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
CHADDOCK
Employer identification number
37-0661191
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.") ....
2,746,687
3,218,119
1,982,453
1,431,260
1,497,054
10,875,573
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
2,746,687
3,218,119
1,982,453
1,431,260
1,497,054
10,875,573
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)..
2,074,757
6
Public support. Subtract line 5 from line 4.
8,800,816
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..
2,746,687
3,218,119
1,982,453
1,431,260
1,497,054
10,875,573
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
79,467
98,399
110,345
116,177
97,556
501,944
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).
11,377,517
12
Gross receipts from related activities, etc. (see instructions)
..................
12
45,343,895
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
77.353 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
68.55 %
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:
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
CHADDOCK
Employer identification number
37-0661191
Identifier
Return Reference
Explanation
F990_P06_S0B_L11b
Form 990, Part VI, Section B, Line 11b
FORM 990, INCLUDING ATTACHMENTS, IS PREPARED BY THE ASSOCIATE DIRECTOR OF FINANCE. THE FORM IS REVIEWED BY THE DIRECTOR OF FINANCE AND PRESIDENT/CEO FOR COMPLETENESS. ANY MAJOR CHANGES TO THE REQUIREMENTS OF THE FORM ARE REVIEWED WITH THE BOARD RESOURCE COMMITTEE WHO REVIEWS ALL FINANCIAL MATTERS. THE BOARD APPOINTS A SPECIAL COMMITTEE OF THREE BOARD TRUSTEES TO REVIEW THE FORM IN DETAIL WITH THE DIRECTOR OF FINANCE. THEY RECEIVE AN EXPLANATION OF THE VARIOUS SECTIONS OF THE FORM, THE REQUIRED SCHEDULES ATTACHED, AND EACH QUESTION IN PART VI (CHECKLIST), PART V (COMPLIANCE), AND PART VI (GOVERANANCE, MANAGEMENT, AND DISCLOSURE). NOTIFICATION OF APPROVAL BY THE SPECIAL COMMITTEE IS EMAILED TO ALL BOARD MEMBERS ALONG WITH A COPY OF THE FORM 990.
F990_P06_S0B_L12c
Form 990, Part VI, Section B, Line 12c
THE BOARD OF TRUSTEES ARE PROVIDED A COPY OF THE CONFLICT OF INTEREST POLICY. AFTER DISCUSSION, EACH BOARD MEMBER IS PROVIDED A FORM CALLED CONFLICT OF INTEREST POLICY ANNUAL DISCLOSURE FORM AND REQUESTED TO COMPLETE THE FORM. THE EXECUTIVE ADMINISTRATIVE ASSISTANT KEEPS A LIST OF ALL FORMS RETURNED AND FOLLOWS UP WITH BOARD MEMBERS UNTIL ALL ARE RECEIVED. THE FORMS ARE REVIEWED FOR COMPLETENESS BY THE PRESIDENT/CEO AND THE DIRECTOR OF OPERATIONS TO BE MADE AWARE OF ANY POTENTIAL CONFLICTS OF INTEREST. THE PRESIDENT/CEO ALSO CONFERS WITH THE BOARD MEMBERS AS QUESTIONS OR OTHER NEEDS ARISE. IF A TRANSACTION OR OTHER MATTER ARISES FOR ACTION AT A BOARD MEETING, THE BOARD MEMBER WITH THE CONFLICT WILL EXPLAIN THAT A CONFLICT EXISTS AND WILL ABSTAIN FROM VOTING ON THE MATTER.
F990_P06_S0B_L15
Form 990, Part VI, Section B, Line 15
THE BOARD OF TRUSTEES EXECUTIVE COMMITTEE CONSISTING OF OFFICERS OF THE BOARD PERFORM AN ANNUAL EVALUATION OF THE PRESIDENT/CEO, WHO PROVIDES THE BOARD WITH CERTAIN INFORMATION ABOUT THE PERFORMANCE OF THE AGENCY IN THE LAST YEAR. THE EXECUTIVE COMMITTEE USES THE INFORMATION AS WELL AS REVIEWS COMPENSATION SURVEYS FROM THE ALLIANCE FOR CHILDREN AND FAMILIES, THE UNITED METHODIST ASSOCIATION, AND THE CHILD CARE AGENCIES OF ILLINOIS TO DETERMINE COMPENSATION FOR THE PRESIDENT/CEO FOR THE COMING YEAR. THE BOARD CHAIRPERSON THEN SENDS AN EMAIL TO NOTIFY THE DIRECTOR OF HUMAN RESOURCES OF THE NEW COMPENSATION AMOUNT. THE COMPENSATION FOR ALL OTHER POSITIONS OF THE AGENCY ARE DETERMINED AT HIRE BASED ON THE JOB DESCRIPTION AND THE EXPERIENCE OF THE STAFF. A SALARY RANGE HAS BEEN DETERMINED FOR EACH CATEGORY OF JOBS AND HAS BEEN COMPARED TO SALARY SURVEYS FROM THE AGENCIES NOTED ABOVE. THE DIRECTOR OF HUMAN RESOURCES CONSULTS WITH THE PRESIDENT/CEO AND/OR THE DEPARTMENT DIRECTOR AND THE DIRECTOR OF FINANCE TO SET THE STARTING SALARY. ALL CURRENT EMPLOYEES OF THE AGENCY PARTICIPATE IN ANNUAL PERFORMANCE EVALUATION PROCESS THAT INCLUDES RATINGS ON CORE COMPETENCIES AND THE AGENCY VALUES BY THEIR IMMEDIATE SUPERVISORS AND BY THE EMPLOYEE THEMSELVES. A LIST OF STRENGTHS AND AREAS FOR IMPROVEMENT IS ALSO COMPLETED. THE SCORE FROM THIS EVALUATION IS USED TO DETERMINE WHETHER THE EMPLOYEE RECEIVES THE % INCREASE SET BY THE AGENCY FOR THE COMING YEAR. THE PRESIDENT/CEO IS THE IMMEDIATE SUPERVISOR OF THE DIRECTOR OF FINANCE AND USES THE ABOVE PROCESS TO DETERMINE THE ANNUAL INCREASE FOR THE COMING YEAR.
F990_P06_S0C_L19
Form 990, Part VI, Section C, Line 19
THE AGENCY MAKES THESE DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST BY ALLOWING INSPECTION AT THE FINANCE DEPARTMENT OFFICES OF THE AGENCY. THE AUDITED FINANCIAL STATEMENTS ARE ALSO INCLUDED ON THE AGENCY WEBSITE FOR COMPLIANCE WITH THE STATE FILING FOR ADOPTION SERVICES.
F990_P09_S00_L11g
Form 990, Part IX, Line 11g
PSYCHIATRIC AND MENTAL HEALTH CONSULTATION FEES
F990_P11_S00_L09
Form 990, Part XI, Line 9
NON DEDUCTIBLE EXPENSES FROM K-1 $-1765
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.