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
EXCHANGE CLUB FAMILY CENTER INC
Employer identification number
62-1237360
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
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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(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 2012 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
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.") .
321,613
286,815
457,878
529,061
548,507
2,143,874
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......
358,758
349,076
112,389
81,399
68,134
969,756
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
90,138
76,576
84,789
59,614
62,397
373,514
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.
770,509
712,467
655,056
670,074
679,038
3,487,144
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
31,792
98,972
24,089
30,467
55,974
241,294
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..
31,792
98,972
24,089
30,467
55,974
241,294
8
Public support (Subtract line 7c from line 6.)
3,245,850
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...
770,509
712,467
655,056
670,074
679,038
3,487,144
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
3
512
1,400
1,915
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
3
512
1,400
1,915
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.)..
770,512
712,467
655,568
670,074
680,438
3,489,059
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
93.030 %
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
93.770 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
0 %
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
EXCHANGE CLUB FAMILY CENTER INC
Employer identification number
62-1237360
Identifier
Return Reference
Explanation
ADDITIONAL INFORMATION
FORM 990
FORM 990, OTHER DISCLOSURES A MEMBER OF THE BOARD OF DIRECTORS IS EMPLOYED BY THE COMPANY THAT ADMINISTERS THE ORGANIZATION'S RETIREMENT PLAN. THIS BOARD MEMBER NORMALLY RECEIVES A COMMISSION OF LESS THAN 100 ANNUALLY FOR MANAGING THE ACCOUNT. THIS TRANSACTION IS NOT REQUIRED TO BE REPORTED ON SCHEDULE L BUT IS NOTED HERE FOR FULL DISCLOSURE. FORM 990, PART IX, LINE 25 DURING THE YEAR ENDING JUNE 30, 2013, THE ORGANIZATION COMPLETED BOTH AN ORGANIZATIONAL ASSESSMENT AND A DEVELOPMENT PLAN TO ENSURE THE ORGANIZATION IS POISED TO BEST IMPLEMENT THE PROGRAM SERVICES NEEDED BY THE COMMUNITY AND TO INCREASE THE FUNDING TO MEET THAT GOAL. ACCORDINGLY, THE ORGANIZATION INCURRED PROFESSIONAL FEES TOTALING 11,750 FOR OUTSIDE EXPERTS TO ASSIST IN THESE TASKS. THESE FEES ARE INCLUDED ON THE STATEMENTS OF FUNCTIONAL EXPENSES AS PROFESSIONAL FEES AND ARE ALLOCATED BETWEEN MANAGEMENT AND GENERAL (7,725) AND FUNDRAISING (4,025). MANAGEMENT IS OF THE OPINION THAT THESE ARE NON-RECURRING EXPENSES.
ANY SIGNIFICANT CHANGES IN CONDUCT FOR PROGRAM SERVICES
FORM 990, PAGE 2, PART III, LINE 3
DURING THE FISCAL YEAR, THE ORGANIZATION ELIMINIATED TWO (2) PROGRAMS: "SUPERVISED VISITS" AND "SAFE EXCHANGE".
MANAGEMENT DELEGATED
FORM 990, PAGE 6, PART VI, LINE 3
THE ORGANIZATION CONTRACTS WITH A FORMER STAFF MEMBER (FORMERLY THE ASSOCIATE DIRECTOR) FOR PROVISION OF SUPERVISION TO THE CLINICAL STAFF AND PREPARATION OF BUDGETS FOR GRANT APPLICATIONS BASED ON THE ANNUAL BUDGET.
SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS
FORM 990, PAGE 6, PART VI, LINE 4
EFFECTIVE MAY 20, 2013, THE BYLAWS WERE AMENDED. IN THIS AMENDMENT, THE COMPOSITION OF THE BOARD OF DIRECTORS WAS CHANGED TO INCLUDE THE REQUIREMENT THAT A MINIMUM OF TWENTY PERCENT (20%) MUST BE MEMBERS OF EXCHANGE CLUBS. IN ADDITION, TWO NEW OFFICERS (PRESIDENT-ELECT AND IMMEDIATE PAST PRESIDENT) WERE ADDED.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
THE AUDIT COMMITTEE AND EXECUTIVE DIRECTOR REVIEW THE FORM 990, PRIOR TO FILING.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
THE ORGANIZATION MONITORS ITS CONFLICT OF INTEREST POLICY BY REQUIRING MEMBERS TO COMPLETE A DISCLOSURE FORM ANNUALLY AND ANY CONFLICTS ARE DISCUSSED AT A SUBSEQUENT BOARD MEETING, WHERE A VOTE IS TAKEN. THE POLICY IS ALSO INCLUDED IN THE BOARD TRAINING.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
A COMPENSATION STUDY IS PERFORMED EVERY 2-3 YEARS. IN THE INTERIM, THE EXECUTIVE COMMITTEE REVIEWS THE COMPENSATION STUDY PREVIOUSLY OBTAINED, PERFORMS AN ANNUAL REVIEW OF THE EXECUTIVE DIRECTOR AND MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. THE FINANCIAL STATEMENTS ARE AVAILABLE ON THE WEBSITES FOR GIVING MATTERS AND GUIDESTAR.
ADDITIONAL INFORMATION
FORM 990, PART XI
CHANGE IN VALUE OF BENEFICIAL INTEREST IN ENDOWMENT FUND 2,115
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.