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
CULPEPER COMMUNITY THRIFT STORE
Employer identification number
82-0570073
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.
0
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...
0
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
0 %
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.") .
331,749
339,916
375,091
386,726
364,443
1,797,925
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.
331,749
339,916
375,091
386,726
364,443
1,797,925
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
250
900
700
700
2,550
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..
250
900
700
700
2,550
8
Public support (Subtract line 7c from line 6.)
1,795,375
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...
331,749
339,916
375,091
386,726
364,443
1,797,925
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
1,764
127
91
74
365
2,421
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
1,764
127
91
74
365
2,421
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.)..
1,800,346
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
99.720 %
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
99.340 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
0.130 %
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
0.480 %
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:
12000225
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
CULPEPER COMMUNITY THRIFT STORE
Employer identification number
82-0570073
Identifier
Return Reference
Explanation
Pt VI, Line 11b
FORM 990 IS REVIEWED BY THE BOARD CHAIRMAN.
FORM 990 IS AVAILABLE TO ANY MEMBER OF THE BOARD UPON REQUEST.
Pt VI, Line 19
COPIES OF GOVERNING DOCUMENTS, FORM 990, AND FINANCIAL
STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
Pt VI, Line 7b
APPOINTMENT OF MEMBERS TO THE BOARD OF DIRECTORS IS SUBJECT
TO REVIEW BY THE CULPEPER COUNTY DEPARTMENT OF
HUMAN SERVICES.
Pt I, Line 1
MISSION & ACTIVITIES: CULPEPER COMMUNITY THRIFT STORE'S
PRIMARY EXEMPT PURPOSE IS TO GENERATE FUNDS USED TO PROVIDE
EMERGENCY SUPPORT FOR INDIGENT AND/OR ELDERLY MEMBERS OF THE
CULPEPER COMMUNITY. ADDITIONALLY FUNDS ARE SET ASIDE TO AID
THIS SEGMENT OF OUR COMMUNITY AND TO MEET FUTURE EMERGENCY
NEEDS AS THEY MAY ARISE.
.
CULPEPER COMMUNITY THRIFT STORE WORKS IN CLOSE COOPERATION
WITH CULPEPER HUMAN SERVICES (FEIN 54-6001236), A DIVISION
OF CULPEPER COUNTY, VIRGINIA, TO ACHIEVE THE ABOVE GOALS
AS WELL AS TO PROVIDE THE FOLLOWING ADDITIONAL SERVICES
TO THE COMMUNITY.
a) Provide a work site for VIEW recipients entering the
Financial Employment Program the goal of which is to
assist these individuals in becoming self sufficient.
b) Provide a work site for the Culpeper County High School
Employment Support Program (challenged students).
c) Partner with the Criminal Justice Program to provide
a work site for those ordered to provide community
Pt I, Line 1
service.
d) Provide a work site for student volunteers working toward
school projects, congressional awards, etc.
e) Donate toiletries and cell phones to SAFE (woman's
abuse shelter).
f) Donate convalescent items to Veterans of Foreign Wars
to be loaned to persons in need.
g) Provide blankets to the Humane Society and the
Animal Shelter.
h) Collect food items for the Culpeper Food Closet.
i) Provide support and referrals for those in need.
j) Provide adequate clothing for anyone preparing for
a job interview.
k) Provide needed items for those who have suffered a
disaster such as flood or fire.
.
Culpeper Community Thrift Store generates funds and
materials, and provides facilities, to accomplish the
above purposes by operating a thrift store which sells,
or uses, goods donated by the general public. Donations
consist primarily of used clothing, furniture, and
household goods. All net proceeds of the thrift store
operation are applied to the exempt purpose goals.
.
For the year ended June 30, 2013, Culpeper Community Thrift
Store provided $21,000 to Culpeper Human Services for the
"Emergency & Elderly Funds". These funds are applied to
Pt I, Line 1
provide food, medical care, in home living assistance,
utility assistance, and other emergency assistance to the
indigent and/or elderly in the Culpeper community.
.
For the year ended June 30, 2013 Culpeper Community Thrift
Store also provided $10,000 to Rappahannock Rapidan
Community Services [a 501(c)3 organization] to assist in
expansion of the Senior Services Center operated by that
organization in Culpeper, VA. The Senior Center provides
nutrition, educational, and social services to low income seniors.
.
Pt III, Line 1
See Part I, Line 1 entry above.
.
Pt III, Line 4
See Part I, Line 1 entry above.
.
Pt VII, Sec A
Culpeper Community Thrift Store works closely with
Culpeper Human Services (FEIN 54-6001236) a division of
Culpeper County, Virginia as noted above. The two
organizations cooperate and are related further as follows:
.
a) Culpeper Community Thrift Store Board of Directors -
the following members of this Board are employees
of Culpeper Human Services (CHS):
.
Lisa Peacock, Director of CHS
Doris Clatterbuck, Executive Assistant, CHS
.
Pt VII, Sec A
b) Culpeper Community Thrift Store Officers/Key Employees
and Compensation:
.
Pamela S. Lohr, Corporate Administrator, is an employee
of CHS as an Administrative Manager.
Kathy L. Gordon, Store Manager, is an employee of CHS.
.
The personnel who operate Culpeper Community Thrift
Store are provided on a contractual basis by CHS. For
the year ended 6/30/13 such personnel contract payments
totaled $244,919 which were allocated as follows:
.
Pamela S. Lohr $ 18,645
Kathy L. Gordon 42,784
Others 244,919
.
c) Culpeper Community Thrift Store rents retail and
office space through a sub-lease with CHS. For the
year ended 6/30/13 such rent totaled $52,200, and is
included in Form 990, Part IX, Line 16, Occupancy.
.
Pt IX, Line 11a
See Part VII, Section A entry above
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.