Short Form. Return of Organization Exempt From Income Tax

Transcription

1 Short Form OMB No Return of Organization Exempt From Income Tax Form 990-EZ Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code 2012 (except black lung benefit trust or private foundation) G Sponsoring organizations of donor advised funds, organizations that operate one or more hospital facilities, and certain Department of the Treasury Internal Revenue Service controlling organizations as defined in section 512(b)(13) must file Form 990 (see instructions). All other organizations with gross receipts less than $200,000 and total assets less than $500,000 at the end of the year may use this form. G The organization may have to use a copy of this return to satisfy state reporting requirements. A For the 2012 calendar year, or tax year beginning, 2012, and ending, C D Open to Public Inspection B Check if applicable: Employer identification number Address change Name change Initial return Terminated Amended return Application pending E Telephone number F Group Exemption Number G Accounting Method: Cash Accrual Other (specify) G H Check G if the organization is not I Website: G required to attach Schedule B (Form J Tax-exempt status (check only one) ' 501(c)(3) 501(c) ( ) H(insert no.) 4947(a)(1) or , 990-EZ, or 990-PF). K Check G if the organization is not a section 509(a)(3) supporting organization or a section 527 organization and its gross receipts are normally not more than $50,00 A Form 990-EZ or Form 990 return is not required though Form 990-N (e-postcard) may be required (see instructions). But if the organization chooses to file a return, be sure to file a complete return. 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 (I, line 25, column (B) below) are $500,000 or more, file Form 990 instead of Form 990-EZ G$ Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for ) Check if the organization used Schedule O to respond to any question in this L 1 Contributions, gifts, grants, and similar amounts received Program service revenue including government fees and contracts Membership dues and assessments Investment income a Gross amount from sale of assets other than inventory a b Less: cost or other basis and sales expenses c Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) Gaming and fundraising events R a Gross income from gaming (attach Schedule G if greater than $15,000) a E V b Gross income from fundraising events (not including $ E N U E from fundraising events reported on line 1) (attach Schedule G if the sum of such gross income and contributions exceeds $15,000) c Less: direct expenses from gaming and fundraising events b of contributions d Net income or (loss) from gaming and fundraising events (add lines 6a and 6b and subtract line 6c) Other revenue (describe in Schedule O) Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and G 9 10 Grants and similar amounts paid (list in Schedule O) Benefits paid to or for members E 12 Salaries, other compensation, and employee benefits P 13 Professional fees and other payments to independent contractors E N 14 Occupancy, rent, utilities, and maintenance S E 15 Printing, publications, postage, and shipping S 16 Other expenses (describe in Schedule O) See Schedule O Total expenses. Add lines 10 through G Excess or (deficit) for the year (Subtract line 17 from line 9) A S N S Western Dressage Association of America Wilson Road Pilot Point, T a Gross sales of inventory, less returns and allowances a 724. b Less: cost of goods sold b 115. c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with end-of-year E E figure reported on prior year's return) T T S 20 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 G 21-8,28 BAA For Paperwork Reduction Act Notice, see the separate instructions. Form 990-EZ (2012) 6 b 6 c (214) c 6 d 7 c G 66, ,77 10,65 25, , ,206. 8, ,34 57,658. 8, ,761. TEEA0803L 12/07/12

2 Form 990-EZ (2012) Western Dressage Association of America Page 2 I Balance Sheets. (see the instructions for I.) Check if the organization used Schedule O to respond to any question in this I (A) Beginning of year (B) End of year 22 Cash, savings, and investments , ,92 23 Land and buildings Other assets (describe in Schedule O) See Schedule O Total assets , ,12 26 Total liabilities (describe in Schedule O) See Schedule O , ,40 27 Net assets or fund balances (line 27 of column (B) must agree with line 21) , ,28 II Statement of Program Service Accomplishments (see the instrs for II.) Expenses Check if the organization used Schedule O to respond to any question in this II (Required for section 501 What is the organization's primary exempt purpose? (c)(3) and 501(c)(4) See Schedule O organizations and section Describe the organization's program service accomplishments for each of its three largest program services, as 4947(a)(1) trusts; optional measured by expenses. In a clear and concise manner, describe the services provided, the number of persons benefited, and other relevant information for each program title. for others.) 28 Presenting clinics throughout the country to train and educate persons in the discipline of western dressage. 29 (Grants $ ) If this amount includes foreign grants, check here G 28 a See Schedule O 7,37 (Grants $ ) If this amount includes foreign grants, check here G 29 a 3, Promoting and encouraging the discipline of western dressage by establishing rules for western dressage and encouraging the United States Equestrian Federation to adopt such rules. (Grants$ ) If this amount includes foreign grants, check here G 30 a Other program services (describe in Schedule O)..... See Schedule O (Grants$ ) If this amount includes foreign grants, check here G 31 a 32 Total program service expenses (add lines 28a through 31a) G 32 11,295. V List of Officers, Directors, Trustees, and Key Employees. List each one even if not compensated. (see the instructions for V.) Check if the organization used Schedule O to respond to any question in this V (b) Average hours per (c) Reportable compensation (a) Name and Title week devoted to (Forms W-2/1099-MISC) position (If not paid, enter -0-) (d) Health benefits, contributions to employee benefit plans, and deferred compensation (e) Estimated amount of other compensation Guy Brown President 0 Ellen DiBella Secretary 15 Darrell Bilke Vice President 0 Georgie Green Treasurer 15 BAA TEEA0812L 12/28/12 Form 990-EZ (2012)

3 Form 990-EZ (2012) Western Dressage Association of America Page 3 Part V Other Information (Note the Schedule A and personal benefit contract statement requirements insee Schedule O the instructions for Part V) Check if the organization used Schedule O to respond to any question in this Part V Did the organization engage in any activity not previously reported to the IRS? If 'Yes,' Yes No provide a detailed description of each activity in Schedule O 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) a 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)? a b If 'Yes,' to line 35a, has the organization filed a Form 990-T for the year? If 'No,' provide an explanation in Schedule O b c 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, II c 36 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 a Enter amount of political expenditures, direct or indirect, as described in the instructions. G 37 a b Did the organization file Form 1120-POL for this year? b 38 a 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? a b If 'Yes,' complete Schedule L, I and enter the total amount involved b 14,40 39 Section 501(c)(7) organizations. Enter: a Initiation fees and capital contributions included on line a N/A b Gross receipts, included on line 9, for public use of club facilities b N/A 40 a Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under: section 4911 G ; section 4912 G ; section 4955 G 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, b c 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 G d Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimbursed by the organization G e 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 e 41 List the states with which a copy of this return is filed G None 42 a The organization's books are in care of G Bonnie Glasgow Telephone no. G (214) Located at G Wilson Road Pilot Point T ZIP + 4 G b At any time during the calendar year, did the organization have an interest in or a signature or other authority over a Yes No financial account in a foreign country (such as a bank account, securities account, or other financial account)? b If 'Yes,' enter the name of the foreign country: G See the instructions for exceptions and filing requirements for Form TD F , Report of Foreign Bank and Financial Accounts. c 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: G 42 c 43 Section 4947(a)(1) nonexempt charitable trusts filing Form 990-EZ in lieu of Form 1041 ' Check here G N/A and enter the amount of tax-exempt interest received or accrued during the tax year G 43 N/A Yes No 44 a Did the organization maintain any donor advised funds during the year? If 'Yes,' Form 990 must be completed instead of Form 990-EZ a b Did the organization operate one or more hospital facilities during the year? If 'Yes,' Form 990 must be completed instead of Form 990-EZ b c Did the organization receive any payments for indoor tanning services during the year? c d If 'Yes' to line 44c, has the organization filed a Form 720 to report these payments? If 'No,' provide an explanation in Schedule O d 45 a Did the organization have a controlled entity of the organization within the meaning of section 512(b)(13)? a b 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) b TEEA0812L 12/28/12 Form 990-EZ (2012)

4 Form 990-EZ (2012) Western Dressage Association of America Page 4 Yes No 46 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 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 Check if the organization used Schedule O to respond to any question in this Part VI Did the organization engage in lobbying activities or have a section 501(h) election in effect during the tax year? If 'Yes,' complete Schedule C, I 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? a b 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.' None (b) Average hours (d) Health benefits, (a) Name and title of each employee per week devoted (c) Reportable compensation contributions to employee (e) Estimated amount of paid more than $100,000 to position (Forms W-2/1099-MISC) benefit plans, and deferred other compensation compensation 49 b Yes No f Total number of other employees paid over $100, G 51 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 address of each independent contractor paid more than $100,000 (b) Type of service (c) Compensation d Total number of other independent contractors each receiving over $100, G 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 G Yes No 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 A Signature of officer A Georgie Green Type or print name and title. Date Treasurer Print/Type preparer's name Preparer's signature Date PTIN Check if self-employed Paid Barbara J Hartline, CPA P Firm's name Preparer G Barbara J. Hartline, CPA, PC Use Only Firm's address G 202 W Louisiana St Ste 104 Firm's EIN G McKinney, T Phone no. (972) May the IRS discuss this return with the preparer shown above? See instructions G Yes No Form 990-EZ (2012) TEEA0812L 12/28/12

5 OMB No SCHEDULE A (Form 990 or 990-EZ) Public Charity Status and Public Support 2012 Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust. Department of the Treasury Internal Revenue Service Name of the organization G Attach to Form 990 or Form 990-EZ. G See separate instructions. Employer identification number Western Dressage Association of America 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.) 1 A church, convention of churches or association of churches described in section 170(b)(1)(A)(i). 2 A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.) 3 A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii). Open to Public Inspection 4 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: 5 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 I.) 6 A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v). 7 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 I.) 8 A community trust described in section 170(b)(1)(A)(vi). (Complete I.) 9 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 II.) 10 An organization organized and operated exclusively to test for public safety. See section 509(a)(4). 11 An organization organized and operated exclusively for the benefit of, to perform the functions of, or 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. e f g h 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 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) 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? (iii) A 35% controlled entity of a person described in (i) or (ii) above? Provide the following information about the supported organization(s). (i) Name of supported (ii) EIN (iii) Type of organization (iv) Is the (v) Did you notify (vi) Is the organization (described on lines 1-9 organization in the organization in organization in above or IRC section column (i) listed in column (i) of your column (i) (see instructions)) your governing support? organized in the document? U.S.? Yes No Yes No Yes No 11g (i) 11g (ii) 11g (iii) Yes No (vii) Amount of monetary support (A) (B) (C) (D) (E) Total BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule A (Form 990 or 990-EZ) 2012 TEEA0401L 08/09/12

6 Schedule A (Form 990 or 990-EZ) 2012 Western Dressage Association of America Page 2 I 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 or if the organization failed to qualify under II. If the organization fails to qualify under the tests listed below, please complete II.) Section A. Public Support Calendar year (or fiscal year beginning in) G 1 Gifts, grants, contributions, and membership fees received. (Do not include any 'unusual grants.') Tax revenues levied for the 2 organization's benefit and either paid to or expended on its behalf The value of services or 3 facilities furnished by a governmental unit to the organization without charge Total. Add lines 1 through 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)... 6 Public support. Subtract line 5 from line Section B. Total Support Calendar year (or fiscal year beginning in) G 7 Amounts from line Gross income from interest, 8 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 10 gain or loss from the sale of capital assets (Explain in V.) Total support. Add lines 7 through (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) Gross receipts from related activities, etc (see instructions) (f) Total (f) Total 13 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 G Section C. Computation of Public Support Percentage Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f)) % 15 Public support percentage from 2011 Schedule A, I, line % 16 a 33-1/3% support test ' If the organization did not check the box on line 13, and the line 14 is 33-1/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization G 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 G 17 a 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, and if the organization meets the 'facts-and-circumstances' test, check this box and stop here. Explain in V how the organization meets the 'facts-and-circumstances' test. The organization qualifies as a publicly supported organization G 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 V how the organization meets the 'facts-and-circumstances' test. The organization qualifies as a publicly supported organization G 18 Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions... G BAA Schedule A (Form 990 or 990-EZ) 2012 TEEA0402L 08/09/12

7 Schedule A (Form 990 or 990-EZ) 2012 Western Dressage Association of America Page 3 II Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 9 of or if the organization failed to qualify under I. If the organization fails to qualify under the tests listed below, please complete I.) Section A. Public Support Calendar year (or fiscal yr beginning in) G (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) Gifts, grants, contributions and membership fees received. (Do not include any 'unusual grants.') Gross receipts from admis- 2 sions, 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 3 that are not an unrelated trade or business under section 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 Total. Add lines 1 through a Amounts included on lines 1, 2, and 3 received from disqualified persons Amounts included on lines 2 b 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 Public support (Subtract line 7c from line 6.) Section B. Total Support Calendar year (or fiscal yr beginning in) G 9 Amounts from line a 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, c 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 V.) (f) Total 10, , ,88 99, , , ,88 99,248. (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total 10, , ,88 99, Total support. (Add lns 9, 10c, 11, and 12.) 10, , ,88 99, 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 G Section C. Computation of Public Support Percentage 15 Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f)) % 16 Public support percentage from 2011 Schedule A, II, line % Section D. Computation of Investment Income Percentage 17 Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f)) % 18 Investment income percentage from 2011 Schedule A, II, line 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 G 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..... G 20 Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions G BAA TEEA0403L 08/09/12 Schedule A (Form 990 or 990-EZ) ,248. %

8 Schedule A (Form 990 or 990-EZ) 2012 Western Dressage Association of America Page 4 V Supplemental Information. Complete this part to provide the explanations required by I, line 10; I, line 17a or 17b; and II, line 12. Also complete this part for any additional information. (See instructions). BAA Schedule A (Form 990 or 990-EZ) 2012 TEEA0404L 08/10/12

9 Schedule B (Form 990, 990-EZ, or 990-PF) Department of the Treasury Internal Revenue Service Name of the organization Schedule of Contributors G Attach to Form 990, Form 990-EZ, or Form 990-PF OMB No Employer identification number Western Dressage Association of America Organization type (check one): 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 $5,000 or more during the year G$ 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 V, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on, line 2, of itsform 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF). BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990, 990EZ, or 990-PF. Schedule B (Form 990, 990-EZ, or 990-PF) (2012) TEEA0701L 11/30/12

10 Schedule B (Form 990, 990-EZ, or 990-PF) (2012) Page 1 of 1 of Part 1 Name of organization Contributors (see instructions). Use duplicate copies of if additional space is needed. Employer identification number Western Dressage Association of America (a) Number (b) Name, address, and ZIP + 4 (c) Total (d) Type of contribution contributions 1 Ellen DiBella Person Payroll Delbert Road $ 14,50 Noncash Parker, CO (Complete I if there is a noncash contribution.) Number Name, address, and ZIP + 4 Total Type of contribution contributions 2 Barbara Molland Person Payroll 5000 Carroll Rd $ 5,57 Noncash Petaluma, CA (Complete I if there is a noncash contribution.) Number Name, address, and ZIP + 4 Total Type of contribution contributions Person Payroll $ Noncash (Complete I if there is a noncash contribution.) Number Name, address, and ZIP + 4 Total Type of contribution contributions Person Payroll $ Noncash (Complete I if there is a noncash contribution.) Number Name, address, and ZIP + 4 Total Type of contribution contributions Person Payroll $ Noncash (Complete I if there is a noncash contribution.) Number Name, address, and ZIP + 4 Total Type of contribution contributions Person Payroll $ Noncash (Complete I if there is a noncash contribution.) BAA TEEA0702L 11/30/12 Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

11 Schedule B (Form 990, 990-EZ, or 990-PF) (2012) Name of organization I Page Noncash Property (see instructions). Use duplicate copies of I if additional space is needed. 1 to 1 of I Employer identification number Western Dressage Association of America (a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received (see instructions) N/A $ (a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received (see instructions) $ (a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received (see instructions) $ (a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received (see instructions) $ (a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received (see instructions) $ (a) No. (b) (c) (d) from Description of noncash property given FMV (or estimate) Date received (see instructions) $ BAA Schedule B (Form 990, 990-EZ, or 990-PF) (2012) TEEA0703L 11/30/12

12 Schedule B (Form 990, 990-EZ, or 990-PF) (2012) Name of organization Page 1 to 1 of II Employer identification number Western Dressage Association of America II 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 II, enter total of exclusively religious, charitable, etc, contributions of $1,000 or less for the year. (Enter this information once. See instructions.) G$ Use duplicate copies of II if additional space is needed. No. from Purpose of gift Use of gift Description of how gift is held N/A N/A (e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee No. from Purpose of gift Use of gift Description of how gift is held (e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee No. from Purpose of gift Use of gift Description of how gift is held (e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee No. from Purpose of gift Use of gift Description of how gift is held (e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee BAA TEEA0704L 11/30/12 Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

13 SCHEDULE L (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Service Name of the organization Transactions With Interested Persons OMB No G Complete if the organization answered 'Yes' on Form 990, V, line 25a, 25b, 26, 27, 28a, 28b, 28c, 2012 or Form 990-EZ, Part V, line 38a or 40b. G Attach to Form 990 or Form 990-EZ. G See separate instructions. Open to Public Inspection Employer identification number Western Dressage Association of America Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only). Complete if the organization answered 'Yes' on Form 990, V, line 25a or 25b, or Form 990-EZ, Part V, line 40b. (a) Name of disqualified person (b) Relationship between disqualified 1 person and organization (1) (2) (3) (4) (5) (6) (c) Description of transaction 2 Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section G$ 3 Enter the amount of tax, if any, on line 2, above, reimbursed by the organization G$ I Loans to and/or From Interested Persons. Complete if the organization answered 'Yes' on Form 990-EZ, Page V, line 38a or Form 990, V, line 26; or if the organization reported an amount on Form 990, Part, line 5, 6, or 22. (a) Name of interested person (7) (8) (9) (10) (b) Relationship with organization (c) Purpose of loan Total G$ II Grants or Assistance Benefiting Interested Persons. Complete if the organization answered 'Yes' on Form 990, V, line 27. (d) Corrected? (d) Loan to or (e) Original (f) Balance due (g) In default? (h) Approved (i) Written from the principal amount by board or agreement? organization? committee? To From Yes No Yes No Yes No (1) Ellen DiBella (2) Fund Sta 5,00 5,00 (3) Barbara Molland (4) (5) (6) Neide Cooley Fund Sta Fund Con 5,00 1,80 1,80 6,80 (a) Name of interested person (b) Relationship between interested person (c) Amount of assistance (d) Type of Assistance (e) Purpose of assistance and the organization Yes No (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule L (Form 990 or 990-EZ) 2012 TEEA4501L 12/11/12

14 Schedule L (Form 990 or 990-EZ) 2012 Western Dressage Association of Ame Page 2 V Business Transactions Involving Interested Persons. Complete if the organization answered 'Yes' on Form 990, V, line 28a, 28b, or 28c. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) Part V (a) Name of interested person (b) Relationship between (c) Amount of (d) Description of transaction (e) Sharing of interested person and the transaction organization's organization revenues? Supplemental Information Complete this part to provide additional information for responses to questions on Schedule L (see instructions). Yes No TEEA4501L 12/11/12 Schedule L (Form 990 or 990-EZ) 2012

15 OMB No SCHEDULE O Supplemental Information to Form 990 or 990-EZ (Form 990 or 990-EZ) 2012 Complete to provide information for responses to specific questions on Form 990 or 990-EZ or to provide any additional information. Open to Public Department of the Treasury G Attach to Form 990 or 990-EZ. Inspection Internal Revenue Service Name of the organization Western Dressage Association of America Form 990-EZ, II - Organization's Primary Exempt Purpose Employer identification number The Association will educate the public about the new discipline of western dressage. Form 990-EZ, II, Line 29 - Statement of Program Service Accomplishments Developing and maintaining a website, the purpose of which is to promote the discipline of western dressage through the education of the public generally, and to provide additional educational material to members of the Association. Form 990-EZ, Part V - Regarding Transfers Associated with Personal Benefit Contracts (a) Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? No (b) Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? No BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. TEEA4901L 12/8/12 Schedule O (Form 990 or 990-EZ) 2012

16 2012 Schedule O - Supplemental Information Page 2 Western Dressage Association of America Form 990-EZ,, Line 16 Other Expenses Advertising and Promotion $ 275. Bank Charges Credit Card Disc Fees franchise taxes Information Technology ,675. Insurance Office Expenses ,386. PayPal Fees Train the Trainer ,37 Travel ,767. Total $ 19,34 Form 990-EZ, I, Line 24 Other Assets Beginning Ending Undeposited Funds $ 625. $ 20 Total $ 625. $ 20 Form 990-EZ, I, Line 26 Total Liabilities Beginning Ending Federal Income Taxes $ Payable to Officers, Directors, Etc $ 19,40 14,40 Total $ 19,40 $ 14,40 Form 990-EZ, II, Line 31 Statement of Program Service Accomplishments Program Service Description Grants Expenses Creating and distributing educational materials such as DVDs and tutorials to educate the public about western dressage. Includes Foreign Grants: No Presenting western dressage clinics throughout the country to members and non-members of the Association. Includes Foreign Grants: No Total $ $

17 2012 Federal Exempt Organization Tax Summary (EZ) Page 1 Western Dressage Association of America Diff FORM 990-EZ REVENUE Contributions, gifts, and grants ,770 13,384 16,386 Program service revenue , ,650 Membership dues and assessments ,110 20,790 4,320 Gross profit (loss) - inventory sales Total revenue ,139 34,174 31,965 EPENSES Salaries and employee benefits , ,206 Professional fees/pymt to contractors ,112 6,897 1,215 Other expenses ,340 28,039-8,699 Total expenses ,658 34,936 22,722 NET ASSETS OR FUND BALANCES Excess or (deficit) for the year , ,243 Net assets/fund bal. at beg. of year ,761-15, Net assets/fund bal. at end of year ,280-16,761 8,481