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
RICHLAND SCHOOL DISTRICT FOUNDATION INC
Employer identification number
39-1829289
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)
No
(ii)
A family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
A 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
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
(A)
RICHLAND SCHOOL DISTRICT
396004159
SCHOOL
Yes
Yes
Yes
0
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 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
RICHLAND SCHOOL DISTRICT FOUNDATION INC
Employer identification number
39-1829289
Return Reference
Explanation
Description of other revenue Part I line 8
Description AmountPRIME RIB SALES 154
List of grants and similar amounts paid Part I line 10
Activity LINCOLN SCHOLARSHIP Grantee LINDSAY SCOTT Street P O BOX 126 City, State, Zip Richland Center, WI 53581Amount 1,000Activity LINCOLN SCHOLARSHIP Grantee HEIDI UNBEHAUN Street 27432 COUNTY HWY O City, State, Zip Richland Center, WI 53581Amount 1,000Activity LINCOLN SCHOLARSHIP Grantee DEVIN KEPLER Street 15725 KEPLER LANE City, State, Zip Viola, WI 54664Amount 1,000Activity MASONIC SCHOLARSHIP Grantee ABBEY BERANEK Street 800 SUMMIT DR City, State, Zip Richland Center, WI 53581Amount 250Activity RUTH DOBBS SCHOLARSHIP Grantee DANA PETERSON Street 18264 US HWY 14 City, State, Zip Richland Center, WI 53581Amount 250Activity OLETA HINES SCHOLARSHIP Grantee STEPHANIE COOPER Street 15658 MAIN ST City, State, Zip Richland Center, WI 53581Amount 2,000Activity FAMILY THRIFT SHOP Grantee STEPHANIE COOPER Street 15658 MAIN ST City, State, Zip Richland Center, WI 53581Amount 250Activity KOHN SCHOLARSHIP Grantee KACIE HOFER Street 695 S CAIRNS AVENUE City, State, Zip Richland Center, WI 53581Amount 250Activity MASONIC SCHOLARSHIP Grantee EVAN EWING Street 926 VALLEY VIEW DRIVE City, State, Zip Richland Center, WI 53581Amount 250Activity OLETA HINDS SCHOLARSHIP Grantee KELSEY COLLINS Street 523 E 8TH STREET City, State, Zip Richland Center, WI 53581Amount 2,000Activity FAMILY THRIFT SHOP SCHOLARSHIP Grantee ROSS BEIER Street 23527 COVERED BRIDGE DR City, State, Zip Richland Center, WI 53581Amount 250Activity KEN BEATTY Grantee KARISSA SIME Street 27041 COUNTY HWY U City, State, Zip Soldiers Grove, WI 54655Amount 500Activity MORA & GARRISON LINCOLN SCHOLARSHIP Grantee BRIDGET RAVIS Street 713 S JAMES ST City, State, Zip Richland Center, WI 53581Amount 1,000Activity FAMILY THRIFT SHOP SCHOLARSHIP Grantee EMILY ANDERSON Street 25665 HILLSIDE LANE City, State, Zip Richland Center, WI 53581Amount 250Activity RICHLAND HOSPITAL HEALTH CARE SCHOLARSHIP Grantee EMILY EKLEBERRY Street 16504 HILL ROAD City, State, Zip Muscoda, WI 53573Amount 250Activity MASONIC LODGE 16 SCHOLARSHIP Grantee ADAM MORTIMER Street 31424 SLOW LANE City, State, Zip Lone Rock, WI 53556Amount 200Activity AVITUS AND JULIE RIPP Grantee MCKENZIE WILSON Street 610 E 2ND STREET City, State, Zip Richland Center, WI 53581Amount 500Activity CHRIS DURST SCHOLARSHIP Grantee JULIA SMITH Street 850 W PARKVIEW DR City, State, Zip Richland Center, WI 53581Amount 500Activity JAMES ALTMAN SCHOLARSHIP Grantee MIKAYLA LAUE Street 23594 BLOOD LANE City, State, Zip Richland Center, WI 53581Amount 1,000Activity TOM MULLARKEY SCHOLARSHIP Grantee ALEC ADSIT Street 17146 COUNTY NN City, State, Zip Richland Center, WI 53581Amount 1,000Activity WILLIAM HUBRICK SCHOLARSHIP Grantee COLTON BARTO Street 1430 N CEDAR ST City, State, Zip Richland Center, WI 53581Amount 500Activity WRCO SCHOLARSHIP Grantee MELISSA HOUMAN Street 1600 W SEMINARY ST City, State, Zip Richland Center, WI 53581Amount 500Activity WALLACE COOPER ELLIOTT SCHOLARSHIP Grantee MATTHEW NELSON Street 565 N CENTRAL AVENUE City, State, Zip Richland Center, WI 53581Amount 500Activity STRANG FAMILY SCHOLARSHIP Grantee BROOKLYN EWING Street 1515 RAINBOW DR City, State, Zip Richland Center, WI 53581Amount 500Activity HOLO ADIX HOMESTEAD SCHOLARSHIP Grantee GRACIELA RUBIO Street 708 N CONGRESS ST City, State, Zip Richland Center, WI 53581Amount 1,000Activity SANDY REETZ SCHOLARSHIP Grantee MIKAYLA NIGL Street 361 N PAEK ST City, State, Zip Richland Center, WI 53581Amount 500Activity RSDF SCHOLARSHIP Grantee EMILY PHETTEPLACE Street 562 E SEMINARY ST City, State, Zip Richland Center, WI 53581Amou
Description of other expenses Part I line 16
Description AmountWEBSITE 22FOOD 155BANK SERVICE FEES 43SUPPLIES 212DEPT OF FINANCIAL INSTITUTIONS FEE 10GIFT TO KEN HANSEN 25
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.