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 BLUE RIDGE CHAPTER
Employer identification number
54-0834654
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.") ....
196,609
208,212
215,503
257,803
222,341
1,100,468
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
196,609
208,212
215,503
257,803
222,341
1,100,468
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.
1,100,468
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..
196,609
208,212
215,503
257,803
222,341
1,100,468
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
10,791
3,346
10,876
13,650
5,238
43,901
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).
1,144,369
12
Gross receipts from related activities, etc. (see instructions)
..................
12
45,399
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
96.160 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
95.780 %
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 BLUE RIDGE CHAPTER
Employer identification number
54-0834654
Identifier
Return Reference
Explanation
ALL OTHER ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4D
RESEARCH - TO MOVE US CLOSER TO A WORLD FREE OF MS, IN 2013, THE BLUE RIDGE CHAPTER CONTRIBUTED TOWARDS THE NATIONAL MULTIPLE SCLEROSIS SOCIETY'S INVESTMENT OF AN ESTIMATED 48.3 MILLION TO SUPPORT MORE THAN 380 RESEARCH PROJECTS AROUND THE WORLD AIMING AT STOPPING MS IN ITS TRACKS, RESTORING FUNCTION, AND ENDING THE DISEASE FOREVER. THE SOCIETY COLLABORATES WORLDWIDE TO DEVELOP SOLUTIONS FOR EVERYONE AFFECTED BY MS, INCLUDING A RECENTLY LAUNCHED INTERNATIONAL PROGRESSIVE MS ALLIANCE, AND ACCELERATES COMMERCIAL DEVELOPMENT OF PROMISING RESEARCH DISCOVERIES, NEW MS THERAPIES AND RESEARCH TOOLS THROUGH FAST FORWARD. SOCIETY ACTIVITIES - COSTS ASSOCIATED WITH FUNDING CONSTITUENT AND COMMUNITY SERVICE, PUBLIC EDUCATION, AND PROFESSIONAL EDUCATION CONDUCTED NATIONWIDE (BEYOND THE CHAPTER'S TERRITORY) FOR THE BENEFIT OF INDIVIDUALS LIVING WITH MULTIPLE SCLEROSIS. THIS PAST YEAR, MORE THAN 200,000 PEOPLE LIVING WITH MS RECEIVED INFORMATION, EMOTIONAL SUPPORT AND CONNECTIONS TO RESOURCES AND PROGRAMS THROUGH THE SOCIETY'S MS NAVIGATOR PROGRAM. IN ADDITION, MORE THAN 100,000 PEOPLE ATTENDED GROUPS AND PROGRAMS, AND OVER 300,000 PEOPLE ENGAGED IN CONVERSATIONS AND ACCESSED INFORMATION AND SUPPORT THROUGH THE SOCIETY'S SOCIAL MEDIA CHANNELS. PROFESSIONAL EDUCATION AND TRAINING - ACTIVITIES OR PROGRAMS DESIGNED TO IMPROVE THE KNOWLEDGE, SKILLS AND CRITICAL JUDGEMENT 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 PROFESSIONAL STHROUGH THE SOCIETY'S CLINCIAL 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.
RELATED PARTY INFORMATION AMONG OFFICERS
FORM 990, PAGE 6, PART VI, LINE 2
ROBERT MEADOR JULIE MEADOR TRUSTEE TRUSTEE MARRIED
CLASSES OF MEMBERS OR STOCKHOLDERS
FORM 990, PAGE 6, PART VI, LINE 6
CHAPTER MEMBERSHIP CONSISTS OF ALL PERSONS WHO ARE MEMBERS OF THE SOCIETY AND WHO RESIDE WITHIN (OR WHO HAVE PREVIOUSLY RESIDED WITHIN AND HAVE INDICATED THAT THEY WISH TO RETAIN THEIR MEMBERSHIP) THE CHAPTER'S TERRITORY. THE CHAPTER HOLDS A MEETING OF ITS MEMBERS ANNUAL FOR THE PURPOSES OF ELECTING A BOARD OF TRUSTEES, CONSIDERING THE TREASURER'S REPORT OF THE ACCOUNTS OF THE CHAPTER (SUBJECT TO AUDIT AND ADJUSTMENT) AND ANY OTHER REPORTS THAT MAY BE PRESENTED, AND FOR THE TRANSACTION OF SUCH OTHER BUSINESS AS MAY PROPERLY COME BEFORE THE MEETING.
ELECTION OF MEMBERS AND THEIR RIGHTS
FORM 990, PAGE 6, PART VI, LINE 7A
CHAPTER MEMBERSHIP CONSISTS OF ALL PERSONS WHO ARE MEMBERS OF THE SOCIETY AND WHO RESIDE WITHIN (OR WHO HAVE PREVIOUSLY RESIDED WITHIN AND HAVE INDICATED THAT THEY WISH TO RETAIN THEIR MEMBERSHIP) THE CHAPTER'S TERRITORY. THE CHAPTER HOLDS A MEETING OF ITS MEMBERS ANNUAL FOR THE PURPOSES OF ELECTING A BOARD OF TRUSTEES, CONSIDERING THE TREASURER'S REPORT OF THE ACCOUNTS OF THE CHAPTER (SUBJECT TO AUDIT AND ADJUSTMENT) AND ANY OTHER REPORTS THAT MAY BE PRESENTED, AND FOR THE TRANSACTION OF SUCH OTHER BUSINESS AS MAY PROPERLY COME BEFORE THE MEETING.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
THE CHAPTER'S AUDIT COMMITTEE REVIEWS AND APPROVES THE IRS FORM 990 AND ACCOMPANYING SCHEDULES PRIOR TO DISTRIBUTION TO THE WHOLE BOARD. A COPY OF THE IRS FORM 990 AND ACCOMPANYING SCHEDULES IS PROVIDED TO THE ENTIRE BOARD WITH A PERIOD FOR PROVIDING COMMENTS, EDITS OR CORRECTIONS PRIOR TO SUBMISSION TO THE IRS.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
ON AN ANNUAL BASIS, CHAPTER MANAGEMENT REVIEWS THE CONFLICT OF INTEREST FORMS FILED BY TRUSTEES, OFFICERS AND EMPLOYEES FOR POTENTIAL CONFLICTS. POTENTIAL CONFLICTS OF INTEREST ARE PRESENTED TO THE CHAPTER'S AUDIT COMMITTEE FOR REVIEW. WHERE CONFLICTS EXIST, THE TRUSTEE, OFFICER OR EMPLOYEE IS NOT ALLOWED TO PARTICIPATE IN ANY VOTE AND TRANSACTIONS ARE SUBJECT TO COMPETITIVE BIDDING. AT CURRENT TIME, NO POTENTIAL CONFLICT OF INTERESTS HAVE BEEN IDENTIFIED.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
A COMPENSATION COMMITTEE FOR EACH CHAPTER, WHICH IS COMPRISED OF AT LEAST THREE BUT NO MORE THAN FIVE INDEPENDENT TRUSTEES, DETERMINES THE COMPENSATION OF THE CHAPTER PRESIDENT AND OTHER KEY EMPLOYEES. THE NATIONAL ORGANIZATION PROVIDES EACH CHAPTER WITH INTERNAL AND EXTERNAL SALARY DATA FOR THE CHAPTER PRESIDENT AND OTHER KEY POSITIONS BASED UPON COMPARABLE BUDGET SIZE AND GEOGRAPHICAL LOCATION. IN ADDITION, THE CHAPTER PRESIDENT'S PERFORMANCE IS EVALUATED ANNUALLY IN A JOINT REVIEW PROCESS INCLUDING THE SOCIETY'S CEO DESIGNEE, REGIONAL EXECUTIVE VICE PRESIDENT AND THE LOCAL COMPENSATION COMMITTEE OF LOCAL TRUSTEES.
COMPENSATION PROCESS FOR OFFICERS
FORM 990, PAGE 6, PART VI, LINE 15B
THE CHAPTER PRESIDENT CONDUCTS PERFORMANCE EVALUATIONS FOR KEY EMPLOYEES ADN THE OUTCOME IS SHARED WITH THE COMPENSATION COMMITTEE TO INFORM THE DECISIONS ABOUT COMPENSATION.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
THE CHAPTER'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. THE CHAPTER'S IRS FORM 990 (AND IRS FORM 990-T, IF APPLICABLE), AND FINANCIAL STATEMENTS ARE AVAIALBLE ON THE CHAPTER'S WEBSITE.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.