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
TOWN OF WALLKILL BOYS & GIRLS CLUB INC
Employer identification number
13-3741014
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.") ....
561,950
430,644
470,599
461,998
638,129
2,563,320
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
561,950
430,644
470,599
461,998
638,129
2,563,320
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.
2,563,320
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..
561,950
430,644
470,599
461,998
638,129
2,563,320
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.)..
2,374
6,357
23
1,140
2,814
12,708
11
Total support (Add lines 7 through 10).
2,576,028
12
Gross receipts from related activities, etc. (see instructions)
..................
12
1,734,491
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
99.510 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
99.580 %
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
TOWN OF WALLKILL BOYS & GIRLS CLUB INC
Employer identification number
13-3741014
Return Reference
Explanation
FORM 990, PART I, LINE 1
IN 2011 OUR CLUBS SERVED 3085 YOUTH, 884 AS REGISTERED MEMBERS AND 2201 THROUGH COMMUNITY EVENTS, OUTREACH, ETC. OUR MEMBERS WERE 51% FEMALE AND 49% MALE. OUR MEMBERS' ETHNICITY BREAKS DOWN TO 12% AFRICAN AMERICAN, 53% CAUCASIAN, 1% ASIAN, 17% HISPANIC AND 17% MULTIRACIAL. OUR PROGRAMMATIC GOALS AND BENCH MARKS FOR 2011 INCLUDED: -ALL AGE-APPROPRIATE AFTERSCHOOL LOCATIONS WILL PROMOTE AND SUPPORT A TORCH AND/OR KEYSTONE CLUB WITH OFFICERS, REGULAR MEETINGS AND MINUTES AND A MONTHLY SERVICE PROJECT. - ALL LOCATIONS, BEFORE AND AFTERSCHOOL, WILL BE RESPONSIBLE FOR HITTING EACH OF THE 5 CORE AREAS OF DEVELOPMENT NO LESS THAN 1X PER WEEK. - ALL LOCATIONS WILL HAVE NO LESS THAN 75% OF MEMBERS PARTICIPATE IN POWER HOUR OR HYLAS AT LEAST 3X PER WEEK. -ALL LOCATIONS WILL HAVE NO LESS THAN 75% OF MEMBERS PARTICIPATE IN PHYSICAL OR RECREATION ACTIVITIES AT LEAST 3X PER WEEK. - ALL AGE-APPROPRIATE LOCATIONS WILL HAVE 75% OF MEMBERS PARTICIPATE IN A SERVICE PROJECT OR SERVICE "MOMENT" AT LEAST 1X PER MONTH. -ALL LOCATIONS WILL HAVE AT LEAST 1 PRESENTATION OR OUTSIDE SPEAKERS PER MONTH. THESE TOPICS AND SPEAKERS ARE TO BE "DRIVEN" THROUGH YOUTH CHOICE. -ALL SPECIALIZED PROGRAMS, FROM INFLUENCEHER, BOYS CLUB, MONEY MATTERS, LITERACY, ETC. WILL HAVE PRE AND POST TESTING TO DEMONSTRATE YOUTH LEARNING, AS WELL AS SKILLS AND KNOWLEDGE ACQUISITION. WE OPERATED TWO BEFORE-SCHOOL PROGRAMS, SEVEN AFTERSCHOOL PROGRAMS AND ONE SUMMER DAY CAMP. WE ALSO PROVIDED FOUR FREE 10-WEEK CLASSES FOR MIDDLE SCHOOLERS DESIGNED TO PROMOTE THEIR EMOTIONAL WELLNESS AND FINANCIAL LITERACY.
FORM 990, PART VI, SECTION B, LINE 11
THE CLUB HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FORM 990 HAS BEEN PREPARED, REVIEWED BY MANAGEMENT AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, IT IS SUBMITTED ELECTRONICALLY TO MEMBERS OF THE ORGANIZATIONS GOVERNING BODY FOR ANY COMMENTS. ANY COMMENTS ARE THEN SUMMARIZED AND PROVIDED TO MANAGEMENT TO BE ADDRESSED UNTIL THE FINAL RETURN IS FINALIZED AND APPROVED FOR FILING.
FORM 990, PART VI, SECTION B, LINE 12C
THE POLICY APPLIES TO THE BOARD OF DIRECTORS AND OFFICERS. THE POLICY IS MONITORED BY SELF-REPORTING, AND ALSO BY THE EXECUTIVE DIRECTOR AND EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. ANNUALLY BOARD MEMBERS AND OFFICERS SIGN A DISCLOSURE STATEMENT THAT THEY BELIEVE THAT THEY ARE IN COMPLIANCE WITH POLICY. IF THEY BELIEVE THEY HAVE A CONFLICT, THEN IT MUST BE DISCLOSED ON THE STATEMENT. SHOULD BOARD MEMBERS/OFFICERS HAVE A CONFLICT OF INTEREST, THEY WOULD BE REQUIRED TO RECUSE THEMSELVES FROM THE DECISION-MAKING PROCESS.
FORM 990, PART VI, SECTION B, LINE 15A
THE CLUB'S EXECUTIVE COMMITTEE ACTS AS THE COMPENSATION COMMITTEE AND MEETS ANNUALLY TO REVIEW THE COMPENSATION OF THE EXECUTIVE DIRECTOR AND ALL SENIOR STAFF. SALARIES OF THE CURRENT EXECUTIVE DIRECTOR AND SENIOR STAFF WERE SET BY THE EXECUTIVE COMMITTEE AND APPROVED BY THE FULL BOARD OF DIRECTORS. SALARY AMOUNTS ARE DETERMINED BY COMPARING SALARY INFORMATION RECEIVED FROM THE NATIONAL BOYS & GIRLS CLUB OF AMERICA AND ALSO PROCESS REGIONAL WHICH PROVIDES NOT-FOR-PROFIT SALARY INFORMATION FOR DECISION MAKING. WRITTEN MINUTES ARE MAINTAINED FOR COMPENSATION REVIEW AND DECISIONS.
FORM 990, PART VI, SECTION C, LINE 19
THE CLUB MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE BY MAKING IT AVAILABLE ON GUIDESTAR.ORG. IN ADDITION, THE FORM 990, FINANCIAL STATEMENTS FORM 1023, AND CONFLICT OF INTEREST POLICY, ARE AVAILABLE UPON WRITTEN REQUEST OR CALLING THE CLUB DIRECTLY.
FORM 990, PART XII, LINE 2C:
THE CLUB'S FINANCE COMMITTEE AND BOARD OF DIRECTORS OVERSEES FINANCIAL CHECKS AND BALANCES FOR THE ORGANIZATION. THE FINANCE COMMITTE AND THE BOARD REVIEWS AND APPROVES THE AUDIT AND FINANCIAL STATEMENTS ALONG WITH THE CLUB'S FORM 990. THIS PROCESS IS UNCHANGED FROM THE PRIOR YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.