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
The Grapevine Family & Community Resource Center
Employer identification number
02-0499088
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.") ....
131,224
143,052
156,458
103,933
97,333
632,000
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
131,224
143,052
156,458
103,933
97,333
632,000
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)..
0
6
Public support. Subtract line 5 from line 4.
632,000
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..
131,224
143,052
156,458
103,933
97,333
632,000
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
0
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
0
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
0
11
Total support (Add lines 7 through 10).
632,000
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
100.000 %
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.") .
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:
12000229
Software Version:
2012v2.0
-
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
The Grapevine Family & Community Resource Center
Employer identification number
02-0499088
Identifier
Return Reference
Explanation
Form 990, Part VI, Line 19
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available
Said Documents are available upon request
Form 990, Part VI, Line 15b
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees
The organization participates in a statewide nonprofit salary survey and uses the resulting report as a guide when establishing compensation rates
Form 990, Part VI, Line 12c
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts
The Conflict of Interest Policy is monitored and enforced with annual disclosure by each Director.
Form 990, Part VI, Line 11b
Form 990, Part VI, Line 11b: Form 990 Review Process
A Committee duly appointed by the Board of Directors reviewed this Form 990 prior to submission. The committee was comprised of the Board Chair, the Board Treasurer, a Director, and the Executive Director.
Form 990, Part III, Line 4d
Form 990, Part III, Line 4d: Other Program Services Description
OTHER PROGRAM SERVICES 4: Community Supports and Resources includesInformation, Referral and Assistance for people in need of basic services and resources such as food, shelter, clothing, transportation, health and dental care, health insurance.Access to basic services: The Grapevine provides an office for regional agencies, bringing closer to home services such as child and family counseling, fuel assistance, employment support for adults with disabilities and school-to-work transition support for students with disabilities, family conflict and landlord/.tenant dispute resolution, and homeless outreach. Community Wood Bank: Provides free firewood for families and individuals who use wood to heat their homes and cannot afford to buy it.Community Suppers in Antrim, Hancock, Bennington and Francestown, free, every week.Strength Training for older adults: Community-based, volunteer driven.NH Easy: In partnership with the Dept. of Health & Human Services. The Grapevine makes financial assistance easier by streamlining the application for food stamps, Medicaid, childrens health insurance, cash benefits and other assistance. NH Easy allows people to apply for assistance at The Grapevine with help from trained Grapevine staff. The 4-Town Citizen Group: A group of citizens from Antrim, Hancock, Bennington and Francestown convened by The Grapevine to consider the health and well-being of people in our towns and mobilize resources to meet community needs. The group organized free community suppers in each of the towns and supported The Grapevine in developing The Peoples Service Exchange. The group was used as a model by the Contoocook Valley Transportation Cooperative to develop regional transportation options that meet the needs of people in the eastern Monadnock Region and worked to ensure that people had the basic resources needed to be healthy and well as the recession began to take hold. The group is convened as needs and opportunities arise.The Brown Bag Coalition: The Grapevine convened a group of representatives from Antrims organizations and government, including law enforcement, parks and recreation, the library, churches, the schools, scouts and civic groups. An early focus of the groupeventually named the Brown Bag Coalition, or BBCwas our youth, both the lack of childcare for young children of working families and the need to coordinate and expand community offerings for adolescents and teens. The BBC was the catalyst for the Before and After School Clubs and the Teen Center. OTHER PROGRAM SERVICES 5: The Peoples Service Exchange A neighbor-helping-neighbor network offering people from all walks of life a community-based, coordinated structure for exchanging services with other members, including transportation, tutoring, cooking, yard work, computer support, carpentry, singing lessons and much more. Any person in the community can convert personal time into purchasing power. The concept is simple: One hour of service equals one time dollar. Each time dollar a member earns is deposited into a time bank to be used when the member requests a service. Each service is as valuable as any other. Currently there are almost 200 members and over 250 services. Because its not a problem if a member is in debt, many people join the PSE when they need services, and they offer services at a later time, when they are able. This has been particularly true in these recession years.Although we keep track of service exchanges each month, we are unable to capture many of the services exchanged. This is due to the fact that friendships are formed, and informal trading begins to occur as people get to know each other. OTHER PROGRAM SERVICES 6: The Learning Vine is a parent-initiated cooperative preschool program for children ages 4 to 5 years, taught by an experienced Masters Level educator. Curriculum includes hands-on activities, problem solving and conflict resolution skills as the families explore community resources and integrate discoveries. The Learning Vine provides preschool learning and play experiences to support the development of children. In addition to the regular classroom activities, children also participate in special craft projects. Each morning starts with songs and simple finger plays, and each month new themes are introduced. The classroom is set up with different areas including art, paint, science, house, blocks, books and toys. These areas changed monthly with seasonal activities and themes, and activities related to field trips being introduced. As part of the cooperative, a different parent assists in the classroom each month. This gives opportunities for parents to work with the children, observe their own children, and also to get information from and ask questions of the teacher.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.