Thursday, February 13, 2020 at 10:41:28 AM Pacific Standard Time

Subject:
Request for records from Dean Knudson, Wisconsin Elec7ons Commission, Feb 11, 2020
Date:
Thursday, February 13, 2020 at 10:31:41 AM Pacific Standard Time
From:
Knudson, Dean - ELECTIONS
To:
AO Records
ADachments: Records requested from Dean Knudson WEC 13Feb2020.zip

Aus7n R Evers
American Oversight
Mr. Evers- Records responsive to your request have been aSached in pdf format within a zip file. The
records include documents that were aSachments to email correspondence with the individuals
covered by your request.
Not included in this response are mass emails, such as legislator's newsleSers, that were sent to many
others as well as myself. These include mass communica7ons from Speaker Vos, Majority Leader
Steineke and Majority Leader Fitzgerald. These mass emails were sent to my personal email account
as part of the legislators' rou7ne communica7ons with their cons7tuents, and they were not
specifically related to my office as Commissioner. Previous ASorney General guidance has indicated
that such communica7ons are not typically included in requests such as yours. If you would prefer to
receive these documents please let me know and we can discuss the costs involved in producing those
documents.
Thank you,
Dean Knudson

Page 1 of 1

 Legislative Fiscal Bureau
One East Main, Suite 301 • Madison, WI 53703 • (608) 266-3847 • Fax: (608) 267-6873
Email: fiscal.bureau@legis.wisconsin.gov • Website: http://legis.wisconsin.gov/lfb

May, 2019

Joint Committee on Finance

Paper #280

Electronic Registration Information Center (Elections Commission)
[LFB 2019-21 Budget Summary: Page 118, #4]

CURRENT LAW
Under current law, the Elections Commission is required to become a member of the
Electronic Registration Information Center (ERIC), an inter-state consortium formed to improve
the accuracy of voter registration data and to assist voters with the registration process. Further,
the Commission is required to comply with the terms of the ERIC membership agreement, signed
on May 17, 2016. Base funding for the Commission does not include amounts for ERIC
membership or participation.
GOVERNOR
Provide $81,300 GPR and $196,900 FED in 2019-20 and $174,400 FED in 2020-21 for:
(a) ERIC membership dues ($33,100 FED annually); (b) mailings to potential eligible voters and
voters who may no longer reside at their registered address, which is required by ERIC ($81,300
GPR in 2019-20 and $141,300 FED annually); and (c) one-time funding of $22,500 FED in 201920 for WisVote election administration system modifications.
DISCUSSION POINTS
1.
The Electronic Registration Information Center is a consortium of 26 states that uses
data matching to identify electors who may be eligible to vote but are not registered, voters who may
have moved, and voters who may no longer be eligible and should be removed from the registration
list. According to the Commission, the goal of ERIC is to encourage electors to register or update
their information ahead of an election to manage the volume of registration activity near Election
Day. Long-term participation is aimed at reducing costs, increasing accuracy, and improving
efficiency in the registration process.

Elections Commission (Paper #280)

Page 1
WI-20-0154-A-000001

 2.
Under 2015 Act 261, the Elections Commission is required to enter into a membership
agreement with ERIC. The agreement must: (a) safeguard the confidentiality of information or data
in the registration list; (b) prohibit the sale or distribution of the information or data in the registration
list to a third-party vendor and prohibit any other action not associated with administration of or
compliance with the agreement; and (c) allow the state to make contact with electors by electronic
mail, whenever possible. The agreement must not affect the exemption for Wisconsin under the
National Voter Registration Act. Further, the Commission is required to comply with the terms of the
membership agreement, including the transmission of information related to the registration of
electors to ERIC for processing and sharing with other member states. Act 261 did not provide
funding for ERIC membership or participation. The Commission signed a membership agreement
with ERIC on May 17, 2016.
3.
Upon execution of the membership agreement, the Commission was required to pay a
one-time membership fee of $25,000, which the Commission paid by reallocating existing funds.
After joining the consortium, each member state must pay annual dues between $25,000 and $50,000
per year, depending on the state's population. Current annual dues for Wisconsin are $33,100.
4.
Under the membership agreement, Wisconsin is required to provide data every 60 days
for all current driver's license and state identification card holders from the Division of Motor Vehicles
(DMV) and all currently registered voters. The Center compares the data to similar files from
participating states and national sources, such as the U.S. Postal Service’s (USPS) National Change
of Address service and death records from the Social Security Administration. After comparing the
data, ERIC provides the state: (a) a list of electors who may be eligible to register to vote but are not
currently registered; and (b) a list of currently registered electors who may no longer be eligible at
their registered address because they may have moved or become deceased.
5.
The agreement requires that the Commission attempt to contact individuals identified as
eligible but unregistered once every two years. In June, 2018, the Commission mailed 383,703
postcards to these individuals with instructions on how to register to vote. As of November, 2018, a
total of 46,406 individuals from the report had registered to vote (12.1%). The total cost of the 2018
mailing was $102,400 ($21,100 for printing and $81,300 for postage and Department of
Administration distribution service fees). The next mailing to potentially eligible but unregistered
voters is scheduled for 2020. The Commission indicates that the Governor's recommendation is based
on postage and distribution service costs incurred during the 2018 mailing.
6.
The agreement requires that the Commission attempt once per year to contact
individuals identified as having moved. The Commission mails electors a notice asking if they wish
to remain registered at their current address. The notice directs electors to re-register if they have
moved or to return a pre-paid postcard to keep their registration current. The notices are forwardable,
so if the voter had provided a new address to USPS, the card would be forwarded to the new address.
The Commission is only required to attempt to contact each elector once at the same address. In
November, 2017, the Commission mailed postcards to 341,855 registered electors identified as
having moved. By March, 2019, 160,863 electors had updated their registrations to reflect new
addresses, 134,517 registrations were deactivated, and 46,475 registrations remained active at the
original address. The total cost of the 2017 mailing was $141,300 (approximately $0.41 per person).
The Commission plans to mail notices to voters identified as having moved in 2020 and 2021 and

Page 2

Elections Commission (Paper #280)
WI-20-0154-A-000002

 indicates that the Governor's recommendation is based on costs incurred during the 2017 mailing.
7.
The Commission indicates that it needs to modify the WisVote election administration
system in order to receive reports from ERIC and update the records of electors identified through
ERIC reports. For example, modifications would allow clerks to distinguish the records of voters
identified by ERIC as having potentially moved from those identified by clerks as having moved and
remove the records of deceased voters. The cost of one-time system updates is estimated to total
$22,500 in 2019-20.
8.
The administration recommends that ERIC expenses be partially funded by federal Help
America Vote Act (HAVA) election security grant funds. In March, 2018, the Commission was
awarded $6,978,300 FED for elections security. Under the grant agreement, which constitutes the
audit standard for the award, the Commission is required to utilize the federal elections security grant
to address security concerns.
9.
On March 20, 2019, the U.S. Election Assistance Commission (EAC) issued a letter
regarding the potential use of the HAVA security grant for ERIC requirements. The letter indicates
that federal funds must be used in accordance with the 2018 grant agreement, which did not include
an allocation of funds to fulfill ERIC requirements. To utilize the grant for ERIC, the Commission
"would need to submit a new plan and budget for review and an amended grant award would need to
be issued." The Commission would be required to demonstrate what "factors or other resources have
been identified to ameliorate the security challenges" outlined in the original grant agreement. Further,
the letter indicates that HAVA security funds must be utilized to "improve the administration of
federal elections."
10. According to the EAC, the reallocation of funds to support ERIC requirements could be
questioned in the next federal Inspector General audit. If the Commission were unable to demonstrate
that "the switch from state to federal payment for ERIC membership and mailings would materially
improve the administration of federal elections," the funds would have to be repaid to the federal
government or restored to the state election fund.
11. In its 2019-21 agency budget request, the Commission requested $278,200 GPR in
2019-20 and $174,400 GPR in 2020-21 for ERIC-related expenses. Given that current law requires
the Commission to participate in ERIC and that funding for this purpose has not yet been provided,
the Committee could approve the agency's request to utilize GPR funds for ERIC requirements.
[Alternative 1]
12. Alternatively, the Commission indicates that, if statutes regarding the use of revenues
from voter data sales were modified, revenues could be used to cover a portion of ERIC-related
expenses. The Commission currently sells voter registration data to various individuals and
organizations and, under state statute, is required to use fee revenue to "cover both the cost of
reproduction and the cost of maintaining the list." The Commission currently charges a $25 base fee
plus $5 for up to 1,000 records, $5 for each additional 1,000 records, and a maximum of $12,500 for
the sale of voter registration data. The Commission estimates that the sale of voter data will generate
annual revenues of $182,200 during the 2019-21 biennium. Revenues are currently deposited to the
Commission's federal appropriation for election administration and are therefore also subject to
federal restrictions. However, the Commission estimates that its original, non-security federal HAVA

Elections Commission (Paper #280)

Page 3
WI-20-0154-A-000003

 funding under the appropriation will be fully expended during 2018-19, after which federal
restrictions relating to voter data sales will no longer apply.
13. To utilize PR funds for ERIC-related expenses, the Committee could: (a) modify statute
to specify that revenue from voter data sales may be used for ERIC requirements; (b) create a biennial
PR appropriation for voter data sales revenue receipts and authorized expenses of such revenue; (c)
provide expenditure authority of $182,200 PR annually under the created appropriation; and (d)
provide $88,200 GPR in 2019-20 to the Commission's general program operations appropriation (the
difference between available PR funds over the biennium and total ERIC-related expenses). Creating
a biennial PR appropriation, funded at $182,200 annually, would establish base funding in the second
year in an amount equal to estimated annual revenue, and would permit the Commission to manage
expenses between years. [Alternative 2] However, given that voter data sales revenue is currently
used to offset the cost to maintain the voter registration system, the Commission cautions that this
alternative could cause a shortfall in the funds necessary to maintain the voter registration system.
14. In a separate provision, the Governor recommends modifying expenditure authority for
the Commission's materials and services appropriation from $1,700 PR to $1,000 PR annually due to
declining activity under the appropriation. Revenues are from the sale of publications and copies of
records, and are used to recover printing costs. The Commission indicates that requests for printed
materials have decreased as publications have been made available online. Further, as a PR
appropriation that receives deposits of revenue, unused funds remain in the appropriation and can be
utilized in subsequent years, subject to expenditure authority and the available balance. Annual
expenditures are not expected to exceed the proposed expenditure authority.
15. As of April 1, 2019, the balance of the materials and services appropriation is $11,300,
due in part to a one-time transfer of accrued revenue from the Government Accountability Board. The
opening balance for 2019-20 is estimated to be $10,700. It could be argued that the balance of the
appropriation, less the amount budgeted for expenditures, could be transferred to the general fund so
it can be utilized to offset election-related expenses. Therefore, the Committee could transfer the
appropriation's balance, less the recommended expenditure limit of $1,000, to the general fund for the
purpose of offsetting a portion of ERIC expenses. This alternative, to transfer $9,700 PR on a onetime basis, may be selected in addition to any other alternative. [Alternative 3]
16. If no funding is provided, the Commission would be required to reallocate existing
resources to fund participation in ERIC. [Alternative 4] Under this alternative, the Commission
indicates that it would pay for ERIC expenses in part by leaving vacant GPR positions unfilled
(although, as of April 1, 2019, the Commission does not have any vacant GPR positions). Such a
reallocation could have a limiting effect on the Commission's operations.
ALTERNATIVES
1.
Provide $278,200 GPR in 2019-20 and $174,400 GPR in 2020-21 for: (a) ERIC
membership dues ($33,100 GPR annually); (b) mailings to potential eligible voters and voters who
may no longer reside at their registered address, which is required by ERIC ($222,600 GPR in 201920 and $141,300 GPR in 2020-21); and (c) one-time funding of $22,500 GPR in 2019-20 for WisVote
election administration system modifications. This would be identical to the amounts and fund

Page 4

Elections Commission (Paper #280)
WI-20-0154-A-000004

 sources designated in the Commission's 2019-21 budget request.
ALT 1

GPR
FED
Total

Change to
Base
Bill
$452,600
0
$452,600

$371,300
- 371,300
$0

2.
Modify statute to specify that revenue from voter data sales may be utilized for ERIC
requirements. Create a biennial PR appropriation for voter data sales revenue receipts and authorized
expenses and provide expenditure authority of $182,200 PR annually. Further, provide $88,200 GPR
to the Commission's general program operations appropriation in 2019-20 for ERIC expenses. Funds
would be allocated to supplies and services in both appropriations for: (a) ERIC membership dues;
(b) mailings to potential eligible voters and voters who may no longer reside at their registered
address, which is required by ERIC; and (c) WisVote election administration system modifications.
ALT 2

GPR
FED
PR
Total

Change to
Base
Bill
$88,200
0
364,400
$452,600

$6,900
- 371,300
364,400
$0

3.
Transfer $9,700 PR in 2019-20 from the Commission's materials and services
appropriation to the general fund for the purpose of offsetting a portion of ERIC expenses. [This
alternative may be selected in addition to any other alternative.]

4.

ALT 3

Change to
Base
Bill

GPR-REV

$9,700

$9,700

Take no action on funding for ERIC requirements.
ALT 4

GPR
FED
Total

Change to
Base
Bill
$0
0
$0

- $81,300
- 371,300
-$452,600

Prepared by: Angela Miller

Elections Commission (Paper #280)

Page 5
WI-20-0154-A-000005

 efile GRAPHIC

rint - DO NOT PROCESS

Department of the
Treasury
Internal Revenue Service

For the 2015 calendar year, or tax year beginning 07-01-2015
C Name of organization
WHEATONFRANCISCANINC
Address change
% ELIZABETHA RITTER
Name change
Doing business as
In1t1a
I return

!Amended

D Employer identif1cat1on number

I

39-0816857

Tax-exempt status
Website: ►

IV 501(c)(3J i

www wfhealthcare

en

◄

H(a)

H(b)

I

(insert no)

4947(a)( 1) or

1527

Is this a group return for

H(c)

I

1Trust

Assoc1at1on

I

attach

IV

Yes

I

1Yes

No

a 11st (see 1nstruct1ons)
number ►

Group exemption

L Year of formation

Other ►

i

subordinates?
No
Are all subordinates
included?
If"No,"

org

IV Corporation

K Form of organIzatIon

)

501(c) (

447-2000

G Gross receipts$ 407,667,856

F Name and address of principal officer
BERNARD SHERRY SR VP
400 WEST RIVER WOODS PARKWAY
MILWAUKEE,WI
53212

J

(414)

City or town, state or province, country, and ZIP or foreign postal code
MILWAUKEE,WI 53210

Appl1cat1onpending

I

E Telephone number

Number and street (or PO box 1f mall Is not delivered to street address)! Room/suite
5000 WESTCHAMBERSSTREET

return

Open to Public
Inspection

, and ending 06-30-2016

B Check 1fapplicable

Final
return/terminated

No 1545-0047

2015

Under section 501(c), 527, or4947(a)(1)
of the Internal Revenue Code (except private
foundations)
► Do not enter social security
numbers on this form as It may be made public
► Information
about Form 990 and its InstructIons
Is at www IRS qov/fotm990

~

I
I
I
I

0MB

Return of Organization Exempt From Income Tax

Form99O

A

DLN:93493135029077

As Filed Data -

0928

M State of legal dom1c1le WI

1927

Summary
1 Briefly describe the organ1zat1on's mIssIon or most s1gn1f1cant actIvItIes
TO PROVIDE INPATIENT
AND OUTPATIENT
HEALTHCARE
SERVICES
WISCONSIN

TO INDIVIDUALS

LOCATED

IN SOUTHEAST

"'
~

~a;
>

2 Check

0

box ►

this

,,:j

3 Number

v••
(II

1fthe organIzatIon

1

:.,
of voting

members

of the governing

4 Numberof1ndependentvot1ng

~'-'

ct

d1scont1nued

members

5 Total

number of 1nd1v1duals employed

In calendar

number of volunteers

1f necessary)

7a Total

unrelated

b Net unrelated

business

business

revenue

taxable

from Part VIII,

income

or disposed

of more than 25%

of its net assets

body (Part VI, line la)

of the governing

6 Total

(estimate

its operations

body (Part VI, line lb)

year 2015

column

from Form 990-T,

3

13

4

3

(Part V, line 2a)

5

3,250

6

209

(C), line 12

7a

line 34

7b
Prior Year

~
~

Qo

B

Contributions

9

Program

>

,,,

10

Investment

C:

11

Other

12

Total
12)

~

and grants

service

revenue

income

revenue

13

Grants
Benefits

15

Salaries,
5-10)

16a

Professional

line lh)

(Part VIII,

line 2g)

(Part VIII,

(Part VIII,

revenue-add

14

(Part VIII,

column

column

and s1m1lar amounts

1,500,588

other compensation,

11 (must equal Part VIII,

(Part IX, column
employee

1,581,316

benefits

401,778,099
-656,200

147,008

(A), lines 3, 4, and 7d)

paid (Part IX, column

paid to or for members

Current Year

416,855,156

4,853,220

(A), lines 5, 6d, Be, 9c, 10c, and lle)

lines 8 through

0

column

(A), line

4,964,641

423,355,972

4 0 7 ,6 6 7 ,8 5 6

25,436

(A), lines 1-3)

13,850
0

(A), line 4)
(Part IX, column

(A), lines

0

169,294,053

1 73 ,4 0 8 , 7 4 2

V,

~

l

fundra1s1ng fees (Part IX, column

0

(A), line lle)

Total fundra1s1ngexpenses (Part IX, column (D), line 25) ► 484,688

b
17

Other

1B

Total

expenses

19

Revenue

(Part IX, column
Add lines 13-17

expenses

less expenses

Subtract

(A), lines lla-lld,

llf-24e)

(must equal Part IX, column

(A), line 25)

line 18 from line 12

(Part X, line 16)

~cl!

20

Total

assets

-2!
~::,

21

Total

l1ab1l1t1es (Part X, line 26)

22

Net assets

Zu.

•z

;~·-

Siqnature

or fund balances

Subtract

line 21 from line 20

~
~

Paid
Preparer
Use Only

"**

this return,
Declaration

-10,181,653
End of Year

320,107,194

211,552,226

84,075,671

113,948,287

236,031,523

97,603,939

1nclud1ng accompanying
schedules and statements,
and to the best of
of preparer (other than officer) Is based on all 1nformat1on ofwh1ch

2017-05-15
Date

lc>I"

Signature of officer
JONATHANW SOHN CFO
Type or pnnt name and title
Pnnt/Type preparer's name

Firm's name

IPreparer's signature

I Date

I

1f
Check
self-employed

this return with the preparer

I PTIN

Firm's EIN ►

►

Firm's address ►

May the IRS discuss
For Paperwork

9 17

Block

Under penalties of periury, I declare that I have examined
my knowledge and belief, It Is true, correct, and complete
preparer has any knowledge

Sign
Here

244,426,

417,849,509

Beg1nn1ngof Current Year

2!

~ C'C

<C0

243,977,781
413,297,270
10,058,702

~;
tl

0

Phone no

shown above?

Reduction Act Notice, see the separate

WI-20-0154-A-000006

(see 1nstruct1ons)

instructions.

Cat

No 11282Y

Form990(2 O 15)

 Form 990 (2015)

1ffilffi
1

Page

Statement

of Program

Service

2

Accomplishments

Check if Schedule O contains a response
Briefly describe the organ1zat1on's m1ss1on

.p

or note to any line 1n this Part III

AS A MEMBER OF WHEATON FRANCISCAN
HEALTHCARE,
OUR AFFILIATES
STRIVE TO LIVE OUT THE HEALING MINISTRY OF
JESUS WHILE PROVIDING
EXCEPTIONAL
AND COMPASSIONATE
HEALTHCARE
SERVICES THAT PROMOTE THE DIGNITY AND
WELL-BEING
OF THE PATIENTS AND COMMUNITIES
WE SERVE OUR VISION
IS TO BE RECOGNIZED
FOR SUPERIOR HEALTHCARE
SERVICE, CLINICAL
EXCELLENCE, AS THE HEALTHCARE
EMPLOYER OF CHOICE, AND THE PREFERRED PARTNER OF PHYSICIANS

2

Did the organ1zat1on undertake

any s1gn1f1cant program

services

during the year which were not listed

on

the prior Form 990 or 990-EZ?
If "Yes,"
3

describe

these new services

on Schedule

Did the organ1zat1on cease conducting,

O

or make s1gn1f1cant changes

1n how 1t conducts,

any program

services?
If"Yes,"
4

4a

1Yes

describe

these changes

on Schedule

~No

O

Describe the organ1zat1on's program service accomplishments
for each of its three largest program services, as measured by
expenses
Section 501(c)(3)
and 501(c)(4)
organ1zat1ons are required to report the amount of grants and allocations
to others,
the total expenses, and revenue, 1f any, for each program service reported
(Code

) ( Expenses $

356,380,933

1nclud1ng grants of$

13,580 ) ( Revenue $

403,694,069

)

WHEATON FRANCISCAN HEALTHCARE IN SOUTHEAST WISCONSIN Wheaton Franciscan Healthcares service to Southeast W1scons1n dates back to 1879 when the
Franciscan Sisters began operating a health care ministry out of a small house Five years later they opened their first hospital ,n Milwaukee St Joseph Over the
next 100 years, the Sisters known as the Wheaton Franciscans after 1947 expanded their Milwaukee health care mInIstry and, ,n 1993, partnered with the Fel1c1an
Sisters Through the union of numerous separate but common functions 1nclud1ng Boards of Directors, medical groups, and corporate services, Wheaton Franciscan
Healthcare has created a fully integrated region that allows ,t to share best practices and create cost efflc1enc1es WHEATON FRANCISCAN HEALTHCARE IN
SOUTHEAST WISCONSIN LJST OF ENTITIES Hospitals Wheaton Franciscan, Inc (Elmbrook Memorial, Midwest Spine and Orthopedic Hospital and W1scons1n Heart
Hospital, and St Joseph Campuses) Wheaton Franciscan Healthcare - All Saints (Spring Street and W1scons1n Ave Campuses) Wheaton Franciscan Healthcare - St
Francis Wheaton Franciscan Healthcare Franklin Midwest Orthopedic Specialty Hospital (J01nt venture) Wheaton Franciscan Medical Group More than 300 phys1c1ans
,n 50 specialty and primary care locations across SE W1scons1n Trans1t1onal & Extended Care Wheaton Franciscan Healthcare - Franciscan Woods Wheaton
Franciscan Healthcare - Lakeshore Manor Wheaton Franciscan Healthcare - The Terrace at St Francis Outpatient Centers Wheaton Franciscan Brown Deer Campus
Wheaton Franciscan Wauwatosa Campus Wheaton Franciscan Healthcare - St Francis Medical Arts Pav1l1on Wheaton Franciscan Healthcare St Francis Outpatient
Center Service Lines Wheaton Franciscan Cancer Care Wheaton Franciscan Women and Infants Wheaton Franciscan Diabetes Care Wheaton Franciscan Heart Care
Wheaton Franciscan Mental Health and Add1ct1on Care Wheaton Franciscan Orthopedic Care Wheaton Franciscan Rehab1l1tat1on Services Wheaton Franciscan Senior
Care Midwest Orthopedic Specialty Services Restore Integrated Work lnJury Solutions Home Health & Hospice Wheaton Franciscan Home Health Wheaton Franciscan
Hospice Wheaton Franciscan Medical Equipment Team Pharmacy Wheaton Franciscan Pharmacy (multiple locations) Laboratory Wheaton Franciscan Laboratory
Ph1lanthrop1c Foundations Wheaton Franciscan Healthcare - All Saints Foundation Wheaton Franciscan Healthcare - Circle of Life Foundation Wheaton Franciscan
Healthcare - Foundation for St Francis and Franklin Wheaton Franciscan - Elm brook Memorial Foundation Wheaton Franciscan - St Joseph Foundation WHEATON
Charity Care Is defined as free or discounted health
FRANCISCAN HEALTHCARE COMMUNITY IMPACT IN SOUTHEAST WISCONSIN/ 2016 Charity Care $17,397,237
services provided to those who cannot afford to pay and who meet all criteria for f1nanc1al assistance Charity care Is based on actual costs, not charges, and does
not include bad debt Unre,mbursed Cost of Public Programs $46,504,102
Unre,mbursed cost of public programs Is defined as the shortfall experienced when
payments received are below the cost of treating public benef1c1aries through Med1ca1d and other local public programs Community Health Improvement
Services
Community Health Improvement Services are defined as cl1n1caland non-cl1n1cal services designed to improve community health, which are provided to
$1,049,972
$1,467,639
F1nanc1al contributions are defined as contributions, 1nclud1ng cash,
the community for free or for fees that did not cover costs F1nanc1al Contributions
non-cash ,terns such as food, furniture, equipment, supplies, and loaned staff for volunteer and charitable purposes, made to 1nd1v1duals, community groups, or
nonprofit organizations for charitable purposes Health Professions Education $10,392,557
Health professions education Is defined as direct costs incurred for
accredited training and education programs for phys1c1ans, nurses, allied health professionals and techn1c1ans (does not include ongoing education for staff)
Community Bu1ld1ngAct1v1t1es $98,698 Community bu1ld1ng actIvItIes are defined as programs that, while not directly related to health care, provide opportunItIes
to address the root causes of health problems, such as poverty, homelessness, and environmental
issues Costs for these actIvItIes include cash and 1n-k1nd
donations Community Benefit Operations $31,963 Community benefit operations are defined as costs associated with dedicated staff and community health
needs and/or assets assessment, as well as other costs associated with community benefit strategy and operations Research $74,940 Research Is defined as
costs incurred for health-related research, such as medical equipment testing, controlled studies of therapeutic protocols, and studies of health care delivery
methods Subs1d1zed Health Services $2,716,513
Subs1d1zed health services are defined as the negative margin for clinical services that are provided despite a
f1nanc1al loss because of an 1dent1f1ed community need that would need to be met by the government or another not-for-profit
1f ,twas not offered The f1nanc1al
losses are so s1gnif1cant that negative margins remain after removing the effects of charity care, bad debt, and Med1ca1d shortfalls TOTAL BENEFIT TO THE
COMMUNITY IN SOUTHEAST WISCONSIN FOR 2016 $79,733,621

4b

(Code

) ( Expenses $

1nclud1ng grants of$

) (Revenue$

4c

(Code

) ( Expenses $

1nclud1ng grants of$

) (Revenue$

4d

Other

program

(Expenses
4e

services

(Describe

$

Total program service

1n Schedule

O )

1nclud1ng grants
expenses ►

of$

) (Revenue$
WI-20-0154-A-000007

356,380,933
Form99O(2015)

 Form 990 (2015)

•~ ,..~- -

Page

Checklist

of Required

Schedules
Yes

1

Is the organIzatIon described
complete Schedule A

In section

501(c)(3)

or4947(a)(l)

(other than a private

If "Yes,"

foundation)?

'!i.l.

2

I s<he o,ga rn,a<m rnq md

3

Did the organIzatIon engage In direct or 1nd1rect pol1t1cal campaign
candidates for public office? If "Yes," complete Schedule C, Part I

actIvItIes

I

l' '!J ·

<o comp Ieee Schedo/e B, Schedo/e of U>fllnbo,C;, {see ms Imc<mos

on behalf of or In opposItIon

5

6

No

Section 501(c)(3)
organizations.
Did the organIzatIon engage In lobbying actIvItIes, or have a section 501(h)
If "Yes," complete Schedule C, Part II ~ .
.
.
.
.
.
.
.
.
.

election
.
.

Is the organIzatIon a section 501(c)(4),
501(c)(5),
or 501(c)(6)
organIzatIon
assessments,
or s1m1lar amounts as defined In Revenue Procedure 98-197
If "Yes," complete Schedule C, Part II I

In effect during the tax year?
.
.

that receives

membership

I I
4

6

Did the organIzatIon receive or hold a conservation
easement, 1nclud1ng easements to preserve open space,
the environment,
historic land areas, or historic structures?
If "Yes,"completeScheduleD,
Part II

7

of works of art, historical

treasures,

Yes

5

Did the organIzatIon maIntaIn any donor advised funds or any s1m1lar funds or accounts for which donors have the
right to provide advice on the d1stribut1on or investment
of amounts In such funds or accounts?
If "Yes," complete Schedule D, Part I

Did the organIzatIon maIntaIn collections
If "Yes," complete Schedule D, Part II I

I

dues,

'!i.l.

8

I yes I

3

'!i.l.

7

2

to

'!i.l.

4

No
No

or other s1m1lar assets?

No

'!i.l.

9

Did the organIzatIon report an amount In Part X, line 21 for escrow or custodial account l1ab1l1ty, serve as a
custodian for amounts not listed In Part X, or provide credit counseling, debt management, credit repair, or debt
negotIatIon services 7 If "Yes," complete Schedule D, Part IV ~ .
Did the organIzatIon, directly or through a related organIzatIon, hold assets In temporarily
permanent endowments, or quas 1-endowments 7 If "Yes," complete Schedule D, Part V

10

restricted

endowments,

No

10

No

'!i.l.

If the organ1zat1on's answer to any of the following
VIII, IX, or X as applicable

11

a

questions

Is "Yes,"

then complete

Did the organIzatIon report an amount for land, bu1ld1ngs, and equipment
If "Yes," complete Schedule D, Part VI

Schedule

D, Parts VI, VII,

In Part X, line 107

'!i.l.

11a

Yes

b Did the organIzatIon
its total assets
c

d
e

report an amount for investments-other
securities
In Part X, line 12 that Is 5% or more of
reported In Part X, line 16 7 If "Yes," complete Schedule D, Part VII ~ .

Did the organIzatIon report an amount for investments-program
related
its total assets reported In Part X, line 167 If "Yes,"completeScheduleD,
Did the organIzatIon report an amount for other assets
reported In Part X, line 167 If "Yes,"completeScheduleD,
Did the organIzatIon

In Part X, line 13 that Is 5% or more of
Part VIII

'!i.l.

In Part X, line 15 that Is 5% or more of its total assets
Part IX~
.

report an amount for other l1ab1l1t1es In Part X, line 257 If "Yes,"completeSchedule

D, Part X

'!i,J
f

No

Yes

Did the organ1zat1on's separate or consolidated
f1nanc1al statements
for the tax year include
addresses the organ1zat1on's l1ab1l1ty for uncertain tax posItIons under FIN 48 (ASC 740)7
If "Yes," complete Schedule D, Part X

a footnote

that

11b

No

Uc

No

11d

No

lle

Yes

llf

No

12a

No

'!i.l

12a

Did the organIzatIon obtain separate, independent audited
If "Yes," complete Schedule D, Parts XI and XII ~ .

f1nanc1al statements

for the tax year?

b Was the organIzatIon

included In consolidated,
independent audited f1nanc1al statements
for the tax year?
If "Yes," and rf the organrzat,on answered "No" to lrne 12a, then completrng Schedule D, Parts XI and XI I Is optronal

13

Is the organIzatIon

14a

Did the organIzatIon

a school
maIntaIn

described

In section

170(b)(l)(A)(11)7

an office, employees,

or agents

'!i.l 12b

Jf"Yes,"completeScheduleE

outside

of the United

Yes

13

No

14a

No

14b

No

'!i.l

15

No

grants or other
. ~

16

States?

b Did the organIzatIon

have aggregate revenues or expenses of more than $10,000
from grantmak1ng,fundra1s1ng,
business, investment,
and program service actIvItIes outside the U n1ted States, or aggregate foreign investments
va I ued at $ 1 O O ,0 O O or more 7 If "Yes," complete Schedule F, Parts I and IV .
.

'!i.l

Did the organIzatIon report on Part IX, column (A), line 3, more than $5,000
F, Parts II and IV .
for any foreign organIzatIon7 If "Yes,"completeSchedule

15

of grants

or other assistance
.

Did the organIzatIon report on Part IX, column (A), line 3, more than $5,000 of aggregate
ass Is ta nc e to or for foreign I nd1v1dua Is 7 If "Yes," complete Schedule F, Parts I II and IV .

16
17

Did the organIzatIon report a total of more than $15,000
of expenses for professional fundra1s1ng services
Part I (see 1nstruct1ons)
IX, column (A), lines 6 and lle7 If "Yes,"completeScheduleG,

18

Did the organIzatIon report more than $15,000
total offundra1s1ng
VI II, lines 1 c and 8 a7 If "Yes," complete Schedule G, Part II

19

Did the organIzatIon report more than $15,000
"Yes," complete Schedule G, Part I I I

20a

D 1d the organIzatIon

b If"Yes"

operate

event gross income and contributions

of gross income from gaming actIvItIes

on Part VIII,

one or more hos p1tal fac 1l1t1es7 If "Yes," complete Schedule H

to line 20a, did the organIzatIon

attach

a copy of1ts audited

f1nanc1al statements

to or

on Part

17

No

18

No

19

No

on Part

line 9a7 If

-~

20a

WI-20-0154-A-000008

to this return?

Yes

'!i,J

20b

Yes
Yes
Form99O(2015)

3

 Page 4

Form 990 (2015)

1:1.t.llM Checklist

of Required

Schedules

(continued)

21

Did the organ1zat1on report more than $5,000 of grants or other assistance
to any domestic organ1zat1on or
domestic government on Part IX, column (A), line 1? If "Yes,"complete Schedule!, Parts I and II

21

No

22

Did the organ1zat1on report more than $5,000 of grants or other assistance
IX, column (A), line 2? If "Yes," complete Schedule I, Parts I and I II

1nd1v1duals on Part

22

No

23

Did the organ1zat1on answer "Yes" to Part VII,
current and former officers, directors, trustees,
complete Schedule J .

Section A, line 3, 4, or 5 about compensation
of the organ1zat1on's
key employees, and highest compensated
employees? If "Yes,"

23

24a

to or for domestic

Did the organ1zat1on 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 1ss ued after December 31, 2 0 0 2? If "Yes," answer lrnes 24b through 24d
and complete Schedule K If "No," go to lrne 25a

b Did the organ1zat1on invest any proceeds

Yes

~

of tax-exempt

bonds beyond a temporary

No

24a

period exception?

24b
C

Did the organ1zat1on ma1nta1n an escrow account
to defease any tax-exempt
bonds?

d

Did the organ1zat1on act as an "on behalf of" issuer for bonds outstanding

25a

Section 501(c)(3),

501(c)(4),

and 501(c)(29)

Did the organ1zat1on engage 1n an excess
complete Schedule L, Part I

other than a refunding

24c

28

25a

No

25b

No

Did the organ1zat1on report any amount on Part X, line 5, 6, or 22 for receivables
from or payables to any current
or former officers, directors, trustees, key employees, highest compensated
employees, or d1squal1f1ed persons?
If "Yes," complete Schedule L, Part II

26

No

Did the organ1zat1on provide a grant or other assistance
to an officer, director, trustee, key employee, substantial
contributor
or employee thereof, a grant selection committee
member, or to a 35% controlled entity or family
member of any of these persons? If "Yes,"completeScheduleL,
Part III

27

No

28a

No

28b

No

28c

No

29

No

30

No

31

No

32

No

33

No

Was the organ1zat1on a party to a business
1nstruct1ons for applicable f1l1ng thresholds,

a

24d

with a d1squal1f1ed person during the year? If "Yes,"

benefit transaction

year, and that the transaction
has not been reported
If "Yes," complete Schedule L, Part I

27

at any time during the year?

organizations.

b Is the organ1zat1on aware that 1t engaged 1n an excess

26

escrow at any time during the year

A current
Part IV

or former officer, director,

b A family member of a current

benefit transaction
with a d1squal1f1ed person 1n a prior
on any of the organ1zat1on's prior Forms 990 or 990-EZ?

transaction
with one of the following
cond1t1ons, and exceptions)

trustee,

director,

(see Schedule

L, Part IV

If "Yes," complete Schedule L,

or key employee?

or former officer,

parties

trustee,

or key employee?

If "Yes," complete Schedule L,

Part IV
C

An entity ofwh1ch a current
an officer, director, trustee,

or former officer, director, trustee, or key employee (or a family member thereof)
or direct or 1nd1rect owner? If "Yes," complete Schedule L, Part IV

29

D 1d the organ1zat1on receive

more than $ 2 5 ,0 0 0 1n non-cash

30

Did the organ1zat1on receive contributions
of art, historical
cons e rvat1on c ontri but1ons? If "Yes," complete Schedule M

31

Did the organ1zat1on l1qu1date, terminate,

32

Did the organ1zat1on sell, exchange,
If "Yes," complete Schedule N, Part II

33

or dissolve

dispose

contributions?

treasures,

of, or transfer

more than 25%

Did the organ1zat1on own 100% of an entity disregarded as separate
sections 301 7701-2
and 301 7701-37
If "Yes,"completeScheduleR,

34

Was the organ1zat1on related
and Part V, lrne 1 .

35a

to any tax-exempt

Did the organ1zat1on have a controlled

entity

or taxable

entity?

w1th1n the meaning

If "Yes," complete Schedule M

or other s1m1lar assets,

and cease operations?

If "Yes,"complete

36
37
38

or qual1f1ed
ScheduleN,

Part I

of its net assets?

from the organ1zat1on under Regulations
Part I
.~

If "Yes," complete ScheduleR,

of section

line 35a, did the organ1zat1on receive any payment from or engage 1n any transaction
w1th1n the meaning of section 512 (b)(l 3 )? If "Yes," complete Schedule R, Part V, lrne 2

Section 501(c)(3)
organizations.
Did the organ1zat1on make any transfers
organ1zat1on? If "Yes," complete Schedule R, Part V, lrne 2

Part II, III, or IV,
-~

512(b)(13)7

b If'Yes'to
entity

was

to an exempt

with a controlled
.~

non-charitable

I I
34

Yes

35a

Yes

35b

Yes

related

I

36

No

Did the organ1zat1on conduct more than 5% of its act1v1t1es through an entity that 1s not a related organ1zat1on
and that 1s treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI ~

37

No

Did the organ1zat1on complete Schedule O and provide explanations
Note. A II Form 990 filers are required to complete Schedule O

38

1n Schedule

~

O for Part

WI-20-0154-A-000009
VI, lines llb and 197

Yes
Form99O(2015)

 Page 5

Form 990 (2015)

■ @fj Statements

Regarding Other IRS Filings and Tax Compliance
Check 1f Schedule O contains a response or note to any line 1n this Part V

la

Enter the number reported

1n Box 3 of Form 1096

b Enter the number of Forms W-2G included
c

2a

Enter -0- 1f not applicable

1n line la

payments

O

'---'------------;
to vendors and reportable

le

Enter the number of employees reported on Form W-3, Transmittal
of Wage and
filed for the calendar year ending with or w1th1n the year covered
Tax Statements,
by this return

3,250

2a

3a

on line 2a, did the organ1zat1on file all required federal employment tax returnsi
the sum of lines la and 2a 1s greater than 250, you may be required to e-f1le (see 1nstruct1ons)

Did the organ1zat1on have unrelated

b If"Yes,"

has 1t filed a Form 990-T

business

gross income of$1,000

for this year7Jf

Yes

2b

b If at least one 1s reported
Note.If

No

0

lb

Enter -0- 1f not applicable

Did the organ1zat1on comply with backup w1thhold1ng rules for reportable
gaming (gambling) w1nn1ngs to prize w1nnersi

Yes

It---+-----------;
la I

.

or more during the yeari

No

3a

"No" to l,ne Jb, provide an explanat,on 1n Schedule O

3b

4a At any time during the calendar year, did the organ1zat1on have an interest 1n, or a signature or other authority
over, a f1nanc1al account 1n a foreign country (such as a bank account, securities
account, or other f1nanc1al
account)}

4a

No

Sa

No

Sb

No

enter the name of the foreign country
►------------------------­
See 1nstruct1ons forf1l1ng requirements
for F1nCEN Form 114, Report of Foreign Bank and F1nanc1al Accounts
(FBAR)

b If"Yes,"

Sa Was the organ1zat1on a party to a proh1b1ted tax shelter

b Did any taxable
c

If"Yes,"

transaction

at any time during the tax yeari

party notify the organ1zat1on that 1t was or 1s a party to a proh1b1ted tax shelter

transact1oni

to line Sa or Sb, did the organ1zat1on file Form 8886-T7
Sc

6a

Does the organ1zat1on have annual gross receipts that are normally greater than $100,000,
and did the
organ1zat1on sol1c1t any contributions
that were not tax deductible as charitable contribut1onsi

b If "Yes," did the organ1zat1on include with every sol1c1tat1on an express

statement

that such contributions

or gifts

were not tax deduct1ble7
7

a

Organizations

6b

that may receive deductible

Did the organ1zat1on receive a payment
services provided to the payori

b If"Yes,"
c

contributions

1n excess

under section 170(c).

of$75

made partly as a contribution

did the organ1zat1on notify the donor of the value of the goods or services

Did the organ1zat1on sell, exchange,
file Form 82827

d If"Yes,"

or otherwise

1nd1cate the number of Forms 8282

dispose

of tangible

personal

Did the organ1zat1on receive

any funds, directly

f

Did the organ1zat1on, during the year, pay premiums,

g

If the organ1zat1on received
req u I red 7

a contribution

ofqual1f1ed

prov1ded7

h If the organ1zat1on received

a contribution

of cars, boats, airplanes,

7b

for which 1t was required

on a personal

or 1nd1rectly, on a personal

intellectual

to

property,

benefit contracP

did the organ1zat1on file Form 8899

No

7f

No

as
7g

did the organ1zat1on file a
7h

Did the sponsoring

organ1zat1on make any taxable

d1stribut1ons

under section

organ1zat1on make a d1stribut1on to a donor, donor advisor,

business

holdings

at any time
8

49667

9a

or related

personi

9b

organizations.Enter

In1t1at1on fees and capital

b Gross receipts,

7e

t---+-------if----

Section 501(c)(7)

a

No

t----+-------<t----

or other vehicles,

Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund ma1nta1ned by the sponsoring organ1zat1on have excess
during the yeari

b Did the sponsoring
10

7c

benefit contracP

Form 1098-Cl

9a

No

7a

I 7d I

or 1nd1rectly, to pay premiums
directly

and partly for goods and

property

filed during the year

e

8

No

6a

included

contributions

included

on Form 990,

Part VIII,

on Part VIII,

i

line 12

line 12, for public use of club

I

1oa
10b

fac1l1t1es

11

Section 501( c)( 12) organizations.

Enter

a

Gross income from members

b

Gross income from other sources (Do not net amounts
against amounts due or received from them )

12a
b
13

Section 4947(a)(1)

If "Yes,"
year

non-exempt

enter the amount

Section 501(c)(29)

or shareholders

charitable

of tax-exempt

qualified

nonprofit

11a

trusts.Is

interest

due or paid to other sources
11b

the organ1zat1on f1l1ng Form 990 1n lieu of Form 1041 7

received

or accrued

during the

I 12b I

health insurance issuers.

a

Is the organ1zat1on licensed to issue qual1f1ed health plans 1n more than one state7Note.
add1t1onal 1nformat1on the organ1zat1on must report on Schedule O

b

Enter the amount of reserves the organ1zat1on 1s required to ma1nta1n by the states
1n which the organ1zat1on 1s licensed to issue qual1f1ed health plans

13b

Enter the amount

13c

C

14a
b

of reserves

Did the organ1zat1on receive
If "Yes,"

12a

on hand
any payments

for indoor tanning

services

See the 1nstruct1ons

during the tax yeari

for
13a

WI-20-0154-A-000010
14a

has 1t f1led a Form 7 2 0 to report these payments 7 If "No," provide an explanat,on 1n Schedule O

I

I

No

14b

Form99O(2015)

 Form 990 (2015)

Page

6

■ @I?• Governance,

Management,
and Disclosure
For each "Yes" response to Imes 2 through 7b below, and for a "No" response to Imes Ba, Sb, or 10b below,
descnbe the Circumstances, processes, or changes m Schedule 0. See mstructIons.
Check if Schedule

Section A. Governinq

O contains

a response

or note to any line 1n this Part VI

.
Yes

la

(1

Body and Manaqement

Enter the number of voting
year

members

of the governing

body at the end of the tax

la

No

13

If there are material differences 1n voting rights among members of the governing
body, or 1fthe governing body delegated broad authority to an executive committee
or s1m1lar committee,
explain 1n Schedule O

b Enter the number of voting members

included

1n line la, above, who are

lb

independent
2

Did any officer, director, trustee, or key employee
other officer, director, trustee, or key employeei

have a family

3

Did the organ1zat1on delegate control over management duties
superv1s1on of officers, directors or trustees, or key employees

4

Did the organ1zat1on make any s1gn1f1cant changes
f11ed7

3

relat1onsh1p or a business

relat1onsh1p with any

customarily
performed by or under the direct
to a management company or other personi

to its governing

documents

Did the organ1zat1on become aware during the year of a s1gn1f1cant d1vers1on of the organ1zat1on's
Did the organ1zat1on have members

8

b Each committee
9

stockholders,
body7

Did the organ1zat1on contemporaneously
year by the following

or other persons

who had the power to elect or appoint

No
Yes

one or

..._7_a_+-_Y_e_s---<>----

document

to (or subject

the meetings

to approval

held or written

by) members,

actions

undertaken

to act on behalf of the governing

stockholders,

7b

Yes

Sa

Yes

Sb

Yes

during the

body7

Is there any officer, director, trustee, or key employee listed 1n Part VII, Section A, who cannot
organ1zat1on's ma1l1ng addressi
If "Yes," provide the names and addresses in Schedule O

Section

Yes

5

body7
with authority

No

6

Are any governance dec1s1ons of the organ1zat1on reserved
or persons other than the governing body7

a The governing

assetsi

or stockholdersi

7a Did the organ1zat1on have members,
b

3

4

6

of the governing

No

since the prior Form 990 was

5

more members

2

be reached

at the
No

9

B. Policies (This Section B requests mformat1on about policies not required bv the Internal

Revenue Code.)
Yes

10a

Did the organ1zat1on have local chapters,

branches,

10a

or aff1l1atesi

No

No

b If "Yes," did the organ1zat1on have written

pol1c1es and procedures governing the act1v1t1es of such chapters,
with the organ1zat1on's exempt purposesi
to ensure their operations are consistent

aff1l1ates, and branches

11a

Has the organ1zat1on provided
the formi

b Describe

12a

1n Schedule

O the process,

Did the organ1zat1on have a written

b Were officers,

directors,
rise to confl1ctsi

c

a complete

or trustees,

copy ofth1s

Form 990 to all members

of1ts governing

1fany, used by the organ1zat1on to rev1ewth1s
conflict

of interest

pol1cyi

and key employees

Did the organ1zat1on regularly and consistently
in Schedule O how this was done

monitor

10b

body before f1l1ng

If "No," go to line 13

required

to disclose

and enforce

annually

compliance

interests

with the pol1cyi

wh1stleblower

14

Did the organ1zat1on have a written

document

15

Did the process for determ1n1ng compensation
of the following persons include a review and approval by
independent persons, comparab1l1ty data, and contemporaneous
substant1at1on of the del1berat1on and dec1s1oni

a The organ1zat1on's CEO, Executive
b Other officers
If"Yes"

16a

or key employees

Director,

pol1cyi

or top management

pol1cyi

the process

Did the organ1zat1on invest 1n, contribute
taxable entity during the yeari

assets

1n Schedule

Yes

12b

Yes

12c

Yes

13

Yes

14

Yes

15a

off1c1al

15b

of the organ1zat1on

to line 15a or 15b, describe

12a

If "Yes," descnbe

Did the organ1zat1on have a written

and destruction

Yes

that could give

13

retention

11a
Form 990

No
Yes

O (see 1nstruct1ons)

to, or part1c1pate 1n a Joint venture

or s1m1lar arrangement

with a

16a

No

b If "Yes," did the organ1zat1on follow a written
part1c1pat1on 1n Joint venture arrangements
organ1zat1on's exempt status with respect

policy or procedure requiring the organ1zat1on to evaluate its
under applicable federal tax law, and take steps to safeguard the
to such arrangementsi

16b

Section C. Disclosure
with which a copy ofth1s Form 990 1s required

to be

filed ►

17

List the States

18

Section 6104 requires an organ1zat1on to make its Form 1023 (or 1024 1fappl1cable), 990, and 990-T
(3)s only) available for public 1nspect1on Indicate how you made these available
Check all that apply

WI

1

19

20

I

I

Own website
Another's website
~ Upon request
Other (explain 1n Schedule O)
Describe 1n Schedule O whether (and 1f so, how) the organ1zat1on made its governing documents,
interest policy, and f1nanc1al statements
available to the public during the tax year
State the name, address,
► ELIZABETH A RITTER

(501(c)

conflict

of

WI-20-0154-A-000011

and telephone number of the person who possesses the organ1zat1on's books and records
400 WEST RIVER WOODS PARKWAY
MILWAUKEE,
WI 53212 (414) 465-3542

Form99O(2015)

 Page 7

Form 990 (2015)

j@ijfj

Compensation
of Officers, Directors,Trustees,
Employees, and Independent
Contractors
Check if Schedule

Section A. Officers,
la Complete

O contains

Directors,

this table for all persons

a response

Highest Compensated

or note to any line In this Part VII

Trustees,

required

Key Employees,

Key Employees,

to be listed

and Highest Compensated

Report compensation

for the calendar

tax year
• List all of the organ1zat1on's current officers, directors, trustees (whether 1nd1v1duals or organ1zat1ons),
of compensation
Enter -0- In columns (D), (E), and (F) 1f no compensation
was paid
• List all of the organ1zat1on's current key employees,

1f any See InstructIons

• List all of the organ1zat1on's former officers, key employees, or highest compensated
of reportable compensation
from the organIzatIon and any related organIzatIons

List persons
compensated

1

In the following order 1nd1v1dual trustees
employees, and former such persons

Check this box 1f neither

the organIzatIon

of amount

director, trustee or key employee)
of more than $100,000
from the

employees

who received

more than $100,000

received, In the capacity as a former director or trustee
from the organIzatIon and any related organIzatIons

or directors,

nor any related

regardless

for def1n1t1on of "key employee"

• List the organ1zat1on's five current highest compensated
employees (other than an officer,
who received reportable compensation
(Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC)
organIzatIon and any related organIzatIons

• List all of the organ1zat1on's formerdirectorsortrusteesthat
organIzatIon, more than $10,000
of reportable compensation

Employees

year ending with or w1th1n the organ1zat1on's

1nst1tut1onal trustees,

organIzatIon

compensated

officers,
any current

(A)

(B)

(C)

Name and Title

Average
hours per
week (11st
any hours
for related
organIzatIons
below
dotted line)

PosItIon (do not check
more than one box,
unless person Is both an
officer and a
d I rec tor/trustee)

key employees,
officer,

highest

director,

(D)
Reportable
compensation
from the
organIzatIon
(W- 2/1099MISC)

of the

or trustee
(F)
E st1mated
amount of
other
compensation
from the
organIzatIon
and related
organIzatIons

(E)
Reportable
compensation
from related
organIzatIons
(W- 2/1099-

MISC)

•t•

IL• CJ

§

-,:,

•I•

.,
:::;

'.::

a
,t,

•I

•T

w.
10

( 1) Saleem Aman MD
Secretary / Treasurer - Direct

X

X

0

525,252

47,536

X

X

0

655,311

78,551

X

0

624,969

47,304

X

0

421,979

42,172

X

0

0

0

X

0

0

0

X

0

0

0

X

0

412,845

59,985

0

405,744

52,973

X

0

37,316

4,454

X

0

0

0

X

0

0

0

40 0
10

(2) Susan Boland
President Des1gnee - Director
(3) Manfred Chiang MD
Director

40 0
10

(4) Kuman Ch1ntamanen1 MD

40 0
10

Director

40 0

(5) Patrick Diem

10

Director

10

(6) Sr M Ramona Dombrowski

10

Director

10

(7) Beth Griffin MD

10

Director

10
10

(8) Jerry Hardacre MD
Director
(9) Thomas Mahn MD

40 0
10

Secretary / Treasurer - Direct

40 0

X

10

( 10) James Mazzulla MD
Director

40 0

( 11) Kevin Roche

10

Director

10

( 12) Brian Sm1gelsk1

10

Director

10
10

( 13) Debra Standridge

X
Vice Chairperson/President

( 14) Sharon Baughman

X

- D

0

X

40 0
40 0
X

CNO Sr VP Patient Services

729,651

WI-20-0154-A-000012
334,375
0

92,815

67,947

10

Form99O(2015)

 Form 990

Page

(2015)

jifl@O

Section

A. Officers,

Directors,

Trustees,

(A)

Key Employees,

(B)

Name and Title

(D)

Pos1t1on (do not check
more than one box,
unless person 1s both an
officer and a
d I rec tor/trustee)

(F)
Estimated
amount of
other
compensation
from the
organ1zat1on
and related
organ1zat1ons

(E)
Reportable
compensation
from related
organ1zat1ons
(W- 2/1099MISC)

Reportable
compensation
from the
organ1zat1on
(W- 2/1099MISC)

X

403,974

0

51,066

X

294,298

0

33,652

X

183,783

0

42,958

X

184,435

0

63,114

X

223,309

0

49,824

X

436,301

0

45,543

X

206,976

0

36,864

40 0

10

Sr VP Operations North Market

40 0

(17) L1J1anca,
Pharmacy Director

10

( 18) Susan Jassak

40 0

Adm,n Director - Card10 Srvcs

10
40 0

( 19) Mary Jo Kohout

10

VP Patient Ca re Services

40 0

(20) Robert Stern MD

10

VP Medical Affairs
(21) Bryan Tollenaar

40 0

10
10

Medical Phys1c1st
(22) Rita Hanson-Melzer MD
Svp/Ch1ef Medical Officer

X

0

679,313

89,637

X

0

175,143

30,151

X

0

208,439

40,960

40 0

10

(23) Tod Poremski

40 0

Phys1c1anEmployee

10

(24) Donald Roach MD
Secretary /Treasuer - Director

40 0

►
►
►

Sub-Total

c

Total from continuation sheets to Part VII, Section A

d

Total (add lines lb and le)
Total number of 1nd1v1duals (1nclud1ng but not l1m1ted to those listed
$100,000
of reportable compensation
from the organ1zat1on ► 110

4,875,962

2,267,451

above) who received

977,506

more than

Yes
3

Did the organ1zat1on 11st any former officer, director or trustee,
on line 1 a? If "Yes," complete Schedule J for such 1nd1v1dual

4

For any 1nd1v1dual listed on line la, 1s the sum of reportable compensation
and other compensation
If "Yes,"completeScheduleJforsuch
organ1zat1on and related organ1zat1ons greater than $150,0007
md1v1dual

5

Did any person listed on line la receive or accrue compensation
from any unrelated
services rendered to the organ1zat1on? If "Yes," complete Schedule J for such person

Section
1

B. Independent

key employee,

or highest

compensated

No

employee

3

Yes

4

Yes

from the

organ1zat1on or 1nd1v1dual for
No

5

Contractors

Complete this table for your five highest compensated
independent contractors
that received more than $100,000
of
compensation
from the organ1zat1on Report compensation
for the calendar year ending with or w1th1n the organ1zat1on's tax year
(A)

(B)

(C)

Name and business address

Description of services

Compensation

MEDICAL COLLEGE OF WISCONSIN,
8701 WATERTOWN PLANK
MILWAUKEE, WI 53226

PHYSICIANS RESIDENTS

6,614,147

JP CULLEN AND SONS INC,
PO BOX 5957
JANESVILLE, WI 53547

CONSTRUCTION

4,495,957

EMERGENCY MEDICINE SPECIALJST,
3237 S 16TH STREET
MILWAUKEE, WI 53215

ER MANAGEMENT SERVIC

3,188,893

SODEXHO INC AND AFFILJATES,
4880 PAYSPHERECIRCLE
CHICAGO, IL 60674

MAINTENANCE SERVICES

2,851,999

ALL ABOUT STAFFFING,
1000 SAWGRASS CORP PARKWAY 6TH FLOO
SUN RISE, FL 33323

TEMPORARY STAFFING

1,863,902

2

8

(continued)

10

( 16) Lynn Grudz,elanek

2

Employees

40 0

VP Medical Affairs North Marke

lb

Compensated

(C)

Average
hours per
week (11st
any hours
for related
organ1zat1ons
below
dotted II ne)

( 15) Enc Christianson MD

and Highest

Total number of independent contractors
(1nclud1ng but not l1m1ted to those listed
$100,000
of compensation
from the organ1zat1on ► 67

WI-20-0154-A-000013
more than

above) who received

Form99O(2015)

 Form 990

(2015)

@fli?ffi

Check

of Revenue
0 contains

if Schedule

a response

i

or note to anv line 1n this Part VIII

(A)
Total

~~

la

==
=
~
...

~

campaigns

la

dues

lb

b

Membership

C

Fundra1s1ng events

le

d

Related

organ1zat1ons

ld

e

Government grants (contributions)

le

f

All other contributions, gifts, grants, and
s1m1laramounts not included above

lf

g

Noncash contributions included 1nlines
la-lf $

h

Total. Add lines 1 a-lf

revenue

(D)

(C)

Related or
exempt
function
revenue

Unrelated
business
revenue

Revenue
excluded from
tax under
sections
512-514

E

<I:

-=
·- ...
C-'

Federated

(B)

C)

C-'
(I)

9

Page

Statement

~

==
E

= ...
-~
=

1,581,316

V, ·C)

rJJ

-=Q)

-=
-=
·.:::0
C)

"C

u

=
i'i::,

►
Business

:i.,

~

'1-

2a

>

~

b

l,

C

..;,

>

I

I

I

1,581,316

Code

PATIENTREVENUES

900099

184,762,619

184,762,619

MEDICAREMEDICAIDPAYMENTS

900099

217,015,480

217,015,480

401,778,099

e

E

O>

I

d

]

ro

I

f

All other program

g

Total. Add lines 2a-2f

►

Investment
income (1nclud1ng d1v1dends, interest,
and other s1m1lar amounts)

►

service

revenue

0

&:

3

91,299

4

Income from investment of tax-exempt bond proceeds

►

0

5

Royalties

►

0

(1) Real

6a
b

Gross

91,299

(11) Personal

1,200,901

rents

Less rental
expenses

C

Rental income
or (loss)

d

Net rental

1,200,901

income

0

or (loss)

►

(1) Securities

7a

b

1,200,901

1,200,901

- 747,499

- 747,499

(11) Other

Gross amount

from sales of
assets other
than inventory
Less cost or
other basis and
sales expenses

C

d
Cl/

Sa

::I

a;

Gain or (loss)

-747,499

Net gain or (loss)

·►

Gross income from fundra1s1ng
events (not 1nclud1ng
$

:>
Cl/

of contributions
reported
See Part IV, line 18

a:

...
Cl/

on line le)

a

-

-=
0

b

Less

C

Net income

9a

direct

b

expenses
or (loss)

from fundra1s1ng events

Gross income from gaming
See Part IV, line 19

0

►

act1v1t1es

a
b

Less

C

Net income

1Oa

direct

b

expenses
or (loss)

from gaming

0

act1v1t1es

►
Gross sales of inventory,
returns and allowances

less

a
b

Less

C

Net income

cost of goods sold
or (loss)

M 1scellaneous

11a
b

Revenue

Business

0

►
Code

EHR REVENUE

900099

445,116

CAFETERIA

722514

1,847,770

900099

1,470,854

REVENUE

C

OTHER

d

All other revenue

e

Total.Add

12

b

from sales of inventory

OPERATING

REVENUE

lines lla-lld

Total revenue. See Instructions

►

3,763,740

►

407,667,856

445,116
1,847,770
1,470,854

WI-20-0154-A-000014
403,694,069

2,392,471

Form99O(2015)

 Form 990 (2015)

Page

■ ffiif:j Statement
Section

501(c)(3)

of Functional

and 501(c)(4)

Check if Schedule

organIzatIons

O contains

10

Expenses
must complete

a response

all columns

All otherorgan1zat1ons

must complete

column

(A)

or note to any line In this Part IX

i
Do not include amounts reported on lines 6b,
7b, Sb, 9b, and 1Db of Part VIII.

1

Grants and other assistance
to domestic organIzatIons
domestic governments
See Part IV, line 21

2

Grants and other assistance
to domestic
1nd1v1duals See Part IV, line 22

3

Grants and other assistance
to foreign organIzatIons,
foreign
governments,
and foreign 1nd1v1duals See Part IV, lines 15
and 16

4

Benefits

5

Compensation
key employees

6

Compensation
not included above, to d1squal1f1ed persons
(as defined under section 4958(f)(l))
and persons
described In section 4958(c)(3)(B)

7

Other salaries

8

Pension plan accruals and contributions
and 403(b) employer contributions)

9

Other employee
Payroll

10

(C)
Management and
general expenses

(D)
Fundra1s1ng
expenses

0

0

13,850

13,850

0

directors,

trustees,

and
1,185,312

and wages
(include

section

402,322

48,230

48,230

135,754,930

135,358,335

782,990

396,595

401(k)

benefits

5,706,457

5,632,946

73,511

20,677,901

20,593,989

83,912

10,035,912

10,035,912

taxes
(non-employees)

Fees for services

11

officers,

Program service
expenses

and

paid to or for members
of current

(B)

(A)
Total expenses

a

Management

0

b

Legal

0

C

A ccountIng

d

Lobbying

0
25,046

e

Professional

f

Investment

fundra1s1ng services

g

Other (If line 1 lg amount exceeds 10% of line 25, column
amount, 11st line 1 lg expenses on Schedule O)

management

12

Advert1s1ng

13

Office expenses

14

I nformat1on tee hnology

See Part IV, line 17

25,046

0

fees

0

(A)

and promotion

28,540,877

28,537,591

3,286

81,903

65,656

16,247

16,129,422

16,105,984

23,438

0

15

Royalties

16

Occupancy

17

Travel

18

Payments of travel or entertainment
state, or local public off1c1als

0

19

Conferences,

20

Interest

21

Payments

conventions,

expenses

7,257,478

7,257,478

330,390

326,954

0

and meetings

46,970

46,970

1,977,192

to aff1l1ates
depletion,

1,977,192
0

22

DeprecIatIon,

23

Insurance

and amortIzatIon

24

Other expenses
Itemize expenses not covered above (List
miscellaneous
expenses In line 24e If line 24e amount exceeds
10% of line 25, column (A) amount, 11st line 24e expenses on
Schedule O )

20,707,311
138,375

a

MANAGEMENT

b

BAD DEBT

C

MEDICAL

FEES

SUPPLIES

d

HOSPITAL

e

A II other expenses

ASSESSMENT

25

Total functional

expenses. Add lines 1 through

26

Joint costs.Complete
this line only 1fthe organIzatIon
reported In column (B) Joint costs from a combined
educational campaign and fundra1s1ng sol1c1tat1on
1ffollow1ng SOP 98-2 (ASC 958-720)
Check here ►

1

3,436

for any federal,

24e

20,707,311
138,375

77,463,396

19,355,427

10,022,667

10,022,667

52,420,285

52,420,285

12,621,460

12,621,460

16,664,145

16,664,145

417,849,509

356,380,933

58,066,283

41,686

60,983,888

484,688

WI-20-0154-A-000015
Form99O(2015)

 Page 11

Form 990 (2015)

■ =tfif:• Balance Sheet
Check if Schedule

O contains

a response

or note to any line In this Part X

(B)

(A)
BegInnIng of year
1

Cash- non- 1nteres t- bearing

2

Savings

and temporary

3

Pledges

and grants

cash investments

receivable,

4

Accounts

5

Loans and other receivables
key employees, and highest
Schedule L

6

Loans and other receivables
from other d1squal1f1ed persons (as defined under
and
section 4958(f)(l)),
persons described In section 4958(c)(3)(B),
contributing
employers and sponsoring organIzatIons
of section 501(c)(9)
voluntary employees'
benef1c1ary organIzatIons
(see 1nstruct1ons) Complete Part
II of Schedule L

',/'I

receivable,

net

net
from current
compensated

<(

7

Notes and loans receivable,

8

Inventories

9

Prepaid expenses

10a
b

V'

-~
:c:

net

for sale or use
and deferred

charges

Land, bu1ld1ngs, and equipment
cost or other basis
Complete Part VI of Schedule D

10a

146,882,710

Less

10b

4,448,185

accumulated

~
(-:;

5

0

0

6

0

705,217

7

423,678

6,998,251

8

6,643,346

1,456,855

9

1,103,778

0

12

0

See Part IV, line 11

0

13

0

0

14

0

6,000,322

15

644,188

320,107,194

16

211,552,226

24,451,325

17

25,704,143

0

18

0

284,895

19

188,265

I nves tments-progra

14

I ntang1ble assets

15

Other assets

16

Total assets.Add

17

Accounts

18

Grants

19

Deferred

20

Tax-exempt

21

Escrow or custodial

22

Loans and other payables to current and former officers, directors, trustees,
key employees, highest compensated
employees, and d1squal1f1ed
persons

Complete

Part II of Schedule

L

23

Secured

mortgages

and notes payable

to unrelated

24

Unsecured

25

Other l1ab1l1t1es (1nclud1ng federal income tax, payables
and other l1ab1l1t1es not included on lines 17-24)
Complete Part X of Schedule D

26

Total liabilities.Add

m-related

See Part IV, line 11
lines 1 through

15 (must equal line 34)
expenses

payable
revenue
bond l1ab1l1t1es
l1ab1l1ty Complete

notes and loans payable to unrelated

Organizations

0

See Part IV, line 11

Investments-other

13

,J\
(I)

4

0

Part IV of Schedule

D

("C

~

0
60,199,512

11

12

-:.0

3

142,434,525

traded securities

account

0
57,751,843

10c

Investments-publicly

and accrued

0
103,199

0

11

payable

1
2

247,017,944

deprec1at1on

securities

0
176,762

and former officers, directors, trustees,
employees
Complete Part II of

(l)

',/'I
',/'I

End of year

lines 17 through

third parties

third parties
to related

here ►

20

0

21

0

0

22

0

0

23

0

0

24

0

59,339,451

25

88,055,879

84,075,671

26

113,948,287

235,400,470

27

96,964,725

631,053

28

639,214

0

29

0

third parties,

25

that follow SFAS 117 (ASC 958), check

0
0

Iv and

complete

lines 27 through 29, and lines 33 and 34.
27

Unrestricted

net assets

(-:;

al

28

~

29

Temporarily

restricted

Permanently

restricted

net assets
net assets

~

L..

Organizations

that do not follow SFAS 117 (ASC 958), check

here ►

~

complete

0

z,J\
(I)
,J\
,J\

<(

(I)

lines 30 through 34.

30

Capital

31

Pa1d-1n or capital

stock

or trust

principal,

32

Retained

33

Total

net assets

34

Total

l1ab1l1t1es and net assets/fund

surplus,

earnings,

or current

funds

30

or land, bu1ld1ng or equipment

endowment,

1

and

accumulated

income,

fund

31

or other funds

32

236,031,523 33
WI-20-0154-A-000016

or fund balances
balances

320,107,194

34

97,603,939
211,552,226
Form990(2015)

 Form 990 (2015)

12

Page

■ @13• Reconcilliation
Check if Schedule

1

Total

revenue

2

Total expenses

of Net Assets
O contains

a response

(must equal Part VIII,

column

(A), line 12)

(must equal Part IX, column

3

Revenue less expenses

Subtract

4

Net assets

5

Net unrealized

6

Donated

7

Investment

8

P nor period adJustments

9

Other changes

10

Net assets or fund balances
column (B))

or fund balances

or note to any line In this Part XI

4 0 7 ,6 67,856

2

417,849,509

3

-10,181,653

4

236,031,523

line 2 from line 1

at beg1nn1ng of year (must equal Part X, line 33, column

gains (losses)

1
(A), line 25)

(A))

on investments
-28,753

5
services

and use offac1l1t1es

6
expenses

7
8
In net assets

or fund balances

(explain

In Schedule

O)
-128,217,178

9

l:r.•-,•:u•

Financial

at end of year

lines 3 through

9 (must equal Part X, line 33,
97,603,939

10

Statements

Check if Schedule

Combine

and Reporting

O contains

a response

Iv

or note to any line In this Part XII
Yes

1

1 Cash Iv Accrual
from a prior year or checked

Accounting
method used to prepare the Form 990
If the organIzatIon changed its method of accounting
Schedule O

2a Were the organ1zat1on's f1nanc1al statements

compiled

or reviewed

by an independent

If'Yes,' check a box below to 1nd1cate whether the f1nanc1al statements
a separate basis, consolidated
basis, or both

1

Separate

basis

1

Consolidated

b Were the organ1zat1on's f1nanc1al statements

1

basis
audited

C

Separate

basis

IVConsolidated

by an independent

I

basis

explain

In

2a

accountant?

for the year were compiled

Both consolidated

If'Yes,' check a box below to 1nd1cate whether the f1nanc1al statements
basis, consolidated
basis, or both

I

1Other
"Other,"

and separate

or reviewed

accountant?

and separate

changed

either its oversight

process

3a As a result ofa federal award, was the organIzatIon
Single Audit Act and O MB Circular

b If"Yes,"
required

A-1337

or selection

required

process

Yes

2c

Yes

basis

during the tax year, explain

to undergo an audit or audits

2b
on a separate

If"Yes,"
to line 2a or 2b, does the organIzatIon have a committee that assumes respons1b1l1ty for oversight
and selection of an independent accountant?
of the audit, review, or comp1lat1on of its f1nanc1al statements
If the organIzatIon
Schedule O

No

on

basis

for the year were audited

Both consolidated

No

In

as set forth In the

3a

did the organIzatIon undergo the required audit oraud1ts7 If the organIzatIon did notWI-20-0154-A-000017
undergo the
audit or audits, explain why In Schedule O and describe any steps taken to undergo such audits
3b

No

Form99O(2015)

 efile

GRAPHIC

rint - DO NOT PROCESS

As Filed Data -

DLN:93493135029077
No 1545-0047

0MB

SCHEDULE A

Public Charity Status and Public Support

(Form 990 or
990EZ)

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.
► Information
about Schedule A (Form 990 or 990-EZ) and its instructions is at

Department of the
Treasury
Internal Revenue Service

www.irs.gov/form

990.

Name of the organization

2015
Open to Public
Inspection

Employer identification

number

WHEATON FRANCISCAN INC

39-0816857

Reason for Public Charity
The organIzatIon
1
2
3
4

1
1
IV
1

5

i

6

i
i

7
8
9

10

11

a

b

C

d

e

f
g

i
i
i
i

Is not a private

A church,

convention

A school

described

A hospital

foundation

Status
because

of churches,

(All organ1zat1ons must complete this part.) See 1nstruct1ons.

It Is (For lines 1 through

or assocIatIon

of churches

In section 170(b)(l)(A)(ii).(Attach

or a cooperative

hospital

service

Schedule

organIzatIon

11, check only one box)

described

In section 170(b)(l)(A)(i).

E (Form 990 or 990-EZ))

described

In section 170(b)(l)(A)(iii).

A medical research organIzatIon operated In coniunctIon
with a hospital described In section 170(b)(l)(A)(iii).
Enter the
hospital's name, city, and state
unit described In section
An organIzatIon operated for the benefit of a college or unIversIty owned or operated by a governmental
170(b)(l)(A)(iv).
(Complete Part II)
unit described In section 170(b)(l)(A)(v).
A federal, state, or local government or governmental
An organIzatIon that normally receives a substantial
part of its support from a governmental
described In section 170(b)(l)(A)(vi).
(Complete Part II)
(Complete Part II)
A community trust described In section 170(b)(l)(A)(vi)

unit or from the general

public

An organIzatIon that normally receives
(1) more than 331/3% of its support from contributions,
membership fees, and gross
to certain exceptions,
and (2) no more than 331/3% of its support
receipts from actIvItIes related to its exempt funct1ons-subJect
from gross investment
income and unrelated business taxable income (less section 511 tax) from businesses acquired by the
(Complete Part III)
organIzatIon after June 30, 1975 Seesection 509(a)(2).
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
described In section 5 0 9 (a )(1) or section 5 0 9 (a)(2) See section 509(a)(3).
Check
one or more publicly supported organIzatIons
llf, and llg
the box In lines lla through lld that describes the type of supporting organIzatIon and complete lines lle,
Type I. A supporting organIzatIon operated, supervised,
or controlled by its supported organ1zat1on(s), typically by gIvIng the
supported organ1zat1on(s) the power to regularly appoint or elect a maJority of the directors or trustees of the supporting
You must complete Part IV, Sections A and B.
organIzatIon
or controlled In connection with its supported organ1zat1on(s), by having control or
Type II. A supporting organIzatIon supervised
management of the supporting organIzatIon vested In the same persons that control or manage the supported organ1zat1on(s) You
must complete Part IV, Sections A and C.
Type III functionally integrated. A supporting organIzatIon operated In connection
with, and functionally
integrated with, its
supported organ1zat1on(s) (see 1nstruct1ons) You must complete Part IV, Sections A, D, and E.
Type III non-functionally
integrated. A supporting organIzatIon operated In connection
with its supported organ1zat1on(s) that Is
requirement
not functionally
integrated
The organIzatIon generally must satisfy a d1stribut1on requirement and an attentiveness
(see 1nstruct1ons) You must complete Part IV, Sections A and D, and Part V.
Check this box 1fthe organIzatIon received a written determ1nat1on from the IRS that It Is a Type I, Type II, Type III functionally
integrated, or Type III non-functionally
integrated supporting organIzatIon
Enter the number of supported organIzatIons
.............
.

i
i
i
i
i

Provide the following

(i)
Name of supported

1nformat1on about the supported
(ii)E IN

organIzatIon

organ1zat1on(s)

(iii)
Type of
organIzatIon
(described on lines
1- 9 above (see
InstructIons ))

(iv)
Is the organIzatIon
listed In your governing
document?

Yes

(vi)
A mount of other
support (see
1nstruct1ons)

No

I
I

WI-20-0154-A-000018

Total
For Paperwork

(v)
A mount of
monetary support
(see 1nstruct1ons)

Reduction Act Notice, see the Instructions

for Form 990 or 990EZ.

Cat No 11285F

Schedule A ( Form 990 or 990-EZ)

2015

 Schedule

A (Form 990 or 990-EZ)

2015

Page

2

■ @If• Support

Schedule for Organizations
Described in Sections 170(b)(l)(A)(iv)
and 170(b)(l)(A)(vi)
(Complete only 1f you checked the box on line 5, 7, or 8 of Part I or 1f the organ1zat1on failed to qualify under
Part III. If the organ1zat1on fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support

Calendar year
(or fiscal year beginning in) ►
and
Gifts, grants, contributions,
1
membership fees received
(Do
not include any unusual grants)
Tax revenues levied for the
2
organ1zat1on's benefit and either
paid to or expended on its behalf
The value of services or fac1l1t1es
3
unit
furnished by a governmental
to the organIzatIon without charge
4
Total. Add lines 1 through 3
The portion of total contributions
5
by each person (other than a
unit or publicly
governmental
supported organ1zat1on) included
on line 1 that exceeds 2% of the
amount shown on line 11, column
(f)
Public support. Subtract line 5
6
from line 4

Section

(a)2011

(b)2012

(c)2013

(d)2014

(e)2015

(f )Tota I

(d)2014

(e)2015

(f )Tota I

B. Total Support

Calendar year
(or fiscal year beginning in) ►
7
Amounts from line 4
Gross income from interest,
8
d1v1dends, payments received on
securities
loans, rents, royalties
and income from s1m1lar sources
Net income from unrelated
9
business actIvItIes, whether or
not the business Is regularly
carried on
Other income Do not include
10
gain or loss from the sale of
capital assets (Explain In Part

(a)2011

(b)2012

(c)2013

VI)

12

Total support. Add lines 7
through 10
Gross receipts from related

13

First five years.If the Form 990 Is for the organ1zat1on's

11

actIvItIes,

check this box and stop here

Section

C. Computation

etc

of Public Support

Public support

percentage

for 2015

(line 6, column

15

Public support

percentage

for 2014

Schedule

16a

331/30/o

support test-2015.Ifthe

17a

b

18

first, second,

third, fourth, or fifth tax year as a section

organIzatIon

501(c)(3)
.►

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

14

and stop here. The organIzatIon
b 331/30/o support test-2014.Ifthe

I 12 I

(see 1nstruct1ons)

organIzatIon,

C

Percentage
(f) d1v1ded by line 11, column

A, Part II, line 14

(f))

14
15

did not check the box on line 13, and line 14 Is 33 1/3% or more, check this box

qual1f1es as a publicly supported organIzatIon
►
organIzatIon did not check a box on line 13 or 16a, and line 15 Is 33 1/3% or more, check this

1

► 1

box and stop here. The organIzatIon qual1f1es as a publicly supported organIzatIon
10%-facts-and-circumstancestest-2015.Ifthe
organIzatIon did not check a box on line 13, 16a, or 16b, and line 14
Is 10% or more, and 1fthe organIzatIon meets the facts-and-circumstances
test, check this box and stop here. Explain
test The organIzatIon qual1f1es as a publicly supported
In Part VI how the organIzatIon meets the "facts-and-circumstances"
organIzatIon
10%-facts-and-circumstancestest-2014.Ifthe
organIzatIon did not check a box on line 13, 16a, 16b, or 17a, and line
15 Is 10% or more, and 1fthe organIzatIon meets the "facts-and-circumstances"
test, check this box and stop here.
Explain In Part VI how the organIzatIon meets the "facts-and-circumstances"
test The organIzatIon qual1f1es as a publicly

► 1

supported organIzatIon
Private foundation.If the organIzatIon

►

InstructIons

I

did not check a box on line 13, 16a, 16 b, 1 7 a, or 1 7 b, check this box and see

WI-20-0154-A-000019
Schedule A ( Form 990 or 990-EZ) 2015

 Schedule

A (Form 990 or 990-EZ)

2015

Page

3

MifiiOM

Support Schedule for Organizations
Described in Section 509(a)(2)
(Complete only 1f you checked the box on line 9 of Part I or 1f the organ1zat1on failed to qualify under Part
II. If the organ1zat1on fails to qualify under the tests listed below, please complete Part II.)
S ect1on A P u bl"IC S upport

Calendar year
(or fiscal year beginning in) ►
and
Gifts, grants, contributions,
1
membership fees received
(Do
not include any "unusual grants")
Gross receipts from adm1ss1ons,
2
merchandise
sold or services
performed, or fac1l1t1es furnished
In any actIvIty that Is related to
the organ1zat1on's tax-exempt
purpose
Gross receipts from actIvItIes
3
that are not an unrelated trade or
business under section 513
Tax revenues levied for the
4
organ1zat1on's benefit and either
paid to or expended on its behalf
The value of services or fac1l1t1es
5
unit
furnished by a governmental
to the organIzatIon without charge
6
Total. Add lines 1 through 5
7a Amounts included on lines 1, 2,
and 3 received from d1squal1f1ed
persons
b Amounts included on lines 2 and
3 received from other than
d1squal1f1ed persons that exceed
the greaterof$5,000
or 1% of
the amount on line 13 for the year
C Add lines 7a and 7b
Public support. (Subtract line 7c
8
from line 6 )

Section
(or
9
10a

b

C

11

12

13
14

(a)2011

(b)2012

(c)2013

(d)2014

(e)2015

(f )Tota I

(b)2012

(c)2013

(d)2014

(e)2015

(f )Tota I

B. Total Support

Calendar year
(a)2011
fiscal year beginning in) ►
Amounts from line 6
Gross income from interest,
d1v1dends, payments received on
securities
loans, rents, royalties
and income from s1m1lar sources
Unrelated business taxable
income (less section 511 taxes)
from businesses acquired after
June 30, 1975
Add lines 10a and 10b
Net income from unrelated
business actIvItIes not included
In line 1 Ob, whether or not the
business Is regularly carried on
Other income Do not include
gain or loss from the sale of
capital assets (Explain In Part
VI)
Total support. (Add lines 9, 10c,
11,and12)
First five years.If the Form 990 Is for the organ1zat1on's

first, second,

third, fourth, or fifth tax year as a section

501(c)(3)

Section

C. Computation

of Public Support

15

Public support

percentage

for 2015

16

Public support

percentage

from 2014

Section

D. Computation

organIzatIon,

►

check this box and stop here
(line 8, column
Schedule

of Investment

(f) d1v1ded by line 13, column

A, Part III,

Income

17

Investment

income

percentage

for 2015 (line 10c, column

18

Investment

income

percentage

from 2014 Schedule

19a

331/30/o

support tests-2015.Ifthe

organIzatIon

C

Percentage
(f))

15

line 15

16

Percentage
(f) d1v1ded by line 13, column

A, Part III,

(f))

17

line 17

18

did not check the box on line 14, and line 15 Is more than 33 1/3%, and line 17 Is not

1

more than 33 1/3%, check this box and stop here. The organIzatIon qual1f1es as a publicly supported organIzatIon
►
b 331/30/o support tests-2014.Ifthe
organIzatIon did not check a box on line 14 or line 19a, and line 16 Is more than 33 1/3% and line
18 Is not more than 33 1/3%, check this box and stop here. The organIzatIon
20

Private foundation.If

the organIzatIon

qual1f1es as a publicly

supported

organIzatIon

WI-20-0154-A-000020

did not check a box on line 14, 19a, or 19b, check this box and see InstructIons

►
► 1

i

Schedule A ( Form 990 or 990-EZ) 2015

 Schedule

■ @f

A (Form 990 or 990-EZ)

d

Supporting

Page 4

2015

Organizations

(Complete only 1fyou checked a box on line 11 of Part I If you checked 11a of Part I, complete Sections A and B If you checked
11b of Part I, complete Sections A and C If you checked 11c of Part I, complete Sections A, D, and E If you checked 11d of Part
I, complete Sections A and D, and complete Part V )

Section A. All Supporting

Organizations
Yes

1

Are all of the organ1zat1on's supported organIzatIons
listed by name In the organ1zat1on's governing documents?
If "No," des en be ,n Part VI how the supported organ,zat10ns are designated If designated by class or purpose,
descnbe the des1gnat10n If h1stonc and cont1nuIng 1elat10nsh1p, expla,n

2

Did the organIzatIon have any supported organIzatIon that does not have an IRS determ1nat1on of status under
section 509(a)(1)
or (2 )7
If "Yes," expla,n ,n Part VI how the 0IganIzat10n dete,m,ned that the supported 01ganIzat10n was descnbed ,n sect/On
509(a)(1) Of (2)

3a Did the organIzatIon

have a supported
If "Yes," answer (b) and (c) below

organIzatIon

described

In section

501(c)(4),

1

2

(5), or (6)7

3a

b Did the organIzatIon

confirm that each supported organIzatIon qual1f1ed under section
sat1sf1ed the public support tests under section 509(a)(2)7
If "Yes," descnbe ,n Part VI when and how the organ,zat10n made the determ1nat10n

501(c)(4),

Was any supported organIzatIon not organized In the United States ("foreign
If "Yes" and if you checked 11a or 11b ,n Part I, answer (b) and (c) below

(5), or (6) and

3b

c Did the organIzatIon ensure that all support to such organIzatIons
was used exclusively
purposes?
If "Yes," expla,n ,n Part VI what controls the organ,zat10n put ,n place to ensure such use

4a

No

for section

170(c)(2)(B)

3c

supported

organ1zat1on")7
4a

b Did the organIzatIon

have ultimate control and d1scret1on In dec1d1ng whether to make grants to the foreign
supported organIzatIon7
If "Yes," descnbe ,n Part VI how the 01ganIzat10n had such control and d1sc1et10n despite be,ng cont/OIied or supervised
by or 1n connection with its supported organ1zat1ons

4b

~-~--~~--

c Did the organIzatIon support any foreign supported organIzatIon that does not have an IRS determ1nat1on under
sections 501(c)(3)
and 509(a)(1)
or(2)7
If "Yes," expla,n ,n Part VI what controls the organ,zat10n used to ensure that all sup port to the foreign supported
organ,zat10n was used exclusively for sect/On 170(c)(2)(B) purposes

Sa Did the organIzatIon

add, substitute,
or remove any supported organIzatIons
during the tax year?
If "Yes," answer (b) and (c) below (if applicable) Also, provide detail ,n Part VI, ,nclud,ng (!) the names and EIN
numbers of the s uppo, ted organ,zat10ns added, subs t1tuted, or removed, (11) the reasons for each such act/On, (111)the
authonty under the organ,zat10n 's organ,zIng document author/Zing such act/On, and (1v) how the act/On was
accomplished (such as by amendment to the organ/Zing document)

b Type I or Type II only. Was any added or substituted
the organ1zat1on's

c Substitutions

organIzIng

supported

organIzatIon

part of a class already

designated

Sa
In

Sb

document?

only. Was the subst1tut1on

the result of an event beyond the organ1zat1on's

control?

Sc

6

Did the organIzatIon provide support (whether In the form of grants or the provIsIon of services orfac1l1t1es) to
anyone other than (a) its supported organIzatIons,
(b) 1nd1v1duals that are part of the charitable class benefited by
or (c) other supporting organIzatIons that also support or benefit one
one or more of its supported organIzatIons,
If "Yes,"prov1dedeta1I ,n Part VI.
or more of the f1l1ng organ1zat1on's supported organIzatIons7

6

7

Did the organIzatIon provide a grant, loan, compensation,
or other s1m1lar payment to a substantial
contributor
(defined In !RC 4958(c)(3)(C)),
a family member of a substantial
contributor,
or a 35-percent
controlled entity
with regard to a substantial
contributor?
If "Yes,"complete Part I of Schedule L (Form 990)

7

8

Did the organIzatIon make a loan to a d1squal1f1ed person (as defined In section
If "Yes," complete Part II of Schedule L (Form 990)

8

4958)

not described

In line 77

9a Was the organIzatIon

controlled directly or 1nd1rectly at any time during the tax year by one or more d1squal1f1ed
described In section 509
persons as defined In section 4946 (other than foundation managers and organIzatIons
(a )(1) or (2 ))7 If "Yes," provide detail ,n Part VI.

b Did one or more d1squal1f1ed persons
supporting

organIzatIon

(as defined In line 9(a)) hold a controlling
had an interest? If "Yes," p1ov1de detail ,n Part VI.

interest

In any entity

9b

c Did a d1squal1f1ed person (as defined In line 9(a)) have an ownership interest In, or derive any personal benefit
from, assets In which the supporting organIzatIon also had an interest? If "Yes," p1ov1de detail ,n Part VI.

10a

Was the organIzatIon subject to the excess business holdings rules of I RC 4943 because of!RC 4943(f)
(regarding certain Type II supporting organIzatIons,
and all Type III non-functionally
integrated supporting
organIzatIons )7 If "Yes," ans we, b below

b Did the organIzatIon

have any excess business holdings
whether the organ,zat10n had excess bus,ness hold,ngs)

11

Has the organIzatIon

accepted

a gift or contribution

c A 35%

controlled

entity

In (a) or (b) above7If

persons?

with persons

described

In (b) and (c) below,

11a

In (a) above?

ofa person described

10a

10b

from any of the following

or 1nd1rectly controls, either alone or together
body of a supported organIzatIon7

b A family member of a person described

9c

In the tax year? (Use Schedule C, Form 4720, to determine

a A person who directly
the governing

9a

In which the

11b

"Yes"toa,

WI-20-0154-A-000021
b, ore, prov1dedeta1I
,n Part VI
Uc
Schedule A ( Form 990 or 990-EZ) 2015

 A (Form 990

Schedule

•@Iii

or 990-EZ)

2015

Page 5

Organizations
(continued)
sect1on
. B T voe IS uooortma 0 raamzat1ons
1

2

Supporting

Did the directors, trustees, or membership of one or more supported organ1zat1ons have the power to regularly
appoint or elect at least a maJority of the organ1zat1on's directors or trustees at all times during the tax year7
If "No," des en be ,n Part VI how the supported organ,zat10n(s) effectively ope, ated, s uperv,sed, or controlled the
organ,zat10n 's act1v1t1es If the 01gan1zat10n had more than one supported 01gan1zat10n, des en be how the powers to
appoint and/or ,emove directors or trustees we,e allocated among the supported organ,zat10ns and what cond1t10ns or
restnct10ns, if any, applied to such powers dunng the tax year

1

Did the organ1zat1on operate for the benefit of any supported organ1zat1on other than the supported organ1zat1on(s)
that operated, supervised, or controlled the supporting organ1zat1on7
If "Yes," exp/am ,n Part VI how p1ov1dmg such benefit earned out the purposes of the supported 01gan1zat10n(s) that
operated, s uperv,sed or controlled the s upport,ng organ,zat10n

2

Yes

No

Yes

No

Yes

No

Section C. T
Were a maJority of the organ1zat1on's directors or trustees during the tax year also a maJority of the directors or
trustees of each of the organ1zat1on's supported organ1zat1on(s )7
If "No," des en be ,n Part VI how cont/OJ or management of the s upport,ng organ,zat10n was vested ,n the same pers ans
that controlled or managed the sup ported organ,zat10n(s)

1

sect1on

D. A II Tvoe III

suooortma

0 raamzat1ons

1

Did the organ1zat1on provide to each of1ts supported organ1zat1ons, by the last day of the fifth month of the
organ1zat1on's tax year, (1) a written notice describing the type and amount of support provided during the prior
tax year, (2) a copy of the Form 990 that was most recently filed as of the date ofnot1f1cat1on, and (3) copies of
the organ1zat1on's governing documents 1n effect on the date of not1f1cat1on, to the extent not previously prov1ded7

2

Were any of the organ1zat1on's officers, directors, or trustees either (1) appointed or elected by the supported
organ1zat1on(s) or (11) serving on the governing body of a supported organ1zat1on7
If "No," exp/am m Part VI how the organ,zat10n maintained a close and continuous workmg relat10nsh1p with the
SU pp 01ted or g an,zat10n ( s )

Section
1

Functionally-Integrated

Supporting

C

i
i
i

The organ1zat1on 1s the parent of each of its supported
The organ1zat1on supported
1nstruct1ons)

Act1v1t1es Test

a governmental

entity

organ1zat1ons

Describe

1.1

I

Organizations

Check the box next to the method that the organ1zat1on used to satisfy the Integral
The organ1zat1on sat1sf1ed the Act1v1t1es Test Complete line 2 below
a

b

2

E. Type III

1

2

By reason of the relat1onsh1p described 1n (2), did the organ1zat1on's supported organ1zat1ons have a s1gn1f1cant
voice 1n the organ1zat1on's investment
pol1c1es and 1n d1rect1ng the use of the organ1zat1on's income or assets at
all times during the tax year7
If "Yes," descnbe ,n Part VI the role the organ,zat10n's supported 01gan,zat10ns played m this rega1d

3

1

Part Test during the year (see instructions)

Complete

line 3 below

1n Part VI how you supported

a government

entity

(see

Answer (a) and (b) below.

Yes

No

a Did substantially

all of the organ1zat1on's act1v1t1es during the tax year directly further the exempt purposes of the
supported organ1zat1on(s) to which the organ1zat1on was respons1ve7
If "Yes," then m Part VI identify
those supported organizations
and explain how these act1v1t1es directly
furthe,ed their exempt pU1poses, how the 01gan1zat10n was responsive to those supported organ,zat10ns, and how the
organ,zat10n determined that these act1v1t1es constituted substantially
all of its act1v1t1es

2a

b Did the act1v1t1es described

1n (a) constitute
act1v1t1es that, but for the organ1zat1on's involvement,
one or more of
the organ1zat1on's supported organ1zat1on(s) would have been engaged 1n7
If "Yes," exp/am ,n Part VI the reasons for the organ,zat10n 's pos1t10n that its supported 01gan1zat10n(s) would have
engaged m these act1v1t1es but for the organ,zat10n's involvement

3

Parent of Supported

O rgan1zat1ons

a Did the organ1zat1on have the power to regularly
each of the supported

organ1zat1ons7

2b

Answer (a) and (b) below.
appoint or elect a maJority of the officers,
Provide details ,n Part VI

directors,

or trustees

of
3a

a substantial
degree of d1rect1on over the pol1c1es, programs and act1v1t1es of each
WI-20-0154-A-000022
3b
orga n1zat1ons 7 If "Yes," des en be ,n Part VI the role played by the organ,zat10n ,n this regard

b Did the organ1zat1on exercise
of its supported

Schedule A ( Form 990 or 990-EZ) 2015

 Schedule

A (Form 990 or 990-EZ)

l:ifli!i
1

Type III

2015

Page

Non-Functionally

Integrated

Check here 1fthe organ1zat1on sat1sf1ed the Integral
Type III

non-functionally

Section

integrated

A - Adjusted

1

Net short-term

2

Recoveries

capital

supporting

509(a)(3)

Supporting

Part Test as a qual1fy1ng trust

organ1zat1ons

must complete

on Nov

Sections

Net Income

gain

of prior-year

Other gross income (see 1nstruct1ons)

3

Add lines 1 through

4

5

Deprec1at1on and depletion

5

6

Portion of operating expenses paid or incurred for production or collection of
gross income or for management, conservation,
or maintenance
of property
held for production of income (see 1nstruct1ons)

6

7

Other expenses

7

8

Adjusted

3

(see 1nstruct1ons)

Net Income (subtract

B - Minimum

Asset Amount

a

Average

monthly

value of securities

b

Average

monthly

cash balances

C

Fair market

d

Total (add lines la, lb, and le)

e

Discount claimed for blockage
(explain 1n detail 1n Part VI)

ld
or other factors

applicable

to non-exempt

2

Subtract

use assets

4

Cash deemed held for exempt
amount, see 1nstruct1ons)

use Enter 1-1/2 % of line 3 (for greater

5

Net value of non-exempt-use

assets

6

M ult1ply line 5 by O3 5

7

Recoveries

8

Minimum Asset Amount (add line 7 to line 6)

3

line 2 from line ld

4

(subtract

line 4 from line 3)

5
6

7

d1stribut1ons

C - Distributable

8

Current Year

Amount

1

Adjusted

net income for prior year (from Section

2

Enter85%

3

M 1n1mum asset amount for prior year (from Section

A, line 8, Column A)

1

2

ofl1ne 1

4

Enter greater

5

Income

6

Distributable Amount. Subtract
emergency temporary reduction

B, line 8, Column A)

3

4

of line 2 or line 3

5

1n prior year

Check here 1fthe current

1

(B) Current Year
(optional)

le

assets

Acqu1s1t1on indebtedness

1nstruct1ons)

(A) Prior Year

1

2

7

(B) Current Year
(optional)

lb

value of other non-exempt-use

tax imposed

(A) Prior Year

la

3

Section

All other

C

8

lines 5, 6 and 7 from line 4)

Aggregate fair market value of all non-exempt-use
assets (see
1nstruct1ons for short tax year or assets held for part of year)

of prior-year

See instructions.

E

1

3

1

20, 1970

A through

2

d1stribut1ons

4

Section

6

Organizations

line 5 from line 4, unless subject
(see 1nstruct1ons)

year 1s the organ1zat1on's

to

6

first as a non-funct1onally-1ntegrated

Type III

supporting

organ1zat1on (see

WI-20-0154-A-000023

Schedule A ( Form 990 or 990-EZ) 2015

 Schedule

A (Form 990

1:1.f.lifJI Type
Section

or 990-EZ)

III

2015

Page

Non-Functionally

Integrated

paid to supported

organ1zat1ons

to accomplish

2

Amounts paid to perform act1v1ty that directly
excess of income from act1v1ty

3

Adm1n1strat1ve

4

Amounts

5

Qual1f1ed set-aside

amounts

6

Other

(describe

expenses

paid to acquire

d1stribut1ons

exempt-use

Distributable

for 2015

exempt
exempt

purposes

purposes
purposes

of supported

of supported

organ1zat1ons,

1n

organ1zat1ons

required)

See 1nstruct1ons

Add lines 1 through

9

6

organ1zat1ons

from Section

to which the organ1zat1on

1s responsive

(provide

C, line 6

d1v1ded by Line 9 amount

E - Distribution
Allocations
instructions)

1 Distributable
6

7

(continued)

assets

1n Part VI)

D1stribut1ons to attentive
supported
details 1n Part VI) See 1nstruct1ons

Line 8 amount

exempt

(prior IRS approval

8

amount

furthers

paid to accomplish

7 Total annual distributions.

amount

for 2015

(see

from Section

(i)
Excess Distributions

(ii)
Underdistributions
Pre-2015

(iii)
Distributable
Amount for 2015

C, line

1fany, for years prior to 2015
requ1red--see
1nstruct1ons)

2 Underd1stribut1ons,
(reasonable
cause
3 Excess

Organizations

Current Year

Amounts

Section

Supporting

D - Distributions

1

10

509(a)(3)

d1stribut1ons

carryover,

1fany,to

2015

a

b
C

d

From 2013.

e

From 2014.

f Total of lines 3a through

e

g

A ppl1ed to underd1stribut1ons

h

Applied

i

to 2015

distributable

Carryover
from 2010
1nstruct1ons)

j Remainder
4 D1stribut1ons

Subtract
for 2015

of prior years
amount

not applied

(see

lines 3g, 3h, and 31 from 3f
from Section

D, line 7

$

a A ppl1ed to underd1stribut1ons
b Applied
C

to 2015

Remainder

distributable

Subtract

of prior years
amount

lines 4a and 4b from 4

5

Rema1n1ng underd1stribut1ons
for years prior to
2015,ifany
Subtract lines 3g and 4a from line 2
(1f amount greater than zero, see 1nstruct1ons)

6

Rema1n1ng underd1stribut1ons
for 2015
Subtract
lines 3h and 4b from line 1 (1famount greater than
zero, see 1nstruct1ons)

7

Excess distributions
3J and 4c

8

Breakdown

carryover to 2016. Add lines

of line 7

a

b
C

Excess

from 2013.

d

From 2014.

e

From 2015.

WI-20-0154-A-000024
Schedule A (Form 990 or 990-EZ)

(2 O 15)

 Schedule

A (Form 990 or 990-EZ)

l:ifli!JI

2015

Page

8

Supplemental
Information.
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV,
Section A, lines 1, 2, 3b, 3c, 4b, 4c, Sa, 6, 9a, 9b, 9c, lla, llb, and llc; Part IV, Section B, lines 1 and 2;
Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines le, 2a, 2b, 3a and 3b;
Part V, line 1; Part V, Section B, line le; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5,
and 6. Also complete this part for any add1t1onal 1nformat1on. (See instructions).
Facts And Circumstances Test

WI-20-0154-A-000025
Return Reference

Explanation
Schedule A ( Form 990 or 990-EZ)

2015

 efile

GRAPHIC

rint

- DO NOT PROCESS

c

SCHEDULE

As Filed

Data -

DLN:93493135029077
0MB

Political Campaign and Lobbying Activities

(Form 990 or
990-EZ)

For Organizations Exempt From Income Tax Under section 501 (c) and section 527
► Complete

if the organization is described below. ► Attach to Form 990 or Form 990-EZ.
about Schedule C (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

2015
Open to Public
Inspection

► Information

Department of the
Treasury
Internal Revenue
Service

No 1545-0047

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
• Section 501(c)(3) organizations Complete Parts I-A and B Do not complete Part I-C
• Section 501 ( c) ( other than section 501 ( c )(3)) organizations Complete Parts I-A and C below Do not complete Part I-B
• Section 527 organizations Complete Part I-A only
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Act1v1ties),then
• Section 501 (c )(3) organizations that have filed Form 5768 (election under section 501 (h)) Complete Part II-A Do not complete Part II-B
• Section 501 (c )(3) organizations that have NOT filed Form 5768 (election under section 501 (h)) Complete Part II-B Do not complete Part II-A
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V,

line 35c (Proxy Tax) (see separate instructions), then
• Section 501(c)(4), (5), or (6) organIzatIons Complete Part Ill
Name of the organIzatIon

Employer identification

number

WHEATON FRANCISCAN INC

39-0816857

Complete

if the organization

1

Provide

2

Pol1t1cal expenditures

3

Volunteer

j@f §:j
1

a description

of the organ1zat1on's direct

Complete

if the organization
of any excise

tax incurred

of any excise

tax incurred

2

Enter the amount
If the organIzatIon

4a

Was a correction

j@f §d

section

501(c)

and 1nd1rect pol1t1cal campaign

or is a section

actIvItIes

527 organization.

In Part IV

$ ________

_

►

$ ________

_

►

$ ________

_

►

Enter the amount

If"Yes,"

under

hours

3

b

is exempt

describe

Complete

incurred

a section

4955

is exempt

under

by the organIzatIon
by organIzatIon

section

under section

managers

501(c)(3).
4955

under section

4955

tax, did It file Form 4 720 for this year?

1Yes

made?

1Yes

In Part IV

if the organization

1

Enter the amount

directly

2

Enter the amount of the f1l1ng organ1zat1on's
exempt function actIvItIes
function

expended

expenditures

is exempt

under

by the f1l1ng organIzatIon
funds contributed

section

for section

501(c),

5 2 7 exempt

to other organIzatIons

except
function

section

501(c)(3).

for section

$ ________

►

actIvItIes

$ _______

►

Add lines 1 and 2 Enter here and on Form 1120-PO

L, line 17b

►

3

Total exempt

4

Did the f1l1ng organIzatIon

5

Enter the names, addresses and employer 1dent1f1cat1on number (EIN) of all section 527 pol1t1cal organIzatIons
to which the f1l1ng
organIzatIon made payments
For each organIzatIon listed, enter the amount paid from the f1l1ng organ1zat1on's funds Also enter the
amount of pol1t1cal contributions
received that were promptly and directly delivered to a separate pol1t1cal organIzatIon, such as a
separate segregated fund or a pol1t1cal action committee
(PAC) If add1t1onal space Is needed, provide 1nformat1on In Part IV

$ ________

f1leForm 1120-POL for this year?

(b) Address

(a) Name

_

527

_
_

1Yes

( c) EI N

(d) A mount paid from
f1l1ng organ1zat1on's
funds If none, enter -0-

(e) A mount of pol1t1cal
contributions
received
and promptly and
directly delivered to a
separate pol1t1cal
organIzatIon
If none,
enter-0-

2
3
4
5

WI-20-0154-A-000026
6
For Paperwork

Reduction

Act Notice,

see the 1nstruct1ons

for Form 990 or 990-EZ.

Cat No 500845

Schedule

C (Form 990 or 990-EZ)

2015

 Schedule

C (Form 990 or 990-EZ)

2015

Page

■ @lf§·j Complete if the organization
under section 501(h)).

is exempt

under section

501(c)(3)

A

Check

► 11fthe
f1l1ng organ1zat1on belongs to an aff1l1ated group (and 11st 1n Part IV each aff1l1ated group member's
expenses, and share of excess lobbying expenditures)

B

Check

►

I

1fthe f1l1na oraan1zat1on checked

box A and "l1m1ted control"

Limits on Lobbying
(The term
la

b
C

d
e

f

g
h
i

"expenditures"

expenditures

to influence

public op1n1on (grass

expenditures

to influence

a leg1slat1ve body (direct

Total

expenditures

(add lines la and lb)

lobbying

Other exempt

purpose

Total exempt
Lobbying

I

organization's

totals

I

(b) Affiliated
group totals

roots
lobbying)

expenditures
amount

(add lines le and ld)

Enter the amount from the following

table 1n both columns

If the amount on line le, column (a) or (b) 1s:

The lobbying nontaxable amount is:

Not over $500,000

20% of the amount on line le

Over $500,000 but not over $1,000,000

$100,000 plus 15% of the excess over $500,000

Over $1,000,000 but not over $1,500,000

$175,000 plus 10% of the excess over $1,000,000

Over $1,500,000 but not over $17,000,000

$225,000 plus 5% of the excess over $1,500,000

Over $17,000,000

$1,000,000

Grassroots

EIN,

expenditures

purpose

nontaxable

(a) Filing

paid or incurred.)

Total lobbying
lobbying)
Total lobbying

name, address,

orov1s1ons aoolv

Expenditures

means amounts

2

and filed Form 5768 (election

nontaxable

amount

Subtract

line lg from line la

Subtract

line lffrom

line le

(enter 25% of line lf)

If zero or less, enter -0If zero or less, enter -0-

If there 1s an amount other than zero on either line lh or line 11, did the organ1zat1on file Form 4720
reporting section 4911 tax for this year?

1 v

e s

4-Year Averaging Period Under section 501(h)
(Some organizations
that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying
Calendar

2a

Lobbying

year (or fiscal year
beg1nn1ng 1n)

nontaxable

Lobbying celling amount
(150% ofl1ne 2a, column(e))

C

Total

d

Grassroots

e

Grassroots
ce1l1ng amount
(150% ofl1ne 2d, column (e))

f

Grassroots

During 4-Year
(a)2012

Averaging

(b)2013

Period
(c)2014

(d)2015

(e) Total

amount

b

lobbying

Expenditures

expenditures

nontaxable

lobbying

amount

WI-20-0154-A-000027

expenditures
Schedule C ( Form 990 or 990-EZ)

2015

 Pa e

Complete if the organization
is exempt under section
filed Form 5768 (election under section 501(h)).

501(c)(3)

3

and has NOT
(b)

For each "Yes" response on lines la through 11 below, provide In Part !Va detailed desc11pt10n of the lobbying
actIvItv

(~
No

Amount

Yes

a

During the year, did the f1l1ng organIzatIon attempt to influence foreign, national, state or local
leg1slat1on, 1nclud1ng any attempt to influence public opInIon on a leg1slat1ve matter or referendum,
through the use of
Volunteers?

b

Paid staff or management

C

Media advertisements?

d

Ma1l1ngs to members,

e

Publ1cat1ons,

f

Grants

g

Direct

1

Rallies,

i

Other actIvItIes

j

Total

In expenses

No

11)7

No

No

purposes?

their staffs,

seminars,

No

statements?

for lobbying

with legislators,

demonstrations,

Yes

government

conventions,

off1c1als, or a leg1slat1ve body?

speeches,

lectures,

25,046

No

or any s1m1lar means?

No

7

Yes

Add lines le through

Did the actIvItIes

11

25,046

In line 1 cause the organIzatIon

to be not described

b

If"Yes,"

enter the amount

of any tax incurred

under section

C

If "Yes,"

enter the amount

of any tax incurred

by organIzatIon

d

If the f1l1ng organIzatIon

IZ ■ --ii ■ 1..-,-.

on lines le through

reported

or the public?

or broadcast

to other organIzatIons
contact

compensation

No

legislators,

or published

h

2a

(include

incurred

a section

4912

Complete if the organization
501 C 6 .

In section

501(c)(3)7

No

4912
managers

under section

tax, did It file Form 4720

is exempt

forth1s

under section

4912

year?

501(c)(4),

section

501(c)(5),

or section
Yes

1

Were substantially

all (90%

or more) dues received

2

Did the organIzatIon

make only in-house

3

Did the organIzatIon

agree to carry over lobbying

lobbying

nondeductible

expenditures

by members?

of$2,000

or less?

and pol1t1cal expenditures

No

1
2

from the prior year?

3

Complete if the organization
is exempt under section 501(c)(4),
section 501(c)(5),
or section
501(c)(6)
and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A,
line 3, is answered "Yes."
1

Dues, assessments

2

Section 162(e) nondeductible
lobbying and pol1t1cal expenditures
expenses for which the section 527(f) tax was paid).

and s1m1lar amounts

a
b

Current year
Carryover from last year

C

Total

from members

1
(do not include amounts of political
2a
2b
2c

3

Aggregate

4

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess
does the organIzatIon agree to carryover to the reasonable estimate of nondeductible
lobbying and
pol1t1cal expenditure
next year?

4

5

Taxable

5

:.r.;

1••

amount

amount

reported

of lobbying

Supplemental

In section

6033(e)(l)(A)

and pol1t1cal expenditures

notices

of nondeductible

(see 1nstruct1ons)

section

162(e)

dues

3

Information

Provide the descriptions
required for Part I-A, line 1, Part I-B, line 4, Part I-C, line 5, Part II-A (aff1l1ated group 11st), Part II-A,
art for an add1t1onal 1nformat1on
2 see InstructIons
, and Part II-B, line 1 Also, com lete this
Return Reference
Schedule C SUPPLEMENTAL
INFORMATION

lines 1 and

Explanation
Schedule C Part 11-B Line 11 Wheaton Franciscan Healthcare was part ofa controlled group of
healthcare organIzatIons through late In the fiscal year, when most of the entItIes were transferred to
new parent organIzatIons
These entItIes were related through these respective dates, through a
common parent organIzatIon, Wheaton Franciscan Services, Inc Certain entItIes w1th1n this
controlled group engaged In l1m1ted lobbying actIvItIes that benefited each organIzatIon collectively
For calendar year 2015, Wheaton Franciscan Healthcare employed two 1nd1v1duals whose
respons1b1l1t1es included oversight and management of lobbying actIvItIes for these organIzatIons
the
SenIorVIce
President of Strategic InItIatIves
and the Director of Government Relations and
Advocacy
The SenIorVIce
President provided strategic oversight for the department and
part1c1pated In vIsIts with key elected off1c1als when appropriate
The Director provides on-the-ground
support, served as the first point of contact for elected off1c1als, and executed on leg1slat1ve lobbying
actIvItIes that supported the strategic interests of the organIzatIon
These lobbying actIvItIes
approximated
50% of total annual salary for the Director and no more than 15% for the SenIorVIce
President
A benefits factor of 25% was added, and the total was allocated amongst the organIzatIons
that received the benefit of these services
The lobbying actIvItIes included advocacy efforts related
to public policy proposals such as changes to Medicare and Med1ca1d funding, federal or state
leg1slat1on that may impact the organIzatIon,
partIcIpatIng
In and coord1nat1ng vIsIts with elected
off1c1als at all levels of government (local, state and federal), mob1l1z1ng grassroots
efforts on behalf of
the organIzatIon on issues of interest, coord1nat1ng advocacy actIvItIes In con1unctIon with relevant
trade assocIatIons,
and prov1d1ng internal awareness on spec1f1c state related leg1slat1ve issues when
the need arises The portion of direct expenses related to annual employee business travel to
Washington DC or other locations, In order to lobby for issues important to healthcare providers and
patients, have been included 1f applicable
Finally, any trade assocIatIon
dues contaInIng a
WI-20-0154-A-000028
percentage portion allocable to lobbying actIvItIes,
has been 1dent1f1ed, and added or estimated as
appropriate
Wheaton Franciscan, Inc #39-0816857
$25,046
Schedule C (Form 990 or 990EZ) 2015

 efile GRAPHIC

rint - DO NOT PROCESS

SCHEDULED

As Filed Data -

DLN:93493135029077
0MB

Supplemental Financial Statements

(Form 990)

Department of the
Treasury
Internal Revenue Service

2015

► Complete if the organization
answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, lle, llf, 12a, or 12b.
► Attach to Form 990.
about Schedule D (Form 990) and its instructions is at www.irs.gov/form

Information

Name of the organization

No 1545-0047

Open to Public
Inspection

990.

Employer identification

number

WHEATON FRANCISCAN INC

39-0816857

Organizations
Maintaining
Donor Advised Funds or Other Similar Funds or Accounts.
Complete 1f the organ1zat1on answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised

1

Total

2

Aggregate
year)

value of contributions

3

Aggregate

value of grants

4

Aggregate

value at end of year

funds

(b)Funds

and other accounts

number at end of year
to (during

from (during year)

5

Did the organIzatIon inform all donors and donor advisors In writing that the assets held In donor advised
funds are the organ1zat1on's property, subject to the organ1zat1on's exclusive legal control?

1Yes

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 1mperm1ss1ble private benefit?

1Yes

■ ffiif• Conservation
P urpose(s)

1

of conservation

1

Preservation
education)

1
1

Protection

easements

held by the organIzatIon

of land for public use (e g, recreation
of natural

Preservation

Complete
easement

2

Complete 1f the organ1zat1on answered "Yes" on Form 990, Part IV, line 7.

Easements.

(check

or

all that apply)

1
1

habitat

Preservation

of an historically

Preservation

of a cert1f1ed historic

important

land area

structure

of open space

lines 2a through 2d 1fthe organIzatIon
on the last day of the tax year

held a qual1f1ed conservation

contribution

In the form ofa conservation
Held at the End of the Year

a

Total

number of conservation

easements

2a

b

Total acreage

c

Number of conservation

easements

d

Number of conservation
historic structure listed

easements included In (c) acquired
In the National Register

Number of conservation

easements

3

restricted

by conservation

easements

2b

on a cert1f1ed historic

structure

mod1f1ed, transferred,

included

In (a)

2c

after 8/17 /06, and not on a
2d

released,

ext1ngu1shed,

or terminated

by the organIzatIon

easement

Is located ►-------

during the

tax year ►------4

Number of states

5

Does the organIzatIon have a written policy regarding the periodic monitoring,
v1olat1ons, and enforcement
of the conservation
easements It holds?

where property

6

Staff and volunteer
year

7

A mount of expenses

hours devoted

subject

to conservation

to monitoring,

InspectIng,

handling

InspectIon,

handling

of
1Yes

of v1olat1ons, and enforcing

conservation

easements

during the

►-------incurred

In monitoring,

InspectIng,

handling

of v1olat1ons, and enforcing

conservation

easements

during the year

► $ ---------8

Does each conservation
easement reported
(B)(1) and section 170(h)(4 )(B)(11)7

9

In Part XIII, describe how the organIzatIon reports conservation
balance sheet, and include, 1f applicable, the text of the footnote
the organ1zat1on's accounting for conservation
easements

•ffiiffi

on line 2(d) above satisfy

the requirements

of section

170(h)(4)

I

Yes

easements In its revenue and expense statement,
and
to the organ1zat1on's f1nanc1al statements
that describes

Organizations
Maintaining Collections of Art, Historical Treasures,
Complete 1f the organ1zat1on answered "Yes" on Form 990, Part IV, line 8.

or Other Similar

Assets.

If the organIzatIon elected, as permitted under SFAS 116 (ASC 958), not to report In its revenue statement and balance sheet
works of art, historical treasures, or other s1m1lar assets held for public exh1b1t1on, education, or research In furtherance of public
service, provide, In Part XIII, the text of the footnote to its f1nanc1al statements
that describes these items

la

b

If the organIzatIon elected, as permitted under SFAS 116 (ASC 958), to report In its revenue
works of art, historical treasures, or other s1m1lar assets held for public exh1b1t1on, education,
service, provide the following amounts relating to these items
(i) Revenue included

(ii) Assets

included

on Form 990,
In Form 990,

Part VIII,

statement and balance sheet
or research In furtherance of public

► $ ---------

line 1

Part X

►

$ _________

If the organIzatIon
following amounts

received or held works of art, historical treasures, or other s1m1lar assets forf1nanc1al
required to be reported underSFAS
116 (ASC 958) relating to these items

a

Revenue included

on Form 990,

b

Assets

2

For Paperwork

included

In Form 990,

Part VIII,

gain, provide the

_________
WI-20-0154-A-000029
►

line 1

$

_

► $

Part X

Reduction Act Notice, see the Instructions

_

for Form 990.

Cat

No 52283D

Schedule D (Form 990) 2015

 Schedule

D (Form 990)

1:ifiih!

2015

Page

Organizations

Maintaining

Collections

of Art, Historical

Treasures,

or Other Similar

2

Assets

continued
Using the organ1zat1on's acqu1s1t1on, accession,
collection
items (check all that apply)

3

a
b
c

1

and other records,

d

Public exh1b1t1on

1
I

Scholarly

e

research

Preservation

check any of the following

I
1

that are a s1gn1f1cant use of its

Loan or exchange

programs

Other

for future generations

4

Provide a description
Part XIII

of the organ1zat1on's collections

and explain

how they further

the organ1zat1on's exempt

5

During the year, did the organ1zat1on sol1c1t or receive donations of art, historical treasures or other s1m1lar
assets to be sold to raise funds rather than to be ma1nta1ned as part of the organ1zat1on's collect1oni

purpose

1n

No

Escrow and Custodial Arrangements.
Complete 1f the organ1zat1on answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990,
Part X, line 21.
la

Is the organ1zat1on an agent, trustee,
included on Form 990, Part xi

custodian

or other 1ntermed1ary for contributions

or other assets

1Yes
Amount

b

If "Yes,"

c

Beg1nn1ng balance

le

explain

the arrangement

1n Part XIII

and complete

the following

table

d

Add1t1ons during the year

ld

e

D1stribut1ons

le

f

Ending balance

2a

b

during the year

1f

Did the organ1zat1on include

If"Yes,"

■ :r.•--'-

explain

an amount

the arrangement

on Form 990,

1n Part XIII

Part X, line 21, for escrow or custodial

Check here 1fthe explanation

C ontribut1ons

C

Net investment
losses

d

Grants

e

Other expenditures
and programs

f

A dm1n1strat1ve expenses

g

End of year balance

earnings,

a

Board designated

b

Permanent

c

Temporarily

(b)Pnor year

b (c)Two years back

(d )Three years back

(e)Four years back

gains, and

or

percentage

of the current

year end balance

(line lg, column

(a)) held as

quasi-endowment ►

endowment ►

on lines 2a, 2b, and 2c should equal 100%

Are there endowment
organ1zat1on by

funds not 1n the possession

of the organ1zat1on that are held and adm1n1stered for the
Yes

1n Part XIII

the intended

I 3a(ii>

organ1zat1ons

listed

as required

uses of the organ1zat1on's

on Schedule

endowment

-I

R7

Buildings, and Equipment.
C amp Iete 1f t h e organ1zat1on answere d ' Yes to Form 990 , Part IV, 1ne lla.
of property

3b

funds

1ffiij1 Land,

Description

No

I 3aCi>

organ1zat1ons

(ii) related organ1zat1ons
If"Yes"
on 3a(11), are the related
Describe

la

□

1n Part XIII

for fac1l1t1es

restricted

(i) unrelated

4

Yes

endowment ►

The percentages

b

I

or scholarships

Provide the estimated

3a

has been provided

l1ab1l1tyi

Beg1nn1ng of year balance

b

2

account

Funds. Complete 1f the organ1zat1on answered "Yes" to Form 990, Part IV, line 10.

Endowment

(a)Current year
la

not

s ee

Form 990 , Part X, ine 1 0

(a)

(b)

Cost or other basis
( investment)

Cost or other basis
(other)

Land

Accumulated
(c)deprec1at1on

9,930,000

(d)Book value

9,930,000

b Bu1ld1ngs
97,312,845
C

Leasehold

improvements

d Equipment

31,094,997

e Other
Total. Add lines 1 a through

1,237,798

3,400

756
3,141,742

WI-20-0154-A-000030
8,541,468
67,889
1 e (Column (d) must equal Form 990, Part X, column (B), /me 10(c))

►

96,075,047
2,644
27,953,255
8,473,579
142,434,525

Schedule D (Form 990) 2015

 Schedule

D (Form 990)

j:ifi@O

2015

Page

Investments-Other
Securities.
See Form 990 Part X line 12

Complete

(a) Description

of security or category
(1nclud1ng name of security)

(l)F1nanc1al

3

1f the organ1zat1on answered 'Yes' on Form 990, Part IV, line llb.
(b)Book

value

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

value

derivatives

(2)Closely-held

equity

interests

(3)0 ther

-

►

Total. (Column (b) must equal Fann 990, Part X, col (B) /me 12)

Investments-Program
Related.
Complete 1f the organ1zat1on answered 'Yes' on Form 990, Part IV, line llc.see
(a) Description

(b) Book value

of investment

Other
1•--···

Total. (Column

•z 1•.--•

Assets. Complete

1fthe orqan1zat1on answered

'Yes' on Form 990,

Part IV, line 1 ld See Form 990,

(a) Description

(b) must

equal Form 990, Part X, col (BJ lrne 15)

(a) Description

►

0

PARTY PAYORS

FAS 47 LONG TERM PAYABLE

6,946,929
SJH

2,152,433

CASH DUE TO CHS FUND

40,247,924

BONDS

38,708,593

PAYABLE

or llf.

(b) Book value

ofl1ab1l1ty

Federal income taxes
DUE TO THIRD

Part X, line 15

(b) Book value

Other Liabilities. Complete 1f the organ1zat1on answered 'Yes' on Form 990, Part IV, line lle
See Form 990 Part X line 25

1.

x, line 13.

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

►

Total. (Column (b) must equal Fann 990, Part X, col (B) /me 13)
■ :r.:

Form 990, Part

TO AFFILIATES

Total. (Column (b) must equal Fann 990, Part X, col (B) /me 25)

►

88,055,879

that reports the
2. L1ab1l1ty for uncertain tax pos1t1ons In Part XIII, provide the text of the footnote to the organ1zat1on's f1nanc1al statements
of the footnote has been provided 1n Part
organ1zat1on's l1ab1l1ty for uncertain tax pos1t1ons under FIN 48 (ASC 740) Check here 1fthe text WI-20-0154-A-000031
XIII

I

Schedule D (Form 990) 2015

 Schedule

D (Form 990)

Page 4

2015

■ ffli•• Reconciliation

of Revenue per Audited Financial Statements With Revenue
Complete 1f the oraanIzatIon answered 'Yes on Form 990 Part IV line 12a.

Total

1

revenue,

Amounts

2

gains, and other support

included

on line 1 but not on Form 990,

a

Net unrealized

gains (losses)

b

Donated

C

Recoveries

d

Other

e

Add lines 2a through

services

(Describe

2b

included

Investment
Other

expenses

C

Add lines 4a and 4b

(Describe

3

on Form 990,

b

revenue

2c
2d
2e

line 2e from line 1
Part VIII,

not included

line 12, but not on line 1

on Form 990,

Part VIII,

line 7b

1n Part XIII)

I 4a I
4b
4c

Add lines 3 and 4c.(Th1s must equal Form 990,

Part I, line 12)

5

Reconciliation of Expenses per Audited Financial Statements With Expenses
Complete 1f the orqanIzatIon answered 'Yes' on Form 990 Part IV line 12a.

1

Total expenses

2

Amounts

and losses

included

a

Donated

b

Prior year adJustments

c

Other

losses

d

Other

(Describe

e

Add lines 2a through

services

per audited

f1nanc1al statements

on line 1 but not on Form 990,

per Return.
1

Part IX, line 25

and use offac1l1t1es

2a
2b
2c

1n Part XIII)

2e

Subtract

line 2e from line 1

4

Amounts

included

on Form 990,

a

Investment

b

Other

C

Add lines 4a and 4b

expenses

(Describe

Total expenses

2d

2d

3

5

2a

2d

Subtract

a

1

line 12

1n Part XIII)

Amounts

Total

Part VIII,

on investments

of prior year grants

4

5

f1nanc1al statements

and use offac1l1t1es

3

1:r.1,1•:u•

per audited

per Return

3

Part IX, line 25, but not on line 1:

not included

on Form 990,

Part VIII,

line 7b

1n Part XIII)

4b
4c

Add lines 3 and 4c. (This must equal Form 990,

■ @f:jffl Supplemental

.1 4a I

Part I, line 18)

5

Information

Provide the descriptions
required for Part II, lines 3, 5, and 9, Part III, lines la and 4, Part IV, lines lb and 2b,
Part V, line 4, Part X, line 2, Part XI, lines 2d and 4b, and Part XII, lines 2d and 4b Also complete this part to provide
1nformat1on
Return Reference

Explanation

any add1t1onal

WI-20-0154-A-000032
Schedule D (Form 990) 2015

 Schedule

D (Form 990)

■ :r.,..;•:•n•

I

Page 5

2015

Supplemental

Return Reference

Information

(continued)

I

Explanation

WI-20-0154-A-000033
Schedule D (Form 990) 2015

 efile GRAPHIC

rint - DO NOT PROCESS

SCHEDULE F
(Form 990)

As Filed Data -

DLN:93493135029077
0MB

Statement of Activities Outside the United States
►

Complete

if the organIzatIon

answered

2015

"Yes" to Form 990,

Part IV, line 14b, 15, or 16.
►

Department of the Treasury
Internal Revenue Service

►

Information

about Schedule

No 1545-0047

Attach to Form 990.

F (Form 990)

and ,ts InstructIons

Open to Public
Inspection

Is at www.irs.gov/form990.

Employer identification

Name of the organIzatIon
WHEATON FRANCISCAN

number

INC
39-0816857

General Information
on Activities Outside the United States.
Complete 1f the organ1zat1on answered "Yes" to Form 990, Part IV, line 14b.
1

Forgrantmakers.
and

other

used

Does

assistance,

to award

the

2

Forgrantmakers.
assistance
outside

3

ActIvItes

per Region

the

the
grants

organIzatIon

grantees'

maintain

records

el1g1b1l1ty for the

or assistance,

the

amount

and

the

of its grants

selection

criteria

IV

or assistance?

Describe
in Part V the
the United States
(The following

(a) Region

organ1zat1on's

procedures

Part I, line 3 table can be duplicated
(b) Number of

for monitoring

region

agents, and

region (by type) (e g,
fundra1s1ng,program

independent

services, investments, grants

Sub-Sa hara n A fnc a

use of its grants

and

Yes

I

No

other

1f add1t1onal space Is needed)

offices In the

region

the

(d) Act1v1t1es
conducted In (e) If actIvIty listed In (d) Is a

(c) Number of
employees,

contractors 1n

( 1)

to substantiate

grants

(f) Total expenditures

program service, describe

for and investments

spec1f1c
type of
serv1ce(s)In region

1n region

to recIpIents located In the
region)
Program Services
Donated

Med Supplies

13,850

( 2)
( 3)
( 4)

( 5)

13,850

3a Sub-total
b Total from contInuatIon
sheets
to Part I
c Totals (add lines 3a and 3b)
For Paperwork

Reduction

Act Notice,

see the Instructions

WI-20-0154-A-000034
13,850
for Form 990.

Cat

No 50082W

Schedule

F (Form 990)

2015

 Schedule

•ffiifi

F (Form 990)

(a)Nameof
organ1zat1on

1

Page 2

2015

Grants and Other Assistance to Organizations
or Entities Outside the United States.
Complete 1f the organIzatIon answered "Yes" to Form 990, Part IV, line 15, for any recIpIent who received more than $5,000. Part II can be duplicated
a dd ItIona I soace Is nee d e d
(b) IRS code

(c) Region

(d) Purpose of

section
and EIN (1f
applicable)

grant

(e) Amount of
cash grant

(f) Manner of
cash
disbursement

(g) A mount
of non-cash
assistance

(h) Description
of non-cash
assistance

1f

(i) Method of
valuation
(book, FM V,
appraisal, other)

( 1)

( 2)
( 3)
( 4)

2

3

Enter total number of recIpIent organIzatIons listed above that are recognized as charities by the foreign country,
tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equ1valency letter
Enter total number of other organIzatIons

or entItIes.

recognized as
►

► WI-20-0154-A-000035
Schedule F (Form 990) 2015

 Schedule

F (Form 990)

Page

2015

■ ffiiff• Grants and Other Assistance to Individuals
Outside the United States.
Part III can b e d up I1cated If a dd 1t1onaI space 1s nee d e d
(a) Type of grant or
assistance

( 1)

Hospital

(b) Region

M1ss1on Sisters Sub-Saharan

A fnca

(c) Number of

(d) A mount of

rec1p1ents

cash grant

13,850

(e)

Complete

Manner of cash
disbursement

(f) Amount
non-cash
assistance

of

(g) Description

( h) Method of
valuation
(book, FM V,
aoora1sal, other)

of non-cash
assistance
Med Supplies

FMV

( 2)
( 3)
( 4)
( 5)
( 6)

( 7)
( 8)
( 9)
( 10)
( 11)
( 12)
( 13)
( 14)
( 15)
( 16)
( 17)
( 18)

3

1f the organ1zat1on answered "Yes" to Form 990, Part IV, line 16.

WI-20-0154-A-000036
Schedule

F (Form

990)

2015

 Schedule

F (Form 990)

■ ffif ¢1 Foreign
1

2

3

4

5

6

Page 4

2015

Forms

Was the organ1zat1on a US transferor of property to a foreign corporation
during the tax yeari If "Yes,"the
organrzatron may be requrred to frle Form 926, Return by a US Transferor of Property to a Forergn Corporatron (see
Instructrons
for Form 926)

1

Yes

iv

No

Did the organ1zat1on have an interest 1n a foreign trust during the tax yeari If "Yes," the organIzat10n may be
requrred to frle Form 3520, Annual Return to Report Transactrons wrth Forergn Trusts and Recerpt of Certain Forergn
Grfts, and/or Form 3520-A, Annual Informatron Return of Forergn Trust Wrth a US Owner (see Instruct10ns for
Forms 3520 and 3520-A, do not frle with Form 990)

1

Yes

iv

No

Did the organ1zat1on have an ownership interest 1n a foreign corporation
during the tax yeari If "Yes," the
organrzatron may be requrred to frle Form 5471, Informatron Return of US Persons wrth Respect to Certarn Forergn
Corporatrons (see Instruct10ns for Form 5471)

1

Yes

iv

No

Was the organ1zat1on a direct or 1nd1rect shareholder
of a passive foreign investment
company or a qual1f1ed
electing fund during the tax yeari If "Yes," the organrzatron may be requrred to file Form 8621, Informatron Return
by a Shareholder of a Passrve Forergn Investment
Company or Qualrfred Electing Fund (see Instructrons
for Form
8621)

1

Yes

iv

No

Did the organ1zat1on have an ownership interest 1n a foreign partnership
during the tax yeari If "Yes," the
organrzatron may be requrred to frle Form 8865, Return of US Persons wrth Respect to Certarn Forergn Partnershrps
(see Instructrons
for Form 8865)

1

Yes

iv

No

Did the organ1zat1on have any operations
1n or related to any boycotting
countries during the tax yeari If
"Yes," the organrzatron may be requrred to file Form 5713, Internatronal Boycott Report (see Instructrons
for Form
WI-20-0154-A-000037Yes
5713, do not frle wrth Form 990)

iv

No

1

Schedule F (Form 990) 2015

 Schedule

F (Form 990)

■ @l!i

2015

Page 5

Supplemental
Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting
method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III
(accounting method); and Part III, column (c) (estimated number of rec1p1ents), as applicable. Also complete
this part to provide any add1t1onal 1nformat1on (see instructions).

990 Schedule

F, Supplemental

Information

Return Reference
SCHEDULE F SUPPLEtv1ENTALINFORllilATION

Explanation
Form 990 Schedule F Part I Line 2 Wheaton Franciscan Healthcare ma1nta1nsfiles and record
s to manage the dec1s1on-mak1ngand assistance process for organizations that 1tprovides
community sponsorship dollars or 1n-k1nddonations to Dec1s1onsare made by a Community S
ponsorsh1p Committee w 1thleaders who hold pos1t1ons1nD1vers1ty.Strategic Planning, Mis
s1on Services, Marketing and Ftulanthropy The Corrmttee generally strives to sponsor orga
nizat1ons that have missions that align w 1ththe mission, v1s1onand values of the organiz
at1on, w 1tha special focus on world disaster relief and human assistance, 1nparticular a
s 1trelates to our healthcare and housing mnistries The committee also looks for certa1
receive contributions, 1nclud1ngb
n other criteria when dec1d1ngw h1ch organizations w 111
ut not limited to supporting healthcare, housing, or other humanitarian needs w orldw 1de,f
urthering d1vers1tyand cultural competency, aligning w 1thother WFH business relat1onsh1p
s or service lines, supporting student academe achievement or workforce development 1nit1
at1ves, and finally, supporting environmental green 1nit1at1vesLeaders periodically meet
w 1threpresentatives of sponsored organizations to discuss obJect1ves 1nclud1nghow dolla
rs w 111
be spent Add1t1onally,Wheaton Franciscan Healthcare may, at a later date, ask fo
r documentation 1norder to monitor that funds were spent for their intended purpose Curr
ently, conf1rmat1onletters are sent to sponsored organizations when award dollars or 1n-k
ind donations are given, that confirm the dollar amount (or approximate fair market value)
awarded and the intended purpose, w 1tha request that the rec1p1entacknowledge receipt o
f the funds 1nwritten correspondence Files are ma1nta1ned1nthe Organizational Change a
nd Leadership Performance Department to include copies of letters of request, award and de
nial letters, add1t1onaldocumentation 1f requested, and acknowledgement receipts from spo
nsored organizations

WI-20-0154-A-000038

 efile GRAPHIC

rint - DO NOT PROCESS

As Filed Data -

SCHEDULE H
(Form 990)

DLN:93493135029077

Hospitals
►

answered "Yes" on Form 990, Part IV, question 20.
Attach to Form 990.
► Information
about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
0MB No 1545-0047

Department of the
Treasury
Internal Revenue

Complete if the organization

►

Service

2015
Open to Public
Inspection
Name of the organization
WHEATONFRANCISCANINC

Employer identification

number

39-0816857

Financial

Assistance

and Certain

Other Community

Benefits

at Cost
Yes

la

Did the organIzatIon

have a f1nanc1al assistance

b If "Yes," was It a written

policy

during the tax yeari

If "No," skip to question

IVApplied

1

uniformly

Generally

to all hospital

tailored

I

fac1l1t1es

to 1nd1v1dual hospital

a

Did the organIzatIon
If"Yes,"

use Federal

1100%

IV 200%

1150%

c

200%

1

1

was the family

1

250%

300%

1

Applied

uniformly

el1g1b1l1ty criteria

income

Other ________________

Yes

appl1cat1on of the
fac1l1t1es

to the largest

income

IV 400%

1

LLL

%

l1m1t for el1g1b1l1ty for discounted

350%

number of the

for free care

In determ1n1ng el1g1b1l1ty for prov1d1ng drscounted carei

If "Yes,"

1nd1cate

care

Other _______________

%

If the organIzatIon used factors other than FPG In determ1n1ng el1g1b1l1ty, describe In Part VI the criteria
used for determ1n1ng el1g1b1l1ty for free or discounted
care Include In the description
whether the organIzatIon
used an asset test or other threshold,
regardless of income, as a factor In determ1n1ng el1g1b1l1ty for free or
discounted
care

Sa

Did the organIzatIon
the tax year 7

budget

amounts

b If "Yes," did the organ1zat1on's

for free or discounted

f1nanc1al assistance

Did the organIzatIon

prepare

a community

benefit

make It available

F1nanc1al Assistance

and

a

F1nanc1al
Assistanceat cost
(from Worksheet 1)

b

Med1ca1d
(from Worksheet 3,
column a)

C

Costs of other means-tested
government programs (from
Worksheet 3, column b)

Certain

Other

(a) Number of
act1v1t1esor programs

exceed

number of its patients

during the tax year

under its f1nanc1al assistance

the budgeted

was the organIzatIon
carei

policy

amount}

Yes

Sa

Yes
No

Sb

unable to provide

free or discounted
Sc

report during the tax yeari

No

6a

6b

provided

Community

4
during

to the publ1ci

Complete the following table using the worksheets
with the Schedule H
worksheets

Financial Assistance
and
Means- Tested
Government
Programs

care provided

expenses

If"Yes"
to line Sb, as a result of budget cons1derat1ons,
care to a patient who was el1g1b1le for free or discounted

b If "Yes," did the organIzatIon

7

to most hospital

l1m1tforel1g1b1l1ty

Did the organ1zat1on's f1nanc1al assistance
policy that applied to the largest
1nd1gent"7
provide for free or discounted
care to the "medically

6a

best describes

that applied

4

c

3a

No

In determ1n1ng el1g1b1l1ty for prov1d1ng free carei

Gu1del1nes (FPG) as a factor
was the FPG family

use FPG as a factor

which of the following

1

Poverty

1nd1cate which of the following

b Did the organIzatIon

Yes

fac1l1t1es

Answer the following based on the f1nanc1al assistance
organ1zat1on's patients during the tax year

3

la

pol1cyi

If the organIzatIon had multiple hospital fac1l1t1es, 1nd1cate which of the following
f1nanc1al assistance
policy to its various hospital fac1l1t1es during the tax year

2

6a

In the Schedule
Benefits

(b) Persons served
(optional)

H InstructIons

Do not submit

these

at Cost

(c) Total community

benefit expense

(d) Direct offsetting
revenue

(e) Net community

benefit expense

(f) Percent of
total expense

( optional)
4,457,290

4,457,290

1 090 %

126,579,125

115,242,186

11,336,939

2 780 %

131,036,415

115,242,186

15,794,229

3 870 %

Total F1nanc1al
Assistance and
d

Means-Tested Government
Programs
Other

Benefits

e

Community health improvement
services and community benefit
operations (from Worksheet 4)

53,969

15,017

38,952

0 010 %

f

Health professions education
(from Worksheet 5)

9,638,546

3,787,103

5,851,443

1 430 %

g

Subsidized health services (from
Worksheet 6)

2,643,574

1,393,132

1,250,442

0 310 %

h

Research (from Worksheet 7)

I

Cash and 1n-k1ndcontributions for
community benefit (from
Worksheet 8)

j

Total. Other Benefits

5,195,252

7,159,646

k

Total. Add lines 7d and 7J

For Paperwork

Reduction

18,809

18,809

12,354,898
Act Notice,

WI-20-0154-A-000039
22,953,875

143,391,313
see the Instructions

for Form 990,

120,437,438
Cat

No 50192T

Schedule

1 750 %
5 620 %

H (Form 990)

2015

 ScheduleH(Form990)2015

Page2

■ @If• Community

Building Activities
Complete this table 1f the organ1zat1on conducted any community building act1v1t1esduring the tax year, and
describe in Part VI how its community building act1v1t1espromoted the health of the commun1t1es 1t serves.
(b) Persons served

(a) Number of
act1v1t1es or programs

(optional)

(c) Total community
bu1ld1ngexpense

(d) Direct offsetting

(e) Net community
bu1ld1ngexpense

revenue

(f) Percent of
total expense

(optional)
Physical improvements and housing

1
2

Economic development

3

Community support

4

Environmental improvements

5

Leadership development and
training for community members

6

Coal1t1onbu1ld1ng

7

Community health improvement
advocacy

8

Workforce development

9

Other

10

Total

l:r.1•••••

Bad Debt, Medicare,

& Collection

12,964

11,014

1,950

12,964

11,014

1,950

Practices

Section A. Bad Debt Expense
Did the organIzatIon
Statement
No 157

1

Yes

report

bad debt expense

In accordance

with Heathcare

2

Enter the amount of the organ1zat1on's
methodology
used by the organIzatIon

3

Enter the estimated amount of the organ1zat1on's bad debt expense attributable
to
patients el1g1ble under the organ1zat1on's f1nanc1al assistance
policy Explain In Part VI
the methodology
used by the organIzatIon to estimate this amount and the rationale, 1f
any, for 1nclud1ng this portion of bad debt as community
benefit

4

bad debt expense
Explain
to estimate this amount

F1nanc1al Management

Provide In Part VI the text of the footnote
or the page number on which this footnote

No

AssocIatIon

1

Yes

9a

Yes

9b

Yes

In Part VI the
2

10,022,667

0

3

to the organ1zat1on's f1nanc1al statements
that describes
Is contained In the attached f1nanc1al statements

bad debt expense

Section B. Medicare

5

Enter total

6

Enter Medicare

7

Subtract

8

Describe In Part VI the extent to which any shortfall reported In line 7 should be treated as community
benefit
Also describe In Part VI the costing methodology
or source used to determine the amount reported on line 6
Check the box that describes the method used

1

revenue

received

allowable

from Medicare

costs

(1nclud1ng DSH andIME)

of care relating

line 6 from line 5 This Is the surplus

Cost accounting

system

IVCost

to payments

on line 5

(or shortfall)

to charge

5

78,352,605

6

77,600,460
752,145

7

ratio

10

ther

Section C. Collection Practices
9a
b

Did the organIzatIon

have a written

debt collection

policy

during the tax year?

If "Yes,"

did the organ1zat1on's collection
policy that applied
contain provIsIons on the collection
practices to be followed
assistance?
Describe In Part VI

■ ffif ¢) Management

Companies

to the largest number of its patients during the tax year
for patients who are known to qualify for f1nanc1al

and Joint Ventures

(owned 10% or more by officers, directors, trustees, key employees, and phys1c1ans-see1nstruct1ons)

(a) Name of entity

(b) Description of primary

actIvIty of entity

(c) Organ12at1on's
profit % or stock
ownership%

(d) Officers, directors,
trustees, or key

employees' profit%
or stock ownership%

(e) Phys1c1ans'
profit % or stock
ownership%

1
2
3
4

5
6

7
8

9
10
11

12
13

WI-20-0154-A-000040
Schedule H (Form 990) 2015

 ScheduleH

(Form990)2015

-:,,:;■---•--

Facility

Section A. Hospital

Page

2

Information
Facilities

(11stin order of size from largest to
smallest-see
instructions)
How many hospital fac1l1t1esdid the
organ1zat1on operate during the tax year?
3
Name, address, primary website address,
and state license number (and 1f a group
return, the name and EIN of the subordinate
hospital organ1zat1on that operates the
hospital fac1l1ty)

r

0

0

•1•

:;

,1,

a:

2.

~
:;

:l
,1,

rp

('

~
•1•

::...
-::,-

,:,
,J)

1J

;::;.
!:.,

-

,1•

::...
()

2..
Qo

~

-

•Q

';['

-::,0

--,

,1,
!:.)
()

';['
~

,CJ

<I•

2..

~

!:.)

-::,-

()

~
()

()

0
,J)

...
...
2..
2..
rp

,:J

..

c-:,. :JJ

1::,

()

<I•
rp
rp

-::,0

!:.)

Q

m
:JJ
I

...

~)

-::,0
C

m
:JJ
I

~

-::,-

~

;j;

~-

rp

...
2..

,:J

()
!:.)

Other (Describe)

Facility reporting
group

See Add1t1onal Data Table

WI-20-0154-A-000041
Schedule H (Form 990) 2015

 ScheduleH

Page 4

(Form990)2015

■ @ij Facility Information

(contmued)
Policies and Practices

Section B. Facility
(Complete

a separate

Section

Name of hospital facility

B for each of the hospital

or letter

fac1l1t1es or fac1l1ty reporting groups listed
WHEATON FRANCISCAN
INC
reporting group

of facility

Line number of hospital facility, or line numbers of hospital facilities
reporting group (from Part V, Section A)·

In Part V, Section

A)

in a facility
Yes

Community
1

Was the hospital fac1l1ty first licensed, registered,
tax year or the 1mmed1ately preceding tax yeari

2

Was the hospital fac1l1ty acquired or placed into service as a tax-exempt
hospital In the current
1mmed1ately preceding tax yeari If"Yes,"
provide details of the acquIsItIon In Section C

3

During the tax year or either of the two 1mmed1ately preceding
(CHNA)} If"No,"
skip to line 12
health needs assessment
If "Yes,"

a
b

1nd1cate what the CHNA

Iv A def1n1t1on of the community served
Iv Demographics of the community
Iv

or s1m1larly recognized

report describes

(check

by the hospital

c 1vEx1st1ng

d

No

Health Needs Assessment

health care fac1l1t1es and resources
of the community
How data was obtained

by a state as a hospital

tax years, did the hospital

fac1l1ty In the current

1

No

2

No

tax year or the

fac1l1ty conduct

a community
3

Yes

5

Yes

6a

Yes

6b

Yes

7

Yes

8

Yes

10

Yes

all that apply)

fac1l1ty

w1th1n the community

that are available

to respond

to the health needs

e 1vThe s1gn1f1cant health needs of the community

f

iv Primary

and chronic

disease

needs and other health issues

of uninsured

persons,

low-income

persons,

and minority

groups
g

Iv The

for 1dent1fy1ng and prioritIzIng

h

Iv The process
Iv Information

gaps that l1m1t the hospital

i

process
needs

for consulting

j 1vOther(describe

with persons

In Section

community
representing

health needs and services
the community's

fac1l1ty's ab1l1ty to assess

to meet the community

interests

the community's

health needs

C)

Indicate the tax year the hospital fac1l1ty last conducted a CHNA 20 l2._
In conducting its most recent CHNA, did the hospital fac1l1ty take into account input from persons who represent the
broad interests of the community served by the hospital fac1l1ty, 1nclud1ng those with special knowledge of or expertise
In public health7 If "Yes," describe In Section Chow the hospital fac1l1ty took into account input from persons who
represent the community, and 1dent1fy the persons the hospital fac1l1ty consulted

4
5

Was the hospital fac1l1ty's CHNA conducted
fac1l1t1es In Section C

with one or more other hospital

fac1l1t1esi If"Yes,"

b Was the hos pita I fac I IIty 's CH NA conducted

with one or more orga nIzatIons

other than hos pita I fac I I ItIes 7" If "Yes," l1st

6a

the other organIzatIons
7

Did the hospital
If"Yes,"

In Section

a

Iv Hospital

fac1l1ty make its CHNA report widely available

b

I

c

Iv Made

fac1l1ty's website

Other website

(11st url)

(check

all that apply)

_S_E_E_N_A_R_R_A_T_I_V_E_S_F_O_R_F_U_L_L_U_R_L
__________________

---1

(11st url)

a paper copy available
In Section

for public InspectIon

without

charge at the hospital

fac1l1ty

C)

Did the hospital fac1l1ty adopt an 1mplementat1on strategy to meet the s1gn1f1cant community
1dent1f1ed through its most recently conducted CHNA 7 If "No," skip to line 11

9

Indicate the tax year the hospital fac1l1ty last adopted an 1mplementat1on strategy
20 l2._
Is the hospital fac1l1ty's most recently adopted 1mplementat1on strategy posted on a webs1tei

(11st url)

other hospital

to the publ1ci

8

a If"Yes"

l1stthe

C

1nd1cate how the CHNA report was made widely available

d 1vOther(describe

10

health

SEE NARRATIVES

b If "No," Is the hospital

health needs

FOR FULL URL

fac1l1ty's most recently

adopted

1mplementat1on

strategy

attached

to this returni

10b
Describe In Section Chow the hospital fac1l1ty Is addressing the s1gn1f1cant needs 1dent1f1ed In its most recently
conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not
being addressed
12a Did the organIzatIon incur an excise tax under section 4959 for the hospital fac1l1ty's failure to conduct a CHNA as
required by section 501 (r)(3 )7

11

12a

b If "Yes" on line 12a, did the organIzatIon

file Form 4 720 to report the section

4959

excise

No

taxi

12b
c If"Yes"

on line 12b, what Is the total amount
all of1ts hospital fac1l1t1esi $

of section

4959

excise

tax the organIzatIon

reported

on Form 4720

for

WI-20-0154-A-000042
Schedule

H (Form 990)

2015

 ScheduleH

Page 5

(Form990)2015

■ @ij Facility Information
Financial

Assistance

(contmued)

Policy (FAP)
WHEATON

Name of hospital facility

or letter of facility

FRANCISCAN

INC

reporting group
Yes

Did the hospital

13

Explained

el1g1b1l1ty criteria

Iv Federal

poverty

c
d
e
f
g
h

such assistance

No

policy that

included

free or discounted

care?

13

Yes

14

Yes

15

Yes

16

Yes

17

Yes

income l1m1t for el1g1b1l1ty for free care of

income

l1m1t for el1g1b1l1ty for discounted

care of

%

1 Income level other than FPG (describe
Iv Asset level
Iv Medical 1nd1gency
Iv Insurance status
Iv U nderinsurance discount
1 Residency
1 other (describe 1n Section C)
Explained

the basis for calculating

15

Explained

the method for applying

If"Yes,"
1nd1cate how the hospital
explained the method for applying

b

and whether

f1nanc1al assistance

1n the FAP

% and FPG family

14

a

explained

gu1del1nes (FPG), with FPG family

200
400

b

for f1nanc1al assistance,

1nd1cate the el1g1b1l1ty criteria

If"Yes,"
a

fac1l1ty have 1n place during the tax year a written

Iv Described
Iv Described

amounts

her appl1cat1on
c 1vProv1ded the contact

charged

C)

to patients?

for f1nanc1al assistance?
fac1l1ty's FAP or FAP appl1cat1on form (1nclud1ng accompanying
for f1nanc1al assistance
(check all that apply)

the 1nformat1on the hospital
the supporting

1n Section

fac1l1ty may require an 1nd1v1dual to provide

documentation

the hospital

1nformat1on of hospital

1nstruct1ons)

as part of his or her appl1cat1on

fac1l1ty may require an 1nd1v1dual to submit

fac1l1ty staff who can provide

as part of his or

an 1nd1v1dual with 1nformat1on about the

FA P and FA P appl1cat1on process
d

Iv Provided
assistance

e

16

1

other

the contact 1nformat1on of nonprofit
with FAP appl1cat1ons

(describe

1n Section

measures

to publ1c1ze the policy w1th1n the community

If "Yes,"

1nd1cate how the hospital
FAP was widely available

SEE NARRATIVES

b 1vThe

Iv A

on a website

Iv A

FAP was available

plain language

1

Not1f1ed members

i 1vOther

(describe

by the hospital

fac1l1ty?

all that apply)

(11st url)

on a website

of the FAP was widely available

upon request

and without

(11st url)

on a website

(11st url)

summary

of the FAP was available

of the community
1n Section

charge (1n public locations

upon request

hospital fac1l1ty and by mail)
g 1vNot1ce ofava1lab1l1ty of the FAP was conspicuously
h

(check

FOR URL

e 1vThe FAP appl1cat1on form was available
and by mail)
f

of

FOR URL
summary

SEE NARRATIVES
d 1vThe

served

fac1l1ty publ1c1zed the policy

FAP appl1cat1on form was widely available

plain language

that may be sources

FOR FULL URL

SEE NARRATIVES
c

agencies

C)

Included
a 1vThe

organ1zat1ons or government

and without
upon request
displayed

1n the hospital

fac1l1ty and by mall)

charge (1n public locations
and without

throughout

charge

the hospital

who are most likely to require f1nanc1al assistance

1n the hospital

(1n public locations

fac1l1ty

1n the

fac1l1ty
about ava1lab1l1ty of the FAP

C)

Billing and Collections

17

Did the hospital fac1l1ty have 1n place during the tax year a separate b1ll1ng and collections
policy, or a written f1nanc1al
assistance
policy (FAP) that explained all of the actions the hospital fac1l1ty or other authorized party may take upon
non-payment?

18

Check all of the following actions against an 1nd1v1dual that were permitted under the hospital fac1l1ty's pol1c1es during
the tax year before making reasonable efforts to determine the 1nd1v1dual's el1g1b1l1ty under the fac1l1ty's FA P

a
b
c

d
e

1 Reporting to credit agency(1es)
1 Selling an 1nd1v1dual's debt to another party
I Actions that require a legal or Jud1c1al process
1 others1m1laract1ons (describe 1n Section C)
Iv None of these actions or other s1m1lar actions

were permitted

WI-20-0154-A-000043
Schedule H (Form 990) 2015

 ScheduleH

(Form990)2015

■ @ij Facility

Page

Information

WHEATON
Name of hospital facility

or letter of facility

FRANCISCAN

INC

reporting group
Yes

19

Did the hospital fac1l1ty or other authorized party perform any of the following actions
reasonable efforts to determine the 1nd1v1dual's el1g1b1l1ty under the fac1l1ty's FAP?

If "Yes,"

check all actions

1n which the hospital

a 1

Reporting

b 1
c

Selling an 1nd1v1dual's debt to another

I

Actions

to credit

b
c

No

19

agency(1es)
party

that require a legal or Jud1c1al process

Iv Not1f1ed 1nd1v1duals of the
Iv Not1f1ed 1nd1v1duals of the
Iv Not1f1ed 1nd1v1duals of the
1nd1v1duals'

d

No

during the tax year before making

fac1l1ty or a third party engaged

(describe 1n Section C)
d 1 others1m1laract1ons
20
Indicate which efforts the hospital fac1l1ty or other authorized
(whether or not checked) 1n line 19 (check all that apply)
a

6

(contmued)

party made before 1n1t1at1ng any of the actions

f1nanc1al assistance

policy on adm1ss1on

f1nanc1al assistance

policy

prior to discharge

f1nanc1al assistance

policy

1n commun1cat1ons

with the 1nd1v1duals regarding

listed

the

bills

Iv Documented

its determ1nat1on of whether
fac1l1ty's f1nanc1al assistance
policy
(describe

1n Section

e 1

other

f

None of these efforts

1nd1v1duals were el1g1ble forf1nanc1al

assistance

under the hospital

C)

were made

1
Policy Relating to Emergency Medical Care
Did the hospital fac1l1ty have 1n place during the tax year a written policy relating to emergency medical care that
required the hospital fac1l1ty to provide, without d1scrim1nat1on, care for emergency medical cond1t1ons to 1nd1v1duals
policy?
regardless ofthe1r el1g1b1l1ty under the hospital fac1l1ty's f1nanc1al assistance

21

21

Yes

If "No," 1nd1cate why
a 1 The hospital
b 1 The hospital
C

1 The hospital
C)

fac1l1ty did not provide

care for any emergency

medical

cond1t1ons

fac1l1ty's policy was not 1n writing
fac1l1ty l1m1ted who was el1g1ble to receive

care for emergency

medical

cond1t1ons (describe

1n Section

d 1 other (describe 1n Section C)
Charqes to Individuals Eliqible for Assistance Under the FA P (FA P-Eliqible Individuals)

22

Indicate how the hospital fac1l1ty determined, during the tax year, the maximum
el1g1ble 1nd1v1duals for emergency or other medically necessary care
hospital fac1l1ty used its lowest negotiated
a 1The
that
can be charged
b

hospital fac1l1ty used the average of its three lowest negotiated
the maximum amounts that can be charged

1 The hospital fac1l1ty used the Medicare
d 1 other (describe 1n Section C)

rates when calculating

that can be charged

rate when calculating

commercial

the maximum

insurance

amounts

the maximum

to FA Pamounts

rates when calculating

that can be charged

During the tax year, did the hospital fac1l1ty charge any FAP-el1g1ble 1nd1v1dual to whom the hospital fac1l1ty provided
emergency or other medically necessary services more than the amounts generally billed to 1nd1v1duals who had
insurance covering such care?

If "Yes,"

24

insurance

iv The

C

23

commercial

amounts

explain

1n Section

During the tax year, did the hospital fac1l1ty charge any FAP-el1g1ble
any service provided to that 1nd1v1dual? .

If "Yes,"

explain

1n Section

23

No

24

No

C

C

1nd1v1dual an amount equal to the gross charge for

WI-20-0154-A-000044

Schedule H (Form 990) 2015

 ScheduleH

Page 7

(Form990)2015

■ @ij Facility

Information

(contmued)

Section C. Supplemental
Information
for Part V, Section B.
Provide descriptions required for Part V, Section B, lines 2, 3J, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 161, 18d, 19d, 20e, 21c,
21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital fac1l1ty in a fac1l1ty reporting group,
designated by fac1l1ty reporting group letter and hospital fac1l1ty line number from Part V, Section A ("A, 1," "A, 4," "B, 2,"
"B, 3," etc.) and name of hospital fac1l1ty.
Form and Line Reference

Explanation

WI-20-0154-A-000045
Schedule

H (Form 990)

2015

 ScheduleH

(Form990)2015

PageS

■ @ij Facility Information

(contmued)

Section D. Other Health Care Facilities That Are Not Licensed,
Hospital Facility
(11stin order of size, from largest to smallest)
How many non-hospital

2

3

4

5

6

7

8

9

10

or Similarly

Recognized

health care fac1l1t1esdid the organ1zat1on operate during the tax year7 _____

WHEATON FRANCISCAN
201 N MAYFAIR RD
WAUWATOSA,
WI 53226
WHEATON FRANCISCAN
19333 W NORTH AVENUE
BROOKFIELD,WI
53045
WHEATON FRANCISCAN
9252 N GREEN BAY RD
BROWN DEER,WI
53209
WHEATON FRANCISCAN
5025 W BURLEIGH ST
MILWAUKEE,WI
53210
WHEATON FRANCISCAN
3070 N 51ST ST
MILWAUKEE,WI
53210
WHEATON FRANCISCAN
19475 W NORTH AVE
BROOKFIELD,WI
53045
WHEATON FRANCISCAN
19305 W NORTH AVE
BROOKFIELD,WI
53045
WHEATON FRANCISCAN
17000 WNORTH AVE
BROOKFIELD,WI
53045
WHEATON FRANCISCAN
19333 W NORTH AVE
BROOKFIELD,WI
53045

as a

"""'9'-------

Tvoe of Fac1l1tv (describe)

Name and address
1

Registered,

WAUWATOSA

HOSPITAL

BASED OUTPATIENT

INC

REHABILITATION

BROWN DEER

HOSPITAL

INC

MEDICAL

OFFICE

BUILDING

INC

MEDICAL

OFFICE

BUILDING

INC

MEDICAL

OFFICE

BUILDING

INC

FRANCIS

HOUSE

INC

OUTPATIENT

INC

PAVLIC

CNTR

UNIT

BASED OUTPATIENT

PERFORMANCE

CNTR

CENTER

CENTER

WI-20-0154-A-000046
Schedule

H (Form 990)

2015

 ScheduleH

(Form990)2015

■ @@• Supplemental
Provide the following

Page

Information

1nformat1on

1

Required descriptions. Provide the descriptions

2

Needs assessment. Describe how the organ1zat1on assesses
CH NAs reported 1n Part V, Section B

3

Patient education of eligibility for assistance. Describe how the organ1zat1on informs and educates patients and persons who may
be billed for patient care about their el1g1b1l1ty for assistance
under federal, state, or local government
programs or under the
organ1zat1on's f1nanc1al assistance
policy

4

Community information.
constituents
1t serves

5

Promotion of community health. Provide any other 1nformat1on important to describing how the organ1zat1on's hospital fac1l1t1es or
other health care fac1l1t1es further its exempt purpose by promoting the health of the community (e g, open medical staff, community
board, use of surplus funds, etc)

6

Affiliated
health care system. If the organ1zat1on 1s part of an aff1l1ated health care system,
organ1zat1on and its aff1l1ates 1n promoting the health of the commun1t1es served

7

State filing of community benefit
a community benefit report

990 Schedule

Describe

H, Supplemental

Form and Line Reference
SCHEDULE H PT VI
SUPPLEMENTAL
INFORMATION

the community

required

for Part I, lines 3c, 6a, and 7, Part II and Part III,
the health care needs of the commun1t1es

the organ1zat1on serves,

report. If applicable,

1dent1fy all states

taking

into account

the geographic

describe

lines 2, 3, 4, 8 and 9b

1t serves,

1n add1t1on to any

area and demographic

the respective

with which the organ1zat1on, or a related

roles of the
organ1zat1on, files

Information
Explanation

WI-20-0154-A-000047

9

  

Schedule (Form 990) 2015

Additional Data

Software
Software

ID:

Version:

39-0816857

EIN:

Name:

Form 990 Schedule

H, Part V Section

Section

Facilities

A. Hospital

A. Hospital
r

(11stin order of size from largest to
smallest-see
instructions)
How many hospital fac1l1t1esdid the
organ1zat1on operate during the tax year?
3

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Facilities
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Name, address, primary website address,
and state license number

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WHEATON FRANCISCAN INC

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Other (Describe)

1

2

WHEATON
FRANCISCAN
INC
5000 WCHAMBERS
MILWAUKEE,
WI 53210
HTTP //WWW MYWHEATON
ORG/STJOSEPH
30 (WI)
WHEATON
FRANCISCAN
INC
10000 WEST BLUEMOUND
ROAD
WAUWATOSA,WI
53226
HTTP /WWW MYWHEATON
ORG/WISCONs1n

X

X

X

X

X

X

X

X

Facility
reporting group

1

HEART

CARE

1

-heart308
3

(WI)

WHEATON
FRANCISCAN
INC
19333 W NORTH AVENUE
BROOKFIELD,
WI 53045
HTTP //WWW MYWHEATON
ORG/ELMBROOK
-MEMO RI
183 (WI)

X

WI-20-0154-A-000049 1

 efile GRAPHIC

rint - DO NOT PROCESS

As Filed Data -

DLN:93493135029077

Compensation Information

Schedule J
(Form 990)

0MB

Directors, Trustees, Key Employees, and Highest
Compensated Employees
► Complete if the organization
answered "Yes" on Form 990, Part IV, line 23.
► Attach to Form 990.
Information
about Schedule l (Form 990) and its instructions is at www.irs.gov/form

No 1545-0047

For certain Officers,

►

Department of the
Treasury
Internal Revenue Service

Name of the organ1zat1on

2015
990.

Open to Public
Ins ection

Employer identification

number

WHEATON FRANCISCAN INC

39-0816857

Questions

Regarding

Compensation
Yes

la

1
1
1
1
b
2

First-class
Travel

or charter

1
1
1
1

travel

for companions

Tax 1demn1f1cat1on and gross-up
D1scret1onary

spending

payments

account

Housing

allowance

Payments

or residence

for business

Health or social
Personal

for personal

use of personal

use

residence

club dues or 1n1t1at1on fees

services

(e g, maid, chauffeur,

If any of the boxes 1n line la are checked, did the organ1zat1on follow a written policy regarding
reimbursement
or prov1s1on of all of the expenses described above? If "No," complete Part III

chef)

payment or
to explain

lb

Did the organ1zat1on require substant1at1on prior to re1mburs1ng or allowing expenses incurred by all
directors, trustees, officers, 1nclud1ng the CEO/Executive
Director, regarding the items checked 1n line la7

2

Indicate which, 1f any, of the following the f1l1ng organ1zat1on used to establish the compensation
of the
organ1zat1on's CEO/Executive
Director
Check all that apply Do not check any boxes for methods
used by a related organ1zat1on to establish compensation
of the CEO/Executive
Director, but explain 1n Part III

3

1

Compensation

I
I

Independent

committee
compensation

consultant

Form 990 of other organ1zat1ons

During the year, did any person listed
or a related organ1zat1on

4

a severance

payment

on Form 990,

Receive

b

Part1c1pate 1n, or receive

payment

from, a supplemental

C

Part1c1pate 1n, or receive

payment

from, an equity-based

Only 501(c)(3),

501(c)(4),

or change-of-control

11st the persons

and 501(c)(29)

For persons listed on Form 990, Part VII,
compensation
contingent on the revenues

5

a

The organ1zat1on7

b

Any related
If"Yes,"

Written

I
I

Compensation

employment

Approval
Section

or study

A, line la with respect

committee

to the f1l1ng organ1zat1on

payment?

organizations

Section
of

contract

survey

by the board or compensation

nonqual1f1ed retirement
compensation

and provide the applicable
must complete

plan?

arrangement?
amounts

4a

No

4b

No

4c

No

Sa

No

Sb

No

for each item 1n Part III

lines 5-9.

A, line la, did the organ1zat1on pay or accrue any

organ1zat1on7

on line Sa or Sb, describe

1n Part III

For persons listed on Form 990, Part VII, Section
compensation
contingent on the net earnings of

6

1

Part VII,

a

If "Yes" to any of lines 4a-c,

A, line la, did the organ1zat1on pay or accrue any

a

The organ1zat1on7

6a

No

b

Any related

6b

No

7

No

8

No

If "Yes,"

organ1zat1on7

on line 6a or 6b, describe

1n Part III

7

For persons listed on Form 990, Part VII, Section
payments not described 1n lines 5 and 67 If"Yes,"

8

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract
subject to the 1n1t1alcontract exception described 1n Regulations section 53 4958-4(a)(3)7
1n Part III

9

No

Check the approp1ate box(es) 1fthe organ1zat1on provided any of the following to or for a person listed on Form
990, Part VII, Section A, line la Complete Part III to provide any relevant 1nformat1on regarding these items

A, line la, did the organ1zat1on provide
describe 1n Part III

If "Yes" on line 8, did the organ1zat1on also follow the rebuttable
section 53 4958-6(c)7

For Paperwork

Reduction Act Notice, see the Instructions

presumption

for Form 990.

procedure

any non-fixed
that was
If "Yes,"

describe

WI-20-0154-A-000050
described
1n Regulations

9

Cat

No 50053T

Schedule l (Form 990) 2015

 Schedule

J (Form 990)

2015

■ @ff• Officers,

Directors,

Page

Trustees,

Key Employees,

and Highest

Compensated

Employees.

Use duplicate

For each 1nd1v1dual whose compensation
must be reported on Schedule J, report compensation
from the organ1zat1on on row (1) and from related
1nstruct1ons, on row (11) Do not 11st any 1nd1v1duals that are not listed on Form 990, Part VII
Note. The sum of columns (B)(1)-(111) for each listed 1nd1v1dual must equal the total amount of Form 990, Part VII, Section A, line la, applicable

(A) Name and Title

(B) Breakdown
Base
(1) compensation

ofW-2

and/or

1099-MISC

(1i)
Bonus & 1ncent1ve
compensation

compensation
(1i1)
Other reportable
compensation

(C) Retirement
other deferred
compensation

and

2

copies 1f add1t1onal space 1s needed.
organ1zat1ons,
column

(D) Nontaxable
benefits

described

1n the

(D) and (E) amounts

for that 1nd1v1dual

(E) Total of columns
(B)(1)-(D)

(F) Compensation
1n
column(B) reported
as deferred on prior
WI-20-0154-A-000051 Form 990

See Add1t1onal Data Table
Schedule l (Form 990) 2015

 Schedule

J (Form 990)

1zjjiffl

Page

2015

Supplemental

Provide the 1nformat1on, explanation,

I

Return Reference

3

Information
or descriptions

I

required

for Part I, lines la, lb, 3, 4a, 4b, 4c, Sa, Sb, 6a, 6b, 7, and 8, and for Part II

this part for any add1t1onal
WI-20-0154-A-000052

Also complete

1nformat1on

Explanation
Schedule l (Form 990) 2015

 Additional Data

Software ID:
Software Version:
EIN:

39-0816857

Name:

,, art II
F orm 990 ,, Sh
C e d u Ie JP

- Off 1cers

1rectors

(B) Breakdown

(A) Name and Title

ofW-2

( i)

(1)

(11)

T rustees,
and/or

Kev E mo ovees,

1099-MISC

(ii)

Base
Compensation
lSaleem Aman MD
Secretary / Treasurer - Direct

WHEATON FRANCISCAN INC

-------------

0

0

------------1,430

-------------

d E mo ovees
(D) Nontaxable
benefits

and

other deferred
compensation

Other
reportable
compensation

0

523,822

(C) Retirement

(iii)

Bonus &
IncentIve
compensation

-------------

an d H"IQ h est C omoensate

compensation

0

------------

20,045

of columns
(B)(1)-(D)

0

-

27,491
lSharon Baughman
CNO Sr VP Patient Services

(1)

247,015

86,600

-------------

(11)

0

-------------

-------------

760

0

30,169

0

-----------0

------------

(1)
(11)

-------------

0

-------------

444,213

0

198,000

0

------------13,098

-------------

0

------------

63,318

0

-

15,233
31.JJianCa1Phannacy Director

(1)

166,488

16,680

-------------

(11)

0

-------------

-------------

615

0

10,257

0

-----------0

(1)
(11)

-------------

0

-------------

616,631

0

6,250

0

------------2,088

-------------

0

------------

14,261

(1)

(11)

-------------

0

-------------

415,730

0

0

------------6,249

-------------

0

------------

19,680

0

-

(1)

312,896

87,500

-------------

(11)

0

3,578

-------------

19,858

-------------

0

-

0

0

-----------0

-----------------------

(1)

218,878

7 5 ,ODO

-------------

(11)

0

-------------

-------------

420

0

23,484

0

-----------0

-----------------------

-

------------

(1)
(11)

-------------

0

-------------

447,175

0

219,500

0

------------12,638

-------------

0

------------

63,129

(1)

(11)

-------------

0

-------------

410,881

0

0

------------1,964

-------------

0

------------

26,792

0

-

(1)

167,657

15,871

-------------

(11)

0

-------------

-------------

907

0

53,723

0

-

0

-----------0

------------

(1)

174,293

48,400

-------------

(11)

0

-------------

-------------

616

0

25,107

0

-----------0

-----------------------

-

------------

(1)
(11)

-------------

0

-------------

402,490

0
0

0

------------3,254

-------------

0

------------

20,045

(1)

(11)

-------------

0

-------------

173,321

0
0

0

------------1,822

-------------

0

------------

12,647

0

-

(1)
(11)

-------------

0

-------------

206,920

0
0

0

------------1,519

-------------

0

------------

21,158

0

-

(1)

(11)

-------------

0

-------------

476,398

0

236,500

0

------------16,753

-------------

0

------------

69,344

0

-

(1)

336,911

93,900

-------------

(11)

0

5,490

-------------

20,156

-------------

0

-

0

0

-----------0

------------

(1)

(11)

206,468

-------------

0

-------------

0
0

-------------

508
0

11,074

25,790

-------------

-----------0

0

0

-

-------------

0
0

-

-------------

0
0

-

-------------

0
0

0

-

-------------

0
0

0

-

-------------

0
0

-

-------------

0
0

-

-------------

0
0

0

---------------------------------------------

0

0

0

0

-

481,844

-

------------

0
17Bryan Tollenaar
Medical Phys1c1st

0

-------------

0
0

-------------

0
0

-------------

0
0

-------------

0
0

822,466

25,387

-------------

-

-------------

249,399

23,471
16Robert Stern MD
VP Medical Affairs

0

205,294

19,802
15Debra Standridge
Vice Chairperson/President D

0

458,717

17,504
14Donald Roach MD
Secretary/Treasuer - Director

0

273,133

32,928

13Tod Poremski
Phys1c1anEmployee

-------------

0

0
12Thomas Mahn MD
Secretary / Treasurer - Direct

-

247,549

24,717

-------------

0

0

0
llMary Jo Kohout
VP Patient Care Services

0

472,830

9,391

-------------

-------------

768,950

33,193
lOSusan Jassak
Adm1n Director - Card10Srvcs

-

327,950

26,508
9Jenry Hardacre MDDirector

0

0

0
8R1ta Hanson-Melzer MD
Svp/Ch1ef Medical Officer

0

455,040

10,168

-------------

0

0

0
7Lynn Grudz1elanek
Sr VP Operations North
Market

-------------

464,151

31,208

-------------

0

672,273

22,492
6Enc Christianson MD
VP Medical Affairs North
Marke

-

226,741

33,043
5Kuman Ch1ntamanern MD
Director

0

0

0
4Manfred Chiang MDDirector

-------------

733,862

32,701

-------------

-

402,322

------------

0
2Susan Boland
President Des1gnee- Director

0

572,788

37,778

-------------

(F) Compensation
In
column (B)
reported as deferred
on prior Form 9 9 O

(E) Total

-

-------------

0

0
243,840

-----------------------WI-20-0154-A-000053
0

0

0

0
0

 efile

GRAPHIC

rint

- DO NOT PROCESS

Data -

Supplemental Information to Form 990 or 990-EZ

SCHEDULE 0
(Form 990 or
990-EZ)
Department of the
Treasury
Internal Revenue
Service

As Filed

►

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
► Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/f
orm990.

Name of the organIzatIon

DLN:93493135029077
0MB No 1545-0047

2015
Open to Public
Inspection

Employer identification

number

WHEATON FRANCISCAN INC

39-0816857

990 Schedule
Return
Reference

O, Supplemental

Information
Explanation

SCHEDULEO
Part IV Lines 12a-12b and Part XII Lines 2a-2c Effective March 1, 2016, Wheaton Franciscan Healthcare organizations In the
SUPPLEMENTAL SE WI region were transferred to Ascension Health As such, all SE WI organization have been included In the consolidated
INFORMATION
Ascension audit report for the period March 1, 2016 June 30, 2016, and we have therefore answered NO, YES accordingly
Part V Line 1a and Part VII Section B Line 1-2 Wheaton Franciscan Healthcare stream1ned their reporting of IRS Forms
1099-MISC so that most 1099-MISC are now reported using the FEINnumber of the parent organization or of a related
organization The actual expense continues to be paid by, or transferred to, the 1nd1v1dual
entity w h1ch Is normally a
subs1d1aryor related organization to the organizat1on(s) IssuIng the 1099 For this reason, the reader may notice on some
990s that there are top 5 independent contractors reported, but no 1099s are reported L1kewIse on the 990s of the
organizat1on(s) reporting number of 1099s, there may be a d1sproport1onateshare of 1099s reported as compared w 1ththe
actual expenses and top 5 independent contractors reported Part VI Section A Line 4 The organizations Articles and
Bylaws were amended effective March 1, 2016 to reflect the transItIon of sponsorship of Wheaton Franciscan Healthcare Southeast W1scons1n,Inc and its subs1d1ariesto Ascension Health The corporate member of Wheaton Franciscan, Inc
continues to be SE WI The board size for Wheaton Franciscan, Inc was also changed from not less than 3 and not more
than 19 to not less than 9 and not more than 13 directors Part VI Section A Line 6-Bb Wheaton Franciscan, Inc has one
member w h1chholds several reserved powers over the entity These reserved powers include, but are not limited to, the
appointment and removal of board members and the board chair and approval of strategic plans, these approvals are based
on recommendations from the governing body Part VI Section B Lines 11a and 11b Ministries that were affiliates of
Wheaton Franciscan Healthcare during the fiscal year ending June 30, 2016 used a multiple-level review process on all IRS
Forms 990 to ensure accurate and timely f1hngfor all organizations Under the d1rect1onof the Tax Manager, the Accounting
Departments In each region prepare Forms 990, 990-T, and associated state filings When complete, the return Is first
reviewed by a Senior-Level (or higher) associate In the Finance Department, who focuses on income statement and balance
sheet items, and schedules where transactions of this type mght be reported If d1screpanc1es are found, the item w 111
be
corrected prior to the next step In the review process Once cleared through Finance, the return Is provided to the Tax
Department, where the Tax Manager concentrates primarily on consistency of reporting between all returns, accuracy of
tax related 1nformat1on,and narrative explanation of any outliers Again, any problems or questions are 1nvest1gatedand
corrected Depending on the level of complexity of the year In question, as well as the 1nd1v1dual
issues spec1f1cto that f1hng,
vary from year to year
certain returns may be selected for outside review by a public accounting firm This dec1s1onw 111
based on many factors, and sometimes outside review Is not utilized at all Also, certain schedules, such as Schedule Hor
Schedule J may be reviewed by committees, such as the Cornrnm1ty Benefit Team or the Compensation Committee In
selected years The board has also asked for formal presentations on various 990 topics over the years This dec1s1onw 111
vary from year to year, again based on many factors Once all levels of review have been completed, the Tax Manager (or
the designated employee In the applicable region) w 111
schedule an appointment w 1ththe signer of the 990 This Is normally a
Senior Vice President or CFO of the applicable region, who w 111
perform an add1t1onal,normally high level review prior to
signing the return Once signed, the return Is cleared to provide to members of the Board of Directors, who at a later date
but prior to ef1hng,are provided access to all 990s throughout their assigned region via an onhne portal Add1t1onally,as a
w 111
also receive access to the portal, where they
courtesy, any 1nd1v1dual
who Is listed on any 990 as a reportable 1nd1v1dual
can view the 990 1fthey so choose, prior to It being filed w 1ththe IRS Part VI Section B Lines 12a 12c The organization has
a Conflict of Interest policy w h1chstates that 1fat any time, an officer or a director become aw are that the board may
discuss or act upon any transaction or arrangement w h1ch may have any bearing of any kind upon, or may relate In any
manner to, a f1nanc1alinterest of the 1nd1v1dual,
the f1nanc1alinterest must be disclosed All associates of the organization
must disclose a potential conflict of interest any time one arises The disclosures are reviewed and a determnat1on Is made
as tow hether a conflict of interest exists and how It mght be managed Add1t1onally,as part of an annual process, conflict
of interest questIonnaIres are sent out to all Officers, Directors, and other 1nd1v1duals
In key posItIons using software
designed to capture this 1nformat1onThe responses are analyzed In order to determine 1nformat1onon potential conflicts, as
well as 1nformat1onon business and family relat1onsh1psand other disclosures required to be made on IRS Forms 990
Responses to these questions are reviewed by the Vice President of Compliance and the Manager of Tax Compliance, and
follow up action, 1fany, Is documented w 1th1nthe software Non-responders are reminded of their outstanding disclosure
requirement automatically through the software system Responses to questions continue to be reviewed and documented
throughout this time period Approximately 1 month prior to the f1hngdeadline of IRS Form 990, responses to date are
compiled Any response requiring disclosure Is entered into the 1nformat1onreturn The remaining non responder names are
determined, and a letter, along w 1ththe actual Conflict of Interest Polley, Is sent to the Chairperson of each board The letter
lists current non responders, as well as any Officer or Board member that has disclosed a f1nanc1alinterest that might pose
a potential conflict of interest Depending upon the nature of the f1nanc1alinterest and work done by the board, several
actions may be considered first, the board member w 1tha f1nanc1alinterest would need to voluntarily excuse him or herself
from the deliberations and/or voting on such a matter If not, the board may, 1fnecessary, determne that the subjects
f1nanc1alinterest was an actual conflict of interest, In w h1chcase the board member would be informed by the board
Chairperson that he or shew ould not be allowed to vote In any such matters due to this real or perceived conflict of interest
Minutes of the board meeting would document this dec1s1onprocess, and reflect whatever act1on(s) are ultimately taken The
board chairperson Is also required to discuss w 1thnon responders the repercussions of not responding, and require the
board member to complete the annual conflict of interest disclosure questions before being allowed to continue In any board
matters If the board member refuses, the Chairperson has the authority to determine the appropriate action, 1nclud1ng,but
not limited to proh1b1t1ng
them from partIcIpatIng In dehberat1ons, preventing them from voting, and/or removing them as a
who served
board member Part VI Section B Lines 15b For calendar year 2015, the f1hngorganization has paid 1nd1v1duals
have the follow Ing compensation
as either Officers or Key Employees during the reporting period These 1nd1v1duals
structure The compensation for the organizations officers and key employees who are paid by the f1hngorganization Is
reviewed and approved on an annual basis, as part of the WFSI Executive Compensation Flan, by the Executive Committee
of the Wheaton Franciscan Services, Inc Board of Directors (the Executive Committee of the WFSI Board), an independent
board, acting In a manner consistent w 1thits conflicts of interest policy The WFSI Boards dec1s1onIs informed by an opinion
on market comparable compensation data provided to the WFSI Board by an independent compensation expert The WFSI
Board maIntaIns contemporaneous documentation of the substant1at1onof the deliberation and dec1s1onsIt makes Part VI
Section C Line 19 Ministries that were affiliates of Wheaton Franciscan Healthcare during the fiscal year ending June 30,
2016 provided upon request certain documents 1nclud1ngour f1nanc1alstatements, conflict of interest policy, and governing
documents that support our tax exempt status, 1nclud1ng,but not hmted to, articles of IncorporatIon and bylaws During fiscal
are currently w ork1ngon policy
2016, all ministries were transferred to new parent organizations and all organizations
WI-20-0154-A-000054
review and

 efile GRAPHIC

rint - DO NOT PROCESS

SCHEDULER
(Form 990)
Department of the Treasury
Internal Revenue Service

As Filed Data -

DLN:93493135029077
0MB

Related Organizations and Unrelated Partnerships
►
►

Complete if the organization

Attach to Form 990.

►

Information

2015

answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
about Schedule R (Form 990) and its instructions

is at www.irs.gov/form

Name of the organ1zat1on

No 1545-0047

990.

Employer identification

Open to Public
Ins ection
number

WHEATON FRANCISCAN INC
39-0816857

■ :Jffill ■

Identification

of Disregarded

Entities

Complete 1f the organ1zat1on answered "Yes" on Form 990 , Part IV , line 33

(a)
Name, address, and EIN (1f applicable) of disregarded entity

■ :r.• .. •••

Identification
of Related
or more re ate d tax-exemot

(b)
Primary actIvIty

(c)
Legal dom1c1le (state
or foreign country)

(d)
Total income

(e)
End-of-year

(f)
Direct controlling
entity

assets

Tax-Exempt
Organizations
Complete 1f the organ1zat1on answered "Yes" on Form 990, Part IV, line 34 because 1t had one
oraan1zat1ons d unna t h e tax vear.

(a)
Name, address, and EIN of related organization

(b)
Primary actIvIty

(c)
Legal dom1c1le (state
or foreign country)

(d)
Exempt Code section

(e)
Public charity status
(1f section 50l(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)
( 13) controlled
entity>
Yes

No

See Add1t1onal Data Table

WI-20-0154-A-000055
For Paperwork

Reduction Act Notice, see the Instructions

for Form 990.

Cat

No 50135Y

Schedule R (Form 990) 2015

 Schedule

R (Form 990)

2015

Page

2

■ ffilff• Identification
of Related Organizations
Taxable as a Partnership
Complete 1f the organ1zat1on answered "Yes" on Form 990, Part IV, line 34
because 1t had one or more related organ1zat1ons treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organIzatIon

(b)
Primary actIvIty

(c)
Legal
dom1c1le
(state or
foreign
country)

(d)
Direct
controlling
entity

(e)
Predominant
1ncome(related,
unrelated,
excluded from
tax under
sections 512514)

(g)
(f)
Share of
Share of
total income end-of-year

assets

(h)
(i)
(J)
D1sproprt1onate Code V-UBI
General or
allocations>
amount in box managing
partner>
20 of
Schedule K-1
( Form 1065)

Yes

1Wlf4

No

Yes

(k)
Percentage
ownership

No

..

Ident1f1cat1on of Related Organizations
Taxable as a Corporation
or Trust Complete 1f the organ1zat1on answered " Yes " on Form 990, Part IV, line
34 because 1t had one or more related organ1zat1ons treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization

(b)
Primary actIvIty

(c)
Legal
dom1c1le
(state or foreign
country)

(d)
Direct controlling
entity

(e)
Type of entity
(C corp, S
corp,
or trust)

(f)
Sha re of tota I
income

(g)
Share of end-ofyear

(h)
Percentage
ownership

assets

(1)
Section 512
(b)(13)
controlled
entity>
Yes

Wheaton Franciscan
(l)Enterprises Inc (2)

No

HOLDING CO

WI

WF HOLDINGS INC

C CORP

No

HOLDING CO

WI

WFH-SE WI

C CORP

No

MED GROUP

WI

WF HOLDINGS INC

C CORP

No

PROVIDER CONTRACT

WI

WFH-SE WI

C CORP

No

CONDO MGMT

WI

FMOB LLC

C CORP

No

CONDO ASSCN

WI

WFH-FRKLN

C CORP

No

FINANCIAL

UK

WFSI

Other

No

400 WEST RIVER WOODS
PARKWAY
GLENDALE, WI 53212
39-1985204

(2)
Wheaton Franciscan Holdings
Inc (2)
400 WEST RIVER WOODS
PARKWAY
GLENDALE, WI 53212
39-1836357
(3)WFMG - Sussex Inc (2)
400 WEST RIVER WOODS
PARKWAY
GLENDALE, WI 53212
39-1361100
Wheaton Franciscan Prov
(4)Network Inc (2
400 WEST RIVER WOODS
PARKWAY
GLENDALE, WI 53212
39-1952140

(5)
FMOB Condo Assoc Inc (2)
400 WEST RIVER WOODS
PARKWAY
GLENDALE, WI 53212
34-1983857

(6)
Wheaton Way Condo Owners
Assoc Inc ( 2)
10101 SOUTH 27TH STREET
FRANKLJN, WI 53132
30-0659830
Wheaton Franciscan
(7)Insurance Company (4)
PO BOX 69 GT
GEORGETOWN,
GRAND CAYMAN
CJ
98-0691609

WI-20-0154-A-000056
Schedule R (Form 990) 2015

 Schedule

R (Form 990)

•@fl

2015

Page

Transactions

Note. Complete

With Related

line 1 1fany entity

Organizations

1s listed

Complete

a

Receipt

b

Gift, grant, or capital

contribution

to related

C

Gift, grant, or capital

contribution

from related

d

Loans or loan guarantees

to or for related

e

Loans or loan guarantees

by related

f

D1v1dends from related

g

Sale of assets

h

Purchase

of assets

from related

i

Exchange

of assets

with related

j
k
I

of (i) interest,

(ii)annu1t1es,

1f the organ1zat1on answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

(iii)royalt1es,

or(iv)rent

transactions

from a controlled

organ1zat1on(s)

la
lb

.

organ1zat1on(s).
organ1zat1on(s).
organ1zat1on(s)

Lease offac1l1t1es, equipment,

or other assets

from related

organ1zat1on(s)

P erforma nc e of s e rv1c es or members h Ip or fu ndra 1sIng sol 1c1tat1ons for related

n Sharing offac1l1t1es, equipment,
of paid employees

orfundra1s1ng

sol1c1tat1ons by related

ma1l1ng lists, or other assets

with related

No
Yes

le

Yes

ld

Yes

le

Yes

lf

organ1zat1on(s).

or membership

organ1zat1on(s)

with related

lg

No

lh

No

li

Yes

lj

Yes

lk

Yes
Yes

orga n1zat1on(s)

11

organ1zat1on(s)

lm Yes

organ1zat1on(s)

.

.

ln

Yes

lo

Yes

p

Reimbursement

paid to related

organ1zat1on(s)

for expenses

lp

Yes

q

Reimbursement

paid by related

organ1zat1on(s)

for expenses

lq

Yes

r

Other transfer

of cash or property

to related

s

Other transfer

of cash or property

from related

2

No

1n Parts II-IV7

organ1zat1on(s)

to related

Sharing

listed

organ1zat1on(s)

or other assets

o

organ1zat1ons

organ1zat1on(s)

to related

of services

with one or more related

entity.

organ1zat1on(s)

Lease offac1l1t1es, equipment,

m Performance

Yes

1n Parts II, III, or IV ofth1s schedule

1 During the tax year, did the orgran1zat1on engage 1n any of the following

3

If the answer to any of the above 1s "Yes,"

organ1zat1on(s)

.

organ1zat1on(s)

see the 1nstruct1ons

for 1nformat1on on who must complete

this line, 1nclud1ng covered

(a)
Name of related organization

(b)
Transaction

relat1onsh1ps

and transaction

(c)
Amount involved

lr

Yes

ls

Yes

thresholds

(d)
Method of determining

amount involved

type (a-s)
{l)WF

- ST JOSEPH FOUNDATION INC

C

410,372

FMV

(2)WF - ELMBROOK MEMORIAL FOUNDATION

C

98,512

FMV

WI-20-0154-A-000057
Schedule R (Form 990) 2015

 Schedule

R (Form 990)

■ @f?•

Page 4

2015

Unrelated

Organizations

Taxable

as a Partnership

Complete

1f the organ1zat1on answered "Yes" on Form 990, Part IV, line 37.

Provide the following 1nformat1on for each entity taxed as a partnership through which the organ1zat1on conducted more than five percent
revenue) that was not a related organ1zat1on See 1nstruct1ons regarding exclusion for certain investment
partnerships
(a)
Name, address, and EIN of entity

(b)
Primary actIvIty

(c)
Legal
dom1c1le
(state or
foreign
country)

(d)
Predominant

(e)
Are all partners

income

section

( related,
unrelated,
excluded from
tax under
sections 512514)

501(c)(3)
organ1zat1ons?

Yes

No

(f)
Share of
total
income

(g)
Share of
end-of-year

of its act1v1t1es (measured
(h)
D1sproprt1onate
allocations>

assets

by total assets

(1)
Code V-UBI
amount 1n

box 20
of Schedule
K-1
(Form 1065)
Yes

No

or gross
(k)
Percentage
ownership

(J)
General or
managing
partner>

Yes

No

WI-20-0154-A-000058
Schedule R (Form 990) 2015

 Schedule

R (Form 990)

■ ffii?f• Supplemental
Provide

Page 5

2015

Information

add1t1onal 1nformat1on for responses

Return Reference
Schedule

R Supplemental

Information

to questions

on Schedule

R (see 1nstruct1ons)
Explanation

(1) Effective March 1, 2016, organ1zat1ons 1n the MarianJoy region were transferred from Wheaton Franciscan Services, Inc to Northwestern
Memorial
Healthcare, and as a result, ceased to be related as ofth1s date (2) Effective March 1, 2016, organ1zat1ons 1n the Southeast W1scons1n region were
transferred from Wheaton Franciscan Services, Inc to Ascension
Health, and as a result, neworgan1zat1ons
became related as ofth1s date (3) Effective
May 1, 2016, organ1zat1ons 1n the Iowa region were transferred from Wheaton Franciscan Services, Inc to Mercy Health Network, and as a result of the
(4) Effective March 1, 2016, organ1zat1ons 1n the Wheaton Franciscan
SE WI transfer to Ascension
Health, ceased to be related as of March 1, 2016
Services, Inc and Wheaton Franciscan Sisters Foundation, Inc region were transferred to Wheaton Franciscan Sisters Corporation
and as a result,
ceased to be related as ofth1s date (5) Effective March 1, 2016, organ1zat1ons 1n the Wheaton Franciscan Services, Inc and Wheaton Franciscan Sisters
with
Foundation, Inc region were transferred to Wheaton Franciscan Sisters Corporation and were considered unrelated as ofth1s date Simultaneously
this transfer, Wheaton Franciscan Sisters Foundation, Inc was removed as the corporate sponsor of Franciscan Sisters of Colorado, Inc, and the
organ1zat1on continued independently
(6) Effective May 4, 2016, OS F Services, Inc changed its legal name to Wheaton Franciscan Sisters Foundation,
Inc (7) Effective June 9, 2016, Canticle M1n1stries, Inc was dissolved, and as such, this will be it's final 990 and the final year 1t will be reported as a
related organ1zat1on through March 1, 2016
(8) UHS, Inc 1s listed without a direct controlling entity because of the two organ1zat1ons with an interest,
KHMC Community
Board and Wheaton Franciscan Sisters Foundation, Inc, neither can appoint a maJority of the board, and since KHMC 1s not an entity (1t
1s a community board), neither body "controls"
(9) Effective March 1, 2016, organ1zat1ons 1n the Wheaton Franciscan Services, Inc and Wheaton
Franciscan Sisters Foundation, Inc region were transferred to Wheaton Franciscan Sisters Corporation and ceased to be considered related as ofth1s
date Effective December 31, 2016 (after the close of the current reporting year), Wheaton Franciscan Sisters Foundation, Inc was removed as the
corporate sponsor of SET M1n1stries, Inc, and future of the organ1zat1on 1s unknown until a new corporate sponsor 1s determined
(10) Ind1anapol1s Manor
1, Inc was incorporated
on September 25, 2015 and was granted exempt status effective November 5, 2015
(11) Kokomo Manor, Inc was incorporated
on September 25, 2015 and was granted exempt status effective April 4, 2016
(12) Ind1anapol1s Manor 2, Inc was incorporated
on September 25, 2015
and was granted exempt status effective November 5, 2015
(13) Paducah M1n1stries 1, Inc was incorporated on September 25, 2015 and was granted
exempt status effective April 15, 2016
(14) Princeton M1n1stries 4, Inc was incorporated
on September 25, 2015 and was granted exempt status
effective March 21, 2016
(15) Richardson M1n1stries, Inc was incorporated
on September 25, 2015 and was granted exempt status effective January
15, 2016
(16) Effingham M1n1stries, Inc was incorporated
on September 25, 2015 and was granted exempt status effective December 21, 2015
(17)
Moline M1n1stries 1, Inc was incorporated
on September 25, 2015 and was granted exempt status effective April 6, 2016
(18) Moline M1n1stries 2, Inc
(19) Lake Wales M1n1stries, Inc was incorporated
on
was incorporated
on September 25, 2015 and was granted exempt status effective March 30, 2016
(20) Pendleton M1n1stries 2, Inc was incorporated
on September 29,
September 25, 2015 and was granted exempt status effective January 7, 2016
on September 2 5, 2 0 15 and was granted
2 0 15 and was granted exempt status effective May 12, 2 0 16 (21) Tucson M 1n1stries, Inc was incorporated
(22) Phoenix M1n1stries 3, Inc was incorporated
on September 25, 2015 and was granted exempt status
exempt status effective February 3, 2016
(23) Davenport M1n1stries, Inc was incorporated
on September 29, 2015 and was granted exempt status effective January 15,
effective March 16, 2016
2016
(24) Alexandria Manor, Inc was incorporated
on September 25, 2015 and was granted exempt status effective February 2, 2016
(25) Effective
be dissolved
(26) Effective November 1,
January 31, 2016, assets of Villa St Clare, Inc were sold to an unrelated party, and the entity will subsequently
2016 (after the close of the current reporting year), a 25% ownership percentage 1n UHS, Inc was transferred from Wheaton Franciscan Sisters
Foundation, Inc to UHS, Inc making them 100% owner of St Catherine's
Hospital, Inc and United Hospital System, Inc With the transfer of the SE WI
orga n1zat1ons to As cens 10n Heat Ih, the orga n1zat1ons under UH S, Inc ceased to be cans 1dered related as of Ma re h 1, 2 0 16 (2 7) Effect1ve Dec ember 2 2,
WI-20-0154-A-000059
2016 (after the close of the current reporting year), Franciscan M1n1stries Community Foundation, Inc was dissolved
With the transfer of the SE WI
organ1zat1ons to Ascension
Health, this organ1zat1on ceased to be considered related as of March 1, 2016
Schedule

R (Form 990)

2015

 Additional Data

Software
Software

ID:

Version:
EIN:

39-0816857

Name:

Form 990, Schedule
Name, address,

R, Part II - Identification

(a)
and EIN of related

organIzatIon

of Related

WHEATON FRANCISCAN INC

Tax-Exempt
(b)
Primary actIvIty

Organizations
(c)

(d)

Legal dom1c1le
(state
or foreign
country)

Exempt Code
section

(e)
Public charity
status
(1fsect1on 501(c)
(3 ))

Direct

(f)
controlling
entity

(g)
Section 512
(b)(l 3)
controlled
entIty7

Yes
Wheaton Franciscan
Services
26 W 171 ROOSEVELT
RD
WHEATON,
IL 60187
36-3262111
Ascension
Health Alliance
PO Box 45998
St LOUIS, MO 63145
45-3358926

No

IL

501(c)(3)

11 - III-FI

NA

No

Heal

MO

501(c)(3)

11-1

NA

No

Heal

MO

501(c)(3)

11-1

Ascension

IL

501(c)(3)

11 - III-FI

WFS!AscensI

No

HOSPITAL

WI

501(c)(3)

3

WFH-SE

WI

No

FOUNDATION

WI

501(c)(3)

11 - I (7)

WFH-AS

INC

No

FO UN DA TIO N

WI

501(c)(3)

11 - Ill-NF

WFH-AS

INC

No

FOUNDATION

WI

501(c)(3)

11 - I

WFH-PE

HOME

WI

501(c)(3)

3

WFH-SE

WI

No

MED GROUP

WI

501(c)(3)

3

WFH-SE

WI

No

FO UN DA TIO N

WI

501(c)(3)

11 - I

WF INC

LA BO RATO RY

WI

501(c)(3)

9

WFH-SE

WI

No

PHARMACY

WI

501(c)(3)

9

WFH-SE

WI

No

HOSPITAL

WI

501(c)(3)

3

WFH-SE

WI

No

FO UN DA TIO N

WI

501(c)(3)

11 - I

WF INC

FOUNDATION

WI

501(c)(3)

11 - I

WFH-SFH

AUXILIARY

WI

501(c)(3)

11 - Ill-FI

WF INC

WI

501(c)(3)

9

WFH-SE

WI

No

HOSPITAL

WI

501(c)(3)

3

WFH-SE

WI

No

MED GROUP

WI

501(c)(3)

3

WFMG

PARENT

CORP

National

National

Inc (4)

(2)

He

No

Ascension
Health (2)
PO Box 45998
St LOUIS, MO 63145
31-1662309
HOLDING
WFH - Southeast
WIsconsIn
400 WEST RIVER WOODS
GLENDALE,
WI 53212
39-1568865

CO

Inc (2)
PARKWAY

WFH - A II Saints Inc (2)
3801 SPRING STREET
RACINE,
WI 53405
39-1264986
WFH - All Saints Foundation
3805B SPRING STREET
RACINE,
WI 53405
39-1570877
Vlntrs In Pnrshp wWFH-AII
3807 SPRING STREET
RACINE,
WI 53405
93-0838390

Inc (2)

Saints

(2)

No

WFH - C 1rcle of Life Foundation
(2)
4300 WEST BROWN DEER RD STE 250
BROWN DEER, WI 53223
56-2426294
HLTH

WF Home Health & Hospice Inc (2)
3070 NORTH 51ST STREET STE 406
MILWAUKEE,
WI 53210
39-1559428
WF M ed1cal Group Inc (2)
400 WEST RIVER WOODS
GLENDALE,
WI 53212
39-1791586

PARKWAY

Yes

WF - E lmbrook Memorial Fndn Inc (2)
19333 WEST NORTH AVENUE
BROOKFIELD,
WI 53045
39-2028808
WF Laboratories
Inc (2)
3237 SOUTH 16TH STREET
MILWAUKEE,
WI 53215
39-1701402
WFH - Pharmacy
Ent & Fran Woods (2)
19525 WEST NORTH AVENUE
BROOKFIELD,
WI 53005
39-1613624
WFH - St Franc IS Inc (2)
3237 SOUTH 16TH STREET
MILWAUKEE,
WI 53215
39-0907740
Yes

WF - St Joseph Foundation
Inc (2)
5000 WEST CHAMBERS
STREET
MILWAUKEE,
WI 53210
39-1636804
WFH - Fndn for St Francis & Franklin
3237 SOUTH 16TH STREET
MILWAUKEE,
WI 53215
32-0135258
WFH - Elmbrook Memorial Aux1l1ary
19333 WEST NORTH AVENUE
BROOKFIELD,
WI 53045
39-6068950

Yes

(2)

NURSING
WFH - Terrace
3200 SOUTH
MILWAUKEE,
39-1486775

No

(2)

HOME

at St Francis Inc (2)
20TH STREET
WI 53215

WFH - Franklin Inc (2)
10101 SOUTH 27TH STREET
FRANKLIN,
WI 53132
56-2592868
Metro Phys1c1ans Inc (2)
400 WEST RIVER WOODS
GLENDALE,
WI 53212
94-3436893

PARKWAY

WI-20-0154-A-000060

No

 Form 990, Schedule
Name, address,

R, Part II - Identification

(a)
and EIN of related

organIzatIon

of Related

Tax-Exempt
(b)
Primary actIvIty

Organizations
( c)

(d)

Legal dom1c1le
(state
or foreign
country)

Exempt Code
section

(e)
Public charity
status
(1fsect1on 50l{c)
(3 ))

Direct

(f)
controlling
entity

(g)
Section 512
(b){l 3)
controlled
entIty7

Yes
Marian1oy Inc (1)
26 W 171 ROOSEVELT
WHEATON,
IL 60187
36-3483589

No

IL

50l{c)(3)

11 - III-FI

WFSI

No

FOUNDATION

IL

50l{c)(3)

7

Ml HOSP

No

AUXILIARY

IL

50l{c)(3)

11 - I

Ml HOSP

No

REHAB HOSPITA

IL

50l{c)(3)

3

MARIANlOY

No

MEDICAL

GRP

IL

50l{c)(3)

3

MARIANlOY

No

HOLDING

CO

WI

50l{c)(3)

11 - III-FI

WFSI

No

IL

50l{c)(3)

7

OSF SVCS INC

No

AUXILIARY

co

50l{c)(3)

7

OSF SVCS INC

No

SOCIAL

WI

50l{c)(3)

9

OSF SVCS INC

No

HOSPITAL

WI

50l{c)(3)

3

OSF SVCS INC

No

HOSPITAL

WI

50l{c)(3)

3

NO NE

No

HIV SUPPORT

IL

50l{c)(3)

9

OSF SVCS INC

No

HOLDING

IA

50l{c)(3)

11 - Ill-FI

WFSI

No

FOUNDATION

IA

50l{c)(3)

9

COV MED CTR

No

HOSPITAL

IA

50l{c)(3)

3

WFH-IOWA

No

HOSPITAL

IA

50l{c)(3)

3

WFH-IOWA

No

IA

50l{c)(2)

N/A

WFH-IOWA

No

FOUNDATION

IA

50l{c)(3)

11 - I

SARTORI

HOSPITAL

IA

50l{c)(3)

3

WFH-IOWA

No

IL

50l{c)(3)

11 - III-FI

WFSI

No

HOLDING

CO

RD

M arian1oy Foundation Inc (1)
26 W 171 ROOSEVELT
RD
WHEATON,
IL 60187
35-2165613
Marian1oy Rehab Center
26 W 171 ROOSEVELT
WHEATON,
IL 60187
36-3896976

Aux1l1ary (1)
RD

Marian1oy Rehab Hospital & Cl1n1cs (1)
26 W 171 ROOSEVELT
RD
WHEATON,
IL 60187
36-2680776
Rehab1l1tat1on Med1c1ne Cl1n1c (1)
26 W 171 ROOSEVELT
RD
WHEATON,
IL 60187
36-3236791
WF Sisters Fndn (fka OSF) (4) (6)
PO Box 667
WHEATON,
IL 601870667
39-14 71463
HOUSING/ADVCY
Canticle MInIstries Inc (4) (7)
PO Box 667
WHEATON,
IL 601870667
36-4091836
Fund of CO (5)
Fran Sisters Charitable
2626 OSCEOLA STREET
DENVER, CO 80212
84-0733072
WORK

SET M InIstry Inc (9)
2977 NORTH 50TH STREET
MILWAUKEE,
WI 53210
39-1618277
Hospital
St Catherines
9555 76TH STREET
PLEASANT PRAIRIE,
39-0855075

Inc (4) (26)
WI 53158

UHS Inc (4) (8) (26)
6308 EIGHTH AVENUE
KENO SHA, WI 53143
39-1956749
Upendo Village NFP (4)
PO Box 667
WHEATON,
IL 601870667
33-1007368
CO

WF Healthcare
- Iowa Inc (3)
3421 WEST NINTH STREET
WATERLOO,
IA 50702
42-1177001
Covenant Foundation Inc (3)
3421 WEST NINTH STREET
WATERLOO,
IA 50702
42-1295784
Covenant Medical Center Inc (3)
3421 WEST NINTH STREET
WATERLOO,
IA 50702
42-126464
7
Mercy Hospital of Fran Sisters
3421 WEST NINTH STREET
WATERLOO,
IA 50702
42-1178403

Inc (3)

HOLDING

CO

NE Iowa Real Estate Invsts (3)
3421 WEST NINTH STREET
WATERLOO,
IA 50702
42-1207432
Sartori Health Care Foundation
3421 WEST NINTH STREET
WATERLOO,
IA 50702
42-1240996

HOSP

No

Inc (3)

Sartori Memorial Hospital Inc (3)
515 COLLEGE STREET
CEDAR FALLS, IA 50613
42-0758901
HOLDING
Franciscan M InIstries Inc (4)
26W171 ROOSEVELT
ROAD
WHEATON,
IL 601870667
36-3259684

CO

WI-20-0154-A-000061

 Form 990, Schedule
Name, address,

R, Part II - Identification

(a)
and EIN of related

organIzatIon

of Related

Tax-Exempt
(b)
P nmary actIvIty

Organizations
( c)
Legal dom1c1le
(state
or foreign country)

(d)
Exempt Code
section

(e)
Public charity
status
(1fsect1on 501(c)
(3 ))

Direct

(f)
controlling
e ntIty

(g)
Section 512
(b)(l 3)
controlled
entIty7

Yes
AssIsI Homes - Batavia Aprtmnts
1259 EAST WILSON STREET
BATAVIA,
IL 60510
36-3914084

No

HOUSING

IL

501(c)(3)

9

FM!

No

HOUSING

IL

501(c)(3)

9

FM!

No

HO USING

IL

501(c)(3)

9

FM!

No

HOUSING

WI

501(c)(3)

9

FM!

No

HO USING

WI

501(c)(3)

9

FM!

No

HOUSING

WI

501(c)(3)

9

FM!

No

HO USING

IL

501(c)(3)

9

FM!

No

HOUSING

IL

501(c)(3)

9

FM!

No

HO USING

WI

501(c)(3)

9

FM!

No

HOUSING

IL

501(c)(3)

9

FM!

No

HO USING

WI

501(c)(3)

9

FM!

No

HOUSING

co

501(c)(3)

9

FM!

No

HO USING

co

501(c)(3)

9

FM!

No

HOUSING

co

501(c)(3)

9

FM!

No

HO USING

co

501(c)(3)

9

FM!

No

FOUNDATION

IL

501(c)(3)

11 - I

FM!

No

HO USING

WI

501(c)(3)

9

FM!

No

HOUSING

IL

501(c)(3)

9

FM!

No

HO USING

IA

501(c)(3)

9

FM!

No

HOUSING

co

501(c)(3)

9

FM!

No

(4)

ASSISI Homes - Colony Park Inc (4)
550 EAST THORNHILL
DRIVE
CAROL STREAM, IL 60188
36-4039278
AssIsI Homes - Cnstn House Inc (4)
401 NORTH CONSTITUTION
DRIVE
AURORA, IL 60506
36-4049150
AssIsI Homes - Jefferson Court Inc (4)
415 EAST KNAPP STREET
MILWAUKEE,
WI 53202
39-1771526
AssIsI Homes - Kenosha
1860 27TH AVENUE
KENO SHA, WI 53140
39-1814815
AssIsI Homes - Saxony
1876 22ND AVENUE
KENOSHA,
WI 53140
39-1790498

Inc (4)

Inc (4)

AssIsI Homes of Gurnee Inc (4)
3495 WEST GRAND AVENUE
GURNEE, IL 60031
36-3942336
ASSISI Homes oflll1no1s Inc (4)
2126 WEST ROOSEVELT
ROAD
WHEATON,
IL 60187
36-3803443
AssIsI Homes of Neenah Inc (4)
210 BYRD AVENUE
NEENAH, WI 54946
36-3767250
Canticle Place Inc (4)
26W171 ROOSEVELT
ROAD
WHEATON,
IL 601870667
36-3957850
Catherine Marian Housing
806 SOUTH WISCONSIN
RACINE, WI 53403
39-1657098

Inc (4)
AVENUE

Clare Gardens Inc (4)
2626 OSCEOLA STREET
DENVER, CO 80212
23-7200039
Clare ofAss1s1 Homes - Westminster
2451 WEST 82ND PLACE
WESTMINSTER,
CO 80031
74-2740978

(4)

Dayspnng Villa Inc (4)
3777 WEST 26TH AVENUE
DENVER, CO 80211
36-3933908
Francis Heights Inc (4)
2626 OSCEOLA STREET
DENVER, CO 80212
84-0626174
Franciscan M InIstnes Comm Fndn (4) (2 7)
26W171 ROOSEVELT
ROAD
WHEATON,
IL 601870667
36-4456204
Marian Housing Center Inc (4)
4105 SPRING STREET
RACINE, WI 53405
39-1515867
Marian Park Inc (4)
2126 WEST ROOSEVELT
WHEATON,
IL 60187
36-2750105

ROAD

Ridgeway Place Inc (4)
155 EAST RIDGEWAY AVENUE
WATERLOO,
IA 50702
42-1416064
Villa Mana Inc (4)
2461 WEST 82ND PLACE
WESTMINSTER,
CO 80031
84-1347868

WI-20-0154-A-000062

 Form 990, Schedule
Name, address,

R, Part II - Identification
(a)
and EIN of related

organIzatIon

of Related

Tax-Exempt
(b)
Primary actIvIty

Organizations
( c)
Legal dom1c1le
(state
or foreign country)

(d)
Exempt Code
section

(e)
Public charity
status
(1fsect1on 50l{c)
(3 ))

Direct

(f)
controlling
entity

(g)
Section 512
(b){l 3)
controlled
entIty7

Yes

No

HOUSING

IN

50l{c)(3)

9

FM!

No

HOUSING

IN

50l{c)(3)

9

FM!

No

HO USING

IN

50l{c)(3)

9

FM!

No

HOUSING

IN

50l{c)(3)

9

FM!

No

HO USING

KY

50l{c)(3)

9

FM!

No

HOUSING

KY

50l{c)(3)

9

FM!

No

HO USING

TX

50l{c)(3)

9

FM!

No

HOUSING

IL

50l{c)(3)

9

FM!

No

HO USING

IL

50l{c)(3)

9

FM!

No

HOUSING

IL

50l{c)(3)

9

FM!

No

HO USING

FL

50l{c)(3)

9

FM!

No

HOUSING

SC

50l{c)(3)

9

FM!

No

HO USING

AZ

50l{c)(3)

9

FM!

No

HOUSING

AZ

50l{c)(3)

9

FM!

No

HO USING

IA

50l{c)(3)

9

FM!

No

HOUSING

WI

50l{c)(3)

9

FM!

No

HO USING

IL

50l{c)(3)

9

FM!

No

Alexandria
Manor Inc (4) (24)
600 East Jackson St Unit M-50
Alexandria,
IN 46001
47-5177987
Ind1anapol1s Manor 1 Inc (4) (10)
7950 Harcourt Rd
Ind1anapol1s, IN 46260
47-5178092
Kokomo Ma nor Inc (4) (11)
510 Elk Dr
Kokomo, IN 46902
47-5189624
Ind1anapol1s Manor 2 Inc (4) (12)
1840 Perkins Ave
Ind1anapol1s, IN 46203
47-5178185
1 Inc (4) (13)
Paducah MInIstries
650 College Ave 77
Paducah, KY 42001
47-5203278
Princeton M InIstries 4 Inc (4) (14)
655 Grace Court
Princeton,
KY 42445
4 7-5202983
Richardson MInIstries Inc (4) (15)
500 Rockingham
Lane
Richardson,
TX 75080
47-5202868
Effingham MInIstries Inc (4) (16)
512 Hendelmeyer
Effingham, IL 62401
47-5190275
1 Inc (4) (17)
Moline MInIstries
4201 22nd Street
Moline, IL 61265
47-5216971
Moline MInIstries 2 Inc (4) (18)
4201 22nd Street
Moline, IL 61265
47-5217175
Lake Wales MInIstries Inc (4) (19)
504 South 4th Street
Lake Wales, FL 33853
47-5190723
Pendleton MInIstries 2 Inc (4) (20)
950 Cherry St G-1
Pendleton, SC 29670
47-5247951
Tucson MInIstries Inc (4) (21)
4131 North Western Winds Drive
Tucson, AZ 85705
47-5239406
Phoenix MInIstries 3 Inc(4)
7220 North 27th Ave
Phoenix, AZ 85051
47-5217326

(22)

Davenport M InIstries Inc (4) (23)
7218 H1llandale Rd Apt 1
Davenport,
IA 52806
47-5227048
Villa St Clare Inc (4) (25)
130 BYRD AVENUE
NEENAH, WI 54946
39-1769395
AssIsI Homes - La Salle Manor Inc (4)
26W171 ROOSEVELT
ROAD
WHEATON,
IL 601890795
80-0623447

WI-20-0154-A-000063

 Form 990, Schedule

R, Part IV - Identification

(a)
Name, address, and EIN of
related organIzatIon

of Related

(b)
P nmary actIvIty

Organizations

Taxable

( c)
Legal
dom1c1le
(state or foreign
country)

(d)
Direct

controlling
entity

as a Corporation
(e)
Type of entity
(C corp, S
corp,
or trust)

or Trust
(f)
Share of total
income

(g)
Share of end-ofyear
assets

(h)
Percentage
ownership

(i)
Section
512(b)(13)
controlled
entity?
Yes

No

Inc (2)
(1) Wheaton Franciscan Enterprises
400 WEST RIVER WOODS PARKWAY
GLENDALE,
WI 53212
39-198S204

HOLDING

CO

WI

WF HOLDINGS
INC

C CORP

No

(1) Wheaton Franciscan Holdings Inc (2)
400 WEST RIVER WOODS PARKWAY
GLENDALE,
WI 53212
39-1836357

HOLDING

CO

WI

WFH-SE

C CORP

No

(2) WFMG - Sussex Inc (2)
400 WEST RIVER WOODS PARKWAY
GLENDALE,
WI 53212
39-1361100

MED GROUP

WI

WF HOLDINGS
INC

C CO RP

No

(3) Wheaton Franciscan Prov Network Inc (2 PROVIDER
400 WEST RIVER WOODS PARKWAY
CONTRACT
GLENDALE,
WI 53212
39-1952140

WI

WFH-SE

C CORP

No

(4) FMOB Condo Assoc Inc (2)
400 WEST RIVER WOODS PARKWAY
GLENDALE,
WI 53212
34-1983857

CONDO

MGMT

WI

FMO B LLC

C CO RP

No

(5)
Wheaton Way Condo Owners Assoc
10101 SOUTH 27TH STREET
FRANKLIN,
WI 53132
30-0659830

CONDO

ASSCN

WI

WFH-FRKLN

C CORP

No

UK

WFSI

Other

No

WI

WI

Inc (2)

(6)
Wheaton Franciscan Insurance
Company
PO BOX 69 GT
GEORGETOWN,GRAND
CAYMAN
CJ
98-0691609

FINANCIAL
(4)

WI-20-0154-A-000064

 Updated 2017-18 Wis. Stats. Published and certified under s. 35.18. December 17. 2019.

6.34

THE ELECTORS

2. A current and valid identification card issued under s.
343.50.
3. Subject to s. 66.0438, any other official identification card
or license issued by a Wisconsin governmental body or unit.
4. An official identification card or license issued by an
employer m the normal course of business that contains a photograph of the cardholder or license holder, but not including a business card.
5. A real property tax bill or receipt for the current year or the
year preceding the date of the election.
6. Except as provided in sub. (2), a re.~1dentiallease.
7 Any of the followmg documents without the address specified m par. (b):
a A university, college. or technical college identrfication
card that contams a photograph of the cardholder together with a
fee payment receipt issued to the cardholder by the university. college, or technical college dated no earlier than 9 months before the
date of the election at which the receipt is presented.
b. An identification card ii:;5uedby a umver.s1ty, college, or
technical college that contains a photograph of the cardholder if
the university, college, or techrucal college that issued the card
provides a certified and current list of students who reside in housing .sponsored by the university, college, or technical col1ege and
who are U.S. citizens to the municipal clerk prior to the election
showing the current address of the students and if the municipal
clerk, election registration official, or mspector verifies that the
student presenting the card 1s included on the JisL
NOTE: In One WisconsinInstitute. Inc. v. Tholllset1,15-cv-324, 198 F. Supp.
3d 896 (2016), the U.S. District Court for the Western Distrid nfWJScoDSin
order~d that "the ftquin:ment that "donn list!;" to be med 11sproof ofreridence
include citizenship lntormatlon Is unconstitutional,"

8. A utility bill for the period commencing not earlier than 90
days before the day registration is made.
9. A bank statement.
JO. A paycheck.
11. A check or other document issued by a unit of government
12. For an occupant of a residential care fac1hty,as defined
ins. 6 875 (1) (bm), for the purpose of regi5itering at the facility,
a contract or intake document prepared by the residential care
faci1ity chat specifie.~ that the occupanl currently resides in the
facility. The contract or intake document may also identify the
room or um t in which the occupant resides
13. An jdenuficauon card is.sued by a federally recogruzed
Indian tribe in this state.
(b) Except as provided in par. (a) 7., the identifymg documents
prescribed in par. ta) shall contain all of the following in order to
be considered proof of residence:
l. A cw-rent and complete name, including both thegiven and
family name.
2. A curren't and complete residential address, including a
numbered street address, if any, and the name of a murucipru..ity.
(c) Identifying documents speCifi.edin par. (a) wluch are valid
for use during a specified period must be valid on the day that an
elector makes application for registration m order to constitute
proof of residence.
(4) The commission ~hall maintain a system that electronically verifies, on an instant basis, information specified under sub.
(3) (h) from the information submitted m lieu of proof of residence
under sub. (2m), using the information maintained by the department of transportation pursuant to the commission's agreement
with the secretary of transportation under s 85.61 (1). If a prospective elector enters informatton specified under sub. (3) (b) 2.
mto the system that does not match such information maintamed
by the deparanent of transportation, the sy5tem shall re-direct the

Updated 17-18 Wis. Stats.

10

the elector may update his or her information with the department
of tnmsportauon.
a.

History: 2005 a. 451 ss. 40, 43,44; 2011 a. 23; 2013 a. 182;2015 a. 261,374,2017
226; 2017 ii, 365 .S, ] 11 2017 11. 36'}

6.35

Filing reglstratlon forms. (1) Under the direction of
the municipal clerk or board of election commissioners. the ong1nal registration forms shall be filed in one of the fol1owing ways,
except as provided in subs ( Im) and (2):
(a) Tn alphabetical order of the electors' names.
(b) In alphabetical order according to street names, in numerical order on each street and in alphabetical order of the electors'
names at each address on the street.
(1m) Original registration forms of electors who have
obtained a confidential listing under s. 6.47 (2) shall be filed in
alphabetical order after the forms of the other electors.
(2) The comrrussion shall prescribe, by rule, the procedure
and methods by which municipal clerks and boards of election
commissioners shall mamtain records of registrations that are
entered electronically under s. 6.30 (5).
(3) Onginal registration forms shall be mamtained in the
office of the municipal clerk or board of election commissioners

at all times.
History: 1971 c. 249; 1971c, 304 s.29 (2;; 1971c. 336; 1975 c. 85; 1'('/7,: 394:
1983 a. 484, 19R5a, 304, 19R9a. 191; 1999 a. 49; 2003 a. 265,326: 2015 a. 261.

6,36 Official registration list. (1) (a) Toe comnuss.ion
shall compile and maintain electronically an official registration
list. The list shall contam all of the following:
l. The name and address of each registered elector m the state
2. The elector's date of birth.
3. The ward and aldermanic d1str1cl of the elector, 1f any.
4. For each elector, a unique registration identification number as:,igned by the c01nmis&on.
5. The number of a valid operator's license issued to the elector under ch. '343, if any, or the 1ast 4 digits of the elector·s social
secunty account number. 1f any.
6. Any identification serial number issued to the elector under
s. 6.47 (3).
7. The dale of any election in which the elector votes.
8. An mdication of whether the elector is an overseas elector,
as defined ins. 6. 24 (1).
9. Any information relating to the elector that appears on the
current list transmitte.d to the commission by the department of
corrections under s 301.03 (20m).
10. An indication of any accommodation required under s.
5.25 (4) (a) to pemut voting by the elector.
11. An indication of the method by which the elector's registranon fonn was received.
12. An indication of whether the elector was required under
s. 6 .34 to provide proof of residence and, if so, the type of identifying document submitted as proof of residence, the name of the
entity or institution that is:med the identifying document, and, if
the idenufying document included a number that applie.~ only to
the individual holding that document, up to the last 4 digits of that
number. If the number on the identifying document submitted by
the elector had 6 or fewer digits. the list under this paragraph may
not contain more than the last 2 digits of that number.
13. A separate column indicating the date on which an elector
applied to vote by in-person absentee balloL
14. Separate columns indicating the date on which the clerk
mailed an absentee ballot to an elector and the date on which the
elector returned the absentee ballot.
15. A separate column indicating the poll1ng location associated with each elector's address and ward or aldermanic district,

electorto thedepartment
of transpmtaiion's
Internetsnesothat if any.
2017-18 Wlscons;n Statutes updated through 2019 Wis. Act 69 and through all Supreme Court and Controlled Substances
Board Orders filed before and in effect on December 17, 2019. Published and certffled under s. 35.18. Changes effective after
December 17, 2019, are designated by NOTES. (Published 12-17-19)

WI-20-0154-A-000065

®

 Updated 2017-18 Wis. Stats. Published and certified under s. 35 18 December 17, 2019

f£)

l

ll

Updated 17-18 Wis. Stats.

16. A separate column indicating the mailmg address for the
municipal clerk associated with each polling location identified
nder subd. 15.
(ae) 1. The chief election officer ihall enter into a membership
agreement with Electronic Registration Information Center. Inc.,
for the purpose of maintaining the official registration list under
this section. Prior to entering into an agreement under tlus subdivision, the chief eleclion officer shall ensure that the agreement
satJ.sfies all of the following conditions:
a. It safeguards the confidentiahty of information or data in
the registration list that may be subjecc co transfer under the agreement and to which access is restricted under par. (b) 1. a.
b. It prohibit,; the sale or distribution of the infonnation or
data in the regi!l.tration list to a 3rd-party vendor and it prohibits
any other act10n not associated with administration of or comphance with the agreement.
c. It does not affect the e.xemption for this state under the
natmn::tl voter registratlon act.
d. It allows the state to make contact with electors by electronic mail, whenever possible.
2. If the chief election officer enters into an agreement under
subd. l • the chief election officer !,;hallcomply with the temu1 of
the agreement, mcludmg the transnussion of mfonnation and data
related to the registration of electors in tins state to the Electronic
Registration Information Center. Inc., for processing and sharing
wit other member states and governmental units.
(am) Toe bst underpar. (a) may contain such other information
as may be detennmed by the commission to facilitate admlnistration of elector registration requirements.
(b) I. The listshall be open to public inspection under s. 19.35
(I) and shall be electronica1ly accessible by any person. except
that:
a Except as provided in pars. (ae), (bm), and (bn). no person
other than an employee of the commission, a county clerk, a deputy county clerli:, an executive direccor of a county board of elec,.
tion commissioners, a deputy designated by the executive director, a municipal clerk. a deputy municipal clerk, an executive
dtrector of a city board of electmn commissioners. or a deputy designated by the executive drrector may view the date of birth, operator's license number, or social secunty account number of an
elector, the address of an elector to whom an identification serial
number is issued under s. 6.47 (3), or any indication of an accommodation required under s. 5.25 (4) (a) to permil voting by an elector.
b No person other than an employee of the commission, a
municipal clerk. or an election official who is authorized by a
muruc1pal clerk may make a change in the hst.
2. The list shall be electronically acces::iib]eby name and shall
also be accessible in alphabetical order of the electors' names for
the entire state and for euch county, municipality, ward, und combination of wards authorized under s. 5 15 (6) (b).
(bm) The cornmiss.ion or any municipal clerk or board of election commissioners may tnmsfer any mformation in the registrntion list to which access is restricted under par. (b) 1. a. to a law
enforcement agency. as defined ins. 165.77 (1) (b). to be used for
law enforcement purposes.
(bn) The cornnliSsion may transfer any information in the registration list to which access is restricted under par. (b) 1. a. to a
subunit of the state government of another state to be used for official purposes.
(c) The list shall be designed in such a way that the municipal
clerk or board of election commissioners of any municipality and
any election official who is authorized by the clerk or executive
director of the board of election comnusMoners may, by electronic
trunsmi:mon, add entnes to or change entnes on the list for any
elector who resides m, or who the list identifies as res1dmg in, that
municipality and no other mumcipality.

THE ELECTORS

6.36

(d) Upon receipt of official notification by the appropriate
election admmisttative authority of another state, tenitory, or possession that an elector whose name appears on the list ha.,;registered to vote in that state, temtory, or possession, the commission
or the municipal clerk of the municipality where the elector formerly resided shall change the elector's registrntion from eligible
to ineligible status.
(e) If the commission adds the name of any elector to the list,
the commission shall promptly notify the municipal clerk of the
municipality where the elector resides. If the commission
changes the registration of any elector from eligible to inehgible
status, the commission shall promptly notify the municipal clerk
of the municipality where the elector resides or, if the elector has
changed his or her residence from one munic1pality to another
municipality in this state, shall promptly notify the municipal
clerk of the mumcipality where the elector resided prior to the
change. Notification shall be made in writing or by electronic
transnus.-;ion. If the commi.-.sion changes the registration of any
elector from eligible to ineligible status, the comrruss1on shall
make an entry on the list giving the date of and the reason for the
change.
(f) The commission shall make all reasonable efforts to ensure
that the list is maintained in a manner that precludes unauthonzed
persons from making alterations to the list.
(2) (a) &cept as provided in par.(bJ. each registration list prepared for use wi a poll list at u polling pluce or for pu.rpwes of canvassing absentee ballots at an election shall contain the full name
and address of each registered elector; a blank column for the
entry of the serial number of the electms when they vote or the poll
list number used by the municipal board of absentee ballot canva.,;sers in canva.-.sing absentee baJlots; an indication next to the
name of each elector for whom proof of residence under s. 6.34
ls required. a space for entry of the type of and the name of the
entity or m.slltution that issued the identifying document submitted by the elector as proof of residence when proof of residence
under s. 6.34 is required; a space for entry of the elector's signature, or .if another person signed the elector's registration form for
the elector by reason of the elector's physical disability, the word
"exempt"; and a fom1 of certificate bearing the certification of the
commission administrator stating that the list is a true and complete registration list of the municipality or the ward or wards for
which the list is prepared. The commission shall, by rule, prescribe the .space and location for entry of each elector's .signature
on lhe poll list which shall provide for entry of the signature without changing the onentatmn of the poll list from the onentauon
used by the elecuon officials.
(b) If an elector obtams a confidenb.al listing under s. 6.47 (2),
the registration list shall be prepared such that the address of the
elector does nor appear on copies of the list that are u.-.edat pollmg
places.
(c) The list shall contain, next to the name of each elector, an
indication of whether proof of residence under s. 6.34 is required
for the elector to be permitted to vote. If proof of residence is provided, the type of identifying document subantted by the elector
and the name of the entity or institution that issued the identifying
document, or an 1mhcat1on that the mformution provided by the
elector in lieu of proof of residence was verified under s. 6.34
(2m). shall be entered on the list in the space provided, Except a,;
provided in .s.6.34 (2m), proof of residence is required if the elector ls not a military elector or an overseas elector and the elector
registers by mail Or by electronic application and has not previously voted in an election in this state,
(3) The original registration forms shall be controlling whenever discrepancies occur in entering information from the forms
under s. 6.33 (5)
(4) The namef: and identification serial numbers of electors
who have obtained a confidential listing under s. 6.47 (2) shall

2017-18 Wisco:151nStatutes updated through 2019 Wis. Act 69 and through all Supreme Court and Controlled Substances
Board Orders flied before and In effect on December 17~2019. Published snd certified under s. 35.1B. Changes eflectfve after
December 17, 2019, are designated by NOTES. (Published 12-17-19)

WI-20-0154-A-000066

 Updated 2017-18 Wis. Stats. Pubhshed and certified under s. 35.18. December 17. 2019.

6.36

THE ELECTORS

Updated 17-18 Wis. Stats.

12

appear separately after the remru.nder of the list. These names and
serrnl numbers shall be arranged alphabetically by last name.
(6) The commission shall establish by rule the fee for obtaining a copy of lhe official registration hst. or a portion of the list,
incJudmg access to the subscription service established under s.
5.05 (14) (b). The amount of the fee shall be set, after consultation
with county and municipal elecnon officials, at an amount estimated to cover both the cost of reproduction and the cost of mamtammg the 11stat the state and local level. The rules shall reqwre
that revenues from fees received be shared between the state and
municipalities or their de...;;igneesunder s. 6.33 (5) (b ), and shall
specify a method for such allocation

of a police department, or a district attorney or the authorized representative of a sheriff, chief. or w~1nct attorney and directed to
the mumci_pal clerk, und that verifies that a person ha:. been
charged with or convicted of an offense relatmg to domestJ.c
abuse, sexual assault. or stalking in which the individual was a victim and reasonably continues to be threatened by that person.
3. An individual who resides ma shelter.
4. An individual who submits a dated statement to the mumc~
1pal clerk that mcludes the mdiv1dual's full name, that .lS signed by
an authorized representative of a domestic abuse v1ct1m service
provider or a sexual a...;;saultvictim service provider, and that indicates that the individual received services from the provLder
History: 1971 C 304 s. 29 (2)' 1975 C. S.S.1977 C 394 U 21 22.53; 1999a. 49:
within the 24-month period endmg on che date of the statement.
2003 a. 265, 327; 2005 a 451. 2007 a. I, 52, 96: 2011 a..23, 7S, 2013 a. 182; 2015
a. 118 ss. 73 to 75, '.!:66(10): 201 S a. 261. '2017 a. 366,
5. An individual who is a participant in the program estabCross-refennce: &c a15o~- 61..3.50, \Vu;. adm. code.
lished ms. 165 68.
(b) ..Offense relating to domestic abuse, sexual assault, or
6.45 Access to registration lisL (1) After the deadline for
stalking" me.ans an offense specified m s. 940.19, 940.20 (Im),
revision of the registrat10n 11st, the municipal clerk shall make
940.201, 940.22, 940.225, 940.235, 940 32, 947 013, 948.02,
copies pf the hst for election use.
948 025. 948.06, 948.085, 948.09, or948.095.
(1m} The registration list and any supplemental hsL'>which
(c) ..Protected individual" means an ind1v1dual whose name
are prepared at polling places or other registration locations under
and address is confidential under sub. (2).
s. 6.55. shall be open to public inspection. Under the regulations
(d) "Protective order'· means a temporary restr<ilillilg order or
prescnbed by the mumcipal c1erk, any person may copy the regis-,
an inJunction issued under s 813.12 or 813.125.
tration hst at the office of the clerk. A registration hst mamtamed
(dm) "Sexual a.~sault victun service provider'' mean.c:an orgaat a polJing place may be ex.ammed by any person who is observnization that is cenified by the department of justice as eligible to
mg the proceedings under s. 7.41 when such use does not interfere
with the conduct of the election. Tlns .subsection does not apply
receive grants under s. 165.93(2) and whose name is included on
the list provided by the comm1ss10n under s. 7.08 (IO).
to information that is confidential under s. 6 ..47.
(2) The municipal clerk shall furnish upon request to each
(e) "Shelter·· means a place where at least 4 unrelated mdlviduals reside that provides residential shelter to individuals whose
candidate who has filed nomination papers for an office which
personal secunty 1s or may be threatened by family members or
represents at least part of the residents of the municipality one
copy of the current registration list for those areasfor which he or other persons with whom the ind1v1duals have had contact.
she is a camhdate for a fee not to exceed the cost of reproduction.
(2) Except as authorized in sub. (8). the commission, each
The clerk shall exclude information that 1s confidential under s. municipal clerk, each agent designated under s. 6.33 (5) (b), and
6.47 (2) from copies of the list, except as authorized under s. 6.47
each election offietal shall withhold from pubhc inspection under
(8).
s.19.35 (I) the name and ad.dress of any eligible individual whose
H"rstol'y: 1975 C. 85. 199: 1977 C 394s.53; 1983 a.4S4: 1989 a. 192. 1999 o.49.
name appearson a poll list or registration list if the individual pro182: 2001 ;1, 38, 2013 a. 166.
vides the municipal clerk with a valid v..rittenrequest to protect the
Cros»-refere,u:e: See also 11. EL 3.50. Wis. 11dm.code,
individuars confidentiality. To be valid, a request under this sub6.46 Poll lists; copying. (1) Poll li<t, ,hall be preserved by section must be accompanied by a copy of a protective order that
ism effect, an affidavit under i::ub.(1) (am) 2. that is dated within
the. municipal clerk until destructmn or other disposition is autho30 days of the date of the request, confinnat1on from the departrized Wlder s. 7.23.
(2) Po11lists shall be open to public inspect10n, exc-ept as pro- ment of justice that the person is a program participant, as provided under s. 165.68 (4) (c). a statement signed by the operator
vided ins. 6 47. The municipal clerk shall furnish upon request
or an authonzed agent of the operator of a shelter that is dated
to each candidate who has filed noru.ination papers for an office
within 30 days of the date of the request and that indicates that the
which repre.">ent'>
at lea..r part of the municipality one copy of the
operator operntes the shelter and that the individual making the
current poll hst for those are.is for which he or she is a candidate
request resides m the shelter, or .a ~'tlltement signed by an authofor a fee not to exceed the cost of reproducbon. lf a copymg
machine 1s not accessible, the clerk shall remove the lists from the rized representative of a domestJ.c abuse victim secvice provider
or a sexual a~sautc victim service provider under sub. (1) (am) 4.
office for the purposes of copying, and return them immediately
that 1sdated within 30 days of the date of the request. A physically
thereafter. The clerk shall exclude infonnation that is confidential
disabled individual who appears personally at the office of the
under s, 6.47 (2) from copies of the list. except as authorized under
municipal clerk accompanied by another elector of this state may
s. 6.47 (8).
designate that elector to make a request under this subsection on
IDstnry: 1975 c. 85. 199; 1999 a. 49.
Crw.,-nfereiu.'1:: See iliio s. EL 3.50. Wis. :u:l!ILcode.
his or her behalf.
(3) Upon receiving a valid wntten request from an elector
6.47 Confidentiality of information relating to victims under sub. (2), the municipal clerk shall L'iSUeto the elector a votof domestic abuse, sexual assault, or slalklng. (1) In this ing identification card on a form prescnbed by the commission
section:
that shall contam the name of the elector's municipality of resi(ag) "Dome~'tlc abuse victim service provider" mearui an orgadence and. in the case of a town. the county in which the town is
ruzatton that is certtfied by the department of children and families
located. the elector's name, the ward in which the elector resides,
as eligible to receive grant,; under s. 49.165 (2) and who~ name
if any, and a unique identification serial number issued by the
is included on the list provided by the commisston under s, 7 .08 comrrussion. Tue number issued to an elector under this subsec(10)
tion shall not be changed for so long as the elector continues to
(am) "Eligible individual'" means·
qualify for a listing under sub. (2).
l. An mdiv1dual who hac:been granted a protective order that
(4) (a) Except as provided in par (b) and sub. (5). a confidential listing under sub. (2) expil'es on the date that a protective order
is in effect.
expires. the date that the protected individual ceases to reside Ill
2. An individual who files an affidavit with the municipal
a shelter, the date that updated information is received from a sherclerk of the municipality where the individual resides, on a form

ora d1s11ict
attomey
orthe
premibedbythecommission.
thatii signed
bya shenff.
thechief iff,thechiefofa policedepartment.
2017-18 Wisconsin Statutes updated through 2019 Wis. Act 69 and through all Supreme Court and Controlled Substances
Board Orders filed before and In effect on December 17, 2019. Published and certified under s. 35.18. Changes effective after
December 17, 2019, are designated by NOTES. (Published 12-17-19)

WI-20-0154-A-000067

 Updated 2017-18 Wis. Stats. Pubhshed andcertrlied under s. 35.18 December 17, 2019.

13

THE ELECTORS

Updated 17-18 Wis. Stats.

authortz.ed represeotah ve of a sheriff, cluef, or distnct attorney. or
at the end of the 24-month period that follows creation or renewal
of the list.mg under sub. (2), whichever is earlier.
(b) A confidential hsting under sub. (2) that is issued to a program participant expires on the-date the individual's: partic1patron
in the program expires pursuant to s. 165.68(3) (b) 4. a. or on the
date the individual cancels his or her partlcipation in the program
pursuant tos. 165.68 (3) (b) 4. f. or is disenrolled from the program
pursuantto s. 165.68 (3) (b) 4. e.
(5) (a) The municipal clerk shall cancel a confident:tal listing
under sub. (2) if:
1. The clerk receives notification from a shenff. cluef of
police, or district attorney or the authorized representative of a
sheriff, chief, or district attorney under sub. (10).
2. The name of the protected mdiv1dual 1s legally changed.
3. The protected individual changes his or her address without
notifying the municipal clerk.
4 The municipal clerk finds that the protected individual provided false infonnation to the clerk for the purpose of obtaining
a confidential hstmg under sub. (2).
(b) An mdividual whose confidential listing is canceled under
par. (a) may file a new request and quahfy under sub. (2) to obtain
a renewal of the listing.
(6) Upon expiration of a confidential listmg on a registration
list under sub. (2). the municipal clerk shall change the registration of the protected individual to ineligible status unless the individual files a new request and qualifies under sub (2) to obtain a
renewal of the listing or unless the individual applies for and qualifies to obtam a nonconfidential voter registration. Except as
authorized in sub. (8), the munic1pal clerk shaJI withhold from
public inspection under s. I 9.35 (I) the name and address of any
individual whose registration is changed under this subsection if
the individual qualified for a confidential listing at the time of that
listmg.
(7) (a) If the municipal clerk has notice that a confidential hstmg under sub. (2) is scheduled to exprre, the municipal clerk shall
provide 30 days· not.1.ceto the protected individual of the scheduled expiration of the listing.
(b) If notice to a protected indIVJ.dualis not provided under par.
(a). the municipal clerk shall provide notice to the snbJect individ•
ual upon changing a li~ted individual to ineligible status under

sub. (6).
(8) The municipal clerk .shall provide access to a name and
address under sub. (2):
(a) To a law enforcement officer for official purposes.
(b) To a state or loc-dl governmental officer pursuant to a specific law that necessitates obtaining the name or address.
(c) Pursuant to a court order citing a reason that accessto the
name or address should be prov1ded.
(e) At the request of a protected individual, for purposes of permitttng that individual to sign a petition under s. 59.05 (2)
(9) No person who obtains access to a name or address under
sub (8) may d1sclose the name or address to any person other than
a public employee for the same purpose for which the information
was obtained.
(10) If a shenff. chief of a police department, or distnct attorney has signed or the authorized representative of a sheriff, chief,
or district attorney has signed an affidavit under sub. (I) (am) 2.
and the shenff, chief, distnct attorney or authonzed represe-ntative
later obtains infonnation that the person who wa~ charged with an
offense relating to domestic abuse, sexual assault, or stalking is no
longer so charged or that the person's judgment of conviction has
been vacated, and the charge or conviction was the sole basis for
the affidavit, the sheriff, chtef, clistnct attorney or authoriz.ed representative shall provide written notice of that mformation to the
municipal clerk to whom the affidavit was directed.
Him>y,y·1999 a. 49. 18& 1003 ,11. 26$; 2005

I\,

l.4\3, 277. 278; 2007 a. 20; 200IJ

, ll!O:
1llllo.16UOIS,. Iii s. 1(,6(10):20\S..ll6. 371:1017~ 144

6.50

6.48 Challenging registration. (1) GENERAL PROCEDURE.
(a) Any registered elector of a murucipality may challenge the
registration of any other registered elector by subnutting to the
municipal clerk or executive director of the board of election commissioners in cities of more than 500,000 population an affidavit
stating that the elector ts not qualified to vote and the reasons
therefor. The clerk or director. upon receipt ot· the affidavit, shall
mail a notification of the challenge to the challenged elector, at hi::i
or her registered addres!l.
(b) The challenged and challenging electors shall appear
before the municipal clerk withm one week of notification or
nrnmge under sub. (2) to appeur before the 1:>o.i.rd
of election commissioners. The challenging elector shall make an affidavit
necessary to detennine the challenged
answering any que.c::tion.~
elector's qualifications. Judgment rests with the municipal clerk
and decisions shall be rendered as soon as heard. If the clerk cannot resolve the-issue or has reservations as to the answers, the clerk
may require the challenging elector to take the oath under s. 6.925.
If the challenged elector appears and contest<: any answer of the
challenging elector, the clerk may require the challenged elector
to take the oath under s. 6. 94 and to answer any question necessary
to determine the challenged elector's qualifications. Tf the challenging elector appears before the municipal clerk or board of
election comnui.s.ioners but the challenged elector fails to appear,
such clerk or board may make the decision without consulting the
challenged elector. lf the municipal clerk or board of election
commissioners does not sustain the challenge, the challenged
elector's registratJ.on remains valid.
(c) If the challengmg elector fails to appear before the municipal clerk within one week or in citie..c;
of more than 500,000 population fails to appear before the board of election commissioners
under sub. (2) to answer questions and take the oath under s. 6.925.
such clerk or board shall cancel the challenge.
(d) If the clerk detenrunes that the challenged elector 1S not
qualified, the clerk .shall change the challenged elector's registration from eligible to ineligible status on lhe registration list and
notify the inspectors for the ward or election district where the
elector was registered.
(2) SPECIAL PROCEDURE IN POPULOUS CITIES (a) In c1t1e.sof
more than 500,000 population, objections may be made before the
board of election commissioners which shall sit on the last
Wednesday before each election from 9 a.m. to 12 am. and from
2 p.m. to 5 p.m. to hear objections then made or deferred under
~ob. (1 J If all the objections cannot then be detemuned, the commissioners shall sit during the same hours the next day.
(b) Upon appearing m person, objectors shall be examined,
under oath, by ilie coI'llltllssioners and testunony taken. Judgment
rests with the board of elect:J.oncommissioners and decisions shall
be rendered a.~soon as heard. All cases are heard and decided
summarily. The commissioners shall determine whether the person objected to is qualified, If they determine that a person 1s not
qualified, the execuhve drrector of the board of election commissioners shall change the elector from eligible to ineligible status
on the registration hst und shall notrfy the proper ward officials of
the change immediately.
(3) CHALLENGF BASED ON INCOMPETENCY. Section 6.03 (3)
applies to any challenge which is made to registration based on an
allegation that an elector is mcapable of understand mg the objective of the elective process and thereby ineligible for reg1.stratLon
(4) DISQUALIFICATION The municipal clerk or board of elecuon commissioners may not disqualify an elector under this section except upon the grounds and in accordance with the procedure specified in .s. 6.325.
111.itory: 1971 C, J04

5,

29 (2): 1973 C. 334; 1975 C. &5, 199; 1977

C.

394, 1979

c. 110; 1983 a.484. 1985 a. 304: 1987 a. 391;2003 u. '.?65.

6.50 Revision of registration
list. (1) No later than June
15 following each general election, the commission shall examine
the registration records for each munic1pality and identify each

electorwhohil.'i
notvotedwithinth, prnioui4 y3rnif qu~lifi~

2017-18 Wisconsin Statutes updated through 2019 Wis. Act 69 and through all Supreme Court and Controlled Substances
Board Orders flied before and In effect on December 17, 2019. Published and certified under s..35.18. Changes effective after
December 17, 2019, are designated by NOTES. (Pub/lshed 12-17-19)

WI-20-0154-A-000068

 Updated 2017-18 Wis. Stats. Published and certified under s. 35.18. December 17. 2019

6.50

THE ELECTORS

to do so dunng that entire period and shall mail a notice to the elector in substantially the followmg fonn.
''NOTICE OF SUSPENSION OF
REGISTRATION
You are hereby notified that your voter registration will be suspended, according to state law, for failure to vote within the previous 4-year period, unless you apply for continuation of your
registrat10n within 30 days. You may continue your registration
by signing the statement below and returning it to the office of the
municipal clerk .... (mailing address and telephone number of
office of municipal clerk or board of election commissioners) by
mail or m person.
APPLICATION FOR CONTINUATION
OF REGISTRATION
I hereby certify that I still reside at the addres.c:at which I am
registered and apply for rontinuatton of registration
Signed ... .
Present Address ... .
Tfyou have changed your residence within this municipality or
changed your name, please contact the office of the municipal
clerk ... (matlmg address and telephone number of office of
municipal clerk or board of election commissioners) to complete
a change of name or address fonn,
[Office of clerk or board of election commissioners
Address
Telephone}".
(2) If an elector to whom a notice of suspension was mailed
under sob. (1) has not applted for continuation of registration
within 30 days of the date of mailing, the commissmnsha11change
the registration status of that elector from eligible to ineligible on

~--..;the

day that falls 30 days after the date of marling.
(2g) The commission may delegate to a municipal clerk or
board of election commissioners of a municipality the responsib1!ity to change the registration status of electors when required

under sub. (2).
(2r) As soon as practicable, but no later than August 1 folJowmg the completion of the process under subs. (1) und (2), the commission shall publi.c:hon tl'- Jntemet f.lte the foUowing information
obtained through that process:
(a) The number of notice.<:malled under sub. (1).
(b} The number of notices described under par. (a) that were
returned to the commission as undeliverable.
(c) The number of notices described under par. (a) that were
returned requesting continuation of registration.
(d} The number of notices described under par (a) that were
returned requesting cancellation of registration.
(e) The number of notices described under par. (a} that were
returned with an indication that the named elector is deceased.
(t) The number of notices described under par. (a) that were not
returned.
(g) The number of electors who received notices under sub. (1)
and whose status changed from eligible to ineligible.
(h} Any other information requested by the legislature or that
the commission considers relevanL
(3) Upon receipt of reliable information 1hat a registeredelector has changed his or her residence to a locatigp outside gf the
ffiumcipahty, the munici al clerk r boa
f
'on commis•
sJOners shallnotify
elector by mailing a notice by 1st class mail
to the elector's registration address stating the source of the information. All municipal departments and agencies receiving information that a registered elector ha.<;changed his or her residence
shall notify the clerk or board of election commissioners. !fjh:f..
elector no longer resides in the munici alit or fails to a 1 for
continuation o re istration wit m 30 da s o t e date the notice
is maile
e c er or
ar o e ect1on comm1ss1on
-c an e the elector's registration om e 1 e to ineli ible status.
ponroro1pt
o reia cm onnation
thata rcg11tercd
e cctor11!

Updated 17-18 Wis. Stats.

14

changed his or her residence w1thm the muwcipality. the municipal clerk or boord of election COIIlllllSSl.oners
shall change the elector's registr.ition and mail the elector a notice of the change. Tim:
subsection does not restnct the right of an elector to challenge any
registration under s. 6.325, 6.48, 6.925, 6.93, or 7.52 (5).
(4) The mumc1pal clerk or board of election commissioners
shall change the registration of deceased electors from ehgible to
ineligible status by means of checking vital statistics reports. No
notice need be sent of registration changes made under this subsection.
(5) The registrauon of any elector whose address is listed at a
building which has been condemned for human habitation by the
municipality under s. 66.0413 (I) (j) shall be investigated by the
municipal clerk or board of elecuon commissioners. If the clerk
or board of election commissioners can find no reason why the
registration of such an elector should not be changed from ehgible
to ineligible status, the clerk or board of election comnuss,oners
shall change the elector's registration status. If the elector ha.<:left
a forwarding address with the U.S. postal service., a notice of
change m status shall be mailed by the clerk or board of election
commissioners to the forwarding address.
(6) The municipal clerk, upon authonzation by an elector,
shall change the elector·s registration from ehgible to inehgible
status.
(7) When an elector's registration IS changed from ehglble to
ineligible status, the commission, municipal clerk, or board of
election commissioners shall make an entry on the registration
list, g1vmg the date of and reason for the change.
(8) Any municipal governing body may direct the municipal
clerk or board of election commissioners to arrange with the U.S
postal service pursuant to applicable federul regulations, to
receive change of address information with respect to individual:re.c:idingwithin the municipality for revision of the elector registration lisL If required by the U.S. postal service, the governing
body may create a registration commission consisting of the
municipal clerk or executive director of the board of election commissioners and 2 other electors of the municipality appointed by
the clerk or executive director for the purpose of making application for address changes and processing the mformatmn received.
The municipal clerk or executive director shall act ac:chauperson
of the commis.<iion. Any authorization under this subsection shall
be for a definite period or until the municipal governing body oth~
erwise determines. The procedure shall apply uniformly to the
entire municipality whenever used. The procedure shall provide
for receipt of complete change of address infonnation on an automatic basis, or not less often than once every 2 years during the
60 days preceding the close of registration for the partisan primary. If a municipality adopt!>the procedure for obtmmng address
corrections under this :mbsecbon, it need not comply with the procedure for mailing address venfication cards under subs. (1) and
(2).

(10) Any qualified elector whose registration is changed from
eligible to ineligible status under this section may reregister as
provided under s. 6.28 (!), 6.29 (2), or 6.55 (2), or, 1fthe elector
ruµ,a current and vaild operator's license issued to the elector
under ch. 343 or a current and valid identificauon card 1s:sued
under s. 343.50, may rereg1$ter under s. 6.30 (5).
History: 1971 C. 242; 1971 c. 304 $. 29 (2}; 1971 C 336 s. 37, 1973 C, 164; 1975
C. 85. 1!,19,200; 1977 C. ]94 ill!, 27, 53: 1979 c. 260; 1983 a. 484; liJ85 a. 304: 1987
11.391: 1999 a. 150 s. 672; 2003 Q, 265. 326~ 2005 ....451. 2011 a. 75; 2013 a. 149;
2015 a. 118 AA.76, 77,266 (10_);2015 3. 261

6.54 Failure to register; rights. No name may be added to
the registration list after the close of registration, but any person
whose name is not on the registrutlon list but who is otherwise u
qualified elector fa entitled to vote at the election upon compliance
with s. 6.29 or 6 .55
History: 1985 a. 304 s. 60.

6.55

Polling place registratiom voting by certification.

(2) (a) Except
wheretheprocedure
underpar.(c)or(cm)1g

2017-18 Wisconsin Statutes updated through 2019 Wis. Act 69 and through all Supreme Court and Controlled Substances
Board Orders flied before and In effect on December 17, 2019. Published and certified under s. 35.18. Changes effective after
December 17, 2019, are designated by NOTES. (Published 12-17-19)

WI-20-0154-A-000069

 Updated 2017-18 Wis. Stats. Published and certified unders. 35.18. December 17, 2019.

7,15

ELECTIONOFFICIALS; DUTIES;CANVASSING

for any referendum shall conform to s. 5.64 (2). If there is already

an official municipal referendum ballot for the election, the question may appear on the same ballot.
(2m) OPERAT10N OF ALTERNATE ABSENTE.E BALLOT SITE, In a
municipality in which the governing body has elected to establish

an alternateabsenteeballot site unders. 6.855, lhe municipalclerk
shall operatesuchsite as though1t were his or her officefor absentee ballot purposes and shall ensure that such site u adequately
staffed.
(3) BALLOT

SUPPLY; SAMPLE BALLOTS

(a)

Where voting

machines are used or where electronic votmg systems are
employed, the municipal clerk shall provide ot least 2 duplicate
sample ballots for each ward in diagram form showing the board

or screeninside each voting machine or the front of each ballot as
it will appear in the voting machine.~ or booths on election day.
lb) Sample ballots and votmg machine ballots shall be furnished to the officials m the ward or election district at least one
day before eachelection.
(4) RECORDING ELECTORS Except as authorized ins. 6.33 (5)
(a), w1thm 30 days after each elect.J.on, c:he municipal clerk shall
enter on the registration Jist under the name of each elector of the
mumcipal.tty who has voted at the elecnon an indicatton of the date
of the election m which the elector voted.
(5) REcORD OF BALLOTS RECEIVED. Eachmumc1pal clerk shall
keep a record of when and in what condition the packages containing the ballots were received from the county clerk. The murucipal clerk shall deliver to the proper officials the unopened packages of ballots the day before the election
(6) SUBSTITUTE BALLOTS. (a) The municipal clerk shall provide sub~titute paper ballots in substantially the fonn of the ortginal ballots whenever the necessary original ballots are not delivered to the municipality. are destroyed. are lost or stolen after
delivery, are not ready for distribullon or the :mpply is exhausted
during polling hours. The municipal clerk may also provide substitute paper ballots, together with ballot boxes and voting booths,
whenever a voting machme or electronic voting system is rendered inoperable by a malfunction which occurs within 24 hours
of the time set for opemng of the polls, Paper ballots may be cast
only in accordance with the procedures prescnbed in ss. 6.80 (2)
and 7 37 (4).
(b) Upon receiving the substitute paper ballots accompanied
by a statement made under oath by the municipal clerk that the ballots have been prepared and furnished by the clerk to replace the

Updated 17-18 Wis. Stats.

4

informat10n concerning whether the elector's vote has been
counted, and if the vote will not be counted, the reason that it will
not be counted
(13) INFORMATIONro COMMISSION. Each municipal clerk shall
provide to the conumssion any infonnahon requested under s.
5.05 (14)

(14) VOTING ACCOMMODATIONS FOR INDIVIDUALS WITH DJSABIUTIES. Each municipal clerk shall make reasonable efforts to
comply with requests for voting accommodation.,; made by individuals with disabtlities whenever feasible.
(15) PROVIDE. NOTICE OF OtrrSTANDlNG PROVTSTONAL BALLOTS.
As soon as possible after the dosing hour for all polhng places in
the municipal.tty on election night, the municipal clerk shall post
at his or her office and on the Internet at a site announced b)' the
clerk before the polls open, and shall m.tlceavailable to any person
upon request, a statement of the number of electors who have cast
provisional ballors at the electton m the muruc1pa1ity that cannot
be counted as of that closing hour because the electors have not
satisfied relevant votmg reqmrements.
Hhfory: 1911 C. 304 S 29 (2t 1973 C. 334 S, 57; 1915 C, 85 SS. 50, 65, 1975 C.
275. 422; 1977 C, 283. ]977 C. 394 S, 54 1977 C 4'27 447, 1979 C, 26Q, 311, 1981
c, 391. l9R3 a.484, 19R5 n.304; 1987 a. 391.19R9 a. 192; 1991 a. 316; 1999 a. 182;
2001 a. 16: 2003 a. 265;2005 a 451,2007 n. l, 2011 a 23,45, 75, llS; 2013 a. 148,
2011 a. 118 "· 88,266 (10)~2015 a. !09 229: 2017 a. 369,

7 .20

Board of election commissioners. (1) A mumcipal

board of election comnuss1oners shall be established in every city
over 500,000 population. A county board of election commissioners shall be established m every county over 750,000 population.
(2) Each board of election commissioners shall consist of 3
members, each member being chosen from lists of at least 3 names
each, selected and approved by the county committee of the 2
political parties receiving the most votes for governor in the
county m the ca.,;eof the county board of election commissioners,
and receiving the most votes for governor in the city in the case
of the city board of election commissioners, m the Inst general
election. The county executive, for the county board of election
commissioners, shall select from the list 2 persons from the majority party and one person from the next highest party in thecounty
The mayor, for the city board of election corrumssioners, shall
select from the list 2 persons from the majority party and one person from the next h1ghest party in the city.
(3) The persons chosen shall be qualified electors and residents. of the state and countv and, for the city board of election
original ballots which arc not available,, or to substitute for a votcomm1:.sioners, of the city ·
ing machine or electronic voting .system which ha~ been rendered
(4) Before beginning their duues a.~clecuon commiss10ncrs
inoperable by a malfunction wh1ch occurred withm 72 hours of
the time set for opening of the polls, the election officials shall use each appointee shall take and file the official oath,
(5) Each board of election commissioners shall choose its own
the substJ.tute ballots in the same manner as tf they had been origichauperson. An act of a majority of the board is an act of the
nal ballots.
board.
(7) REQUEST CANVASS ASSISTANCE. The municipal clerk may
(6) The election commissioners shall not hold any other pubrequest all election officials to assist the inspectors in canvassing
lic office and are inehgible for any appointive or elective publtc
the votes received at the respective polhng places.
office, except the office of notary public, during their term.
(8) REsOLVINGNOTICEDOUBTS. When m doubt as to com(7) The term of office shall be 4 years, and until successors
pliance with the statutory requirements for election notices or the
correct fees to be paid for them, the mumcipal clerk may com,--ult have been commissioned and qualified. beginning on July 1 each
year following a presidential election.
Successors shall be
the commission
appointed the .same way.
(9) VOTEREDUCATION. Each municipal clerk shall assist the
History, 1973 c :334, 1975 e. 124; 1983 a. 484 s. 172 (1); 1993 a. 184, 2013 a.
commission in conducting educational programs under s. 5 ,05
373.
(12) to inform electors about the voting process.
(10)

FREE ELECTION INFORMATION EXCHANGE.

Eachmunicipal

clerk shall as..::istthe commission in maintaining toll-free telephone lines and any other free access systems under s. 5.05 (13)
for exchange of voting mformation.
(11) TRAININGOF ELECTION
OFFICIALSEach municipal clerk
:.hall train election officials under :.s. 7 31 and 7 315.
(12) FREE VOTE COUNTING INFORMATION. Each muwcipal
clerk shall maintam a free access infonnation system under which

7.21 Election commissioners, duties and regulations.
(1) All powers and duties a.~signed co the municipal or county
clerk or the mumc1pal or county board of canvassers under chs. 5
to 12 shall be earned out by the municipal or county boord of election commissioners or its executive director, unless spccrfically
re tamed or assigned m this section or s. 7 .22.
(2) The county clerk shall serve as executive drrector of the
county board of election commissioners. The clerk :,hall perfonn

dutiestheboardofelectioncommissioners
assignsto
anelectorwhovotesunders. 6.96or6 97mayascertam
current whatever
2011.19 Wisconsin Statutes updated through 2019 Wis. Act 69 and through all supreme Court and controlled Substances
Board Orders flted,before and In effect on December 17, 2019. Published and certified under s. 35.18. Changes effective after
December17,2019, are designatedby NOTES.(Published12-17-19)

WI-20-0154-A-000070

 Case 2019CV000449

Document 34

Filed 11-27-2019

Page 1 of 8

FILED
11-27-2019
Ozaukee County, WI
Mary Lou Mueller CoCC
2019CV000449

ELECTRONIC REGISTRATION INFORMATION CENTER, INC.
MEMBERSIUP AGREEMENT
th
This membership agreement (this "Agreement") is made and entered into as of the 17- day"of
Registration
by and between Electronic
Date"),
May 2016 (the "Effective
Wisconsin
and
("ERIC")
nonstock corporation
Information Center, Inc., a Delaware
GovernmentAccountability Board (the "Member").

WHEREAS, ERJC was fonned for charitable and educational purposes to engage in meaningful,
evidence-basedreform of the election system in the United States; and
WHEREAS, ERIC seeks to lessen the burdens of government by facilitating the collaboration of
states and local government units to conduct research, develop technology, and perform other
charitable and educational activities designed to reduce the costs and increase the accuracies and
efficiencies associated with their use of voter registration systems; and
WHEREAS, ERIC seeks the direct involvement of states and loca l government units in
furthering its charitable and educational purposes by such states and local government units
becoming members of ERIC and furnishing voter registration and other data to help ERIC
understand the needs of states and local government units with respect to their use of voter
registration systems, and assist state and local government units in making their voter registration
lists and processes more accurate, more complete, and fully compliant with federal, state and
local laws; and

WHEREAS, in consideration for the Member's performance as described below, ERIC will
provide the service to the Members of sharing and processing data that relates to the maintenance
of their voter registration lists and provide regula r (at least on a monthly basis) reports to the
Member.

NOWTHEREFORE,in consideration of the foregoing, the terms and conditions hereinafter set forth

and other good and valuable consideration, the receipt and sufficiency of which are hereby
acknowledged, the parties agree as follows:

1. Annual Dues. The Member shall pay annual dues to ERIC as determined by the Board of
Directors of ERIC (the "ERIC Board") pursuant to Article II , Section 5 ofERIC's
Bylaws. If the Member fails to pay dues by the date determined by the ERIC Board,
ERIC shall not deliver, nor shall the Member receive, any services or data from ERIC
until such payment is received. Any Member that fails to pay dues within ninety (90)
days of a dues payment deadline shall be automatically removed as a Member in
accordance with ERIC's Bylaws (the "Bylaws").
2. Voter Files and Motor Vehicle Records. The Member shall transmit to ERIC the
following data related to its voter files and motor vehicle records (collectively, the
"Member Data").

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Ex. A

WI-20-0154-A-000071

 Case 2019CV000449

Document 34

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Page 2 of 8

EXHIBiTA
a. A reasonable time after admission, the Corporation and the Member will agree
upon a 'Certification Date' that obligates the Member to the following two
sections herein. The Member shall be notified in writing by the Corporation of the
CertificationDate.
b. Within sixty (60) days of the Certification Date, and at least every sixty (60) days
thereafter, the Member shall transmit: (1) all inactive and active voter files
(excluding those records that are confidential or protected from disclosure by
law), including those fields identified in Exhibit B, and (2) all licensing or
identification records contained in the motor vehicles database (excluding those
fields unrelated to voter eligibility, such as fields related to an individual's driving
record), including those fields identified in Exhibit B. Under no circumstances
shall the Member transmit an individual's record where the record contains
documentation or other information indicating that the individual is a non-citizen
of the United States. Should Member believe it has an alternative source of data
that is equivalent to or better than the motor vehicle database ("Alternative Data
Source"), Member may apply in writing to the Executive Director of ERIC to
substitute the Alternative Data Source for motor vehicle data. Such written
application shall explain the basis for Member's assertion that the A l ternative
Data Source is equivalent or better and why using it will effectively serve the
goals of ERIC. If, in the Executive Director's assessment, the request
is
reasonable, the Executive Director shall submit the Member's request to the
Board for approval. If membership in ERIC is contingent upon a jurisdiction's
ability to use an Alternative Data Source, the jurisdiction may seek approval of a
data substitution request in advance of joining ERIC.
c. If the Member fails to transmit the required Member Data as described above,
ERIC shall not deliver, nor shall the Member receive, any Data or services from
ERIC until ERIC receives the required Member Data from the Member. Should
Member fail to transmit Member Data in any sixty (60) day period as provided in
sub-section b, Member shall, upon written notice from ERIC, have a thirty (30)
day grace period in which to provide such Member Data. Should this grace period
expire without a transmission to ERIC of Member Data from the Member, the
Member shall be automatically removed from membership in accordance with the
Bylaws. Member may submit a written appeal to the Executive Director of ERIC
for a reasonable extension of the grace period deadline if Member is unable to
meet that deadline because of a technical issue or a problem accessing or
receiving the Member Data. Whether or not to grant the extension or to proceed to
automatic removal shall be in the sole discretion ofERIC 's Executive Directo1·.
3. State Agency Records . The Member shall use its best efforts to transmit, on a regular
basis, data relating to individuals that exists in the records of other agencies within its
jurisdict ion that perform any voter registration functions, including, but not limited to,
those required to perform voter registration pursuant to the National Voter Registration
Act, 43 U.S,C. 1973gg-5 ("Additional Member Data"). Notwithstanding this section, a ·
state's failure to transmit Additional Member Data under this section shall not affect the
Member's compliance with this Section or its standing as a member of ERIC.

13
Last updatedon March28, 2014; May 21, 2015; October28, 201S

Ex. A

WI-20-0154-A-000072

 Case 2019CV000449

Document 34

Filed 11-27-2019

Page 3 of 8

EXHIBIT A
4. Privacy; Use of Data.
a. Use and Protection of Data: The Member and ERIC shall use their best efforts to
prevent the unauthorized use or transmission of any private or protected Member
Data; Additional Member Data; and data included in reports provided by ERIC
("ERIC Data") (Member Data, Additional Member Data and ERIC Data shall be
collectively referred to as "Data") in its possession. The Member represents and
warrants that all uses and transmissions of Data originating from the Member to
ERIC and/or ERIC's agents, contractors or subcontractors comply fully with
applicable state, federal and local laws, rules and regulations. The Member shall
not use or transmit any ERIC Data for any purpose other than the administration
of elections under state or federal law. Should a Member receive a request to
disclose ERIC Data and determines that it is legally obligated, in whole or in part,
to comply with such request, it shall not make the disclosure without first
obtaining a court order compelling it to do so, a copy of which shall be provided
to ERIC.
b. Unauthorized Use or Disclosure of Data--Member: Should there be an
unauthorized or impermissible use, disclosure or transmission of Data, regardless
of whether it is accidental or intentional (for example, member intentionally sells,
distributes, publishes or uses any ERIC Data for any purpose other than election
administration, including any commercial purpose) or the responsibility of a third
party (collectively, "Unauthorized Disclosure"), Member shall, within ninety (90)
days of ERIC receiving notic e of the Unauthorized Disclosure a) explain in
writing to ERIC that such Unauthorized Disclosure has been cured and how it was
cured or, if the breach is not curable, provides a written explanation to ERIC of
what steps it has taken to mitigate the risks to ERIC and its Members resulting
from such breach; and b) provide a written explanation of what processes it has
implemented to prevent such Unauthorized Disclosure in the future. Upon written
application, the Executive Director of ERIC, in consultation with the Board Chair,
may extend the deadline for Member to comply with this sect ion . At its first
meeting following the Member's compliance with sub-sections a and b above, the
Board will consider the information submitted by the Member and vote on
Member's continued membership. Should Member fail to provide any
information in response to sub-sections a and/orb above, Member shall be
automatically removed. To the extent permitted under each Member's state law ,
the Member agrees to indemnify, defend and hold harmless ERIC against any
claims related to the Unauthorized Disclosure.
c. Notice to ERIC: Each Member shall report to the Executive Director of ERIC as
soon as is practicable if a Member is required by law to sell, distribute, publish,
disclose or use any ERIC Data for any purpose other than election administration.
Each Member shall report to the Executive Director of ERIC immediately upon
learning of any Unauthorized Disclosure.
d. Unauthorized Disclosure of Data-ERIC: Should there be an unauthorized
disclosure of motor vehicle data by ERIC, whether accidental or intentional or the

14
Last updatedon March28, 2014; May 21, 2015; October28, 2015

Ex. A

WI-20-0154-A-000073

 Case 2019CV000449

Document 34

Filed 11-27-2019

Page 4 of 8

EXHIBITA
responsibility of a third party ("ERJC Unauthori zed Disclosure "), ERI C shall
immediately give notice to Members. Understanding that ERIC ' s primary source
of funds are fees and dues paid by Members, and subj ect to consultation and
approval by the Board, ERIC agrees to indemnify , defend and hold hannl ess state
motor vehicle agencies against any claims related to an ERIC Unauthorized
Disclosure of Data.
This provision 4 shall not be construed to limit any Member's sovereign immunity ,
rights, claims or defenses which arise as a matter of law or pursuant to any other
provision of this Agreement.
5. State Voter Registration Systems . To foster ERIC's goal of improving the accuracy of
state voter registration data, Members are strongly encouraged to establish a regular
schedu le for requesting ERIC Data with a minimum of one request every calendar year.
When a Member Representative requests ERIC Data, upon receipt of such ERIC Data,
the Member shall talce the following actions in connection with the improvement of its
state voter registration systems. (If Member rescinds in writing its request for ERIC Data
within seven (7) business days of malci.ngits original request , the following requirements
will not apply.) If a Member fails to malce at least one request for ERIC Data for 425
days, ERIC will automatically provide ERIC Data within seven (7) business days of the
425th day, thereby triggering the following requirements.
a. When the Member receives ERIC Data regarding eligible or possibly eligible
citizens who are not registered to vote , the Member shall, at a minimum, initiate
contact with each and every eligible or possibly eligible citizen and inform them
how to register to vote . Each Member shall have until October 1 or fifteen ( 15)
days before the close ofregistration, whichever is earlier, of the next Federal
. General Election year to initiate contact with at least 95% of the eligib l e or
potentially eligible citizens on whom data was provided and address validation
was performed, as described above. Members shall not be required to initiate
contact with eligible or possibly eligible voters more than once at the same
address, nor shall Members be required to contact any indiv idual who has
affirmatively confirmed their desire not to be contacted for purposes of voter
registration or is otherwise ineligible to vote in the Member's jurisdiction. No
later than December 1 (or, if December 1 falls on a weekend, the next business
day) following the Federal General Election, the Member Representative shall
provide a written certification to the Executive Director of ERlC that Member has
or has not complied with the provisions of this section. Members that have not
complied with this section, or do not provide the written certification, shall be
automatically removed from membership. If a Member adopts legislation or
policies that have the potential to accomplish the objectives of this section by
alternative means, Member may apply to ERIC for an exemption from the
requirements oftbis section of the Membersbip Agreement by sending a written
request to the Executive Director of ERIC and the Chair of the Board. Such
written application shall explain the basis for Member's assert ion that the
a lternative means will effectively achieve the objectives ofthis section. If the
Executive Director of ERIC and the Cha ir of the Board believe the request is

15
Lastupdatedon March28, 2014; May21, 2015; October28, 2015

Ex. A

WI-20-0154-A-000074

 Case 2019CV000449

Document 34

Filed 11-27-2019

Page 5 of 8

EXHIBITA
reasonable, it shall be presented to the Board for a vote a nd, if granted,
detennination on the timing of implementation of the exemption.)

a

b. When the Member receives credible ERIC Data (meaning the state has validated
the data) indicating that information in an existing voter's record is deemed to be
inaccurate or out-of-date, the Member shall, at a minimum, initiate contact with
that voter in order to correct the inaccuracy or obtain information sufficient to
inactivate or update the voter's record. Each Member has ninety (90) days after
the data was sent to initiate contact with at least 95% of the voters on whom data
indicating a record was inaccurate or out-of-date, as described above, was
provided.
Within ten (10) business days of the ninetieth day, the Member Representative
shall provide a written certification to the Executive Director of ERIC that
Member has complied or not complied with this section and, if out of compliance,
the extent of such non-compliance. If Member is out of compliance, Member
st
shall have a 30-day grace period, which begins on the 91 day, within which to
complete the required contacts. Within ten (10) business days following the
expiration of the grace period, the Member Representative shall provide a written
certification to the Executive Director of ERIC that Member has complied or not
complied with this section. If Member is still out of compliance, or fails to
provide the certification, Member shall be automaticallyremoved.
c. The Member shall use its best efforts to provide for a mechanism by which any
eligible voter whose registration appears to have been erroneously processed or
unprocessed shall be offered the opportunity to cast a ballot that will be counted,
unless the voter is otherwise ineligible.
d. The Member shall use its best efforts to provide for a mechanism by which an
eligible voter may register to vote over the internet without need to complete
and/or deliver a paper voter registration form.
e. The Member shall use its best efforts to provide for a mechanism by which voter
registration transactions performed at state agencies is more fully automated and
reduces or eliminates paper transactions.
6. Single Point of Transfer.
The Member shall designate and maintain a single point of
transfer of data and a single data source/point of data per data feed.
7. Performance Data. Within 30 days of the date of execution of this agreement, and every
one hundred eighty (180) days thereafter, the Member shall report to ERlC data relating
to performance under this Agreement, as described in Exhibit C.
8. State Specific Requirements. From time to time, legislation or implementing regulations
enabling states to become members of ERIC will contain state-specific membership
requirements not applicable to all Members. Such state-specific requirements are set
forth in Exhibit D.

16
Last updatedon March28, 2014; May 21, 2015; October28, 2015

Ex. A

WI-20-0154-A-000075

 Case 2019CV000449

Document 34

Filed 11-27-2019

Page 6 of 8

EXHIBITA
9. Publicity. The Member shall not make or permit any person connected with it to make
any announcement or statement purporting to be on behalf of ERIC, or use any logo ,
trademark, service mark, or business or trading name of ERIC or any other Member of
ERIC without the prior written approval of ERIC or the affected Member, as applicable.
Furthermore ERIC shall not make or permit any person connected with it to make any
announcement or statement purporting to be on behalf of any Member, or use any logo ,
trademark, service mark, or business or trading name of any Member of ERIC without
the prior written approval of the affected Member.

10. Waiver. No waiver by any party for any breach by the other of any of the provisions of
this Agreement shall be deemed a waiver of any preceding or succeeding breach of the
same or any other provisions hereof. No such waiver shall be effective unless in writing
and then only to the extent expressly set forth in wiiting.
11. Severabi lity. The provisions of this Agreement are separate and severable, and the
invalidity of any of them shall not affect or impair the validity or enforcement of the
remaining provisions.
12. Assignment. ERIC may not sell, assign, or otherwise transfer any of its rights or interests
or delegate any of its duties or obligations in this Agreement, without the prior written
consent of the Members. The Member may not sell, assign, or otherwise transfer any of
its rights or interests or delegate any of its duties or obligations in this Agreement,
without the prior written consent of ERIC. Any sale, assignment, or transfer in violation
of this Section is void and without effect.
13. No Partner or Agency. This Agreement does not constitute or create a partnership or
joint venture with any Member or among the Members; appoint any Member as an agent
for ERIC or any other Member, or appoint ERIC as an agent for any Member; or create
any fiduciary obligations among the Members, except as may be expressly set forth in
this Agreement.
14. Amendments.
Amendments or modifications of this Agreement shall be effective
immediately upon approval of such changes by the entire membership in accordance with
Article VI, Section 5 of the Bylaws.
15. Communications; Notices. All communications and notices that are required to be given
by ERIC or a Member pursuant to this Agreement must be in writing and sent to the
recipient either by electronic mai l, personal delive1y, overnight commercial courier
service, or facsimile. Members may request a preferred method of delivery and the
Corporation will make all reasonable efforts to oblige such requests. Communications
and notices must be sent using the Notice Details set forth on the signature page of this
Agreement, unless these details are changed by delivery of a written notice to ERIC, if
the change related to a Member, or the Member, if the change relates to ERJC. The
Executive Director of ERIC shall maintain or cause to be maintained a roster of Members
that contains a compilation of Notice Details for each Member, and which shall be
distributed periodically to the Members.

17
Lastupdatedon March28, 2014;May21, 2015;October28, 2015

Ex. A

WI-20-0154-A-000076

 Case 2019CV000449

Document 34

Filed 11-27-2019

Page 7 of 8

EXHIBITA
16. Counterparts. This Agreement may be executed in two (2) or more counterparts, each of
which when fully executed shall be an original, and all of said counterparts taken together
shall be deemed to constitute one and the same agreement.
17. Complete Agreement. This Agreement is the parties ' final and binding expression of
their agreement and the complete and exclusive statement of its terms . This Agreement
cancels, supersedes and revokes all prior negotiations, representations and agreements
between the parties, whether oral or written, relating to the subject matter of this
Agreement.
18. Headings and Subsections.
Section headings are provided for reference and do not
constitute part of this Agreement.
19. Definitions. As used herein, the term "state" includes the fifty (50) states, the District of
Columbia, and the territories of the United States.

18
Last updatedon March28, 2014; May21, 2015; October28, 20l5

Ex. A

WI-20-0154-A-000077

 Case 2019CV000449

Document 34

Filed 11-27-2019

Page 8 of 8

ELECTRONICREGISTRATIONINFORMATIONCENTER,INC.

By, ~

~

Name~rs

Title: Board Chair
Date:
Notice Details:

With a copy to:

Name:
Angie Rogers
Title:
Board Chair
Address: P.O. Box 94125
Baton Rouge, LA 70802-9125
Phone:
(225) 922-0900
(225) 922-0945
Fax:

Name: John Lindback
Title:
Executive Director
Address: 1155 F Street NW Suite 1050
WashingtonDC 20004
Phone: (202) 695-3464
(866) 200-2651
Fax:

Wisconsin Government Accountability Board/Wisconsin Elections Commission

:ZBy:
;:::,
Name: KeJ-mJ. Kennedy
Title: Directorand General Counsel
Date: May 17, 2016
Notice Details:

With a copy to:

Name:
Title:

Name:
Title:

Michael Haas
Elections Division Administrator/
Wisconsin Elections Commission Administrator
Address: PO Box 7984, Madison, WI 53707-7984
212 E. Washington Ave, Third Floor
Madison, WI 53703
608-266-0136
Phone:
608-267-0500
Fax:

Ross Hein
Elections Supervisor

Address: PO Box 7984, Madison, WI
212 E. WashingtonAve
Madison, WI 53703
Phone: 608-267-3666
Fax:
608-267-0500

Note: Effective June 30, 2016 the Wisconsin Government Accountability Board becomes the Wisconsin
Elections Commission.

19

Ex. A

WI-20-0154-A-000078

 SCOTT FITZGERALD
WISCO SINSTATESENATOR
S E ATE MAJORITY LEADER

October 16, 2019

The Honorable Tony Evers, Governor:
Pursuant to Wis. Stats. 15.61(1)(a), I appoint the following individual to serve on the Wisconsin
Elections Commission, effective immediately:
Bob Spindell of Milwaukee
Sincerely,

Senator Scott Fitzgerald
Majority Leader

cc:

Meagan Wolfe, Wisconsin Elections Commission
Dean Knudson, Wisconsin Elections Commission

STAT E CAPIT OL
P.O . Box 7882 . NIJ\DJSON,WISCONSIN53707-7882 . SE 1.FITZGERALD®LEG!S.WISC0NSIN .G0V

TELEPJJONE:(608) 266-5660

WI-20-0154-A-000079

 SCOTT FITZGERALD
WISCO SINSTATESENATOR
S E ATE MAJORITY LEADER

October 16, 2019

The Honorable Tony Evers, Governor:
Pursuant to Wis. Stats. 15.61(1)(a), I appoint the following individual to serve on the Wisconsin
Elections Commission, effective immediately:
Bob Spindell of Milwaukee
Sincerely,

Senator Scott Fitzgerald
Majority Leader

cc:

Meagan Wolfe, Wisconsin Elections Commission
Dean Knudson, Wisconsin Elections Commission

STAT E CAPIT OL
P.O . Box 7882 . NIJ\DJSON,WISCONSIN53707-7882 . SE 1.FITZGERALD®LEG!S.WISC0NSIN .G0V

TELEPJJONE:(608) 266-5660

WI-20-0154-A-000080

 2/13/2020

Gmail - Appointment to Wisconsin Elections Commission

Dean Knudson <dean.knudson@gmail.com>

Appointment to Wisconsin Elections Commission
Dean Knudson <dean@deanknudson.com>
Wed, Apr 17, 2019 at 11:21 AM
To: Robin Vos <rep.vos@legis.wi.gov>, "Toftness, Jenny" <Jenny.Toftness@legis.wisconsin.gov>

Dear Speaker Vos,
I have enjoyed serving on the Elec ons Commission. My current term expires at the end of this month. I
would like to be re-appointed to serve another term. Please send an appointment le er to the Commission
regarding your appointment for the term star ng May 1st.
The term of Beverly Gill is also expiring this month. Commissioner Gill serves as an appointee of the
Governor selected from a list of former clerks provided by the Republican leaders in the legislature.
Commissioner Gill provides a valuable perspec ve to the Commission. Her re-appointment would serve the
interests of the State, however the statute also requires the leaders to forward addi onal names from
which the Governor may appoint.
The structure of the Elec ons Commission is balanced with three appointees from each major poli cal
party. A vacancy will exist beginning May 1st with the expira on of Commissioner Gill's term. The
Commission's next mee ng is on June 11, 2019.
Thank you for your considera on,
Dean Knudson

WI-20-0154-A-000081

https://mail.google.com/mail/u/0?ik=6b9cf7731f&view=pt&search=all&permmsgid=msg-a%3Ar-3883661058099765192&simpl=msg-a%3Ar-38836610…

1/1

 2/13/2020

Gmail - Medicaid care costs hospitals more than bad debts and charity care

Dean Knudson <dean.knudson@gmail.com>

Medicaid care costs hospitals more than bad debts and charity care
Dean Knudson <dknudson@comcast.net>
Thu, May 9, 2019 at 12:47 PM
To: Robin Vos <rep.vos@legis.wi.gov>, Rep.nygren@legis.wisconsin.gov, rep.zimmerman@legis.wisconsin.gov,
rep.born@legis.wisconsin.gov, rep.loudenbeck@legis.wisconsin.gov

RepresentativesToday during the JFC debate on Medicaid expansion, Senator Johnson asserted that Medicaid expansion would reduce
the losses hospitals incur due to uncompensated care. This is a myth that ignores the fact that hospitals lose more
money each year treating Medicaid patients than they do on charity care or uncollected bad debts.
Senator Taylor brought up the Ascension system in Milwaukee as an example during debate. The tax return for Wheaton
Franciscan (Ascension) from 2015 is attached. Look at page 2 and page 35 marked in red.
Losses due to Medicaid $46 million, Charity $17 million, Bad debt $10 million, Medicare $1 million. Medicaid care is
always a loser for providers. It always shifts costs to other patients.
Dean Knudson
Ascension tax return 2015.pdf
2382K

WI-20-0154-A-000082

https://mail.google.com/mail/u/0?ik=6b9cf7731f&view=pt&search=all&permmsgid=msg-a%3Ar-2912332384515020327&simpl=msg-a%3Ar-29123323…

1/1

 2/13/2020

Gmail - Sarah Yacoub appearance at Rotary meeting

Dean Knudson <dean.knudson@gmail.com>

Sarah Yacoub appearance at Rotary meeting
Dean Knudson <dknudson@comcast.net>
To: Jenny Toftness <jenny.toftness@gmail.com>

Thu, Nov 7, 2019 at 7:45 AM

Yesterday morning at the 7:00am meeting of the Hudson Daybreak Rotary Club, member Roy Sjoberg (chair of the St.
Croix County Democrat party) introduced Sarah Yacoub as his guest and asked that she be given a few minutes to
speak. Yacoub spoke from the front of the room for a few minutes explaining her background and why she was running.
She asked for support at the November 2020 election for state assembly. She pointed out that a relative had been
involved in the creation of the Lucas the Spider plush toy. She had placed one at each place setting and pointed out that
she had a case in the back of the room if anyone wanted additional toys. She said they were not in production but were
available on Ebay.
Yacoub left before the end of the meeting. At the end of the meeting I mentioned to Roy that I hoped the value of these
toys was less than $1 or it would be a violation. Roy quickly said he thought they would be worth less than one dollar.
Upon checking Ebay later in the day I saw that the toys were selling for $6 or more. Attached is a sale from yesterday.
Searching ebay for "lucas spider" yields many for sale for more. There were over 50 in attendance at the meeting.
I also wonder how this item will be reported on the CFIS report.

LUCAS THE SPIDER 1ST EDITION PLUSH TOY DOLL NEW _ eBay.pdf
483K

WI-20-0154-A-000083

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1/1

 December 19, 2019
From: Dean Knudson
To: Speaker Robin Vos
Potential Legislation related to ERIC, the Electronic Registration Information Center
Suggested action steps:
1. A standalone bill to mandate the Wisconsin Election Commission to request from ERIC at least
once every 12 months the list of duplicate cross-state voters, I.e. individuals for whom there is
evidence of voting twice in the same election in two different states. Require that the

Commission treat the data provided by ERIC as an official complaint to be handled
under the statutory powers of the Commission in s. 5.05, etc. Require that the
Commission refer these individuals to the appropriate district attorney after a review of
the records available from Wisconsin and the other state. The Commission is already
doing this but without any statutory direction or mandate. In the absence of legislation
a future Commission could decide not to request these optional lists.
2. A follow-up bill to 2015 Wisconsin Act 261 to add definitions and clarification. Add a section

to s. 6.50 to require the Elections Commission to annually send a mailing to the ERIC “instate movers” similar to the mandate for the four year mailing. Specify inactivation as
required in s. 650(2) or in s. 6.36(1)(d). Specify that the ERIC “in-state movers” list is not
subject to local clerks’ determination of reliability. Grant authority to WEC to
promulgate administrative rules for the ERIC process.
3. Authorize Legislative Reference Bureau staff to have discussions with Elections

Commission staff about specific statutory language changes. Currently WEC staff have
been informed by LRB that this subject is not to be discussed.
Review of Current Statutes
A. Wis. Stats. 6.36(a) contains general responsibility for maintaining the registrations lists.
No mention of ERIC. No direction or authority for how to handle ERIC. No direction
about whether to participate in optional ERIC activities. No authority or directive to
promulgate rules.
B. Wis. Stats. 6.36(ae) made Wisconsin a member of ERIC without any further mention of
any of the optional or discretionary aspects of ERIC membership.
C. Wis. Stats. 6.36(d) requires a voter’s status to be changed to ineligible if another state
notifies WEC of a registration or voting in that state. This section does not apply to ERIC
because ERIC is not another state, but it could be expanded to cover ERIC.
Wis. Stats. 6.36(6) allows the sale of voter lists but doesn’t cover the question of release
of the ERIC movers list, which is considered confidential information under the ERIC
membership agreement.
D. Wis. Stats. 6.50(1) & (2) cover the “four year maintenance” mailings with specific
processes. These processes do not apply to ERIC mailings but this template could be
followed, or ERIC could be added to this process.
E. Wis. Stats. 6.50(3) is the section currently under litigation. This section specifically
applies only to local clerks but WEC used this section for the original ERIC movers
mailing in 2017. Clerks in Green Bay and Milwaukee later exercised their right to define
the ERIC information as not “reliable” and reactivated the list. The process is not as

WI-20-0154-A-000084

 defined as the “four year maintenance” process and has been in place for years to apply
to individual electors rather than large groups. It should be improved.
F. Wis. Stats. 7.20 defines “Board of Election Commissioners” as used in Wis. Stats. 6.50(3).
Some have read 6.50(3) to include the Wisconsin Election Commission as being included
in this definition but the statutes define WEC in another area of Chapter 7.
Background
Wisconsin is unique among the twenty-nine ERIC members in that Wisconsin does not register
voters at the DMV as part of driver licensing. Of six states exempt from the federal motor
voter act, only Minnesota and Wisconsin are members of ERIC. Like Wisconsin, Minnesota is
exempt because they have same-day registration. But Minnesota differs by voluntarily
registering voters at the point of driver licensing.
Upon joining ERIC Wisconsin became the first and only ERIC state to have never previously
done a complete cross-match of our DMV lists with our voter registration lists. In 2017
Wisconsin sent a mailing using the ERIC in-state movers list for the first time. In preparing and
mailing these postcards the Elections Commission operated under the assumption that the
mailing would meet the requirements of both ERIC and Wis. Stats. 6.50. The postcards included
a notification under Wis. Stats. 6.50 that the voters' registrations would be inactivated after 30
days unless the voter responded.
WEC encountered an unusually high number of false results during our first matching of the
voter registration lists with the Department of Transportation lists. As a result of these firsttime problems, some municipalities and clerks raised the question of whether the 2017 ERIC
movers list constituted "reliable information". A close reading of s. 6.50(3) reveals that local
clerks are given the authority and responsibility to contact voters that may have moved.
There were many reasons for these false positive matches, where voters who had not moved
were falsely reported as having moved. In some cases the address was slightly different. In
other cases the name differed slightly. We learned that vehicle owners who registered a
vehicle at a second home or cabin would be reported as having moved to that address. Some
voters had registered their vehicle in another county to avoid the Milwaukee wheel tax. In the
end we experienced a false positive match rate of not less than 6%, meaning 6% of the voters
that were initially flagged as possibly having moved to a new address later confirmed that they
still resided at their original address.
WEC staff worked with DOT and ERIC to find and eliminate as many of these errors as possible.
While we will not know until later how successful these efforts have been, the staff members
working on the problem estimated that the 6% error rate in 2017 should be reduced
significantly in the 2019 process.
Membership in ERIC requires that voters appearing on the in-state movers list must be
notified of the information, but ERIC does not require inactivation. Many of the ERIC member
states, possibly a majority of the states, send these voters a mailing informing them to verify
their registration status but take no action to inactivate them.
A change in the law to specify that ERIC information constitutes "reliable information" under s.
6.50(3) would assure a uniform approach across the state.
Political Aspects
Governor Evers’ budget proposal for the current biennium included funding for the required
ERIC mailing to eligible but unregistered voters. Gov. Evers did not fund the “movers list”

WI-20-0154-A-000085

 mailing but suggested the use of federal HAVA funds for this activity. Federal officials informed
the state this use of HAVA would not be allowable. The Joint Committee on Finance added
funding for the mover’s list mailing to the budget. JFC also added funding to create the
watermark system on the pollbooks to demarcate those individuals on the mover’s list.
Democrats in general and Governor Evers are not as supportive of voter registration list
maintenance as Republicans. Neither party supports or condones voter fraud. A standalone
bill dealing with fraudulent voting in two states should receive bipartisan support and the
Governors signature.
Need for clarification in statutes related to ERIC membership activities
Members in ERIC agree to these mandatory activities:
1) contact individuals who are believed to be eligible to vote but are not yet registered before
every federal election (every 2 years)
2) contact registered voters who may have moved within the state to inform them
3) inactivate the registration of voters who are found to have registered or voted in another
state
Members in ERIC may optionally choose to:
4) request a list of duplicate voters, i.e. voters who may have voted in two states in one election
– cross-state duplicate voters
5) inactivate the registrations of voters who may have moved within the state (some states
inactivate while others do not)
Wisconsin statutes also require other list maintenance activities such as inactivation of
registrations of individuals who have not voted in four years under s. 6.50(1). We refer to this
as “four year list maintenance” and this has been practiced in Wisconsin for many years.
I believe that Wisconsin should fully utilize the tools provided by ERIC to assist in our list
maintenance activities.
ERIC movers list mailing in 2019 – funding, approval and process
The Elections Commission 2019-2021 biennial budget request included a request for funding of
both the mailings required in the ERIC membership agreement. In his Executive Budget
proposal Governor Evers included funding for the ERIC mailing to eligible unregistered voters,
but did not include funding for the ERIC in-state movers mailing. On May 14, 2019 the Joint
Committee on Finance considered this issue in budget paper #280 (attached). In discussion
points #6 & #7 the Legislative Fiscal Bureau recapped the 2017 ERIC mailings and discussed
funding options for 2019 and 2021. The budget paper explains the requirements of ERIC
membership related to the movers mailing. LFB made no mention of deactivation of voters
under Wis. Stats. 6.50. LFB explained in discussion point #7 the Commission's request for
funding to make modifications to the voter administration system to "allow clerks to distinguish
the records of voters identified by ERIC as having potentially moved from those identified by
clerks as having moved".
The Elections Commission does not believe it has the statutory authority to send a mailing to
“in-state movers” under 6.50(3) which grants this power to local clerks or to “boards of election

WI-20-0154-A-000086

 commissioners”. The definition of “boards of election commissioners” in Chapter 7 makes clear
that the WEC is not a “board of election commissioners” under statute. WEC instead sent the
“movers list” mailing under WEC’s general authority to maintain the registration list.
In June 2019 the Commission adopted a plan to alter the poll list by placing the words "movers
list" in the space where a voter signs the poll book. The Commission also voted to require the
poll worker to ask these voters before they vote the following question: "We have received
information that you may have moved from this address. By signing here you are affirming you
still reside at this address."
Judge Malloy in Ozaukee county circuit court ruled in the WILL lawsuit last week. Judge Malloy
ruled that the ERIC movers list does constitute reliable information. His ruling found that WEC
is required to follow the process in Stat. 6.50(3) with inactivation of voters after a mailing. This
ruling has been appealed by DOJ. Another federal lawsuit has been filed to prevent inactivation
of voters.
The judicial review of the actions of the Commission related to the ERIC movers list hinges on
three questions:
1) Does the 2019 ERIC in-state mover list constitute "reliable information" under Wis. Stat.
6.50?
2) In 2017 local officials claimed the statutory right to make the determination of reliability at
the local level. Do local officials have the authority to determine whether the 2019 ERIC instate mover list constitutes "reliable information"?
3) Did the governor and legislature intend in 2019 Act 9, the biennial budget bill, to authorize
expenditure of funds for a mailing to the ERIC in-state movers list as a required notice under
Wis. Stat. 6.50 including notification that the voters' registration would be inactivated in 30
days? Or did the governor and legislature authorize funding for a required mailing under 2015
Act 261, with a plan to contact the voters by mail and highlight their presence on the movers
list in the election administration system?

WI-20-0154-A-000087

 WI-20-0154-A-000088

 11/7/2019

LUCAS THE SPIDER 1ST EDITION PLUSH TOY DOLL NEW   eBay
Sell

Hi Dean!

Search for anything
Back to search results   Listed in category:

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Collectibles > Animation Art & Characters > Animation Characters > Other Animated Characters

Bidding has ended on this item. The seller has relisted this item or one like this.

LUCAS THE SPIDER 1ST EDITION PLUSH TOY DOLL NEW See original listing
Condition: New
Ended: Nov 06, 2019 , 9:35PM
Winning bid:

US $6.50 [ 10 bids ]

Shipping: $9.98 Standard SpeedPAK from China/Hong Kong/Taiwan
Item location: GuangDong, China
Seller: anime-dolphin (7909

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WI-20-0154-A-000093

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Mail - Knudson, Dean - ELECTIONS - Outlook

Letter from Sen. Fitzgerald
Fitzgerald, Scott - LEGIS <Sen.Fitzgerald@legis.wisconsin.gov>
Wed 1/16/2019 12:43 PM
To: Magney, Reid - ELECTIONS <Reid.Magney@wisconsin.gov>; Knudson, Dean - ELECTIONS <Dean.Knudson@wisconsin.gov>;
Wolfe, Meagan - ELECTIONS <Meagan.Wolfe@wisconsin.gov>
1 attachments (370 KB)
Letter to Elections Commission.pdf;

Greetings –
Attached, please find a letter to the Elections Commission from Senator Fitzgerald.

WI-20-0154-A-000094

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 2/13/2020

Mail - Knudson, Dean - ELECTIONS - Outlook

Fw: Today's decisions
Knudson, Dean - ELECTIONS <Dean.Knudson@wisconsin.gov>
Tue 1/21/2020 5:37 PM
To: Rep.Vos - LEGIS <Rep.Vos@legis.wisconsin.gov>

FYI - I no ce Mr. Belling had intended to copy you on his message...so sending this for your informa on.
Dean Knudson

From: Knudson, Dean - ELECTIONS <Dean.Knudson@wisconsin.gov>
Sent: Tuesday, January 21, 2020 4:05 PM
To: BELLING, MARK C. <MARKBELLING@iheartmedia.com>
Cc: rep.vos@legis.wisconsin.com <rep.vos@legis.wisconsin.com>
Subject: Re: Today's decisions
 

Hi Mark, I reviewed the complaints related to nomina on papers for three Milwaukee area candidates
including Kennedy, Sullivan and King. None of these cases was a close call. Kennedy and Sullivan
violated a state law specifically wri en to prevent the circula on by one individual of nomina on papers
for two candidates for the same office. The law and the intent of the legislature was very clear as
applied to the Kennedy and Sullivan cases.
Unfortunately King did not file enough valid nomina on signatures to gain ballot access. It is ul mately
the responsibility of each candidate to review the papers to ensure a sufficient number of signatures are
submi ed. The law allows a candidate to submit twice the minimum number as a protec on against
failing to reach the minimum due to problems with some of them. King submi ed three nomina on
papers with missing or incomplete address informa on for the circulator statements. WEC accepted
both the papers with incomplete addresses. The paper without any address informa on for the
circulator was not accepted as valid. This is consistent with past prac ce and nothing new.
The Commission has a special mee ng scheduled on Friday at 4:00pm this week. In my judgment it was
cri cally important to resolve these ma ers in a mely manner. I do not believe a mee ng of the full
Commission would have reached a different conclusion. The candidates have the right to appeal the
decisions to have a judge review their arguments.
Dean Knudson
From: BELLING, MARK C. <MARKBELLING@iheartmedia.com>
Sent: Tuesday, January 21, 2020 2:48 PM
To: Knudson, Dean - ELECTIONS <Dean.Knudson@wisconsin.gov>
Cc: rep.vos@legis.wisconsin.com <rep.vos@legis.wisconsin.com>
Subject: Today's decisions
 
Dean
In an email, Reid Magney informed me that the decision to strike the name of Milwaukee mayoral candidate
David King (the endorsed candidate of the Milwaukee County Republican Party) and two candidates for
Milwaukee County Execu ve was made by you, without a commission vote, and based on recommenda on of the
Commission’s Madison staff.
WI-20-0154-A-000095

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 2/13/2020

Mail - Knudson, Dean - ELECTIONS - Outlook

Why did you not schedule a full Commission vote on this?
Did you personally listen to any of the arguments made on the appeals?
What is the point of having a six member commission if the most important decisions are relegated to staff and
the other five commissioners are not even given a chance to par cipate?
It would seem to be that a challenge to ballot access is THE MOST IMPORTANT DECISION THE COMMISSION CAN
MAKE. How in the world can this therefore be a one person decision?
Mark Belling
PM Drive Talk Show Host WISN-AM, Western Great Lakes Region
iHeartMedia
12100 W. Howard Ave, Greenfield, WI, 53228
P: 414-545-8900
America’s #1 Audio Company
Reaching 9 out of 10 Americans every month.
Radio/Podcasts/Digital/Social/Influencers/Data/Events

WI-20-0154-A-000096

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 2/13/2020

Mail - Knudson, Dean - ELECTIONS - Outlook

Re: Oconomowoc Mayoral Candidate Removal
Knudson, Dean - ELECTIONS <Dean.Knudson@wisconsin.gov>
Thu 1/23/2020 5:32 PM
To: BELLING, MARK C. <MARKBELLING@iheartmedia.com>; Wolfe, Meagan - ELECTIONS <Meagan.Wolfe@wisconsin.gov>
Bcc: Vos, Robin - LEGIS <Robin.Vos@legis.wisconsin.gov>

Hi Mark The clerk in Oconomowoc originally cer fied 200 signatures for Kowieski. My understanding is that she
counted each page and wrote the number of valid signatures on the page, then she added all the
numbers she had wri en on the individual pages. At no point did she actually perform a simple
aggregate count of all the signatures. On one page the number she wrote on the page didn't reflect the
number of signatures on that page, i.e. on one page the number she wrote appears to have been two
greater than the number of actual signatures on that page.
Upon receiving the complaint WEC staff disregarded the wri en nota ons and simply counted the
signatures that were cer fied as valid. The number counted was 198 or 2 signatures short of the
necessary number. When the clerk was called to inquire about the difference, she recounted and
realized her mistake. The clerk then emailed WEC sta ng that "I just wanted to let you know that I
recounted (slowly) and it is 198". The clerk herself then, a er consulta on with the Oconomowoc City
A orney, issued an amended sufficiency determina on and reversed their original determina on –
finding the minimum of 200 valid signatures had not been submi ed, and therefore the candidate’s
name should not appear on the ballot. In short, a simple mistake had been made by the clerk. This
made the original complaint to WEC moot and no further ac on was taken by WEC. It would not be
correct to state that the WEC told her to do anything in this case but rather simply acted as another set
of eyes on the documents. These nomina on papers would be an open record if you wish to request
them.
Kowieski has the right to challenge the clerk's ac ons and decisions in this case.
Candidates are ul mately responsible for insuring that a sufficient number of valid signatures are
submi ed. Candidates for Mayor in Oconomowoc are allowed to submit 400 signatures to meet the
minimum of 200 valid signatures. Candidates submi ng only a few signatures more than the minimum,
as in this case, are at risk of not making the ballot if some of the signatures are not valid.
There is no evidence of par san bias in this case. There was no decision or ruling or judgment by
anyone at WEC. There was no persuasion or direc on by WEC other than to point out the obvious
coun ng error.
Dean Knudson
From: BELLING, MARK C. <MARKBELLING@iheartmedia.com>
Sent: Thursday, January 23, 2020 2:03 PM
To: Knudson, Dean - ELECTIONS <Dean.Knudson@wisconsin.gov>
Subject: Oconomowoc Mayoral Candidate Removal
 
Dean
Did you, or the en re Commission, make a ruling on the challenge to the ballot access of Oconomowoc mayoral
candidate Lou Kowielewski?
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The Waukesha Democra c Party challenged his pe ons because some lacked a date on the top of the
nomina ng page and some did not include the tle of the office. The Oconomowoc City Clerk ruled the
candidate’s pe ons were valid. This morning, she says she was told by the “Commission” to remove the
candidate.
Who did this? The Commission staff? You? The en re Commission?
This is the latest instance in which a complaint was filed by a Democrat or, in this case, the Democra c Party and
the Commission has sided with it. Yet, I can’t find any evidence of an actual decision by the Commission. I have
obvious concerns that I have raised with Speaker Vos that the Commission is derelict in its du es and is being
steamrollered by a par san Madison staff. As you know, I was appalled that the recent Milwaukee cases were
decided without a full Commission vote and in each case sided with a challenge made by Democrats.
The purpose, I was told at the me, of having three Republicans and three Democrats on the Commission, was to
guarantee that the Madison staff would not func on in a par san fashion as it did during the GAB era. Yet the
Commission seems to me to now be far worse than the GAB ever was and I see no evidence of oversight by the
Commission of its par san and biased staff.
If the full Commission did not consider the Oconomowoc case, why not? And why is the Commission staff, on its
own, being allowed to order any municipal officials to do anything? The Commission staff, I have been told
repeatedly, is there to enforce Commission decisions and not to make rulings or decisions on its own.
I fear that tomorrow your Commission will throw Jus ce Kelly off the ballot.
Mark Belling
PM Drive Talk Show Host WISN-AM, Western Great Lakes Region
iHeartMedia
12100 W. Howard Ave, Greenfield, WI, 53228
P: 414-545-8900
America’s #1 Audio Company
Reaching 9 out of 10 Americans every month.
Radio/Podcasts/Digital/Social/Influencers/Data/Events

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Followup to our phone conversation re: Milwaukee's plan in regard to Wis. Stat 7.15(1)
(cm)
Knudson, Dean - ELECTIONS <Dean.Knudson@wisconsin.gov>
Tue 2/11/2020 12:02 PM
To: Handrick, Joe X - LEGIS <joe.handrick@legis.wisconsin.gov>
1 attachments (196 KB)
WEC Absentee Ballot Reponse .pdf;

Joe- This item will be discussed at a Elec ons Commission mee ng tomorrow. I think the law is clear
and unambiguous that the ballots must be sent 47 days in advance. My guidance to the WEC staff during
the development of the A/B guidance was that, regardless of past prac ce to the contrary, the WEC staff
should advise the clerks to follow the law. Just sending this for your informa on only because legisla on
will likely be required in the future.
Dean Knudson

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Re: Elections Commission Background Information
Knudson, Dean - ELECTIONS <Dean.Knudson@wisconsin.gov>
Thu 12/19/2019 12:50 PM
To: Luke, Ashley - LEGIS <Ashley.Luke@legis.wisconsin.gov>; Rep.Vos - LEGIS <Rep.Vos@legis.wisconsin.gov>
4 attachments (2 MB)
Knudson memo on ERIC legislation.pdf; ERIC related statutes.pdf; 001 - Paper 280 Electronic Registration Information Center
(Alternatives 1 and 3) (1).pdf; Exh. A - ERIC Membership Agreement.pdf;

Hi Ashley,
The Wisconsin Elec ons Commission has voted to seek legisla on clarifying the procedures related to
Wisconsin's membership in ERIC. Please forward my a ached memo, a pdf with per nent statutes, a
copy of the JFC issue paper from May, and a copy of the ERIC membership agreement. These
documents will be helpful during our telephone discussion tomorrow.
Thanks,
Dean Knudson
From: Luke, Ashley - LEGIS <Ashley.Luke@legis.wisconsin.gov>
Sent: Thursday, December 19, 2019 8:18 AM
To: Knudson, Dean - ELECTIONS <Dean.Knudson@wisconsin.gov>
Subject: Elec ons Commission Background Informa on
 
Hello Dean,
Thank you for speaking with me on the phone this morning. I look forward to hearing back from you so I can pass
along the background informa on to staff in the office on your behalf!
Thanks again,

Ashley Luke
Office of Assembly Speaker Robin Vos
608-266-9171, 1-888-534-0063
Ashley.Luke@legis.wisconsin.gov

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FW: Fitzgerald appointment to Elections Commission
Wolfe, Meagan - ELECTIONS <Meagan.Wolfe@wisconsin.gov>
Wed 10/16/2019 4:26 PM
To: EL DL Elections Comm <ELECdlelectionscommision@wisconsin.gov>
Cc: Rydecki, Richard H - ELECTIONS <Richard.Rydecki@wisconsin.gov>; Haas, Michael R - ELECTIONS
<Michael.Haas@wisconsin.gov>; Judnic, Nathan - ELECTIONS <Nathan.Judnic@wisconsin.gov>; Kehoe, Robert Y - ELECTIONS
<robert.kehoe@wisconsin.gov>; Hauge, Sharrie - ELECTIONS <Sharrie.Hauge@wisconsin.gov>

2 attachments (403 KB)
Fitzgerald Appt to WEC - Oct 19 2019.pdf; Fitzgerald Appt to WEC - Oct 19 2019.pdf;

CommissionersA ached please find a le er from Senate Majority Leader Fitzgerald to Governor Evers appoin ng Bob Spindell of
Milwaukee as a Commissioner. I did not receive any contact informa on, but will reach out to Commissioner
Spindell once I do.
Please note he will not be on today’s call and this is not an item on today’s Commission agenda.
Meagan
From: Romportl, Dan - LEGIS <Dan.Romportl@legis.wisconsin.gov>
Sent: Wednesday, October 16, 2019 3:35 PM
To: Csontos, Flora - GOV <flora.csontos@wisconsin.gov>; Wolfe, Meagan - ELECTIONS
<Meagan.Wolfe@wisconsin.gov>
Subject: Fitzgerald appointment to Elec ons Commission
Hi Flora & Meagan,
Please see the a ached le er regarding Senator Fitzgerald’s appointment to the vacant board posi on at the
Wisconsin Elec ons Commission.
Feel free to contact me with any ques ons.
Thank you,
Dan Romportl
Chief of Staff
Senator Scott Fitzgerald
Senate Majority Leader
13th Senate District
(608) 266-5660

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