990 Return of Organization Exempt From Income Tax 09...10B956 IB 67 200912 670 201021 116626...

Form 990 Departmenl of Ihe Treasury Internal Revenue Service

Return of Organization Exempt From Income Tax U n d e r s e c t i o n 501 (c ) , 5 2 7 , o r 4 9 4 7 ( a ) ( 1 ) o f t h e In te rna l R e v e n u e C o d e ( e x c e p t b l a c k lung

benef i t t rus t o r p r iva te f o u n d a t i o n )

• The organizat ion may have to use a copy of this return to satisfy state reporting requirements.

OMB No. 1545-0047

09

A F o r t h e 2 0 0 9 c a l e n d a r year , o r tax y e a r b e g i n n i n g

D Check if applicable: Address change

Name change

Initial return

Termination

Amended leturn Application pending

Please use IRS label or print or type. See

Specific Instructions.

, 2 0 0 9 , a n d e n d i n g

Open to Public

Inspect ion

2 0

C Name of organization AMERICAN ACADEMY OF FAMILY PHYSICIANS FOUNDAT

Doing Business As

Number and street (or P.O. box if mail is not delivered to street address)

11400 TOMAHAWK CREEK PARKWAY, SUITE 430 City or town, state or country, and ZIP + 4

LEAWOOD, KS 66211

Room/suite

130

BOBiSONAnACH©

D Employer identification number

4 4 - 6 0 1 3 6 7 1 E Telephone number

( 9 1 3 ) 9 0 6 - 6 0 0 0

G Gross receipts $

F Name and address of principal officer: 1 1 , 0 3 5 , 7 2 1 .

I Tax-exempt status: X 501(c) ( 3 ) •< (insert no.) 4947(a)(1) or 527 J Website: • WWW.AAFPFOUNDATION.ORG K Type of organization: X Corporation Trust Association Other •

H(a) Is this a group return for affiliates?

H(b) Are ail affiliates included?

If "No," attach a list, (see instructions)

H(c ) Group exemplion number •

Yes

Yes _X_ No

No

L Year of formation: 1 9 5 8 M State of legal domicile:

S u m m a r y

1 Briefly describe the organization's mission or most significant activities:

THE_AMERICAN_ACADEMY_OF_FA^ THE VALUE_OF_FAMIL^^

SCIENTIFIC INITIATIVES THAT IMPROVE THE HEALTH OF ALL PEOPLE. > o

0. in

.<_ > <

OJ

UL

w HI

c a X

° u

s__ _ _ • «

Mi

2 Check this box ^. | | if the organization discontinued its operations or disposed of more than 25% of its assets. 3 Number of voting members of the governing body (Part VI, line 1 a) 4 Number of independent voting members of the governing body (Part VI, I 5 Total number of employees (Part V, line 2a)

nelb)

6 Total number of volunteers (estimate if necessary) 7a Total gross unrelated business revenue from Part VIII, line 12, column (C

b Net unrelated business taxable income from Form 990-T, line 34 . . .

8 Contribution and grants (Part VIII, line 1h) 9 Program service revenue (Part VIII, line 2g)

10 Investment income (Part VIII, column (A), lines 3, 4, and 7d) 11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11 e) 12 Total revenue - add lines 8 through 11 (must equal Part VIII, column (A), I

COPY FOR PUBLIC INSPECTION

ne 12) . . . 13 Grants and similar amounts paid (Part IX, column (A), lines 1-3) 14 Benefits paid to or for members (Part IX, column (A), line 4) 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) 16 a Professional fundraising fees (Part IX, column (A), line 11e)

b Total fundraising expenses, Part IX, column (D), line 25) )» 7 2 5 , 2 7 9 . , 17 Other expenses (Part IX, column (A), lines 11a-11d, 11f-24f) 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) 19 Revenue less expenses. Subtract line 18 from line 12

20 Total assets (Part X, line 16) | U D L I V 11 l O i L U 1 1 V 1 1

21 Total liabilities (Part X, line 26) (\ AOV!

22 Net assets or fund balances. Subtract line 21 from l ine-t /Vjj lTlJj

3 4 5 6

7a 7b

Prior Year

5 , 8 4 3 , 3 9 0 .

9 6 3 , 4 6 0 . - 1 1 9 , 7 3 5 .

6 , 6 8 7 , 1 1 5 . 3 , 2 9 3 , 5 3 1 .

0 .

3 , 3 2 1 , 3 4 3 . 6 , 6 1 4 , 8 7 4 .

7 2 , 2 4 1 . Beginning of Year

1 1 , 9 9 8 , 3 8 5 . 2 , 5 2 6 , 8 5 6 . 9 , 4 7 1 , 5 2 9 .

18 17

0 169

Current Year

______ _ 9, 8 0 0 , 6 7 3 . 0 .

3 8 4 , 7 7 5 . 1 5 , 5 2 2 .

1 0 , 2 0 0 , 9 7 0 . 6 , 2 0 0 , 0 3 4 .

0 . 1 7 , 7 7 5 .

0 .

3 , 5 4 8 , 9 8 2 . 9 , 7 6 6 , 7 9 1 .

4 3 4 , 1 7 9 . End of Year

1 4 , 4 3 0 , 3 1 6 . 2 , 2 5 8 , 9 0 4 .

1 2 , 1 7 1 , 4 1 2 .

Sign Here

Paid

Preparer's

Use Only

S i g n a t u r e B l o c k

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of mv knowledae and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.

Signature of officer Date

Type or print name and title

Preparer's signature

Firm's name (or yours if self-employed), address, and ZIP t 4

Date Check if self-employed

J.OUSE PARK & DOBRATZ, P . C .

605 W. 47TH STREET, SUITE 301 KANSAS CITY, MO 6.112 May the IRS discuss this return with the preparer shown above? (See instructions)

Preparer's Identifying number (see instructions)

P 0 0 6 4 6 9 9 8 EIN 4 3 - 1 5 6 2 2 0 9 Phone no. • . 1 6 - 9 3 1 - 3 3 9 3

For Pr ivacy A c t and Paperwork Reduc t ion Ac t Not ice, see t he separate ins t ruc t ions . JSA

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X Yes

700

No

Form 9 9 0 (2009)

PAGE 1

10B956

IB 67 200912 670 201021 116626

Deparlmentof the Treasury Intcrnul Revenue .Service OGDEN UT 84201-0074

4844 66211 IRS USE ONLY

1089S6.734989.0332.007 1 KS 0.357 375

AMERICAN ACADEMY OF FAMILY PHYSICIANS FOUNDATION

11400 TOMAHAWK CREEK PKWY STE 430 LEAWOOD KS 66211-268105Z

29404-128-6167S-O 446013671

For n_sistm.ce, call: 1-877-829-5500

Notice Number: CP211A Date: June 7,2010

Taxpayer I.lcii.lflca.ioii Number: 44-601367. Tax Form: 990 Tax Period: December 31,2009

A0170883 21 TE 3

APPLICATION FOR EXTENSION OF TIME TO FILE AN EXEMPT ORGANIZATION RETURN - APPROVED

We received and approved your Form 8868, Application for Extension of Time to File an Exempt Organization Return, for the return (form) and tax period identified above. Your extended due date to file your return is August 15, 2010.

When it's time to file your Form 990, 990-EZ, 990-PF or 1120-POL, you should consider filing electronically, Electronic filing is the fastest, easiest and most accurate way to file your return. For more information, visit the Charities and Nonprofit web at www,irs,gov/eo. This site will provide information about:

- The type of returns that can be filed electronically, - approved e-File providers, and - if you are required to file electronically.

If you have any questions, please call us at the number shown above, or you may write us at the address shown at the top of this letter,

Page 1

Form 990 (2009) 4 4 - 6 0 1 3 6 7 1 Page 2

ISTTTTTT Statement of Program Service Accomplishments

1 Briefly describe the organization's mission: THE AMERICAN ACADEMY OF FAMILY PHYSICIANS FOUNDATION ADVANCES THE VALUES OF FAMILY MEDICINE BY PROMOTING HUMANITARIAN, EDUCATIONAL, AND SCIENTIFIC INITIATIVES THAT IMPROVE THE HEALTH OF ALL PEOPLE.

2 Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990-EZ? E H Yes \~x] No If "Yes," describe these new services on Schedule O.

3 Did the organization cease conducting, or make significant changes in how it conducts, any program s e r v i c e s ? O e s [ x ] No If "Yes," describe these changes on Schedule O.

4 Describe the exempt purpose achievements for each of the organization's three largest program services by expenses. Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4a (Code: )(Expenses$ .,_8B,.2.. including grants of $ 3,347,070. )(Revenue$ ) PHILANTHROPIC ENDEAVORS TO ENHANCE HEALTHCARE QUALITY, STIMULATING RESEARCH PROGRAMS, BRING TOGETHER FAMILY MEDICINE ORGANIZATIONS, ~ SPONSOR EDUCATIONAL SEMINARS AND TEACHER DEVELOPMENT AWARDS. ~~

4b (Code: ) (Expenses$ 1.2, ,47. including grants of $ ) (Revenue $ HISTORY FOR THE CENTER OF FAMILY MEDICINE - SEE ATTACHED

STATEMENT.

4c (Code: )(Expenses$ 4.444.B69. including grants of $ 2,852,964. ) (Revenue $ PEERS FOR PROGRESS EVALUATES, DEMONSTRATES AND PROMOTES PEER SUPPORT FOR DIABETES MANAGEMENT AROUND THE WORLD.

4d Other program services. (Describe in Schedule O.) (Expenses $ including grants of $ ) (Revenue $

4e Total program service expenses • 8 , 675 , 740 .

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Form 990 (2009)

•;ETil-TJ Checklist of Required Schedules 44-6013671 Page 3

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Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule A

Is the organization required to complete Schedule B, Schedule of Contributors? Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes,"complete Schedule C, Part I

Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If "Yes," complete Schedule C, Part II

Sections 501(c)(4), 501(c)(5), and 501(c)(6) organizations. Is the organization subject to the section 6033(e) notice and reporting requirement and proxy tax? If "Yes, "complete Schedule C, Part III Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I

Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures? If "Yes,"complete Schedule D, Part II Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"

complete Schedule D, Part III

Did the organization report an amount in PartX, line 21; serve as a custodian for amounts not listed in Part

X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV _ Did the organization, directly or through a related organization, hold assets in term, permanent, or quasi-endowments? If" Yes,"complete Schedule D, PartV

Is the organization's answer to any of the following questions "Yes"? If so, complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable ' \

Did the organization report an amount for land, buildings, and equipment in PartX, line 10? If "Yes,"complete Schedule D, Part VI.

Did the organization report an amount for investments—other-securities in PartX, line 12 that is 5% or more of its total assets reported in PartX, line 16? If "Yes," complete Schedule D, Part VII.

Did the organization report an amount for investments-program related in Part X, line 13 that is 5% or more of its total assets reported in PartX, line 16? If "Yes," complete Schedule D, Part VIII.

Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in PartX, line 16? If "Yes," complete Schedule D, Part IX.

Did the organization report an amount for other liabilities in PartX, line 25? If "Yes,"complete Schedule D, PartX. Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization's liability for uncertain tax positions under FIN 48? If "Yes,"complete Schedule D, PartX. Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete Schedule D, Parts XI, XII, and XIII.

12 A Was the organization included in consolidated, independent audited financial statement for the tax year? If "Yes," completing Schedule D, Parts XI, XII, and XIII is optional. | 1 2 A

13 Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E.

14 a Did the organization maintain an office, employees, or agents outside of the United States? b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising

business, and program service activities outside the United States?If "Yes,"complete Schedule F, Part I Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the United States?//" 'Yes,"complete Schedule F, Part II Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the United States? If "Yes, "complete Schedule F, Part III Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11 e? If "Yes,"complete Schedule G,Parti Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes,"complete Schedule G, Part II Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes, "complete Schedule G, Part III '.....

Did the organization operate one or more hospitals? If "Yes," complete Schedule H

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Yes No

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14a

14b

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Yes No

X Form 990 (2009)

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Form 990 (2009)

fJTtii'M Checklist of Required Schedules (continued)

44-6013671 Page 4

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24 a

b c

d 25 a

26

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29 30

31

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Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If "Yes,"complete Schedule I, Parts I and II Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If "Yes," complete Schedule I, Parts I and III

Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated

employees? If "Yes, "complete Schedule J Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? // "Yes," answer lines 24b through 24d and complete Schedule K. If "No,"go to question 25

Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds? Did the organization act as an "on behalf o f issuer for bonds outstanding at any time during the year? Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes, "complete Schedule L, Part I Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ?//" "Yes, "complete Schedule L, Part I Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization's tax year?//" "Yes,"complete Schedule L, Part II. Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? // "Yes, "complete Schedule L, Part III Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions): A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV An entity of which a current or former officer, director, trustee, or key employee of the organization (or a family member) was an officer, director, trustee, or direct or indirect owner? If "Yes,"complete Schedule L, Part IV Did the organization receive more than $25,000 in non-cash contributions? //" "Yes,"complete Schedule M Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? // "Yes, "complete Schedule M Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes,"complete Schedule N, Parti Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?//" "Yes,"complete Schedule N, Part II Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes,"complete Schedule R, Part I Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Parts II, III, IV, and V, line 1 Is any related organization a controlled entity within the meaning of section 512(b)(13)? If "Yes,"complete Schedule R, Part V, line 2 Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes,"complete Schedule R, Part V.line 2 Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O

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Form 990 (2009)

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Form 990 (2009)

l - f f ! V J Statements Regarding Other IRS Filings and Tax Compliance"

44-6013671 Page 5

1a 1b

1a Enter the number reported in Box 3 of Form 1096, Annual Summary and Transmittal of U.S. Information Returns. Enter -0- if not applicable

b Enter the number of Forms W-2G included in line 1a. Enter-0-if not applicable c Did the organization comply with backup withholding rules for reportable payments to vendors and reportable

gaming (gambling) winnings to prize winners? 2a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax i i

Statements, filed for the calendar year ending with or within the year covered by this return . I 2a |

35

3a

If at least one is reported on line 2a, did the organization file all required federal employment tax returns? Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file this return, (see

instructions) Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return?

b If "Yes," has it filed a Form 990-T for this year? If "No,"provide an explanation in Schedule O 4a At any time during the calendar year, did the organization have an interest in, or a signature or other authority

over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?

b If "Yes," enter the name of the foreign country: • See the instructions for exceptions and filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.

5a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction? c If "Yes," to question 5a or 5b, did the organization file Form 8886-T, Disclosure by Tax-Exempt Entity Regarding

Prohibited Tax Shelter Transaction? 6a Does the organization have annual gross receipts that are normally greater than $100,000, and did the

organization solicit any contributions that were not tax deductible? b If "Yes," did the organization include with every solicitation an express statement that such contributions or

gifts were not tax deductible? 7 Organizations that may receive deductible contributions under section 170(c).

a Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?

b If "Yes," did the organization notify the donor of the value of the goods or services provided? c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was

required to file Form 8282? d If "Yes," indicate the number of Forms 8282 filed during the year I 7d |

Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal

benefit contract? Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? For all contributions of qualified intellectual property, did the organization file Form 8899 as required? For contributions of cars, boats, airplanes, and other vehicles, did the organization file a Form 1098-C as required?

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a b

I

a b

a b

Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year? Sponsoring organizations maintaining donor advised funds. Did the organization make any taxable distributions under section 4966? Did the organization make a distribution to a donor, donor advisor, or related person? Section 501(c)(7) organizations. Enter: Initiation fees and capital contributions Included on Part VIII, line 12 Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities . . . . Section 501(c)(12) organizations. Enter: Gross income from members or shareholders Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.)

12a Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041? b If "Yes," enter the amount of tax-exempt interest received or accrued during the year 112b I

10a 10b

11a

11b

1c

2b

3a 3b

4a

5a 5b

______

6a

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1SL

7h

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Yes No

___

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Form 990 (2009) 4 4 - 6 0 1 3 6 7 1 Page 6

IJT.Vii Governance. Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to line 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.

Section A. Governing Body and Management

a

1b

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7a

1a 1b

Enter the number of voting members of the governing body Enter the number of voting members that are independent Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? Did the organization make any significant changes to its organizational documents since the prior Form 990 was filed?

Did the organization become aware during the year of a material diversion of the organization's assets? .

Does the organization have members or stockholders? Does the organization have members, stockholders, or other persons who may elect one or more members

of the governing body? Are any decisions of the governing body subject to approval by members, stockholders, or other persons?

Did the organization contemporaneously document the meetings held or written actions undertaken during

the year by the following: The governing body? Each committee with authority to act on behalf of the governing body?

Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization's mailing address? If "Yes," provide the names and addresses in Schedule O

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7a 7b

8a 8b

9a

Yes No

Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.) ——

Does the organization have local chapters, branches, or affiliates? If "Yes," does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? Has the organization provided a copy of this Form 990 to all members of its governing body before filing the

form? Desribe in Schedule O the process, if any, used by the organization to review this Form 990. Does the organization have a written conflict of interest policy? If "No," go to line 13 Are officers, directors or trustees, and key employees required to disclose annually interests that could give

rise to conflicts? Does the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes,"

describe in Schedule O how this is done Does the organization have a written whistleblower policy? Does the organization have a written document retention and destruction policy? Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?

The organization's CEO, Executive Director, or top management official Other officers or key employees of the organization If "Yes" to line 15a or 15b, describe the process in Schedule O. (See instructions.) Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement

with a taxable entity during the year? b If "Yes," has the organization adopted a written policy or procedure requiring the organization to evaluate

its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization's exempt status with respect to such arrangements?

Section C. Disclosure ___

10a b

11

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13 14 15

a b

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List the states with which a copy of this Form 990 is required to be filed • _ A T T A C H M E N T — 6 . Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply. __} Own website L D Another's website [ x ] u P o n request

Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest

policy, and financial statements available to the public. State the name, physical address, and telephone number ofthe person who possesses the books and records of the organization- • JyL__l_____Y_.NSON_104^^

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PAGE 6

Form990(2009) 4 4 - 6 0 1 3 6 7 1 Page 7

VJmVim Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees

1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization's tax year. Use Schedule J-2 if additional space is needed.

• List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

• List all of the organization's current key employees. See instructions for definition of "key employee." • List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee)

who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the organization and any related organizations.

• List all of the organization's former officers, key employees, and highest compensated employees who received more than $100,000 of reportable compensation from the organization and any related organizations.

• List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of the organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest compensated employees; and former such persons. | | Check this box if the organization did not compensate any current officer, director, or trustee.

(A) Name and Title

MARK H. BELFER, D . O .

PRESIDENT RICHARD G. ROBERTS, M.D.

VICE PRESIDENT

MARY JO WELKER, M.D.

TREASURER AND AT-LARGE

CRAIG M. DOANE

EXECUTIVE DIRECTOR - NONVOTING

JEFFREY J . CAIN, M.D.

BOARD MEMBER

GLEN R. STREAM, M.D.

BOARD MEMBER

DENIS E . CHAGNON, M.D.

BOARD MEMBER MICHAEL FLEMING, M.D.

BOARD MEMBER

RONALD E . CHRISTENSEN, M.D.

BOARD MEMBER

CANDACE S . HOWELL, MPH

BOARD MEMBER

KATHLEEN L . WISHNER, P H . D .

BOARD MEMBER

J E F F G. HIMMELBERG

BOARD MEMBER KENNETH P . MORITSUGU, M.D.

BOARD MEMBER

JANE A. WEIDA (CORSON), M.D.

BOARD MEMBER

LINDA STONE, M.D.

BOARD MEMBER ROBERT C M . BOURNE, M.D.

BOARD MEMBER

(B) Average hours per

week

1 . 0 0

1 . 0 0

1 . 0 0

4 0 . 0 0

1 . 0 0

1 . 0 0

1 . 0 0

1 . 0 0

1 . 0 0

1 . 0 0

1 . 0 0

1 . 0 0

1 . 0 0

1 . 0 0

1 . 0 0

1 . 0 0

(C) Position (check all that apply)

s$ ID Q . __ c

o SI ~" B cg_

CD CD

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

x

_3 V>

c o __j __L 5 (A

Ol

rp

o 3 o CO

X

X

X

X

p .

CD

CD

3 x> •S <P

5 £ 3 (O _ — O CD

^ CA (0 - *

a g 3 — CD 3 (rt JU (D O .

-F1 O

1 CD

(D) Reportable

compensation from the

organization (W-2/1099-MISC)

4 , 0 5 0 .

3 , 8 2 5 .

2 , 4 0 0 .

0 .

0 .

0 .

1 , 2 0 0 .

1 5 0 .

4 5 0 .

0 .

0 .

0 .

0 .

1 , 6 5 0 .

7 5 0 .

1 , 0 5 0 .

(E) Reportable

compensation from related organizations

(W-2/1099-MISC)

900

900

600

1 8 3 , 3 0 4 .

1 , 9 9 9 .

4 , 6 3 5 .

6 0 0 .

3 0 0 .

6 0 0 .

0

0

0

0

0

0

ol

(F) Estimated amount of

other compensation

from the organization and related

organizations

0 .

0 .

0 .

5 9 , 6 3 1 .

0 .

0 .

0 .

0 .

0 .

0 .

0 .

0 .

0 .

0 .

0 .

0 .

JSA

961041 2.000 51P1ZD 0000 6/25/2010 11:13:34 AM 700

Form 990 (2009)

PAGE 7

Form 990 (2009) 4 4 - 6 0 1 3 6 7 1 Page 8

l_£T_l r _l l S e c t i o n A . Of f icers , D i rec tors , T r u s t e e s , Key E m p l o y e e s , a n d H i g h e s t C o m p e n s a t e d Emp loyee^con r / nuea ,

(A) Name and title

JASON E . MARKER, M . D .

BOARD MEMBER

M I C H A E L A . O L L E R , I I , M . D .

BOARD MEMBER

DOUGLAS HENLEY, M . D .

BOARD MEMBER

(B) Average hours per

week

1 . 0 0

1 . 0 0

4 0 . 0 0

(C) Position (check all that apply)

CD a.

~" 2 H-CD CD

X

X

X

__J

I c" o" ZJ p j

a CD CD

O 31 8

— CD

CD

3 — o • < CD CD

-3^ ~ ZT o 5S

• < Crt (D £• co g

3 -a CD — (rt SI CD Q.

o 1 CD

1b Total •

(D) Reportable

compensation from the

organization (W-2/1099-MISC)

1 , 0 5 0 .

1 , 2 0 0 .

0 .

1 7 , 7 7 5 .

(E) Reportable

compensation from related

organizations (W-2/1099-MISC)

0 .

0 .

4 6 8 , 0 6 8 .

6 6 1 , 9 0 6 .

(F) Estimated amount of

other compensation

from the organization and related

organizations

0 .

0 .

1 0 8 , 8 3 4 .

1 6 8 , 4 6 5 .

2 Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organization • 0

3 Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes,"complete Schedule J for such individual

4 For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? // "Yes," complete Schedule J for such individual

5 Did any person listed on line 1a receive or accrue compensation from any unrelated organization for services rendered to the organization? If "Yes,"complete Schedule J for such person

Yes No

Section B. Independent Contractors 1 Complete this table for your five highest compensated independent contractors that received more than $100,000 of

compensation from the organization.

(A) Name and business address

(B) Description of services

2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization • o

(C) Compensation

JSA

9E1050 1.000 51P1ZD 0 0 0 0 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM 700

Form 990 (2009)

PAGE 8

Form

171 990 (2009)

iWIH Statement of Revenue

_3 10

M Dl 0

s _. iff o « __ _. 3 O

§13 O M

-> 3 01 > 01

Q_ CU

o E _> E IS Ol

Q.

0) 3 C

> HI

Q_ L_ 0>

o

e Government grants (contributions) . .

f All other contributions, gifts, grants,

g Noncash contributions included in lines 1 a-1 f:

1a

1b

1c

1d

1e

1f

3 8 , 0 8 2 .

3 6 7 , 9 6 2 .

9 , 3 9 4 , 6 2 9 .

$ 3 8 , 0 8 2 .

•

2a

h

r.

r.

R

f All other program service revs

Business Code

•

3 Investment income (including dividends, interest, and other similar amounts) . . A T T ^ C H M E N T 1 •

4 Income from investment of tax-exempt bond proceeds . . . ^

b Less: rental expenses . . .

c Rental income or (loss) . . d Net rental income or (loss) .

7a Gross amount from sales of

assets other than inventory

b Less: cost or other basis

and sales expenses . . . .

(i) Real (ii) Personal

• (i) Securities

7 2 4 , 4 6 9 .

- 7 2 4 , 4 6 9 .

(ii) Other

•

8a Gross income from fundraising

events (not Including S 38,082.

of contributions reported on line 1c).

c Net income or (loss) from fundraising events .

9a Gross income from gaming activities. See Part IV, line 19 a

c Net income or (loss) from gaming activitie

10a Gross sales of inventory, less returns and allowances

ATCH 8

73 ,553 .

110,282.

A T C H . 9 . •

•

Miscellaneous Revenue

1 1 a MISCELLANEOUS

h

r.

Business Code

9 0 0 0 9 9

e Total. Add lines 11 a-11d • 12 Total Revenue. See instructio •

(A) Total revenue

9 , 8 0 0 , 6 7 3 .

0.

1 , 1 0 9 , 2 4 4 .

0.

0.

0 .

- 7 2 4 , 4 6 9 .

- 3 6 , 7 2 9 .

0.

0.

5 2 , 2 5 1 .

5 2 , 2 5 1 .

1 0 , 2 0 0 , 9 7 0 .

Page 9

4 4 - 6 0 1 3 6 7 1

(B) Related or exempt function revenue

5 2 , 2 5 1 .

5 2 , 2 5 1 .

(C) Unrelated business revenue

(D) Revenue

excluded from tax under sections

512, 513, or514

1 , 1 0 9 , 2 4 4 .

1 , 1 0 9 , 2 4 4 .

JSA

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Form 990 (2009)

PAGE 9

Form 990 (2009) 44-6013671 Page 10

Statement of Functional Expenses Section 501(c)(3) and 501(c)(4) organizati

All other organizations must complete column (A) but are ions must complete all columns. not required to complete columns (B), (C), and (D).

Do not Include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.

1 Grants and other assistance to governments and

organizations in the U.S. See Part IV, line 21 . .

2 Grants and other assistance to individuals in

the U.S. See Part IV, line 22

3 Grants and other assistance to governments,

organizations, and individuals outside the

U.S. See Part IV, lines 15 and 16

4 Benefits paid to or for members

5 Compensation of current officers, directors,

trustees, and key employees

6 Compensation not included above, to disqualified

persons (as defined under section 4958(f)(1)) and

persons described in section 4958(c)(3)(B) . . .

8 Pension plan contributions (include section 401 (k)

and section 403(b) employer contributions) . . .

11 Fees for services (non-employees):

a Management

e Professional fundraising services. See Part IV, line 17

18 Payments of travel or entertainment expenses

for any federal, state, or local public officials

19 Conferences, conventions, and meetings . . . .

22 Depreciation, depletion, and amortization . . . .

23 Insurance , .

24 Other expenses. Itemize expenses not

covered above. (Expenses grouped together

and labeled miscellaneous may not exceed

5% of total expenses shown on line 25 below.)

a S T A F F DEVELOPMENT AND EDUCAT

b A N N U A L REPORT

C A R T & P R I N T I N G

d B U L L E T I N

e B A N K CHARGES

f All other expenses

25 Total functional expenses. Add lines 1 through 24f

26 Joint Costs. Check here • | | If following SOP 98-2. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation

(A) Total expenses

4 , 9 3 5 , 5 6 6 .

3 7 , 0 0 0 .

1 , 2 2 7 , 4 6 8 .

0 .

1 7 , 7 7 5 .

0 .

0 .

0 .

0 .

0 .

0 .

1 , 2 2 5 .

1 2 , 5 7 8 .

0 .

0 .

0 .

2 , 7 0 2 , 8 5 1 .

3 1 , 4 8 8 .

0 .

1 0 4 , 9 0 9 .

0 .

0 .

1 2 6 , 4 8 1 .

0 .

3 4 4 , 8 2 1 .

0 .

0 .

9 , 8 2 4 .

8 , 7 6 3 .

2 , 3 2 0 .

7 , 0 6 9 .

1 1 , 3 9 4 .

7 5 , 1 0 9 .

1 2 , 4 7 8 .

9 7 , 6 7 2 .

9 , 7 6 6 , 7 9 1 .

(B) Program service

expenses

4 , 9 3 5 , 5 6 6 .

3 7 , 0 0 0 .

1 , 2 2 7 , 4 6 8 .

2 , 9 0 0 .

985 .

1 , 9 8 9 , 5 0 0 .

2 7 , 1 8 8 .

8 2 , 0 3 5 .

6 1 , 0 3 6 .

2 5 1 , 9 2 7 .

8 1 8 .

2 , 2 8 5 .

3 , 5 3 5 .

7 , 4 7 9 .

2 4 , 7 8 6 .

2 6 5 .

2 0 , 9 6 7 .

8 , 6 7 5 , 7 4 0 .

(C) Management and general expenses

1 0 , 0 2 5 .

2 4 0 .

1 2 , 5 7 8 .

2 6 8 , 8 5 1 .

6 0 .

4 2 , 8 0 0 .

7 , 6 6 8 .

3 , 3 2 8 .

8 , 7 6 3 .

1 , 2 9 6 .

1 0 , 1 6 3 .

3 6 5 , 7 7 2 .

(D) Fundraising expenses

4 , 8 5 0 .

4 4 4 , 5 0 0 .

4 , 3 0 0 .

2 2 , 8 1 4 .

2 2 , 6 4 5 .

8 5 , 2 2 6 .

5 , 6 7 8 .

3 5 .

3 , 5 3 4 .

2 , 6 1 9 .

5 0 , 3 2 3 .

1 2 , 2 1 3 .

6 6 , 5 4 2 .

7 2 5 , 2 7 9 .

JSA 9E1052 1.000

51P1ZD 0000 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM 700

Form 990 (2009)

PAGE 10

Form 990 (2009)

IZOIVX Balance Sheet 44-6013671 Page 11

Hi in in

<

in

3 nj

!_J

I/I <u u c

ro DO

c _J

U_

o

_) 1/1

<

1 2 3 4 5

6

7 8 9

10a

b 11 12 13 14 15 16 17 18 19 20 21 22

23 24 25 26

27 28 29

30 31 32 33 34

Cash - non-interest-bearing Savings and temporary cash investments Pledges and grants receivable, net Accounts receivable, net Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of Schedule L Notes and loans receivable, net Inventories for sale or use Prepaid expenses and deferred charges

Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D

10a

10b

2 5 9 , 2 1 4 .

1 9 1 , 9 2 8 .

Investments - other securities. See Part IV, line 11 Investments - program-related. See Part IV, line 11

Total assets. Add lines 1 throuqh 15 (must equal line 34)

Escrow or custodial account liability. Complete Part IV of Schedule D Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified persons. Complete Part II of Schedule L Secured mortqaqes and notes payable to unrelated third parties Unsecured notes and loans payable to unrelated third par ties

Total liabilities. Add lines 17 throuqh 25

Organizations that follow SFAS 117, check here • L__J and complete lines 27 through 29, and lines 33 and 34.

Unrestricted net assets Temporarily restricted net assets Permanently restricted net assets Organizations that do not follow SFAS 117, check here • | | and complete lines 30 through 34.

Capital stock or trust principal, or current funds Paid-in or capital surplus, or land, building, or equipment fund

Retained earnings, endowment, accumulated income, or other funds . . . . Total net assets or fund balances Total liabilities and net assets/fund balances

(A) Beginning of year

7 3 , 3 4 0 . 2 , 9 2 7 , 5 7 7 .

2 9 , 0 9 6 . 9 3 , 0 1 4 .

2 3 , 3 5 3 .

7 , 6 1 2 . 6 , 6 6 3 , 3 8 5 . 2 , 1 8 1 , 0 0 8 .

1 1 , 9 9 8 , 3 8 5 . 8 1 4 , 8 6 8 . 2 1 3 , 1 8 0 .

1 , 4 9 8 , 8 0 8 .

2 , 5 2 6 , 8 5 6 .

7 , 2 6 9 , 2 6 9 . 1 , 0 2 9 , 2 0 9 . 1 , 1 7 3 , 0 5 1 .

9 , 4 7 1 , 5 2 9 . 1 1 , 9 9 8 , 3 8 5 .

1 2 3 4

5

6 7 8 9

10c 11 12 13 14 15 16 17 18 19 20 21

22 23 24 25 26

27 28 29

30 31 32 33 34

(B) End of year

1 7 7 , 0 7 3 . 3 , 4 4 9 , 8 0 6 .

3 3 , 7 1 5 . 9 3 , 5 5 5 .

2 3 , 0 4 7 .

6 7 , 2 8 6 . 8 , 5 9 6 , 8 8 2 . 1 , 9 8 8 , 9 5 2 .

1 4 , 4 3 0 , 3 1 6 . 1 , 6 0 4 , 5 4 1 .

2 9 9 , 1 1 6 . 3 5 5 , 2 4 7 .

2 , 2 5 8 , 9 0 4 .

9 , 5 3 0 , 9 5 0 . 1 , 3 6 6 , 3 0 6 . 1 , 2 7 4 , 1 5 6 .

1 2 , 1 7 1 , 4 1 2 . 1 4 , 4 3 0 , 3 1 6 .

Form 990 (2009)

JSA

9E1053 1.000

51P1ZD 0000 6/25/2010 11:13:34 AM 700 PAGE 11

Form 990 (2009)

f 3? f f I 3¥ Financial Statements and Reporting

1 Accounting method used to prepare the Form 990: __\ Cash QT] Accrual Q ] Other If the organization changed its method of accounting from a prior year or checked "Other," explain in Schedule O.

2a Were the organization's financial statements compiled or reviewed by an independent accountant?

b Were the organization's financial statements audited by an independent accountant? c If "Yes" to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of

the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.

d If "Yes" to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a consolidated basis, separate basis, or both:

I I Separate basis __} Consolidated basis __\ Both consolidated and separate basis 3a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in

the Single Audit Act and OMB Circular A-133? b If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the

required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.

Page 12

2a 2b

2c

3a

3b

Yes No

Form 990 (2009)

9E1054 2.000

51P1ZD 0000 6/25/2010 11:13:34 AM 700 PAGE 12

SCHEDULE A (Form 990 or 990-EZ)

Department of the Treasury Internal Revenue Service

Public Charity Status and Public Support Complete if the organization is a section 501(c)(3) organization or a section

4947(a)(1) nonexempt charitable trust.

• Attach to Form 990 or Form 990-EZ. • See separate instructions.

OMB No. 1545-0047

109 Open to Public

Inspection

Name of the organization

AMERICAN ACADEMY OF FAMILY PHYSICIANS FOUNDAT Employer identification number

44-6013671

5 •

l - f f f l l Reason for Public Charity Status (All organizations must complete this part.) See instructions. The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i). A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.) A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii). A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state: An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.) A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v). An organization that normally receives a substantial part of its support from a governmental unit or from the general public

described in section 170(b)(1)(A)(vi). (Complete Part II.) A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.) An organization that normally receives: (1) more than 331/3 % of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions - subject to certain exceptions, and (2) no more than 331/3% 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. See section 509(a)(2). (Complete Part III.) An organization organized and operated exclusively to test for public safety. See section 509(a)(4). An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h. a {__ Type I b \__\ Type II c ______ Type III - Functionally integrated d \___~_2 Type III - Other By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting

organization, check this box [_____] Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons? (i) A person who directly or indirectly controls, either alone or together with persons described in

and (iii) below, the governing body of the supported organization? (ii) A family member of a person described in (i) above? (iii) A 35% controlled entity of a person described in (i) or (ii) above?

h Provide the following information about the supported organization(s).

10 11

»[x]

g

(ii) HBO) 11g(H) 11g(iii)

Yes No

X

X

X

(i) Name of supported organization

ATTACHMENT

Total

(ii) EIN

1

(Hi) Type of organization (described on lines 1-9 above or IRC section (see instructions))

(iv) Is the organization in col. (i) listed in your governing document?

Yes No

(v) Did you notify the organization in

col. (i) of your support?

Yes No

(vi)ls the organization in col. (i) organized in the

U.S.?

Yes No

(vii) Amount of support

2 , 9 8 2 , 5 6 0 .

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Schedule A (Form 990 or 990-EZ) 2009

JSA

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51P1ZD 0000 6/25/2010 11:13:34 AM 700 PAGE 13

Schedule A (Form 990 or 990-EZ) 2009 4 4 - 6 0 1 3 6 7 1 Page 2

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I.)

Section A. Public Support Calendar year (or fiscal year beginning in) ) •

1 Gifts, grants, contributions, and membership fees received. (Do not

2 Tax revenues levied for the organization's benefit and either paid to or expended on

3 The value of services or facilities furnished by a governmental unit to the

5 The portion of total contributions by each

person (other than a governmental unit or

publicly supported organization) included

on line 1 that exceeds 2% of the amount

6 Public support. Subtract line 5 from line 4.

(a) 2005 (b) 2006 (c) 2007 (d) 2008 (e) 2009 (f) Total

Section B. Total Support Calendar year (or fiscal year beginning in) y

7 Amounts from line 4

8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources

9 Net income from unrelated business activities, whether or not the business is regularly carried on . .

10

11

12

13

Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)

Total support. Add lines 7 through 10 . .

(a) 2005 (b) 2006 (c) 2007 (d)2008 (e) 2009

12

(f) Total

Gross receipts from related activities, etc. (see instructions) First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here •

Section C. Computation of Public Support Percentage

14 15 16a

17a

14

15 % %

18

Public support percentage for 2009 (line 6, column (f) divided by line 11, column (f)) Public support percentage from 2008 Schedule A, Part II, line 14 331/3 % support test - 2009. If the organization did not check the box on line 13, and line 14 is 331/3 % or more, check this box and stop here. The organization qualifies as a publicly supported organization • I I 331/3 % support test - 2008. If the organization did not check a box on line 13 or 16a, and line 15 is 331/3 % or more, check this box and stop here. The organization qualifies as a publicly supported organization • I I 10%-facts-and-circumstances test -2009. If the organization did not check a box on line 13, 16a or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization • I I 10%-facts-and-circumstances test -2008. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part IV how the organzation meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization • I I Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions • I I


JSA

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51P1ZD 0000 6/25/2010 11:13:34 AM 700 PAGE 14


1-fTIIII Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 9 of Part I.)

4-6013671 Page 3

Section A. Public Support Calendar year (or fiscal year beginning in) •

1 Gifts, grants, contributions, and

membership fees received. (Do not include

any "unusual grants.")

2 Gross receipts from admissions, merchandise

sold or services performed, or facilities

furnished in any activity that Is related to the

organization's tax-exempt purpose

3 Gross receipts from activities that are not an

unrelated trade or business under section 513 ,

4 Tax revenues levied for the organization's

benefit and either paid to or expended on

its behalf

5 The value of services or facilities

furnished by a governmental unit to the

organization without charge

Total. Add lines 1 through 5

Amounts included on lines 1, 2, and 3 received from disqualified persons . . . . Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year

Add lines 7a and 7b

Public support (Subtract line 7c from

line 6.)

6

7a

(a) 2005 (b)2006 (c) 2007 (d) 2008 (e) 2009 (f) Total

Section B. Total Support Calendar year (or fiscal year beginning in) •

10 a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar

b Unrelated business taxable income (less

section 511 taxes) from businesses

acquired after June 30, 1975

c Add lines 10a and 10b

11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly

12 Other income. Do not include gain or

loss from the sale of capital assets

13 Total support. (Add lines 9, 10c, 11,

and 12.)

(a) 2005 (b) 2006 (c) 2007 (d)2008 (e) 2009 (f) Total

14 First five years. If the Form 990 is for the organization's

organization, check this box and stop here

first, second, third, fourth, or fifth tax year as a section 501(c)(3)

Section C. Computation of Public Support Percentage 15 Public support percentage for 2009 (line 8, column (f) divided by line 13, column (f))

16 Public support percentage from 2008 Schedule A, Part III, line 15

15 16

Section P. Computation of Investment Income Percentage 17 Investment income percentage for 2009 (line 10c, column (f) divided by line 13, column (f))

18

19a

20

17

18 Investment income percentage from 2008 Schedule A, Part III, line 17

33 1/3% support tests - 2009. If the organization did not check the box on line 14, and line 15 is more than 331/3 %, and line

17 is not more than 33 1/3 %, check this box and stop here. The organization qualifies as a publicly supported organization •

33 1/3 % support tests - 2008. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 331/3 %, and

line 18 is not more than 331/3%, check this box and stop here. The organization qualifies as a publicly supported organization •

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions •

•

JSA 9E1221 1 000

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PAGE 15

4 4 - 6 0 1 3 6 7 1

Schedule A (Form 990 or 990-EZ) 2009 Page 4

l-Effl-Jl Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Provide any other additional information. See instructions

~~~ " ~~ ATTACHMENT 1 ~

<:r-HrniiT.E - , P - B T T - TNmRMATinu _.Rniir_ quppnRTF.n ORGANIZATIONS—

( I I I ) TYPE OF (IV) (V) (VI) ( V I I ) AMOUNT OF

( I ) NAME OF SUPPORTED ORGANIZATION ( I I ) EIN ORGANIZATION YES NO YES NO YES NO SUPPORT

AMERICAN ACADEMY OF FAMILY PHYSICIANS 4 . - 0 5 3 6 0 5 1 09 X X X 2 , 9 8 2 , 5 6 0 .

TOTAL AMOUNT OF SUPPORT ? ,UB?,5f i0

Schedule A (Form 990 or 990-EZ) 2009 JSA

9E1225 2.000

51P1ZD 0000 6/25/2010 11:13:34 AM 700 PAGE 16

Schedule B (Form 990, 990-EZ, or 990-PF) Department of the Treasury internal Revenue Service

Schedule of Contributors • Attach to Form 990, 990-EZ, or 990-PF.


AMERICAN ACADEMY OF FAMILY PHYSICIANS FOUNDAT

Organization type (check one):

Filers of:

Form 990 or 990-EZ

Form 990-PF

OMB No. 1545-0047

09 Employer identification number

44-6013671

Section:

| X I 501 (c)( 3 ) (enter number) organization

| | 4947(a)(1) nonexempt charitable trust not treated as a private foundation

| | 527 political organization

I | 501(c)(3) exempt private foundation

| | 4947(a)(1) nonexempt charitable trust treated as a private foundation

I I 501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule. Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See

instructions.

General Rule

[~X~l For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or

property) from any one contributor. Complete Parts I and II.

Special Rules

I | For a section 501 (c)(3) organization filing Form 990 or 990-EZ that met the 33 1/3 % support test of the regulations under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h or (ii) Form 990-EZ, line 1. Complete Parts land

| | For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor, during the year, aggregate contributions of more than $1,000 for use exclusively for religious, charitable, scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and III.

• For a section 501 (c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor, during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did not aggregate to more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more during the year • $

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990, 990-EZ, or 990-PF), but it must answer "No" on Part IV, line 2 of its Form 990, or check the box on line H of its Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990, 990-EZ, or 990-PF.

Schedule B (Form 990, 990-EZ, or 990-PF) (2009)

JSA

9E1251 1 000

51P1ZD 0000 6/25/2010 11:13:34 AM 700 PAGE 17

Schedule B (Form 990, 990-EZ, or 990-PF) (2009) Page_ of Part I

Name of organization AMERICAN ACADEMY OF FAMILY PHYSICIANS FOUNDAT Employer identification number

4 4 - 6 0 1 3 6 7 1

JSA

9E1253 1.000

LEill (a) No.

1

(a) No.

2

(a) No.

3

(a) No.

4

(a) No.

5

(a) No.

6

Contributors (see instructions)

(b) Name, address, and ZIP + 4






(c) Aggregate contributions

$ 2 7 , 0 0 0 .


$ 1 5 , 0 0 0 .


$ 5 0 , 0 0 0 .


£ 4 5 , 0 0 0 .


$ 7 5 , 0 0 0 .


$ 5 , 0 0 0 .

(d) Type of contribution

Person Payroll Noncash

X

(Complete Part II if there is a noncash contribution.)



X




X




X




X




X

(Complete Part II if there is Wl.)

51P1ZD 0 0 0 0 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM


7 0 0 PAGE 1!


Name of organization AMERICAN ACADEMY OF FAMILY PHYSICIANS FOUNDAT Employer identification number 44-6013671

JSA

9E1253 1.000

IJSRII

(a) No.

7

(a) No.

8

(a) No.

9

(a) No.

10

(a) No.

11

(a) No.

12









$ 5 , 0 0 0 .


S 5 , 0 0 0 .


$ 5 , 0 0 0 .


$ 5 , 0 0 0 .


$ 2 0 , 0 0 0 .


$ 2 5 , 0 0 0 .



X




X




X




X




X




X

(Complete Part II if there is

51P1ZD 0000 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM 700


PAGE 19


Name of organization

Page_ of Part I


JSA

9E1253 1.000

Employer identification number

4 4 - 6 0 1 3 6 7 1

IZED (a)

No.

13

(a) No.

14

(a) No.

15

(a) No.

16

(a) No.

17

(a) No.

18









$ 5 , 0 0 0 .


$ 2 5 , 0 0 0 .


$ 1 5 , 0 0 0 .


$ 1 5 , 0 0 0 .


$ 1 5 , 0 0 0 .


$ 4 5 5 , 2 9 0 .



X




X




X




X




X




X

(Complete Part II if there is a nnnr.ash contribution )

51P1ZD 0 0 0 0 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM


7 0 0 PAGE 20



4 4 - 6 0 1 3 6 7 1

JSA

9E1253 1.000

l£T__l| (a) No.

19

(a) No.

20

(a) No.

21

(a) No.

22

(a) No.

23

(a) No.

24









$ 4 0 , 0 0 0 .


$ 1 5 , 0 0 0 .


$ 1 5 , 0 0 0 .


$ 7 9 5 , 1 1 2 .


$ 1 5 3 , 0 0 0 .


$ 1 5 , 5 0 0 .



X




X




X




X




X




X


51P1ZD 0 0 0 0 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM 700


PAGE 2 1


Name of organization AMERICAN ACADEMY OF FAMILY PHYSICIANS FOUNDAT


(a) No.

25

(a) No.

26

(a) No.

27

(a) No.

(a) No.

29

(a) No.

30

JSA

9E1253 1.000







51P1ZD 0000 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM


44-6013671


2 5 , 0 0 0 .


3 0 , 0 0 0 .


4 0 , 0 0 0 ,


5 , 0 0 0 .


2 5 , 0 0 0 .


1 5 , 0 0 0 .






X













X


700


PAGE 22



44-6013671


JSA

9E1253 1 000

(a) No.

31

(a) No.

32

(a) No.

33

(a) No.

34

(a) No.

35

(a) No.

36








$ 2 5 , 0 0 0 .


$ 1 0 , 0 0 0 .


$ 2 4 0 , 0 0 0 .


$ 5 , 0 3 0 .


$ 1 0 , 4 5 7 .


$ 1 0 , 0 0 0 .


Person Payroll

X



Person Payroll

X



Person Payroll

X



Person Payroll

X



Person Payroll

X



Person Payroll

X

(Complete Part II if there is d IIUIH_d_ll UUMUI UUII JR. ;

51P1ZD 0000 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM


700 PAGE 23



44-6013671

JSA

9E1253 1.000

\_JiiI (a) No.

37

(a) No.

38

(a) No.

39

(a) No.

40

(a) No.

41

(a) No.

42









S 5 , 0 0 0 .


$ 1 , 2 0 0 , 0 0 0 .


$ 4 5 , 3 5 0 .


$ 1 5 , 0 0 0 .


$ 1 5 , 0 0 0 .


$ 2 0 , 0 5 0 .



X




X




X




X




X




X


51P1ZD 0000 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM 700


PAGE 2 4



Page_ of Part I

(a) No.

43

(a) No.

44

(a) No.

45

(a) No.

46

(a) No.

47

(a) No.

48

JSA

9E1253 1.000








S1P1ZD 0 0 0 0 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM

Employer identification number 4 4 - 6 0 1 3 6 7 1


4 , 4 1 5 ,


5 , 0 0 0 .


4 0 , 0 0 0 .


5 , 4 5 0 .


1 5 , 0 0 0 ,


3 , 5 3 8 , 9 3 4




X
















X

700


PAGE 2 5



(a) No.




44-6013671



49

(a) No.


1 0 , 4 6 3 .





50

(a) No.

5 1

(a) No.

52

(a) No.

53

(a) No.

54

JSA

9E1253 1 000





51P1ZD 0 0 0 0 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM

1 5 , 0 0 0 .





1 0 , 0 0 0 ,


1 5 , 0 0 0 .







9 9 , 4 1 6 .


1 5 , 0 0 0 .







700


PAGE 2 6



44-6013671

JSA

9E1253 1.000

~~n (a) No.

55

(a) No.

56

(a) No.

57

(a) No.

58

(a) No.

59

(a) No.

60









$ 2 4 0 , 0 0 0 .


$ 3 8 , 0 0 0 .


$ 1 0 3 , 2 4 6 .


$ 3 , 0 6 0 .


$ 8 , 0 6 5 .


$ 2 7 0 , 2 6 5 .



X




X




X




X




X




X


51P1ZD 0000 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM 700


PAGE 27



4 4 - 6 0 1 3 6 7 1

JSA

9E1263 1 000

rEffii (a) No.

61

(a) No.

62

(a) No.

63

(a) No.

64

(a) No.

65

(a) No.

66









$ 1 7 , 0 5 5 .


$ 5 , 4 7 0 .


$ 5 , 0 0 0 .


$ 2 , 6 4 7 .


$ 1 , 4 9 7 .


$ 1 0 , 5 5 5 .



X




X




X




X

X




X

X




X

(Complete Part II if there is . . i i . /

51P1ZD 0 0 0 0 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM 700

I (Form 990, 990-EZ, or 990-PF) (2009)

PAGE 2_


Name of organization

of Part I


JSA

9E1253 1.000


4 4 - 6 0 1 3 6 7 1

n~n (a) No.

67

(a) No.

(a) . No.

(a) No.

(a) No.

(a) No.









$ 2 , 5 8 0 .


_>


$


$


$


$



X

X

















51P1ZD 0 0 0 0 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM


7 0 0 PAGE 29

Schedule B (Form 990, 990-EZ, or 990-PF) (2009) Page_ of Part II


|-J!T_IH Noncash Property (see instructions)

(a) No. from Parti

64

(a) No. from Parti

65

(a) No. from Parti

67

(a) No. from Parti

(a) No. from Parti

(a) No. from Parti

JSA

9E1254 1.000

(b) Description of noncash property given

CLOTHING AND HOUSEHOLD, JEWELRY, TOYS


ARTS - WORKS OF ART, TOYS CLOTHING AND HOUSEHOLD


ARTS - WORK OF ART,

CLOTHING & HOUSEHOLD COLLECTIBLES, FOOD




51P1ZD 0 0 0 0 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM


4 4 - 6 0 1 3 6 7 1

(c) FfVIV (or estimate) (see instructions)

2 , 6 4 7 .

(c) FMV (or estimate) (see instructions)

1 , 4 9 7 ,


2 , 5 8 0 .




(d) Date received

(d) Date received

(d) Date received

(d) Date received

(d) Date received

(d) Date received


7 0 0 PAGE 30

SCHEDULE D (Form 990)


Supplemental Financial Statements • Complete if the organization answered "Yes," to Form 990,

Part IV, line 6, 7, 8, 9,10,11, or 12. • Attach to Form 990. • See separate instructions.

OMB No. 1545-0047

09 Open to Public

Inspection Name of the organization



44-6013671

I3ff7n Organizations Maintaining Donor Advised Funds or Other Similar Funds the organization answered "Yes" to Form 990, Part IV, line 6.

2 Aggregate contributions to (during year) . . . .

(a) Donor advised funds

or AccountsComplete if

(b) Funds and other accounts

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization's property, subject to the organization's exclusive legal control?

6 Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit?

I J fH I I I Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7

• vesD

D Yes L l

No

No

Purpose(s) of conservation easements held by the organization (check all that apply). ____ Preservation of land for public use (e.g., recreation or pleasure) — Preservation of an historically important land area

Protection of natural habitat I—I Preservation of a certified historic structure I Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.

2a

2b

2c

2d

Held at the End of the Year

Total number of conservation easements Total acreage restricted by conservation easements Number of conservation easements on a certified historic structure included in (a) . . . . Number of conservation easements included in (c) acquired after 8/17/06 Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the tax year • . Number of states where property subject to conservation easement is located • Does the organization have a written policy regarding the periodic monitoring, inspection, handling of — — violations, and enforcement of the conservation easements it holds? I—I Yes I—I No Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year

• $ 8 Does each conservation easement reported on line 2(d) above satisfy the requirements of section

170(h)(4)(B)(i)and 170(h)(4)(B)(ii)? 9 In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and

balance sheet, and include, if applicable, the text of the footnote to the organization's financial statements that describes the organization's accounting for conservation easements.

l - f f l l l l l Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.

______ Yes [Z] Nc

Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

1a If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of art historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIV, the text of the footnote to its financial statements that describes these items. If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items: (i) Revenues included in Form 990, Part VIII, line 1 (II) Assets included in Form 990, Part X If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the following amounts required to be reported under SFAS 116 relating to these items: Revenues included in Form 990, Part VIII, line 1 • $ Assets included in Form 990, PartX . • • $

•

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

JSA 9E1268 1.000

51P1ZD 0000 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM 700

Schedule D (Form 990) 2009

PAGE 31

Schedule D (Form 990)2009 4 4 - 6 0 1 3 6 7 1

l-Eff 111! Organizat ions Maintain ing Col lect ions of Art , Histor ical Treasures, or Other Simi lar Assels(continued)

3 Using the organization's acquisition, acces sion, and other records, check any of the following that are a significant use of its

collection items (check all that apply): Public exhibition d Q Loan or exchange programs Scholarly research e Preservation for future generations

Page 2

Other

4 Provide a description of the organization's collections and explain how they further the organization's exempt purpose in

Part XIV. 5 During the year, did the organization solid t or receive donations of art, historical treasures, or other similar

assets to be sold to raise funds rather than to be maintained as part of the organization's collection? | | Yes No

1-37171 Escrow and Custodia l Ar rangements . Complete if the organization answered "Yes" to Form 990, Part IV, line 9, or reported an amount on Form 990, Par tX, line 2 1 .

1a

c d e f

2a b

Is the organization an agent, trustee, custo dian or other intermediary for contributions or other assets not

included on Form 990, PartX? • Yes | | No If "Yes," explain the arrangement in Part XI V and complete the following table:

1d

1e

Beginning balance Additions during the year Distributions during the year Ending balance , ^__^__ Did the organization include an amount on Form 990, PartX, line 21? I I Yes I | No If "Yes," explain the arrangement in Part XI V.

1c

1f

Amount

I ~lVi Endowment Funds. Complete if organization answered "Yes" to Form 990, Part IV, line 10.

1a Beginning of year balance . . b Contributions c Net investment earnings, gains,

and losses d Grants or scholarships . . . . e Other expenditures for facilities

and programs f Administrative expenses . . . g End of year balance

2 Provide the estimated percentage of the y ear end balance held as: a Board designated or quasi-endowment • 8 7 . 0 0 0 0 % b Permanent endowment c Term endowment •

(a) Current Year

7 , 0 3 9 , 3 8 3 .

91 ,127 .

1, 449,284 .

40 ,017 .

8 , 5 3 9 , 7 7 7 .

(b) Prior year

9, 468 ,568 .

158,070.

- 2 , 5 1 8 , 3 9 0 .

68 ,865.

7 , 0 3 9 , 3 8 3 .

(c) Two years back (d) Three years back (e) Four years back

1 3 . 0 0 0 0 % %

3a Are there endowment funds not in the pos session of the organization that are held and administered for the

organization by: (i) unrelated organizations (ii) related organizations

b If "Yes" to 3a(ii), are the related organizati ons listed as required on Schedule R? 4 Describe in Part XIV the intended uses of t he organization's endowment funds.

3a(i) 3a(ii)

3b

Yes No X X

l_H7l'_l Investments - Land, Buildings, and EquipmentSee Form 990, Part X, line 10. Description of Investment (a) Cost or other basis

(investment)

0.

(b) Cost or other basis (other)

2 5 9 , 2 1 4 .

(c) Accumulated depreciation

1 9 1 , 9 2 8

(d) Book value

6 7 , 2 8 6 . 6 7 , 2 8 6 .


JSA

9E1289 1.000

51P1ZD 0000 6/25/2010 11:13:34 AM 700 PAGE 32


l i f l l V . l l investments

44-6013671 Page 3

Other Securities. See Form 990, PartX, line 12.

(a) Description of security or category (including name of security)

Financial derivatives . . . .

Closely-held equity interests

Other

Total. (Column (b) must equal Fomt 990, PartX, col. (B) line 12.)

(b) Book value

7 5 3 , 9 1 3 .

1 , 2 3 5 , 0 3 9 .

1 , 9 8 8 , 9 5 2 ,

(c) Method of valuation: Cost or end-of-year market value

ATTACHMENT 2 ATTACHMENT 3

l_n_V_ill Investments - Program Related. See Form 990, PartX, line 13. (a) Description of investment type

Total. (Column (b) must equal Form 990, PartX, col. (B) line 13.) •

(b) Book value (c) Method of valuation: Cost or end-of-year market value

IJ f f f lHI Other Assets. See Form 990, PartX, line 15,

(a) Description (b) Book value

Total. (Column (b) must equal Form 990, PartX, col. (B) line 15.) , .

\~\VM Other Liabilities. See Form 990, Part X, line 25.

1. (a) Description of liability (b) Amount

Federal income taxes

Total. (Column (b) must equal Form 990, PartX, col. (B) line 25.)

2. FIN 48 Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the

organization's liability for uncertain tax positions under FIN 48. JSA

9E1270 1.000 51P1ZD 0000 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM 700


PAGE 33

4 4 - 6 0 1 3 6 7 1 Schedule D (Form 990) 2009

1-ff l lNI Reconciliation of Change in Net Assets from Form 990 to Audited Financial Statements

1

2

3

4

5

6

7

8

9

10

Total revenue (Form 990, Part VIII, column (A), line 12)

Total expenses (Form 990, Part IX, column (A), line 25) Excess or (deficit) for the year. Subtract line 2 from line 1

Net unrealized gains (losses) on investments Donated services and use of facilities

Investment expenses Prior period adjustments Other (Describe in Part XIV.) Total adjustments (net). Add lines 4 through 8 Excess or (deficit) for the year per audited financial statements. Combine lines 3 and 9

1

10

I J f f f l N I I Reconci l iat ion of Revenue per Aud i ted Financial Statements Wi th Revenue per Return

Total revenue, gains, and other support per audited financial statements Amounts included on line 1 but not on Form 990, Part VIII, line 12:

Net unrealized gains on investments Donated services and use of facilities

Recoveries of prior year grants Other (Describe in Part XIV.) Add lines 2a through 2d Subtract line 2e from line 1 Amounts included on Form 990, Part VIII, line 12, but not on line 1: Investment expenses not included on Form 990, Part VIII, line 7b , Other (Describe in Part XIV.) Add lines 4a and 4b Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.)

2a 2b 2c

2d

2 , 1 3 9 , 1 7 0 ,

4a 4b - 7 2 , 2 0 0

2e

4c

I J f f f lN I I I Reconci l iat ion of Expenses per Aud i ted Financial Statements Wi th Expenses per Return

Total expenses and losses per audited financial statements Amounts included on line 1 but not on Form 990, Part IX, line 25: Donated services and use of facilities Prior year adjustments

Other losses Other (Describe in Part XIV.) '_ Add lines 2a through 2d Subtract line 2e from line 1 Amounts included on Form 990, Part IX, line 25, but not on line Investment expenses not included on Form 990, Part VIII, line 7b Other (Describe in Part XIV.) Add lines 4a and 4b Total expenses. Add line's 3 and 4c. (This must equal Form 990, Part I, line 18.)

2a

2b 2c 2d 7 2 , 2 0 0 .

1: 4a 4b

2e

4c

Page 4

1 0 , 2 0 0 , 9 7 0 .

9 , 7 6 6 , 7 9 1

4 3 4 , 1 7 9 .

2 , 1 3 9 , 1 7 0 ,

2 , 1 3 9 , 1 7 0 .

2 , 5 7 3 , 3 4 9 .

1 2 , 4 1 2 , 3 4 0 ,

2 , 1 3 9 , 1 7 0 .

1 0 , 2 7 3 , 1 7 0 ,

- 7 2 , 2 0 0 ,

1 0 , 2 0 0 , 9 7 0 ,

f__fffyHfl_| Supplemental In format ion

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part IV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide j_ny ad^tjonaljnforjT^ation.

SEE PAGE 5

9 , 8 3 8 , 9 9 1 .

7 2 , 2 0 0 ,

9 , 7 6 6 , 7 9 1 ,

9 , 7 6 6 , 7 9 1 ,

JSA

9E1271 1 000

51P1ZD 0 0 0 0 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM 700


PAGE 34


_r_EJITT-TO| Supplemental Information (continued^ 44-6013671 Page 5

RECONCILIATION OF FINANCIAL STATEMENTS TO 990

SCHEDULE D PART Xll LINE 4B AND PART XIII LINE 4B

SPECIAL EVENTS EXPENSES NETTED AGAINST REVENUE FOR 990, INCLUDED IN

EXPENSES FOR FINANCIAL REPORTING PURPOSES - $72,200

INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS

SCHEDULE D PART V LINE 4

MEDICAL RESEARCH BENEFITTING FAMILY PRACTICE THROUGH THE ROBERT GRAHAM

CENTER.

SUPPORT OF FAMILY PRACTICE MEDICAL RESIDENTS THROUGH SCHOLARSHIPS, GRANT

FUNDING AND OTHER.

GRANTS TO SUPPORT RESEARCH THAT IMPACTS FAMILY PHYSICIAN PATIENT CARE.

SUPPORT OF THE CENTER FOR THE HISTORY OF FAMILY MEDICINE. SEE

DESCRIPTION IN PART III OF FORM 990.

SCHEDULE D, PART VII - INVESTMENTS - FINANCIAL DERIVATIVES

DESCRIPTION BOOK VALUE

ATTACHMENT 2

ALTERNATIVE INVESTMENTS

COST OR FMV

753,913. FMV

TOTALS 753,913.

SCHEDULE D, PART VII - INVESTMENTS - CLOSELY HELD EQUITY INTERESTS

DESCRIPTION

INVESTMENT IN AAFP INS SVCS

TOTALS

ATTACHMENT 3 ESTS

BOOK VALUE

1,235,039.

1,235,039.

COST OR FMV

COST


JSA

9E1226Z.000

51P1ZD 0000 6/25/2010 11:13:34 AM 700 PAGE 35

Schedule F (Form 990)


Statement of Activities Outside the United States ^- Complete if the organization answered "Yes" to Form 990,

Part IV, line 14b line 15, or line 16. • Attach to Form 990. • See separate instructions.

OMB No. 1545-0047

09 Open to Public Inspection

Name of the organization AMERICAN ACADEMY OF FAMILY PHYSICIANS FOUNDAT

Employer identification number 44-6013671

General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.

1 For grantmakers. Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used to award

the grants or assistance? L___J Yes

2 For grantmakers. Describe in Part IV the organization's procedures for monitoring the use of grant funds outside the

United States.

• No

3 Activities per Region. (Use Schedule F-1 (Form 990) if additional space is needed.)

(a) Region

EAST ASIA AND THE PACIFIC

EUROPE

3UB-SAHARAN AFRICA

SOUTH AMERICA

Totals •

(b) Number of offices in the

region

(c) Number of employees or

agents in region

(d) Activities conducted in region (by type) (i.e.,

fundraising, program services, grants lo recipients located in

the region)

GRANTMAKING

GRANTMAKING

GRANTMAKING

GRANTMAKING

(e) If activity listed In (d) Is a program service,

describe specific type of service(s) in region

(f) Total expenditures in

region

667,749.

433 ,107 .

180 ,000 .

50 ,000 .

1 ,370,B56.

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule F (Form 990) 2009

JSA 9E1274 1 000

51P1ZD 0000 6/25/2010 11:13:34 AM 700 PAGE 3 6

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Schedule F (Form 990) 2009 4 4 - 6 0 1 3 6 7 1 Page 4

f_3H71 Supplemental Information Complete this part to provide the information required in Part I, line 2, and any additional information.

MONITORING_THE_USE_OF_GRANTS_OUTSIDE_T

__3_?J_?_P_yiJ_?--f----------i!--_:-i_-I-.l._2

SEE ATTACHED STATEMENT.

Schedule F (Form 990) 2009 JSA

9E1277 1 000

51P1ZD 0000 6/25/2010 11:13:34 AM 700 PAGE 3.

American Academy ofFamily Physicians Foundation EIN 44-6013671 2009 Form 990

Monitoring the use of grants outside the US Schedule F, Part 1, Line 2

Peers for Progress - is a program that addresses the global diabetes epidemic. In support of these goals, research grants are awarded. Peers for Progress (PFP) requires each of its grantees to provide progress and financial reports every six months in order to receive the next funding installment.

Reports are reviewed and approved by the Foundation's PFP staff. The progress report summarizes all research activity conducted by the grantee for that time period. The financial report details, by category, financial expenditures incurred by the grantee team during that same period.

Schedule F attachment.doc

SCHEDULEG

(Form 990 or 990-EZ)


Supplemental Information Regarding Fundraising or Gaming Activities

Complete if the organization answered "Yen" to Form 990, Part IV, lines 17,18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a.

• Attach to Form 990 or Form 990-EZ. •See separate instruction!.

OMB No. 1545-0047

09 Open To Public Inspection




44-6013671

Fundraising Activities.Complete if the organization answered "Yes" to Form 990, Part IV, line 17. Form 990-EZ filers are not required to complete this part.

1 a b c d

2a

Indicate whether the organization raised funds through any of the following activities. Check all that apply. Solicitation of non-government grants Solicitation of government grants Special fundraising events

Mail solicitations Internet and email solicitations Phone solicitations

, , In-person solicitations Did the organization have a written or oral agreement with any individual (including officers, directors, trustees or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is to be compensated at least $5,000 by the organization.

• Yes • No

(i)Name of individual or entity (fundraiser)

(ii) Activity (iii) Did fundraiser have custody or control of

contributions?

Yes No

(iv) Gross receipts from activity

(v) Amount paid to (or retained by)

fundraiser listed in col. (i)

(vi) Amount paid to (or retained by)

organization

3 List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.

ALL STATES

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. JSA

9E1281 1 000 51P1ZD 0 0 0 0 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM 700

Schedule G (Form 990 or 990-EZ) 2009

PAGE 4 0

Schedule G (Form 990 or 990-EZ) 2009 44-6013671 •SfflW Fundraising Events.Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported

more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.

Page 2

CO

C 0 > 0 Q_

o. d) CO

0 a. X til

8. b

1 Gross receipts 2 Less: Charitable

contributions 3 Gross income (line 1

4 Cash prizes

5 Noncash prizes

6 Rent/facility costs

7 Food and beverages

8 Entertainment

9 Other direct expenses

10 Direct expense summary. Add lines 4 t 11 Net income summary. Combine line 3,

(a) Event #1

A U C T I O N

(event type)

1 1 1 , 6 3 5 .

3 8 , 0 8 2 .

7 3 , 5 5 3 .

1 1 0 , 2 8 2 .

hrough 9 in column (d) column (d), and line 10

(b) Event #2

(evenl type)

(c) Other Events

0

{tola! number)

•

•

(d) Total events (add col. (a) through

col. (c))

1 1 1 , 6 3 5

3 8 , 0 8 2

7 3 , 5 5 3

1 1 0 , 2 8 2 .

( 1 1 0 , 2 8 2 . )

- 3 6 , 7 2 9 .

r E n m Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

0 --c i 0

in in c 0 Q. X LU

t>

Q

1 Gross revenue

2 Cash prizes

4 Rent/facility costs

5 Other direct expenses

6 Volunteer labor

(a) Bingo

Yes %

No

(b) Pull tabs/Instant bingo/progressive bingo

Yes %

No

7 Direct expense summary. Add lines 2 through 5 in column (d)

8 Net gaming income summary. Combine line 1, column d, and line 7

9 Enter the state(s) in which the organization operates gaming activities: a Is the organization licensed to operate gaming activities in each of thes b

10a b

11 12

If "No,"explain: 3 states?

Were any ofthe organization's gaming licenses revoked, suspended or terminated during t If "Yes," explain:

Does the organization operate gaming activities with nonmembers? Is the organization a grantor, beneficiary o formed to administer charitable gaming?

rtf ust 3e of a trust or a m ember of a partnership

(c) Other gaming

Yes %

No

•

•

(d) Total gaming (add col. (a) through col. (c))

( )

ie tax year?

3r other entity

9a

10a

11

12

Yes No

JSA 9E12B2 1.000

51P1ZD 0000 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM 700 Schedule G (Form 990 or 990-EZ) 2009

PAGE 41

Schedule G (Form 990 or 990-EZ) 2009 44-6013671 Page 3

13a 13b %

13 Indicate the percentage of gaming activity operated in: a The organization's facility b An outside facility

14 Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name •

Address •

15 a Does the organization have a contract with a third party from whom the organization receives gaming

revenue? b If "Yes,"enter the amount of gaming revenue received by the organization W> and the

amount of gaming revenue retained by the third party 1$ . c If "Yes," enter name and address of the third party:

Name •

16

Address •

Gaming manager information:

Name *"

Gaming manager compensation • $

Description of services provided •

I | Director/officer [______} Employee I I Independent contractor

17 Mandatory distributions: a Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? b Enter the amount of distributions required under state law to be distributed to other exempt organizations

or spent in the organization's own exempt activities during the tax year • $

15a

17a

Yes No

Schedule G (Form 990 or 990-EZ) 2009

JSA

9E1283 1.000

51P1ZD 0000 6/25/2010 11:13:34 AM 700 PAGE 42

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Procedures for Monitoring the Use of Grant Funds

The Foundation administers several grant and award programs to achieve its goals. Based on the type of program, the procedures may vary slightly as follows:

Board-Approved and Fiscal Sponsor Grants - primarily provides support for AAFP programs. A Letter of Agreement (LOA) is created between the grantee and the Foundation to set forth the terms and conditions for receipt of grant funds. A fully executed LOA is required before any funds are disbursed and one or more financial and progress reports (depending on length of program) are required for disbursement of funds. The Foundation's Grant Manager reviews the report for compliance with reporting requirements as stated in the LOA, and in accordance with guidelines regulating non-profit agencies.

Student Externship Matching Grants - are available only to AAFP Constituent Chapters and Chapter Foundations. Matching grants are used to stimulate interest among medical students to pursue a career in Family Medicine. Constituent chapters/chapter foundations submit a Letter of Intent including proof of matching funds to support clinical and/or research medical student externships in their state. Matching grants are awarded in February and disbursement ofthe funds to chapters/chapter foundations is contingent upon submission of a Disbursement of Funds request, which verifies the externship activities. The completed Disbursement of Funds request is reviewed and approved by the Program Manager and all funds are distributed prior to December 31 of each year.

AAFP Foundation Wyeth Immunization Awards - is a competitive award program available only to Family Medicine residency programs achieving high or improved immunization rates or implementing a system to improve childhood immunization rates in medically underserved areas. A slate of award recipients is determined by an 8-member Immunization Awards Committee, which reviews and scores all applications. The slate receives final approved by AAFP Foundation Board of Trustees. Disbursement ofthe monetary award is made upon announcement ofthe awards.

Pfizer Teacher Development Awards - is a competitive award program available only to new, community-based family physicians (graduates from an ACGME-approved family medicine residency program within the past six years) that are part-time teachers of family medicine. A slate of award recipients is determined by the 4-member Teacher Development Subcommittee ofthe Board of Trustees and approved by the AAFP Board. Disbursement ofthe monetary award, which is to be used to attend a skill-building workshop of choice and to help host a recognition ceremony, is made as requested by the recipient and the recipient's teaching center.

Family Medicine Philanthropic Consortium (FMPC) Grant Awards - provide for grants to AAFP Constituent Chapters and Chapter Foundations. Applications are received and reviewed by the FMPC Review Committee which is made up ofthe FMPC Steering Committee. Each application is reviewed and scored by four Reviewers, with at least one physician Reviewer. Special care is taken that no conflict of interest exists with any of the reviewers. Once final approval is received from the FMPC, it must be approved by the Foundation's Board of Trustees. A FMPC Grant Award Agreement is created and signed by all parties. An interim report detailing progress toward outcomes and budget is required in August ofthe year funded. A final report summarizing program implementation and final budget is due in March ofthe following year. The Foundation's Program Manager reviews all reports and financial submission. Any extension ofthe grant period requires a written request no later than 30 days prior to the grant period end date. Any amounts unspent must be repaid to the Foundation.

Research Grant Awards - includes Joint Grant Awards Program (JGAP), Resident Research Grant Awards, Research Stimulation, and Practice-Based Research Network (PBRN) Stimulation Grants. These grants are awarded to family practice physicians, Family Medicine organizations or associations, Departments of Family Medicine, or health care institutions in support of research of value to the practicing family physician. Applications with a detailed budget are received and reviewed by the AAFP Foundation Research Committee (RC). Final approval is given by the Foundation's Board of Trustees. Once approved, Foundation's Program Administrator will review submission of written reports received at the midpoint and upon completion ofthe project. Ninety percent ofthe award will be paid periodically if timeline is over six months. The remaining ten percent will be distributed upon review of final financial and progress reports. If funds have not all been used, they must be returned to the Foundation.

Peers for Progress - is a program that addresses the global diabetes epidemic. In support of these goals, research grants are awarded. Peers for Progress (PFP) requires each of its grantees to provide progress and financial reports every six months in order to receive the next funding installment. Reports are reviewed and approved by the Foundation's PFP staff. The progress report summarizes all research activity conducted by the grantee for that time period. The financial report details, by category, financial expenditures incurred by the grantee team during that same period.

SCHEDULE J (Form 990)

Department of the Treasury

Internal Revenue Service

Compensation Information For certain Officers, Directors, Trustees, Key Employees, and Highest

Compensated Employees __* Complete if the organization answered "Yes" to Form 990,

Part IV, line 23. • Attach to Form 990. • See separate instructions.

OMB No. 1545-0047

09

Name ofthe organization AMERICAN ACADEMY OF FAMILY PHYSICIANS FOUNDAT

Questions Regarding Compensation

Open to Public Inspection

Employer identification number 4 4 - 6 0 1 3 6 7 1

1a Check the appropriate box(es) if the organization provided any of the following to or for a person listed in Form 990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Travel for companions Tax indemnification and gross-up payments Discretionary spending account

Housing allowance or residence for personal use Payments for business use of personal residence Health or social club dues or initiation fees Personal services (e.g., maid, chauffeur, chef)

b If any of the boxes on line 1a is checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain

2 Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a?

Indicate which, if any, of the following the organization uses to establish the compensation ofthe organization's CEO/Executive Director. Check all that apply.

Compensation committee Independent compensation consultant Form 990 of other organizations

Written employment contract Compensation survey or study Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization: Receive a severance payment or change-of-control payment? Participate in, or receive payment from, a supplemental nonqualified retirement plan? Participate in, or receive payment from, an equity-based compensation arrangement? If 'Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part

Only section 501(c)(3) and 501(c)(4) organizations must complete lines 5-9. For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any compensation contingent on the revenues of: The organization? Any related organization? If "Yes" to line 5a or 5b, describe in Part III. For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any compensation contingent on the net earnings of: The organization? Any related organization? If "Yes" to line 6a or 6b, describe in Part III. For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed payments not described in lines 5 and 6? If "Yes," describe in Part III Were any amounts reported in Form 990, Part VII, paid or accrued pursuant to a contract that was subject to the initial contract exception described in Regs, section 53.4958-4(a)(3)? If "Yes," describe in Part III If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)?

Yes

1b

4a 4b

4c

5a

5b

6a

6b


No

_._/£ Ih

_X_ X

Schedule J (Form 990) 2009

JSA 9E1290 1.000

51P1ZD 0000 6/25/2010 1:44:36 PM 700 PAGE 5 4

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SCHEDULEM (Form 990)


Noncash Contributions Complete if the organizations answered "Yes" on Form

990, Part IV, lines 29 or 30. • Attach to Form 990.

OMBNo. 1545-0047

09



Open To Public Inspection


44-6013671

I_£T_1I Tvoes of Prooertv

1 ? 3 4 5

6 7 R 9

10 11

1? 13

14

15 16 17 18 19 70 ?1 7? ?3 74 75 76 27 28

29

30 a

b 31

32 a

b 33

Clothing and household

Securities-Publicly traded Securities-Closely held stock . . . Securities-Partnership, LLC,

Securities-Miscellaneous Qualified conservation contribution-Historic

Qualified conservation

Drugs and medical supplies . . . .

Other • ( ATCH 4 ) Other • ( ) Other • ( ) Other • ( )

(a) Check if

applicable

X

X

X

X

(b) Number of contributions

42

9

134 .

Number of Forms 8283 received by the organization during the tax year for cc which the organization completed Form 8283, Part IV, Donee Acknowledgem

During the year, did the organization receive it must hold for at least three years from the used for exempt purposes for the entire holding If "Yes," describe the arrangement in Part II. Does the organization have a gift accept

(c) Revenues reported on

Form 990, Part VIII, line 1g

6 , 4 8 5 .

153 .

2 , 8 9 4 .

1 , 2 9 2 .

2 7 , 2 5 8 .

.ntributions for

(d) Method of determining

revenues

AUCTION VALUE

AUCTION VALUE

AUCTION VALUE

AUCTION VALULE

29

by contribution any property reported in Part 1, line 1-28 that date of the initial contribution, and which is not required to be period?

ance policy that requires the review of any non-standard

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

If "Yes," describe in Part II. If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,

describe in Part II.

30a

31

32a

Yes No

X

X

X


JSA

9E1298 1.000

51P1ZD 0000 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM 700

Schedule M (Form 990) 2009

PAGE 4E

Schedule M (Form 990) 2009 4 4 - 6 0 1 3 6 7 1 page 2

E 3 3 H Supplemental Information. Complete this part to provide the information required by Part I, lines 30b, 32b, and 33. Also complete this part for any additional information.

SCHEDULE M, PART I - OTHER NONCASH CONTRIBUTIONS

ATTACHMENT 4

DESCRIPTION (A) CHECK (B) NUMBER OF CONTRIBUTIONS

(C) REVENUES REPORTED

(D) METHOD OF DETERMINING

BEAUTY SUPPLII

EDUCATION

ELECTRONICS

FOOD

JEWELRY

TOYS

_S & SERVICE

TRAVEL & ENTERTAINMENT

WINE

X

X

X

X

X

X

X

X

12

4

1

4

55

16

33

9

656.

2,195.

330.

350.

5,896.

843.

16,038.

950.

AUCTION

AUCTION

AUCTION

AUCTION

AUCTION

AUCTION

AUCTION

AUCTION

VALUE

VALUE

VALUE

VALUE

VALUE

VALUE

VALUE

VALUE

TOTALS 1 3 4 . 2 7 , 2 5 8 .

9E1299 1.000

51P1ZD 0000 6/25/2010 11:13:34 AM 700

Schedule M (Form 990) 2009

PAGE 4 9

SCHEDULEO (Form 990)

Department of (he Treasury Internal Revenue Service

Supplemental Information to Form 990 Complete to provide information for responses to specific questions on

Form 990 or to provide any additional information. • Attach to Form 990.

OMBNo. 1545-0047

>§09



Open to Public Inspection


4 4 - 6 0 1 3 6 7 1 ATTACHMENT 5

CONFLICT OF INTEREST POLICY MONITORING AND ENFORCEMENT.

PART VI SECTION B LINE 12C.

ON AN ANNUAL BASIS, ALL BOARD MEMBERS ARE REQUIRED TO SIGN A CONFLICT OF

INTEREST STATEMENT WHICH DISCLOSES ANY CONFLICTS OR STATES THAT THERE ARE

NONE.

PROCESS TO REVIEW FORM 9 90

PART VI, SECTION B, LINE 11A

1) AFTER THE 990 TAX RETURN HAS BEEN DRAFTED BY THE EXTERNAL AUDITOR,

THE ASA FINANCIAL MANAGER AND EXTERNAL CPA ON THE AUDIT COMMITTEE WILL

REVIEW.

2) AFTER THE REVIEW, THE 990 TAX RETURN WILL GO BACK TO THE EXTERNAL

AUDITOR TO INCORPORATE SUGGESTED CHANGES.

3) WHEN THE CHANGES ARE MADE (OR IF NO CHANGES ARE REQUIRED), A

CONFERENCE CALL WILL BE SCHEDULED WITH THE AUDIT COMMITTEE AND THE

EXTERNAL CPA WILL FACILITATE A DISCUSSION OF THE 990 TAX RETURN AND

ADDRESS QUESTIONS.

4) WHEN THE DISCUSSION IS OVER, THE AUDIT COMMITTEE MEMBERS WILL VOTE

TO MAKE A RECOMMENDATION TO THE BOARD TO APPROVE THE 990 TAX RETURN.

5) THE 990 TAX RETURN WILL THEN BE SENT TO THE FULL BOARD (OR THE

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. 9E1227 2.000

51P1ZD 0000 6/25/2010 11:13:34 AM 700

Schedule O (Form 990) 2009

PAGE 50




Page 2


4 4 - 6 0 1 3 6 7 1

ATTACHMENT 5 (CONT'D) EXECUTIVE COMMITTEE, WHICH CAN ACT ON BEHALF OF THE FULL BOARD, IF THE

FULL BOARD CANNOT BE CONVENED WITHIN A REASONABLE PERIOD OF TIME) FOR

APPROVAL.

6) AFTER THE 990 TAX RETURN IS APPROVED, IT WILL BE SIGNED BY THE

EXECUTIVE DIRECTOR OF THE FOUNDATION AND SUBMITTED TO THE IRS FOR

PROCESSING.

PUBLIC INSPECTION

PART VI, SECTION C, LINE 19

THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL

STATEMENTS ARE AVAILABLE UPON REQUEST.

FORM 990, PART VI, LINE 17 - STATES___

A L , A K , A Z , A R , C A , C O , CT,

F L , G A , I L , K S , K Y , M E , M D , M A , M I ,

MN,MS,MO,NH,NJ ,NM,NY,NC,ND,OH,OK,OR,PA,

R I , S C , T N , U T , V A , W A , W V , W I ,

ATTACHMENT 6

ATTACHMENT 7 FORM 9 9 0 , PART V I I I - INVESTMENT INCOME

DESCRIPTION

INTEREST AND DIVIDENDS NET OF EXPENSES

CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS

(A)

TOTAL

REVENUE

1 7 3 , 4 3 7 .

2 0 , 0 7 2 .

(B)

RELATED OR

EXEMPT REVENUE UNRELATED

BUSINESS REV. EXCLUDED

REVENUE

20 ,072 .

JSA

9E1228 2.000 51P1ZD 0 0 0 0 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM 700


PAGE 5 1

Schedule O (Form 990) 2009 Page 2


AMERICAN ACADEMY OF FAMILY PHYSICIANS FOUNDAT Employer identification number

4 4 - 6 0 1 3 6 7 1

FORM 990, PART VIII - INVESTMENT INCOME

DESCRIPTION

EARNINGS OF SUBSIDIARY AAFP INSURANCE SERVICES 915,735.

TOTALS i , inQ,._4_

ATTACHMENT 7 (CONT'D)

(A)

TOTAL

REVENUE

(B)

RELATED OR

EXEMPT REVENUE

(C)

UNRELATED

BUSINESS REV.

(D)

EXCLUDED

REVENUE

9 1 5 , 7 3 5 .

1 , i n Q , •>_.__

FORM 990, PART VIII - EXCLUDED CONTRIBUTIONS,

DESCRIPTION

ANNUAL AUCTION

TOTAL

ATTACHMENT 8

AMOUNT

3 8 ,

3 8 ,

0 8 2 .

0 8 2 .

FORM 990, PART VIII - FUNDRAISING EVENTS ATTACHMENT 9

DESCRIPTION

ANNUAL AUCTION

TOTALS

GROSS INCOME

7 3 , 5 5 3 .

7 3 , 5 5 3 .

DIRECT EXPENSES

1 1 0 , 2 8 2 .

1 1 0 , 2 8 2 .

NET INCOME

- 3 6 , 7 2 9 .

- 3 6 , 7 2 9 .

FORM 9 9 0 , PART X - PREPAID EXPENSES AND DEFERRED CHARGES

DESCRIPTION

PREPAID EXPENSES

TOTALS

ATTACHMENT 10

ENDING BOOK VALUE

2 3 , 0 4 7

2 3 , 0 4 7

JSA

9E1226 2.000 51P1ZD 0 0 0 0 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM 700


PAGE 52




FORM 990, PART X - INVESTMENTS - PUBLICLY TRADED SECURITIES.

Page 2


44-6013671

ATTACHMENT 11

DESCRIPTION

EQUITIES

CORPORATE BONDS

FIXED INCOME MUTUAL FUNDS

TREASURY & FEDERAL AGENCY OBL

CASH EQUIVALENTS

TOTALS

ENDING COST

BOOK VALUE OR FMV

5,613,541. FMV

869,465. FMV

1,653,230. FMV

267,319. FMV

193,327. FMV

8,596,882.

JSA

9E122B 2.000

51P1ZD 0000 6 / 2 5 / 2 0 1 0 1 1 : 1 3 : 3 4 AM 700


PAGE 53

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990 Return of Organization Exempt From Income Tax 09...10B956 IB 67 200912 670 201021 116626...

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Transcript of 990 Return of Organization Exempt From Income Tax 09...10B956 IB 67 200912 670 201021 116626...