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
NORTHERN TIER COMMUNITY ACTION CORP
Employer identification number
25-1201846
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.") ....
4,986,972
6,400,936
6,475,187
5,420,608
4,077,354
27,361,057
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
0
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
4
Total. Add lines 1 through 3
4,986,972
6,400,936
6,475,187
5,420,608
4,077,354
27,361,057
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)..
0
6
Public support. Subtract line 5 from line 4.
27,361,057
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..
4,986,972
6,400,936
6,475,187
5,420,608
4,077,354
27,361,057
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
-21,480
-35,140
-15,259
18,383
38,259
-15,237
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
0
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
0
11
Total support (Add lines 7 through 10).
27,345,820
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 2012 (line 6, column (f) divided by line 11, column (f))
.........
14
100.000 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
100.000 %
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:
12000229
Software Version:
2012v2.0
-
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
NORTHERN TIER COMMUNITY ACTION CORP
Employer identification number
25-1201846
Identifier
Return Reference
Explanation
Form 990, Part IX, Line 24e
Form 990, Part IX, Line 24e: Other Expenses
TRAINING & TECH. ASSIST.: Column (A) - Total = $36175; Column (B) - Program Services = $36175; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e
Form 990, Part IX, Line 24e: Other Expenses
TELEPHONE: Column (A) - Total = $49094; Column (B) - Program Services = $48178; Column (C) - Management & General = $916; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e
Form 990, Part IX, Line 24e: Other Expenses
SUBCONTRACT WORK: Column (A) - Total = $95662; Column (B) - Program Services = $95662; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e
Form 990, Part IX, Line 24e: Other Expenses
REPAIRS & MAINTENANCE: Column (A) - Total = $1326; Column (B) - Program Services = $1326; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e
Form 990, Part IX, Line 24e: Other Expenses
Postage and Shipping: Column (A) - Total = $11690; Column (B) - Program Services = $12263; Column (C) - Management & General = $-573; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e
Form 990, Part IX, Line 24e: Other Expenses
PAYROLL PROCESSING: Column (A) - Total = $5487; Column (B) - Program Services = $5632; Column (C) - Management & General = $-145; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e
Form 990, Part IX, Line 24e: Other Expenses
PARENT ACTIVITIES: Column (A) - Total = $11195; Column (B) - Program Services = $11195; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e
Form 990, Part IX, Line 24e: Other Expenses
OTHER EXPENSES: Column (A) - Total = $30036; Column (B) - Program Services = $28356; Column (C) - Management & General = $1680; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e
Form 990, Part IX, Line 24e: Other Expenses
NON-FOOD ITEMS: Column (A) - Total = $9343; Column (B) - Program Services = $9343; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e
Form 990, Part IX, Line 24e: Other Expenses
MEMBERSHIPS/DUES: Column (A) - Total = $3336; Column (B) - Program Services = $3111; Column (C) - Management & General = $225; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e
Form 990, Part IX, Line 24e: Other Expenses
MAINT. AND VEHICLE OPERATION: Column (A) - Total = $24231; Column (B) - Program Services = $24231; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e
Form 990, Part IX, Line 24e: Other Expenses
IN HOUSE COMPUTER SVCS: Column (A) - Total = $19527; Column (B) - Program Services = $19527; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e
Form 990, Part IX, Line 24e: Other Expenses
EQUIPMENT & VEHICLES: Column (A) - Total = $81982; Column (B) - Program Services = $81982; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e
Form 990, Part IX, Line 24e: Other Expenses
CONTRACTED TRANSPORT: Column (A) - Total = $38151; Column (B) - Program Services = $38151; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e
Form 990, Part IX, Line 24e: Other Expenses
CONSULTANT/PROFESSIONAL: Column (A) - Total = $85651; Column (B) - Program Services = $85276; Column (C) - Management & General = $375; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e
Form 990, Part IX, Line 24e: Other Expenses
COMMODITIES DISTRIBUTED: Column (A) - Total = $30890; Column (B) - Program Services = $30890; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part VI, Line 19
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available
Interested parties must provide a written request to review governing documents, policies, tax returns, and financial statements. All of the above will be made available to the public for review at the corporate offices during normal business hours.
Form 990, Part VI, Line 15b
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees
A review is conducted annually to evaluate the performances of key employees and to adjust their compensation packages accordingly.
Form 990, Part VI, Line 12c
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts
Annually, the board is required to disclose interests that could give rise to conflicts.
Form 990, Part VI, Line 11b
Form 990, Part VI, Line 11b: Form 990 Review Process
The completed Federal Form 990 is reviewed by both the Corporation's executive director and fiscal officer. Prior to signing and filing Form 990,the Executive Director presents Federal Form 990 to an officer of the Corporation's Board of Directors for final review and approval.
Form 990, Part III, Line 4d
Form 990, Part III, Line 4d: Other Program Services Description
OTHER PROGRAM SERVICES 4: Child Care Information Services (CCIS)Funded through the PA Department of Public Welfare provides Subsidized Child Care Services in Cameron, Elk, McKean, and Potter Counties. This program makes subsidies available for children in registered/licensed facilities as well as those children who receive services in relative/neighbor child care homes. The service is open to all eligible applicants with weekly co-payments determined by family size and household income. CCIS also provides consumer education in addition to resource and referral services.In FY 2012-2013 Child Care Information Servces provided services to 480 Individuals/ 215 Families OTHER PROGRAM SERVICES 5: HOMELESS ASSISTANCE PROGRAMS - Homeless Assistance Program (HAP)/ Human Services Development Fund (HSDF), Emergency Food and Shelter Program (EFSP) The Emergency Food & Shelter Program provides rental assistance economically disadvantaged families. The NTCAC Homeless Assistance Program funded through the Department of Public Welfare (DPW) and Cameron County, provides rental assistance to families who are in imminent danger of eviction or are currently homeless. Additional case management is provided through Cameron County HSDF. These programs are designed for stabilizing families in crisis situations who are in immediate need of housing. OTHER PROGRAM SERVICES 6: WORK READY OTHER PROGRAM SERVICES 7: Child and Adult Care Food Program - NTCAC sponsors the PA Department of Education, Child and Adult Care Food Program, which aids in the provision of nutritious meals to children in Head Start. In FY 2012 - 2013 the Child and Adult Care Food Program provided a total of 55,924 meals to 557 children enrolled in Head Start OTHER PROGRAM SERVICES 8: ENERGY ASSITANCE - These programs are of last resort in providing services to individuals meeting eligibility requirements who have exhausted all other means of assistance for purchasing deliverable fuels and/or are having problems meeting utility payments.In FY 2012 - 2013 Energy Assistance services were provided to 1364 Individuals/ 603 Families OTHER PROGRAM SERVICES 9: LOCAL PLANNING INITIATIVE OTHER PROGRAM SERVICES 10: HSSAP PROGRAM OTHER PROGRAM SERVICES 11: PRE-K COUNTS - NTCAC Pre-K Counts program in Cameron County provides curriculum designed to help children grow academically and socially in preparation for kindergarten entry. This program, working directly with school districts, served 15 children ages 3 to kindergarten eligible.In FY 2012 - 2013 Pre-K Counts services were provided to 19 Children/ 18 Families OTHER PROGRAM SERVICES 12: FOOD & NUTRITION PROGRAMS - Provides food boxes to low-income families. Food items are obtained through local donations and from funds and commodities provided by The Emergency Food Assistance Program (TEFAP), State Food Purchase Program (SFPP), and the funds and commodities provided by The Emergency Food Assistance Program (TEFAP), State Food Purchase Program (SFPP), and the items available to food banks in Cameron and Elk counties. NTCAC serves as the lead agency assisting local food banks with receiving, distribution and reporting. There are currently three food banks in Elk County and one in Cameron. In FY 2012 - 2013 Food & Nutrition services were provided distributing 10,134 boxes of food to 1882 Individuals/ 866 Families OTHER PROGRAM SERVICES 13:
Client Note 1 - We acknowledge that our Federal Form 990 has been filed past the extension due date. We assure you that it was not our intention to do so. During the 2013 calendar year, we experienced a change in our fiscal department which created hardships in our fiscal operations. In the process of getting everyone on board and accustomed to financial procedures, we inadvertently overlooked the filing date of our Federal Form 990. We are aware that late filing penalties can be charged by the Internal Revenue Service for filing returns past the extended due date; however, we are requesting your consideration in this matter and that penalties, if any, be waived. We have many years of unblemished tax compliance with the Internal Revenue Service and other tax collecting authorities. It is our policy that all tax filings, whether it be with Federal, State and/or Local governments, be completed professionally and in a timely manner. Regrettably this was not the case in this isolated instance. We are therefore requesting your consideration in this matter. Thank you.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.