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
UNITED WAY OF WAYNE & HOLMES CO
Employer identification number
34-0946973
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.") ....
1,344,226
1,629,593
1,514,343
1,351,830
1,524,180
7,364,172
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
1,344,226
1,629,593
1,514,343
1,351,830
1,524,180
7,364,172
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.
7,364,172
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..
1,344,226
1,629,593
1,514,343
1,351,830
1,524,180
7,364,172
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
41,140
88,174
70,448
36,918
68,264
304,944
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
1,692
1,271
100
3,039
6,102
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).
7,675,218
12
Gross receipts from related activities, etc. (see instructions)
..................
12
4,190
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
95.950 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
96.390 %
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
UNITED WAY OF WAYNE & HOLMES CO
Employer identification number
34-0946973
Identifier
Return Reference
Explanation
ORGANIZATION'S MISSION
FORM 990 - ORGANIZATION'S MISSION
OUR MISSION STATEMENT, "UNITING PEOPLE AND RESOURCES IN A COMMUNITY-WIDE EFFORT TO IMPROVE LIVES," DESCRIBES OUR TRUE FOCUS. WE ZERO-IN ON THE ISSUES, THE STRATEGIES AND THE ACTIONS NEEDED TO IMPROVE LIVES AND CREATE LASTING CHANGE IN OUR COMMUNITIES. BEYOND TRYING TO MAKE SURE THAT PEOPLE IN CRISIS HAVE ACCESS TO BASIC EMERGENCY NEEDS, UNITED WAY WORKS TO ASSESS COMMUNITY NEEDS IN THE IMPACT AREAS OF EDUCATION, FAMILY AND FINANCIAL STABILITY, AND HEALTH. THESE ARE THE BUILDING BLOCKS FOR A STRONG COMMUNITY-QUALITY EDUCATION FOR CHILDREN, SELF-SUFFICIENT FAMILIES, AND ACCESS TO PRIMARY HEALTH CARE. THE WORK BEING ACCOMPLISHED IS MUCH MORE COMPLEX THAN OUR PREVIOUS WORK. THIS COMPREHENSIVE APPROACH MEANS THE DIFFERENCE BETWEEN DEVELOPING MORE HOMELESS SHELTERS OR FOOD BANKS TO SERVE OUR MOST VULNERABLE POPULATIONS VERSUS, DEVELOPING A WAY TO ADDRESS THE ROOT CAUSES WHICH IMPACT PEOPLES' ABILITY TO MAINTAIN A ROOF OVER THEIR HEAD AND FOOD ON THEIR TABLE, AND BECOME SELF-SUFFICIENT. THIS WORK REQUIRES COLLABORATION NOT ONLY TO IDENTIFY PRIORITIES, BUT ALSO TO DECIDE WHICH STRATEGIES ARE NEEDED TO BRING RESOLUTION TO THESE CHALLENGES.
FIRST ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4A
-PARENT PROJECT: PROVIDES PARENT TRAINING AND SUPPORT PROGRAM FOR PARENTS OF STRONG-WILLED, DEFIANT OR OUT-OF-CONTROL TEENAGERS -MENTAL HEALTH COUNSELING: USING A SLIDING FEE PROGRAM AND OFFERING SERVICES AT WOOSTER AND RITTMAN OFFICE -GOODWILL INDUSTRIES ORGANIZATIONAL EMPLOYMENT: PROVIDES EMPLOYMENT OF INDIVIDUALS WITH SEVERE DISABILITIES AS WELL AS WORK EXPERIENCE POSITIONS FOR LOW INCOME INDIVIDUALS ON PUBLIC ASSISTANCE USING JOB COACH WHO SUPERVISES AND TRAINS THEM -GREENLEAF FAMILY CENTER COMMUNITY SERVICES FOR THE DEAF: STRIVES TO ELIMINATE COMMUNICATION BARRIERS BETWEEN THE DEAF AND HEARING WORLDS AND TO ASSIST PERSONS WHO ARE DEAF/HARD OF HEARING TO ACCESS NEEDED COMMUNITY RESOURCES -UNITED WAY'S 2-1-1: CONNECTS PEOPLE AND THE RESOURCES AVAILABLE TO THEM TO MEET THEIR HEALTH AND HUMAN SERVICE NEEDS -LIBERTY CENTER CONNECTIONS: HOUSING-PROVIDES TRANSITIONAL HOUSING, RENTAL ASSISTANCE, INTENSIVE BUDGET REVIEW, HOME INSPECTIONS, HOUSEHOLD MANAGEMENT SERVICES, AND FINANCIAL MANAGEMENT COURSES
SECOND ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4B
-VIOLA STARTZMAN FREE CLINIC HEALTHCARE FOR THE UNINSURED: PROVIDES ROUTINE, COMPREHENSIVE AND FOCUSED HEALTH CARE TO RESIDENTS OF WAYNE COUNTY WHO WOULD OTHERWISE BE UNABLE TO RECEIVE HEALTH CARE DUE TO THE INABILITY TO PAY
THIRD ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4C
HIGH QUALITY CHILDCARE FOR CHILDREN OF WORKING PARENTS USING A SLIDING FEE SCHEDULE -ORRVILLE AREA BOYS & GIRLS CLUB: PROVIDES PROGRAMS WHICH ACCOMPLISH THE FOLLOWING: -CULTIVATES SOCIAL SKILLS, LEADERSHIP SKILLS, AND HELP MEMBERS TO LEARN TO WORK IN SMALL AND LARGE GROUPS -REINFORCES THE EDUCATIONAL PROCESS ALONG WITH THE SCHOOLS -WORKS WITH YOUTH AND THEIR ATTITUDES AND CURRENT STATE AS IT RELATES TO ALCOHOL, TOBACCO, DRUGS, PEER PRESSURE AND PREMATURE SEXUAL ACTIVITY -WORKS ON BASIC PHYSICAL HEALTH ISSUES USING A SERIES OF EXERCISES AND EVENTS -PROVIDE A LOW-COST AFTER SCHOOL AND SUMMER CHILDCARE PROGRAM FOR WORKING PARENTS -PROMOTES CREATIVITY AND TEACHES ARTISTIC TECHNIQUES -SALVATION ARMY FAMILY LIFE CENTER-YOUTH CENTER: PROVIDES LOW-INCOME, HIGH-RISK YOUNG ADULTS WITH PROGRAMS WHICH UTILIZE RECREATIONAL/EDUCATIONAL ACTIVITIES, FAMILY INVOLVEMENT, COUNSELING, TUTORING AND EMPOWERING CLASSES -WOOSTER CITY SCHOOLS: AFTER SCHOOL PROGRAM-PROVIDES CURRICULUM-BASED PROGRAMMING AND TUTORING FOCUSED ON INCREASING ACADEMIC PERFORMANCE. ADDITIONALY THE PROGRAM WORKS ON LIFE SKILLS, COMMUNITY SERVICE AND OPPORTUNITIES FOR EXERCISE AND RECREATION TO ACADEMICALLY AT-RISK STUDENTS. -YMCA OF WOOSTER THE SPOT: OFFERS ELEMENTARY SCHOOL AGE CHILDREN A SAFE, SUPPORTIVE AND FUN PLACE TO SPEND THEIR LEISURE TIME THROUGH BOTH RECREATIONAL AND EDUCATIONAL PROGRAMS -KNIGHTS FIELD: PROVIDES A FREE DAY CAMP WHERE ELEMENTARY AGE YOUTH CAN BUILD SELF-ESTEEM, LEARN SPORTS, AND POSITIVE SOCIAL INTERACTION WITH PEERS AND ADULTS
ALL OTHER ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4D
VARIOUS OTHER PURPOSE ACHIEVEMENTS TOWARDS UNITED WAY'S MISSION INCLUDING CORE EMERGENCY SERVICES SUCH AS: -AMERICAN RED CROSS ARMED FORCES EMERGENCY ASSISTANCE: PROVIDES WORLDWIDE EMERGENCY COMMUNICATIONS BETWEEN ACTIVE DUTY MEMBERS AND VETERANS OF THE ARMED FORCES AND THEIR FAMILIES -EMERGENCY DISASTER RELIEF SERVICES: PROVIDES IMMEDIATE AND APPROPRIATE EMERGENCY ASSISTANCE TO VICTIMS OF MAN-MADE AND NATURAL DISASTERS -COMMUNITY LEGAL AID: CIVIL LEGAL SERVICES-HELPS LOW-INCOME RESIDENTS OF WAYNE COUNTY WHO HAVE NO OTHER MEANS OF OBTAINING CIVIL LEGAL ASSISTANCE -EVERY WOMAN'S HOUSE: CRISIS SHELTER PROGRAM-OFFERS SAFETY AND SUPPORT FOR THOSE WHO HAVE EXPERIENCED FAMILY VIOLENCE/SEXUAL ASSAULT AND WHO ARE IN IMMEDIATE NEED OF SAFE HOUSING -PEOPLE TO PEOPLE MINISTRIES: EMERGENCY ASSISTANCE-PROVIDES PEOPLE WITH BASIC NEEDS SUCH AS FOOD FROM THE FOOD PANTRY, HOUSEHOLD AND CLOTHING ITEMS, AND FINANCIAL ASSISTANCE FOR THE FOLLOWING NEEDS: SHELTER, UTILITY DISCONNECTS, EMERGENCY TRANSPORTATION AND BASIC HEALTHCARE -SALVATION ARMY-RITTMAN: RITTMAN EMERGENCY ASSISTANCE-PROVIDES EMERGENCY FINANCIAL ASSISTANCE FOR UTILITIES, PRESCRIPTION ASSISTANCE, RENT, AND OTHER BASIC NEEDS -SALVATION ARMY-WOOSTER CORPS: 24-HOUR OPEN DOOR EMERGENCY SHELTER-PROVIDES TEMPORARY SHELTER FOR HOMELESS POPULATION AND FAMILIES IN CRISIS WHILE THEY SEEK A PERMANENT SOLUTION TO THEIR SITUATION. SOUP KITCHEN-PROVIDES A NUTRITIOUS MEAL 5 DAYS-A-WEEK TO THOSE IN NEED TO HELP ALLEVIATE HUNGER FOR FAMILIES AND INDIVIDUALS
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
A FULL PRESENTATION OF THE FORM 990 IS DONE FOR THE MEMBERS OF THE EXECUTIVE COMMITTE AND THE BOARD OF DIRECTORS FOR REVIEW AND INPUT PRIOR TO FILING.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
WHEN INDUCTING A NEW BOARD MEMBER, THEY GO THROUGH A NEW BOARD TRAINING. AT THAT TRAINING, THEY NOT ONLY ARE GIVEN A CONFLICT OF INTEREST SHEET TO COMPLETE, THEY RECEIVE A MANUAL WHICH DESCRIBES CONFLICT OF INTEREST AS FOLLOWS:BOARD MEMBERS MUST AVOID CONFLICTS OF INTEREST BETWEEN THE INTERESTS OF THE UNITED WAY OF WAYNE AND ANY PERSONAL, PROFESSIONAL, AND/OR BUSINESS INTERESTS. THIS INCLUDES AVOIDING POTENTIAL AND ACTUAL CONFLICTS OF INTEREST, AS WELL AS PERCEPTIONS OF CONFLICTS OF INTEREST. MEMBERS OF THE BOARD OF DIRECTORS WILL PROVIDE WRITTEN NOTICE OF SUCH INTEREST OR RELATIONSHIP TO THE UNITED WAY OF WAYNE AND HOLMES COUNTIES INC. THIS WILL INCLUDE THE BOARD MEMBER HAVING EITHER DIRECT OR INDIRECT INTEREST IN OR RELATIONSHIP WITH ANY INDIVIDUAL OR ORGANIZATION - BUSINESS OR NONPROFIT, FAMILY, AND/OR SIGNIFICANT OTHER, EMPLOYER, OR CLOSE ASSOCIATES THROUGH THIS RELATIONSHIP THAT WOULD RECEIVE A BENEFIT OR GAIN FROM SERVING ON THE BOARD. ONCE THEY ARE ON THE BOARD, EACH TIME A VOTE IS CONSIDERED WHERE A POTENTIAL CONFLICT OF INTEREST MIGHT OCCUR SUCH AS DURING THE PROCESS OF APPROVING AN ALLOCATIONS TO AN AGENCY, DECISIONS ABOUT WHERE MONEY IS INVESTED, INSURANCE PURCHASED, SERVICES CONTRACTED FOR, MEMBERS ARE ENCOURAGED TO IDENTIFY THEMSELVES AND RECORD AN ABSTENTION.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
THE BOARD OFFICERS WILL RECCOMMEND THE SALARY ADJUSTMENT OF THE EXECUTIVE DIRECTOR.
COMPENSATION PROCESS FOR OFFICERS
FORM 990, PAGE 6, PART VI, LINE 15B
SALARY DETERMINATION BASED ON BUT NOT LIMITED TO, LOCAL SALARY RANGES FOR SIMILAR POSITIONS, NATIONAL/STATE SALARY LEVELS FOR SIMILAR POSITIONS, EXPERIENCE, AND QUALIFICATION.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE PROVIDED UPON REQUEST.
RECONCILIATION OF CHANGES - OTHER
FORM 990, PART XI, LINE 9
DONOR DESIGNATIONS -17,650 PROVISION FOR UNCOLLECTIBLE PLEDGES -13,330 LOSS ON DISPOSAL 1,861 DONOR DESIGNATIONS 17,650 PROVISION FOR UNCOLLECTIBLE PLEDGES 13,330 LOSS ON DISPOSAL -1,861
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.