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
Associated Services for the Blind Inc
Employer identification number
23-1370508
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.") ....
1,139,116
1,424,337
919,993
658,593
650,209
4,792,248
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
1,139,116
1,424,337
919,993
658,593
650,209
4,792,248
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.
4,792,248
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..
1,139,116
1,424,337
919,993
658,593
650,209
4,792,248
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
586,625
1,266,446
1,245,691
902,944
786,813
4,788,519
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.)..
10,167
13,260
25,320
25,025
10,493
84,265
11
Total support (Add lines 7 through 10).
9,665,032
12
Gross receipts from related activities, etc. (see instructions)
..................
12
7,747,422
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
49.580 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
51.970 %
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.") .
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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
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
Associated Services for the Blind Inc
Employer identification number
23-1370508
Return Reference
Explanation
Form 990, Part III, line 3
Expansion of Satellite Office locations from two to four making services readily available and more convenient to clients living outside of the Center City Philadelphia area and beyond.
Form 990, Part VI, Section A, line 4
The By-Laws of the organization were revised during the year.
Form 990, Part VI, Section B, line 11
The Board of Directors of Associated Service for the Blind (ASB) has approved the following procedure for the preparation, review and approval of the organization's IRS 990 Tax Form at its meeting on June 18, 2009. - The IRS 990 Tax document is prepared by the organization's Audit Firm with the assistance from ASB's Controller. - ASB's Controller will work with the organization's Development / Public Relations Department as well as with agency Program Directors to draft / review all narrative documentation that is to be presented on the IRS 990 Form. - Once the draft of the form has been completed and undergone review by the Audit Firm, a copy is forwarded to ASB's Controller for review. The Controller will draft any recommended changes / corrections and discuss with the Audit Firm. - A copy of the revised draft will be forwarded to the Controller for review to assure that all changes / corrections have been completed. - After the Controller has reviewed and approved all necessary changes, a copy of the drafted document will be forwarded to the organization's CEO & President for review and approval. (If there are any changes / corrections, the CEO & President will ask the Controller to contact the Audit Firm.) - The drafted document will then be forwarded to all Audit Committee Members and the Board Chairman for review and approval. (If there are any changes / corrections, the CEO & President will be notified to have the Controller contact the Audit Firm.) - After the review and final approval of the drafted document by the Board Chairman and Audit Committee Members, the Controller will contact the Audit Firm and authorize them to "finalize" the document and forward an "original" and copy of the IRS 990 to the attention of the CEO & President for signing. - The CEO & President will officially sign off on both copies of the IRS 990 and forward to the Controller for processing. - The Controller will prepare and mail the original signed copy to the IRS. A copy of the Form is kept in the Controller's office. (Copies are available upon request.)
Form 990, Part VI, Section B, line 12c
Conflict of Interest Statements are provided to board members on an annual basis at the Annual Board Meeting in October each year. Updated statements are required from board members only if their existing information on file has changed. New board members are provided with a Conflict of Interest Statement in their welcome packet and are required to submit their statements prior to the next scheduled board meeting.
Form 990, Part VI, Section B, line 15
a. The organizations CEO, Executive Director, or top management official - Each year, the process for determining the compensation of the organization's President & CEO is carried out by a committee consisting of several board members, which are selected by the Board Chairman. Members of the committee differ from year to year. In order to make an informed decision, the committee gathers information encompassing both financial and organizational matters in which the President & CEO plays a key role. The committee holds a meeting to discuss their findings and determines the appropriate compensation. Once a decision is made, the Board Chairman meets with the President & CEO to relay the outcome and then sends an official letter with a copy to the Human Services Manager for further processing. b. Other officers or key employees of the organization - Performance appraisals are conducted before the end of the evaluation period and at least once annually, to set goals for the coming year, and to help determine an employee's future compensation. The performance appraisal consists of a discussion between supervisor and employee regarding areas of improvement, setting goals for the coming year, and to help determine employee's future employment with ASB. The result is a written report by the supervisor evaluating the employee's performance based on the job description. The supervisor and employee must sign this performance appraisal and a copy is given to the employee. The employee's signature does not signify agreement or disagreement, only receipt of the report. If the employee does not concur with the appraisal, he/she may submit a written exception to the appraisal within five (5) working days of having received the appraisal, and this written exception will be attached to the appraisal. If an employee's job performance is judged unsatisfactory by the supervisor at any given time, an additional performance appraisal shall be given for three months in order to improve performance. All employees receive a copy of their job descriptions and their evaluation forms with their signature. A copy is also placed in their Personnel Files.
Form 990, Part VI, Section C, line 19
All organizational governing documents and financial statements are available to the public upon request. ASB's IRS 990 Form can be found online at Guidestar.com and on Charity Navigator. It is also available upon request.
Form 990, Part XI, Line 2C
No change from the prior year.
Form 990, Part V, Lines 7G & 7H
Not applicable.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.