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
CITY ON A HILL INC
Employer identification number
39-2017873
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) 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.") .
607,442
531,349
551,746
621,285
655,409
2,967,231
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......
323,481
293,132
328,327
296,611
325,142
1,566,693
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
7,730
12,979
54,685
7,491
82,885
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.
930,923
832,211
893,052
972,581
988,042
4,616,809
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
140,987
57,355
138,540
95,910
87,475
520,267
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.
131,003
166,625
143,315
130,246
157,484
728,673
c
Add lines 7a and 7b..
271,990
223,980
281,855
226,156
244,959
1,248,940
8
Public support (Subtract line 7c from line 6.)
3,367,869
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...
930,923
832,211
893,052
972,581
988,042
4,616,809
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.)..
930,923
832,211
893,052
972,581
988,042
4,616,809
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
72.950 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
73.270 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
0 %
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
CITY ON A HILL INC
Employer identification number
39-2017873
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 4
THE FOLLOWING CHANGES WERE MADE TO THE ORGANIZATION'S BYLAWS. 1. TO SPECIFY THAT CITY ON A HILL WILL ACCEPT IN-KIND GIFTS (OF ITEMS SUCH AS VEHICLES, PROPERTY, TIME SHARES) ONLY AFTER DETERMINING THAT THEY WILL NOT UNDULY ENCUMBER THE MINISTRY. 2. TO CLARIFY THE BOARD OF PRESBYTERS RESERVE POWERS TO INCLUDE: A. APPROVAL OF LOANS B. HIRING OF THE EXECUTIVE DIRECTOR C. APPROVAL OF SALE OR TRANSFER OF PROPERTY IN ADDITION TO: D. APPROVAL OF AMENDMENTS TO ARTICLES OF INCORPORATION OR BYLAWS E. ELECTION OF BOARD OF DIRECTORS F. APPROVAL OF OPERATING, CAPITAL AND CONSTRUCTION BUDGETS G. APPROVAL OF MERGERS AND DISSOLUTIONS BUT TO EXCLUDE: APPROVAL OF CAPITAL PURCHASES ALREADY INCLUDED IN THE MINISTRY'S ANNUAL BUDGET. 3. TO ALLOW THE ANNUAL MEETING OF THE "CORPORATE MEMBERS" (PRESBYTERS) TO OCCUR ANYTIME DURING THE YEAR. 4. TO INCREASE THE CORPORATE MEMBER MEETING QUORUM REQUIREMENT FROM 10% TO 30%. 5. TO CHANGE BOARD TERMS OF OFFICE FROM 1 YEAR TO "UP TO 3 YEARS." 6. TO ALLOW THE COAH ANNUAL BOARD MEETING TO OCCUR ANYTIME DURING THE FIRST QUARTER OF THE YEAR. 7. TO INCREASE THE COAH BOARD MEETING QUORUM NUMBER FROM 40% TO 50%. 8. TO CLARIFY THE ROLE OF PRESIDENT OF THE CORPORATION - FILLED BY THE CHAIRMAN OF THE BOARD OF COAH, AND THE ROLE OF EXECUTIVE DIRECTOR - THE PERSON WHO LEADS THE MINISTRY AND CARRIES OUT THE DIRECTIVES OF THE BOARD OF COAH AND ADHERES TO THE POLICIES OF THE BOARD OF PRESBYTERS. 9. TO SPECIFY THAT THE ROLES OF PRESIDENT AND SECRETARY OF THE BOARD CANNOT BE HELD BY THE SAME PERSON. 10. TO CLARIFY THAT THE BOARD SECRETARY MAY DELEGATE THE DUTIES OF HIS/HER OFFICE. 11. TO CLARIFY THAT THE STOCKS AND BONDS MENTIONED IN ARTICLE V WOULD INCLUDE THOSE PURCHASED BY OR GIFTED TO THE MINISTRY. 12. TO SPECIFY THAT THE COAH FISCAL YEAR ENDS ON DECEMBER 31ST.
FORM 990, PART VI, SECTION A, LINE 6
CITY ON A HILL'S SOLE CORPORATE MEMBER IS THE WISCONSIN AND NORTHERN MICHIGAN DISTRICT COUNCIL OF THE ASSEMBLIES OF GOD.
FORM 990, PART VI, SECTION A, LINE 7A
THE DIRECTORS OF THE WISCONSIN AND NORTHERN MICHIGAN DISTRICT COUNCIL OF THE ASSEMBLIES OF GOD APPROVE DECISIONS ON CERTAIN MATTERS MADE BY CITY ON A HILL'S GOVERNING BODY, INCLUDING THE ELECTION OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B
THE DIRECTORS OF THE WISCONSIN AND NORTHERN MICHIGAN DISTRICT COUNCIL OF THE ASSEMBLIES OF GOD APPROVE THE DECISIONS OF CITY ON A HILL'S GOVERNING BODY REGARDING CHANGES TO ITS ORGANIZING OR GOVERNING DOCUMENTS, ELECTION OF DIRECTORS, BUDGETS, PROPERTY ACQUISITION OR SALE, HIRING OR DISMISSAL OF THE EXECUTIVE DIRECTOR, MERGERS, AND DISSOLUTION.
FORM 990, PART VI, SECTION B, LINE 11
THE PREPARED FORM 990 IS REVIEWED BY THE ORGANIZATION'S EXECUTIVE DIRECTOR AND BUSINESS MANAGER AND IS PRESENTED TO THE MEMBERS OF THE GOVERNING BODY FOR APPROVAL BEFORE THE RETURN IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C
NO MEMBER OF CITY ON A HILL'S GOVERNING BODY OR THE TOP MANAGEMENT OFFICIAL MAY PARTICIPATE IN ANY DISCUSSION OR VOTE ON ANY MATTER IN WHICH HE OR SHE HAS A POTENTIAL CONFLICT OF INTEREST DUE TO A MATERIAL ECONOMIC INVOLVEMENT REGARDING THE MATTER BEING DISCUSSED, WHETHER PERSONALLY, AS A FAMILY MEMBER, OR AS A REPRESENTATIVE OF ANOTHER ORGANIZATION. WHEN SUCH A SITUATION PRESENTS ITSELF, THE INDIVIDUAL MUST ANNOUNCE THE POTENTIAL CONFLICT, DISQUALIFY HIMSELF OR HERSELF, AND BE EXCUSED FROM THE MEETING UNTIL DISCUSSION ON THE MATTER INVOLVED IS OVER. THE CHAIR IS EXPECTED TO MAKE INQUIRY IF SUCH CONFLICT APPEARS TO EXIST, SUCH AS IN THE AREAS OF EMPLOYMENT, PARTNERSHIPS, OR CONTRACTS AND THE PERSON HAS NOT MADE IT KNOWN. THE MINUTES OF THE MEETING REFLECT THE ACTION TAKEN TO IDENTIFY AND ADDRESS THE POTENTIAL CONFLICT OF INTEREST. TO COMMUNICATE AND ENFORCE THIS POLICY, POTENTIAL DIRECTORS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT BEFORE THEY STAND FOR ELECTION. CONTINUING DIRECTORS AND THE TOP MANAGEMENT OFFICIAL ARE REQUIRED TO SIGN A STATEMENT EACH YEAR OF THEIR SERVICE. IN THIS STATEMENT, THE DIRECTORS AND THE TOP MANAGEMENT OFFICIAL IDENTIFY ORGANIZATIONS IN WHICH THEY CURRENTLY HOLD GOVERNANCE OR STAFF POSITIONS AND ATTEST TO THE FACT THAT THEY HAVE NOT ENGAGED IN ANY TRANSACTION OR ACTIVITY THAT RESULTED IN PERSONAL BENEFIT. THE CONFLICT OF INTEREST POLICY IS REVIEWED AT LEAST ANNUALLY DURING THE ORIENTATION AND THE EVALUATION OF THE MEMBERS OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 15A
THE COMPENSATION OF THE TOP MANAGEMENT OFFICIAL AND OTHER MANAGEMENT STAFF MEMBERS IS ANNUALLY REVIEWED AND APPROVED BY THE MEMBERS OF CITY ON A HILL'S GOVERNING BODY. THE COMPENSATION PACKAGE, INCLUDING BASE SALARY, BENEFITS, AND ANY BONUSES, IS DETERMINED BY THE COMPENSATION COMMITTEE, WHICH IS COMPRISED OF INDEPENDENT DIRECTORS WHO DO NOT HAVE ANY PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENT. EACH TIME THE COMPENSATION PACKAGE CHANGES MATERIALLY, THE COMMITTEE OBTAINS COMPARABILITY DATA FOR THE POSITION. THE COMPARABILITY DATA MAY BE BASED ON INDUSTRY SURVEYS, THE COMPENSATION OF PERSONS HOLDING SIMILAR POSITIONS AT SIMILAR ORGANIZATIONS AS REPORTED ON THE FORM 990 OF THESE ORGANIZATIONS, EXPERT COMPENSATION STUDIES, OR OTHER COMPARABLE DATA. THE COMPENSATION COMMITTEE DOCUMENTS THE BASIS FOR ITS DETERMINATION CONCURRENTLY WITH THE APPROVAL OF THE COMPENSATION PACKAGE, INCLUDING THE TERMS OF THE APPROVED TRANSACTION AND THE DATE APPROVED, THE MEMBERS OF THE COMMITTEE WHO VOTED ON THE DECISION, THE COMPARABILITY DATA THAT WAS RELIED ON BY THE COMMITTEE, AND HOW THE DATA WAS OBTAINED. THIS PROCESS WAS COMPLETED IN 2013.
FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S WEBSITE ALSO PROVIDES INFORMATION ABOUT HOW TO MAKE A REQUEST FOR THIS INFORMATION.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.