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
NATIONAL MULTIPLE SCLEROSIS SOCIETY SOUTHERN CALIFORNIA & NEVADA CHAPTER
Employer identification number
95-1727656
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.") ....
6,593,897
10,940,988
9,306,472
9,671,149
8,497,926
45,010,432
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
6,593,897
10,940,988
9,306,472
9,671,149
8,497,926
45,010,432
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)..
3,819,724
6
Public support. Subtract line 5 from line 4.
41,190,708
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..
6,593,897
10,940,988
9,306,472
9,671,149
8,497,926
45,010,432
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
44,046
99,014
40,187
35,884
32,313
251,444
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.)..
0
11
Total support (Add lines 7 through 10).
45,261,876
12
Gross receipts from related activities, etc. (see instructions)
..................
12
16,215
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
91.005 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
95.310 %
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
NATIONAL MULTIPLE SCLEROSIS SOCIETY SOUTHERN CALIFORNIA & NEVADA CHAPTER
Employer identification number
95-1727656
Identifier
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 2: THE FOLLOWING TRUSTEES HAVE FAMILY
RELATIONSHIPS: DINA TECIMER AND TIMUR TECIMER DAVID PERREN AND SCOTT PERREN MADELEINE SHERAK AND THOMAS SHERAK BRITTA SCHRAM AND ARTHUR SCHRAM LISA KARPE AND RAY KARPE
FORM 990, PART VI, SECTION B, LINE 11B: FORM 990 IS DRAFTED BY THE
CHAPTER'S OUTSIDE ACCOUNTANTS. IT IS THEN REVIEWED BY THE DIRECTOR OF
FINANCE, VP OF FINANCE AND THE CHAPTER PRESIDENT, AS WELL AS THE ORGANIZATION'S AUDIT COMMITTEE. A COPY OF THE FORM 990 AND ACCOMPANYING SCHEDULES ARE PROVIDED TO THE ENTIRE BOARD WITH A PERIOD FOR PROVIDING COMMENTS, EDITS, OR CORRECTIONS PRIOR TO SUBMISSION TO THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C: ON AN ANNUAL BASIS, THE AUDIT
COMMITTEE REVIEWS THE CONFLICT OF INTEREST FORMS FILLED BY TRUSTEES,
OFFICERS, AND EMPLOYEES FOR POTENTIAL CONFLICTS. WHERE POTENTIAL CONFLICTS EXIST, THE TRUSTEE, OFFICER, OR EMPLOYEE IS NOT ALLOWED TO PARTICIPATE IN ANY VOTE AND TRANSACTIONS ARE SUBJET TO COMPETITIVE BIDDING.
FORM 990, PART VI, SECTION B, LINE 15A AND 15B: THE COMPENSATION
COMMITTEE, WHICH IS COMPRISED OF AT LEAST THREE, BUT NO MORE THAN FIVE,
INDEPENDENT TRUSTEES, DETERMINES THE COMPENSATION OF THE PRESIDENT AND REVIEWS COMPENSATION FOR OTHER KEY EMPLOYEES. THE NATIONAL ORGANIZATION PROVIDES EACH CHAPTER WITH COMPARABLE SALARY DATA FOR PRESIDENTS AND OTHER KEY POSITIONS AT NATIONAL MULTIPLE SCLEROSIS CHAPTERS AND OTHER VOLUNTARY HEALTH AGENCIES OF SIMILAR BUDGET SIZE AND GEOGRAPHIC LOCATIONS. IN ADDITION, THE PRESIDENT'S PERFORMANCE IS EVALUATED ANNUALLY IN A JOINT REVIEW PROCESS BY THE NATIONAL ORGANIZATION'S CEO OR HER DESIGNEE AND THE LOCAL COMMITTEE OF INDEPENDENT TRUSTEES. THE PRESIDENT CONDUCTS PERFORMANCE EVALUATIONS OF THE KEY EMPLOYEES, THE OUTCOME OF WHICH IS SHARED WITH THE COMPENSATION COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19: THE CHAPTER'S GOVERNING DOCUMENTS
AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. THE CHAPTER'S
FORM 990 AND FINANCIAL STATEMENTS ARE AVAILABLE ON THE CHAPTER'S WEBSITE AND WILL ALSO BE PROVIDED IN A HARD COPY FORMAT UPON REQUEST.
FORM 990, PART III, LINE 4D: THE ORGANIZATION'S OTHER PROGRAM SERVICES
ARE: PUBLIC EDUCATION: THERE ARE MANY WAYS THE SOCIETY EDUCATES THE PUBLIC ABOUT MULTIPLE SCLEROSIS INCLUDING THE SOCIETY'S ANNUAL MS AWARENESS CAMPAIGN, PUBLIC SERVICE ANNOUNCEMENTS, MOMENTUM, THE SOCIETY'S FLAGSHIP MAGAZINE DISTRIBUTED QUARTERLY TO PEOPLE WITH MS, HEALTHCARE PROVIDERS, SUPPORTERS OF THE SOCIETY AND MORE. CHAPTERS ALSO DISTRIBUTE MS CONNECTION TO THEIR CONSTITUENTS, A REGULAR NEWSLETTER THAT INCLUDES LOCAL ANNOUNCEMENTS AND INFORMATION ON UPCOMING PROGRAMS AND SERVICES, AND MORE. IN TOTAL, MORE THAN ONE MILLION PEOPLE RECEIVE SOCIETY PUBLICATIONS, NEWSLETTERS AND MOMENTUM EACH YEAR. CLIENT SERVICES: AN EXTENSIVE VARIETY OF PROGRAMS, SERVICES, AND RESOURCES ARE PROVIDED FOR PEOPLE LIVING WITH MS AND AFFECTED BY MS, INCLUDING FAMILY MEMBERS, CAREGIVERS AND OTHER MEMBERS OF THEIR SUPPORT SYSTEMS. MANY COMMUNITY BASED PROGRAMS ARE AVAILABLE TO FACILITATE EDUCATION, RECREATION, PHYSICAL AND EMOTIONAL WELLNESS, CONNECTION WITH OTHERS WITH MS, AND FAMILY COMMUNICATION. THE FINANCIAL ASSISTANCE PROGRAM IS COMPRISED OF A RANGE OF INITIATIVES THAT SUPPORT INDEPENDENCE, SAFETY, HEALTH AND QUALITY OF LIFE FOR PEOPLE LIVING WITH MS, AS WELL AS THEIR FAMILIES. THE PROGRAM OFFERS GUIDANCE AND RESOURCES TO HELP CONTAIN THE FINANCIAL IMPACT OF MS. PROFESSIONAL EDUCATION AND TRAINING: ACTIVITIES OR PROGRAMS DESIGNED TO IMPROVE THE KNOWLEDGE, SKILLS AND CRITICAL JUDGMENT OF PHYSICIANS AND OTHER HEALTHCARE PROFESSIONALS ENGAGED (DIRECTLY OR INDIRECTLY) IN PROVIDING CLIENT SERVICES BY KEEPING THEM ABREAST OF NEW DIAGNOSTIC TECHNIQUES, THERAPIES, ETC. THE SOCIETY PROVIDES INFORMATION AND EDUCATION TO THOUSANDS OF HEALTH CARE PROFESSIONALS THROUGH THE SOCIETY'S CLINICAL CARE NETWORK AND WEBSITE, THE SOCIETY'S MD ON CALL PROGRAM, AND EDUCATIONAL MATERIALS FOR PHYSICAL AND OCCUPATIONAL THERAPISTS, MENTAL HEALTH PROFESSIONAL, NURSES AND CNAS AND OTHERS. A FREE ELECTRONIC NEWSLETTER IS DISTRIBUTED QUARTERLY TO MORE THAN 10,000 HEALTH CARE PROFESSIONALS, AND THE SOCIETY'S DIAGNOSTIC AND SYMPTOM MANAGEMENT SMARTPHONE APP HAS BEEN DOWNLOADED NEARLY 12,000 TIMES.
FORM 990, PART VI, SECTION A, QUESTION 6: THE BYLAWS ALLOW FOR MEMBERS.
Only members voted to the Board of Directors are able to vote upon matters pertaining to the Chapter business and governance.
FORM 990, PART VI, SECTION A, QUESTION 7A: NEW BOARD MEMBERS ARE VOTED
TO THE BOARD UPON RECOMMENDATION OF THE GOVERNANCE BOARD.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.