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
ALBANY COUNTY CORRECTIONAL FACILITY FOR CHILDRENS BENEFIT INC
Employer identification number
26-0013956
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.") .
43,940
51,488
43,799
54,339
31,786
225,352
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.
43,940
51,488
43,799
54,339
31,786
225,352
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.)
225,352
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...
43,940
51,488
43,799
54,339
31,786
225,352
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.)
0
0
13
Total support (Add lines 9, 10c, 11 and 12.).
43,940
51,488
43,799
54,339
31,786
225,352
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
100 %
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
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
0 %
18
Investment income percentage from 2010 Schedule A, Part III, line 17
.............
18
0 %
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:
11000129
Software Version:
v1.00
-
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
ALBANY COUNTY CORRECTIONAL FACILITY FOR CHILDRENS BENEFIT INC
Employer identification number
26-0013956
Identifier
Return Reference
Explanation
F99Z_P01_S00_L16
Form 990-EZ, Part I, Line 16
In 2011 we assisted the following children and their families with the generous contributions ACCFCB received from our community supporters- James Deere age 4 of Clifton Park, NY (ACCFCB support- $1079) On 4/12/10 he entered AMCH emergency room with what was believed to be a "stomach virus" when in fact tests proved it was a very rare strep type A blood infection. James decompensated very quickly and was in kidney failure, septic (Lack of blood and oxygen to tissue), and suffering from toxic shock (Bacterial Infection) due to the strep group A entering his blood stream. Normally this bug would only result in a typical "sore" strep throat; however, if it finds its way into the bloodstream it will wreak havoc. Unfortunately, James left arm and right leg were amputated due to the damage done by the disease. After spending several month's at AMCH, James was transferred to Boston Children's Hospital. He was finally able to come home on 2/23/2011 to continue medical treatment, rehabilitation and Physical Therapy. James is slowly improving. A gently used van was generously offered to the Deere family at ACCFCB`s request by Joel DeNooyer, Owner of DeNooyer Chevrolet located on Wolf Road in Colonie, NY. This van was understandably declined by the Deere family because someone offered them a brand new van. DeNooyer Chevrolet was very generous to make this offer to them! Daniel Dingley age 9 of Green Island, NY (ACCFCB support- $17,723) Daniel was trapped in his burning home on April 2, 2010. He was found unconscious and was rescued by the Green Island Fire Department. Daniel was resuscitated and given life saving medical treatment by Empire Ambulance Service. Daniel continues on his long road to recovery and travels back and forth to Boston Shriners Hospital for Children with the help of ACCFCB to undergo several corrective surgeries while coping with extensive Physical Therapy. Matthew 'Buddy' Lafontaine age 16 of Delanson, NY (ACCFCB support- $2,302) Buddy was diagnosed in April 2002 with Primary Hyperoxaluria Type I. This is a rare genetic condition of too much oxalate (salt form of acid) present in the urine causing kidney stones/ kidney failure which eventually required a transplant operation. On January 22, 2009, Buddy courageously underwent a triple transplant surgery replacing his Liver and both Kidneys @ Boston Children's Hospital which would not have been possibly without the generosity of an unknown organ donor. He celebrates a new birthday- January 22. Buddy returns to Boston Children's Hospital for regular checkups. Hunter Sanchez age 14 of Castleton, NY (ACCFCB support- $3,082) At the age of 8, Hunter complained of leg pain which doctors diagnosed as Bi-Lateral Legg-Calve Perthes Disease- (a rare disease that causes bone death in the ball of both hips due to a lack of blood flow). He went from being a very active child to confinement in a wheelchair. Hunter had surgery in January 2007 and spent 5 months recovering @ Sinai Hosp in Baltimore, Maryland. He was finally able to come home in May and faced a yearlong extensive Physical Therapy regiment. Hunter had another surgery on May 11, 2010 and returned home on May 22, 2010 to face several months of bed rest and a year of Physical Therapy. Hunter continues to go to Baltimore for regular checkups and is expected to require further medical treatment as he grows. Zackary VanAllen age 15 of Hudson, NY (ACCFCB support- $10,303) Zackary was born with SpinaBifida- a birth defect of the spinal cord resulting in paralysis, bowel & bladder problems and other medical complications. Zackary is confined to a wheelchair; He suffers with infections of the kidney and bladder. He uses a catheter to help him go to the bathroom. Zackary has difficulty moving about the family's small trailer they reside in. Aiden Torres age 2 of Port Ewen, NY (ACCFCB support- $1,054) Aiden was born on Thanksgiving 2009 with Gastroschesis (Intestines outside of his body) and remained in Albany Medical Center's Neonatal ICU since birth. He was released from the hospital on March 22, 2010 after a 117 day stay only to be re-admitted for 23 more days to undergo more surgery and procedures. Aiden is doing very well these days with only slight complications. Max Kelsey age 3 of Cohoes, NY (ACCFCB support- $508) Max suffers with Down Syndrome. He and mom traveled to Boston Children's Hospital to see a pediatric eye specialist due to being nearly blind in one eye. Max had an unsuccessful surgery locally and this trip was for a second opinion. We covered all travel expenses for their trip to Boston. Logan Siciliano age 1 of Latham, NY (ACCFCB support- $331) Note: ACCFCB met family at the end of 2011. Logan was diagnosed with Marfan Syndrome (MFS), a genetic disorder of connective tissue which holds all parts of the body together and helps control growth. MFS affects the heart, blood vessels, bones, joints, eyes, lungs and skin. He was born with leaky heart valves and an enlarged aorta causing congestive heart failure. Logan underwent open heart surgery on September 1, 2011 at Boston Children's Hospital to repair 3 valves and replace part of his stretched aorta. Logan is nearsighted and recently received his first pair of glasses. He is stable and we plan to follow up with Logan's family in 2012. Foundation Expenses- 1 year cell phone 518-588-5055- $1,014; Laptop Computer- $1,166; Misc Expenses (meetings, supplies)- $696 American Heart Association (ACCFCB donated $200) Albany County Correctional Facility for Children's Benefit, Inc's above support total for 2011- $39,458 ACCFCB's 2011 'Teed off for Tots' golf event raised $17,077 Albany County Employees donated $14,552 directly from their paychecks to ACCFCB in 2011! The Albany County Correctional Facility staff continues to be ACCFCB's 'Bread and Butter' supporters. We are also very grateful to all of our supporters for which we couldn't do what we do without all of you!
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.