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
Presbyterian Night Shelter of Tarrant County
Employer identification number
75-1985591
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.") ....
2,619,480
3,791,101
3,581,821
4,146,415
6,104,805
20,243,622
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
0
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
4
Total. Add lines 1 through 3..
2,619,480
3,791,101
3,581,821
4,146,415
6,104,805
20,243,622
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)..
303,896
6
Public Support. Subtract line 5 from line 4.
19,939,726
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..
2,619,480
3,791,101
3,581,821
4,146,415
6,104,805
20,243,622
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
299,336
227,394
93,512
224,745
148,072
993,059
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
0
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
8,600
20,394
100,600
7,200
136,794
11
Total support (Add lines 7 through 10).
21,373,475
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
3,347,234
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
93.290 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
90.670 %
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.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
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
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2010 Schedule A, Part III, line 17
.............
18
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
A CORPORATE SUPPORTER PROVIDES OFFICE SPACE TO PRESBYTERIAN NIGHT SHELTER WITHOUT CHARGE. THIS IS VALUED AT $9,600 PER YEAR AND HAS BEEN INCLUDED IN THE CONTRIBUTIONS, GIFTS AND GRANTS REPORTED ON PART IIA, LINE 1.
Schedule A (Form 990 or 990-EZ) 2011
Additional Data
Software ID:
11000144
Software Version:
2011v1.2
-
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
Presbyterian Night Shelter of Tarrant County
Employer identification number
75-1985591
Identifier
Return Reference
Explanation
Form 990, Part VI, Line 19
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available
Upon public request and submission of written request to the executive director, governing documents, policies, and procedures are available for the general public to review at the PNS administrative office.
Form 990, Part VI, Line 12c
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts
On an annual basis each board member is required to sign the disclosure statement which requires board members to specifically detail any individual or business-related exceptions that may apply. The exceptions are reviewed by the executive committee and procedures are followed to determine if a conflict exists and appropriate actions to take.
Form 990, Part VI, Line 11
Form 990, Part VI, Line 11: Form 990 Review Process
Presbyterian Night Shelter utilizes the following review process before filing the 990 and attachments with the IRS. The executive management reviews the return in detail with the paid preparer; the return is the forwarded to all members of the board prior to signature and filing.
Form 990, Part VI, Line 5
Form 990, Part VI, Line 5: Description of Material Diversion of Assets
Subsequent to year end, a group of staff members were found to be involved in a highly collusive and elaborate fraudulent misuse of the Shelter's resources over the approximate period of 2009 to 2012. This discovery is shocking and disappointing to find such a deliberate act against the homeless clients, community and donors that support the Shelter. The Shelter has very clear expectations of its employees: that they behave in an ethical manner, abide by the Shelter's policies and adhere to state and federal law. As a result, all known employees involved have been dismissed; all Shelter findings have been filed with the District Attorney's office on behalf of the Shelter. The Shelter has also gone through a thorough analysis of procedures to prevent an incident such as this from happening again as well as contracting a third party to review all policies. The Shelter holds a theft and criminal insurance policy. A claim has been made on this policy for the resources lost and management has accrued an estimate of $84,000 which expected to be recovered under the insurance policy. In accordance with generally accepted accounting principles, the financial statements have been restated to reflect the insurance receivable owed to the Shelter and the related impact on retained earnings.
Form 990, Part III, Line 4d
Form 990, Part III, Line 4d : Other Program Services Description
OTHER PROGRAM SERVICES 4: The Lowdon Schutts shelter for women and children at PNS provides emergency shelter and transitional living services to homeless women with high risk prenancies and women with children. This shelter is the only one of its kind in Fort Worth that accepts women with teenage children. In addition to their nights of stay, the client receives three meals a day and two snacks for the children. The families also have access to shower facilities, case management services and parenting classes. The Lowdon Schutts Women & Children Emergency Shelter program collaborates with Cook's Children's Hospital which meets with clients weekly to assess their health and well being. In addition to a program manager, three case managers work with the parent to ensure compliance with the local school district guidelines and conducting activities to enhance the child's overall well being. Case management services include assistance with securing housing, employment and securing additional income (Food stamps, SSI, SSDI, etc.) for those able to work. Case managers also assist clients with obtaining critical documents such as social security cards, birth certificates and state identification. In 2011, PNS served approximately 200 single parent families. The objectives of the Lowdon Schutt's Women & Children Emergency Shelter program are 1. to move consumers out of the cycle of homelessness, 2. to increase parenting skills and 3. to decrease the need for crisis intervention with these families including referrals to CPS and calls for emergency services. OTHER PROGRAM SERVICES 5: Safe Haven is a transitional housing program without length of stay requirements designed to serve individuals who meet both the definitions of chronically homeless and mental illness. Individuals may also struggle with addiction to substances, domestic violence, or may be a veteran of the armed forces. The Mimi Hunter Fitzgerald Safe Haven program offers the residents intensive case management, group support opportunities, life skills education and other supports to increase their stability. Through a partnership with Tarrant County Mental Health Mental Retardation services, residents may receive onsite psychiatric medication management, monitoring and crisis stabilization. The program, located on the campus of the Presbyterian Night Shelter, offers safe, comfortable housing for 10 men and 10 women, meals and assistance with clothing and hygiene supplies. OTHER PROGRAM SERVICES 6: A NUMBER OF SMALL PROGRAMS THAT ASSIST CUSTOMERS IN THEIR TRANSITION TO EMPLOYMENT AND A PERMANENT LIVING SITUATION. THESE INCLUDE, BUT ARE NOT LIMITED TO, KITCHEN WORK AND TRASH COLLECTION.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.