Attach to Form 990 or Form 990-EZ.
See separate instructions.| (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 | |||||||||
| 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.") .... | 3,213,251 | 3,430,336 | 3,447,689 | 3,268,582 | 3,382,741 | 16,742,599 |
| 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.. | 3,213,251 | 3,430,336 | 3,447,689 | 3,268,582 | 3,382,741 | 16,742,599 |
| 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. | 16,742,599 | |||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 3,213,251 | 3,430,336 | 3,447,689 | 3,268,582 | 3,382,741 | 16,742,599 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 14,355 | 13,083 | 9,651 | 5,045 | 4,590 | 46,724 |
| 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.. | ||||||
| 11 | Total support (Add lines 7 through 10). | 16,789,323 | |||||






| 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.) | 0 | |||||
| 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.). | ||||||




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | 11000175 |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI, Line 7a | There are no classes of persons with rights that are in addition to the | |
| rights of any other persons. Open solicitations for nominees are advertised | ||
| locally in each area from which a board member will be elected. Nominees | ||
| must be residents of the area they represent. Official ballots and polling | ||
| places are advertised in community newspapers prior to election. Any | ||
| persons 60 years of age or older is eligible to vote. One polling location | ||
| per county designated by board at March meeting. Elections held during | ||
| May on a date designated by Board. Results of elections submitted to Board | ||
| by June 1. One board member chosen per county. Any vacany occurring | ||
| prior to an election shall be selected from the representative county by | ||
| governance committee and appointed by the Board Chairman and said | ||
| director shall serve the unexpired term of their predecessor. | ||
| Pt VI, Line 11a | The process for review is as follows: the executive director and fiscal | |
| officer collaborate with the auditor to complete Form 990. This step | ||
| may involve receiving information from employees, board members, | ||
| contractors and others who have business-related activities with | ||
| the Organization. The auditor provides a completed Form 990 to | ||
| the executive director and fiscal officer for their review. | ||
| Once approval of the executive director and fiscal officer is | ||
| granted, each board member will receive a copy, including | ||
| required schedules, as ultimately filed with the IRS for their | ||
| review at the next regularly scheduled board meeting. The | ||
| review is conducted by the executive director, fiscal officer | ||
| and board. A review checklist is utilized. After completion of the | ||
| review, the board resolves to approve the Form 990. If at any | ||
| step in the process a revision to the Form 990 is requested, | ||
| Form 990EZ, Part II, Line 24 | ACCOUNTS RECEIVABLE - NET GRANTS RECEIVABLE - NET PREPAIDS | |
| Form 990EZ, Part II, Line 26 | ACCOUNTS PAYABLE & ACCRUED EXPENSES MISSOURI DIVISION OF SENIOR SERVICES FUNDS HELD IN TRUST | |
| Form 990, Part IX, Line 24f | MISC 1637. 118. 1519. 0. | |
| the revised information is given to the auditor, the Form 990 | ||
| is revised, and the process begins again. | ||
| Pt VI, Line 12c | The board has establised a number of policies and procedures to | |
| guard against conflict of interest regarding proposed and | ||
| ongoing transactions. All board members and staff are trained | ||
| on, and subject to, these policies and procedures. Annually, | ||
| the board of directors and key employees sign a statement | ||
| certifying no conflicts of interest or describing potential | ||
| conflicts of interest that may exist. The board, with assistance | ||
| of executive director, is responsible to determine whether | ||
| a conflict exists and resolution. Should a conflict be | ||
| identified, such person would be prohibited from participating | ||
| in the board deliberation and decision in the transaction. | ||
| Pt VI, Line 15 | Compensation for executive director and fiscal officer are | |
| approved annually by Board. Board utilizes a salary schedule that | ||
| establishes a maximum salary of $75,000 for executive director | ||
| and $55,000 for fiscal officer. Merit increases, of up to 6% | ||
| may be given, by the board, to employees at the time of | ||
| their annual evaluation. | ||
| Pt VI, Line 19 | The Organization makes its governing documents, conflict of interest | |
| policy, and audited financial statements available, at the | ||
| Organization's office, to general public upon request. Also | ||
| post annual audited financial statements on the website. | ||
| Pt IX, Line 25, Col D | The primary purpose of the Organization is the establishment | |
| of the priorities and development of overall plans for programs | ||
| on aging in the Multi-County Area of Northeast Missouri. | ||
| The Organization receives funds under Title III and other | ||
| Titles of the Older Americans Act (OAA) and such other sources | ||
| as may become available. The Organization is mandated by the | ||
| OAA to use subgrants or contracts with service providers to | ||
| provide all services under OAA funding sources. The Organization | ||
| may request a waiver, from the Missouri Department of Health | ||
| and Senior Services to provide a service directly. Due to the | ||
| nature of funding received and the strict limitations placed | ||
| on the use of that funding by grantor agencies, the Organization | ||
| did not conduct any fundraising activities for 2011-2012. | ||
| Pt XII, Line 2c | The audit is procured by the State of Missouri on behalf of | |
| the Organization. During the audit, the board of directors and | ||
| executive director assume responsibility for oversight of the | ||
| audit. Upon completion of the audit, the Missouri Department | ||
| of Health & Senior Services reviews and approves the audit report; | ||
| board of directors reviews audit report, holds exit conference | ||
| with the auditor and formally votes to accept audit report. | ||
| This process is followed consistently from year to year. |
| Software ID: | 11000175 |
| Software Version: |