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
MACHIS LOWER CREEK INDIAN TRIBE OF ALABAMA
Employer identification number
63-0836859
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
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.") ....
246,840
124,032
74,532
74,532
237,645
757,581
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
246,840
124,032
74,532
74,532
237,645
757,581
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.
757,581
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..
246,840
124,032
74,532
74,532
237,645
757,581
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.)..
171
82
18
8
4
283
11
Total support (Add lines 7 through 10).
757,864
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
1.000 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
100 %
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.") .
24,684
124,032
66,881
74,532
237,645
527,774
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.
24,684
124,032
66,881
74,532
237,645
527,774
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.)
527,774
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...
24,684
124,032
66,881
74,532
237,645
527,774
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
171
82
18
8
4
283
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
171
82
18
8
4
283
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.)..
24,855
124,114
66,899
74,540
237,649
528,057
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
99.946 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
100 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
0.053 %
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
0 %
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:
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.
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
MACHIS LOWER CREEK INDIAN TRIBE OF ALABAMA
Employer identification number
63-0836859
Return Reference
Explanation
REASON FOR FILING LATE
I WAS DIAGNOSED WITH CANCER UNDERWENT SURGERY TWICE THEN HAD CANCER TREATMENT. WHEN I DID THE 990EZ THROUGH THE APLOS SOFTWARE WHICH WAS DENIED BY IRS. INSTRUCTED TO DO A 990 INSTEAD.
PART III 4D
FT RUCKER EEO FT RUCKER SOL CTR BLDG 5700 FT RUCKER AL 36362 GRANT 500 REV 1759 EXPENSE 2259
PART IV CHECKLIST OF REQUIRED SCHEDULES. 1.
EDUCATIONAL CHARITABLE HISTORICAL RELIGIOUS LITERACY RECREATIONAL SOCIAL OR CULTURAL PURPOSES.
PART IV CHECKLIST OF REQUIRED SCHEDULES. 11 A.
120 AC LAND-320000METAL OFFICE BLDG-200000OFFICE TLR-30000
PART VI GOVERNANCE MANAGEMENT AND DISCLOSURE. SECTION A GOVERNING BODY AND MANGEMENT.2.
CHIEF JAMES WRIGHT AND SECRETARY-TREASURER NANCY CARNLEY ARE SIBLINGS. MARY E. HUGHES IS THE DAUGHTER OF NANCY CARNLEY AND NIECE TO CHIEF JAMES WRIGHT.
PART VI GOVERNANCE MANAGEMENT SECTION A 8B.
THE COMMITTEES CAN MAKE DECISIONS REGARDING POLICIES EDUCATIONAL HISTORICAL ACTIVITIES. THEY ARE NOT ALLOWED TO MAKE ANY FINANCIAL DECISIONS.
PART VI SECTION A 9
JOHN W. SHACKLEFORD DIED ON WEDNESDAY AUGUST 28 2013.
PART VI SECTION C POLICIES 19
A COPY OF THE GOVERNING DOCUMENTSCONFLICT OF INTREST POLICYWHISTLE BLOWER POLICY RETENTION AND DESTRUCTION POLICY FINANCIAL STATEMENTS ARE MADE AVAILABLE FOR INSPECTION.
PART VI GOVERNANCE MANAGEMENT AND DISCLOSURE. GOVERNING BODY AND MANAGEMENT. SECTION B POLICIES
CONFLICT OF INTEREST ARISES WHENEVER THE PERSONAL OR PROFESSIONAL INTEREST OF A BOARD MEMBER IS POTENTIALLY AT ODDS WITH THE BEST INTERESTS OF MACHIS LOWER CREEK INDIAN TRIBE OF ALABAMA. IF AN ISSUE IS TO BE DECIDED BY THE BOARD THAT INVOLVES POTENTIAL CONFLICT OF INTEREST FOR A BOARD MEMBER IT IS THE RESPONSIBILITY OF THE BOARD MEMBER TO 1. IDENTIFY POTENTIAL CONFLICT OF INTEREST. 2. NOT PARTICIPATE IN DISCUSSION OF THE PROGRAM OR MOTION BEING CONSIDERED. 3. NOT VOTE ON THE ISSUE IT IS THE RESPONSIBILITY OF THE BOARD TO 1. ONLY DECIDE TO HIRE OR CONTRACT WITH THE CHIEF OR TRIBAL COUNCIL PERSON IF THEY ARE THE BEST QUALIFIED INDIVIDUALS AVAILABLE AND WILLING TO PROVIDE THE GOODS OR SERVICES NEEDED AT THE BEST PRICE. 2.RECORD IN THE MINUTES OF THE BOARD MEETING THE POTENTIAL CONFLICT OF INTEREST AND THE USE OF THE PROCEDURES AND CRITERIAL OF THIS POLICY. ALTHOUGH IT IS NOT A CONFLICT OF INTEREST TO REIMBURSE CHIEF OR TRIBAL COUNCIL MEMBER FOR EXPENSES INCURRED (SUCH AS PURCHASE OF SUPPLIES) CHIEF OR TRIBAL COUNCIL MEMBER ARE PROHIBITED BY LAW FROM SERVING ON THE BOARD. GENERALLY CHIEF OR TRIBAL COUNCIL MEMBER WILL NOT RECEIVE PASS-THROUGH DOLLARS FOR INDIVIDUAL PROJECTS. OFFICERS DIRECTORS COMMITTEE MEMBERS STAFF MEMBERS AND CERTAIN CONSULTANTS. NO MEMBER OF THE BOARD OR ANY OF ITS COMMITTEES SHALL DERIVE ANY PERSONAL PROFIT OR GAIN DIRECTLY OR INDIRECTLY BY REASON OF HIS OR HER PARTICIPATION WITH THE MACHIS LOWER CREEK INDIAN TRIBE OF ALABAMA NONPROFIT. EACH INDIVIDUAL SHALL DISCLOSE TO THE ORGANIZATION ANY PERSONAL INEREST WHICH HE OR SHE MAY HAVE IN ANY MATTER PENDING BEFORE THE ORGANIZATION AND SHALL REFRAIN FROM PARTICIPATION IN ANY DECISION ON SUCH MATTER. ANY MEMBER OF THE BOARD (CHIEF ANDOR TRIBAL COUNCIL) ANY COMMITTEE OR STAFF WHO IS AN OFFICER BOARD MEMBER A COMMITTEE MEMBER OR STAFF MEMBER OF A CLIENT ORGANIZATION OR VENDOR OF MACHIS LOWER CREEK INDIAN TRIBE OF ALABAMA NONPROFIT SHALL IDENTIFY HIS OR HER AFFILIATION WITH SUCH AGENCY OR AGENCIES FURTHER IN CONNECTION WITH ANY COMMITTEE FOR BOARD ACTION SPECIFICALLY DIRECTED TO THAT AGENCYSHE SHALL NOT PARTICIPATE IN THE DECISION AFFECTING THAT AGENCY AND THE DECISION MUST BE MADE ANDOR RATIFIED BY THE FULL BOARD. ANY MEMBER OF THE BOARD ANY COMMITTEE STAFF AND CERTAIN CONSULTANTS SHALL REFRAIN FROM OBTAINING ANY LIST OF CLIENTS FOR PERSONAL OR PRIVATE SOLICITATION PURPOSES AT ANY DURING THE TERM OF THEIR AFFILIATION.
PART VI GOVERNANCE MANAGEMENT AND DISCLOSURE. GOVERNING BODY AND MANAGEMENT SECTION B (CONT'D)
AT THIS TIME I AM A BOARD MEMBER COMMITTEE MEMBER OR AN EMPLOYEE OF THE FOLLOWING ORGANIZA- TIONS NOW THIS IS TO CERTIFY THAT I EXCEPT AS DESCRIBED BELOW AM NOT NOR AT ANY TIME DURING THE PAST YEAR HAVE BEEN 1. A PARTICIPANT DIRECTLY OR INDIRECTLY IN ANY ARRANGEMENT AGREEMENT INVESTMENT OR OTHER ACTIVITY WITH ANY VENDOR SUPPLIER OR OTHER PARTY DOING BUSINESS WITH THE MACHIS LOWER CREEK INDIAN TRIBE OF ALABAMA NONPROFIT WHICH HAS RESULTED OR COULD RESULT IN PERSONAL BENEFIT TO ME. 2. A RECIPIENT DIRECTLY OR INDIRECTLY OF ANY SALARY PAYMENTS OR LOANS OR GIFTS OF ANY KIND OR ANY FREE SERVICE OR DISCOUNTS OR OTHER FEES FROM OR ON BEHALF OF ANY PERSON OR ORGANIZATION ENGAGED IN ANY TRANSACTION WITH THE MACHIS LOWER CREEK INDIAN TRIBE OF ALABAMA NONPROFIT. ANY EXCEPTIONS TO 1 OR 2 ABOVE ARE STATED BELOW WITH A FULL DESCRIPTION OF THE TRANSACTIONS AND OF THE INTEREST WHETHER DIRECT OR INDIRECT WHICH I HAVE (OR HAVE HAD DURING THE PAST YEAR) IN THE PERSONS OR ORGANIZATIONS HAVING TRANSACTIONS WITH THE MACHIS LOWER CREEK INDIAN TRIBE OF ALABAMA NONPROFIT.
PART VI SECTION B POLICIES 12 B
ANY TIME A VENDOR CONSULTANT POTENTIAL EMPLOYEE POTENTIAL VOLUNTEER COMMITTEE POSITION. A CONFLICT OF INTEREST STATUS MUST BE FIRST DETERMINED. IF NO OTHER PERSON OR CANDIDATE IS BEST QUALIFIED TO PROVIDE SUCH SERVICES TO THE MACHIS LOWER CREEK INDIAN TRIBE OF ALABAMA THE EMPLOYMENT SERVICE MAY BE PROVIDED BY THE PERSON.
PART VI GOVERNANCE MANAGEMENT AND DISCLOSURE. GOVERNING BODY AND MANAGEMENT. SECTION B POLICIES 12 C
A CONFLICT OF INTEREST IS DONE ANNUALLY AND ANYTIME A VENDOR CONSULTANT POTENTIAL EMPLOYEE IS HIRED.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.