** PUBLIC DISCLOSURE COPY ** 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, 527, or 4947(1) of the Internal Revenue Code (except private foundations) OMB Department of the Treasury Internal Revenue Service Open to Public Inspection A For the 2013 calendar year, or tax year beginning and ending B Check if applicable: C Name of organization D Employer identification number Address change Name change HIGH RISK HOPE, INC Initial return Number and street (or P.O. box, if mail is not delivered to street address) Room/suite E Telephone number Terminated 1702 NORTH AVENIDA REPUBLICA DE CUBA (813) Amended return City or town, state or province, country, and ZIP or foreign postal code F Group Exemption TAMPA, FL 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(3) 501 ( ) (insert no.) 4947(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 Gross profit or (loss) sales of inventory (Subtract line 7b line 7a) ~~~~~~~~~~~~~~~~~~~ 7c Other revenue (describe in Schedule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ SEE SCHEDULE O Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and , Occupancy, rent, utilities, and maintenance ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Printing, publications, postage, and shipping ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ , Other expenses (describe in Schedule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ SEE SCHEDULE O 16 26, Total expenses. Add lines 10 through , Excess or (deficit) for the year (Subtract line 17 line 9) ~~~~~~~~~~~~~~~~~~~~~~~~~~ 18 43, 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 (I, column (B) below) are 500,000 or more, file Form 990 instead of Form 990-EZ 82,833. 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 1 Contributions, gifts, grants, and similar amounts received ~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 53,774. LHA Program service revenue including government fees and contracts For Paperwork Reduction Act Notice, see the separate instructions. ~~~~~~~~~~~~~~~~~~~~~~~ Membership dues and assessments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Investment income 5a Gross amount sale of assets other than inventory~~~~~~~~~~~~~ Less: cost or other basis and sales expenses ~~~~~~~~~~~~~~~~~ Gain or (loss) sale of assets other than inventory (Subtract line 5b line 5a) ~~~~~~~~~~~~~~~ Gaming and fundraising events Gross income gaming (attach Schedule G if greater than 15,000) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6a Gross income fundraising events (not including 5,246. of contributions fundraising events reported on line 1) (attach Schedule G if the sum of such gross income and contributions exceeds 15,000) Less: direct expenses gaming and fundraising events ~~~~~~~~~~~~~~ ~~~~~~~~~~ Net income or (loss) 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 ~~~~~~~~~~~~~~~~~~~~~~~~~~ Grants and similar amounts paid (list in Schedule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Benefits paid to or for members~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Salaries, other compensation, and employee benefits ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Professional fees and other payments to independent contractors ~~~~~~~~~~~~~~~~~~~~~~~~ Net assets or fund balances at beginning of year ( 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) 5a 5b 6b 6c 7a 7b 28, ,464. ~~~~~~~~~~~~~~~~~~~~~~ Net assets or fund balances at end of year. Combine lines 18 through c 6d ,302. 2, , ,420. Form 990-EZ (2013)

2 Form 990-EZ (2013) HIGH RISK HOPE, INC 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 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 27, , Land and buildings ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other assets (describe in Schedule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~ SEE SCHEDULE O 8, , Total assets ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 36, , Total liabilities (describe in Schedule O) ~~~~~~~~~~~~~~~~~~~~~~~~ Net assets or fund balances (line 27 of column (B) must agree with line 21) 36, ,420. II Statement of Program Service Accomplishments (see the instructions for II) Expenses (Required for section Check if the organization used Schedule O to respond to any question in this II 501(3) and 501(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(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 (Grants ) If this amount includes foreign grants, check here (Grants ) If this amount includes foreign grants, check here (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 23,877. 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 Name and title Average hours Reportable 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 HEATHER BARROW EECUTIVE DIRECTOR AND FOUNDER SUSIE BRAY SECRETARY AND TREASURER KERRI KIBBEY DIRECTOR AMBER BENNETT DIRECTOR ELIZABETH CARRERE DIRECTOR KIM BARRS DIRECTOR DR. ROBERT YELVERTON, JR. DIRECTOR MEREDITH MUELLER DIRECTOR a 29a 23, Form 990-EZ (2013) 2

3 Form 990-EZ (2013) HIGH RISK HOPE, 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 44a b c d 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 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(4), 501(5), or 501(6) organization subject to section 6033(e) notice, reporting, and proxy tax requirements during the year? If "Yes," complete Schedule C, II ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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 0. Did the organization borrow, 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, I and enter the total amount involved ~~~~~~~~~~~~~~ 38b N/A Section 501(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(3) organizations. Enter amount of tax imposed on the organization during the year under: section ; section ; section b Section 501(3) and 501(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, ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Section 501(3) and 501(4) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and 4958 ~~~~~~~~~~~~~~~ Section 501(3) and 501(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 FL The organization s books are in care of HEATHER BARROW, CPA Telephone no. (813) Located at 1702 N AVENIDA REPUBLICA DE CUBA, TAMPA, FL 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(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 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(13)? ~~~~~~~~~~~~~~~~~~~~~~~~ 45b Did the organization receive any payment or engage in any transaction with a controlled entity within the meaning of section 512(13)? If "Yes," Form 990 and Schedule R may need to be completed instead of Form 990-EZ (see instructions) 39a 39b N/A N/A a 35b 35c 36 38a 40b 42b 42c 44a 44b 44c 44d 45a 45b N/A Yes No Yes No Form 990-EZ (2013) 3

4 Form 990-EZ (2013) f b d 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(3) organizations only All section 501(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 the organization. If there is none, enter "None." Name and title of each employee Average hours Reportable 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 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 the organization. If there is none, enter "None." NONE Name and business address of each independent contractor Type of service Compensation Total number of other independent contractors each receiving over 100,000 ~~~~~~~~~~~~~~ 52 Did the organization complete Schedule A? Note. All section 501(3) organizations and 4947(1) nonexempt charitable trusts must attach a completed Schedule A 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 = = Signature of officer HIGH RISK HOPE, INC Type or print name and title Print/Type preparer s name Preparer s signature Date Check if PTIN self- employed Paid SAM A. LAZZARA P Preparer Firm s name RIVERO, GORDIMER & COMPANY, P.A. Firm s EIN Use Only 9 9 Firm s address 9 P. O. BO Phone no. (813) TAMPA, FL May the IRS discuss this return with the preparer shown above? See instructions Yes No Date 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, I Is the organization a school as described in section 170(1)(A)(ii)? If "Yes," complete Schedule E ~~~~~~~~~~~~~~~~~~~ a Did the organization make any transfers to an exempt non-charitable related organization? ~~~~~~~~~~~~~~~~~~~~~~ 49a HEATHER BARROW, EECUTIVE DIRECTOR AND FOUNDER Form 990-EZ (2013)

5

6 OMB SCHEDULE A (Form 990 or 990-EZ) Public Charity Status and Public Support Complete if the organization is a section 501(3) organization or a section (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 HIGH RISK HOPE, INC 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(1)(A)(i). A school described in section 170(1)(A)(ii). (Attach Schedule E.) A hospital or a cooperative hospital service organization described in section 170(1)(A)(iii). A medical research organization operated in conjunction with a hospital described in section 170(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(1)(A)(iv). (Complete I.) A federal, state, or local government or governmental unit described in section 170(1)(A)(v). An organization that normally receives a substantial part of its support a governmental unit or the general public described in section 170(1)(A)(vi). (Complete I.) A community trust described in section 170(1)(A)(vi). (Complete I.) An organization that normally receives: (1) more than 33 1/3% of its support contributions, membership fees, and gross receipts activities related to its exempt functions - subject to certain exceptions, and (2) no more than 33 1/3% of its support gross investment income and unrelated business taxable income (less section 511 tax) businesses acquired by the organization after June 30, See section 509(2). (Complete II.) An organization organized and operated exclusively to test for public safety. See section 509(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(1) or section 509(2). See section 509(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(1) or section 509(2). If the organization received a written determination 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 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). (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 11g(i) 11g(ii) 11g(iii) 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)

7 Schedule A (Form 990 or 990-EZ) 2013 HIGH RISK HOPE, INC Page 2 I Support Schedule for Organizations Described in Sections 170(1)(A)(iv) and 170(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) Total. Add lines 1 through 3 ~~~ 6 Public support. Subtract line 5 line 4. Calendar year (or fiscal year beginning in) assets (Explain in V.) ~~~~ Total support. Add lines 7 through (e) 2013 (f) Total (e) 2013 (f) Total 24, , , , 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 line 4 ~~~~~~~ Gross income interest, dividends, payments received on securities loans, rents, royalties and income similar sources ~ Net income unrelated business activities, whether or not the business is regularly carried on ~ Other income. Do not include gain or loss the sale of capital Gross receipts related activities, etc. (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~ Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f)) ~~~~~~~~~~~~ Public support percentage 2012 Schedule A, I, line 14 ~~~~~~~~~~~~~~~~~~~~~ 24, , , , , , , ,824. 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 V 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 V 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 , , , First five years. If the Form 990 is for the organization s first, second, third, fourth, or fifth tax year as a section 501(3) organization, check this box and stop here Section C. Computation of Public Support Percentage Schedule A (Form 990 or 990-EZ) 2013 % %

8 Schedule A (Form 990 or 990-EZ) 2013 II Support Schedule for Organizations Described in Section 509(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 disqualified persons b Amounts included on lines 2 and 3 received 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 line 6.) Calendar year (or fiscal year beginning in) 9 Amounts line 6 ~~~~~~~ 10a Gross income interest, dividends, payments received on securities loans, rents, royalties and income similar sources ~ b Unrelated business taxable income (less section 511 taxes) businesses acquired after June 30, 1975 ~~~~ c (e) 2013 (f) Total (e) 2013 (f) Total 14 First five years. If the Form 990 is for the organization s first, second, third, fourth, or fifth tax year as a section 501(3) organization, check this box and stop here Section C. Computation of Public Support Percentage Public support percentage 2012 Schedule A, II, line 15 Section D. Computation of Investment Income Percentage Page 3 Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f)) ~~~~~~~~~~~~ 15 % 19a 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 20 (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 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ~~ Gross receipts admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization s tax-exempt purpose Gross receipts 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 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 the sale of capital assets (Explain in V.) ~~~~ Total support. (Add lines 9, 10c, 11, and 12.) Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f)) Investment income percentage 2012 Schedule A, II, line 17 ~~~~~~~~~~~~~~~~~~ 16 ~~~~~~~~ 17 % more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ~~~~~~~~~~ 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 Schedule A (Form 990 or 990-EZ) % %

9 Schedule A (Form 990 or 990-EZ) 2013 HIGH RISK HOPE, INC Page 4 V Supplemental Information. 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) Schedule A (Form 990 or 990-EZ)

10 ** ** 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): HIGH RISK HOPE, INC Filers of: Section: Form 990 or 990-EZ 501( 3 ) (enter number) organization 4947(1) nonexempt charitable trust not treated as a private foundation 527 political organization Form 990-PF 501(3) exempt private foundation 4947(1) nonexempt charitable trust treated as a private foundation 501(3) taxable private foundation Check if your organization is covered by the General Rule or a Special Rule. Note. Only a section 501(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) any one contributor. Complete Parts I and II. Special Rules For a section 501(3) organization filing Form 990 or 990-EZ that met the 33 1/3% support test of the regulations under sections 509(1) and 170(1)(A)(vi) and received 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(7), (8), or (10) organization filing Form 990 or 990-EZ that received 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(7), (8), or (10) organization filing Form 990 or 990-EZ that received any one contributor, during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did not total to more than 1,000. 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 V, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on its Form 990-PF,, 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)

11 Schedule B (Form 990, 990-EZ, or 990-PF) (2013) Name of organization Employer identification number Page 2 HIGH RISK HOPE, INC Contributors (see instructions). Use duplicate copies of if additional space is needed. Name, address, and ZIP + 4 Total contributions Type of contribution 1 Person Payroll 15,000. Noncash Name, address, and ZIP + 4 Total contributions Type of contribution 2 Person Payroll 5,000. Noncash Name, address, and ZIP + 4 Name, address, and ZIP + 4 Name, address, and ZIP + 4 Total contributions Total contributions Total contributions (Complete I for noncash contributions.) (Complete I for noncash contributions.) Type of contribution Person Payroll Noncash (Complete I for noncash contributions.) Type of contribution Person Payroll Noncash (Complete I for noncash contributions.) Type of contribution Person Payroll Noncash (Complete I for noncash contributions.) Name, address, and ZIP + 4 Total contributions Type of contribution Person Payroll Noncash (Complete I for noncash contributions.) Schedule B (Form 990, 990-EZ, or 990-PF) (2013) 10

12 Schedule B (Form 990, 990-EZ, or 990-PF) (2013) Name of organization Page 3 Employer identification number HIGH RISK HOPE, INC I Noncash Property (see instructions). Use duplicate copies of I if additional space is needed. Description of noncash property given FMV (or estimate) (see instructions) Date received Description of noncash property given Description of noncash property given Description of noncash property given Description of noncash property given FMV (or estimate) (see instructions) FMV (or estimate) (see instructions) FMV (or estimate) (see instructions) FMV (or estimate) (see instructions) Date received Date received Date received Date received Description of noncash property given FMV (or estimate) (see instructions) Date received Schedule B (Form 990, 990-EZ, or 990-PF) (2013) 11

13 Schedule B (Form 990, 990-EZ, or 990-PF) (2013) Name of organization Page 4 Employer identification number HIGH RISK HOPE, INC II Exclusively religious, charitable, etc., individual contributions to section 501(7), (8), or (10) organizations that total more than 1,000 for the year. Complete columns through (e) and the following line entry. For organizations completing II, 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 II if additional space is needed. Purpose of gift Use of gift Description of how gift is held Transferee s name, address, and ZIP + 4 (e) Transfer of gift Relationship of transferor to transferee 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 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 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 Schedule B (Form 990, 990-EZ, or 990-PF) (2013) 12

14 SCHEDULE G OMB (Form 990 or 990-EZ) Complete if the organization answered "Yes" to Form 990, V, lines 17, 18, or 19, or if the organization entered more than 15,000 on Form 990-EZ, line 6a. Department of the Treasury Attach to Form 990 or Form 990-EZ. Open To Public Internal Revenue Service Inspection Information about Schedule G (Form 990 or 990-EZ) and its instructions is at Name of the organization Employer identification number 2 a Did the organization have a written or oral agreement with any individual (including officers, directors, trustees or b If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is to be (i) Total 3 Fundraising Activities. Complete if the organization answered "Yes" to Form 990, V, line 17. Form 990-EZ filers are not required to complete this part. 1 Indicate whether the organization raised funds through any of the following activities. Check all that apply. a Mail solicitations e Solicitation of non-government grants b Internet and solicitations f Solicitation of government grants c Phone solicitations g Special fundraising events d In-person solicitations FL key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services? compensated at least 5,000 by the organization. Name and address of individual or entity (fundraiser) Supplemental Information Regarding Fundraising or Gaming Activities HIGH RISK HOPE, INC (ii) Activity (iii) Did fundraiser (iv) Gross receipts have custody or control of activity contributions? Yes No Yes (v) Amount paid to (or retained by) fundraiser listed in col. (i) 2013 List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt registration or licensing. No (vi) Amount paid to (or retained by) organization LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule G (Form 990 or 990-EZ)

15 Schedule G (Form 990 or 990-EZ) 2013 HIGH RISK HOPE, INC Page 2 I Fundraising Events. Complete if the organization answered "Yes" to Form 990, V, line 18, or reported more than 15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than 5,000. Revenue Direct Expenses Event #1 Event #2 Other events NONE TOT TROT 11 Net income summary. Subtract line 10 line 3, column II Gaming. Complete if the organization answered "Yes" to Form 990, V, line 19, or reported more than Revenue Direct Expenses Gross receipts ~~~~~~~~~~~~~~ Less: Contributions Bingo Pull tabs/instant bingo/progressive bingo Other gaming Yes % Yes % Yes % No No No a Is the organization licensed to operate gaming activities in each of these states? ~~~~~~~~~~~~~~~~~~~~ b If "No," explain: ~~~~~~~~~~~ Gross income (line 1 minus line 2) Cash prizes Noncash prizes ~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~ Rent/facility costs ~~~~~~~~~~~~ Food and beverages ~~~~~~~~~~ Entertainment ~~~~~~~~~~~~~~ Other direct expenses ~~~~~~~~~~ Direct expense summary. Add lines 4 through 9 in column 15,000 on Form 990-EZ, line 6a. Gross revenue Cash prizes Noncash prizes ~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~ Rent/facility costs ~~~~~~~~~~~~ Other direct expenses Volunteer labor ~~~~~~~~~~~~~ Direct expense summary. Add lines 2 through 5 in column Net gaming income summary. Subtract line 7 line 1, column Enter the state(s) in which the organization operates gaming activities: (event type) (event type) (total number) ~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~ Total events (add col. through col. ) 34, ,012. 5,246. 5, , ,766. 2,837. 2,837. 2,812. 2,812. 1,144. 1,144. 1,100. 1,100. 2,571. 2, , ,302. Total gaming (add col. through col. ) Yes No 10a Were any of the organization s gaming licenses revoked, suspended or terminated during the tax year? ~~~~~~~~~ b If "Yes," explain: Yes No Schedule G (Form 990 or 990-EZ)

16 Schedule G (Form 990 or 990-EZ) 2013 HIGH RISK HOPE, INC Page Does the organization operate gaming activities with nonmembers? ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity formed to administer charitable gaming? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes Yes No No 13 Indicate the percentage of gaming activity operated in: a The organization s facility ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 13a % b An outside facility ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 13b % 14 Enter the name and address of the person who prepares the organization s gaming/special events books and records: Name Address 15a Does the organization have a contract with a third party whom the organization receives gaming revenue? ~~~~~~ b If "Yes," enter the amount of gaming revenue received by the organization and the amount of gaming revenue retained by the third party. c If "Yes," enter name and address of the third party: Name Address 16 Gaming manager information: Name Gaming manager compensation Description of services provided Director/officer Employee Independent contractor 17 Mandatory distributions: a Is the organization required under state law to make charitable distributions the gaming proceeds to retain the state gaming license? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ b Enter the amount of distributions required under state law to be distributed to other exempt organizations or spent in the organization s own exempt activities during the tax year V Supplemental Information. Provide the explanations required by, line 2b, columns (iii) and (v), and II, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions). Yes Yes No No Schedule G (Form 990 or 990-EZ)

17 Schedule G (Form 990 or 990-EZ) HIGH RISK HOPE, INC V Supplemental Information (continued) Page Schedule G (Form 990 or 990-EZ) 16

18 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 HIGH RISK HOPE, INC FORM 990-EZ, PART I, LINE 8, OTHER REVENUE: DESCRIPTION OF OTHER REVENUE: AMOUNT: CASH BACK PROGRAM - CREDIT CARD 293. FORM 990-EZ, PART I, LINE 16, OTHER EPENSES: DESCRIPTION OF OTHER EPENSES: AMOUNT: PROGRAM EPENSES 23,649. MANAGEMENT AND GENERAL 2,370. FUNDRAISING AND DEVELOPMENT 186. TOTAL TO FORM 990-EZ, LINE 16 26,205. FORM 990-EZ, PART II, LINE 24, OTHER ASSETS: DESCRIPTION BEG. OF YEAR END OF YEAR PROGRAM SUPPLIES 8, ,598. PREPAID EPENSE OTHER DEPRECIABLE ASSETS TOTAL TO FORM 990-EZ, LINE 24 8, ,973. FORM 990-EZ, PART III, PRIMARY EEMPT PURPOSE - HIGH RISK HOPE, INC. (THE "ORGANIZATION") IS A NOT-PROFIT ORGANIZATION FORMED ON FEBRUARY 16, 2011 TO PROVIDE SUPPORT, ENCOURAGEMENT, INFORMATION AND RESOURCES TO WOMEN AND FAMILIES WHO ARE EPERIENCING A HIGH RISK PREGNANCY RESULTING IN HOSPITAL BED REST, POTENTIAL PREMATURE BIRTH AND NEONATAL INTENSIVE CARE AFTER DELIVERY. FORM 990-EZ, PART III, LINE 28, PROGRAM SERVICE ACCOMPLISHMENTS: LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule O (Form 990 or 990-EZ) (2013)

19 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 HIGH RISK HOPE, INC THE ORGANIZATION PROLONGS HIGH RISK PREGNANCIES AND IMPROVES OUTCOMES FOR PREMATURE INFANTS BY SUPPORTING PATIENTS ADMITTED TO THE HIGH RISK OBSTETRIC AND NEONATAL INTENSIVE CARE UNIT IN THE HOSPITAL, AND IS THE ONLY LOCAL AND NATIONAL NON-PROFIT ORGANIZATION PROVIDING THESE SERVICES. THE ORGANIZATION REACHES OVER 1,200 PATIENTS ANNUALLY AT LOCAL HOSPITALS, WHERE BABIES ARE BORN HEALTHIER AND THEIR FAMILIES HOSPITAL STAYS ARE MORE MANAGEABLE BECAUSE OF THE ORGANIZATION S SERVICES. 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)