Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
THE ESTAUGH TA MEDFORD LEAS
Employer identification number
21-0633410
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
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) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(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—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2,135,880
1,504,573
316,204
154,000
389,698
4,500,355
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......
26,408,491
25,342,355
26,479,715
26,022,000
27,548,140
131,800,701
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.
28,544,371
26,846,928
26,795,919
26,176,000
27,937,838
136,301,056
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
288,357
5,000
14,643
14,545
322,545
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.
0
c
Add lines 7a and 7b..
288,357
5,000
14,643
14,545
322,545
8
Public Support (Subtract line 7c from line 6.)
135,978,511
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...
28,544,371
26,846,928
26,795,919
26,176,000
27,937,838
136,301,056
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
1,052,647
2,190,699
1,216,490
1,116,000
1,150,259
6,726,095
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
1,052,647
2,190,699
1,216,490
1,116,000
1,150,259
6,726,095
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.)
7,329
7,329
13
Total support (Add lines 9, 10c, 11 and 12.).
29,597,018
29,037,627
28,012,409
27,292,000
29,095,426
143,034,480
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
95.070 %
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
94.700 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
4.700 %
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
4.610 %
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
THE ESTAUGH TA MEDFORD LEAS
Employer identification number
21-0633410
Identifier
Return Reference
Explanation
FORM 990, PART VI, SECTION B, LINE 11
THE FINANCE COMMITTEE IS PROVIDED A DRAFT OF THE FORM 990 FOR DISCUSSION AND COMMENT. AFTER IT HAS BEEN REVIEWED AND APPROVED BY THE FINANCE COMMITTE, A COPY OF THE FORM 990 WILL BE CIRCULATED TO THE FULL BOARD OF TRUSTEES. EACH BOARD MEMBER WILL BE GIVEN AMPLE OPPORTUNITY TO COMMENT ON THE INFORMATION CONTAINED IN THE 990 PRIOR TO ITS FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C
THE CONFLICT OF INTEREST POLICY COVERS ALL BOARD OF TRUSTEES AND CORPORATION MEMBERS OF THE ESTAUGH T/A MEFORD LEAS. IT IS THE RESPONSIBILITY OF ALL INDIVIDUALS TO DISCLOSE ANY CONFLICT OR POSSIBLE CONFLICT IMMEDIATELY. THIS DISCLOSURE IS DOCUMENTED AND RECORDED AS PART OF THE MINUTES OR OTHERWISE IS MADE A MATTER OF RECORD. ANY INDIVIDUAL HAVING A POSSIBLE CONFLICT OF INTEREST SHALL NOT PARTICIPATE IN THE BOARD'S ACTIONS WITH RESPECT TO THAT INTEREST OR USE HIS/HER PERSONAL INFLUENCE IN THE MATTER. SUCH INDIVIDUAL SHALL NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING, EVEN WHEN PERMITTED BY LAW. THE MINUTES WILL REFLECT THAT A DISCLOSURE OF A POTENTIAL CONFLICT OF INTEREST WAS MADE, THAT THE AFFECTED BOARD MEMBER DID NOT PARTICIPATE IN THE BOARD'S ACTION AND THAT A QUORUM OF THE BOARD WAS PRESENT FOR THE ACTION WITHOUT COUNTING THE AFFECTED BOARD MEMBER. THIS RESOLUTION WILL BE RE-AFFIRMED EACH YEAR AT THE ANNUAL MEETING OF THE BOARD. THE ORGANIZATION MONITORS COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH AN ANNUAL QUESTIONNAIRE/DISCLOSURE STATEMENT THAT IS DISTRIBUTED TO THESE INDIVIDUALS. POTENTIAL CONFLICTS ARE INVESTIGATED IMMEDIATELY BY THE BOARD CHAIR OR COMMITTEE CHAIR.
FORM 990, PART VI, SECTION B, LINE 15
IT IS THE RESPONSIBILTY OF THE FINANCE COMMITTEE OF THE BOARD TO REVIEW AND RECOMMEND FOR APPROVAL BY THE FULL BOARD THE AMOUNTS, TYPES, AND SALARY RANGES APPLICABLE TO EACH JOB DESCRIPTION OF THE EXEUTIVE MANAGEMENT TEAM. THE TITLES INCLUDED IN THIS CATEGORY ARE: CHIEF EXECUTIVE OFFICER, MEDICAL DIRECTOR, AND ALL ORGANIZATIONAL LEADERS DIRECTLY REPORTING TO THE CHIEF EXECUTIVE OFFICER. THE RANGE OF TOTAL COMPENSATION LEVELS FOR EACH INDIVIDUAL POSITION IS INTENDED TO REFLECT THE SCOPE OF ORGANIZATIONAL RESPONSIBILITY, SPECIALIZED KNOWLEDGE AND EXPERIENCE REQUIRED BY THE POSITION DESCRIPTION. THE FINANCE COMMITEE, TOGETHER WITH THE DIRECTOR OF HUMAN RESOURCES, WILL CONDUCT A SURVEY OF EXECUTIVE COMPENSATION OF MEDFORD LEAS' COMPARISON GROUP EVERY THREE YEARS TO DETERMINE REASONABLE AND COMPETITIVE COMPENSATION FOR EXECUTIVE MANAGMENT POSITIONS, AND MAY ENGAGE A CONSULTANT TO ASSIST IN THE PROCESS. IT IS EXPECTED THAT EACH PERIODIC UPDATE WILL RESULT IN A NORMAL PROGRESSION OF COMPENSATION LEVELS. THE SURVEY MAY OCCUR MORE FREQUENTLY IF COMPENSATION TRENDS AND RECRUITMENT AREAS OR INDUSTRIES CHANGE SIGNIFICANTLY IN PREPARATION FOR CONDUCTING THE SURVEY, THE TOTAL COMPENSATION FOR EACH EXECUTIVE POSITION WILL BE DEFINED. THE FINANCE COMMITTEE, IN CONCERT WITH THE DIRECTOR OF HUMAN RESOURCES, WILL DETERMINE AND RECOMMEND TO THE BOARD THE REASONABLE AND COMPETITIVE COMPENSATION RANGES FOR EXECUTIVE MANAGEMENT POSITIONS BASED ON SURVEY RESULTS. IF IT IS DETERMINED THAT EXECUTIVE MANAGEMENT COMPENSATION IS NOT REASONABLE AND COMPETITIVE, THE FINANCE COMMITTEE WILL RECOMMEND AN ACTION PLAN TO THE BOARD TO ACHIEVE REASONABLE AND COMPETITIVE COMPENSATION. THE COMMITTEE WILL CONSULT WITH THE DIRECTOR OF HUMAN RESOURCES AND CHIEF FINANCIAL OFFICER TO DETERMINE THE APPROPRIATE TIMELINE FOR ANY SUCH ACTION PLAN BASED ON ORGANIZATION FINANCIAL CONSTRAINTS. INCENTIVE COMPENSATION WILL BE BASED ON ATTAINMENT OF SPECIFIC MEASURABLE GOALS IN ALIGNMENT WITH THE OVERALL RESPONSIBILITIES OF THE RECIPIENT.
FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION WILL MAKE THE FOLLOWING DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST GOVERNING DOCUMENTS (ARTICLES OF INCORPORATION AND BYLAWS), CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS.
CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 5:
NET UNREALIZED GAINS ON INVESTMENTS: 1,967,162. PRIOR PERIOD ADJUSTMENTS: 1,065,211. VALUATION LOSS, SPLIT INTEREST AGREEMENTS -66,417. VALUATION GAIN, BENEFICIAL INTEREST IN PERPETUAL TRUSTS 120,919. TOTAL TO FORM 990, PART XI, LINE 5: 3,086,875.
THE ORGANIZATION'S BOARD OF TRUSTEES VOTES ON THE APPOINTMENT OF THE AUDITOR. THE TRUSTEE APPROVAL IS DOCUMENTED IN THE BOARD MINUTES. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS.
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
Additional Data
Software ID:
Software Version:
-
TIN:
TY 2010 ReasonableCauseExplanation
Name:
THE ESTAUGH TA MEDFORD LEAS
EIN: 21-0633410
Explanation:
REASONABLE CAUSE STATEMENTTHIS RETURN IS BEING FILED BETWEEN MARCH 1, 2012, AND MARCH 30, 2012, AS DIRECTED BY THE IRS IN NOTICE 2012-4, BECAUSE ELECTRONIC FILING WAS NOT AVAILABLE JANUARY 1, 2012 THROUGH FEBRUARY 29, 2012. WE REQUEST THAT PENALTIES BE WAIVED BECAUSE IT WOULD BE INEQUITABLE TO IMPOSE A PENALTY ON US DUE TO THE UNUSUAL CIRCUMSTANCES REQUIRING US TO DELAY THE FILING OF THIS RETURN.