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. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
CHENANGO UNITED WAY INC
Employer identification number
16-0998159
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
626,825
423,061
397,533
461,476
445,213
2,354,108
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
0
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
4
Total. Add lines 1 through 3
626,825
423,061
397,533
461,476
445,213
2,354,108
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)..
320,062
6
Public support. Subtract line 5 from line 4.
2,034,046
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
7
Amounts from line 4..
626,825
423,061
397,533
461,476
445,213
2,354,108
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
21,800
35,150
29,892
28,883
27,339
143,064
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
0
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
9,774
4,409
2,775
16,958
11
Total support (Add lines 7 through 10).
2,514,130
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 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
80.900 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
79.720 %
16a
33 1/3% support test—2013.
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—2012.
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—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
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) 2013
Additional Data
Software ID:
13000170
Software Version:
2013v3.1
-
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.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
CHENANGO UNITED WAY INC
Employer identification number
16-0998159
Return Reference
Explanation
Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder
The members of the Corporation shall be the persons who have contributed to the Corporation during the fiscal year immediately preceding the annual Celebration Event. The Board of Directors shall serve as the voting body of the Corporation and shall represent the interests of the membership.
Form 990, Part VI, Line 11b: Form 990 Review Process
EACH YEAR THE CPO AND THE BOARD TREASURER WILL REVIEW THE FORM 990 FOR ACCURACY AND COMPLETION. THE AUDIT AND FORM 990 WILL BE REVIEWED WITH THE FINANCE/AUDIT COMMITTEE BEFORE SUBMISSION. THE FINAL AUDIT WILL ALSO BE PRESENTED TO THE BOARD OF DIRECTORS IN JUNE OF EACH YEAR.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts
BOARD MEMBERS. STAFF AND VOLUNTEERS PLEDGE TO ACCEPT THIS CODE AS A MINIMUM GUIDELINE FOR ETHICAL CONDUCT AND STEWARDSHIP SHALL PROVIDE WRITTEN VERIFICATION THAT THEY WILL COMPLY WITH THIS POLICY ON AN ANNUAL BASIS: DEFINITIONS. A CONFLICT OF INTEREST EXISTS WHEN A MATTER TO BE ACTED UPON BY THE BOARD OF DIRECTORS OR AN ACTING SUBCOMMITTEE OF THE BOARD CONFERS A DIRECT, SUBSTANTIAL BENEFIT TO ANY DIRECTOR, BUSINESS OR AGENCY FROM WHICH THE DIRECTOR OF THE BOARD DERIVES AN INCOME OR HAS AUTHORITY IN GOVERNANCE. ATTENTION. A DIRECTOR SHALL ABSTAIN FROM VOTING ON ANY MATTER BEFORE THE BOARD WHICH PLACES HIM OR HER IN A CONFLICT OF INTEREST, PARTICULAR IN REGARD TO MATTERS INVOLVING MEMBER AGENCIES. PROCEDURES. PRIOR TO VOTING ON MATTERS IN WHICH A POTENTIAL CONFLICT OF INTEREST EXISTS FOR ANY DIRECTOR, THE BOARD CHAIR SHALL INQUIRE WHETHER ANY DIRECTOR OF THE BOARD DESIRES TO ABSTAIN FROM VOTING BECAUSE OF A CONFLICT OF INTEREST, AND ANY DIRECTOR OF THE BOARD SHALL DELCARE THAT HE OR SHE ABSTAINS FROM VOTING DUE TO A CONFLICT OF INTEREST. PRIOR TO VOTING ON ANY MATTER, A DIRECTOR OF THE BOARD MAY BE REQUESTED BY ANOTHER DIRECTOR OF THE BOARD TO ABSTAIN FROM VOTING DUE TO A CONFLICT OF INTEREST. IF THE CHALLENGED DIRECTOR REFUSES TO ABSTAIN FROM VOTING AS REQUESTED, THE BOARD CHAIR SHALL IMMEDIATELY CALL FOR A VOTE OF THE DIRECTORS TO DETERMINE WHETHER THE CHALLENGED DIRECTOR IS IN CONFLICT OF INTEREST AND SHALL BE REQUIRED TO ABSTAIN FROM VOTING ON THE MATTER BEFORE THE BOARD. IF A TWO-THIRDS (2/3) MAJORITY OF THE DIRECTORS PRESENT VOTES TO REQUIRE ATTENTION OF THE CHALLENGED DIRECTOR, THE DIRECTOR SHALL NOT BE PERMITTED TO VOTE.
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management
LED BY THE BOARD CHAIR, THE CHENANGO UNITED WAY EXECUTIVE COMMITTEE WILL CONDUCT AN ANNUAL PERFORMANCE REVIEW OF THE EXECUTIVE DIRECTOR IN NOVEMBER OF EACH YEAR. THE PERFORMANCES REVIEW SHALL INCLUDE REVIEW OF THE FOLLOWING ITEMS: -PERFORMANCE OF OBJECTIVES,INCLUDING SIGNIFICANT ACCOMPLISHMENTS, CHALLENGES AND OPPORTUNITIES-METHODS USED TO ACHIEVE RESULTS, INCLUDING JOB PERFORMANCE, ABILITY TO COMMUNICATE AND INTERACT, LEADERSHIP ABILITYA FORMAL PERFORMANCE REVIEW SHALL BE PRESENTED TO THE EXECUTIVE DIRECTOR AND REVIEWED BY THE BOARD CHAIR BEFORE THE END OF THE CALENDAR YEAR. FEEDBACK AND DISCUSSION FROM THIS REVIEW WILL BE USED TO IDENTIFY WORK PLAN GOALS FOR THE NEXT CALENDER YEAR. EVERY THREE YEARS, THE EXECUTIVE DIRECTOR AND THE EXECUTIVE COMMITTEE SHALL HAVE THE OPPORTUNITY TO NEGOTIATE A THREE-YEAR EMPLOYMENT CONTRACT, AS RECOMMENDED BY THE UNITED WAY OF NYS AND THE UNITED WAY OF AMERICA. THIS EMPLOYMENT CONTRACT SHALL IDENTIFY THE TERMS OF EMPLOYMENT, COMPENSATION PACKAGE, BUSINESS EXPENSE REIMBURSEMENT, CONTRACT CANCELLATIONS, CONFIDENTIALITY AND NON-COMPETE CLAUSES, INDEMNIFICATION AND SUCCESSOR CLAUSES.
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees
LED BY THE BOARD CHAIR, THE CHENANGO UNITED WAY EXECUTIVE COMMITTEE WILL CONDUCT AN ANNUAL PERFORMANCE REVIEW OF THE EXECUTIVE DIRECTOR IN NOVEMBER OF EACH YEAR. THE PERFORMANCES REVIEW SHALL INCLUDE REVIEW OF THE FOLLOWING ITEMS: -PERFORMANCE OF OBJECTIVES,INCLUDING SIGNIFICANT ACCOMPLISHMENTS, CHALLENGES AND OPPORTUNITIES-METHODS USED TO ACHIEVE RESULTS, INCLUDING JOB PERFORMANCE, ABILITY TO COMMUNICATE AND INTERACT, LEADERSHIP ABILITYA FORMAL PERFORMANCE REVIEW SHALL BE PRESENTED TO THE EXECUTIVE DIRECTOR AND REVIEWED BY THE BOARD CHAIR BEFORE THE END OF THE CALENDAR YEAR. FEEDBACK AND DISCUSSION FROM THIS REVIEW WILL BE USED TO IDENTIFY WORK PLAN GOALS FOR THE NEXT CALENDER YEAR. EVERY THREE YEARS, THE EXECUTIVE DIRECTOR AND THE EXECUTIVE COMMITTEE SHALL HAVE THE OPPORTUNITY TO NEGOTIATE A THREE-YEAR EMPLOYMENT CONTRACT, AS RECOMMENDED BY THE UNITED WAY OF NYS AND THE UNITED WAY OF AMERICA. THIS EMPLOYMENT CONTRACT SHALL IDENTIFY THE TERMS OF EMPLOYMENT, COMPENSATION PACKAGE, BUSINESS EXPENSE REIMBURSEMENT, CONTRACT CANCELLATIONS, CONFIDENTIALITY AND NON-COMPETE CLAUSES, INDEMNIFICATION AND SUCCESSOR CLAUSES.
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available
COPIES OF THE ANNUAL FINANCIAL STATEMENTS, AUDIT AND FORM 990 WILL BE MADE AVAILABLE TO THE COMMUNITY BY REQUEST. THE CUW ANNUAL REPORT WILL BE MADE AVAILABLE ON THE ORGANIZATION'S WEBSITE EACH YEAR. ALSO, COPIES MAY BE FOUND ON THE CHARITIES BUREAU WEBSITE.
Other Changes In Net Assets Or Fund Balances - Other Increases
INCREASE IN TRUST ACCOUNT = $6487
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.