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
UNITED WAY OF BEMIDJI AREA
Employer identification number
41-1567744
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.") ....
426,465
590,840
455,340
493,417
497,785
2,463,847
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
426,465
590,840
455,340
493,417
497,785
2,463,847
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.
2,463,847
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..
426,465
590,840
455,340
493,417
497,785
2,463,847
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
4,607
7,283
6,543
6,176
11,752
36,361
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.)..
5,596
5,557
2,287
3,048
2,188
18,676
11
Total support (Add lines 7 through 10).
2,518,884
12
Gross receipts from related activities, etc. (see instructions)
..................
12
24,825
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
97.820 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
98.090 %
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.") .
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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
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
UNITED WAY OF BEMIDJI AREA
Employer identification number
41-1567744
Return Reference
Explanation
FORM 990 - ORGANIZATION'S MISSION
UNITED WAY OF BEMIDJI AREA'S MISSION IS TO IMPROVE LIVES BY MOBILIZING THE CARING POWER OF THE COMMUNITY. OUR FOCUS ON ADVANCING THE COMMON GOOD CREATES A MEANINGFUL DIFFERENCE IN THE LIVES OF AREA CHILDREN, YOUTH, AGING ADULTS AND THEIR CAREGIVERS, PEOPLE IN CRISIS AND PEOPLE WITH MENTAL AND PHYSICAL DISABILITIES BY FOCUSING ON THE BUILDING BLOCKS FOR A GOOD LIFE: EDUCATION - HELPING CHILDREN, YOUTH AND ADULTS ACHIEVE THEIR FULL POTENTIAL; INCOME - PROMOTING FINANCIAL STABILITY, INCREASING SELF- SUFFICIENCY AND INDEPENDENCE; AND, HEALTH - IMPROVING PEOPLE'S HEALTH AND SOCIAL WELL-BEING, AND PROVIDING EMERGENCY SERVICES. THE UNITED WAY'S AGENDA FOR ADVANCING THE COMMON GOOD INCLUDES: INVESTING IN NONPROFIT HEALTH AND HUMAN SERVICE PROGRAMS AND SERVICES THAT ADDRESS THE MOST CRITICAL NEEDS AND DELIVER THE GREATEST IMPACT POSSIBLE; IMPLEMENTING COMMUNITY IMPACT INITIATIVES AND SUPPORT YEAR ROUND PROGRAMS THAT ADDRESS NEW AND EMERGING NEEDS; AND, FORMING STRATEGIC PARTNERSHIPS AND COLLABORATIONS.
FORM 990, PAGE 2, PART III, LINE 4A
FUNDING, REVIEWING THE AGENCY'S FINANCIALS, THE PROGRAM'S OUTCOMES, THE AGENCY'S COLLABORATIVE EFFORTS, THE AGENCY'S ABILITY TO EFFECTIVELY MEET COMMUNITY AND CLIENT NEEDS, AND THE ALIGNMENT TO UNITED WAY'S FOCUS ON ADVANCING THE COMMON GOOD. THE BOARD OF DIRECTORS IS RESPONSIBLE FOR FINAL INVESTMENT DECISIONS WHEN THEY APPROVE THE TOTAL INVESTMENTS TO PARTNER AGENCIES EACH YEAR. ADDITIONAL INVESTMENTS ARE APPROVED BY THE BOARD OF DIRECTORS TO IMPLEMENT COMMUNITY IMPACT INITIATIVES AND PROGRAMS THAT ADDRESS GAPS IN RESPONDING TO CRITICAL, NEW AND EMERGING COMMUNITY NEEDS AROUND THE AREAS OF EDUCATION, INCOME AND HEALTH.
FORM 990, PAGE 2, PART III, LINE 4D
COMMUNITY IMPACT INITIATIVES - UNITED WAY IDENTIFIES A LIMITED NUMBER OF CRITICAL ISSUES (GAPS IN SERVICES OR EMERGING NEEDS) WHERE ACTION IS REQUIRED AND DEVELOPS IMPACT STRATEGIES AND PROGRAMS IN RESPONSE. SUCH STRATEGIES INCLUDE: COATS FOR THE COMMUNITY, THE EARNED INCOME AND CHILD TAX CREDIT OUTREACH AND AWARENESS CAMPAIGN, FAMILYWIZE, A FREE PRESCRIPTION DISCOUNT CARD FOR THE UNINSURED, AND THE VENTURE GRANT PROGRAM WHICH PROVIDES ONE-TIME FUNDING TO AGENCIES AND PROGRAMS FOR THE DEVELOPMENT OF NEW OR EXPANSION OF EXISTING PROGRAMS.
FORM 990, PAGE 6, PART VI, LINE 6
THE ORGANIZATION'S BYLAWS STATE ALL MEMBERS ARE THOSE WHO HAVE CONTRIBUTED TIME OR MONEY TO THE ORGANIZATION IN THE PAST 12 MONTHS.
FORM 990, PAGE 6, PART VI, LINE 11B
AN INDEPENDENT CERTIFIED AUDIT, IRS FORM 990, AND CHARITABLE ORGANIZATION ANNUAL REPORT WILL BE CONDUCTED BY A CERTIFIED PUBLIC ACCOUNTANT ANNUALLY. THE AUDIT WILL BE PREPARED IN ACCORDANCE WITH STANDARDS ESTABLISHED BY THE AMERICAN INSTITUTE OF CERTIFIED PUBLIC ACCOUNTANTS. THE CERTIFIED PUBLIC ACCOUNTANT THAT COMPLETED THE AUDIT WILL PRESENT THEIR FINDINGS TO THE BOARD FOR APPROVAL. THE AUDITOR'S REPORT WILL BE MADE AVAILABLE TO ALL POTENTIAL AND CURRENT DONORS UPON REQUEST. INFORMATION ON THE IRS FORM 990 WILL BE MADE AVAILABLE TO THE PUBLIC VIA SEVERAL ON-LINE FUNDERS' SITES.
FORM 990, PAGE 6, PART VI, LINE 12C
BOARD OF DIRECTORS, COMMUNITY INVESTMENT CABINET MEMBERS, AND UNITED WAY STAFF ARE GIVEN A CONFLICT OF INTEREST POLICY TO SIGN AT THE BEGINNING OF EACH YEAR. A STANDING AGENDA ITEM ASKING IF THERE ARE ANY APPARENT CONFLICTS OF INTEREST IS AT THE BEGINNING OF ALL AGENDAS FOR MEETINGS HELD WITH THE BOARD OF DIRECTORS AND THE ALLOCATIONS COMITTEE MEMBERS.
FORM 990, PAGE 6, PART VI, LINE 15A
UNITED WAY OF BEMIDJI AREA'S EXECUTIVE DIRECTOR AND ALL OTHER OFFICE STAFF WILL BE EVALUATED ANNUALLY. AT THIS TIME, DISCUSSION OF DISCHARGE OF ALL RESPONSIBLITIES AND GOALS WILL BE DISCUSSED. THE EXECUTIVE DIRECTOR PROVIDES SALARY REVIEWS TO THE EXECUTIVE COMITTEE OF THE EXECUTIVE DIRECTOR AND ADMINISTRATIVE ASSISTANT EVERY TWO YEARS, PRIOR TO THE EVALUATIONS BEING COMPLETED. THE EXECUTIVE COMMITTEE WILL BE RESPONSIBLE FOR DETERMINING THE EXECUTIVE DIRECTOR'S SALARY PACKAGE. THE EXECUTIVE DIRECTOR IS RESPONSIBLE FOR ADMINISTERING THE EMPLOYEE REVIEWS FOR ALL OTHER OFFICE STAFF.
FORM 990, PAGE 6, PART VI, LINE 19
NO DOCUMENTS AVAILABLE TO THE PUBLIC
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.