Form990-EZ
Click to see attachment
Department of the Treasury
Internal Revenue Service
Short Form
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code
(except black lung benefit trust or private foundation)
bullet Sponsoring organizations of donor advised funds, organizations that operate one or more hospital facilities, and certain controlling organizations as defined in section 512(b)(13) must file Form 990 (see instructions).
All other organizations with gross receipts less than $200,000 and total assets less than $500,000 at the end of the year may use this form.
bulletThe organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-1150
2012
Open to Public
Inspection
A
For the 2012 calendar year, or tax year beginning 01-01-2012, and ending 12-31-2012
B
Check if applicable:
C Name of organization
DOWN SYNDROME ASSN OF NE INDIANA
 
Number and street (or P. O. box, if mail is not delivered to street address)PO BOX 13611
  Room/suite
City or town, state or country, and ZIP + 4 FORT WAYNE, IN46865
D Employer identification number

35-2096448
E Telephone number

(260) 471-9964
F Group Exemption
Number. . bullet  
G Accounting Method: Other (specify) bullet   H Check bulletI Website:bulletWWW.DSANI.ORGJ Tax-exempt status(check only one)—Click to see attachment(   ) bullet(insert no.) or
K Check bullet A Form 990-EZ or Form 990 return is not required though Form 990-N (e-postcard) may be required (see instructions). But if the organization chooses to file a return, be sure to file a complete return.
L Add lines 5b, 6c, and 7b, to line 9 to determine gross receipts. If gross receipts are $200,000 or more, or if total assets (Part II, line 25, column (B) below) are $500,000 or more, file Form 990 instead of Form 990-EZ . . . . . . . bullet $ 90,522
Part I
Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part I)Check if the organization used Schedule O to respond to any question in this Part I...................
VerticalRevenue 1 Contributions, gifts, grants, and similar amounts received............... 1 87,630
2 Program service revenue including government fees and contracts ............ 2  
3 Membership dues and assessments...................... 3 2,755
4 Investment income........................... 4 137
5a Gross amount from sale of assets other than inventory........ 5a  
b Less: cost or other basis and sales expenses........... 5b  
c Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) ...... 5c  
6 Gaming and fundraising events
a Gross income from gaming (attach Schedule G if greater than $15,000) . 6a  
b Gross income from fundraising events (not including $   of contributions
from fundraising events reported on line 1) (attach Schedule G if the
sum of such gross income and contributions exceeds $15,000) 6b  
c Less: direct expenses from gaming and fundraising events....... 6c  
d Net income or (loss) from gaming and fundraising events (add lines 6a and 6b and subtract line 6c) 6d  
7a Gross sales of inventory, less returns and allowances........ 7a  
b Less: cost of goods sold................. 7b  
c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) ......... 7c  
8 Other revenue (describe in Schedule O) ..................... 8  
9 Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8.............. Bullet 9 90,522
VerticalExpenses 10 Grants and similar amounts paid (list in Schedule O) ................. 10  
11 Benefits paid to or for members........................ 11  
12 Salaries, other compensation, and employee benefits................ 12 13,564
13 Professional fees and other payments to independent contractors............ 13 1,479
14 Occupancy, rent, utilities, and maintenance................... 14  
15 Printing, publications, postage, and shipping................... 15 3,331
16 Other expenses (describe in Schedule O) .................... 16 43,993
17 Total expenses. Add lines 10 through 16 ................. Bullet 17 62,367
VerticalNetAssets 18 Excess or (deficit) for the year (Subtract line 17 from line 9)............ 18 28,155
19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with
end-of-year figure reported on prior year’s return)................ 19 128,279
20 Other changes in net assets or fund balances (explain in Schedule O) .......... 20  
21 Net assets or fund balances at end of year. Combine lines 18 through 20.........Bullet 21 156,434
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 10642I Form 990-EZ (2012)
Form 990-EZ (2012)
Page 2
Part IIBalance Sheets (see the instructions for Part II)Check if the organization used Schedule O to respond to any question in this Part II.................

(A) Beginning of year(B) End of year
22Cash, savings, and investments................
127,459
22
155,895
23Land and buildings....................
 
23
 
24Other assets (describe in Schedule O) ..........
820
24
539
25Total assets......................
128,279
25
156,434
26
Total liabilities (describe in Schedule O) .............
 
26
 
27Net assets or fund balances (line 27 of column (B) must agree with line 21)..
128,279
27
156,434
Part IIIStatement of Program Service Accomplishments (see the instructions for Part III) Check if the organization used Schedule O to respond to any question in this Part III . Expenses
(Required for section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts; optional for others.)
What is the organization's primary exempt purpose? THE MISSION OF THE DOWN SYNDROME ASSOCIATION OF NORTHEAST INDIANA, INC. IS TO ENHANCE THE LIVES OF PEOPLE AFFECTED BY DOWN SYNDROME,TO ADVOCATE ON THEIR BEHALF, TO PROVIDE INFORMATION AND SUPPORT TO FAMILIES AND PROFESSIONALS, AND TO PROMOTE ACCEPTANCE AND INCLUSION OF PEOPLE WITH DOWN SYNDROME IN NORTHEAST INDIANA.
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. In a clear and concise manner, describe the services provided, the number of persons benefited, and other relevant information for each program title.
28 THE DOWN SYNDROME ASSOCIATION OF NORTHEAST INDIANA, INC. SERVED 177 MEMBER FAMILIES AND PROFESSIONALS BY PROVIDING SUPPORT IN THE FOLLOWING AREAS: DSANI STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS 2012 INFANT-TODDLER PLAYGROUPS: THIS GROUP FOCUSES ON CREATING OPPORTUNITIES FOR INFANTS THROUGH KINDERGARTEN TO PLAY AND SOCIALIZE WHILE THEIR PARENTS AND SIBLINGS FIND SUPPORT IN A FUN ENVIRONMENT. 28 FAMILIES ON GROUP'S E-MAIL LIST ACTIVITIES INCLUDED: BI-MONTHLY PLAYGROUPS-AVERAGE ATTENDANCE 25 PEOPLE WEEKLY SUMMER SWIM HOUR AT NORTH SIDE PARK, AVERAGE ATTENDANCE 12 FAMILIES SPRING GYMNASTICS CLASSES WITH BUDDY CLUB -AVERAGE ATTENDANCE 14 CHILDREN AND PARENTS BUKCKNER PARK PICNIC JULY 7, 2012 38 PEOPLE FALL OUTING WITH BUDDY CLUB-STEEL FARM- 109 PEOPLE FAMILY PARTY AT ANDORFER COMMONS ALONG WITH BUDDY CLUB - 96 PEOPLE BUDDY CLUB: THIS GROUP OFFERS SOCIAL AND RECREATIONAL ACTIVITIES FOR CHILDREN 6 TO 12 YEARS OLD AND THEIR FAMILIES. THERE ARE 61 FAMILIES ON THIS GROUP'S EMAIL LIST. ACTIVITIES INCLUDED: FAMILY PARTY WITH INFANT GROUP AT ANDORFER COMMONS SPRING GYMNASTICS CLASSES WITH INFANT GROUP BUCKNER PARK PICNIC WEEKLY SUMMER SWIM HOUR AT NORTH SIDE PARK FALL OUTING WITH INFANT GROUP AT STEELE FARM FRIENDSHIP CLUB: AIMED AT TEENS AND YOUNG ADULTS, AGES 12 TO 21. THIS GROUP INCLUDES MEMBERS WITH DOWN SYNDROME AND THOSE WITH OTHER LEARNING DISABILITIES AS WELL. THE MEMBERS DEVELOP FRIENDSHIPS AND ENJOY HAVING A BUSY SOCIAL CALENDAR LIKE ANY TEEN. THERE ARE 27 FAMILIES ON THIS GROUP'S EMAIL LIST. ACTIVITIES INCLUDED: ST. PATRICK'S DAY DANCE 39 PEOPLE VALENTINE'S DAY DANCE - 42 PEOPLE SPRING SEMI-FORMAL DINNER DANCE - 63 PEOPLE HALLOWEEN PARTY AND DANCE - 71 PEOPLE HOLIDAY PARTY - 74 PEOPLE SELF-ADVOCATES: INDIVIDUALS WITH DOWN SYNDROME WHO ARE 21 AND OLDER. THIS GROUP CONTINUES TO GROW AS THE MEMBERS AGE AND NEW MEMBERS JOIN. EVENTS ARE A CHANCE TO SOCIALIZE AND BUILD NEW FRIENDSHIPS AS WELL AS ENJOY THOSE THAT ARE LONG-LASTING. THERE ARE OVER 30 SELF-ADVOCATES ON THIS EMAIL LIST. ACTIVITIES INCLUDED: ST. PATRICK'S DAY DANCE 39 PEOPLE SPRING SEMI-FORMAL DINNER DANCE 63 PEOPLE SWIM PARTY 21 PEOPLE HALLOWEEN PARTY AND DANCE 71 PEOPLE HOLIDAY PARTY 24 PEOPLE GRANDPARENTS GROUP: THIS GROUP OFFERS A WONDERFUL OPPORTUNITY FOR GRANDPARENTS TO SUPPORT FAMILY MEMBERS AND EACH OTHER IN A NURTURING CARING ENVIRONMENT. THIS GROUP IS GROWING AND EXPANDING INTO FUNDRAISING AND SUPPORTING THE ANNUAL BUDDY WALK FUNDRAISER. ACTIVITIES INCLUDED: 2 MEETINGS AT LOCAL RESTAURANTS 7-10 IN ATTENDANCE A REPRESENTATIVE SERVING ON THE BUDDY WALK COMMITTEE AND SECURING PUBLIC RELATIONS AND FUNDING OPPORTUNITIES OUTREACH PROGRAM: AT THE BEGINNING OF THE YEAR, THE OUTREACH COMMITTEE CREATED AN UPDATED "NEW PARENT PACKET" FOR DISTRIBUTION TO FAMILIES OF BABIES NEWLY DIAGNOSED WITH DOWN SYNDROME. DURING THE YEAR, TEN PACKETS WERE GIVEN TO FAMILIES IN NORTHEAST INDIANA. OUTREACH VOLUNTEERS HELP PARENTS CONNECT WITH COMMUNITY SERVICES SUCH AS FIRST STEPS AND THE MEDICAID WAIVER. OUTREACH COMMITTEE MEMBERS MET WITH STAFF FROM PARKVIEW HOSPITAL AT A BOARD MEETING TO SHARE THE NEW PARENT PACKETS AND THE MISSION OF DSANI. IN ADDITION, THE COMMITTEE MEMBERS HAVE BEEN IN CONTACT WITH LUTHERAN HOSPITAL AND ST. JOE HOSPITAL AND HAVE A GOOD WORKING RELATIONSHIP WITH THEM. THEIR STAFF HAS BEEN RECEPTIVE TO CONTACTING DSANI AND GIVING NEW PARENTS DSANI'S CONTACT INFORMATION. PROGRAM EVENTS: IN ADDITION TO THE SPECIAL-INTEREST OR AGE-SPECIFIC ACTIVITIES THAT DSANI SPONSORED IN 2012 A NUMBER OF OTHER PROGRAMS WERE PROVIDED. EVENTS INCLUDED: FAMILY NIGHT AT FORT WAYNE MAD ANTS BASKETBALL GAME. 90 IN ATTENDANCE ANNUAL MEETING WITH KEYNOTE SPEAKER TOM O'NEILL 40 MEMBERS ATTENDED SPONSORED AND PARTICIPATED IN DISABILITIES EXPO. THERE WERE OVER 100 EXHIBITORS AND 1000 ATTENDEES. SPONSORED TWO WEEKS OF CAMP RED CEDAR AND PROVIDED PARTIAL SCHOLARSHIPS AND HORSEBACK RIDING PROGRAM. 39 PARTICIPANTS FAMILY OUTING AT THE FORT WAYNE TIN CAPS BASEBALL GAME WITH 150 PEOPLE IN ATTENDANCE. 14TH ANNUAL BUDDY WALK AT SHOAFF PARK WITH OVER 1000 PEOPLE ATTENDING, INLCUDING 172 VOLUNTEERS. HOLIDAY PARTY FOR THE INFANT AND BUDDY CLUBS WITH 166 MEMBERS ALONG WITH OUR MANY GROUPS AND PROGRAMS, DSANI ALSO PROVIDED: AN ANNUAL REPORT AND SURVEY DISTRIBUTED TO 650 ADDRESSES ON THE MAILING LIST LIBRARY RESOURCES INCLUDING BOOKS AND VIDEOS ON A RANGE OF TOPICS DSANI.ORG WEBSITE THAT IS UPDATED WITH EVENTS REGULARLY MONTHLY MEMBER ALERTS SENT THROUGH EMAIL WITH 476 EMAIL ADDRESSES FACEBOOK PAGE WITH EVENTS, UPDATES, AND INFORMATION PARTICIPATED IN THE KNIGHTS OF COLUMBUS ANNUAL TOOTSIE ROLL DRIVE SUPPORT OF SPECIAL OLYMPICS DSANI CURRENTLY HAS 177 ACTIVE MEMBERS IN A DATABASE (ALL MEMBERS OF A FAMILY ARE CONSIDERED 1 MEMBERSHIP ENTRY IN THE DATABASE). THERE ARE 309 INDIVIDUALS LISTED WHO HAVE DOWN SYNDROME OR HAVE A DIRECT FAMILY MEMBER WITH DOWN SYNDROME.
(Grants $   ) If this amount includes foreign grants, check here ...MediumBullet		 28a 46,066
29
(Grants $   ) If this amount includes foreign grants, check here ...MediumBullet 		29a
30
(Grants $   ) If this amount includes foreign grants, check here ...MediumBullet 		30a
31 Other program services (describe in Schedule O)
(Grants $   ) If this amount includes foreign grants, check here...MediumBullet		 31a
32 Total program service expenses (add lines 28a through 31a).......... bullet 32 46,066
Part IV
List of Officers, Directors, Trustees, and Key Employees List each one even if not compensated (see the instructions for Part IV)Check if the organization used Schedule O to respond to any question in this Part IV............
(a) Name and title (b) Average
hours per week
devoted to position		 (c)Reportable compensation
(Forms W-2/1099-MISC) (if not paid, enter -0-) 		(d) Health benefits, contributions to employee benefit plans,
and deferred compensation		 (e) Estimated amount
of other compensation
STEVE EHINGERClick to see attachmentPRESIDENT JA 1.00 0    
JEFF ZINNClick to see attachmentDIRECTOR 1.00 0    
TOM O'NEILLClick to see attachmentSR ADVISOR 1.00 0    
BRANDI BUCKClick to see attachmentDIRECTOR 1.00 0    
DEBBIE GAVETTEClick to see attachmentDIRECTOR 1.00 0    
CHRIS FLEISCHERClick to see attachmentPRESIDENT AU 1.00 0    
KATHY MEEKSClick to see attachmentSECRETARY JA 1.00 0    
SHERYL STERNALClick to see attachmentDIRECTOR 1.00 0    
LAURA LAHRMANClick to see attachmentSECRETARY AU 1.00 0    
MEGAN WEAVERClick to see attachmentADMIN DIRECT 20.00 12,600    
DAN LAHRMANClick to see attachmentVICE PRESIDE 1.00 0    
DEBORAH NORMANClick to see attachmentTREASURER 2.00 0    
MINDY FLEISCHERClick to see attachmentDIRECTOR 1.00 0    
Form 990-EZ (2012)
Form 990-EZ (2012)
Page 3
Part V
Other Information
(Note the Schedule A and personal benefit contract statement requirements in the
instructions for Part V.) Check if the organization used Schedule O to respond to any question in this Part V.......
Yes
No
33
Did the organization engage in any significant activity not previously reported to the IRS? If "Yes," provide a detailed description of each activity in Schedule O ...................
33
 
No
34
Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the amended documents if they reflect a change to the organization’s name. Otherwise, explain the changeon Schedule O (see instructions) ..........................
34
 
No
35a
Did the organization have unrelated business gross income of $1,000 or more during the year from business activities (such as those reported on lines 2, 6a, and 7a, among others)? ............
35a
 
No
b
If "Yes," to line 35a, has the organization filed a Form 990-T for the year? If "No," provide an explanation in Schedule O
35b
 
 
c
Was the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e) notice, reporting, and proxy tax requirements during the year? If "Yes," complete Schedule C, Part III
35c
 
No
36
Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If “Yes,” complete applicable parts of Schedule N ................
36
 
No
37a
Enter amount of political expenditures, direct or indirect, as described in the instructions. bullet
37a
 
b
Did the organization file Form 1120-POL for this year?...................
37b
 
No
38a
Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were
any such loans made in a prior year and still outstanding at the end of the tax year covered by this return?..
38a
 
No
b
If “Yes,” complete Schedule L, Part II and enter the total amount involved .
38b
 
39
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on line 9.......
39a
 
b
Gross receipts, included on line 9, for public use of club facilities.....
39b
 
40a
Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under:
section 4911 bullet   ; section 4912 bullet   ; section 4955 bullet  
b
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefittransaction during the year, or did it engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I ......
40b
 
No
c
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and 4958...bullet  
d
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimbursed by the organization...........................bullet  
e
All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? If "Yes," complete Form 8886-T ......................
40e
 
No
41List the states with which a copy of this return is filed. bulletIN
42aThe organization's books are in care of bulletDEBORAH NORMAN Telephone no. bullet (260) 471-9964
Located at bullet4202 PIPER DRIVEFORT WAYNE,IN ZIP + 4bullet46809
b
At any time during the calendar year, did the organization have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)?
Yes
No
42b
 
No
If “Yes,” enter the name of the foreign country: bullet
See the instructions for exceptions and filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
c
At any time during the calendar year, did the organization maintain an office outside the U.S.?
42c
 
No
If “Yes,” enter the name of the foreign country: bullet
43.......bullet
and enter the amount of tax-exempt interest received or accrued during the tax year....bullet43
 
Yes
No
44a
Did the organization maintain any donor advised funds during the year? If "Yes," Form 990 must be completed instead of
Form 990-EZ................................
44a
 
No
b
Did the organization operate one or more hospital facilities during the year? If "Yes," Form 990 must be completedinstead of Form 990-EZ.............................
44b
 
No
c
Did the organization receive any payments for indoor tanning services during the year?.........
44c
 
No
d
If "Yes," to line 44c, has the organization filed a Form 720 to report these payments? If "No," provide an
explanation in Schedule O ............................
44d
 
 
45a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?.........
45a
 
No
45b
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," Form 990 and Schedule R may need to be completed instead of Form 990-EZ (see instructions)......................
45b
 
No
Form 990-EZ (2012)
Form 990-EZ (2012)
Page 4
Yes
No
46
Did the organization engage, directly or indirectly, in political campaign activities on behalf of or in opposition tocandidates for public office? If “Yes,” complete Schedule C, Part I. ..............
46
 
No
Part VI
Section 501(c)(3) organizations only All section 501(c)(3) organizations must answer questions 47-49b and 52, and complete the tables for lines 50 and 51 Check if the organization used Schedule O to respond to any question in this Part VI ................
Yes
No
47
Did the organization engage in lobbying activities or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II .......................
47
 
No
48
Is the organization a school as described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E ..
48
 
No
49a
Did the organization make any transfers to an exempt non-charitable related organization?......
49a
 
No
b
If "Yes," was the related organization a section 527 organization?................
49b
 
 
50
Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key employees) who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and title of each employee paid more than $100,000 (b) Average
hours per week
devoted to position		 (c) Reportable compensation
(Forms W-2/1099-MISC) 		(d) Health benefits, contributions to employee benefit plans, and deferred compensation (e) Estimated amount of other compensation
NONE
f
Total number of other employees paid over $100,000 .................bullet  

51
Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and address of each independent contractor paid more than $100,000 (b) Type of service (c) Compensation
NONE
d
Total number of other independent contractors each receiving over $100,000..........bullet  
52
Did the organization complete Schedule A? NOTE: All Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A ...............bullet
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name bullet

Firm's EIN bullet
Firm's address bullet



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
Form 990-EZ (2012)


Form 990-EZ, Special Condition Description:
Special Condition Description

Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

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.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
DOWN SYNDROME ASSN OF NE INDIANA
 
Employer identification number

35-2096448
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
f
g
(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) right arrow (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.") .... 67,853 95,425 76,487 72,567 90,385 402,717
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 67,853 95,425 76,487 72,567 90,385 402,717
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)..           13,866
6 Public support. Subtract line 5 from line 4.           388,851
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
7 Amounts from line 4.. 67,853 95,425 76,487 72,567 90,385 402,717
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... 159 143 116 87 137 642
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).           403,359
12
12
2,755
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........................................right arrow
Section C. Computation of Public Support Percentage
14
14
96.400 %
15
15
96.660 %
16a
b
17a
b
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 ..................................................... right arrow
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) right arrow (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) right arrow (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
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
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:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2012
Name of the organization
DOWN SYNDROME ASSN OF NE INDIANA
 
Employer identification number

35-2096448
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet   $    
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 2
Name of organization
DOWN SYNDROME ASSN OF NE INDIANA
  		Employer identification number

35-2096448
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 3
Name of organization
DOWN SYNDROME ASSN OF NE INDIANA
  		Employer identification number

35-2096448
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 4
Name of organization
DOWN SYNDROME ASSN OF NE INDIANA
  		Employer identification number

35-2096448
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Additional Data


Software ID:  
Software Version:  
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.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
DOWN SYNDROME ASSN OF NE INDIANA
 
Employer identification number

35-2096448
Identifier Return Reference Explanation
OTHER EXPENSES FORM 990-EZ, PART I, LINE 16 EXPENSES ANNUAL MEETING 682 PROPERTY/LIABILITY INSURANCE 1,229 WORKERS COMPENSATION INSURANC 323 D&O LIABILITY INSURANCE 800 OFFICE SUPPLIES 961 INTERNET/WEBSITE 287 TELEPHONE 854 BUDDY WALK EXPENSES 12,389 NEW PARENT PACKETS/OUTREA 769 PROGRAM EXPENSES 23,407 FEES 145 OFFICE EQUIPMENT MTCE 686 OTHER OFFICE 116 GENERAL POSTAGE 690 PRINTING 374 NON-INVESTMENT DEPRECIATION 281 TOTAL 43,993
OTHER CHANGES IN NET ASSETS OR FUND BALANCES FORM 990-EZ, PART I, LINE 20 ROUNDING 0
OTHER ASSETS FORM 990-EZ, PART II, LINE 24 22,776 22,776 LESS ACCUMULATED DEPRECIATION 21,956 22,237 TOTAL 820 539
PRIMARY EXEMPT PURPOSE FORM 990-EZ, PART III THE MISSION OF THE DOWN SYNDROME ASSOCIATION OF NORTHEAST INDIANA, INC. IS TO ENHANCE THE LIVES OF PEOPLE AFFECTED BY DOWN SYNDROME,TO ADVOCATE ON THEIR BEHALF, TO PROVIDE INFORMATION AND SUPPORT TO FAMILIES AND PROFESSIONALS, AND TO PROMOTE ACCEPTANCE AND INCLUSION OF PEOPLE WITH DOWN SYNDROME IN NORTHEAST INDIANA.
FIRST ACCOMPLISHMENT FORM 990-EZ, PART III, LINE 28 THE DOWN SYNDROME ASSOCIATION OF NORTHEAST INDIANA, INC. SERVED 177 MEMBER FAMILIES AND PROFESSIONALS BY PROVIDING SUPPORT IN THE FOLLOWING AREAS: DSANI STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS 2012 INFANT-TODDLER PLAYGROUPS: THIS GROUP FOCUSES ON CREATING OPPORTUNITIES FOR INFANTS THROUGH KINDERGARTEN TO PLAY AND SOCIALIZE WHILE THEIR PARENTS AND SIBLINGS FIND SUPPORT IN A FUN ENVIRONMENT. 28 FAMILIES ON GROUP'S E-MAIL LIST ACTIVITIES INCLUDED: BI-MONTHLY PLAYGROUPS-AVERAGE ATTENDANCE 25 PEOPLE WEEKLY SUMMER SWIM HOUR AT NORTH SIDE PARK, AVERAGE ATTENDANCE 12 FAMILIES SPRING GYMNASTICS CLASSES WITH BUDDY CLUB -AVERAGE ATTENDANCE 14 CHILDREN AND PARENTS BUKCKNER PARK PICNIC JULY 7, 2012 38 PEOPLE FALL OUTING WITH BUDDY CLUB-STEEL FARM- 109 PEOPLE FAMILY PARTY AT ANDORFER COMMONS ALONG WITH BUDDY CLUB - 96 PEOPLE BUDDY CLUB: THIS GROUP OFFERS SOCIAL AND RECREATIONAL ACTIVITIES FOR CHILDREN 6 TO 12 YEARS OLD AND THEIR FAMILIES. THERE ARE 61 FAMILIES ON THIS GROUP'S EMAIL LIST. ACTIVITIES INCLUDED: FAMILY PARTY WITH INFANT GROUP AT ANDORFER COMMONS SPRING GYMNASTICS CLASSES WITH INFANT GROUP BUCKNER PARK PICNIC WEEKLY SUMMER SWIM HOUR AT NORTH SIDE PARK FALL OUTING WITH INFANT GROUP AT STEELE FARM FRIENDSHIP CLUB: AIMED AT TEENS AND YOUNG ADULTS, AGES 12 TO 21. THIS GROUP INCLUDES MEMBERS WITH DOWN SYNDROME AND THOSE WITH OTHER LEARNING DISABILITIES AS WELL. THE MEMBERS DEVELOP FRIENDSHIPS AND ENJOY HAVING A BUSY SOCIAL CALENDAR LIKE ANY TEEN. THERE ARE 27 FAMILIES ON THIS GROUP'S EMAIL LIST. ACTIVITIES INCLUDED: ST. PATRICK'S DAY DANCE 39 PEOPLE VALENTINE'S DAY DANCE - 42 PEOPLE SPRING SEMI-FORMAL DINNER DANCE - 63 PEOPLE HALLOWEEN PARTY AND DANCE - 71 PEOPLE HOLIDAY PARTY - 74 PEOPLE SELF-ADVOCATES: INDIVIDUALS WITH DOWN SYNDROME WHO ARE 21 AND OLDER. THIS GROUP CONTINUES TO GROW AS THE MEMBERS AGE AND NEW MEMBERS JOIN. EVENTS ARE A CHANCE TO SOCIALIZE AND BUILD NEW FRIENDSHIPS AS WELL AS ENJOY THOSE THAT ARE LONG-LASTING. THERE ARE OVER 30 SELF-ADVOCATES ON THIS EMAIL LIST. ACTIVITIES INCLUDED: ST. PATRICK'S DAY DANCE 39 PEOPLE SPRING SEMI-FORMAL DINNER DANCE 63 PEOPLE SWIM PARTY 21 PEOPLE HALLOWEEN PARTY AND DANCE 71 PEOPLE HOLIDAY PARTY 24 PEOPLE GRANDPARENTS GROUP: THIS GROUP OFFERS A WONDERFUL OPPORTUNITY FOR GRANDPARENTS TO SUPPORT FAMILY MEMBERS AND EACH OTHER IN A NURTURING CARING ENVIRONMENT. THIS GROUP IS GROWING AND EXPANDING INTO FUNDRAISING AND SUPPORTING THE ANNUAL BUDDY WALK FUNDRAISER. ACTIVITIES INCLUDED: 2 MEETINGS AT LOCAL RESTAURANTS 7-10 IN ATTENDANCE A REPRESENTATIVE SERVING ON THE BUDDY WALK COMMITTEE AND SECURING PUBLIC RELATIONS AND FUNDING OPPORTUNITIES OUTREACH PROGRAM: AT THE BEGINNING OF THE YEAR, THE OUTREACH COMMITTEE CREATED AN UPDATED "NEW PARENT PACKET" FOR DISTRIBUTION TO FAMILIES OF BABIES NEWLY DIAGNOSED WITH DOWN SYNDROME. DURING THE YEAR, TEN PACKETS WERE GIVEN TO FAMILIES IN NORTHEAST INDIANA. OUTREACH VOLUNTEERS HELP PARENTS CONNECT WITH COMMUNITY SERVICES SUCH AS FIRST STEPS AND THE MEDICAID WAIVER. OUTREACH COMMITTEE MEMBERS MET WITH STAFF FROM PARKVIEW HOSPITAL AT A BOARD MEETING TO SHARE THE NEW PARENT PACKETS AND THE MISSION OF DSANI. IN ADDITION, THE COMMITTEE MEMBERS HAVE BEEN IN CONTACT WITH LUTHERAN HOSPITAL AND ST. JOE HOSPITAL AND HAVE A GOOD WORKING RELATIONSHIP WITH THEM. THEIR STAFF HAS BEEN RECEPTIVE TO CONTACTING DSANI AND GIVING NEW PARENTS DSANI'S CONTACT INFORMATION. PROGRAM EVENTS: IN ADDITION TO THE SPECIAL-INTEREST OR AGE-SPECIFIC ACTIVITIES THAT DSANI SPONSORED IN 2012 A NUMBER OF OTHER PROGRAMS WERE PROVIDED. EVENTS INCLUDED: FAMILY NIGHT AT FORT WAYNE MAD ANTS BASKETBALL GAME. 90 IN ATTENDANCE ANNUAL MEETING WITH KEYNOTE SPEAKER TOM O'NEILL 40 MEMBERS ATTENDED SPONSORED AND PARTICIPATED IN DISABILITIES EXPO. THERE WERE OVER 100 EXHIBITORS AND 1000 ATTENDEES. SPONSORED TWO WEEKS OF CAMP RED CEDAR AND PROVIDED PARTIAL SCHOLARSHIPS AND HORSEBACK RIDING PROGRAM. 39 PARTICIPANTS FAMILY OUTING AT THE FORT WAYNE TIN CAPS BASEBALL GAME WITH 150 PEOPLE IN ATTENDANCE. 14TH ANNUAL BUDDY WALK AT SHOAFF PARK WITH OVER 1000 PEOPLE ATTENDING, INLCUDING 172 VOLUNTEERS. HOLIDAY PARTY FOR THE INFANT AND BUDDY CLUBS WITH 166 MEMBERS ALONG WITH OUR MANY GROUPS AND PROGRAMS, DSANI ALSO PROVIDED: AN ANNUAL REPORT AND SURVEY DISTRIBUTED TO 650 ADDRESSES ON THE MAILING LIST LIBRARY RESOURCES INCLUDING BOOKS AND VIDEOS ON A RANGE OF TOPICS DSANI.ORG WEBSITE THAT IS UPDATED WITH EVENTS REGULARLY MONTHLY MEMBER ALERTS SENT THROUGH EMAIL WITH 476 EMAIL ADDRESSES FACEBOOK PAGE WITH EVENTS, UPDATES, AND INFORMATION PARTICIPATED IN THE KNIGHTS OF COLUMBUS ANNUAL TOOTSIE ROLL DRIVE SUPPORT OF SPECIAL OLYMPICS DSANI CURRENTLY HAS 177 ACTIVE MEMBERS IN A DATABASE (ALL MEMBERS OF A FAMILY ARE CONSIDERED 1 MEMBERSHIP ENTRY IN THE DATABASE). THERE ARE 309 INDIVIDUALS LISTED WHO HAVE DOWN SYNDROME OR HAVE A DIRECT FAMILY MEMBER WITH DOWN SYNDROME.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  

TY 2012 CompensationExplanation
Name:
DOWN SYNDROME ASSN OF NE INDIANA
EIN: 35-2096448
Person Name Explanation
STEVE EHINGER  
JEFF ZINN  
TOM ONEILL  
BRANDI BUCK  
DEBBIE GAVETTE  
CHRIS FLEISCHER  
KATHY MEEKS  
SHERYL STERNAL  
LAURA LAHRMAN  
MEGAN WEAVER  
DAN LAHRMAN  
DEBORAH NORMAN  
MINDY FLEISCHER