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
COMMUNITY SERVICE ALLIANCE
Employer identification number
20-1418132
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.") ....
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.") .
142,890
160,947
360,686
316,589
222,793
1,203,905
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......
67,226
64,764
131,990
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.
142,890
160,947
360,686
383,815
287,557
1,335,895
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
14,569
10,704
132,500
157,773
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..
14,569
10,704
132,500
157,773
8
Public Support (Subtract line 7c from line 6.)
1,178,122
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...
142,890
160,947
360,686
383,815
287,557
1,335,895
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
3,692
2,092
2,007
2,220
2,286
12,297
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
3,692
2,092
2,007
2,220
2,286
12,297
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.).
146,582
163,039
362,693
386,035
289,843
1,348,192
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
87.390 %
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
72.020 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f))
......
17
1.000 %
18
Investment income percentage from 2010 Schedule A, Part III, line 17
.............
18
1.000 %
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
COMMUNITY SERVICE ALLIANCE
Employer identification number
20-1418132
Identifier
Return Reference
Explanation
FIRST ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4A
INDIVIDUALS. WE ENVISION A FUTURE WHERE EIGHT KEY COMMUNITIES - BUSINESS, PEOPLE OF FAITH, SERVICE PROVIDERS, LOCAL GOVERNMENT, NEIGHBORHOOD RESIDENTS, FOUNDATIONS, LANDLORDS, AND THE HOMELESS - COME TOGETHER IN PARTNERSHIP TO SERVE CLEVELAND NEIGHBORHOODS AND EACH OTHER IN WAYS THAT HAVE NEVER BEFORE BEEN POSSIBLE. WE ARE THE ONLY PROGRAM OF OUR KIND IN THE REGION, AND SINCE OUR INCEPTION SIX YEARS AGO, OUR UNIQUE APPROACH HAS HELPED MORE THAN 850 PEOPLE WITH HOUSING, EMPLOYMENT, AND PERSONAL AND SOCIAL SUPPORT. WHAT WE ARE MOST PROUD OF ARE THE POSITIVE OUTCOMES WE CAN SHOW - MORE THAN 80% OF MEN AT PROCOP HOUSE, OUR HOUSING RESIDENCE, SUCCESSFULLY MOVE ON TO PERMANENT, INDEPENDENT HOUSING WITH A FULL OR PART TIME JOB AND THE BEHAVIORS AND SKILLS NEEDED TO BE PRODUCTIVE, CONTRIBUTING MEMBERS OF SOCIETY. STRATEGIC GROWTH. THE SUCCESS OF CSA HAS LED THE ORGANIZATION TO OPEN A SECOND LOCATION TO FURTHER ENHANCE THE MISSION OF THE ORGANIZATION AND REACH OUT TO MORE INDIVIDUALS IN NEED. CSA'S SECOND HOUSING SITE - FULTON HOUSE - WILL OPERATE IN THE FORMER CONVENT AT THE BLESSED SACRAMENT CAMPUS ON THE WEST SIDE OF CLEVELAND. THIS NEW SITE WILL PROVIDE CSA WITH 13 ADDITIONAL ROOMS TO MEET THE GROWING NEED FOR SHORT-TERM HOUSING AND WORK EXPERIENCE FOR MEN TRANSITIONING FROM HOMELESSNESS TO INDEPENDENCE. SERVICES FOR VETERANS. AS IMPORTANTLY, THE NEW LOCATION WILL ENABLE CSA TO FOCUS SERVICES AT THE NEW SITE TO MEET THE NEEDS OF VETERANS EMERGING FROM HOMELESSNESS, AND PROVIDE AN ORGANIZED APPROACH TO ADDRESSING THEIR HOUSING, WORK EXPERIENCE, AND PERSONAL AND BEHAVIORAL NEEDS IN CONJUNCTION WITH ESTABLISHED VA PROGRAMS ALREADY PROVIDING SIMILAR SUPPORTIVE SERVICES. WE STRONGLY BELIEVE SUCH AN APPROACH WOULD HAVE A SIGNIFICANT, POSITIVE IMPACT ON THE COMPLETE NEEDS OF THIS POPULATION, INCLUDING BUT NOT LIMITED TO HOUSING, EMPLOYMENT ASSISTANCE, FINANCIAL LITERACY AND CREDIT REPAIR SERVICES, LEGAL SERVICES, MEDICAL, HEALTH AND MENTAL HEALTH RESOURCES, FOOD AND NUTRITION PROGRAMS, FAMILY AND CHILDREN'S SERVICES, AND OTHERS. 2012 WAS TRULY A WONDERFULLY EXCITING YEAR IN THE LIFE OF CSA IN SO MANY WAYS, IT'S HARD TO BELIEVE WE WERE ABLE TO ACCOMPLISH ALL OF THESE AMAZING THINGS IN A SHORT 12 MONTHS WE PROVIDED HOUSING TO AN UNPRECEDENTED NUMBER OF MEN IN NEED; WE RENOVATED AND OPENED A SECOND HOUSING SITE - FULTON HOUSE - PROVIDING US THE CHANCE TO ENHANCE OUR MISSION, WHILE ALSO FOCUSING SERVICES AT THE SITE ON VETERANS TRANSITIONING FROM HOMELESSNESS TO INDEPENDENCE AND SELF- SUFFICIENCY; OUR AWARD-WINNING DOCUMENTARY, "AIN'T DONE YET", WAS FINALLY DEBUTED TO REMARKABLE ENTHUSIASM AND SUCCESS, AND IS HELPING RAISE AWARENESS OF THE VITAL WORK WE ARE DOING HERE IN THE GREATER CLEVELAND AREA; CSA ALUMNI - MEN WHO MAY HAVE LEFT CSA BUT WHO ALWAYS FEEL A DEEP CONNECTION WITH THE ORGANIZATION - CONTINUE TO GROW IN NUMBER AND ARE AMAZING AMBASSADORS FOR US IN THE COMMUNITY; WE GAVE THANKS FOR EVERYONE WHO IS A PART OF CSA - PAST, PRESENT AND FUTURE - AT OUR ANNUAL THANKSGIVING CELEBRATION ATTENDED BY A RECORD-SETTING 172+ PEOPLE; WE CELEBRATED THE VERY SPECIAL CONTRIBUTION OF TIME, TALENT AND TREASURE OF MICHAEL CALLAHAN, CSA'S 2012 VOLUNTEER OF THE YEAR, FOR HIS HARD WORK AND EFFORT WITH THE VETERANS MEMORIAL GARDEN AND PATIO AT FULTON HOUSE; AND WE RECOGNIZED THE GENEROUS AND GRACIOUS CONTRIBUTIONS OF TWO PARTNER ORGANIZATIONS - ST. JOHN NEUMANN CHURCH AND THE FAMILY MINISTRY CENTER - WITH MISSION PARTNER AWARDS IN RECOGNITION OF THEIR COMMITMENT TO AND SUPPORT OF OUR MISSION AND THE MEN WE SERVE.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
THE FORM 990 IS PREPARED BY AN INDEPENDENT CPA. NO FURTHER REVIEW WAS PERFORMED FOR THE YEAR.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
EACH YEAR, THE BOARD MEMBERS ARE ASKED TO REVIEW THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. AMONG OTHER THINGS, THE POLICY MAKES CLEAR THAT ALL DECISIONS OF THE BOARD, OFFICERS, AND EMPLOYEES OF THE ORGANIZATION ARE MADE SOLELY ON THE BASIS OF A DESIRE TO PROMOTE THE BEST INTEREST OF THE ORGANIZATION AND THE PUBLIC GOOD. THE CONFLICT OF INTEREST STATEMENT REQUESTS BOARD MEMBERS TO IDENTIFY TO THE BEST OF THEIR KNOWLEDGE AFFILIATIONS WITH ORGANIZATIONS THAT MAY BE POTENTIALLY RELATED TO THE FINANCIALS OR OTHER SUBSTANTIVE OPERATIONS OF THE ORGANIZATION. THEY ARE ALSO ASKED TO IDENTIFY CIRCUMSTANCES INVOLVING EITHER THEMSELVES, OR A MEMBER OF THEIR EXTENDED FAMILY, THAT MAY BE CONSTRUED AS A CONFLICT OF INTEREST. AT THE STAFF LEVEL, THE ORGANIZATION'S PERSONNEL ALSO ENSURE THAT THERE ARE NO CONFLICTS OF INTEREST WHEN CONSIDERING THE ENGAGEMENT OF A NEW VENDOR. IF A POTENTIAL CONFLICT IS IDENTIFIED, APPROPRIATE STEPS ARE TAKEN TO BOTH ASSESS THE NATURE OF THE POTENTIAL CONFLICT AND, SUBSEQUENTLY, TO ENSURE THAT THE POSSIBILITY OF AN ACTUAL CONFLICT IS MITIGATED. SUCH MITIGATION IS MANAGED AND THE LETTER AND SPIRIT OF THE CONFLICTS POLICY ARE UPHELD.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
THE EXECUTIVE COMMITTEE ANNUALLY EVALUATES THE PERFORMANCE OF THE EXECUTIVE DIRECTOR. COMPENSATION IS BASED ON PERFORMANCE AND COMPARED TO OTHER AREA MISSION-COMPARABLE ORGANIZATIONS OF SIMILAR SIZE. THE BOARD HAS ADOPTED THE IRS-WRITTEN "REBUTTABLE PRESUMPTION" CHECKLIST WHICH IS COMPLETED CONTEMPORANEOUS WITH THE PERFORMANCE REVIEW.
COMPENSATION PROCESS FOR OFFICERS
FORM 990, PAGE 6, PART VI, LINE 15B
COMPENSATION FOR STAFF WITHIN THE ORGANIZATION IS DETERMINED BY THE EXECUTIVE DIRECTOR. THE LEVEL OF COMPENSATION IS SET BASED ON PERFORMANCE AND IN RELATION TO OTHER AREA MISSION-COMPARABLE ORGANIZATIONS OF SIMILAR SIZE. THIS COMPENSATION IS A COMPONENT OF THE BUDGET, WHICH IS REVIEWED AND APPROVED BY THE FINANCE COMMITTEE AND ALSO BY THE BOARD AS A WHOLE.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
THE ORGANIZATION'S GOVERNING DOCUMENTS, FORM 1023, FORM 990 CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE FORM 990, WITHOUT SCHEDULE B) CAN ALSO BE FOUND ON SEVERAL PUBLICLY-ACCESSIBLE WEBSITES.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.