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
2012
Open to Public Inspection
Name of the organization
YMCA OF CALLAWAY COUNTY
Employer identification number
43-1552855
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 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 monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
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 2012 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2012.
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—2011.
If the organization did not check a 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—2012.
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—2011.
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) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
83,476
93,527
240,999
166,122
159,766
743,890
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......
507,287
534,599
563,980
569,554
654,074
2,829,494
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.
590,763
628,126
804,979
735,676
813,840
3,573,384
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.)
3,573,384
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
9
Amounts from line 6...
590,763
628,126
804,979
735,676
813,840
3,573,384
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
14,857
2,809
1,194
1,614
2,135
22,609
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
14,857
2,809
1,194
1,614
2,135
22,609
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.)
..
21,751
10,043
31,794
13
Total support. (Add lines 9, 10c, 11, and 12.)..
605,620
652,686
816,216
737,290
815,975
3,627,787
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 2012 (line 8, column (f) divided by line 13, column (f))
.........
15
98.500 %
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
96.090 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
1.000 %
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
1.000 %
19a
33 1/3% support tests—2012.
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—2011.
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) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information.
Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012
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
2012
Open to Public Inspection
Name of the organization
YMCA OF CALLAWAY COUNTY
Employer identification number
43-1552855
Identifier
Return Reference
Explanation
ORGANIZATION'S MISSION
FORM 990 - ORGANIZATION'S MISSION
THE YMCA OF CALLAWAY COUNTY IS A CHARITABLE, COMMUNITY SERVICE ORGANIZATION COMPRISED OF PERSONS OF ALL AGES, ETHNIC GROUPS AND RELIGIOUS AFFILIATIONS DEDICATED TO PUTTING CHRISTIAN PRINCIPLES INTO PRACTICE THROUGH PROGRAMS THAT BUILD HEALTHY SPIRIT, MIND AND BODY FOR ALL. ALL PERSONS ARE WELCOME AT THE YMCA REGARDLESS OF THEIR ABILITY TO PAY. OUR YMCA IS FOUNDED AND LED BY VOLUNTEERS FROM OUR COMMUNITY, WHOM NOT ONLY PROVIDE LEADERSHIP BUT ALSO VOLUNTEER AS MENTORS, COACHES, PROGRAM LEADERS AND MORE. FINANCIAL ASSISTANCE IS AVAILABLE TO THOSE IN NEED.
FIRST ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4A
THE YMCA HAS LEVERAGED SUPPORT FOR SPECIALTY PROGRAMS SUPPORTING CHILDREN AND FAMILIES WITH ASTHMA, OFFERING EDUCATION AND PROGRAMMING TO SUPPORT BOTH THE CHILD AND THE FAMILY UNIT. FINALLY, THE YMCA PROVIDES SPORTS AND PLAY OPPORTUNITIES FOR CHILDREN OF ALL AGES TO LEARN FUNDAMENTAL SKILLS, TEAMWORK AND OTHER POSITIVE CHARACTER DEVELOPMENT. THE YMCA OFFERS SWIMMING, SOCCER, TBALL,BASKETBALL AND MANY MORE ACTIVITES. HEALTHY LIVING 4,000 HELPING PEOPLE OF ALL AGES AND ABILITIES DEVELOP HEALTH IN SPIRIT, MIND AND BODY IS AT THE CORE OF THE YMCA. OUR PROGRAMS ARE DESIGNED TO HELP PEOPLE CREATE REALISTIC GOALS FOR SELF IMPROVEMENT AND EMPHASIZE DISEASE PREVENTION THROUGH REGULAR EXERCISE, PROPER NUTRITION, STRESS MANAGEMENT AND HEALTH EDUCATION. SPORTS PROGRAMS FOR YOUTH, FAMILIES AND ADULTS PROMOTE TEAMWORK, INTERACTION AND DEVELOPMENT OF SOCIAL AND PHYSICAL SKILLS. IN LIGHT OF THE RISING OBESITY RATES IN THE US, THE YMCA PARTICIPATES IN THE ACTIVATE AMERICA INITIATIVE AND ENGAGES IN A VARIETY OF EVENTS AND COMMUNITY ACTIVITIES DESIGNED TO HELP THE AT RISK POPULATION TO DEVELOP HABITS AND RELATIONSHIPS THAT LED TO MORE ACTIVE LIFESTYLES. THE YMCA OFFERS ACTIVITIES, GROUP EXERCISE AND INDIVIDUALIZED INSTRUCTION TO MAXIMIZE EVERY HEALTH SEEKERS POTENTIAL. FROM CHURCH LEAGUE SOFTBALL, PING PONG, BASKETBALL TO AEROBICS, PERSONAL TRAINING AND MORE, THE YMCA STRIVES TO REACH THOSE OF ALL AGES. HUMAN SERVICES: 15,000 BENEFIT FROM PLANNING AND COLLABORATIONS. OUR YMCA WORKS IN COLLABORATION WITH OUR SCHOOLS, CITY AND COUNTY GOVERNMENTS, LOCAL PUBLIC HEALTH DEPARTMENT AND MANY SOCIAL SERVICE AGENCIES TO PROVIDE COUNTY WIDE HEALTH PLANNING AND PROGRAMMING TO HELP OUR RESIDENTS, FAMILIES AND COMMUNITIES BECOME STRONGER AND HEALTHIER. THE YMCA HAS LED EFFORTS IN OUR COMMUNITY TO ADDRESS ASTHMA CARE, DENTAL CARE AND TO BRING COMPREHENSIVE HEALTH SERVICES TO THOSE IN NEED. THE YMCA HAS STARTED COMMUNITY GARDENS AND WORKS TIRELESSLY TO PROMOTE HEALTHY LIVING AND HEALTHY HABITS.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
A COPY OF THE 990 WILL BE EMAILED TO ALL BOARD MEMBERS AND WILL INCLUDE A "READ RECEIPT" NOTIFICATION.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
BOARD MEMBERS UPDATE THE CONFLICT OF INTEREST INFORMATION EACH YEAR.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
THE EXECUTIVE COMMITTEE PERFORMS MARKET RESEARCH AND REVIEWS COMPENSATION OF EXECUTIVE DIRECTOR'S AT YMCAS OF SIMILAR SIZE AND BUDGET. THE COMMITTEE THEN MAKES A RECOMMENDATION TO THE BOARD FOR APPROVAL.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.