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 ROBBY ATHERTON FOUNDATION
Employer identification number
27-1716474
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.") ....
98,650
72,691
71,214
242,555
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
98,650
72,691
71,214
242,555
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)..
44,147
6
Public support. Subtract line 5 from line 4.
198,408
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..
98,650
72,691
71,214
242,555
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
61
218
664
943
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
13,183
14,675
21,297
49,155
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).
292,653
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
67.800 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
62.830 %
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
THE ROBBY ATHERTON FOUNDATION
Employer identification number
27-1716474
Identifier
Return Reference
Explanation
GRANTS AND SIMILAR AMTS PAID TO ORGANIZATIONS
FORM 990-EZ, PART I, LINE 10
SHELBY TWP., PARKS & RECREATION PARK RENOVATION 03/27/2012 SHELBY TWP., PARKS & RECREATION 52700 VAN DYKE AVENUE 27,000 0 52700 VAN DYKE AVENUE 27,000 CASH PAID CASH PAID SHELBY TOWNSHIP, MI 48315 SHELBY TWP., PARKS & RECREATION PARK RENOVATION 05/15/2012 SHELBY TWP., PARKS & RECREATION 52700 VAN DYKE AVENUE 27,000 0 52700 VAN DYKE AVENUE 27,000 CASH PAID CASH PAID SHELBY TOWNSHIP, MI 48315
OTHER EXPENSES
FORM 990-EZ, PART I, LINE 16
EXPENSES OFFICE EXPENSE 655 FOREIGN DIVIDEND TAXES 22 TOTAL 677
OTHER CHANGES IN NET ASSETS OR FUND BALANCES
FORM 990-EZ, PART I, LINE 20
UNREALIZED GAINS WELLS FARGO MUTUAL FUNDS 1,745
PRIMARY EXEMPT PURPOSE
FORM 990-EZ, PART III
ROBBY ATHERTON FOUNDATION PRIMARY EXEMPT PURPOSE THE ROBBY ATHERTON FOUNDATION HAS BEEN ESTABLISHED TO PROVIDE VARIOUS FORMS OF ASSISTANCE TO FAMILIES, COMMUNITIES AND ORGANIZATIONS WITHIN SOUTHEAST MICHIGAN. IN ORDER TO PROVIDE THIS ASSISTANCE, WE HOLD ANNUAL CHARITY FUNDRAISING EVENTS SUCH AS A GOLF OUTING, BOWLING EVENTS, SOFTBALL TOURNAMENTS AND OTHER FUNDRAISING EVENTS. THROUGH THE PROCEEDS OF THESE EVENTS AND VARIOUS OTHER PRIVATE AND CORPORATE DONOR CONTRIBUTIONS WE ARE ABLE TO PROVIDE THIS ASSISTANCE IN THE FORM OF COLLEGE SCHOLARSHIPS AND DONATIONS TO OTHER LOCAL CHARITABLE ORGANIZATIONS, LOCAL MEMORIAL FUNDS AND FOUNDATIONS. IN ADDITION WE ARE ACTIVELY SEEKING WAYS OF BECOMING INVOLVED IN NON-FUNDRAISING EVENTS BY PARTNERING WITH OTHER CHARITY GROUPS. EXPAMPLES OF THESE EVENTS WOULD BE FOOD BANKS, SOUP KITCHENS AND OTHER COMMUNITY SERVICE ACTIVITIES.
FIRST ACCOMPLISHMENT
FORM 990-EZ, PART III, LINE 28
ROBBY ATHERTON FOUNDATION 2012 ACCOMPLISHMENTS SCHOLARSHIP PROGRAMS: THE ROBBY ATHERTON FOUNDATION PROVIDED FOUR INDIVIDUAL SCHOLARSHIPS AT 1,200.00 EACH TO HIGH SCHOOL STUDENTS AT UTICA EISENHOWER HIGH SCHOOL. THESE SCHOLARSHIPS WERE PROVIDED TO LOCAL STUDENT ATHLETES WHO MET THE CRITERIA AND GUIDLINES ESTABLISHED BY THE ROBBY ATHERTON FOUNDATION SCHOLARSHIP COMMITTEE. THE SCHOLARSHIP AWARD WINNERS WERE AS FOLLOWS; JUWAN NIXON - UTICA EISENHOWER HIGH SCHOOL - IKE STUDENT ATHLETE AWARD 1,200.00 PAID TO MICHIGAN STATE UNIVERSITY FINANCIAL AID OFFICE GINA CHERNIAWSKI - UTICA EISENHOWER HIGH SCHOOL - IKE STUDENT ATHLETE AWARD 1,200.00 PAID TO MICHIGAN STATE UNIVERSITY FINANCIAL AID OFFICE BRYAN KOLPACKE - UTICA EISENHOWER HIGH SCHOOL - IKE STUDENT ATHLETE AWARD 1,200.00 PAID TO MICHIGAN STATE UNIVERSITY FINANCIAL AID OFFICE JOE SCRIVANO - UTICA EISENHOWER HIGH SCHOOL - IKE STUDENT ATHLETE AWARD 1,200.00 PAID TO UNIVERSITY OF MICHIGAN FINANCIAL AID OFFICE
ALL OTHER ACCOMPLISHMENT
FORM 990-EZ, PART III, LINE 31
ROBBY ATHERTON FOUNDATION 2012 ACCOMPLISHMENTS RAINBOW CONNECTION: CONTRIBUTION WAS MADE TO RAINBOW CONNECTION OF ROCHESTER, MICHIGAN TO SPONSOR ONE SEPARATE "MAKE-A-WISH" REQUESTS FOR A LOCAL CHILD WHO HAS BEEN DIAGNOSED WITH A TERMINAL ILLNESS. THE DONATION WAS FOR 4,500.00. JOEL ZITO TRUST FUND: A DONATION WAS MADE IN THE AMOUNT OF 5,000.00 TO SUPPORT THE JOEL ZITO FAMILY. BENEFIT TRUST FUND ESTABLISHED TO ASSIST WITH OUTSTANDING MEDICAL EXPENSES FOR INDIVIDUAL RECIPIENT NO LONGER ABLE TO WORK AND NO LONGER HAS HEALTH INSURANCE. MI ADVISOR 529-DONATION TO BENEFIT MARIE SPINOSI & FAMILY: A DONATION WAS MADE IN THE AMOUNT OF 2,000.00 TO SUPPORT MARIE SPINOSI & FAMILY DUE TO MR. SPINOSI SUDDENLY PASSING AWAY IN 2011 AND MARIE LEFT WITH TWO YOUNG CHILDREN TO RAISE. MI ADVISOR 529 ESTABLISHED TO ASSIST IN COLLEGE FUND AND OTHER POTENTIAL EMERGENCY EXPENSES. THE FUND IS BEING ADMINISTERED BY A 3RD PARTY FINANCIAL ADVISOR. SPECIAL DREAMS FARM: A DONATION WAS MADE IN THE AMOUNT OF 1,000.00 TO HELP WITH A LOCAL CHARITY THAT PROVIDES TERMINALLY ILL CHILDREN WITH SUMMER CAMPS AT A LOCAL FARM. VISION HOPE: A DONATION WAS MADE IN THE AMOUNT OF 2,495.00 TO A LOCAL CHARITY THAT HELPS PROVIDE ASSISTANCE TO TERMINALLY ILL CHILDREN. AMERICAN CANCER SOCIETY: A DONATION WAS MADE IN THE AMOUNT OF 500.00 TO THE LOCAL CHAPTER OF THE AMERICAN CANCER SOCIETY IN UTICA MICHIGAN TO PROVIDE ASSISTANCE FOR TERMINALLY ILL INDIVIDUALS. UTICA COMMUNITY SCHOOLS EDUCATION EXCELLENCE FOUNDATION: A DONATION WAS MADE IN THE AMOUNT OF 300.00 TO THE FOUNDATIONS GENERAL FUND. SHELBY TOWNSHIP PARKS & RECREATION DEPARTMENT: THREE SEPARATE DONATIONS WERE MADE TO THE SHELBY TOWNSHIP PARKS & RECREATION DEPARTMENT FOR THE RENOVATION OF THE MAE STECKER BASKETBALL COURTS AND LIGHTING FOR THE COURTS IN THE TOTAL AMOUNT OF 56,400.00 FOR THE TOTAL RENOVATION PROJECT.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.