Attach to Form 990 or Form 990-EZ.
See separate instructions.| (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? |
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| Yes | No | Yes | No | Yes | No | ||||
| (1)
ARIZONA SENIOR ACADEMY |
860748530 | 9 | Yes | Yes | Yes | 621,638 | |||
| Total | 621,638 | ||||||||
| 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. | ||||||
| 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). | ||||||






| 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 | 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.) | ||||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (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.). | ||||||




| Facts And Circumstances Test |
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| Explanation |
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Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
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| FORM 990, PART I, LINE 1: THE ORGANIZATION'S SOLE PURPOSE IS TO SUPPORT THE ARIZONA SENIOR ACADEMY, AN ARIZONA NON-PROFIT CORPORATION, WHICH IS RECOGNIZED AS EXEMPT FROM TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. A PRIMARY RESPONSIBILITY OF THE ORGANIZATION IS TO PROVIDE SPECIFIED SERVICES TO ELDERLY INDIVIDUALS RESIDING AT THE ACADEMY VILLAGE SO THAT SUCH INDIVIDUALS ARE EMPOWERED AND ENABLED TO COLLECTIVELY PROVIDE SERVICES TO PUBLIC ENTITIES AND OTHER TAX-EXEMPT ORGANIZATIONS IN SOUTHERN ARIZONA. IN FURTHERANCE OF THE MISSION AND PURPOSE OF THE ARIZONA SENIOR ACADEMY, PART III OF THIS RETURN OUTLINES SOME OF THE MOST SIGNIFICANT ACTIVITIES. FORM 990, PART III, LINE 1: BYLAWS OF THE ACADEMY SERVICES CORPORATION: ARTICLE 1, SECTION 1, PURPOSES: THIS CORPORATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR CHARITABLE , EDUCATIONAL, SCIENTIFIC AND LITERARY PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE CODE, AND THIS CORPORATION SHALL RECEIVE AND ADMINISTER, EXPEND AND DISPURSE FUNDS EXCLUSIVELY FOR SUCH PURPOSES WITHOUT LIMITATION OF THE FOREGOING, THIS CORPORATION SHALL HAVE THE FOLLOWING PURPOSES: (1) IN ASSOCIATION WITH THE ARIZONA SENIOR ACADEMY, AN ARIZONA NON-PROFIT CORPORATION (SENIOR ACADEMY) , TO PROVIDE HIGH QUALITY FACILITIES AND SERVICES IN THE SOUTHERN ARIZONA AREA TO GIFTED AND STILL PRODUCTIVE RETIRED ELDERLY INDIVIDUALS IN A LEARNING AND PERFORMING COMMUNITY AND TO PROVIDE SUCH ELDERLY INDIVIDUALS WITH THOSE PHYSICAL, HUMAN, AND INTELLECTUAL RESOURCES THAT WILL PROVIDE A FAVORABLE ENVIRONMENT FOR THEIR CONTINUED PRODUCTIVITY. (2) TO ADMINISTER AND PROVIDE MEDICAL AND HEALTHCARE SERVICES TO ELDERLY PERSONS RESIDING IN THE RETIREMENT COMMUNITY KNOWN AS THE ACADEMY VILLAGE. (3)TO ADMINISTER AND PROVIDE OTHER SERVICES THAT MEET THE NEEDS OF ELDERLY INDIVIDUALS RESIDING AT THE ACADEMY VILLAGE. (4) TO PROVIDE CONSULTING SERVICES AND OTHER TYPES OF ASSISTANCE WITH RESPECT TO THE DEVELOPMENT, CONSTRUCTION, MAINTENANCE, AND OPERATION OF THE FACILITIES THAT WILL BE BUILT, MAINTAINED AND OPERATED FOR THE BENEFIT OF THE ELDERLY RESIDENTS WHO RESIDE AT THE ACADEMY VILLAGE. (5) TO PROVIDE SERVICES AND SUPPORT WITH RESPECT TO THE EDUCATIONAL, CHARITABLE, LITERARY AND SCIENTIFIC PROGRAMS AND ACTIVITIES OF THE SENIOR ACADEMY. (6)TO HAVE SUCH OTHER PURPOSES WITHIN THE GENERAL CHARITABLE, EDUCATIONAL, SCIENTIFIC, AND LITERARY PURPOSES OF THIS CORPORATION AS MAY BE DETERMINED BY THE BOARD OF DIRECTORS OF THIS CORPORATION. ALL SERVICES AND THE RIGHTS TO USE FACILITIES PROVIDED BY THIS CORPORATION SHALL BE FURNISHED ON A NONPROFIT BASIS AND SHALL BE DESIGNED TO MEET THE NEEDS OF THE ELDERLY INDIVIDUALS LIVING AT THE ACADEMY VILLAGE AND TO CONTRIBUTE TO THEIR HEALTH, SECURITY AND WELL BEING NOTWITHSTANDING ANY PROVISIONS HEREIN. IN ALL OF ITS POLICIES AND PRODECURES, THIS CORPORATION SHALL ADHERE TO A POLICY OF EQUAL OPPORTUNITY AND SHALL CONDUCT ALL OF ITS ACTIVITIES AND MAKE AVAILABLE ALL OF ITS SERVICES AND FACILITIES IN A MANNER WHICH DOES NOT DESCRIMINATE ON THE BASIS OF RACE, COLOR, CREED, RELIGION, NATIONAL OR ETHNIC ORIGIN, SEX, MARITAL STATUS, OR HANDICAP. FORM 990, PART III, LINE 4d: ACADEMY SERVICES CORPORATION MADE PAYMENTS OF $763 FROM TEMPORARILY RESTRICTED ENDOWMENT EARNINGS TO SUPPORT CONTINUING EDUCATION OF ASSISTED LIVING VILLA STAFF OPERATED BY AFFILIATE AV MEDICAL SERVICES, LLC. IN ADDITION, ACADEMY SERVICES CORPORATION PAID $588 FROM TEMPORARILY RESTRICTED FUNDS TO AFFILIATE AV WELLNESS FOR HOME CARE PROGRAM SUPPORT WHEN ITS RECEIPTS WERE NOT ENOUGH TO COVER EXPENSES. FORM 990, PART VI, SECTION B, LINE 11B: THE MANAGEMENT COMMITTEE REVIEWS THE 990 AND SUBMITS IT TO THE BOARD OF DIRECTORS. ONCE APPROVED BY THE BOARD OF DIRECTORS, IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C: THE POLICY IS PROVIDED TO BOARD MEMBERS, COMMITTEES, OFFICERS, AND KEY STAFF ANNUALLY AND DISCLOSURES ARE REQUIRED AT THAT TIME OR AT ANY TIME DURING THE YEAR WHEN A CONFLICT IS ESTABLISHED. FORM 990, PART VI, SECTION B, LINES 15A AND 15B: NO OFFICERS OR MANAGEMENT RECEIVE COMPENSATION. THE SALARIES OF PROFESSIONAL PERSONNEL (NURSES) ARE REVIEWED ANNUALLY AND COMPARED TO COMMUNITY NORMS. FORM 990, PART VI, SECTION C, LINE 19: THE ORGANIZATION FILES ITS MINUTES, QUARTERLY FINANCIAL REPORTS, ANNUAL FINANCIAL REPORTS, AND IRS FORM 990 WITH SCHEDULES IN A BINDER IN THE CORPORATE OFFICE THAT IS AVAILABLE FOR REVIEW UPON REQUEST FROM A MEMBER OF THE PUBLIC. |
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