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
UCP HORIZONS FOUNDATION INC
Employer identification number
56-2172655
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.") ....
3,000
108,780
301,356
211,247
842,053
1,466,436
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..
3,000
108,780
301,356
211,247
842,053
1,466,436
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)..
791,706
6
Public Support. Subtract line 5 from line 4.
674,730
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..
3,000
108,780
301,356
211,247
842,053
1,466,436
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
12,813
15,735
20,605
25,499
40,663
115,315
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).
1,581,751
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
42.660 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
62.910 %
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
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) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(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 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
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
UCP HORIZONS FOUNDATION INC
Employer identification number
56-2172655
Identifier
Return Reference
Explanation
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
THE FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE AND PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING OF THE FINAL RETURN.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
IT IS THE POLICY OF THE ORGANIZATION (EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.(ESUCP) AND EASTER SEALS UCP HORIZONS FOUNDATION, RELATED ORGANIZATIONS AS DISCLOSED ON SCHEDULE R) TO PROVIDE ON-GOING MONITORING, CONDUCT A REVIEW AND UPDATE THE AGENCY'S POLICIES AS NECESSARY. THE POLICIES ARE REVIEWED ON AN ANNUAL BASIS. THE POLICIES ARE REVISED AS NEEDED WITH APPROVAL BY THE EXECUTIVE TEAM. THE CFO IS RESPONSIBLE FOR ENSURING ENFORCEMENT BY ESTABLISHING AND PROVIDING TRAINING OF PROCESSES AND PROCEDURES, AS NEEDED, WHICH COMPLY WITH THE APPROVED POLICIES. THE ORGANIZATION REQUIRES THE BOARD OF DIRECTORS, OFFICERS AND LEADERSHIP (INCLUDES ALL MANAGEMENT LEVEL POSITIONS) TO ACT IN THE BEST INTERESTS OF THE ORGANIZATION, AND NOT IN THE FURTHERANCE OF PERSONAL INTERESTS OR THE INTERESTS OF THIRD PARTIES. THESE INDIVIDUALS ARE REQUIRED TO PROVIDE A FULL DISCLOSURE OF ANY RELATIONSHIP, INFLUENCE OR ACTIVITY THAT MIGHT IMPAIR, OR EVEN APPEAR TO IMPAIR, THE ABILITY TO MAKE OBJECTIVE AND FAIR DECISIONS WHEN REPRESENTING THE ORGANIZATION, ANY EMPLOYMENT, CONSULTING RELATIONSHIP OR ADVISORY ACTIVITY WITH A COMPETITOR, POTENTIAL COMPETITOR, CUSTOMER OR POTENTIAL CUSTOMER OF THE ORGANIZATION, ANY SITUATIONS IN WHICH MATERIALS, SPECIALIZED KNOWLEDGE, AND/OR TECHNIQUES HAVE BEEN PROVIDED AS A RESULT OF AFFILIATION WITH THE ORGANIZATION, ANY RELATIONSHIP (PERSONAL OR FAMILY), INTEREST OR OWNERSHIP WITH A VENDOR, CONTRACTOR, GRANTOR, SUPPLIER OR CONSULTANT WITH WHOM THE ORGANIZATION DOES OR INTENDS TO DO BUSINESS, AND ANY BUSINESS OR FAMILY RELATIONSHIP, WITH ANY OTHER OFFICER, DIRECTOR, TRUSTEE OR KEY EMPLOYEE OF THE ORGANIZATION. DISCLOSURE IS REQUIRED TO BE IN WRITING AND UPDATED ON AN ANNUAL BASIS THEREAFTER. IF CIRCUMSTANCES CHANGE BEFORE THE ANNUAL DISCLOSURE REQUEST, REVISED INFORMATION IS REQUIRED AS IT OCCURS. ANY DISCLOSURE INFORMATION PROVIDED BY THE BOARD OF DIRECTORS AND OFFICERS IS REVIEWED BY THE BOARD OF DIRECTORS' EXECUTIVE COMMITTEE. LEADERSHIP DISCLOSURES ARE REVIEWED BY HUMAN RESOURCES AND OFFICERS.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
NO COMPENSATION IS PAID TO EXECUTIVES DIRECTLY BY THIS ORGANIZATION. THE BOARD OF DIRECTORS' PERSONNEL, COMPENSATION & EXECUTIVE EVALUATION COMMITTEE (COMMITTEE) FOR ITS AFFILIATE ORGANIZATION EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC. (AS DISCLOSED ON SCH. R) ESTABLISHES THE COMPENSATION OF THE CEO. IN ARRIVING AT REASONABLE COMPENSATION THE COMMITTEE UTILIZES VARIOUS RESOURCES INCLUDING AN INDEPENDENT CONSULTANT, CEO COMPENSATION REPORTED ON THE FORM 990 FOR SIMILAR ORGANIZATIONS, AS WELL AS OTHER RELEVANT COMPENSATION RESOURCES. THE COMMITTEE MAKES A RECOMMENDATION TO THE BOARD OF DIRECTORS. BASED ON THE INFORMATION PROVIDED AND DELIBERATION BY THE BOARD OF DIRECTORS, THE CEO COMPENSATION IS ESTABLISHED THROUGH A WRITTEN EMPLOYMENT CONTRACT. IN ADDITION THE COMMITTEE ANNUALLY EVALUATES THE PERFORMANCE OF THE CEO.
COMPENSATION PROCESS FOR OFFICERS
FORM 990, PAGE 6, PART VI, LINE 15B
NO COMPENSATION IS PAID DIRECTLY BY THIS ORGANIZATION TO ANY OFFICERS OR KEY EMPLOYEES. AS WITH THE COMPENSATION POLICY AND PROCEDURES OBSERVED FOR THE "TOP OFFICIAL" (AS DISCLOSED ABOVE UNDER PART VI, LINE 15A), ALL COMPENSATION REMUNERATED TO OFFICERS OR KEY EMPLOYEES BY THE ORGANIZATION'S AFFILIATE ORGANIZATION, EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC. IS SUBJECT TO THE DECISIONS OF THE BOARD OF DIRECTORS' PERSONNEL, COMPENSATION & EXECUTIVE EVALUATION COMMITTEE. COMPENSATION DECISIONS FOR OFFICERS AND KEY EMPLOYEES ALSO INCLUDES REFERENCE TO CONTEMPORANEOUS COMPARABLE EXTERNAL SALARY DATA AND RECOMMENDATIONS FROM THE CEO.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
REQUEST FOR PUBLIC FINANCIAL INFORMATION AND/OR GOVERNING DOCUMENTS ARE AVAILABLE AT THE PRINCIPAL OFFICE OR BY REQUESTING IN WRITING (INCLUDING EMAIL).
ADDITIONAL INFORMATION
FORM 990, PART VII
JOYCE STEVENS, FORMER CFO, VOLUNTARILY SEVERED HER EMPLOYMENT WITH THE ORGANIZATION'S AFFILIATE EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC. IN MARCH, 2011. BRAD ROBERTS SUCCEEDED TO THE CFO POSITION DURING 2011 AND THEREFORE WILL NOT RECEIVE HIS INITIAL FORM W-2 FROM THE ORGANIZATION UNTIL JANUARY, 2012.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.