Form990-EZ
Click to see list of attachments
Department of the Treasury
Internal Revenue Service
Short Form
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code
(except private foundation)
bullet Do not enter Social Security numbers on this form as it may be made public. By law, the
IRS generally cannot redact the information on the form.
bullet Information about Form 990-EZ and its instructions is at www.irs.gov/form990.
OMB No. 1545-1150
2013
Open to Public
Inspection
A
For the 2013 calendar year, or tax year beginning 07-01-2013, and ending 06-30-2014
B
Check if applicable:
C Name of organization
ROTARY INTERNATIONAL DUBLIN AM ROTARY CLUB
 
Number and street (or P. O. box, if mail is not delivered to street address)PO BOX 0671
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code DUBLIN, OH430170617
D Employer identification number

31-1301839
E Telephone number

(614) 413-4000
F Group Exemption
Number. . bullet  
G Accounting Method: Other (specify) bullet   H Check bulletI Website:bulletWWW.DUBLINAMROTARY.ORGJ Tax-exempt status(check only one)?( 4) bullet(insert no.) or
K Form of organization:  
L Add lines 5b, 6c, and 7b, to line 9 to determine gross receipts. If gross receipts are $200,000 or more, or if total assets (Part II, column (B) below) are $500,000 or more, file Form 990 instead of Form 990-EZ . . . . . . . . . bullet $ 83,881
Part I
Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part I)Check if the organization used Schedule O to respond to any question in this Part I...................
VerticalRevenue 1 Contributions, gifts, grants, and similar amounts received............... 1 28,840
2 Program service revenue including government fees and contracts ............ 2 23,476
3 Membership dues and assessments...................... 3 23,506
4 Investment income........................... 4 167
5a Gross amount from sale of assets other than inventory........ 5a  
b Less: cost or other basis and sales expenses........... 5b  
c Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) ...... 5c  
6 Gaming and fundraising events
a Gross income from gaming (attach Schedule G if greater than $15,000) . 6a  
b Gross income from fundraising events (not including $ 5,000 of contributions
from fundraising events reported on line 1) (attach Schedule G if the
sum of such gross income and contributions exceeds $15,000) 6b 3,809
c Less: direct expenses from gaming and fundraising events....... 6c 3,030
d Net income or (loss) from gaming and fundraising events (add lines 6a and 6b and subtract line 6c) 6d 779
7a Gross sales of inventory, less returns and allowances........ 7a  
b Less: cost of goods sold................. 7b  
c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) ......... 7c  
8 Other revenue (describe in Schedule O) ..................... 8 4,083
9 Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8.............. Bullet 9 80,851
VerticalExpenses 10 Grants and similar amounts paid (list in Schedule O) ................. 10 50,183
11 Benefits paid to or for members........................ 11  
12 Salaries, other compensation, and employee benefits................ 12  
13 Professional fees and other payments to independent contractors............ 13 8,510
14 Occupancy, rent, utilities, and maintenance................... 14  
15 Printing, publications, postage, and shipping................... 15 115
16 Other expenses (describe in Schedule O) .................... 16 39,826
17 Total expenses. Add lines 10 through 16 ................. Bullet 17 98,634
VerticalNetAssets 18 Excess or (deficit) for the year (Subtract line 17 from line 9)............ 18 -17,783
19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with
end-of-year figure reported on prior year’s return)................ 19 61,635
20 Other changes in net assets or fund balances (explain in Schedule O) .......... 20 0
21 Net assets or fund balances at end of year. Combine lines 18 through 20.........Bullet 21 43,852
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 10642I Form 990-EZ (2013)
Form 990-EZ (2013)
Page 2
Part IIBalance Sheets (see the instructions for Part II)Check if the organization used Schedule O to respond to any question in this Part II.................

(A) Beginning of year(B) End of year
22Cash, savings, and investments................
63,071
22
45,532
23Land and buildings....................
 
23
 
24Other assets (describe in Schedule O) ..........
50
24
0
25Total assets......................
63,121
25
45,532
26
Total liabilities (describe in Schedule O) .............
1,486
26
1,680
27Net assets or fund balances (line 27 of column (B) must agree with line 21)..
61,635
27
43,852
Part IIIStatement of Program Service Accomplishments (see the instructions for Part III) Check if the organization used Schedule O to respond to any question in this Part III . Expenses
(Required for section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts; optional for others.)
What is the organization's primary exempt purpose? THE MISSION OF THE ORGANIZATION IS TO PROVIDE SERVICE TO OTHERS, PROMOTE INTEGRITY, AND ADVANCE WORLD UNDERSTANDING, GOODWILL, AND PEACE THROUGH ITS FELLOWSHIP OF BUSINESS, PROFESSIONAL AND COMMUNITY LEADERS. ROTARY VOLUNTEER PROGRAMS FOSTER AND FACILITATE ACTIVE VOLUNTEER INVOLVEMENT IN COMMUNITY AND INTERNATIONAL SERVICE PROJECTS.
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. In a clear and concise manner, describe the services provided, the number of persons benefited, and other relevant information for each program title.
28 ROTARY INTERNATIONAL PROVIDES SUPPORT FOR INTERNATIONAL SERVICE PROJECTS AND CULTIVATES INTERNATIONAL UNDERSTANDING AND GOODWILL THROUGH HUMANITARIAN SERVICE.
(Grants $ 0) If this amount includes foreign grants, check here ...MediumBullet		 28a 29,808
29 FELLOWSHIP ACTIVITIES SUPPORT ENCOURAGES MEMBERS TO INTERACT WITH EACH OTHER THROUGH COMMUNITY SERVICE AND MEET NEW FRIENDS AND MAKE LASTING RELATIONSHIPS.
(Grants $ 0) If this amount includes foreign grants, check here ...MediumBullet		 29a 24,915
30 VOCATIONAL SERVICE EFFORTS PLAY A VITAL ROLE IN IMPROVING THE LIVES OF COMMUNITY MEMBERS WHO NEED DIRECTION AND EXPERTISE. ROTARIANS USE THEIR PROFESSIONAL SKILLS AND EXPERIENCE WHEREVER HELP IS NEEDED.
(Grants $ 0) If this amount includes foreign grants, check here ...MediumBullet		 30a 7,995
COMMUNITY PROJECTS HELP TO SUPPORT SERVICE PROJECTS IN THE LOCAL COMMUNITY AND INCREASE AWARENESS OF VOLUNTEER OPPORTUNITIES.
(Grants $ 0) If this amount includes foreign grants, check here ...MediumBullet		 12,016
NEW GENERATIONS IS DESIGNED TO HELP SUPPORT HIGH SCHOOL COMMUNITY SERVICE CLUBS, SUPPORT ROTARY CLUB FOR 21-30 YEAR OLD YOUNG PROFESSIONALS, AND FACILITATE EXCHANGE INCOMING AND OUTGOING STUDENT PROGRAMS.
(Grants $ 0) If this amount includes foreign grants, check here ...MediumBullet		 6,861
31 Other program services (describe in Schedule O)
(Grants $   ) If this amount includes foreign grants, check here...MediumBullet		 31a
32 Total program service expenses (add lines 28a through 31a).......... bullet 32 81,595
Part IV
List of Officers, Directors, Trustees, and Key Employees (list each one even if not compensated — see the instructions for Part IV)Check if the organization used Schedule O to respond to any question in this Part IV............
(a) Name and title (b) Average
hours per week
devoted to position		 (c)Reportable compensation
(Forms W-2/1099-MISC) (if not paid, enter -0-) 		(d) Health benefits, contributions to employee benefit plans,
and deferred compensation		 (e) Estimated amount
of other compensation
DAVID HOLLIDAYPAST PRESIDENT 4.00 0 0 0
MIKE CLOSEPRESIDENT 4.00 0 0 0
RICH WEBERSECRETARTY-TREASURER 4.00 0 0 0
DAVID WILLIAMSONSERGEANT AT ARMS 4.00 0 0 0
WENDY SHERIDANDIRECTOR 4.00 0 0 0
JULIE ERWIN-RINALDIPRESIDENT ELECT 4.00 0 0 0
WOLFGANG LANTVICE PRESIDENT 4.00 0 0 0
BONNIE COLEY-MALIRDIRECTOR 4.00 0 0 0
MICHAEL BLACKWELLDIRECTOR 4.00 0 0 0
DWIGHT SEELEYDIRECTOR 4.00 0 0 0
AMBER HULMEDIRECTOR 4.00 0 0 0
STEVE SMITHDIRECTOR 4.00 0 0 0
Form 990-EZ (2013)
Form 990-EZ (2013)
Page 3
Part V
Other Information
(Note the Schedule A and personal benefit contract statement requirements in the
instructions for Part V.) Check if the organization used Schedule O to respond to any question in this Part V.......
Yes
No
33
Did the organization engage in any significant activity not previously reported to the IRS? If "Yes," provide a detailed description of each activity in Schedule O ...................
33
 
No
34
Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the amended documents if they reflect a change to the organization’s name. Otherwise, explain the changeon Schedule O (see instructions) ..........................
34
 
No
35a
Did the organization have unrelated business gross income of $1,000 or more during the year from business activities (such as those reported on lines 2, 6a, and 7a, among others)? ............
35a
 
No
b
If "Yes," to line 35a, has the organization filed a Form 990-T for the year? If "No," provide an explanation in Schedule O
35b
 
 
c
Was the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e) notice, reporting, and proxy tax requirements during the year? If "Yes," complete Schedule C, Part III
35c
 
No
36
Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If “Yes," complete applicable parts of Schedule N ................
36
 
No
37a
Enter amount of political expenditures, direct or indirect, as described in the instructions. bullet
37a
0
b
Did the organization file Form 1120-POL for this year?...................
37b
 
 
38a
Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were
any such loans made in a prior year and still outstanding at the end of the tax year covered by this return?..
38a
 
No
b
If “Yes," complete Schedule L, Part II and enter the total amount involved .
38b
 
39
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on line 9.......
39a
 
b
Gross receipts, included on line 9, for public use of club facilities.....
39b
 
40a
Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under:
section 4911 bullet   ; section 4912 bullet   ; section 4955 bullet  
b
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefittransaction during the year, or did it engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ? If “Yes," complete Schedule L, Part I ......
40b
 
No
c
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and 4958...bullet0
d
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimbursed by the organization...........................bullet0
e
All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? If "Yes," complete Form 8886-T ......................
40e
 
No
41List the states with which a copy of this return is filed. bullet
42aThe organization's books are in care of bulletAMY BARNHART Telephone no. bullet (614) 866-6724
Located at bullet1142 BERGENIA DRIVEREYNOLDSBURG,OH ZIP + 4bullet43068
b
At any time during the calendar year, did the organization have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)?
Yes
No
42b
 
No
If “Yes," enter the name of the foreign country: bullet
See the instructions for exceptions and filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
c
At any time during the calendar year, did the organization maintain an office outside the U.S.?
42c
 
No
If “Yes," enter the name of the foreign country: bullet
43.......bullet
and enter the amount of tax-exempt interest received or accrued during the tax year....bullet43
 
Yes
No
44a
Did the organization maintain any donor advised funds during the year? If "Yes," Form 990 must be completed instead of
Form 990-EZ................................
44a
 
No
b
Did the organization operate one or more hospital facilities during the year? If "Yes," Form 990 must be completedinstead of Form 990-EZ.............................
44b
 
No
c
Did the organization receive any payments for indoor tanning services during the year?.........
44c
 
No
d
If "Yes," to line 44c, has the organization filed a Form 720 to report these payments? If "No," provide an
explanation in Schedule O ............................
44d
 
 
45a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?.........
45a
 
No
45b
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," Form 990 and Schedule R may need to be completed instead of Form 990-EZ (see instructions)......................
45b
 
 
Form 990-EZ (2013)
Form 990-EZ (2013)
Page 4
Yes
No
46
Did the organization engage, directly or indirectly, in political campaign activities on behalf of or in opposition tocandidates for public office? If “Yes," complete Schedule C, Part I. ..............
46
 
No
Part VI
Section 501(c)(3) organizations only All section 501(c)(3) organizations must answer questions 47-49b and 52, and complete the tables for lines 50 and 51 Check if the organization used Schedule O to respond to any question in this Part VI ................
Yes
No
47
Did the organization engage in lobbying activities or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II .......................
47
 
 
48
Is the organization a school as described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E ..
48
 
 
49a
Did the organization make any transfers to an exempt non-charitable related organization?......
49a
 
 
b
If "Yes," was the related organization a section 527 organization?................
49b
 
 
50
Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key employees) who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and title of each employee (b) Average
hours per week
devoted to position		 (c) Reportable compensation
(Forms W-2/1099-MISC) 		(d) Health benefits, contributions to employee benefit plans, and deferred compensation (e) Estimated amount of other compensation
 
f
Total number of other employees paid over $100,000 .................bullet  

51
Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and business address of each independent contractor (b) Type of service (c) Compensation
 
d
Total number of other independent contractors each receiving over $100,000..........bullet  
52
Did the organization complete Schedule A? NOTE: All Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A ...............bullet
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name bullet

Firm's EIN bullet
Firm's address bullet



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
Form 990-EZ (2013)


Form 990-EZ, Special Condition Description:
Special Condition Description

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Name of the organization
ROTARY INTERNATIONAL DUBLIN AM ROTARY CLUB
 
Employer identification number

31-1301839
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 2
Name of organization
ROTARY INTERNATIONAL DUBLIN AM ROTARY CLUB
  		Employer identification number

31-1301839
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

   
RESTRICTED
RESTRICTED
RESTRICTED, RESTRICTEDRESTRICTED

$RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 3
Name of organization
ROTARY INTERNATIONAL DUBLIN AM ROTARY CLUB
  		Employer identification number

31-1301839
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 4
Name of organization
ROTARY INTERNATIONAL DUBLIN AM ROTARY CLUB
  		Employer identification number

31-1301839
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Additional Data


Software ID:  
Software Version:  
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.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet 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
ROTARY INTERNATIONAL DUBLIN AM ROTARY CLUB
 
Employer identification number

31-1301839
Return Reference Explanation
FORM 990-EZ, PART I, LINE 4 - OTHER INVESTMENT INCOME DESCRIPTION: INTEREST INCOME. AMOUNT: 167.
FORM 990-EZ, PART I, LINE 8 - OTHER REVENUE DESCRIPTION: MISCELLANEOUS. AMOUNT: 4,083.
FORM 990-EZ, PART I, LINE 10 - PAYMENTS TO AFFILIATES AFFILIATE NAME: ROTARY INTERNATIONAL FOUNDATION. AFFILIATE ADDRESS: 14280 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693. PURPOSE OF PAYMENT: EREY. AMOUNT OF PAYMENT: 2,000.
FORM 990-EZ, PART I, LINE 10 - PAYMENTS TO AFFILIATES AFFILIATE NAME: ROTARY INTERNATIONAL FOUNDATION. AFFILIATE ADDRESS: 14280 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693. PURPOSE OF PAYMENT: POLIO PLUS. AMOUNT OF PAYMENT: 4,000.
FORM 990-EZ, PART I, LINE 10 - PAYMENTS TO AFFILIATES AFFILIATE NAME: ROTARY DISTRICT 6690. AFFILIATE ADDRESS: PO BOX 387 HILLIARD, OH 43016. PURPOSE OF PAYMENT: DUES. AMOUNT OF PAYMENT: 2,592.
FORM 990-EZ, PART I, LINE 10 - PAYMENTS TO AFFILIATES AFFILIATE NAME: ROTARY INTERNATIONAL. AFFILIATE ADDRESS: 14280 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693. PURPOSE OF PAYMENT: DUES AND SUBSCRIPTIONS. AMOUNT OF PAYMENT: 7,976.
FORM 990-EZ, PART I, LINE 10 - PAYMENTS TO AFFILIATES AFFILIATE NAME: ROTARY INTERNATIONAL FOUNDATION. AFFILIATE ADDRESS: 14280 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693. PURPOSE OF PAYMENT: SHARE FUND-CLUB MATCHING CONTRIBUTION. AMOUNT OF PAYMENT: 1,150.
FORM 990-EZ, PART I, LINE 10 - PAYMENTS TO AFFILIATES AFFILIATE NAME: ROTARY DISTRICT 6690. AFFILIATE ADDRESS: PO BOX 387 HILLIARD, OH 43026. PURPOSE OF PAYMENT: RYLA. AMOUNT OF PAYMENT: 600. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 18,318.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: INTERVENTION RADIOLOGY. GRANTEE NAME: NATIONWIDE CHILDREN'S HOSPITAL FOUNDATION. GRANTEE ADDRESS: 700 CHILDREN'S DRIVE COLUMBUS, OH 43205. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 10/09/13. AMOUNT GIVEN: 3,500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: INTERNATIONAL SERVICES. GRANTEE NAME: PACK H2O, LLC. GRANTEE ADDRESS: 274 MARCONI BLVD, SUITE 400 COLUMBUS, OH 43215. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 09/25/13. AMOUNT GIVEN: 374.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: INTERNATIONAL SERVICES. GRANTEE NAME: PACK H2O, LLC. GRANTEE ADDRESS: 274 MARCONI BLVD, SUITE 400 COLUMBUS, OH 43215. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 10/24/13. AMOUNT GIVEN: 3,638.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: INTERNATIONAL SERVICES. GRANTEE NAME: PARTNERS FOR CARE US. GRANTEE ADDRESS: 2001 BRECKENRIDGE LANE ALPHARETTA, GA 30005. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 09/25/13. AMOUNT GIVEN: 350.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: COMMUNITY SERVICE. GRANTEE NAME: DUBLIN CITY SCHOOLS. GRANTEE ADDRESS: 2335 WEST CASE ROAD DUBLIN, OH 43235. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 10/02/13. AMOUNT GIVEN: 128.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: GENERAL GRANT. GRANTEE NAME: DUBLIN FOOD PANTRY. GRANTEE ADDRESS: 81 WEST BRIDGE STREET DUBLIN, OH 43017. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 12/04/13. AMOUNT GIVEN: 230.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: GENERAL GRANT. GRANTEE NAME: DUBLIN FOOD PANTRY. GRANTEE ADDRESS: 81 WEST BRIDGE STREET DUBLIN, OH 43014. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 06/30/14. AMOUNT GIVEN: 356.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: SINAN YAYKIN - LEADERSHIP DUBLIN. GRANTEE ADDRESS: 129 S. HIGH STREET DUBLIN, OH 43017. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 10/09/13. AMOUNT GIVEN: 995.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: RAMONA PENLAND-COYLE -LEADERSHIP DUBLIN. GRANTEE ADDRESS: 129 S. HIGH STREET DUBLIN, OH 43017. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 10/09/13. AMOUNT GIVEN: 995.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: ELIZABETH RECHEL & VALPARAISO UNIVERSITY. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/30/14. AMOUNT GIVEN: 1,000.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: JENNIFER SLACK & UNIVERSITY OF KENTUCKY. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/30/14. AMOUNT GIVEN: 1,000.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: ALEXANDRA MIEKLE & OHIO UNIVERSITY. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/30/14. AMOUNT GIVEN: 750.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: AMULYA DEGA & NEOMED. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/30/14. AMOUNT GIVEN: 500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCHOLARSHIPS. GRANTEE NAME: ABIGAIL MOORE & COLORADO COLLEGE. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/30/14. AMOUNT GIVEN: 750.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: COMMUNITY SERVICE. GRANTEE NAME: STRIDES FOR SOBRIETY. GRANTEE ADDRESS: 6352 CONLETH CIRCLE DUBLIN, OH 43017. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 03/28/14. AMOUNT GIVEN: 2,500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: COMMUNITY SERVICE. GRANTEE NAME: MIRACLE LEAGUE OF CENTRAL OHIO. GRANTEE ADDRESS: PO BOX 1303 DUBLIN, OH 43017. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/19/14. AMOUNT GIVEN: 500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: MOLDOVA ORPHANAGE. GRANTEE NAME: WORD MADE FLESH. GRANTEE ADDRESS: PO BOX 15068 PORTLAND, OR 15068. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 10/02/13. AMOUNT GIVEN: 2,000.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCIENCE & TECHNOLOGY. GRANTEE NAME: DUBLIN ROBOTICS BOOSTERS. GRANTEE ADDRESS: 6780 COFFMAN ROAD DUBLIN, OH 43017. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 01/15/14. AMOUNT GIVEN: 1,000.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCIENCE & TECHNOLOGY. GRANTEE NAME: DUBLIN ROBOTICS BOOSTERS. GRANTEE ADDRESS: 6780 COFFMAN ROAD DUBLIN, OH 43017. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 03/19/14. AMOUNT GIVEN: 1,000.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCIENCE & TECHNOLOGY. GRANTEE NAME: OHIO FIRST. GRANTEE ADDRESS: 1003 KINNEAR ROAD COLUMBUS, OH 43212. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 01/16/14. AMOUNT GIVEN: 1,000.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SCIENCE & TECHNOLOGY. GRANTEE NAME: CORI/PAST FOUNDATION. GRANTEE ADDRESS: 1003 KINNEAR ROAD COLUMBUS, OH 43212. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 01/15/14. AMOUNT GIVEN: 1,000.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: GENERAL GRANT. GRANTEE NAME: DUBLIN AM ROTARY CLUB CHARITABLE FOUNDATION. GRANTEE ADDRESS: PO BOX 671 DUBLIN, OH 43017. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/30/14. AMOUNT GIVEN: 16.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: INTERNATIONAL SERVICES - LIBRARIES. GRANTEE NAME: INTERNATIONAL OFFICE-CAMP SIERRA LEONE AM. GRANTEE ADDRESS: 272 FOXWORTH DRIVE COLUMBUS, OH 43231. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 06/04/14. AMOUNT GIVEN: 500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: VETERAN'S SERVICES. GRANTEE NAME: FISHER HOUSE FOUNDATION. GRANTEE ADDRESS: 111 ROCKVILLE PIKE ROCKVILLE, MD 20850. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 03/28/14. AMOUNT GIVEN: 400.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: VETERAN'S SERVICES. GRANTEE NAME: RESURRECTING LIVES FOUNDATION. GRANTEE ADDRESS: 6724 PERIMETER LOOP RD DUBLIN, OH 43017. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 03/28/14. AMOUNT GIVEN: 400.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: VETERAN'S SERVICES. GRANTEE NAME: WOUNDED WARRIOR PROJECT. GRANTEE ADDRESS: PO BOX 758517 TOPEKA, KS 66675. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 03/28/14. AMOUNT GIVEN: 456.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: LITERACY PROJECT. GRANTEE NAME: DUBLIN CITY SCHOOLS. GRANTEE ADDRESS: 2335 WEST CASE ROAD COLUMBUS, OH 43235. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 03/04/14. AMOUNT GIVEN: 500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: INTERNATIONAL SERVICES. GRANTEE NAME: IMPACT ECONOMICS. GRANTEE ADDRESS: 274 MARCONI BLVD, SUITE 400 COLUMBUS, OH 43215. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 05/07/14. AMOUNT GIVEN: 1,491.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: INTERNATIONAL SERVICES - LN4. GRANTEE NAME: ELLEN MEADOWS PROSTHETIC HANDS FOUNDATION. GRANTEE ADDRESS: 1101 SISKIYOU BLVD. ASHLAND, OR 97520. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 06/04/14. AMOUNT GIVEN: 500.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: LITERACY PROJECT. GRANTEE NAME: DUBLIN CITY SCHOOLS. GRANTEE ADDRESS: 2335 WEST CASE ROAD COLUMBUS, OH 43235. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: DICTIONARIES FOR STUDENTS. METHOD USED TO DETERMINE BOOK VALUE: PURCHASE PRICE. METHOD USED TO DETERMINE FMV: PURCHASE PRICE. BOOK VALUE OF PROPERTY: 2,536. DATE OF GIFT: 09/19/13. AMOUNT GIVEN: 2,536.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: LITERACY PROJECT. GRANTEE NAME: SISLEY ROTARY CLUB. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 06/30/14. AMOUNT GIVEN: 1,500. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 31,865.
FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES DESCRIPTION: OFFICE SUPPLIES. AMOUNT: 249. DESCRIPTION: OFFICERS/DIRECTORS INSURANCE. AMOUNT: 678. DESCRIPTION: DISTRICT EXPENSES. AMOUNT: 353. DESCRIPTION: MEMBER UNIFORMS. AMOUNT: 292. DESCRIPTION: CLUB ADMINISTRATION EXPENSES. AMOUNT: 414. DESCRIPTION: MEALS AND FELLOWSHIP ACTIVITIES. AMOUNT: 24,915. DESCRIPTION: BANK SERVICE CHARGES AND PAYPAL FEES. AMOUNT: 231. DESCRIPTION: REVEILLE AND OTHER PROGRAMS. AMOUNT: 1,099. DESCRIPTION: SALVATION ARMY CHRISTMAS. AMOUNT: 2,104. DESCRIPTION: NEW GENERATIONS EXPENSES. AMOUNT: 6,261. DESCRIPTION: ADVERTISING. AMOUNT: 695. DESCRIPTION: MISCELLANEOUS PROGRAM EXPENSES. AMOUNT: 2,535. TOTAL TO FORM 990-EZ, LINE 16: 39,826.
FORM 990-EZ, PART II, LINE 24 - OTHER ASSETS DESCRIPTION: UNDEPOSITED FUNDS. BEG. OF YEAR AMOUNT: 50. END OF YEAR AMOUNT: 0.
FORM 990-EZ, PART II, LINE 26 - OTHER LIABILITIES DESCRIPTION: DUE TO ANGEL FUND. BEG. OF YEAR AMOUNT: 1,286. END OF YEAR AMOUNT: 1,471. DESCRIPTION: ACCOUNTS PAYABLE. BEG. OF YEAR AMOUNT: 200. END OF YEAR AMOUNT: 209.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2013

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TY 2013 TransferPrsnlBnftContractsDecl
Name:
ROTARY INTERNATIONAL DUBLIN AM ROTARY CLUB
EIN: 31-1301839
Declaration:
THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.