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
ANN ARBOR YMCA
Employer identification number
38-1525162
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.") .
372,520
474,849
441,228
491,178
454,191
2,233,966
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......
6,106,402
6,442,602
6,216,159
6,360,968
6,558,846
31,684,977
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
210,949
189,469
192,891
197,910
67,755
858,974
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.
6,689,871
7,106,920
6,850,278
7,050,056
7,080,792
34,777,917
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.)
34,777,917
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...
6,689,871
7,106,920
6,850,278
7,050,056
7,080,792
34,777,917
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
77,346
94,072
39,919
28,422
27,137
266,896
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
77,346
94,072
39,919
28,422
27,137
266,896
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.)..
6,767,217
7,200,992
6,890,197
7,078,478
7,107,929
35,044,813
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
99.240 %
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
98.920 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
1.000 %
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
1.000 %
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
ANN ARBOR YMCA
Employer identification number
38-1525162
Identifier
Return Reference
Explanation
FIRST ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4A
ADULT TEAM SPORTS AND RECREATION, AND LIVESTRONG AT THE YMCA, A FREE FITNESS AND SUPPPORT PROGRAM FOR CANCER SURVIVORS. OUR PROGRAMS ARE ACCESSIBLE, AFFORDABLE AND OPEN TO ALL FAITHS, BACKGROUNDS, ABILITIES AND INCOME LEVELS. IN 2012 THE ANN ARBOR YMCA PROVIDED 598,611 IN FINANCIAL ASSISTANCE TO INDIVIDUALS WHO WOULD HAVE FACED ECONOMIC BARRIERS TO PARTICIPATION.
ALL OTHER ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4D
OTHER PROGRAM SERVICES-OTHER PROGRAM SERVICES INCLUDE CHILD CARE, TEEN EDUCATION AND LEADERSHIP AND YOUTH VOLUNTEER PROGRAMS. CHILD CARE:THE YMCA'S NAEYC-ACCREDITED EARLY CHILD CARE AND AFTER SCHOOL PROGRAMS PROVIDE A NURTURING ENVIRONMENT WHERE CHILDREN CAN LEARN, GROW AND DEVELOP SOCIAL SKILLS. THESE PROGRAMS ALSO REINFORCE THE YMCA VALUES OF HONESTY, CARING, RESPECT AND RESPONSIBILITY AMONG CHILDREN AND THEIR FAMILIES. AN ADDITIONAL ELEMENT TO THE Y'S CHILD CARE PROGRAMS IS THE HEALTHY EATING / PHYSICAL ACTIVITY CIRRICULUM IMPLEMENTED TO HELP REDUCE CHILDHOOD OBESITY. THE Y MAKES IT POSSIBLE FOR FAMILIES OF ALL BACKGROUNDS AND INCOME LEVELS TO PARTICIPATE IN OUR PROGRAMS ON A SLIDING FEE SCALE. IN 2012, 26 FAMILIES RECEIVED THIS FINANCIAL SUPPORT. AT THE Y, WE HELP TEENS SET AND ACHIEVE THEIR GOALS. THROUGH OUR TEEN EDUCATION AND LEADERSHIP PROGRAMS, INCLUDING THE TEEN AFTER SCHOOL PROGRAM,YOUTH IN GOVERNMENT AND LEADERS CLUB, TEENS AGES 11-17 HAVE THE OPPORTUNITY TO DEVELOP SELF- CONFIDENCE AND TAKE AN ACTIVE ROLE IN STRENGTHENING THEIR COMMUNITY. IN 2012, OVER 120 TEENS PARTICIPATED IN THESE EDUCATION AND LEADERSHIP PROGRAMS. YOUTH VOLUNTEER CORPS IS A SERVICE LEARNING PROGRAM THAT EMPOWERS YOUNG PEOPLE THROUGH EXTENDED VOLUNTEER SERVICE EXPERIENCES. IN 2012 OVER 300 YOUTH PROVIDED OVER 8,000 HOURS OF COMMUNITY SERVICE. THESE ACTIVITIES STRENGTHENED THE FOUNDATIONS OF OUR COMMUNITY THROUGH THE YOUTH TO 32 COMMUNITY AGENCIES. AN EXTENSION OF THE YOUTH VOLUNTEER CORPS IS THE Y'S CHAIN OF PLENTY PROGRAM. IN 2012, THIS PROGRAM GAVE 18 TEENS WITH SPECIAL NEEDS THE OPPORTUNITY TO GAIN JOB AND LIFE SKILLS, WHILE THEY PREPARED A TOTAL OF 15,000 LUNCHES FOR PATRONS OF THE LOCAL HOMELESS SHELTER.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
A DRAFT OF THE FORM 990 IS FIRST REVIEWED BY THE FINANCE COMMITTEE, WHICH ALSO HAS REPSONSIBILITY FOR ALL MATTERS RELATED TO THE ORGANIZATION'S ANNUAL AUDIT. ONCE APPROVED AT THE COMMITTEE LEVEL, THE FORM, INCLUDING ALL ATTACHMENTS, IS EMAILED TO THE BOARD PRIOR TO A REGULARLY SCHEDULED BOARD MEETING. AT THE BOARD MEETING, THE TREASURER, WHO CHAIRS THE FINANCE COMMITTEE, REPORTS ON ANY DISCUSSIONS RELATED TO THE FORM 990 THAT OCCURED AT ITS MEETING AND ASKS FOR ADDITIONAL COMMENTS OR QUESTIONS FROM THE BOARD MEMBERS. WHEN ALL MATTERS HAVE BEEN ADDRESSED AT THE BOARD LEVEL, THE RETURN IS PROMPTLY FILED.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
BOARD MEMBERS AND OFFICERS (CEO, VP OF OPERATIONS, VP OF PROGRAMS AND COMMUNITY DEVELOPMENT AND CFO) ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY AND COMPLETE THE RELATED QUESTIONNAIRE ANNUALLY. THERE ARE NO STAFF MEMBERS WHO QUALIFY AS KEY EMPLOYEES. THE DIRECTOR OF BUSINESS OPERATIONS REVIEWS THE RESPONSES TO THE QUESTIONNAIRE, DOCUMENTS POTENTIAL CONFLICTS AND PROVIDES A SUMMARY REPORT TO THE EXECUTIVE COMMITTEE OF THE BOARD. THE CHAIR OF THE BOARD PERIODICALLY REMINDS THE BOARD MEMBERS AND THE OFFICERS, WHO ALSO ATTEND BOARD MEETINGS, OF THEIR RESPONSIBILITY TO NOTIFY A MEMBER OF THE EXECUTIVE COMMITTEE IF THERE IS A CHANGE IN PERSONAL OR PROFESSIONAL RELATIONSHIPS THAT MAY CREATE A NEW CONFLICT OF INTEREST. IN ADDITION, SEVERAL MEMBERS OF THE EXECUTIVE COMMITTEE ARE ALSO MEMBERS OF THE FINANCE COMMITTEE, WHICH PROVIDES A FURTHER OVERSIGHT AND COMPLIANCE CAPABILITY. ALL SIGNIFICANT FINANCIAL TRANSACTIONS ARE REVIEWED AND DISCUSSED AT THE COMMITTEE LEVEL,INCLUDING THOSE INVOLVING POTENTIAL CONFLICTS OF INTEREST, BEFORE PRESENTATION TO THE BOARD.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
THE EXECUTIVE COMMITTEE OF THE BOARD DETERMINES THE COMPENSATION OF THE ORGANIZATION'S CEO. THE COMMITTEE MEETS ANNUALLY TO REVIEW THE PERFORMANCE OF THE CEO AND TO DETERMINE COMPENSATION. EACH BOARD MEMBER IS ASKED TO COMPLETE A CEO PERFORMANCE APPRAISAL SURVEY. THE RESULTS OF THE SURVEY ARE COMPILED BY THE CHAIR OF THE BOARD AND REVIEWED BY ALL MEMBERS OF THE EXECUTICE COMMITTEE. THE EXECUTIVE COMMITTEE'S OVERALL EVALUATION OF PERFORMANCE IS BASED ON CATEGORIES OUTLINED IN THE ORGANIZATION'S SALARY ADMINISTRATION PLAN AND PRE-AGREED-UPON ANNUAL GOALS FOR THE CEO. COMPENSATION DATA IS COMPILED FOR CEO'S OF OTHER YMCA'S AND OTHER NON-PROFITS WITH SIMILIAR SIZE BUDGETS IN THE ORGANIZATION'S GEOGRAPHIC REGION. THE RESULTS ARE COMPARED TO THE CURRENT CEO PAY RANGE ESTABLISHED IN ACCORDANCE WITH THE MODIFIED HAY PLAN CHARTS PROVIDED BY THE YMCA OF USA AND UTILIZED FOR ALL EXEMPT AND NON-EXEMPT STAFF POSITIONS IN THE ORGANIZATION. THE SALARY REVIEW PROCESS AND SUBSEQUENT ADJUSTMENT ARE DOCUMENTED WITH THE SIGNATURES OF ALL THE MEMBERS OF THE EXECUTIVE COMMITTEE, INDICATING THEIR PARTICIPATION, CONCURRENCE AND COMPLETION DATE. THE FINAL RESULTS ARE REPORTED TO THE BOARD AT ITS NEXT REGULARLY SCHEDULED BOARD MEETING.
COMPENSATION PROCESS FOR OFFICERS
FORM 990, PAGE 6, PART VI, LINE 15B
THE BOARD HAS DELEGATED TO THE CEO THE AUTHORITY TO REVIEW AND DETERMINE THE COMPENSATION OF THE ORGANIZATION'S OFFICERS, WHICH INCLUDE THE VP OF OPERATIONS/COO, VP OF PROGRAMS AND COMMUNITY DEVELOPMENT AND THE CFO, IN ACCORDANCE WITH AN ESTABLISHED SALARY ADMINISTRATION PLAN BASED ON THE MODIFIED HAY PLAN CHARTS PROVIDED BY THE YMCA OF THE USA. THE CEO MEETS INDIVIDUALLY WITH EACH OFFICER IN A FORMAL REVIEW SESSION TO EVALUATE THE PROGRESS ON PRE-AGREED-UPON ANNUAL PERFORMANCE GOALS AND TO DETERMINE COMPENSATION. SALARY RANGES FOR EACH POSITION ARE DETERMINED BASED ON REQUIRED COMPETENCIES. PERCENTAGE INCREASES ARE PREDETERMINED FOR VARIOUS PERFORMANCE CATEGORIES AND APPLIED BASED ON THE OFFICER'S POSITION IN HIS/HER RESPECTIVE SALARY RANGE. CONTEMPORANEOUS DOCUMENTATION OF THE ANNUAL REVIEW AND COMPENSATION ADJUSTMENT IS SIGNED BY BOTH THE CEO AND THE OFFICER.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
RECONCILIATION OF CHANGES - OTHER
FORM 990, PART XI, LINE 9
DIRECT EXPENSES RELATED TO FUNDRAISING EVENTS 1,931 COST OF GOODS SOLD RELATED TO MERCHANDISE PURCHASES 43,392 DIRECT EXPENSES RELATED TO FUNDRAISING EVENTS -1,931 COST OF GOODS SOLD RELATED TO MERCHANDISE PURCHASES -43,392
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.