Attach to Form 990 or Form 990-EZ.
See separate instructions.| (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 | |||||||||
| 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.") .... | 1,514,188 | 1,754,887 | 1,766,860 | 1,863,105 | 1,938,075 | 8,837,115 |
| 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.. | 1,514,188 | 1,754,887 | 1,766,860 | 1,863,105 | 1,938,075 | 8,837,115 |
| 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. | 8,837,115 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 1,514,188 | 1,754,887 | 1,766,860 | 1,863,105 | 1,938,075 | 8,837,115 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 12,729 | 2,195 | 754 | 2,036 | 3,503 | 21,217 |
| 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). | 8,858,332 | |||||






| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public Support (Subtract line 7c from line 6.) | 0 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) | ||||||
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | ||||||




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | 11000175 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI, Line 11a | The President shall sign and certify that the IRS Form 990 is accurate and complete. | |
| The Executive Committee shall review and approve the IRS Form 990 annual tax filing prior to submission, | ||
| and the full board shall receive a copy of the IRS Form 990 within 30 days of its submission. | ||
| Pt VI, Line 12c | The Operations Manager provides conflict of interest policies and forms for attestation of this | |
| information annually to all Board members. Statements are reviewed and if a potentional | ||
| conflict exists, the Executive Director is notified and discusses the conflict with the | ||
| Board member and Executive Committee. Should a conflict exist for a specific matter, | ||
| Board members may recuse themselves or be excluded from discussions or votes | ||
| on the matter of concern. A Board member may also be asked to resign or be removed | ||
| by a vote of the Board if a general and overarching conflict cannot be overcome and inhibits | ||
| a member's ability to regularly participate in Board activities. | ||
| Pt VI, Line 15 | Compensation of executives from local health associations and comparative information from third parties | |
| of salary information on area Executive Directors with similar responsibilities, company size and | ||
| experience/education are compared and provided to the Executive Committee for consideration | ||
| when determining Executive Director compensation. Minutes of the Executive Committee meeting | ||
| contemporaneously document the deliberation and action. | ||
| Pt VI, Line 19 | VHI Articles of incorporation and Bylaws are available at no cost upon request. | |
| The VHI Conflict of Interest Policy is available at at no cost upon request. | ||
| Consistent with the requirements of 6104(d) of the Internal Revenue Code and the regulations thereunder, | ||
| copies of the organizations Form 990 shall be made available, upon request, in a timely manner, and without charge to | ||
| any individuals who request it. The VHI 990 is electronically available through GuideStar (http://www.guidestar.org/). | ||
| An electronic copy of VHIs annual independent audit is part of VHIs Annual Report and Strategic plan update. | ||
| This document shall be available on VHIs website . | ||
| A detailed independent financial audit is posted on VHIs website and is part of our Annual Report and Strategic Plan | ||
| Update at no cost. | ||
| Form 990, Part III, Line 4d | PROVIDED HEALTH CARE INFORMATION TO CONSUMERS, PROVIDERS, 385024. 0. 1124676. | |
| Form 990, Part IX, Line 24f | GRAPHIC DESIGN AND PRINTING 7699. 6768. 931. 0. MAINTENANCE AND REPAIRS 7695. 6262. 1433. 0. MARKETING 5309. 4481. 828. 0. MISCELLANEOUS 363. 294. 69. 0. NETWORK MAINTENANCE 7363. 6125. 1238. 0. PAYROLL ADMINISTRATION 1538. 1252. 286. 0. PHONE FAX AND TELECONFERENCEING 13450. 10961. 2489. 0. POSTAGE AND DELIVERY 7031. 5905. 1126. 0. PRODUCT DEVELOPMENT 12940. 10531. 2409. 0. REAL ESTATE TAX 8413. 6847. 1566. 0. UTILITIES 7988. 6501. 1487. 0. |
| Software ID: | 11000175 |
| Software Version: |