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
DANE COUNTY HUMANE SOCIETY INC
Employer identification number
39-0806335
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)
(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
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
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.") ....
1,246,106
1,036,748
1,352,090
1,892,769
1,661,870
7,189,583
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..
1,246,106
1,036,748
1,352,090
1,892,769
1,661,870
7,189,583
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)..
786,991
6
Public Support. Subtract line 5 from line 4.
6,402,592
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..
1,246,106
1,036,748
1,352,090
1,892,769
1,661,870
7,189,583
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
85,714
102,371
29,615
12,795
19,317
249,812
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..
20,771
25,454
22,506
17,191
20,355
106,277
11
Total support (Add lines 7 through 10).
7,545,672
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
4,674,193
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
84.850 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
88.570 %
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, PART II, LINE 10, EXPLANATION OF OTHER INCOME: GROSS INCOME FROM FUNDRAISING EVENTS GROSS INCOME FROM GAMING ACTIVITIES RESTITUTION MISCELLANEOUS REVENUE
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
DANE COUNTY HUMANE SOCIETY INC
Employer identification number
39-0806335
Identifier
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 6
DANE COUNTY HUMANE SOCIETY HAS A SINGLE CATEGORY OF MEMBERSHIP FOR WHICH A MINIMUM AMOUNT OF DUES IS REQUIRED TO BE ENTITLED TO VOTING RIGHTS. THE SOCIETY HAS FIVE ADDITIONAL GIVING LEVELS FOR THOSE PERSONS WHO CONTRIBUTE AMOUNTS ABOVE THE MINIMUM REQUIRED DUES.
FORM 990, PART VI, SECTION A, LINE 7A
THE MEMBERS ELECT THE DIRECTORS OF THE SOCIETY AT THE ANNUAL MEMBERSHIP MEETING.
FORM 990, PART VI, SECTION A, LINE 7B
ALL CURRENT MEMBERS, EXCEPT FOR YOUTH MEMBERS UNDER AGE EIGHTEEN, ARE ENTITLED TO VOTE AT ANY MEMBERSHIP MEETING OF THE SOCIETY PROVIDED, HOWEVER, THAT THE MEMBER SHALL NOT HAVE VOTING RIGHTS UNTIL HE OR SHE HAS BEEN A MEMBER OF THE SOCIETY FOR THREE MONTHS. A SPECIAL MEMBERSHIP MEETING MAY BE CALLED AT ANY TIME BY THE BOARD OF DIRECTORS OR BY ANY TWENTY-FIVE MEMBERS QUALIFIED TO VOTE UPON THEIR FILING WITH THE PRESIDENT A WRITTEN REQUEST FOR A MEETING. AT ANY MEMBERSHIP MEETING OF THE SOCIETY, THOSE VOTING MEMBERS PRESENT IN PERSON (BUT NOT FEWER THAN TWELVE) HAVE THE AUTHORITY TO TRANSACT ALL BUSINESS THAT MAY COME BEFORE THE MEMBERSHIP MEETING. VOTING BY PROXY IS NOT PERMITTED AT MEMBERSHIP MEETINGS.
FORM 990, PART VI, SECTION B, LINE 11
THE FORM 990 IS PREPARED BY AN INDEPENDENT CERTIFIED PUBLIC ACCOUNTANT AS PART OF THE ANNUAL FINANCIAL STATEMENT AUDIT ENGAGEMENT. WHEN COMPLETED, THE FORM 990 IS REVIEWED BY THE SOCIETY'S EXECUTIVE DIRECTOR AND THE BOARD OF DIRECTORS. UPON APPROVAL OF THE COMPLETED FORM 990 BY BOTH THE EXECUTIVE DIRECTOR AND THE BOARD OF DIRECTORS, THE FORM 990 WILL BE FILED WITH THE IRS. EACH MEMBER OF THE BOARD OF DIRECTORS IS GIVEN ACCESS TO A SECURE SECTION OF THE SOCIETY'S WEBSITE WHERE A DRAFT FORM 990 RESIDES. NOTICE OF THE POSTING OF THE UPDATED DRAFT FORM 990 IS GIVEN TO EACH DIRECTOR AT THE MEETING FOLLOWING THE POSTING OF THE UPDATED DRAFT AND BY EMAIL FROM THE PRESIDENT. THE CONTENT OF THE UPDATED DRAFT FORM 990 IS APPROVED BY THE EXECUTIVE DIRECTOR AND THE FINANCE COMMITTEE PRIOR TO POSTING. EACH DIRECTOR IS RESPONSIBLE FOR REVIEWING THE POSTED DRAFT PRIOR TO THE NEXT MEETING. AT THE BOARD MEETING FOLLOWING THE POSTING AND REVIEW OF THE UPDATED DRAFT FORM 990, AN AGENDA ITEM IS ADDED TO DISCUSS QUESTIONS OR CONCERNS REGARDING THE INFORMATION CONTAINED IN THE FORM 990. ONCE ALL ISSUES REGARDING THE FORM 990 HAVE BEEN RESOLVED, THE BOARD OF DIRECTORS FORMALLY APPROVES THE COMPLETED FORM 990. UPON APPROVAL BY THE BOARD OF DIRECTORS, THE FORM 990 IS FILED WITH THE IRS. THE SECTIONS OF THE APPROVED FORM 990 OPEN TO PUBLIC INSPECTION ARE POSTED ON THE SOCIETY'S WEBSITE ONCE FILED. THE PRESIDENT IS RESPONSIBLE FOR ENSURING THAT THIS PROCEDURE IS FOLLOWED ANNUALLY.
FORM 990, PART VI, SECTION B, LINE 12C
ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS ARE COVERED UNDER THE SOCIETY'S CONFLICT OF INTEREST POLICY. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS. AFTER DISCLOSURE OF THE INTEREST AND ALL MATERIAL FACTS, THE INTERESTED PERSON SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON BY THE REMAINING BOARD OR COMMITTEE MEMBERS. THE GOVERNING BOARD OR A DESIGNATED COMMITTEE CONDUCTS PERIODIC REVIEWS TO ENSURE THE SOCIETY DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS TAX-EXEMPT STATUS.
FORM 990, PART VI, SECTION B, LINE 15A
THE PERFORMANCE OF THE EXECUTIVE DIRECTOR OF DANE COUNTY HUMANE SOCIETY IS REVIEWED BY THE BOARD OF DIRECTORS ON AN ANNUAL BASIS. THIS REVIEW OCCURS WITHIN FOUR WEEKS OF THE ANNIVERSARY OF THE EXECUTIVE DIRECTOR'S HIRE DATE. WHEN THE REVIEW HAS BEEN COMPLETED AND FORMALLY APPROVED BY THE BOARD OF DIRECTORS, THE BOARD OF DIRECTORS DETERMINES AND APPROVES ANY SALARY ADJUSTMENT AND SUBMITS THE CHANGE TO THE SOCIETY'S ACCOUNTANT. APPROXIMATELY SIXTY DAYS PRIOR TO THE EXECUTIVE DIRECTOR'S ANNIVERSARY DATE, THE BOARD OF DIRECTORS APPOINTS A DIRECTOR TO LEAD THE REVIEW EFFORT. THE LEAD IS REPONSIBLE FOR (A) CREATING A SCHEDULE TO COMPLETE THE REVIEW BY THE EXECUTIVE DIRECTOR'S ANNIVERSARY DATE, (B) SOLICITING COMPLETION OF DRAFT REVIEWS BY ALL DIRECTORS, (C) SOLICITING COMPLETION OF THE REVIEW BY THE EXECUTIVE DIRECTOR IN A SELF-EVALUATION PROCESS AND SHARING THE SELF-EVALUATION WITH THE BOARD OF DIRECTORS, (D) COMPILING THE DRAFT REVIEWS INTO A SINGLE, COHESIVE REVIEW TO BE APPROVED BY THE BOARD OF DIRECTORS, (E) MEETING WITH THE EXECUTIVE DIRECTOR TO SHARE AND DISCUSS THE FINAL COHESIVE REVIEW AND ANY SALARY ADJUSTMENT APPROVED BY THE BOARD OF DIRECTORS, (F) IDENTIFYING ANY PERFORMANCE CONCERNS AND EITHER DEVELOPING AN APPROPRIATE MANAGEMENT SUPPORT PLAN FOR THE EXECUTIVE DIRECTOR OR RETURNING TO THE BOARD THE RESPONSIBILITY FOR MANAGEMENT SUPPORT OF THE EXECUTIVE DIRECTOR, AND (G) SHARING ANY PERTINENT DISCUSSION FROM THE REVIEW PROCESS WITH THE BOARD OF DIRECTORS. EACH DIRECTOR IS RESPONSIBLE FOR SUBMITTING A COMPLETED ANNUAL REVIEW FORM TO THE LEAD DIRECTOR ON THE SCHEDULE SET BY THE LEAD DIRECTOR. THE LEAD THEN COMPILES ALL COMMENTS SUBMITTED AND CREATES A SINGLE COHESIVE REVIEW THAT WILL EVENTUALLY BE SHARED WITH THE EXECUTIVE DIRECTOR. THIS COMPILED REVIEW IS PRESENTED TO THE BOARD OF DIRECTORS AND REQUIRES FORMAL APPROVAL OF THE CONTENT BEFORE BEING SHARED WITH THE EXECUTIVE DIRECTOR. THIS APPROVAL OCCURS IN A CLOSED SESSION AT THE MEETING OF THE BOARD OF DIRECTORS HELD PRIOR TO THE EXECUTIVE DIRECTOR'S ANNIVERSARY DATE. ONCE THE BOARD OF DIRECTORS APPROVES THE COMPILED REVIEW, THE BOARD OF DIRECTORS IS RESPONSIBLE FOR DISCUSSING AND APPROVING ANY SALARY ADJUSTMENTS. SALARY ADJUSTMENTS ARE PUT INTO EFFECT THROUGH COMPLETION OF A DCHS PAYROLL CHANGE FORM AND SUBMISSION TO THE ACCOUNTANT. ANY CONCERNS OR ISSUES WITH PERFORMANCE ARE HANDLED BY THE BOARD OF DIRECTORS OUTSIDE OF THE ANNUAL REVIEW PROCESS. ANY SALARY ADJUSTMENTS REQUIRE APPROVAL OF THE BOARD OF DIRECTORS AND SHOULD INCLUDE DISCUSSION OF THE STANDARD SALARY ADJUSTMENT LEVELS IN USE FOR OTHER MANAGEMENT STAFF AT THE SOCIETY. THE PRESIDENT IS RESPONSIBLE FOR ENSURING THAT THIS PROCEDURE IS FOLLOWED ANNUALLY.
FORM 990, PART VI, SECTION C, LINE 19
THE SOCIETY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 5:
NET UNREALIZED GAINS ON INVESTMENTS: 143,492. LOSS ON DISPOSAL OF PROPERTY AND EQUIPMENT -1,683. TOTAL TO FORM 990, PART XI, LINE 5: 141,809.
TRUSTEES:
FORM 990, PART VII, SECTION A, LINE 1A, TERMS FOR OFFICERS, DIRECTORS, AND
CATHY HOLMES, PRESIDENT - TERM EXPIRES IN 2013 ELLEN MARKEY, VICE PRESIDENT - TERM EXPIRES IN 2011 BRIDGET BUSH, TREASURER - TERM EXPIRES IN 2011 CRIS MARSH, SECRETARY - TERM EXPIRES IN 2011 SUZANNE ALEXANDER, DIRECTOR - TERM EXPIRED IN MAY 2010 MARY BOISEN, DIRECTOR - TERM EXPIRES IN 2011 JOHN BLOODGOOD, DIRECTOR - TERM EXPIRES IN 2012 CHERYL BREUER, DIRECTOR - TERM EXPIRES IN 2013 SHIRLEY CROCKER, DIRECTOR - TERM EXPIRES IN 2012 GARY GODDING, DIRECTOR - TERM EXPIRES IN 2012 JOSEPH GOODE, DIRECTOR - TERM EXPIRES IN 2013 JAMES WEST, DIRECTOR - TERM EXPIRES IN 2012 AARON ZITZELSBERGER, DIRECTOR - TERM EXPIRED IN DECEMBER 2010
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.