Short Form Return of Organization Exempt From Income Tax

Transcription

1 Form 990-EZ Short Form Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) OMB Department of the Treasury Internal Revenue Service A For the 2013 calendar year, or tax year beginning B Check if applicable: C Name of organization and ending Open to Public Inspection D Employer identification number Address change Name change 200 ORPHANAGES WORLDWIDE, INC Initial return Number and street (or P.O. box, if mail is not delivered to street address) Room/suite E Telephone number Terminated TH ST N Amended return City or town, state or province, country, and ZIP or foreign postal code F Group Exemption SARTELL, MN Application pending Number G Accounting Method: Cash Accrual Other (specify) H Check if the organization is not I Website: required to attach Schedule B J Tax-exempt status (check only one) 501(c)(3) 501(c) ( ) (insert no.) 4947(a)(1) or 527 (Form 990, 990-EZ, or 990-PF). K Form of organization: Corporation Trust Association Other Revenue Expenses Net Assets b c a b c d b c Membership dues and assessments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3 Investment income SEE SCHEDULE O Other revenue (describe in Schedule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 8 Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and ,008. Grants and similar amounts paid (list in Schedule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ SEE SCHEDULE O 10 25,83 Professional fees and other payments to independent contractors ~~~~~~~~~~~~~~~~~~~~~~~~ 13 Occupancy, rent, utilities, and maintenance ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ SEE SCHEDULE O 14 2, Printing, publications, postage, and shipping ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other expenses (describe in Schedule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ SEE SCHEDULE O 16 14, Total expenses. Add lines 10 through , Excess or (deficit) for the year (Subtract line 17 from line 9) ~~~~~~~~~~~~~~~~~~~~~~~~~~ 18 14, Do not enter Social Security numbers on this form as it may be made public. Information about Form 990-EZ and its instructions is at L Add lines 5b, 6c, and 7b, to line 9 to determine gross receipts. If gross receipts are 200,000 or more, or if total assets (Part II, column (B) below) are 500,000 or more, file Form 990 instead of Form 990-EZ 58,008. Part I Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part I) Check if the organization used Schedule O to respond to any question in this Part I 1 Contributions, gifts, grants, and similar amounts received ~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 57,421. LHA Program service revenue including government fees and contracts 5a Gross amount from sale of assets other than inventory~~~~~~~~~~~~~ Less: cost or other basis and sales expenses ~~~~~~~~~~~~~~~~~ For Paperwork Reduction Act Notice, see the separate instructions. ~~~~~~~~~~~~~~~~~~~~~~~ Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) ~~~~~~~~~~~~~~~ Gaming and fundraising events Gross income from gaming (attach Schedule G if greater than 15,000) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Gross income from fundraising events (not including from fundraising events reported on line 1) (attach Schedule G if the sum of such gross income and contributions exceeds 15,000) Less: direct expenses from gaming and fundraising events ~~~~~~~~~~~~~~ ~~~~~~~~~~ 5a 5b 6a of contributions Net income or (loss) from gaming and fundraising events (add lines 6a and 6b and subtract line 6c) ~~~~~~~~~ 7a Gross sales of inventory, less returns and allowances ~~~~~~~~~~~~~ Less: cost of goods sold ~~~~~~~~~~~~~~~~~~~~~~~~~~ Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) 6b 6c 7a 7b ~~~~~~~~~~~~~~~~~~~ Benefits paid to or for members~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Salaries, other compensation, and employee benefits Net assets or fund balances at beginning of year (from line 27, column (A)) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ (must agree with end-of-year figure reported on prior year s return) ~~~~~~~~~~~~~~~~~~~~~~~ Other changes in net assets or fund balances (explain in Schedule O) ~~~~~~~~~~~~~~~~~~~~~~ Net assets or fund balances at end of year. Combine lines 18 through c 6d 7c , ,734. Form 990-EZ (2013)

2 Form 990-EZ (2013) 200 ORPHANAGES WORLDWIDE, INC Page 2 Part II Balance Sheets (see the instructions for Part II) Check if the organization used Schedule O to respond to any question in this Part II (A) Beginning of year (B) End of year 22 Cash, savings, and investments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 139, , Land and buildings ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other assets (describe in Schedule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~ SEE SCHEDULE O 1, Total assets ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 141, , Total liabilities (describe in Schedule O) ~~~~~~~~~~~~~~~~~~~~~~~~ Net assets or fund balances (line 27 of column (B) must agree with line 21) 141, ,734. Part III Statement of Program Service Accomplishments (see the instructions for Part III) Expenses (Required for section Check if the organization used Schedule O to respond to any question in this Part III 501(c)(3) and 501(c)(4) What is the organization s primary exempt purpose? SEE SCHEDULE O organizations and section Describe the organization s program service accomplishments for each of its three largest program services, as measured by expenses. In a clear and concise 4947(a)(1) trusts; optional manner, describe the services provided, the number of persons benefited, and other relevant information for each program title. for others.) 28 SEE SCHEDULE O 29 (Grants 25,33 ) If this amount includes foreign grants, check here 28a 30 (Grants ) If this amount includes foreign grants, check here 29a (Grants ) If this amount includes foreign grants, check here 30a 31 Other program services (describe in Schedule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ (Grants ) If this amount includes foreign grants, check here 31a 32 Total program service expenses (add lines 28a through 31a) 32 Part IV List of Officers, Directors, Trustees, and Key Employees (list each one even if not compensated - see the instructions for Part IV) Check if the organization used Schedule O to respond to any question in this Part IV (a) Name and title (b) Average hours (c) Reportable (d) Health benefits, (e) Estimated compensation (Forms contributions to per week devoted to W-2/1099-MISC) employee benefit amount of other position (if not paid, enter -0-) plans, and deferred compensation compensation JESSE BOWMAN BOARD CHAIR/TREASURER 2.00 JAN M HANSON EECUTIVE/DIRECTOR 400 BRODIE MILLER VICE CHAIR 2.00 MONIQUE AIKEN SECRETARY 2.00 JASON HASTINGS BOARD MEMBER 2.00 LORI FUCHS BOARD MEMBER Form 990-EZ (2013) 2

3 Form 990-EZ (2013) 200 ORPHANAGES WORLDWIDE, INC Page 3 Part V Other Information (Note the Schedule A and personal benefit contract statement requirements in the instructions for Part V) Check if the organization used Sch. O to respond to any question in this Part V Yes No 33 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 O ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ b c 37a 38a b Did the organization file Form 1120-POL for this year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 37b b a b c d e 42a 43 b c Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the amended documents if they reflect a change to the organization s name. Otherwise, explain the change on Schedule O (see instructions) ~~~~~~ 35a Did the organization have unrelated business gross income of 1,000 or more during the year from business activities (such as those reported on lines 2, 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 Schedule O ~~~~~~~~~~~ Was the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e) notice, reporting, and proxy tax requirements during the year? If "Yes," complete Schedule C, Part III ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If "Yes," complete applicable parts of Schedule N Enter amount of political expenditures, direct or indirect, as described in the instructions ~~~~~ 37a Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were any such loans made in a prior year and still outstanding at the end of the tax year covered by this return? If "Yes," complete Schedule L, Part II and enter the total amount involved ~~~~~~~~~~~~~~ 38b N/A Section 501(c)(7) organizations. Enter: Initiation fees and capital contributions included on line 9 ~~~~~~~~~~~~~~~~~~~~~ Gross receipts, included on line 9, for public use of club facilities ~~~~~~~~~~~~~~~~~~ 40a Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under: section 4911 ; section 4912 ; section 4955 b Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year, or did it engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and 4958 ~~~~~~~~~~~~~~~ Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimbursed by the organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? If "Yes," complete Form 8886-T ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 40e List the states with which a copy of this return is filed MN The organization s books are in care of JESSE BOWMAN, CPA Telephone no Located at P.O. BO 159, ST CLOUD, MN ZIP At any time during the calendar year, did the organization have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes," enter the name of the foreign country: See the instructions for exceptions and filing requirements for Form TD F , Report of Foreign Bank and Financial Accounts. At any time during the calendar year, did the organization maintain an office outside of the U.S.? ~~~~~~~~~~~~~~~~~~~~ If "Yes," enter the name of the foreign country: Section 4947(a)(1) nonexempt charitable trusts filing Form 990-EZ in lieu of Form Check here and enter the amount of tax-exempt interest received or accrued during the tax year ~~~~~~~~~~~~~~~~~ 43 N/A 39a 39b N/A N/A 34 35a 35b 35c 36 38a 40b 42b 42c N/A Yes No 44a b c d Did the organization maintain any donor advised funds during the year? If "Yes," Form 990 must be completed instead of Form 990-EZ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization operate one or more hospital facilities during the year? If "Yes," Form 990 must be completed instead of Form 990-EZ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization receive any payments for indoor tanning services during the year? ~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes" to line 44c, has the organization filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 45a Did the organization have a controlled entity within the meaning of section 512(b)(13)? ~~~~~~~~~~~~~~~~~~~~~~~~ 45b Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," Form 990 and Schedule R may need to be completed instead of Form 990-EZ (see instructions) 44a 44b 44c 44d 45a 45b Yes No Form 990-EZ (2013) 3

4 Form 990-EZ (2013) b 200 ORPHANAGES WORLDWIDE, INC Did the organization engage, directly or indirectly, in political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I Part VI Section 501(c)(3) organizations only All section 501(c)(3) organizations must answer questions 47-49b and 52, and complete the tables for lines 50 and 51. If "Yes," was the related organization a section 527 organization? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Complete this table for the organization s five highest compensated employees (other than officers, directors, trustees and key employees) who each received more than 100,000 of compensation from the organization. If there is none, enter "None." (a) Name and title of each employee (b) Average hours (c) Reportable (d) Health benefits, (e) Estimated compensation (Forms contributions to per week devoted to W-2/1099-MISC) employee benefit amount of other position plans, and deferred NONE compensation compensation 46 49b Page 4 Yes No Check if the organization used Schedule O to respond to any question in this Part VI Yes No Did the organization engage in lobbying activities or have a section 501(h) election in effect during the tax year? If "Yes," complete Sch. C, Part II Is the organization a school as described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E ~~~~~~~~~~~~~~~~~~~ a Did the organization make any transfers to an exempt non-charitable related organization? ~~~~~~~~~~~~~~~~~~~~~~ 49a 51 f Total number of other employees paid over 100,000 ~~~~~~~~~~~~~~~~ Complete this table for the organization s five highest compensated independent contractors who each received more than 100,000 of compensation from the organization. If there is none, enter "None." NONE (a) Name and business address of each independent contractor (b) Type of service (c) Compensation d Total number of other independent contractors each receiving over 100,000 ~~~~~~~~~~~~~~ 52 Did the organization complete Schedule A? Note. All section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A Yes Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge. Sign Here = = Signature of officer BOARD CHAIR Type or print name and title Print/Type preparer s name Preparer s signature Date Check if PTIN self- employed Paid JESSE J. BOWMAN CPA P Preparer Firm s name MILLER WELLE HEISER & CO., LTD. Firm s EIN Use Only 9 9 Firm s address THIELMAN LANE PO BO 159 Phone no. (320) ST. CLOUD, MN May the IRS discuss this return with the preparer shown above? See instructions Yes No Date No Form 990-EZ (2013)

5 OMB SCHEDULE A (Form 990 or 990-EZ) Public Charity Status and Public Support Complete if the organization is a section 501(c)(3) organization or a section (a)(1) nonexempt charitable trust. Department of the Treasury Attach to Form 990 or Form 990-EZ. Open to Public Internal Revenue Service Information about Schedule A (Form 990 or 990-EZ) and its instructions is at Inspection Name of the organization Employer identification number 200 ORPHANAGES WORLDWIDE, INC Part I Reason for Public Charity Status (All organizations must complete this part.) See instructions. The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.) e f g h A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i). A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.) A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii). A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital s name, city, and state: An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.) A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v). An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.) A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.) An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions - subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, See section 509(a)(2). (Complete Part III.) An organization organized and operated exclusively to test for public safety. See section 509(a)(4). An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h. a Type I b Type II c Type III - Functionally integrated d Type III - Non-functionally integrated By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons? (i) (ii) (iii) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ A person who directly or indirectly controls, either alone or together with persons described in (ii) and (iii) below, the governing body of the supported organization? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ A family member of a person described in (i) above? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ A 35% controlled entity of a person described in (i) or (ii) above? ~~~~~~~~~~~~~~~~~~~~~~~~ Provide the following information about 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) (described on lines 1-9 in col. (i) listed in your organization in col. organization in col. Amount of monetary organization (i) organized in the support above or IRC section governing document? (i) of your support? U.S.? (see instructions) ) Yes No Yes No Yes No Total LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule A (Form 990 or 990-EZ)

6 Schedule A (Form 990 or 990-EZ) 2013 Page 2 Part II Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box 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 below, please complete Part III.) Section A. Public Support Calendar year (or fiscal year beginning in) Total. Add lines 1 through 3 ~~~ 6 Public support. Subtract line 5 from line 4. Calendar year (or fiscal year beginning in) assets (Explain in Part IV.) ~~~~ Total support. Add lines 7 through 10 (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total First five years. If the Form 990 is for the organization s first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here Section C. Computation of Public Support Percentage a 33 1/3% support test If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box and 17a 10% -facts-and-circumstances test If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, 18 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ~~ Tax revenues levied for the organization s benefit and either paid to or expended on its behalf ~~~~ The value of services or facilities furnished by a governmental unit to the organization without charge ~ The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ~~~~~~~~~~~~ Section B. Total Support Amounts from line 4 ~~~~~~~ Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources ~ Net income from unrelated business activities, whether or not the business is regularly carried on ~ Other income. Do not include gain or loss from the sale of capital Gross receipts from related activities, etc. (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~ Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f)) ~~~~~~~~~~~~ Public support percentage from 2012 Schedule A, Part II, line 14 ~~~~~~~~~~~~~~~~~~~~~ stop here. The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ b 33 1/3% support test If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~ b 10% -facts-and-circumstances test If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ~~~~~~~~ Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions Schedule A (Form 990 or 990-EZ) 2013 % %

7 Schedule A (Form 990 or 990-EZ) ORPHANAGES WORLDWIDE, INC Part III Support Schedule for Organizations Described in Section 509(a)(2) Calendar year (or fiscal year beginning in) The value of services or facilities furnished by a governmental unit to the organization without charge ~ Total. Add lines 1 through 5 ~~~ 7a Amounts included on lines 1, 2, and 3 received from disqualified persons b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of 5,000 or 1% of the amount on line 13 for the year ~~~~~~ c Add lines 7a and 7b ~~~~~~~ 8 Public support (Subtract line 7c from line 6.) Calendar year (or fiscal year beginning in) 9 Amounts from line 6 ~~~~~~~ 10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources ~ b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975 ~~~~ c (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total Page 3 (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total 16, , , , , , First five years. If the Form 990 is for the organization s first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here Section C. Computation of Public Support Percentage 15 Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f)) ~~~~~~~~~~~~ % 16 Public support percentage from 2012 Schedule A, Part III, line % Section D. Computation of Investment Income Percentage 17 Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f)) ~~~~~~~~ % 18 Investment income percentage from 2012 Schedule A, Part III, line 17 ~~~~~~~~~~~~~~~~~~ % 20 (Complete only if you checked the box 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 below, please complete Part II.) Section A. Public Support Gifts, grants, contributions, and membership 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 tax-exempt purpose Gross receipts from activities that are not an unrelated trade or business under section 513 ~~~~~ Tax revenues levied for the organization s benefit and either paid to or expended on its behalf ~~~~ Section B. Total Support Add lines 10a and 10b ~~~~~~ Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on ~~~~~~~ Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ~~~~ Total support. (Add lines 9, 10c, 11, and 12.) 16, , , , , , , , , , , ,446. b 33 1/3% support tests If the organization did not check a box 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%, check this box and stop here. The organization qualifies as a publicly supported organization~~~~ Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions 300,446. 2, ,117. 2, , , , , , , , a 33 1/3% support tests If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ~~~~~~~~~~ Schedule A (Form 990 or 990-EZ)

8 Schedule A (Form 990 or 990-EZ) ORPHANAGES WORLDWIDE, INC Page 4 Part IV Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions) Schedule A (Form 990 or 990-EZ)

9 Schedule B (Form 990, 990-EZ, or 990-PF) Department of the Treasury Internal Revenue Service Name of the organization Schedule of Contributors Attach to Form 990, Form 990-EZ, or Form 990-PF. Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at OMB Employer identification number Organization type(check one): 200 ORPHANAGES WORLDWIDE, INC Filers of: Section: Form 990 or 990-EZ 501(c)( 3 ) (enter number) organization 4947(a)(1) nonexempt charitable trust not treated as a private foundation 527 political organization Form 990-PF 501(c)(3) exempt private foundation 4947(a)(1) nonexempt charitable trust treated as a private foundation 501(c)(3) taxable private foundation Check if your organization is covered by the General Rule or a Special Rule. Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions. General Rule For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, 5,000 or more (in money or property) from any one contributor. Complete Parts I and II. Special Rules For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33 1/3% support test of the regulations under sections 509(a)(1) and 170(b)(1)(A)(vi) and received from any one contributor, during the year, a contribution of the greater of (1) 5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II. For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor, during the year, total contributions of more than 1,000 for use exclusively for religious, charitable, scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and III. For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor, during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did not total to more than 1,00 If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions of 5,000 or more during the year ~~~~~~~~~~~~~~~~~ Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990, 990-EZ, or 990-PF), but it must answer "No" on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on its Form 990-PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF). LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990, 990-EZ, or 990-PF. Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

10 Schedule B (Form 990, 990-EZ, or 990-PF) (2013) Name of organization Employer identification number Page ORPHANAGES WORLDWIDE, INC Part I Contributors (see instructions). Use duplicate copies of Part I if additional space is needed. (a) (b) Name, address, and ZIP + 4 (c) Total contributions (d) Type of contribution 1 DENNIS & JAN HANSON Person Payroll TH ST N 30,00 Noncash SARTELL, MN (Complete Part II for noncash contributions.) (a) (b) Name, address, and ZIP + 4 (c) Total contributions (d) Type of contribution 2 C FRED CORNFORTH IV Person Payroll 4110 EATON AVE STE A 6,50 Noncash CALDWELL, ID (Complete Part II for noncash contributions.) (a) (b) Name, address, and ZIP + 4 (c) Total contributions (d) Type of contribution Person Payroll Noncash (Complete Part II for noncash contributions.) (a) (b) Name, address, and ZIP + 4 (c) Total contributions (d) Type of contribution Person Payroll Noncash (Complete Part II for noncash contributions.) (a) (b) Name, address, and ZIP + 4 (c) Total contributions (d) Type of contribution Person Payroll Noncash (Complete Part II for noncash contributions.) (a) (b) Name, address, and ZIP + 4 (c) Total contributions (d) Type of contribution Person Payroll Noncash (Complete Part II for noncash contributions.) Schedule B (Form 990, 990-EZ, or 990-PF) (2013) 10

11 Schedule B (Form 990, 990-EZ, or 990-PF) (2013) Name of organization Page 3 Employer identification number 200 ORPHANAGES WORLDWIDE, INC Part II Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed. (a) from Part I (b) Description of noncash property given (c) FMV (or estimate) (see instructions) (d) Date received (a) from Part I (b) Description of noncash property given (c) FMV (or estimate) (see instructions) (d) Date received (a) from Part I (b) Description of noncash property given (c) FMV (or estimate) (see instructions) (d) Date received (a) from Part I (b) Description of noncash property given (c) FMV (or estimate) (see instructions) (d) Date received (a) from Part I (b) Description of noncash property given (c) FMV (or estimate) (see instructions) (d) Date received (a) from Part I (b) Description of noncash property given (c) FMV (or estimate) (see instructions) (d) Date received Schedule B (Form 990, 990-EZ, or 990-PF) (2013) 11

12 Schedule B (Form 990, 990-EZ, or 990-PF) (2013) Name of organization Page 4 Employer identification number 200 ORPHANAGES WORLDWIDE, INC Part III (a) from Part I Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations that total more than 1,000 for the year. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of 1,000 or less for the year. (Enter this information once.) Use duplicate copies of Part III if additional space is needed. (b) Purpose of gift (c) Use of gift (d) Description of how gift is held (e) Transfer of gift Transferee s name, address, and ZIP + 4 Relationship of transferor to transferee (a) from Part I (b) Purpose of gift (c) Use of gift (d) Description of how gift is held (e) Transfer of gift Transferee s name, address, and ZIP + 4 Relationship of transferor to transferee (a) from Part I (b) Purpose of gift (c) Use of gift (d) Description of how gift is held (e) Transfer of gift Transferee s name, address, and ZIP + 4 Relationship of transferor to transferee (a) from Part I (b) Purpose of gift (c) Use of gift (d) Description of how gift is held (e) Transfer of gift Transferee s name, address, and ZIP + 4 Relationship of transferor to transferee Schedule B (Form 990, 990-EZ, or 990-PF) (2013) 12

13 Depreciation and Amortization DetailFORM 990-EZ PAGE EZ Asset Number Date placed in service Method/ IRC sec. Life or rate Line Cost or other basis Description of property Basis reduction Accumulated depreciation/amortization Current year deduction 1COMPUTER DB , * TOTAL 990-EZ PG 1 DEPR 1, # - Current year section 179 (D) - Asset disposed 12.1

14 SCHEDULE O (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Service Name of the organization Supplemental Information to Form 990 or 990-EZ 2013 OMB Complete to provide information for responses to specific questions on Form 990 or 990-EZ or to provide any additional information. Attach to Form 990 or 990-EZ. Open to Public Information about Schedule O (Form 990 or 990-EZ) and its instructions is at Inspection Employer identification number 200 ORPHANAGES WORLDWIDE, INC FORM 990-EZ, PART I, LINE 4, OTHER INVESTMENT INCOME: DESCRIPTION OF PROPERTY: AMOUNT: INVESTMENT REVENUE 587. FORM 990-EZ, PART I, LINE 10, GRANTS AND ALLOCATIONS: ACTIVITY CLASSIFICATION: GRANTEE NAME: ANGEL OF MERCY GRANTEE ADDRESS: P.O. BO OAKDALE, MN DATE OF GIFT: 05/30/13 AMOUNT GIVEN: 2,53 ACTIVITY CLASSIFICATION: GRANTEE NAME: ANGEL OF MERCY GRANTEE ADDRESS: P.O. BO OAKDALE, MN DATE OF GIFT: 11/07/13 AMOUNT GIVEN: 1,00 ACTIVITY CLASSIFICATION: GRANTEE NAME: NGATHA INTERNATIONAL GRANTEE ADDRESS: PO BO 644 WAITE PARK, MN DATE OF GIFT: 12/02/13 AMOUNT GIVEN: 1,80 ACTIVITY CLASSIFICATION: GRANTEE NAME: NIBAKURE CHILDREN S VILLAGE LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule O (Form 990 or 990-EZ) (2013)

15 SCHEDULE O (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Service Name of the organization Supplemental Information to Form 990 or 990-EZ 2013 OMB Complete to provide information for responses to specific questions on Form 990 or 990-EZ or to provide any additional information. Attach to Form 990 or 990-EZ. Open to Public Information about Schedule O (Form 990 or 990-EZ) and its instructions is at Inspection Employer identification number 200 ORPHANAGES WORLDWIDE, INC GRANTEE ADDRESS: 275 E 4TH STREET ST. PAUL, MN DATE OF GIFT: 12/02/13 AMOUNT GIVEN: 2,00 ACTIVITY CLASSIFICATION: GRANTEE NAME: VOICE OF THE GOSPEL C/O MERCY HOMES GRANTEE ADDRESS: PO BO 93 MEDON, TN DATE OF GIFT: 12/02/13 AMOUNT GIVEN: 13,00 ACTIVITY CLASSIFICATION: GRANTEE NAME: HALO FOUNDATION GRANTEE ADDRESS: 1600 GENESEE #528 KANSAS CITY, MO DATE OF GIFT: 12/02/13 AMOUNT GIVEN: 1,00 ACTIVITY CLASSIFICATION: GRANTEE NAME: JBFC-ONLINE GRANTEE ADDRESS: 1934 EAST 45TH PLACE TULSA, OK DATE OF GIFT: 12/02/13 AMOUNT GIVEN: 3,20 ACTIVITY CLASSIFICATION: GRANTEE NAME: VOICE OF THE GOSPEL C/O MERCY HOMES GRANTEE ADDRESS: PO BO 93 MEDON, TN DATE OF GIFT: 05/30/13 LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule O (Form 990 or 990-EZ) (2013)

16 SCHEDULE O (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Service Name of the organization Supplemental Information to Form 990 or 990-EZ 2013 OMB Complete to provide information for responses to specific questions on Form 990 or 990-EZ or to provide any additional information. Attach to Form 990 or 990-EZ. Open to Public Information about Schedule O (Form 990 or 990-EZ) and its instructions is at Inspection Employer identification number 200 ORPHANAGES WORLDWIDE, INC AMOUNT GIVEN: 1,30 TOTAL INCLUDED ON FORM 990-EZ, LINE 10 25,83 FORM 990-EZ, PART I, LINE 14, OCCUPANCY, RENT, UTILITIES, AND MAINTENANCE: DESCRIPTION OF EPENSES: AMOUNT: DEPRECIATION 57. OTHER EPENSES 2,711. TOTAL TO FORM 990-EZ, LINE 14 2,768. FORM 990-EZ, PART I, LINE 16, OTHER EPENSES: DESCRIPTION OF OTHER EPENSES: AMOUNT: BANK CHARGES 798. FUNDRAISING EPENSE 8,008. INSURANCE 1,75 DIRECTORY EPENSE 107. STATE FEE 75. WEBSITE EPENSE 185. TELEPHONE 284. OFFICE EPENSE 1,932. ADVERTISING 1,249. CONSULTING SERVICES 142. DUES & SUBSCRIPTIONS 444. TOTAL TO FORM 990-EZ, LINE 16 14,974. FORM 990-EZ, PART II, LINE 24, OTHER ASSETS: DESCRIPTION BEG. OF YEAR END OF YEAR LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule O (Form 990 or 990-EZ) (2013)

17 SCHEDULE O (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Service Name of the organization Supplemental Information to Form 990 or 990-EZ 2013 OMB Complete to provide information for responses to specific questions on Form 990 or 990-EZ or to provide any additional information. Attach to Form 990 or 990-EZ. Open to Public Information about Schedule O (Form 990 or 990-EZ) and its instructions is at Inspection Employer identification number 200 ORPHANAGES WORLDWIDE, INC PLEDGE RECEIVABLE 1,525. OTHER DEPRECIABLE ASSETS TOTAL TO FORM 990-EZ, LINE 24 1, FORM 990-EZ, PART III, PRIMARY EEMPT PURPOSE - RAISE FUNDS TO PROVIDE BUILDING STRUCTURES FOR ORPHANAGES AROUND THE WORLD. FORM 990-EZ, PART III, LINE 28, PROGRAM SERVICE ACCOMPLISHMENTS: THE ORGANIZATION IS RAISING FUNDS FOR OTHER ORGANIZATIONS THAT ARE DEVELOPING ORPHANAGES FOR ORPHANED CHILDREN. IN 2013 THE ORGANIZATION WAS ABLE TO FUND SI SEPERATE PROJECTS FROM REQUESTS OF ORPHANAGES. THE REQUESTS RANGE FROM BUILDING HOUSING FOR THE CHILDREN TO PROVIDING A FENCE FOR THE ORPHANAGES FOR SECURITY TO BUILDING A CHICKEN COOP. FORM 990-EZ, PART V, INFORMATION REGARDING PERSONAL BENEFIT CONTRACTS: THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY, OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT. THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY, OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT. LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule O (Form 990 or 990-EZ) (2013)

18 Form (Rev. January 2014) Department of the Treasury Internal Revenue Service File by the due date for filing your return. See instructions. File a separate application for each return. Information about Form 8868 and its instructions is at If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box ~~~~~~~~~~~~~~~~~~~ If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II (on page 2 of this form). Do not complete Part II unless you have already been granted an automatic 3-month extension on a previously filed Form Electronic filing (e-file). You can electronically file Form 8868 if you need a 3-month automatic extension of time to file (6 months for a corporation required to file Form 990-T), or an additional (not automatic) 3-month extension of time. You can electronically file Form 8868 to request an extension Personal Benefit Contracts, which must be sent to the IRS in paper format (see instructions). For more details on the electronic filing of this form, visit and click on e-file for Charities & Nonprofits. Part I Automatic 3-Month Extension of Time. Only submit original (no copies needed). A corporation required to file Form 990-T and requesting an automatic 6-month extension - check this box and complete Part I only ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ All other corporations (including 1120-C filers), partnerships, REMICs, and trusts must use Form 7004 to request an extension of time to file income tax returns. Enter filer s identifying number Type or print 8868 Application for Extension of Time To File an Exempt Organization Return OMB of time to file any of the forms listed in Part I or Part II with the exception of Form 8870, Information Return for Transfers Associated With Certain Name of exempt organization or other filer, see instructions. Number, street, and room or suite no. If a P.O. box, see instructions TH ST N City, town or post office, state, and ZIP code. For a foreign address, see instructions. SARTELL, MN Employer identification number (EIN) or 200 ORPHANAGES WORLDWIDE, INC Social security number (SSN) Enter the Return code for the return that this application is for (file a separate application for each return) ~~~~~~~~~~~~~~~~~ 0 1 Application Is For Form 990 or Form 990-EZ Form 990-BL Form 4720 (individual) Form 990-PF Form 990-T (sec. 401(a) or 408(a) trust) 1 Return Code Application Is For Form 990-T (trust other than above) 06 Form 8870 JESSE BOWMAN, CPA The books are in the care of P.O. BO ST CLOUD, MN Telephone Fax Return Code Form 990-T (corporation) 07 Form 1041-A Form 4720 (other than individual) Form 5227 Form 6069 If the organization does not have an office or place of business in the United States, check this box~~~~~~~~~~~~~~~~~ If this is for a Group Return, enter the organization s four digit Group Exemption Number (GEN). If this is for the whole group, check this box. If it is for part of the group, check this box and attach a list with the names and EINs of all members the extension is for. I request an automatic 3-month (6 months for a corporation required to file Form 990-T) extension of time until AUGUST 15, 2014, to file the exempt organization return for the organization named above. The extension is for the organization s return for: calendar year2013 or tax year beginning, and ending a b c If the tax year entered in line 1 is for less than 12 months, check reason: Initial return Final return Change in accounting period If this application is for Forms 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any nonrefundable credits. See instructions. If this application is for Forms 990-PF, 990-T, 4720, or 6069, enter any refundable credits and estimated tax payments made. Include any prior year overpayment allowed as a credit. Balance due. Subtract line 3b from line 3a. Include your payment with this form, if required, by using EFTPS (Electronic Federal Tax Payment System). See instructions. Caution. If you are going to make an electronic funds withdrawal (direct debit) with this Form 8868, see Form 8453-EO and Form 8879-EO for payment instructions. LHA For Privacy Act and Paperwork Reduction Act Notice, see instructions. Form 8868 (Rev ) a 3b 3c

19 2014 DEPRECIATION AND AMORTIZATION REPORT - NET YEAR FEDERAL ORPHANAGES WORLDWIDE, INC. Asset Date Description Acquired Method Life Unadjusted Cost Or Basis * Reduction In Basis Basis For Depreciation Accumulated Depreciation Amount Of Depreciation 1COMPUTER DB5.00 1, * TOTAL 990-EZ PG 1 DEPR 1, (D) - Asset disposed * ITC, Section 179, Salvage, HR 3090, Commercial Revitalization Deduction, GO Zone

20 STATE OF MINNESOTA CHARITABLE ORGANIZATION INITIAL REGISTRATION & ANNUAL REPORT FORM ATTORNEY GENERAL LORI SWANSON Annual Reporting Initial Registration SUITE 1200, BREMER TOWER 445 MINNESOTA STREET ST. PAUL, MN FEDERAL EIN NUMBER: (651) (651) (TTY) FOR YEAR ENDING: 12/31/2013 SECTION A: REQUIRED INFORMATION FOR INITIAL REGISTRATION & ANNUAL REPORTING 1. Legal Name of Organization: 200 ORPHANAGES WORLDWIDE, INC. If annual reporting, is this a new name since the organization s last filing? Yes No If so, please state former name: 2. List all names under which the organization solicits contributions: 200 ORPHANAGES WORLDWIDE 3. Mailing Address of Organization (required) Physical Address of Organization (required) TH ST N TH ST N SARTELL, MN SARTELL, MN Contact Person Tel. JAN HANSON Fax JANH@200ORPHANAGESWORLDWIDE.O 5. Does the organization use the services of a professional fund-raiser (outside solicitor or consultant)? Yes No If so, provide name and address of any outside professional fund-raiser employed by the organization and state the total amount of compensation each outside fund-raiser received from the filing organization during the year. Attach schedule if more than one. Name Address City State ZIP Compensation 6. a) Does this professional fund-raiser solicit or consult in Minnesota? Yes No b) Is this professional fund-raiser registered to solicit or consult in Minnesota? Yes No 7. Month and day accounting year ends: 12/31 8. Has the organization included the filing fee, late fee (if any) and all attachments required by the instructions? Yes No Office Use Only: ARF N (e-postcard) 990 EZ PF FES SIG BD SAL Audit 01/13 Upon request this material can be made available in alternate formats

21 9. This Section A(9) must be completed by organizations filing a 990-N (e-postcard) or organizations whose filing does not contain the information requested below. This includes organizations that: 1) do not file an IRS Form 990, 2) file an IRS Form 990-EZ or 990-PF, or 3) organizations that file a group return that does not include the filing organization s individual financial information. INCOME Contributions from the public Government Grants Other revenue TOTAL REVENUE 57, ,008. ECESS or DEFICIT TOTAL Assets TOTAL Liabilities 14, ,734. END OF YEAR FUND BALANCE/NET WORTH (Assets minus Liabilities) 155,

22 SECTION C: REQUIRED FOR ANNUAL REPORTING ONLY ALL Annual Report filers MUST complete questions Has the organization s accounting year changed since the last report was filed? If yes, provide the new year-end date: Yes No 2. Attach an explanation if there has been any change in the organization s tax status with the Internal Revenue Service; a significant change in the purposes of the organization; or if the organization s right to solicit funds has been denied, suspended, revoked or enjoined by any state agency or court in any state, or if there are proceedings pending. None Attached 3. List of the five highest paid directors, officers, and employees of the organization and its related organizations, as that term is defined by section 317A.011, subdivision 18, that receive total compensation of more than 100,000, together with the compensation paid to each. For purposes of this subdivision, "compensation" is defined as the total amount reported on Form W-2 (Box 5) or Form 1099-MISC (Box 7) issued by the organization and its related organizations to the individual. The value of fringe benefits and deferred compensation paid by the charitable organization and all related organizations as that term is defined by section 317A.011, subdivision 18, shall also be reported as a separate item for each person whose compensation is required to be reported pursuant to this subdivision. Name/Title Compensation Deferred Compensation Fringe Benefits Attach a list of organization s board of directors. Attached Included in IRS return 5. Attach a GAAP audit if total revenue exceeds 750,00 Attached Audit not included under the Food Shelf Exemption (excluding from total revenue the value of food donated to a nonprofit food shelf for redistribution at no cost). Audit not required 6. Minnesota law requires that an organization file a copy of all tax or informational returns filed with the IRS, including IRS Form 990-N (e-postcard), 990, 990-EZ, or 990-PF, including all schedules and amendments. Has the organization included with this annual report a copy of all tax or informational returns, including IRS Form 990-N (e-postcard), 990, 990-EZ or 990-PF that it filed with the IRS (excluding Schedule B or any other donor list)? Yes No (Not required to file a return with IRS or files a group return). NOTE: By answering YES to the above question, you are attesting that the IRS informational return filed with this office is an exact copy, including all schedules and attachments, of the IRS informational return filed with the IRS (excluding Schedule B or any other donor list the IRS may require)