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
HEFFTER RESEARCH INSTITUTE INC
Employer identification number
85-0414512
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.") ....
147,339
236,681
467,430
354,239
1,413,493
2,619,182
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
147,339
236,681
467,430
354,239
1,413,493
2,619,182
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)..
2,121,045
6
Public support. Subtract line 5 from line 4.
498,137
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..
147,339
236,681
467,430
354,239
1,413,493
2,619,182
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
5,419
517
94
66
57
6,153
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).
2,625,335
12
Gross receipts from related activities, etc. (see instructions)
..................
12
296
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
18.970 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
32.500 %
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
TEN-PERCENT-OF-SUPPORT REQUIREMENT: AT LEAST TEN PERCENT OF THE INSTITUTE'S TOTAL SUPPORT (INCLUDING INVESTMENT INCOME) COMES FROM GOVERNMENTAL UNITS, INDIVIDUALS, TRUSTS OR CORPORATIONS, EACH OF WHOM CONTRIBUTES LESS THAN 2% OF THE TOTAL SUPPORT OF THE INSTITUTE DURING THE COMPUTATION PERIOD IN QUESTION, EXCEPT QUALIFYING GRANTS FROM PUBLIC CHARITIES OF ANY AMOUNT MAY BE INCLUDED IN THE TEN PERCENT. ATTRACTION OF PUBLIC SUPPORT: THE INSTITUTE IS ORGANIZED AND OPERATED TO ATTRACT NEW AND ADDITIONAL PUBLIC SUPPORT ON A CONTINUOUS BASIS. IT MAINTAINS A CONTINUOUS AND BONA FIDE PROGRAM FOR SOLICITATION OF FUNDS FROM THE GENERAL PUBLIC, GOVERNMENTAL UNITS AND OTHER CHARITABLE ORGANIZATIONS DESCRIBED IN SECTION 509(A)(1). THESE INCLUDE AN ANNUAL FUNDRAISING EVENT AND AN ACTIVE PRESENCE ON THE INTERNET AT WWW.HEFFTER.ORG THAT REQUESTS THE GENERAL PUBLIC DONATE ONLINE. THE PUBLIC SUPPORT FACTORS RELEVANT TO THE INSTITUTE ARE THE FOLLOWING: 1. PERCENTAGE OF FINANCIAL SUPPORT FACTOR: THE PERCENTAGE OF THE ORGANIZATION'S SUPPORT FROM THE GENERAL PUBLIC OR GOVERNMENTAL SOURCES IS AT LEAST 10%. 2. SOURCES OF SUPPORT FACTOR: THE INSTITUTE RECEIVES ITS SUPPORT FROM A REPRESENTATIVE NUMBER OF PERSONS. THOUGH THE RESEARCH CONDUCTED IS PRIMARILY LIMITED TO A SPECIAL FIELD, PSYCHOACTIVE DRUGS AND THE NERVOUS SYSTEM, THE BENEFITS OF SUCH RESEARCH INCLUDE THE BROAD AREAS OF THE TREATMENT OF MEDICAL AND EMOTIONAL ILLNESSES AND THE UNDERSTANDING OF BRAIN FUNCTION. THESE AREAS APPEAL TO A LARGE NUMBER OF PERSONS. 3. REPRESENTATIVE GOVERNING BODY FACTOR: THE GOVERNING BODY IS COMPOSED OF EIGHT PERSONS HAVING SPECIAL KNOWLEDGE OR EXPERTISE IN THE PARTICULAR FIELDS AND DISCIPLINES IN WHICH THE INSTITUTE OPERATES: DAVID NICHOLS, PHD, MARK GEYER, PHD, CHARLES GROB, MD, DENNIS MCKENNA, PHD, GEORGE GREER, MD, FRANZ VOLLENWEIDER, MD, ROLAND GRIFFITHS, PHD AND STEPHEN ROSS, MD. 4. AVAILABILITY OF PUBLIC SERVICES FACTOR: THE RESULTS OF ALL RESEARCH IS SUBMITTED FOR PUBLICATION IN RECOGNIZED SCIENTIFIC JOURNALS WIDELY USED BY COLLEGES AND UNIVERSITIES AND/OR MEMBERS OF THE GENERAL PUBLIC, AND/OR IS PRESENTED AS ORAL REPORTS AT PUBLIC SCIENTIFIC MEETINGS. THE CURRENT LIST OF PUBLICATIONS OF RESEARCH SUPPORTED AT LEAST IN PART BY THE INSTITUTE CAN BE FOUND AT: HTTP://WWW.HEFFTER.ORG/RESEARCH-ALL.HTM, WHERE OVER 75 PUBLICATIONS ARE NOW LISTED. ANY RESULTS NOT ACCEPTED FOR PUBLICATION IN A SCIENTIFIC JOURNAL OR PRESENTED AT A PUBLIC MEETING WILL BE PUBLISHED BY THE INSTITUTE AND MADE AVAILABLE TO THE PUBLIC ON A NONDISCRIMINATORY BASIS. PROSPECTIVE RESEARCHERS FOR THE INSTITUTE HAVE LONG HISTORIES OF PUBLICATIONS IN SUCH RECOGNIZED SCIENTIFIC JOURNALS. RECIPIENTS OF INSTITUTE FUNDS FOR RESEARCH ARE REQUIRED TO MAKE AVAILABLE THEIR RESULTS IN THE SAME MANNER. NO ORGANIZATIONS OR INDIVIDUALS RECEIVE PREFERENCE AS TO ANY RESULTS OR THE TIME OF THEIR RELEASE.
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
HEFFTER RESEARCH INSTITUTE INC
Employer identification number
85-0414512
Identifier
Return Reference
Explanation
FIRST ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4A
GRANT TO NEW YORK UNIVERSITY TO STUDY THE TREATMENT OF ANXIETY WITH PSILOCYBIN IN CANCER PATIENTS. THE STUDY OF THIS GRANT (300,000) IS STILL IN PROCESS. GRANT TO UNIVERSITY HOSPITAL, ZURICH SWITZERLAND TO STUDY THE EFFECTS OF PSILOCYBIN IN THE BRAIN. THE STUDY OF THIS GRANT (90,043.95) IS STILL IN PROCESS. GRANT TO THE UNIVERSITY OF NEW MEXICO TO STUDY THE USE OF PSILOCYBIN TO TREAT ALCOHOL DEPENDENCE. THE STUDY GRANT (129,880.31)IS STILL IN PROCESS.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTANT AND THEN IS REVIEWED BY THE ENTITIES ACCOUNTANT AND MEDICAL DIRECTOR PRIOR TO SUBMISSION. COPIES OF THE 990 ARE THEN MADE AVAILABLE TO ALL BOARD MEMBERS AT THE FOLLOWING MEETING.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
EACH BOARD MEMBER IS REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY STATEMENT EVERY YEAR.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
COMPENSATION FOR THE MEDICAL DIRECTOR IS BASED ON COMPETENT SURVEY INFORMATION AND IS THE RESULT OF ARM'S LENGTH BARGAINING. SURVEY INFORMATION FROM HTTP://WWW.SALARY.COM/PSYCHIATRIST-SALARY.HTML.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
ALL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. POSTAGE AND PRINTING CHARGES WIL BE APPLIED. INDIVIDUALS MAY REQUEST DOCUMENTS BY PHONE, MAIL OR EMAIL.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.