For the 2016 calendar year, or tax year beginning

Transcription

1 Form 990 OMB Department of the Treasury Internal Revenue Service A B For the 0 calendar year, or tax year beginning C Check if applicable: Address change Name change Initial return 0 Return of Organization Exempt From Income Tax Under section 0(c), 7, or 97(a)() of the Internal Revenue Code (except private foundations) G Do not enter social security numbers on this form as it may be made public. G Information about Form 990 and its instructions is at Open to Public Inspection, 0, and ending S. College Avenue Bloomington, IN 70, D Employer identification number E Telephone number --70 Final return/terminated G Amended return Application pending F Same As C Above )H (insert no.) 0(c) ( 0(c)() Website: G Form of organization: Trust Association OtherG K Corporation Part I Summary I J Tax-exempt status Gross receipts,,9. H(a) Is this a group return for subordinates? Name and address of principal officer: 97(a)() or H(b) Are all subordinates included? If ',' attach a list. (see instructions) 7 H(c) Group exemption number L Year of formation: 9 M G State of legal domicile: IN Briefly describe the organization's mission or most significant activities: United Way improves people's lives by addressing critical needs today and working to reduce those needs tomorrow. Funds are raised from a broad community base and granted to tax exempt agencies. See Schedule O. 7a b Check this box G if the organization discontinued its operations or disposed of more than % of its net assets. Number of voting members of the governing body (Part VI, line a) Number of independent voting members of the governing body (Part VI, line b) Total number of individuals employed in calendar year 0 (Part V, line a) Total number of volunteers (estimate if necessary) Total unrelated business revenue from Part VIII, column (C), line a Net unrelated business taxable income from Form 990-T, line b Prior Year Current Year Contributions and grants (Part VIII, line h) ,7,9.,,. Program service revenue (Part VIII, line g) ,.,. Investment income (Part VIII, column (A), lines,, and 7d) Other revenue (Part VIII, column (A), lines, d, c, 9c, 0c, and e) Total revenue ' add lines through (must equal Part VIII, column (A), line ).....,,7.,,9. Grants and similar amounts paid (Part I, column (A), lines -) ,.,7. Benefits paid to or for members (Part I, column (A), line ) ,. 0,. 9,9.,7,. -,. 9,99,07,09.,0 Salaries, other compensation, employee benefits (Part I, column (A), lines -0)..... a Professional fundraising fees (Part I, column (A), line e) b Total fundraising expenses (Part I, column (D), line ) G,9 7 9 Other expenses (Part I, column (A), lines a-d, f-e) Total expenses. Add lines -7 (must equal Part I, column (A), line ) Revenue less expenses. Subtract line from line Total assets (Part, line ) Total liabilities (Part, line ) Net assets or fund balances. Subtract line from line Beginning of Current Year Part II End of Year,9,9.,7. 9,7.,0,,0,0, Signature Block 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 A Signature of officer Date Type or print name and title Print/Type preparer's name Preparer's signature Duane L Vaught Duane L Vaught Paid Preparer Firm's name G Duane L. Vaught Use Only Firm's address G 70 N Thames Dr Bloomington, IN 70 Date Check self-employed Firm's EIN Phone no. if PTIN P00070 G -9-7 May the IRS discuss this return with the preparer shown above? (see instructions) For Paperwork Reduction Act tice, see the separate instructions. TEEA0L // Form 990 (0)

2 Statement of Program Service Accomplishments Form 990 (0) Part III Page Check if Schedule O contains a response or note to any line in this Part III Briefly describe the organization's mission: United Way improves people's lives by addressing critical needs today and working to reduce those needs tomorrow. Funds are raised from a broad community base and granted to tax exempt agencies. See Schedule O. Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990-EZ? If ',' describe these new services on Schedule O. Did the organization cease conducting, or make significant changes in how it conducts, any program services?.... If ',' describe these changes on Schedule O. Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 0(c)() and 0(c)() organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported. ) (Revenue ),0,00. including grants of United Way of Monroe County works with member agencies and a network of other community partners to provide comprehensive and collaborative solutions that help local residents improve their lives. The organization focuses on the building blocks of a better life, Education, Earnings & Essentials - to create and support solutions to the most pressing issues in our community. Priorities and results are contained in Schedule O. a (Code: ) (Expenses b (Code: ) (Expenses including grants of ) (Revenue ) c (Code: ) (Expenses including grants of ) (Revenue ) d Other program services (Describe in Schedule O.) (Expenses including grants of e Total program service expenses G,0,00. TEEA00L ) (Revenue // ) Form 990 (0)

3 Checklist of Required Schedules Form 990 (0) Part IV Page Is the organization described in section 0(c)() or 97(a)() (other than a private foundation)? If ',' complete Schedule A Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If ',' complete Schedule C, Part I Section 0(c)() organizations. Did the organization engage in lobbying activities, or have a section 0(h) election in effect during the tax year? If ',' complete Schedule C, Part II Is the organization a section 0(c)(), 0(c)(), or 0(c)() organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 9-9? If ',' complete Schedule C, Part III Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If ',' complete Schedule D, Part I Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures? If ',' complete Schedule D, Part II Did the organization maintain collections of works of art, historical treasures, or other similar assets? If ',' complete Schedule D, Part III Did the organization report an amount in Part, line, for escrow or custodial account liability, serve as a custodian for amounts not listed in Part ; or provide credit counseling, debt management, credit repair, or debt negotiation services? If ',' complete Schedule D, Part IV Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If ',' complete Schedule D, Part V If the organization's answer to any of the following questions is '', then complete Schedule D, Parts VI, VII, VIII, I, or as applicable. a Did the organization report an amount for land, buildings, and equipment in Part, line 0? If ',' complete Schedule D, Part VI a b Did the organization report an amount for investments ' other securities in Part, line that is % or more of its total assets reported in Part, line? If ',' complete Schedule D, Part VII b c Did the organization report an amount for investments ' program related in Part, line that is % or more of its total assets reported in Part, line? If ',' complete Schedule D, Part VIII c d Did the organization report an amount for other assets in Part, line that is % or more of its total assets reported in Part, line? If ',' complete Schedule D, Part I d e Did the organization report an amount for other liabilities in Part, line? If ',' complete Schedule D, Part e f Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization's liability for uncertain tax positions under FIN (ASC 70)? If ',' complete Schedule D, Part.... f a Did the organization obtain separate, independent audited financial statements for the tax year? If ',' complete Schedule D, Parts I and II a b Was the organization included in consolidated, independent audited financial statements for the tax year? If ',' and if the organization answered '' to line a, then completing Schedule D, Parts I and II is optional b a Did the organization maintain an office, employees, or agents outside of the United States? a b Did the organization have aggregate revenues or expenses of more than 0,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at 00,000 or more? If ',' complete Schedule F, Parts I and IV b Is the organization a school described in section 70(b)()(A)(ii)? If ',' complete Schedule E Did the organization report on Part I, column (A), line, more than,000 of grants or other assistance to or for any foreign organization? If ',' complete Schedule F, Parts II and IV Did the organization report on Part I, column (A), line, more than,000 of aggregate grants or other assistance to or for foreign individuals? If ',' complete Schedule F, Parts III and IV Did the organization report a total of more than,000 of expenses for professional fundraising services on Part I, column (A), lines and e? If ',' complete Schedule G, Part I (see instructions) Did the organization report more than,000 total of fundraising event gross income and contributions on Part VIII, lines c and a? If ',' complete Schedule G, Part II Did the organization report more than,000 of gross income from gaming activities on Part VIII, line 9a? If ',' complete Schedule G, Part III TEEA00L // Form 990 (0)

4 Checklist of Required Schedules (continued) Form 990 (0) Part IV Page 0a Did the organization operate one or more hospital facilities? If ',' complete Schedule H a b If '' to line 0a, did the organization attach a copy of its audited financial statements to this return? b Did the organization report more than,000 of grants or other assistance to any domestic organization or domestic government on Part I, column (A), line? If ',' complete Schedule I, Parts I and II Did the organization report more than,000 of grants or other assistance to or for domestic individuals on Part I, column (A), line? If ',' complete Schedule I, Parts I and III Did the organization answer '' to Part VII, Section A, line,, or about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees? If ',' complete Schedule J a Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than 00,000 as of the last day of the year, that was issued after December, 00? If ',' answer lines b through d and complete Schedule K. If ', 'go to line a b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? a b c Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds? d Did the organization act as an 'on behalf of' issuer for bonds outstanding at any time during the year? c d a Section 0(c)(), 0(c)(), and 0(c)(9) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If ',' complete Schedule L, Part I a b Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ? If ',' complete Schedule L, Part I b Did the organization report any amount on Part, line,, or for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If ',' complete Schedule L, Part II Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a % controlled entity or family member of any of these persons? If ',' complete Schedule L, Part III a A current or former officer, director, trustee, or key employee? If ',' complete Schedule L, Part IV a b A family member of a current or former officer, director, trustee, or key employee? If ',' complete Schedule L, Part IV b c An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If ',' complete Schedule L, Part IV Did the organization receive more than,000 in non-cash contributions? If ',' complete Schedule M c 9 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If ',' complete Schedule M Did the organization liquidate, terminate, or dissolve and cease operations? If ',' complete Schedule N, Part I Did the organization sell, exchange, dispose of, or transfer more than % of its net assets? If ',' complete Schedule N, Part II Did the organization own 00% of an entity disregarded as separate from the organization under Regulations sections and ? If ',' complete Schedule R, Part I Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions): 0 Was the organization related to any tax-exempt or taxable entity? If ',' complete Schedule R, Part II, III, or IV, and Part V, line a Did the organization have a controlled entity within the meaning of section (b)()? b If '' to line a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section (b)()? If ',' complete Schedule R, Part V, line a b Section 0(c)() organizations. Did the organization make any transfers to an exempt non-charitable related organization? If ',' complete Schedule R, Part V, line Did the organization conduct more than % of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If ',' complete Schedule R, Part VI Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines b and 9? te. All Form 990 filers are required to complete Schedule O TEEA00L // Form 990 (0)

5 Part V Statements Regarding Other IRS Filings and Tax Compliance Form 990 (0) Page Check if Schedule O contains a response or note to any line in this Part V a Enter the number reported in Box of Form 09. Enter -0- if not applicable b Enter the number of Forms W-G included in line a. Enter -0- if not applicable a b 0 c Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? c a Enter the number of employees reported on Form W-, Transmittal of Wage and Tax Statements, filed for the calendar year ending with or within the year covered by this return..... a b If at least one is reported on line a, did the organization file all required federal employment tax returns? b te. If the sum of lines a and a is greater than 0, you may be required to e-file (see instructions) a Did the organization have unrelated business gross income of,000 or more during the year? b If ',' has it filed a Form 990-T for this year? If '' to line b, provide an explanation in Schedule O a b a a b c a Does the organization have annual gross receipts that are normally greater than 00,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? a b If ',' did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? b a 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)? b If ',' enter the name of the foreign country: G See instructions for filing requirements for FinCEN Form, Report of Foreign Bank and Financial Accounts (FBAR). a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction? c If ',' to line a or b, did the organization file Form -T? Organizations that may receive deductible contributions under section 70(c). a Did the organization receive a payment in excess of 7 made partly as a contribution and partly for goods and services provided to the payor? b If ',' did the organization notify the donor of the value of the goods or services provided? c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form? d If ',' indicate the number of Forms filed during the year d e Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? f Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? g If the organization received a contribution of qualified intellectual property, did the organization file Form 99 as required? h If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 09-C? Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? Sponsoring organizations maintaining donor advised funds. a Did the sponsoring organization make any taxable distributions under section 9? b Did the sponsoring organization make a distribution to a donor, donor advisor, or related person? Section 0(c)(7) organizations. Enter: a Initiation fees and capital contributions included on Part VIII, line b Gross receipts, included on Form 990, Part VIII, line, for public use of club facilities..... Section 0(c)() organizations. Enter: a Gross income from members or shareholders a 7b 7c 7e 7f 7g 7h 9a 9b 0 a 0 b a b Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) b a Section 97(a)() non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 0? b If ',' enter the amount of tax-exempt interest received or accrued during the year b Section 0(c)(9) qualified nonprofit health insurance issuers. a Is the organization licensed to issue qualified health plans in more than one state? te. See the instructions for additional information the organization must report on Schedule O. b Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans b c Enter the amount of reserves on hand c a Did the organization receive any payments for indoor tanning services during the tax year? b If ',' has it filed a Form 70 to report these payments? If ',' provide an explanation in Schedule O TEEA00L // a a a b Form 990 (0)

6 Page Governance, Management, and Disclosure For each '' response to lines through 7b below, and for a '' response to line a, b, or 0b below, describe the circumstances, processes, or changes in Schedule O. See instructions. Check if Schedule O contains a response or note to any line in this Part VI Section A. Governing Body and Management Form 990 (0) Part VI a Enter the number of voting members of the governing body at the end of the tax year a 9 If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O. b Enter the number of voting members included in line a, above, who are independent b 9 Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors, or trustees, or key employees to a management company or other person? Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? Did the organization become aware during the year of a significant diversion of the organization's assets? Did the organization have members or stockholders? a Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? a b Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? b Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following: a The governing body? b Each committee with authority to act on behalf of the governing body? a b Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization's mailing address? If ',' provide the names and addresses in Schedule O Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.) 0 a Did the organization have local chapters, branches, or affiliates? b If ',' did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? a Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? b Describe in Schedule O the process, if any, used by the organization to review this Form 99 See Schedule O a Did the organization have a written conflict of interest policy? If ',' go to line b Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? c Did the organization regularly and consistently monitor and enforce compliance with the policy? If ',' describe in Schedule O how this was done.....see......schedule o Did the organization have a written whistleblower policy? Did the organization have a written document retention and destruction policy? Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision? a The organization's CEO, Executive Director, or top management official Schedule O... b Other officers or key employees of the organization... See If '' to line a or b, describe the process in Schedule O (see instructions). 0 b a a b c a b a Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? a b If ',' did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization's exempt status with respect to such arrangements? b 0 a Section C. Disclosure IN 7 List the states with which a copy of this Form 990 is required to be filed G Section 0 requires an organization to make its Forms 0 (or 0 if applicable), 990, and 990-T (Section 0(c)()s only) available for public inspection. Indicate how you made these available. Check all that apply. Other (explain in Schedule O) Another's website Own website Upon request 9 Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year. See Schedule O State the name, address, and telephone number of the person who possesses the organization's books and records: G 0 United Way of Monroe County S. College Ave TEEA00L // Bloomington IN Form 990 (0)

7 Page 7 Part VII Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors Form 990 (0) Check if Schedule O contains a response or note to any line in this Part VII Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization's tax year.? List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.? List all of the organization's current key employees, if any. See instructions for definition of 'key employee.'? List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee) who received reportable compensation (Box of Form W- and/or Box 7 of Form 099-MISC) of more than 00,000 from the organization and any related organizations.? List all of the organization's former officers, key employees, and highest compensated employees who received more than 00,000 of reportable compensation from the organization and any related organizations.? List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of the organization, more than 0,000 of reportable compensation from the organization and any related organizations. List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest compensated employees; and former such persons. Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee. (C) () () () () () () (7) () (9) (0) (A) (B) Name and Title Average hours per week (list any hours for related organizations below dotted line) Logan Good Director Lisa Abbott Vice President Heidi Schulz President David Johnson Director Nancy Richman Director Kate Zilvinskis Director Steve Deckard Director Debbie Landrum Director Kyle Parker Treasurer Barry D. Lessow Executive Direc Position (do not check more than one box, unless person is both an officer and a director/trustee) (D) Reportable compensation from the organization (W-/099-MISC) (E) (F) Reportable compensation from related organizations (W-/099-MISC) Estimated amount of other compensation from the organization and related organizations,9. () () () () TEEA007L // Form 990 (0)

8 Page Part VII Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued) Form 990 (0) (B) (A) Name and title Average hours per week (list any hours for related organiza - tions below dotted line) (C) Position (do not check more than one box, unless person is both an officer and a director/trustee) (D) (E) (F) Reportable compensation from the organization (W-/099-MISC) Reportable compensation from related organizations (W-/099-MISC) Estimated amount of other compensation from the organization and related organizations () () (7) () (9) (0) () () () () () b Sub-total G,9. c Total from continuation sheets to Part VII, Section A G d Total (add lines b and c) G,9. Total number of individuals (including but not limited to those listed above) who received more than 00,000 of reportable compensation from the organization G 0 Did the organization list any former officer, director, or trustee, key employee, or highest compensated employee on line a? If ',' complete Schedule J for such individual For any individual listed on line a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than 0,000? If ',' complete Schedule J for such individual Did any person listed on line a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If ',' complete Schedule J for such person Section B. Independent Contractors Complete this table for your five highest compensated independent contractors that received more than 00,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization's tax year. (A) Name and business address (B) Description of services (C) Compensation Total number of independent contractors (including but not limited to those listed above) who received more than 00,000 of compensation from the organization G 0 TEEA00L // Form 990 (0)

9 Part VIII Statement of Revenue Form 990 (0) Page 9 Check if Schedule O contains a response or note to any line in this Part VIII (A) Total revenue a b c d e Federated campaigns Membership dues Fundraising events Related organizations Government grants (contributions)..... a b c d e (B) Related or exempt function revenue (C) Unrelated business revenue (D) Revenue excluded from tax under sections -,9.,0. f All other contributions, gifts, grants, and similar amounts not included above.... f,,. g ncash contributions included in lines a-f: h Total. Add lines a-f G,,. Business Code a Designations-admin fee b c d e f All other program service revenue.... g Total. Add lines a-f G Investment income (including dividends, interest and other similar amounts) G Income from investment of tax-exempt bond proceeds... G. Royalties G a b c d Gross rents Less: rental expenses Rental income or (loss).... Net rental income or (loss) G (i) Real 7 a Gross amount from sales of assets other than inventory (i) Securities,.,., (ii) Personal (ii) Other b Less: cost or other basis and sales expenses c Gain or (loss) d Net gain or (loss) G a Gross income from fundraising events (not including.. of contributions reported on line c). See Part IV, line a b Less: direct expenses b c Net income or (loss) from fundraising events G 9 a Gross income from gaming activities. See Part IV, line a b Less: direct expenses b c Net income or (loss) from gaming activities G 0 a Gross sales of inventory, less returns and allowances a b Less: cost of goods sold b c Net income or (loss) from sales of inventory G Miscellaneous Revenue Business Code a Miscellaneous b c d All other revenue e Total. Add lines a-d G Total revenue. See instructions G 0,,9. TEEA009L //,. 7. Form 990 (0)

10 Statement of Functional Expenses Form 990 (0) Part I Page 0 Section 0(c)() and 0(c)() organizations must complete all columns. All other organizations must complete column (A). Check if Schedule O contains a response or note to any line in this Part I (A) (B) (C) (D) Do not include amounts reported on lines Total expenses Management and Fundraising Program service b, 7b, b, 9b, and 0b of Part VIII. expenses general expenses expenses Grants and other assistance to domestic organizations and domestic governments. See Part IV, line ,7.,7. Grants and other assistance to domestic individuals. See Part IV, line Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines and Benefits paid to or for members Compensation of current officers, directors, trustees, and key employees ,0.,,09. 0,07. Compensation not included above, to disqualified persons (as defined under section 9(f)()) and persons described in section 9(c)()(B) ,9. 7,7.,. 9, 7 Other salaries and wages Pension plan accruals and contributions (include section 0(k) and 0(b) employer contributions) ,9.,.,9. 7,. 9 Other employee benefits ,.,9. 9,.,. 0 Payroll taxes ,97.,.,07.,. Fees for services (non-employees): a Management b Legal c Accounting ,.,0., d Lobbying e Professional fundraising services. See Part IV, line 7... f Investment management fees g Other. (If line g amount exceeds 0% of line, column 7,7. 7,7. (A) amount, list line g expenses on Schedule O.)..... Advertising and promotion Office expenses Information technology Royalties Occupancy ,.,0,0.,. 7 Travel ,. 7,9.,. 9. Payments of travel or entertainment expenses for any federal, state, or local public officials Conferences, conventions, and meetings Interest ,0,0 Payments to affiliates ,. 7,. Depreciation, depletion, and amortization...., Insurance ,0.,0 7. Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line e. If line e amount exceeds 0% of line, column (A) amount, list line e expenses on Schedule O.) a b c d Campaign Costs Supplies Miscellaneous Telephone e All other expenses Total functional expenses. Add lines through e.... 9,.,7.,.,90 7,9.,07,09.,9. 9,99.,9.,,0,00.,9.,..,.,. 9,., ,9 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here G if following SOP 9- (ASC 9-70) TEEA00L // Form 990 (0)

11 Balance Sheet Form 990 (0) Part Page Check if Schedule O contains a response or note to any line in this Part (A) Beginning of year Cash ' non-interest-bearing Savings and temporary cash investments Pledges and grants receivable, net Accounts receivable, net ,.,. 77,9.,7. (B) End of year Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L Loans and other receivables from other disqualified persons (as defined under section 9(f)()), persons described in section 9(c)()(B), and contributing employers and sponsoring organizations of section 0(c)(9) voluntary employees' beneficiary organizations (see instructions). Complete Part II of Schedule L tes and loans receivable, net Inventories for sale or use Prepaid expenses and deferred charges a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D a 9,. b Less: accumulated depreciation b,. Investments ' publicly traded securities Investments ' other securities. See Part IV, line Investments ' program-related. See Part IV, line Intangible assets Other assets. See Part IV, line Total assets. Add lines through (must equal line ) Accounts payable and accrued expenses Grants payable Deferred revenue Tax-exempt bond liabilities Escrow or custodial account liability. Complete Part IV of Schedule D Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified persons. Complete Part II of Schedule L Secured mortgages and notes payable to unrelated third parties Unsecured notes and loans payable to unrelated third parties Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 7-). Complete Part of Schedule D. Total liabilities. Add lines 7 through Organizations that follow SFAS 7 (ASC 9), check here G and complete lines 7 through 9, and lines and. Unrestricted net assets Temporarily restricted net assets Permanently restricted net assets ,9,. 0 c,9,9. 7,.,.,9. 7,0., ,.,.,0,,,9.,7.,.,9.,7. 9,.,0,9. 7,7. 9,79. 7,. 9 Organizations that do not follow SFAS 7 (ASC 9), check here G and complete lines 0 through. 0 Capital stock or trust principal, or current funds Paid-in or capital surplus, or land, building, or equipment fund Retained earnings, endowment, accumulated income, or other funds Total net assets or fund balances Total liabilities and net assets/fund balances ,7.,9,9. 0,0,,0, Form 990 (0) TEEA0L //

12 Reconciliation of Net Assets Form 990 (0) Part I Page,,9.,07,09.,0 9,7. Check if Schedule O contains a response or note to any line in this Part I Total revenue (must equal Part VIII, column (A), line ) Total expenses (must equal Part I, column (A), line ) Revenue less expenses. Subtract line from line Net assets or fund balances at beginning of year (must equal Part, line, column (A)) Net unrealized gains (losses) on investments Donated services and use of facilities Investment expenses Prior period adjustments Other changes in net assets or fund balances (explain in Schedule O)...See......Schedule O... 9,. 0 Net assets or fund balances at end of year. Combine lines through 9 (must equal Part, line, column (B)) ,0, Part II Financial Statements and Reporting Check if Schedule O contains a response or note to any line in this Part II Accounting method used to prepare the Form 990: Cash Accrual Other If the organization changed its method of accounting from a prior year or checked 'Other,' explain in Schedule O. a Were the organization's financial statements compiled or reviewed by an independent accountant? a b c If '' to line a or b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? c If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-? a If ',' check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both: Consolidated basis Both consolidated and separate basis Separate basis b Were the organization's financial statements audited by an independent accountant? If ',' check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both: Consolidated basis Both consolidated and separate basis Separate basis b If ',' did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits TEEA0L // b Form 990 (0)

13 Public Charity Status and Public Support SCHEDULE A (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Service OMB Complete if the organization is a section 0(c)() organization or a section 97(a)() nonexempt charitable trust. G Attach to Form 990 or Form 990-EZ. G Information about Schedule A (Form 990 or 990-EZ) and its instructions is at Name of the organization 0 Open to Public Inspection Employer identification number Part I Reason for Public Charity Status (All organizations must complete this part.) See instructions. The organization is not a private foundation because it is: (For lines through, check only one box.) A church, convention of churches, or association of churches described in section 70(b)()(A)(i). A school described in section 70(b)()(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).) A hospital or a cooperative hospital service organization described in section 70(b)()(A)(iii). A medical research organization operated in conjunction with a hospital described in section 70(b)()(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 70(b)()(A)(iv). (Complete Part II.) 7 A federal, state, or local government or governmental unit described in section 70(b)()(A)(v). An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 70(b)()(A)(vi). (Complete Part II.) A community trust described in section 70(b)()(A)(vi). (Complete Part II.) 9 An agricultural research organization described in section 70(b)()(A)(ix) operated in conjunction with a land-grant college or university or a non-land-grant college of agriculture (see instructions). Enter the name, city, and state of the college or university: 0 An organization that normally receives: () more than -/% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions'subject to certain exceptions, and () no more than -/% of its support from gross investment income and unrelated business taxable income (less section tax) from businesses acquired by the organization after June 0, 97. See section 09(a)(). (Complete Part III.) An organization organized and operated exclusively to test for public safety. See section 09(a)(). 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 09(a)() or section 09(a)(). See section 09(a)(). Check the box in lines a through d that describes the type of supporting organization and complete lines e, f, and g. Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B. a b Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C. c Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E. Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V. d e Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization. f Enter the number of supported organizations g Provide the following information about the supported organization(s). (i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines -0 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions) (A) (B) (C) (D) (E) Total For Paperwork Reduction Act tice, see the Instructions for Form 990 or 990-EZ. TEEA00L 09// Schedule A (Form 990 or 990-EZ) 0

14 Part II Support Schedule for Organizations Described in Sections 70(b)()(A)(iv) and 70(b)()(A)(vi) Page Schedule A (Form 990 or 990-EZ) 0 (Complete only if you checked the box on line, 7, or of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.) Section A. Public Support Calendar year (or fiscal year beginning in) G 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.... Total. Add lines through... The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line that exceeds % of the amount shown on line, column (f)... Public support. Subtract line from line (a) 0 (b) 0 (c) 0 (d) 0 (e) 0 (f) Total,0,.,7,7.,0,.,7,9.,,. 7,0,7.,0,.,7,7.,0,.,7,9.,,. 7,0,7.,77. 7,7,9. Section B. Total Support Calendar year (or fiscal year beginning in) G 7 Amounts from line Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources Net income from unrelated business activities, whether or not the business is regularly carried on Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. See Part VI (a) 0 (b) 0 (c) 0 (d) 0 (e) 0 (f) Total,0,.,7,7.,0,.,7,9.,, ,0,7.,7. 9,77.,7. 7,9. 7,.,9. Total support. Add lines 7 through Gross receipts from related activities, etc. (see instructions) , 7,9,7. First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 0(c)() organization, check this box and stop here G Section C. Computation of Public Support Percentage Public support percentage for 0 (line, column (f) divided by line, column (f)) Public support percentage from 0 Schedule A, Part II, line % 99.0 % a -/% support test'0. If the organization did not check the box on line, and line is -/% or more, check this box and stop here. The organization qualifies as a publicly supported organization G b -/% support test'0. If the organization did not check a box on line or a, and line is -/% or more, check this box and stop here. The organization qualifies as a publicly supported organization G 7a 0%-facts-and-circumstances test'0. If the organization did not check a box on line, a, or b, and line is 0% or more, and if the organization meets the 'facts-and-circumstances' test, check this box and stop here. Explain in Part VI how the organization meets the 'facts-and-circumstances' test. The organization qualifies as a publicly supported organization b 0%-facts-and-circumstances test'0. If the organization did not check a box on line, a, b, or 7a, and line is 0% or more, and if the organization meets the 'facts-and-circumstances' test, check this box and stop here. Explain in Part VI 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, a, b, 7a, or 7b, check this box and see instructions... G G G Schedule A (Form 990 or 990-EZ) 0 TEEA00L 09//

15 Support Schedule for Organizations Described in Section 09(a)() Schedule A (Form 990 or 990-EZ) 0 Part III Page (Complete only if you checked the box on line 0 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.) Section A. Public Support Calendar year (or fiscal year beginning in) G Gifts, grants, contributions, and membership fees received. (Do not include any 'unusual grants.') Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose Gross receipts from activities that are not an unrelated trade or business under section. 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 through... 7a Amounts included on lines,, and received from disqualified persons b Amounts included on lines and received from other than disqualified persons that exceed the greater of,000 or % of the amount on line for the year c Add lines 7a and 7b (a) 0 (b) 0 (c) 0 (d) 0 (e) 0 (f) Total Public support. (Subtract line 7c from line.) Section B. Total Support (a) 0 (b) 0 (c) 0 (d) 0 (e) 0 (f) Total Calendar year (or fiscal year 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 taxes) from businesses acquired after June 0, c Add lines 0a and 0b Net income from unrelated business activities not included in line 0b, whether or not the business is regularly carried on Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) Total support. (Add Iines 9, 0c,, and.) First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 0(c)() organization, check this box and stop here G Section C. Computation of Public Support Percentage Public support percentage for 0 (line, column (f) divided by line, column (f)) Public support percentage from 0 Schedule A, Part III, line % % Section D. Computation of Investment Income Percentage Investment income percentage for 0 (line 0c, column (f) divided by line, column (f)) Investment income percentage from 0 Schedule A, Part III, line a -/% support tests'0. If the organization did not check the box on line, and line is more than -/%, and line 7 is not more than -/%, check this box and stop here. The organization qualifies as a publicly supported organization b -/% support tests'0. If the organization did not check a box on line or line 9a, and line is more than -/%, and line is not more than -/%, 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, 9a, or 9b, check this box and see instructions % % 7 TEEA00L 09// G G G Schedule A (Form 990 or 990-EZ) 0

16 Page Supporting Organizations (Complete only if you checked a box in line on Part I. If you checked a of Part I, complete Sections A and B. If you checked b of Part I, complete Sections A and C. If you checked c of Part I, complete Sections A, D, and E. If you checked d of Part I, complete Sections A and D, and complete Part V.) Section A. All Supporting Organizations Schedule A (Form 990 or 990-EZ) 0 Part IV Are all of the organization's supported organizations listed by name in the organization's governing documents? If ',' describe in Part VI how the supported organizations are designated. If designated by class or purpose, describe the designation. If historic and continuing relationship, explain. Did the organization have any supported organization that does not have an IRS determination of status under section 09(a)() or ()? If ',' explain in Part VI how the organization determined that the supported organization was described in section 09(a)() or (). a Did the organization have a supported organization described in section 0(c)(), (), or ()? If ',' answer (b) and (c) below. a b Did the organization confirm that each supported organization qualified under section 0(c)(), (), or () and satisfied the public support tests under section 09(a)()? If ',' describe in Part VI when and how the organization made the determination. b c Did the organization ensure that all support to such organizations was used exclusively for section 70(c)()(B) purposes? If ',' explain in Part VI what controls the organization put in place to ensure such use. c a Was any supported organization not organized in the United States ('foreign supported organization')? If '' and if you checked a or b in Part I, answer (b) and (c) below. a b Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If ',' describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations. b c Did the organization support any foreign supported organization that does not have an IRS determination under sections 0(c)() and 09(a)() or ()? If ',' explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 70(c)()(B) purposes. c a Did the organization add, substitute, or remove any supported organizations during the tax year? If ',' answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document). a b Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document? b c Substitutions only. Was the substitution the result of an event beyond the organization's control? c Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization's supported organizations? If ',' provide detail in Part VI. 7 Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 9(c)()(C)), a family member of a substantial contributor, or a % controlled entity with regard to a substantial contributor? If ',' complete Part I of Schedule L (Form 990 or 990-EZ). 7 Did the organization make a loan to a disqualified person (as defined in section 9) not described in line 7? If ',' complete Part I of Schedule L (Form 990 or 990-EZ). 9a Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 9 (other than foundation managers and organizations described in section 09(a)() or ())? If ',' provide detail in Part VI. 9a b Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If ',' provide detail in Part VI. 9b c Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If ',' provide detail in Part VI. 9c 0a Was the organization subject to the excess business holdings rules of section 9 because of section 9(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If ',' answer 0b below. b Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 70, to determine whether the organization had excess business holdings.) TEEA00L 09// 0a 0b Schedule A (Form 990 or 990-EZ) 0

17 Supporting Organizations (continued) Schedule A (Form 990 or 990-EZ) 0 Part IV Page Has the organization accepted a gift or contribution from any of the following persons? a A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization? a b A family member of a person described in (a) above? b c A % controlled entity of a person described in (a) or (b) above? If '' to a, b, or c, provide detail in Part VI. c Section B. Type I Supporting Organizations Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization's directors or trustees at all times during the tax year? If ',' describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization's activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year. Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If ',' explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised, or controlled the supporting organization. Section C. Type II Supporting Organizations Were a majority of the organization's directors or trustees during the tax year also a majority of the directors or trustees of each of the organization's supported organization(s)? If ',' describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s). Section D. All Type III Supporting Organizations Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization's tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization's governing documents in effect on the date of notification, to the extent not previously provided? Were any of the organization's officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If ',' explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s). By reason of the relationship described in (), did the organization's supported organizations have a significant voice in the organization's investment policies and in directing the use of the organization's income or assets at all times during the tax year? If ',' describe in Part VI the role the organization's supported organizations played in this regard. Section E. Type III Functionally Integrated Supporting Organizations Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions). a The organization satisfied the Activities Test. Complete line below. b The organization is the parent of each of its supported organizations. Complete line below. c The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions). Activities Test. Answer (a) and (b) below. a Did substantially all of the organization's activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If ',' then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities. a b Did the activities described in (a) constitute activities that, but for the organization's involvement, one or more of the organization's supported organization(s) would have been engaged in? If ',' explain in Part VI the reasons for the organization's position that its supported organization(s) would have engaged in these activities but for the organization's involvement. b Parent of Supported Organizations. Answer (a) and (b) below. a Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI. a b Did the organization exercise a substantial degree of direction over the policies, programs, and activities of each of its supported organizations? If ',' describe in Part VI the role played by the organization in this regard. b TEEA00L 09// Schedule A (Form 990 or 990-EZ) 0

18 Type III n-functionally Integrated 09(a)() Supporting Organizations Schedule A (Form 990 or 990-EZ) 0 Part V Page Check here if the organization satisfied the Integral Part Test as a qualifying trust on v. 0, 970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E. Section A ' Adjusted Net Income Net short-term capital gain Recoveries of prior-year distributions Other gross income (see instructions) Add lines through. Depreciation and depletion Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 7 Other expenses (see instructions) 7 Adjusted Net Income (subtract lines,, and 7 from line ). Section B ' Minimum Asset Amount (A) Prior Year (B) Current Year (optional) (A) Prior Year (B) Current Year (optional) Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): a Average monthly value of securities a b Average monthly cash balances b c Fair market value of other non-exempt-use assets c d Total (add lines a, b, and c) d e Discount claimed for blockage or other factors (explain in detail in Part VI): Acquisition indebtedness applicable to non-exempt-use assets Subtract line from line d. Cash deemed held for exempt use. Enter -/% of line (for greater amount, see instructions). Net value of non-exempt-use assets (subtract line from line ) Multiply line by.0. 7 Recoveries of prior-year distributions 7 Minimum Asset Amount (add line 7 to line ) Section C ' Distributable Amount Current Year Adjusted net income for prior year (from Section A, line, Column A) Enter % of line. Minimum asset amount for prior year (from Section B, line, Column A) Enter greater of line or line. Income tax imposed in prior year Distributable Amount. Subtract line from line, unless subject to emergency temporary reduction (see instructions). 7 Check here if the current year is the organization's first as a non-functionally integrated Type III supporting organization (see instructions). Schedule A (Form 990 or 990-EZ) 0 TEEA00L 09//

19 Page 7 Part V Type III n-functionally Integrated 09(a)() Supporting Organizations (continued) Current Year Section D ' Distributions Schedule A (Form 990 or 990-EZ) 0 Amounts paid to supported organizations to accomplish exempt purposes Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity Administrative expenses paid to accomplish exempt purposes of supported organizations Amounts paid to acquire exempt-use assets Qualified set-aside amounts (prior IRS approval required) Other distributions (describe in Part VI). See instructions. 7 Total annual distributions. Add lines through. Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions. 9 Distributable amount for 0 from Section C, line 0 Line amount divided by Line 9 amount Section E ' Distribution Allocations (see instructions) Distributable amount for 0 from Section C, line Underdistributions, if any, for years prior to 0 (reasonable cause required ' explain in Part VI). See instructions. (i) Excess Distributions (ii) Underdistributions Pre-0 (iii) Distributable Amount for 0 Excess distributions carryover, if any, to 0: a b c From d From e From f Total of lines a through e g Applied to underdistributions of prior years h Applied to 0 distributable amount i Carryover from 0 not applied (see instructions) j Remainder. Subtract lines g, h, and i from f. Distributions for 0 from Section D, line 7: a Applied to underdistributions of prior years b Applied to 0 distributable amount c Remainder. Subtract lines a and b from. Remaining underdistributions for years prior to 0, if any. Subtract lines g and a from line. For result greater than zero, explain in Part VI. See instructions. Remaining underdistributions for 0. Subtract lines h and b from line. For result greater than zero, explain in Part VI. See instructions. 7 Excess distributions carryover to 07. Add lines j and c. Breakdown of line 7: a b Excess from c Excess from d Excess from e Excess from Schedule A (Form 990 or 990-EZ) 0 TEEA007L 09//

20 Page Supplemental Information. Provide the explanations required by Part II, line 0; Part II, line 7a or 7b;Part III, line ; Part IV, Section A, lines,, b, c, b, c, a,, 9a, 9b, 9c, a, b, and c; Part IV, Section B, lines and ; Part IV, Section C, line ; Part IV, Section D, lines and ; Part IV, Section E, lines c, a, b, a, and b; Part V, line ; Part V, Section B, line e; Part V, Section D, lines,, and ; and Part V, Section E, lines,, and. Also complete this part for any additional information. (See instructions.) Schedule A (Form 990 or 990-EZ) 0 Part VI Part II, Line 0 - Other Income Nature and Source Miscellaneous Administrative fee CFC Campaign fees ,. 7,. 7,9. Total,9. 7,. 7,9. TEEA00L 09// 0,0.,., ,9.,70. 9,77. Schedule A (Form 990 or 990-EZ) 0

21 OMB Schedule B (Form 990, 990-EZ, or 990-PF) Department of the Treasury Internal Revenue Service Schedule of Contributors G Attach to Form 990, Form 990-EZ, or Form 990-PF. G Information about Schedule B (Form 990, 990-EZ, 990-PF) and its instructions is at 0 Name of the organization Employer identification number Organization type (check one): Filers of: Form 990 or 990-EZ Section: 0(c)( ) (enter number) organization 97(a)() nonexempt charitable trust not treated as a private foundation 7 political organization Form 990-PF 0(c)() exempt private foundation 97(a)() nonexempt charitable trust treated as a private foundation 0(c)() taxable private foundation Check if your organization is covered by the General Rule or a Special Rule. te. Only a section 0(c)(7), (), or (0) 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, contributions totaling,000 or more (in money or property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions. Special Rules For an organization described in section 0(c)() filing Form 990 or 990-EZ that met the -/% support test of the regulations under sections 09(a)() and 70(b)()(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line, a, or b, and that received from any one contributor, during the year, total contributions of the greater of (),000 or () % of the amount on (i) Form 990, Part VIII, line h, or (ii) Form 990-EZ, line. Complete Parts I and II. For an organization described in section 0(c)(7), (), or (0) filing Form 990 or 990-EZ that received from any one contributor, during the year, total contributions of more than,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III. For an organization described in section 0(c)(7), (), or (0) filing Form 990 or 990-EZ that received from any one contributor, during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than,00 If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling,000 or more during the year G Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990, 990-EZ, or 990-PF), but it must answer '' on Part IV, line, of its Form 990; or check the box on line H of its Form 990-EZ or on its Form 990-PF, Part I, line, to certify that it doesn't meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF). For Paperwork Reduction Act tice, see the Instructions for Form 990, 990-EZ, or 990-PF. TEEA070L 0/09/ Schedule B (Form 990, 990-EZ, or 990-PF) (0)

22 Page Schedule B (Form 990, 990-EZ, or 990-PF) (0) of of Part I Name of organization Employer identification number Part I (a) Number Contributors (see instructions). Use duplicate copies of Part I if additional space is needed. (b) Name, address, and ZIP + (c) Total contributions Person Indiana Association of United Ways Payroll 900 N Meridian St Suite 0,7. ncash (Complete Part II for noncash contributions.) Indianapolis, IN 0-0 (a) Number (d) Type of contribution (b) Name, address, and ZIP + (c) Total contributions (d) Type of contribution Person Payroll ncash (Complete Part II for noncash contributions.) (a) Number (b) Name, address, and ZIP + (c) Total contributions (d) Type of contribution Person Payroll ncash (Complete Part II for noncash contributions.) (a) Number (b) Name, address, and ZIP + (c) Total contributions (d) Type of contribution Person Payroll ncash (Complete Part II for noncash contributions.) (a) Number (b) Name, address, and ZIP + (c) Total contributions (d) Type of contribution Person Payroll ncash (Complete Part II for noncash contributions.) (a) Number (b) Name, address, and ZIP + (c) Total contributions (d) Type of contribution Person Payroll ncash (Complete Part II for noncash contributions.) TEEA070L 0/09/ Schedule B (Form 990, 990-EZ, or 990-PF) (0)

23 to Page Schedule B (Form 990, 990-EZ, or 990-PF) (0) of Part II Name of organization Employer identification number Part II ncash Property (see instructions). Use duplicate copies of Part II if additional space is needed. (a). from Part I (b) Description of noncash property given (c) FMV (or estimate) (see instructions) (d) Date received (c) FMV (or estimate) (see instructions) (d) Date received (c) FMV (or estimate) (see instructions) (d) Date received (c) FMV (or estimate) (see instructions) (d) Date received (c) FMV (or estimate) (see instructions) (d) Date received (c) FMV (or estimate) (see instructions) (d) Date received N/A (a). from Part I (b) Description of noncash property given (a). from Part I (b) Description of noncash property given (a). from Part I (b) Description of noncash property given (a). from Part I (b) Description of noncash property given (a). from Part I (b) Description of noncash property given Schedule B (Form 990, 990-EZ, or 990-PF) (0) TEEA070L 0/09/

24 Page Schedule B (Form 990, 990-EZ, or 990-PF) (0) Name of organization to of Part III Employer identification number Part III Exclusively religious, charitable, etc., contributions to organizations described in section 0(c)(7), (), or (0) that total more than,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of,000 or less for the year. (Enter this information once. See instructions.) G Use duplicate copies of Part III if additional space is needed. (a). from Part I (b) Purpose of gift (c) Use of gift N/A (d) Description of how gift is held N/A (e) Transfer of gift Transferee's name, address, and ZIP + (a). from Part I Relationship of transferor to transferee (b) Purpose of gift (c) Use of gift (d) Description of how gift is held (e) Transfer of gift Transferee's name, address, and ZIP + (a). from Part I Relationship of transferor to transferee (b) Purpose of gift (c) Use of gift (d) Description of how gift is held (e) Transfer of gift Transferee's name, address, and ZIP + (a). from Part I Relationship of transferor to transferee (b) Purpose of gift (c) Use of gift (d) Description of how gift is held (e) Transfer of gift Transferee's name, address, and ZIP + Relationship of transferor to transferee Schedule B (Form 990, 990-EZ, or 990-PF) (0) TEEA070L 0/09/

25 SCHEDULE D (Form 990) Department of the Treasury Internal Revenue Service Name of the organization OMB Supplemental Financial Statements G Complete if the organization answered '' on Form 990, Part IV, line, 7,, 9, 0, a, b, c, d, e, f, a, or b. G Attach to Form 99 G Information about Schedule D (Form 990) and its instructions is at 0 Open to Public Inspection Employer identification number Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Part I Complete if the organization answered '' on Form 990, Part IV, line. (a) Donor advised funds (b) Funds and other accounts Total number at end of year Aggregate value of contributions to (during year) Aggregate value of grants from (during year) Aggregate value at end of year Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization's property, subject to the organization's exclusive legal control? Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? Part II Conservation Easements. Complete if the organization answered '' on Form 990, Part IV, line 7. Purpose(s) of conservation easements held by the organization (check all that apply). Preservation of land for public use (e.g., recreation or education) Protection of natural habitat Preservation of open space Preservation of a historically important land area Preservation of a certified historic structure Complete lines a through d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year. Held at the End of the Tax Year a Total number of conservation easements a b Total acreage restricted by conservation easements b c Number of conservation easements on a certified historic structure included in (a) c d Number of conservation easements included in (c) acquired after /7/0, and not on a historic structure listed in the National Register d Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the tax year G Number of states where property subject to conservation easement is located G Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year G 7 Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year G Does each conservation easement reported on line (d) above satisfy the requirements of section 70(h)()(B)(i) and section 70(h)()(B)(ii)? In Part III, describe how the organization reports conservation easements in its revenue and expense statement, and balance sheet, and include, if applicable, the text of the footnote to the organization's financial statements that describes the organization's accounting for conservation easements. Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets. Complete if the organization answered '' on Form 990, Part IV, line. a If the organization elected, as permitted under SFAS (ASC 9), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part III, the text of the footnote to its financial statements that describes these items. b If the organization elected, as permitted under SFAS (ASC 9), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items: (i) Revenue included on Form 990, Part VIII, line G (ii) Assets included in Form 990, Part G If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the following amounts required to be reported under SFAS (ASC 9) relating to these items: a Revenue included on Form 990, Part VIII, line G b Assets included in Form 990, Part G For Paperwork Reduction Act tice, see the Instructions for Form 99 TEEA0L 0// Schedule D (Form 990) 0

26 Page Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued) Schedule D (Form 990) 0 Using the organization's acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply): Public exhibition Loan or exchange programs a d Scholarly research Other b e Preservation for future generations c Provide a description of the organization's collections and explain how they further the organization's exempt purpose in Part III. During the year, did the organization solicit or receive donations of art, historical treasures, or other similar assets to be sold to raise funds rather than to be maintained as part of the organization's collection? Part IV Escrow and Custodial Arrangements. Complete if the organization answered '' on Form 990, Part IV, line 9, or reported an amount on Form 990, Part, line. a Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not included on Form 990, Part? b If ',' explain the arrangement in Part III and complete the following table: Amount See Part III c Beginning balance c 9,. d Additions during the year d e Distributions during the year e 9,. f Ending balance f a Did the organization include an amount on Form 990, Part, line, for escrow or custodial account liability?..... b If ',' explain the arrangement in Part III. Check here if the explanation has been provided on Part III Part V See Part III Endowment Funds. Complete if the organization answered '' on Form 990, Part IV, line (a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back a Beginning of year balance b Contributions c Net investment earnings, gains, and losses d Grants or scholarships e Other expenditures for facilities and programs f Administrative expenses g End of year balance Provide the estimated percentage of the current year end balance (line g, column (a)) held as: % a Board designated or quasi-endowment G % Permanent endowment G b % c Temporarily restricted endowment G The percentages on lines a, b, and c should equal 00%. a Are there endowment funds not in the possession of the organization that are held and administered for the organization by: (i) unrelated organizations a(i) (ii) related organizations a(ii) b If '' on line a(ii), are the related organizations listed as required on Schedule R? b Describe in Part III the intended uses of the organization's endowment funds. Part VI Land, Buildings, and Equipment. Complete if the organization answered '' on Form 990, Part IV, line a. See Form 990, Part, line Description of property (a) Cost or other basis (investment) (b) Cost or other basis (other) a Land b Buildings c Leasehold improvements d Equipment (c) Accumulated depreciation 0. (d) Book value e Other ,.,09.,. Total. Add lines a through e. (Column (d) must equal Form 990, Part, column (B), line 0c.) G,. Schedule D (Form 990) 0 TEEA0L 0//

27 Page Part VII Investments ' Other Securities. N/A Complete if the organization answered '' on Form 990, Part IV, line b. See Form 990, Part, line. Schedule D (Form 990) 0 (a) Description of security or category (including name of security) (b) Book value (c) Method of valuation: Cost or end-of-year market value () Financial derivatives () Closely-held equity interests () Other (A) (B) (C) (D) (E) (F) (G) (H) (I) Total. (Column (b) must equal Form 990, Part, column (B) line.)... G N/A Part VIII Investments ' Program Related. Complete if the organization answered '' on Form 990, Part IV, line c. See Form 990, Part, line. (a) Description of investment (b) Book value (c) Method of valuation: Cost or end-of-year market value () () () () () () (7) () (9) (0) Total. (Column (b) must equal Form 990, Part, column (B) line.)... Part I G Other Assets. N/A Complete if the organization answered '' on Form 990, Part IV, line d. See Form 990, Part, line. (a) Description (b) Book value () () () () () () (7) () (9) (0) Total. (Column (b) must equal Form 990, Part, column (B) line.) G Part Other Liabilities. Complete if the organization answered '' on Form 990, Part IV, line e or f. See Form 990, Part, line (a) Description of liability () Federal income taxes () Designations Payable () () () () (7) () (9) (0) () (b) Book value 9,. Total. (Column (b) must equal Form 990, Part, column (B) line.) G 9,.. Liability for uncertain tax positions. In Part III, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN (ASC 70). Check here if the text of the footnote has been provided in Part III See......Part III... TEEA0L 0// Schedule D (Form 990) 0

28 Page Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered '' on Form 990, Part IV, line a. Total revenue, gains, and other support per audited financial statements ,0, Schedule D (Form 990) 0 Part I Amounts included on line but not on Form 990, Part VIII, line : a Net unrealized gains (losses) on investments b Donated services and use of facilities c Recoveries of prior year grants d Other (Describe in Part III.)... See Part III... a b c d 9,,77. e Add lines a through d Subtract line e from line Amounts included on Form 990, Part VIII, line, but not on line : a Investment expenses not included on Form 990, Part VIII, line 7b a......part III... b Other (Describe in Part III.)....See b,. c Add lines a and b Total revenue. Add lines and c. (This must equal Form 990, Part I, line.) e,77.,077,. c,.,,9. Part II Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered '' on Form 990, Part IV, line a. Total expenses and losses per audited financial statements Amounts included on line but not on Form 990, Part I, line : a Donated services and use of facilities a 9, b Prior year adjustments b c Other losses c Part III... d Other (Describe in Part III.)... See d,77. e Add lines a through d Subtract line e from line Amounts included on Form 990, Part I, line, but not on line : a Investment expenses not included on Form 990, Part VIII, line 7b a b Other (Describe in Part III.)....See......Part III... b 99,707. c Add lines a and b Total expenses. Add lines and c. (This must equal Form 990, Part I, line.) ,90,. e,77.,007,9. c 99,707.,07,09. Part III Supplemental Information. Provide the descriptions required for Part II, lines,, and 9; Part III, lines a and ; Part IV, lines b and b; Part V, line ; Part, line ; Part I, lines d and b; and Part II, lines d and b. Also complete this part to provide any additional information. Part IV, Line b - Contributions Or Other Assets t Included on B/S Organization manages area Combined Federal Campaign under contract from LFCC and subject to Federal Office of Personnel Management. Funds do not belong to organization and are not combined with organization funds. Part IV, Line b - Explanation Of Escrow Account Liability Escrow liability reported on balance sheet represents funds held by organization for and under direction of other organizations. Funds are not segregated form organization funds. Schedule D (Form 990) 0 TEEA0L 0//

29 Part III Supplemental Information (continued) Schedule D (Form 990) 0 Page Part - FIN Footnote The agency files Federal and Indiana income tax returns as an exempt organization under section 0(c)() of the Internal Revenue Code and does not report any unrelated business income or other income taxes. The agency is not considered to be a private foundation. The agency s Federal and Indiana income tax returns for 0 and later are subject to examination by the IRS and state of Indiana, generally for three years after they were filed. The agency recognizes tax benefits only to the extent the agency believes it is more likely than not that its tax positions would be sustained upon examination. There were no tax positions considered less than 0% likely of sustainability. There were no income tax penalties or interest incurred in 0 or 0. Schedule D, Part I, Line d Other Revenue Included In F/S But t Included On Form 990 Uncollectible pleges Total,77.,77. Schedule D, Part I, Line b Other Revenue Included On Form 990 But t Included In F/S Designated contributions Total,.,. Schedule D, Part II, Line d Other Expenses And Losses Per Audited F/S Uncollectible pleges Total,77.,77. Schedule D, Part II, Line b Other Expenses Included On Form 990 But t Included In F/S Designated contributions paid Total TEEA0L 0// 99, ,707. Schedule D (Form 990) 0

30 (Form 990) Department of the Treasury Internal Revenue Service OMB Grants and Other Assistance to Organizations, Governments, and Individuals in the United States SCHEDULE I 0 Complete if the organization answered '' on Form 990, Part IV, line or. G Attach to Form 99 G Information about Schedule I (Form 990) and its instructions is at Open to Public Inspection Name of the organization Employer identification number Part I General Information on Grants and Assistance Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used to award the grants or assistance? Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States. See Part IV Part II Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered '' on Form 990, Part IV, line, for any recipient that received more than,00 Part II can be duplicated if additional space is needed. (a) Name and address of organization or government (b) EIN (c) IRC section (if applicable) (d) Amount of cash grant (e) Amount of non-cash assistance (f) Method of valuation (book, FMV, appraisal, other) (g) Description of noncash assistance () American Red Cross E 7 St Bloomington, IN 70-07,. () Amethyst House PO Box 77 Bloomington, IN ,77. () Area 0 Agency on Aging 0 W Edgewood Dr Ellettsville, IN ,9. () Big Brothers Big Sisters of M PO Box Bloomington, IN 70-0,. () Boys& Girls Club of Bloomingt PO Box 7 Bloomington, IN ,7. () Catholic Charities of Bloomin N College Ave Bloomington, IN ,0. (7) Community Kitchen of Monroe C 97 S Rogers Bloomington, IN ,. () Girls Inc. 0 W th St Bloomington, IN ,70. Enter total number of section 0(c)() and government organizations listed in the line table G Enter total number of other organizations listed in the line table G For Paperwork Reduction Act tice, see the Instructions for Form 99 TEEA90L /0/ (h) Purpose of grant or assistance General & disaster & emergency General & addiction services General & elderly services General & youth services General & youth services General & counseling & education General & food for low income General & youth services 0 Schedule I (Form 990) (0)

31 Grants and Other Assistance to Domestic Individuals. Complete if the organization answered '' on Form 990, Part IV, line. Part III can be duplicated if additional space is needed. Schedule I (Form 990) (0) Part III (a) Type of grant or assistance (b) Number of recipients (c) Amount of cash grant (d) Amount of noncash assistance (e) Method of valuation (book, FMV, appraisal, other) Page (f) Description of noncash assistance 7 Part IV Supplemental Information. Provide the information required in Part I, line ; Part III, column (b); and any other additional information. Part I, Line - Procedures for Monitoring Use of Grants Funds in U.S. United Way only provides Community Action Fund allocation grants to human service agencies that have successfully been certified by our board as meeting standards of efficiency, effectiveness, and governance. The amounts of these grants are based on a separate application in which the agency describes past results and anticipated outcomes. Formal re-certification and re-allocation processes are conducted triennially (and alternate so agencies participate in one process every months), and agencies submit financial, administrative, and programmatic documentation annually. We also evaluate the outcomes of any other projects (for example, those funded through grants we've received) via periodic reports, participation in project meetings, and as appropriate, on-site visits. Schedule I (Form 990) (0) TEEA90L /0/

32 Continuation Sheet for Schedule I (Form 990) 0 G Attach to Form 990 to list additional information for Schedule I (Form 990), Part II and Part III. Continuation Page Name of the organization of Employer identification number Part II Continuation of Grants and Other Assistance to Domestic Organizations and Domestic Governments. (Schedule I (Form 990), Part II.) (a) Name and address of organization or government Hoosier Hills Food Bank PO Box 97 Bloomington, IN 70 Indiana Legal Services N Delware St Suite 0 Indianapolis, IN 0 MCCSC School Assistance Fund rth Dr Bloomington, IN 70 Middle Way House 0 W Kirkwood Ave Bloomington, IN 70 Monroe County United Ministri 7 W th Court Bloomington, IN 70 People & Animal Learning PO Box 0 Bloomington, IN 70 Planned Parenthood of Indiana 00 S Meridian St #00 Indianapolis, IN 0 Harmony School (Rhino's) 909 E nd St Bloomington, IN 70 Salvation Army PO Box 7 Bloomington, IN 70 Shalom Community Center PO Box Bloomington, IN 70 (b) EIN (c) IRC section (if applicable) (d) Amount of cash grant (e) Amount of noncash assistance (f) Method of valuation (book, FMV, appraisal, other) (g) Description of noncash assistance (h) Purpose of grant or assistance -00, Food for disadvantaged -09,. Legal service for poor -79,. -700,. Shelter abused women -090,. Child care & emrgency ser -070,. Therapy with animals -077,9. Reproductive ed & care -9,0 General & youth services -790,0. Indigent food & shelter 7-09,. TEEA00L /0/ School education Indigent food & shelter Schedule I Cont (Form 990) 0

33 Continuation Sheet for Schedule I (Form 990) 0 G Attach to Form 990 to list additional information for Schedule I (Form 990), Part II and Part III. Continuation Page Name of the organization of Employer identification number Part II Continuation of Grants and Other Assistance to Domestic Organizations and Domestic Governments. (Schedule I (Form 990), Part II.) (a) Name and address of organization or government Stone Belt Arc. E 0th St Bloomington, IN 70 Volunteers in Medicine PO Box Bloomington, IN 70 Mother Hubbards Cupboard 00 S. Walnut Suite G Bloomington, IN 70 Stepping Stones P.O. Box Bloomington, IN 70 LIFEDesigns 00 E Winslow Road Bloomington, IN 70 New Hope Family Shelter PO Box Bloomington, IN 70 (b) EIN (c) IRC section (if applicable) (d) Amount of cash grant (e) Amount of noncash assistance (f) Method of valuation (book, FMV, appraisal, other) (g) Description of noncash assistance (h) Purpose of grant or assistance -097,9. Developmental disability 0-9,7. Underserved medical care -0,90. Food distribution ,. Youth Assistance -07,99. Support the disabled ,. TEEA00L /0/ Winter Shelter Schedule I Cont (Form 990) 0

34 SCHEDULE O (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Service Supplemental Information to Form 990 or 990-EZ OMB Complete to provide information for responses to specific questions on Form 990 or 990-EZ or to provide any additional information. G Attach to Form 990 or 990-EZ. G Information about Schedule O (Form 990 or 990-EZ) and its instructions is at 0 Open to Public Inspection Name of the organization Employer identification number Form 990, Part VI, Line b - Form 990 Review Process Reviewed by a committee of the board and available to the entire board. Detailed review by Executive Director with President and Treasurer Form 990, Part VI, Line c - Explanation of Monitoring and Enforcement of Conflicts All Board members must complete a conflict of interest form each year and summit it to the organization. The conflict of interest form would disclose any conflicts that may be present which then could be explored to determine the extent of the conflict. So far, there have been no conflicts to report except for board member also serving as uncompensated board member of an agency receiving allocation. Member abstains from any vote relating to that agency. Form 990, Part VI, Line b - Compensation Review & Approval Process - Officers & Key Employees Every year a systematic review of salaries for all employees is conducted. Comparisons are made to local, regional and national norms Form 990, Part VI, Line 9 - Other Organization Documents Publicly Available We make our Articles of Incorporation, IRS Letter, Code of Ethics, and Form 990 available to the public in our offices. On our Web site, we place our Code of Ethics, n-discrimination Policy, Independent Auditor's report, and Form 990, our Program Service Accomplishments, and the United Way Worldwide membership standards. Form 990, Part I, Line 9 Other Changes In Net Assets Or Fund Balances Designations paid Designations received Total For Paperwork Reduction Act tice, see the Instructions for Form 990 or 990-EZ. TEEA90L 0// 99,707. -,.,. Schedule O (Form 990 or 990-EZ) (0)

35 UNITED WAY OF MONROE COUNTY # Form 990, Schedule O Program Service Accomplishments United Way of Monroe County works with member agencies and a network of other community partners to provide comprehensive and collaborative solutions that help local residents improve their lives. We have served Monroe County since 9, and became a United Fund/Way in 9. We are a fully-certified member of Indiana United Ways and United Way Worldwide. By focusing on the building blocks of a better life Education, Earnings Stability & Essentials we create and support solutions to the most pressing issues in our community. Donations and grants are used to ensure people learn more, earn more, and lead safer and healthier lives. Specifically, we work to meet these priorities: Our Priorities Education Helping children, youth, and adults achieve their potential by: Entering kindergarten ready to succeed Graduating school with a purposeful plan Building job and life skills Earnings Helping hard working families get ahead by: Gaining and maintaining stable employment Increasing and retaining income Building savings and assets Support high-quality child care, after-school programs, healthy habits, and mentoring. Promote the development of children birth-to-five. Support efforts that help youth graduate high school with a viable plan for the future. Increase the number of Earned Income Tax Credit filings. Increase financial opportunity, literacy, and capability. Provide job-related supports that help hard-working families make ends meet. Essentials Helping individuals and families meet basic needs with access to: Sufficient food A stable place to live Health care and wellness Crisis management skills Our Strategies Invest in programs to ensure everyone has the essentials. Support programs that increase health and wellness. Ensure our community is ready to help people recover from natural disasters. In 0, United Way invested,0,00 in support of certified member agencies, other exempt organizations, and United Way initiatives. Below are a few highlights of our efforts: We Partner in Initiatives that Achieve Results EDUCATION: Monroe Smart Start continues to increase kindergarten readiness, support our youngest learners, and empower parents and other caregivers. United Way partners with the Community Foundation of Bloomington and Monroe County to support and manage this collaboration. To promote early literacy and school readiness skills United Way partnered with IU Health Riley Physicians for the Let s Read program to distribute information packets and,7 books to children at their -months through -years wellness visits. Working with local early childhood education and health care providers, we bring United Way s Born Learning into childcare centers, nonprofit agencies, and pediatricians offices. Born Learning encourages parents, grandparents, and caregivers to turn everyday tasks into learning experiences. UNITED WAY OF MONROE COUNTY # Form 990, Schedule O Program Service Accomplishments