Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
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)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 10-01-2010 and ending 09-30-2011
BCheck if applicable:
CName of organization
CHILD MIND INSTITUTE INC
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
445 PARK AVENUE NO 2ND FL
 
Room/suite
City or town, state or country, and ZIP + 4
NEW YORK, NY10022
D Employer identification number

80-0478843
E Telephone number

G Gross receipts $ 9,115,344
F Name and address of principal officer:
DR HAROLD KOPLEWICZMD
445 PARK AVENUE NO 2ND FL
NEW YORK,NY10022
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.CHILDMIND.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 2009
M State of legal domicile: NY
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: WE ARE DEDICATED TO TRANSFORMING MENTAL HEALTH CARE FOR CHILDREN EVERYWHERE. OUR ORGANIZATION IS COMMITTED TO FINDING MORE EFFECTIVE TREATMENTS FOR CHILDHOOD PSYCHIATRIC AND LEARNING DISORDERS, BUILDING THE SCIENCE OF HEALTHY BRAIN DEVELOPMENT, AND EMPOWERING CHILDREN AND THEIR FAMILIES WITH HELP, HOPE, AND ANSWERS.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 34
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 34
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 26
6 Total number of volunteers (estimate if necessary) .... 6 37
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 8,570,923 8,975,012
9 Program service revenue (Part VIII, line 2g) ......... 0 0
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 2,513 11,131
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 0 -26,536
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 8,573,436 8,959,607
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 690,000
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 879,483 2,132,516
16a Professional fundraising fees (Part IX, column (A), line 11e).... 62,812 130,531
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet934,776    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 1,115,939 3,111,197
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 2,058,234 6,064,244
19 Revenue less expenses. Subtract line 18 from line 12...... 6,515,202 2,895,363
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 6,668,530 9,797,368
21 Total liabilities (Part X, line 26)............ 153,328 386,803
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 6,515,202 9,410,565
Part II
Signature Block
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's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: THE CHILD MIND INSTITUTE IS DEDICATED TO TRANSFORMING MENTAL HEALTH CARE FOR CHILDREN EVERYWHERE. OUR ORGANIZATION IS COMMITTED TO FINDING MORE EFFECTIVE TREATMENTS FOR CHILDHOOD PSYCHIATRIC AND LEARNING DISORDERS, BUILDING THE SCIENCE OF HEALTHY BRAIN DEVELOPMENT, AND EMPOWERING CHILDREN AND THEIR FAMILIES WITH HELP, HOPE, AND ANSWERS.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 1,279,778 including grants of $   ) (Revenue $   )
PUBLIC EDUCATIONTHE CHILD MIND INSTITUTE HAS A PUBLIC EDUCATION MISSION TO PROVIDE AUTHORITATIVE, SCIENCE-BASED INFORMATION AND RESOURCES ABOUT CHILDREN'S MENTAL HEALTH TO PARENTS, EDUCATORS AND OTHER MENTAL HEALTH PROFESSIONALS. CHILDMIND.ORG - THE CHILD MIND INSTITUTE'S WEB SITE CONTAINS A WEALTH OF INFORMATION, NEWS, ADVICE AND STRATEGIES FOR PARENTS, EDUCATORS, AND MENTAL HEALTH PROFESSIONALS DEALING WITH PSYCHIATRIC AND LEARNING DISORDERS IN CHILDREN AND ADOLESCENTS. AN INTERACTIVE SYMPTOM CHECKER AND MENTAL HEALTH GUIDE OFFER THE LATEST THINKING ON COMMON DISORDERS, FROM SYMPTOMS TO TREATMENTS. MENTAL HEALTH EXPERTS FROM INSTITUTIONS AROUND THE COUNTRY OFFER INFORMATION AND INSIGHT ON THEIR SPECIALTIES IN DOZENS OF EDUCATIONAL VIDEOS. FEATURE ARTICLES ADDED AT LEAST WEEKLY DISCUSS ISSUES OF INTEREST TO PARENTS, WHETHER OR NOT THEY HAVE A CHILD WITH A PSYCHIATRIC OR LEARNING DISORDER. BRAINSTORM, A BLOG UPDATED DAILY, OFFERS SUMMARIES OF NEWS, LINKS TO ARTICLES OF INTEREST ELSEWHERE, AND COMMENTARY ON ISSUES RELATED TO CHILDREN'S MENTAL HEALTH. CHILDMIND.ORG HAS PARTNERED WITH DOZENS OF OTHER SITES AND BLOGS TO SHARE CONTENT AND ENLARGE THE FOOTPRINT OF THE ARTICLES AND RESOURCES WE HAVE CREATED, AND A ROBUST SOCIAL MEDIA CAMPAIGN USES FACEBOOK AND TWITTER TO SPREAD THE WORD. SPEAK UP FOR KIDS! - THE CHILD MIND INSTITUTE'S SPEAK UP FOR KIDS IS A GLOBAL CAMPAIGN TO INCREASE PUBLIC AWARENESS OF THE SIGNS AND SYMPTOMS OF PSYCHIATRIC AND LEARNING DISORDERS IN CHILDREN, AND THE IMPORTANCE OF EARLY INTERVENTION THAT CAN TURN AROUND THEIR LIVES. EVERY MAY, DURING NATIONAL CHILDREN'S MENTAL HEALTH AWARENESS WEEK, THE CHILD MIND INSTITUTE WORKS WITH PARTNER ORGANIZATIONS WORLDWIDE TO SPONSOR EVENTS, INCLUDING FREE LECTURES BY PSYCHIATRISTS AND OTHER PROFESSIONALS, OPEN DAYS AT CLINICIANS' OFFICES AND NEUROSCIENCE LABS, EXHIBITIONS ABOUT CHILDREN'S MENTAL HEALTH, SOCIAL MEDIA ACTIVITIES, CLASSROOM WORKSHOPS, AND MORE. OVER THE LAST TWO YEARS, SPEAK UP FOR KIDS HAS HAD HUNDREDS OF THOUSANDS OF PARTICIPANTS "TURNING THE GLOBE GREEN", THE CAMPAIGN'S SIGNATURE COLOR, BY SPREADING THE WORD, GIVING A TALK, OR HOSTING A TALK IN THEIR LOCAL COMMUNITIES OR THROUGH SOCIAL MEDIA TOOLS, SUCH AS FACEBOOK OR TWITTER.ADAM JEFFREY KATZ MEMORIAL LECTURE - DESIGNED TO RAISE AWARENESS AND EDUCATE THE PUBLIC ABOUT ADHD AND DYSLEXIA, THIS ANNUAL LECTURE WAS LAUNCHED BY THE KATZ FAMILY IN 2003 AS A LIVING MEMORIAL TO ADAM KATZ, WHO STRUGGLED WITH BOTH DISORDERS. THE TWO-PART PROGRAM IS HELD EVERY MAY, DURING NATIONAL MENTAL HEALTH MONTH, AND FEATURES A LECTURE BY OR DISCUSSION WITH A LEADING EXPERT IN THE FIELD, AND A CANDID CONVERSATION WITH A CELEBRITY GUEST ABOUT LIVING WITH A MENTAL HEALTH DISORDER. PAST CELEBRITIES HAVE INCLUDED ACTOR ORLANDO BLOOM AND ACTRESS AND PRODUCER TRUDIE STYLER.ON THE SHOULDER OF GIANTS - EACH YEAR, THE CHILD MIND INSTITUTE SCIENTIFIC RESEARCH COUNCIL SELECTS A SCIENTIST TO RECEIVE THE DISTINGUISHED SCIENTIST AWARD FOR HIS OR HER LIFETIME OF RESEARCH AND CONTRIBUTIONS TO THE FIELDS OF CHILD MENTAL HEALTH AND DEVELOPMENTAL NEUROSCIENCE. AT THE ON THE SHOULDERS OF GIANTS SYMPOSIUM, THE AWARDEE IS A FEATURED SPEAKER, ALONG WITH TWO GENERATIONS OF HIS OR HER PROTEGES. THIS PRESENTATION GIVES THE RESEARCH COMMUNITY - AND PARTICULARLY YOUNGER SCIENTISTS - A VIEW INTO THE TRANSFORMATIONAL POWER OF DEDICATION AND COLLABORATION IN SCIENCE.CHILD MIND INSTITUTE STUDENT ART PROJECT - THE CHILD MIND INSTITUTE BELIEVES THE ARTS ARE CRITICAL TO CHILD DEVELOPMENT AND ACADEMIC SUCCESS BECAUSE THEY PROMOTE SELF-ESTEEM AND PROVIDE OPPORTUNITIES FOR SELF-EXPRESSION. THAT'S WHY THE CHILD MIND INSTITUTE INVITES PUBLIC AND INDEPENDENT SCHOOLS TO PARTICIPATE IN THE STUDENT ART PROJECT, OUR GALLERY PROGRAM DEDICATED TO DISPLAYING WORKS OF ART CREATED BY STUDENT ARTISTS. IN FOUR EXHIBITIONS A YEAR, STUDENT PIECES ARE DISPLAYED PROMINENTLY AT THE CHILD MIND INSTITUTE HEADQUARTERS, WHICH ACCOMMODATES 34 WORKS OF ART. EACH SHOW IS BASED ON A THEME CHOSEN BY AN ART TEACHER FROM THE SCHOOL. THE EXHIBITIONS LAUNCH WITH AN OPENING RECEPTION HOSTED BY THE CHILD MIND INSTITUTE FOR THE STUDENT ARTISTS, THEIR FAMILIES, AND THE ENTIRE SCHOOL COMMUNITY. A VIRTUAL GALLERY IS ALSO AVAILABLE ON CHILDMIND.ORG. PARENT AND EDUCATOR WORKSHOPS ON CLINICAL TOPICS - THE PARENT AND EDUCATOR WORKSHOPS COVER A RANGE OF ISSUES AFFECTING CHILDREN, INCLUDING SELECTIVE MUTISM (SM), ATTENTION-DEFICIT HYPERACTIVITY DISORDER (ADHD), OBSESSIVE-COMPULSIVE DISORDER (OCD), AND OTHERS. THESE EDUCATIONAL WORKSHOPS PROVIDE AN OPPORTUNITY FOR PARENTS, TEACHERS, AND OTHER CARING PROFESSIONALS TO GAIN NEW KNOWLEDGE, INSIGHTS AND SKILLS TO IMPROVE THEIR ABILITY TO PARENT AND NURTURE KIDS WITH THESE DISORDERS AND HELP THEM THRIVE. SESSIONS ARE HELD AT THE CHILD MIND INSTITUTE ONCE PER WEEK DURING THE SCHOOL YEAR AND ARE ALSO AVAILABLE ONLINE.
4b (Code:   ) (Expenses $ 594,946 including grants of $   ) (Revenue $   )
SCIENCE AND INNOVATIONTHE CHILD MIND INSTITUTE HAS A SCIENCE AND INNOVATION MISSION THAT UNDERSCORES THE TRANSFORMATIVE POWER OF COLLABORATIVE RESEARCH IN THE FIELD OF CHILD MENTAL HEALTH.CENTER FOR THE DEVELOPING BRAIN - THE CHILD MIND INSTITUTE LAUNCHED THE CENTER FOR THE DEVELOPING BRAIN IN AUGUST 2011 TO LEAD AN INNOVATIVE NEUROSCIENCE INITIATIVE TO EXAMINE AND UNDERSTAND THE DEVELOPING BRAIN, AND ACCELERATE THE PACE OF DISCOVERY IN THE FIELD. FOCUSED ON PROMOTING "OPEN SCIENCE" IN THE NEUROIMAGING FIELD, THE CENTER SPEARHEADS LARGE-SCALE DEMONSTRATIONS OF THE FEASIBILITY AND VALUE OF PROSPECTIVE DATA-SHARING: DISTRIBUTING THOUSANDS OF IMAGING DATASETS TO MULTIDISCIPLINARY SCIENTISTS WORLDWIDE FOR STUDY. THIS INITIATIVE IS KNOWN AS THE INTERNATIONAL DATA-SHARING INITIATIVE (INDI) AND IS A GAME-CHANGER IN THE SCIENTIFIC COMMUNITY OF CHILD PSYCHIATRY AND LEARNING DISORDERS; A FEW YEARS AGO, SCIENTISTS VIEWED A MERE FEW DOZEN DATASETS AS A MAJOR RESOURCE. CHILD MIND INSTITUTE ENDEAVOR SCIENTIST PROGRAM - THE ENDEAVOR SCIENTIST PROGRAM IS A PIONEERING EFFORT LAUNCHED BY THE CHILD MIND INSTITUTE TO SUPPORT THE DEVELOPMENT OF TALENTED, MULTIDISCIPLINARY SCIENTISTS IN RESEARCH POSITIONS AT ACADEMIC AND MEDICAL INSTITUTIONS AROUND THE GLOBE. RECRUITED FROM VARIOUS FIELDS SUCH AS COMPUTER SCIENCE, ENGINEERING, MATHEMATICS, AND STATISTICS, THESE SCIENTISTS WILL COLLABORATE ON RESEARCH THAT PURSUES A DEEPER UNDERSTANDING OF HUMAN BRAIN DEVELOPMENT. BRINGING DIVERSE THINKERS TOGETHER WILL BRING US CLOSER TO DEVELOPING BETTER INTERVENTIONS, AND EVENTUALLY PREVENTATIVE MEASURES, FOR PSYCHIATRIC AND LEARNING DISORDERS IN CHILDREN AND ADOLESCENTS. HEALTHY BRAIN NETWORK - THE HEALTHY BRAIN NETWORK AIMS TO ACQUIRE A FULL PICTURE OF HOW THE BRAIN MATURES AND FUNCTIONS AS A CHILD GROWS INTO ADOLESCENCE AND ADULTHOOD. BY COLLECTING NEUROIMAGING AND DNA DATA ON AN UNPRECEDENTED SCALE, CHILD MIND INSTITUTE SCIENTISTS WILL WORK TO CREATE A LANDMARK DATABASE, THE CHILD MIND INSTITUTE BIOBANK, THAT WILL ENABLE THE CREATION OF "BEFORE BRAIN IN BRAIN GROWTH CHARTS." THESE WILL BE THE WORLD'S FIRST COMPREHENSIVE MAPS OF HUMAN BRAIN FUNCTION OVER THE COURSE OF DEVELOPMENT, MIMICKING THE CHARTS PEDIATRICIANS USE TO TRACK CHILDREN'S HEIGHT AND WEIGHT. GIVING CLINICIANS THESE MAPS WILL IMPROVE THE EARLY IDENTIFICATION, ACCURATE DIAGNOSIS, AND APPROPRIATE TREATMENT OF MENTAL ILLNESS.SCIENTIFIC RESEARCH COUNCIL - COMPRISED OF 13 OF THE NATION'S TOP CHILD MENTAL HEALTH SCIENTISTS FROM 10 OF THE LEADING ACADEMIC INSTITUTIONS, THE SCIENTIFIC RESEARCH COUNCIL BRINGS TOGETHER BASIC SCIENTISTS AND RESEARCH CLINICIANS TO CREATE A GLOBAL INCUBATOR FOR COLLABORATIVE RESEARCH IN CHILD MENTAL HEALTH. FUNCTIONING AS A MULTI-INSTITUTIONAL SCIENTIFIC THINK-TANK, THE COUNCIL INCLUDES DISTINGUISHED SCIENTISTS IN THE FIELD OF CHILD AND ADOLESCENT PSYCHIATRY, PSYCHOLOGY, NEUROSCIENCE, AND NEUROLOGY, AND EXPERTISE IN ANXIETY AND MOOD DISORDERS, ATTENTION-DEFICIT HYPERACTIVITY DISORDER, AUTISM SPECTRUM DISORDERS, AND EATING DISORDERS.
4c (Code:   ) (Expenses $ 182,801 including grants of $   ) (Revenue $   )
ACCESS TO CLINICAL CARETHE CHILD MIND INSTITUTE AIMS TO PROVIDE RESOURCES TO CHILDREN, TEENS, AND FAMILIES TO IMPROVE ACCESS TO THE CLINICAL CARE THEY NEED TO LIVE HEALTHY, FULFILLING LIVES. FINANCIAL AID PROGRAM - THE CHILD MIND INSTITUTE LAUNCHED THE FINANCIAL AID PROGRAM IN AN EFFORT TO HELP CHILDREN AND FAMILIES RECEIVE CARE AND TREATMENT, REGARDLESS OF ECONOMIC STANDING, BY CLINICIANS AT THE CHILD MIND MEDICAL PRACTICE, A MEDICAL PRACTICE FORMED TO SUPPORT THE CLINICAL MISSION OF THE CHILD MIND INSTITUTE. MODELED AFTER GUIDELINES SIMILAR TO THOSE ADOPTED BY DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD) PROGRAMS, THE FINANCIAL AID PROGRAM OFFERS ELIGIBLE FAMILIES A FEE DISCOUNT BETWEEN 30% AND 90% OF THE COST OF SERVICES. IT IS DESIGNED IN A WAY THAT ALLOWS PATIENTS FROM LOW-INCOME FAMILIES TO QUALIFY, WHILE ALSO ACCOMMODATING FAMILIES WITH HIGHER THAN AVERAGE INCOME WHO HAVE OTHER FINANCIAL STRAINS, SUCH AS CHILDREN IN COLLEGE OR OTHER MEDICAL BILLS. THIS PAST YEAR, THE FOUNDATION RAISED $450,000 FOR FINANCIAL AID, WHICH CHILD MIND MEDICAL PRACTICE CLINICIANS MATCH WITH DONATED SERVICES ON A DOLLAR-FOR-DOLLAR BASIS. THIS ENABLED THE PRACTICE TO OFFER FINANCIAL AID WORTH $900,000.
(Code:   ) (Expenses $ 690,000 including grants of $   ) (Revenue $   )
IN JULY 2010, THE CHILD MIND MEDICAL PRACTICE, PLLC ("PRACTICE") AND THE CHILD MIND INSTITUTE, INC. ("CMI") ENTERED INTO A RESTRICTED GRANT AGREEMENT WHEREBY CMI WOULD MAKE ONE OR MORE INITIAL GRANTS NOT TO EXCEED $750,000 IN AGGREGATE (SUBSEQUENTLY INCREASED BY CMI BOARD TO $1,750,000 IN AGREEGATE), TO THE PRACTICE IN ORDER TO ENABLE THE PRACTICE TO COVER ITS START UP COSTS AND BEGIN TREATING PATIENTS. AS A RESULT OF THIS AGREEMENT, CMI RECORDED GRANT EXPENSES AMOUNTING TO $690,000 FOR THE YEAR ENDED SEPTEMBER 30, 2011.
4d Other program services. (Describe in Schedule O.)
(Expenses $ 690,000 including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 2,747,525
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II.........................
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
 
No
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part IClick to see attachment
17
Yes
 
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II.......... Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III................... Click to see attachment
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. .....
20b
 
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................
23
 
No
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule MClick to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I........................... Click to see attachment
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1.....................
34
 
No
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
 
No
a
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,” complete Schedule R, Part V, line 2...
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2...........
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
24
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
26
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
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 or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
 
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
 
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
34
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
34
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
 
No
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
 
No
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
NY
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
SHERINE KHALIL
445 PARK AVENUE
NEW YORK,NY10022
(212) 308-3118
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) ARTHUR G ALTSCHUL JR
DIRECTOR
 .50 X           0 0 0
(2) DEBRA G PERELMAN
VICE CHAIR AND DIRECTOR
 2.50 X   X       0 0 0
(3) MARGARET GRIEVE
DIRECTOR
 1.50 X           0 0 0
(4) PHYLLIS GREEN
DIRECTOR
 .50 X           0 0 0
(5) RANDOLPH COWEN
DIRECTOR
 .50 X           0 0 0
(6) MEGAN DOWLEY
DIRECTOR
 .50 X           0 0 0
(7) MARK DOWLEY
DIRECTOR
 .50 X           0 0 0
(8) BARBARA EIG
DIRECTOR
 .50 X           0 0 0
(9) NORMAN EIG
DIRECTOR
 .50 X           0 0 0
(10) ELIZABETH FASCITELLI
SECRETARY AND DIRECTOR
 .50 X   X       0 0 0
(11) MICHAEL FASCITELLI
DIRECTOR
 .50 X           0 0 0
(12) GIDEON M GIL
DIRECTOR
 .50 X           0 0 0
(13) LORI HALL
DIRECTOR
 .50 X           0 0 0
(14) GEORGE HALL
DIRECTOR
 .50 X           0 0 0
(15) JANE ROSENTHAL
DIRECTOR
 .50 X           0 0 0
(16) CRAIG HATKOFF
DIRECTOR
 .50 X           0 0 0
(17) JOSEPH HEALEY
DIRECTOR
 .50 X           0 0 0
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) ELLEN KATZ
DIRECTOR
 .50 X           0 0 0
(19) HOWARD KATZ
DIRECTOR
 .50 X           0 0 0
(20) CHRISTINE MACK
DIRECTOR
 .50 X           0 0 0
(21) RICHARD MACK
DIRECTOR
 .50 X           0 0 0
(22) STEVEN MARCUS
DIRECTOR
 .50 X           0 0 0
(23) ANNE WELSH MCNULTY
TREASURER AND DIRECTOR
 .50 X   X       0 0 0
(24) JULIE MINSKOFF
DIRECTOR
 .50 X           0 0 0
(25) MARCIA MISHAAN
DIRECTOR
 .50 X           0 0 0
(26) RICHARD MISHAAN
DIRECTOR
 .50 X           0 0 0
(27) DANIEL NEIDICH
DIRECTOR
 .50 X           0 0 0
(28) JORDAN SCHAPS
DIRECTOR
 .50 X           0 0 0
(29) LINDA SCHAPS
DIRECTOR
 .50 X           0 0 0
(30) CLAUDE WASSERSTEIN
DIRECTOR
 .50 X           0 0 0
(31) PREETHI KRISHNA
DIRECTOR
 .50 X           0 0 0
(32) RAM SUNDARAM
DIRECTOR
 .50 X           0 0 0
(33) BROOKE GARBER NEIDICH
CHAIR AND DIRECTOR
 3.00 X   X       0 0 0
(34) MARGARET BILOTTI
DIRECTOR
 .50 X           0 0 0
(35) DR HAROLD KOPLEWICZ MD
PRES. (SEE SCHEDULE O)
 20.00     X       41,667 0 23,385
(36) SHERINE KHALIL
CHIEF OPERATING OFFICER
 40.00     X       110,641 0 2,810
(37) REBECCA BENGHIAT
CHIEF OF STAFF
 40.00     X       86,574 0 7,965
(38) GREGORY ALCOCK
VP, INSTITUTIONAL ADVANCEMENT
 40.00         X   135,250 0 10,860
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 374,132 0 45,020
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet2
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
 
No
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
RED INTERACTIVE AGENCY LLC
3420 OCEAN PK BLVD STE 3080
SANTA MONICA,CA90405 		MARKETING 240,000
GLOBAL PHILANTHROPY GROUP LLC
1500 4TH AVENUE SUITE 600
SEATTLE,WA98101 		CONSULTING 129,379
SULLIVAN & CROMWELL LLP
125 BROAD STREET
NEW YORK,NY100042498 		LEGAL FEES 106,563
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet3
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 5,059,281
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		3,915,731
g Noncash contributions included in lines 1a-1f:$ 255,859
h Total. Add lines 1a-1f.......MediumBullet 8,975,012
Program Service Revenue Business Code
2a
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet  
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 11,131     11,131
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses    
c Gain or (loss)    
d Net gain or (loss)..........MediumBullet        
8a Gross income from fundraising events (not including
$ 5,059,281
of contributions reported on line 1c). See Part IV, line 18 ...
a 112,230
b Less: direct expenses ...b 155,737
c Net income or (loss) from fundraising events..MediumBullet -43,507   -43,507
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a MISCELLANEOUS REVENUE 900,099 16,971 16,971    
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 16,971
12 Total revenue. See Instructions....MediumBullet 8,959,607 16,971 0 -32,376
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 690,000 690,000
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 919,181 218,983 399,406 300,792
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 874,600 721,644 19,133 133,823
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....        
9 Other employee benefits ....... 338,735 102,050 196,110 40,575
10 Payroll taxes ...........        
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 72,936   72,936  
c Accounting ........... 115,019   115,019  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17.. 130,531 130,531
f Investment management fees ......        
g Other .......... 786,560 297,735 378,190 110,635
12 Advertising and promotion .... 182,406 178,423 3,983  
13 Office expenses ....... 155,569 13,062 47,056 95,451
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 518,802 27,344 440,899 50,559
17 Travel ............ 70,290 30,486 27,667 12,137
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 5,323 4,933   390
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 283,913   283,913  
23 Insurance .............. 39,255   39,255  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a WEB DEV. AND DESIGN 428,713 394,360 336 34,017
b COMPUTERS & EQUIPMENT 283,414 20,322 251,896 11,196
c TELEPHONE 46,114 5,008 39,555 1,551
d BANK FEES 30,312 101 30,161 50
e PRINTING 28,267 9,217 8,945 10,105
f All other expenses 64,304 33,857 27,483 2,964
25 Total functional expenses. Add lines 1 through 24f 6,064,244 2,747,525 2,381,943 934,776
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 4,021,363 1 5,190,112
2 Savings and temporary cash investments ....... 10,983 2 81,082
3 Pledges and grants receivable, net ......... 1,686,489 3 1,357,393
4 Accounts receivable, net .........   4  
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use ..............   8  
9 Prepaid expenses and deferred charges ............ 197,963 9 184,589
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 2,749,616
b Less: accumulated depreciation. ..... 10b 301,207 190,417 10c 2,448,409
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ......   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 561,315 15 535,783
16 Total assets. Add lines 1 through 15 (must equal line 34)... 6,668,530 16 9,797,368
Liabilities 17 Accounts payable and accrued expenses . 153,328 17 363,645
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 0 25 23,158
26 Total liabilities. Add lines 17 through 25..... 153,328 26 386,803
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 4,670,330 27 7,514,954
28 Temporarily restricted net assets ..... 1,844,872 28 1,895,611
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 6,515,202 33 9,410,565
34 Total liabilities and net assets/fund balances ..... 6,668,530 34 9,797,368
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
8,959,607
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
6,064,244
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
2,895,363
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
6,515,202
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
0
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
9,410,565
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, 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
2010
Open to Public
Inspection
Name of the organization
CHILD MIND INSTITUTE INC
 
Employer identification number

80-0478843
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) 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.") ....       8,570,923 8,975,012 17,545,935
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..       8,570,923 8,975,012 17,545,935
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)..           4,219,040
6 Public Support. Subtract line 5 from line 4.           13,326,895
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..       8,570,923 8,975,012 17,545,935
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..       2,513 11,131 13,644
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).           17,559,579
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
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
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) 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:  
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
2010
Name of organization
CHILD MIND INSTITUTE INC
 
Employer identification number

80-0478843
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 in the heading of its
Form 990-EZ, or on 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) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
CHILD MIND INSTITUTE INC
  		Employer identification number

80-0478843
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate 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)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
CHILD MIND INSTITUTE INC
  		Employer identification number

80-0478843
Part II
Noncash Property (see Instructions)
     
(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) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
CHILD MIND INSTITUTE INC
  		Employer identification number

80-0478843
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating 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 $  
(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) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CHILD MIND INSTITUTE INC
 
Employer identification number

80-0478843
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................      
b Buildings ................        
c Leasehold improvements ............   1,247,511   1,247,511
d Equipment ................   1,402,105 301,207 1,100,898
e Other .................   100,000   100,000
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 2,448,409
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) SECURITY DEPOSITS 125,309
(2) DUE FROM CHILD MIND MEDICAL PRACTICE, PLLC 410,474







Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 535,783
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
DEFERRED RENT LIABILITY 23,158








Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 23,158
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 8,959,607
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 6,064,244
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 2,895,363
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 0
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 2,895,363
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 8,959,607
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e 0
3 Subtract line 2e from line 1..................... 3 8,959,607
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c 0
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 8,959,607
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 6,064,244
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e 0
3 Subtract line 2e from line 1..................... 3 6,064,244
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c 0
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 6,064,244
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: CMI HAS NO UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2011 AND 2010 IN ACCORDANCE WITH ACCOUNTING STANDARDS CODIFICATION ("ASC") TOPIC 740, INCOME TAXES, WHICH PROVIDES STANDARDS FOR ESTABLISHING AND CLASSIFYING ANY TAX PROVISION FOR UNCERTAIN TAX POSITIONS.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE G
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CHILD MIND INSTITUTE INC
 
Employer identification number

80-0478843
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
 
EVENT ASSOCIATESINC
162 WEST 56TH ST
 
NY, NY10019 		FUNDRAISING FOR GALA   No 5,171,511 76,666 5,094,845
Total .................right arrow 5,171,511 76,666 5,094,845
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
NY
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

GALA EVENT
(event type) 		(b) Event #2

 
(event type) 		(c) Other Events

  
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 5,171,511     5,171,511
2 Less: Charitable
contributions . . . 		5,059,281     5,059,281
3 Gross income (line 1
minus line 2) . . . 		112,230     112,230
VerticalDirectExpenses 4 Cash prizes . . .        
5 Non-cash prizes . .        
6 Rent/facility costs . .        
7 Food and beverages . .        
8 Entertainment . . .        
9 Other direct expenses . 155,737     155,737
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 155,737
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow -43,507
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ...........................
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
EXPLANATION OF FUNDRAISING PAYMENTS SCHEDULE G, PART I, LINE 2B, COLUMN (V) THE $76,666 INDICATED REPRESENTS THE AMOUNT PAID TO FUNDRAISER COMPANY, EVENT ASSOCIATES, TOWARDS THE PLANNING OF THE DECEMBER 2010 ANNUAL BENEFIT DINNER. OF THAT AMOUNT, $53,353 WAS PRE-PAID TO EVENT ASSOCIATES IN THE PREVIOUS FISCAL YEAR 2010, TOWARD THE PLANNING OF DECEMBER 2010 ANNUAL BENEFIT DINNER. THE TOTAL AMOUNT PAID TO EVENT ASSOCIATES FOR THE PLANNING OF THE DECEMBER 2010 ANNUAL DINNER WAS $76,666, WHICH INCLUDED $65,000 CONTRACT, PLUS $8,313 IN REIMBURSABLE EXPENSES (I.E. POSTAGE, PRINTERS, ETC.). FURTHER, A NEW CONTRACT WITH EVENT ASSOCIATES TO PLAN THE DECEMBER 2011 ANNUAL BENEFIT DINNER WAS EXECUTED, AND $43,000 WAS PRE-PAID TOWARDS THAT CONTRACT IN FISCAL YEAR 2011.
Schedule G (Form 990 or 990-EZ) 2010
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
CHILD MIND INSTITUTE INC
 
Employer identification number
80-0478843
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) CHILD MIND MEDICAL PRACTICE PLLC445 PARK AVENUE
NEW YORK,NY10022 		27-3037790   690,000   FMV   SEE PART IV






















2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
0
3
Enter total number of other organizations ................................ . Bullet Image
1
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
SCHEDULE I, PART II, LINE 1A   A FUNDAMENTAL COMPONENT OF THE CHILD MIND INSTITUTE'S ("CMI") MISSION IS TO CONDUCT RESEARCH IN FURTHERANCE OF ADVANCING BRAIN SCIENCE, PRIMARILY AIMED AT DEVELOPING INNOVATIVE AND EFFECTIVE EVIDENCED-BASED TREATMENTS AND EXPERT DIAGNOSIS TO IMPROVE THE MENTAL HEALTH OF CHILDREN. INHERENT IN THE FOREGOING OBJECTIVE IS THE CONDUCT OF CERTAIN ACTIVITIES THAT ARE CONSIDERED TO INVOLVE THE CLINICAL PRACTICE OF MEDICINE. NEW YORK LAW PROVIDES FOR A STRICT PROHIBITION AGAINST THE "CORPORATE PRACTICE OF MEDICINE." UNDER THE CORPORATE PRACTICE OF MEDICINE DOCTRINE, ONLY INDIVIDUALS WHO ARE LICENSED TO PRACTICE MEDICINE AND PROFESSIONAL ENTITIES, SUCH AS PROFESSIONAL SERVICE CORPORATIONS OR PROFESSIONAL SERVICE LIMITED LIABILITY COMPANIES WHOSE OWNERS ARE INDIVIDUALS LICENSED TO PRACTICE MEDICINE, MAY ENGAGE IN THE CONDUCT OF THE CLINICAL PRACTICE OF MEDICINE. CONSEQUENTLY, CMI, BEING A NOT-FOR-PROFIT CORPORATION, IS NOT AUTHORIZED TO DIRECTLY ENGAGE IN THE PRACTICE OF MEDICINE IN NEW YORK. TO FULFILL ITS MISSION TO CONDUCT RESEARCH IN CHILD MENTAL HEALTH AND PROVIDE ACCESS TO EXPERT CLINICAL DIAGNOSIS, CARE AND TREATMENT, CMI FACILITATED THE CREATION OF THE CHILD MIND MEDICAL PRACTICE, PLLC (THE "PRACTICE"), A SEPARATE NEW YORK PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY TO CONDUCT CLINICAL RESEARCH AND PROVIDE MEDICAL TREATMENT AND HEALTH SERVICES TO CHILDREN. BECAUSE UNDER NEW YORK LAW, ONLY INDIVIDUALS LICENSED TO PRACTICE MEDICINE MAY HOLD AN OWNERSHIP INTEREST IN A PROFESSIONAL SERVICES ENTITY, SUCH AS THE PRACTICE, FORMED TO PROVIDE MEDICAL SERVICES, CMI IS NOT PERMITTED TO HOLD AN OWNERSHIP INTEREST IN THE PRACTICE. TO ADDRESS THIS LIMITATION, DR. HAROLD KOPLEWICZ, MD, THE PRESIDENT OF CMI, SERVES AS THE SOLE MEMBER OF THE PRACTICE. THE RELATIONSHIP AMONG CMI, THE PRACTICE AND DR. KOPLEWICZ IS STRUCTURED SO THAT DR. KOPLEWICZ RECEIVES NO ECONOMIC BENEFIT FROM HIS MEMBERSHIP INTEREST IN THE PRACTICE. THE PRACTICE DOES NOT FALL UNDER THE DEFINITION OF A "RELATED ORGANIZATION" UNDER THE FORM 990 INSTRUCTIONS. TO FACILITATE THE FORMATION OF THE PRACTICE AND THE CONDUCT BY THE PRACTICE OF PROGRAMS AND SERVICES THAT FURTHER CMI'S CHARITABLE, SCIENTIFIC AND EDUCATIONAL MISSION, CMI MADE A SPECIAL PURPOSE RESTRICTED GRANT TO THE PRACTICE, THE TERMS AND CONDITIONS OF SUCH RESTRICTED GRANT BEING SET FORTH IN A BINDING WRITTEN RESTRICTED GRANT AGREEMENT BETWEEN CMI AND THE PRACTICE, WHICH TERMS AND CONDITIONS INCLUDE, WITHOUT LIMITATION, THAT (I) THE PRACTICE IS REQUIRED TO OPERATE IN MANNER THAT IS, AND LIMIT ITS ACTIVITIES TO THOSE THAT ARE, CONSISTENT WITH AND FURTHER THE CHARITABLE, SCIENTIFIC AND EDUCATIONAL MISSION OF CMI, (II) THE GRANT MUST BE USED BY THE PRACTICE EXCLUSIVELY IN CONNECTION WITH THE CONDUCT OF ACTIVITIES THAT FURTHER AND SUPPORT CMI'S CHARITABLE, SCIENTIFIC AND EDUCATIONAL MISSIONS, (III) THE PRACTICE MUST OBSERVE VARIOUS REPORTING, BUDGETARY AND OTHER FINANCIAL LIMITATIONS AND ITS AUDITORS MUST BE ACCEPTABLE TO CMI. IF THE PRACTICE FAILS TO OBSERVE THE REQUIREMENTS OF THE RESTRICTED GRANT AGREEMENT, IT IS REQUIRED TO IMMEDIATELY REPAY TO CMI THE FULL AMOUNT OF THE GRANT. THE SPECIAL PURPOSE RESTRICTED GRANT TO THE PRACTICE WAS APPROVED BY CMI'S BOARD IN 2010. THE GRANT IS MONITORED BY THE FINANCE COMMITTEE OF CMI'S BOARD OF DIRECTORS. THE AMOUNT OF THE RESTRICTED GRANT BY CMI TO THE PRACTICE FOR THE YEAR ENDED SEPTEMBER 30, 2011 WAS $690,000. NOTE THAT THE RESTRICTED GRANT WAS INADVERTENTLY REFLECTED INCORRECTLY ON CMI'S FORM 990 (SCHEDULE L, TRANSACTION WITH AN INTERESTED PERSON) FOR FY 9/30/2010 AS A LOAN TRANSACTION. THE CHARACTERIZATION OF THE RESTRICTED GRANT AS A GRANT IS NOW PROPERLY REFLECTED ON THIS FORM 990.
Schedule I (Form 990) 2010


Additional Data


Software ID:  
Software Version:  


Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CHILD MIND INSTITUTE INC
 
Employer identification number

80-0478843
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) CMMP PLLC SEE PART V 410,474 SEE PART V   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS:   (A) NAME OF ENTITY: CHILD MIND MEDICAL PRACTICE, PLLC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: CHILD MIND INSTITUTE ("CMI") FACILITATED THE CREATION OF THE CHILD MIND MEDICAL PRACTICE, PLLC ("PRACTICE"). DR. HAROLD KOPLEWICZ, MD IS THE PRESIDENT OF CMI AND THE SOLE MEMBER OF THE PRACTICE. THE PRACTICE DOES NOT FALL UNDER THE DEFINITION OF A "RELATED ORGANIZATION" TO CMI UNDER THE FORM 990 INSTRUCTIONS.(D) DESCRIPTION OF TRANSACTION: IN ORDER TO FURTHER ITS MISSION OF PROVIDING ACCESS TO CLINICAL CARE AND TREATMENT AND CONDUCTING RESEARCH ON CHILD MENTAL HEALTH, CMI FACILITATED THE FORMATION OF A SEPARATE NEW YORK PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY, THE CHILD MIND MEDICAL PRACTICE, PLLC (THE "PRACTICE"), TO PROVIDE MEDICAL TREATMENT AND HEALTH SERVICES TO CHILDREN. UNDER NEW YORK STATE LAW, ONLY INDIVIDUALS WHO ARE LICENSED TO PRACTICE MEDICINE MAY HOLD AN OWNERSHIP INTEREST IN SUCH AN ENTITY THAT IS LICENSED TO PROVIDE MEDICAL SERVICES. THE RELATIONSHIP AMONG CMI, THE PRACTICE AND DR. KOPLEWICZ IS STRUCTURED SO THAT DR. KOPLEWICZ RECEIVES NO ECONOMIC BENEFIT FROM HIS MEMBERSHIP INTEREST IN THE PRACTICE. FOR ADMINISTRATIVE CONVENIENCE, CMI PROVIDES CERTAIN ADMINISTRATIVE SERVICES TO THE PRACTICE FOR WHICH THE PRACTICE COMPENSATES CMI. CONSISTENT WITH CMI'S INTERNAL POLICIES AND PROCEDURES, THE FEE PAID BY THE PRACTICE TO CMI IS BASED ON THE FAIR MARKET VALUE OF THE PROVIDED SERVICES DETERMINED UNDER AN ARM'S LENGTH PROCESS BASED ON GUIDANCE BY EXTERNAL INDEPENDENT ADVISORS. THE METHODOLOGY FOR DETERMINING THE FAIR VALUE OF SUCH SERVICES IS INDEPENDENTLY MONITORED PERIODICALLY BY CMI'S INDEPENDENT AUDITORS. PAYMENT BY THE PRACTICE TO CMI FOR SERVICES PROVIDED DURING THE PAST FISCAL YEAR ARE REFLECTED AS A RECEIVABLE ON CMI'S BOOKS IN THE AMOUNT OF $410,474, AS REFLECTED IN PART X AND SCHEDULE D, PART IX, OF SCHEDULE F OF FORM 990.
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
NonCash Contributions
Right pointing arrow large imageComplete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CHILD MIND INSTITUTE INC
 
Employer identification number

80-0478843
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of Contributions or items contributed 		(c)
Contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 9 255,859 FMV
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( )
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
 
No
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell non-cash
contributions? ............................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) 2010
Schedule M (Form 990) 2010
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33. Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule M (Form 990) 2010
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
2010
Open to Public
Inspection
Name of the organization
CHILD MIND INSTITUTE INC
 
Employer identification number

80-0478843
Identifier Return Reference Explanation
NEW PROGRAM SERVICES FORM 990, PART III, LINE 2 EACH ACTIVITY THAT IS NEW IS IDENTIFIED AS SUCH IN PART III.
FORM 990, PART VI, SECTION A, LINE 2   PHYLLIS GREEN AND RANDOLPH COWEN ARE HUSBAND AND WIFE MEGAN AND MARK DOWLEY ARE HUSBAND AND WIFE BARBARA AND NORMAN EIG ARE HUSBAND AND WIFE ELIZABETH AND MICHAEL FASCITELLI ARE HUSBAND AND WIFE DEBRA G. PERELMAN AND GIDEON M. GIL ARE HUSBAND AND WIFE LORI AND GEORGE HALL ARE HUSBAND AND WIFE JANE ROSENTHAL AND CRAIG HATKOFF ARE HUSBAND AND WIFE ELLEN AND HOWARD KATZ ARE HUSBAND AND WIFE CHRISTINE AND RICHARD MACK ARE HUSBAND AND WIFE MARCIA AND RICHARD MISHAAN ARE HUSBAND AND WIFE BROOKE GARBER NEIDICH AND DANIEL NEIDICH ARE HUSBAND AND WIFE JORDAN SCHAPS IS THE SON OF LINDA SCHAPS LINDA SCHAPS IS THE MOTHER OF JORDAN SCHAPS PREETHI KRISHNA AND RAM SUNDARAM ARE HUSBAND AND WIFE
FORM 990, PART VI, SECTION B, LINE 11   CHILD MIND INSTITUTE'S ("CMI") FORM 990 IS PREPARED BY ITS INDEPENDENT ACCOUNTING FIRM WITH THE ASSISTANCE OF CMI STAFF. THE DRAFT FORM 990 IS THEN REVIEWED BY CMI'S CHIEF OPERATING OFFICER AND BY EXTERNAL INDEPENDENT LEGAL COUNSEL. THE DRAFT FORM 990 IS REVIEWED BY THE FINANCE COMMITTEE OF CMI'S BOARD OF DIRECTORS, WHICH WAS DELEGATED RESPONSIBILITY BY THE FULL BOARD OF DIRECTORS TO REVIEW THE FORM 990 IN DETAIL. THE FINANCE COMMITTEE REVIEWS THE FORM 990 AND DISCUSSES THE CONTENTS THEREOF AT A MEETING WITH CMI'S INDEPENDENT AUDITORS. THE DRAFT FORM 990 IS THEN PRESENTED AND DISCUSSED BY THE CHAIR OF THE FINANCE COMMITTEE AT THE ANNUAL MEETING OF THE FULL BOARD. PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE, A COPY OF THE FINAL VERSION OF THE FORM 990 IS PROVIDED TO EACH MEMBER OF THE ENTIRE BOARD FOR REVIEW AND COMMENT.
  FORM 990, PART VI, SECTION B, LINE 12C DISCLOSURE OF CONFLICT OF INTEREST IS INQUIRED AT EACH BOARD MEETING AND ADDRESSED AS NECESSARY. UNDER THE CONFLICT OF INTEREST POLICY, DIRECTORS ARE ALSO REQUIRED TO DISCLOSE TO THE PRESIDENT ANY CONFLICT OF INTEREST THAT MAY ARISE BETWEEN MEETINGS SO THAT IT CAN BE ADDRESSED.
  FORM 990, PART VI, SECTION B, LINE 15 ALL EXECUTIVE LEVEL COMPENSATION IS REVIEWED BY A CONTRACTED INDEPENDENT CONSULTANT, QUALIFIED TO REVIEW SIMILAR POSITIONS IN SIMILAR NON-PROFIT HEALTHCARE ENTITIES. THE REVIEW INCLUDES THE INDIVIDUAL'S CV, YEARS OF EXPERIENCE, JOB DESCRIPTION AND GOALS FOR CURRENT POSITION, COMPARISON TO THE MARKET, AND SPECIAL CONSIDERATIONS SUCH AS RELOCATION, PAST PERFORMANCES OF ACCOMPLISHMENTS, AND NICHE EXPERTISE / KNOWLEDGE OF REQUIRED AREAS. NON-INTERESTED MEMBERS OF THE COMPENSATION COMMITTEE OF THE CMI BOARD OF DIRECTORS REVIEW THE COMPENSATION CONSULTANT'S REPORT AND MAKE A DETERMINATION ABOUT COMPENSATION BASED ON ALL RELEVANT FACTORS. THE COMPENSATION COMMITTEE'S DELIBERATIONS AND DECISIONS ARE DOCUMENTED CONTEMPORANEOUSLY IN THE MINUTES AND THE DOCUMENTATION RELIED ON BY THE COMMITTEE IS RETAINED IN CHILD MIND INSTITUTE RECORDS.
  FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE AT CHILD MIND INSTITUTE'S HEADQUARTERS UPON REQUEST. FORM 990, PART VII, SECTION A, COLUMN D: UNTIL THE BEGINNING OF 2011, DR. KOPLEWICZ WAS ALSO THE DIRECTOR OF THE NATHAN S. KLINE INSTITUTE FOR PSYCHIATRIC RESEARCH, RESULTING IN THE POTENTIAL LIMITATION ON THE COMPENSATION THE DIRECTOR COULD RECEIVE FROM OTHER SOURCES, INCLUDING THE CHILD MIND INSTITUTE. DR. KOPLEWICZ'S COMPENSATION FROM THE CHILD MIND INSTITUTE IS ANTICIPATED TO INCREASE IN FUTURE YEARS. COMPENSATION OF THE PRESIDENT AND OTHER KEY EXECUTIVES IS SUBJECT TO THE CHILD MIND INSTITUTE'S WRITTEN COMPENSATION POLICY WHICH INCLUDES REVIEW BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION, BY THE BOARD'S COMPENSATION COMMITTEE.
  FORM 990, PART XI, LINE 2C: THE CHILD MIND INSTITUTE INITIALLY RETAINED MARKS PANETH & SHRON THROUGH A COMPETITIVE PROCESS. SUBSEQUENTLY, IN 2011 THE BOARD, UPON THE RECOMMENDATION OF THE FINANCE COMMITTEE, DETERMINED TO CONTINUE TO RETAIN THEIR SERVICES AS THE INDEPENDENT AUDITOR FOR THE CHILD MIND INSTITUTE.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

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