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
LENBROOK SQUARE FOUNDATION INC
Employer identification number
58-1416841
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)
No
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
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.") ....
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) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(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—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.") .
165,093
136,914
126,875
263,786
356,401
1,049,069
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......
13,364,020
14,661,660
20,007,669
23,462,505
26,875,942
98,371,796
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.
13,529,113
14,798,574
20,134,544
23,726,291
27,232,343
99,420,865
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
0
0
0
0
0
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
0
0
0
0
c
Add lines 7a and 7b..
0
0
0
0
0
8
Public Support (Subtract line 7c from line 6.)
99,420,865
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...
13,529,113
14,798,574
20,134,544
23,726,291
27,232,343
99,420,865
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
718,757
630,087
449,421
328,171
332,947
2,459,383
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
718,757
630,087
449,421
328,171
332,947
2,459,383
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.).
14,247,870
15,428,661
20,583,965
24,054,462
27,565,290
101,880,248
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
97.586 %
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
96.724 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f))
......
17
2.414 %
18
Investment income percentage from 2010 Schedule A, Part III, line 17
.............
18
3.276 %
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
LENBROOK SQUARE FOUNDATION INC
Employer identification number
58-1416841
Identifier
Return Reference
Explanation
CONFLICT OF INTEREST POLICY
PART VI, B, 12C
THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY WHICH DEFINES A CONFLICT OF INTEREST, EXPLAINS HOW DISCLOSURE OF POTENTIAL CONFLICTS SHOULD BE FACILITATED AND THE PROCEDURES TO MANAGE CONFLICTS. ANNUALLY, BOARD MEMBERS ARE REQUIRED TO REAFFIRM IN WRITING THEIR INTEREST TO CONTINUE ON THE BOARD AND THEIR KNOWLEDGE OF OUR CONFLICT OF INTEREST POLICY AND RECUSAL FORM IF THEY PERCEIVE THEY MAY HAVE A POTENTIAL CONFLICT.
COMPENSATION POLICY
PART VI, B, 15A and 15B COMPENSATION POLICY
THE ORGANIZATION HAS A COMPENSATION POLICY FOR OFFICERS AND KEY EMPLOYEES WHICH OUTLINES THE REVIEW AND APPROVAL PROCESS, THE USE OF COMPARABLE DATA AND THE RECORDING OF COMPENSATION DECISIONS. THE COMPENSATION COMMITTEE OF THE BOARD REVIEWS AND APPROVES RECOMMENDATIONS OF COMPENSATION FOR KEY EMPLOYEES, COMPARABLE MARKET DATA AND LENBROOK'S COMPENSATION PLAN.
FORM 990 REVIEW PROCESS
FORM 990, PART VI, LINE 10
THE ORGANIZATION'S FORM 990 IS REVIEWED BY THE CFO, CEO, FINANCE DIRECTOR, ACCOUNTING DIRECTOR AND MEMBERS OF THE FINANCE COMMITTEE. CHANGES ARE MADE, IF APPLICABLE, AND A COPY OF THE REVIEWED FORM 990 IS DISTRIBUTED TO BOARD MEMBERS PRIOR TO FILING.
INFORMATION AVAILABLE TO PUBLIC
FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION PROVIDES A COPY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST. DOCUMENTS ARE MADE AVAILABLE BY ARRANGEMENT WITH THE INDIVIDUAL REQUESTING THE DOCUMENTS.
BONDS-SCH K, PARTS I AND II
SCHEDULE K, PARTS 1 AND PART II
PART I, A: ISSUER NAME RESIDENTIAL CARE FACILITIES FOR THE ELDERLY AUTHORITY OF FULTON COUNTY (GEORGIA) COL. F: DESCRIPTION OF PURPOSE 1) ACQUISITION, CONSTRUCTION, FURNISHING AND EQUIPPING OF RENOVATION AND EXPANSION OF THE ORGANIZATION'S SENIOR LIVING; 2) CURRENTLY REFUND THE ORGANIZATION'S 1996 BONDS ORIGINALLY ISSUED ON OCTOBER 18, 1996; AND 3) CURRENTLY REFUND OUTSTANDING TAXABLE LINES OF CREDIT OF THE ORGANIZATION. -------------------------------------------------------------------------- PART II, LINE 3: TOTAL PROCEEDS OF ISSUE AS OF 6/30/2012 ARE $181,010,318, WHICH ARE SALE PROCEEDS OF $171,011,386 PLUS INVESTMENT EARNINGS OF $9,998,932. EXCLUDED ARE TRANSFERRED PROCEEDS FROM THE DEBT SERVICE RESERVE FUND FOR THE 1996 BONDS OF $1,869,000 WHICH WERE USED TO CURRENTLY REFUND THE 1996 BONDS. -------------------------------------------------------------------------- PART II, LINE 6: THE CURRENT REFUNDING ESCROW WAS EXPENDED ON 12/29/2006. -------------------------------------------------------------------------- PART II, LINE 9: SUCH PROCEEDS WERE DEPOSITED IN THE OPERATING RESERVE FUND AND WERE USED TO PAY OPERATING EXPENSES (IN AN AMOUNT LESS THAN FIVE PERCENT [5%] OF THE SALE PROCEEDS) DIRECTLY RELATED TO CAPITAL EXPENDITURES FINANCED BY THE 2006 BONDS. -------------------------------------------------------------------------- PART II, LINE 10: CAPITAL EXPENDITURES FROM PROCEEDS OF $132,034,465 DO NOT INCLUDE CAPITALIZED INTEREST OF $19,402,358. -------------------------------------------------------------------------- PART II, LINE 12: SUCH UNSPENT PROCEEDS AS OF 6/30/2012 ARE IN AN OPERATING RESERVE FUND USED TO PAY OPERATING EXPENSES DIRECTLY RELATED TO CAPITAL EXPENDITURES FINANCED BY THE 2006 BONDS.
BONDS-SCH K, PART III
SCHEDULE K, PART III
PART III, LINE 2: THE ORGANIZATION HAS LEASE ARRANGEMENTS WITH A BEAUTY SALON PROVIDER AND A PHYSICAL THERAPY PROVIDER. THE AGGREGATE SPACE OCCUPIED BY THESE PROVIDERS RELATIVE TO THE TOTAL BOND FINANCIAL PROPERTY IS APPROXIMATELY 0.2%. -------------------------------------------------------------------------- PART III, LINE 3A: THE ORGANIZATION HAS DETERMINED THAT ITS MANAGEMENT OR SERVICE CONTRACTS MEET THE SAFE HARBOR UNDER REV. PROC. 97-13, 1997-1 C.B. 632 -------------------------------------------------------------------------- PART III, LINE 7: THE ORGANIZATION IS IN THE PROCESS OF DOCUMENTING AND ADOPTING WRITTEN SPECIFIC MANAGEMENT PRACTICE AND PROCEDURES TO ENSURE THE POST-ISSUANCE COMPLIANCE OF ITS TAX-EXEMPT BOND LIABILITIES.
BONDS-SCH K, PART IV
SCHEDULE K, PART IV
PART IV, LINE 3E: ACCORDING TO ITS TERMS, THE HEDGE TERMINATED ON FEBRUARY 28, 2010. -------------------------------------------------------------------------- LINES 4B AND 4C: A PORTION OF GROSS PROCEEDS WAS INVESTED IN FOUR GICS: 1. GIC PROVIDER: DEPFA BANK PLC; TERM OF GIC: 10.5 YEARS -------------------------------------------------------------------------- 2. GIC PROVIDER: TRANSAMERICA OCCIDENTAL LIFE INSURANCE COMPANY, TERM OF GIC: 1.5 YEARS -------------------------------------------------------------------------- 3. GIC PROVIDER: TRANSAMERICA OCCIDENTAL LIFE INSURANCE COMPANY, TERM OF GIC: 1.4 YEARS -------------------------------------------------------------------------- 4. GIC PROVIDER: TRANSAMERICA OCCIDENTAL LIFE INSURANCE COMPANY, TERM OF GIC: 2.5 YEARS
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.