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
Lighthouse International
Employer identification number
13-1096620
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.") ....
9,701,990
13,301,327
24,186,523
15,657,927
14,586,320
77,434,087
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
0
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
4
Total. Add lines 1 through 3
9,701,990
13,301,327
24,186,523
15,657,927
14,586,320
77,434,087
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)..
1,022,834
6
Public support. Subtract line 5 from line 4.
76,411,253
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..
9,701,990
13,301,327
24,186,523
15,657,927
14,586,320
77,434,087
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
1,097,077
633,489
1,003,895
991,435
976,908
4,702,804
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
4,678,990
3,083,466
3,265,088
4,208,099
4,677,456
19,913,099
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
2,043,760
661,340
890,802
844,722
771,552
5,212,176
11
Total support (Add lines 7 through 10).
107,262,166
12
Gross receipts from related activities, etc. (see instructions)
..................
12
16,671,797
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
71.238 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
81.652 %
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.") .
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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(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 2012 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
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
Lighthouse International
Employer identification number
13-1096620
Identifier
Return Reference
Explanation
Process used to review form 990
FORM 990, PART VI, LINE 11
Form 990 was prepared by a nationally renowned accounting firm in conjunction with the organization's financial department. A copy of the draft Form 990 was circulated to the full Board of Trustees for discussion and comment. Each Board Member was provided ample opportunity to comment on the information contained in the 990 prior to its filing with the Internal Revenue Service.
Conflict of interest policy monitoring & enforcement
FORM 990, PART VI, LINE 12
Lighthouse International's Conflict of Interest Policy for Directors, Officers and Other Key Employees is as follows: 1. SCOPE: The following statement of policy applies to each member of the Board and to all officers of Lighthouse International (LI). Further, it is intended to serve for the guidance of all persons employed by the institution regardless of position. 2. FIDUCIARY RESPONSIBILITY: Members of the Board, Officers, and staff serve a public-interest role and thus have a clear obligation to conduct all affairs of the Lighthouse International in a manner consistent with this concept. All decisions of the Board and Officers of the Administration of Lighthouse International are to be made solely on the basis of a desire to promote the best interests of Lighthouse International and the public good. 3. Any Board member or Officer must report a conflict, or potential conflict, of interest in the event that any transaction for Lighthouse International which also involves a 1)member of the Board or any officer of Lighthouse International or a member of his or her family or 2) an organization with which a member of the Board or any officer of Lighthouse International is affiliated, such board member or officer, at the first knowledge of the transaction, shall disclose fully the precise nature of the interest or involvement. 4. RESTRAINT ON PARTICIPATION: Directors or Officers who have declared or been found to have conflict of interest in any matter before the administration or the Board shall refrain from participating in consideration of the proposed transaction, unless for special reasons for the Board or Administration requests information or interpretation from the person or persons involved. The person or persons involved should not vote on such matters and should not be presented at the time of vote. 5. DISCIPLINARY ACTION: Violation of these standards by a member of the Board or by the President/CEO shall be addressed by the Board. Sanctions available to the Board in its discretion range from an oral or written admonishment to removal of a trustee from the Board for cause. In accordance with the Bylaws of the Board, any removal of a member of the Board for cause shall be by a vote of two-thirds (2/3) of all the trustees taken at a regular or special meeting. Violations of these standards by a Lighthouse International officer other than the President/CEO shall be addressed by the President/CEO. Sanctions available to the President range from an oral or written admonishment to termination of employment. Any Board member or Officer of Lighthouse International who is uncertain about possible conflict of interest in any matter, may request the Board to determine whether a possible conflict prevails; the Board shall resolve the question by majority vote. When possible, the question of potential conflict should be referred to counsel for an opinion prior to the Board's vote.
Process for determining compensation
FORM 990, PART VI, LINE 15
The Finance & Administration Committee of the Board of Directors of Lighthouse International reviews and approves corporate officers' compensation and benefit programs including the 401K plan annually, to ensure that programs are competitive and cost effective. Compensation decisions, including salary, bonus and other compensation, are recommended to the full Board of Directors for its approval. For all other employees, including key employees all recommendations are reviewed by human resources and the President/CEO. Human resources regularly reviews compensation through various external market surveys and sources. Deliberation includes evaluation of individual performance measured against personal and corporate goals.
Availability of documents to the public
FORM 990, PART VI, LINE 19
The organization makes its Form 990 available to the public by making the copy retained at its place of business readily available for public inspection. The Form 990 is also available on the organization's website at www.lighthouse.org as well as on the internet at www.guidestar.org. The organization's financial statements, governing documents and conflict of interest policy are not ordinarily made available to the public, but, if requested, will be provided at management's discretion.
Other Program Service Activities
Form 990, Part III, line 4d
In addition to the three largest program services, Lighthouse International undertakes the following other program activities: 1)Volunteers and reading services recruit outstanding individuals including college interns and business professionals who give of their time and expertise, volunteering in support of Lighthouse programs and its mission. 2)The Lighthouse Music School is the largest community music school program for people of all ages with vision loss in the United States. 3)Professional education offers accredited professional continuing education courses in low vision care and vision rehabilitation as well as paraprofessional training. 4)Career, academic and technology services enable people who are legally blind achieve their academic goals, prepare for, obtain or retain a job in the competitive marketplace, and provide evaluation and training on the use of assistive technology. Adult basic education, English as a Second Language (ESL), GED, tutoring and college preparation are some of the academic offerings. Matching employers with qualified candidates and ensuring workplace accessibility for employees with vision loss are key components of these programs. 5)Consumer products include the Optical Dispensary and Retail and Online Lighthouse Store which provide a wide range of lighting, magnifying and adaptive devices all of which are designed to make life easier for people with vision loss available to those who need them. 6)The Arlene R. Gordon Research Institute conducts studies designed to translate scientific findings and advances in technology into practical solutions that can help people who are visually impaired function more effectively in everyday life. 7)Public Information disseminates communications through various media outlets to raise widespread awareness of the prevalence of vision loss, and to promote the importance of prevention and early intervention, as well as the benefits of vision rehabilitation for people who are blind or visually impaired. 8)Early intervention services are dedicated to helping children with visual impairments and/or developmental delays from birth to three years of age. Programs help infants and toddlers with vision problems and developmental delays reach the same developmental milestones as their peers. 9)Social services assist people and their families and caregivers in adjusting to and coping with vision loss, by addressing the emotional and psychological impact of the vision loss so that independence, dignity and quality of life are maintained. Services are provided in individual and group settings. 10)Outreach encompasses the development of strategic initiatives and activities to advance awareness of vision related issues, and provides education and referrals for the full range of services provided by Lighthouse International in the New York metropolitan area. 11)Policy and advocacy includes outreach to raise awareness of vision impairment; and advocacy initiatives, which promote the rights of people with vision loss and their inclusion in mainstream society.
Reconciliation of net assets
Part XI, Line 9
Other Changes in Net Assets: Change in split-interest agreements $ 600,036 Minimum Pension Liability $(1,673,575) ------------ Total $(1,073,539) ============
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.