Form990-EZ
Click to see list of attachments
Department of the Treasury
Internal Revenue Service
Short Form
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code
(except black lung benefit trust or private foundation)
bullet Sponsoring organizations of donor advised funds, organizations that operate one or more hospital facilities, and certain controlling organizations as defined in section 512(b)(13) must file Form 990 (see instructions).
All other organizations with gross receipts less than $200,000 and total assets less than $500,000 at the end of the year may use this form.
bulletThe organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-1150
2010
Open to Public
Inspection
A
For the 2010 calendar year, or tax year beginning 01-01-2010, and ending 12-31-2010
B
Check if applicable:
C Name of organization
ARTS AND HEALING INITIATIVE
 
Number and street (or P. O. box, if mail is not delivered to street address)2626 33RD ST
  Room/suite
City or town, state or country, and ZIP + 4 SANTA MONICA, CA90405
D Employer identification number

26-1485541
E Telephone number

(310) 452-1439
F Group Exemption
Number. . bullet  
G Accounting method: Other (specify) bullet   H Check bulletI Website:bulletUCLARTSANDHEALING.NETJ Tax-Exempt status(check only one)—Click to see attachment(   ) bullet(insert no.) or
K Check bullet A Form 990-EZ or Form 990 return is not required though Form 990-N (e-postcard) may be required (see instructions). But if the organization chooses to file a return, be sure to file a complete return.
L Add lines 5b, 6c, and 7b, to line 9 to determine gross receipts; If gross receipts are $200,000 or more, or if total assets (Part II, line 25, column (B) below) are $500,000 or more, file Form 990 instead of Form 990-EZ.. . bullet $ 40,254
Part IRevenue, Expenses, and Changes in Net Assets or Fund Balances (See the instructions for Part I.) Check if the organization used Schedule O to respond to any question in this Part I . . . . . . . .
VerticalRevenue 1 Contributions, gifts, grants, and similar amounts received . . . . . . . . . 1 15,412
2 Program service revenue including government fees and contracts . . . . . . . 2 15,693
3 Membership dues and assessments . . . . . . . . . . . . . . 3  
4 Investment income . . . . . . . . . . . . . . . . . . 4 5
5a Gross amount from sale of assets other than inventory . . . . 5a  
b Less: cost or other basis and sales expenses . . 5b 0
c Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) . . 5c  
6 Gaming and fundraising events
a Gross income from gaming (attach Schedule G if greater than $15,000) 6a  
b Gross income from fundraising events (not including $ 9,144 of contributions from fundraising events reported on line 1) (attach Schedule G if the sum of such gross income and contributions exceed $15,000) . . . . . . .
c Less: direct expenses from gaming and fundraising events . . . 6c 6,022
d Net income or (loss) from gaming and fundraising events (Add lines 6a and 6b and subtract line 6c) 6d 3,122
7a Gross sales of inventory, less returns and allowances . . . . 7a  
b Less: cost of goods sold . . . . . . . . . . 7b 0
c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) . . . . . . 7c  
8 Other revenue (describe in Schedule O) . . . . . . . . . 8  
9 Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8 . . . . . . . . . 9 34,232
VerticalExpenses 10 Grants and similar amounts paid (list in Schedule O) . . . . . . . . 10  
11 Benefits paid to or for members . . . . . . . . . . . . . . . 11  
12 Salaries, other compensation, and employee benefits . . . . . . . . . . . 12  
13 Professional fees and other payments to independent contractors . . . . . . . . 13 5,186
14 Occupancy, rent, utilities, and maintenance . . . . . . . . . . . . . 14  
15 Printing, publications, postage, and shipping . . . . . . . . . . . . 15 1,236
16 Other expenses (describe in Schedule O) . . . . . . . . . . 16 21,804
17 Total expenses. Add lines 10 through 16 . . . . . . . . . . . . 17 28,226
VerticalNetAssets 18 Excess or (deficit) for the year (Subtract line 17 from line 9) . . . . . . . . . 18 6,006
19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with
end-of-year figure reported on prior year’s return) . . . . . . . . . . . 19 6,788
20 Other changes in net assets or fund balances (explain in Schedule O) . . . . . . . 20  
21 Net assets or fund balances at end of year. Combine lines 18 through 20 . . . . . Bullet 21 12,794
Part IIBalance Sheets Check if the organization used Schedule O to respond to any question in this Part II. . . . . . . . .

(See the instructions for Part II.)(A) Beginning of year(B) End of year
22Cash, savings, and investments . . . . . . . . . .
8,511
22
38,719
23Land and buildings . . . . . . . . . . . . .
 
23
 
24Other assets (describe in Schedule O) . . . . . .
1,947
24
37,154
25Total assets . . . . . . . . . . . . . .
10,458
25
75,873
26
Total liabilities (describe in Schedule O) . . . . .
3,670
26
63,079
27Net assets or fund balances (line 27 of column (B) must agree with line 21) .
6,788
27
12,794
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 10642I Form 990-EZ (2010)
Form 990-EZ (2010)
Page 2
Part IIIStatement of Program Service Accomplishments Check if the organization used Schedule O to respond to any question in this Part III . Expenses
(Required for section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts; optional for others.)
What is the organization's primary exempt purpose? To facilitate the use of arts-based tools for mind-body healing in the community as a vehicle for empowerment and transformation.
Describe what was achieved in carrying out the organization's exempt purposes. In a clear and concise manner, describe the services provided, the number of persons benefited, and other relevant information for each program title.
28 OTHER SELECTED ACCOMPLISHMENTS CONTINUE:Joint collaboration on a local partner consortium grant with YWCA is in final phases of completion (YWCA is lead agency - they are currently seeking evaluation services from an organization like RAND). Goal of grant application is to facilitate positive development of middle school girls in leadership, decision-making, health, reproductive health, and social-emotional skill building using the arts. UCLArts and Healing is the primary agency to offer services in social-emotional skill building using the arts, which will serve students directly during the school day, as well as offer training programs for school personnel and families. These programs will also be open to the public and generate matching funds for UCLArts and Healing. This can be a model for other YWCAs as well.We served 71 Boys and Girls Club staff in a second pilot training program held at the Santa Monica Club, which included representatives from a number of other clubs, including Malibu, Watts, Carson, Burbank, and East Valley. The training program included Movement for Special Needs and Theater Activities for Social-Emotional Development on Day 1, which served 41; and it included Movement for Teens and Beat the Odds Drumming on Day 2, which served 30. The survey data that we collected will be used to apply for grant funding for a larger future project.Two sessions of Medicine Dance were held at the YWCA, after which time we decided that the program (which had been shown to be helpful with cancer patients) belonged at the Wellness Community WC). After arranging with the WC to host the remaining 4 sessions, we found tremendous interest in it among WC members because it allowed them to get back in touch with their bodies after experiencing much trauma. Subsequently, in the Fall the WC adopted this program permanently in its offerings in response to member demand.UCLArts and Healing ran a successful set of experiential sessions for UCLA Collaborative Centers for Integrative Medicine (CCIM) - Integrative Medicine Day at UCLA. UCLArts and Healing has been asked to do this again this coming February. These are signs that awareness is growing regarding the use of the arts as a tool for healing: More UCLA undergrads, grad students and medical students contact UCLArts and Healing seeking mentorship and classroom presentations (NCAM group. ArtsBridge, ArtsIN group, UCLA Staff Assembly, CEWM summer IM course). UCLA Extension is also interested. We have brought two programs to them. One medical trainee obtained a Schweitzer Fellowship to use art with hospitalized children, an undergrad started an arts program for foster children in the community.
(Grants $   ) If this amount includes foreign grants, check here ...MediumBullet		 28a  
29 Other selected accomplishments:Bookkeeping and Accounting Services put into in place. Financial review completed by accountant to facilitate grant applications. Drumming Study published in eCAM. It included literature reviews of other art forms as well, to maximize research and practical value. This publication is making a difference. We are receiving steady inquiries. One from a teacher in Tennessee.Summer survey of constituents: (about 10% response rate - approx 200 out of 2000 sent out). Everything needed to grow this program is contained within our constituents. The first fundraiser proved this to be true. The book Tribes says that what is important is not the size of a group being led, but the investment level of the group that is being led. UCLArts and Healing has a very invested group behind it that is actually quite interconnected professionally; the fundraiser in September served as a meaningful gathering opportunity for them.Interest in topics promoted by UCLArts and Healing: meditation and mind-based practices (60.9%), movement such as tai chi and Alexander Technique (59.8%), yoga (53.3%), music (48.9%), dance and creative movement (48.4%), writing (47.3%), drumming (44.6%), intuition (40.2%), humor (39.1%), art (37%), poetry (31%), theater arts (27.2%).Interest in populations of interest to UCLArts and Healing: women (47.8%), people that have experienced trauma of any type (42.4%), older adults (37%), people living with illness (35.9%), children or people interested in working with children (27.2%) who they represent and art forms they use: 37 respondents represent agencies that offer services utilizing arts-based tools for mind/body healing. 63 were individual service providers utilizing arts-based tools for mind/body healing. Art, meditation, and writing are the three most commonly used forms of interventions used. Drumming and music next most commonly used. Individual services providers also used humor and intuition.Who can offer pro bono services and space; and who needs services by UCLArts and Healing: 8 agencies and 17 individuals are able to offer services pro bono to UCLArts and Healing (not including maybes, which doubles the numbers respectively). 4 agencies and 5 individuals are able to offer space pro bono to UCLArts and Healing (not including maybes, which quadruples and quintuples the numbers respectively). Found 21 agencies in need of services from UCLArts and Healing (and 46 that MAY need services).Ways in which they can help: The survey cited funding of the drumming study and Boys and Girls Club training sessions as examples of how individuals can develop their vision. 57 people indicated definite interest in being informed of potential projects they could help support and 51 said they may be interested. 17 said that they knew others who may be interested as well; 58 said that they MIGHT know others who would be interested. 9 people offered grant writing services; another 27 said they would consider it. Also had 58 offers of silent auction items. 20 offered suggestions for food and beverages for a fundraising event. 67 offered a spectrum of volunteer services for UCLArts and Healing in general.
(Grants $   ) If this amount includes foreign grants, check here ...MediumBullet		 29a  
30 Continued course dates:05/18/2010 Medicine Dance: Inner-Directed Movement for Healing - with CEUs for MFT, LCSW, and RN - Medicine Dance: Inner-Directed Movement for Healing 5/005/18/2010 Medicine Dance: Inner-Directed Movement for Healing 15 /2 05/16/2010 Program Postponed until Fall Music for the Soul 114 /105/16/2010 Program Postponed until Fall Music for the Soul 1 - With CMTEs & CEUs for MFT, LCSW, & RN 6 /105/12/2010 Attuning to Needs: Nonverbal Communication for Caregivers 40 /4 05/12/2010 Attuning to Needs: Nonverbal Communication for Caregivers - with CEUS for MFT, LCSW, & RN 10 /1 05/10/2010 Everyday Intuition 50 /11 05/06/2010 Yoga: It's More than You Think - Session 2 only10 /1 05/03/2010 Yoga: It's More than You Think - with Veronica Zador 20 /7 05/03/2010 Yoga: It's More than You Think - Session 1 only 10 /3 04/26/2010 Sustainable Movement 24/7: Breaking Barriers of Self-Limitation - Introductory Workshop 30 /3 04/26/2010 Sustainable Movement 24/7: Breaking Barriers of Self-Limitation - Introductory Workshop with CEUs for RN 5 /0 04/20/2010 Medicine Dance: Inner-Directed Movement for Healing - Medicine Dance: Inner-Directed Movement for Healing 15 /2 04/20/2010 Medicine Dance: Inner-Directed Movement for Healing - with CEUs for MFT, LCSW, and RN - Medicine Dance: Inner-Directed Movement for Healing 5 /0 03/31/2010 Rituals for Life 15 /10 03/31/2010 Rituals for Life - with CEUs for MFT/LCSW 5 /4 03/23/2010 Medicine Dance 15 /0 03/23/2010 Medicine Dance - with CEUs for MFT, LCSW, and RN 5 /0 03/14/2010 Beat the Odds: Social and Emotional Skill Building Delivered in a Framework of Drumming - A Training Program for Working with Children - with CEUs for MFT/LCSW 10 /6 03/14/2010 Beat the Odds: Social and Emotional Skill Building Delivered in a Framework of Drumming - A Training Program for Working with Children 30 /4 03/08/2010 Awakening from Trauma through Breath, Sound, and Movement - 4-Part Follow-Up Workshop 20 /6 03/08/2010 Awakening from Trauma through Breath, Sound, and Movement - 4-Part Follow-Up Workshop - with CEUs for MFT/LCSW 10 /4 03/01/2010 Awakening from Trauma through Breath, Sound, and Movement - Introductory Workshop - with CEUs for MFT/LCSW 10 /5 03/01/2010 Awakening from Trauma through Breath, Sound, and Movement - Introductory Workshop 30 /15 02/28/2010 Beat the Odds: Social and Emotional Skill Building Delivered in a Framework of Drumming - A Training Program for Working with Children 30 /5 02/28/2010 Beat the Odds: Social and Emotional Skill Building Delivered in a Framework of Drumming - A Training Program for Working with Children - with CEUs for MFT/LCSW 10 /1 02/24/2010 Medicine Dance 15 /6 02/24/2010 Medicine Dance - with CEUs for MFT, LCSW, and RN 5 /2 02/04/2010 Sustainable Movement 24/7: Breaking Barriers of Self-Limitation - 3-Part Follow-up Workshop 20 /4 02/04/2010 Sustainable Movement 24/7: Breaking Barriers of Self-Limitation - 3-Part Follow-up Workshop - Student Registration Site 3 /2 02/03/2010 UCLA Conference on Integrative Medicine - free experiential workshops in T'ai Chi Chih, meditation, Alexander technique, Acupressure/Self-Care, Yoga Therapy 200 /1 02/01/2010 Sustainable Movement 24/7: Breaking Barriers of Self-Limitation - Introductory Workshop30 /17 01/27/2010 Medicine Dance 15 /8 01/27/2010 Medicine Dance - with CEUs for MFT, LCSW, and RN5 /1
(Grants $   ) If this amount includes foreign grants, check here ...MediumBullet		 30a  
The Arts and Healing Initiative offered 29 programs in 2010. The following list shows online registration for programs with and without Continuing Education Units (CEUs) for Marriage and Family Therapists and Licensed Clinical Social Workers as well as Music Therapists.The number of people that enrolled through the website is indicated by the number after the "/" at the end of each line. (The number before the "/" is the number of spaces we had available). Typically, we have several people per event who also register but not through the website, and have an average of 20 persons per event. In addition, at the annual benefit event 85 people donated volunteer services or items for the silent auction and we let them in for free (i.e., they are not accounted for in the list below). We also served 250 people at the free UCLA Integrative Medicine Conference. The estimated number of people served through our programs in 2010 was 624, plus an estimated 26 people who registered at the door = 650, plus the Boys and Girls Club staff trainings cited below served 41 and 30, making the total number served = 721. The estimated number does not include the individuals who also discovered other recommended programs through our website or who received referrals and advice on career development and service opportunities.Programs conducted were:11/14/2010 Beat the Odds: Social and Emotional Skill Building Delivered in a Framework of Drumming 60 /211/14/2010 With CEUs for MFT/LCSW - Beat the Odds: Social and Emotional Skill Building Delivered in a Framework of Drumming 20 /4 11/12/2010 Family Registration Site Getting into the Groove 120 /8 11/12/2010 Getting into the Groove 120 /6 10/25/2010 Happy Endings: Re-writing Your Life 30/11 10/25/2010 With CEUs for MFT/LCSW - Happy Endings: Re-writing Your Life 10/4 10/09/2010How Close Can We Get? Dimensions of Intimacy: Exploring a Path Towards More Authentic and Satisfying Relationships 30 /12 10/09/2010 With CEUs for MFT/LCSW - How Close Can We Get? Dimensions of Intimacy: Exploring a Path Towards More Authentic and Satisfying Relationships 10 /1 09/26/2010 The Healing Beat: Festive Program Sampler & Creative Silent Auction featuring master drum circle facilitator & music therapist, Christine Stevens, & mini-workshops in theater arts, writing, movement, and more 200 /15 09/13/2010 Memories to Memoirs: Leaving Your Legacy 30 /10 09/13/2010 With CEUs for MFT/LCSW - Memories to Memoirs: Leaving Your Legacy 10 /306/27/2010 Beat the Odds: Social and Emotional Skill Building Delivered in a Framework of Drumming 30 /1606/27/2010 Beat the Odds: Social and Emotional Skill Building Delivered in a Framework of Drumming - with CMTEs & CEUs for MFT, LCSW 10 /3 06/15/2010 Medicine Dance: Inner-Directed Movement for Healing - with CEUs for MFT, LCSW, and RN - Medicine Dance: Inner-Directed Movement for Healing - 5 /0 06/15/2010 Medicine Dance: Inner-Directed Movement for Healing - Medicine Dance: Inner-Directed Movement for Healing - 15 /1 06/14/2010 Sustainable Movement 24/7: Breaking Barriers of Self-Limitation - 3-Part Follow-up Workshop 40 /16 06/07/2010 Sustainable Movement 24/7: Breaking Barriers of Self-Limitation - Introductory Workshop 30 /7 05/24/2010 Sustainable Movement 24/7: Breaking Barriers of Self-Limitation - Introductory Workshop 30 /6 05/23/2010 Music for the Soul - With CMTEs & CEUs for MFT, LCSW, & RN 6 /2
(Grants $ 20,422) If this amount includes foreign grants, check here ...MediumBullet		  
31 Other program services (describe in Schedule O) . . . . . . . . . . . .
(Grants $   ) If this amount includes foreign grants, check here...MediumBullet		 31a
32 Total program service expenses (add lines 28a through 31a) . . . . . . . . . bullet 32 20,422
Part IVList of Officers, Directors, Trustees, and Key Employees. List each one even if not compensated. (See the instructions for Part IV.) Check if the organization used Schedule O to respond to any question in this Part IV . . . . . . . .
(a) Name and address (b) Title and average
hours per week
devoted to position		 (c) Compensation
(If not paid,
enter -0-.) 		(d) Contributions to
employee benefit plans &
deferred compensation		 (e) Expense
account and
other allowances
KATIE COUTURIER
2626 33RD ST
SANTA MONICA,CA904053111
 Secretary/tres.1.00 0    
REMO BELLI
2626 33RD ST
SANTA MONICA,CA904053111
 Director3.00 0    
AMI BELLI
2626 33RD ST
SANTA MONICA,CA904053111
 Director1.00 0    
JOHN WEEKS
2626 33RD ST
SANTA MONICA,CA904053111
 Director1.00 0    
LONNIE K ZELTZER MD
2626 33RD ST
SANTA MONICA,CA904053111
 Director1.00 0    
ELIE NICOLAI
2626 33RD ST
SANTA MONICA,CA904053111
 Director1.00 0    
LUCY S GONDA
2626 33RD ST
SANTA MONICA,CA904053111
 Director2.00 0    
PING HO
2626 33RD ST
SANTA MONICA,CA904053111
 Executive Direc40.00 0    
Form 990-EZ (2010)
Form 990-EZ (2010)
Page 3
Part VOther Information(Note the statement requirements in the instructions for Part V.)YesNo Check if the organization used Schedule O to respond to any question in this Part V . . . .
33
Did the organization engage in any activity not previously reported to the IRS? If "Yes," provide a detailed description of each activity in Schedule O ..............
33
 
No
34
Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the amended documents if they reflect a change to the organization’s name. Otherwise, explain the change on Schedule O (see instructions). ...................
34
 
No
35
If the organization had income from business activities, such as those reported on lines 2, 6a, and 7a (among others), but not reported on Form 990-T, explain in Schedule O why the organization did not report the income on Form 990-T. ........................
a
Did the organization have unrelated business gross income of $1,000 or more or was it a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e) notice, reporting, and proxy tax requirements?
35a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year? (see instructions) ........
35b
 
 
36
Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If “Yes,” complete applicable parts of Schedule N .............
36
 
No
37a
Enter amount of political expenditures, direct or indirect, as described in the instructions. bullet
37a
 
b
Did the organization file Form 1120-POL for this year? ...............
37b
 
No
38a
Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were
any such loans made in a prior year and still outstanding at the end of the tax year covered by this return?
38a
 
No
b
If “Yes,” complete Schedule L, Part II and enter the total amount involved .
38b
 
39
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on line 9 ......
39a
0
b
Gross receipts, included on line 9, for public use of club facilities ....
39b
0
40a
Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under:
section 4911 bullet   ; section 4912 bullet   ; section 4955 bullet  
b
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year or did it engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I. ....
40b
 
No
c
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and 4958 ..bullet  
d
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimbursed by the organization ...................bullet  
e
All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? If "Yes," complete Form 8886-T. .................
40e
 
No
41List the states with which a copy of this return is filed. bulletCA
42aThe organization's books are in care of bulletPING HO Telephone no. bullet (310) 435-4578
Located at bullet2626 33RD ST
SANTA MONICA,CA ZIP + 4bullet904053111
b
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)?
Yes
No
42b
 
No
If “Yes,” enter the name of the foreign country: bullet  
See the instructions for exceptions and filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
c
At any time during the calendar year, did the organization maintain an office outside of the U.S.?
42c
 
No
If “Yes,” enter the name of the foreign country: bullet  
43.......bullet
and enter the amount of tax-exempt interest received or accrued during the tax year . . . bullet43
 
44a
Did the organization maintain any donor advised funds? If "Yes", Form 990 must be completed instead of
Yes
No
Form 990-EZ.. . . . . . . . . . . . . . . . . . . .
44a
 
No
b
Did the organization operate one or more hospital facilities during the year? If ‘Yes,’ Form 990 must be completed instead of Form990-EZ. . . . . . . . .
44b
 
No
c
Did the organization receive any payments for indoor tanning services during the year? . . . . . . .
44c
 
No
d
If 'Yes' to line 44c, has the organization filed a Form 720 to report these payments? If ‘No,’ provide an explanation in Schedule O. . . . . . . . .
44d
 
No
45
Is any related organization a controlled entity of the organization within the meaning of section 512(b)(13)? If ‘Yes,’ Form 990 and Schedule R must be completed instead of Form990-EZ. . . . . . . . .
45
 
No
45a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If ‘Yes,’ Form 990 and Schedule R must be completed instead of Form990-EZ. .
45a
 
No
46
Did the organization engage, directly or indirectly, in political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I. . . . . . . . . .
46
 
No
Form 990-EZ (2010)
Form 990-EZ (2010)
Page 4
Part VI
Section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts only. All section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts must answer questions 47-49b and 52. Check if the organization used Schedule O to respond to any question in this Part VI . . . . . . . .
Yes
No
47
Did the organization engage in lobbying activities? If "Yes," complete Schedule C, Part II . . . .
47
 
No
48
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E . . .
48
 
No
49a
Did the organization make any transfers to an exempt non-charitable related organization? . . . .
49a
 
No
b
If "Yes," was the related organization a section 527 organization? . . . . . . . . .
49b
 
No
50
Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key employees) who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and address of each employee paid more than $100,000 (b) Title and average
hours per week
devoted to position		 (c) Compensation
 (d) Contributions to
employee benefit plans &
deferred compensation		 (e) Expense
account and
other allowances
NONE
50(f)
Total number of other employees paid over $100,000 . . . . . . . . . . . . . bullet  

51
Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and address of each independent contractor paid more than $100,000 (b) Type of service (c) Compensation
NONE
51(d)
Total number of other independent contractors each receiving over $100,000 . . . . . . . bullet  
52
Did the organization complete Schedule A? NOTE: All Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A ....................
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
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(See instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
Form 990-EZ (2010)

Additional Data


Software ID: 10000105
Software Version: 2010v3.2

Form 990-EZ, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

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.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
ARTS AND HEALING INITIATIVE
 
Employer identification number

26-1485541
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
f
g
(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
(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.") ....   11,600 20,945 29,421 15,412 77,378
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......           0
3 The value of services or facilities furnished by a governmental unit to the organization without charge..           0
4 Total. Add lines 1 through 3..   11,600 20,945 29,421 15,412 77,378
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)..           66,563
6 Public Support. Subtract line 5 from line 4.           10,815
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..   11,600 20,945 29,421 15,412 77,378
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..       8 5 13
9 Net income from unrelated business activities, whether or not the business is regularly carried on..           0
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..           0
11 Total support (Add lines 7 through 10).           77,391
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
0 %
15
15
 
16a
b
17a
b
18
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
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
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: 10000105
Software Version: 2010v3.2
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
ARTS AND HEALING INITIATIVE
 
Employer identification number

26-1485541
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
ARTS AND HEALING INITIATIVE
  		Employer identification number

26-1485541
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
ARTS AND HEALING INITIATIVE
  		Employer identification number

26-1485541
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
ARTS AND HEALING INITIATIVE
  		Employer identification number

26-1485541
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (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 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (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 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (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 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (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 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID: 10000105
Software Version: 2010v3.2
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.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
ARTS AND HEALING INITIATIVE
 
Employer identification number

26-1485541
Identifier Return Reference Explanation
Form 990-EZ, Part II, Line 26.1006 Total Liabilities.1006 Payable to Officers, Directors, Etc. - Beginning $3670 Payable to Officers, Directors, Etc. - Ending $36494
Form 990-EZ, Part II, Line 26.1001 Total Liabilities.1001 Accounts Payable and Accrued Expenses - Beginning $0 Accounts Payable and Accrued Expenses - Ending $26585
Form 990-EZ, Part II, Line 24.1005 Other Assets.1005 Accounts Receivable - Beginning $740 Accounts Receivable - Ending $0
Form 990-EZ, Part II, Line 24.1002 Other Assets.1002 Furniture and Fixtures - Beginning $1207 Furniture and Fixtures - Ending $37154
Form 990-EZ, Part I, Line 16.14 Other Expenses.14 RENTAL $30
Form 990-EZ, Part I, Line 16.13 Other Expenses.13 FEES $115
Form 990-EZ, Part I, Line 16.12 Other Expenses.12 MEMBERSHIP DUES $130
Form 990-EZ, Part I, Line 16.11 Other Expenses.11 MISCELLANEOUS $160
Form 990-EZ, Part I, Line 16.10 Other Expenses.10 REFERENCE MATERIAL $192
Form 990-EZ, Part I, Line 16.9 Other Expenses.9 MEALS AND ENTERTAINMENT $245
Form 990-EZ, Part I, Line 16.8 Other Expenses.8 SUPPLIES $283
Form 990-EZ, Part I, Line 16.7 Other Expenses.7 WEB HOSTING AND DESIGN $323
Form 990-EZ, Part I, Line 16.6 Other Expenses.6 EQUIPMENT RENTAL & MAINTENANCE $447
Form 990-EZ, Part I, Line 16.5 Other Expenses.5 AUDIO VISUAL $516
Form 990-EZ, Part I, Line 16.4 Other Expenses.4 TELEPHONE $612
Form 990-EZ, Part I, Line 16.2 Other Expenses.2 BANK & MERCHANT FEES $1416
Form 990-EZ, Part I, Line 16.1 Other Expenses.1 INSTRUCTOR PAYMENTS $8306
Form 990-EZ, Part I, Line 16.1012 Other Expenses.1012 Insurance $2764
Form 990-EZ, Part I, Line 16.1009 Other Expenses.1009 Depreciation $4613
Form 990-EZ, Part I, Line 16.1007 Other Expenses.1007 Conferences, Conventions, and Meetings $870
Form 990-EZ, Part I, Line 16.1005 Other Expenses.1005 Travel $782
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID: 10000105
Software Version: 2010v3.2