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
Central New York Research Corporation
Employer identification number
16-1365231
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
SYRACUSE VA MEDICAL CENTER,
,
SYRACUSE,
NY
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.") ....
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) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(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—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 (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
10000105
Software Version:
2010v3.2
-
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
Central New York Research Corporation
Employer identification number
16-1365231
Identifier
Return Reference
Explanation
SHEDULE J, PART II
INDIVIDUALS IDENTIFIED AS RECEIVING COMPENSATION FROM "RELATED ORGANIZATIONS" IN PART VII OF THE CORE FORM 990 ARE EMPLOYEES OF THE SYRACUSE VA MEDICAL CENTER. COMPENSATION INFORMATION WAS REQUESTED FROM THESE INDIVIDUALS BY THE EXECUTIVE DIRECTOR OF CENTRAL NEW YORK RESEARCH CORPORATION. COMPENSATION AMOUNTS ARE FROM THE 2010 W-2'S. IN ADDITION, THE LISTED INDIVIDUALS WERE UNABLE TO PROVIDE DETAILED INFORMATION ABOUT THEIR BENEFITS. BASED ON THE ESTIMATED FRINGE BENEFIT RATE THAT THE VA OFTEN USES FOR BUDGETARY PURPOSES, CENTRAL NEW YORK RESEARCH CORPORATION ESTIMATES FRINGE BENEFITS FOR LISTED INDIVIDUALS TO BE 30% OF COMPENSATION AND HAS CALCULATED THEM ACCORDINGLY.
SCHEDULE R PART II, COLUMN A
The Syracuse VA Medical Center is related to Central New York Research Corporation. The Organization's have shared employees and facilities. Also, some officers and directors of the Corporation receive compensation from the Syracuse VA Medical Center. The amount of compensation per officer is detailed in Part VII, Column E of the Form 990.
Form 990, Part VI, Line 19
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available
Copies of the tax returns are kept at the Corporation's office. Returns are also avaialbe at http://www.charitiesnys.com.
Form 990, Part VI, Line 11
Form 990, Part VI, Line 11: Form 990 Review Process
The Form 990 is distributed in draft form via e-mail to all board members, any questions are directed to the CFO for further review. Once the CFO receives approvals from all board member the return is finalized.
Form 990, Part VI, Line 4
Form 990, Part VI, Line 4: Description of Significant Changes to Organizational Documents
BY-LAW REVISIONS WERE MADE AND ADOPTED BY THE BOARD OF DIRECTORS IN JANUARY 2011.Article 1: NameThe name of this corporation shall be Central New York Research Corporation (hereinafter referred to as the "Corporation").Article 2: Principal OfficeThe principal office of the Corporation shall be located within the Syracuse VA Medical Center (VAMC) at 800 Irving Avenue, Syracuse, New York 13210. The Corporation may also have offices at such other places as the Board of Directors may from time to time determine.Article 3: PurposeThe Central New York Research Corporation exists to facilitate research and related information sharing that promotes scientific advancement and therapeutic innovation of veteran healthcare. As a nonprofit corporation, its purpose is to provide a flexible funding mechanism that enables research and related functions at the Syracuse VAMC, its affiliated VA medical centers, and/or its affiliated VA community based outpatient clinics. Article 4: DefinitionsCorporation refers to the Central New York Research Corporation or CNYRC.Board refers to the Board of Directors.Director refers to a member of the Board of Directors.Syracuse VAMC refers to the Veterans Administration Medical Center, Syracuse, NY.VA refers to the US Department of Veterans Affairs.Article 5: Board of Directors5.1 General PowersThe property and affairs of the Corporation shall be governed by or under the direction of the Board. All corporate powers except as otherwise provided herein or by law, shall be vested in and exercised by the Board.5.1.1 QuorumA majority of all Directors of the Board shall constitute a quorum for the transaction of business at any meeting of the Board. A majority vote of a quorum shall be the final determination and act of the Board.5.2 DirectorsThe Board of Directors shall consist of no less than seven (7) members, and its composition shall be consistent with sections 5.2.1, 5.2.2, and 5.2.3 of these bylaws.5.2.1 Statutory VA Directors The persons who hold the following positions at Syracuse VAMC shall, by virtue of holding those positions, be Statutory VA Directors of the Corporation: 1)The Medical Center Director 2)The Chief of Staff (COS)3)The Associate Chief of Staff for Research and Development (ACOS/R)During extended times when the positions of Medical Center Director, COS, and/or ACOS/R positions are vacant, those officials who are responsible for carrying out the equivalent responsibilities shall serve on the board until a permanent VA replacement has been appointed.5.2.2 Statutory Non-Federal DirectorsThere shall be no less than two (2) Directors who are not officers or employees of the Federal Government. These Directors shall have backgrounds in business, legal, financial, or medical or scientific expertise of benefit to CNYRC operations. Corporation employees and persons with Federal appointments, with or without compensation, are not eligible to hold these statutory non-Federal positions. 5.2.3 Investigator Directors There shall be no less than two (2) and no more than four (4) Investigator Directors who have appointments, with or without compensation, at the Syracuse VAMC or affiliated VA medical centers. Such Investigator Directors must be actively participating in at least one on-going research project administered by the Corporation at the time of appointment and must continue to be actively engaged in VA research at the Syracuse without a lapse of more than one (1) year. 5.3 Conflict of InterestDirectors, officers and employees shall be subject to the Corporation conflict of interest policy.5.4 NominationsThe Executive Director shall solicit nominations of prospective Board members at any time from any officer of the Corporation and/or any member of the Board and/or any VA Investigator currently active in a VA research program. Such nominations shall be obtained at least eight (8) weeks prior to the end of a Director's term or as needed for a vacant Board
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.