Short Form Return of Organization Exempt From Income Tax

Transcription

1 Form 990-EZ Short Form Return of Organization Exempt From Inome Tax Under setion 501(), 57, or 4947(a)(1) of the Internal Revenue Code (exept private foundations) OMB No Department of the Treasury Internal Revenue Servie Open to Puli Inspetion A For the 013 alendar year, or tax year eginning and ending B Chek if appliale: C Name of organization D Employer identifiation numer Address hange FOUNDATION OF THE ARC Name hange OF THE UNITED STATES Initial return Numer and street (or P.O. ox, if mail is not delivered to street address) Room/suite E Telephone numer Terminated 185 K STREET, NW Amended return City or town, state or provine, ountry, and ZIP or foreign postal ode F Group Exemption WASHINGTON, DC 0006 Appliation pending Numer G Aounting Method: Cash Arual Other (speify) H Chek if the organization is not I Wesite: required to attah Shedule B J Tax-exempt status (hek only one) 501()(3) 501() ( ) (insert no.) 4947(a)(1) or 57 (Form 990, 990-EZ, or 990-PF). K Form of organization: Corporation Trust Assoiation Other L Add lines 5, 6, and 7, to line 9 to determine gross reeipts. If gross reeipts are $00,000 or more, or if total assets (Part II, olumn (B) elow) are $500,000 or more, file Form 990 instead of Form 990-EZ $ 4,38. Part I Revenue, Expenses, and Changes in Net Assets or Fund Balanes (see the instrutions for Part I) Chek if the organization used Shedule O to respond to any question in this Part I 1 Contriutions, gifts, grants, and similar amounts reeived ~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 Revenue Expenses Net Assets a d Memership dues and assessments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3 Investment inome SEE SCHEDULE O 4 4,38. Other revenue (desrie in Shedule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 8 Total revenue. Add lines 1,, 3, 4, 5, 6d, 7, and 8 9 4,38. Grants and similar amounts paid (list in Shedule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ SEE SCHEDULE O 10 13, Printing, puliations, postage, and shipping ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 16 Other expenses (desrie in Shedule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 17 Total expenses. Add lines 10 through Do not enter Soial Seurity numers on this form as it may e made puli. Information aout Form 990-EZ and its instrutions is at Program servie revenue inluding government fees and ontrats 5a Gross amount from sale of assets other than inventory~~~~~~~~~~~~~ Less: ost or other asis and sales expenses ~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~ Gain or (loss) from sale of assets other than inventory (Sutrat line 5 from line 5a) ~~~~~~~~~~~~~~~ Gaming and fundraising events Gross inome from gaming (attah Shedule G if greater than $15,000) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Gross inome from fundraising events (not inluding $ from fundraising events reported on line 1) (attah Shedule G if the sum of suh gross inome and ontriutions exeeds $15,000) Less: diret expenses from gaming and fundraising events ~~~~~~~~~~~~~~ ~~~~~~~~~~ 19 Net assets or fund alanes at eginning of year (from line 7, olumn (A)) (must agree with end-of-year figure reported on prior year's return) ~~~~~~~~~~~~~~~~~~~~~~~ , Other hanges in net assets or fund alanes (explain in Shedule O) ~~~~~~~~~~~~~~~~~~~~~~ SEE SCHEDULE O 0 65, Net assets or fund alanes at end of year. Comine lines 18 through ,158. LHA For Paperwork Redution At Notie, see the separate instrutions. Form 990-EZ (013) 5a 5 6a of ontriutions Net inome or (loss) from gaming and fundraising events (add lines 6a and 6 and sutrat line 6) ~~~~~~~~~ 7a Gross sales of inventory, less returns and allowanes ~~~~~~~~~~~~~ Less: ost of goods sold ~~~~~~~~~~~~~~~~~~~~~~~~~~ Gross profit or (loss) from sales of inventory (Sutrat line 7 from line 7a) 6 6 7a 7 ~~~~~~~~~~~~~~~~~~~ Benefits paid to or for memers~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Salaries, other ompensation, and employee enefits ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Professional fees and other payments to independent ontrators ~~~~~~~~~~~~~~~~~~~~~~~~ Oupany, rent, utilities, and maintenane ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Exess or (defiit) for the year (Sutrat line 17 from line 9) ~~~~~~~~~~~~~~~~~~~~~~~~~~ 5 6d , ,983. 5, FOUNDATION OF THE ARC OF TH

2 FOUNDATION OF THE ARC Form 990-EZ (013) OF THE UNITED STATES Page Part II Balane Sheets (see the instrutions for Part II) Chek if the organization used Shedule O to respond to any question in this Part II (A) Beginning of year (B) End of year Cash, savings, and investments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 366, ,09. 3 Land and uildings ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4 Other assets (desrie in Shedule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~ 4 5 Total assets ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 366, ,09. 6 Total liailities (desrie in Shedule O) ~~~~~~~~~~~~~~~~~~~~~~~~ SEE SCHEDULE O 9, , Net assets or fund alanes (line 7 of olumn (B) must agree with line 1) 336, ,158. Part III Statement of Program Servie Aomplishments (see the instrutions for Part III) Expenses (Required for setion Chek if the organization used Shedule O to respond to any question in this Part III 501()(3) and 501()(4) What is the organization's primary exempt purpose? SEE SCHEDULE O organizations and setion Desrie the organization's program servie aomplishments for eah of its three largest program servies, as measured y expenses. In a lear and onise 4947(a)(1) trusts; optional manner, desrie the servies provided, the numer of persons enefited, and other relevant information for eah program title. for others.) 8 SUPPORTED THE CHARITABLE PURPOSES OF THE ARC OF THE UNITED STATES, INC. 3 9 (Grants $ 13,983. ) If this amount inludes foreign grants, hek here 8a 13, (Grants $ ) If this amount inludes foreign grants, hek here 9a (Grants $ ) If this amount inludes foreign grants, hek here 30a 31 Other program servies (desrie in Shedule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ (Grants $ ) If this amount inludes foreign grants, hek here 31a 3 Total program servie expenses (add lines 8a through 31a) 3 13,983. Part IV List of Offiers, Diretors, Trustees, and Key Employees (list eah one even if not ompensated - see the instrutions for Part IV) Chek if the organization used Shedule O to respond to any question in this Part IV (a) Name and title () Average hours () Reportale (d) Health enefits, (e) Estimated ompensation (Forms ontriutions to per week devoted to W-/1099-MISC) employee enefit amount of other position (if not paid, enter -0-) plans, and deferred ompensation ompensation PETER BERNS (SEE SCHEDULE O) CHIEF EECUTIVE OFFICER NANCY WEBSTER PRESIDENT RONALD BROWN VICE PRESIDENT MOHAN MEHRA IMMEDIATE PAST PRESIDENT ELISE MCMILLAN SECRETARY M.J. BARTELMAY TREASURER Form 990-EZ (013) FOUNDATION OF THE ARC OF TH

3 FOUNDATION OF THE ARC Form 990-EZ (013) OF THE UNITED STATES Page 3 Part V Other Information (Note the Shedule A and personal enefit ontrat statement requirements in the instrutions for Part V) Chek if the organization used Sh. O to respond to any question in this Part V Yes No 33 Did the organization engage in any signifiant ativity not previously reported to the IRS? If "Yes," provide a detailed desription of eah ativity in Shedule O ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ a 38a Did the organization file Form 110-POL for this year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 37 a d e 4a 43 Were any signifiant hanges made to the organizing or governing douments? If "Yes," attah a onformed opy of the amended douments if they reflet a hange to the organization's name. Otherwise, explain the hange on Shedule O (see instrutions) ~~~~~~ 35a Did the organization have unrelated usiness gross inome of $1,000 or more during the year from usiness ativities (suh as those reported on lines, 6a, and 7a, among others)? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes" to line 35a, has the organization filed a Form 990-T for the year? If "No," provide an explanation in Shedule O ~~~~~~~~~~~ Was the organization a setion 501()(4), 501()(5), or 501()(6) organization sujet to setion 6033(e) notie, reporting, and proxy tax requirements during the year? If "Yes," omplete Shedule C, Part III ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization undergo a liquidation, dissolution, termination, or signifiant disposition of net assets during the year? If "Yes," omplete appliale parts of Shedule N Enter amount of politial expenditures, diret or indiret, as desried in the instrutions ~~~~~ 37a 0. Did the organization orrow from, or make any loans to, any offier, diretor, trustee, or key employee or were any suh loans made in a prior year and still outstanding at the end of the tax year overed y this return? If "Yes," omplete Shedule L, Part II and enter the total amount involved ~~~~~~~~~~~~~~ 38 N/A Setion 501()(7) organizations. Enter: Initiation fees and apital ontriutions inluded on line 9 ~~~~~~~~~~~~~~~~~~~~~ Gross reeipts, inluded on line 9, for puli use of lu failities ~~~~~~~~~~~~~~~~~~ 40a Setion 501()(3) organizations. Enter amount of tax imposed on the organization during the year under: setion ; setion ; setion Setion 501()(3) and 501()(4) organizations. Did the organization engage in any setion 4958 exess enefit transation during the year, or did it engage in an exess enefit transation in a prior year that has not een reported on any of its prior Forms 990 or 990-EZ? If "Yes," omplete Shedule L, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Setion 501()(3) and 501()(4) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under setions 491, 4955, and 4958 ~~~~~~~~~~~~~~~ Setion 501()(3) and 501()(4) organizations. Enter amount of tax on line 40 reimursed y the organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ All organizations. At any time during the tax year, was the organization a party to a prohiited tax shelter transation? If "Yes," omplete Form 8886-T ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 40e List the states with whih a opy of this return is filed NONE The organization's ooks are in are of PETER BERNS Telephone no Loated at 185 K STREET, NW, WASHINGTON, DC ZIP At any time during the alendar year, did the organization have an interest in or a signature or other authority over a finanial aount in a foreign ountry (suh as a ank aount, seurities aount, or other finanial aount)? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes," enter the name of the foreign ountry: See the instrutions for exeptions and filing requirements for Form TD F 90-.1, Report of Foreign Bank and Finanial Aounts. At any time during the alendar year, did the organization maintain an offie outside of the U.S.? ~~~~~~~~~~~~~~~~~~~~ If "Yes," enter the name of the foreign ountry: Setion 4947(a)(1) nonexempt haritale trusts filing Form 990-EZ in lieu of Form Chek here and enter the amount of tax-exempt interest reeived or arued during the tax year ~~~~~~~~~~~~~~~~~ 43 N/A 39a 39 N/A N/A a a N/A Yes No 44a d Did the organization maintain any donor advised funds during the year? If "Yes," Form 990 must e ompleted instead of Form 990-EZ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization operate one or more hospital failities during the year? If "Yes," Form 990 must e ompleted instead of Form 990-EZ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization reeive any payments for indoor tanning servies during the year? ~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes" to line 44, has the organization filed a Form 70 to report these payments? If "No," provide an explanation in Shedule O ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 45a Did the organization have a ontrolled entity within the meaning of setion 51()(13)? ~~~~~~~~~~~~~~~~~~~~~~~~ 45 Did the organization reeive any payment from or engage in any transation with a ontrolled entity within the meaning of setion 51()(13)? If "Yes," Form 990 and Shedule R may need to e ompleted instead of Form 990-EZ (see instrutions) 44a d 45a 45 Yes No Form 990-EZ (013) FOUNDATION OF THE ARC OF TH

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5 OMB No SCHEDULE A (Form 990 or 990-EZ) Puli Charity Status and Puli Support Complete if the organization is a setion 501()(3) organization or a setion (a)(1) nonexempt haritale trust. Department of the Treasury Attah to Form 990 or Form 990-EZ. Open to Puli Internal Revenue Servie Information aout Shedule A (Form 990 or 990-EZ) and its instrutions is at Inspetion Name of the organization FOUNDATION OF THE ARC Employer identifiation numer OF THE UNITED STATES Part I Reason for Puli Charity Status (All organizations must omplete this part.) See instrutions. The organization is not a private foundation eause it is: (For lines 1 through 11, hek only one ox.) 1 A hurh, onvention of hurhes, or assoiation of hurhes desried in setion 170()(1)(A)(i). A shool desried in setion 170()(1)(A)(ii). (Attah Shedule E.) 3 A hospital or a ooperative hospital servie organization desried in setion 170()(1)(A)(iii). 4 A medial researh organization operated in onjuntion with a hospital desried in setion 170()(1)(A)(iii). Enter the hospital's name, e f g h ity, and state: An organization operated for the enefit of a ollege or university owned or operated y a governmental unit desried in setion 170()(1)(A)(iv). (Complete Part II.) A federal, state, or loal government or governmental unit desried in setion 170()(1)(A)(v). An organization that normally reeives a sustantial part of its support from a governmental unit or from the general puli desried in setion 170()(1)(A)(vi). (Complete Part II.) A ommunity trust desried in setion 170()(1)(A)(vi). (Complete Part II.) An organization that normally reeives: (1) more than 33 1/3 of its support from ontriutions, memership fees, and gross reeipts from ativities related to its exempt funtions - sujet to ertain exeptions, and () no more than 33 1/3 of its support from gross investment inome and unrelated usiness taxale inome (less setion 511 tax) from usinesses aquired y the organization after June 30, See setion 509(a)(). (Complete Part III.) An organization organized and operated exlusively to test for puli safety. See setion 509(a)(4). An organization organized and operated exlusively for the enefit of, to perform the funtions of, or to arry out the purposes of one or more pulily supported organizations desried in setion 509(a)(1) or setion 509(a)(). See setion 509(a)(3). Chek the ox that desries the type of supporting organization and omplete lines 11e through 11h. a Type I Type II Type III - Funtionally integrated d Type III - Non-funtionally integrated By heking this ox, I ertify that the organization is not ontrolled diretly or indiretly y one or more disqualified persons other than foundation managers and other than one or more pulily supported organizations desried in setion 509(a)(1) or setion 509(a)(). If the organization reeived a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, hek this ox ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Sine August 17, 006, has the organization aepted any gift or ontriution from any of the following persons? (i) (ii) (iii) A person who diretly or indiretly ontrols, either alone or together with persons desried in (ii) and (iii) elow, the governing ody of the supported organization? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ A family memer of a person desried in (i) aove? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ A 35 ontrolled entity of a person desried in (i) or (ii) aove? ~~~~~~~~~~~~~~~~~~~~~~~~ Provide the following information aout the supported organization(s). 11g(i) 11g(ii) 11g(iii) Yes No (i) Name of supported (ii) EIN (iii) Type of organization (iv) Is the organization (v) Did you notify the (vi) Is the (vii) (desried on lines 1-9 in ol. (i) listed in your organization in ol. organization in ol. Amount of monetary organization (i) organized in the support aove or IRC setion governing doument? (i) of your support? U.S.? (see instrutions) ) Yes No Yes No Yes No THE ARC OF THE U.S (A)(1) 13,983. Total LHA For Paperwork Redution At Notie, see the Instrutions for Form 990 or 990-EZ ,983. Shedule A (Form 990 or 990-EZ) FOUNDATION OF THE ARC OF TH

6 Shedule A (Form 990 or 990-EZ) 013 Page Part II Support Shedule for Organizations Desried in Setions 170()(1)(A)(iv) and 170()(1)(A)(vi) (Complete only if you heked the ox on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed elow, please omplete Part III.) Setion A. Puli Support Calendar year (or fisal year eginning in) Total. Add lines 1 through 3 ~~~ 6 Puli support. Sutrat line 5 from line 4. Calendar year (or fisal year eginning in) assets (Explain in Part IV.) ~~~~ Total support. Add lines 7 through 10 (a) 009 () 010 () 011 (d) 01 (e) 013 (f) Total (a) 009 () 010 () 011 (d) 01 (e) 013 (f) Total 13 First five years. If the Form 990 is for the organization's first, seond, third, fourth, or fifth tax year as a setion 501()(3) organization, hek this ox and stop here Setion C. Computation of Puli Support Perentage a 33 1/3 support test If the organization did not hek the ox on line 13, and line 14 is 33 1/3 or more, hek this ox and stop here. The organization qualifies as a pulily supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 17a 10 -fats-and-irumstanes test If the organization did not hek a ox on line 13, 16a, or 16, and line 14 is 10 or more, 18 Gifts, grants, ontriutions, and memership fees reeived. (Do not inlude any "unusual grants.") ~~ Tax revenues levied for the organization's enefit and either paid to or expended on its ehalf ~~~~ The value of servies or failities furnished y a governmental unit to the organization without harge ~ The portion of total ontriutions y eah person (other than a governmental unit or pulily supported organization) inluded on line 1 that exeeds of the amount shown on line 11, olumn (f) ~~~~~~~~~~~~ Setion B. Total Support Amounts from line 4 ~~~~~~~ Gross inome from interest, dividends, payments reeived on seurities loans, rents, royalties and inome from similar soures ~ Net inome from unrelated usiness ativities, whether or not the usiness is regularly arried on ~ Other inome. Do not inlude gain or loss from the sale of apital Gross reeipts from related ativities, et. (see instrutions) ~~~~~~~~~~~~~~~~~~~~~~~ Puli support perentage for 013 (line 6, olumn (f) divided y line 11, olumn (f)) ~~~~~~~~~~~~ Puli support perentage from 01 Shedule A, Part II, line 14 ~~~~~~~~~~~~~~~~~~~~~ 33 1/3 support test If the organization did not hek a ox on line 13 or 16a, and line 15 is 33 1/3 or more, hek this ox and stop here. The organization qualifies as a pulily supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ and if the organization meets the "fats-and-irumstanes" test, hek this ox and stop here. Explain in Part IV how the organization meets the "fats-and-irumstanes" test. The organization qualifies as a pulily supported organization ~~~~~~~~~~~~~~~ 10 -fats-and-irumstanes test If the organization did not hek a ox on line 13, 16a, 16, or 17a, and line 15 is 10 or more, and if the organization meets the "fats-and-irumstanes" test, hek this ox and stop here. Explain in Part IV how the organization meets the "fats-and-irumstanes" test. The organization qualifies as a pulily supported organization ~~~~~~~~ Private foundation. If the organization did not hek a ox on line 13, 16a, 16, 17a, or 17, hek this ox and see instrutions Shedule A (Form 990 or 990-EZ) FOUNDATION OF THE ARC OF TH

7 Shedule A (Form 990 or 990-EZ) 013 Part III Support Shedule for Organizations Desried in Setion 509(a)() Calendar year (or fisal year eginning in) The value of servies or failities furnished y a governmental unit to the organization without harge ~ Total. Add lines 1 through 5 ~~~ 7a Amounts inluded on lines 1,, and 3 reeived from disqualified persons Amounts inluded on lines and 3 reeived from other than disqualified persons that exeed the greater of $5,000 or 1 of the amount on line 13 for the year ~~~~~~ Add lines 7a and 7 ~~~~~~~ 8 Puli support (Sutrat line 7 from line 6.) Calendar year (or fisal year eginning in) 9 Amounts from line 6 ~~~~~~~ 10a Gross inome from interest, dividends, payments reeived on seurities loans, rents, royalties and inome from similar soures ~ Unrelated usiness taxale inome (less setion 511 taxes) from usinesses aquired after June 30, 1975 ~~~~ (a) 009 () 010 () 011 (d) 01 (e) 013 (f) Total (a) 009 () 010 () 011 (d) 01 (e) 013 (f) Total Page 3 14 First five years. If the Form 990 is for the organization's first, seond, third, fourth, or fifth tax year as a setion 501()(3) organization, hek this ox and stop here Setion C. Computation of Puli Support Perentage 15 Puli support perentage for 013 (line 8, olumn (f) divided y line 13, olumn (f)) ~~~~~~~~~~~~ Puli support perentage from 01 Shedule A, Part III, line 15 Setion D. Computation of Investment Inome Perentage (Complete only if you heked the ox on line 9 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 omplete Part II.) Setion A. Puli Support Gifts, grants, ontriutions, and memership fees reeived. (Do not inlude any "unusual grants.") ~~ Gross reeipts from admissions, merhandise sold or servies performed, or failities furnished in any ativity that is related to the organization's tax-exempt purpose Gross reeipts from ativities that are not an unrelated trade or usiness under setion 513 ~~~~~ Tax revenues levied for the organization's enefit and either paid to or expended on its ehalf ~~~~ Setion B. Total Support Add lines 10a and 10 ~~~~~~ Net inome from unrelated usiness ativities not inluded in line 10, whether or not the usiness is regularly arried on ~~~~~~~ Other inome. Do not inlude gain or loss from the sale of apital assets (Explain in Part IV.) ~~~~ Total support. (Add lines 9, 10, 11, and 1.) Investment inome perentage for 013 (line 10, olumn (f) divided y line 13, olumn (f)) Investment inome perentage from 01 Shedule A, Part III, line 17 ~~~~~~~~~~~~~~~~~~ 16 ~~~~~~~~ 17 19a 33 1/3 support tests If the organization did not hek the ox on line 14, and line 15 is more than 33 1/3, and line 17 is not more than 33 1/3, hek this ox and stop here. The organization qualifies as a pulily supported organization ~~~~~~~~~~ 33 1/3 support tests If the organization did not hek a ox on line 14 or line 19a, and line 16 is more than 33 1/3, and line 18 is not more than 33 1/3, hek this ox and stop here. The organization qualifies as a pulily supported organization~~~~ 0 Private foundation. If the organization did not hek a ox on line 14, 19a, or 19, hek this ox and see instrutions Shedule A (Form 990 or 990-EZ) FOUNDATION OF THE ARC OF TH

8 FOUNDATION OF THE ARC Shedule A (Form 990 or 990-EZ) 013 OF THE UNITED STATES Page 4 Part IV Supplemental Information. Provide the explanations required y Part II, line 10; Part II, line 17a or 17; and Part III, line 1. Also omplete this part for any additional information. (See instrutions) Shedule A (Form 990 or 990-EZ) FOUNDATION OF THE ARC OF TH

9 SCHEDULE O (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Servie Name of the organization Supplemental Information to Form 990 or 990-EZ 013 OMB No Complete to provide information for responses to speifi questions on Form 990 or 990-EZ or to provide any additional information. Attah to Form 990 or 990-EZ. Open to Puli Information aout Shedule O (Form 990 or 990-EZ) and its instrutions is at Inspetion FOUNDATION OF THE ARC Employer identifiation numer OF THE UNITED STATES FORM 990-EZ, PART I, LINE 4, OTHER INVESTMENT INCOME: DESCRIPTION OF PROPERTY: AMOUNT: INTEREST INCOME 4,38. FORM 990-EZ, PART I, LINE 10, GRANTS AND ALLOCATIONS: ACTIVITY CLASSIFICATION: GRANT GRANTEE NAME: THE ARC OF THE US GRANTEE ADDRESS: 185 K STREET, NW, SUITE 100 WASHINGTON, DC 0006 GRANTEE RELATIONSHIP: RELATED ORGANIZATION AMOUNT GIVEN: 13,983. FORM 990-EZ, PART I, LINE 0, CHANGES IN NET ASSETS: CHANGES IN NET ASSETS OR FUND BALANCES: AMOUNT: UNREALIZED GAIN 65,160. FORM 990-EZ, PART II, LINE 6, OTHER LIABILITIES: DESCRIPTION BEG. OF YEAR END OF YEAR DUE TO THE ARC OF THE UNITED STATES 9, ,871. FORM 990-EZ, PART III, PRIMARY EEMPT PURPOSE - TO PROMOTE, SUPPORT AND FURTHER THE INTERESTS AND PURPOSES OF THE ARC OF THE UNITED STATES, INC. FORM 990-EZ, PART IV: PETER BERNS, CEO, IS COMPENSATED BY A RELATED ORGANIZATION, THE ARC OF THE UNITED STATES. LHA For Paperwork Redution At Notie, see the Instrutions for Form 990 or 990-EZ. Shedule O (Form 990 or 990-EZ) (013) FOUNDATION OF THE ARC OF TH

10 Form (Rev. January 014) Department of the Treasury Internal Revenue Servie File y the due date for filing your return. See instrutions. File a separate appliation for eah return. Information aout Form 8868 and its instrutions is at If you are filing for an Automati 3-Month Extension, omplete only Part I and hek this ox ~~~~~~~~~~~~~~~~~~~ If you are filing for an Additional (Not Automati) 3-Month Extension, omplete only Part II (on page of this form). Do not omplete Part II unless you have already een granted an automati 3-month extension on a previously filed Form Eletroni filing (e-file). You an eletronially file Form 8868 if you need a 3-month automati extension of time to file (6 months for a orporation required to file Form 990-T), or an additional (not automati) 3-month extension of time. You an eletronially file Form 8868 to request an extension Personal Benefit Contrats, whih must e sent to the IRS in paper format (see instrutions). For more details on the eletroni filing of this form, visit and lik on e-file for Charities & Nonprofits. Part I Automati 3-Month Extension of Time. Only sumit original (no opies needed). A orporation required to file Form 990-T and requesting an automati 6-month extension - hek this ox and omplete Part I only ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ All other orporations (inluding 110-C filers), partnerships, REMICs, and trusts must use Form 7004 to request an extension of time to file inome tax returns. Enter filer's identifying numer Type or print 8868 Appliation for Extension of Time To File an Exempt Organization Return OMB No of time to file any of the forms listed in Part I or Part II with the exeption of Form 8870, Information Return for Transfers Assoiated With Certain Name of exempt organization or other filer, see instrutions. Employer identifiation numer (EIN) or FOUNDATION OF THE ARC OF THE UNITED STATES Numer, street, and room or suite no. If a P.O. ox, see instrutions. 185 K STREET, NW, NO. 100 City, town or post offie, state, and ZIP ode. For a foreign address, see instrutions. WASHINGTON, DC 0006 Soial seurity numer (SSN) Enter the Return ode for the return that this appliation is for (file a separate appliation for eah return) ~~~~~~~~~~~~~~~~~ 0 1 Appliation Is For Form 990 or Form 990-EZ Form 990-BL Form 470 (individual) Form 990-PF Form 990-T (se. 401(a) or 408(a) trust) 1 3a Return Code Appliation LHA For Privay At and Paperwork Redution At Notie, see instrutions. Form 8868 (Rev ) Is For Balane due. Sutrat line 3 from line 3a. Inlude your payment with this form, if required, Caution. If you are going to make an eletroni funds withdrawal (diret deit) with this Form 8868, see Form 8453-EO and Form 8879-EO for payment instrutions. 3a 3 3 $ $ $ Return Code Form 990-T (orporation) 07 Form 1041-A Form 470 (other than individual) Form 57 Form 6069 Form 990-T (trust other than aove) 06 Form PETER BERNS The ooks are in the are of 185 K STREET, NW, NO WASHINGTON, DC 0006 Telephone No Fax No. If the organization does not have an offie or plae of usiness in the United States, hek this ox~~~~~~~~~~~~~~~~~ If this is for a Group Return, enter the organization's four digit Group Exemption Numer (GEN). If this is for the whole group, hek this ox. If it is for part of the group, hek this ox and attah a list with the names and EINs of all memers the extension is for. I request an automati 3-month (6 months for a orporation required to file Form 990-T) extension of time until AUGUST 15, 014, to file the exempt organization return for the organization named aove. The extension is for the organization's return for: alendar year013 or tax year eginning, and ending. If the tax year entered in line 1 is for less than 1 months, hek reason: Initial return Final return Change in aounting period If this appliation is for Forms 990-BL, 990-PF, 990-T, 470, or 6069, enter the tentative tax, less any nonrefundale redits. See instrutions. If this appliation is for Forms 990-PF, 990-T, 470, or 6069, enter any refundale redits and estimated tax payments made. Inlude any prior year overpayment allowed as a redit. y using EFTPS (Eletroni Federal Tax Payment System). See instrutions FOUNDATION OF THE ARC OF TH