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
100 BLACK MEN OF METROPOLITAN BATON ROUGE LTD
Employer identification number
72-1235682
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.") ....
178,789
102,216
107,537
129,628
153,408
671,578
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
178,789
102,216
107,537
129,628
153,408
671,578
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.
671,578
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..
178,789
102,216
107,537
129,628
153,408
671,578
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
2,927
3,134
3,080
3,125
3,371
15,637
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.)..
312
8,056
3,247
8,395
6,151
26,161
11
Total support (Add lines 7 through 10).
713,376
12
Gross receipts from related activities, etc. (see instructions)
..................
12
5,337
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
94.140 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
79.720 %
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.)
0
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
0 %
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
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).
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
100 BLACK MEN OF METROPOLITAN BATON ROUGE LTD
Employer identification number
72-1235682
Identifier
Return Reference
Explanation
Pt VI, Line 6
THE ORGANIZATION IS A MEMBERSHIP ORGANIZATION
Pt VI, Line 7a
THE FULL MEMBERSHIP ELECTS THE OFFICERS AND DIRECTORS
Pt VI, Line 10b
WE DO NOT HAVE WRITTEN POLICIES AND PROCEDURES GOVERING THE
Pt VI, Line 10b
ACTIVITIES OF THE COLLEGIATE 100 BRANCH OF OUR ORGANIZATION.
Pt VI, Line 10b
HOWEVER, ACITIVITES OF THE COLLEGIATE 100 ARE MANAGED AND MONITORED
Pt VI, Line 10b
BY MEMBERS OF THE MAIN ORGANIZATION TO ENSURE CONSISTENCY WITH OUR EXEMPT PURPOSES.
Pt VI, Line 11b
FORM 990 IS PREPARED BY THE ORGANIZATION'S CPA AND REVIEWED
Pt VI, Line 11b
WITH ITS FISCAL OFFICER BEFORE BEING FILED. IF TIME PERMITS,
Pt VI, Line 11b
THE 990 WILL BE PRESENTED TO THE BOARD FOR REVIEW AND
Pt VI, Line 11b
COMMENT BEFORE FILING. THIS YEAR'S 990 WAS REVIEWED WITH THE BOARD ON MAY 7, 2014.
Pt VI, Line 12c
ANNUALLY THE OFFICERS AND BOARD DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS
Pt VI, Line 15b
THE ORGANIZATION'S MANAGER IS HIRED AT A FIXED SALARY WHEN
Pt VI, Line 15b
HE FIRST TAKES THE JOB. THE SALARY HE IS PAID IS DISCUSSED
Pt VI, Line 15b
AND DELIBERATED BY THE BOARD PRIOR TO HIRING. IF ANY FUTURE
Pt VI, Line 15b
RAISES OR BONUSES ARE LATER AWARDED THEY ARE ALSO DISCUSSED
Pt VI, Line 15b
BY THE BOARD BEFORE BEING PAID TO THE ORGANIZATION'S MANAGER.
Pt VI, Line 19
THESE DOCUMENTS ARE AVAILABLE AT THE ORGANIZATION'S MAIN OFFICE
Pt VI, Line 19
AND WILL BE MADE AVAILABLE FOR REVIEW AT THAT OFFICE SHOULD
Pt VI, Line 19
ANYONE ASK TO SEE THEM
Pt XI
THE $11,806 ON LINE 5 REPRESENTS THE INCREASE IN UNREALIZED
Pt XI
APPRECIATION OF MUTUAL FUND INVESTMENTS DURING THE YEAR
Form 990EZ, Part I, Line 8
MERCHANDISE SALES 690.
Form 990EZ, Part I, Line 10
SCHOLARSHIP SCHOLARSHIP BARANCO CLARK YMCA NONE 1000. SCHOLARSHIP SCHOLARSHIP DARRELL FORTENBERRY NONE 500. SCHOLARSHIP SCHOLARSHIP JOSHUA L. COURTNEY NONE 500. SCHOLARSHIP SCHOLARSHIP WILLIAM B. TILLEY NONE 500.
Form 990EZ, Part I, Line 16
ADVERTISING 2069. ANNUITY PREMIUM 0. AWARDS AND RECOGNITION 12691. BANK SERVICE CHARGES 639. BANQUETS 691. BOOKS AND PUBLICATIONS 2486. CONFERENCES AND CONVENTIONS 18569. DUES AND SUBSCRIPTIONS 4836. ENTERTAINMENT 2300. EQUIPMENT RENT & POST OFFICE BOX RENT 0. EVENT SPONSORSHIPS 6488. FILING FEE 0. FLOWERS AND GIFTS 1667. INTEREST EXPENSE 1. MEALS & REFRESHMENTS 5234. MENTEE ACTIVITIES 3685. MILEAGE AND CELLPHONE REIMBURSEMENT 0. MISCELLANEOUS 0. OFFICE EXPENSE 1172. PAYROLL TAXES 3430. PHOTOGRA
Form 990EZ, Part I, Line 20
UNREALIZED GAIN - INCREASE IN FAIR MARKET VALUE OF MUTUAL FUNDS 11806.
Form 990EZ, Part II, Line 24
RECEIVABLE FROM LORIN CRENSHAW 2500. 2500. UNCONDITIONAL PROMISES TO GIVE 12000. 0. PREPAID EXPENSES 1000. 0.