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
DENVER OSTEOPATHIC FOUNDATION
Employer identification number
84-0425368
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.") ....
89,163
131,096
102,409
91,997
87,792
502,457
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
89,163
131,096
102,409
91,997
87,792
502,457
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.
502,457
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..
89,163
131,096
102,409
91,997
87,792
502,457
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
159,815
41,817
54,660
56,779
65,632
378,703
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.)..
75
75
11
Total support (Add lines 7 through 10).
881,235
12
Gross receipts from related activities, etc. (see instructions)
..................
12
37,463
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
57.020 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
44.430 %
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
DENVER OSTEOPATHIC FOUNDATION
Employer identification number
84-0425368
Identifier
Return Reference
Explanation
ADDITIONAL INFORMATION
FORM 990, PART III
THE DENVER OSTEOPATHIC FOUNDATION IS A NON-PROFIT WITH A MISSION THAT SERVES THE COMMUNITY AND SUPPORTS OSTEOPATHIC MEDICINE THROUGH EDUCATION. THE DENVER OSTEOPATHIC FOUNDATION SOLICITS GRANT FUNDS AND PROVIDES MATCHING FUNDS TO SUPPORT ITS COMMUNITY SERVICE PROGRAMS. PROGRAMS INCLUDE: BUCKLE UP FOR LOVE - A CHILD PASSENGER SAFETY PROGRAM, SAVE A FRIEND SAVE YOURSELF JUVENILE TRAFFIC SAFETY - CHILDREN 8-13 YEARS OLD NEED TO RIDE IN THE BACK SEAT AWAY FROM AIRBAGS, STOP-LOOK-LISTEN - A PEDESTRIAN SAFETY PROGRAM FOR CHILDREN, SKILLS ON WHEELS - A BICYCLE SAFETY PROGRAM, FOOD-FUN-FITNESS - AN EARLY EDUCATION PROGRAM TEACHING PERSONAL HYGIENE, EXERCISE, AND NUTRITION. THE PEDESTRIAN AND BUCKLE UP FOR LOVE SAFETY PROGRAMS PROVIDE TEACHERS, PARENTS AND CHILDREN WITH PEDESTRIAN AND SEAT BELT SAFETY EDUCATION AT DENVER METRO AREA PRESCHOOLS AND ELEMENTARY SCHOOLS FOCUSING ON LOW-INCOME NEIGHBORHOODS. THE DUAL PROGRAMS ASSIST CHILDREN IN LEARNING ABOUT PEDESTRIAN SAFETY AND THE USE OF CAR SEATS AND SEATBELTS THROUGH EDUCATIONAL TRAINING AND THE DISTRIBUTION OF SAFETY MATERIALS. DENVER OSTEOPATHIC FOUNDATION COMMUNITY PROGRAMS CHILD PASSENGER AND PEDESTRIAN SAFETY GOAL: TO INCREASE BOOSTER SEAT USE IN PRE K - 2ND GRADE STUDENTS AT SELECTED ELEMENTARY SCHOOLS IN THE DENVER METRO AREA THROUGH A COMBINATION OF STUDENT AND PARENT EDUCATION AND LIMITED DISTRIBUTION OF CHILD SAFETY/BOOSTER SEATS. TO INCREASE THE KNOWLEDGE AND SAFE PEDESTRIAN BEHAVIORS OF PRE K - 2ND GRADE STUDENTS IN SELECTED ELEMENTARY SCHOOLS IN THE DENVER METRO AREAS THROUGH A COMBINATION OF STUDENT AND PARENT EDUCATION. TO INCREASE PARENT KNOWLEDGE ABOUT COLORADO'S CHILD PASSENGER SAFETY LAW AND PEDESTRIAN SAFETY BEHAVIOR. BICYCLE SAFETY GOAL: TO INCREASE KNOWLEDGE AND SKILLS ABOUT BICYCLE SAFETY AMONG STUDENTS IN GRADES 3RD, 4TH AND 5TH AT SELECTED ELEMENTARY SCHOOLS IN THE DENVER METRO AREA THROUGH A COMBINATION OF STUDENT AND PARENT EDUCATION AND BICYCLE SKILLS COURSE WORK. YOUTH PASSENGER SAFETY GOAL: TO INCREASE THE NUMBER OF 8-12 YEAR OLDS SITTING SAFELY BUCKLED UP IN THE BACK SEAT. THE TARGET AUDIENCE WILL BE 4TH AND 5TH GRADE STUDENTS AND THEIR PARENTS AT SELECTED ELEMENTARY SCHOOLS IN THE DENVER METRO AREA. INTERVENTIONS INCLUDE ASSESSING THE ATTITUDES AND BEHAVIORS OF STUDENTS AND PARENTS FROM SURVEYS, CONDUCTING WORKSHOPS/ASSEMBLIES WITH STUDENTS ABOUT INJURIES RESULTING FROM BEING IN THE FRONT SEAT AND UNRESTRAINED. PROVIDE PARENTS WITH INFORMATION ABOUT HOW TO TRANSPORT THEIR CHILD SAFELY. STRATEGIES AND INITIATIVES: THE DENVER OSTEOPATHIC FOUNDATION PARTNERS WITH DENVER PUBLIC SCHOOLS TO CONDUCT HEALTH AND SAFETY PROGRAMS IN ELEMENTARY AND MIDDLES SCHOOLS IN THE DISTRICT. ADDITIONALLY, PROGRAMS ARE CONDUCTED AT SELECTIVE DOUGLAS COUNTY ELEMENTARY SCHOOLS AND CHERRY CREEK ELEMENTARY SCHOOLSA DN JEFFERSON COUNTY SCHOOLS. TEACHERS AGREE TO COMPLETE A PROGRAM EVALUATION SURVEY GIVING US FEEDBACK ABOUT PROGRAM MATERIALS, PRESENTATION AND QUALITY. CHILDREN COMPLETE A PRE AND POST SURVEY. BUCKLE UP FOR LOVE - IS A 30 MINUTE INTERACTIVE PROGRAM THAT FOCUSES ON CAR SEAT SAFETY USING AGE-APPROPRIATE CLASSROOM ACTIVITIES. STUDENTS LEARN THAT IT IS IMPORTANT FOR THEM TO SIT IN A CAR/BOOSTER SEAT AND FOR THEM TO RIDE IN THE BACK SEAT. HEIGHT MEASUREMENTS ARE TAKEN FOR EACH CHILD, AND THE PRESENTER DEMONSTRATES WITH THE CHILD HOW TO PROPERLY BUCKLE UP. STUDENTS TAKE HOME THE SAFE N' SMART KIDS NEWSLETTER ABOUT THE CHILD PASSENGER SAFETY LAW IN COLORADO. THE NEWSLETTER ALSO SPEAKS TO PARENTS/GUARDIANS ABOUT PEDESTRIAN SAFETY AND OFFERS HELPFUL HINTS ABOUT REINFORCING SAFE BEHAVIOR WITH CHILDREN. PARENTS ARE ASKED TO TALK TO THEIR CHILDREN ABOUT WHAT THEY LEARNED AND ABOUT CHILD PASS- ENGER CHILD PASSENGER SAFETY AND AND PEDESTRIAN SAFETY. STOP, LOOK, LISTEN - PEDESTRIAN SAFETY - IS A 30 MINUTE INTERACTIVE PROGRAM THAT FOCUSES ON PEDESTRIAN SAFETY USING AGE-APPROPRIATE CLASSROOM ACTIVITIES. STUDENTS LEARN THE STEPS (STOP, LOOK, LISTEN, THEN CROSS) THROUGH SEQUENCING ACTIVITIES AND STORY BOARD. THE CHILDREN HAVE THE OPPORTUNITY TO ROLE PLAY THE ACTIONS OF STOPPING, LOOKING AND LISTENING BECORE CROSSING THE STREET, AS WELL AS LEARN A SONG TO REMIND THEM OF OF GOOD SAFETY PRACTICES. STUDENTS LEARN THE "STOP, LOOK AND LISTEN" SONG/RHYME AND MAKE HAND MOVEMENTS POINTING TO THE EYES, EARS AS THEY RECITED THE FOLLOWING "STOP, LOOK AND LISTEN BEFORE YOU CROSS THE STREET. USE YOUR EYES AND USE YOUR EARS BEFORE YOU USE YOUR FEET." SAVE A FRIEND SAVE YOURSELF PASSENGER SAFETY - IS A 60 MINUTE PROGRAM EDUCATING STUDENTS IN 4TH, 5TH & 6TH GRADES ABOUT THE IMPORTANCE OF THIS AGE GROUP SITTING IN THE BACK SEAT, BELTED - AWAY FROM THE FRONT SEAT AIR BAGS. THE DOF MET WITH TARGET SCHOOLS PRINCIPALS AND PHYSICAL EDUCATION TEACHERS AND DPS RISK MANAGEMENT STAFF TO REVIEW PROGRAM MATERIALS AND TIMELINES. STUDENTS LEARN ABOUT THE DANGERS OF SITTING IN THE FRONT SEAT. THROUGH A POWERPOINT PRESENTATION, STUDENTS LEARN ABOUT THE PHYSICS OF MOTION AND HOW THAT IS IMPORTANT IN A CRASH. STUDENTS LEARN ABOUT THE DYNAMICS OF A CAR CRASH AND WHAT HAPPENS TO THE BODY WHEN IT IS NOT BELTED IN A CRASH. STUDENTS LEARN ABOUT POTENTIAL INJURY AND HOW THOSE INJURIES CAN POSSIBLY CHANGE YOUR LIFE PERMANENTLY. STUDENTS TAKE HOME AN EDUCATIONAL NEWSLETTER TO SHARE WITH PARENTS. STUDENTS COMPLETE A SURVEY ABOUT THEIR ATTITUDES AND PERCEPTIONS ABOUT RIDING BUCKLED UP AND IN THE BACK SEAT. SKILLS ON WHEELS - IS A 120 MINUTE PROGRAM CONDUCTED IN TWO SECTIONS. THE FIRST HOUR IS A POWER POINT PRESENTATION ABOUT THE RULES OF THE ROAD AND HAND SIGNALS. STUDENTS VIEW CRASH SCENARIOS AND DETERMINE WHAT COULD AND SHOULD HAVE BEEN DONE DIFFERENTLY. FOLLOWING THE PRESENTATIONS PRACTICE WHAT THEY HAVE LEARNED ON A SKILLS COURSE. THIS SECTION LASTS 60 MINUTES OR LONGER DEPENDING ON THE NUMBER OF STUDENTS PARTICIPATING. STUDENTS LEARN THE RULES OF THE ROAD AND THEN PRACTICE THEM ON THE SKILLS COURSE. STUDENTS LEARN HAND SIGNALS AND THE PRACTICE THEM ON THE SKILLS COURSE. STUDENTS TAKE A PRE AND POST TEST TO ASSESS THEIR KNOWLEDGE ABOUT SAFE BICYCLING. STUDENTS TAKE HOME A PRACTICE MANUAL TO ADVANCE THEIR SKILLS. STUDENTS RECEIVE AN ORANGE BRACELET ENGRAVED WITH THE WORDS "RIDE RIGHT". THEY WEAR THIS ON THEIR RIGHT WRIST AS A REMINDER THAT THEY SHOULD ALWAYS RIDE ON THE RIGHT SIDE OF THE ROAD WITH TRAFFIC. ADDITIONAL INFORMATION THE FOUNDATION IN COLLABORATION WITH DENVER PUBLIC SCHOOLS IS CREATING CURRICULUM FOR TEACHERS THAT IS CONSISTENT WITH STATE ACADEMIC STANDARDS IN ORDER TO CREATE OUTREACH TO OTHER SCHOOLS IN THE DISTRICT. THE DENVER OSTEOPATHIC FOUNDATION IN COLLABORATION WITH RVU OSTEOPATHIC MEDICAL SCHOOL AND DENVER PUBLIC SCHOOLS CONDUCTED 102 SPORTS PHYSICALS FOR STUDENTS IN NEED. SUMMARY OF DATA COLLECTION FOR PROGRAMS OF STUDENTS SERVED 6221 RESULTS A TOTAL OF 2088 STUDENTS RECEIVED THE STOP-LOOK-LISTEN -PEDESTRIAN SAFETY PROGRAM. A TOTAL OF 3293 STUDENTS RECEIVED THE BUCKLE UP FOR LOVE PROGRAM. A TOTAL OF 840 STUDENTS RECEIVED THE FOOD FUN FITNESS PROGRAM. A TOTAL OF 202 TEACHERS COMPLETED THE SATISFACTION SURVEY. PEDESTRIAN SAFETY EVALUATION: STUDENTS 2088. WHEN ASKED WHAT IS THE FIRST THINK YOU NEED TO DO BEFORE YOU CROSS THE STREET. PRIOR TO THE PROGRAM 22% ANSWERED CORRECTLY, AFTER THE PROGRAM 100% ANSWERED CORRECTLY TO STOP FIRST. BUCKLE UP FOR LOVE EVALUATION: STUDENTS 3293 WHEN ASKED WHERE DO YOU NEED TO RIDE IN THE CAR, FRONT OR BACK SEAT? PRIOR TO THE PROGRAM 25% ANSWERED CORRECTLY. AFTER THE PROGRAM 100% ANSWERED CORRECTLY TO RIDE IN THE BACK SEAT. TEACH SATISFACTION SURVEY: TEACHERS 202. WHEN ASKED ABOUT THE PROGRAM DELIVERY, MATERIALS AND COVERING THE TOPICS OF SAFETY, 98% OF THE TEACHERS RANKED THE PROGRAMS GOOD-EXCELLENT
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
THE EXECUTIVE DIRECTOR REVIEWS AND APPROVES THE 990 FOR FILING. THE 990 IS THEN PRESENTED TO THE BOARD AT THE NEXT BOARD MEETING.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
THE BOARD OF DIRECTORS ANNUALLY MONITORS COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. POTENTIAL CONFLICTS ARE DEALT WITH AS THEY ARISE.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
EXECUTIVE DIRECTOR COMPENSATION IS REVIEWED ANNUALLY PER CONTRACT. SALARY REVIEW BASED ON PERFORMANCE AND COLORADO NONPROFIT COMPENSATION SURVEY. REVIEWED BY BOARD PRESIDENT AND THEN BOARD MEMBERS.
COMPENSATION PROCESS FOR OFFICERS
FORM 990, PAGE 6, PART VI, LINE 15B
EMPLOYEE COMPENSATION IS DETERMINED BY THE EXECUTIVE DIRECTOR; NON-PROFIT SALARY SURVEYS ARE USED.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
OTHER FEES FOR SERVICES
FORM 990, PART IX, LINE 11G
OUTSIDE CONTRACTS 43,371 4,342 0
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.