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
INCARNATE WORD FOUNDATION MISSOURI
Employer identification number
91-2035797
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)
No
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
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
(1)
ACCESS ACADEMIES
203443231
501(C)(3)
No
Yes
Yes
2,000
(2)
ANGELS ARMS
431894074
501(C)(3)
No
Yes
Yes
7,500
(3)
BIG BROTHERS AND BIG SISTERS SW IL
371095468
501(C)(3)
No
Yes
Yes
5,000
(4)
BOARDLINKSTL
430714167
501(C)(3)
No
Yes
Yes
1,000
(5)
BOYS HOPE GIRLS HOPE OF STL
431202596
501(C)(3)
No
Yes
Yes
1,000
(6)
CASA
431727959
501(C)(3)
No
Yes
Yes
5,000
(7)
CASA EAST ST LOUIS
371233728
501(C)(3)
No
Yes
Yes
7,500
(8)
CATHOLIC DAY CARE CENTER
370922459
501(C)(3)
No
Yes
Yes
7,500
(9)
CHRISTIAN ACTIVITY CENTER
364182760
501(C)(3)
No
Yes
Yes
20,000
(10)
CITIZENS - MISSOURI'S CHILDREN
431270569
501(C)(3)
No
Yes
Yes
10,000
(11)
COMMUNITY PARTNERSHIP
431768614
501(C)(3)
No
Yes
Yes
5,000
(12)
COVENANT HOUSE MISSOURI
431821599
501(C)(3)
No
Yes
Yes
1,000
(13)
CITY GARDEN MONTESSORI CHARTER
431671014
501(C)(3)
No
Yes
Yes
5,000
(14)
CULTURAL LEADERSHIP
201269305
501(C)(3)
No
Yes
Yes
500
(15)
DE LASALLE MIDDLE SCHOOL
431932840
501(C)(3)
No
Yes
Yes
20,000
(16)
EAST SIDE HEART & HOME
371352360
501(C)(3)
No
Yes
Yes
10,000
(17)
EL PUENTE
500005943
501(C)(3)
No
Yes
Yes
90,000
(18)
EPWORTH FOSTER CARE
431069741
501(C)(3)
No
Yes
Yes
10,000
(19)
FAITH IN ACTION COALITION
371315680
501(C)(3)
No
Yes
Yes
25,000
(20)
GRACE HILL SETTLEMENT HOUSE
237216273
501(C)(3)
No
Yes
Yes
22,625
(21)
GRASSROOTS GRANTMAKERS
271380459
501(C)(3)
No
Yes
Yes
500
(22)
GUARDIAN ANGEL SETTLEMENT ASSOCIATION
430658636
501(C)(3)
No
Yes
Yes
5,000
(23)
HEADWATERS COALITION
741676917
501(C)(3)
No
Yes
Yes
35,000
(24)
IMMIGRENTREFUGEE WOMENS PROGRAM
431886548
501(C)(3)
No
Yes
Yes
20,000
(25)
INCARNATE WORD ACADEMY
430893321
501(C)(3)
No
Yes
Yes
32,500
(26)
INCARNATE WORD MISSIONARIES
741676917
501(C)(3)
No
Yes
Yes
7,000
(27)
INNOVATIVE CONCEPT ACADEMY
430652657
501(C)(3)
No
Yes
Yes
8,000
(28)
JAMISON MEMORIAL HR & DEVELOPMENT
431700604
501(C)(3)
No
Yes
Yes
3,000
(29)
JOIN HANDS
431607996
501(C)(3)
No
Yes
Yes
8,000
(30)
JUSTINE PETERSEN
431769074
501(C)(3)
No
Yes
Yes
10,500
(31)
LET'S START
431601320
501(C)(3)
No
Yes
Yes
10,000
(32)
LETS START THE MUSIC
431601320
501(C)(3)
No
Yes
Yes
300
(33)
LEWIS PL HISTORICAL PRESERVATION
311741742
501(C)(3)
No
Yes
Yes
4,500
(34)
MARIAN MIDDLE SCHOOL
431873629
501(C)(3)
No
Yes
Yes
11,000
(35)
MEDS AND FOOD FOR KIDS
201257910
501(C)(3)
No
Yes
Yes
10,000
(36)
MIDTOWN CATHOLIC COMMUNITY SERVICES
431338511
501(C)(3)
No
Yes
Yes
15,000
(37)
MISSION ST LOUIS
208983607
501(C)(3)
No
Yes
Yes
500
(38)
MISSOURI WOMEN IN TRADES
262037298
501(C)(3)
No
Yes
Yes
25,000
(39)
MO FOUNDATION FOR BICYCLING & WALKING
203389214
501(C)(3)
No
Yes
Yes
3,000
(40)
NEW SUNNY MT COMMUNITY OUTREACH
550893976
501(C)(3)
No
Yes
Yes
10,000
(41)
NORTHSIDE COMMUNITY CENTER
431028098
501(C)(3)
No
Yes
Yes
10,000
(42)
OUR LADY OF GUADALUPE SCHOOL
430708879
501(C)(3)
No
Yes
Yes
10,000
(43)
OUR LITTLE HAVEN
431567500
501(C)(3)
No
Yes
Yes
10,000
(44)
PROGRESSIVE YOUTH CONNECTION
237386330
501(C)(3)
No
Yes
Yes
7,500
(45)
SCHOLARS ACADEMY
562453518
501(C)(3)
No
Yes
Yes
5,000
(46)
SGSM NETWORK
300152463
501(C)(3)
No
Yes
Yes
20,000
(47)
SHALOM HOUSE
430915808
501(C)(3)
No
Yes
Yes
1,000
(48)
SKANDALARIS CENTER AT WASHINGTON UNIVERSITY
430653611
501(C)(3)
No
Yes
Yes
5,000
(49)
SOUTH CITY CATHOLIC SCHOOL COLLABORTIVE
430653471
501(C)(3)
No
Yes
Yes
80,000
(50)
SISTER THEA BOWMAN CATHOLIC SCHOOL
370673467
501(C)(3)
No
Yes
Yes
10,100
(51)
SISTER KATHLEEN KOENEN (SOUTH CITY CATHOLIC SCHOOL COLLABORATIVE)
431338511
501(C)(3)
No
Yes
Yes
20,000
(52)
ST ANTHONY CATHOLIC HIGH SCHOOL
200234338
501(C)(3)
No
Yes
Yes
7,500
(53)
ST ELIZABETH ACADEMY
431579606
501(C)(3)
No
Yes
Yes
6,500
(54)
ST ELIZABETH MTR OF ST JOHN THE BAPTIST
861061468
501(C)(3)
No
Yes
Yes
15,000
(55)
ST FRANCES CABRINI ACADEMY
352195630
501(C)(3)
No
Yes
Yes
30,050
(56)
ST JOAN OF ARC SCHOOL
430653481
501(C)(3)
No
Yes
Yes
2,900
(57)
ST JOHN COMMUNITY IMPROVEMENT CO
542086681
501(C)(3)
No
Yes
Yes
8,000
(58)
ST LOUIS ARTWORKS
431735450
501(C)(3)
No
Yes
Yes
100
(59)
ST LOUIS BOARD OF EDUCATION
436003220
501(C)(3)
No
Yes
Yes
2,000
(60)
ST LOUIS CARE & COUNSELING SERVICES
841628468
501(C)(3)
No
Yes
Yes
2,000
(61)
ST LOUIS DANCING CLASSROOMS
900509284
501(C)(3)
No
Yes
Yes
30,000
(62)
ST LOUIS FOR KIDS
900509284
501(C)(3)
No
Yes
Yes
10,000
(63)
ST LOUIS MENNONITE PEACE CENTER
431760904
501(C)(3)
No
Yes
Yes
850
(64)
ST LOUIS UNIVERSITY
430654872
501(C)(3)
No
Yes
Yes
500
(65)
SOUTH CITY DEANERY PSR
430653482
501(C)(3)
No
Yes
Yes
2,187
(66)
THE ACTS PARTNERSHIP
300496520
501(C)(3)
No
Yes
Yes
2,000
(67)
UNITED CONGREGATION OF METRO EAST
364409776
501(C)(3)
No
Yes
Yes
5,000
(68)
UNIVERSITY IW
741109661
501(C)(3)
No
Yes
Yes
3,000
(69)
URBAN K-LIFE
202605251
501(C)(3)
No
Yes
Yes
6,000
(70)
VILLAGE AT INCARNATE WORD
741109717
501(C)(3)
No
Yes
Yes
36,572
(71)
VINCENT GRAY ALTERNATIVE HIGH SCHOOL
371087899
501(C)(3)
No
Yes
Yes
5,000
(72)
VISION FOR CHILDREN AT RISK
431853499
501(C)(3)
No
Yes
Yes
15,000
(73)
VISITATION HOUSE MINISTRIES
742447137
501(C)(3)
No
Yes
Yes
75,000
(74)
VOICES FOR CHILDREN
431807059
501(C)(3)
No
Yes
Yes
5,000
(75)
WASHINGTON TABERNACLE BAPTIST CHURCH
430785849
501(C)(3)
No
Yes
Yes
5,000
(76)
WHOLE HEALTH OUTREACH
431577997
501(C)(3)
No
Yes
Yes
10,000
(77)
WHOLE KIDS OUTREACH
431839370
501(C)(3)
No
Yes
Yes
3,000
(78)
WOMEN'S GLOBAL CONNECTION
421619919
501(C)(3)
No
Yes
Yes
60,000
(79)
WOMEN'S HELPING HANDS BK
431338511
501(C)(3)
No
Yes
Yes
1,000
(80)
YOUTH & FAMILY CENTER
430652663
501(C)(3)
No
Yes
Yes
8,000
(81)
YOUTH IN NEED
431033862
501(C)(3)
No
Yes
Yes
8,000
Total
1,018,184
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.") ....
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..
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.
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
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
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).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
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
INCARNATE WORD FOUNDATION MISSOURI
Employer identification number
91-2035797
Identifier
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 2
ELIOT SIMON (FOUNDATION BOARD TREASURER) IS ALOYS LITTEKEN'S (FOUNDATION BOARD CHAIR) STOCK BROKER.
FORM 990, PART VI, SECTION A, LINE 4
ARTICLES OF INCORPORATION WERE AMENDED ON SEPTEMBER 27, 2010.
FORM 990, PART VI, SECTION A, LINE 7A
THE ORGANIZATION HAS A CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7B
DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY CORPORATE MEMBER
FORM 990, PART VI, SECTION B, LINE 11
FINANCE COMMITTEE REVIEWS AND APPROVES. FINANCE COMMITTEE PRESENTS FORM 990 TO THE BOARD. THE BOARD MUST REVIEW FORM 990 BEFORE IT IS FILED.
FORM 990, PART VI, SECTION B, LINE 12C
IT IS MANDATED THAT EVERYONE COMPLETE THE CONFLICTS OF INTEREST DISCLOSURE AND UPDATE THE FORM EACH YEAR. ALL CONFLICTS OF INTEREST DISCLOSURES ARE KEPT ON FILE.
FORM 990, PART VI, SECTION B, LINE 15
THE EXECUTIVE COMMITTEE REVIEWS COMPARABLE SALARY SCHEDULES TO DETERMINE CHANGES IN COMPENSATION. THE EXECUTIVE DIRECTOR THEN CONDUCTS AN ANNUAL REVIEW WITH EACH EMPLOYEE TO DETERMINE CHANGES THAT NEED TO BE MADE TO COMPENSATION. THIS WAS LAST DONE JANUARY 2010.
FORM 990, PART VI, SECTION C, LINE 19
ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. NOTICE ON WEBSITE GIVES INDIVIDUALS INFORMATION ON HOW TO OBTAIN THESE DOCUMENTS.
CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 5:
NET UNREALIZED GAINS ON INVESTMENTS: 695,225.
FORM 990, PART XI, LINE 2C
PROCESSES HAVE NOT CHANGED FROM THE PRIOR YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.