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
DIVERSIFIED FAMILY SERVICES INC
Employer identification number
25-1576497
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.") ....
4,483,873
5,944,377
6,190,158
6,797,989
7,587,747
31,004,144
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
0
0
0
0
0
0
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
0
0
0
0
0
4
Total. Add lines 1 through 3
4,483,873
5,944,377
6,190,158
6,797,989
7,587,747
31,004,144
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.
31,004,144
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..
4,483,873
5,944,377
6,190,158
6,797,989
7,587,747
31,004,144
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
11,486
17,520
51,981
13,059
61,404
155,450
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
0
0
0
0
0
0
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
193,167
387,872
355,421
407,667
557,994
1,902,121
11
Total support (Add lines 7 through 10).
33,061,715
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
93.777 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
94.150 %
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
This figure represents client room and board payments, rent rebates, and food stamps. This total also includes the revenue generated by the service area program activities for selling client items made, cleaning services provided, etc.
Schedule A (Form 990 or 990-EZ) 2012
Additional Data
Software ID:
12000197
Software Version:
v1.00
-
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
DIVERSIFIED FAMILY SERVICES INC
Employer identification number
25-1576497
Identifier
Return Reference
Explanation
F990_P06_S0A_L06
Form 990, Part VI, Section A, Line 6
As a nonprofit corporation, dFs has members. Members are eligible to vote from the proposed ballot of the Board of Directors at the annual meeting. Each member shall be entitled to one vote on any matter submitted to a vote.
F990_P06_S0A_L07a
Form 990, Part VI, Section A, Line 7a
Members shall be eligible to vote from the proposed ballot of the Board of Directors at the annual meeting. Each member shall be entitled to one vote on any matter submitted to a vote of the members.
F990_P06_S0B_L11b
Form 990, Part VI, Section B, Line 11b
The 990 is emailed/mailed to the members of the Board prior to submitting it. The Audit/Finance Committee reviews the 990 and makes recommendations for revision. The Audit/Finance committee recommends the acceptance of the 990 to the Board.
F990_P06_S0B_L12c
Form 990, Part VI, Section B, Line 12c
Procedures for the Review of Actual or Potential Conflicts: Where an actual or potential conflict exists between interests of dFs and an interested party, dFs will refrain from the proposed action or transaction until such time as the proposed action or transaction has been approved by the disinterested members of the Board of Directors. The Director's presence may be counted in determining quorum for any vote with respect to a dFs business transaction which he or she has a possible conflict of interest. However, the interested party, who has the actual or potential interest, shall not participate in any way, or be present during the deliberations and decision making of dFs with respect to such actions or transactions. The interested party may, upon request, be available to answer any questions or provide material factual information about the proposed action or transaction. The disinterested members of the Board may approve the proposed action or transaction upon finding that it is in the best interest of the organization in which the terms are at least fair and reasonable to dFs as those which would otherwise be available to dFs if it were dealing with an unrelated party, and whether it would be possible, with reasonable effort, to find a more advantageous arrangement with a party or entity that is not an interested party. Approval by the disinterested members of the Board shall reflect that the conflict disclosure was made, the vote was taken, and that the interested party abstained from the discussion and voting. A written record of any report of possible conflict and of any adjustments made to avoid possible conflicts of interest shall be kept by the Executive Director, or where applicable, in the Board file.
F990_P06_S0B_L15
Form 990, Part VI, Section B, Line 15
The Compensation Review Committee of the Board of Directors reviewed the wages & benefits for the following key employees: Executive Director, Program Director, Administrative Office & Accountant in 2013. The primary guidelines for external competitiveness were the median salary agencies of "Budget Size" and "Agencies Outside of Allegheny County" in the most recent "Wage and Benefit Survey of Southwestern PA Nonprofit Organizations." Secondary factors were taken into consideration depending upon the specific positions were "Primary Source of Funding";"Number of Employees"; and "Level of Education Required." Also for management positions, "Number of Years in Position" and "Number of Employees Managed" were considered. Within the given parameters, compensation will be linked to individual performance. The Compensation Review Committee recommends salary & benefits which were approved by the full Board of Directors.
F990_P06_S0C_L19
Form 990, Part VI, Section C, Line 19
The agency's 990, which includes financial statements, is posted on Guidestar. The mission statement is on the agency brochure and also on the agency website. The articles of incorporation and bylaws are on file with the PA Corporation Bureau. Board minutes and the annual financial statement are made available upon request.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2012
Additional Data
Software ID:
12000197
Software Version:
v1.00
-
TIN:
TY 2012 ReasonableCauseExplanation
Name:
DIVERSIFIED FAMILY SERVICES INC
EIN: 25-1576497
Software ID:12000197
Software Version:v1.00
Explanation:
dFs is required to participate in the single county audit performed for Mercer County Behavioral Health Commission. We had not received our final audited financial statements until the end of February.