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.") .... | 3,557,549 | 3,557,468 | 3,507,552 | 3,537,887 | 3,320,987 | 17,481,443 |
| 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.. | 3,557,549 | 3,557,468 | 3,507,552 | 3,537,887 | 3,320,987 | 17,481,443 |
| 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. | 17,481,443 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 3,557,549 | 3,557,468 | 3,507,552 | 3,537,887 | 3,320,987 | 17,481,443 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 4,936 | 2,566 | 2,426 | 1,681 | 1,655 | 13,264 |
| 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). | 17,494,707 | |||||






| 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 7a | There are no classes of persons with rights that are in | |
| addition to the rights of any other persons. Each regional | ||
| council provides opportunity in their region for nominations | ||
| to the Board of Directors. Nominations are open to be | ||
| made by the 60+ public and held during the last full week | ||
| of March. The Board has ruled that senior centers that | ||
| are contracted through the Area Agency on Aging be | ||
| approved as polling places for the elections held the | ||
| first Tuesday following the first Monday in May. The | ||
| service delivery area is divided into 3 regions. Each of | ||
| those regions have 3 positions on the Board elected for 3 | ||
| year terms, rotating one position each year. Each vacancy | ||
| is filled in the same manner as the vacated member was | ||
| originally elected, to fill the unexpired term for the vacancy. | ||
| Pt VI, Line 11a | The process for review is as follows: the exective director | |
| and financial manager collaborate with the Auditor to complete | ||
| Form 990. This step may involve receiving information from | ||
| employees, board members, contractors and others who have | ||
| business-related activities with the Organization. The | ||
| Auditor provides a completed Form 990 to the executive | ||
| director and financial manager for their review. Once | ||
| approval of the executive director and financial manager | ||
| is granted, each board member will receive a copy, including | ||
| required schedules, as ultimately filed with the IRS for | ||
| their review at the next regularly scheduled board meeting. | ||
| The review is conducted by the executive director, financial | ||
| Form 990EZ, Part II, Line 24 | ACCOUNTS RECEIVABLE - NET GRANTS RECEIVABLE - NET PREPAIDS | |
| Form 990EZ, Part II, Line 26 | ACCOUNTS PAYABLE & ACCRUED EXPENSES | |
| Form 990, Part IX, Line 24f | MISCELLANEOUS | |
| manager and board. A review checklist is utilized. After | ||
| completion of the review, the board resolves to approve | ||
| the Form 990. If at any step in the process a revision | ||
| to the Form 990 is requested, the revised information is | ||
| given to the auditor, the Form 990 is revised, and the | ||
| process begins again. | ||
| Pt VI, Line 12c | The board has established a number of policies and procedures | |
| to guard against conflict of interest regarding proposed and | ||
| ongoing transactions. All board members and staff are | ||
| trained on, and subject to, these policies and procedures. | ||
| Annually, the board of directors and key employees sign a | ||
| statement certifying no conflicts of interest or describing | ||
| potential conflicts of interest that may exist. The board, | ||
| with assistance of executive director, is responsible to | ||
| determine whether a conflict exists and resolution. Should | ||
| a conflict be identified, such person would be prohibited | ||
| from participating in the board deliberation & decision in | ||
| the transaction. | ||
| Pt VI, Line 15 | Compensation for executive director approved annually by | |
| Board of Directors. Board follows a salary schedule that | ||
| was developed by utilizing outside independent sources. | ||
| This salary schedule was approved by the board. Compensation | ||
| is based on salary schedule. Executive director is evaluated | ||
| annually by the board. Salary schedule provides for salary cap | ||
| on executive director's pay of $77,000. | ||
| Pt VI, Line 19 | The Organization makes its governing documents, conflict | |
| of interest policy, and audited financial statements | ||
| available, at the Organization's office, to general public | ||
| upon request. | ||
| Pt IX, Line 25, col d | The primary purpose of the Organization is the establishment | |
| of the priorities and development of overall plans for | ||
| programs on aging in the Multi-County Area of Northwest | ||
| Missouri. The Organization receives fund under Title III | ||
| and other titles of the Older Americans Act (OAA) and such | ||
| other sources as may become available. The Organization is | ||
| mandated by the OAA to use subgrants or contracts with | ||
| service providers to provide all services under OAA funding | ||
| sources. The Organization may request a waiver, from the | ||
| Missouri Department of Health and Senior Services to provide | ||
| a service directly. Due to the nature of funding received | ||
| and the strict limitations placed on the use of that funding | ||
| by grantor agencies, the Organization did not conduct any | ||
| fundraising activities for 2011-2012. | ||
| Pt XII, Line 2c | The audit is procured by the State of Missouri on behalf of | |
| the Organization. During the audit, the board of directors and | ||
| executive director assume responsibility for oversight of the | ||
| audit. Upon completion of the audit, the Missouri Department | ||
| of Health & Senior Services reviews and approves the audit report; | ||
| board of directors reviews audit report, holds exit conference | ||
| with the auditor and formally votes to accept audit report. | ||
| This process is followed consistently from year to year. |
| Software ID: | 11000175 |
| Software Version: |