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
CHOICE BOOKS OF NORTHERN VIRGINIA INC
Employer identification number
54-0987761
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.") ....
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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(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 2012 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
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.") .
36,016
38,253
101,693
42,177
20,213
238,352
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......
15,650,187
14,751,786
16,269,303
17,058,885
16,468,170
80,198,331
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.
15,686,203
14,790,039
16,370,996
17,101,062
16,488,383
80,436,683
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
1,780
1,860
5,060
3,520
3,095
15,315
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.
8,876,021
8,412,536
9,568,529
9,921,346
9,674,302
46,452,734
c
Add lines 7a and 7b..
8,877,801
8,414,396
9,573,589
9,924,866
9,677,397
46,468,049
8
Public support (Subtract line 7c from line 6.)
33,968,634
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...
15,686,203
14,790,039
16,370,996
17,101,062
16,488,383
80,436,683
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
26,543
29,705
33,334
31,990
40,626
162,198
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
26,543
29,705
33,334
31,990
40,626
162,198
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.)
..
144,264
146,966
181,766
192,314
242,935
908,245
13
Total support. (Add lines 9, 10c, 11, and 12.)..
15,857,010
14,966,710
16,586,096
17,325,366
16,771,944
81,507,126
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
41.680 %
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
41.940 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
0.200 %
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
0.200 %
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
Other income (Part II, line 10 or Part III, line 12) DETAIL OF OTHER INCOME: INCOME FROM EQUITY INVESTMENT $679,977 MISCELLANEOUS INCOME 228,268 ---------------------------------------------- TOTAL OTHER INCOME $908,245
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
CHOICE BOOKS OF NORTHERN VIRGINIA INC
Employer identification number
54-0987761
Identifier
Return Reference
Explanation
O01
Officer directors etc family relationship Part VI line 2
SIMON SCHROCK, PRESIDENT, HAS A FAMILY RELATIONSHIP WITH DAVID NISLY, CFO.
O02
Form 990 governing body review Part VI line 11
CBNOVA9S CHIEF FINANCIAL OFFICER REVIEWS FORM 990 PRIOR TO ITS FILING WITH THE INTERNAL REVENUE SERVICE. A DRAFT VERSION IS ALSO SENT TO EACH BOARD MEMBER FOR THEIR COMMENTS AND QUESTIONS. A FINAL VERSION IS DISTRIBUTED TO EACH BOARD MEMBER PRIOR TO ITS FILING WITH THE INTERNAL REVENUE SERVICE.
O03
Conflict of interest policy compliance Part VI line 12c
CBNOVA HAS ADOPTED A POLICY THAT INFORMS BOARD MEMBERS, PROVIDES ANNUAL REVIEWS, AND MONITORS RELATED PARTY TRANSACTIONS. IN THE EVENT TRANSACTIONS INVOLVING BOARD MEMBERS, OFFICERS, OR MEMBERS OF MANAGEMENT OCCUR, THE FOLLOWING PROCEDURES ARE REQUIRED: 1. ALL MATERIAL TRANSACTIONS, AS DETERMINED BY THE AUDITOR, ARE TO BE REPORTED TO THE BOARD ANNUALLY. 2. THE BOARD RECORD WILL DEMONSTRATE THAT THE TRANSACTION IS TRULY IN THE BEST INTEREST OF CBNOVA, AS PROVIDED BY COMPETITIVE BID OR COMPARATIVE VALUATION, AND THAT IT DOES NOT VIOLATE STATE LAW. 3. THE RELATED PARTY IS TO BE EXCUSED DURING THE PROCESS OF BOARD DELIBERATION AND VOTING, OTHER THAN TO RESPOND TO QUESTIONS, AND IS TO ABSTAIN FROM VOTING. 4. THE BOARD WILL PERFORM AN ANNUAL REVIEW OF POTENTIAL AND KNOW RELATED PARTY TRANSACTIONS THROUGH CONFLICT OF INTEREST QUESTIONNAIRES. THESE WILL BE COMPLETED BY EACH BOARD MEMBER, OFFICER, AND SENIOR MANAGEMENT OF THE CORPORATION, INCLUDING RELATED ENTITIES. 5. CONTROLS ARE TO BE ESTABLISHED TO ASSURE THAT THE NORMAL CORPORATE CONTROLS AND ACCOUNTABILITY ARE MAINTAINED. IN SOME CASES, THIS MAY INVOLVE THE ASSIGNMENT OF ANOTHER BOARD MEMBER TO ACT ON BEHALF OF CBNOVA IN DEALING WITH THE TRANSACTIONS.
O04
CEO executive director top management comp Part VI line 15a
THE GOVERNING BOARD DOES ESTABLISH THE COMPENSATION LEVEL OF THE TOP MANAGEMENT OFFICAL OF CBNOVA, BUT THE PROCESS IN DOING SO DID NOT CONTAIN ALL THREE ELEMENTS REQUIRED TO CHECK 4YES4.
O05
Other officer or key employee compensation Part VI line 15b
THE COMPENSATION LEVEL OF OTHER OFFICERS OF CBNOVA WAS DETERMINED BY THE GOVERNING BOARD, BUT THE PROCESS IN DOING SO DID NOT CONTAIN THE THREE ELEMENTS REQUIRED TO CHECK 4YES4.
O06
Governing documents etc available to public Part VI line 19
CBNOVA MAKES IT ANNUAL AUDITED FINANCIAL STATEMENTS AND OTHER GOVERNING DOCUMENTS SUCH AS ITS CONFLICT OF INTEREST POLICY, BY LAWS, AND ARTICLES OF INCORPORATION AVAILABLE UPON REQUEST. THESE DOCUMENTS MAY ALSO BE INSPECTED AT CBNOVA9S CORPORATE HEADQUARTERS LOCATED IN BRISTOW, VIRGINIA.
O07
General explanation attachment
PART VI, LINE 17 ADDITIONAL INFORMATION: THE FOLLOWING ARE ADDITIONAL STATES WHERE CBNOVA FILES FORM 990: SC, GA, KY, HI, OH, IL, AND OR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.