Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
990
Department
of theTreasury
InternalRevenue
Service
!,.lnder section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung
benefit trust or private foundation)
~
D
D
D
D
D
D
Open
to Public
Inspection
, 20
D Employeridentification number
20-2641983
E Telephonenumber
Terminated
~@12
The organization may have to use a copy of this return to satisfy state reporting requirements
OMBNo 1545-0047
202-261-6592
G Grossreceipts$
440,017
foraffiliates?
0 Yes [Z] No
H(a)Isthisagroupreturn
Amendedreturn
Washinaton DC 20036
Applicationpending F Nameand addressof principalofficer
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organization
or disposed
3
4
5
6
7a
7b
Total number of 1nd1v1duals employed in calendar year 2012 (Part V, line 2a)
Total number of volunteers (estimate 1f necessary)
Total unrelated business revenue from Part VIII, column (C}, ltne 12
Net unrelated business taxable income from Form 990-T, line 34
2
0
0
0
Prior Year
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10
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Contributions
Current Year
297,000
440,017
297,000
440,017
35,000
------------------------
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12,005
Beg1nmng
of CurrentYear
~
290,566
438,641
1,376
End of Year
3,520
4,896
3,520
4,896
175,138
Total expenses. Add lines 13-17 (must eq ratf>art IX,_cglul!'n (At line '25)
284,995
Subtract
ltne 18 f om
11r5{1z_
l_,;t::j V ~ n
0
Total assets (Part X, line 16)
Total l1abil1ties (Part X, hne 26)
Net assets or fund balances. Subtract
Signature
Block
113,075
109,862
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Underp enalt1es
of periury, I declarethat I haveexaminedth,s return,1nc1uain
g accomp anying sclieaules'fnd statements,and to the best of my knowledg e and belief,1t1s
true,correct,and complete Declarationof preparer(o er than officer)1sbasedon all informationof which preparerhasany knowledge
JJ,
Date
Sign
Here
Typeor print nameand title
Paid
Pnntffype preparer'sname
P~'s
s1gnatu;r
Date
Use
C>nlyr--F1_rm_'_s_na~m_ec_..__~~~H~o_w~a_rd.CC.....CS~c~k~o~ln_1~k~,C.c..-P_A~~~~~~~~~~~~~~~~~~~-+-;_;...;.;..;...c:...::.;_;_.:_..~~~~~~~~~~
Firm'saddress ~ 11646 N 129th Wa Scottsdale.AZ 85259
602-524-0974
May the IRS discuss this return with the preparer shown above? (see instructions)
[Z]Yes O No
Cat No 11282Y
Page2
1@1j(i
1
.o
4a
Did the organization undertake any significant program services during the year which were not listed on the
prior Form 990 or 990-EZ? . . .
. . . . .
. . . . . .
. . . .
O Yes 0
No
4b
4c
(Expenses $
including grants of$
Total program service expenses ~
) (Revenue$
289.615
Form
990 (2012)
..
Page3
l!A
complete Schedule A .
2
3
4
5
7
8
9
,/
1
2
,/
,/
3
4
Is the organization a section 501 (c)(4), 501 (c)(5), or 501(c)(6) organization that receives membership dues,
assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part Ill .
No
Is the organization described 1n section 501 (c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes,"
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors
have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If
"Yes," complete Schedule D, Part I
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part JI
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
,/
./
./
./
Did the organization report an amount in Part X, line 21, for escrow or custodial account liability; serve as a
custodian for amounts not listed ,n Part X; or provide credit counseling, debt management, credit repair, or
debt negotiation services? If "Yes," complete Schedule D, Part IV .
./
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted
endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part V
11
If the organization's answer to any of the following questions 1s "Yes," then complete Schedule D, Parts VI,
VII, VIII, IX, or X as applicable.
a Did the organization report an amount for land, buildings, and equipment in Part X, line 1O? If "Yes,"
complete Schedule D, Part VI
10
'_1
'
'
./
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L..;.r
11a
./
11b
./
11c
./
11d
11e
e Did the organization report an amount for other liab11it1es
in Part X, line 25? If "Yes," complete Schedule D, Part X
f Did the organization'sseparate or consolidated f1nanc1al
statementsfor the tax year include a footnote that addresses
under FIN 48 (ASC740)?If "Yes," complete Schedule 0, Part X
the organization'sliabilityfor uncertaintax pos1t1ons
11f
12a Did the organization obtain separate, independent audited f1nanc1alstatements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
12a
b Was the organizationincluded 1nconsolidated,independentaudited financialstatementsfor the tax year? If "Yes,"and tf
the organizationanswered "No" to ltne 12a, then completing Schedule D, Parts XI and XII is opt,onal
12b
13
13
Is the organization a school described in section 170(b)(1)(A)(i1)?If "Yes," complete Schedule E
14a Did the organization maintain an office, employees, or agents outside of the United States?
14a
b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking,
fundraising, business, investment, and program service activ1t1esoutside the United States, or aggregate
foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.
14b
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any
organization or entity located outside the United States? If "Yes," complete Schedule F, Parts II and IV .
15
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance
to 1nd1vidualslocated outside the United States? If "Yes," complete Schedule F, Parts /JIand IV
16
Did the organization report a total of more than $15,000 of expenses for professional fundra,smg services on
17
Part IX, column (A), Imes 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions)
17
18
Did the organization report more than $15,000 total of fundra1smg event gross income and contributions on
Part VIII, lines 1c and Ba? If "Yes," complete Schedule G, Part II .
18
Did the organization report more than $15,000 of gross income from gaming activ1t1eson Part VIII, line 9a?
19
If "Yes," complete Schedule G, Part Ill
19
If "Yes," complete Schedule H .
20a Did the organization operate one or more hospital fac11it1es?
20a
b If "Yes" to line 20a, did the orQanizat1onattach a copy of its audited financial statements to this return?
20b
./
./
b Did the organization report an amount for investments-other securities in Part X, line 12 that 1s5% or more
of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VII
c Did the organization report an amount for investments-program related in Part X, line 13 that ,s 5% or more
of ,ts total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII
d Did the organization report an amount for other assets in Part X, line 15 that 1s5% or more of its total assets
reported m Part X, line 16? If "Yes," complete Schedule D, Part IX
Form
./
./
./
./
./
./
./
./
./
./
./
./
990 (2012)
Page4
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization
in the United States on Part IX, column (A), line 1? If "Yes," complete Schedule I, Parts I and II
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States
on Part IX, column (A), line 2? If "Yes," complete Schedule I, Parts I and Ill
22
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the
organization's current and former officers, directors, trustees, key employees, and highest compensated
employees? If "Yes," complete Schedule J .
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than
$100,000 as of the last day of the year, that was issued after December 31, 2002? If "Yes," answer lines 24b
through 24d and complete Schedule K. If "No," go to line 25 .
b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? .
c Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
d Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year? .
25a Section 501 (c)(3) and 501 (c)(4) organizations. Did the organization engage 1nan excess benefit transaction
with a disqualified person during the year? If "Yes," complete Schedule L, Part I
21
No
./
22
./
23
./
24a
24b
./
24c
24d
25a
./
year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ?
If "Yes," complete Schedule L, Part I .
25b
./
26
Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee,or
d1squalif1ed
personoutstandingas of the end of the organization'stax year?If "Yes," complete Schedule L, Part II .
26
./
27
Did the organization 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," complete Schedule L, Part Ill .
Was the organization a party to a business transaction with one of the following parties (see Schedule L,
Part IV instructions for applicable filing thresholds, conditions, and exceptions):
27
./
28a
./
28b
./
28c
29
./
./
30
./
31
./
32
./
33
./
34
./
./
b Is the organization aware that it engaged in an excess benefit transaction with a d1squahf1edperson in a prior
28
a A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV
b A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete
Schedule L, Part IV
c An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof)
was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV
29
30
31
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified
conservation contributions? If "Yes," complete Schedule M
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes,"
complete Schedule N, Part II
33
34
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations
sections 301. 7701-2 and 301. 7701-3? If "Yes," complete Schedule R, Part I .
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, Ill,
or IV, and Part V, /me 1
35a Did the organization have a controlled entity within the meaning of section 512(b)(13)?
b If "Yes" to line 35a, did the organization receive any payment from or engage in any transaction with a
35a
controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, /me 2 .
35b
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable
related organization? If "Yes," complete Schedule R, Part V, /me 2
37
38
36
37
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and
19? Note. All Form 990 filers are required to complete Schedule O .
38
Form
./
./
990
(2012)
N=Zffl11
Statements
Page
c
2a
b
3a
b
4a
b
Sa
b
c
6a
b
7
a
Enter the number reported in Box 3 of Form 1096. Enter -0- 1fnot applicable
1--~-~-+-----,-i~
Enter the number of Forms W-2G included 1nline 1a. Enter -0- if not applicable .
Did the organization comply with backup withholding rules for reportable payments to vendors and
reportable gaming (gambling) winnings to prrze winners?
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax
Statements, filed for the calendar year ending with or within the year covered by this return
2a
1
'---'------i
If at least one 1sreported on line 2a, did the organizatron frle all required federal employment tax returns?
Note. If the sum of lines 1a and 2a 1sgreater than 250, you may be required to e-file (see instructions)
Did the organization have unrelated business gross income of $1,000 or more during the year?
If "Yes," has 1tfried a Form 990-T for this year? If "No," provide an explanation m Schedule O .
At any time during the calendar year, drd the organization have an interest in, or a signature or other authority
over, a financial account 1n a foreign country (such as a bank account, securities account, or other financial
account)? .
. . . .
. . . . . . . . . .
. . . .
If "Yes," enter the name of the foreign country: ..,.
See rnstruct1onsfor filing requrrementsfor Form TD F 90-22.1, Report of Foreign Bank and FrnancialAccounts.
Was the organization a party to a prohibited tax shelter transaction at any trme during the tax year? .
Did any taxable party notrfy the organizatron that rt was or is a party to a proh1brted tax shelter transaction?
If "Yes" to line 5a or 5b, drd the organizatron frle Form 8886-T? . . . .
Does the organizatron have annual gross receipts that are normally greater than $100,000, and drd the
organizatron solicrt any contrrbut1ons that were not tax deductible as charitable contributions? . .
If "Yes," did the organization include wrth every solic1tatron an express statement that such contrrbut1ons or
gifts were not tax deductrble? . .
. . . . . . . . .
Organizations that may receive deductible contributions under section 170(c).
Did the organrzation receive a payment in excess of $75 made partly as a contrrbutron and partly for goods
and services provided to the payor? .
. . . .
b
c
If "Yes," drd the organization notify the donor of the value of the goods or services provided? . .
Did the organization sell, exchange, or otherwise dispose of tangible personal property for whrch it was
required to file Form 8282? .
. . . . .
d
e
f
g
h
If "Yes," indrcate the number of Forms 8282 fried durrng the year
7d
Did the organizatron recerve any funds, directly or indrrectly, to pay premiums on a personal benefit contract?
Ord the organization, during the year, pay premiums, directly or indrrectly, on a personal benefrt contract? .
If the organrzatronrecerveda contrrbutronof qualrfiedrntellectualproperty,did the organizationfrle Form 8899 as required?
If the organizatronreceiveda contrrbutronof cars, boats,arrplanes,or othervehicles,drd the organrzationfile a Form1098-C?
Sponsoring organizations
maintaining
donor advised funds and section 509(a)(3) supporting
organizations. Did the supporting organization, or a donor advrsed fund maintained by a sponsoring
organizatron, have excess busrness holdrngs at any trme durrng the year?
Sponsoring organizations maintaining donor advised funds.
Did the organization make any taxable drstrrbutions under section 4966? .
Ord the organization make a drstribut1on to a donor, donor advisor, or related person?
Section 501 (c)(7) organizations. Enter:
10a
Initiation fees and capital contributions included on Part VIII, line 12
Gross recerpts, included on Form 990, Part VIII, line 12, for public use of club facrlitres
10b
Section 501 (c)(12) organizations. Enter:
Gross income from members or shareholders
11a
Gross income from other sources (Do not net amounts due or paid to other sources
against amounts due or recerved from them.) .
11b
9
a
b
10
a
b
11
a
b
.
Yes
1a
b
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1c
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3a
3b
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4a
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6a
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6b
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7b
7c
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7h
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12a
b
13
a
b
c
14a
b
Section 4947(a)(1) non-exempt charitable trusts. ls the organization filing Form 990 in lieu of Form 1041?
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
~1_2_b~------.\f~,
Section 501(c)(29) qualified nonprofit health insurance issuers.
Is the organizatron licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organizatron must report on Schedule 0.
Enter the amount of reserves the organizatron is required to maintain by the states in whrch
. . . . .
the organizatron 1slicensed to rssue qualifred health plans
13b
Enter the amount of reserves on hand
13c
Did the organization receive any payments for rndoor tanning servrces durrng the tax year?
If "Yes," has it fried a Form 720 to re ort these a ments? If "No," rov,de an ex lanation m Schedule O
12a
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13a
14a
14b
Form
./
990 (2012)
Page
1@19.iGovernance, Management,
and Disclosure For each "Yes" response to lines 2 through lb below, and for a "No"
response to line Ba, Bb, or 1Ob below, descnbe the c/fcumstances, processes, or changes m Schedule 0. See instructions.
Check 1fSchedule O contains a response to any question in this Part VI
1a
b
2
3
4
5
6
7a
b
8
a
b
9
Enter the number of voting members of the governing body at the end of the tax year .
1--1_a
____
If there are material differences m voting rights among members of the governing body, or
if the governing body delegated broad authority to an executive committee or similar
committee, explain m Schedule 0.
-'-l 4
Enter the number of voting members included in line 1a, above, who are independent
.__1_b
____
_2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with
any other officer, director, trustee, or key employee?
Did the organization delegate control over management duties customarily performed by or under the direct
supervision of officers, directors, or trustees, or key employeesto a management company or other person?
Did the organizationmake any significant changesto its governingdocuments since the prior Form 990 was flied?
Did the organization become aware during the year of a significant d1vers1onof the organization's assets? .
Did the organization have members or stockholders?
Did the organization have members, stockholders, or other persons who had the power to elect or appoint
one or more members of the governing body?
Are any governance decisions of the organization reserved to (or subject to approval by) members,
stockholders, or persons other than the governing body?
Did the organization contemporaneously document the meetings held or written actions undertaken during
the year by the following:
The governing body?
Each committee with authority to act on behalf of the governing body?
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at
the organization's mailing address? If "Yes," provide the names and addresses m Schedule O .
''
No
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3
4
6
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7a
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7b
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Section B. Policies (This Section B requests information about poltctes not required by the Internal Revenue Code.)
Yes
10a
b
11a
b
12a
b
c
13
14
15
a
b
16a
b
10a
No
./
10b
11a ./
12a
12b
./
12c
16b
Section C. Disclosure
17
18
List the states with which a copy of this Form 990 is required to be filed ~
None
Section 6104 requires an organization to make its Forms 1023 (or 1024 1fapplicable), 990, and 990-T (Section 501 (c)(3)s only)
available for public inspection. Indicate how you made these available. Check all that apply.
D
19
20
Own website
D Another's website
0 Upon request D Other (exp/am in Schedule 0)
Describe in Schedule O whether (and 1f so, how), the organization made its governing documents, conflict of interest policy,
and financial statements available to the public during the tax year.
State the name, physical address, and telephone number of the person who possesses the books and records of the
organization:~
990 (2012)
1:tfft,IN
Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated
Page
Employees, and
Independent Contractors
Check if Schedule O contains a response to any question in this Part VII .
D
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed Report compensation for the calendar year ending with or within the
organization's tax year.
List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount of
compensation. Enter -0- in columns (D), (E), and (F) 1fno compensation was paid.
List all of the organization's current key employees, if any. See instructions for definition of "key employee."
List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.
List all of the organization's former officers, key employees, and highest compensated employees who received more than
$100,000 of reportable compensation from the organization and any related organizations.
List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.
List persons in the following order: ind1v1dual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box 1fneither the organization nor any related organization compensated any current officer, director, or trustee.
(Cl
(A)
(B)
Average
hours per
week (list an,
hours for
related
organizations
below dotted
line)
Pos1t1on
(do not check more than one
box, unless person 1sboth an
officer and a director/trustee)
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(F)
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(D)
Reportable
Reportable
compensation
compensation from
from
related
the
orgarnzat1ons
organization
CN-2/1099-MISC)
r,N-2/1099-MISC)
"O
co
Estimated
amount of
other
compensation
from the
organization
and related
organizations
:J
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a.
-------------
20
-------------
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./
./
105,000
./
15,000
./
./
Langer._Treasurer ___________________
_
1
-------------
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-------------
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- (5) _______
-------------- ------ ----- ----- --- ------ ---. (6) ___
------ -------- ------ -------. ------- ------ ------ ---- (7) _-------- -------------- ------ -------- --- ------ --------- -
- (8) ___________
---------------------------------- (9) ____
------------------------------
-- ----------
-------- -------------
(1O)____
---------------------------------------_-------____
_
(11)_____________
------------------------ -------- ------ --- ----(12)__--- -. - - ----_--_----- __----____
--.. ____
. ___
. ___
. __--__
(13)____________
---------------
_---------- ---
(14)_____
--------- ---------- ------- __----- _----- _--- -------- --Form
990 (2012)
~'JI
Page8
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(C)
(A)
(B)
Average
hours per
week (hst an,
hours for
related
orgarnzat1ons
below dotted
lme)
Pos1t1on
(do not check more than one
box, unless person 1s both an
officer and a director/trustee)
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(D)
(E)
(F)
Reportable
Reportable
compensation
compensation from
from
related
orgarnzat1ons
the
IY'/-2/1099-MISC)
orgarnzat1on
!!l IY'/-2/1099-MISC)
Estimated
amount of
other
compensation
from the
orgarnzat1on
and related
organizations
"O
(D
:,
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CD
( 15)__--_________
--_____
------______
--________________________
_
(17)_______
--------__-----------_-----------___-----------_---_
( 18)__--_______
----_____
---- __--_______
--_____________________
_
-------------------------------(19) ________
----------------- --
--_--________
--_______
--___________________
_
(20) _____
--- ---____
(21 )_________________________________
--_______________________
_
(22)_---------------------------------------------------------(23) _____
--_-----_______
----______
----________
--______________
_
(24) ____________________
---___
--______________________________
_
(25) __________________________________________________________
_
1 b Sub-total .
c
d
120,000
120,000
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of
reportable compensation from the organization ~ 1
Did the organization hst any former officer, director, or trustee, key employee, or highest compensated
employee on line 1a? If "Yes," complete Schedule J for such individual
,~4,: '
_...,_
For any ind1v1duallisted on hne 1a, 1sthe sum of reportable compensation and other compensation from the
organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
indtvtdual
''.J!
No
Yes
- -::...9
\.:.J
,/
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual
for services rendered to the organization? If "Yes," complete Schedule J for such person
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5
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of
compensation from the organization. Report compensation for the calendar year ending with or within the organization's tax
year.
(A)
Name and business address
(B)
(C)
Compensation
Description of services
None
Total number of independent contractors (1nclud1ngbut not limited to those listed above) who
received more than $100,000 of compensation from the organization~
0
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Form
990 (2012)
Page9
Utf#19Jii
Statement
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c
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Ba
a;
'-------~-------!
____
~----.. ---1------"--1-------+-------+-------Net rental income or (;-lo_s_s.,_)
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(1)Secunt1es
assetsotherthaninventory 1--------+---------1
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andsalesexpenses
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QI
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440,017
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512,513,or514
.._______
~-~---.----i-----~~~
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_1_c--+--------=-io
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t--1_d
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______
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Membership dues
(C)
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business
revenue
(B)
Related or
exempt
function
revenue
(A)
Total revenue
b
c
9a
c
10a
b
c
a 1--------l
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Less: direct expenses
b '---------1
Net income or (loss) from gaming activities
. ..
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less
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440,017
Form 990
-----
(2012)
Rfflif!I
Statement
Page
Section '501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).
Check 1fSchedule O contains a response to any question in this Part IX .
(A)
(B)
(D)
(C)
Do not include amounts reported on lines 6b, 7b,
Total expenses
Program service
Fundraising
Management and
Bb, 9b, and 10b of Part VIII.
expenses
general expenses
expenses
1
2
35,000
7
8
a
b
c
d
e
f
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105.000
0
0
0
0
8,075
8,075
0
8,150
8,255
0
0
0
164,950
24,667
12
13
14
15
16
17
18
19
20
21
22
23
24
8,150
8.255
,,
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164,950
24,667
17,225
0
0
2,322
48,925
2,322
48,925
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35,000
4
5
10
11
10
of Functional Expenses
------------------------------------------------------------
438,641
289,615
149,026
Form
990
(2012)
Page 11
l@l,'I
Balance Sheet
Check if Schedule O contains a response to any question in this Part X
.o
(A)
(B)
End of year
Beginning of year
1
2
3
4
5
VI
QI
VI
VI
<(
7
8
9
10a
b
11
12
13
14
15
16
17
18
19
20
21
VI
QI
22
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24
25
26
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27
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QI
VI
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30
31
32
33
34
Cash-non-interest-bearing
Savings and temporary cash investments
Pledges and grants receivable, net
Accounts receivable, net
Loans and other receivables from current and former officers, directors,
trustees, key employees, and highest compensated employees.
Complete Part II of Schedule L
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12
13
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15
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17
18
19
20
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31
32
33
34
Form
990 (2012)
Page
l=Ztt4f.31
Reconciliation of Net Assets
Ch ec k I'f S c hedu Ie O contains a response to any question m t h'1s Part XI
Total revenue (must equal Part VIII, column (A), line 12) .
Total expenses (must equal Part IX, column (A), line 25)
Revenue less expenses. Subtract line 2 from line 1
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) .
Net unrealized gains (losses) on investments
Donated services and use of facilities
Investment expenses
Prior period adjustments .
Other changes in net assets or fund balances (explain in Schedule 0)
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line
33, column (B))
2
3
4
5
6
7
8
9
10
Financial Statements
:F.Tii:~11
0
1
440.017
438,641
1,376
3,520
0
0
0
0
0
2
3
4
5
6
7
8
9
10
4,896
and Reporting
' J'
Yes
--------
2a
O Separate basis
12
O Consolidated
basis
O Both
No
'
'
~---
. . . .
If "Yes," check a box below to indicate whether the financial statements for the year were audited on a
separate basis, consolidated basis, or both
./
O Separate basis
c
2b
If the organization changed either its oversight process or selection process during the tax year, explain in
Schedule 0.
3a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in
the Single Audit Act and OMB Circular A-133?
b If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the
required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits
2c
3a
1----,1------1--
3b
Form
990
(2012)
SCHEDULE I
(Form 990)
Department of the Treasury
Internal Revenue Service
ame of the organization
OMS No 1545-0047
Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22.
Open to Public
Inspection ~
~@12
20-2641983
1:fljljl
1 (a) Name
D No
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the orgarnzatron answered "Yes" to Form 990,
Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(h) Purpose of grant
I (d) Amount of cash I (e) Amount of non- 1(1)Method of valuation
(g) Description of
(c) IRC section
and address of organization
I
(b) EIN
grant
1fapplicable
or government
cash assistance
or assistance
non-cash assistance
501C-3
7,500
Public Education
501C-4
17,500
0.
Public Education
54-2050093
(6)
--------------------------------------------------------------
. (7) _____
----- -------------- ------------------. (8) _-------------------------- ---------------- (9) ___
------------------------- ------- -------(10)
- - - -
(11)
- --
--
-----------------------------------
(12) _____
--------------------------------------
2
3
Enter total number of section 501 (c)(3) and government organizations listed in the line 1 table
Enter total number of other organizations listed in the hne 1 table
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
....
....-----------------------------
Cat No 50055P
Page 2
@illi
Grants and Other Assistance to Individuals in the United States. Complete rt the organization answered "Yes" to Form 990, Part IV, line 22.
Part Ill can be duplicated if additional space is needed.
(a) Type of grant or assistance
(b) Number of
rec1p1ents
(c) Amount of
cash grant
(d) Amount of
non-cash assistance
1
2
3
4
5
6
~~'
7
- .
.. .
..
..
"
''
"
'.
..
--
Ill
,. '
..
'
..
,nformatron.
,::ti_~_lnst1!!J.te_For_
L1berty maintains records in its corporate and accountin_g_records regarding_ the amounts _of grants_ made to_or.9anizat1ons. the status of those or9.anizat1ons,___________________
_
and the apJxoval of grants by the board of directors_ The_lnst1tute For Libert:_ydoes not monitor the_use of grant funds_once_g_rants_arcmade--------------------------------------------------------------
,
SCHEDULEO
(Form '990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
OMB No 1545-0047
~12
Open to Public
Inspection
Employer identification
number
20-2641983
Part VI #11 - A draft of_the return_ has been circulated to_members of_the _governing_board------------------------------------------------------------------Part VI #19 - Upon written req_uestthe Or_garnzat1on's_governing_documents._confl1ct of interestJ>ol1cy and financial statements will ______________
_
____________________
_
be ma de av a I Iab Ie___________________________________________________________________________________________________________________
Part IX - Line 11g - Education_and advocacy services _provided _by field _consultants---------------------------------------------------------------------------
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat No 51056K