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
LEAP INC
Employer identification number
31-1740634
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.") ....
30,012
59,049
76,628
41,991
24,586
232,266
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
30,012
59,049
76,628
41,991
24,586
232,266
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)..
8,148
6
Public support. Subtract line 5 from line 4.
224,118
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..
30,012
59,049
76,628
41,991
24,586
232,266
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
491
190
152
105
70
1,008
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.)..
938
1,504
1,003
1,394
1,073
5,912
11
Total support (Add lines 7 through 10).
239,186
12
Gross receipts from related activities, etc. (see instructions)
..................
12
59,653
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
93.700 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
93.410 %
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
LEAP INC
Employer identification number
31-1740634
Identifier
Return Reference
Explanation
OTHER EXPENSES
FORM 990-EZ, PART I, LINE 16
EXPENSES INSURANCE 1,019 SUPPLIES 155 TELEPHONE 703 POSTAGE 9 POSTAGE 19 REPAIRS & MAINTENANCE 883 PRINTING AND PUBLICATION 492 BANK CHARGES 160 COST OF SALES - COFFEE SH 28,847 COMMUNITY SIGN EXPENSES 2,000 LICENSES AND FEES 394 LICENSES AND FEES 25 MISCELLANEOUS 921 MISCELLANEOUS 156 UTILITIES 4,192 LIBRARY EXPENSES 7,676 HOOKED ON FISHING PROJECT 1,105 FRIENDS OF TRAIL PROJECT 464 CENTRAL MN LYME PROJECT 1,791 LEADERS END POVERTY 462 S/M EARLY CHILDHOOD COALI 850 NON-INVESTMENT DEPRECIATION 967 TOTAL 53,290
OTHER ASSETS
FORM 990-EZ, PART II, LINE 24
INVENTORIES FOR SALE OR USE 2,476 0 EQUIPMENT & LHI 23,401 0 LESS ACCUMULATED DEPRECIATION 14,282 0 TOTAL 11,595 0
OBJECTIVES ARE TO: 1. WORK AS A LIAISON BETWEEN THE COMMUNITY AND SCHOOL DISTRICT, 2. SUPPORT VOLUNTEERISM IN THE SCHOOL AND COMMUNITY, 3. IDENTIFY VIABLE WAYS FOR THE SCHOOL TO ADAPT TO CURRENT ECONOMICS AND DEMOGRAPHIC CIRCUMSTANCES, 4. DETERMINE THE STRENGTHS AND WEAKNESSES OF THE DISTRICT THROUGH FOCUS GROUP MEETINGS AND DECIDE WHICH OPTIONS PROVIDE THE MOST BENEFITS FOR THE COMMUNITY AND THE SCHOOL DISTRICT, 5. BUILDING A STRONGER STAPLES COMMUNITY THAT WILL ENRICH THE QUALITY OF LIFE NOW AND FOR FUTURE GENERATIONS, 6. DETERMINE THE STRENGTHS AND WEAKNESSES OF THE COMMUNITY THROUGH FOCUS GROUP MEETINGS AND DECIDE WHICH OPTIONS PROVIDE THE MOST BENEFITS FOR THE COMMUNITY AND BUSINESSES, 7. FACILITATE THE CITIZENS, CITY GOVERNMENT, AND BUSINESSES IN STAPLES TO IMPROVE COMMUNICATION AND PLANNING AND WORK TOGETHER ON PROJECTS.
FIRST ACCOMPLISHMENT
FORM 990-EZ, PART III, LINE 28
THE COFFEE SHOP PROVIDED A BUSINESS SETTING WHERE YOUTH WERE EDUCATED TO PARTICIPATE IN RUNNING A BUSINESS. YOUTH WERE ALSO PROVIDED OPPORTUNITIES ON A REGULAR BASIS FOR ARTISTIC EXPRESSION SUCH AS OPEN MIC NIGHT,VISUAL ARTS DISPLAYS AND MUSICAL PERFORMANCES. THE SHOP ALSO PROVIDED A SAFE ATMOSPHERE FOR STUDENTS TO MINGLE,PARTICIPATE IN STUDY GROUPS, SURF THE INTERNET OR PLAY GAMES. THE SHOP CLOSED FOR BUSINESS ON APRIL 21, 2013.
ALL OTHER ACCOMPLISHMENT
FORM 990-EZ, PART III, LINE 31
ASSISTED A LOCAL GROUP OF VOLUNTEERS IN HOSTING A "HOOKED ON FISHING, NOT ON DRUGS" EVENT FOR LOCAL 4TH GRADERS. HELPED THE LOCAL GROUP "FRIENDS OF THE TRAIL" RUN AN EVENT TO BRING ATTENTION TO THE WANTS AND NEEDS OF A TRAIL SYSTEM IN THE AREA. ASSISTED CENTRAL MN LYME AWARENESS GROUP IN THEIR "LYME TIME AWARENESS" PROJECT. PROVIDED HELP WITH A SPEAKER, MEETING SPACE, AND EDUCATIONAL MATERIALS. ASSISTED THE CHAMBER OF COMMERCE IN PROMOTING A CITY FESTIVAL. ASSISTED THE SPRINKLE AND SPROUT CLUB IN CITY BEAUTIFICATION PROJECTS. ASSISTED THE LEADERS PARTNERING TO END POVERTY PROGRAM (LPEPP)IN BRINGING IN A SPEAKER MULTIPLE TIMES TO GIVE WORKSHOPS ON POVERTY ISSUES. ASSISTED STAPLES MOTLEY EARLY CHILDHOOD COALITION IN PROMOTING PROGRAMS FOR YOUNG CHILDREN (0-5) AND THEIR PARENTS. THE MISSION IS TO ENSURE THAT ALL CHILDREN HAVE A HEALTHY START AND ARE WELL-PREPARED TO START THEIR SCHOOL JOURNEY. CURRENT FOCUSES ARE: REDUCING BARRIERS TO ECFE AND SCHOOL READINESS, REDUCING BARRIERS TO HEALTHCARE (MENTAL, DENTAL, AND HEALTH),AND INCREASING OPPORTUNITIES AND AWARENESS FOR FAMILIES WITH CHILDREN 0-5 YEARS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.