Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
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)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2010 and ending 12-31-2010
BCheck if applicable:
CName of organization
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
 
Doing Business As
ACHIEVE
 
Number and street (or P.O. box if mail is not delivered to street address)
125 CUTLER POND ROAD
 
Room/suite
City or town, state or country, and ZIP + 4
BINGHAMTON, NY13905
D Employer identification number

15-0619307
E Telephone number

G Gross receipts $ 18,003,212
F Name and address of principal officer:
DANIEL K BALLARD
125 CUTLER POND ROAD
BINGHAMTON,NY13905
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
N/A
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet1256
K Form of organization:
 
L Year of formation: 1949
M State of legal domicile: NY
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO IMPROVE THE QUALITY OF LIFE FOR PERSONS WITH DEVELOPMENTAL DISABILITIES IN EVERY MANNER POSSIBLE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 138
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 138
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 454
6 Total number of volunteers (estimate if necessary) .... 6 16
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 730,209 303,880
9 Program service revenue (Part VIII, line 2g) ......... 17,525,826 17,657,431
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,121 6,996
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 0 0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 18,257,156 17,968,307
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 12,093,396 12,303,469
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 5,113,474 5,701,436
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 17,206,870 18,004,905
19 Revenue less expenses. Subtract line 18 from line 12...... 1,050,286 -36,598
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 8,367,949 7,769,154
21 Total liabilities (Part X, line 26)............ 3,989,124 3,401,990
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 4,378,825 4,367,164
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
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) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: TO PROVIDE LEADERSHIP, ADVOCACY AND OPPORTUNITIES WHICH ENABLE PERSONS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES AND THEIR FAMILIES TO ENHANCE THE QUALITY OF THEIR LIVES.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 7,473,871 including grants of $   ) (Revenue $ 8,148,940 )
RESIDENTIAL SERVICES: ACHIEVE OPERATED SUPERVISED AND SUPPORTIVE INDIVIDUAL RESIDENTIAL ALTERNATIVES FOR 115 INDIVIDUALS. EACH TYPE OF RESIDENCE PROVIDES A HOME FOR INDIVIDUALS WHO HAVE INTELLECTUAL AND OTHER DEVELOPMENTAL DISABILITIES. INDIVIDUALS LIVING IN A RESIDENCE HAVE THE OPPORTUNITY TO IMPROVE AND ENHANCE THEIR LEVEL OF INDEPENDENCE AS WELL AS INTEGRATE INTO THE COMMUNITY. EACH RESIDENCE IS LICENSED BY THE NYS OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES. IN ADDITION, 20 INDIVIDUALS RECEIVED INDIVIDUAL SUPPORT SERVICES IN 2010 ALLOWING THEM MORE CHOICE IN WHERE THEY LIVE AND THE SERVICES THEY RECEIVE. THE RESPITE BED PROGRAM PROVIDED TEMPORARY PLACEMENT FOR INDIVIDUALS LIVING AT HOME AND ALLOWED FOR CAREGIVER RESPITE.
4b (Code:   ) (Expenses $ 6,283,465 including grants of $   ) (Revenue $ 7,198,554 )
VOCATIONAL SERVICES- THE PRE-VOCATIONAL PROGRAM IS DESIGNED TO IMPROVE AND ENHANCE VOCATIONAL AND PRE-VOCATIONAL OPPORTUNITIES, INCREASE PRODUCTIVITY AND EARNING POTENTIAL, AND PROMOTE INDEPENDENCE AND IDENTITY AS A VALUED MEMBER OF THE WORK FORCE AND COMMUNITY. SERVICES PROVIDED TO APPROXIMATELY 294 INDIVIDUALS INCLUDING PRE-VOCATIONAL TRAINING, BEHAVIORAL MANAGEMENT, WORK ADJUSTMENT/ASSIMILATION, AND OTHER WORK SKILLS TRAINING. SERVICES PROVIDED TO 123 CONSUMERS THROUGH OUR DAY HABILITATION PROGRAM INCLUDE: ACTIVITIES OF DAILY LIVING SKILLS, COGNITIVE SKILL DEVELOPMENT, RECREATION, COMMUNICATION DEVELOPMENT, OCCUPATIONAL, PHYSICAL AND SPEECH THERAPY, AND COMPREHENSIVE NURSING SERVICES. SUPPORTED EMPLOYMENT PROVIDED SERVICES TO 189 CONSUMERS WORKING TOWARD PLACING THOSE INDIVIDUALS IN AN OUTSIDE WORK ENVIRONMENT.
4c (Code:   ) (Expenses $ 648,112 including grants of $   ) (Revenue $ 850,204 )
FAMILY SUPPORT SERVICES- FAMILY SUPPORT SERVICES ARE AN ARRAY OF PROGRAMS AND SERVICES THAT PROVIDE ASSISTANCE TO FAMILIES THAT HAVE AN INDIVIDUAL WITH INTELLECTUAL AND OTHER DEVELOPMENTAL DISABILIES LIVING AT HOME. THE FAMILY EMPOWERMENT PROGRAM PROVIDED FINANCIAL REIMBURSEMENT TO FAMILIES OF 101 INDIVIDUALS FOR SHORT-TERM RESPITE SERVICES THAT ARE PROVIDED IN THE FAMILY'S HOME. EACH FAMILY IDENTIFIES, TRAINS AND SUPERVISES THEIR RESPITE CARE PROVIDER AND ESTABLISHES PAYMENT RATES FOR SERVICE. THE COMMUNITY HABILITATION PROGRAM WORKED CLOSELY WITH THE FAMILIES OF 51 INDIVIDUALS TO ESTABLISH A COMMUNITY HABILITATION PLAN FOR THE INDIVIDUAL AND ARE IMPLEMENTED IN EITHER THE HOME OR THE COMMUNITY WITH THE END GOAL OF INCREASING SKILL LEVELS. IN-HOME RESPITE PROGRAMS AND RECREATION RESPITE PROGRAMS OFFERED FAMILIES A BRIEF RESPITE BY PROVIDING A CARE PROVIDER OR RECREATIONAL, EDUCATIONAL AND SOCIAL ACTIVITIES FOR ADULTS AND TEENS LIVING AT HOME WITH THEIR FAMILIES WHILE, AT THE SAME TIME,PROVIDING A BRIEF RESPITE TO FAMILY MEMBERS THROUGH A VARIETY OF PROGRAMS. 8 SIBSHOPS WERE HELD IN 2010 FOR SIBLINGS AGES 8-13 THAT HAVE A BROTHER OR SISTER WITH AN INTELLECTUAL AND/OR DEVELOPMENTAL DISABILITY WHERE INFORMATION AND DISCUSSION ACTIVITIES ARE PLANNED TO HELP SIBLINGS BETTER UNDERSTAND THEIR BROTHER OR SISTER WITH SPECIAL NEEDS. THERE WERE 8 PARTY NIGHT EVENTS HELD IN 2010 WITH AN AVERAGE OF 100 INDIVIDUALS ATTENDING, WHICH CONSISTS OF DANCES, BINGO, BARBECUES, AND OTHER SOCIAL EVENTS WHICH PROVIDED AGE APPROPRIATE RECREATIONAL AND SOCIAL ACTIVITIES FOR ADULTS WITH DEVELOPMENTAL DISABILITIES. THE ACHIEVE CHILDREN'S SUMMER PROGRAM OPERATED FOR 6 WEEKS DURING THE SUMMER AND OFFERED 194 CHILDREN A VARIETY OF ACTIVITIES. THE GOAL OF THE PROGRAM WAS TO BROADEN THE LIFE EXPERIENCES OF CHILDREN WITH DISABILITIES AND PROVIDE THEM WITH BASIC LEARNING CONCEPTS THAT WILL ENHANCE SKILL LEVELS.
(Code:   ) (Expenses $ 608,175 including grants of $   ) (Revenue $ 720,553 )
MEDICAID SERVICE COORDINATION
(Code:   ) (Expenses $ 108,010 including grants of $   ) (Revenue $ 110,203 )
SUMMER PROGRAM
(Code:   ) (Expenses $ 621,621 including grants of $   ) (Revenue $ 625,323 )
TRANSPORTATION
(Code:   ) (Expenses $ 597,710 including grants of $   ) (Revenue $ 920 )
CHAPTER FUNDS
(Code:   ) (Expenses $ 114,642 including grants of $   ) (Revenue $ 5 )
FUNDRAISING AND DEVELOPMENT
(Code:   ) (Expenses $ 0 including grants of $   ) (Revenue $ 2,729 )
ADMINISTRATIVE EXPENSES
4d Other program services. (Describe in Schedule O.)
(Expenses $ 2,050,158 including grants of $   ) (Revenue $ 1,459,733 )
4e Total program service expensesMediumBullet$ 16,455,606
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II.........................
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
Yes
 
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. .....
20b
 
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III.....
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................
23
 
No
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
Yes
 
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule MClick to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I........................... Click to see attachment
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
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,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
372
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
454
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
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 or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
No
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
No
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
No
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
138
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
138
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
Yes
 
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
Yes
 
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
Yes
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
NY
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
SANDY RADZIWON
125 CUTLER POND ROAD
BINGHAMTON,NY13905
(607) 723-8361
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) MIKE MISNER
BOARD MEMBER
 2.00 X           0 0 0
(2) VINCENT FIACCO
BOARD MEMBER
 2.00 X           0 0 0
(3) DENIS WICKHAM
PRESIDENT
 10.00 X   X       0 0 0
(4) DANIEL BALLARD
TREASURER
 2.00 X   X       0 0 0
(5) ROBERT SALANKIEWICZ
ASSISTANT TREASURER
 2.00 X   X       0 0 0
(6) TINA BARBER
BOARD MEMBER
 2.00 X           0 0 0
(7) JAMES M HAYES ESQ
BOARD MEMBER
 2.00 X           0 0 0
(8) JOHN STEVENS
BOARD MEMBER
 2.00 X           0 0 0
(9) COLLEEN FRIENDS
BOARD MEMBER
 2.00 X           0 0 0
(10) DR ROBERT BETHJE
BOARD MEMBER
 2.00 X           0 0 0
(11) GARY SHAY
BOARD MEMBER
 2.00 X           0 0 0
(12) DAN MARTINDALE
BOARD OF GOV. REP.
 .50 X           0 0 0
(13) NICKI FRENCH
SECRETARY
 2.00 X   X       0 0 0
(14) JERRY SHENKMAN
BOARD OF GOV. REP.
 .50 X           0 0 0
(15) LISA LEE
1ST VICE PRESIDENT
 2.00 X   X       0 0 0
(16) ELLEN FELDMAN
2ND VICE PRESIDENT
 2.00 X   X       0 0 0
(17) RUTH VITALE
BOARD OF GOV. REP.
 .50 X           0 0 0
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) MILTON KAPLAN
BOARD OF GOV. REP.
 .50 X           0 0 0
(19) JEFFREY PLATT
BOARD OF GOV. REP.
 .50 X           0 0 0
(20) LINDA CLAYSON
BOARD OF GOV. REP.
 .50 X           0 0 0
(21) THOMAS J TALBETT JR
BOARD OF GOV. REP.
 .50 X           0 0 0
(22) JERRY ISAACS
BOARD OF GOV. REP.
 .50 X           0 0 0
(23) AL TURK
BOARD OF GOV. REP.
 .50 X           0 0 0
(24) IDA RIOS
BOARD OF GOV. REP.
 .50 X           0 0 0
(25) RAPHAEL SMITH
BOARD OF GOV. REP.
 .50 X           0 0 0
(26) MARYANN BRUNER
BOARD OF GOV. REP.
 .50 X           0 0 0
(27) BETTY BUTZ
BOARD OF GOV. REP.
 .50 X           0 0 0
(28) SUE CUNNINGHAM
BOARD OF GOV. REP.
 .50 X           0 0 0
(29) DR JAMES ASHE
BOARD OF GOV. REP.
 .50 X           0 0 0
(30) JILL ABDALLAH
BOARD OF GOV. REP.
 .50 X           0 0 0
(31) JENNIFER HARVEY
BOARD OF GOV. REP.
 .50 X           0 0 0
(32) GILBERT DUKEN
BOARD OF GOV. REP.
 .50 X           0 0 0
(33) MERRILEE HAMLIN
BOARD OF GOV. REP.
 .50 X           0 0 0
(34) MARY SKILLAN
BOARD OF GOV. REP.
 .50 X           0 0 0
(35) CYNTHIA LACKI
BOARD OF GOV. REP.
 .50 X           0 0 0
(36) DOROTHY WHEELER
BOARD OF GOV. REP.
 .50 X           0 0 0
(37) ROSE MARY CELLA
BOARD OF GOV. REP.
 .50 X           0 0 0
(38) DONALD GEER
BOARD OF GOV. REP.
 .50 X           0 0 0
(39) LUELLA ROGERS
BOARD OF GOV. REP.
 .50 X           0 0 0
(40) MARK METZGER ESQ
BOARD OF GOV. REP.
 .50 X           0 0 0
(41) DONNA L BURDEN ESQ
BOARD OF GOV. REP.
 .50 X           0 0 0
(42) SCOTT GORSKI
BOARD OF GOV. REP.
 .50 X           0 0 0
(43) GERALD EDWARDS
BOARD OF GOV. REP.
 .50 X           0 0 0
(44) MARLA RODRIGUEZ
BOARD OF GOV. REP.
 .50 X           0 0 0
(45) ROBERT KLEPPANG
BOARD OF GOV. REP.
 .50 X           0 0 0
(46) GAIL CORBIN
BOARD OF GOV. REP.
 .50 X           0 0 0
(47) JUDY SCHELLE
BOARD OF GOV. REP.
 .50 X           0 0 0
(48) CANDIE POCOCK
BOARD OF GOV. REP.
 .50 X           0 0 0
(49) THELMA MONTREAL
BOARD OF GOV. REP.
 .50 X           0 0 0
(50) RONALD GEORGE
BOARD OF GOV. REP.
 .50 X           0 0 0
(51) GARY RUFF
BOARD OF GOV. REP.
 .50 X           0 0 0
(52) BETTY BRESLER
BOARD OF GOV. REP.
 .50 X           0 0 0
(53) DEBORAH A VINK
BOARD OF GOV. REP.
 .50 X           0 0 0
(54) CHERYL ENGLERT
BOARD OF GOV. REP.
 .50 X           0 0 0
(55) MARCY VANZANDT
BOARD OF GOV. REP.
 .50 X           0 0 0
(56) RANDY SCHAAL ESQ
BOARD OF GOV. REP.
 .50 X           0 0 0
(57) ERIC STICKELS
BOARD OF GOV. REP.
 .50 X           0 0 0
(58) MAYTHORNE WINTERKORN
BOARD OF GOV. REP.
 .50 X           0 0 0
(59) MARY BETH WUNSCH
BOARD OF GOV. REP.
 .50 X           0 0 0
(60) DAWN DESMOND
BOARD OF GOV. REP.
 .50 X           0 0 0
(61) JOEL KAPLAN
BOARD OF GOV. REP.
 .50 X           0 0 0
(62) SALLY ROMANO
BOARD OF GOV. REP.
 .50 X           0 0 0
(63) JACK GAROFALO
BOARD OF GOV. REP.
 .50 X           0 0 0
(64) SAUNDRA M GUMEROVE
BOARD OF GOV. REP.
 .50 X           0 0 0
(65) DOROTHY LENOWICZ
BOARD OF GOV. REP.
 .50 X           0 0 0
(66) HARRIET TRAVERSA
BOARD OF GOV. REP.
 .50 X           0 0 0
(67) LAURA KENNEDY
BOARD OF GOV. REP.
 .50 X           0 0 0
(68) CHARLES KING
BOARD OF GOV. REP.
 .50 X           0 0 0
(69) EDITH NIEDERT
BOARD OF GOV. REP.
 .50 X           0 0 0
(70) GENEVIEVE O'NEIL
BOARD OF GOV. REP.
 .50 X           0 0 0
(71) RADY BRUELL
BOARD OF GOV. REP.
 .50 X           0 0 0
(72) MARILYN JAFFE-RUIZ
BOARD OF GOV. REP.
 .50 X           0 0 0
(73) MARIE-THERESE FRIERI
BOARD OF GOV. REP.
 .50 X           0 0 0
(74) DONALD SMITH
BOARD OF GOV. REP.
 .50 X           0 0 0
(75) DR JOHN KOWALCZYK
BOARD OF GOV. REP.
 .50 X           0 0 0
(76) RUTH RIDGWAY
BOARD OF GOV. REP.
 .50 X           0 0 0
(77) JOYCE CARMEN
BOARD OF GOV. REP.
 .50 X           0 0 0
(78) GORDON EYER
BOARD OF GOV. REP.
 .50 X           0 0 0
(79) JOSEPH M BOGNANNO
BOARD OF GOV. REP.
 .50 X           0 0 0
(80) ELIZABETH PALMATIER
BOARD OF GOV. REP.
 .50 X           0 0 0
(81) JOANNE GRANT
BOARD OF GOV. REP.
 .50 X           0 0 0
(82) JAMES CANNON
BOARD OF GOV. REP.
 .50 X           0 0 0
(83) REV KEN DEGNAN
BOARD OF GOV. REP.
 .50 X           0 0 0
(84) MARLENE HILL
BOARD OF GOV. REP.
 .50 X           0 0 0
(85) MARY ANN BARBARINO
BOARD OF GOV. REP.
 .50 X           0 0 0
(86) RICHARD RIMA
BOARD OF GOV. REP.
 .50 X           0 0 0
(87) WALTER HOGAN
BOARD OF GOV. REP.
 .50 X           0 0 0
(88) LAURA DODGE
BOARD OF GOV. REP.
 .50 X           0 0 0
(89) HEATHER STRICKLAND
BOARD OF GOV. REP.
 .50 X           0 0 0
(90) SUSAN LUCAS
BOARD OF GOV. REP.
 .50 X           0 0 0
(91) EDIE HALL
BOARD OF GOV. REP.
 .50 X           0 0 0
(92) HENRIETTA MESSIER
BOARD OF GOV. REP.
 .50 X           0 0 0
(93) HOWARD JURIST
BOARD OF GOV. REP.
 .50 X           0 0 0
(94) DR IRVING CAMINSKY
BOARD OF GOV. REP.
 .50 X           0 0 0
(95) SONIA CRANNAGE ESQ
BOARD OF GOV. REP.
 .50 X           0 0 0
(96) LYNDA MELTZER
BOARD OF GOV. REP.
 .50 X           0 0 0
(97) GISELA SCHMIDT
BOARD OF GOV. REP.
 .50 X           0 0 0
(98) AUDREY TARANTINO
BOARD OF GOV. REP.
 .50 X           0 0 0
(99) KAREN FEINSTEIN
BOARD OF GOV. REP.
 .50 X           0 0 0
(100) PATRICIA CAMPANELLA
BOARD OF GOV. REP.
 .50 X           0 0 0
(101) CAROLYN SMITH
BOARD OF GOV. REP.
 .50 X           0 0 0
(102) DR LAWRENCE FEIN
BOARD OF GOV. REP.
 .50 X           0 0 0
(103) ROBERT DESIO
BOARD OF GOV. REP.
 .50 X           0 0 0
(104) PATRICIA ROSS
BOARD OF GOV. REP.
 .50 X           0 0 0
(105) BELLA STUART
BOARD OF GOV. REP.
 .50 X           0 0 0
(106) ROBERTA BROOKS
BOARD OF GOV. REP.
 .50 X           0 0 0
(107) JOHN DESANTO
BOARD OF GOV. REP.
 .50 X           0 0 0
(108) HAROLD HOFFMEIER JR
BOARD OF GOV. REP.
 .50 X           0 0 0
(109) MARCIA KASPRZYK
BOARD OF GOV. REP.
 .50 X           0 0 0
(110) JOHN BECKER II
BOARD OF GOV. REP.
 .50 X           0 0 0
(111) ROSE PALMEIERI
BOARD OF GOV. REP.
 .50 X           0 0 0
(112) PAUL GREENFIELD
BOARD OF GOV. REP.
 .50 X           0 0 0
(113) ARTHUR STILWELL
BOARD OF GOV. REP.
 .50 X           0 0 0
(114) JOSEPH DEL BROCCOLO
BOARD OF GOV. REP.
 .50 X           0 0 0
(115) JAMES MCENEANEY
BOARD OF GOV. REP.
 .50 X           0 0 0
(116) FRED SALZBERG
BOARD OF GOV. REP.
 .50 X           0 0 0
(117) KENNETH WALKER
BOARD OF GOV. REP.
 .50 X           0 0 0
(118) IRENE KIRTACK
BOARD OF GOV. REP.
 .50 X           0 0 0
(119) STEVEN DROBYSH
BOARD OF GOV. REP.
 .50 X           0 0 0
(120) ROBERT BOENING
BOARD OF GOV. REP.
 .50 X           0 0 0
(121) THOMAS HITCHCOCK
BOARD OF GOV. REP.
 .50 X           0 0 0
(122) BARBARA ROESER
BOARD OF GOV. REP.
 .50 X           0 0 0
(123) ANNE MARIE LOCKHART
BOARD OF GOV. REP.
 .50 X           0 0 0
(124) CAROL KENYON
BOARD OF GOV. REP.
 .50 X           0 0 0
(125) JOSEPH VANHAELST
BOARD OF GOV. REP.
 .50 X           0 0 0
(126) DIAN CIFUNI
BOARD OF GOV. REP.
 .50 X           0 0 0
(127) NELVA TUREK
BOARD OF GOV. REP.
 .50 X           0 0 0
(128) ANTHONY ASSALONE
BOARD OF GOV. REP.
 .50 X           0 0 0
(129) MOHAN MEHRA
BOARD OF GOV. REP.
 .50 X           0 0 0
(130) SHERYL R FRISHMAN
BOARD OF GOV. REP.
 .50 X           0 0 0
(131) PATRICIA POKLEMBA
BOARD OF GOV. REP.
 .50 X           0 0 0
(132) MARY ELLEN MURPHY
BOARD OF GOV. REP.
 .50 X           0 0 0
(133) ELLEN OWENS
BOARD OF GOV. REP.
 .50 X           0 0 0
(134) GREG BOOTH
BOARD OF GOV. REP.
 .50 X           0 0 0
(135) DR MELVIN GERTNER
BOARD OF GOV. REP.
 .50 X           0 0 0
(136) MISCHELLE K SHATTUCK
BOARD OF GOV. REP.
 .50 X           0 0 0
(137) PAULA GIROUX
BOARD MEMBER
 2.00 X           0 0 0
(138) REV DIANE PRENTICE
BOARD MEMBER
 2.00 X           0 0 0
(139) MARY JO THORN
CEO
 40.00     X       116,578 0 17,247
(140) AVA DOUGLASS
ASST. EXECUTIVE DIRECTOR O
 40.00     X       68,537 0 5,557
(141) SANDRA RADZIWON
CHIEF FINANCIAL OFFICER
 40.00     X       9,543 0 61
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 194,658 0 22,865
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet1
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
 
No
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
BEARSCH COMPEAU KNUDSEN ARCHITECTS & ENG
41 CHENANGO STREET
BINGHAMTON,NY13901 		ARCHITECT/ENGINEERING 508,435
DONSON TRANSPORTATION INC
300 WAYNE STREET
ENDWELL,NY13760 		TRANSPORTATION 133,880
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet2
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b 10,655
c Fundraising events....1c 58,365
d Related organizations...1d  
e Government grants (contributions)1e 123,816
f All other contributions, gifts, grants, and
similar amounts not included above1f 		111,044
g Noncash contributions included in lines 1a-1f:$ 74,403
h Total. Add lines 1a-1f.......MediumBullet 303,880
Program Service Revenue Business Code
2a GOVERNMENT FEES 623,990 14,567,174 14,567,174    
b CONSUMER FEES 623,990 1,519,761 1,519,761    
c CONTRACT SALES 624,310 1,447,953 1,447,953    
d WORKSHOP CAFETERIA REV 900,099 112,655 112,655    
e MISCELLANEOUS 900,099 9,888 9,888    
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 17,657,431
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 6,996     6,996
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses    
c Gain or (loss)    
d Net gain or (loss)..........MediumBullet        
8a Gross income from fundraising events (not including
$ 58,365
of contributions reported on line 1c). See Part IV, line 18 ...
a 34,905
b Less: direct expenses ...b 34,905
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet  
12 Total revenue. See Instructions....MediumBullet 17,968,307 17,657,431 0 6,996
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21    
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 207,919   207,919  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 8,782,019 8,017,444 764,575  
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 299,205 265,759 33,446  
9 Other employee benefits ....... 2,275,707 2,063,777 211,930  
10 Payroll taxes ........... 738,619 659,738 78,881  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 21,015 2,146 18,869  
c Accounting ........... 18,500   18,500  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other .......... 54,260 43,979 10,281  
12 Advertising and promotion ....        
13 Office expenses ....... 414,472 334,089 80,383  
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 270,516 257,319 13,197  
17 Travel ............ 695,386 683,431 11,955  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings ....        
20 Interest ........... 29,767 27,604 2,163  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 564,692 529,146 35,546  
23 Insurance .............. 82,672 71,721 10,951  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a LEASE/RENTAL EXPENSE 650,269 643,878 6,391  
b CONSUMER WAGES 583,699 583,699    
c CONTRIBUTION AND GRANT 546,369 546,369    
d CONSUMER/FAMILY RELATED 465,065 465,065    
e CONTRACT MATERIAL 424,814 424,814    
f All other expenses 879,940 835,628 44,312  
25 Total functional expenses. Add lines 1 through 24f 18,004,905 16,455,606 1,549,299 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ..........   1  
2 Savings and temporary cash investments ....... 967,512 2 2,088,412
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 3,335,075 4 1,977,443
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 111,460 8 72,150
9 Prepaid expenses and deferred charges ............ 124,903 9 102,395
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 8,074,655
b Less: accumulated depreciation. ..... 10b 4,698,941 3,094,973 10c 3,375,714
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ......   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 734,026 15 153,040
16 Total assets. Add lines 1 through 15 (must equal line 34)... 8,367,949 16 7,769,154
Liabilities 17 Accounts payable and accrued expenses . 1,520,117 17 1,344,793
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 236,032 21 151,124
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 1,055,497 23 814,147
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 1,177,478 25 1,091,926
26 Total liabilities. Add lines 17 through 25..... 3,989,124 26 3,401,990
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 4,085,198 27 4,104,520
28 Temporarily restricted net assets ..... 293,627 28 262,644
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 4,378,825 33 4,367,164
34 Total liabilities and net assets/fund balances ..... 8,367,949 34 7,769,154
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
17,968,307
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
18,004,905
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
-36,598
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
4,378,825
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
24,937
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
4,367,164
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, 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
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
 
Employer identification number

15-0619307
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.") .... 683,460 882,706 827,221 684,524 303,880 3,381,791
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.. 683,460 882,706 827,221 684,524 303,880 3,381,791
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.           3,381,791
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.. 683,460 882,706 827,221 684,524 303,880 3,381,791
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 17,104 10,979 7,521 1,121 6,996 43,721
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.. 10,030 17,699 29,483 45,685   102,897
11 Total support (Add lines 7 through 10).           3,528,409
12
12
81,557,949
13
Section C. Computation of Public Support Percentage
14
14
95.840 %
15
15
96.170 %
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:  
Software Version:  
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
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
 
Employer identification number

15-0619307
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
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
  		Employer identification number

15-0619307
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
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
  		Employer identification number

15-0619307
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
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
  		Employer identification number

15-0619307
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:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
 
Employer identification number

15-0619307
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 192,398 188,095 199,258
b Contributions ........      
c Investment earnings or losses ... 1,553 4,303 -11,163
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		3,312    
f Administrative expenses ....      
g End of year balance ...... 190,639 192,398 188,095
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet100.000 %
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................      
b Buildings ................        
c Leasehold improvements ............   4,573,966 2,041,222 2,532,744
d Equipment ................   1,609,256 1,401,532 207,724
e Other .................   1,891,433 1,256,187 635,246
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 3,375,714
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
DUE TO OPWDD 614,011
REFUNDABLE ADVANCES 161,863
HEALTH REIMBURSEMENT ACCOUNTS 316,052






Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 1,091,926
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 17,968,307
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 18,004,905
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 -36,598
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8 24,937
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 24,937
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 -11,661
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ISSUED INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, WHICH IS NOW KNOWN AS FASB ASC 740-10. FASB ASC 740-10 IS AN INTERPRETATION OF FASB STATEMENT NO. 109, ACCOUNTING FOR INCOME TAXES WHICH IS NOW KNOWN AS FASB ASC 740-10 AND 740-30. FASB ASC 740-10 REQUIRES ENTITIES TO DISCLOSE IN THEIR FINANCIAL STATEMENTS THE NATURE OF ANY UNCERTAINTY IN THEIR TAX POSITION. FOR TAX-EXEMPT ENTITIES, THEIR TAX-EXEMPT STATUS ITSELF IS DEEMED TO BE AN UNCERTAINTY, SINCE EVENTS COULD OCCUR TO JEOPARDIZE THEIR TAX-EXEMPT STATUS. NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER IMPLEMENTED FASB ASC 740-10 AND ITS CURRENT ACCOUNTING POLICY FOR EVALUATING UNCERTAIN TAX POSITIONS IS IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. THE NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER HAS NOT RECOGNIZED ANY BENEFITS FROM UNCERTAIN TAX POSITIONS IN 2010 AND BELIEVES IT HAS NO UNCERTAIN TAX POSITIONS FOR WHICH IT IS REASONABLY POSSIBLE THAT THE TOTAL AMOUNTS OF UNRECOGNIZED TAX BENEFITS WILL SIGNIFICANTLY INCREASE OR DECREASE WITHIN 12 MONTHS OF THE STATEMENT OF FINANCIAL POSITION DATE.
PART XI, LINE 8 - OTHER ADJUSTMENTS:   CONTRIBUTIONS-IN-KIND - GOODS AND SERVICES
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE G
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
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
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
 
Employer identification number

15-0619307
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

BOWLING TOURNAMENT
(event type) 		(b) Event #2

MASTER'S GOLF
(event type) 		(c) Other Events

4
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 12,591 11,800 68,879 93,270
2 Less: Charitable
contributions . . . 		8,970 5,150 44,245 58,365
3 Gross income (line 1
minus line 2) . . . 		3,621 6,650 24,634 34,905
VerticalDirectExpenses 4 Cash prizes . . .   350   350
5 Non-cash prizes . .   6,300   6,300
6 Rent/facility costs . . 1,620     1,620
7 Food and beverages . .        
8 Entertainment . . .        
9 Other direct expenses . 2,001   24,634 26,635
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 34,905
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow 0
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ...........................
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
Schedule G (Form 990 or 990-EZ) 2010
Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
 
Employer identification number

15-0619307
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) JAMES HAYES PARTNER @ HINMAN, HOWARD & KATTELL LAW FIRM 7,852 LEGAL FEES   No
(2) MATTHEW THORN NEPHEW OF CEO 20,326 COMPENSATION   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
NonCash Contributions
Right pointing arrow large imageComplete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
 
Employer identification number

15-0619307
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of Contributions or items contributed 		(c)
Contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles .. X 1 74,403 FMV
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded .        
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( )
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell non-cash
contributions? ............................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) 2010
Schedule M (Form 990) 2010
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33. Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule M (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
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
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
 
Employer identification number

15-0619307
Identifier Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 6   NYSARC, INC. IS A UNITARY CORPORATION CONSISTING OF ITS 55 CHAPTERS. NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER IS ONE DIVISION OF THE CORPORATION. THE CORPORATION AND CHAPTER'S GOVERNING BODY IS THE BOARD OF GOVERNORS REPRESENTING THE INDIVIDUAL MEMBERSHIP IN EACH CHAPTER'S JURISDICTION. EACH CHAPTER HAS FROM 1 TO 6 GOVERNORS BASED ON MEMBERSHIP. THE CORPORATION THROUGH ITS BYLAWS DELEGATES DAY-TO-DAY OPERATING AUTHORITY TO THE CHAPTER'S BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE OF THE BOARD OF GOVERNORS (SEE PART VI, LINE 7A BELOW) COMPRISES THE CORPORATION'S ELECTED OFFICERS AND EXCERCISES ALL POWERS OF THE BOARD OF GOVERNORS BETWEEN PLANARY MEETINGS OF THE GOVERNORS.
FORM 990, PART VI, SECTION A, LINE 7A   THE DELEGATION ASSEMBLY, WHICH REPRESENTS NYSARC'S 70,000 MEMBERS, ELECTS THE CORPORATION PRESIDENT, SECRETARY,TREASURER AND ASSISTANT TREASURER TO 1-YEAR TERMS. DELEGATES ELECT REGIONAL VICE PRESIDENTS TO 1-YEAR TERMS FROM THEIR RESPECTIVE REGIONS. THE BOARD OF GOVERNORS ELECTS ONE SENIOR VICE PRESIDENT. THE BROOME-TIOGA COUNTY CHAPTER ELECTION PROCEDURE IS AS FOLLOWS: CHAPTER MEMBERS ARE NOTIFIED PRIOR TO THE DATE OF THE ANNUAL MEETING WITH THE NAMES OF CHAPTER OFFICERS, DIRECTORS AND NOMINATING COMMITTEE MEMBER NOMINEES. VOTING TAKES PLACE AT THE ANNUAL MEETING IN PERSON OR BY PROXY. DIRECTORS SHALL BE ELECTED FOR A TERM OF THREE YEARS. OFFICERS, CONSISTING OF PRESIDENT, VICE PRESIDENT, SECOND VICE PRESIDENT, SECRETARY, TREASURER, ASSISTANT TREASURER AND SUCH OTHER OFFICERS AS THE BOARD DEEMS NECESSARY SHALL BE ELECTED FOR A TERM OF ONE YEAR. EACH MEMBER OF THE NOMINATING COMMITTEE SHALL SERVE FOR A TERM OF ONE YEAR.
FORM 990, PART VI, SECTION A, LINE 7B   CHAPTER BYLAW AMENDMENTS ARE SUBJECT TO BOARD OF GOVERNOR APPROVAL. ANY ACTION OF THE BOARD OF GOVERNORS MAY BE REVIEWED AT THE SUCCEEDING DELEGATE ASSEMBLY. NO ACTION OF THE GOVERNORS THAT AFFECTS THE IRREVOCABLE RIGHTS OF THIRD PARTIES MAY BE RESCINDED. CORPORATE BYLAW AMENDMENTS ARE SUBJECT TO APPROVAL BY A MAJORITY OF CHAPTERS.
FORM 990, PART VI, SECTION B, LINE 11   THE BOARD OF GOVERNORS DOES NOT REVIEW THE CHAPTER'S FORM 990'S BEFORE THEY ARE FILED. EACH INDIVIDUAL CHAPTER SUBMITS A COPY OF ITS FORM 990 TO THE CORPORATIONS BOARD OF GOVERNORS WHEN THE FORM 990 IS FILED BY THE CHAPTER. EACH CHAPTER MUST HAVE A POLICY AND PROCEDURE PROCESS FOR ITS BOARD OF DIRECTORS TO REVIEW THE CHAPTER'S FORM 990. THE POLICY OF NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER, WILL BE, ON AN ANNUAL BASIS, TO HAVE THE BUDGET AND FINANCE COMMITTEE REVIEW AND RECOMMEND APPROVAL OF THE FEDERAL FORM 990 TO THE FULL BOARD OF DIRECTORS AND THE BOARD WILL BE REQUIRED TO APPROVE THE FORM 990. THE TREASURER OR, ANY OFFICER IF THE TREASURER IS UNAVAILABLE, WILL PROVIDE THE SIGNATURE REQUIRED ON THE FEDERAL FORM 990 BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. THIS POLICY WILL SATISFY THE NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER'S RESPONSIBILITY FOR COMPLIANCE WITH THE INTERNAL REVENUE SERVICE REQUIRMENT FOR PRIOR BOARD REVIEW AND APPROVAL OF THE FEDERAL FORM 990 ON AN ANNUAL BASIS.
  FORM 990, PART VI, SECTION B, LINE 12C AT TIME OF HIRE AND EACH YEAR THEREAFTER, ALL STAFF ARE PROVIDED WITH A CONFLICT OF INTEREST POLICY TO REVIEW, SIGN IN AGREEMENT AND DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST. IF DURING ANY BUSINESS TRANSACTION IT APPEARS THERE MAY BE A CONFLICT, IT IS INVESTIGATED AND RESOLVED AT THAT TIME.
  FORM 990, PART VI, SECTION B, LINE 15 AS IT RELATES TO THE CHIEF EXECUTIVE OFFICER'S COMPENSATION REVIEW, THE EXECUTIVE COMMITTEE WILL BE GUIDED BY THE FOLLOWING: 1. REVIEWS AND DETERMINES, BASED ON THE PERFORMANCE EVALUATION, THE COMPENSATION AND BENEFITS OF THE CEO AND RECOMMENDS THEM TO THE FULL BOARD. 2. RETAINS, AS NECESSARY, CONSULTANT AND/OR DATA AND INFORMATION TO ASSIST THE COMMITTEE IN THE EVALUATION OF THE COMPENSATION OF THE CEO. THIS EVALUATION MUST BE ADEQUATE IN SCOPE TO SATISFY THE INTERNAL REVENUE SERVICE REQUIRMENTS REGARDING EXCESS COMPENSATION IN ITS INTERMEDIATE SANCTION REGULATIONS. 3. A REVIEW OF EXECUTIVE COMPENSATION PLANS TO THE EXTENT REQUIRED BY FEDERAL AND STATE LAWS AND REGULATIONS. THE EXECUTIVE COMMITTEE UTILIZES A COMPENSATION AND REVIEW PROCESS THAT ENSURES DUE DILIGENCE,WHICH MAY INCLUDE ANALYSIS OF SALARIES FOR COMPARABLE POSITIONS (990 FORMS FROM OTHER LIKE AGENCIES,SURVEY INFORMATION, ETC.), BUDGET CONSIDERATION, AND A REVIEW OF INTERNAL EQUITY CONSIDERATIONS. THE PERFORMANCE EVALUATION WILL BE A KEY FACTOR IN THE COMPENSATION RECOMMENDATIONS. PRIOR TO FORMALIZING ANY COMPENSATION PLAN, OR PLAN REVISION, THE CHAIRPERSON MAY REVIEW THE PLAN WITH THE CHIEF FINANCIAL OFFICER TO ENSURE COMPLIANCE WITH ALL APPLICABLE LAWS AND REGULATIONS AS WELL AS TO ENSURE FEASIBILITY OF ADMINISTRATION OF THE PLAN WITHIN THE STRUCTURE AND POLICIES OF THE AGENCY. THE EXECUTIVE COMMITTEE WILL REVIEW AS REQUIRED THE CONTRACT FOR THE CEO AND PROVIDE RECOMMENDATIONS REGARDING CHANGE THERE TO. ANY CHANGES REGARDING THESE BENEFITS ARE REFLECTED IN THE CEO CONTRACT. A COPY OF THE CONTRACT WILL BE KEPT IN THE CEO'S PERSONNEL FILE. THE CHAIRPERSON OF THE COMMITTEE SHALL REPORT TO THE BOARD THE DELIBERATIONS, ACTIONS, AND RECOMMENDATIONS OF THE COMMITTEE. THE CHAIRPERSON (OR DESIGNEE) WILL MEET WITH THE CEO TO INFORM HIM/HER OF CHANGES IN THE CONTRACT AND IN COMPENSATION AND BENEFITS AGREED UPON BY THE BOARD. KEY EXECUTIVE MANAGEMENT STAFF ARE EVALUATED ANNUALLY BY THE CEO. ANY CHANGES IN COMPENSATION ARE MADE BASED ON COMPARATIVE MARKET ANALYSIS AND AGENCY BUDGET COMPARATIVE DATA.
  FORM 990, PART VI, SECTION C, LINE 19 UNDER REGULATIONS THAT BECAME EFFECTIVE IN 1999, NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER IS SUBJECT TO FEDERAL REQUIREMENTS TO MAKE THE FOLLOWING FORMS "WIDELY AVAILABLE" TO ALL MEMBERS OF THE GENERAL PUBLIC: 1. THE THREE MOST RECENT ANNUAL INFORMATION RETURNS (FORM 990), EXCLUDING THE LIST OF SIGNIFICANT DONORS (SCHEDULE B) THAT IS ATTACHED TO THE FORM 990, BUT INCLUDING THE ACCOMPANYING SCHEDULE A, AND 2. NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER'S ORIGINAL APPLICATION FOR RECOGNITION OF ITS TAX-EXEMPT STATUS (FORM 1023), FILED WITH IRS AND ALL ACCOMPANYING SCHEDULES AND ATTACHMENTS. IT IS THE POLICY OF NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER TO ADHERE TO THE FOLLOWING GUIDELINES IN ORDER TO COMPLY WITH THE PRECEDING PUBLIC DISCLOSURE REQUIRMENTS: 1. ANYONE APPEARING IN PERSON AT THE OFFICES OF NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER DURING NORMAL WORKING HOURS MAKING A REQUEST TO INSPECT THE FORMS WILL BE GRANTED ACCESS TO A FILE COPY OF THE FORMS. THE CONTROLLER SHALL BE RESPONSIBILE FOR MAINTAINING THIS COPY OF EACH FORM AND FOR MAKING IT AVAILABLE TO ALL REQUESTERS. 2. FOR ALL WRITTEN REQUESTS FOR COPIES OF FORMS RECEIVED BY NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER , THE ORGANIZATION SHALL REQUIRE PRE-PAYMENT OF ALL COPYING AND SHIPPING CHARGES. FOR REQUESTS FOR COPIES THAT ARE RECEIVED WITHOUT PREPAYMENT, NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER WILL NOTIFY THE REQUESTER OF THIS POLICY VIA PHONE CALL OR BY LETTER WITHIN 7 DAYS OF RECEIPT OF THE ORIGINAL REQUEST. 3. THE COPYING COST CHARGED BY NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER FOR PROVIDING COPIES OF REQUESTED FORMS SHALL BE $1.00 FOR THE FIRST PAGE COPIES AND $0.15 FOR EACH SUBSEQUENT PAGE. ALL COPIES SHALL BE SHIPPED TO REQUESTERS VIA REGULAR FIRST CLASS MAIL, THUS, SHIPPING CHARGES WILL BE A STANDARD $3.00 PER SHIPMENT. 4. AFTER PAYMENT IS RECEIVED BY NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER, ALL REQUESTED COPIES SHALL BE SHIPPED TO REQUESTERS WITHIN 30 DAYS. MAKING ALL COPIES AND SHIPPING WITHIN THE 30-DAY TIME PERIOD SHALL BE THE RESPONSIBILITY OF THE BUSINESS OFFICE. 5. FOR REQUESTS FOR COPIES MADE IN PERSON DURING NORMAL BUSINESS HOURS, COPIES SHALL BE PROVIDED WHILE THE REQUESTER WAITS. 6. NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER SHALL ACCEPT CERIFIED CHECKS AND MONEY ORDERS FOR REQUESTS FOR COPIES MADE IN PERSON. NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER SHALL ACCEPT CERTIFIED CHECKS, MONEY ORDERS AND CREDIT CARDS AS PAYMENT FOR COPIES OF FORMS REQUESTED IN WRITING.
CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC FORM 990, PART VII DAN MARTINDALE - 393 DELAWARE AVENUE, DELMAR, NY 12054. JERRY SHENKMAN - 393 DELAWARE AVENUE, DELMAR, NY 12054. RUTH VITALE - 393 DELAWARE AVENUE, DELMAR, NY 12054. MILTON KAPLAN - 393 DELAWARE AVENUE, DELMAR, NY 12054. JEFFREY PLATT - 393 DELAWARE AVENUE, DELMAR, NY 12054. LINDA CLAYSON - 393 DELAWARE AVENUE, DELMAR, NY 12054. THOMAS J. TALBETT, JR. - 393 DELAWARE AVENUE, DELMAR, NY 12054. JERRY ISAACS - 393 DELAWARE AVENUE, DELMAR, NY 12054. AL TURK - 393 DELAWARE AVENUE, DELMAR, NY 12054. IDA RIOS - 393 DELAWARE AVENUE, DELMAR, NY 12054. RAPHAEL SMITH - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARYANN BRUNER - 393 DELAWARE AVENUE, DELMAR, NY 12054. BETTY BUTZ - 393 DELAWARE AVENUE, DELMAR, NY 12054. SUE CUNNINGHAM - 393 DELAWARE AVENUE, DELMAR, NY 12054. DR. JAMES ASHE - 393 DELAWARE AVENUE, DELMAR, NY 12054. JILL ABDALLAH - 393 DELAWARE AVENUE, DELMAR, NY 12054. JENNIFER HARVEY - 393 DELAWARE AVENUE, DELMAR, NY 12054. GILBERT DUKEN - 393 DELAWARE AVENUE, DELMAR, NY 12054. MERRILEE HAMLIN - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARY SKILLAN - 393 DELAWARE AVENUE, DELMAR, NY 12054. CYNTHIA LACKI - 393 DELAWARE AVENUE, DELMAR, NY 12054. DOROTHY WHEELER - 393 DELAWARE AVENUE, DELMAR, NY 12054. ROSE MARY CELLA - 393 DELAWARE AVENUE, DELMAR, NY 12054. DONALD GEER - 393 DELAWARE AVENUE, DELMAR, NY 12054. LUELLA ROGERS - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARK METZGER, ESQ. - 393 DELAWARE AVENUE, DELMAR, NY 12054. DONNA L. BURDEN, ESQ. - 393 DELAWARE AVENUE, DELMAR, NY 12054. SCOTT GORSKI - 393 DELAWARE AVENUE, DELMAR, NY 12054. GERALD EDWARDS - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARLA RODRIGUEZ - 393 DELAWARE AVENUE, DELMAR, NY 12054. ROBERT KLEPPANG - 393 DELAWARE AVENUE, DELMAR, NY 12054. GAIL CORBIN - 393 DELAWARE AVENUE, DELMAR, NY 12054. JUDY SCHELLE - 393 DELAWARE AVENUE, DELMAR, NY 12054. CANDIE POCOCK - 393 DELAWARE AVENUE, DELMAR, NY 12054. THELMA MONTREAL - 393 DELAWARE AVENUE, DELMAR, NY 12054. RONALD GEORGE - 393 DELAWARE AVENUE, DELMAR, NY 12054. GARY RUFF - 393 DELAWARE AVENUE, DELMAR, NY 12054. BETTY BRESLER - 393 DELAWARE AVENUE, DELMAR, NY 12054. DEBORAH A. VINK - 393 DELAWARE AVENUE, DELMAR, NY 12054. CHERYL ENGLERT - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARCY VANZANDT - 393 DELAWARE AVENUE, DELMAR, NY 12054. RANDY SCHAAL, ESQ. - 393 DELAWARE AVENUE, DELMAR, NY 12054. ERIC STICKELS - 393 DELAWARE AVENUE, DELMAR, NY 12054. MAYTHORNE WINTERKORN - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARY BETH WUNSCH - 393 DELAWARE AVENUE, DELMAR, NY 12054. DAWN DESMOND - 393 DELAWARE AVENUE, DELMAR, NY 12054. JOEL KAPLAN - 393 DELAWARE AVENUE, DELMAR, NY 12054. SALLY ROMANO - 393 DELAWARE AVENUE, DELMAR, NY 12054. JACK GAROFALO - 393 DELAWARE AVENUE, DELMAR, NY 12054. SAUNDRA M. GUMEROVE - 393 DELAWARE AVENUE, DELMAR, NY 12054. DOROTHY LENOWICZ - 393 DELAWARE AVENUE, DELMAR, NY 12054. HARRIET TRAVERSA - 393 DELAWARE AVENUE, DELMAR, NY 12054. LAURA KENNEDY - 393 DELAWARE AVENUE, DELMAR, NY 12054. CHARLES KING - 393 DELAWARE AVENUE, DELMAR, NY 12054. EDITH NIEDERT - 393 DELAWARE AVENUE, DELMAR, NY 12054. GENEVIEVE O'NEIL - 393 DELAWARE AVENUE, DELMAR, NY 12054. RADY BRUELL - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARILYN JAFFE-RUIZ - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARIE-THERESE FRIERI - 393 DELAWARE AVENUE, DELMAR, NY 12054. DONALD SMITH - 393 DELAWARE AVENUE, DELMAR, NY 12054. DR. JOHN KOWALCZYK - 393 DELAWARE AVENUE, DELMAR, NY 12054. RUTH RIDGWAY - 393 DELAWARE AVENUE, DELMAR, NY 12054. JOYCE CARMEN - 393 DELAWARE AVENUE, DELMAR, NY 12054. GORDON EYER - 393 DELAWARE AVENUE, DELMAR, NY 12054. JOSEPH M. BOGNANNO - 393 DELAWARE AVENUE, DELMAR, NY 12054. ELIZABETH PALMATIER - 393 DELAWARE AVENUE, DELMAR, NY 12054. JOANNE GRANT - 393 DELAWARE AVENUE, DELMAR, NY 12054. JAMES CANNON - 393 DELAWARE AVENUE, DELMAR, NY 12054. REV. KEN DEGNAN - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARLENE HILL - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARY ANN BARBARINO - 393 DELAWARE AVENUE, DELMAR, NY 12054. RICHARD RIMA - 393 DELAWARE AVENUE, DELMAR, NY 12054. WALTER HOGAN - 393 DELAWARE AVENUE, DELMAR, NY 12054. LAURA DODGE - 393 DELAWARE AVENUE, DELMAR, NY 12054. HEATHER STRICKLAND - 393 DELAWARE AVENUE, DELMAR, NY 12054. SUSAN LUCAS - 393 DELAWARE AVENUE, DELMAR, NY 12054. EDIE HALL - 393 DELAWARE AVENUE, DELMAR, NY 12054. HENRIETTA MESSIER - 393 DELAWARE AVENUE, DELMAR, NY 12054. HOWARD JURIST - 393 DELAWARE AVENUE, DELMAR, NY 12054. DR. IRVING CAMINSKY - 393 DELAWARE AVENUE, DELMAR, NY 12054. SONIA CRANNAGE, ESQ. - 393 DELAWARE AVENUE, DELMAR, NY 12054. LYNDA MELTZER - 393 DELAWARE AVENUE, DELMAR, NY 12054. GISELA SCHMIDT - 393 DELAWARE AVENUE, DELMAR, NY 12054. AUDREY TARANTINO - 393 DELAWARE AVENUE, DELMAR, NY 12054. KAREN FEINSTEIN - 393 DELAWARE AVENUE, DELMAR, NY 12054. PATRICIA CAMPANELLA - 393 DELAWARE AVENUE, DELMAR, NY 12054. CAROLYN SMITH - 393 DELAWARE AVENUE, DELMAR, NY 12054. DR. LAWRENCE FEIN - 393 DELAWARE AVENUE, DELMAR, NY 12054. ROBERT DESIO - 393 DELAWARE AVENUE, DELMAR, NY 12054. PATRICIA ROSS - 393 DELAWARE AVENUE, DELMAR, NY 12054. BELLA STUART - 393 DELAWARE AVENUE, DELMAR, NY 12054. ROBERTA BROOKS - 393 DELAWARE AVENUE, DELMAR, NY 12054. JOHN DESANTO - 393 DELAWARE AVENUE, DELMAR, NY 12054. HAROLD HOFFMEIER, JR. - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARCIA KASPRZYK - 393 DELAWARE AVENUE, DELMAR, NY 12054. JOHN BECKER, II - 393 DELAWARE AVENUE, DELMAR, NY 12054. ROSE PALMEIERI - 393 DELAWARE AVENUE, DELMAR, NY 12054. PAUL GREENFIELD - 393 DELAWARE AVENUE, DELMAR, NY 12054. ARTHUR STILWELL - 393 DELAWARE AVENUE, DELMAR, NY 12054. JOSEPH DEL BROCCOLO - 393 DELAWARE AVENUE, DELMAR, NY 12054. JAMES MCENEANEY - 393 DELAWARE AVENUE, DELMAR, NY 12054. FRED SALZBERG - 393 DELAWARE AVENUE, DELMAR, NY 12054. KENNETH WALKER - 393 DELAWARE AVENUE, DELMAR, NY 12054. IRENE KIRTACK - 393 DELAWARE AVENUE, DELMAR, NY 12054. STEVEN DROBYSH - 393 DELAWARE AVENUE, DELMAR, NY 12054. ROBERT BOENING - 393 DELAWARE AVENUE, DELMAR, NY 12054. THOMAS HITCHCOCK - 393 DELAWARE AVENUE, DELMAR, NY 12054. BARBARA ROESER - 393 DELAWARE AVENUE, DELMAR, NY 12054. ANNE MARIE LOCKHART - 393 DELAWARE AVENUE, DELMAR, NY 12054. CAROL KENYON - 393 DELAWARE AVENUE, DELMAR, NY 12054. JOSEPH VANHAELST - 393 DELAWARE AVENUE, DELMAR, NY 12054. DIAN CIFUNI - 393 DELAWARE AVENUE, DELMAR, NY 12054. NELVA TUREK - 393 DELAWARE AVENUE, DELMAR, NY 12054. ANTHONY ASSALONE - 393 DELAWARE AVENUE, DELMAR, NY 12054. MOHAN MEHRA - 393 DELAWARE AVENUE, DELMAR, NY 12054. SHERYL R. FRISHMAN - 393 DELAWARE AVENUE, DELMAR, NY 12054. PATRICIA POKLEMBA - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARY ELLEN MURPHY - 393 DELAWARE AVENUE, DELMAR, NY 12054. ELLEN OWENS - 393 DELAWARE AVENUE, DELMAR, NY 12054. GREG BOOTH - 393 DELAWARE AVENUE, DELMAR, NY 12054. DR. MELVIN GERTNER - 393 DELAWARE AVENUE, DELMAR, NY 12054. MISCHELLE K. SHATTUCK - 393 DELAWARE AVENUE, DELMAR, NY 12054.
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: CONTRIBUTIONS-IN-KIND - GOODS AND SERVICES 24,937. TOTAL TO FORM 990, PART XI, LINE 5: 24,937.
    FORM 990 PART XI LINE 2C - THE PROCESS HAS NOT CHANGED SINCE PRIOR YEAR.
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:  
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SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
 
Employer identification number

15-0619307
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) THE FOUNDATION OF THE BROOME-TIOGA ASSOCIATION FOR RETARDED CITIZENS

125 CUTLER POND ROAD

BINGHAMTON,NY13905
22-3273829 		PLANNED GIVING ACTIVITIES NY 501(C)(3) 7 N/A
Yes
 
(2) COUNTRY VALLEY INDUSTRIES INC

125 CUTLER POND ROAD

BINGHAMTON,NY13905
22-3081071 		REALTY COMPANY NY 501(C)(3) 7 N/A
Yes
 
(3) COUNTRY VALLEY COMMUNITY RESIDENCE INC

125 CUTLER POND ROAD

BINGHAMTON,NY13905
16-1082590 		REALTY COMPANY NY 501(C)(2)   N/A
Yes
 








For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership












Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) COUNTRY VALLEY INDUSTRIES INC

 B 486,581 FMV
(2) COUNTRY VALLEY COMMUNITY RESIDENCE INC

 J 52,149 FMV
(3) COUNTRY VALLEY INDUSTRIES INC

 J 465,566 FMV
(4)
(5)
(6)
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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Software Version: