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
2011
Open to Public Inspection
Name of the organization
GOVERNORS HIGHWAY SAFETY ASSOCIATION
Employer identification number
52-1021004
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 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 support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 2
Part II
Support Schedule for Organizations Described in IRC 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) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2,744,625
2,355,651
2,495,389
2,939,677
3,294,873
13,830,215
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..
2,744,625
2,355,651
2,495,389
2,939,677
3,294,873
13,830,215
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)..
11,686,315
6
Public Support. Subtract line 5 from line 4.
2,143,900
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
7
Amounts from line 4..
2,744,625
2,355,651
2,495,389
2,939,677
3,294,873
13,830,215
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
70,453
46,002
44,417
36,328
36,884
234,084
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
44,275
18,748
6,354
7,681
62,610
139,668
11
Total support (Add lines 7 through 10).
14,203,967
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
3,843,441
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 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15.094 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16.065 %
16a
33 1/3% support test—2011.
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—2010.
If the organization did not check the 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—2011.
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—2010.
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 3
Part III
Support Schedule for Organizations Described in IRC 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) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(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) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(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 2011 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2010 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2011.
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—2010.
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
THIS STATEMENT IS ATTACHED IN ACCORDANCE WITH THE INSTRUCTIONS FOR SCHEDULE A (FORM 990) REGARDING AN ORGANIZATION THAT BELIEVES IT IS PUBLICLY SUPPORTED ACCORDING TO APPLICABLE REGULATIONS. TREAS. REG. SEC. 1.170A-9(F)(3) PROVIDES THAT AN ORGANIZATION may BE TREATED AS "PUBLICLY SUPPORTED" UNDER THE FACTS AND CIRCUMSTANCES TEST EVEN IF IT FAILS TO MEET THE 33 1/3 PERCENT MECHANICAL TEST. UNDER THE FACTS AND CIRCUMSTANCES TEST, AN ORGANIZATION WILL BE TREATED AS PUBLICLY SUPPORTED IF IT NORMALLY RECEIVES A SUBSTANTIAL PART OF ITS SUPPORT FROM GOVERNMENTAL UNITS, FROM DIRECT OR INDIRECT CONTRIBUTIONS FROM THE GENERAL PUBLIC, OR FROM A COMBINATION OF THESE SOURCES, AND MEETS CERTAIN OTHER REQUIREMENTS. THE PERTINENT FACTORS SET FORTH IN THE REGULATIONS ARE DISCUSSED BELOW: I) TEN PERCENT-OF-SUPPORT LIMITATION GHSA RECEIVES SUPPORT FROM CONTRIBUTIONS MADE DIRECTLY BY THE GENERAL PUBLIC in EXCESS OF THE MINIMUM 10% THRESHHOLD. II) ATTRACTION OF PUBLIC SUPPORT GHSA IS ORGANIZED AND OPERATED TO ATTRACT NEW AND ADDITIONAL PUBLIC SUPPORT ON A CONTINUOUS BASIS. GHSA MAINTAINS A CONTINUOUS AND BONA FIDE PROGRAM FOR SOLICITATION OF FUNDS FROM THE GENERAL PUBLIC, COMMUNITY, AND MEMBERSHIP GROUPS INVOLVED. III) PERCENTAGE OF FINANCIAL SUPPORT UNDER THE REGULATIONS, THE HIGHER THE PERCENTAGE OF SUPPORT ABOVE THE 10% REQUIREMENT FROM PUBLIC SOURCES THE LESSER WILL BE THE BURDEN OF ESTABLISHING THE PUBLICLY SUPPORTED NATURE OF THE ORGANIZATION THROUGH OTHER FACTORS. THE PERCENTAGE OF SUPPORT RECEIVED FROM THE GENERAL PUBLIC FOR THE YEAR ENDED JUNE 30, 2012 IS greater than 15%. IV) SOURCES OF SUPPORT GHSA EXCEEDS THE 10% MINIMUM THRESHOLD BY DERIVING SUPPORT FROM NUMEROUS CORPORATE CONTRIBUTORS, RATHER THAN RECEIVING ALMOST ALL OF ITS SUPPORT FROM THE MEMBERS OF A SINGLE FAMILY. GHSA'S ACTIVITIES APPEAL TO A BROAD CROSS-SECTION OF PERSONS NATIONWIDE WHO ARE INTERESTED IN HIGHWAY TRAFFIC SAFETY AND RELATED PUBLIC POLICY. GHSA DOES NOT LIMIT ITS ACTIVITIES TO A PARTICULAR COMMUNITY OR REGION OR TO ACTIVITIES WHICH APPEAL TO A LIMITED NUMBER OF PERSONS. V) REPRESENTATIVE GOVERNING BODY GHSA HAS A GOVERNING BODY REPRESENTATIVE OF THE BROAD INTERESTS OF THE PUBLIC, HAVING SPECIAL KNOWLEDGE OR EXPERTISE IN THE PARTICULAR FIELD IN WHICH THE ORGANIZATION OPERATES. THE CURRENT (2011-2012) BOARD OF TRUSTEES CONSISTS OF THE FOLLOWING: NAME AFFILIATION* TROY E. COSTALES, OREGON TRANSPORTATION SAFETY DIVISION TERRY HENDERSON, HIGHWAY SAFETY PROGRAM MANAGER, ALABAMA DEPARTMENT OF ECONOMIC AND COMMUNITY AFFAIRS JOHN SAUNDERS, VIRGNIA TRANSPORTATION SAFETY SERVICE LEANNA DEPUE, MISSOURI TRAFFIC AND HIGHWAY SAFETY DIVISION CHRISTOPHER J. MURPHY, CALIFORNIA OFFICE OF TRAFFIC SAFETY KENDELL POOLE, TENNESSEE GOVERNOR'S HIGHWAY SAFETY OFFICE PETER THOMSON, NEW HAMPSHIRE HIGHWAY SAFETY AGENCY LAUREN V. STEWART, MAINE BUREAU OF HIGHWAY SAFETY CHUCK DEWEESE, NEW YORK DEPARTMENT OF MOTOR VEHICLES JANA SIMPLER, DELAWARE OFFICE OF HIGHWAY SAFETY MICHAEL PRINCE, MICHIGAN OFFICE OF HIGHWAY SAFETY PLANNING LT. COL. JOHN LEBLANC, LOUISIANA HIGHWAY SAFETY COMMISSION PHIL RILEY, SOUTH CAROLINA DEPARTMENT OF PUBLIC SAFETY OFFICE OF HIGHWAY SAFETY ALBERTO GUTIER, ARIZONA GOVERNOR'S OFFICE OF HIGHWAY SAFETY Daniel T. DiBiasio, rhode island Office of Highway Safety Girish Modi, Pennsylvania Department of Transportation Becky Wallace, north carolina Governors Highway Safety Program Ryan Klitzsch, Indiana Traffic Safety Division, Criminal Justice Institute Mark Allen, Mississippi Department of Public Safety Bridget S. White, arizona Highway Safety Office Lee Axdahl, South Dakota Department of Public Safety *FOR IDENTIFICATION PURPOSES ONLY VI) AVAILABILITY OF PUBLIC FACILITIES OR SERVICES; PUBLIC PARTICIPATION IN PROGRAMS OR POLICIES GHSA PROVIDES SERVICES DIRECTLY FOR THE BENEFIT OF THE GENERAL PUBLIC ON A CONTINUING BASIS, INCLUDING PROGRAMS THAT MEMBERS OF THE PUBLIC HAVING SPECIAL KNOWLEDGE OR EXPERTISE, PUBLIC OFFICIALS, AND CIVIC AND COMMUNITY LEADERS PARTICIPATE IN. NEARLY 500 STATE, NATIONAL, AND PRIVATE SECTOR HIGHWAY SAFETY REPRESENTATIVES ATTENDED GHSA'S ANNUAL CONFERENCE.
Schedule A (Form 990 or 990-EZ) 2011
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
2011
Open to Public Inspection
Name of the organization
GOVERNORS HIGHWAY SAFETY ASSOCIATION
Employer identification number
52-1021004
Identifier
Return Reference
Explanation
DETERMINING COMPENSATION
FORM 990, PART VI, LINE 15A & 15B
THE EXECUTIVE BOARD CONDUCTS A PERFORMANCE REVIEW OF THE EXECUTIVE DIRECTOR AND DETERMINES HER COMPENSATION AMOUNT. THE EXECUTIVE DIRECTOR CONDUCTS PERFORMANCE REVIEWS AND RECOMMENDS TO THE EXECUTIVE BOARD THE COMPENSATION OF THE ASSOCIATION STAFF. THE EXECUTIVE BOARD ULTIMATELY APPROVES THE COMPENSATION AMOUNT OF ASSOCIATION STAFF.
AVAILABILITY OF OTHER DOCUMENTS
FORM 990, PART VI, LINE 19
FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE ON GHSA'S WEBSITE.
VOTING RIGHTS
FORM 990, PART VI, LINE 1A AND 1B
THE ORGANIZATION HAS 26 VOTING MEMBERS. REGION ALTERNATES MAY ONLY VOTE IF THEY ATTEND MEETINGS IN PLACE OF THEIR RESPECTIVE REGION REPRESENTATIVES.
ELECTION OF MEMBERS
FORM 990, PART VI, LINE 7A & 7B
NOMINATIONS FOR ASSOCIATION OFFICERS SHALL BE BY A COMMITTEE OF AT LEAST THREE PERSONS APPOINTED BY THE CHAIR. NOMINATIONS OR ANNOUNCEMENTS OF CANDIDACY FOR ELECTED OFFICERS SHALL BE MADE IN WRITING TO THE CHAIR OF THE NOMINATIONS COMMITTEE NO LATER THAN 60 DAYS PRIOR TO THE ANNUAL MEETING AND BY NOMINATIONS FROM THE FLOOR AT A BUSINESS MEETING WHERE THE VOTING WILL TAKE PLACE. THE ELECTION OF OFFICERS SHALL BE AT THE ANNUAL MEETING AND SHALL BE CONDUCTED BY SECRET BALLOT OR BY ACCLAMATION. THE REGIONAL REPRESENTATIVES SHALL BE ELECTED ANNUALLY FROM THE MEMBER STATES OF THEIR RESPECTIVE REGIONS AT EACH ANNUAL MEETING. MEMBERS OF THE EXECUTIVE BOARD MAY HOLD OFFICE ONLY WHEN THEIR RESPECTIVE JURISDICTIONS ARE MEMBERS IN GOOD STANDING AND THEY ARE ASSOCIATION MEMBERS OR DESIGNATED ALTERNATES. THE EXECUTIVE BOARD DETERMINES GENERAL POLICIES DURING INTERIM PERIODS BETWEEN ANNUAL MEETINGS. SUCH POLICIES SHALL BE SUBJECT TO CONFIRMATION BY THE MEMBERSHIP AT THE SUBSEQUENT ANNUAL MEETING.
CONFLICT OF INTEREST POLICY
FORM 990, PART VI, LINE 12C
TO ENSURE THE ASSOCIATION OPERATES IN A MANNER CONSISTENT WITH CHARITABLE PURPOSES AND DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS TAX-EXEMPT STATUS, PERIODIC REVIEWS SHALL BE CONDUCTED. THE REVIEW SHALL, AT A MINIMUM ADDRESS WHETHER PARTNERSHIPS, JOINT VENTURES AND ARRANGEMENTS WITH MANAGEMENT ORGANIZATIONS CONFORM TO THE ASSOCIATION'S WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE INVESTMENTS OR PAYMENTS FOR GOODS OR SERVICES, FURTHER CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT, IMPERMISSIBLE PRIVATE BENEFIT OR IN AN EXCESS BENEFIT TRANSACTION.
ACCOUNTING METHOD
FORM 990, PART XI, LINE 1 AND FORM 990, PART IV, LINE 12
THE ASSOCIATION'S POLICY IS TO PREPARE ITS FINANCIAL STATEMENTS ON A MODIFIED CASH BASIS WHICH INCLUDES RECORDING OF DEPRECIATION ON CAPITALIZED ASSETS AND PAYROLL WITHHOLDINGS. UNDER THIS BASIS, REVENUE IS RECOGNIZED WHEN COLLECTED RATHER THAN WHEN EARNED, AND EXPENDITURES ARE GENERALLY RECOGNIZED WHEN PAID RATHER THAN WHEN INCURRED. CONSEQUENTLY, ACCOUNTS RECEIVABLE, ACCOUNTS PAYABLE AND ACCRUED EXPENSES ARE NOT INCLUDED IN THE FINANCIAL STATEMENTS. INVESTMENTS ARE CARRIED AT FAIR VALUE WITH REALIZED AND UNREALIZED GAINS AND LOSSES REFLECTED IN THE FINANCIAL STATEMENTS. THESE FINANCIAL STATEMENTS ARE AUDITED BY AN INDEPENDENT ACCOUNTANT.
FORM 990 REVIEW PROCESS
FORM 990, PART VI, LINE 11A
The FORM 990 IS reviewed by the Executive Director before it is filed with the IRS. A DRAFT COPY OF FORM 990 WAS PROVIDED TO THE MEMBERS OF THE GOVERNING BODY PRIOR TO FILING WITH THE IRS.
OTHER PROGRAM SERVICES
FORM 990, PART III, LINE 4D
GHSA WORKED ON VARIOUS PROGRAMS RELATING TO DISTRACTED DRIVING. DRIVER INATTENTION IS A LEADING FACTOR IN MANY CRASHES, AND CELL PHONE USE AND TEXTING ARE SOME OF THE MOST COMMON DRIVER DISTRACTIONS. WHILE MORE AND MORE STATES AND LOCALITIES ARE BANNING SPECIFIC DISTRACTIONS, GHSA'S MESSAGE TO ALL DRIVERS IS: DON'T USE CELL PHONES OR OTHER ELECTRONIC DEVICES WHILE DRIVING, REGARDLESS OF THE CURRENT LAW. IN 2010, GHSA ASKED STATE HIGHWAY SAFETY OFFICES (SHSOS) TO COMPLETE A SURVEY DETAILING THEIR DISTRACTED DRIVING EFFORTS. FIFTY STATES PLUS THE DISTRICT OF COLUMBIA, GUAM AND AMERICAN SAMOA RESPONDED. THE RESults of this survey are published in this report. the report details a host of approaches states are implementing, including: stronger laws, incresased data collection, new education programs, public/private partnerships and a growing reliance on new media to spread the message. a complete copy of the report can be downloaded at the organization's website http://www.ghsa.org/html/publications/survey/distraction2010.html
other changes in net assets
form 990, part xi, line 5
unrealized loss -23,547
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.