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 SOUTHEAST MISSOURI
Employer identification number
43-1666987
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.") .
590,746
211,101
135,392
160,630
200,704
1,298,573
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......
327,727
812,398
1,035,846
1,009,901
1,107,401
4,293,273
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
10,257
4,743
5,125
96,944
117,069
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.
918,473
1,033,756
1,175,981
1,175,656
1,405,049
5,708,915
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
90,170
90,170
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..
90,170
90,170
8
Public support (Subtract line 7c from line 6.)
5,618,745
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...
918,473
1,033,756
1,175,981
1,175,656
1,405,049
5,708,915
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
4,865
27,314
9,422
5,207
2,362
49,170
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
4,865
27,314
9,422
5,207
2,362
49,170
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
66,771
66,771
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.)..
923,338
1,061,070
1,185,403
1,180,863
1,474,182
5,824,856
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
96.460 %
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
85.340 %
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 SOUTHEAST MISSOURI
Employer identification number
43-1666987
Identifier
Return Reference
Explanation
EXPLANATION ON VOLUNTEERS AND TYPES OF SERVICES OR BENEFITS
FORM 990, PAGE 1, PART I, LINE 6
VOLUNTEERS PRIMARILY SERVE AT THE FRONT DESK AND AS PROGRAM LEADERS.
ALL OTHER ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4D
THE YMCA OFFERS NUMEROUS ADULT PROGRAMS WHICH AIM TO ENHANCE THE BODY, MIND AND SPIRIT OF PARTICIPANTS. MANY EXERCISE ACTIVITIES ARE OFFERED FOR ADULTS AND SENIOR CITIZENS. BUILT INTO THESE PROGRAMS ARE OPPORTUNITIES FOR SOCIAL ACTIVITIES THAT GO BEYOND THE PROGRAMS THEMSELVES. PERIODICALLY ADULTS ARE ASKED TO PARTICIPATE IN OTHER Y VOLUNTEER FUNCTIONS OR COMMUNITY SERVICE ACTIVITIES. THE Y ALSO OFFERS AN ARTHRITIS EXERCISE PROGRAM IN COLLABORATION WITH THE LOCAL HEALTH DEPARTMENT WHICH IS AVAILABLE TO THE COMMUNITY AT LARGE AT NO CHARGE. THE Y FACILITY HOUSES NUMEROUS Y PROGRAMS AND THE FACILITIES ARE AVAILABLE TO Y MEMBERS. MEMBERS MAY USE THE FITNESS CENTER, GYMNASIUM, NURSERY, AND YOUTH CENTER AT NO ADDITIONAL CHARGE. THE Y FACILITIES ARE ALSO AVAILABLE TO THE GENERAL PUBLIC, ESPECIALLY YOUTH, FOR A DAILY FEE. YOUTH MAY PAY 2 FEE AFTER SCHOOL, WEEKENDS AND SOME WEEK NIGHT EVENINGS AND MAY USE THESE SAME Y FACILITIES. THE Y ALSO HAS SEVERAL YOUTH-SERVING AGENCIES THAT ARE PROVIDED MEMBERSHIPS THROUGH ITS FINANCIAL ASSISTANCE PROGRAM. THESE ARE TYPICALLY YOUTH AND THE Y MEMBERSHIPS PROVIDE THEM AND THEIR GROUP LEADERS A PLACE TO RECREATE. THE Y ALSO PROVIDES USE OF ITS GYM TO THE LOCAL SCHOOL DISTRICT AT NO CHARGE FOR PHYSICAL EDUCATION FOR ITS ALTERNATIVE SCHOOL PROGRAM.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
A FINAL COPY OF THE 990 WAS CIRCULATED TO THE BOARD BY E-MAIL. A LIST OF AREAS FOR THE BOARD TO PAY ATTENTION TO WAS ALSO CIRCULATED. THERE WERE NO CONCERNS BY THE BOARD.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
THE FIRST MEETING OF EACH YEAR CONFLICT OF INTEREST STATEMENTS ARE CIRCULATED TO THE BOARD MEMBERS TO BE FILLED OUT AND SIGNED. MEMBERS ARE REQUIRED TO IMMEDIATELY NOTIFY THE EXECUTIVE DIRECTOR IF ANY NEW CONFLICTS OF INTEREST HAVE OCCURRED.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
THE BOARD MUST ANNUALLY APROVE THE COMPENSATION OF THE EXECUTIVE DIRECTOR. THE EXECUTIVE DIRECTOR IS THE ONLY EMPLOYEE THAT IS AN OFFICER OR KEY EMPLOYEE. THE BOARD DELEGATES ITS POWER TO ITS EXECUTIVE COMMITTEE. THERE IS NO MEMBER ON THE EXECUTIVE COMMITTEE THAT HAS A PERSONAL INTEREST IN THE DIRECTOR'S COMPENSATION. THE EXECUTIVE COMMITTEE DETERMINES IF THE COMPENSATION IS REASONABLE BY COMPARING THE COMPENSATION TO EQUIVALENT YMCA'S IN OTHER TOWNS OF COMPARABLE DEMOGRAPHICS. THE EXECUTIVE COMMITTEE THEN MAKES A WRITTEN RECOMMENDATION TO THE BOARD. THIS RECOMMENDATION INCLUDES PROPOSED COMPENSATION, THE IDENTITY AND SOURCE OF COMPARABILITY DATA, WHO WAS PRESENT FOR THE VOTE, AND HOW EACH MEMBER VOTED. THE COMPENSATION MAY NOT BE INCREASED UNTIL THE BOARD HAS APPROVED THE REPORT, WHICH SHOULD OCCUR WITHIN 60 DAYS OF RECOMMENDATION. THE BOARD MUST INCLUDE IN ITS MINUTES A DETAILED RECORD OF THE BOARD MEMBERS' PRESENCE AND VOTE.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
DOCUMENTS ARE AVAILABLE BY MAIL OR PERSONAL REQUEST.
RECONCILIATION OF CHANGES - OTHER
FORM 990, PART XI, LINE 9
DIRECT FUNDRAISING EXPENSE 31,535 DIRECT FUNDRAISING EXPENSE -31,535 BOOK / TAX DEPRECIATION DIFFERENCE -105,349
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.