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
WINSTON-SALEM INDUSTRIES FOR THE BLIND INC
Employer identification number
56-6001467
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.") .
647,329
829,152
234,160
590,447
1,055,929
3,357,017
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......
78,839,410
80,729,748
100,769,704
115,088,903
133,913,149
509,340,914
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.
79,486,739
81,558,900
101,003,864
115,679,350
134,969,078
512,697,931
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
94,711
153,475
575
34,750
168,041
451,552
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..
94,711
153,475
575
34,750
168,041
451,552
8
Public Support (Subtract line 7c from line 6.)
512,246,379
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...
79,486,739
81,558,900
101,003,864
115,679,350
134,969,078
512,697,931
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
32,264
9,802
9,984
11,939
19,206
83,195
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
159,656
362,670
522,326
c
Add lines 10a and 10b.
32,264
9,802
9,984
171,595
381,876
605,521
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.)
85,754
-43,586
233,809
340,202
-45,990
570,189
13
Total support (Add lines 9, 10c, 11 and 12.).
79,604,757
81,525,116
101,247,657
116,191,147
135,304,964
513,873,641
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
99.680 %
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
99.680 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
0.120 %
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
0.080 %
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
WINSTON-SALEM INDUSTRIES FOR THE BLIND INC
Employer identification number
56-6001467
Identifier
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 2
JOHN GOOGE - MEMBER OF THE BOARD OF DIRECTORS IS THE FATHER OF DAVID GOOGE - MEMBER OF THE BOARD OF DIRECTORS. TODD LYNCH - MEMBER OF THE BOARD OF DIRECTORS IS THE SON-IN-LAW OF JUDY BULLARD - MEMBER OF THE BOARD OF DIRECTORS. RICHARD SIEG - MEMBER OF THE BOARD OF DIRECTORS IS THE SON-IN-LAW OF DAVID PLYLER - MEMBER OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11
AFTER REVIEW BY FINANCIAL MANAGEMENT PERSONNEL AT IFB, THE FORM 990 IS DISTRIBUTED TO ALL MEMBERS OF THE AUDIT COMMITTEE OF THE BOARD, THE GOVERNANCE BODY CHARGED WITH APPROVAL OF THE FILING OF THE RETURN, IN ADVANCE OF A SCHEDULED MEETING OF THE AUDIT COMMITTEE FOR THE PURPOSE OF CONDUCTING A DETAILED REVIEW OF THE FORM 990. THE CHIEF FINANCIAL OFFICER (CFO) AND A REPRESENTATIVE FROM IFB'S TAX RETURN PREPARER MEET WITH THE AUDIT COMMITTEE FOR AN IN-DEPTH REVIEW OF THE FORM 990. FROM THIS MEETING, THE AUDIT COMMITTEE APPROVES THE RETURN FOR FILING AS PREPARED, OR WITH AGREED-UPON CHANGES. FOLLOWING AUDIT COMMITTEE APPROVAL, A COPY OF THE FORM 990 IS DISTRIBUTED TO ALL MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO TIMELY FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C
ON AN ANNUAL BASIS, THE CORPORATE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS DISTRIBUTES A CONFLICTS OF INTEREST DISCLOSURE STATEMENT TO ALL BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES. THE COMMITTEE, ALONG WITH COMPLIANCE PERSONNEL, EXAMINE THE COMPLETED STATEMENTS AND PROMPTLY INVESTIGATE AND RESOLVE ANY REAL OR PERCEIVED CONFLICTS.
FORM 990, PART VI, SECTION B, LINE 15
ANNUAL COMPENSATION OF THE EXECUTIVE DIRECTOR AND EXECUTIVE CHAIRMAN IS SET BY THE BOARD OF DIRECTORS. THE BOARD CONDUCTS ANNUAL PERFORMANCE EVALUATIONS OF THE EXECUTIVE DIRECTOR AND EXECUTIVE CHAIRMAN, AND ALONG WITH THE RESULTS OF THE EVALUATIONS, THE BOARD USES PERIODIC COMPENSATION SURVEYS CONDUCTED BY OUTSIDE CONSULTANTS AND CONSULTS COMPARATIVE COMPENSATION DATA RELATED TO THE COMPENSATION PACKAGES OF TOP EXECUTIVES AT ORGANIZATIONS OF SIMILAR SIZE AND MISSION, INCLUDING EXAMINATION OF THE ORGANIZATIONS' FORMS 990, IN ORDER TO DETERMINE THE COMPENSATION OF THE EXECUTIVE DIRECTOR AND EXECUTIVE CHAIRMAN ON A YEARLY BASIS. FOR OTHER OFFICERS AND KEY EMPLOYEES, ANNUAL COMPENSATION IS SET BY THE EXECUTIVE DIRECTOR. THE EXECUTIVE DIRECTOR CONDUCTS AN ANNUAL PERFORMANCE EVALUATION FOR EACH OFFICER AND KEY EMPLOYEE, AND ALONG WITH THE RESULTS OF THE EVALUATION, THE EXECUTIVE DIRECTOR CONSULTS COMPARATIVE COMPENSATION DATA RELATED TO OFFICERS AND KEY EMPLOYEES AT ORGANIZATIONS OF SIMILAR SIZE AND MISSION, INCLUDING EXAMINATION OF THE ORGANIZATIONS' FORMS 990, IN ORDER TO DETERMINE EACH OFFICER'S AND KEY EMPLOYEE'S COMPENSATION ON A YEARLY BASIS.
FORM 990, PART VI, SECTION C, LINE 19
ALL GOVERNING DOCUMENTS ARE MAINTAINED BY THE EXECUTIVE ASSISTANT TO THE EXECUTIVE DIRECTOR. THIS EMPLOYEE MAKES THESE DOCUMENTS AVAILABLE UPON REQUEST. THE FINANCIAL STATEMENTS ARE MAINTAINED BY THE CFO. THE CFO MAKES THESE STATEMENTS, AS DISCLOSED IN THE FORM 990, AVAILABLE UPON REQUEST. ALSO, SUMMARIZED FINANCIAL INFORMATION IS INCLUDED IN THE ORGANIZATION'S ANNUAL REPORT. THE CONFLICT OF INTEREST POLICY IS MAINTAINED BY THE CORPORATE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS. THE COMMITTEE CHAIR MAKES THIS POLICY AVAILABLE UPON REQUEST.
CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 5:
NET UNREALIZED GAINS ON INVESTMENTS: 6,108. DONATED SERVICES AND USE OF FACILITIES: 48,533. TOTAL TO FORM 990, PART XI, LINE 5: 54,641.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.