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
SR FOUNDATION INC
Employer identification number
43-1684214
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.") ....
12,100
358
1,995
1,460
150
16,063
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
0
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
4
Total. Add lines 1 through 3
12,100
358
1,995
1,460
150
16,063
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)..
9,180
6
Public support. Subtract line 5 from line 4.
6,883
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..
12,100
358
1,995
1,460
150
16,063
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
18,468
18,468
0
0
0
36,936
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
0
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
0
11
Total support (Add lines 7 through 10).
52,999
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
12.987 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
17.983 %
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
SR FOUNDATION, INC. MEETS THE 10% FACTS AND CIRCUMSTANCES TEST BASED ON THE FOLLOWING CRITERIA: SR FOUNDATION, INC.'S PUBLIC SUPPORT COMES FROM A NUMBER OF UNRELATED DONORS. THE BOARD REPRESENTS A DIVERSE CROSS-SECTION OF THE METROPOLITAN COMMUNITY WITH LONG TRACK RECORDS OF COMMUNITY INVOLVEMENT. DAVID OLSEN IS THE FORMER CITY MANAGER OF THE CITY OF KANSAS CITY, MISSOURI AND PRESENTLY A RESIDENT OF THE NORTHERN AREAS OF THE METROPOLITAN CITY. HE CONTINUES IN HIS ACTIVE CIVIC INVOLVEMENT REPRESENTING THE DIVERSE INTERESTS OF THE COMMUNITY. PATRICIA WYATT, A RESIDENT OF THE SOUTHEASTERN AREA OF THE METROPOLITAN COMMUNITY, IS THE CHIEF EXECUTIVE OFFICER OF SWOPE RIDGE GERIATRIC CENTER, A REGISTERED NURSE WITH A LONG HISTORY OF SERVICE TO THE COMMUNITY AND AN IMPRESSIVE UNDERSTANDING OF LONG-TERM CARE AND THE NURSING AND HOSPITALITY INDUSTRIES, ALL OF WHICH UNIQUELY COINCIDE IN PROVIDING INSIGHT TO SUPPORT THE FRAIL ELDERLY OF THE CITY AND HOW THE CORPORATION CAN BEST ASSIST THOSE NEEDS OF THE COMMUNITY. LANDON ROWLAND, A RESIDENT OF THE NORTHEASTERN PART OF THE METROPOLITAN COMMUNITY, FORMER CHAIRMAN AND CHIEF EXECUTIVE OFFICER OF ONE OF KANSAS CITY'S LARGEST PRIVATE EMPLOYERS, CHAIR AND MEMBER OF THE LINC COMMISSION, FOUNDING MEMBER OF GREATER KANSAS CITY HEALTHCARE FOUNDATION AND CO-CHAIRMAN OF THE HEALTH COMMISSION OF KANSAS CITY. MR. ROWLAND'S COMMUNITY SERVICE AND PHILANTHROPY CROSS SOCIO-ECONOMIC AND ETHNIC BOUNDARIES. HE IS A CIVIC LEADER AND HIGHLY INVOLVED IN THE NEEDS OF THE COMMUNITY, SUPPORTING BOTH YOUTH AND SENIORS IN A BROAD ARRAY OF ACTIVITIES. ALBERT P. MAURO, COMMUNITY LEADER, PHILANTHROPIST, FORMER MEMBER OF THE KANSAS CITY, MISSOURI SCHOOL BOARD, AND WORKS IN SUPPORT OF HEALTH, EDUCATION AND WELFARE OF OUR CITIZENRY. MR. MAURO IS A RESIDENT OF THE CITY'S CORE. ROBERT C. COLLINS, FORMER CITY MANAGER OF THE CITY OF KANSAS CITY, MISSOURI, AND PROBLEM-SOLVER FOR THE URBAN ISSUES. MICHELLE SWEENEY, VICE PRESIDENT OF INGRAMS MAGAZINE, PHILANTHROPIST AND HIGHLY CONNECTED SOCIAL AND BUSINESS LEADER. MS. SWEENEY BRINGS INSIGHT AND GROUNDING TO THE ORGANIZATION IN MEETING ITS MISSION TO ASSIST THE FRAIL AND ELDERLY, LESS FORTUNATE OF OUR COMMUNITY. SUSAN MCGREEVY, ATTORNEY AND PHILANTHROPIST WITH A REGIONAL PRACTICE. MS. MCGREEVY REGULARLY LECTURES ON BOTH SOCIAL AND LEGAL ISSUES IMPACTING THE CONSTRUCTION INDUSTRY. SHE HAS BEEN A SUPPORTER OF THE FRAIL ELDERLY, LESS FORTUNATE OF OUR COMMUNITY FOR MORE THAN A DECADE, BEING INSTRUMENTAL IN BRINGING AFFORDABLE SENIOR HOUSING TO THE COMMUNITY, AND SHE IS A RESIDENT OF THE CITY'S CORE. GREG SPIES, AN ATTORNEY AND RESIDENT OF THE SOUTHWESTERN PART OF THE METROPOLITAN AREA, HAS BEEN A SUPPORTER OF HEALTHCARE INITIATIVES IN THE CITY'S CORE FOR MORE THAN TWO DECADES, ASSISTING WITH HEALTHCARE ISSUES AFFECTING DISADVANTAGED AND THE FRAIL ELDERLY OF THE COMMUNITY. THE UNIQUE BACKGROUNDS OF THE VARIOUS BOARD MEMBERS PROVIDE A SYNERGY TO MEET THE ORGANIZATION'S PURPOSE AND THE BROAD INTERESTS OF THE PUBLIC IN FULFILLING THOSE GOALS. THE BOARD MEMBERS IDENTIFIED ABOVE HAVE SPECIALIZED KNOWLEDGE IN HEALTHCARE, SOME ARE PUBLIC AND FORMER PUBLIC OFFICIALS, AND ALL CIVIC AND COMMUNITY LEADERS. THEY ASSIST IN PROVIDING THE DIRECTION, THROUGH THE CORPORATION AS IT AIDS THE FRAIL ELDERLY OF THE AREA PRESENTLY PROVIDING SUBSTANTIAL SUPPORT TO CARE CENTER OF KANSAS CITY IN ITS EFFORT TO UPGRADE AND ENHANCE ITS PROVISION OF SERVICES TO THE FRAIL ELDERLY WHILE EMPLOYING THE WORKING POOR. PUBLIC OFFICIALS PARTICIPATE IN THE PROGRAMS OF THE CORPORATION BY ASSISTING CARE CENTER OF KANSAS CITY WITH BOTH FINANCIAL AND ENGINEERING SUPPORT TO ENHANCE THE BRICKS AND MORTAR OF SWOPE RIDGE GERIATRIC CENTER WHILE THE CORPORATION ASSISTS IN PROVIDING THE SOFTER MATERIALS THAT PROVIDE A MEANINGFUL LIFE EXPERIENCE TO BOTH THE RESIDENTS AND EMPLOYEES OF SWOPE RIDGE GERIATRIC CENTER, AND AN ENHANCEMENT TO THE COMMUNITY AS A WHOLE. THE ORGANIZATION'S DEFINITIVE PROGRAM FOR ACCOMPLISHING ITS CHARITABLE WORK IS THREEFOLD: 1) ASSISTING SWOPE RIDGE GERIATRIC CENTER IN MEETING THE NEEDS OF THE FRAIL ELDERLY AND WORKING POOR THROUGH ITS ADJACENT FACILITY, 2) MAINTAINING AND ENHANCING THE COMMUNITY ATHEISTICALLY WHILE 3) EVALUATING POTENTIAL SYNERGISTIC USES AND COMPANIONS TO EFFICIENTLY UTILIZE THE ADDITIONAL LAND POSSESSED BY THE CORPORATION ADJACENT TO SWOPE RIDGE GERIATRIC CENTER WITH AN OVERALL GOAL TO PROVIDE A GENERAL CONTINUUM OF CARE TO THE FRAIL AND UNDERSERVED OF THE COMMUNITY CONSISTENT WITH THE NEW HEALTHCARE DIRECTION AND HEALTHCARE VISION OF THE FUTURE. IN LIGHT OF THE SUBSTANTIAL ECONOMIC DOWNTURN AND UNCERTAINTY OF THE DIRECTION OF HEALTHCARE, THE CORPORATION IS WITHHOLDING ITS DECISIONS ON BEST UTILIZATION OF ITS REAL ESTATE UNTIL THOSE PLANS CAN BE MORE FIRMLY DEVELOPED TO AVOID MISSTEPS THAT HAVE PLAGUED HEALTHCARE AND SOCIAL NEEDS FACILITIES IN TIMES OF SOCIAL CHANGE.
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
SR FOUNDATION INC
Employer identification number
43-1684214
Identifier
Return Reference
Explanation
OTHER EXPENSES SCHEDULE
FORM 990EZ PART I LINE 16
Description:REGISTRATION & FEES Amount:116
OTHER EXPENSES SCHEDULE
FORM 990EZ PART I LINE 16
Description:TAXES Amount:3082
OTHER ASSETS SCHEDULE
FORM 990EZ PART II LINE 24
Description:NOTE RECEIVABLE - SRGC BOY Amount:455296 EOY Amount:430296
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.