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
SERV CENTERS OF NEW JERSEY INC
Employer identification number
22-2090976
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) 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.") ....
12,547,336
14,186,059
14,529,623
14,937,486
15,009,334
71,209,838
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..
12,547,336
14,186,059
14,529,623
14,937,486
15,009,334
71,209,838
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.
71,209,838
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..
12,547,336
14,186,059
14,529,623
14,937,486
15,009,334
71,209,838
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9,516
5,432
2,962
8,356
8,531
34,797
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..
250
250
11
Total support (Add lines 7 through 10).
71,244,885
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
99.950 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
99.950 %
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, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISC. INCOME
Schedule A (Form 990 or 990-EZ) 2010
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
2010
Open to Public Inspection
Name of the organization
SERV CENTERS OF NEW JERSEY INC
Employer identification number
22-2090976
Identifier
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 6
THE SOLE MEMBER OF THE CORPORATION IS SERV BEHAVIORAL HEALTH SYSTEM, INC.
FORM 990, PART VI, SECTION A, LINE 7A
SERV BEHAVIORAL HEALTH SYSTEM INC, THE SOLE MEMBER OF THE ORGANIZATION, ACTING THROUGH ITS BOARD OF DIRECTORS HAS THE SOLE POWER TO APPROVE THE DIRECTORS OF THE ORGANIZATION AND THE SOLE POWER TO REMOVE OFFICERS AND DIRECTORS WITH AND WITHOUT CAUSE.
FORM 990, PART VI, SECTION A, LINE 7B
SERV BEHAVIORAL HEALTH SYSTEMS INC, THE SOLE MEMBER OF THE ORGANIZATION, ACTING THROUGH ITS BOARD OF DIRECTORS HAS THE POWER TO DO THE FOLLOWING: APPROVE THE SELECTION OF THE CHIEF OPERATING OFFICER; AMEND THE CERTIFICATE OF INCORPORATION AND THE BY-LAWS; DISPOSE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION; APPROVE THE ANNUAL AND ANY CAPITAL BUDGET; MERGE, CONSOLIDATE, DISSOLVE OR OTHERWISE CHANGE THE CORPORATE STRUCTURE OF THE ORGANIZATION; APPROVE ALL EXPENDITURES EXCEEDING $50,000 NOT INCLUDED IN THE APROVED BUDGET; SELECT THE ATTORNEY AND APPROVE THE CERTIFIED PUBLIC ACCOUNTANT FOR THE ORGANIZATION; APPROVE THE PURCHASE, SALE, EXCHANGE, CONVEYANCE OR LEASE FOR A TERM IN EXCESS OF THREE YEARS OF REAL ASSETS, THE BORROWING OF MONEY, THE ISSUANCE OF NOTES OR BONDS OR THE REPAYMENT THEREOF WITH INTEREST, AND THE GRANTING OF SUCH PLEDGES, MORTGAGES, OR OTHER SECURITY INTERESTS WITH RESPECT TO PROPERTY AS SHALL BE REQUIRED THEREIN UPON SUCH TERMS AND CONDITIONS AS SHALL HAVE BEEN RECOMMENDED BY THE BOARD OF DIRECTORS; REQUIRE THE CERTIFIED AUDIT OF CORPORATE FUNDS AT ANY TIME; AND AUTHORIZE ANY FUND DRIVE OR SOLICITATION OFFERS.
FORM 990, PART VI, SECTION B, LINE 11
THE CHIEF FINANCIAL OFFICER WILL PERFORM AN INITIAL REVIEW. ONCE THE CFO APPROVES THE DRAFT, THE 990 IS EMAILED TO THE FINANCE COMMITTEE AND BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C
THE ORGANIZATION HAS A COMPLIANCE OFFICER WHO CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE POLICY. THE POLICY COVERS EMPLOYEES, CONTRACTORS AND BOARD MEMBERS. BOARD MEMBERS ARE REQUIRED TO FILL OUT ANNUAL CONFLICT OF INTEREST QUESTIONNAIRES. ANY CONFLICTS ARE DETERMINED BY THE COMPLIANCE OFFICER AND THE COMPLIANCE COMMITTEE. IF A CONFLICT IS DISCOVERED, A CONFLICT MANAGEMENT PLAN IS PUT IN PLACE TO MANAGE THE CONFLICT. IF BOARD MEMBERS AND OFFICERS HAVE ANY CONFLICTS THEY ABSTAIN FROM ANY BOARD VOTES OR DECISIONS WHICH INVOLVE THE CONFLICT. AS EMPLOYEES OF THE ORGANIZATION, THE PRESIDENT AND KEY EMPLOYEES ARE COVERED UNDER THE EMPLOYEE CONFLICT OF INTEREST POLICY. AS SUCH THEY SIGN ANNUAL STATEMENTS AND ARE EXPECTED TO ADHERE TO ALL DISCLOSURE REQUIREMENTS.
FORM 990, PART VI, SECTION B, LINE 15
THE BOARD ANNUALLY MEETS TO DETERMINE AND APPROVE COMPENSATION. COMPENSATION SURVEYS ARE USED TO SHOW COMPARABLE RATES IN THE AREAS SURROUNDING THE ORGANIZATION AND THEN PRESENTED TO THE BOARD. THIS PROCESS COVERS THE CEO OF THE ORGANIZATION AND DISCUSSIONS RELATING TO THE PROCESS ARE DOCUMENTED IN THE BOARD MINUTES. COMPENSATION DECISIONS FOR OTHER OFFICERS, KEY EMPLOYEES AND HIGHLY COMPENSATED EMPLOYEES ARE MADE AT MANAGEMENT'S DISCRETION. MANAGEMENT FOLLOWS A SIMILAR PROCESS TO ENSURE THAT THE COMPENSATION FOR KEY EMPLOYEES AND HIGHLY COMPENSATED EMPLOYEES ARE WITHIN FAIR MARKET RANGE FOR THE INDUSTRY.
FORM 990, PART VI, SECTION C, LINE 19
THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 5:
NET UNREALIZED GAINS ON INVESTMENTS: 55,001.
AUDIT OVERSIGHT:
FORM 990, PAGE 12, PART XII, LINE 2C
THE BOARD OF DIRECTORS FOR THE PARENT, SERV BEHAVIORAL HEALTH SYSTEM, INC., HAS RESPONSIBILITY FOR SELECTION OF AUDITORS AND OVERSIGHT OF THE AUDIT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
HOURS WORKED FOR RELATED ORGANIZATIONS:
FORM 990, PAGE 7, PART VII, COLUMN B
CERTAIN OFFICERS AND HIGHLY COMPENSATED EMPLOYEES OF THE FILING ORGANIZATION WORK VARIOUS HOURS FOR THE ORGANIZATION'S RELATED AFFILIATES. THE HOURS REPORTED ON PART VII, COLUMN B REPRESENT THE HOURS SPENT WORKING FOR THE FILING ORGANIZATION WITH THE REMAINDER OF THE EMPLOYEES' TIME DEVOTED TO AFFILIATE ORGANIZATIONS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.