Attach to Form 990 or Form 990-EZ.
See separate instructions.| (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? |
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|---|---|---|---|---|---|---|---|---|---|
| Yes | No | Yes | No | Yes | No | ||||
| (1)
Delta Dental of New Jersey Inc |
221896118 | 501(c)4 | Yes | Yes | Yes | 0 | |||
| Total | 0 | ||||||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3.. | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public Support. Subtract line 5 from line 4. | ||||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets.. | ||||||
| 11 | Total support (Add lines 7 through 10). | ||||||






| 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.) | ||||||
| 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.). | ||||||




| Facts And Circumstances Test |
|---|
| Explanation |
|---|
| Delta Dental of New Jersey Foundation, Inc. is a nonprofit 501(c)3 corporation established for the purpose of promoting and assisting projects devoted to the enhancement of dental health research, education and oral health. This organization serves as Delta Dental of New Jersey, Inc.'s arm for charitable outreach to the general public, and specifically, to those segments of society within New Jersey and Connecticut that are underserved for dental care. |
| Software ID: | 10000077 |
| Software Version: | v1.00 |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| F990_P06_S0A_L06 | Form 990, Part VI, Section A, Line 6 | The members of the organization are the Board of Trustees of Delta Dental of New Jersey Inc which are: Gerald A Sydell DDS, Chairman, Ronald Deblinger DMD, Vice Chairman, William Faherty Jr, Corresponding Trustee, Robert H Barney Esq, Carl Chaityn DDS, William Faulkner, Jerome Feldman DDS, John P Hall Jr, Henry F Henderson Jr, W Thomas Margetts Esq, George C McLaughlin DMD, Gene Napoliello DDS, Morton Reinhart, Debra Salman DDS, Howard A Schwartz DDS |
| F990_P06_S0A_L07a | Form 990, Part VI, Section A, Line 7a | The Board of Trustees of Delta Dental of New Jersey Inc elects members of the governing body of the organization. |
| F990_P06_S0B_L11a | Form 990, Part VI, Section B, Line 11a | Senior management of the organization reviewed the internally prepared Form 990 which was provided to the Board of Trustees prior to its filing. |
| F990_P06_S0B_L12c | Form 990, Part VI, Section B, Line 12c | The organization monitors and enforces compliance with the conflict of interest policy by annually requiring the completion of questionnaires which call for disclosures of material information and reviewing of those responses by management and by the Audit Committee of the Board of Trustees of the organization. |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | Its articles of incorporation and financial statements are filed with New Jersey and therefore available for public review there. It has not made its conflicts of interest policy publicly available. |
| Software ID: | 10000077 |
| Software Version: | v1.00 |