Short Form 990-EZ Return of Organization Exempt From Income Tax

Transcription

1 Form B G I Short Form 990-EZ Return of Organization Exempt From Inome Tax 2013 Under setion 501(), 527, or 4947(a)(1) of the Internal Revenue Code (exept private foundations) Do not enter Soial Seurity numers on this form as it may e made puli. Department of the Treasury Internal Revenue Servie Information aout Form 990-EZ and its instrutions is at A For the 2013 alendar year, or tax year eginning, 2013, and ending, 20 Open to Puli Inspetion D Employer identifiation numer Numer and street (or P.O. ox, if mail is not delivered to street address) Room/suite E Telephone numer Aounting Method: Cash Arual Other (speify) H Chek if the organization is not Wesite: J Tax-exempt status (hek only one) - 501()(3) 501()( ) (insert no.) 4947(a)(1) or 527 (Form 990, 990-EZ, or 990-PF). K Form of organization: Corporation Trust Assoiation Other L Add lines 5, 6, and 7, to line 9 to determine gross reeipts. If gross reeipts are $200,000 or more, or if total assets (Part II, olumn (B) elow) are $500,000 or more, file Form 990 instead of Form 990-EZ... $ 93,520 Part I Revenue, Expenses, and Changes in Net Assets or Fund Balanes (see the instrutions for Part I) Chek if the organization used Shedule O to respond to any question in this Part I... 1 Contriutions, gifts, grants, and similar amounts reeived ,053 2 Program servie revenue inluding government fees and ontrats ,595 3 Memership dues and assessments ,870 4 Investment inome a Gross amount from sale of assets other than inventory... 5a Less: ost or other asis and sales expenses... 5 Gain or (loss) from sale of assets other than inventory (Sutrat line 5 from line 5a) Gaming and fundraising events Revenue a Gross inome from gaming (attah Shedule G if greater than $15,000)... Gross inome from fundraising events (not inluding $ from fundraising events reported on line 1) (attah Shedule G if the sum of suh gross inome and ontriutions exeeds $15,000)... 6 Less: diret expenses from gaming and fundraising events... 6 d Net inome or (loss) from gaming and fundraising events (add lines 6a and 6 and sutrat line 6)... 6d 7a Gross sales of inventory, less returns and allowanes... 7a Less: ost of goods sold... 7 Gross profit or (loss) from sales of inventory (Sutrat line 7 from line 7a) Other revenue (desrie in Shedule O) Total revenue. Add lines 1, 2, 3, 4, 5, 6d, 7, and Grants and similar amounts paid (list in Shedule O) Benefits paid to or for memers Salaries, other ompensation, and employee enefits Professional fees and other payments to independent ontrators Oupany, rent, utilities, and maintenane Printing, puliations, postage, and shipping Other expenses (desrie in Shedule O) Total expenses. Add lines 10 through Exess or (defiit) for the year (Sutrat line 17 from line 9) Net assets or fund alanes at eginning of year (from line 27, olumn (A)) (must agree with end-of-year figure reported on prior year's return) Other hanges in net assets or fund alanes (explain in Shedule O) Net assets or fund alanes at end of year. Comine lines 18 through For Paperwork Redution At tie, see the separate instrutions. Expenses Net Assets Chek if appliale: Address hange Name hange Initial return Terminated Amended return Appliation pending C Name of organization PO BO (615) City or town, state or provine, ountry, and ZIP or foreign postal ode NASHVILLE, TN a of ontriutions F Group Exemption Numer required to attah Shedule B OMB ,520 40,000 1,100 3, ,788 88,607 4,913 48,531 53,444

2 Part II Page 2 Balane Sheets (see the instrutions for Part II) Chek if the organization used Shedule O to respond to any question in this Part II... (A) Beginning of year (B) End of year 22 Cash, savings, and investments... 48, , Land and uildings Other assets (desrie in Shedule O) , Total assets... 48, , Total liailities (desrie in Shedule O) , Net assets or fund alanes (line 27 of olumn (B) must agree with line 21)... 48, ,444 Part III Statement of Program Servie Aomplishments (see the instrutions for Part III) Expenses Chek if the organization used Shedule O to respond to any question in this Part III... (Required for setion What is the organization's primary exempt purpose? PROMOTES WELFARE OF HUMAN RESOURCES 501()(3) and 501()(4) Desrie the organization's program servie aomplishments for eah of its three largest program servies, as measured y expenses. In a lear and onise manner, desrie the servies provided, the numer of persons enefited, and other relevant information for eah program title THE ORGANIZATION PROVIDES TRAINING CONFERENCES HELD REGIONALLY ACROSS TN AND SENDS NEWSLETTERS. THEY ALSO STUDY, RESEARCH AND ANALYSIS VARIOUS AREAS OF SOCIAL (Grants $ ) If this amount inludes foreign grants, hek here... organizations and setion 4947(a)(1) trusts; optional for others.) 28a 0 30 (Grants $ ) If this amount inludes foreign grants, hek here... 29a (Grants $ ) If this amount inludes foreign grants, hek here... 30a 31 Other program servies (desrie in Shedule O)... (Grants $ ) If this amount inludes foreign grants, hek here... 31a 32 Total program servie expenses (add lines 28a through 31a) Part IV List of Offiers, Diretors, Trustees, and Key Employees (list eah one even if not ompensated (see the instrutions for Part IV) Chek if the organization used Shedule O to respond to any question in this Part IV... (a) Name and title () Reportale (d) Health enefits, () Average ompensation ontriutions to employee (e) Estimated amount of hours per week (Form W-2/1099-MISC) enefit plans, and other ompensation devoted to position (if not paid, enter -0-) deferred ompensation JEFFREY B WEESNER MBA PRESIDENT DUSTIN KELLER PHD LPC-MHSP VICE PRESIDENT LATAMERA WOODLEY LAPSW SECRETARY ELIZABETH COTELLESE LMSW TREASURER DIANNE K POLLY JD RDN LDN PAST PRESIDENT PHIL ACORD CARLA SNODGRASSS BSW MPA CARLA SEWELL CAROL WESTLAKE SHERRY JO ANDERSON JACK PARKS EVE NIGHT

3 Part V Page 3 Other Information (te the Shedule A and personal enefit ontrat statement requirements in the instrutions for Part V) Chek if the organization used Shedule O to respond to any question in this Part V... opy of the amended douments if they reflet a hange to the organization's name. Otherwise, explain the hange on Shedule O (see instrutions) a Did the organization have unrelated usiness gross inome of $1,000 or more during the year from usiness ativities (suh as those reported on lines 2, 6a, and 7a, among others)?... If "," to line 35a, has the organization filed a Form 990-T for the year? If "," provide an explanation in Shedule O... Was the organization a setion 501()(4), 501()(5), or 501()(6) organization sujet to setion 6033(e) notie, reporting, and proxy tax requirements during the year? If "," omplete Shedule C, Part III Did the organization undergo a liquidation, dissolution, termination, or signifiant disposition of net assets during the year? If "," omplete appliale parts of Shedule N a Enter amount of politial expenditures, diret or indiret, as desried in the instrutions... 37a Did the organization file Form 1120-POL for this year? a Did the organization orrow from, or make any loans to, any offier, diretor, trustee, or key employee or were any suh loans made in a prior year and still outstanding at the end of the tax year overed y this return?... If "," omplete Shedule L, Part II and enter the total amount involved Setion 501()(7) organizations. Enter: a Initiation fees and apital ontriutions inluded on line a Gross reeipts, inluded on line 9, for puli use of lu failities a Setion 501()(3) organizations. Enter amount of tax imposed on the organization during the year under: 41 d e 42 a 43 At any time during the alendar year, did the organization have an interest in or a signature or other authority over a finanial aount in a foreign ountry (suh as a ank aount, seurities aount, or other finanial aount)? If "," enter the name of the foreign ountry: Did the organization engage in any signifiant ativity not previously reported to the IRS? If "," provide a detailed desription of eah ativity in Shedule O... Were any signifiant hanges made to the organizing or governing douments? If "," attah a onformed setion 4911 ; setion 4912 ; setion 4955 Setion 501()(3) and 501()(4) organizations. Did the organization engage in any setion 4958 exess enefit transation during the year, or did it engage in an exess enefit transation in a prior year that has not een reported on any of its prior Forms 990 or 990-EZ? If "," omplete Shedule L, Part I... Setion 501()(3) and 501()(4) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under setions 4912, 4955, and Setion 501()(3) and 501()(4) organizations. Enter amount of tax on line 40 reimursed y the organization... All organizations. At any time during the tax year, was the organization a party to a prohiited tax shelter transation? If "," omplete Form 8886-T... List the states with whih a opy of this return is filed The organization's ooks are in are of TERRI LAWSON Telephone no Loated at PO BO , NASHVILLE, TN ZIP See the instrutions for exeptions and filing requirements for Form TD F , Report of Foreign Bank and Finanial Aounts. At any time during the alendar year, did the organization maintain an offie outside the U.S.? If "," enter the name of the foreign ountry: Setion 4947(a)(1) nonexempt haritale trusts filing Form 990-EZ in lieu of Form 1041-Chek here... and enter the amount of tax-exempt interest reeived or arued during the tax year a Did the organization maintain any donor advised funds during the year? If "," Form 990 must e ompleted instead of Form 990-EZ... 44a Did the organization operate one or more hospital failities during the year? If "," Form 990 must e ompleted instead of Form 990-EZ Did the organization reeive any payments for indoor tanning servies during the year? d If "," to line 44, has the organization filed a Form 720 to report these payments? If "," provide an explanation in Shedule O... 44d 45 a Did the organization have a ontrolled entity within the meaning of setion 512()(13)?... 45a 45 Did the organization reeive any payment from or engage in any transation with a ontrolled entity within the meaning of setion 512()(13)? If "," Form 990 and Shedule R may need to e ompleted instead of Form 990-EZ (see instrutions) a a 40 40e

4 46 Did the organization engage, diretly or indiretly, in politial ampaign ativities on ehalf of or in opposition to andidates for puli offie? If "," omplete Shedule C, Part I Part VI Setion 501()(3) organizations only All setion 501()(3) organizations must answer questions and 52, and omplete the tales for lines 50 and 51. Chek if the organization used Shedule O to respond to any question in this Part VI Did the organization engage in loying ativities or have a setion 501(h) eletion in effet during the tax year? If "," omplete Shedule C, Part II Is the organization a shool as desried in setion 170()(1)(A)(ii)? If "," omplete Shedule E a Did the organization make any transfers to an exempt non-haritale related organization?... 49a If "," was the related organization a setion 527 organization? Complete this tale for the organization's five highest ompensated employees (other than offiers, diretors, trustees and key employees) who eah reeived more than $100,000 of ompensation from the organization. If there is none, enter "ne." () (d) Health enefits, () Average Reportale ontriutions to employee (e) Estimated amount of (a) Name and title of eah employee hours per week ompensation enefit plans, and deferred other ompensation devoted to position (Forms W-2/1099-MISC) ompensation Page 4 NONE 51 f Total numer of other employees paid over $100, Complete this tale for the organization's five highest ompensated independent ontrators who eah reeived more than $100,000 of ompensation from the organization. If there is none, enter "ne." (a) Name and usiness address of eah independent ontrator () Type of servie () Compensation NONE 52 d Sign Here Paid Preparer Use Only Total numer of other independent ontrators eah reeiving over $100, Did the organization omplete Shedule A? te: All setion 501()(3) organizations and 4947(a)(1) nonexempt haritale trusts must attah a ompleted Shedule A... Under penalties of perjury, I delare that I have examined this return, inluding aompanying shedules and statements, and to the est of my knowledge and elief, it is true, orret, and omplete. Delaration of preparer (other than offier) is ased on all information of whih preparer has any knowledge. Signature of offier Type or print name and title Print/Type preparer's name Preparer's signature Date Chek if PTIN BOB BELLENFANT CPA self-employed P Firm's name Firm's address May the IRS disuss this return with the preparer shown aove? See instrutions TERRI LAWSON TERRI LAWSON, EECUTIVE DIRECTOR BELLENFANT & MILES PLLC 136 WILSON PIKE CIRCLE Date Firm's EIN BRENTWOOD TN Phone no

5 SCHEDULE A (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Servie Name of the organization Puli Charity Status and Puli Support Complete if the organization is a setion 501()(3) organization or a setion 4947(a)(1) nonexempt haritale trust. Attah to Form 990 or Form 990-EZ. Part I Reason for Puli Charity Status (All organizations must omplete this part.) See instrutions. The organization is not a private foundation eause it is: (For lines 1 through 11, hek only one ox.) e f g h (A) A hurh, onvention of hurhes, or assoiation of hurhes desried in setion 170()(1)(A)(i). A shool desried in setion 170()(1)(A)(ii). (Attah Shedule E.) A hospital or a ooperative hospital servie organization desried in setion 170()(1)(A)(iii). A medial researh organization operated in onjuntion with a hospital desried in setion 170()(1)(A)(iii). Enter the hospital's name, ity, and state: An organization operated for the enefit of a ollege or university owned or operated y a governmental unit desried in setion 170()(1)(A)(iv). (Complete Part II.) A federal, state, or loal government or governmental unit desried in setion 170()(1)(A)(v). An organization that normally reeives a sustantial part of its support from a governmental unit or from the general puli desried in setion 170()(1)(A)(vi). (Complete Part II.) A ommunity trust desried in setion 170()(1)(A)(vi). (Complete Part II.) An organization that normally reeives: (1) more than 33 1/3% of its support from ontriutions, memership fees, and gross reeipts from ativities related to its exempt funtions - sujet to ertain exeptions, and (2) no more than 33 1/3% of its support from gross investment inome and unrelated usiness taxale inome (less setion 511 tax) from usinesses aquired y the organization after June 30, See setion 509(a)(2). (Complete Part III.) An organization organized and operated exlusively to test for puli safety. See setion 509(a)(4). An organization organized and operated exlusively for the enefit of, to perform the funtions of, or to arry out the purposes of one or more pulily supported organizations desried in setion 509(a)(1) or setion 509(a)(2). See setion 509(a)(3). Chek the ox that desries the type of supporting organization and omplete lines 11e through 11h Open to Puli Inspetion a Type I Type II Type III-Funtionally integrated d Type III-n-funtionally integrated By heking this ox, I ertify that the organization is not ontrolled diretly or indiretly y one or more disqualified persons other than foundation managers and other than one or more pulily supported organizations desried in setion 509(a)(1) or setion 509(a)(2). If the organization reeived a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, hek this ox... Sine August 17, 2006, has the organization aepted any gift or ontriution from any of the following persons? Information aout Shedule A (Form 990 or 990-EZ) and its instrutions is at Employer identifiation numer (i) A person who diretly or indiretly ontrols, either alone or together with persons desried in (ii) and (iii) elow, the governing ody of the supported organization?... (ii) A family memer of a person desried in (i) aove?... (iii) A 35% ontrolled entity of a person desried in (i) or (ii) aove?... Provide the following information aout the supported organization(s). OMB (i) Name of supported (ii) EIN (iii) Type of organization (iv) Is the organization (v) Did you notify (vi) Is the (vii) Amount of monetary organization (desried on lines 1-9 in ol. (i) listed in your the organization in organization in ol. support aove or IRC setion governing doument? ol. (i) of your (i) organized in the (see instrutions)) support? U.S.? 11g(i) 11g(ii) 11g(iii) (B) (C) (D) (E) Total For Paperwork Redution At tie, see the Instrutions for Form 990 or 990-EZ. Shedule A (Form 990 or 990-EZ) 2013

6 Shedule A (Form 990 or 990-EZ) 2013 Page 2 Part II Support Shedule for Organizations Desried in Setions 170()(1)(A)(iv) and 170()(1)(A)(vi) (Complete only if you heked the ox on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed elow, please omplete Part III.) Setion A. Puli Support Calendar year (or fisal year eginning in) (a) 2009 () 2010 () 2011 (d) 2012 (e) 2013 (f) Total 1 2 Gifts, grants, ontriutions, and memership fees reeived. (Do not inlude any "unusual grants.")... Tax revenues levied for the organization's enefit and either paid to or expended on its ehalf The value of servies or failities furnished y a governmental unit to the organization without harge... Total. Add lines 1 through 3... The portion of total ontriutions y eah person (other than a governmental unit or pulily supported organization) inluded on line 1 that exeeds 2% of the amount shown on line 11, olumn (f)... 6 Puli support. Sutrat line 5 from line 4.. Setion B. Total Support Calendar year (or fisal year eginning in) 7 Amounts from line Gross inome from interest, dividends, payments reeived on seurities loans, rents, royalties and inome from similar soures... (a) 2009 () 2010 () 2011 (d) 2012 (e) 2013 (f) Total 9 Net inome from unrelated usiness ativities, whether or not the usiness is regularly arried on Other inome. Do not inlude gain or loss from the sale of apital assets (Explain in Part IV.) Total support. Add lines 7 through Gross reeipts from related ativities, et. (see instrutions) First five years. If the Form 990 is for the organization's first, seond, third, fourth, or fifth tax year as a setion 501()(3) organization, hek this ox and stop here... Setion C. Computation of Puli Support Perentage 14 Puli support perentage for 2013 (line 6, olumn (f) divided y line 11, olumn (f)) % 15 Puli support perentage from 2012 Shedule A, Part II, line % 16a 33 1/3% support test If the organization did not hek the ox on line 13, and line 14 is 33 1/3% or more, hek this ox and stop here. The organization qualifies as a pulily supported organization /3% support test If the organization did not hek a ox on line 13 or 16a, and line 15 is 33 1/3% or more, hek this ox and stop here. The organization qualifies as a pulily supported organization... 17a 10%-fats-and-irumstanes test If the organization did not hek a ox on line 13, 16a, or 16, and line 14 is 10% or more, and if the organization meets the "fats-and-irumstanes" test, hek this ox and stop here. Explain in 18 Part IV how the organization meets the "fats-and-irumstanes" test. The organization qualifies as a pulily supported organization... 10%-fats-and-irumstanes test If the organization did not hek a ox on line 13, 16a, 16, or 17a, and line 15 is 10% or more, and if the organization meets the "fats-and-irumstanes" test, hek this ox and stop here. Explain in Part IV how the organization meets the "fats-and-irumstanes" test. The organization qualifies as a pulily supported organization... Private foundation. If the organization did not hek a ox on line 13, 16a, 16, 17a, or 17, hek this ox and see instrutions... Shedule A (Form 990 or 990-EZ) 2013

7 Shedule A (Form 990 or 990-EZ) 2013 Page 3 Part III Support Shedule for Organizations Desried in Setion 509(a)(2) (Complete only if you heked the ox on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed elow, please omplete Part II.) Setion A. Puli Support Calendar year (or fisal year eginning in) (a) 2009 () 2010 () 2011 (d) 2012 (e) 2013 (f) Total a Gifts, grants, ontriutions, and memership fees reeived. (Do not inlude any "unusual grants.") Gross reeipts from admissions, merhandise sold or servies performed, or failities furnished in any ativity that is related to the organization's tax-exempt purpose Gross reeipts from ativities that are not an unrelated trade or us. under se 513 Tax revenues levied for the organization's enefit and either paid to or expended on its ehalf The value of servies or failities furnished y a governmental unit to the organization without harge Total. Add lines 1 through 5 Amounts inluded on lines 1, 2, and 3 reeived from disqualified persons ,615 34,750 34,686 15,720 18, ,824 64,274 48,696 63,253 80,914 75, , ,889 83,446 97,939 96,634 93, ,426 Amounts inluded on lines 2 and 3 reeived from other than disqualified persons that exeed the greater of $5,000 or 1% of the amount on line 13 for the year Add lines 7a and 7 8 Puli support (Sutrat line 7 from line 6.)... Setion B. Total Support Calendar year (or fisal year eginning in) 9 Amounts from line a..... Gross inome from interest, dividends, payments reeived on seurities loans, rents, royalties and inome from similar soures.. 485,426 (a) 2009 () 2010 () 2011 (d) 2012 (e) 2013 (f) Total 113,889 83,446 97,939 96,634 93, , Unrelated usiness taxale inome (less setion 511 taxes) from usinesses aquired after June 30, 1975 Add lines 10a and Net inome from unrelated usiness ativities not inluded in line 10, whether or not the usiness is regularly arried on Other inome. Do not inlude gain or loss from the sale of apital assets (Explain in Part IV.)... 1,324 1, Total support. (Add lines 9, 10, 11, and 12.) ,960 83,450 97,942 97,959 93, , First five years. If the Form 990 is for the organization's first, seond, third, fourth, or fifth tax year as a setion 501()(3) organization, hek this ox and stop here... Setion C. Computation of Puli Support Perentage 15 Puli support perentage for 2013 (line 8, olumn (f) divided y line 13, olumn (f)) % 16 Puli support perentage from 2012 Shedule A, Part III, line % Setion D. Computation of Investment Inome Perentage 17 Investment inome perentage for 2013 (line 10, olumn (f) divided y line 13, olumn (f)) % 18 Investment inome perentage from 2012 Shedule A, Part III, line % 19a 33 1/3% support tests If the organization did not hek the ox on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, hek this ox and stop here. The organization qualifies as a pulily supported organization /3% support tests If the organization did not hek a ox on line 14 or line 19a, and line 16 is more than 33 1/3%, and line 18 is not more than 33 1/3%, hek this ox and stop here. The organization qualifies as a pulily supported organization Private foundation. If the organization did not hek a ox on line 14, 19a, or 19, hek this ox and see instrutions... Shedule A (Form 990 or 990-EZ) 2013

8 SCHEDULE C (Form 990 or 990-EZ) Politial Campaign and Loying Ativities For Organizations Exempt From Inome Tax Under setion 501() and setion Complete if the organization is desried elow. Attah to Form 990 or Form 990-EZ. Department of the Treasury See separate instrutions. Information aout Shedule C (Form 990 or 990-EZ) and its Open to Puli Internal Revenue Servie Instrutions is at Inspetion If the organization answered "," to Form 990, Part IV, line 3, or Form 990-EZ, Part V, line 46 (Politial Campaign Ativities), then If the organization answered "," to Form 990, Part IV, line 4, or Form 990-EZ, Part VI, line 47 (Loying Ativities), then If the organization answered "," to Form 990, Part IV, line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35 (Proxy Tax), then Employer identifiation numer Part I-A Complete if the organization is exempt under setion 501() or is a setion 527 organization. 1 Provide a desription of the organization's diret and indiret politial ampaign ativities in Part IV. 2 Politial expenditures... $ 3 Volunteer hours... Part I-B Complete if the organization is exempt under setion 501()(3). 1 Enter the amount of any exise tax inurred y the organization under setion $ 2 Enter the amount of any exise tax inurred y organization managers under setion $ 3 If the organization inurred a setion 4955 tax, did it file Form 4720 for this year?... 4a Was a orretion made?... If "," desrie in Part IV. Part I-C Complete if the organization is exempt under setion 501(), exept setion 501()(3). 1 Enter the amount diretly expended y the filing organization for setion 527 exempt funtion ativities... $ 2 Enter the amount of the filing organization's funds ontriuted to other organizations for setion 527 exempt funtion ativities... $ 3 Total exempt funtion expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line $ 4 Did the filing organization file Form 1120-POL for this year?... 5 Enter the names, addresses and employer identifiation numer (EIN) of all setion 527 politial organizations to whih the filing (1) Setion 501()(3) organizations: Complete Parts I-A and B. Do not omplete Part I-C. Setion 501() (other than setion 501()(3)) organizations: Complete Parts I-A and C elow. Do not omplete Part I-B. Setion 527 organizations: Complete Part I-A only. Setion 501()(3) organizations that have filed Form 5768 (eletion under setion 501(h)): Complete Part II-A. Do not omplete Part II-B. Setion 501()(3) organizations that have NOT filed Form 5768 (eletion under setion 501(h)): Complete Part II-B. Do not omplete Part II-A. Setion 501()(4), (5), or (6) organizations: Complete Part III. Name of organization organization made payments. For eah organization listed, enter the amount paid from the filing organization's funds. Also enter the amount of politial ontriutions reeived that were promptly and diretly delivered to a separate politial organization, suh as a separate segregated fund or a politial ation ommittee (PAC). If additional spae is needed, provide information in Part IV. OMB (a) Name () Address () EIN (d) Amount paid from (e) Amount of politial filing organization's ontriutions reeived and funds. If none, enter -0-. promptly and diretly delivered to a separate politial organization. If none, enter -0-. (2) (3) (4) (5) (6) For Paperwork Redution At tie, see the Instrutions for Form 990 or 990-EZ. Shedule C (Form 990 or 990-EZ) 2013

9 Shedule C (Form 990 or 990-EZ) 2013 A B Part II-A 1a d e f g h i j Chek Chek Page 2 Complete if the organization is exempt under setion 501()(3) and filed Form 5768 (eletion under setion 501(h)). if the filing organization elongs to an affiliated group (and list in Part IV eah affiliated group memer's name, address, EIN, expenses, and share of exess loying expenditures). if the filing organization heked ox A and "limited ontrol" provisions apply. Limits on Loying Expenditures (The term "expenditures" means amounts paid or inurred.) Total loying expenditures to influene puli opinion (grass roots loying)... Total loying expenditures to influene a legislative ody (diret loying)... Total loying expenditures (add lines 1a and 1)... Other exempt purpose expenditures... Total exempt purpose expenditures (add lines 1 and 1d)... Loying nontaxale amount. Enter the amount from the following tale in oth olumns. If the amount on line 1e, olumn (a) or () is: The loying nontaxale amount is : t over $500,000 20% of the amount on line 1e. Over $500,000 ut not over $1,000,000 $100,000 plus 15% of the exess over $500,000. Over $1,000,000 ut not over $1,500,000 $175,000 plus 10% of the exess over $1,000,000. Over $1,500,000 ut not over $17,000,000 $225,000 plus 5% of the exess over $1,500,000. (a) Filing organization's totals Over $17,000,000 $1,000,000. Grassroots nontaxale amount (enter 25% of line 1f)... Sutrat line 1g from line 1a. If zero or less, enter Sutrat line 1f from line 1. If zero or less, enter If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting setion 4911 tax for this year?... 4-Year Averaging Period Under Setion 501(h) (Some organizations that made a setion 501(h) eletion do not have to omplete all of the five olumns elow. See the instrutions for lines 2a through 2f on page 4.) Loying Expenditures During 4-Year Averaging Period () Affiliated group totals Calendar year (or fisal year (a) 2010 () 2011 () 2012 (d) 2013 (e) Total eginning in) 2a Loying nontaxale amount Loying eiling amount (150% of line 2a, olumn (e)) Total loying expenditures d e f Grassroots nontaxale amount Grassroots eiling amount (150% of line 2d, olumn (e)) Grassroots loying expenditures Shedule C (Form 990 or 990-EZ) 2013

10 Shedule C (Form 990 or 990-EZ) 2013 Page 3 Part II-B Complete if the organization is exempt under setion 501()(3) and has NOT filed Form 5768 (eletion under setion 501(h)). For eah "" response to lines 1a through 1i elow, provide in Part IV a detailed desription of the loying ativity. (a) () Amount 1 During the year, did the filing organization attempt to influene foreign, national, state or loal legislation, inluding any attempt to influene puli opinion on a legislative matter or referendum, through the use of: a Volunteers?... Paid staff or management (inlude ompensation in expenses reported on lines 1 through 1i)?... Media advertisements?... d Mailings to memers, legislators, or the puli?... e Puliations, or pulished or roadast statements?... f Grants to other organizations for loying purposes?... g Diret ontat with legislators, their staffs, government offiials, or a legislative ody?... h Rallies, demonstrations, seminars, onventions, speehes, letures, or any similar means?... i Other ativities?... j Total. Add lines 1 through 1i... 2a Did the ativities in line 1 ause the organization to e not desried in setion 501()(3)?... If "," enter the amount of any tax inurred under setion If "," enter the amount of any tax inurred y organization managers under setion d If the filing organization inurred a setion 4912 tax, did it file Form 4720 for this year?... Part III-A Complete if the organization is exempt under setion 501()(4), setion 501()(5), or setion 501()(6). 1 Were sustantially all (90% or more) dues reeived nondedutile y memers? Did the organization make only in-house loying expenditures of $2,000 or less? Did the organization agree to arry over loying and politial expenditures from the prior year?... 3 Part III-B Complete if the organization is exempt under setion 501()(4), setion 501()(5), or setion 501()(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "," OR () Part III-A, line 3, is answered "." 1 Dues, assessments and similar amounts from memers Setion 162(e) nondedutile loying and politial expenditures (do not inlude amounts of politial expenses for whih the setion 527(f) tax was paid). a Current year... 2a Carryover from last year... 2 Total Aggregate amount reported in setion 6033(e)(1)(A) noties of nondedutile setion 162(e) dues If noties were sent and the amount on line 2 exeeds the amount on line 3, what portion of the exess does the organization agree to arryover to the reasonale estimate of nondedutile loying and politial expenditure next year? Taxale amount of loying and politial expenditures (see instrutions)... 5 Part IV Supplemental Information Provide the desriptions required for Part I-A, line 1; Part I-B, line 4; Part I-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part II-B, line 1. Also, omplete this part for any additional information. Shedule C (Form 990 or 990-EZ) 2013

11 SCHEDULE O (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Servie Name of the organization Supplemental Information to Form 990 or 990-EZ Complete to provide information for responses to speifi questions on Form 990 or 990-EZ or to provide any additional information. Attah to Form 990 or 990-EZ. Information aout Shedule O (Form 990 or 990-EZ) and its instrutions is at Desription of other expenses (Part I, line 16) OMB Open to Puli Inspetion Employer identifiation numer DESCRIPTION AMOUNT DEPRECIATION 140 TRAVEL 4,029 FEES AND REFUNDS 1,590 BUSINESS OPERATIONS 1,215 WEBSITE 129 PROFESSIONAL DEVELOPMENT 292 PAYROLL TAES 3,060 INSURANCE 1,328 OFFICE 2,768 CONFERENCE AND REGIONS 29, Desription of other assets (Part II, line 24) CATEGORY BEGINNING OF YEAR END OF YEAR ACCOUNTS RECEIVABLE 0 1, Desription of total liailities (Part II, line 26) CATEGORY BEGINNING OF YEAR END OF YEAR ACCOUNTS PAYABLE DEFERRED REVENUE For Paperwork Redution At tie, see the Instrutions for Form 990 or 990-EZ. Shedule O (Form 990 or 990-EZ) (2013)