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
THE SYNERGOS INSTITUTE INC
Employer identification number
13-3392006
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.") ....
8,703,523
14,095,679
4,947,100
3,873,104
5,460,135
37,079,541
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..
8,703,523
14,095,679
4,947,100
3,873,104
5,460,135
37,079,541
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)..
9,369,410
6
Public Support. Subtract line 5 from line 4.
27,710,131
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..
8,703,523
14,095,679
4,947,100
3,873,104
5,460,135
37,079,541
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
199,561
1,047,897
707,756
505,772
472,700
2,933,686
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..
44,240
80,754
183,463
97,582
34,500
440,539
11
Total support (Add lines 7 through 10).
40,453,766
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
1,725,099
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
68.500 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
68.520 %
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, PART II, LINE 10, EXPLANATION OF OTHER INCOME: SPECIAL EVENT MISCELLANEOUS
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
THE SYNERGOS INSTITUTE INC
Employer identification number
13-3392006
Identifier
Return Reference
Explanation
NEW PROGRAM SERVICES
FORM 990, PART III, LINE 2
IN LATE 2010, THE SYNERGOS INSTITUTE (SOUTH AFRICA) TOOK OVER THE LEAD ROLE AND MANAGEMENT OF THE LEADERSHIP & INNOVATION NETWORK FOR CHILDREN ("LINC") PROJECT FROM CONVENE VENTURE PHILANTHROPY ("CONVENE"). CONVENE & SYNERGOS HAD BEEN PARTNERS IN THE LINC PROJECT CONDUCTED BY CONVENE IN JOBURG, SA SINCE ITS INCEPTION IN 2007. AS CONVENE IS WITHDRAWING FROM ITS ROLE AS LEAD AGENCY, SYNERGOS HAS AGREED TO TAKE OVER AND MANAGE THE PROJECT.
FORM 990, PART VI, SECTION B, LINE 11
THE EXTERNAL AUDIT AND ACCOUNTING FIRM PREPARES A DRAFT FORM 990 BASED ON THE INFORMATION PROVIDED IN THEIR QUESTIONNAIRE AND RELATED ATTACHMENTS. A DRAFT OF THE US FORM 990 IS SENT TO THE ORGANIZATION BY THE EXTERNAL AUDIT AND ACCOUNTING FIRM FOR REVIEW. THE FINANCE STAFF WILL REVIEW THE DRAFT 990 AND THE CFO WILL PROVIDE FINAL REVIEW. AN OVERVIEW OF THE SIGNIFICANT SECTIONS OF THE DRAFT 990 IS PROVIDED TO THE PRESIDENT AND SENIOR DIRECTORS OF THE ORGANIZATION BY THE FINANCE STAFF. CORRECTIONS AND CLARIFICATIONS ARE MADE WITH THE EXTERNAL AUDIT AND ACCOUNTING FIRM AND THEN THE FINAL US FORM 990 IS PREPARED BY THE EXTERNAL AUDIT AND ACCOUNTING FIRM. THE BOARD RECEIVES AN UPDATE OF THE STATUS OF THE 990 FILINGS AND COPIES OF FORM 990 ARE PROVIDED AT BOARD MEETINGS, FINANCE COMMITTEE AND AUDIT COMMITTEE MEETINGS. SO IT IS AVAILABLE TO THE BOARD MEMBERS TO REVIEW OR TO TAKE WITH THEM. A REVIEW OF THE FINAL DRAFT AND SCHEDULES/ATTACHMENTS IS COMPLETED BY THE FINANCE STAFF AND CFO PRIOR TO SIGNATURE OF THE 990. THE 990 IS THEN SIGNED AND SUBMITTED TO THE US GOVERNMENT.
FORM 990, PART VI, SECTION B, LINE 12C
THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY AND REQUIRES ALL NEW EMPLOYEES AND BOARD MEMBERS TO SIGN A CONFLICT OF INTEREST STATEMENT, WHICH IS KEPT ON FILE AT THE ORGANIZATION. EMPLOYEES AND BOARD MEMBERS ARE REMINDED OF THE CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS (AT MINIMUM) AND THE ORGANIZATION REQUIRES ALL BOARD MEMBERS AND EMPLOYEES TO SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. THESE ARE KEPT ON FILE AT THE ORGANIZATION. FURTHER MONITORING OF THE CONFLICT OF INTEREST POLICY OCCURS INFORMALLY THROUGHOUT THE YEAR: DURING ANNUAL AND MID-YEAR REVIEWS BETWEEN EMPLOYEES AND SUPERVISORS, AND DURING FORMAL AND INFORMAL MEETINGS WITH BOARD MEMBERS.
FORM 990, PART VI, SECTION B, LINE 15
THE CEO'S COMPENSATION IS REVIEWED AND SET ANNUALLY BY THE BOARD OF DIRECTORS. IN PREPARATION FOR THIS PROCESS, THE BOARD OF DIRECTORS REVIEWS THE COMPENSATION OF SIMILAR LEADERSHIP POSITIONS OF ORGANIZATIONS OF SIMILAR SIZE, TYPE, BUDGET IN ORDER TO ENSURE THAT THE CEO'S COMPENSATION FALLS WITHIN A COMPARABLE RANGE FOR SIMILAR ROLES AND RESPONSIBILITIES IN THE INDUSTRY AND REGION. COMPENSATION FOR ALL OTHER EMPLOYEES IS SET BY THE CEO IN CONSULTATION WITH OTHER SENIOR STAFF. THE HUMAN RESOURCES DEPARTMENT OBTAINS SALARY SURVEY INFORMATION AT LEAST ANNUALLY IN ORDER TO PROVIDE DATA ON CURRENT SALARY RANGES FOR COMPARABLE POSITIONS AT ORGANIZATIONS OF SIMILAR SIZE, BUDGET, AND TYPE. THIS INFORMATION IS MADE AVAILABLE TO THE CEO AND SENIOR MANAGEMENT SO THAT SALARY DECISIONS REFLECT COMPETITIVE AND COMPARABLE RANGES FOR SIMILAR POSITIONS AT SIMILAR ORGANIZATIONS. COMPENSATION FOR EACH POSITION IS REVIEWED BY SENIOR MANAGEMENT AND THE CEO DURING THE ANNUAL BUDGETING PROCESS AND SALARY RANGES FOR EACH POSITION FOR THE COMING YEAR ARE DETERMINED AT THAT TIME. A CONSIDERATION OF COST OF LIVING INCREASES IN THE REGION IN THE PAST YEAR IS TAKEN INTO ACCOUNT, INCLUDING KNOWLEDGE OF WHAT SIMILAR ORGANIZATIONS ARE DOING FOR THEIR STAFF WITH REGARD TO COST OF LIVING INCREASES. THE ORGANIZATION HAS IN SOME YEARS, BUT NOT ALL YEARS, MADE COMPENSATION ADJUSTMENTS ACROSS THE BOARD TO REFLECT COST OF LIVING INCREASES. ALL COMPENSATION CHANGES FOR EMPLOYEES ARE APPROVED BY THE CEO PRIOR TO ANNOUNCING OR INSTITUTING THE CHANGE.
FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION MAKES THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST, FINANCIAL STATEMENTS, FORM 1023 AND FORM 990 PUBLIC THOROUGH ITS WEBSITE AND UPON REQUEST.
CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 5:
NET UNREALIZED GAINS ON INVESTMENTS: 875,272. FOREIGN CURRENCY TRANSACTIONS GAIN 70,340. TOTAL TO FORM 990, PART XI, LINE 5: 945,612.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.