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
DONOR NETWORK OF ARIZONA
Employer identification number
86-0707697
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.") .
392,123
324,208
145,945
324,840
299,214
1,486,330
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......
28,122,189
31,125,261
36,728,827
35,062,601
39,792,225
170,831,103
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.
28,514,312
31,449,469
36,874,772
35,387,441
40,091,439
172,317,433
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
0
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.
0
c
Add lines 7a and 7b..
0
8
Public support (Subtract line 7c from line 6.)
172,317,433
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...
28,514,312
31,449,469
36,874,772
35,387,441
40,091,439
172,317,433
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
24,650
142,801
248,753
338,728
382,381
1,137,313
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
24,650
142,801
248,753
338,728
382,381
1,137,313
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.)
..
2,656
2,656
13
Total support. (Add lines 9, 10c, 11, and 12.)..
28,538,962
31,592,270
37,126,181
35,726,169
40,473,820
173,457,402
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
99.340 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
99.490 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
0.660 %
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
0.510 %
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
DONOR NETWORK OF ARIZONA
Employer identification number
86-0707697
Return Reference
Explanation
FORM 990, PART VI, SECTION B, LINE 11
THE 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND, UPON COMPLETION, A DRAFT IS EMAILED TO ALL MEMBERS OF THE BOARD OF DIRECTORS FOR THEIR REVIEW AND COMMENT. AFTER THEIR REVIEW IS COMPLETE, THE FIRM IS PROVIDED WITH ANY COMMENTS OR CHANGES AND/OR INSTRUCTED TO FILE THE RETURN.
FORM 990, PART VI, SECTION B, LINE 12C
ALL MEMBERS OF THE DNA BOARD OF DIRECTORS WILL BE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT UPON AFFILIATION WITH DNA OR HIRING AND TO UPDATE THE STATEMENT AT LEAST ANNUALLY. THE CHIEF EXECUTIVE DIRECTOR SHALL PREPARE A REPORT FOR THE DNA BOARD OF DIRECTORS' ANNUAL MEETING LISTING ALL TRANSACTIONS BETWEEN DNA AND DNA BOARD OF DIRECTORS. THE REPORT WILL INCLUDE: - A DESCRIPTION OF THE TRANSACTION AND ITS DATE. - THE AMOUNT OF THE TRANSACTION AND ITS IMPACT ON DNA. - THE NAME OF THE DNA BOARD OF DIRECTOR MEMBER INVOLVED AND THE NAME OF THE OTHER ENTITY, IF ANY, AND A DESCRIPTION OF THE NATURE OF THE DNA BOARD OF DIRECTOR'S INTEREST IN THE TRANSACTION. IF A CONFLICT OF INTEREST CANNOT BE AVOIDED, THE BOARD MEMBER WHO HAS A CONFLICT OF INTEREST SHALL NOT VOTE ON, PARTICIPATE IN OR ATTEMPT TO INFLUENCE ANY DNA DECISION AFFECTED BY THE CONFLICT OF INTEREST, EXCEPT TO PROVIDE INFORMATION AS SPECIFICALLY REQUESTED BY DECIDING COMMITTEE OR BODY.
FORM 990, PART VI, SECTION B, LINE 15
PROCEDURE: COMPENSATION PHILOSOPHY AND STRATEGY THE OBJECTIVES OF DNA'S EXECUTIVE COMPENSATION PROGRAM ARE TO PROVIDE A COMPETITIVE EXECUTIVE TOTAL COMPENSATION PROGRAM COMPARED TO OTHER ORGANIZATIONS OF SIMILAR SIZE AND TYPE, PARTICULARLY HEALTHCARE ORGANIZATIONS. DNA'S PHILOSOPHY IS TO: STRONGLY LINK PAY WITH PERFORMANCE. RETAIN THE TALENTED SENIOR MANAGEMENT TEAM AND DEMONSTRATE THAT DNA VALUES THEM. ENSURE REASONABLE COMPENSATION AS COMPARED TO PEERS. IT IS THE COMMITTEE'S INTENT TO USE PEER DATA FROM SIMILAR POSITIONS IN SIMILAR ORGANIZATIONS UNDER SIMILAR CIRCUMSTANCES. POSITION BASE SALARY COMPETITIVELY AT LEAST AT THE MEDIAN LABOR MARKET AS COMPARED TO PEERS. ENSURE THAT DNA'S TOTAL COMPENSATION, INCLUDING TOTAL CASH COMPENSATION AND EMPLOYEE AND EXECUTIVE BENEFITS, IS POSITIONED AT COMPETITIVE PRACTICE OVERALL WHEN DNA MEETS ITS KEY GOALS. - DNA PROVIDES AN EXECUTIVE COMPENSATION PROGRAM THAT INTEGRATES ALL ELEMENTS OF COMPENSATION AND BENEFITS. - BASE SALARY IS MARKET-BASED AND REFLECTS AN INDIVIDUAL'S PERFORMANCE. ANNUALLY AN INDIVIDUAL'S PERFORMANCE IS EVALUATED RELATIVE TO THEIR POSITION ACCOUNTABILITIES AND PERFORMANCE CRITERIA AS WELL AS ORGANIZATIONAL ACCOUNTABILITIES. - THE ORGANIZATIONAL INCENTIVE PLAN, DNA'S ANNUAL INCENTIVE, REWARDS ACHIEVEMENT ON KEY ORGANIZATIONAL GOALS THAT REPRESENT SUCCESS MEASURES FOR ORGAN PROCUREMENT, EYE AND TISSUE ORGANIZATIONS. INCENTIVE GOALS STRONGLY ALIGN WITH DNA'S MISSION. THE PLAN REWARDS ORGANIZATION-WIDE PERFORMANCE TO REINFORCE TEAMWORK. A THRESHOLD OF FINANCIAL PERFORMANCE IS NECESSARY FOR THE PLAN TO BE AFFORDABLE. PROCEDURE: COMPENSATION COMMITTEE RESPONSIBILITIES AND DUTIES THE COMPENSATION COMMITTEE WILL MEET REGULARLY AS SCHEDULED IN CONJUNCTION WITH BOARD MEETINGS. THE COMPENSATION COMMITTEE WILL BE RESPONSIBLE TO CONTRACT AN OUTSIDE CONSULTANT TO REVIEW AND TREND CURRENT MARKET DATA AND TOTAL EXECUTIVE COMPENSATION TO ENSURE EXECUTIVES ARE REASONABLY COMPENSATED. THIS WILL BE DONE AT A MINIMUM OF TWO TO THREE YEARS OR AS NEEDED. THE COMMITTEE WILL OVERSEE AND SUPERVISE THE CONSULTANT'S WORK PRODUCT. ALL COMPENSATION AGREEMENTS AND DECISIONS MADE BY THE COMMITTEE WILL BE MADE INDEPENDENTLY AND WITH DUE DILIGENCE. ALL COMPENSATION AGREEMENTS AND DECISIONS WILL BE THOROUGHLY DOCUMENTED IN THE FINANCE/COMPENSATION COMMITTEE MINUTES OR THE EXECUTIVE SESSION BOARD MINUTES AS APPROPRIATE. GUIDELINES FOR DOCUMENTATION ARE AS FOLLOWS AND WILL INCLUDE: - IDENTIFICATION OF ATTENDEES - VERIFICATION AND STATEMENT THAT NO MEMBER HAS A CONFLICT OF INTEREST. - DOCUMENTATION THAT THOSE WHO HAVE A CONFLICT WILL BE EXCUSED. - IDENTIFICATION OF SOURCE AND COLLECTION OF COMPENSATION DATA DETAILED DOCUMENTATION OF THE TERMS OF THE COMPENSATION BEING APPROVED IF COMPENSATION VALUE DIFFERS FROM COMPARABILITY DATA, THE BASIS FOR DETERMINATION WILL BE STATED. WITH EACH DECISION REGARDING EXECUTIVE COMPENSATION, THE COMMITTEE WILL BE RESPONSIBLE TO ESTABLISH A "REBUTTABLE PRESUMPTION OF REASONABLENESS". IN DOING SO, THE COMMITTEE WILL: - ENSURE PARTICIPANTS ARE INDEPENDENT - MAKE DECISIONS BASED ON APPROPRIATE COMPARABILITY DATA. - ENSURE MINUTES REFLECT A WRITTEN RECORD OF THE COMMITTEE'S WORK. THE COMPENSATION COMMITTEE WILL REPORT ALL DECISIONS REGARDING EXECUTIVE COMPENSATION TO THE FULL BOARD. THE CEO'S REVIEW AND THE OTHER OFFICERS' REVIEWS WERE PERFORMED ON JANUARY 23, 2014.
FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION'S ARTICLES OF INCORPORATION, BY-LAWS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.