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
KENTUCKY DOMESTIC VIOLENCE ASSOCIATION
Employer identification number
61-1110432
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.") .
8,581,387
8,957,283
9,764,959
9,648,719
9,349,749
46,302,097
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......
0
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
0
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
0
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
6
Total. Add lines 1 through 5.
8,581,387
8,957,283
9,764,959
9,648,719
9,349,749
46,302,097
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
0
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.
0
c
Add lines 7a and 7b..
8
Public support (Subtract line 7c from line 6.)
46,302,097
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...
8,581,387
8,957,283
9,764,959
9,648,719
9,349,749
46,302,097
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
7,844
4,886
6,150
12,140
24,364
55,384
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
0
c
Add lines 10a and 10b.
7,844
4,886
6,150
12,140
24,364
55,384
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
0
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
113,724
115,873
163,121
431,512
489,407
1,313,637
13
Total support. (Add lines 9, 10c, 11, and 12.)..
8,702,955
9,078,042
9,934,230
10,092,371
9,863,520
47,671,118
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
97.130 %
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
97.940 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
0.120 %
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
0.120 %
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:
12000229
Software Version:
2012v2.0
-
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
KENTUCKY DOMESTIC VIOLENCE ASSOCIATION
Employer identification number
61-1110432
Identifier
Return Reference
Explanation
Form 990, Part VI, Line 19
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available
REQUEST OF PUBLIC RECORDS ARE DESCRIBED IN THE KENTUCKY DOMESTIC VIOLENCE ASSOCIATION'S ACCOUNTING AND POLICIES PROCEDURES MANUAL.
Form 990, Part VI, Line 15b
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees
BOARD MEMBERS RETIRE TO EXECUTIVE SESSION TO DISCUSS SALRIES OF KEY PERSONNEL.
Form 990, Part VI, Line 15a
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management
BOARD MEMBERS RETIRE TO EXECUTIVE SESSION TO DISCUSS SALARIES OF KEY PERSONNEL.
Form 990, Part VI, Line 12c
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts
COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM.
Form 990, Part VI, Line 11b
Form 990, Part VI, Line 11b: Form 990 Review Process
FORM 990 WILL BE REVIWED BY FINANCE ADMINISTRATOR AND EXECUTIVE DIRECTOR.
Form 990, Part III, Line 4d
Form 990, Part III, Line 4d: Other Program Services Description
OTHER PROGRAM SERVICES 4: KENTUCKY CABINET FOR HEALTH AND FAMILY SERVICES (GRANT 416)THESE FUNDS ARE A CONTRACT WITH THE CABINET FOR HEALTH AND FAMILY SERVICES OF THE STATE OF KENTUCKY. THE PURPOSE OF THIS CONTRACT IS TO PROVIDE SERVICES TO INDIVIDUALS WHO ARE VICTIMS OF DOMESTIC VIOLENCE THROUGH SUB-CONTRACTS WITH THE PRIMIARY SERVICE PROVIDERS OF EACH AREA DEVELOPMENT DISTRICT. OTHER PROGRAM SERVICES 5: KENTUCKY HOUUSING COUNCIL (GRANT 512)THESE FUNDS ARE TO FUND ADMINSTRATIVE COSTS AND STAFF SUPPORT FOR KENTUCKY DOMESTIC VIOLENCE ASSOCIATION'S SCATTERED TAX CREDIT PROJECT WHICH IS TO PROVIDE SAFE, DECENT, AFFORDABLE HOUSING FOR LOW AND MODERATE, INVOME PERSONS AND FAMILIES IN KENTUCKY. OTHER PROGRAM SERVICES 6: US DEPARTMENT OF JUSTICE OFFICE ON VIOLENCE AGAINST WOMEN (GRANT 520)THESE FUNDS ARE FROM THE SECOND CHANCE ACT GRANT MONEY RECEIVED DIRECTLY AND AUTHORIZED BY VIOLENCE AGAINST WOMEN ACT FOR THE PURPOSE OS IMPLEMENTING MENTORING PROJECTS TO PROMOTE THE SAFE AND SUCCESSFUL REINTEGRATION INTO THE COMMUNITY OF ADULTS WHO HAVE BEEN INCARCERATED. OTHER PROGRAM SERVICES 7: US DEPARTMENT OF JUSTICE OFFICE ON VIOLENCE AGAINST WOMEN(GRANT 527 AND 827)THESE FUNDS ARE USED TO HELP DOMESTIC VIOLENCE VICTIMS BECOME ASSET-OWNING MEMBERS OF SOCIETY THROUGH PARTICIPATION IN AN INDEPENDENT DEVELOPMENT ACCOUNT. OTHER PROGRAM SERVICES 8: ALLSTATE FOUNDATION(GRANTS 531 AND 540)THESE FUNDS ARE FOR ADIMINSTRATIVE COSTS AND STAFF SUPPORT FOR THE ECONOMIC JUSTICE PROGRAM. OTHER PROGRAM SERVICES 9: TOYOTA(GRANT 563)THESE FUNDS ARE FOR THE SUPPORT OF BOTH INDIRECT AND DIRECT TRAVEL AND SALARY TO FUTHER THE KENTUCKY ASSET SUCCESS INSTITUTE. PROVIDING ACCESS TO FREE TAX PREPARATION, FINANCIAL EDUCATION, INDEPENDENT DEVELOPMENT ACCOUNTS, CAR INDEPENDENT DEVELOPMENT ACCOUNTS AND EMERGENCY FUNDS FOR LOW TO MODERATE INCOME FAMILIES. OTHER PROGRAM SERVICES 10: MARY REYNOLDS BABCOCK FOUNDATION(GRANT 568)THIS GRANT WILL COVER A PORTION OF THE SALARIES OF OUR EASTERN KENTUCKY ECONOMIC JUSTICE COORDINATOR WHO IS THE PROJECT DIRECTO THAT WILL BE SUPERVISING THIER WORK. THE GRANT WILL ALSO PAY FOR THEIR TRAVEL IN EASTERN KENTUCKY AND CREDIT REPORTS FOR PARTICIPANTS WHO RECEIVE FINANCIAL EDUCATION AND ONE-ON-ONE CREDIT COUNSELING IN ORDER TO ASSIST INMOVING VICTIMS OF DOMESTIC VIOLENCE OUT OF A CONDITION OF POVERTY. OTHER PROGRAM SERVICES 11: KENTUCKY CABINET FOR HEALTH AND FAMILY SERVICES(GRANT 571 AND 671)THESE FUNDS ARE FOR DIRECT PROJECT SUPPORT TO PROVIDE AMERICORPS MEMBERS FOR PLACEMENT IN KENTUCKY DOMESTIC VIOLENCE ASSOCIATION'S DOMESTIC VIOLENCE PROGRAMS. THE FUNDS PROVIDE FOR OVERALL SUPERVISION AND CONTINUING DEVELOPMENT TRAINING. MEMBER PROGRAMS PROVIDE A SITE MATCH FOR THIER AMERICORP PERSON. OTHER PROGRAM SERVICES 12: CORPORATION FOR NATIONAL AND COMMUNITY SERVICE(GRANTS 574 AND 674)THESE FUNDS ARE FOR DIRECT PROJECT SUPPORT TO PROVIDE AMERICORPS*VISTA MEMBERS FOR PLACEMENT IN KENTUCKY DOMESTIC VIOLENCE ASSOCIATION'S DOMESTIC VIOLENCE PROGRAMS. THE FUNDS PROVIDE FOR OVERALL SUPERVISION AND CONTINUING DEVELOPMENT TRAINING. ALSO CORPORATION FOR NATIONAL AND COMMUNITY SERVICES PROVIDES DIRECT ASSISTANCE TO THE VOLUNTEERS AND KENTUCKY DOMESTIC VIOLENCE ASSOCIATION PROVIDES A COST-SHARE. OTHER PROGRAM SERVICES 13: KENTUCKY COLONELS(GRANT 584)THESE FUNDS ARE USED FOR THE PURCHASE OF EQUIPMENT USED FOR THE ECONCOMIC JUSTICE PROGRAM. OTHER PROGRAM SERVICES 14: US DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT(GRANT 585 AND 885)THESE FUNDS ARE PASSED THROUGH FROM KENTUCKY HOUSING CORPORATION TO PROVIDE ASSISTANCE OF SECURITY DEPOSITS, SLOTS OF ON-GOING RENTAL ASSISTANC AND UTILITY DEPOSITS.HOUSEHOLD ASSISTED MUST BE VICTIMS OF DOMESTIC VIOLENCE. OTHER PROGRAM SERVICES 15: VARIOUS PRIVATE CONTRIBUTIONS(GRANT 605)POOL OF FUNDING FOR PREVENTION ACTIVITIES OTHER PROGRAM SERVICES 16: VERIZON(GRANTS 610 AND 615)THESE FUNDS ARE USED TO HELP FUND THE PREVENTION PROJECT TO EDUCATE THE YOUTH COMMUNITY ABOUT DOMESTIC VIOLENCE. OTHER PROGRAM SERVICES 17: BEREA COLLEGE(GRANT 620)THESE FUNDS ARE USED TO SUPPORT THE GEAR-UP PROJECT AT BEREA COLLEGE FOR THE ECONOMIC JUSTICE PROGRAM. OTHER PROGRAM SERVICES 18: US DEPARTMENT OF TREASURY INTERNAL REVENUE SERVICE(GRANT 673)THESE FUNDS ARE A DIRECT GRANT FROM THE INTERNAL REVENUE SERVICE DESIGNATED TO PROMOTE AND SUPPORT FREE TAX PREPARATION SERVICE FOR THE UNDERSERVED LOW INCOME POPULATIONS WHICH INCLUDES THE ELDERLY, DISABLED, LIMITED ENGLISH PROFICIENT, NON URBAN AND NATIVE AMERICAN TAXPAYERS. OTHER PROGRAM SERVICES 19: US DEPARTMENT OF JUSTICE(GRANTS 708 AND 718)THESE FUNDS ARE THE STATE COALITION GRANT MONEY RECEIVED DIRECTLY AND AUTHORIZED BY VIOLENCE AGAINST WOMEN ACT FOR THE PURPOSE OF COORDINATING STATE VICTIM SERVICE ACTIVITIES, AND COLLABORATING AND COORDINATING WITH FEDERAL, STATE AND LOCAL ENTITIES ENGAGED IN VIOLENCE AGAINST WOMEN ACTIVITIES. OTHER PROGRAM SERVICES 20: US DEPARTMENT OF JUSTICE OFFICE ON VIOLENCE AGAINST WOMEN(GRANT 715)THESE FUNDS ARE FOR ADMINISTRATIVE COSTS AND DIRECT SUPPORT TO KENTUCKY DOMESTIC VIOLENCE ASSOCATION HOMES TO SUPPLY HOUSING FOR RURAL AND IMMIGRANT VICTIMS OF DOMESTIC VIOLENCE. OTHER PROGRAM SERVICES 21: BRANCH BANKING AND TRUST(GRANT 828)THESE FUNDS ARE USED FOR EMERGENCY ASSISTANCE FOR INDEPENDENT DEVELOPMENT ACCOUNT PARTICIPANTS. OTHER PROGRAM SERVICES 22: VARIOUS PRIVATE CONTRIBUTIONS(GRANT 837)POOL OF FUNDING FOR ECONOMIC EMPOWERMENT ACTIVITIES. OTHER PROGRAM SERVICES 23: ALLSTATE FOUNDATION(GRANTS 856 AND 878)THESE FUNDS ARE USED TO HELP DOMESTIC VIOLENCE VICTIMS BDCOME ASEET-OWNING MEMBERS OF SOCIETY THROUGH PARTICIAPATION IN AN INDEPENDENT DEVELOPMENT ACCOUNT FOR PURCHASE OF INDIVIDUAL TRANSPORTATION. OTHER PROGRAM SERVICES 24: COMMONWEALTH OF KENTUCKY(GRANT 867)TO PROVIDE EMERGENCY FUNDING TO VICTIMS OF DOMESTIC VIOLENCE. OTHER PROGRAM SERVICES 25: THE HOUSING PARTNERSHIP(GRANT 869)THESE FUNDS WERE AWARDED AS A DEVELOPMENT FEE FOR WORK DONE ON KENTUCKY DOMESTIC VIOLENCE ASSOCIATION HOMES. OTHER PROGRAM SERVICES 26: US DEPARTMENT OF JUSTICE OFFICE ON VIOLENCE AGAINST WOMEN(GRANT 872)THESE FUNDS PROVIDE GRANTEES WITH TEH EXPERTISE AND SUPPORT THEY NEED TO DEVELOP AND IMPLEMENT SUCCESSFUL STATE, LOCAL, TRIBAL AND CAMPUS PROJECTS, INCREASE VICTIM SAFETY AND BOLSTER OFFENDER ACCOUNTABILITY. OTHER PROGRAM SERVICES 27: PENNSYLVANIA COALITION AGAINST DOMESTIC VIOLENCE AND NATIONAL RESOURCE CENTER ON DOMESTIC VIOLENCE(GRANT 881)THESE FUNDS ARE PASSED THROUGH PENNSYLVANIA COALITION AGAINST DOMESTIC VIOLENCE. THE AWARD IS TO BE USED TO ASSIT PARTICIPANTS WITH ECONOMIC EMPOWERMENT OBJECTIVES. OTHER PROGRAM SERVICES 28: KENTUCKY FOUNDATION FOR WOMEN(GRANT 887)THESE FUNDS ARE TO BE USED TO ASSIST IN THE WOMEN IN PRISON PROJECT. OTHER PROGRAM SERVICES 29: VICTIM SURVIVOR FUNDFUNDING FROM CONTRIBUTIOINS AND INTEREST FROM CONTRACT CHECKING ACCOUNT TO BE USED TO PROVIDE SUPPORT FOR DOMESTIC VIOLENCE VICTIMS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.