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.") .... | 3,975,189 | 3,799,672 | 4,263,119 | 3,261,507 | 3,471,200 | 18,770,687 |
| 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.. | 3,975,189 | 3,799,672 | 4,263,119 | 3,261,507 | 3,471,200 | 18,770,687 |
| 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. | 18,770,687 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 3,975,189 | 3,799,672 | 4,263,119 | 3,261,507 | 3,471,200 | 18,770,687 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 615 | 28 | 2 | 1 | 2 | 648 |
| 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). | 18,771,335 | |||||






| 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 Form 990 was completed in coordination with the annual independent auditors, | |
| the Senior Finance Director and the Executive Director. The final draft of the 990 | ||
| was forwarded to the Executive Committee of the Board via email with comments regarding | ||
| any final corrections/changes. The Executive Committee reviewed and submitted any | ||
| final comments/recommendations which inturn were implemented in the final copy | ||
| submitted to the IRS.All correspondence and comments/recommendations are documented | ||
| in the permanent 990 - 2011 file maintained by the Heartland Works' administrative offfice. | ||
| Pt VI, Line 12c | Board members complete the "Statement of Substantial Interest". Management staff | |
| make note of Board members affiliated interests and ensure such Board members | ||
| are not involved in procurement procedures, contract approval, awarding of funds, etc. | ||
| that would involve a conflict of interest. Members are requested to abstain from | ||
| any voting action that involves any affiliated interests and such abstentions | ||
| are recorded in official minutes. | ||
| Pt VI, Line 15 | Line 15a - Key employees are compensated salaries as approved by the Board of Directors. | |
| Benefits include health insurance coverage, $30,000 life insurance coverage, | ||
| short term and long term disability and a 5% (of gross salary) employer contribution in the 403(b) | ||
| retirement plan when the employee is eligible to participate. Key employees may defer | ||
| part of their salaries in to a section 125 plan for coverage of dependents and | ||
| spouse health insurance and may defer part of their salaries in to the 403(b) | ||
| retirement plan. Key employees are not eligible to vote during Board of Director's | ||
| meetings. Board of Directors are volunteers and are not compensated. | ||
| Pt VI, Line 15 | Line 15b - Board members approved the "Factor Evaluation System" as the foundation of compensation | |
| for all staff. Board members are not compensated. The Factor Evaluation System | ||
| establishes the base pay for all positions. Staff are assigned goals annually | ||
| and based on their attainment of such goals, staff may receive an increase | ||
| of up to 3% annually.Staff are rated by their supervisors and | ||
| the Executive Director is rated by the Board Chair. | ||
| Pt VI, Line 19 | Further Governing documents are available at http://www.heartlandworks.org |
| Software ID: | 11000175 |
| Software Version: |