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
TAMMY LYNN MEMORIAL FOUNDATION INC
Employer identification number
56-0999619
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.") ....
436,949
479,924
541,189
469,116
1,003,440
2,930,618
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
436,949
479,924
541,189
469,116
1,003,440
2,930,618
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)..
152,376
6
Public support. Subtract line 5 from line 4.
2,778,242
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..
436,949
479,924
541,189
469,116
1,003,440
2,930,618
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
3,148
453
747
250
397
4,995
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.)..
10
125
35,468
35,603
11
Total support (Add lines 7 through 10).
2,971,216
12
Gross receipts from related activities, etc. (see instructions)
..................
12
1,356,176
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
93.510 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
91.200 %
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
SECTION B, LINE 12 INCLUDES INTERCOMPANY RENTS REPORTED WITHIN THE FINANCIAL STATEMENTS BETWEEN THE CONTROLLED GROUP MEMBERS, HOWEVER THESE AMOUNTS ARE ELIMINATED AT CONSOLIDATION.
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
TAMMY LYNN MEMORIAL FOUNDATION INC
Employer identification number
56-0999619
Identifier
Return Reference
Explanation
ORGANIZATION'S MISSION
FORM 990 - ORGANIZATION'S MISSION
THE TAMMY LYNN CENTER FOR DEVELOPMENTAL DISABILITIES OFFERS EDUCATION, RESIDENTIAL AND FAMILY SUPPORT SERVICES TO CHILDREN AND ADULTS WITH SPECIAL NEEDS. THE CENTER'S GOAL IS TO PROVIDE THE INDIVIDUALS IT SERVES THE OPPORTUNITY TO MAXIMIZE THEIR ABILITIES IN A LOVING, NURTURING ENVIRONMENT. SEE SCHEDULE R FOR A DESCRIPTION OF THE ORGANIZATION'S CONTROL GROUP INCLUDING TAMMY LYNN MEMORIAL FOUNDATION, INC., TLC OPERATIONS, INC., TAMMY LYNN ENDOWMENT, INC. AND TAMMY LYNN CENTER, INC.
ALL OTHER ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4D
RESPITE CARE - THE CENTER TRAINS CARE PROVIDERS TO PROVIDE CARE IN THE HOMES OF PARENTS OF CHILDREN AND ADULTS WHO HAVE DEVELOPMENTAL DISABILIES. EARLY INTERVENTION - THE CENTER PROVIDES COMPREHENSIVE INDIVIDUALIZED IN-HOME THERAPIES, HOME TRAINING PROGRAMS AND FAMILY SUPPORT SERVICES TO CHILDREN BIRTH TO THREE YEARS OLD WHO HAVE DEVELOPMENTAL DISABILITIES.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
A DRAFT COPY OF THE FORM 990 WILL BE REVIEWED BY THE EXECUTIVE COMMITTEE FOR QUESTION AND COMMENT. ANY MATTERS RAISED DURING THIS REVIEW THAT ARE NOT RESOLVED INTERNALLY ARE REFERRED TO THE OUTSIDE ACCOUNTANTS FOR FURTHER COLLABORATION AND ULTIMATE RESOLUTION. COPIES OF THE RETURN ARE THEN DISTRIBUTED TO THE MEMBERS OF THE BOARD OF DIRECTORS TO PROVIDE OPPORTUNITY FOR BOARD MEMBER REVIEW AND COMMENT. BY CONSENT, AND DOCUMENTED IN THE ORGANIZATION'S RECORDS, THE BOARD HAS NAMED HOLLY RICHARD AS THE AUTHORIZED SIGNATOR FOR THE FORM 990.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
IT IS EXPECTED THAT DIRECTORS, TRUSTEES, OR KEY EMPLOYEES WILL DISCLOSE ANY INTERESTS THAT COULD GIVE RISE TO CONFLICTS AT ANY TIME THAT A REAL OR PERCEIVED CONFLICT IS RECOGNIZED. EACH INDIVIDUAL IS MANDATED TO DISCLOSE ANY CONFLICTS OF INTEREST THAT HAVE ARISEN DURING THE PERIODIC BOARD MEETINGS THAT ARE HELD AT LEAST FIVE TIMES A YEAR. IF ANY POTENTIAL CONFLICT ANYWHERE IN THE CORPORATE STRUCTURE WOULD BE KNOWN TO THE COLLECTIVE OFFICERS AND DIRECTORS OF THE ENTIRE CONSOLIDATED TAMMY LYNN CENTER GROUP OF ENTITIES, SPECIFIC INQUIRY, ACTION, AND DOCUMENTATION WOULD OCCUR.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
NO OFFICERS ARE ACTIVELY INVOLVED WITH THE ORGANIZATION. ALL DECISION- MAKING IS CONTROLLED BY THE BOARD OF DIRECTORS, WHO ARE UNCOMPENSATED.
COMPENSATION PROCESS FOR OFFICERS
FORM 990, PAGE 6, PART VI, LINE 15B
NO OFFICERS ARE ACTIVELY INVOLVED WITH THE ORGANIZATION. ALL DECISION- MAKING IS CONTROLLED BY THE BOARD OF DIRECTORS, WHO ARE UNCOMPENSATED.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
INTERESTED PERSONS MAY VISIT THE ORGANIZATION WEBSITE OR CONTACT THE OFFICE TO REQUEST PUBLIC DISCLOSURE DOCUMENTS.
ADDITIONAL INFORMATION
FORM 990, PART XI
LINE 9 - OTHER CHANGES IN NET ASSETS EXPLANATION THE CHANGE IN NET ASSETS RELATE TO INTERCOMPANY ACTIVITIES SUBJECT TO RECONCILIATION AND ELIMINATION WITHIN THE CONSOLIDATED FINANCIAL STATEMENTS (SEE SCHEDULE R), AS WELL AS SEPERATELY STATED ITEMS REPORTED ON SCHEDULE D, PARTS XI AND XII.
RECONCILIATION OF CHANGES - OTHER
FORM 990, PART XI, LINE 9
FUNDRAISING EXPENSES REPORTED ON RELATED ENTITY 16,184
OTHER CHANGES IN NET ASSETS EXPLANATION
FORM 990, PART XI, LINE 9
CHANGE IN INTERCOMPANY RECEIVABLE 981,000
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.