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
NYS TROOPERS PBA SIGNAL 30 FUND INC
Employer identification number
20-4062957
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.") ....
101,295
208,001
426,691
356,770
421,150
1,513,907
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..
101,295
208,001
426,691
356,770
421,150
1,513,907
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.
1,513,907
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..
101,295
208,001
426,691
356,770
421,150
1,513,907
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
5,971
2,333
2,947
1,874
1,862
14,987
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).
1,528,894
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
425,125
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
99.020 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
98.770 %
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
NYS TROOPERS PBA SIGNAL 30 FUND INC
Employer identification number
20-4062957
Identifier
Return Reference
Explanation
ORGANIZATION'S MISSION
FORM 990 - ORGANIZATION'S MISSION
THE FUND WAS DESIGNED TO FOSTER, ENCOURAGE, AND SUPPORT CAREERS IN LAW ENFORCEMENT BY: (A) PROVIDING SCHOLARSHIPS, GRANTS AND OTHER FORMS OF FINANCIAL ASSISTANCE TO WORTHY STUDENTS SEEKING EDUCATION TO PURSUE AND FURTHER CAREERS IN LAW ENFORCEMENT; (B)PROVIDING SUPPORT TO HELP AND ASSIST THE FAMILIES OF LAW ENFORCEMENT PROFESSIONALS IN TIMES OF FINANCIAL EMERGENCY CAUSED BY ACCIDENT, ACTS OF GOD,NATURAL DISASTERS, FLOODS, STORMS, ILLNESS, HOSPITALIZATION, MEDICAL BILLS AND OTHER UNFORSEEN EVENTS THAT CAUSE FINANCIAL DISTRESS FOR THE FAMILIES OF LAW ENFORCEMENT PERSONNEL; (C) PROVIDING FINANCIAL AID, SUPPORT AND ASSISTANCE TO WORTHY PROGRAMS WHICH ENHANCE THE CAREER FIELD OF LAW ENFORCEMENT; (D) PROVIDING FINANCIAL AID, SUPPORT AND ASSISTANCE TO PUBLIC EDUCATIONAL PROGRAMS WHICH ENHANCE LAW ENFORCEMENT AND CAREERS IN LAW ENFORCEMENT;(E) ESTABLISHING AND FUNDING SCHOLARSHIPS FOR THE FAMILIES OF LAW ENFORCEMENT PROFESSIONALS WHO ARE PURSUING DEGREES IN HIGHER EDUCATION.
FIRST ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4A
SUPPORT AND ASSISTANCE TO WORTHY PROGRAMS WHICH ENHANCE THE CAREER FIELD OF LAW ENFORCEMENT; (D) PROVIDING FINANCIAL AID, SUPPORT AND ASSISTANCE TO PUBLIC EDUCATIONAL PROGRAMS WHICH ENHANCE LAW ENFORCEMENT AND CAREERS IN LAW ENFORCEMENT;(E) ESTABLISHING AND FUNDING SCHOLARSHIPS FOR THE FAMILIES OF LAW ENFORCEMENT PROFESSIONALS WHO ARE PURSUING DEGREES IN HIGHER EDUCATION.
ELECTION OF MEMBERS AND THEIR RIGHTS
FORM 990, PAGE 6, PART VI, LINE 7A
THE MEMBERS GET TO VOTE ON APPROVING CHANGES IN THE ORGANIZATION'S BYLAWS AND APPROVING OTHER SIGNIFICANT DECISIONS OF THE GOVERNING BOARD.
DECISIONS SUBJECT TO APPROVAL OF MEMBERS
FORM 990, PAGE 6, PART VI, LINE 7B
THE MEMBERS GET TO VOTE ON APPROVING CHANGES IN THE ORGANIZATION'S BYLAWS AND APPROVING OTHER SIGNIFICANT DECISIONS OF THE GOVERNING BOARD.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
THE ORGANIZATION'S PRESIDENT REVIEWS THE FORM 990 ALONG WITH A DRAFT OF THE FINANCIAL STATEMENTS WITH THE OUTSIDE ACCOUNTANT APPROXIMATELY ONE WEEK BEFORE THE FORM 990 IS FILED WITH THE INTERNAL REVENUE SERVICE.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
INDIVIDUALS WHO KNOWINGLY VIOLATE AND/OR REFUSE TO ABIDE BY THE CONFLICT OF INTEREST POLICY MAY BE SUBJECT TO TERMINATION OF THEIR RELATIONSHIP WITH THE ORGANIZATION.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
THE EXECUTIVE BOARD ANNUALLY APPROVES THE PRESIDENT'S COMPENSATION. THE EXECUTIVE BOARD BASES ITS REVIEW OF THE PRESIDENT'S COMPENSATION ON COMPARABLE COMPENSATION PAID BY OTHER SIMILAR ORGANIZATIONS.
COMPENSATION PROCESS FOR OFFICERS
FORM 990, PAGE 6, PART VI, LINE 15B
THE EXECUTIVE BOARD ANNUALLY APPROVES THE OFFICERS' COMPENSATION. THE EXECUTIVE BOARD BASES ITS REVIEW OF THE OFFICERS' COMPENSATION ON COMPARABLE COMPENSATION PAID BY OTHER SIMILAR ORGANIZATIONS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND FORM 990 AVAILABLE UPON WRITTEN REQUEST. INTERESTED PARTIES SHOULD CONTACT THE PRESIDENT AT 120 STATE STREET, ALBANY, NY 12207 TO REQUEST A COPY OF ANY OF THE DOCUMENTS.
ADDITIONAL INFORMATION
FORM 990, PART XII
STATEMENT OF FUNCTIONAL EXPENSES THE SIGNAL 30 FUND IS RELATED TO THE POLICE BENEVOLENT ASSOCATION OF THE NEW YORK STATE TROOPERS, INC. (THE "PBA") THROUGH CERTAIN COMMON BOARD MEMBERS. THE PBA PAID ALL OF THE SIGNAL 30 FUND'S MANAGEMENT AND GENERAL EXPENSES TOTALING 238,733. THIS AMOUNT IS INCLUDED AS DONATION REVENUE IN PART VIII STATEMENT OF REVENUE FOR THE YEAR. THE FOLLOWING PROGRAM EXPENSES ARE INCLUDED IN THE SIGNAL 30 FUND'S EXPENSES PAID BY THE PBA: EMPLOYEE EXPENSES -12,729 INSURANCE EXPENSES - 632 OFFICE AND MEETINGS EXPENSES - 5,788 OTHER OPERATING EXPENSES -49,448 WAGES AND SALARIES EXPENSES - 87,519 PAYROLL TAXES EXPENSES -5,655 PROMOTIONAL ITEMS EXPENSES - 8,600 RENT EXPENSES - 10,011 CHARITABLE DONATIONS EXPENSES -300 THE FOLLOWING MANAGEMENT AND GENERAL EXPENSES ARE INCLUDED IN THE SIGNAL 30 FUND'S EXPENSES PAID BY THE PBA: EMPLOYEE BENEFITS EXPENSES -2,246 INSURANCE EXPENSES -112 OFFICE AND MEETINGS EXPENSES - 1,021 OTHER OPERATING EXPENSES -8,726 WAGES AND SALARIES EXPENSES - 15,445 PAYROLL TAXES EXPENSES - 998 PROFESSIONAL FEES EXPENSES - 7,458 RENT EXPENSES - 1,766 THE FOLLOWING FUNDRAISING EXPENSES ARE INCLUDED IN THE SIGNAL 30 FUND'S EXPENSES PAID BY THE PBA: AWARDS DINNER EXPENSES - 12,390 CASINO NIGHT EXPENSES - 1,885 GOLF OUTING EXPENSES (LONG ISLAND) - 6,004
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.