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
NORTHWEST DOCUMENTARY ARTS & MEDIA
Employer identification number
51-0458157
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.
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...
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
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.") .
39,758
42,519
63,169
56,098
92,705
294,249
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......
58,721
52,669
50,137
64,436
48,903
274,866
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
10,455
6,677
4,376
3,514
25,022
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.
98,479
105,643
119,983
124,910
145,122
594,137
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
20,725
21,015
22,420
12,225
12,899
89,284
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.
5,000
5,000
c
Add lines 7a and 7b..
20,725
21,015
22,420
12,225
17,899
94,284
8
Public support (Subtract line 7c from line 6.)
499,853
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...
98,479
105,643
119,983
124,910
145,122
594,137
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
919
401
206
48
33
1,607
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
919
401
206
48
33
1,607
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
717
717
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.)..
99,398
106,044
120,189
124,958
145,872
596,461
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
83.800 %
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
86.110 %
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 %
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.
EQUIPMENT 51,638 54,752 LESS ACCUMULATED DEPRECIATION 22,993 31,951 TOTAL 28,645 22,801
PRIMARY EXEMPT PURPOSE
FORM 990-EZ, PART III
TO CREATE, INSTRUCT, AND SHARE THE ART OF DOCUMENTARY STORYTELLING.
FIRST ACCOMPLISHMENT
FORM 990-EZ, PART III, LINE 28
PRODUCTION. AS LEADERS IN THE FIELD OF DOCUMENTARY STORYTELLING, WE ACTIVELY ENGAGE IN THE CREATION OF ORIGINAL STORIES OF ARTISTIC, CULTURAL, AND HISTORIC VALUE. NW DOCUMENTARY'S ORIGINAL PRODUCTIONS HAVE GARNERED MORE THAN A DOZEN PRESTIGIOUS AWARDS, INCLUDING THE NW EMMY, AND HAVE BEEN RECOGNIZED IN INTERNATIONAL FILM FESTIVALS AND MAJOR ART CENTERS, SUCH AS THE SAN FRANCISCO MUSEUM OF MODERN ART, MONTRAL'S FESTIVAL INTERNATIONAL DU FILM SUR L'ART (FIFA), AND FESTIVALS LIKE TRIBECA, CLARMONT-FERRAND, AND LONDON. THE ORIGINAL PRODUCTIONS AT NW DOCUMENTARY HAVE BECOME AN ACTIVE FOCAL POINT IN THE ORGANIZATION, ALLOWING PEOPLE FROM A WIDE VARIETY OF BACKGROUNDS TO APPLY SKILLS AND ENERGY TOWARD A SHARED ARTISTIC ENDEAVOR. PROJECTS ENGAGE CREATIVE SKILLS AND OFFER PORTFOLIO-BUILDING OPPORTUNITIES TO INDEPENDENT PROFESSIONALS, SUCH AS GRAPHIC DESIGNERS, MUSICIANS, AUDIO ENGINEERS, AND PHOTOGRAPHERS. OUR PROJECTS ALSO GIVE COLLEGE STUDENTS INTERNSHIPS, COLLEGE CREDIT, AND A CHANCE TO BECOME A CRITICAL PART OF A PROFESSIONAL TEAM. IN 2012, WE ENTERED INTO PRODUCTION FOR OUR NEXT ORIGINAL DOCUMENTARY, LES VOYAGEURS SANS TRACE. WE HAVE SET OUT TO TELL THE UNTOLD STORY OF THREE DASHING YOUNG FRENCH PEOPLE WHO, IN 1938, WERE THE FIRST TO TAKE KAYAKS DOWN THE GREEN AND COLORADO RIVERS. AMAZINGLY, THEY FILMED THEIR 900-MILE JOURNEY IN STUNNING 16MM COLOR FILM. WITH A CREW OF SKILLED FILMMAKERS, FRENCH TRANSLATORS, AND SCHOLARS IN RIVER RUNNING AND THE AMERICAN WEST, WE WILL TELL THIS THRILLING, UNTOLD CHAPTER OF HISTORY, AND PAIR IT WITH NEW FOOTAGE OF THE RIVERS, AND THE PEOPLE AND PLACES ALONG THE WAY.
SECOND ACCOMPLISHMENT
FORM 990-EZ, PART III, LINE 29
EDUCATION. IN RESPONSE TO THE GROWTH OF USING DIGITAL MEDIA AS THE PRIMARY TOOL TO RECORD AND SHARE THE STORIES OF OUR TIME, OUR PROGRAMS OFFER TECHNICAL AND ARTISTIC TRAINING TO BECOME EFFECTIVE NON-FICTION STORYTELLERS IN A DIGITAL AGE. SINCE 2003, WE HAVE REACHED MORE THAN HALF A MILLION PEOPLE THROUGH OUR CLASSES, PRESENTATIONS, AND BROADCASTS. YOUTH AND ADULTS FROM DIVERSE BACKGROUNDS HAVE USED OUR WORKSHOPS TO CREATE MORE THAN 300 NEW DOCUMENTARIES. WE OFFER THREE TERMS OF WORKSHOPS PER YEAR TEACHING NON-FICTION STORYTELLING AND DOCUMENTARY FILMMAKING. NW DOCUMENTARY WORKSHOPS ARE OPEN TO ALL-AGES AND BACKGROUNDS. ECONOMIC BACKGROUNDS VARY WIDELY AS A RESULT OF CONSCIOUSLY SETTING OUR TUITION AT AN AFFORDABLE RATE AND OFFERING SCHOLARSHIPS AND FINANCIAL ASSISTANCE. WE OFFER TWO YOUTH PROGRAMS, DOCUMENTARY EXPLORERS CAMP AND RECORDING RESILIENCE. THESE WORKSHOPS ARE OFFERED IN PARTNERSHIP WITH LOCAL NON-PROFIT ORGANIZATIONS OMSI AND THE DOUGY CENTER. IN DOCUMENTARY EXPLORERS CAMP, WE TAKE KIDS INTO THE OUTDOORS TO USE DOCUMENTARY FILMMAKING AS A TOOL TO EXPLORE SCIENCE AND NATURE. IN RECORDING RESILIENCE, WE WORK WITH TEENS FROM THE DOUGY CENTER COMMUNITY WHO ARE SUFFERING FROM THE LOSS OF A PARENT OR SIBLING, AND TOGETHER MAKE A DOCUMENTARY TO TELL THEIR STORY AND HONOR THEIR LOVED ONE. NW DOCUMENTARY WORKSHOPS ARE TAUGHT BY TALENTED PROFESSIONALS WHO SHARE THEIR REAL-WORLD EXPERIENCE AND THEIR PERSONAL PASSION FOR DOCUMENTARY STORYTELLING WITH OUR STUDENTS. WE CAP WORKSHOP SIZES TO MAINTAIN LOW STUDENT TO INSTRUCTOR RATIOS. IN SOME CASES, THE RATIO IN OUR YOUTH PROGRAMS IS 1:1, GIVING EACH STUDENT PERSONAL LEARNING AND MENTORSHIP. DURING OUR EDUCATION TERMS WE OFFER OPEN LAB FOR OUR COMMUNITY. STUDENTS AND MEMBERS CAN USE OUR FACILITIES FREE OF CHARGE, INCLUDING EDIT STATIONS, OUR AUDIO BOOTH, SCREENING AREA, AND OUR DOCUMENTARY RESOURCE LIBRARY. WE ALSO OFFER AFFORDABLE CAMERA AND AUDIO EQUIPMENT RENTALS. IN 2012,: WE HELD THREE TERMS OF SUCCESSFUL WORKSHOPS AT NW DOCUMENTARY, FEATURING OUR POPULAR DIY DOCUMENTARY WORKSHOP. WE HELD DOCUMENTARY EXPLORERS CAMP IN PARTNERSHIP WITH OMSI, AND RECORDING RESILIENCE IN PARTNERSHIP WITH THE DOUGY CENTER. WE HOSTED THREE HOMEGROWN DOCFEST SCREENINGS AT THE MISSION THEATER, SHOWCASING OUR COMMUNITY'S WORK.
THIRD ACCOMPLISHMENT
FORM 990-EZ, PART III, LINE 30
COMMUNITY. NW DOCUMENTARY EVENTS PRESENT MEANINGFUL DOCUMENTARY STORYTELLING TO THE PUBLIC. DOCUMENTARY STORYTELLING PROVIDES THE OPPORTUNITY TO ENGAGE A PUBLIC AUDIENCE IN A POWERFUL AND MEANINGFUL WAY; THE ART OF DOCUMENTARY IS A HYBRID OF ARTISTIC GENRES, SUCH AS LITERARY NON-FICTION, PHOTOGRAPHY, ORAL HISTORY, AND MUSIC. NW DOCUMENTARY HAS SHARED ITS WORKS IN SCHOOLS, LIBRARIES, MUSEUMS, AND CULTURAL CENTERS. OUR HOMEGROWN DOCFEST HAS BECOME AN ANTICIPATED EVENT IN PORTLAND, REGULARLY FILLING THE MISSION THEATER. HELD THREE TIMES A YEAR AT THE CONCLUSION OF EACH EDUCATION TERM, IT IS A SHOWCASE OF LOCALLY-MADE DOCUMENTARIES FEATURING STORIES FROM OUR COMMUNITY. IN 2012,: WE HOSTED MONTHLY GATHERINGS FOR THE NW DOCUMENTARY ALUMNI & MEMBER GROUP, FEATURING PRESENTATIONS BY DOCUMENTARY FILMMAKERS FOR DOCUMENTARY FILMMAKERS TO LEARN AND NETWORK. WE LAUNCHED A PARTNERSHIP WITH FILMED BY BIKE, A FILM FESTIVAL BASED IN PORTLAND, OR CELEBRATING 10 YEARS OF BIKE RELATED FILMS. COMMUNITY FILM GROUPS SUCH AS DOC GROUP MEET IN OUR MEDIA CENTER, OPENING OUR DOORS TO NEW AUDIENCES, AND FURTHERING OUR MISSION TO SHARE THE ART OF NON-FICTION STORYTELLING. WE HOSTED THE NW DOCUMENTARY FILM SERIES IN PARTNERSHIP WITH THE HOLLYWOOD THEATRE. IN 2012, WE BROUGHT A NEW DOCUMENTARY TO PORTLAND AUDIENCES EACH MONTH, AND PAIRED THE SCREENINGS WITH Q+A SESSIONS AND WORKSHOPS WITH VISITING FILMMAKERS
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.