-000 2006.05070 THE
THE HEIMLICH
HEIMLICH INSTITUTE
INSTITUTE FOUN
FOUN 12053-01
Form 990 (2006)
Form 990 (2006) THE HEIMLICH INSTITUTE FOUNDATION 2 3-7303161
23-7303161 Page?
Page 7
I Part VIJ
Part VI Other
Other Information (continued)
Information (contmued) Yes No
82 a Did
82 D!d the organization receive donated
donated services or the use of matenals, equipment,
equipment, or facilities at no charge or at substantially
substantially
less than fair rental value? 82a
82a X
b If "Yes," you may indicate
Indicate the value of these items
Items here. Do not include
Include this
amount as revenue In in Part I or as an expense in In Part II -- - -.- --
(See instructions
Instructions in
In Part III.)
111.) | 82b
82b I I I N/A
N/A
83
83 a Did
Old the organization comply
comply with
wrth the public inspection
Inspection requirements
requrremsnts for returns and exemption applications?
applications? 83a
83a X
Did the organization comply
b Old comply with thethe disclosure
requirements relating to quid pro quo contnbutions?
contributions? 83b
83b X
84 a Did
84 Old the organization solicit
solicit any contributions
contnbutions or gifts that were not tax deductible?
deductible? 84a
84a X
"Yes," did
b If "Yes," did the organization
organization Include
include with
with every solicrtatron
solicitation an express statement
statement that
that such
such contributions
contributions or gifts
gifts were not _ --
--
tax deductible?
deductible? . . . NN/ / A
A 84b
84b
85
85 501(c)(4), (5), or(6)
501 (c)(4),(5), organizations, a Were substantially all dues nondeductible
or (6) organizatIons. nondeductible by members? N/A
N/A 85a
85a
b Old
Did the organization make make only m-house
in-house lobbYing
expenditures of $2,000
$2,000 or less? N/A
N/A 85b
85b
If "Yes" was answered to either 85a or 85b, do not completecomplete 85c through 85h below unless the organization received a
waiver for proxy tax owed for the pnor year.
e Dues, assessments, and similarSimilar amounts
amounts from members 85c
85e N/A
N/A I
d Section 162(e)
162(e) lobbying and political expenditures
expenditures 85d
85d N/A I
nondeductible amount of section 6033(e)(1)(A)dues

e Aggregate nondeductible 6033(e)(1)(A) dues notices
notices 85e
85e N/A <. , "
'j
f Taxable amount of lobbYing
lobbying and political
political expenditures (line 85d less 85e) 85f
85f N/A
g Does the organization elect to pay the section 6033(e)6033(e) tax on the amount on line 85t?
85f? N/A
N/A 85g
8511
h If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount on line 85f
6033(e)(1)(A)dues
its reasonable estimate of dues allocable to nondeductible
to ItS nondeductible lobbymq
lobbying and political expenditures for the
following tax year?
followmq N/A 85h
86
86 501(c)(7)
50 organizations. Enter: a Initiation fees and capital contributions
1(c)(7)orgamzatlons. contnbutions included
Included on I' ": "I
!
line 12 86a
86a N/A
N/A
b Gross receipts,
receipts, included
Included on line 12, for public use of club tacihtres
facilities 86b
86b N/A
N/A
orqsneettons. Enter: a Gross income
Income from members or shareholders 87a
87a N/A
b Gross Income
income from other
other sources.
sources. (Do not net amounts
amounts due or paid to otherother sources
sources
against amounts due or received from them.) 87b
87b N/A
88
88 a At any time dunng the year, did the organization own a 50% or greater interest in
5()o,A, In a taxable corporation or partnership,
partnership,
or an entity disregarded as separate from the organization under Regulations sections 301.7701 301 .7701·2 -2 and
and 301
301.7701 -3?
.7701·3? _. . _._ ..J
If "Yes," complete
complete Part IX IX 88a
88a X
time dunng
b At any time during the year, did the
the orqarnzanon,
organization, directly
directly or Indirectly,
indirectly, own a controlled
controlled entity
entity Within
within the meaning
meaning of
section 512(b)(13)?
512(b)(13)? If "Yes,"
"Yes," complete Part XI .... 88b
88b X
'I
89
89 a 501(c)(3)
501(c)(3)
b 50
organizations. Enter: Amount
501 (c)(3)orgamzatlons.
section 4911....
section 4911 ►
and 501(c)(4)
1(c)(3)and
°.;
Amount of tax imposed
organizations. Old
501(c)(4)orgamzatlons.
Imposed on the organization during
O^.;section 4912►
section4912....
Did the
the orqarnzation
organization engage
engage In in any
any section
°.;
dunng the year under:
(K_; section4955
section 4958
section 4955 ....
4958 excess
►
excess benefit
benefit
0.
-=o:.....=_
transaction during
transaction dunng the year or did Itit become aware of an excess benefit transaction
transaction from a pnor
prior year? _. ._~.J
If "Yes," attach
attach a statement
statement explaining each transaction
transaction 89b
89b X
e Enter: Amount
Amount of tax Imposed
imposed on the orqamzanon
organization managers or disqualified
disqualified persons dunng the year under
sections 4912,
4912, 4955, and 4958 ► 0
0=--=-.. , ,,'
d Enter: Amount
Amount of tax on line 89c,a9c, above,
above, reimbursed by the organization .► ....:o~.
0.
e organizations. At any time
All organizatIons. time dunng
during the
the tax year, was the organtzation
organization a party to a prohibited
prohibited tax shelter transaction?
transaction? 89e
8ge X
f organizations. Old
All organIzatIons. Did the organization acquire a direct or Indirect
indirect Interest
interest in any applicable Insurance
insurance contract?
contract? 89f
89f X
g organizations and sponsonng orgamzatlons
For supporting orgamzatlons organizations mamtammg
maintaining donor adVIsed
advised funds. Old
Did the supporting
supporting organization,
organization,
or a fund maintained by a sponsoring
sponsonng organization, have excess businessbusmess holdings at any time during the year? 8911 X
90
90 a List
Ltst the states
states with which a copy of this return is
Withwhich ISfiled ....~O~H~
filed ► OH ---r __ ,-- _
b employed In
Number of employees employed in the
the pay penod
period that
that Includes
includes March 12,2006
12, 2006 I 90b
90b I 1
91a
91a The books
The are m
books are in care of
ot ►
.... TTHE
HE H HEIMLICH
E I M L I C H IINSTITUTE
FOUNDATION Telephone n o . ► (513)559-2391
Telephoneno..... (513)559-2391
Located at ....
Locatedat ► 3 311
1 1 STRAIGHT
S T R A I G H T STREET
S T R E E T ,l CINCINNATI
C I N C I N N A T I ,l OH OH ZIPH-4
ZIP+4 ►.... 45219
45219
b At any time
time dunng
during the calendar
calendar year, did
did the organization have an Interest
interest In
in or a signature or other
other authority
authority over
over Yes No
a financial account
account In in a foreign
foreign country
country (such as a bank account,
account, secunties
securities account,
account, or other financial account)?
account)? 91b
91b --- X
If "Yes," enter the name of the foreign country ► .... NLA
N /A
See the Instructions
instructions for exceptions
exceptions and filing requirements for Form
Form TO
TD F 90-22.1,
90-22.1, Report of Foreign Bank
and Financial Accounts.
Accounts.
Form 990
Form 9 9 0 (2006)
(2006)
823182/01-18-07
623162/01·18-07
7
11130718 758050 12053-000 2006.05070 THE HEIMLICH INSTITUTE
Form
Form 990 (2006)
990 (2006) THE
THE HEIMLICH
HEIMLICH INSTITUTE
FOUNDATION 23-7303161 PaqeS
.Other Information
Part VI .Other Information (continued)
(contmued) Yes No
c At any time dunng
during the calendar year, did the organization
organization maintain an office outside
outside of the United States?
States? 91c
If "Yes," enter the name of the foreign country
country ► ~ -=N"-'-/.::.A=-
N/A _
92 Section 4947(a)(1) nonexempt chantable
charitable trusts fllmg
filing Form 990 m in lieu of Form
Form 1041-
1041- Check here
and enter the amount of tax-exempt interest
Interest received or accrued during
dunnq the tax year •► |1-92-1
92 | N/A
N /A
I I Income-Producing Activities
Part VII Analysis of Income-Producing Activities (See
(See thethe instructions)
mstructions)
Note: otherwise
Note: Enter gross amounts unless otherwIse Unrelatedbusiness
Unrelated businessIncome
income Excluded by
by section 512, 513, or 514
(e) (E)
mdtcetea.
indicated. (A) (8)
(B) (C) n
((0) )
Business
Business Exclu-
Exclu Related
Related or exempt
exempt
Amount
Amount sion Amount
Amount
93 Program service revenue,
revenue. code
code cede
code functron Income
function income
a EDUCATIONAL
a EDUCATIONAL VIDEOS
VIDEOS &
bb POSTERS
POSTERS 177 . 1133.
1 33.
c
d
e
f Medicare/Medicaid
payments
gg Fees and contracts
contracts from govemment
government agencies
assessments
95 Interest
Intereston
on savings
savingsandtemporarycashInvestments
and temporary cash investments 14
14 9 , 9957.
9 57.
96 Dividends and Interest
DIvidends interest from securities
securities 14
14 10
1 0 . 5539.
39.
(loss) from real estate:
/
!
■■
' -
~
' ~~'
i' . - { • ~,
' ",, ■/ :I
; ~~
! Jv\ , , _,
„> , ~
^
1 - !i
""
a debt-financed
property
b
b not debt-flnanced
property -
(loss) from personal property
property
99 Other investment
Investment Income
income
100 Gain
Gam or (loss)
(loss) from sales of assets
other than Inventory
inventory
-- 18
18 38
3 8 , 5539.
39.
101 Net Income
income or (loss) from special events
102 Gross profit or (loss) from sales of Inventory
inventory
103 Other revenue:
a REFUND
a REFUND OF
OF UNEMPLOYMENT
UNEMPLOYMENT 8,606.
8 .606.
b REFUND
b REFUND OF
OF BWC
BWC 322.
322.
c
d
e
104 Subtotal
Subtotal (add columns (8),
(B), (D), (E»
(D), and (E)) o.
0. 599 . 0035.
5 35. 26~O61.
2 6.061.
105 Total
Total (add line 104, columns (B), (8), (D), (E»
(D), and (E)) ~ __ ------'8:<....:5::..1,
85.096,
Note: Lme
Note: Line 105
10S plus line 1e, Part I,
Ime 1e, I, should
should equal
equalthe
theamount
amount on
onhne
line 12,
12,Part
Part1_ I.
Part VIII Relationship of Activities to the Accomplishment of Exempt Purposes (See the instructions.)
Line No. Explain how each
Explainhow eachactivity for which income is reported in column
whichIncomeISreportedIn (E) of Part
column(E)of VII contributed
PartVII importantly to the
contributedImportantlyto the accomplishment the orpamzanon's
accomplishmentof the organization's
T exemptpurposes(otherthanby
exempt purposes (other than by providing
prOVidingfunds
funds for such purposes),
such purposes).
N/A
Part IX Information Regarding Taxable Subsidiaries and Disregarded Entities (See the instructions.)
n (B) ~
Name, address, and EIN of corporation, Percentage of
ownership interest Nati
partnership, or disregarded entity
%
N/A
Part X | Information Regarding Transfers Associated

(a) Did the organization, during the year, receive any funds, directly or indirectly,
(b) Did the organization, during the year, pay premiums, directly or indirectly, on
Note: If "Yes"
Note: ·Yes' to (b), file Form 8870 and
and Form 4720 (see instructions)
623163
823183
01-18-07
01-18-07
11130718 758050
11130718 758050 12053-000
12053-000 2006.0507
Form
Form 990 (2006)
990(2006) THE HEIMLICH INSTITUTE FOUNDATION 23-7303161
23-7303161 Paqe9
Pa e9
Part__XI
L.:-~ -' |.. Information
Information Regarding Transfers To and From Controlled
Controlled Entities. Complete only
Complete only if the
If the organization
organIZation IS a is a
controlling
controllmg organization
organization as defined
defined in section 5 12(b)(13).
section 512(b)(13). N/A
N /A
Yes No
106 Old the
Did the reporting organization make any transfers to
to a controlled entity as defined inIn section 512(b)(13)

Heimlich Institute IRS 990s, 1989+1995 Through The Most Recent (2022)

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Heimlich Institute IRS 990s, 1989+1995 Through The Most Recent (2022)

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/ Return of Organization

Return of Organization Exempt

'Wi'l Statement Revenue, Expenses

1 Contributions, gifts, grants, and similar amounts received:

. £>£.<f . j9f7K/r«£i .vS..tKOUK«= .

b Did you file

Use Only yours it sell-employed)

Compensation of t h ee Five Highest

.......-- ...---.-------- .._----- ..------------.

-----_.------- ....-----_ .._---------------------_ ..--- .._-------_._-----

Statements About Activities

1 hav'e you attempted to influence national, state, or local regislation,including

'.:mlnizatlcln not a private

PAR! VI - LIST OF OFFICERS, DIRECTORS AND TRUSTEES

Joseph J. Dehner Secretary None

Mrs. Winston C. Atteberry

Kathy and Ray Carr Trustee None

Arthur and Kathryn Murray Trustee None

c Gross profit or (loss)(loss) from sales

izations complettna columns ( B W D ) . carry these totals 44

(Grants and allocations $ 106,178.

45 Cash non interest bearing 12.569. M. 48,171.

47a Accounts receivable.

48a Pledges receivable

Under penalties of perjury,

Preparer's Date Check

(Form 990) (Except Private

P$ri ffl Statements About

b Lending of money or other extension of credit?

c Furnishing of goods, services, or facilities?

3 fellowships, student loans, etc.? .....

~:R":]Mm Reason for

29 Does the organization have a racially

If you answered "No" to any of the above, please

a Students' rights or privileges? 33a

b Admissions policies? . . . . 33b_

c Employment of faculty or administrative staff? . 32c.

d Scholarships or other financial assistance?

h Other extracurricular activiti

1e tne instructions Tor lines i a inrouan su.i . __

46 Lobbying ceiling amount C150% of line 45(el1. . .

47 Total lobbying expenditures

48 Grassroots nontaxable amount

49 Grassroots ceiling amount C150% of line 48 fell . .

5ft Gjassroofs lobbying expenditures

This report summarizes

Johnson Investment Counsel, Inc.

ADVANCES AND OTHER ASSETS

GOVERNMENT AGENCY BONDS

Johnson Investment Counsel,

Less: rental expenses . . . . . . . . . . . .

(loss) (subtract line 6b from line 6a)

(Grants and allocations $ 56,136.

Note: Where attached schedules

45 Cash non interest bearing 48,171. 45 6,374.

accumulated depreciation (attach

stock, trust principal, or current funds

75 Did anyany officer,

83a Did Did the organization

Membership dues and assessments. . ...

.Under pe erjury, i decJare that I have examined

Date Check if Preparer's SSN

For Paperwork Reduction

City zt town, state or country, ano ZIP- FprChtck