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
LIGHTHOUSE OF PINELLAS INC
Employer identification number
23-7042938
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.") ....
1,701,070
1,541,610
1,650,084
1,710,118
1,563,233
8,166,115
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
1,701,070
1,541,610
1,650,084
1,710,118
1,563,233
8,166,115
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.
8,166,115
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..
1,701,070
1,541,610
1,650,084
1,710,118
1,563,233
8,166,115
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
45
138
67
27
15,762
16,039
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
3,976
2,040
3,725
2,881
10,609
23,231
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
424
1,422
5,604
9,531
745
17,726
11
Total support (Add lines 7 through 10).
8,223,111
12
Gross receipts from related activities, etc. (see instructions)
..................
12
525,998
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
99.310 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
99.560 %
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.") .
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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(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 2012 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
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
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
LIGHTHOUSE OF PINELLAS INC
Employer identification number
23-7042938
Identifier
Return Reference
Explanation
ADDITIONAL INFORMATION
FORM 990
(CONTINUED FROM 990, PAGE 1, LINE 1) OUR PROGRAMS ARE NATIONALLY ACCREDITED AND ARE PROVIDED IN THE HOME, AT THE CENTER, OR IN THE COMMUNITY. OUR PROGRAMS ENABLE PEOPLE TO MAXIMIZE THEIR INDEPENDENCE, HEALTH AND SAFETY THROUGH TRAINING GEARED TO EACH PERSON'S INDIVIDUAL NEEDS.
ADDITIONAL INFORMATION
FORM 990, PART III
(CONTINUED FROM 990, PAGE 2, LINE 1) THIS IS ACCOMPLISHED THROUGH A CONTINUUM OF COMPREHENSIVE VISION REHABILITATION PROGRAMS WHICH ARE NATIONALLY ACCREDITED AND PROVIDED BY HIGHLY TRAINED AND CREDENTIALED PROFESSIONAL STAFF.
ANY SIGNIFICANT CHANGES IN CONDUCT FOR PROGRAM SERVICES
FORM 990, PAGE 2, PART III, LINE 3
THE ORGANIZATION CEASED PERFORMING 2 PROGRAMS (CAMP VISION & LIFE SKILLS CAMP AND LIVING WELL PROGRAM) DURING THE YEAR DUE TO REDUCTIONS IN AVAILABLE FUNDING. THE COMBINED ACTIVITY FROM THESE TWO PROGRAMS DOES NOT REPRESENT GREATER THAN 25% OF THE ORGANIZATION'S ACTIVITIES.
FIRST ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4A
(CONTINUED FROM 990, PAGE 2, LINE 4A) SELF-MANAGEMENT OF DIABETES, AS WELL AS USE OF ADAPTIVE COMPUTER TECHNOLOGY ARE PROVIDED TO EACH PERSON ENROLLED IN THIS PROGRAM. THIS FISCAL YEAR 215 PEOPLE RECEIVED REHABILITATIVE TRAINING SERVICES IN THE INDEPENDENT LIVING PROGRAM.
SECOND ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4B
(CONTINUED FROM 990, PAGE 2, LINE 4B) AS WELL AS ADJUSTMENT TO VISION LOSS COUNSELING. THIS TRAINING IS PROVIDED IN THE HOME, AT THE CENTER, OR IN THE COMMUNITY BASED UPON THE NEEDS OF EACH PERSON. THIS FISCAL YEAR 60 PEOPLE RECEIVED SERVICES THAT ASSISTED THEM TOWARDS ACHIEVING THEIR EMPLOYMENT GOALS.
THIRD ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4C
(CONTINUED FROM 990, PAGE 2, LINE 4C) TO REDUCE ANY DEVELOPMENTAL GAPS THAT MAY EXIST TO THE GREATEST EXTENT POSSIBLE. CHILDREN AND THEIR FAMILIES MAY PARTICIPATE IN THE EARLY INTERVENTION PROGRAM UNTIL THE CHILD HAS ACHIEVED THEIR HIGHEST LEVEL OF FUNCTIONING OR UNTIL THE CHILD REACHES THE AGE OF 6 YEARS. THIS FISCAL YEAR 87 CHILDREN AND THEIR FAMILIES WERE SERVED.
ALL OTHER ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4D
INDIVIDUAL ASSISTANCE: INDIVIDUAL ASSISTANCE IS PROVIDED TO PEOPLE WHO NEED ONE-TIME SUPPORT FROM OUR PROFESSIONAL PROGRAM STAFF. ASSISTANCE PROVIDED ARE THINGS SUCH AS A HOME VISIT TO REPLACE A BROKEN WHITE CANE, APPLYING BRAILLE TOUCH BUTTONS TO ADAPT A KITCHEN FOR SOMEONE WHO IS VISUALLY IMPAIRED, OR AN INTAKE INTERVIEW FOR OTHER COMMUNITY SERVICES WHEN THE INDIVIDUAL IS NOT ELIGIBLE FOR LIGHTHOUSE OF PINELLAS SERVICES. THIS FISCAL YEAR 59 PEOPLE RECEIVED ONE-TIME INDIVIDUAL ASSISTANCE SERVICES FROM LIGHTHOUSE OF PINELLAS PROFESSIONAL STAFF. TEEN TRANSITION PROGRAM: TEENAGERS 14 YEARS OF AGE THROUGH THEIR HIGH SCHOOL GRADUATION ARE ELIGIBLE TO PARTICIPATE IN THIS PROGRAM. SERVICES ARE OFFERED TWICE A WEEK DURING THE SCHOOL YEAR AND FOR FOUR WEEKS DURING THE SUMMER. THIS PROGRAM HELPS EACH YOUNG PERSON LEARN TO BECOME SELF-SUFFICIENT AND PREPARE FOR COLLEGE, JOB PLACEMENT OR VOCATIONAL TRAINING. ONCE-A-MONTH FIELD TRIPS ARE ALSO OFFERED. SKILLS SUCH AS PERSONAL, FINANCIAL, AND HOME MANAGEMENT; HOW TO COMPLETE A JOB APPLICATION; INTERVIEW SKILLS AND USE OF ADAPTIVE COMPUTER TECHNOLOGY ARE LEARNED THROUGHOUT THE SCHOOL YEAR. THE SUMMER PROGRAM GIVES THE STUDENTS THE EXPERIENCE OF VISITING A COLLEGE CAMPUS FOR A WEEK TO LEARN FIRST-HAND WHAT LIFE ON A COLLEGE CAMPUS IS ALL ABOUT. STUDENTS HAVE THE OPPORTUNITY TO PRACTICE HOME MANAGEMENT SKILLS IN A DIFFERENT BUT REALISTIC ENVIRONMENT. THIS HELPS THEM TO LEARN HOW TO GET AROUND SAFELY ON THE CAMPUS AND HOW TO ADAPT THE ORIENTATION AND MOBILITY TRAINING THEY HAVE RECEIVED TO MASTER NEW EXPERIENCES. STUDENTS IN THE SUMMER TRANSITION PROGRAM ARE ABLE TO PARTICIPATE IN A PAID WORK EXPERIENCE TO DEVELOP JOB SKILLS AND GAIN VALUABLE EMPLOYMENT EXPERIENCE. THIS FISCAL YEAR 19 YOUNG PEOPLE PARTICIPATED IN THE TEEN TRANSITION PROGRAM. VETERANS ADMINISTRATION: VETERANS RECEIVE ALL SERVICES OFFERED IN THE ADULT PROGRAM, BUT SHOULD AN INDIVIDUAL REQUIRE ADDITIONAL COMPUTER TRAINING, THE VETERANS ADMINISTRATION DID FUND THIS ADDITIONAL TRAINING BEYOND WHAT IS OFFERED IN THE INDEPENDENT LIVING PROGRAM. THIS FISCAL YEAR 6 VETERANS RECEIVED ADDITIONAL COMPUTER TRAINING.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
THE AGENCY'S BOARD OF DIRECTORS EACH RECEIVE AND REVIEW THE FORM 990 RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX AND APPROVE ITS SUBMISSION PRIOR TO FILING.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
THE BOARD OF DIRECTORS PROVIDES EACH NEW BOARD MEMBER WITH AN APPLICATION PACKET THAT INCLUDES INFORMATION ON THE CONFLICT OF INTEREST POLICY AND THE REQUIREMENT FOR INFORMATION TO BE UPDATED AT LEAST ANNUALLY. IN ADDITION, BOARD MEMBERS ARE MADE AWARE OF THE AGENCY'S POLICY MANUAL WHICH INCLUDES THE WHISTLEBLOWER AND DOCUMENT RETENTION AND DESTRUCTION POLICY.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
DURING THE ANNUAL BUDGETING PROCESS, THE SALARIES OF ALL EMPLOYEES, INCLUDING THE PRESIDENT & CEO, VICE PRESIDENT & COO, THE DIRECTOR OF FINANCE, AND THE DIRECTOR OF PROGRAMS ARE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. SALARIES OF KEY EMPLOYEES ARE BASED ON COMPARABLE DATA FOR COMPARABLE ORGANIZATIONS.
COMPENSATION PROCESS FOR OFFICERS
FORM 990, PAGE 6, PART VI, LINE 15B
DURING THE ANNUAL BUDGETING PROCESS, THE SALARIES OF ALL EMPLOYEES, INCLUDING THE PRESIDENT & CEO, VICE PRESIDENT & COO, THE DIRECTOR OF FINANCE, AND THE DIRECTOR OF PROGRAMS ARE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. SALARIES OF KEY EMPLOYEES ARE BASED ON COMPARABLE DATA FOR COMPARABLE ORGANIZATIONS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
THE AGENCY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, GIFT POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST OR THROUGH INSPECTION AT THEIR OFFICE. IN ADDITION, THE AGENCY'S FORM 990 IS AVAILABLE ON THE INTERNET AT WWW.GUIDESTAR.ORG.
RECONCILIATION OF CHANGES - OTHER
FORM 990, PART XI, LINE 9
RENTAL EXPENSES - INDIRECT 34,658 SPECIAL EVENT EXPENSES -3,372 RENTAL EXPENSES - INDIRECT -34,658 SPECIAL EVENT EXPENSES 3,372
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.