Return of Organization Exempt From Income Tax

Transcription

1 Form 99 Rturn of Organization Exmpt From Inom Tax Unr stion 51(), 527, or 4947(a)(1) of th Intrnal Rvnu Co (xpt lak lung nfit trust or privat founation) Dpartmnt of th Trasury Intrnal Rvnu Srvi Th organization may hav to us a opy of this rturn to satisfy stat rporting rquirmnts. A For th 21 alnar yar, or tax yar ginning, 21, an ning, 2 B Chk if applial: G J Plas us IRS lal or print or typ. S Spifi Instrutions. C Nam of organization Numr an strt (or P.O. ox if mail is not livr to strt arss) Room/suit City or town, stat or ountry, an ZIP + 4 K Chk hr if th organization s gross ripts ar normally not mor than 25,. Th organization n not fil a rturn with th IRS; ut if th organization riv a Form 99 Pakag in th mail, it shoul fil a rturn without finanial ata. Som stats rquir a omplt rturn. OMB No D Employr intifiation numr E Tlphon numr M Chk if th organization is not rquir L Gross ripts: A lins 6, 8, 9, an 1 to lin 12 15,442,865 to attah Sh. B (Form 99, 99-EZ, or 99-PF). Part I Rvnu, Expnss, an Changs in Nt Assts or Fun Balans (S Spifi Instrutions on pag 16.) Rvnu Expnss Nt Assts Arss hang Nam hang Initial rturn Final rturn Amn rturn Appliation pning W sit: Organization typ (hk only on) Stion 51()(3) organizations an 4947(a)(1) nonxmpt harital trusts must attah a omplt Shul A (Form 99 or 99-EZ). 51() ( 3 ) (insrt no.) 4947(a)(1) or Contriutions, gifts, grants, an similar amounts riv: a Dirt puli support 1a 23,369 Inirt puli support 1 14,832,318 Govrnmnt ontriutions (grants) 1 Total (a lins 1a through 1) (ash 15,5,38 nonash 12,379 ) 1 15,62,687 2 Program srvi rvnu inluing govrnmnt fs an ontrats (from Part VII, lin 93) 2 3 Mmrship us an assssmnts 3 4 Intrst on savings an tmporary ash invstmnts 4 59,559 5 Divins an intrst from suritis 5 6a Gross rnts 6a 4,46 Lss: rntal xpnss 6 39,663 Nt rntal inom or (loss) (sutrat lin 6 from lin 6a) Othr invstmnt inom (sri ) 7 8a Gross amount from sals of assts othr (A) Suritis (B) Othr than invntory 8a Lss: ost or othr asis an sals xpnss 8 Gain or (loss) (attah shul) 8 Nt gain or (loss) (omin lin 8, olumns (A) an (B)) 8 9 Spial vnts an ativitis (attah shul) a Gross rvnu (not inluing of ontriutions rport on lin 1a) 9a Lss: irt xpnss othr than funraising xpnss 9 Nt inom or (loss) from spial vnts (sutrat lin 9 from lin 9a) 9 1a Gross sals of invntory, lss rturns an allowans 1a Lss: ost of goos sol 1 Gross profit or (loss) from sals of invntory (attah shul) (sutrat lin 1 from lin 1a) 1 11 Othr rvnu (from Part VII, lin 13) 11 28, Total rvnu (a lins 1, 2, 3, 4, 5, 6, 7, 8, 9, 1, an 11) 12 15,43,22 13 Program srvis (from lin 44, olumn (B)) 13 13,587, Managmnt an gnral (from lin 44, olumn (C)) 14 1,146, Funraising (from lin 44, olumn (D)) ,62, 16 Paymnts to affiliats (attah shul) Total xpnss (a lins 16 an 44, olumn (A)) 17 15,462, Exss or (fiit) for th yar (sutrat lin 17 from lin 12) 18 (59,337) 19 Nt assts or fun alans at ginning of yar (from lin 73, olumn (A)) 19 1,385,22 2 Othr hangs in nt assts or fun alans (attah xplanation) 2 (16,29) 21 Nt assts or fun alans at n of yar (omin lins 18, 19, an 2) 21 1,39,476 For Paprwork Rution At Noti, s th sparat instrutions. Opn to Puli Insption July 1 Jun 3 2 Gloal Impat (formrly Intrnational Srvi Agnis) 66 Canal Cntr Plaza 31 Alxanria, VA F Aounting mtho: Cash Arual Othr (spify) H an I ar not applial to stion 527 organizations. H(a) Is this a group rturn for affiliats? Ys No H() If Ys, ntr numr of affiliats H() Ar all affiliats inlu? Ys No (If No, attah a list. S instrutions.) H() Is this a sparat rturn fil y an organization ovr y a group ruling? Ys No I Entr 4-igit GEN Cat. No Y ( ) 21 Form 99 (21)

2 Form 99 (21) Part II Statmnt of Funtional Expnss Do not inlu amounts rport on lin 6, 8, 9, 1, or 16 of Part I. Pag 2 All organizations must omplt olumn (A). Columns (B), (C), an (D) ar rquir for stion 51()(3) an (4) organizations an stion 4947(a)(1) nonxmpt harital trusts ut optional for othrs. (S Spifi Instrutions on pag 21.) (A) Total (B) Program srvis (C) Managmnt an gnral (D) Funraising 22 Grants an alloations (attah shul) (ash 12,243,93 nonash ) 22 12,243,93 12,243,93 23 Spifi assistan to iniviuals (attah shul) Bnfits pai to or for mmrs (attah shul) Compnsation of offirs, irtors, t , ,77 173,51 161,6 26 Othr salaris an wags , ,33 31, ,14 27 Pnsion plan ontriutions ,12 161,98 163, , Othr mploy nfits ,738 36,314 77,133 32, Payroll taxs ,598 45,863 39,983 31,752 3 Profssional funraising fs 3 31 Aounting fs 31 19,872 19, Lgal fs 32 2, , Supplis 33 12,848 19,12 75,779 7, Tlphon 34 42,851 23,734 11,524 7, Postag an shipping 35 22,483 2,23 1, Oupany ,422 98,382 33,65 17, Equipmnt rntal an maintnan 37 21,758 6,564 15, Printing an puliations 38 59,655 55,78 3, Travl ,26 8,347 28,175 14,684 4 Confrns, onvntions, an mtings 4 72,364 13,92 44,661 14, Intrst Dpriation, pltion, t. (attah shul) 42 49,284 49, Othr xpnss not ovr aov (itmiz): a Campaign xpnss Insuran Misllanous Consul 43a ,281 28,971 15,74 2,694 46,12 175,913 41,89 15,74 2,694 23,46 33,58 44 Total funtional xpnss (a lins 22 through 43). Organizations omplting olumns (B)-(D), arry ths totals to lins ,462,539 13,587,612 1,146, ,62 Joint Costs. Chk if you ar following SOP Ar any joint osts from a omin uational ampaign an funraising soliitation rport in (B) Program srvis? Ys No If Ys, ntr (i) th aggrgat amount of ths joint osts ; (ii) th amount alloat to Program srvis ; (iii) th amount alloat to Managmnt an gnral ; an (iv) th amount alloat to Funraising Part III Statmnt of Program Srvi Aomplishmnts (S Spifi Instrutions on pag 24.) What is th organization s primary xmpt purpos? Program Srvi Expnss All organizations must sri thir xmpt purpos ahivmnts in a lar an onis mannr. Stat th numr (Rquir for 51()(3) an of lints srv, puliations issu, t. Disuss ahivmnts that ar not masural. (Stion 51()(3) an (4) (4) orgs., an 4947(a)(1) trusts; ut optional for organizations an 4947(a)(1) nonxmpt harital trusts must also ntr th amount of grants an alloations to othrs.) othrs.) a S Statmnt 1 (Grants an alloations 12,243,93 ) 13,587,612 (Grants an alloations ) (Grants an alloations ) f (Grants an alloations ) Othr program srvis (attah shul) (Grants an alloations ) Total of Program Srvi Expnss (shoul qual lin 44, olumn (B), Program srvis) 13,587,612 Form 99 (21)

3 Form 99 (21) Pag 3 Part IV Balan Shts (S Spifi Instrutions on pag 24.) Not: Whr rquir, attah shuls an amounts within th sription olumn shoul for n-of-yar amounts only. 45 Cash non-intrst-aring 46 Savings an tmporary ash invstmnts (A) Bginning of yar (B) En of yar ,462, ,727,692 47a Aounts rival Lss: allowan for outful aounts 47a ,597 69, ,597 Assts 48a Plgs rival 48a 11,531,797 Lss: allowan for outful aounts ,89 9,761, ,531,97 49 Grants rival 49 8, 5 Rivals from offirs, irtors, trusts, an ky mploys (attah shul) 5 51a Othr nots an loans rival (attah shul) 51a Lss: allowan for outful aounts Invntoris for sal or us Prpai xpnss an frr hargs 78, , Invstmnts suritis (attah shul) Cost FMV 447, ,768 55a Invstmnts lan, uilings, an quipmnt: asis 55a Lss: aumulat priation (attah shul) Invstmnts othr (attah shul) 56 57a Lan, uilings, an quipmnt: asis 57a 272,632 Lss: aumulat priation (attah shul) ,516 13, , Othr assts (sri S Statmnt 8 ) 13, ,243,197 Liailitis 59 Total assts (a lins 45 through 58) (must qual lin 74) 13,53, ,717,332 6 Aounts payal an aru xpnss 338, , Grants payal Dfrr rvnu 71, , Loans from offirs, irtors, trusts, an ky mploys (attah shul) 63 64a Tax-xmpt on liailitis (attah shul) 64a Mortgags an othr nots payal (attah shul) ,83 65 Othr liailitis (sri S Statmnt 9 ) 11,257, ,811,343 Nt Assts or Fun Balans 66 Total liailitis (a lins 6 through 65) 11,668, ,47,856 Organizations that follow SFAS 117, hk hr an omplt lins 67 through 69 an lins 73 an Unrstrit 1,385, ,183, Tmporarily rstrit , Prmanntly rstrit 69 Organizations that o not follow SFAS 117, hk hr an omplt lins 7 through Capital stok, trust prinipal, or urrnt funs 7 71 Pai-in or apital surplus, or lan, uiling, an quipmnt fun Rtain arnings, nowmnt, aumulat inom, or othr funs Total nt assts or fun alans (a lins 67 through 69 OR lins 7 through 72; olumn (A) must qual lin 19; olumn (B) must qual lin 21) 1, , Total liailitis an nt assts / fun alans (a lins 66 an 73) 13,53, Form 99 is availal for puli insption an, for som popl, srvs as th primary or sol sour of information aout a partiular organization. How th puli privs an organization in suh ass may trmin y th information prsnt on its rturn. Thrfor, plas mak sur th rturn is omplt an aurat an fully sris, in Part III, th organization s programs an aomplishmnts.

4 Form 99 (21) Pag 4 Part IV-A Roniliation of Rvnu pr Auit Part IV-B Roniliation of Expnss pr Auit Finanial Statmnts with Rvnu pr Finanial Statmnts with Expnss pr Rturn (S Spifi Instrutions, pag 26.) Rturn a Total rvnu, gains, an othr support a Total xpnss an losss pr pr auit finanial statmnts a 3,146,13 auit finanial statmnts a 3,221,649 Amounts inlu on lin a ut not on Amounts inlu on lin a ut not lin 12, Form 99: on lin 17, Form 99: (1) Nt unraliz gains (1) Donat srvis on invstmnts (16,29) an us of failitis 3, (2) Donat srvis (2) Prior yar ajustmnts an us of failitis 3, rport on lin 2, (3) Rovris of prior Form 99 yar grants (3) Losss rport on (4) Othr (spify): lin 2, Form 99 (4) Othr (spify): A amounts on lins (1) through (4) (13,29) A amounts on lins (1) through (4) 3, Lin a minus lin 3,159,312 Lin a minus lin 3,218,649 (1) Amounts inlu on lin 12, Form 99 ut not on lin a: Invstmnt xpnss not inlu on lin 6, Form 99 (2) Othr (spify): (2) Othr (spify): S Statmnt 1 S Statmnt 11 12,243,89 12,243,89 A amounts on lins (1) an (2) 12,243,89 A amounts on lins (1) an (2) 12,243,89 Total rvnu pr lin 12, Form 99 Total xpnss pr lin 17, Form 99 (lin plus lin ) 15,43,22 (lin plus lin ) 15,462,539 Part V List of Offirs, Dirtors, Trusts, an Ky Employs (List ah on vn if not ompnsat; s Spifi Instrutions on pag 26.) S Statmnt 12 (A) Nam an arss (1) (B) Titl an avrag hours pr wk vot to position Amounts inlu on lin 17, Form 99 ut not on lin a: Invstmnt xpnss not inlu on lin 6, Form 99 (C) Compnsation (If not pai, ntr --.) (D) Contriutions to mploy nfit plans & frr ompnsation (E) Expns aount an othr allowans 75 Di any offir, irtor, trust, or ky mploy riv aggrgat ompnsation of mor than 1, from your organization an all rlat organizations, of whih mor than 1, was provi y th rlat organizations? If Ys, attah shul s Spifi Instrutions on pag 27. Ys No Form 99 (21)

5 Form 99 (21) Pag 5 Part VI Othr Information (S Spifi Instrutions on pag 27.) Ys No 76 Di th organization ngag in any ativity not prviously rport to th IRS? If Ys, attah a tail sription of ah ativity Wr any hangs ma in th organizing or govrning oumnts ut not rport to th IRS? If Ys, attah a onform opy of th hangs a Di th organization hav unrlat usinss gross inom of 1, or mor uring th yar ovr y this rturn? 78a If Ys, has it fil a tax rturn on Form 99-T for this yar? Was thr a liquiation, issolution, trmination, or sustantial ontration uring th yar? If Ys, attah a statmnt 79 8a Is th organization rlat (othr than y assoiation with a statwi or nationwi organization) through ommon mmrship, govrning ois, trusts, offirs, t., to any othr xmpt or nonxmpt organization? 8a If Ys, ntr th nam of th organization an hk whthr it is xmpt OR nonxmpt. 81a Entr irt or inirt politial xpniturs. S lin 81 instrutions 81a Di th organization fil Form 112-POL for this yar? 81 82a Di th organization riv onat srvis or th us of matrials, quipmnt, or failitis at no harg or at sustantially lss than fair rntal valu? 82a If Ys, you may iniat th valu of ths itms hr. Do not inlu this amount as rvnu in Part I or as an xpns in Part II. (S instrutions in Part III.) 82 3, 83a Di th organization omply with th puli insption rquirmnts for rturns an xmption appliations? 83a Di th organization omply with th islosur rquirmnts rlating to qui pro quo ontriutions? 83 84a Di th organization soliit any ontriutions or gifts that wr not tax util? 84a If Ys, i th organization inlu with vry soliitation an xprss statmnt that suh ontriutions or gifts wr not tax util? ()(4), (5), or (6) organizations. a Wr sustantially all us nonutil y mmrs? 85a Di th organization mak only in-hous loying xpniturs of 2, or lss? 85 If Ys was answr to ithr 85a or 85, o not omplt 85 through 85h low unlss th organization riv a waivr for proxy tax ow for th prior yar. Dus, assssmnts, an similar amounts from mmrs 85 Stion 162() loying an politial xpniturs 85 Aggrgat nonutil amount of stion 633()(1)(A) us notis 85 f Taxal amount of loying an politial xpniturs (lin 85 lss 85) 85f g Dos th organization lt to pay th stion 633() tax on th amount on lin 85f? 85g h If stion 633()(1)(A) us notis wr snt, os th organization agr to a th amount on lin 85f to its rasonal stimat of us alloal to nonutil loying an politial xpniturs for th following tax yar? 85h 86 51()(7) orgs. Entr: a Initiation fs an apital ontriutions inlu on lin 12 86a Gross ripts, inlu on lin 12, for puli us of lu failitis ()(12) orgs. Entr: a Gross inom from mmrs or sharholrs 87a Gross inom from othr sours. (Do not nt amounts u or pai to othr sours against amounts u or riv from thm.) At any tim uring th yar, i th organization own a 5 or gratr intrst in a taxal orporation or partnrship, or an ntity isrgar as sparat from th organization unr Rgulations stions an ? If Ys, omplt Part IX 88 89a 51()(3) organizations. Entr: Amount of tax impos on th organization uring th yar unr: stion 4911 ; stion 4912 ; stion ()(3) an 51()(4) orgs. Di th organization ngag in any stion 4958 xss nfit transation uring th yar or i it om awar of an xss nfit transation from a prior yar? If Ys, attah a statmnt xplaining ah transation 89 Entr: Amount of tax impos on th organization managrs or isqualifi prsons uring th yar unr stions 4912, 4955, an 4958 Entr: Amount of tax on lin 89, aov, rimurs y th organization 9a List th stats with whih a opy of this rturn is fil S Statmnt 13 Numr of mploys mploy in th pay prio that inlus Marh 12, 21 (S instrutions.) Th ooks ar in ar of Stphani Murphy Tlphon no. ( 73 ) Loat at 66 Canal Cntr Plaza, Suit 31 Alxanria, VA ZIP Stion 4947(a)(1) nonxmpt harital trusts filing Form 99 in liu of Form 141 Chk hr an ntr th amount of tax-xmpt intrst riv or aru uring th tax yar 92 Form 99 (21)

6 Form 99 (21) Part VII Analysis of Inom-Prouing Ativitis (S Spifi Instrutions on pag 32.) Unrlat usinss inom Not: Entr gross amounts unlss othrwis iniat. 93 Program srvi rvnu: a f Miar/Miai paymnts g Fs an ontrats from govrnmnt agnis 94 Mmrship us an assssmnts 95 Intrst on savings an tmporary ash invstmnts 96 Divins an intrst from suritis 97 Nt rntal inom or (loss) from ral stat: a t-finan proprty not t-finan proprty 98 Nt rntal inom or (loss) from prsonal proprty 99 Othr invstmnt inom 1 Gain or (loss) from sals of assts othr than invntory 11 Nt inom or (loss) from spial vnts 12 Gross profit or (loss) from sals of invntory (A) Businss o (B) Amount Exlu y stion 512, 513, or 514 (C) Exlusion o (D) Amount Pag 6 (E) Rlat or xmpt funtion inom 13 Othr rvnu: a Stat Rg/Donor Ak 3 91, PCFO Rimursmnt Cost Shar rimursmnt Sutotal (a olumns (B), (D), an (E)) 151,817 95, 93, , Total (a lin 14, olumns (B), (D), an (E)) 34,515 Not: Lin 15 plus lin 1, Part I, shoul qual th amount on lin 12, Part I. Part VIII Rlationship of Ativitis to th Aomplishmnt of Exmpt Purposs (S Spifi Instrutions on pag 32.) Lin No Explain how ah ativity for whih inom is rport in olumn (E) of Part VII ontriut importantly to th aomplishmnt of th organization s xmpt purposs (othr than y proviing funs for suh purposs). Part IX Information Rgaring Taxal Susiiaris an Disrgar Entitis (S Spifi Instrutions on pag 33.) (A) (B) (C) (D) (E) Nam, arss, an EIN of orporation, Prntag of Natur of ativitis Total inom En-of-yar partnrship, or isrgar ntity ownrship intrst assts Part X Information Rgaring Transfrs Assoiat with Prsonal Bnfit Contrats (S Spifi Instrutions on pag 33.) (a) Di th organization, uring th yar, riv any funs, irtly or inirtly, to pay prmiums on a prsonal nfit ontrat? () Di th organization, uring th yar, pay prmiums, irtly or inirtly, on a prsonal nfit ontrat? Not: If Ys to (), fil Form 887 an Form 472 (s instrutions). Plas Sign Hr Pai Prparr s Us Only Unr pnaltis of prjury, I lar that I hav xamin this rturn, inluing aompanying shuls an statmnts, an to th st of my knowlg an lif, it is tru, orrt, an omplt. Dlaration of prparr (othr than offir) is as on all information of whih prparr has any knowlg. Signatur of offir Typ or print nam an titl. Prparr s signatur Firm s nam (or yours if slf-mploy), arss, an ZIP + 4 Dat 14 59, Rimursmnt of osts for xpnss inurr in onjuntion with ating as Prinipal Comin Funraising Organization for th Comin Fral Campaign-Ovrsas an raising funs for stat ampaign. Rimursmnt from mmr agnis for a portion of th ampaign avrtising onut y Gloal Impat. Stphani Murphy, Vi Prsint of Oprations Chk if slfmploy Dat EIN Phon no. ( ) Ys Ys No No Prparr s SSN or PTIN (S Gn. Inst. W) Form 99 (21)