Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
American Academy of Neurology Institute
Employer identification number
41-0726167
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public Support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2011.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2010.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2011.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
8,855,741
7,557,606
6,276,833
5,568,560
2,499,991
30,758,731
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......
17,038,761
16,831,853
17,318,283
18,653,411
16,942,464
86,784,772
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.
25,894,502
24,389,459
23,595,116
24,221,971
19,442,455
117,543,503
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.
2,954,904
255,868
31,345
122,583
3,364,700
c
Add lines 7a and 7b..
0
2,954,904
255,868
31,345
122,583
3,364,700
8
Public Support (Subtract line 7c from line 6.)
114,178,803
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
9
Amounts from line 6...
25,894,502
24,389,459
23,595,116
24,221,971
19,442,455
117,543,503
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
952,130
192,212
700,644
800,540
814,290
3,459,816
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
21,208
213,407
103,633
338,248
c
Add lines 10a and 10b.
952,130
192,212
721,852
1,013,947
917,923
3,798,064
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
21,208
213,407
103,633
338,248
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
1,165
98,175
39,621
91,597
84,430
314,988
13
Total support (Add lines 9, 10c, 11 and 12.).
26,847,797
24,679,846
24,377,797
25,540,922
20,548,441
121,994,803
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2011 (line 8 column (f) divided by line 13 column (f))
.........
15
93.593 %
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
93.25 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f))
......
17
3.113 %
18
Investment income percentage from 2010 Schedule A, Part III, line 17
.............
18
3.17 %
19a
33 1/3% support tests—2011.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2010.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A, Part III, line 12: Miscellaneous Income
Schedule A (Form 990 or 990-EZ) 2011
Additional Data
Software ID:
11000129
Software Version:
v1.00
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
American Academy of Neurology Institute
Employer identification number
41-0726167
Identifier
Return Reference
Explanation
F990_P06_S0A_L01a
Form 990, Part VI, Section A, Line 1a
Filer operates with an Executive Committee comprised of key Officers who are members of the Board and two other Directors designated by the President. The Executive Committee's decisions must be ratified by the full Board of Directors.
F990_P06_S0A_L02
Form 990, Part VI, Section A, Line 2
Terrence Cascino and Gregory Cascino, family relationship. All Officers and Key Employees of thie corporation aside from Lisa DeAngelis and Terrence Cascino (i.e., Bruce Sigsbee, Robert Griggs, Lisa Shulman, Timothy Pedley, Catherine Rydell, Timothy Engel, Christine Phelps, Bruce Levi and Rodney Larson) have a business relationship with filer's Board members and other Officers as all of these individuals concomitantly served as Directors and/or Officers of filer's parent 501 (c)(6) organization, American Academy of Neuorlogy (AAN), and these Officers and Key employees are paid by AAN. Terrence Cascino, Bruce Sigsbee, Timothy Pedley, Tim Engel, and Catherine Rydell also have a business relationship through their Board and/or Officer role at American Academy of Neurology Enterprises, Inc. and Lisa Shulman has a business relationship with all Directors due to her contract-services role at that entity.
F990_P06_S0A_L07a
Form 990, Part VI, Section A, Line 7a
and Line 6: Members of the organization's parent entity, AAN, elected that entity's Board of Directors who in turn, prior to April 2012 reorganization of filer's Board via Restatement of its Articles of Incorporation, had duality of Board service in both organizations.
F990_P06_S0B_L11b
Form 990, Part VI, Section B, Line 11b
The CFO and Controller undertook extensive review of the draft form 990 as initially prepared by the Finance Business Manager. The draft 990 was then reviewed by the filer's exempt organizations tax professional. The form was then presented to the Audit Committee by the CFO and other members of the management team for the Committee's comments. The finalized Form 990 will be brought to the Board for discussion and approval (required per State law) in September 2012. At that time, a complete overview of this Form 990 will be provided to the Board by the CFO and General Counsel.
F990_P06_S0B_L12c
Form 990, Part VI, Section B, Line 12c
The Institute's conflict of interest policy covers individuals serving as an officer, director, committee member, teacher, author, consultant or other positions of official responsibility of leadership. All covered individuals are required to complete a relationship disclosure statement annually, or as changes in personal circumstances occur. The statements are reviewed and actions determined according to the institute's heirarchy based on position and recommendation of General Counsel; or by the Executive Committee if a resolution cannot be made. Potential conflicts are handled on an individual basis. Actions taken depend on the severity of the conflict which include no action required, on-going monitoring with appropriate disclosure, or withdrawal from the conflicting relationship. Conflict of interest proceedings are documented in meeting minutes or as appropriate.
F990_P06_S0B_L16a
Form 990, Part VI, Section B, Line 16a
Filer participates in scientific journals writing and promotion both with the participation of its wholly-owned limited liability company, the American Academy of Neurology Enterprises, Inc. and with services of a for-profit publishing company. Contracting with those parties is per longstanding contract that effects arms-length terms and provides priority in favor of both 501(c)(3) output and without diminuition of filer's control.
F990_P06_S0C_L19
Form 990, Part VI, Section C, Line 19
The Institute makes its governing documents, conflict of interest policy, and financial statements available to its parent entity's members on its website.
F990_P07_S0A_L01b
Form 990, Part VII, Section A, Line 1b
The corporation's Executive Director, CFO, General Counsel, Deputy Executive Director, Chief Health Policy Officer, and former General Counsel are employees of this corporation's parent entity, AAN. The number of hours per week of services they technically provided to AAN are 60, 45, 45, 46, 46, and 45, respectively. Included in those numbers are the numbers of hours of service provided to this corporation as shown in this line's column b.
F990_P11_S00_L05
Form 990, Part XI, Line 5
A late 2010 transaction for the sale of name rights was recorded for the 2010 IRS Form 990 but General Accepted Accounting Principles treated this as a 2011 transaction for financial reporting. Total to Form 990 Part XI, Line 5 $(223,957)
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.