Form990-EZ
Click to see attachment
Department of the Treasury
Internal Revenue Service
Short Form
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code
(except black lung benefit trust or private foundation)
bullet Sponsoring organizations of donor advised funds, organizations that operate one or more hospital facilities, and certain controlling organizations as defined in section 512(b)(13) must file Form 990 (see instructions).
All other organizations with gross receipts less than $200,000 and total assets less than $500,000 at the end of the year may use this form.
bulletThe organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-1150
2011
Open to Public
Inspection
A
For the 2011 calendar year, or tax year beginning 01-01-2011, and ending 12-31-2011
B
Check if applicable:
C Name of organization
DOWN SYNDROME ASSN OF NE INDIANA
 
Number and street (or P. O. box, if mail is not delivered to street address)PO BOX 13611
 
Room/suite
City or town, state or country, and ZIP + 4 FORT WAYNE, IN46865
D Employer identification number

35-2096448
E Telephone number

(260) 471-9964
F Group Exemption
Number. . bullet  
G Accounting method: Other (specify) bullet   H Check bulletI Website:bulletWWW.DSANI.ORGJ Tax-Exempt status(check only one)—Click to see attachment(   ) bullet(insert no.) or
K Check bullet A Form 990-EZ or Form 990 return is not required though Form 990-N (e-postcard) may be required (see instructions). But if the organization chooses to file a return, be sure to file a complete return.
L Add lines 5b, 6c, and 7b, to line 9 to determine gross receipts; If gross receipts are $200,000 or more, or if total assets (Part II, line 25, column (B) below) are $500,000 or more,file Form 990 instead of Form 990-EZ........... bullet $ 72,654
Part IRevenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part I.)Check if the organization used Schedule O to respond to any question in this Part I...........
VerticalRevenue 1 Contributions, gifts, grants, and similar amounts received............... 1 72,209
2 Program service revenue including government fees and contracts ............ 2  
3 Membership dues and assessments...................... 3 358
4 Investment income........................... 4 87
5a Gross amount from sale of assets other than inventory........ 5a  
b Less: cost or other basis and sales expenses........... 5b  
c Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) ...... 5c  
6 Gaming and fundraising events
a Gross income from gaming (attach Schedule G if greater than $15,000) . 6a  
b Gross income from fundraising events (not including $   of contributions
from fundraising events reported on line 1) (attach Schedule G if the
sum of such gross income and contributions exceeds $15,000) 6b  
c Less: direct expenses from gaming and fundraising events....... 6c  
d Net income or (loss) from gaming and fundraising events (Add lines 6a and 6b and subtract line 6c) 6d  
7a Gross sales of inventory, less returns and allowances........ 7a  
b Less: cost of goods sold................. 7b  
c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) ......... 7c  
8 Other revenue (describe in Schedule O) ..................... 8  
9 Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8................. 9 72,654
VerticalExpenses 10 Grants and similar amounts paid (list in Schedule O) ................. 10 6,725
11 Benefits paid to or for members........................ 11  
12 Salaries, other compensation, and employee benefits................ 12 16,015
13 Professional fees and other payments to independent contractors............ 13 1,676
14 Occupancy, rent, utilities, and maintenance................... 14  
15 Printing, publications, postage, and shipping................... 15 3,986
16 Other expenses (describe in Schedule O) .................... 16 44,017
17 Total expenses. Add lines 10 through 16 .................... 17 72,419
VerticalNetAssets 18 Excess or (deficit) for the year (Subtract line 17 from line 9)............ 18 235
19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with
end-of-year figure reported on prior year’s return)................ 19 128,044
20 Other changes in net assets or fund balances (explain in Schedule O) .......... 20  
21 Net assets or fund balances at end of year. Combine lines 18 through 20.........Bullet 21 128,279
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 10642I Form 990-EZ (2011)
Form 990-EZ (2011)
Page 2
Part IIBalance Sheets (see the instructions for Part II.)Check if the organization used Schedule O to respond to any question in this Part II.............

(See the instructions for Part II.)(A) Beginning of year(B) End of year
22Cash, savings, and investments................
126,943
22
127,459
23Land and buildings....................
 
23
 
24Other assets (describe in Schedule O) ..........
1,101
24
820
25Total assets......................
128,044
25
128,279
26
Total liabilities (describe in Schedule O) .............
 
26
 
27Net assets or fund balances (line 27 of column (B) must agree with line 21)..
128,044
27
128,279
Part IIIStatement of Program Service Accomplishments (see the instructions for Part III.) Check if the organization used Schedule O to respond to any question in this Part III . Expenses
(Required for section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts; optional for others.)
What is the organization's primary exempt purpose? THE MISSION OF THE DOWN SYNDROME ASSOCIATION OF NORTHEAST INDIANA, INC. IS TO ENHANCE THE LIVES OF PEOPLE AFFECTED BY DOWN SYNDROME,TO ADVOCATE ON THEIR BEHALF, TO PROVIDE INFORMATION AND SUPPORT TO FAMILIES AND PROFESSIONALS, AND TO PROMOTE ACCEPTANCE AND INCLUSION OF PEOPLE WITH DOWN SYNDROME IN NORTHEAST INDIANA.
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. In a clear and concise manner, describe the services provided, the number of persons benefited, and other relevant information for each program title.
28 THE DOWN SYNDROME ASSOCIATION OF NORTHEAST INDIANA, INC. SERVED 195 MEMBER FAMILIES AND PROFESSIONALS BY PROVIDING SUPPORT IN THE FOLLOWING AREAS: DSANI STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS 2011 INFANT-TODDLER PLAYGROUPS: THE PLAYGROUP CREATES OPPORTUNITIES FOR INFANTS AND YOUNGSTERS THROUGH KINDERGARTEN TO PLAY AND SOCIALIZE WHILE THEIR PARENTS AND SIBLINGS FIND SUPPORT IN A FUN ENVIRONMENT. 63 FAMILIES ON GROUP'S E-MAIL LIST ACTIVITIES INCLUDED: MONTHLY PLAYGROUPS IN A HOME,AVERAGE ATTENDANCE-8 FAMILIES WEEKLY SUMMER POOL PARTIES AT NORTH SIDE PARK, AVERAGE ATTENDANCE 8 FAMILIES GYMNASTICS CLASSES - 10 CHILDREN FALL OUTING WITH BUDDY CLUB-STEEL FARMS FAMILY PARTY AT ANDORFER COMMONS ALONG WITH BUDDY CLUB - 75 PEOPLE BUDDY CLUB: THIS GROUP OFFERS SOCIAL AND RECREATIONAL ACTIVITIES FOR CHILDREN 6 TO 12, AND TYPICALLY MEETING EVERY THREE MONTHS. CURRENT AVERAGE ATTENDANCE - 24, INCLUDING FAMILY MEMBERS. ACTIVITIES INCLUDED: ANDORFER COMMONS PARTY WITH INFANT PROGRAM. BUCKNER PARK PICNIC - 25 PEOPLE SWIM PARTY AT MIHUIC POOL - 6 FAMILIES STEEL FARM TOUR WITH INFANT GROUP, 80 PEOPLE FRIENDSHIP CLUB: AIMED AT TEENS AND YOUNG ADULTS, AGES 12 TO 21. THIS GROUP INCLUDES TEENS WITH DOWN SYNDROME AND OTHER LEARNING DISABILITIES, AS YOUTHS WITH DOWN SYNDROME DEVELOP FRIENDSHIPS IN SCHOOL AND THE COMMUNITY. AVERAGE ATTENDANCE FOR EVENTS 25-30 TEENS. ACTIVITIES INCLUDED: ST. PATRICK'S DAY DANCE 31 TEENS VALENTINE'S DAY DANCE - 38 TEENS FAMILY GYM NIGHT SEMI-FORMAL DINNER DANCE - 42 TEENS BACK TO SCHOOL PIZZA PARTY - 20 TEENS HALLOWEEN PARTY AND DANCE - 30 TEENS HOLIDAY PARTY - 67 PEOPLE SELF-ADVOCATES: INDIVIDUALS WITH DOWN SYNDROME WHO ARE 21 AND OLDER. AVERAGE ATTENDANCE FOR SOCIAL EVENTS - 15. ACTIVITIES INCLUDED: MAD ANTS BASKETBALL GAME- 28 SWIM PARTY - 10 HOLIDAY PARTY - 24 VOLUNTEERED AT NIDAC EVENT ATTENDED JESTERS PROGRAM PIZZA PARTY & BUDDY WALK CRAFTMAKING ATTENDED SEMI-FORMAL DANCE HOSTED BY FRIENDSHIP CLUB SENT REPRESENTATIVE TO BUDDY WALK ON WASHINGTON GRANDPARENTS GROUP: THIS GROUP OFFERS A WONDERFUL OPPORTUNITY FOR GRANDPARENTS TO SUPPORT FAMILY MEMBERS AND EACH OTHER IN A NURTURING CARING ENVIRONMENT. ACTIVITIES INCLUDED: 3 OFFICIAL MEETINGS - 7 TO 10 IN ATTENDANCE ASSISTED AT BUDDY WALK- 20 MEMBERS DADS GROUP: DADS APPRECIATING DOWN SYNDROME. THIS GROUP PROVIDES SPECIAL EVENTS TO BRING TOGETHER DADS IN SUPPORT OF EACH OTHER AND TO BUILD STRONG FAMILIES. AVERAGE ATTENDANCE - 10-13 DADS. EVENTS INCLUDED: MARCH MADNESS BASKETBALL EVENT SPONSORED 9TH ANNUAL STEWART GOLF OUTING WITH 10 TEAMS OUTREACH PROGRAM: OUTREACH EFFORTS INCLUDED UPDATING OUR EXPECTANT AND NEW PARENT PACKETS, CHANGING TO A REFERRAL PROGRAM AND DELIVERING THESE RESOURCES TO FAMILIES OF NEWLY DIAGNOSED BABIES WITH DOWN SYNDROME. OUTREACH VOLUNTEERS HELP PARENTS CONNECT WITH COMMUNITY SERVICES SUCH AS FIRST STEPS AND MEDICAID WAIVER. ALONG WITH PROVIDING INFORMATION, DSANI PARTICIPATED IN DOWN SYNDROME AWARENESS AND BUDDY WALK INFORMATION DAY AT FORT WAYNE TINCAPS GAME. PROGRAM EVENTS: IN ADDITION TO THE SPECIAL-INTEREST OR AGE-SPECIFIC ACTIVITIES THAT DSANI SPONSORED IN 2011 A NUMBER OF OTHER PROGRAMS MET WITH GREAT SUCCESS. EVENTS INCLUDED: DSANI ANNUAL MEETING WITH KEYNOTE SPEAKER MICHAEL REMUS - 80 ATTENDED DSANI FAMILY NIGHT, MAD ANTS BASKETBALL GAME WORKSHOP WITH MICHAEL REMUS "MORE THAN SHARED CLASSROOM:EDUCATING KIDS WITH AND WITHOUT DISABILITIES TOGETHER SUCCESSFULLY". SPONSORED WITH ST. FRANCIS UNIVERSITY; 50 ATTENDEES. SPONSORED NIDAC ABILITIES ABOUND RECEPTION WITH PARALYMPIAN MARK WELLMAN 120 ATTENDEES SPONSORED AND PARTICIPATED IN DISABILITIES EXPO. 105 EXHIBITORS AND APPROXIMATELY 1100 ATTENDESS PARENTS NIGHT OUT, 8 COUPLES ATTENDED DSANI FAMILY ZOO DAY- 95 TICKETS DISTRIBUTED SPONSORED CAMP RED CEDAR WITH PARTIAL SCHOLORSHIPS FOR 35 CHILDREN DSANI FAMILY OUTING- TIN CAPS BASEBALL GAME- 121 ATTENDEES 13TH ANNUAL BUDDY WALK--APPROXIMATELY 1200 PARTICIPANTS INCLUDING 110 VOLUNTEERS SPONSORED "ANITA IN ARGENTINA" MOVIE AT CINEMA CENTER WITH FORT WAYNE JEWISH FEDERATION- 50 ATTENDEES DSANI ANNUAL HOLIDAY PARTY - 150 FAMILY MEMBERS ALONG WITH OUR MANY GROUPS AND PROGRAMS, DSANI ALSO PROVIDES: A QUARTLY NEWSLETTER DISTRIBUTED TO 575 ADDRESSES ON MAILING LIST FAMILY DIRECTORY DISTRIBUTED TO FAMILIES AND PROFESSIONALS - 300 LIBRARY RESOURCES WEBSITE-UPDATED IN 2011 MONTHLY MEMBER ALERTS SENT THROUGH EMAIL FACEBOOK PAGE WITH CALENDAR OF EVENTS, UPDATES AND INFORMATION SUPPORTED FORD IRONMAN LOUISVILLE COMPETITION TO BRING AWARENESS OF DOWN SYNDROME PARTICIPATED IN KNIGHTS OF COLUMBUS ANNUAL TOOTSIE ROLL DRIVE SUPPORT SPECIAL OLYMPICS IN SEVERAL COUNTIES PARTICIPATED IN LEGISLATIVE FORUM SPONSORED SCOUTS DISABILITES AWARENESS DAY PARTICPATED IN MED TECH COLLEGE CAREER FAIR
(Grants $   ) If this amount includes foreign grants, check here ...MediumBullet
28a 58,642
29
(Grants $   ) If this amount includes foreign grants, check here ...MediumBullet
29a
30
(Grants $   ) If this amount includes foreign grants, check here ...MediumBullet
30a
31 Other program services (describe in Schedule O) ..................
(Grants $   ) If this amount includes foreign grants, check here...MediumBullet
31a
32 Total program service expenses (add lines 28a through 31a)..............bullet 32 58,642
Part IV List of Officers, Directors, Trustees, and Key Employees. List each one even if not compensated. (see the instructions for Part IV.)Check if the organization used Schedule O to respond to any question in this Part IV..........
(a) Name and title (b) Average
hours per week
devoted to position
(c)Reportable compensation
(Forms W-2/1099-MISC)
(if not paid, enter -0-)
(d) Health benefits, contributions to employee benefit plans,
and deferred compensation
(e) Estimated amount
of other compensation
STEVE EHINGERClick to see attachment
PO BOX 13611
FORT WAYNE,IN46865
PRESIDENT1.00 0    
JEFF ZINNClick to see attachment
PO BOX 13611
FORT WAYNE,IN46865
DIRECTOR1.00 0    
JENNIFER BOENClick to see attachment
PO BOX 13611
FORT WAYNE,IN46865
DIRECTOR1.00 0    
LISA TEETSClick to see attachment
P O BOX 13611
FORT WAYNE,IN46865
TREASURER1.00 0    
TOM RITA O'NEILLClick to see attachment
PO BOX 13611
FORT WAYNE,IN46865
SR ADVISORS2.00 0    
BRANDI BUCKClick to see attachment
PO BOX 13611
FORT WAYNE,IN46865
DIRECTOR1.00 0    
DEBBIE GAVETTEClick to see attachment
PO BOX 13611
FORT WAYNE,IN46865
DIRECTOR1.00 0    
CHRIS FLEISCHERClick to see attachment
PO BOX 11361
FORT WAYNE,IN46865
VICE PRESIDE1.00 0    
KATHY MEEKSClick to see attachment
PO BOX 13611
FORT WAYNE,IN46865
SECRETARY1.00 0    
SHERYL STERNALClick to see attachment
PO BOX 13611
FORT WAYNE,IN46865
DIRECTOR1.00 0    
LAURA LAHRMANClick to see attachment
PO BOX 13611
FORT WAYNE,IN46865
DIRECTOR1.00 0    
KIMBERLY MCCOYClick to see attachment
PO BOX 13611
FORT WAYNE,IN46865
ADMIN DIRECT20.00 14,877    
Form 990-EZ (2011)
Form 990-EZ (2011)
Page 3
Part VOther Information(Note the Schedule A and personal benefit contract statement requirements in the instructions for Part V.) Check if the organization used Schedule O to respond to any question in this Part V
Yes
No
33
Did the organization engage in any significant activity not previously reported to the IRS? If "Yes," provide a detailed description of each activity in Schedule O ...................
33
 
No
34
Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the amended documents if they reflect a change to the organization’s name. Otherwise, explain the changeon Schedule O (see instructions). ..........................
34
 
No
35a
Did the organization have unrelated business gross income of $1,000 or more during the year from business activities (such as those reported on lines 2, 6a, and 7a, among others)? ............
35a
 
No
b
If ‘Yes’ to line 35a, has the organization filed a Form 990-T for the year? If ‘No,’ provide an explanation in Schedule O.
35b
 
 
c
Was the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e) notice, reporting, and proxy tax requirements during the year? If "Yes," complete Schedule C, Part III.
35c
 
No
36
Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If “Yes,” complete applicable parts of Schedule N ................
36
 
No
37a
Enter amount of political expenditures, direct or indirect, as described in the instructions. bullet
37a
 
b
Did the organization file Form 1120-POL for this year?...................
37b
 
No
38a
Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were
any such loans made in a prior year and still outstanding at the end of the tax year covered by this return?..
38a
 
No
b
If “Yes,” complete Schedule L, Part II and enter the total amount involved .
38b
 
39
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on line 9.......
39a
 
b
Gross receipts, included on line 9, for public use of club facilities.....
39b
 
40a
Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under:
section 4911 bullet   ; section 4912 bullet   ; section 4955 bullet  
b
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefittransaction during the year or did it engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I. ......
40b
 
No
c
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and 4958...bullet  
d
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimbursed by the organization....................bullet  
e
All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? If "Yes," complete Form 8886-T. ......................
40e
 
No
41List the states with which a copy of this return is filed. bulletIN
42aThe organization's books are in care of bulletLISA TEETS Telephone no. bullet (260) 471-9964
Located at bullet4202 PIPER DRIVE
FORT WAYNE,IN
ZIP + 4bullet46809
b
At any time during the calendar year, did the organization have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)?
Yes
No
42b
 
No
If “Yes,” enter the name of the foreign country: bullet  
See the instructions for exceptions and filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
c
At any time during the calendar year, did the organization maintain an office outside the U.S.?
42c
 
No
If “Yes,” enter the name of the foreign country: bullet  
43.......bullet
and enter the amount of tax-exempt interest received or accrued during the tax year....bullet43
 
Yes
No
44a
Did the organization maintain any donor advised funds during the year? If "Yes," Form 990 must be completed instead of
Form 990-EZ.................................
44a
 
No
b
Did the organization operate one or more hospital facilities during the year? If ‘Yes,’ Form 990 must be completedinstead of Form990-EZ.............................
44b
 
No
c
Did the organization receive any payments for indoor tanning services during the year?.........
44c
 
No
d
If 'Yes' to line 44c, has the organization filed a Form 720 to report these payments? If ‘No,’ provide an explanationin Schedule O................................
44d
 
 
45a
Did the organization have a controlled entity within the meaning of
section 512(b)(13)?............................
45a
 
No
45b
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," Form 990 and Schedule R may need to be completed instead of Form990-EZ (see instructions).....................
45b
 
No
Form 990-EZ (2011)
Form 990-EZ (2011)
Page 4
Yes
No
46
Did the organization engage, directly or indirectly, in political campaign activities on behalf of or in opposition tocandidates for public office? If “Yes,” complete Schedule C, Part I. ..............
46
 
No
Part VI
Section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts only. All section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts must answer questions 47-49b and 52. Check if the organization used Schedule O to respond to any question in this Part VI ...........
Yes
No
47
Did the organization engage in lobbying activities or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II .......................
47
 
No
48
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E ....
48
 
No
49a
Did the organization make any transfers to an exempt non-charitable related organization?......
49a
 
No
b
If "Yes," was the related organization a section 527 organization?................
49b
 
 
50
Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key employees) who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and title of each employee paid more than $100,000 (b) Average
hours per week
devoted to position
(c) Reportable compensation
(Forms W-2/1099-MISC)
(d) Health benefits, contributions to employee benefit plans, and deferred compensation (e) Estimated amount of other compensation
NONE
f
Total number of other employees paid over $100,000 .................bullet  

51
Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and address of each independent contractor paid more than $100,000 (b) Type of service (c) Compensation
NONE
d
Total number of other independent contractors each receiving over $100,000..........bullet  
52
Did the organization complete Schedule A? NOTE:All Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A .....................
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid preparer use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
Firm's address Right pointing arrowhead image



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
Form 990-EZ (2011)

Additional Data


Software ID:  
Software Version:  

Form 990-EZ, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

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.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
DOWN SYNDROME ASSN OF NE INDIANA
 
Employer identification number

35-2096448
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
f
g
(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
(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.") .... 78,441 67,853 95,425 76,487 72,567 390,773
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.. 78,441 67,853 95,425 76,487 72,567 390,773
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)..           11,296
6 Public Support. Subtract line 5 from line 4.           379,477
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.. 78,441 67,853 95,425 76,487 72,567 390,773
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 1,309 159 143 116 87 1,814
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).           392,587
12
12
358
13
Section C. Computation of Public Support Percentage
14
14
96.660 %
15
15
98.110 %
16a
b
17a
b
18
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.") .            
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) 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.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
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:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2011
Name of organization
DOWN SYNDROME ASSN OF NE INDIANA
 
Employer identification number

35-2096448
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 2
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
DOWN SYNDROME ASSN OF NE INDIANA
 
Employer identification number

35-2096448
Part I
Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
DOWN SYNDROME ASSN OF NE INDIANA
 
Employer identification number

35-2096448
Part II
Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
     
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions).
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions).
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions).
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions).
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions).
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions).
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 4
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
DOWN SYNDROME ASSN OF NE INDIANA
 
Employer identification number

35-2096448
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  

Use duplicate copies of Part III if additional space is needed
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data


Software ID:  
Software Version:  
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.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
DOWN SYNDROME ASSN OF NE INDIANA
 
Employer identification number

35-2096448
Identifier Return Reference Explanation
PAYMENTS TO AFFILIATES FORM 990-EZ, PART I, LINE 10 NATIONAL DOWN SYNDROME ASSOCIATION BUDDY WALK LICENSE 6,725
OTHER EXPENSES FORM 990-EZ, PART I, LINE 16 EXPENSES BUDDY WALK ON DC 1,666 ANNUAL MEETING 4,882 STRATEGIC PLANNING MEETING 80 PROPERTY/LIABILITY INSURANCE 1,234 WORKERS COMPENSATION INSURANC 333 D&O LIABILITY INSURANCE 800 OFFICE SUPPLIES 497 INTERNET/WEBSITE 4,784 TELEPHONE 798 BUDDY WALK EXPENSES 15,218 NEW PARENT PACKETS/OUTREA 280 PROGRAM EXPENSES 11,625 FEES 300 OFFICE EQUIPMENT MTCE 537 OTHER OFFICE 702 NON-INVESTMENT DEPRECIATION 281 TOTAL 44,017
OTHER CHANGES IN NET ASSETS OR FUND BALANCES FORM 990-EZ, PART I, LINE 20 ROUNDING 0
OTHER ASSETS FORM 990-EZ, PART II, LINE 24 22,776 22,776 LESS ACCUMULATED DEPRECIATION 21,675 21,956 TOTAL 1,101 820
PRIMARY EXEMPT PURPOSE FORM 990-EZ, PART III THE MISSION OF THE DOWN SYNDROME ASSOCIATION OF NORTHEAST INDIANA, INC. IS TO ENHANCE THE LIVES OF PEOPLE AFFECTED BY DOWN SYNDROME,TO ADVOCATE ON THEIR BEHALF, TO PROVIDE INFORMATION AND SUPPORT TO FAMILIES AND PROFESSIONALS, AND TO PROMOTE ACCEPTANCE AND INCLUSION OF PEOPLE WITH DOWN SYNDROME IN NORTHEAST INDIANA.
FIRST ACCOMPLISHMENT FORM 990-EZ, PART III, LINE 28 THE DOWN SYNDROME ASSOCIATION OF NORTHEAST INDIANA, INC. SERVED 195 MEMBER FAMILIES AND PROFESSIONALS BY PROVIDING SUPPORT IN THE FOLLOWING AREAS: DSANI STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS 2011 INFANT-TODDLER PLAYGROUPS: THE PLAYGROUP CREATES OPPORTUNITIES FOR INFANTS AND YOUNGSTERS THROUGH KINDERGARTEN TO PLAY AND SOCIALIZE WHILE THEIR PARENTS AND SIBLINGS FIND SUPPORT IN A FUN ENVIRONMENT. 63 FAMILIES ON GROUP'S E-MAIL LIST ACTIVITIES INCLUDED: MONTHLY PLAYGROUPS IN A HOME,AVERAGE ATTENDANCE-8 FAMILIES WEEKLY SUMMER POOL PARTIES AT NORTH SIDE PARK, AVERAGE ATTENDANCE 8 FAMILIES GYMNASTICS CLASSES - 10 CHILDREN FALL OUTING WITH BUDDY CLUB-STEEL FARMS FAMILY PARTY AT ANDORFER COMMONS ALONG WITH BUDDY CLUB - 75 PEOPLE BUDDY CLUB: THIS GROUP OFFERS SOCIAL AND RECREATIONAL ACTIVITIES FOR CHILDREN 6 TO 12, AND TYPICALLY MEETING EVERY THREE MONTHS. CURRENT AVERAGE ATTENDANCE - 24, INCLUDING FAMILY MEMBERS. ACTIVITIES INCLUDED: ANDORFER COMMONS PARTY WITH INFANT PROGRAM. BUCKNER PARK PICNIC - 25 PEOPLE SWIM PARTY AT MIHUIC POOL - 6 FAMILIES STEEL FARM TOUR WITH INFANT GROUP, 80 PEOPLE FRIENDSHIP CLUB: AIMED AT TEENS AND YOUNG ADULTS, AGES 12 TO 21. THIS GROUP INCLUDES TEENS WITH DOWN SYNDROME AND OTHER LEARNING DISABILITIES, AS YOUTHS WITH DOWN SYNDROME DEVELOP FRIENDSHIPS IN SCHOOL AND THE COMMUNITY. AVERAGE ATTENDANCE FOR EVENTS 25-30 TEENS. ACTIVITIES INCLUDED: ST. PATRICK'S DAY DANCE 31 TEENS VALENTINE'S DAY DANCE - 38 TEENS FAMILY GYM NIGHT SEMI-FORMAL DINNER DANCE - 42 TEENS BACK TO SCHOOL PIZZA PARTY - 20 TEENS HALLOWEEN PARTY AND DANCE - 30 TEENS HOLIDAY PARTY - 67 PEOPLE SELF-ADVOCATES: INDIVIDUALS WITH DOWN SYNDROME WHO ARE 21 AND OLDER. AVERAGE ATTENDANCE FOR SOCIAL EVENTS - 15. ACTIVITIES INCLUDED: MAD ANTS BASKETBALL GAME- 28 SWIM PARTY - 10 HOLIDAY PARTY - 24 VOLUNTEERED AT NIDAC EVENT ATTENDED JESTERS PROGRAM PIZZA PARTY & BUDDY WALK CRAFTMAKING ATTENDED SEMI-FORMAL DANCE HOSTED BY FRIENDSHIP CLUB SENT REPRESENTATIVE TO BUDDY WALK ON WASHINGTON GRANDPARENTS GROUP: THIS GROUP OFFERS A WONDERFUL OPPORTUNITY FOR GRANDPARENTS TO SUPPORT FAMILY MEMBERS AND EACH OTHER IN A NURTURING CARING ENVIRONMENT. ACTIVITIES INCLUDED: 3 OFFICIAL MEETINGS - 7 TO 10 IN ATTENDANCE ASSISTED AT BUDDY WALK- 20 MEMBERS DADS GROUP: DADS APPRECIATING DOWN SYNDROME. THIS GROUP PROVIDES SPECIAL EVENTS TO BRING TOGETHER DADS IN SUPPORT OF EACH OTHER AND TO BUILD STRONG FAMILIES. AVERAGE ATTENDANCE - 10-13 DADS. EVENTS INCLUDED: MARCH MADNESS BASKETBALL EVENT SPONSORED 9TH ANNUAL STEWART GOLF OUTING WITH 10 TEAMS OUTREACH PROGRAM: OUTREACH EFFORTS INCLUDED UPDATING OUR EXPECTANT AND NEW PARENT PACKETS, CHANGING TO A REFERRAL PROGRAM AND DELIVERING THESE RESOURCES TO FAMILIES OF NEWLY DIAGNOSED BABIES WITH DOWN SYNDROME. OUTREACH VOLUNTEERS HELP PARENTS CONNECT WITH COMMUNITY SERVICES SUCH AS FIRST STEPS AND MEDICAID WAIVER. ALONG WITH PROVIDING INFORMATION, DSANI PARTICIPATED IN DOWN SYNDROME AWARENESS AND BUDDY WALK INFORMATION DAY AT FORT WAYNE TINCAPS GAME. PROGRAM EVENTS: IN ADDITION TO THE SPECIAL-INTEREST OR AGE-SPECIFIC ACTIVITIES THAT DSANI SPONSORED IN 2011 A NUMBER OF OTHER PROGRAMS MET WITH GREAT SUCCESS. EVENTS INCLUDED: DSANI ANNUAL MEETING WITH KEYNOTE SPEAKER MICHAEL REMUS - 80 ATTENDED DSANI FAMILY NIGHT, MAD ANTS BASKETBALL GAME WORKSHOP WITH MICHAEL REMUS "MORE THAN SHARED CLASSROOM:EDUCATING KIDS WITH AND WITHOUT DISABILITIES TOGETHER SUCCESSFULLY". SPONSORED WITH ST. FRANCIS UNIVERSITY; 50 ATTENDEES. SPONSORED NIDAC ABILITIES ABOUND RECEPTION WITH PARALYMPIAN MARK WELLMAN 120 ATTENDEES SPONSORED AND PARTICIPATED IN DISABILITIES EXPO. 105 EXHIBITORS AND APPROXIMATELY 1100 ATTENDESS PARENTS NIGHT OUT, 8 COUPLES ATTENDED DSANI FAMILY ZOO DAY- 95 TICKETS DISTRIBUTED SPONSORED CAMP RED CEDAR WITH PARTIAL SCHOLORSHIPS FOR 35 CHILDREN DSANI FAMILY OUTING- TIN CAPS BASEBALL GAME- 121 ATTENDEES 13TH ANNUAL BUDDY WALK--APPROXIMATELY 1200 PARTICIPANTS INCLUDING 110 VOLUNTEERS SPONSORED "ANITA IN ARGENTINA" MOVIE AT CINEMA CENTER WITH FORT WAYNE JEWISH FEDERATION- 50 ATTENDEES DSANI ANNUAL HOLIDAY PARTY - 150 FAMILY MEMBERS ALONG WITH OUR MANY GROUPS AND PROGRAMS, DSANI ALSO PROVIDES: A QUARTLY NEWSLETTER DISTRIBUTED TO 575 ADDRESSES ON MAILING LIST FAMILY DIRECTORY DISTRIBUTED TO FAMILIES AND PROFESSIONALS - 300 LIBRARY RESOURCES WEBSITE-UPDATED IN 2011 MONTHLY MEMBER ALERTS SENT THROUGH EMAIL FACEBOOK PAGE WITH CALENDAR OF EVENTS, UPDATES AND INFORMATION SUPPORTED FORD IRONMAN LOUISVILLE COMPETITION TO BRING AWARENESS OF DOWN SYNDROME PARTICIPATED IN KNIGHTS OF COLUMBUS ANNUAL TOOTSIE ROLL DRIVE SUPPORT SPECIAL OLYMPICS IN SEVERAL COUNTIES PARTICIPATED IN LEGISLATIVE FORUM SPONSORED SCOUTS DISABILITES AWARENESS DAY PARTICPATED IN MED TECH COLLEGE CAREER FAIR
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  

TY 2011 CompensationExplanation
Name:
DOWN SYNDROME ASSN OF NE INDIANA
EIN: 35-2096448
Person Name Explanation
STEVE EHINGER  
JEFF ZINN  
JENNIFER BOEN  
LISA TEETS  
TOM RITA ONEILL  
BRANDI BUCK  
DEBBIE GAVETTE  
CHRIS FLEISCHER  
KATHY MEEKS  
SHERYL STERNAL  
LAURA LAHRMAN  
KIMBERLY MCCOY