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
HEBREW GEMILATH CHASODIM ASSOCIATIO
Employer identification number
34-0281800
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.") .
116,013
83,612
32,387
42,888
29,907
304,807
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......
19,648
29,194
4,889
61,259
126,782
241,772
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.
135,661
112,806
37,276
104,147
156,689
546,579
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.
14,648
24,194
38,842
c
Add lines 7a and 7b..
14,648
24,194
38,842
8
Public Support (Subtract line 7c from line 6.)
507,737
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...
135,661
112,806
37,276
104,147
156,689
546,579
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
25,343
-65,231
43,044
26,415
29,571
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
25,343
-65,231
43,044
26,415
29,571
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.).
161,004
47,575
80,320
130,562
156,689
576,150
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
88.130 %
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
84.560 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f))
......
17
5.000 %
18
Investment income percentage from 2010 Schedule A, Part III, line 17
.............
18
7.000 %
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
HEBREW GEMILATH CHASODIM ASSOCIATIO
Employer identification number
34-0281800
Identifier
Return Reference
Explanation
ALL OTHER ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4D
PROVIDE INTEREST FREE LOANS TO WORTHY PEOPLE REGARDLESS OF RACE OR RELIGION.
RELATED PARTY INFORMATION AMONG OFFICERS
FORM 990, PAGE 6, PART VI, LINE 2
STUART SHARPE SHAYNA SHARPE PRESIDENT DIRECTOR FATHER/DAUGHTER DAVID EDELMAN RACHEL EDELMAN VICE PRESIDE DIRECTOR BROTHER/SISTER JEROME FRANKEL CHARLES FRANKEL PAST PRESIDE PAST PRESIDE FATHER/SON
OFFICERS WHO CANNOT BE REACHED
FORM 990, PAGE 6, PART VI, LINE 9
RON ABRAMS PO BOX 21622 SOUTH EUCLID, OH 44121 KEVIN S. ADELSTEIN 6540 DORSET LANE SOLON, OH 44139 ANTHONY BABIN 39252 LANDER RD ORANGE VILLAGE, OH 44022 VALERA BENDERSKY 4384 BAYARD ROAD SOUTH EUCLID, OH 44121 BARNETT BOOKATZ 1985 S. TAYLOR ROAD CLEVELAND HEIGHTS, OH 44118 ANDREW FINGER 8134 CHAGRIN ROAD CHAGRIN FALLS, OH 44023 CHARLES FRANKEL 583 EMERALD COURT AURORA, OH 44202 JEFFREY BOGART 28525 SCIENCE PARK DRIVE BEACHWOOD, OH 44122 JEROME FRANKEL 505 S CHILLICOTHE ROAD 113 AURORA, OH 44202 STANLEY FRIEDLANDER 1300 EAST NINTH STREET CLEVELAND, OH 44114 MICHAEL A. LEWIS 3798 HILLBROOK UNIVERSITY HEIGHTS, OH 44118 MARC BLOCH 6005 PARKLAND DRIVE CHAGRIN FALLS, OH 44022 MARCIA COVEN 250 BLOSSOM LANE MORELAND HILLS, OH 44022 DAVID EDELMAN 26201 RICHMOND ROAD BEDFORD HEIGHTS, OH 44146 RICHARD POLLACK 1932 HARBOURSIDE DR LONGBOAT KEY, FL 34228 WENDY ALBIN SATTIN 6540 DORSET LANE SOLON, OH 44139 PHILLIP FINE 3681 GREEN RD SUITE 410 BEACHWOOD, OH 44122 RACHEL EDELMAN 2142 WEST 7TH ST FRONT DOOR CLEVELAND, OH 44113 DAVID LEAVITT 26500 HENDON ROAD BEACHWOOD, OH 44122 MICHAEL J. LEVINE 34396 BLUE HERON DRIVE SOLON, OH 44139 JODI RICH 26601 N WOODLAND ROAD BEACHWOOD, OH 44122 LORIE GELB 2493 CEDARWOOD RD PEPPER PIKE, OH 44124 STUART J. SHARPE 1100 CHESTER AVE CLEVELAND, OH 44115 SHAYNA N SHARPE 5468 BIG CREEK PARKWAY PARMA, OH 44129 ALEX SHVARTSHTEYN 23607 E GOVELAND BEACHWOOD, OH 44122 CYNTHIA WINTERS 3341 WARRENSVILLE CTR RD SUITE 108 SHAKER HEIGHTS, OH 44122 RICHARD T. STREEM 29001 CEDAR ROAD PEPPER PIKE, OH 44124 MICHAEL LORBER 24645 SHAKER BLVD BEACHWOOD, OH 44122 LISA LOWE 32675 BURLWOOD DRIVE SOLON, OH 44139 PAUL MIKHLI 3690 ORANGE PLACE SUITE 540 BEACHWOOD, OH 44122 MICHAEL PERLMUTER 3010 KERSDALE ROAD PEPPER PIKE, OH 44124
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
NO REVIEW WAS OR WILL BE CONDUCTED.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
ANNUALLY THE CONFILICT OF EACH INTEREST STATEMENT IS REQUIRED TO BE SIGNED AND COMPLIANCE AKNOWLEDGED
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
NO DOCUMENTS AVAILABLE TO THE PUBLIC
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.