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
CORVILLA INC
Employer identification number
35-6062577
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.") .
90,298
179,117
91,840
79,782
92,295
533,332
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......
2,265,568
2,306,515
2,274,724
2,167,922
2,279,097
11,293,826
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
0
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
0
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
6
Total. Add lines 1 through 5.
2,355,866
2,485,632
2,366,564
2,247,704
2,371,392
11,827,158
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
0
0
0
0
0
0
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.
0
0
0
0
0
0
c
Add lines 7a and 7b..
0
0
0
0
0
0
8
Public support (Subtract line 7c from line 6.)
11,827,158
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...
2,355,866
2,485,632
2,366,564
2,247,704
2,371,392
11,827,158
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
75,570
58,485
46,895
64,119
84,451
329,520
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
0
c
Add lines 10a and 10b.
75,570
58,485
46,895
64,119
84,451
329,520
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
0
0
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
1,506
3,348
500
185
566
6,105
13
Total support. (Add lines 9, 10c, 11, and 12.)..
2,432,942
2,547,465
2,413,959
2,312,008
2,456,409
12,162,783
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
97.240 %
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
96.370 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
2.700 %
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
3.550 %
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
OTHER INCOME, SCHEDULE A, PART III, LINE 12, DESCRIPTION - MISCELLANEOUS INCOME, COLUMN A - 1506, COLUMN B - 3348, COLUMN C - 500, COLUMN D - 185, COLUMN E - 566, COLUMN F - 6105;,
Schedule A (Form 990 or 990-EZ) 2012
Additional Data
Software ID:
12000266
Software Version:
v2012.1.0
-
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
CORVILLA INC
Employer identification number
35-6062577
Identifier
Return Reference
Explanation
PROGRAM SERVICE ACCOMPLISHMENTS
FORM 990, PART III, LINE 4A
(CONTINUED FROM PART III, LINE 4A) CORVILLA'S GOAL FOR THE FUTURE IS TO CONTINUALLY DESIGN SOLUTIONS FOR AREA FAMILIES WHO STRUGGLE TO COPE WITH THE DIFFICULTIES OF CARING FOR A DEVELOPMENTALLY DISABLED FAMILY MEMBER. WE RELY ON THE GENEROUS SUPPORT OF BUSINESSES, ORGANIZATIONS AND INDIVIDUALS IN OUR COMMUNITY TO MAINTAIN A GOOD QUALITY OF LIFE FOR THE RESIDENTS.
Delegate broad authority to a committee
Form 990, Part VI, Section A, Line 1a
PURSUANT TO SECTION 7.02 OF THE BYLAWS OF CORVILLA, INC. , THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE PRESIDENT, VICE-PRESIDENT, SECRETARY, AND TREASURER. THE EXECUTIVE DIRECTOR SHALL BE AN EX-OFFICIO MEMBER OF THE EXECUTIVE COMMITTEE, BUT SHALL NOT HAVE ANY RIGHT TO VOTE. THE PRESIDENT SHALL BE THE PRESIDING OFFICER OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL BE RESPONSIBLE FOR THE GENERAL MANAGEMENT OF THE CORPORATION AND SHALL DEVELOP SUCH POLICIES AND PROCEDURES AS ARE NECESSARY FOR THIS PURPOSE, WHICH POLICIES SHALL BE APPROVED BY THE BOARD OF TRUSTEES BY MAJORITY VOTE. THE EXECUTIVE COMMITTEE IS AUTHORIZED TO DELEGATE CERTAIN MANAGEMENT RESPONSIBILITIES TO ANY MEMBER OF THE BOARD OF TRUSTEES, THE EXECUTIVE DIRECTOR, OR TO ANY OTHER EMPLOYEE IN ORDER TO ASSIST THE EXECUTIVE COMMITTEE IN THE DAY-TO-DAY MANAGEMENT OF THE CORPORATION. ANY AND ALL POLICIES AND PROCEDURES WHICH ARE REQUIRED FOR THE EFFECTIVE MANAGEMENT OF THE CORPORATION SHALL BE PRESENTED TO THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL THEN FINALIZE AND RECOMMEND FOR APPROVAL ALL SUCH POLICIES TO THE BOARD OF TRUSTEES FOR FINAL APPROVAL. THE EXECUTIVE COMMITTEE MEETS PERIODICALLY AND ACTS IN THE NAME OF THE FULL BOARD WHEN IT IS NOT MEETING, CONDUCTS ANNUAL EVALUATIONS OF THE EXECUTIVE DIRECTOR, AND ACTS TO STEER, COORDINATE AND CLARIFY THE WORK ALL COMMITTEES.
Review of form 990 by governing body
Form 990, Part VI, Section B, Line 11b
ALL BOARD MEMBERS AND OFFICERS RECEIVE A COPY OF THE FINAL FORM 990 FOR REVIEW VIA EMAIL PRIOR TO ITS FILING. ALL BOARD MEMBERS AND OFFICERS ARE REQUESTED BY THE EXECUTIVE DIRECTOR AND THE ACCOUNTING MANAGER TO REVIEW AND SEND COMMENTS NOTING APPROVAL.
Conflict of interest policy
Form 990, Part VI, Section B, Line 12c
ANNUAL DISCLOSURE IS PROVIDED TO EACH OFFICER, BOARD MEMBER, AND ADMINISTRATIVE STAFF (THE ORGANIZATION DOES NOT HAVE ANY KEY EMPLOYEES OR HIGHEST COMPENSATED EMPLOYEES). EACH PERSON COMPLETES AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE. ONCE THE QUESTIONNAIRES ARE COMPLETED, THE PRESIDENT'S ASSISTANT REVIEWS THE RESPONSES AND DETERMINES WHETHER OR NOT THERE ARE ANY CONFLICTS OF INTEREST. IF THERE IS A POTENTIAL CONFLICT OF INTEREST, THE PRESIDENT, TREASURER AND CONTROLLER REVIEW THE CORRESPONDING ISSUE AND DETERMINE IF THERE IS AN ACTUAL CONFLICT OF INTEREST. IF AN ACTUAL CONFLICT OF INTEREST IS DETERMINED TO EXIST, THAT PERSON IS EXCLUDED FROM ANY DISCUSSIONS CONCERNING THE CONFLICTING ISSUE. ANY PURCHASES AND/OR BIDDING PROPOSALS ARE ALSO REVIEWED FOR ANY POTENTIAL CONFLICTS OF INTEREST PRIOR TO SUBMITTING BIDS OR MAKING PURCHASES.
PROCESS USED TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL
FORM 990, PART VI, LINE 15A
THE PROCESS FOR DETERMINING COMPENSATION FOR THE ORGANIZATION'S EXECUTIVE DIRECTOR INCLUDED A REVIEW BY THE BOARD OF DIRECTORS' COMPENSATION COMMITTEE, WHICH CONSISTED OF INDEPENDENT PERSONS. THE EXECUTIVE DIRECTOR'S COMPENSATION WAS COMPARED TO THE INARF SALARY AND COMPENSATION REPORT FOR CHIEF EXECUTIVE OFFICERS. THE BOARD OF DIRECTORS COMPENSATION COMMITTEE REVIEWS COMPENSATION ON A REGULAR BASIS, AND THE LAST COMPENSATION REVIEW WAS PERFORMED IN JANUARY 2013. THE COMPENSATION COMMITTEE'S REVIEW AND APPROVAL OF COMPENSATION WAS DOCUMENTED IN THE MEETING MINUTES. THE EXECUTIVE DIRECTOR'S COMPENSATION HAS NOT CHANGED SINCE THE REVIEW THAT TOOK PLACE IN JANUARY 2008.
PROCESS USED TO ESTABLISH COMPENSATION OF OTHER OFFICERS/KEY EMPLOYEES
FORM 990, PART VI, LINE 15B
THE ORGANIZATION DOES NOT HAVE OTHER OFFICERS OR KEY EMPLOYEES THAT RECEIVE COMPENSATION. THEREFORE, THIS QUESTION IS NOT APPLICABLE AND HAS BEEN ANSWERED "NO" IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS.
Governing documents, conflict of interest policy and financial statements available to the public
Form 990, Part VI, Section C, Line 19
A COPY OF THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.