Short Form Return of Organization Exempt From Income Tax

Transcription

1 99O"EZ Short Form Return of Organization Exempt From Income Tax Under section 51(c), 527, or 4947(a)(1) of the Internal Revenue Code (except'private foundations) OMB No Department cf the Treasury Internal Revenue Service ' Do not enter social security numers on this form as it may e made pulic llp Information aout Form 99El and its instructions is at wwwirsgov1form99 A For the 216 calendar year, or tax year eginning January 1 B Check if applicale: E Address change Name change Initial return C Name of organization Minnesota Wildflowers Information Numer and street lot PO ox, if mail is not delivered to street address) Final returrullorrnlnated 159 Long Lake Rd City or town, state or province, country, and ZIP or foreign postal code ' Amended return 216, and ending Decemer 31, 2 16 Roomsuite D Employer identification numer E Telephone numer F Group Exemption Numer G Accounting Method: L] Cash Li Accrual Other (specify) H Check if the organization is not I Wesite: required to attach Schedule B J Taxexempt status (check only one) 51(c)(3) 51(c) ( ) 4 (insert no) 4947(a)(1) or 527 (Form 99, 99EZ, or 99PF) K Form of organization: E1 Corporation Trust Association Other L Add lines 5, 6c, and 7 to line 9 to determine gross receipts If gross receipts are $2, or more, or if total assets (Part II, column (B) elow) are $5, or more, file Form 99 instead of Form 99EZ ITiII Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part I) Check if the nrr]ni7tinn used Schedule to resoond to any auestion in this Part I 171 I Contriutions, gifts, grants, and similar amounts received I 6, Program service revenue including government fees and contracts 2 3 Memership dues and assessments 3 4 Investment income a Gross amount from sale of assets other than inventory 5a Less: cost or other asis and sales expenses 5 c Gain or (loss) from sale of assets other than inventory (Sutract line 5 from line 5a) Sc 6 Gaming and fundraising events a Gross income from gaming (attach Schedule G if greater than $15) 6a I Gross income from fundraising events (not including $ of contriutions from fundraising events reported on line 1) (attach Schedule G if the sum of such gross income and contriutions exceeds $15,) 6 c Less: direct expenses from gaming and fundraising events 6c d Net income or (loss) from gaming and furidraising events (add lines 6a and 6 and sutract line 6c) 7a Gross sales of inventory, less returns and allowances 7a Less: cost of goods sold 7 c Gross profit or (loss) from sales of inventory (Sutract line 7 from line 7a) 7c 8 Other revenue (descrie in Schedule ) Total revenue Add lines 1, 2, 3, 4, 5c, 6d, 7c and , Grants and similar amounts paid (list in Schedule ) 1 11 Benefits paid to or for memers Salaries, other compensation, and employee enefits 12 56, Professional fees and other payments to independent contractors a 14 Occupancy, rent, utilities, and maintenance 14 LU 15 Printing, pulications, postage, and shipping Other expenses (descrie in Schedule ) 16 15, Total expenses Add lines 1 through ,66728, 18 Excess or (deficit) for the year (Sutract line 17 from line 9) 18 (9,47397) 19 Net assets or fund alances at eginning of year (from line 27 column (A)) (must agree with endofyear figure reported on prior year's return) 19 23,62687 ' 2 Other changes in net assets or fund alances (explain in Schedule ) 2 Z J 21 Net assets or fund alances at end of year Comine lines 18 through ,1529 For Paperwork Reduction Act Notice, see the separate instructions Cat No Form 99EL (216) s

2 Page Form 99EZ (216) iiiii 2 Balance Sheets (see the instructions for Part II) Check if the organization used Schedule to respond to any question in thiê Part II (B) End of year (A) Beginning of year 22 Cash, savings, and investments ,319 Land and uildings Other assets (descrie in Schedule ) 24 assets 25, ,319 Total 25 liailities (descrie in Schedule ) 1, Total Net assets or fund alances (line 27 of column (B) must agree with line 21) 14, , FT1111 Statement of Program Service Accomplishments (see the instructions for Part Ill) Expenses Check if the organization used Schedule to respond to any question in this Part Ill D trequired for section What is the organization's primary exempt purpose? Environmental EducationWe Pulishing organizations; optional for oth er s) Descrie the organization's program service accomplishments for each of its three largest program services, as measured y expenses In a clear and concise manner, descrie the services provided, the numer of persons enefited, and other relevant information for each program title q 'im2y to the plants of Minnesota ti on,,guide va ri ous sta9es of development and pulish an online identifica 28 We ased otan i cal reference free to pu In (Grants $ 5,98,12) If this amount includes foreign grants, check here 28a 73, ) If this amount includes foreign grants, check here (Grants $ 29a D 3 D 3a (Grants $ ) If this amount includes foreign grants, check here 31 Other program services (descrie in Schedule ) 31a (Grants $ ) If this amount includes foreign grants, check here 32 Total program service expenses (add lines 28a through 31 a) 32 List of Officers, Directors, Trustees, and Key Employees (list each one even if not compensated see the instructions for Part lv) IT1IY1 (h k if th rirr1ni7tinn iisd Snhcd1JlA C) to rsnond to any nuestion in this Part IV El ' () Average I& Name and title hours per week devoted to position Catherine Ch ~ykzjj!qt~ ident: (C) Reportale (d) Health enefits, contriutions to employee (e) Estimated amount of other compensation enefit plans, and (Forms W21 99 MISC) compensation (if not paid, enter ) deferred compensation master, auth or, managing editor, field otanist, photographer 44 36,6895 coordinator,peter photographer, field otanist, pulishing assistant 4 19, Victoria Ranua, Treasurer A9hy!1LPe_ Form 99EZ (216)

3 Page Form 99EZ (216) 3 I1I1WI Other Information (Note the Schedule A and personal enefit contract statement requirements in the instructions for Part V) Check if the organization used Schedule to responto any question in this Part V IYesl No Did the organization engage in any significant activity not previously reported to the IRS? If "Yes," provide a detailed description of each activity in Schedule Were any significant changes made to the organizing or governing docunents? If "Yes," attach a conformed copy of the amended documents if they reflect a change to the organization's name Otherwise, explain the 34 change on Schedule (see instructions) Did the organization have unrelated usiness gross income of $1, or more during the year from usiness activities (such as those reported on lines 2, 6a, and 7a, among others)" 35 C 36 37a 38a 39 a 4a If "Yes," to line 35a, has the organization filed a Form 99T for the year? If "No," provide an explanation in Schedule 35 Was the organization a section 51(c)(4), 51(c)(5), or 51(c)(6) organization suject to section 633(e) notice, reporting, and proxy tax requirements during the year? If "Yes," complete Schedule C, Part Ill Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If "Yes," complete applicale parts of Schedule N I 37a J o Enter amount of political expenditures, direct & indirect, as descried in the instructions Did the organization file Form 1 12POL for this year? 37 Did the organization orrow from, or make any loans to, any officer, director, trustee, or key employee or were any such loans made in a prior year and stilt outstanding at the end of the tax year covered y this return? 381 If "Yes," complete Schedule L, Part II and enter the total amount involved Section 51(c)(7) organizations Enter: Initiation fees and capital contriutions included on line 9 39a 39 Gross receipts, included on line 9, for pulic use of clu facilities Section 51(c)(3) organizations Enter amount of tax imposed on the organization during the year under: section , section 4911 ; section 4955 Section 51(c)(3), 51(c)(4), and 51 (c)(29) organizations Did the organization engage in any section 4958 excess enefit transaction during the year, or did it engage in an excess enefit transaction in a prior year that has not een reported on any of its prior Forms 99 or 99EZ? If "Yes," complete Schedule L, Part I C Section 51 (c)(3), 51(c)(4), and 51 (c)(29) organizations Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and 4958 Section 51(c)(3), 51(c)(4), and 51(c)(29) organizations Enter amount of tax on line 4c reimursed y the organization d e 41 42a I 4 All organizations At any time during the tax year, was the organization a party to a prohiited tax shelter transaction? If "Yes," complete Form 8886T List the states with which a copy of this return is filed 1, Minnesota Catherine Chayk Telephone no The organization's ooks are in care of Long Lake Rd, New Brighton, MN ZIP + 4 ' Located at At any time during ihw calendar year, did the organization have an interest in or a signature or other authority over Yes No a financial account in a foreign country (such as a ank account, securities account, or other financial account)? 421 If "Yes," enter the name of the foreign country: See the instructions for exceptions and filing requirements for FInCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR) C 43 42c At any time during the calendar year, did the organization maintain an office outside the United States? If "Yes," enter the name of the foreign country: No Section 4947(a)(1) nonexempt charitale trusts filing Form 99EZ in lieu of Form 141 Check here 143 and enter the amount of taxexempt interest received or accrued during the tax year lyesl No Did the organization maintain any donor advised funds during the year? If "Yes," Form 99 must e completed instead of Form 99EZ Did the organization operate one or more hospital facilities during the year? If "Yes," Form 99 must e completed instead of Form 99E7 1 44a C d 45a mmm mmm "on Did the organization receive any payments for indoor tanning services during the year? If "Yes" to line 44c, has the organization filed a Form 72 to report these payments? If "No,' provide an explanation in Schedule Did the organization have a controlled entity within the meaning of section 512()(1 3)9 Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512()(13)? If "Yes," Form 99 and Schedule R may need to e completed instead of Form 99EZ (see instructions) IMMEAr I 45 I Form 99EZ 1 I (216)

4 Form 99EZ (216) Page 4 1 No 46 Did the organization engage, directly or indirectly, in political campaign activities on thaif of or in opposition to candidates for pulic office? If "Yes," complete Schedule C, Part I 46 ITI'AI Section 51(c)(3) organizations only All section 51 (c)(3) organizations must answer questions 4749 and 52, and complete the tales for lines 5O and 5l Check if the organization used Schedule to respond to any question in this Part VI Vest No 47 Did the organization engage in loying activities or have a section 51(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II Is the organization a school as descried in section 1 7()(1)(A)(ii)? If "Yes," complete Schedule E 48 49a Did the organization make any transfers to an exempt noncharitale related organization? 49a If "Yes," was the related organization a section 527 organization? 49 5 Complete this tale for the organization's five highest compensated employees (other than officers, directors, trustees, and key employees) who each received more than $1, of compensation from the organization If there is none, enter "None" (a) Name and title of each employee 1 () Average hours per week devoted to position (c) Reportale compensation (Forms W21 99MISC) Health enefits contriutions to employee enefit plans, and deferred compensation (e) Estimated amount of other compensation f Total numer of other employees paid over $1, 51 Complete this tale for the organization's five highest compensated independent contractors who each received more than $1, of compensation from the organization If there is none, enter "None" (a) Name and usiness address of each independent contractor () Type of service (c) Compensation d Total numer of other independent contractors each receiving over $1, 1 52 Did the organization complete Schedule A? Note: All section 51(c)(3) organizations must attach a completed Schedule A EZI Yes No Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the est of my knowledge and elief, It is true, correct, and complete Declaration of preparer (other than officer) is ased on all information of which preparer has any knowledge i Sign 9' Signature of officer Date Here Ch O,,k,l, Z I k 2V 17 9' Type or print name and title Paid Preparer Use Only PrintType preparer's name Preparer's signature Date Firm's name Firm's address Phone no May the IRS discuss this return with the preparer shown aove? See instructions if PuN Check I selfemployed Firm's EIN Yes No Form 99EZ (216)

5 SCHEDULE Supplemental Information to Form 99 or 99EZ OMB No (Form 99 or 99EZ) Complete to provide information for responses to specific questions on Form 99 or 99EZ or to provide any additional information L4' U16 Department of the Treasury Attach to Form 99 or 99EZ S Internal Revenue Service 11 Information aout Schedule (Form 99 or 99EZ) and its instructions is at wwwirsgov1form99,, e M Name of the organization Employer identification numer Minnesota Wildflowers Information 1, Line 8, Other revenue: promotion of native plant vendors income $27, commercial photo usage riahts $5 A ' _ppt~q~~113167, camer equipment $4135, ooks & suscriptions $17628, ank and merchant account fees $33119, travel $95244, conferences & conventions $28, outside computer services $3447 advertisinq $878, organization fee $25 Part 11, Line 26, Total liailities: pavroll withholdinq taxes $87819 For Paperwork Reduction Act Notice, see the Instructions for Form 99 or 99 EZ Cat No 5156K Schedule (Form 99 or 99EZ) (216)

6 OMB No Pulic Charity Status and Pulic Support SCHEDULE A (Form 99 or 99EZ) Department of the Treasury Internal Revenue Service I6 Complete if the organization is a section 51(c)(3) organization or a section 4947(a)(1) nonexempt charitale trust Attach to Form 99Oor Form 99OEZ ', Information aout Schedule A (Form 99 or 99EZ) and its instructions is at wwwirsgovlform99 i Employer identification numer Name of the organization Minnesota Wildflowers Information I1II Reason for Pulic Charity Status (All organizations must complete this part) See instructions The organization is not a private foundation ecause it is: (For lines 1 through 12, check only one ox) A church, convention of churches, or association of churches descried in section 17()(1)(A)(i) 1 A school descried in section 17()(1)(A)(ii) (Attach Schedule E (Form 99 or 99EZ)) A hospital or a cooperative hospital service organization descried in section 17()(1)(A)(iii) A medical research organization operated in conjunction with a hospital descried in section 17()(1)(A)(iii) Enter the hospital's name, city, and state: 5 I An organization operated for the enefit of a college or university owned or operated y a governmental unit descried in section 17()(1)(A)(iv) (Complete Part II) 6 7 II A federal, state, or local government or governmental unit descried in 8 A community trust descried in section 17()(1)(A)(vi) (Complete Part IL) An agricultural research organization descried in section 17()(1)(A)(ix) operated in conjunction with a landgrant college section 17()(1)(A)(v) I An organization that normally receives a sustantial part of its support from a governmental unit or from the general pulic descried in section 17()(1)(A)(vi) (Complete Part II) 9 or university or a nonlandgrant college of agriculture (see instructions) Enter the name, city, and state of the college or university: a 3313% of its support from contriutions, memership fees, an d gross An organization that normally receives: (1) more thhan receipts from activities related to its exempt functions suject to certain exceptions, and (2) no more than 3313% of its support from gross investment income and unrelated usiness taxale income (less section 511 tax) from usinesses See section 59(a)(2) (Complete Part Ill) acquired y the organization after June 3, 1975 An organization organized and operated exclusively to test for pulic safety See section 59(a)(4) 1 11 I I An organization organized and operated exclusively for the enefit of, to perform the functions of, or to carry out the purposes 12 of one or more pulicly supported organizations descried in section 59(a)(1) or section 59(a)(2) See section 59(a)(3) Check the ox in lines 12a through 12d that descries the type of supporting organization and complete lines 12e, 12f, and 12g a I Type I A supporting organization operated, supervised, or controlled y its supported organization(s), typically y giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization You must complete Part IV, Sections A and B Type II A supporting organization supervised or controlled in connection with its supported organization(s), y having control or management of the supporting organization vested in the same persons that control or manage the supported organization (s) You must complete Part IV, Sections A and C c I Type Ill functionally integrated A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions) You must complete Part IV, Sections A, D, and E d I Type Ill nonfunctionally integrated A supporting organization operated in connection with its supported organization(s) that is not functionally integrated The organization generally must satisfy a distriution requirement and an attentiveness requirement (see instructions) You must complete Part IV, Sections A and D, and Part V e Check this ox if the organization received a written determination from the IRS that it is a Type I, Type II, Type Ill functionally integrated, or Type Ill nonfunctionally integrated supporting organization Enter the numer of supported organizations f g Provide the following information aout the supported organization(s) (I) Name of supported organization (ii) EIN (iii) Type of organization (descried on lines 11 aove (see instructions)) (iv) Is the organization (v) Amount of monetary listed in your governing support (see document? instructions) Yes (vi) Amount of other support (see instructions) No (A) (B) (C) (D) (E) Total For Paperwork Reduction Act Notice, see the Instructions for Form 99 or 99EZ Cat No 11285F Schedule A (Form 99 or 99EZ) 216

7 Page Schedule A (Form 99 or 99EZ) fl11l1 Support Schedule for Organizations Descried in Section 59(a)(2) (Complete only if you checked the ox on line 1 of Part I or if the organization failed to qualify under Part II If the organization fails to qualify under the tests listed elow, please complete Part II) Section A Pulic Sunoort (a) 212 Calendar year (or fiscal year eginning in) Gifts, grants, contriutions, and memership fees received (Do not include any "unusual grants") Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's taxexempt purpose Gross receipts from activities that are not an unrelated trade or usiness under section 513 I for the Tax revenues levied organization's enefit and either paid to or expended on its ehalf 5 The value of services or facilities furnished y a governmental unit to the organization without charge 6 Total Add lines 1 through 5 7a Amounts included on lines 1, 2, and 3 received from disqualified persons Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5, or 1% of the amount on line 13 for the year c Add lines 7a and 7 Pulic support (Sutract line 7c from line 6) () 213 (c) 214 (d) 215 (f) Total (e) 216 3,382 8, , ,951 6, , ,1875 3,46 3,5968 4,274 3,3 3,1 17,648 7,542 12, , , , , ,8279 Section B Total Support Calendar year (or fiscal year eginning in) No 9 loa Amounts from line 6 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources (a) 212 () 213 (c)214 (e) 216 (d) 215 (f)total 7,542 12, , , , , , , , , , ,5778 Unrelated usiness taxale income (less section 511 taxes) from usinesses acquired after June 3, c Add lines laand 1 O Net income from unrelated usiness activities not included in line lo, whether or not the usiness is regularly carried on 12 Other income Do not include gain or loss from the sale of capital assets (Explain in Part VI) 13 Total support (Add lines 9, loc, 11, and 12) First five years If the Form 99 is for the organization's first, second, third, fourth, or fifth tax year as a section 51(c)(3) ' organization, check this ox and stop here 14 Section C Computation of Pulic Support Percentage Pulic support percentage for 216 (line 8, column (f) divided y line 13, column (f)) Pulic support percentage from 215 Schedule A, Part Ill, line % % Section D Computation of Investment Income Percentage 17 Investment income percentage for 216 (line 1 Oc, column (f) divided y line 13, column (f)) % Investment income percentage from 215 Schedule A, Part Ill, line % 18 19a 3313% support tests216 If the organization did not check the ox on line 14, and line 15 is more than 33113%, and line 17 is not more than 3313%, check this ox and stop here The organization qualifies as a pulicly supported organization % support tests215 If the organization did not check a ox on line 14 or line 19a, and line 16 is more than 3313%, and line 18 is not more than 3313%, check this ox and stop here The organization qualifies as a pulicly supported organization Private foundation If the organization did not check a ox on line 14, 19a, or 19, check this ox and see instructions Schedule A (Form 99 or 99EZ) 216

8 Schedule B (Form 99, 99EZ, or 99PF) Department of the Treasury Internal Revenue Service Name of the organization Schedule of Contriutors Attach to Form 99, Form 99El, or Form 99PF Information aout Schedule B (Form 99, 99EZ, or 99PF) and its instructions is at wwirsgovform99 OMB No Employer identification numer Minnesota Wildflowers Information Organization type (check one): Filers of: Section: Form 99 or 99EZ 21 51(c)( 3 ) (enter numer) organization 4947(a)(1) nonexempt charitale trust not treated as a private foundation 527 political organization Form 99PF I 51(c)(3) exempt' rivate foundation 4947(a)(1) nonexempt charitale trust treated as a private foundation I 51 (c)(3) taxale private foundation Check if your organization is covered y the General Rule or a Special Rule Note: Only a section 51(c)(7), (8), or (1) organization can check oxes for oth the General Rule and a Special Rule See instructions General Rule For an organization filing Form 99, 99EZ, or 99PF that received, during the year, contriutions totaling $5, or more (in money or property) from any one contriutor Complete Parts I and H See instructions for determining a contriutor's total contriutions Special Rules For an organization descried in section 51(c)(3) filing Form 99 or 99EZ that met the 3313 % support test of the regulations under sections 59(a)(1) and 17()(1)(A)(vi), that checked Schedule A (Form 99 or 99EZ), Part II, line 13, 16a, or 16, and that received from any one contriutor, during the year, total contriutions of the greater of (1) $5, or (2) 2% of the amount on (I) Form 99, Part VIII, line 1 h, or (ii) Form 99EZ, line 1 Complete Parts I and II For an organization descried in section 51 (c)(7), (8), or (1) filing Form 99 or 99EZ that received from any one contriutor, during the year, total contriutions of more than $1, exclusively for religious, charitale, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals Complete Parts I, II, and Ill For an organization descried in section 51 (c)(7), (8), or (1) filing Form 99 or 99EZ that received from any one contriutor, during the year, contriutions exclusively for religious, charitale, etc, purposes, ut no such contriutions totaled more than $1, If this ox is checked, enter here the total contriutions that were received during the year for an exclusively religious, charitale, etc, purpose Don't complete any of the parts unless the General Rule applies to this organization ecause it received nonexclusively religious, charitale, etc, contriutions totaling $5, or more during the year $ Caution: An organization that isn't covered y the General Rule andor the Special Rules doesn't file Schedule B (Form 99, 99EZ, or 99PF), ut it must answer "No" on Part IV, line 2, of its Form 99; or check the ox on line H of its Form 99EZ or on its Form 99PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 99, 99EZ, or 99PF) For Paperwork Reduction Act Notice, see the Instructions for Form 99, 99EZ, or 99PF cat No 3613X Schedule B (Form 99, 99EZ, or 99PF) (216)

9 Schedule B (Form 99, 99EZ, or 99PF) (216) Page 2 Name of organization Employer identification numer Minnesota Wildflowers Information Contriutors (See instructions) Use duplicate copies of Part I if additional space is needed (a) () (c) (d) No Name, address, and ZIP +4 Total contriutions Type of contriution 1 State of Minnesota Person Payroll 658 cedar Street Suite 4 $ 5,9812 Noncash St Paul, Minnesota noncash contriutions) (a) () (c) (d) No Name, address, and ZIP +4 Total contriutions Type of contriution Person Payroll $ Noncash noncash contriutions) (a) () (c) (d) No Name, address, and ZIP +4 Total contriutions Type of contriution Person Payroll $ Noncash noncash contriutions) (a) () () (d) No Name, address, and ZIP +4 Total contriutions Type of contriution Person Payroll $ Noncash noncash contriutions) (a) () (c) (d) No Name, address, and ZIP +4 Total contriutions Type of contriution Person Payroll $ Noncash noncash contriutions) (a) () (c) (d) No Name, address, and ZIP +4 Total contriutions Type of contriution Person Payroll $ Noncash noncash contriutions) Schedule B (Form 99, 99EZ, or 99PF) (216)