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
YMCA BLUE RIDGE ASSEMBLY INC
Employer identification number
56-0532130
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.") .
37,200
370,579
290,338
333,494
328,762
1,360,373
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......
3,440,426
3,503,614
3,401,484
3,538,742
3,527,579
17,411,845
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
142,094
14,513
8,619
84,698
249,924
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.
3,477,626
4,016,287
3,706,335
3,880,855
3,941,039
19,022,142
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
10,700
10,700
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..
10,700
10,700
8
Public support (Subtract line 7c from line 6.)
19,011,442
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...
3,477,626
4,016,287
3,706,335
3,880,855
3,941,039
19,022,142
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
74,301
54,321
49,625
47,430
27,084
252,761
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
74,301
54,321
49,625
47,430
27,084
252,761
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.)..
3,551,927
4,070,608
3,755,960
3,928,285
3,968,123
19,274,903
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
98.630 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
97.880 %
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
2.000 %
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
YMCA BLUE RIDGE ASSEMBLY INC
Employer identification number
56-0532130
Return Reference
Explanation
FORM 990 - ORGANIZATION'S MISSION
TO ENABLE STAFF AND GUESTS, ESPECIALLY THE YOUNG, TO DEVELOP THEIR FULLEST POTENTIAL IN SPIRIT, MIND AND BODY. YMCA BLUE RIDGE ASSEMBLY SEEKS TO FULFILL THIS PURPOSE BY: 1) SERVING YMCA AND OTHER NON-PROFIT TRAINING EVENTS AND CONFERENCES OF A RELIGIOUS, EDUCATIONAL OR COMMUNITY SERVICE NATURE. 2) SERVING STAFF BY PROVIDING LEADERSHIP TRAINING IN A WORK EXPERIENCE WITH A CHRISTIAN ATMOSPHERE. 3) PROVIDING PROGRAMS WHICH DEVELOP SELF-ESTEEM AND SELF CONFIDENCE, BUILD LASTING RELATIONSHIPS, ENCOURAGE INTERPERSONAL UNDERSTANDING OF INDIVIDUAL DIFFERENCES AND INCREASE CIVIC ENGAGEMENT. 4) SERVICES ARE OFFERED AT AFFORDABLE FEES WITH FINANCIAL ASSISTANCE AVAILABLE FOR THOSE WHO CANNOT AFFORD THE FULL FEE.
FORM 990, PAGE 1, PART I, LINE 6
BRA HAS ALL VOLUNTEER MEMBERS ON THE BOARD OF DIRECTORS AND THE BOARD OF TRUSTEES. OTHER VOLUNTEER ROLES INCLUDE ASSISTING IN THE GIFT SHOP, CRAFT ROOM, MAINTENANCE DEPARTMENT, AND/OR DINING ROOM.
FORM 990, PAGE 6, PART VI, LINE 1A
THE EXECUTIVE COMMITTEE CONSISTS OF THE PRESIDENT, TWO VICE PRESIDENTS, THE SECRETARY, THE TREASURER, THE IMMEDIATE PAST PRESIDENT, AND THE CHAIRMAN OF THE BOARD OF TRUSTEES. DURING THE INTERIMS BETWEEN MEETINGS OF THE BOARD OF DIRECTORS, THE EXECUTIVE COMMITTEE MANAGES AND CONTROLS THE BUSINESS AND AFFAIRS OF THE ORGANIZATION, EXCEPT FOR CERTAIN ACTIONS LISTED IN THE ORGANIZATION'S BYLAWS THAT REQUIRE RATIFICATION BY THE FULL BOARD.
FORM 990, PAGE 6, PART VI, LINE 6
CORPORATE MEMBERSHIP IN THE ORGANIZATION CONSISTS OF ALL CORPORATE YOUNG MEN'S CHRISTIAN ASSOCIATIONS (AND BRANCHES THEREOF) IN THE STATES OF ALABAMA, FLORIDA, GEORGIA, KENTUCKY, LOUISIANA, MISSISSIPPI, NORTH CAROLINA, SOUTH CAROLINA, TENNESSEE, VIRGINIA, AND SUCH OTHER CORPORATE YMCA'S AND BRANCHES IN SUCH OTHER STATES TO WHICH THE BOARD OF DIRECTORS MAY FROM TIME TO TIME EXTEND THE PRIVILEGE OF MEMBERSHIP, PROVIDED ONLY THAT IN ORDER TO BE RECOGNIZED FOR MEMBERSHIP, EACH SUCH CORPORATE YMCA MUST BE RECOGNIZED FOR MEMBERSHIP IN THE NATIONAL COUNCIL PURSUANT TO ALL RELEVANT PROVISIONS OF THE NATIONAL CONSTITUTION.
FORM 990, PAGE 6, PART VI, LINE 7A
THE BOARD OF DIRECTORS CONSISTS OF DIRECTORS ELECTED BY THE CORPORATE MEMBERSHIP IN THE RATIO OF ONE YMCA EMPLOYED OFFICER AND TWO VOLUNTEERS REPRESENTING THE STATES OF ALABAMA, FLORIDA, GEORGIA, KENTUCKY, LOUISIANA, MISSISSIPPI, NORTH CAROLINA, SOUTH CAROLINA, TENNESSEE, AND VIRGINIA.
FORM 990, PAGE 6, PART VI, LINE 11B
THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTANT WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. UPON COMPLETION AND REVIEW BY THE FINANCE AND EXECUTIVE COMMITTEES OF THE BOARD, THE RETURN WAS PROVIDED TO ALL VOTING BOARD MEMBERS PRIOR TO ITS SUBMISSION TO THE IRS.
FORM 990, PAGE 6, PART VI, LINE 12C
THE ORGANIZATION USES A DISCIPLINED APPROACH FOR BIDDING PROFESSIONAL SERVICES, INSURANCE CONTRACTS, CAPITAL PROJECTS, ETC. AT THE POINT OF ENGAGEMENT, ANY POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED AND DECLARED. THE CONFLICTED PARTY IS DISALLOWED FROM THE DECISION-MAKING PROCESS. CONFLICT OF INFORMATION FORMS ARE SIGNED AND COLLECTED ANNUALLY FOR ALL VOTING BOARD MEMBERS.
FORM 990, PAGE 6, PART VI, LINE 15A
COMPENSATION FOR THE CEO IS REVIEWED ANNUALLY BY THE PERFORMANCE REVIEW AND COMPENSATION COMMITTEE OF THE BOARD. COMPARABILITY DATA IS PROVIDED BY THE YMCA OF THE UNITED STATES SALARY POINTING AND RANGE.
FORM 990, PAGE 6, PART VI, LINE 15B
THE PROCESS DESCRIBED IN LINE 15A ABOVE ALSO APPLIES TO OTHER OFFICERS AND KEY PERSONNEL OF THE ORGANIZATION.
FORM 990, PAGE 6, PART VI, LINE 19
THE ORGANIZATION'S CONFLICT OF INTEREST POLICIES ARE INCORPORATED INTO ITS PERSONNEL POLICY WHICH IS DISTRIBUTED TO ALL EMPLOYEES. FINANCIAL STATEMENTS ARE SUBMITTED TO THE YMCA OF THE USA AND ARE MADE AVAILABLE THROUGH THEIR WEBSITE. AS WITH THE 990, THE FINANCIAL STATEMENTS ARE KEPT IN THE MAIN OFFICE OF BRA AND ARE AVAILABLE FOR REVIEW UPON RECEIPT OF A WRITTEN REQUEST TO THE ORGANIZATION'S ADMINISTRATIVE OFFICE.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.