Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MOVEMBER INC
Employer identification number
77-0714052
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
3,208,672
7,498,600
10,707,272
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
3,208,672
7,498,600
10,707,272
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public Support. Subtract line 5 from line 4.
10,707,272
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
3,208,672
7,498,600
10,707,272
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
6,906
7,078
13,984
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
10,721,256
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
51,023
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
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......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MOVEMBER INC
Employer identification number
77-0714052
Identifier
Return Reference
Explanation
ORGANIZATION'S MISSION STATEMENT
FORM 990, PART I, LINE 1 & FORM 990, PART III, LINE 1
DURING NOVEMBER EACH YEAR, MOVEMBER IS RESPONSIBLE FOR THE SPROUTING OF MOUSTACHES ON THOUSANDS OF MEN'S FACES, IN THE US AND AROUND THE WORLD. WITH THEIR MOUSTACHES, THESE MEN RAISE VITAL FUNDS AND AWARENESS FOR MEN'S HEALTH, SPECIFICALLY PROSTATE CANCER AND OTHER CANCERS THAT AFFECT MEN. THE STRATEGIC GOALS FROM THE FUNDS RAISED ARE: SURVIVORSHIP: - WE WILL FUND SURVIVORSHIP INITIATIVES THAT PROVIDE INFORMATION AND SUPPORT FOR MEN AND THEIR FAMILIES AFFECTED BY PROSTATE CONCERN AND DEPRESSION THAT HELPS THEM MAKE INFORMED DECISIONS AND IMPROVES THEIR QUALITY OF LIFE. AWARENESS AND EDUCATION: - THROUGH OUR ANNUAL CAMPAIGN AND FUNDED PROGRAMS WE WILL SIGNIFICANTLY INCREASE THE UNDERSTANDING OF THE HEALTH RISK THAT MEN FACE AND ENCOURAGE MEN TO ACT ON THAT KNOWLEDGE. PROSTATE CANCER RESEARCH: - WE WILL FUND CATALYTIC RESEARCH AND CLINICAL TRIALS INFRASTRUCTURE THAT LEADS TO SIGNIFICANTLY IMPROVED DIAGNOSTIC AND PROGNOSTIC TESTS AND TREATMENTS TO REDUCE THE BURDEN OF PROSTATE CANCER. INFLUENCING CHANGE IN MEN'S HEALTH: - WE WILL FUND RESEARCH THAT HELPS TO INFORM HEALTH POLICY AND KNOWLEDGE TRANSLATION THAT ACCELERATES IMPROVED HEALTH OUTCOMES FOR MEN.
FORM 990, PART VI, SECTION A, LINE 2
ADAM GARONE AND TRAVIS GARONE, BOTH FOUNDERS AND DIRECTORS, HAVE A FAMILY RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 6
THE SOLE MEMBER OF MOVEMBER, INC. IS THE AUSTRALIA BASED CHARITY MOVEMBER GROUP PTY LTD AS TRUSTEE FOR THE MOVEMBER FOUNDATION.
FORM 990, PART VI, SECTION A, LINE 8B
DURING THIS PERIOD THERE WERE NO SUBCOMMITTEES FOR MOVEMBER, INC.
FORM 990, PART VI, SECTION B, LINE 11
THE IRS FORM 990 IS REVIEWED BY SENIOR MANAGEMENT (CEO AND CFO) OF MOVEMBER. AFTER MANAGEMENT IS SATISIFED THAT THE 990 IS ACCURATE AND COMPLETE, THE 990 IS MADE AVAILABLE TO THE DIRECTORS PRIOR TO FILING THE FORMS.
FORM 990, PART VI, SECTION B, LINE 12C
THE MOVEMBER GROUP PTY LTD MAINTAINS A "CONFLICTS REGISTER" THAT IS REGULARY REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. EVERY EFFORT IS MADE TO IDENTIFY POTENTIAL AREAS OF CONFLICT AND WHERE THEY ARE IDENTIFIED ACTION IS TAKEN TO REMOVE THE CONFLICT. THIS WOULD NORMALLY RESULT IN EXCLUSION OF THE CONFLICTEE FROM DELIBERATIONS AROUND OPERATIONAL AREAS WHERE THE CONFLICT ARISES.
FORM 990, PART VI, SECTION B, LINE 15A
THE CEO OF THE ORGANIZATION IS ALSO THE CEO OF THE MOVEMBER FOUNDATION. HIS SALARY WAS SET IN 2009 FOLLOWING BENCHMARKING BY AN INDEPENDENT CONSULTING FIRM AND HAS INCREASED ANNUALLY THEREAFTER BY MODEST AMOUNTS APPROXIMATING GENERAL PRICE INCREASES.
FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION WILL MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE ON REQUEST.
REPORTABLE COMPENSATION FROM ORGANIZATIONS FOR RELATED ORGANIZATIONS
PART VII, SECTION A, LINE 1A
THE OFFICER REPORTED ON PART VII OF FORM 990 IS COMPENSATED BY THE ORGANIZATION. THE COMPENSATION AMOUNTS REPORTED IN PART VII OF FORM 990 REPRESENT THE PORTION OF THE COMPENSATION ALLOCATED TO THE ORGANIZATION. THE OFFICER SERVES AS A CORPORATE OFFICER FOR THE AFFILIATED ENTITY, MOVEMBER GROUP PTY LTD. THE ORGANIZATION RECEIVES REIMBURSEMENTS FROM THE AFFILIATE FOR THE SHARED EMPLOYEE COSTS AND FURTHER DETAIL IS PROVIDED ON SCHEDULE R. ADAM GARONE DEVOTES 26 HOURS TO THE AFFILIATED ENTITY AND 14 HOURS TO THE FILING ORGANIZATION. OF THE $223,767 OF REPORTABLE W-2 COMPENSATION PAID BY THE ORGANIZATION, $150,973 WAS REIMBURSED BY THE AFFILIATE TO THE ORGANIZATION FOR THE AFFILIATE'S SHARE OF THE COST. THE AMOUNT REPORTED ON PART VII OF FORM 990, $72,794, REPRESENTS THE ORGANIZATION'S SHARE OF THE COST. $19,711 OF OTHER COMPENSATION IS PAID BY THE AFFILIATE AND $6,164 IS REIMBURSED BY THE ORGANIZATION TO THE AFFILIATE FOR THE ORGANIZATION'S SHARE OF OTHER COMPENSATION COSTS. THIS AMOUNT IS REPORTED ON PART VII OF FORM 990. $13,547 REPRESENTS THE AFFILIATE'S SHARE OF OTHER COMPENSATION COSTS.
RELATED PARTY PAYABLE INCLUDED IN ACCOUNTS PAYABLE AND ACCRUED EXPENSES
FORM 990, PAGE 11, LINE 17
MGPL CHARGED THE ORGANIZATION FOR ITS SHARE OF CERTAIN COSTS FOR CENTRAL SERVICES. THESE SERVICES ARE CONDUCTED CENTRALLY TO ACHIEVE ECONOMIES OF SCALE FOR MOVEMBER'S GLOBAL PROGRAMS, THEREBY RESULTING IN LOWER COSTS IN EACH COUNTRY. THE SERVICES CARRIED OUT CENTRALLY INCLUDE: WEBSITE DEVELOPMENT; HOSTING AND MAINTENANCE; CAMPAIGN THEME DESIGN AND RELATED MATERIALS; FINANCIAL & ACCOUNTING SERVICES; HUMAN RESOURCES SERVICES AND GENERAL MANAGEMENT WHICH INCLUDES PROGRAM IMPLEMENTATION AND BENEFICIARY PARTNER MANAGEMENT SERVICES. THE CHARGE FROM MGPL IS SIGNIFICANTLY LESS THAN IF MOVEMBER INC WERE TO CONDUCT ALL OF THESE ACTIVITIES ON A STAND-ALONE LOCAL BASIS. AS OF APRIL 30, 2011, THE ORGANIZATION'S PAYABLE TO MGPL FOR THE CROSS CHARGES TOTALED $503,962. THIS BALANCE IS INCLUDED IN THE ACCOUNTS PAYABLE AND ACCRUED EXPENSES BALANCE OF $551,312.
RELATED PARTY LOAN PAYABLE
FORM 990, PAGE 11, LINE 22
MGPL ADVANCED FUNDS TO THE ORGANIZATION TO PAY FOR VARIOUS START UP AND OPERATING COSTS. THE LOAN AGREEMENT WAS DATED JULY 8, 2008 AND WAS REPAID BY THE ORGANIZATION IN MAY 2010. AS OF APRIL 30, 2010 AMOUNTS DUE TO MGPL TOTALED $207,031.
AUDIT AND COMPLIANCE COMMITTEE
FORM 990, PART XI, LINE 2C
FOR THE PAST 2 YEARS OF OPERATION, THE AUDIT COMMITTEE OF THE MOVEMBER GROUP (THE PARENT ENTITY OF MOVEMBER, INC.) HAS UNDERTAKEN RESPONSIBILITY FOR ENGAGING INDEPENDENT AUDITORS AND MONITORING THE AUDIT PROCESS. A SEPERATE AUDIT COMMITTEE FOR MOVEMBER INC. HAS BEEN SET UP, COMPRISED FULLY OF INDEPENDENT DIRECTORS. THE CEO ATTENDS THE COMMITTEE MEETINGS BUT IS NOT A MEMBER.
PHONE NUMBER OF THE PERSON WHO POSSESSES THE BOOKS AND RECORDS
PART VI SECTION C LINE 20
MOVEMBER GROUP PTY LTD MAY BE REACHED AT THE FOLLOWING TELEPHONE NUMBER, +1 310 450 3331. THE ORGANIZATION'S PHONE NUMBER WAS USED AT SECTION C LINE 20 IN ORDER TO ELECTRONICALLY FILE THE RETURN TO THE IRS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.