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
KETTLE MORAINE YMCA INC YOUNG MENS CHRISTIAN ASSOCIATION
Employer identification number
39-1175559
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.") ....
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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
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.") .
366,500
1,732,512
1,542,664
796,966
497,706
4,936,348
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......
4,041,089
4,416,157
4,795,166
4,836,467
4,931,694
23,020,573
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
48,607
68,890
78,466
80,074
276,037
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.
4,407,589
6,197,276
6,406,720
5,711,899
5,509,474
28,232,958
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
806,823
760,794
45,720
30,000
1,643,337
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.
55,577
75,002
46,192
151,725
49,605
378,101
c
Add lines 7a and 7b..
55,577
881,825
806,986
197,445
79,605
2,021,438
8
Public support (Subtract line 7c from line 6.)
26,211,520
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...
4,407,589
6,197,276
6,406,720
5,711,899
5,509,474
28,232,958
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
34,667
52,640
33,663
30,573
30,067
181,610
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
34,667
52,640
33,663
30,573
30,067
181,610
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.)..
4,442,256
6,249,916
6,440,383
5,742,472
5,539,541
28,414,568
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
92.250 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
92.050 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
1.000 %
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
1.000 %
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
KETTLE MORAINE YMCA INC YOUNG MENS CHRISTIAN ASSOCIATION
Employer identification number
39-1175559
Return Reference
Explanation
FORM 990, PAGE 2, PART III, LINE 4A
CARE AT THREE LOCATIONS AND DAY CAMP PARTICIPANTS. MCA CHILD CARE CURRICULA HELP CHILDREN DEVELOP MORAL AND ETHICAL BEHAVIOR, SELF-ESTEEM AND LEADERSHIP. Y CHILD CARE ALLOWS PARENTS TO REMAIN GAINFULLY EMPLOYED, KNOWING THAT THEIR CHILDREN ARE THRIVING IN A SAFE, DEVELOPMENTALLY SOUND ENVIRONMENT. YMCA "YOUTH FIT FOR LIFE" IS AN ADDITIONAL CURRICULUM THAT WAS ADDED TO THE AFTER SCHOOL PROGRAMS TO HELP COMBAT CHILDHOOD OBESITY BY HELPING TO PROVIDE EXERCISE, EDUCATION AND BEHAVIOR MODIFICATION IN YOUTH. YMCA FINANCIAL ASSISTANCE POLICIES HELP TO ENSURE THAT THE YMCA IS A PLACE WHERE CHILDREN OF ALL ECONOMIC LEVELS, RECEIVE THE SAME QUALITY CARE IN THE SAME SETTING.
FORM 990, PAGE 2, PART III, LINE 4B
RELATIONSHIPS THAT LEAD TO MORE ACTIVE LIFESTYLES. THE YMCA USES THE ASSETS FOR YOUTH MODEL IN ITS TEEN PROGRAMMING. WORKING TO INSTILL THESE 40 DEVELOPMENTAL ASSETS WILL MOTIVATE AND PREPARE OUR YOUTH TO ACHIEVE POSITIVE, HAPPY AND HEALTHY FUTURES. OUR PROGRAMS GIVE ADOLESCENTS GOOD ROLE MODELS TO HELP THEM DEVELOP SELF-ESTEEM AND POSITIVE VALUES, INCLUDING COOPERATION, RESPECT FOR THE BODY, GOOD CITIZENSHIP AND A STRONG WORK ETHIC. TEEN ACTIVITIES ARE AMONG THE MOST RAPIDLY GROWING YMCA PROGRAMS, REFLECTING THE INCREASING AWARENESS THAT ADOLESCENTS NEED STRUCTURE AND ACTIVITIES, ESPECIALLY IN THE AFTER-SCHOOL HOURS. POSITIVE INTERACTION WITH TEENS WILL HELP PREVENT THE SENSELESS VIOLENCE THAT HAS PLAGUED SO MANY OF OUR COMMUNITIES. IN THE YEAR 2013, WE HAD 11,210 ADULT CLASS PARTICIPANTS AND 988 ADULTS THAT TOOK ADVANTAGE OF OUR FREE ONE-ON-ONE WELLNESS CONSULTATIONS. THIS YEAR 4,873 PRE-SCHOOL AND SCHOOL-AGED CHILDREN PARTICIPATED IN SWIM LESSONS AND 7,371 CHILDREN PARTICIPATED IN YMCA TEAM SPORTS AND OTHER YOUTH CLASSES INCLUDING GYMNASTICS, DANCE AND TAE KWON DO. PEOPLE WITH DISABILITIES AND THOSE WITH CHRONIC AILMENTS, SUCH AS ARTHRITIS, CANCER AND HEART DISEASE FIND YMCA PROGRAMS THAT ARE TAILORED TO THEM. FOR EXAMPLE, "JOINT EFFORT", IS OFFERED FOR THOSE THAT ARE SEEKING RELIEF FROM CHRONIC ARTHRITIS PAIN AND IS A WELCOME ALTERNATIVE TO THOSE THAT ARE NORMALLY SHUT OUT OF REGULAR EXERCISE PROGRAMS. THE YMCA OFFERS A CARING, COMFORTABLE AND ACCEPTING ATMOSPHERE THAT SUPPORTS AND ENCOURAGES ALL MEMBERS OF THE COMMUNITY TO PARTICIPATE IN REGULAR PHYSICAL EXERCISE THAT WILL HELP THEM LEAD HEALTHIER LIVES. OUR ADULT CLASSES ARE OFFERED FREE OF CHARGE FOR OUR MEMBERS, AND AT AFFORDABLE FEES FOR THE COMMUNITY AT LARGE, WITH REASONABLE ACCOMMODATIONS FOR THOSE WITH SPECIAL NEEDS. THE YMCA HELPS PEOPLE OF ALL INCOMES TAKE RESPONSIBILITY FOR THEIR OWN HEALTH. YMCA FINANCIAL ASSISTANCE POLICIES HELP LOW INCOME PEOPLE, WHO ARE LESS LIKELY TO EXERCISE, TO GAIN ACCESS TO YMCA MEMBERSHIP AND PROGRAMS. OUTSIDE THE WALLS OF THE YMCA, THE KETTLE MORAINE YMCA IS A KEY PARTNER IN THE HEALTHY PEOPLE PROJECT OF WASHINGTON COUNTY, WHICH EMPHASIZES PROVIDING GOOD NUTRITION WITH ACCESS TO FRESH FRUITS AND VEGETABLES, PREVENTION OF INACTIVITY BY ENCOURAGING LIFELONG WELLNESS ON SURROUNDING BIKE PATHS, PARKS, ETC. THE HEALTHY PEOPLE PROJECT ALSO PROMOTES POLICY CHANGE TO COMBAT BOTH INACTIVITY AND POOR NUTRITION.
FORM 990, PAGE 2, PART III, LINE 4C
PLACE FOR THEIR CHILDREN WHILE THEY ARE EXERCISING, REDUCING STRESS AND ENJOYING THEMSELVES. ADULTS MAY CHOOSE TO LAP SWIM OR ENJOY THE HEALING EFFECTS OF THE WHIRLPOOL. SPECIAL NEEDS LOCKERROOMS MAKE IT CONVENIENT FOR FAMILIES OR COMMUNITY MEMBERS WITH PHYSICAL DISABILITIES TO USE YMCA SERVICES. OUR NEWER PROGRAM SITE, THE KETTLE MORAINE YMCA AT RIVER SHORES, OFFERS PROGRAMMING SPECIFICALLY FOR THE ADULT "HEALTH SEEKER". KNOWING THAT 80% OF THE ADULT POPULATION HAS NEVER EXERCISED OR IS CONSIDERED A START/STOP EXERCISER, WE HAVE ADOPTED A NATIONALLY RECOGNIZED PROGRAM CALLED "THE COACH APPROACH". THIS PROGRAM MEASURES WHERE THE "HEALTH SEEKER" IS AT AND THEN THE YMCA COACHING STAFF HELPS THEM TO MAKE A LIFESTYLE CHANGE THAT WILL BENEFIT THEM FOR YEARS TO COME. HEALTHIER INDIVIDUALS LEAD TO A HEALTHIER COMMUNITY.
FORM 990, PAGE 6, PART VI, LINE 11B
THE FORM 990 WILL BE REVIEWED PRIOR TO ISSUANCE BY BOARD OF DIRECTORS.
FORM 990, PAGE 6, PART VI, LINE 12C
THE CONFLICT OF INTEREST POLICY WILL BE REVIEWED ANNUALLY AT THE BOARD MEETING.
FORM 990, PAGE 6, PART VI, LINE 15A
THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWS THE PERFORMANCE OF THE EXECUTIVE DIRECTOR EACH YEAR. HIS PERFORMANCE IS ASSESSED AGAINST GOALS PREVIOUSLY SET AND HIS COMPENSATION IS COMPARED TO DATA RECEIVED FROM THE NATIONAL YMCA ORGANIZATION.
FORM 990, PAGE 6, PART VI, LINE 15B
THE PERFORMANCE OF OTHER KEY EMPLOYEES IS REVIEWED BY THE DIRECT SUPERVISOR AND ALSO REVIEWED BY PEERS (RANDOMLY CHOSEN). COMPENSATION DATA FROM THE NATIONAL YMCA IS ALSO USED FOR DETERMINATION OF THE SALARIES FOR OTHER KEY EMPLOYEES.
FORM 990, PAGE 6, PART VI, LINE 19
FORM 990, GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST FROM THE BUSINESS OFFICE WITHIN 24 HOURS.