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 METHODIST CHILDREN'S HOME OF THE NORTH GA CONFERENCE INC
Employer identification number
58-0632081
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)
No
(ii)
A family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
A 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
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
(A)
NORTH GA CONFERENCE OF THE UNITED METHODIST CHURCH
580572421
1
Yes
Yes
Yes
0
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.") .
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 METHODIST CHILDREN'S HOME OF THE NORTH GA CONFERENCE INC
Employer identification number
58-0632081
Identifier
Return Reference
Explanation
ORGANIZATION'S MISSION
FORM 990 - ORGANIZATION'S MISSION
PROVIDE REDEMPTIVE, HEALING SERVICES THAT BRING MEANINGFUL CHANGES TO THE LIVES OF CHILDREN AND FAMILIES. SIGNIFICANT ACTIVITIES INCLUDE PROVISION OF FOSTER CARE, TRANSITIONAL HOUSING, TRANSITIONAL AND INDEPENDENT LIVING ASSISTANCE, AND FAMILY PRESERVATION SERVICES.
FIRST ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4A
ACHIEVEMENTS: -FAMILY HOUSING UNITS HAVE EXPANDED TO ACCOMMODATE 12 FAMILIES -12 FAMILIES COMPLETED PARENTING CLASSES -7 RESIDENTS RECEIVED THEIR GED AND OR JOB RELATED CERTIFICATIONS
SECOND ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4B
ACHIEVEMENTS: -NEWLY APPROVED HOMES - 12 -74 CHILDREN WERE SERVED THROUGH FOSTER CARE SERVICE -RANKED NUMBER ONE IN THE STATE
THIRD ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4C
OLDER ADOLESCENTS IN A MANNER THAT PROVIDES A BRIDGE BETWEEN FOSTER CARE AND BECOMING INDEPENDENT. EACH PARTICIPANT WILL HAVE THE OPPORTUNITY TO DEVELOP A LONG-TERM PLAN TO PREPARE FOR THE TRANSITIONAL LIVING PROGRAM, COLLEGE, THE MILITARY OR SELF-SUFFICIENCY. ACHIEVEMENTS: -3 RESIDENTS STARTED JOB CORE -6 RESIDENTS GRADUATED FROM HIGH SCHOOL AND 22 RESIDENTS WERE SERVED IN OUR ON-CAMPUS GED PROGRAM -5 RESIDENTS WHO ACHIEVED 80% OF THEIR EDUCATIONAL GOALS WENT ON A COLLEGE TRIP TO WASHINGTON DC -3 RESIDENTS STARTED COLLEGE THIS PROGRAM IS ALSO ONE OF THE BEST PERFORMING PROGRAMS IN THE STATE. TRANSITIONAL LIVING: THE TRANSITIONAL LIVING PROGRAM ALLOWS YOUNG ADULTS TO LIVE IN THE COMMUNITY IN THEIR OWN HOMES WHILE CONTINUING TO PARTICIPATE IN A STRUCTURED PROGRAM THAT TEACHES AND SUPPORTS THE CONTINUED DEVELOPMENT OF ESSENTIAL LIFE SKILLS. THIS PROGRAM GIVES YOUNG ADULTS THE TOOLS THEY NEED TO SUCCEED AND ENCOURAGES HEALTHY, SPIRITUAL, EMOTIONAL, AND PHYSICAL GROWTH. WE MUST PROVIDE FOR A SENSE OF BELONGING WHILE PROMOTING THE DEVELOPMENT OF THE RESIDENT'S UNIQUE INDIVIDUALITY. ACHIEVEMENTS : 2 RESIDENTS WERE ACCEPTED TO COLLEGE 1 RESIDENT OBTAINED A FULL-TIME JOB WITH BENEFITS ALL RESIDENTS WERE ENROLLED IN AN EDUCATIONAL PROGRAM OR WORKING 20 HOURS PER MONTH. NURTURING CONNECTIONS: NURTURING CONNECTIONS SECOND CHANCE PROGRAM (NCSCP) SERVES TO EMPOWER, EMOTIONALLY SUPPORT, AND FOSTER PARENTING TEENS INTO BECOMING, RESPONSIBLE, NURTURING AND ACCOMPLISHED YOUNG ADULTS. NCSCP INTRODUCES PARENTING TEENS TO A HIGH LEVEL OF SUPERVISION AND TEACHING IN A HOME BASED ENVIRONMENT. THE PROGRAM GIVES PARENTING TEENS A SENSE OF PRIDE AND INVOLVEMENT. NCSCP ALSO INCREASES THEIR LEVEL OF INDEPENDENCE BY CHALLENGING THEM TO TAKE RESPONSIBILITY FOR ALL AREAS OF THEIR LIFE. EACH PARENT IS TAUGHT TO MAKE POSITIVE LIFE DECISIONS ON BEHALF OF HERSELF AND HER CHILD WHILE BECOMING PRODUCTIVE CITIZENS.
ALL OTHER ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4D
OTHER PROGRAMS INCLUDE YOUTH AFTER-SCHOOL AND SUMMER PROGRAM AND RELIGIOUS LIFE PROGRAM.
ADDITIONAL INFORMATION
FORM 990, PART VI
AT THE TIME OF FILING THE RETURN, THE ORGANIZATION WAS IN PROCESS OF IMPLEMENTING A DOCUMENT RETENTION AND DESTRUCTION POLICY.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
MANAGEMENT AND THE BOARD REVIEW THE 990 PRIOR TO FILING.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
WRITTEN POLICY IS GIVEN TO ALL EMPLOYEES AND BOARD MEMBERS. MANAGEMENT MONITORS THROUGH INTERVIEWS AND OBSERVATIONS.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
COMPENSATION IS RECOMMENDED BY MANAGEMENT, REVIEWED BY PERSONNEL PRACTICES COMMITTEE, REVIEWED AS PART OF BUDGET AND DISCUSSED AND APPROVED BY THE BOARD AS A WHOLE.
COMPENSATION PROCESS FOR OFFICERS
FORM 990, PAGE 6, PART VI, LINE 15B
COMPENSATION IS RECOMMENDED BY MANAGEMENT, REVIEWED BY PERSONNEL PRACTICES, REVIEWED AS PART OF BUDGET AND DISCUSSED AND APPROVED BY THE BOARD AS A WHOLE.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE BY REQUEST. FORM 990 IS AVAILABLE BY REQUEST AND THROUGH GUIDESTAR.ORG.
OTHER CHANGES IN NET ASSETS EXPLANATION
FORM 990, PART XI, LINE 9
PRIOR PERIOD ADJUSTMENT 77,121
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.