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
THE LITTLE FORKS CONSERVANCY INC
Employer identification number
38-3353122
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.") ....
597,279
879,277
428,837
318,017
616,041
2,839,451
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..
597,279
879,277
428,837
318,017
616,041
2,839,451
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)..
1,117,609
6
Public Support. Subtract line 5 from line 4.
1,721,842
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..
597,279
879,277
428,837
318,017
616,041
2,839,451
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
26,500
20,246
13,691
2,119
1,007
63,563
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..
26,290
16,306
42,596
11
Total support (Add lines 7 through 10).
2,945,610
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
58.450 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
66.280 %
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
Schedule A (Form 990 or 990-EZ) 2011
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
2011
Open to Public Inspection
Name of the organization
THE LITTLE FORKS CONSERVANCY INC
Employer identification number
38-3353122
Identifier
Return Reference
Explanation
ADDITIONAL INFORMATION
FORM 990
ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION. RIVERVIEW PROJECT: IN 2008 THE CONSERVANCY BEGAN A 1.5 MILLION FUNDRAISING DRIVE TO ACQUIRE TWO PARCELS OF LAND WITH APPROXIMATELY TWO MILES OF FRONTAGE ON THE TITTABAWASSEE RIVER IN HOMER TOWNSHIP, JUST UPSTREAM FROM THE CITY OF MIDLAND, MICHIGAN. THE FUNDRAISING DRIVE WAS COMPLETED IN 2011. THE CONSERVANCY PURCHASED THE LAND WITH A COMBINATION OF DONATED FUNDS AND TWO SHORT-TERM LOANS FROM THE CONSERVATION FUND, A NON-PROFIT BASED IN ARLINGTON, VIRGINIA. THE CONSERVANCY WAS ABLE TO PAY-OFF THE MORTGAGE NOTE FOR THE CHRISTENSEN PARCELS ON JUNE 20, 2011. PAYMENTS IN 2011 TOTALED 457,429. THE HERBERT H. AND GRACE A. DOW FOUNDATION AWARDED A GRANT OF 350,000 TO HELP CLOSE THE CAMPAIGN IN 2011.
FIRST ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4A
CONSERVANCY WORKED WITH THE UNIVERSITY OF MICHIGAN-FLINT AND THE CEDAR RIVER STEERING COMMITTEE TO COMPLETE AN UPDATE TO THE CEDAR RIVER WATERSHED MANAGEMENT PLAN. THE CONSERVANCY COMPLETED ONE CONSERVATION EASEMENT PROJECT THAT PROTECTED 40 ACRES OF LAND WITH NEARLY 4,400 FEET OF RIVER SHORELINE ALONG THE PINE RIVER IN MIDLAND COUNTY. THE CONSERVATION EASEMENT WAS DONATED TO THE CONSERVANCY BY THE FAMILY OF FRED HUBERT. ALONG WITH THE SIGNIFICANT AMOUNT OF RIVER FRONTAGE, THE PROPERTY CONTAINS FORESTED FLOODPLAIN AND IMPORTANT WILDLIFE HABITAT ALONG THE RIVER CORRIDOR.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
UPON RECEIPT OF THE DRAFT 990, AN ELECTRONIC COPY IS SENT TO ALL BOARD MEMBERS FOR REVIEW AND COMMENT. IF CORRECTIONS ARE NEEDED THEY ARE MADE. THE FINAL DRAFT IS REVIEWED BY THE FINANCE COMMITTEE AND SIGNED BY EITHER THE PRESIDENT OR TREASURER.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
ANY DIRECTOR, PRINCIPAL OFFICE, STAFF MEMBER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS IS REQUIRED TO COMPLY WITH THE CONFLICT OF INTEREST POLICY. DETERMINATION OF A CONFLICT OF INTEREST IS DONE AT THE GOVERNING BOARD OR COMMITTEE LEVEL WITH ANY INTERESTED PERSON REMOVED FROM THE DISCUSSION. CONFLICT DISCLOSURE STATEMENTS ARE FILED AT THE BEGINNING OF EACH YEAR IN ACCORDANCE WITH THE DUTY TO DISCLOSE PORTION OF THE CONFLICT OF INTEREST POLICY. THE CONSERVANCY HAS NOT HAD A CONFLICT UNDER ITS POLICY REQUIRING ANY ENFORCEMENT.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
THE ORGANIZATION USES COMPENSATION SURVEY OR STUDY FROM COMPARABLE COMPENSATION SURVEYS OR STUDIES FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS, THE CONSUMER PRICE INDEX, AND REVIEW AND APPROVAL BY THE EXECUTIVE COMMITTEE AND FINANCE COMMITTEE TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S EXECUTIVE DIRECTOR AS DOCUMENTED IN THE COMMITTEE MINUTES. FULL BOARD VOTES ON THE TOTAL BUDGET AS DOCUMENTED IN THE BOARD MINUTES.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
THE CONSERVANCY INCLUDES THE STATEMENT OF ACTIVITIES IN A SUMMER NEWSLETTER WHICH IS DISTRIBUTED TO MEMBERS AND KEY COMMUNITY STAKEHOLDERS. THE NEWSLETTER IS ALSO PUBLISHED ON THEIR WEBSITE. ALL OTHER DOCUMENTS ARE AVAILABLE AT THE CONSERVANCY'S OFFICE FOR PUBLIC VIEW IF REQUESTED. THE CONSERVANCY'S FORM 990 IS POSTED ON WWW.GUIDESTAR.ORG FOR REGISTERED USERS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.