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
2011
Open to Public Inspection
Name of the organization
GATE-GATEWAY TO INDEPENDENCE
Employer identification number
86-1084910
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(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) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(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—2011.
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—2010.
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—2011.
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—2010.
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
19,389
96,204
25,749
25,546
27,396
194,284
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......
21,555
27,951
27,076
7,225
10,690
94,497
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.
40,944
124,155
52,825
32,771
38,086
288,781
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
31,327
12,000
5,000
10,000
58,327
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.
43,000
5,000
48,000
c
Add lines 7a and 7b..
74,327
17,000
5,000
10,000
106,327
8
Public Support (Subtract line 7c from line 6.)
182,454
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
9
Amounts from line 6...
40,944
124,155
52,825
32,771
38,086
288,781
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
1,465
1,581
784
640
1,909
6,379
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
1,465
1,581
784
640
1,909
6,379
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
25,594
30,813
56,407
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.).
42,409
125,736
53,609
59,005
70,808
351,567
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 2011 (line 8 column (f) divided by line 13 column (f))
.........
15
51.900 %
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
68.100 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f))
......
17
2.000 %
18
Investment income percentage from 2010 Schedule A, Part III, line 17
.............
18
2.000 %
19a
33 1/3% support tests—2011.
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—2010.
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2011
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
2011
Open to Public Inspection
Name of the organization
GATE-GATEWAY TO INDEPENDENCE
Employer identification number
86-1084910
Identifier
Return Reference
Explanation
OTHER REVENUE
FORM 990-EZ, PART I, LINE 8
REFUNDS 3 TOTAL 3
OTHER EXPENSES
FORM 990-EZ, PART I, LINE 16
EXPENSES GENERAL LIABILITY 1,286 OFFICER AND DIRECTOR 1,014 OFFICE SUPPLIES 520 PROFESSIONAL DUES 165 POST OFFICE BOX RENTAL 42 MISCELLANEOUS 499 STATE TAX/FILING FEES 172 BANK FEES 18 PROMOTIONAL FEES 411 POSTAGE 111 DUES 35 SUPPLIES 56 PARTICIPANT EXPENSES 454 WEBSITE 290 NON-INVESTMENT DEPRECIATION 377 TOTAL 5,450
OTHER ASSETS
FORM 990-EZ, PART II, LINE 24
EQUIPMENT 2,458 2,638 LESS ACCUMULATED DEPRECIATION 1,695 2,072 TOTAL 763 566
PRIMARY EXEMPT PURPOSE
FORM 990-EZ, PART III
THE GATE- GATEWAY TO INDEPENDENCE ASSISTS YOUNG ADULTS WITH SEVERE DISABILITIES TO ACHIEVE INDEPENDENCE BY PROVIDING THEM WITH SOCIAL AND VOCATIONAL ACTIVITIES. PARTICIPANTS ENTER THE PROGRAM BETWEEN THE AGES OF 22-30 BUT MAY REMAIN IN THE PROGRAM AS LONG AS THEY WISH. THE PARTICIPANTS COME TOGETHER SEVERAL DAYS EACH WEEK WITH STAFF AND VOLUNTEERS FROM THE COMMUNITY TO ENJOY EACH OTHERS COMPANY AND TO USE SKILLS THAT FOSTER INDEPENDENCE. THE FOCUS OF THE PROGRAM IS ON EACH INDIVIDUALS ABILITIES AND ON DEVELOPING A COMMUNITY OF PEOPLE WHO APPRECIATE AND CARE ABOUT EACH OTHER. JUST AS IMPORTANT, THE GATE PROVIDES A RESPITE SERVICE TO THE FAMILY/CARETAKER WHO IS ABLE TO LEAVE THE PARTICIPANT WITH US KNOWING THAT THEY ARE IN A SAFE AND NURTURING ENVIRONMENT. FOR MANY FAMILIES, THIS IS THE ONLY RESPITE THEY HAVE. WITHOUT THIS PROGRAM , MOST OF THESE YOUNG ADULTS FACE A LIFE OF ISOLATION AND EXCLUSION. THE GATE IS A MODEL OF WHAT AN INCLUSIVE COMMUNITY CAN BE. THE PROGRAM IS FUNDED THROUGH DONATIONS, FUND RAISERS AND GRANTS.
FIRST ACCOMPLISHMENT
FORM 990-EZ, PART III, LINE 28
THE GATE- GATEWAY TO INDEPENDENCE ASSISTS YOUNG ADULTS WITH SEVERE DISABILITIES TO ACHIEVE INDEPENDENCE BY PROVIDING THEM WITH SOCIAL AND VOCATIONAL ACTIVITIES. PARTICIPANTS ENTER THE PROGRAM BETWEEN THE AGES OF 22-30 BUT MAY REMAIN IN THE PROGRAM AS LONG AS THEY WISH . THE PARTICIPANTS COME TOGETHER SEVERAL DAYS EACH WEEK WITH STAFF AND VOLUNTEERS FROM THE COMMUNITY TO ENJOY EACH OTHERS COMPANY AND TO USE SKILLS THAT FOSTER INDEPENDENCE. THE FOCUS OF THE PROGRAM IS ON EACH INDIVIDUALS ABILITIES AND ON DEVELOPING A COMMUNITY OF PEOPLE WHO APPRECIATE AND CARE ABOUT EACH OTHER. JUST AS IMPORTANT, THE GATE PROVIDES A RESPITE SERVICE TO THE FAMILY/CARETAKER WHO IS ABLE TO LEAVE THE PARTICIPANT WITH US KNOWING THAT THEY ARE IN A SAFE AND NURTURING ENVIRONMENT. FOR MANY FAMILIES, THIS IS THE ONLY RESPITE THEY HAVE. WITHOUT THIS PROGRAM , MOST OF THESE YOUNG ADULTS FACE A LIFE OF ISOLATION AND EXCLUSION. THE GATE IS A MODEL OF WHAT AN INCLUSIVE COMMUNITY CAN BE. THE PROGRAM IS FUNDED THROUGH DONATIONS, SPECIAL EVENTS AND GRANTS. THE PROGRAMS SERVE 30 PARTICIPANTS WHICH PROVIDES A RESPITE FOR 60 PARENT/CARETAKERS. THERE ARE 12 COLLEGE STUDENT VOLUNTEERS WHO RECEIVE COMMUNITY SERVICE HOURS FOR THEIR VOLUNTEER WORK AT THE PROGRAM.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.