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
MT ZION CHILD DEVELOPMENT CENTER INC
Employer identification number
39-1713521
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.
0
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...
0
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
0 %
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.") .
20,294
23,747
17,562
17,024
15,260
93,887
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......
153,818
153,246
163,702
156,074
220,910
847,750
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
10,144
9,948
12,987
12,418
10,888
56,385
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.
184,256
186,941
194,251
185,516
247,058
998,022
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.)
998,022
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...
184,256
186,941
194,251
185,516
247,058
998,022
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
93
47
167
109
129
545
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
93
47
167
109
129
545
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.)..
998,567
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
99.950 %
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
99.950 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
0.050 %
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
0.050 %
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:
12000225
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
MT ZION CHILD DEVELOPMENT CENTER INC
Employer identification number
39-1713521
Identifier
Return Reference
Explanation
Pt VI, Line 11b
The licensed certified public accountant (CPA) that completes
Form 990 for the organization reviews the form with the
Assistant Treasurer. In turn, the Assistant Treasurer presents
copies of the form to each director and officer prior to a
properly scheduled Board meeting to discuss the filing. At
the meeting, all directors and officers have an opportunity to
ask questions about the form or to otherwise make comments
about the form and its contents. If the Assistant Treasurer
cannot adequately answer a question about the form, the
question is passed on to and is answered by the CPA via a
telephone call. Once all questions are adequately answered,
the Board passes a motion to have the Assistant Treasurer
sign the paper return and authorize the CPA to e-file the return.
.
Pt VI, Line 12c
A copy of the organization's written conflict of interest policy
is timely distributed to all new directors, officers and
employees as well as to all existing directors, officers and
employees every time the policy is modified. The policy requires
that any director, officer or employee must disclose to the
President (or to at least two Directors if the discloser is the
President or a Director) any pending or contemplated transaction
that might give rise to a potential conflict of interest.
The President (or the two Directors) then determines whether
the transaction constitutes a conflict, and so informs the
discloser. Both the disclosure and decision are recorded in the
discloser's personnel record and is reported at the next
SHARLIE F. MCCAIN W135N7273 LUND CIR MENOMONEE FALLS WI XXX-XX-XXXX BURMA L. HUDSON 9437 W ROCHELLE AVE MILWAUKEE WI XXX-XX-XXXX JAMES C. HAMBERLIN 6920 N LINCOLNSHIRE CIR MILWAUKEE WI XXX-XX-XXXX ALFRED DAVIS 9405 N 67TH ST MILWAUKEE WI XXX-XX-XXXX DESSIE E. HARRIS 5869 N 74TH ST MILWAUKEE WI XXX-XX-XXXX PASTOR LOUIS E. SIBLEY, III 1849 N 1ST ST MILWAUKEE WI XXX-XX-XXXX JUANITA WILLIAMS 2541 N 14TH ST MILWAUKEE WI XXX-XX-XXXX JENNELL CALVERT 5244 N 67TH ST MILWAUKEE WI XXX-XX-XXXX MARTHA E. CARTER 3867 N 68TH
Board meeting. The policy also encourages any employee
to anonymously report any possible conflict of interest they
observe. Also, the outside bookkeeper and CPA remain
diligent in looking for possible conflicts of interest.
.
Pt VI, Line 15a
The organization's independent Directors within the
Pt VI, Line 15b
Personnel Committee review and approve all compensation and
benefits for all officers, other top management staff and key
employees. The Directors use in their deliberations compara-
bility data consisting of salary and benefit survey results of
similar organizations. The Committee's decisions are
a part of its contemporaneous meeting minutes, which are
then forwarded to the full Board for discussion and approval.
.
Pt VI, Line 19
The organization's governing documents, conflict of interest
policy, financial statements and Form 990 are made available
to the public upon demand. Any person who requests any
of these documents from any director, officer or employee
in person, by mail or by telephone are promptly provided
with a free copy of each of the requested document(s).
.
Part I, Line 22
Beginning of the Year Net Asset Balance is not the same as
Part X, Line 33(A)
the End of Year Net Asset Balance from the 2011 Form 990-EZ,
Part XI, Line 4
Part I, Line 21, and Part II, Line 27, which were $74,096.
This is because the paid tax return preparer made three related
errors on the 2011 return as follows.
Part I, Line 20, Other changes in net assets:
Showed $1,385 with no explanation; this should be -0-.
End of Year Net Asset Balance is then correctly $70,584.
Part X, Line 10c(A)
Part II, Line 24, Other assets (B) End of Year:
Showed $46,695 with no detail on Schedule O other than
correct description that this is supposed to be the book
value of all furniture, fixtures, equipment, leashold improve-
ments & vehicles. However, he understated the cost basis
of the Ford Passenger Van purchased 01/12/2011 by $2,199.
See 2011 Form 4562, Part V, Line 26:
Showed $19,191 as cost and basis for depreciation;
the actual cost was $21,390 (no effect on max depr exp)
Tax preparer also did not add 2011 depreciation of $5,711
to beginning of year accumulated depreciation when calculating
end of year book value, which should be $46,695 + $2,199
- $5,711 = $43,183.
Part X, Line 16(A)
Part II, Line 25, Total Assets:
Showed $84,734; should be line 22 of $38,039 plus
corrected line 25 of $43,183 = $81,222.
Part II, Line 27, Net Asset Balance (B) End of Year:
Showed $74,096; should be line 25 of $81,222 less
line 26 of $10,638 = $70,584.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.