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
COMMUNITY ACTION SOUTHWEST
Employer identification number
25-1153028
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.") ....
12,851,137
13,536,985
13,628,728
12,046,326
11,212,359
63,275,535
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
12,851,137
13,536,985
13,628,728
12,046,326
11,212,359
63,275,535
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.
63,275,535
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..
12,851,137
13,536,985
13,628,728
12,046,326
11,212,359
63,275,535
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
58,008
46,081
24,579
30,816
27,811
187,295
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
172,823
245,729
381,786
453,019
232,797
1,486,154
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
61,305
65,734
59,236
62,374
100,972
349,621
11
Total support (Add lines 7 through 10).
65,298,605
12
Gross receipts from related activities, etc. (see instructions)
..................
12
1,327,828
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
96.900 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
97.140 %
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:
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.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
COMMUNITY ACTION SOUTHWEST
Employer identification number
25-1153028
Identifier
Return Reference
Explanation
ORGANIZATION'S MISSION
FORM 990 - ORGANIZATION'S MISSION
COMMUNITY ACTION SOUTHWEST SERVES AS A CATALYST TO MOBILIZE THE RESOURCES OF THE ENTIRE COMMUNITY TO ENABLE FAMILIES AND INDIVIDUALS IN SOUTHWESTERN PENNSYLVANIA TO OBTAIN THE SKILLS, KNOWLEDGE, MOTIVATIONS AND OPPORTUNITIES TO BECOME SELF-SUFFICIENT.
ALL OTHER ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4D
SENIOR SERVICES: SENIOR SERVICES COORDINATE THE PLANNING AND DELIVERY OF CARE TO OLDER ADULTS TO IMPROVE THE QUALITY OF LIFE. THE SERVICES PROVIDED INCLUDE SENIOR CENTER ACTIVITIES, CONGREGATE MEALS, HOME DELIVERED MEALS AND CARE MANAGEMENT. NUTRITION: PRIMARILY CONSISTS OF THE WOMEN INFANTS & CHILDREN (WIC) PROGRAM WHICH PROVIDES A RANGE OF NUTRITION SERVICES IN A SUPPORTIVE ENVIRONMENT FOR PREGNANT WOMEN, POSTPARTUM AND BREASTFEEDING WOMEN, AND INFANTS AND CHILDREN UNDER AGE FIVE WHO RESIDE IN WASHINGTON OR GREENE COUNTIES. DOC SOLUTIONS: SUBSIDIARY OF COMMUNITY ACTION SOUTHWEST THAT WAS ESTABLISHED AS AN ELECTRONIC ARCHIVING BUSINESS WHICH INCLUDES ON-LINE HOSTING OF DOCUMENTS AND DATA AS A FOR-PROFIT ENTITY AND TO PROVIDE JOBS AND TRAINING FOR LOW- INCOME INDIVIDUALS.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
FORM 990 IS REVIEWED & APPROVED BY THE BOARD FINANCE & AUDIT COMMITTEE AND THEN FORWARDED TO THE FULL BOARD FOR REVIEW AND APPROVAL BEFORE IT IS FILED.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
THE CONFLICT OF INTEREST POLICY IS SIGNED AT THE JANUARY BOARD MEETING EVERY YEAR. IF ANY BOARD MEMBER OR OFFICER HAS A CONFLICT OF INTEREST IT SHOULD BE DISCLOSED IN WRITING WHEN THE POLICY IS SIGNED. IN ADDITION, IF ANY CONTRACTS OR PURCHASES ARE ENTERED INTO BY BOARD MEMBERS OR OFFICERS AFTER THE SIGNING OF THE POLICY THEY SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS BEFORE ANY CONTRACT OF TRANSACTIONS IS CONSUMATED. THIS POLICY ALSO IS ADHERED TO BY KEY EMPLOYEES OF DOC SOLUTIONS.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
THE CHIEF ECEVUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS BASED ON COMPARABILITY STUDIES, AND THE CEO'S PROGRAM YEAR PERFORMANCE AND ACHIEVEMENT OF THE GOALS SET FOR THE YEAR. OFFICERS AND EMPLOYEES COMPENSATION IS BASED ON WAGE COMPARABILITY STUDIES, UNION CONTRACTS AND FUNDING SOURCE REQUIREMENTS. ALL EMPLOYEES' COMPENSATION IS APPROVED BY THE BOARD OF DIRECTORS.
COMPENSATION PROCESS FOR OFFICERS
FORM 990, PAGE 6, PART VI, LINE 15B
DOC SOLUTIONS EMPLOYEES COMPENSATION IS APPROVED BY THE CEO OF COMMUNITY ACTION SOUTHWEST, BASED ON WAGE COMPARABILITY STUDIES AND FUNDING SOURCE REQUIREMENTS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
COMMUNITY ACTIONS SOUTHWEST MAKES AVAILABLE TO THE PUBLIC ALL DOCUMENTS UPON WRITTEN REQUEST. IN ADDITION, FORM 990 IS AVAILABLE ON GUIDESTAR.ORG.
RECONCILIATION OF CHANGES - OTHER
FORM 990, PART XI, LINE 9
FUNDRAISING 36,054 FUNDRAISING -36,054
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.