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
CLAIRVAUX INSTITUTE
Employer identification number
26-2994486
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.") .
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 E(Form 990 or 990-EZ) Department of the Treasury Internal Revenue Service
SchoolsComplete if the organization answered "Yes" to Form 990, Part IV, line 13, or Form 990-EZ, Part VI, line 48. Attach to Form 990 or Form 990-EZ. Information about Schedule E (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
CLAIRVAUX INSTITUTE
Employer identification number
26-2994486
Part I
YES
NO
1
Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws,
other governing instrument, or in a resolution of its governing body?
......................
1
No
2
Does the organization include a statement of its racially nondiscriminatory policy toward students in all its
brochures, catalogues, and other written communications with the public dealing with student admissions,
programs, and scholarships?
......................................
2
Yes
3
Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during
the period of solicitation for students, or during the registration period if it has no solicitation program, in a way
that makes the policy known to all parts of the general community it serves? If "Yes," please describe. If "No,"
please explain. If you need more space use Part II.
.............................
3
No
4
Does the organization maintain the following?
a
Records indicating the racial composition of the student body, faculty, and administrative staff?
..........
4a
Yes
b
Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory
Other extracurricular activities?
.....................................
5h
No
If you answered "Yes" to any of the above, please explain. If you need more space, use Part II.
6a
Does the organization receive any financial aid or assistance from a governmental agency?
...........
6a
No
b
Has the organization's right to such aid ever been revoked or suspended?
...................
6b
No
If you answered "Yes" to either line 6a or line 6b, explain on Part II.
7
Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05
of Rev. Proc. 75-50, 1975-2 C.B. 587, covering racial nondiscrimination? If "No," explain on Part II.
7
Yes
Paperwork Reduction Act Notice, see the Instructions for Form 990 or Form 990-EZ.
Cat. No. 50085D
Schedule E (Form 990 or 990-EZ) 2013
Schedule E (Form 990 or 990EZ) 2013
Page 2
Part II
Supplemental Information. Provide the explanations required by Part I, lines 3, 4d, 5h, 6b, and 7, as applicable. Also complete this part to provide any other additional information (see instructions).
Return Reference
Explanation
FORM 990, SCHEDULE E, LINE 7:
CLAIRVAUX INSTITUTE CURRENTLY FOLLOWS A RACIAL NONDISCRIMINATORY POLICY WHICH MAINTAINS IT DOES NOT DISCRIMINATE AGAINST ANY RACE, COLOR OR NATIONAL OR ETHNIC ORIGIN AND ALLOWS ANY AND ALL STUDENTS THAT HAVE A CATHOLIC FAITH AND VISION. SINCE THE ORGANIZATION IS STILL IN ITS STARTUP STAGES, IT IS WORKING ON UPDATING ITS BYLAWS AND GOVERNING DOCUMENTS TO INCLUDE A COMPLETE AND EXHAUSTIVE RACIAL NONDISCRIMINATORY POLICY AND WILL MAKE THE POLICY KNOWN TO THE GENERAL COMMUNITY UPON ITS COMPLETION. THIS PROCESS IS EXPECTED TO BE COMPLETED WITHIN THE NEXT TAX YEAR.
Schedule E (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
CLAIRVAUX INSTITUTE
Employer identification number
26-2994486
Return Reference
Explanation
FORM 990, PART III, LINE 2
IN 2013, CLAIRVAUX INSTITUTE CHANGED IT EXEMPT PURPOSES TO FOUNDING AND GOVERNING GREGORY THE GREAT ACADEMY, A BOARDING SCHOOL FOR HIGHSCHOOL AGED BOYS IN THE INTELLECTUAL, SPIRITUAL, AND LITURGICAL TRADITION OF THE ROMAN CATHOLIC CHURCH. TO INSTRUCT STUDENTS IN THE DOCTRINES AND MORAL TEACHINGS OF THE CATHOLIC CHURCH, AND TO TEACH STUDENTS THE IMPORTANCE OF ORDERING THE WHOLE OF THEIR LIVES TOWARD GOD.
FORM 990, PART VI, SECTION A, LINE 4
THE CLAIRVAUX INSTITUTE AMENDED ITS BYLAWS ON FEBRUARY 22, 2013 TO REVISE THE PURPOSE OF THE ORGANIZATION AS FOLLOWS: (A) TO FINANCIALLY AID ALREADY EXISTING SCHOOLS THAT CONFORM TO THE CLAIRVAUX INSTITUTES MISSION. (B) TO FOUND AND GOVERN GREGORY THE GREAT ACADEMY, A BOARDING SCHOOL FOR HIGHSCHOOL AGED BOYS IN THE INTELLECTUAL, SPIRITUAL, AND LITURGICAL TRADITION OF THE ROMAN CATHOLIC CHURCH. TO INSTRUCT STUDENTS IN THE DOCTRINES AND MORAL TEACHINGS OF THE CATHOLIC CHURCH, AND TO TEACH STUDENTS THE IMPORTANCE OF ORDERING THE WHOLE OF THEIR LIVES TOWARD GOD. (C) TO FOUND AND GOVERN LIBERAL ARTS SCHOOLS IN THE CATHOLIC INTELLECTUAL TRADITION ON THE PRIMARY, SECONDARY, AND/OR COLLEGIATE LEVELS. (D) TO FOUND AND PROMOTE EDUCATIONAL YOUTH ORGANIZATIONS. (E) TO PROVIDE SCHOLARSHIPS, FELLOWSHIPS, EDUCATION LOANS, AND OTHER EDUCATIONAL GRANTS FOR A VARIETY OF EDUCATIONAL AND CULTURAL ENDEAVORS TO INDIVIDUALS AND ORGANIZATIONS THAT CONFORM TO THE MISSION OF THE CLAIRVAUX INSTITUTE. (F) TO FOUND AND SUSTAIN A SCHOOL OF THOUGHT TO FURTHER ELABORATE, CLARIFY AND EXPOUND THE INITIAL VISION OF THE CLAIRVAUX INSTITUTE. (G) TO FOUND AND PROMOTE A SCHOOL OF TRADITIONAL CRAFTS. (H) TO FOUND AND PROMOTE MENTORING, COACHING, AND TUTORING PROGRAMS. (I) TO SPONSOR AND DIRECT ANNUAL COURSES AND CAMPS OF VARIOUS LENGTHS SUCH AS WEEKEND, ONE-WEEK, OR TWO-WEEK ETC. (J) TO SPONSOR AND DIRECT PERIODIC SEMINARS. (K) TO PRODUCE AND DISTRIBUTE A VARIETY OF PERIODICALS BOTH SCHOLARLY AND POPULAR, PROMOTING THE MISSION OF THE CLAIRVAUX INSTITUTE. (L) TO PRODUCE AND DISTRIBUTE BOOKS, PAMPHLETS, AND SIMILAR BOUND PRINTED MATERIAL THAT PROMOTES THE MISSION OF THE CLAIRVAUX INSTITUTE. (M) TO DESIGN AND FOSTER A VARIETY OF WEB-BASED MEDIA WHICH PROMOTE THE MISSION AND PROJECTS OF THE CLAIRVAUX INSTITUTE. (N) TO PRODUCE, DISTRIBUTE, AND MAKE USE OF A VARIETY OF OTHER INTELLECTUAL PROPERTY PROMOTING THE MISSION OF THE CLAIRVAUX INSTITUTE. (O) TO INITIATE AND PROMOTE ARTISTS CIRCLES FOR THE INFORMAL SHARING AND ENCOURAGEMENT OF SONGS, STORIES, POETRY AND OTHER ARTISTIC PRODUCTIONS. (P) TO INITIATE AND SUSTAIN READERS CIRCLES ON TOPICS BEARING ON THE MISSION OF THE THE CLAIRVAUX INSTITUTE. (Q) TO SPONSOR AND DIRECT EDUCATIONAL FESTIVALS OF VARIOUS LENGTHS TO PROMOTE CULTURAL AND ARTISTIC ACTIVITIES. (R) TO SPONSOR AND DIRECT PILGRIMAGES (ESP. WALKING AND BIKING) TO PLACES OF CULTURAL AND RELIGIOUS INTEREST.
FORM 990, PART VI, SECTION B, LINE 11
A COPY OF THE FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS FOR APPROVAL BEFORE IT IS FILED.
FORM 990, PART VI, SECTION B, LINE 12C
EACH BOARD MEMBER HAS A DUTY TO DISCLOSE ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST AND MUST DISCLOSE THE EXISTENCE OF A FINANCIAL INTEREST AND ALL MATERIAL FACTS. THE GOVERNING BOARD WILL THEN REVIEW ALL APPROPRIATE FACTS AND CIRCUMSTANCES TO DETERMINE IF A CONFLICT OF INTEREST DOES EXIST AND WHAT ACTIONS SHOULD TO BE MADE. THIS PROCESS IS TO BE COMPLETED WHENEVER A POSSIBLE CONFLICT OF INTEREST OCCURS.
FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION WILL MAKE THEIR FORM 990 AVAILABLE UPON REQUEST.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.