Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
SHEBOYGAN AND PLYMOUTH AREA UNITED WAY INC
Employer identification number
39-0808471
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
No
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
(1)
211 FOX CITIES
390912895
501(C)(3)
No
No
Yes
11,250
(2)
ALZHEIMER'S ASSOCIATION
391350965
501(C)(3)
No
No
Yes
5,996
(3)
AMERICAN RED CROSS-SHEBOYGAN COUNTY CHAPTER
530196605
501(C)(3)
No
No
Yes
112,861
(4)
BIG BROTHERSBIG SISTERS
391102065
501(C)(3)
No
No
Yes
119,153
(5)
BOY SCOUTS OF AMERICA-BAY LAKES COUNCIL
391184320
501(C)(3)
No
No
Yes
39,375
(6)
BOYS AND GIRLS CLUB OF SHEBOYGAN COUNTY
391246782
501(C)(3)
No
No
Yes
102,043
(7)
CAMP EVERGREEN
396007027
501(C)(3)
No
No
Yes
6,577
(8)
CATHOLIC CHARITIES
390806321
501(C)(3)
No
No
Yes
72,483
(9)
CHILDREN'S SERVICE SOCIETY OF WISCONSIN
390806380
501(C)(3)
No
No
Yes
90,475
(10)
FAMILY CONNECTIONS INC
391688188
501(C)(3)
No
No
Yes
61,462
(11)
FAMILY RESOURCE CENTERS OF SHEBOYGAN COUNTY
391857835
501(C)(3)
No
No
Yes
108,467
(12)
FAMILY SERVICE ASSOCIATION
390808501
501(C)(3)
No
No
Yes
94,193
(13)
FOSTER GRANDPARENT PROGRAM
396004431
501(C)(3)
No
No
Yes
25,038
(14)
GIRL SCOUTS OF MANITOU COUNCIL INC
390920672
501(C)(3)
No
No
Yes
35,972
(15)
HMONG MUTUAL ASSISTANCE ASSOCIATION
391389177
501(C)(3)
No
No
Yes
26,209
(16)
LUTHERAN SOCIAL SERVICES
390816846
501(C)(3)
No
No
Yes
75,688
(17)
MEALS ON WHEELS OF SHEBOYGAN COUNTY INC
391238290
501(C)(3)
No
No
Yes
63,131
(18)
MENTAL HEALTH ASSOCIATION OF SHEBOYGAN COUNTY
391018013
501(C)(3)
No
No
Yes
111,087
(19)
PARTNERS FOR COMMUNITY DEVELOPMENT
391216413
501(C)(3)
No
No
Yes
28,100
(20)
RAINBOW KIDS INC
391652323
501(C)(3)
No
No
Yes
13,912
(21)
SAFE HARBOR
391690041
501(C)(3)
No
No
Yes
28,422
(22)
SALVATION ARMY
390806889
501(C)(3)
No
No
Yes
188,965
(23)
SHEBOYGAN AREA FAMILY LITERACY PROGRAM
396004431
501(C)(3)
No
No
Yes
16,904
(24)
SHEBOYGAN COUNTY INTERFAITH ORGANIZATION
391654340
501(C)(3)
No
No
Yes
20,472
(25)
SHEBOYGAN COUNTY YMCA
390830271
501(C)(3)
No
No
Yes
25,000
(26)
ST VINCENT DE PAUL
390833611
501(C)(3)
No
No
Yes
1,500
(27)
PLYMOUTH INTERGENERATIONAL COALITION
392037053
501(C)(3)
No
No
Yes
59,669
(28)
SHEBOYGAN AREA COMMUNITY CLINICS INC
264321839
501(C)(3)
No
No
Yes
10,000
Total
1,554,404
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public Support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
SHEBOYGAN AND PLYMOUTH AREA UNITED WAY INC
Employer identification number
39-0808471
Identifier
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 6
ALL CURRENT DONORS TO SHEBOYGAN & PLYMOUTH AREA UNITED WAY ARE MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7A
THE MEMBERS CAN BE ELECT ONE OF THEIR MEMBERS AT THE ANNUAL MEETING.
FORM 990, PART VI, SECTION A, LINE 7B
BOARD MEMBERS APPROVE DECISIONS MADE BY THE GOVERNING BOARD.
FORM 990, PART VI, SECTION B, LINE 11
BOARD OF DIRECTORS AT ITS JUNE MEETING DELEGATES TO THE FINANCE COMMITTEE THE AUTHORITY TO REVIEW AND APPROVE THE 990 BEFORE IT IS SENT TO THE INTERNAL REVENUE SERVICE. THE COMMITTEE CONVENES IN THE SECOND HALF OF JUNE TO REVIEW THE 990 IN DETAIL AND APPROVE ITS SUBMISSION.
FORM 990, PART VI, SECTION B, LINE 12C
EACH YEAR THE BOARD OF DIRECTORS REVIEWS THE CONFLICT OF INTEREST POLICY AND ACTIVELY DISCUSSES IMPLEMENTATION. EACH MEMBER OF THE BOARD OF DIRECTORS THEN SIGNS A STATEMENT EXPRESSING THEIR SUPPORT FOR THE POLICY AND THAT THEY WILL ABIDE BY IN THE COMING YEAR. AT THE STAFF LEVEL WE REVIEW THE POLICY ONCE A YEAR ASSURING THAT CURRENT FINANCIAL AND ORGANIZATIONAL COMMITMENTS DO NOT VIOLATE THE STATED POLICY OF THE BOARD OF DIRECTORS. WE AS A STAFF ALL SIGN A STATEMENT STATING THAT WE WILL COMPLY WITH THE CONFLICT OF INTEREST POLICY OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 15
EACH YEAR THE PERSONNEL AND NOMINATING COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE PREFORMANCE OF THE EXECUTIVE DIRECTOR OF THE ORGANIZATION. DURING THAT PERFORMANCE REVIEW COMMITTEE STUDIES THE COMPENSATION OF OTHER EXECUTIVES OF SIMILAR RESPONSIBILITY TO SEE IF THE CURRENT COMPENSATION OF OUR EXECUTIVE DIRECTOR IS COMPARABLE TO MARKET CONDITIONS.
FORM 990, PART VI, SECTION C, LINE 19
MANY OF THESE DOCUMENTS HAVE BEEN PLACED ON OUR WEB, AND ANY DONOR MAY ASK FOR A COPY TO BE SENT TO THEIR HOME OR EMAIL ADDRESS.
CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 5:
NET UNREALIZED GAINS ON INVESTMENTS: 26,300. INVESTMENT EXPENSES: -2,910. TOTAL TO FORM 990, PART XI, LINE 5: 23,390.
FROM 990, PART XI, LINE 2C:
THE BOARD OF DIRECTORS IS RESPONSIBLE FOR OVERSIGHT OF THE AUDIT AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT.
MEMBERSHIP IN UNITED WAY OF AMERICA CONSTITUTES AN AFFILIATE RELATIONSHIP UNDER THE IRS DEFINITION OF FEDERATED FUNDRAISING AGENCIES AND AS SUCH DUES PAID TO UNITED WAY OF AMERICA BY THE SHEBOYGAN AND PLYMOUTH AREA UNITED WAY ARE REPORTED ON LINE 21 OF FORM 990 PART IX. THE PAYMENT REPORTED HERE IS A QUOTA SUPPORT PAYMENT TO UNITED WAY OF AMERICA FOR WHICH THE SHEBOYGAN AND PLYMOUTH AREA UNITED WAY RECEIVES, AMONG OTHER THINGS, THE RIGHT TO USE THE NATIONAL BRAND IN CHARITABLE ENDEAVORS, NATIONAL ADVOCACY OF ISSUES, MEMBER EDUCATION AND TRAINING, CENTRALIZED CREATION AND SUPPORT FOR MARKETING OF FUNDRAISING CAMPAIGNS, FOSTERING OF RELATIONSHIPS WITH NATIONAL ORGANIZATIONS THAT SUPPORT MULTIPLE MEMBERS, ESTABLISHMENT AND MONITORING OF COMPLIANCE WITH STANDARDS OF ACCOUNTABILITY BY MEMBERS, ESTABLISHMENT OF POLICIES AND PROCESSES THAT IMPROVE OPERATIONAL EFFICIENCIES AMONG MEMBERS, AND PROMOTION OF THE CONCEPT OF LOCAL COMMUNITY IMPACT ON A NATIONAL SCALE.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.