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
FAMILY SUPPORT NETWORK OF SENC
Employer identification number
58-1868436
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.") ....
90,652
53,804
29,906
48,170
25,014
247,546
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
90,652
53,804
29,906
48,170
25,014
247,546
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.
247,546
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..
90,652
53,804
29,906
48,170
25,014
247,546
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).
247,546
12
Gross receipts from related activities, etc. (see instructions)
..................
12
50,650
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
100.000 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
100.000 %
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
FAMILY SUPPORT NETWORK OF SENC
Employer identification number
58-1868436
Identifier
Return Reference
Explanation
OTHER EXPENSES
FORM 990-EZ, PART I, LINE 16
EXPENSES OFFICE SUPPLIES 905 POSTAGE 2 TRAVEL 3,007 BANK SERVICE CHARGES 95 DUES & SUBSCRIPTIONS 691 INSURANCE 2,494 EDUCATION & TRAINING 75 PARENT/COMMUNITY TRAINING 1,642 INSURANCE - WORKERS COMP 2,568 SERVICE-RELATED SUPPLIES 775 EQUIPMENT RENTAL 2,193 TOTAL 14,447
OTHER ASSETS
FORM 990-EZ, PART II, LINE 24
OFFICE EQUIPMENT 6,934 6,934 LESS ACCUMULATED DEPRECIATION 6,934 6,934 COMPUTER EQUIPMENT 0 0 ACCUMULATED DEPRECIATION 0 0 TOTAL 0 0
OTHER LIABILITIES
FORM 990-EZ, PART II, LINE 26
PAYROLL LIABILITY 1,536 0
PRIMARY EXEMPT PURPOSE
FORM 990-EZ, PART III
WE PROVIDE FAMILIIES OF CHILDREN WITH SPECIAL NEEDS EMOTIONAL AND EDUCATIONAL SUPPORT, ASSISTANCE IN ACCESSING COMMUNITY SERVICES, AND PROMOTE FAMILY CENTERED PRACTICES IN BRUNSWICK, COLUMBUS, DUPLIN, NEW HANOVER AND PENDER COUNTIES.
FIRST ACCOMPLISHMENT
FORM 990-EZ, PART III, LINE 28
NEW HANOVER COUNTY SCHOOLS EXCEPTIONAL CHILDREN PROJECT (NHCS/EC) THIS PROJECT RAN FROM JULY 1, 2012 TO JUNE 30, 2013. UNDER THESE FUNDS, A 'COMING TOGETHER CONFERENCE' WAS ORGANIZED AND HOSTED. BASIC TRAINING WORKSHOPS WERE HELD THAT HELP PARENTS BETTER UNDERSTAND THE INDIVIDUAL EDUCATION PLAN PROCESS, THE FEDERAL EDUCATION LAW AND HOW PARENTS CAN BE EQUAL TEAM MEMBERS IN THIS PROCESS. ONE STAFF PERSON IS FUNDED IN THIS CONTRACT TO WORK WITH NEW HANOVER COUNTY FAMILIES ONE-ON-ONE TO BETTER UNDERSTAND THEIR CHILD'S EVALUATIONS, SPECIALIZED INSTRUCTION PLAN AND WILL ALSO ATTEND SCHOOL MEETINGS WITH THEM.
SECOND ACCOMPLISHMENT
FORM 990-EZ, PART III, LINE 29
CHILDREN'S DEVELOPMENTAL SERVICES AGENCY(CDSA) (ALSO KNOWN AS NC INFANT TODDLER PROGRAM OR EARLY INTERVENTION PROGRAM) THIS PROGRAM RAN FROM JULY 1, 2012 TO JUNE 30, 2013 UNDER THIS PROJECT, THE CENTRAL DIRECTORY OF RESOURCES AND FSN RESOURCES WERE PUBLICIZED THROUGH OUT THE AREA INCLUDING THE WILMINGTON CDSA OFFICE WITH PRINT PIECES LIKE BROCHURES OR BUSINESS CARDS AND POSTERS. RESPONDED TO FAMILY REQUESTS FOR INFORMATION ABOUT COMMUNITY RESOURCES AND MADE APPROPRIATE REFERRALS TO THOSE RESOURCES. MUCH OF THIS INFORMATION WAS GIVEN TO FAMILIES WHILE THEY WERE IN THE NEONATAL INTENSIVE CARE UNIT OF NEW HANOVER REGIONAL MEDICAL CENTER SO THEY WOULD KNOW WHERE THEY COULD TURN IF THEY NEEDED IT ONCE THEY TOOK THEIR BABY HOME FROM THE HOSPITAL. WEEKLY NICU 101 MEETINGS WERE HELD TO PROVIDE A VARIETY OF INFORMATION TO APPROXIMATELY 60 FAMILIES. SOME OF THESE FAMILIES WERE ELIGIBLE FOR EARLY INTERVENTION SERVICES AND IN THESE CASES TRANSITIONS WERE FACILITATED FROM THE HOSPITAL TO EARLY INTERVENTION SERVICES. ACTIVELY PARTICIPATED IN LOCAL INTERAGENCY COORDINATING COUNCIL MEETINGS IN CATCHMENT AREA. CONDUCTED ONE PARENT SUPPORT TRAINING WHERE THREE PEOPLE WERE TRAINED TO BECOME TRAINED SUPPORT PARENTS. SOMETIMES A PARENT WANTED TO TALK TO ANOTHER PARENT WHO WAS WORKING SUCCESSFULLY AT NAVIGATING SYSTEMS AND SERVICES AND WE HELPED PARENTS MAKE THOSE CONNECTIONS WITH SOMEONE WHO HAD BEEN TRAINED TO PROVIDE THAT SUPPORT. OVER 40 TRAINED VOLUNTEER SUPPORT PARENTS ARE AVAILABLE. PROVIDED SUPPORT TO A LOCAL PARENT RUN PARENT SUPPORT GROUP THAT MET MONTHLY AND HELD A VARIETY OF SOCIAL FUNCTIONS THROUGH THE YEAR. PROVIDED THE WILMINGTON CDSA WITH ONE IN-SERVICE WORKSHOP FOR INFANT TODDLER CREDITS. ALSO PROVIDED WORKSHOPS AT OUR COMING TOGETHER CONFERENCE THAT WERE FOR INFANT TODDLER CREDITS.
THIRD ACCOMPLISHMENT
FORM 990-EZ, PART III, LINE 30
EARLY INTERVENTION COLLABORATIVE PROJECT (EICP) THIS PROJECT RAN FROM JULY 1, 2012 TO JUNE 30, 2013. PROVIDED INTENSIVE IN HOME SERVICES TO PARENTS WHO HAVE A CHILD AGED BIRTH TO FIVE DIAGNOSED WITH A SPECIAL NEED OR BEHAVIORAL ISSUE. THIS IS A COLLABORATION BETWEEN THE HEALTH DEPARTMENT'S CARE COORDINATION 4 CHILDREN PROJECT AND FAMILY SUPPORT NETWORK OF SENC TO PROVIDE MORE FAMILY SUPPORT THAN THEY WOULD OTHERWISE RECEIVE. REFERRALS FOR THIS PROJECT HAVE COME FROM A VARIETY OF COMMUNITY AGENCIES - LIKE THE SCHOOL SYSTEM, NEW HANOVER DEPARTMENT OF SOCIAL SERVICES, LOCAL THERAPISTS AND OTHER DEPARTMENTS WITHIN THE HEALTH DEPARTMENT. SAW 20 FAMILIES IN THIS PROJECT AND PROVIDED ONE-ON-ONE SUPPORT IN THE CHILD'S HOMES.
ALL OTHER ACCOMPLISHMENT
FORM 990-EZ, PART III, LINE 31
OTHER GENERAL SUPPORT SERVICES FOR FAMILIES WITH SPECIAL NEEDS CHILDREN - INCLUDING PROJECTS SUCH AS THE DSS/FOSTER FAMILY PROJECT AND THE DOWN SYNDROME AND EXCEPTIONAL FRIENDS PARENT SUPPORT PROJECT.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.