2020 E empt Organi ation Business Ta Return e a ed f : Orphan Care Alliance, Inc. 115 N Wa e T a , S e 201 L e, KY 40243
Curr , Drake and Associates, LLC 12700 T e a Wa , Da e B dg L e, KY 40243
For m
990
Ret ur nofOr gani z at i onExemptFr om I ncomeTax Donotent ersoci alsecur i t ynumber sont hi sf or m asi tmaybemadepubl i c. Got owww. i r s. gov/ For m990f ori nst r uct i onsandt hel at esti nf or mat i on.
A Fort he2020cal endary ear ,ort axyearbegi nni ng Checki fappl i cabl e:
CNameofor gani z at i onOrphan
Numberandst r eet( orP. O.boxi fmai l i snotdel i ver edt os t r eetaddr ess )
I ni t i al r et ur n
115 N Watterson Trail, Ste 201
Fi nalr et ur n/ t er mi nat ed
Ci t yort own,s t at eorpr ovi nce,count r y ,andZI Porf or ei gnpost al code
I
Taxexemptst at us:
J
Websi t e:
K
For m ofor gani z at i on:
Act i vi t i es&Gov er nance
(502)498-4765
H( a)I st hi sagr oupr et ur nf orsubor di nat es?
Yes
No
Darren Washa sen, 115 N Watterson Trail, Ste 201, Lo is ille, KY 40243
H( b)Ar eal ls ubor di nat esi ncl uded?
Yes
No
501( c) ( 3)
501( c)(
) ( i nser tno. )
4947( a) ( 1)or
527
I f“ No, ”at t achal i st .Seei nst r uct i ons
.orphancarealliance.org Cor por at i on
Tr ust
Associ at i on
H( c)Gr oupexempt i onnumber Ot her
LYearoff or mat i on:
Summar y
2009
M St at eofl egal domi ci l e:KY
Br i ef l ydes cr i bet heor gani z at i on’ smi ssi onormosts i gni f i cantact i v i t i es:Orphan Care Alliance eq ips, connects, and mobili es Christians
lnerable children and families
Checkt hi sbox i ft heor gani z at i ondi scont i nuedi t soper at i onsordi s pos edofmor et han25% ofi t snetasset s. 7 Numberofv ot i ngmember soft hegover ni ngbody( Par tVI ,l i ne1a). . . . . . . . . 3 7 Numberofi ndependentv ot i ngmember soft hegover ni ngbody( Par tVI ,l i ne1b) . . . . 4 14 Tot alnumberofi ndi vi dual sempl oy edi ncal endaryear2020( Par tV,l i ne2a) . . . . . 5 Tot alnumberofvol unt eer s( est i mat ei fneces sar y ). . . . . . . . . . . . . . 6 150 Tot alunr el at edbus i nes sr evenuef r om Par tVI I I ,col umn( C) ,l i ne12 . . . . . . . . 7a 0. Netunr el at edbus i nesst axabl ei ncomef r om For m 990T,Par tI ,l i ne11 . . . . . . . 7b 0.
NetAsset sor FundBal ances
Expenses
Revenue
Pr i orYear
8 9 10 11 12 13 14 15 16a b 17 18 19
Cont r i but i onsandgr ant s( Par tVI I I ,l i ne1h). . . . . . . . . . . . Pr ogr am ser v i cer evenue( Par tVI I I ,l i ne2g) . . . . . . . . . . . I nves t menti ncome( Par tVI I I ,col umn( A) ,l i nes3,4,and7d) . . . . . . Ot herr evenue( Par tVI I I ,col umn( A) ,l i nes5,6d,8c,9c,10c,and11e). . . Tot alr evenue—addl i nes8t hr ough11( mustequalPar tVI I I ,col umn( A) ,l i ne12) Gr ant sands i mi l aramount spai d( Par tI X,col umn( A) ,l i nes1–3). . . . . Benef i t spai dt oorf ormember s( Par tI X,col umn( A) ,l i ne4) . . . . . . Sal ar i es,ot hercompensat i on,empl oyeebenef i t s( Par tI X,col umn( A) ,l i nes5–10) Pr of ess i onalf undr ai s i ngf ees( Par tI X,col umn( A) ,l i ne11e) . . . . . . 37,639. Tot alf undr ai si ngexpens es( Par tI X,col umn( D) ,l i ne25) Ot herexpens es( Par tI X,col umn( A) ,l i nes11a–11d,11f – 24e) . . . . . Tot alexpenses.Addl i nes13–17( mustequal Par tI X,col umn( A) ,l i ne25) . Rev enuel essexpenses.Subt r actl i ne18f r om l i ne12 . . . . . . . .
20 21 22
Tot alass et s( Par tX,l i ne16) . . . . . . . . . . . . . . . . Tot all i abi l i t i es( Par tX,l i ne26). . . . . . . . . . . . . . . . Netass et sorf undbal ances.Subt r actl i ne21f r om l i ne20 . . . . . .
Cur r entYear
499,522. 36,117. 460. 536,099.
494,638. 73,260. 14,494. -8,116. 574,276.
332,026.
315,337.
332,026. 204,073.
156,593. 471,930. 102,346.
Begi nni ngofCur r entYear
Par tI I
574,276.
G Gr os sr ecei pt s$
FNameandaddr essofpr i nci pal of f i cer :
to ser e 2 3 4 5 6 7a b
ETel ephonenumber
Room/ sui t e
Lo is ille, KY 40243
Appl i cat i onpendi ng
1
,20 DEmpl oyeri dent i f i cat i onnumber
26-4549276
Doi ngbusi nessas
Namechange
Amendedr et ur n
Opent oPubl i c I nspect i on
,2020,andendi ng
Care Alliance, Inc.
Addr esschange
Par tI
2020
Undersect i on501( c) ,527,or4947( a) ( 1)oft heI nt er nalRevenueCode( exceptpr i vat ef oundat i ons)
Depar t mentoft heTr easur y I nt er nalRevenueSer vi ce B
OMBNo.15450047
Si gnat ur eBl ock
810,377. 13,788. 796,589.
EndofYear
909,442. 10,507. 898,935.
Underpenal t i esofper j ur y ,Idecl ar et hatIhav eexami nedt hi sr et ur n,i ncl udi ngaccompanyi ngschedul esandst at ement s,andt ot hebestofmyknowl edge andbel i ef ,i ti s t r ue,cor r ect ,andcompl et e.Decl ar at i onofpr epar er( ot hert hanof f i cer )i sbasedonal l i nf or mat i onofwhi chpr epar erhasanyknowl edge.
Si gn Her e
05/17/2021
Si gnat ur eofof f i cer
Dat e
Darren Washa sen, E ec ti e Director
Typeorpr i ntnameandt i t l e Pr i nt / Typepr epar er ’ sname
Pr epar er ’ ssi gnat ur e
Pai d Jeffer N Drake, CPA Pr epar er C rr , Drake and Associates, LLC UseOnl y Firm’sname Fi r m’ saddr ess
Dat e
N Check i f PTI sel f empl oyed P01776702 Fi r m’ sEI N
12700 To nepark Wa , Dan ille Bldg, Lo is ille, KY 40243
61-1398209
Phoneno.(502)254-6180
Mayt heI RSdi s cus st hi sr et ur nwi t ht hepr epar ershownabove?Seei nst r uct i ons . . . . . . . . . . .
Yes
ForPaper wor kReduct i onActNot i ce,seet hesepar at ei nst r uct i ons.BAA
For m9 2020) 90(
REV 05/18/21 PRO
No
Page2
For m 990( 2020)
Par tI I I St at ementofPr ogr am Ser vi ceAccompl i shment s Checki fSchedul eO cont ai nsar es pons eornot et oanyl i nei nt hi sPar tI I I............. 1
Br i ef l ydes cr i bet heor gani z at i on’ smi ssi on:
Orphan Care Alliance eq ips, connects, and mobili es Christians to ser e lnerable children and families 2
3
4
Di dt heor gani z at i onunder t akeanysi gni f i cantpr ogr am ser vi cesdur i ngt hey earwhi chwer enotl i st edont he pr i orFor m 990or990EZ? . . . . . . . . . . . . . . . . . . . . . . . . . . . I f“ Yes, ”descr i bet hesenewser v i cesonSchedul eO. Di dt he or gani zat i on cease conduct i ng,ormake s i gni f i cantchanges i n how i tconduct s,any pr ogr am ser vi ces ?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I f“ Yes, ”descr i bet hesechangesonSchedul eO.
Yes
No
Yes
No
Des cr i bet heor gani z at i on’ spr ogr am ser v i ceaccompl i shment sf oreachofi t st hr eel ar ges tpr ogr am ser vi ces,asmeas ur edby expenses.Sect i on501( c) ( 3)and501( c) ( 4)or gani zat i onsar er equi r edt or epor tt heamountofgr ant sandal l ocat i onst oot her s, t het ot al expenses,andr evenue,i fany,f oreachpr ogr am s er v i cer epor t ed.
4a ( Code:
0. )
4b ( Code:
0. )
4c ( Code:
0. )
)( Expens es$ ncl udi nggr ant sof$ Rev enue$ 130,153. i 0. )( Ministr De elopment is the area that is bringing a areness of the needs of kids in foster care to the Ch rch in order to recr it reso rces and ol nteers in se eral areas incl ding Foster Parenting, Safe Harbor for Families, Life Coaches, CASA Workers, Professional S pport, and Friends.
50,235. i 0. )( )( Expens es$ ncl udi nggr ant sof$ Rev enue$ Safe Harbor for families operates a program to pre ent kids from entering foster care as ell as pro iding goods and s pplies to families caring for small children
)( Expens es$ ncl udi nggr ant sof$ Rev enue$ 61,649. i 0. )( Famil S pport pro ides s pport to caregi ers of children ho are adopted or in foster care. It pro ides s pport gro ps, ed cational seminars, and training. Also pro iding s pport to families ho are adopting children both nationall and internationall either b grant or interest free short term loan.
4d Ot herpr ogr am s er v i ces( Des cr i beonSchedul eO. ) ( Ex penses$ ncl udi nggr ant sof$ Rev enue$ 80,902. i 42,372. )( 4e Tot alpr ogr am s er vi ceex penses 322,939. REV 05/18/21 PRO
0. ) For m9 2020) 90(
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Par tI V
Checkl i stofRequi r edSchedul es Yes No
1 2 3 4 5 6
7 8 9
10 11 a b c d e f
I st heor gani z at i ondescr i bed i nsect i on501( c) ( 3)or4947( a) ( 1)( ot hert hanapr i vat ef oundat i on) ?I f“ Yes , ” compl et eSchedul eA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I st heor gani z at i onr equi r edt ocompl et eSchedul eB,Schedul eofCont r i but or sSeei nst r uct i ons? . . . . Di dt heor gani z at i onengagei ndi r ectori ndi r ectpol i t i calcampai gnact i vi t i esonbehal fofori nopposi t i ont o candi dat esf orpubl i cof f i ce?I f“ Yes , ”compl et eSchedul eC,Par tI. . . . . . . . . . . . . . Sect i on501( c) ( 3)or gani zat i ons.Di dt heor gani z at i onengagei nl obby i ngact i vi t i es,orhav easect i on501( h) el ect i oni nef f ectdur i ngt het axyear ?I f“ Yes , ”compl et eSchedul eC,Pa r tI I. . . . . . . . . . . I st he or gani z at i on a sect i on 501( c) ( 4) ,501( c) ( 5) ,or501( c) ( 6)or gani z at i on t hatr ecei ves member shi p dues, assessment s,orsi mi l aramount sasdef i nedi nRevenuePr ocedur e9819?I f“ Yes , ”compl et eSchedul eC,Par tI I I Di dt heor gani z at i onmai nt ai nanydonoradvi sedf undsoranysi mi l arf undsoraccount sf orwhi chdonor s hav et her i ghtt opr ovi deadvi ceont hedi s t r i but i onori nv est mentofamount si ns uchf undsoraccount s?I f “ Yes , ”compl et eSchedul eD,Par tI . . . . . . . . . . . . . . . . . . . . . . . . Di dt heor gani z at i onr ecei veorhol daconser v at i oneasement ,i ncl udi ngeasement st opr es er v eopenspace, t heenvi r onment ,hi st or i cl andar eas,orhi st or i cst r uct ur es?I f“ Yes , ”compl et eSchedul eD,Par tI I ... Di dt heor gani z at i onmai nt ai ncol l ect i onsofwor ksofar t ,hi s t or i cal t r eas ur es,orot hers i mi l arass et s ?I f“ Yes , ” compl et eSchedul eD,Par tI I I.......................... Di dt heor gani z at i onr epor tanamounti nPar tX,l i ne21,f orescr ow orcus t odi alaccountl i abi l i t y,ser v easa cus t odi anf oramount snotl i st edi nPar tX;orpr ov i decr edi tcounsel i ng,debtmanagement ,cr edi tr epai r ,or debtnegot i at i ons er v i ces?I f“ Yes , ”compl et eSchedul eD,Par tI V. . . . . . . . . . . . . . Di dt heor gani z at i on,di r ect l yort hr oughar el at edor gani z at i on,hol dasset si ndonor r est r i ct edendowment s ori nquasiendowment s ?I f“ Yes , ”compl et eSchedul eD,Par tV . . . . . . . . . . . . . . . I ft heor gani z at i on’ sanswert oanyoft hef ol l owi ngquest i onsi s“ Yes, ”t hencompl et eSchedul eD,Par t sVI , VI I ,VI I I ,I X,orXasappl i cabl e. Di dt he or gani z at i on r epor tan amountf orl and,bui l di ngs,and equi pmenti n Par tX,l i ne 10? I f“ Yes, ” compl et eSchedul eD,Par tVI . . . . . . . . . . . . . . . . . . . . . . . . . . Di dt heor gani z at i onr epor tanamountf ori nvest ment s—ot hersecur i t i esi nPar tX,l i ne12,t hati s5% ormor e ofi t st ot alass et sr epor t edi nPar tX,l i ne16?I f“ Yes , ”compl et eSchedul eD,Par tVI I. . . . . . . . Di dt heor gani z at i onr epor tanamountf ori nves t ment s—pr ogr am r el at edi nPar tX,l i ne13,t hati s5% ormor e ofi t st ot alass et sr epor t edi nPar tX,l i ne16?I f“ Yes , ”compl et eSchedul eD,Par tVI I I. . . . . . . . Di dt heor gani z at i onr epor tanamountf orot heras set si nPar tX,l i ne15,t hati s5% ormor eofi t st ot alass et s r epor t edi nPar tX,l i ne16?I f“ Yes , ”compl et eSchedul eD,Par tI X .............. Di dt heor gani zat i onr epor tanamountf orot herl i abi l i t i esi nPar tX,l i ne25? I f“ Yes , ”compl et eSchedul eD,Par tX Di dt heor gani zat i on’ ssepar at eorconsol i dat edf i nanci alst at ement sf ort het axyeari ncl udeaf oot not et hataddr esses t heor gani zat i on’ sl i abi l i t yf oruncer t ai nt axposi t i onsunderFI N48( ASC740) ?I f“ Yes, ”compl et eSchedul eD,Par tX
12a Di dt heor gani z at i onobt ai ns epar at e,i ndependentaudi t edf i nanci alst at ement sf ort het axy ear ?I f“ Yes , ”compl et e Schedul eD,Par t sXIandXI I. . . . . .. . . . . .. . . . . .. . . . . .. . .
b Wast heor gani z at i oni ncl uded i nconsol i dat ed,i ndependentaudi t edf i nanci alst at ement sf ort het axyear ?I f “ Yes , ”andi ft heor gani z at i onans wer ed“ No”t ol i ne12a,t hencompl et i ngSchedul eD,Par t sXIandXI Ii sopt i onal 13 I st heor gani z at i onas chooldescr i bedi nsect i on170( b) ( 1) ( A) ( i i ) ?I f“ Yes , ”compl et eSchedul eE . . . . 14a Di dt heor gani z at i onmai nt ai nanof f i ce,empl oy ees,oragent sout si deoft heUni t edSt at es ? ..... b Di dt he or gani z at i on have aggr egat er ev enues orexpenses ofmor et han $10, 000 f r om gr ant maki ng, f undr ai s i ng,bus i ness ,i nves t ment ,and pr ogr am s er v i ceact i vi t i esout si det heUni t ed St at es,oraggr egat e f or ei gni nves t ment sval uedat$100, 000ormor e?I f“ Yes , ”compl et eSchedul eF,Par t sIandI V. . . . .
1 2 3 4 5
6 7 8
9 10
11a 11b 11c 11d 11e 11f 12a 12b 13 14a
14b
15
Di dt heor gani z at i onr epor tonPar tI X,col umn( A) ,l i ne3,mor et han$5, 000ofgr ant sorot heras si st ancet oor f oranyf or ei gnor gani z at i on?I f“ Yes , ”compl et eSchedul eF,Par t sI Ia ndI V ........... 16 Di dt heor gani z at i onr epor tonPar tI X,col umn( A) ,l i ne3,mor et han$5, 000ofaggr egat egr ant sorot her assi st ancet oorf orf or ei gni ndi vi dual s?I f“ Yes , ”compl et eSchedul eF,Par t sI I IandI V. . . . . . . . 17 Di dt heor gani z at i onr epor tat ot alofmor et han$15, 000ofexpensesf orpr of ess i onalf undr ai si ngser vi ceson Par tI X,col umn( A) ,l i nes6and11e?I f“ Yes , ”compl et eSchedul eG,Par tISeei nst r uct i ons. . . . . . 18 Di dt heor gani z at i onr epor tmor et han$15, 000t ot aloff undr ai si ngeventgr ossi ncomeandcont r i but i onson Par tVI I I ,l i nes1cand8a?I f“ Yes , ”compl et eSchedul eG,Par tI I. . . . . . . . . . . . . . . 19 Di dt heor gani z at i onr epor tmor et han$15, 000ofgr ossi ncomef r om gami ngact i vi t i esonPar tVI I I ,l i ne9a? I f“ Yes , ”compl et eSchedul eG,Par tI I I ....................... 20a Di dt heor gani z at i onoper at eoneormor ehospi t al f aci l i t i es ?I f“ Yes , ”compl et eSchedul eH . . . . . . b I f“ Yes”t ol i ne20a,di dt heor gani z at i onat t achacopyofi t saudi t edf i nanci alst at ement st ot hi sr et ur n? . 21 Di dt heor gani zat i onr epor tmor et han$5, 000ofgr ant sorot herass i st ancet oanydomest i cor gani z at i onor domest i cgover nmentonPar tI X,col umn( A) ,l i ne1?I f“ Yes , ”compl et eSchedul eI ,Par t sIandI I. . . . REV 05/18/21 PRO
15 16 17 18 19 20a 20b 21 For m9 2020) 90(
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Par tI V
Checkl i stofRequi r edSchedul es( cont i nued) Yes No
22 23
24a
b c d 25a b
26
27
28 a b c 29 30 31 32 33 34 35a b 36 37 38
Di dt heor gani z at i onr epor tmor et han$5, 000ofgr ant sorot heras si st ancet oorf ordomest i ci ndi v i dual son Par tI X,col umn( A) ,l i ne2?I f“ Yes , ”compl et eSchedul eI ,Par t sIandI I I ............ 22 Di dt he or gani z at i on ans wer“ Yes”t o Par tVI I ,Sect i on A,l i ne 3,4,or5 aboutcompensat i on oft he or gani z at i on’ scur r entand f or merof f i cer s,di r ect or s,t r ust ees ,keyempl oy ees,and hi ghestcompensat ed empl oy ees?I f“ Yes , ”compl et eSchedul eJ. . . . . . . . . . . . . . . . . . . . . . 23 Di dt heor gani z at i on have at axex emptbond i ssuewi t h an out s t andi ng pr i nci palamountofmor et han $100, 000asoft hel as tdayoft heyear ,t hatwasi ssuedaf t erDecember31,2002?I f“ Yes, ”ans werl i nes24b t hr ough24dandcompl et eSchedul eK.I f“ No, ”got ol i ne25a . . . . . . . . . . . . . . . 24a Di dt heor gani z at i oni nvestanypr oceedsoft ax ex emptbondsbeyondat empor ar yper i odexcept i on? . . 24b Di dt heor gani z at i onmai nt ai nanescr ow accountot hert hanar ef undi nges cr ow atanyt i medur i ngt heyear t odef eas eanyt axexemptbonds ? . . . . . . . . . . . . . . . . . . . . . . . . 24c Di dt heor gani z at i onactasan“ onbehal fof ”i s suerf orbondsout s t andi ngatanyt i medur i ngt heyear ?. . 24d Sect i on501( c) ( 3) ,501( c) ( 4) ,and501( c) ( 29)or gani zat i ons.Di dt heor gani zat i onengagei nanexcessbenef i t t r ans act i onwi t hadi s qual i f i edper s ondur i ngt hey ear ?I f“ Yes , ”compl et eSchedul eL,Par tI . . . . . 25a I st heor gani zat i onawar et hati tengagedi nanexcessbenef i tt r ansact i onwi t hadi s qual i f i edper s oni napr i or year ,andt hatt het r ansact i onhasnotbeenr epor t edonanyoft heor gani z at i on’ spr i orFor ms990or990EZ? I f“ Yes , ”compl et eSchedul eL,Par tI. . . . . . . . . . . . . . . . . . . . . . . . 25b Di dt heor gani z at i onr epor tanyamountonPar tX,l i ne5or22,f orr ecei v abl esf r om orpayabl est oanycur r ent orf or merof f i cer ,di r ect or ,t r ust ee,key empl oyee,cr eat ororf ounder ,subst ant i alcont r i but or ,or35% cont r ol l edent i t yorf ami l ymemberofanyoft heseper sons?I f“ Yes , ”compl et eSchedul eL,Par tI I ... 26 Di dt heor gani z at i onpr ovi deagr antorot herass i s t ancet oanycur r entorf or merof f i cer ,di r ect or ,t r ust ee,key empl oyee,cr eat ororf ounder ,subst ant i alcont r i but ororempl oyee t her eof ,a gr antsel ect i on commi t t ee member ,ort oa35% cont r ol l ed ent i t y( i ncl udi nganempl oyeet her eof )orf ami l ymemberofanyoft hese per sons?I f“ Yes , ”compl et eSchedul eL,Par tI I I. . . . . . . . . . . . . . . . . . . . 27 Wast heor gani zat i onapar t yt oabus i nesst r ans act i onwi t honeoft hef ol l owi ngpar t i es( s eeSchedul eL,Par t I Vi nst r uct i ons,f orappl i cabl ef i l i ngt hr eshol ds,condi t i ons ,andexcept i ons ) : Acur r entorf or merof f i cer ,di r ect or ,t r ust ee,k eyempl oy ee,cr eat ororf ounder ,ors ubs t ant i alcont r i but or ?I f “ Yes , ”compl et eSchedul eL,Par tI V . . . . . . . . . . . . . . . . . . . . . . . . 28a Af ami l ymemberofanyi ndi vi dual descr i bedi nl i ne28a?I f“ Yes , ”compl et e Schedul eL,Par tI V . . . . 28b A 35% cont r ol l ed ent i t yofoneormor ei ndi vi dual sand/ oror gani z at i onsdescr i bedi nl i nes28aor28b?I f “ Yes , ”compl et eSchedul eL,Par tI V . . . . . . . . . . . . . . . . . . . . . . . . 28c Di dt heor gani z at i onr ecei vemor et han$25, 000i nnoncashcont r i but i ons?I f“ Yes , ”compl et eSchedul eM 29 Di dt he or gani zat i on r ecei vecont r i but i onsofar t ,hi s t or i calt r eas ur es ,orot hersi mi l arasset s,orqual i f i ed cons er v at i oncont r i but i ons ?I f“ Yes , ”compl et eSchedul eM . . . . . . . . . . . . . . . . 30 Di dt heor gani zat i onl i qui dat e,t er mi nat e,ordi ssol veandceaseoper at i ons?I f“ Yes , ”compl et eSchedul eN,Par tI 31 Di dt heor gani z at i on s el l ,exchange,di spose of ,ort r ans f ermor et han 25% ofi t snetas set s? I f“ Yes, ” compl et eSchedul eN,Par tI I .......................... 32 Di dt heor gani z at i onown100% ofanent i t ydi s r egar dedassepar at ef r om t heor gani z at i onunderRegul at i ons s ect i ons301. 77012and301. 77013?I f“ Yes , ”compl et eSchedul eR,Par tI. . . . . . . . . . . 33 Wast heor gani z at i onr el at edt oanyt axexemptort axabl eent i t y?I f“ Yes, ”compl et eSchedul eR,Par tI I ,I I I , orI V,andPar tV,l i ne1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Di dt heor gani z at i onhaveacont r ol l edent i t ywi t hi nt hemeani ngofsect i on512( b) ( 13) ? . . . . . . . 35a I f“ Yes”t ol i ne35a,di dt heor gani z at i on r ecei veanypaymentf r om orengagei nanyt r ans act i on wi t ha cont r ol l edent i t ywi t hi nt hemeani ngofs ect i on512( b) ( 13) ?I f“ Yes , ”compl et eSchedul eR,Par tV,l i ne2. . 35b Sect i on 501( c) ( 3)or gani z at i ons.Di dt he or gani z at i on make anyt r ansf er st o an exemptnonchar i t abl e r el at edor gani z at i on?I f“ Yes , ”compl et eSchedul eR,Par tV,l i ne2 . . . . . . . . . . . . . . 36 Di dt heor gani z at i onconductmor et han5% ofi t sact i v i t i est hr oughanent i t yt hati snotar el at edor gani z at i on andt hati st r eat edasapar t ner shi pf orf eder al i ncomet axpur pos es ?I f“ Yes , ”compl et eSchedul eR,Par tVI 37 Di dt heor gani z at i oncompl et eSchedul eO andpr ov i deex pl anat i onsi nSchedul eO f orPar tVI ,l i nes11band 19?Not e:Al lFor m 990f i l er sar er equi r edt ocompl et eSchedul eO. 38
Par tV
St at ement sRegar di ngOt herI RSFi l i ngsandTaxCompl i ance Checki fSchedul eO cont ai nsar es pons eornot et oanyl i nei nt hi sPar tV . . . . . . . . . . . . . Yes No
3 1a Ent ert henumberr epor t edi nBox3ofFor m 1096.Ent er0-i fnotappl i cabl e .... 1a b Ent ert henumberofFor msW2Gi ncl udedi nl i ne1a.Ent er0-i fnotappl i cabl e. . . . 1b 20 c Di dt he or gani zat i on compl y wi t h backup wi t hhol di ng r ul es f orr epor t abl e payment st ov endor s and r epor t abl egami ng( gambl i ng)wi nni ngst opr i z ewi nner s ? ................. 1c REV 05/18/21 PRO
For m9 2020) 90(
Page5
For m 990( 2020)
Par tV
St at ement sRegar di ngOt herI RSFi l i ngsandTaxCompl i ance( cont i nued) Yes No
2a Ent ert he numberofempl oy eesr epor t ed on For m W3,Tr ansmi t t alofWage and Tax 14 St at ement s,f i l edf ort hecal endaryearendi ngwi t horwi t hi nt heyearcover edbyt hi sr et ur n 2a b I fatl eastonei sr epor t edonl i ne2a,di dt heor gani z at i onf i l eal lr equi r edf eder alempl oy mentt axr et ur ns? . Not e:I ft hesum ofl i nes1aand2ai sgr eat ert han250,youmayber equi r edt oef i l e( seei nst r uct i ons ). . 3a Di dt heor gani z at i onhaveunr el at edbusi nessgr os si ncomeof$1, 000ormor edur i ngt heyear ? .... b I f“ Yes, ”hasi tf i l edaFor m 990Tf ort hi syear ?I f“ No”t ol i ne3b,pr ov i dea nex pl anat i ononSchedul eO . 4a Atanyt i medur i ngt hecal endaryear ,di dt heor gani z at i onhaveani nt er esti n,orasi gnat ur eorot heraut hor i t yover , af i nanci alaccounti naf or ei gncount r y( suchasabankaccount ,secur i t i esaccount ,orot herf i nanci alaccount ) ? b I f“ Yes, ”ent ert henameoft hef or ei gncount r y Seei nst r uct i onsf orf i l i ngr equi r ement sf orFi nCENFor m 114,Repor tofFor ei gnBankandFi nanci alAccount s( FBAR) . 5a Wast heor gani z at i onapar t yt oapr ohi bi t edt axs hel t ert r ans act i onatanyt i medur i ngt het axyear ?. . . b Di danyt axabl epar t ynot i f yt heor gani z at i ont hati twasori sapar t yt oapr ohi bi t edt axs hel t ert r ans act i on? c I f“ Yes”t ol i ne5aor5b,di dt heor gani z at i onf i l eFor m 8886T? . . . . . . . . . . . . . . . 6a Doest heor gani z at i on have annualgr ossr ecei pt st hatar e nor mal l ygr eat ert han $100, 000,and di dt he or gani z at i onsol i ci tanycont r i but i onst hatwer enott axdeduct i bl easchar i t abl econt r i but i ons?. . . . . b I f“ Yes , ”di dt heor gani zat i oni ncl udewi t hever ysol i ci t at i onanexpr essst at ementt hats uchcont r i but i onsor gi f t swer enott axdeduct i bl e? . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Or gani zat i onst hatmayr ecei vededuct i bl econt r i but i onsundersect i on170( c) . a Di dt heor gani z at i onr ecei v eapaymenti nexcessof$75madepar t l yasacont r i but i onandpar t l yf orgoods andser vi cespr ov i dedt ot hepay or ?........................ b I f“ Yes, ”di dt heor gani z at i onnot i f yt hedonoroft hev al ueoft hegoodsors er vi cespr ovi ded? . . . . . c Di dt he or gani zat i on sel l ,exchange,orot her wi sedi sposeoft angi bl eper sonalpr oper t yf orwhi chi twas r equi r edt of i l eFor m 8282? . . . . . . . . . . . . . . . . . . . . . . . . . . . d I f“ Yes, ”i ndi cat et henumberofFor ms8282f i l eddur i ngt heyear . . . . . . . . 7d e Di dt heor gani z at i onr ecei veanyf unds ,di r ect l yori ndi r ect l y,t opaypr emi umsonaper sonal benef i tcont r act ? f Di dt heor gani z at i on,dur i ngt heyear ,paypr emi ums,di r ect l yori ndi r ect l y ,onaper sonal benef i tcont r act ?. g I ft heor gani zat i onr ecei vedacont r i but i onofqual i f i edi nt el l ect ualpr oper t y,di dt heor gani zat i onf i l eFor m 8899asr equi r ed? h I ft heor gani zat i onr ecei vedacont r i but i onofcar s,boat s,ai r pl anes,orot hervehi cl es,di dt heor gani zat i onf i l eaFor m 1098C? 8 Sponsor i ngor gani zat i onsmai nt ai ni ngdonoradvi sedf unds.Di dadonoradvi sedf undmai nt ai nedbyt he s pons or i ngor gani z at i onhav eexcessbusi nesshol di ngsatanyt i medur i ngt heyear ?. . . . . . . . 9 Sponsor i ngor gani zat i onsmai nt ai ni ngdonoradvi sedf unds. a Di dt hes ponsor i ngor gani z at i onmakeanyt ax abl edi st r i but i onsundersect i on4966? . . . . . . . . b Di dt hes ponsor i ngor gani z at i onmakeadi s t r i but i ont oadonor ,donoradv i s or ,orr el at edper s on? . . . 10 Sect i on501( c) ( 7)or gani zat i ons.Ent er : a I ni t i at i onf eesandcapi t alcont r i but i onsi ncl udedonPar tVI I I ,l i ne12 . . . . . . . 10a b Gr ossr ecei pt s,i ncl udedonFor m 990,Par tVI I I ,l i ne12,f orpubl i cuseofcl ubf aci l i t i es . 10b 11 Sect i on501( c) ( 12)or gani zat i ons.Ent er : a Gr ossi ncomef r om member sors har ehol der s . . . . . . . . . . . . . . . 11a b Gr ossi ncome f r om ot hersour ces ( Do notnetamount sdue orpai dt o ot hersour ces agai ns tamount sdueorr ecei vedf r om t hem. ). . . . . . . . . . . . . . . 11b 12a Sect i on4947( a) ( 1)nonexemptchar i t abl et r ust s.I st heor gani z at i onf i l i ngFor m 990i nl i euofFor m 1041? b I f“ Yes, ”ent ert heamountoft ax ex empti nt er es tr ecei vedoraccr ueddur i ngt hey ear. . 12b 13 Sect i on501( c) ( 29)qual i f i ednonpr of i theal t hi nsur ancei ssuer s. a I st heor gani z at i onl i censedt oi s suequal i f i edheal t hpl ansi nmor et hanonest at e? . . . . . . . . Not e:Seet hei ns t r uct i onsf oraddi t i onali nf or mat i ont heor gani zat i onmus tr epor tonSchedul eO. b Ent ert heamountofr eser vest heor gani z at i oni sr equi r edt omai nt ai nbyt hes t at esi nwhi ch t heor gani z at i oni sl i cens edt oi ssuequal i f i edheal t hpl ans . . . . . . . . . . 13b c Ent ert heamountofr eser vesonhand . . . . . . . . . . . . . . . . . 13c 14a Di dt heor gani z at i onr ecei veanypayment sf ori ndoort anni ngser v i cesdur i ngt het axy ear ?. . . . . . b I f“ Yes, ”hasi tf i l edaFor m 720t or epor tt hes epayment s?I f“ No, ”pr ov i deanex pl anat i ononSchedul eO . 15 I st heor gani zat i onsubj ectt ot hes ect i on4960t axonpay ment ( s)ofmor et han$1, 000, 000i nr emuner at i onor exces spar achut epayment ( s)dur i ngt heyear ? .................... I f“ Yes, ”s eei ns t r uct i onsandf i l eFor m 4720,Schedul eN. 16 I st heor gani z at i onaneducat i onali nst i t ut i ons ubj ectt ot hesect i on4968exci set axonneti nvest menti ncome? I f“ Yes, ”compl et eFor m 4720,Schedul eO. REV 05/18/21 PRO
2b 3a 3b 4a
5a 5b 5c 6a 6b
7a 7b 7c 7e 7f 7g 7h 8 9a 9b
12a
13a
14a 14b 15 16 For m9 2020) 90(
Page6 Par tVI Gover nance,Management ,andDi scl osur e Foreach“ Yes”r esponset ol i nes2t hr ough7bbel ow,andf ora“ No” r esponset ol i ne8a,8b,or10bbel ow,descr i bet heci r cumst ances,pr ocesses,orchangesonSchedul eO.Seei nst r uct i ons. Checki fSchedul eO cont ai nsar es pons eornot et oanyl i nei nt hi sPar tVI . . . . . . . . . . . . . Sect i onA.Gover ni ngBodyandManagement For m 990( 2020)
Yes No
1a Ent ert henumberofv ot i ngmember soft hegover ni ngbodyatt heendoft het axyear. . 1a I ft her ear emat er i aldi f f er encesi nv ot i ngr i ght samongmember soft hegover ni ngbody,or i ft he gover ni ng body del egat ed br oad aut hor i t yt o an execut i ve commi t t ee ors i mi l ar commi t t ee,expl ai nonSchedul eO.
7
b Ent ert henumberofvot i ngmember si ncl udedonl i ne1a,abov e,whoar ei ndependent . 1b 7 2 Di danyof f i cer ,di r ect or ,t r us t ee,orkeyempl oyeehaveaf ami l yr el at i onshi porabus i nessr el at i onshi pwi t h anyot herof f i cer ,di r ect or ,t r ust ee,orkeyempl oyee? . . . . . . . . . . . . . . . . . . 3 Di dt heor gani z at i ondel egat econt r olov ermanagementdut i escus t omar i l yper f or medbyorundert hedi r ect super v i s i onofof f i cer s,di r ect or s,t r ust ees,orkeyempl oyeest oamanagementcompanyorot herper son?. 4 Di dt heor gani z at i onmakeanysi gni f i cantchangest oi t sgover ni ngdocument ssi ncet hepr i orFor m 990wasf i l ed? 5 Di dt heor gani z at i onbecomeawar edur i ngt hey earofasi gni f i cantdi ver si onoft heor gani z at i on’ sasset s ?. 6 Di dt heor gani z at i onhavemember sorst ockhol der s ? .................. 7a Di dt heor gani z at i onhav emember s,s t ockhol der s,orot herper sonswhohadt hepowert oel ectorappoi nt oneormor emember soft hegover ni ngbody? . . . . . . . . . . . . . . . . . . . . b Ar e any gov er nance deci si ons oft he or gani z at i on r eser v ed t o( orsubj ectt o appr ovalby )member s, st ockhol der s,orper sonsot hert hant hegover ni ngbody? . . . . . . . . . . . . . . . . . 8 Di dt heor gani z at i oncont empor aneousl ydocumentt hemeet i ngshel dorwr i t t enact i onsunder t akendur i ng t hey earbyt hef ol l owi ng: a Thegover ni ngbody? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Eachcommi t t eewi t haut hor i t yt oactonbehal foft hegover ni ngbody? . . . . . . . . . . . . 9 I st her eanyof f i cer ,di r ect or ,t r ust ee,orkeyempl oy eel i s t edi nPar tVI I ,Sect i onA,whocannotber eachedat t heor gani z at i on’ smai l i ngaddr es s? I f“ Yes , ”pr ov i det henamesa ndaddr ess esonSchedul eO . . . .
2 3 4 5 6 7a 7b
8a 8b 9
Sect i onB.Pol i ci es ( Thi sSect i onBr eques t si nf or mat i onaboutpol i ci esnotr equi r edbyt heI nt er nalRevenueCode. ) Yes No
10a Di dt heor gani z at i onhavel ocal chapt er s,br anches,oraf f i l i at es ? .............. b I f“ Yes , ”di dt heor gani zat i onhavewr i t t enpol i ci esandpr ocedur esgover ni ngt heact i vi t i esofsuchchapt er s, af f i l i at es,andbr anchest oensur et hei roper at i onsar econsi st entwi t ht heor gani z at i on’ sexemptpur poses? 11a Hast heor gani zat i onpr ovi dedacompl et ecopyoft hi sFor m 990t oal lmember sofi t sgover ni ngbodybef or ef i l i ngt hef or m? b Des cr i bei nSchedul eOt hepr ocess ,i fany ,usedbyt heor gani z at i ont or ev i ew t hi sFor m 990. 12a Di dt heor gani z at i onhaveawr i t t enconf l i ctofi nt er es tpol i cy ?I f“ No, ”got ol i ne13 . . . . . . . . b Wer eof f i cer s,di r ect or s,ort r ust ees,andkeyempl oyeesr equi r edt odi scl oseannual l yi nt er est st hatcoul dgi ver i set oconf l i ct s? c Di dt heor gani z at i onr egul ar l yand cons i s t ent l ymoni t orandenf or cecompl i ancewi t ht hepol i cy ?I f“ Yes , ” des cr i bei nSchedul eO how t hi swasdone. . . . . . . . . . . . . . . . . . . . . . 13 Di dt heor gani z at i onhaveawr i t t enwhi st l ebl owerpol i cy? . . . . . . . . . . . . . . . . . 14 Di dt heor gani z at i onhaveawr i t t endocumentr et ent i onanddest r uct i onpol i cy ? ......... 15 Di dt he pr ocessf ordet er mi ni ng compensat i on oft he f ol l owi ng per sonsi ncl ude a r evi ew and appr ovalby i ndependentper sons,compar abi l i t ydat a,andcont empor aneoussubst ant i at i onoft hedel i ber at i onanddeci si on? a Theor gani z at i on’ sCEO,Execut i veDi r ect or ,ort opmanagementof f i ci al . . . . . . . . . . . . herof f i cer sorkeyempl oy eesoft heor gani zat i on . . . . . . . . . . . . . . . . . . . b Ot I f“ Yes”t ol i ne15aor15b,descr i bet hepr ocessi nSchedul eO ( s eei nst r uct i ons) . 16a Di dt heor gani z at i oni nvesti n,cont r i but eas set st o,orpar t i ci pat ei naj oi ntvent ur eors i mi l arar r angement wi t hat axabl eent i t ydur i ngt heyear ?. . . . . . . . . . . . . . . . . . . . . . . . b I f“ Yes , ”di dt heor gani zat i onf ol l ow awr i t t enpol i cyorpr ocedur er equi r i ngt heor gani zat i ont oeval uat ei t s par t i ci pat i oni nj oi ntv ent ur ear r angement sunderappl i cabl ef eder alt axl aw,andt akest epst osaf eguar dt he or gani z at i on’ sexempts t at uswi t hr es pectt os uchar r angement s ? ..............
Sect i onC.Di scl osur e 17 18
19 20
10a 10b 11a 12a 12b 12c 13 14
15a 15b
16a
16b
Li stt hes t at eswi t hwhi chacopyoft hi sFor m 990i sr equi r edt obef i l ed KY Sect i on6104r equi r esanor gani z at i ont omakei t sFor ms1023( 1024or1024A,i fappl i cabl e) ,990,and990T( Sect i on501( c) ( 3) sonl y)avai l abl ef orpubl i ci nspect i on.I ndi cat ehowyoumadet hes eavai l abl e.Checkal l t hatappl y . Ownwebs i t e Anot her ’ swebsi t e Uponr equest Ot her( ex pl a i nonSchedul eO) Des cr i beonSchedul eO whet her( andi fso,how)t heor gani z at i onmadei t sgover ni ngdocument s ,conf l i ctofi nt er estpol i cy, andf i nanci al st at ement savai l abl et ot hepubl i cdur i ngt het axy ear . St at et hename,addr ess ,andt el ephonenumberoft heper sonwhopossess est heor gani z at i on’ sbooksandr ecor ds
Cristi Fo le, 12011 Parkland Co rt, Lo is ille, KY 40243 (502)609-7898 REV 05/18/21 PRO
For m9 2020) 90(
Page7 Par tVI I Compensat i onofOf f i cer s,Di r ect or s,Tr ust ees,KeyEmpl oyees,Hi ghestCompensat edEmpl oyees,and I ndependentCont r act or s Checki fSchedul eO cont ai nsar es pons eornot et oanyl i nei nt hi sPar tVI I. . . . . . . . . . . . . Sect i onA. Of f i cer s,Di r ect or s,Tr ust ees,KeyEmpl oyees,andHi ghestCompensat edEmpl oyees For m 990( 2020)
1aCompl et et hi st abl ef oral lper s onsr equi r ed t obel i s t ed.Repor tcompensat i onf ort hecal endary earendi ngwi t horwi t hi nt he or gani z at i on’ st axyear . •Li s tal loft heor gani z at i on’ scur r entof f i cer s,di r ect or s,t r ust ees( whet heri ndi vi dual soror gani zat i ons ) ,r egar dl essofamountof compens at i on.Ent er0-i ncol umns( D) ,( E) ,and( F)i fnocompensat i onwaspai d. •Li s tal loft heor gani z at i on’ scur r entkeyempl oyees,i fany.Seei nst r uct i onsf ordef i ni t i onof“ keyempl oyee. ” •Li stt heor gani z at i on’ sf i v ecur r enthi ghestcompens at edempl oy ees( ot hert hananof f i cer ,di r ect or ,t r us t ee,orkeyempl oy ee) whor ecei ved r epor t abl ecompensat i on( Box5ofFor m W2and/ orBox7 ofFor m 1099MI SC)ofmor et han $100, 000f r om t he or gani z at i onandanyr el at edor gani z at i ons. •Li stal loft heor gani zat i on’ sf or merof f i cer s,keyempl oyees,andhi ghes tcompensat edempl oyeeswhor ecei v edmor et han $100, 000ofr epor t abl ecompensat i onf r om t heor gani z at i onandanyr el at edor gani z at i ons. •Li stal loft heor gani z at i on’ sf or merdi r ect or sort r ust eest hatr ecei v ed,i nt hecapaci t yasaf or merdi r ect orort r ust eeoft he or gani z at i on,mor et han$10, 000ofr epor t abl ecompensat i onf r om t heor gani zat i onandanyr el at edor gani zat i ons. Seei nst r uct i onsf ort heor deri nwhi cht ol i stt heper sonsabove. Checkt hi sboxi fnei t hert heor gani z at i onnoranyr el at edor gani z at i oncompens at edanycur r entof f i cer ,di r ect or ,ort r ust ee. ( C)
For mer
President ( 2) Glenn White Vice President ( 3) Brandon Karem Secretar ( 4) Cristi Fo le Treas rer ( 5) Jim Walters Director ( 6) Scott Eberle Director ( 7) Cla H me Director
Hi ghestcompensat ed empl oyee
( 1) Darren Washa sen
Keyempl oyee
Aver age hour s perweek ( l i s tany hour sf or r el at ed or gani z at i ons bel ow dot t edl i ne)
Of f i cer
Nameandt i t l e
Posi t i on ( donotcheckmor et hanone box ,unl essper soni sbot han of f i cerandadi r ect or / t r ust ee) I ns t i t ut i onalt r us t ee
( B)
I ndi vi dualt r us t ee ordi r ect or
( A)
( D)
( E)
( F)
Repor t abl e Repor t abl e compensat i on compensat i on f r om t he f r om r el at ed or gani z at i on or gani z at i ons ( W2/ 1099MI SC) ( W2/ 1099MI SC)
Es t i mat edamount ofot her compens at i on f r om t he or gani z at i onand r el at edor gani z at i ons
40.00 0.00 0.00 0.00 0.00 0.00 0.00
70,000.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
( 8) ( 9) ( 10) ( 11) ( 12) ( 13) ( 14) REV 05/18/21 PRO
For m9 2020) 90(
Page8 Par tVI I Sect i onA.Of f i cer s,Di r ect or s,Tr ust ees,KeyEmpl oyees,andHi ghestCompensat edEmpl oyees( cont i nued)
For m 990( 2020)
( C)
For mer
Hi ghestcompensat ed empl oyee
Keyempl oyee
Aver age hour s perweek ( l i s tany hour sf or r el at ed or gani z at i ons bel ow dot t edl i ne)
Of f i cer
Nameandt i t l e
Posi t i on ( donotcheckmor et hanone box ,unl essper soni sbot han of f i cerandadi r ect or / t r ust ee) I ns t i t ut i onalt r ust ee
( B)
I ndi vi dualt r us t ee ordi r ect or
( A)
( D)
( E)
( F)
Repor t abl e Repor t abl e compensat i on compensat i on f r om t he f r om r el at ed or gani z at i on or gani z at i ons ( W2/ 1099MI SC) ( W2/ 1099MI SC)
Es t i mat edamount ofot her compens at i on f r om t he or gani z at i onand r el at edor gani z at i ons
( 15) ( 16) ( 17) ( 18) ( 19) ( 20) ( 21) ( 22) ( 23) ( 24) ( 25) 1b c d 2
70,000. 0. Subt ot al . . . . . . . . . . . . . . . . . . . . . Tot alf r om cont i nuat i onsheet st oPar tVI I ,Sect i onA . . . . . Tot al( addl i nes1band1c). . . . . . . . . . . . . . . 70,000. 0. Tot alnumberofi ndi vi dual s( i ncl udi ngbutnotl i mi t edt ot hosel i st edabov e)whor ecei v edmor et han$100, 000of r epor t abl ecompensat i onf r om t heor gani zat i on
3
Di dt he or gani z at i on l i stany f or merof f i cer ,di r ect or ,t r ust ee,key empl oyee,orhi ghestcompensat ed empl oyeeonl i ne1a?I f“ Yes , ”compl et eSchedul eJf ors uchi ndi v i dual . . . . . . . . . . . . Foranyi ndi vi duall i st edonl i ne1a,i st hesum ofr epor t abl ecompensat i onandot hercompensat i onf r om t he or gani z at i on and r el at ed or gani z at i ons gr eat ert han $150, 000? I f“ Yes , ”compl et e Schedul eJf ors uch i ndi v i dua l. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0. 0. Yes No
4
5
3
4 Di danyper sonl i s t edonl i ne1ar ecei v eoraccr uecompens at i onf r om anyunr el at edor gani z at i onori ndi vi dual f orser vi cesr ender edt ot heor gani z at i on?I f“ Yes , ”compl et eSchedul eJf ors uchper s on . . . . . . 5
Sect i onB.I ndependentCont r act or s 1
Compl et et hi st abl ef oryourf i ve hi ghestcompensat ed i ndependentcont r act or st hatr ecei ved mor et han $100, 000 of compensat i onf r om t heor gani z at i on.Repor tcompensat i onf ort hecal endaryearendi ngwi t horwi t hi nt heor gani zat i on’ st axyear . ( A) Nameandbusi nessaddr ess
2
( B) Descr i pt i onofs er v i ces
( C) Compens at i on
Tot alnumberofi ndependentcont r act or s( i ncl udi ng butnotl i mi t ed t ot hose l i st ed above)who r ecei vedmor et han$100, 000ofcompensat i onf r om t heor gani z at i on REV 05/18/21 PRO
90( For m9 2020)
Page9
For m 990( 2020)
Par tVI I I St at ementofRevenue Checki fSchedul eO cont ai nsar es pons eornot et oanyl i nei nt hi sPar tVI I I. . . . . . . . . . . . .
Pr ogr am Ser vi ce Revenue
Cont r i but i ons,Gi f t s,Gr ant s andOt herSi mi l arAmount s
( A) Tot alr ev enue
Feder at edcampai gns . . . . 1a Member shi pdues . . . . . 1b Fundr ai si ngevent s . . . . . 1c Rel at edor gani z at i ons . . . . 1d Gover nmentgr ant s( cont r i but i ons ) 1e Al lot hercont r i but i ons,gi f t s,gr ant s, andsi mi l aramount snoti ncl udedabove 1f 494,638. g Noncas hcont r i but i onsi ncl udedi n l i nes1a–1f. . . . . . . . 1g $ h Tot al .Addl i nes1a– 1f. . . . . . . . . .
1a b c d e f
624110 2a jLifesong grants b c d e f Al l ot herpr ogr am ser vi cer evenue . . g Tot al .Addl i nes2a– 2f. . . . . . . . . . nves t menti ncome ( i ncl udi ng di vi dends,i nt er es t ,and 3 I ot hersi mi l aramount s). . . . . . . . . . 4 I ncomef r om i nvest mentoft axexemptbondpr oceeds 5 Roy al t i es . . . . . . . . . . . . . . ( i )Real
Ot herRevenue
494,638.
Busi nes sCode
6a b c d
Mi scel l aneous Revenue
( B) ( C) ( D) Rel at edorexempt Unr el at ed Rev enueexcl uded f unct i onr evenue busi nessr evenue f r om t axunder s ect i ons512– 514
73,260.
0.
0.
73,260.
14,494.
14,494.
0.
0.
-8,116.
0.
0.
-8,116.
-8,116. 574,276.
14,494.
0.
73,260.
( i i )Per sonal
Gr ossr ent s . . 6a Less:r ent alexpenses 6b Rent ali ncomeor( l oss) 6c Netr ent al i ncomeor( l oss ) ........
( i )Secur i t i es ( i i )Ot her 7a Gr ossamountf r om sal es of asset s ot hert hani nvent or y 7a b Less:costorot herbasi s andsal esexpenses . 7b c Gai nor( l os s). . 7c d Netgai nor( l os s) . . . . . . . . . . . 8a Gr oss i ncome f r om f undr ai si ng event s( noti ncl udi ng$ ofcont r i but i onsr epor t ed on l i ne 1c) .SeePar tI V,l i ne18 . . . 8a b Less :di r ectexpens es . . . . 8b c Neti ncomeor( l oss)f r om f undr ai si ngevent s .. 9a Gr oss i ncome f r om gami ng act i v i t i es.SeePar tI V,l i ne19 . 9a b Less :di r ectexpens es . . . . 9b c Neti ncomeor( l oss)f r om gami ngact i vi t i es . . . 10a Gr oss s al es of i nvent or y ,l es s r et ur nsandal l owances . . . 10a b Less :cos tofgoodssol d . . . 10b c Neti ncomeor( l oss)f r om sal esofi nvent or y. . . Busi nes sCode
11a b c d e 12
Other
624110
Al l ot herr evenue . . . . . . . Tot al .Addl i nes11a–11d . . . . . . . . . Tot alr evenue.Seei ns t r uct i ons . . . . . . REV 05/18/21 PRO
65,144. For m9 2020) 90(
0 Page1
For m 990( 2020)
Par tI X St at ementofFunct i onalExpenses Sect i on501( c) ( 3)and501( c) ( 4)or gani z at i onsmus tcompl et eal l col umns .Al l ot heror gani z at i onsmus tcompl et ecol umn( A) .
Checki fSchedul eO cont ai nsar es pons eornot et oanyl i nei nt hi sPar tI X ............. Donoti ncl udeamount sr epor t edonl i nes6b,7b, 8b,9b,and10bofPar tVI I I . 1 Gr ant sandot herassi st ancet odomest i cor gani zat i ons anddomest i cgover nment s.SeePar tI V,l i ne21 . 2 Gr ant s and ot her assi st ance t o domest i c i ndi vi dual s.SeePar tI V,l i ne22. . . . . 3
4 5 6
7 8 9 10 11 a b c d e f g 12 13 14 15 16 17 18 19 20 21 22 23
Gr ant s and ot her ass i s t ance t o f or ei gn or gani z at i ons , f or ei gn gover nment s , and f or ei gni ndi vi dual s.SeePar tI V,l i nes15and16 Benef i t spai dt oorf ormember s .... Compens at i on ofcur r entof f i cer s,di r ect or s, t r us t ees,andk eyempl oyees . . . . . Compensat i onnoti ncl udedabovet odi squal i f i ed per sons( asdef i nedundersect i on4958( f ) ( 1) )and per sonsdescr i bedi nsect i on4958( c) ( 3) ( B). . Ot hersal ar i esandwages . . . . . . Pensi onpl anaccr ual sandcont r i but i ons( i ncl ude sect i on401( k)and403( b)empl oyercont r i but i ons) Ot herempl oy eebenef i t s. . . . . . . Payr ol l t axes. . . . . . . . . . . Feesf ors er v i ces( nonempl oy ees) : Management . . . . . . . . . . Legal . . . . . . . . . . . . . Account i ng . . . . . . . . . . . Lobbyi ng . . . . . . . . . . . . Pr of essi onalf undr ai si ngser vi ces.SeePar tI V,l i ne17 I nves t mentmanagementf ees . . . . . Ot her .( I fl i ne11gamountexceeds10% ofl i ne25,col umn ( A)amount ,l i stl i ne11gexpensesonSchedul eO. ) . Adv er t i s i ngandpr omot i on . . . . . . Of f i ceexpenses . . . . . . . . . I nf or mat i ont echnol ogy . . . . . . . Roy al t i es . . . . . . . . . . . . Occupancy . . . . . . . . . . . Tr avel. . . . . . . . . . . . . Payment soft r av elorent er t ai nmentexpenses f oranyf eder al ,st at e,orl ocal publ i cof f i ci al s Conf er ences ,conv ent i ons ,andmeet i ngs . I nt er est . . . . . . . . . . . . Payment st oaf f i l i at es . . . . . . . . Depr eci at i on,depl et i on,andamor t i z at i on . I nsur ance. . . . . . . . . . . .
24
Ot herexpenses.I t emi ze expenses notcover ed above( Li stmi scel l aneousexpensesonl i ne24e.I f l i ne24eamountexceeds10% ofl i ne25,col umn ( A)amount ,l i stl i ne24eexpensesonSchedul eO. )
a b c d e 25 26
Direct benefits Program e penses Lifesong grants Al l ot herex penses Tot alf unct i onalexpenses.Addl i nes1t hr ough24e Joi ntcost s.Compl et et hi sl i ne onl yi ft he or gani z at i onr epor t edi ncol umn( B)j oi ntcost s f r om a combi ned educat i onalcampai gn and i f f undr ai s i ng sol i ci t at i on.Check her e f ol l owi ngSOP982( ASC958720) . . .
( A) Tot alexpenses
( B) Pr ogr am ser vi ce expens es
( C) Managementand gener al expenses
( D) Fundr ai si ng ex pens es
70,000.
70,000.
0.
0.
245,337.
172,847.
72,490.
0.
36,081. 19,111. 4,569.
0. 14,234. 0.
0. 4,877. 3,011.
36,081. 0. 1,558.
18,256.
0.
18,256.
0.
7,684.
1,296.
6,388.
0.
6,330.
0.
6,330.
0.
7,135. 15,055. 42,372.
7,135. 15,055. 42,372.
0. 0. 0.
0. 0. 0.
471,930.
322,939.
111,352.
37,639.
REV 05/18/21 PRO
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1 Page1
For m 990( 2020)
Par tX
Bal anceSheet Checki fSchedul eO cont ai nsar es pons eornot et oanyl i nei nt hi sPar tX . . . . . . . . . . . . . ( A) Begi nni ngofy ear
NetAsset sorFundBal ances
Li abi l i t i es
Asset s
1 2 3 4 5
Cas h—noni nt er es t bear i ng . . . . . . . . . . . . . . . Savi ngsandt empor ar ycashi nves t ment s........... Pl edgesandgr ant sr ecei vabl e,net . . . . . . . . . . . . . Account sr ecei vabl e,net . . . . . . . . . . . . . . . . Loansandot herr ecei vabl esf r om anycur r entorf or merof f i cer ,di r ect or , t r us t ee,keyempl oyee,cr eat ororf ounder ,s ubst ant i alcont r i but or ,or35% cont r ol l edent i t yorf ami l ymemberofanyoft heseper sons . . . . . 6 Loansandot herr ecei vabl esf r om ot herdi squal i f i edper sons( asdef i ned undersect i on4958( f ) ( 1) ) ,andper sonsdescr i bedi nsect i on4958( c) ( 3) ( B). 7 Not esandl oansr ecei vabl e,net . . . . . . . . . . . . . . 8 I nvent or i esf orsal eoruse . . . . . . . . . . . . . . . . 9 Pr epai dex pens esanddef er r edchar ges . . . . . . . . . . . 10a Land,bui l di ngs,andequi pment :cos torot her 7,733. bas i s .Compl et ePar tVIofSchedul eD . . . 10a b Less :accumul at eddepr eci at i on . . . . . 10b 11 I nves t ment s —publ i cl yt r adedsecur i t i es . . . . . . . . . . . 12 I nves t ment s —ot hersecur i t i es.SeePar tI V,l i ne11 . . . . . . . . 13 I nves t ment s —pr ogr amr el at ed.SeePar tI V,l i ne11 . . . . . . . . 14 I nt angi bl easset s ................... 15 Ot herasset s.SeePar tI V,l i ne11 . . . . . . . . . . . . . . 16 Tot alasset s.Addl i nes1t hr ough15( mus tequal l i ne33). . . . . . 17 Account spayabl eandaccr uedexpenses . . . . . . . . . . . 18 Gr ant spayabl e. . . . . . . . . . . . . . . . . . . . 19 Def er r edr evenue . . . . . . . . . . . . . . . . . . . 20 Taxexemptbondl i abi l i t i es. . . . . . . . . . . . . . . . 21 Escr ow orcust odi al accountl i abi l i t y .Compl et ePar tI VofSchedul eD . . 22 Loans and ot herpayabl es t o any cur r entorf or merof f i cer ,di r ect or , t r ust ee,keyempl oyee,cr eat ororf ounder ,s ubs t ant i alcont r i but or ,or35% cont r ol l edent i t yorf ami l ymemberofanyoft heseper sons . . . . . 23 Secur edmor t gagesandnot espay abl et ounr el at edt hi r dpar t i es . . . 24 Unsecur ednot esandl oanspayabl et ounr el at edt hi r dpar t i es . . . . 25 Ot herl i abi l i t i es( i ncl udi ng f eder ali ncomet ax,payabl est or el at ed t hi r d par t i es,andot herl i abi l i t i esnoti ncl udedonl i nes17–24) .Compl et ePar tX ofSchedul eD . . . . . . . . . . . . . . . . . . . . 26 Tot all i abi l i t i es.Addl i nes17t hr ough25 . . . . . . . . . . .
27 28
29 30 31 32 33
Or gani z at i onst hatf ol l ow FASBASC958,checkher e andcompl et el i nes27,28,32,and33. Netass et swi t houtdonorr est r i ct i ons . . . . . . . . . . . Netass et swi t hdonorr es t r i ct i ons . . . . . . . . . . . . Or gani z at i onst hatdonotf ol l ow FASBASC958,checkher e andcompl et el i nes29t hr ough33. Capi t al st ockort r us tpr i nci pal ,orcur r entf unds . . . . . . . . Pai di norcapi t als ur pl us,orl and,bui l di ng,orequi pmentf und . . . Ret ai nedear ni ngs ,endowment ,accumul at edi ncome,orot herf unds . Tot alnetasset sorf undbal ances. . . . . . . . . . . . . Tot all i abi l i t i esandnetasset s/ f undbal ances . . . . . . . . . REV 05/18/21 PRO
( B) Endofyear
377,976. 1 92,128. 2 51,513. 3 4
567,950. 293,849. 28,240.
5 6 7 8 9
8,758. 10c 11 12 13 14 280,002. 15 810,377. 16 13,788. 17 18 19 20 21
11,670.
7,733.
909,442. 10,507.
22 23 24
25
13,788. 26
10,507.
. .
638,194. 27 158,395. 28
270,771. 628,164.
. . . . .
29 30 31 796,589. 32 810,377. 33
898,935. 909,442. 90( For m9 2020)
2 Page1 Par tXI Reconci l i at i onofNetAsset s Checki fSchedul eO cont ai nsar es pons eornot et oanyl i nei nt hi sPar tXI . . . . . . . . . . . . . 1 Tot alr evenue( mustequalPar tVI I I ,col umn( A) ,l i ne12). . . . . . . . . . . . . . 1 574,276. 2 Tot alexpenses( mustequalPar tI X,col umn( A) ,l i ne25) . . . . . . . . . . . . . 2 471,930. 3 Rev enuel essexpenses.Subt r actl i ne2f r om l i ne1 . . . . . . . . . . . . . . . 3 102,346. 4 Netass et sorf undbal ancesatbegi nni ngofyear( mus tequal Par tX,l i ne32,col umn( A) ). . . 4 796,589.
For m 990( 2020)
5 6 7 8 9 10
Netunr eal i z edgai ns( l oss es)oni nv es t ment s ................. Donat edser vi cesandus eoff aci l i t i es . . . . . . . . . . . . . . . . . . . I nves t mentexpens es . . . . . . . . . . . . . . . . . . . . . . . . . Pr i orper i odadj ust ment s. . . . . . . . . . . . . . . . . . . . . . . . Ot herchangesi nnetasset sorf undbal ances( expl ai nonSchedul eO). . . . . . . . . Netas set sorf undbal ancesatendofyear .Combi nel i nes3t hr ough9( mus tequalPar tX,l i ne 32,col umn( B) ). . . . . . . . . . . . . . . . . . . . . . . . . . .
5 6 7 8 9
898,935. 10 Par tXI I Fi nanci alSt at ement sandRepor t i ng Checki fSchedul eO cont ai nsar es pons eornot et oanyl i nei nt hi sPar tXI I. . . . . . . . . . . . . Yes No
1
Account i ngmet hodusedt opr epar et heFor m 990: Cas h Accr ual Ot her I ft he or gani z at i on changed i t s met hod ofaccount i ng f r om a pr i oryearorchecked “ Ot her , ”expl ai ni n Schedul eO. 2a Wer et heor gani z at i on’ sf i nanci al st at ement scompi l edorr ev i ewedbyani ndependentaccount ant ?. . . 2a I f“ Yes, ”checkaboxbel ow t oi ndi cat ewhet hert hef i nanci alst at ement sf ort heyearwer e compi l ed or r evi ewedonasepar at ebas i s ,cons ol i dat edbasi s ,orbot h: Separ at ebasi s Cons ol i dat edbasi s Bot hconsol i dat edandsepar at ebasi s b Wer et heor gani z at i on’ sf i nanci al st at ement saudi t edbyani ndependentaccount ant ? ....... 2b I f“ Yes, ”checkaboxbel ow t oi ndi cat ewhet hert hef i nanci alst at ement sf ort hey earwer eaudi t edona s epar at ebas i s ,cons ol i dat edbasi s,orbot h: Separ at ebasi s Cons ol i dat edbasi s Bot hconsol i dat edandsepar at ebasi s c I f“ Yes ”t ol i ne2aor2b,doest heor gani z at i onhav eacommi t t eet hatassumesr esponsi bi l i t yf orover si ghtof t heaudi t ,r evi ew,orcompi l at i onofi t sf i nanci als t at ement sandsel ect i onofani ndependentaccount ant ? . 2c I ft heor gani zat i onchangedei t heri t sov er s i ghtpr ocessorsel ect i onpr oces sdur i ngt het axy ear ,expl ai non Schedul eO. 3a Asar esul tofaf eder alawar d,wast heor gani z at i onr equi r edt ounder goanaudi toraudi t sass etf or t hi nt he Si ngl eAudi tActandOMBCi r cul arA133? . . . . . . . . . . . . . . . . . . . . . . 3a b I f“ Yes, ”di dt heor gani z at i onunder got her equi r edaudi toraudi t s?I ft heor gani z at i ondi dnotunder got he 3b r equi r edaudi toraudi t s ,expl ai nwhyonSchedul eOanddescr i beanyst epst akent ounder gos uchaudi t s. REV 05/18/21 PRO
For m9 2020) 90(